Healthy Matters - with Dr. David Hilden

S01_E03 - Hilden's House Calls - An AMA with the MD MPH FACP

January 09, 2022 Hennepin Healthcare Season 1 Episode 3
Healthy Matters - with Dr. David Hilden
S01_E03 - Hilden's House Calls - An AMA with the MD MPH FACP
Show Notes Transcript

01/09/22
The Healthy Matters Podcast
Episode - 3 - Hilden's House Calls - An AMA with the MD MPH FACP

Why does it hurt when I do this?  Will my hair ever grow back?  What is that ringing in my ears?

We've all got questions for the doctor, and now you have a doctor for all of those questions!

Apparently there's been a bug going around for the past couple years and Dr. Hilden addresses your questions and concerns regarding COVID-19 with the most up-to-date knowledge.  Get the latest on the new variant and best practices for staying safe as well as insights on other pressing healthcare topics.

Got a question for the doctor?  Or an idea for a show?  Contact us!

Email - healthymatters@hcmed.org
Call - 612-873-TALK (8255)
Twitter - @drdavidhilden
Find out more at www.healthymatters.org

Speaker 1:

Welcome to the healthy matters podcast with Dr . David Hilton , primary care physician and acute care hospitalist at Hennepin healthcare in downtown Minneapolis, where we cover the latest in health healthcare , and what matters to you. And now here's your host, Dr . David Hilton.

Speaker 2:

Hi and welcome. Come back to the healthy matters podcast. I'm Dr. David Hilton. And today on episode three, we are introducing a new segment called Hilton's house calls. Hilton's house calls will be a regular feature on the healthy matters podcast. In this segment, I'll be taking your questions about any healthcare topic in our first two episodes. You sort of got cheated in that. We didn't do , uh , questions from listen. So today we're gonna be focusing solely on questions from healthy matters listeners. We'll be right back,

Speaker 1:

Have a question or a comment for the doctor become a part of our show by reaching out to us@healthymattersathcmed.org . Or give us a call at six one two eight seven three . Talk.

Speaker 2:

I've an answer questions from listeners for over a decade on the radio. And I remember one of my very first shows back in 2009 came from a listener and she asked me a question about her ears. And she, she , uh , she said something to the effect of, you know, I , I feel like I have a fog horn in my ears and my response was, well, do you live in Duluth? And for you, aren't from Minnesota. Uh , Duluth is , uh , an inland port on lake superior where they indeed have big ships with far horns. And so , uh, that was how I started off , uh, answering questions from listeners. The point being you can ask me anything, maybe it's about COVID 19. That seems to be a hot topic. Uh , as of late, maybe it's about your, your heart. Maybe it's about that sore knee you've been having. Maybe it's about the Foghorn buzzing in your ear. It can be about anything. Now I'm an internal medicine doctor, so I won't have the answers to everything, but over the years, I've answered thousands and thousands of questions from listeners. And if I don't know the answer, you know what I'll tell you. I don't have the answer to that question, but I'll try to point you in the right direction. Information on healthcare is so varied and it's, it's so ubiquitous. You can get it everywhere in our society. And how do you know what to trust? I think you can trust that I will give you the best scientific answers I can. And that if I don't know what, what the answer is, I'll tell you. So, and so keep your question coming and I'll try to get to 'em on future episodes of the podcast today, we've lined up a number of really good questions about COVID 19 and other topics. So let's get to it.

Speaker 1:

Here's our first question from George in St . Paul, Minnesota, what do you make of the COVID home self test kits and are they even accurate and regarding hand washing now that we have hands sanitizer everywhere, I've gotten lazy about actually washing my hands with soap and water. Are they equally effective at killing germs, more specifically COVID or is one better

Speaker 2:

Than the other great questions, George. So do you remember about a year and a half ago when the pandemic was first starting and we were washing literally everything, whether it moved or not. I remember coming home from the grocery store and wiping down my milk carton and the box of cereal and everything with wipes. I think it was even hard to find the COVID wipes , uh , or the sanitary wipes at the , at your store, cuz we were wiping everything down that's because we thought that that it's possible that you could get COVID 19 from surfaces. At the same time, we were suggesting to everybody to wash your hands. And so where we are now is that you no longer need to wipe down surfaces, but you do still need to wash your hands. The reasons are this viruses live on surfaces and they live on our hands and it turns out they live quite some time on your hands, many hours. In some cases, it , it could even be longer than that. And what do we do with our hands? We touch other people's hands. We shake hands, we hug people. And then what do we do? We touch our nose in our face as much as we try not to. Most of us do that. And so you can pass that virus from your hands directly to your nose. And that's why we tell people to wash their hands. And you should still be doing that to this day. How you do, that's kind of up to you. If you want to use soap and water, that's a very effective way. And maybe what you should do most of the time. If you do use soap and water, just make sure you do it long enough. There's the old adage that you should sing happy birthday twice , uh , while you're washing your hands. And that's about 20 seconds. So make sure you get under your wedding ring or any other jewelry you have on and wash your hands and really scrub them down for 20 seconds and then rinse them in warm water. That's effective if that's not available, the wipes work as well, the hands sanitizing gels work, the, the foams work. So I'd like to carry one of those with me in my cup holder of my car. If you carry a bag around, it's a great idea to carry a hand sanitizing gel, and you should continue to do that. Now you can stop wiping down your groceries though. You don't have to do that. As for the other question from George about the home test , I have a stack of those that , uh , home tests at my house. And I'm also wondering, so how do we use these things? And I know they're people are using them so much. Now that they're hard to come by. What , what I suggest for the home test is that they're better than nothing, but don't count on them as the absolute truth. The , the home tests use something called an antigen and the COVID antigen tests are sort of like the strep throat tests that you might be familiar with. You go into the clinic with a sore throat and they swab your throat and they tell you if it's positive, you can believe it. You have strep throat. Here's some antibiotics, but if it's negative, you might remember that. They often say, we'll still have to get back to you in a couple days. If, if the culture becomes positive, if that's an antigen test, it's similar with the home test for COVID, you swab your nostrils. You may or may not be getting the virus on there. And then you run the test. If it's positive, you can believe it. In other words, you have COVID , uh , or almost certainly have it. And that you should take steps to , uh, stay away from other people, isolate yourself and so forth. The problem is that if it's negative, it could well be falsely negative. It simply didn't pick up your COVID . That's especially true with a new Omicron variant. It is less picked up by the, by the test and it might be as, as poor as half the time it misses it. So what do you do about those tests? They still have a place. It is one additional layer of protection. So I use them when I'm, for instance, planning on going to an event with other people might suggest you shouldn't be going to large events right about now. But if you're going to say a family dinner, ask everybody to do the test and then if everybody's negative, it doesn't mean that's you're certainly don't have COVID, but at least it's less likely they have COVID. And certainly if one of them is positive, they should stay away from that gathering. So the whole tests have a place just don't uh , think that they're the, the absolute truth on whether you're not, they have COVID they're pretty good. They have a place. Uh , and that's how I use them when I'm going to small gatherings with other people.

Speaker 1:

Thanks for that. And moving on to Carol from Buffalo, she asks, can you explain how Omicron is different from other variants of COVID and should we all expect that we are going to get it? Even if me and my husband are both vaccinated and boosted,

Speaker 2:

The <inaudible> variant of, of the coronavirus that's causing COVID 19 is a real nasty one. So many of you have seen , uh, pictures of the virus or little cartoons , uh, where it's, it looks like a ball with these little spikes sticking out of it. Those little spikes are the things that the vaccines work on. It's also the way that the virus attaches to the inside of your nose and your lungs. It's actually why they call it coronavirus. Because under certain microscopes, the first people who discovered this thing thought that those little spikes made it look like a crown. And that's what Corona means. Corona means crown. It , it a little bit of an aside. It's the same. Why reason your , the arteries on your heart are called your coronaries. It's from the same word, because your , those arteries wrap around your heart on the outside, like a crown, that's why they're called coronary arteries. So those little spikes look like a crown. They are the, the , the target for all of our therapies. And they're how the virus need , uh , propagates itself. Well , the Omicron variant, a bunch of the, the , those spike proteins have a mutation in them and, and viruses don't live very long. We're talking hours, days . And in those, when it , when any organism replicates every now and then it has a mutation, most of those mutations do nothing and they don't cause any damage, but sometimes one of those mutations causes the virus to be stronger. It is evolution in a, in a, in a rapid fashion. And, and that's what happened to oon . It has all these mutations that made it stronger. And therefore it is the strong kid on the block. It is the one that is able to muscle out all the other viruses. And unfortunately for us, our, our treatments and our vaccines scenes were developed before this variant came along. And that's why OCN is so scary for people. The, the , what the result of the OCN mutations is that those spike proteins are stickier and less susceptible to our vaccines. And so therefore it's more transmissible. Omicron is known to be highly, highly transmissible, or , uh , you know , to put it another way more contagious. So this thing can pass like wildfire, what we're hopeful for, what we don't know yet, but what it , what we're hopeful for is that although it's more contagious, it might be less virulent. Virulent is the word. That means ho the ability to cause serious disease and a highly contagious virus that doesn't cause serious disease is something we can probably D live with. Think of the common cold, and maybe just maybe the <inaudible> variant is the evolution towards a virus us that we can live with. Like the common cold. We don't know that yet, but the past versions of the coronavirus that causes COVID were deadly. And we're hopeful that these mutations in the OCN will be less deadly. That's a great question, Carol. And thank you for sending it in , uh , more information is needed to be honest and think in the next few months, in first quarter of 2022, we'll be learning much more about Omicron , but for now we have to do everything we can to not get it because <laugh> , it is so contagious and people are still susceptible to it. Let's go to another question.

Speaker 3:

Hi, Dr . Hill , this is Eric and Mankato. I'm wondering how come people have different symptoms when they get COVID . Some people get fever and chills. Others have digestive issues or lose their sense of taste and smell. And some people don't get any symptoms, even though they've tested positive, I'm hoping you could help me understand that. Thank you.

Speaker 2:

The symptoms that people are getting with COVID have been , um, all over the place. It , the earliest ones, you know , people might remember that , uh , the symptom people was getting when I can't smell anything, or I can't taste anything. And those often went hand in hand and that just all threw us all for a loop. It's like, why is that happening? You know, we had no idea. And some people got a fever, others got cough, others just got some kind of general malaise , you know, sort of getting the crus and other people. Some even got like gastrointestinal problems, which is really weird because this is not, this is not really , uh , a gastrointestinal bug. The COVID bug is a respiratory bug. So that's how it all started. And what we're seeing in later versions like this OCN one is that the taste and smell symptom is a little, little less common and what people are getting more, they're getting headaches and, and a newer symptom is they're getting night sweats. They're getting like hot sweatiness while they're sleeping. So the symptoms really are all over the map. Uh, the , what we think it's, and of course we're always learning more, the scientific communities learning more. But what we think is that COVID the initial infection is indeed respiratory. In other words, it latches onto your nose and your nostrils and your throat. And it works its way into your lungs. That is the primary infection of COVID 19 a respiratory infection. But what it does is that your body never having seen this new invader before goes crazy about it, it's it ? It has this inflammatory response that's that is sometimes overwhelming. And, and what does that mean? Well, your , some people get heart inflammation after getting COVID and that's not because of the, the initial infection it's because your body inflammatory response set up shop in your heart. You , if you're getting gastrointestinal problems, it's probably because of all the inflammation in your gut, and you're getting headaches and you're getting malaise , and you're getting all of this , these other weird symptoms, even the taste and smell one, it's probably your body's massive immune response to the, not the infection itself. In fact, that is why some people get so, so seriously sick. And unfortunately , uh , um , why it's so deadly is the massive inflammatory response to that infection. If that sets up, shop in your lungs, it's disastrous. And so that's why people were dying of, of COVID . Uh , why do some get it worse than others? That's a really good, good point, Eric. And, and we think, we think it's because not everybody's immune systems are at the same level of readiness, just like some people have allergies. You know, an allergy is an over hyperactive immune system. It's not a poor immune system. It's one that's working on hyperdrive. So some people have just really touchy immune systems and other people a little less. So , uh, so that's why we think, we think some people get more serious illness and others don't is because they get their immune systems. Just, just go, go on overdrive. And other people's immune systems are a little bit , uh , less active, and that's why some people get more symptoms, some get less, and some don't get symptoms at all. Uh, but we're learning more all the time about , uh , uh , about , um , how this thing works. But that's the current state of the, of the science.

Speaker 1:

And I suppose this is a follow up to that from Maggie in Omaha, what's the best type of masks for people to wear cloth surgical, N 95. And with so many people wearing masks, why are so many people still getting sick?

Speaker 2:

Ah , the masks that we all love so much, you know, you know , for , for some of us, the masks are just part of a life, you know, working in a hospital, I wear it all day every day and have for two years. So for me, it doesn't make , um , it feels just sort of part of life now, but others, you don't have to wear one so often. So you have to make kind of a choice of what should I wear. It is true. Despite what people hear it is true that masks reduce transmission of this virus. So anything is better than nothing. So one analogy about the mask is if you've got two people who are three feet apart having a conversation, and, and if one of them sneezes a big wet sneeze with, with , you know, and just sneezes and nobody is wearing a mask, everybody's gonna get wet. <laugh> the person that is , um, uh , an arms distance away is gonna get , uh, get some of those droplets when the person sneezes on them a little bit better than that is if the person who is at the receiving end is wearing a mask. Then if somebody sneezes on you, most of those droplets won't get onto you. And so you've protected yourself and that's why a mask protects yourself. But some of those droplets still will it'll get on your face. And, and the like, so if the person who's doing the sneezing is also wearing a mask, the vast majority of those droplets get caught in their own mask. So that is much safer for both parties involved. So when you wear a mask, if you're wearing one for yourself , uh, that's great. Uh , it will protect you, but it will mostly protect somebody else. So a mask wearing is not just a personal decision about your own personal safety. That's part of it, but it is very much about caring for your neighbor and protecting someone else. And it's not just about sneezing. You know, that's a , a more , um , obvious example, but just when you're breathing, you are exhaling , um, uh, uh, air , uh , water droplets into the air when you're talking, you clearly are. And when you're, for instance, singing, you are, or when you're in a crowded bar and talking loudly and maybe , uh , uh , having a good time, you really are expelling droplets. So just our, our normal daily living , uh , um, is a risky situation in the era of COVID mask to wear a cloth. One is okay, but it's only okay for the biggest droplets. And, and when we say droplets, that's like when you sneeze a big rain drop falls to the ground, and COVID certainly is carried by that way. And so if you're within an arms distance of somebody and they, and they sneeze, if you're are a mask, that's great. So a cloth one is good for that. Uh , but they're not particularly great for stopping aerosolized , um , uh , droplets and aerosolized means it's just like a mist in the air. And it is likely that COVID passes that way, not like a rain shower , but more like a fog mist in the air and cloth masks are relatively ineffective against that. So you should wear, if you can get your hands on one that has at least two or preferably three layers, that's better than cloth, better than that is a surgical mask that they wear that have in hospitals, because as they have a protective coat on them, better than that is a K N 95 mask, which is a , which is the , it , it prevents most of those aerosolized particles. Uh , but it's not the , um , the best, but it's almost the K N 95. The gold standard, the best you can possibly get is an N 95 that is fitted to your face. This is what healthcare workers wear when you're going into a room with someone with COVID 19. So in that order from worst to best cloth, triple layer, cloth surgical, K N 95, and then the N 95, you know , you know , it's kind of informative for the first year of this pandemic. I cared for many, many patients with COVID 19. I was in hospital rooms and they were coughing and sneezing and breathing on me in an enclosed room. And I wasn't vaccinated. It wasn't out yet there , we didn't have the vaccine and yet I didn't get COVID 19. And I had people literally dying in front of me with COVID . Why was that? It's because I was wearing a mask and more importantly, I was wearing an N 95 mask. So they really work. So masks do work something's better than nothing, but , uh , um , depending on your level of risk, those are the , uh , the , the masks that work the best.

Speaker 4:

And here's another question from our phone line. I , Hey, Dr . Hilton , my name is Chris and I'm calling from Cambridge. I do have a question in your expert opinion, do you see similarities between the OMA crime variant and the variant of the Spanish flu that ultimately ended that pandemic back in 1918? Is there any reason for us to be optimistic? Thanks so much, have a good day.

Speaker 2:

I'm really fascinated by studying the, the pan DEIC influenza of 1918. And what can we learn from it now in, in , uh , over a hundred years later, because the, what , what was called the Spanish flu of 1918, which , uh , another little bit of a side , the Spanish flu probably started in Kansas. It , you know, it , it , but no one's gonna call it that , uh, it's, it's one of the reasons we've gotten away from calling things by where they originated, because it's so inexact and it's frankly , uh , it's not helpful, but that influenza pandemic of 1918 , uh, is informative to us today. First of all, it , um, it has some similarities in some differences it's similar in that it was a virus, it was caused by an influenza virus, a , uh, uh, and , and the coronavirus is a , is a different virus. It's also similar than it was highly transmissible, just like coronavirus. It's a li and, and it , it affected a great number of people. It's a little bit different in some regards , uh, it's different in that fully, like a third of the world's population was infected with the , with influenza in 1918, and tens of millions of people died. That is not where we are with COVID 19. It's something like 1% of the world has been infected. So there are some differences, but we can really learn. And I hope we really learn from what they did in, in, in 1918. First of all, they knew then that social distancing and masking was helpful. And there are there, you can look this up on online. There are cities in this country that did pandemic responses, social distance, and masking. I wanna say it was Philadelphia. That was really good at that. Um , I might be wrong on that. And then other cities did not in the cities where, where the 1918 influenza was particularly bad, where , where they did not do social distancing and masking. And clearly they didn't have some of the things we have today . They did not have vaccines back then. They did not have monoclonal antibodies. They didn't have ICUs with, with , um , ventilators. So that's why so many people , uh , died from it, but they did know basic public health. And, and that's why I find it fascinating that we're still having conversations about whether or not we should be masking in social distancing. We've known for over a hundred years, that we should be doing those things, but then it's helpful to, to look at, well, why did it end? How did, how did the one in 1918 end? And first of all, it lasted about a year and a half. So we're already a little bit longer than the one in 1918. It was primarily in the year , um , 1918, mostly in the fall. And then into 1919, there were some more little outbreaks in surges even into, into 1920 , um, similar to what we're having now, but the reason it likely simply faded away is that it is that it ran out of victims. Uh, think of a forest fire, a forest fire, you know, goes gene through , uh , an unburned forest. And it, it fizzles out. It moves on when there's no more trees to burn. And that's, that's sort of what happened back then. So many people got sick and died , uh, that the virus didn't have anyone left to infect, or at least it was harder for virus to find , uh , um , a fresh forest to burn down if you will, it's similar to what we have today, but our response needs to be different back then it required 50 million people to die. And it required hundreds of millions of people to get the virus. If, if that, if we were to re heat that today, it would be a catastrophic loss of life. We just can't, we couldn't tolerate that now, when we have ways to prevent that, but we still have to get rid of firewood for this forest fire. That is COVID 19. And so if we, if we can do that, we can, we can, this one will fizzle out too. And the way we do that is clearly with vaccinations. Um, imagine there's two ways for a , a forest fire to die out. Really one is to, to, for the trees, to all be burned. The other is to put a armor around those trees. So they can't burn. And that's what we're , uh , attempting to do in this one today. And, and if enough people were to get vaccinated globally, not just in the rich countries, but globally, if enough people were to get vaccinated. In other words, put a coat of armor around those unburned trees. This virus will mutate it itself to something less problematic. It, it requires , uh, uh , vulnerable populations to survive. And so our job over the next few years is to remove vulnerable populations. And we do that by vaccinating the world. I don't mean just people in, in, in the United States, in Europe and in rich countries, we need to vaccinate the world so that this virus will , uh , then mutate itself into something less , um , dangerous. I'm hopeful that Omicron is the first step toward that time will tell. But , uh, that is how this thing is gonna end when we simply remove the firewood for this forest fire. It's a great question, Chris. Uh , thank you for that. Uh, let's go to another podcast listener and your question, and

Speaker 1:

Here's another one from Sarah and grand rapids. She asks, I understand it's different for men and women, but how do you know when chest pain is something you need to be concerned about?

Speaker 2:

So heart disease remains the top , uh, cause of death in our country and heart attacks and other heart problems , um, are common that people do get different symptoms that the , everybody knows what like the, the , what you see on TV or something. The classic symptom of a heart attack is it's usually an older guy. He's usually about seven years old with a little gray hair on him and he's walking around or he is in his, his office building and he suddenly grabs his chest and he has this, a crushing chest pain. And he, and he says, oh my goodness, there's a crushing chest pain. And my left shoulder hurts. And it's like an, an elephant to sitting on my chest. That's the, the typical sort of , um , what we think of the classic presentation of, of chest pain, that's due to a heart problem. It's it's , uh , and that is , that does happen. I actually seen people like that, where they grab their chest and , oh my goodness, I'm having a heart attack. It's not how it happens for most people though. Although that's the classic example. Most people get a , some kind of new little squirrly pain in their chest. Yeah. It might be a fullness in your chest. It might be , uh , uh , something that kind of , um, goes up to your left arm might actually go down into your belly. Uh, and , uh, sometimes it's, it's not even pain at all, but it just feels like a , an ache or, or even an , a feeling of nausea. Uh , and, and that's how some people have , um, their manifestation of their heart disease, those weird symptoms, you know, kind of the atypical ones are more common in women. For instance, it is a true thing that most heart disease research back in the, in the last 50 years was done on men. Uh , fortunately were changing that, but women , um , uh , are more likely to have nausea. I , I just, I feel nauseated of something like it came on this morning and it won't go away, or they're more likely to have just an achy fatigue feeling, but they're a little less likely to , to have that classic symptom where they want to grab their chest, like an elephants in and on them . People with diabetes who have early coronary disease, that's also true. Um , often have atypical symptom. So what I tell patients is that any symptom in your chest that is new to you, that is different. That's what you should have looked at. Certainly if you're having crushing chest pain and especially on the left side of your chest, and it goes to your left arm, that's your heart. You should call 9 1 1. You shouldn't drive yourself to the clinic. You call 9 1 1, but even if you're having something different, if it's new for you, you've got some really weird symptom that just I've never had this before. It's not going away. It just happened today. I've got this weird achy sensation. You should go in and have that checked out right away. Because time is, there's an old saying , time is myocardium. Um , myocardium mean heart muscle, and, and the every minute counts with your heart muscle. Every minute that it's not receiving enough, oxygen is not, is , uh , not good for you. So if you're having anything that's new for you call your doctor more importantly, if it's really something that is concerning you, you call 9 1 1. This is that's what it's there for you don't , uh , don't feel bad. You call 9 1 1, and they'll talk you through it. If you're having any symptom in your chest, that's new. Whether or not you look like that person on the TV show having a heart attack. So there's lots of ways to get your questions to us here on the podcast. You can either drop us a phone message or, or a text message , uh , via Twitter. You can also send us an email like this listener Connie from spring lake parks sent this in on our email line. Um, she has a question about the healthcare system and a logistic. She says, if I have a medical issue, should I start with seeing my primary doctor, if I have one and be referred to a specialist, but if I'm hurt or not feeling well, the last thing I wanna do is go to two appointments and also emergency room versus urgent care versus waiting to see a well thanks, Connie, for sending in those questions. Our healthcare system is awfully fragmented. In fact, I often say we don't really have a healthcare system. We have a whole bunch of fragmented , um, uh, uh, um , systems. So we have emergency rooms. We have urgent cares. We have our primary doctor. Everybody thinks you need to go to a specialist. It's, it's bewildering and a for people trying to get healthcare . What I do recommend , uh , to , to Connie and to everybody listening is that you do get a primary care doctor. First, if you have a relationship with a clinic, you have a , a go-to person to ask questions. You have somebody who already knows you. That's the value of a primary care doctor is they already know you. So you don't have, you can dispense with the , the formalities. And when you, when you go to see him or her, you can talked about their questions and they know, oh, this is new for you, or know is nothing to worry about. Someone you trust, your primary care doctor needs to be someone you trust. So make sure you have one. And, and then if you have some new symptom that is, is either minor, or it's been nagging at you for months on end, you call your primary care doctor. And I would let that person help you decide whether you need a specialist. I do generally discourage people from immediately calling a specialist. And here's why in medicine, there are 15, 20 different specialties just of internal medicine. That's what I do. Surgery has their own subspecialties and, and neurology has their own subspecialties. But you know, you've got your cardiologist, your pulmonologists, your nephrologists , all these allergi . How do you know which one to call? If you, if you call a specialist first, you're sort of like, you've already come to your own diagnosis. Like, well, I know this is my kidney, so I better call the kidney specialist. How would you possibly know that? And so you're liable to be a little bit on a wild goose chase. So I recommend you call your primary care doctor first as for the emergency room versus urgent care. That's also a difficult one because emergency departments were initially set up, believe it or not for emergencies. And, and now they have become the first line of care for so many people. That's what, getting back to get yourself a primary care doctor. First, don't use the emergency department. And as your primary care doctor, I certainly tell you to go to an emergency department. If you have some new symptom that's really concerning to you like the chest pain. If you're having chest pain, if you're having signs or symptoms of a stroke , uh , and just as an aside, those signs and symptoms are speech problems, weakness , uh, things like that, and a sudden onset of weakness in your limbs, or you can't speak correctly, or you can't hold your arms up. You go to an emergency department for your more minor issues. I think it's okay to seek out in urgent care if it's after hours. Uh , I , you know , if you have a sore throat or, or you're having a little bit of belly pain, that's okay for those nag in symptoms to go to an urgent care, you . But the best thing to do is if it's, especially, if it's open call your clinic first and get their advice, they'll help you decide where which place would be best for you to go to. I, it is, it is a little bit bewilderingly bewildering , uh, the, the various places we get healthcare in this country, but my main in message get a primary care doctor. So that's all we have time for today. Thanks for sending in your questions. Join me for episode four of the healthy matters podcast. I'm really excited that I've asked my friend, Dr. Charlie Resnikoff, who is an addiction medicine specialist to talk about addictions in the opioid crisis. I hope you'll join us. And in the meantime, be healthy and be well.

Speaker 1:

Thanks for listening to the healthy matters podcast with Dr. David Hilton, to keep up to date with the latest in healthcare and your health, subscribe to this podcast, wherever you get your podcasts for more information on healthy matters, or to browse the archive, visit our website@healthymatters.org . And if you have a question or comment for the doctor, email us at healthy matters, HC M E d.org , or give us a call at six one two eight seven three . Talk to catch all the latest from Dr . Hilton and the healthy matters podcast. Follow us on Twitter at Dr. David Hilton. Finally, if you enjoyed this podcast and would like to support us, please leave us a review and share the healthy matters podcast with your friends and family. The healthy matters podcast is made possible by Hennepin healthcare in Minneapolis, Minnesota, and engineered by John Lucas at Hibal executive. Producers are Jonathan Camuto and Christine Hill. Remember , we can only give general medical advice during this program, and every case is unique. We urge you to consult with your personal physician, if you have more serious or pressing health concerns until next time, be healthy and be well.