Episodes
-
Live Better, Longer
A Longevity Physicians Secrets to Health and Fulfillment
Available for free at: wondermedicine.com
See full written episode description on our blog available at:
https://www.wondermedicine.com/wonder-medicine-blog
4 Amazing Ways Ketamine Will Change Your Brain
Ketamine is an amazing medication. It is an anesthetic, painkiller, mental health treatment, and entheogen all wrapped into one. We have successfully treated hundreds of patients with depression, anxiety, PTSD, OCD, suicidal ideation, and addiction using ketamine at Wonder Medicine. Greater than 90% of the people we treat get better. But, having the right plan for therapy will greatly increase your odds of success.What is an Entheogen?
An entheogen is a mind-altering substance that helps people develop spiritually. Ketamine causes a profoundly mind-altering experience that expands consciousness, understanding, and connectivity when used with intention in the right therapeutic setting.
Why do some Patients Not Respond to Ketamine?
Some people do not respond to ketamine treatments. Most often there is an identifiable reason. Some of these reasons include:
- Abusing substances actively while undergoing therapy (e.g. going home and drinking a bottle or two of wine after therapy)
- Not enough treatments received (major illness requires more therapy, sometimes > 6 treatments for response)
- Trauma or Mindset roadblocks that prevent patients from continuing therapy.
- Some people just donât respond. This may be due to their underlying biology (estimated < 2%)
Why do > 90% of Ketamine Patients Experience Benefit
Ketamine does 4 amazing things that help people get their lives back on track.
-
Executive Summary
The Longevity and Performance Program at Wonder Medicine is a physician directed-proactive healthcare program for high performing individuals. Its principle aims are health optimization, disease prediction and prevention, exceptional performance, emotional wellness, and longevity.The program is anchored by a full day executive physical that we refer to as a program members âBiological Birthdayâ. On this day, program members subjective and objective biomarkers most strongly linked to health, performance, and longevity are collected and fed into a robust data structure. A report is then generated that predicts biological (functional) age and predicted death age. The report utilizes proprietary algorithms and technology to inform both patients and their care team regarding overall health status and disease risks. The Biological birthday is performed every year and information is tracked in real time so that any health issues can be identified at the earliest stage possible.
A multidisciplinary team including a physician, longevity coach, exercise physiologist, technician, registered nurse, and member concierge execute the program. This small team is in constant communication and reviews all patients as a group multiple times a year. Patients in the program will have encounters with each team member at least 3 to 5 times a year. These team members will know you and care deeply about your success.
Every year, program members have a 90-minute Longevity Visit with the physician. At this visit all data obtained is reviewed and a personalized longevity and performance plan is provided to be executed over the following calendar year.
Wonder Medicine is a research-based institution that runs clinical trials on all patients at all times with the goal of discovering those inputs that deliver exceptional longevity and performance. All program members have the opportunity to enroll in additional longevity focused clinical trials that include pharmaceuticals, nutraceuticals, regenerative therapeutics, and lifestyle protocols. Additionally, many chronic medications can be managed through the program. But optimizing mindset, behaviors, and environment to align with program member current and future goals is Wonder Medicineâs principle aim.
Being enrolled in the program affords members several additional benefits and add on services. These include movement therapy, behavioral change therapy, additional testing, and discounts on all Wonder Medicine services including IV infusions, ketamine therapy, and aesthetic services.
If exceptional health, longevity, disease prevention, emotional wellness, and high performance are desired, this is the program for you. If data, research, and the advancement of knowledge in longevity are important to you, this is your Center. The Program is capped at 360 members every year so that outstanding attention, communication, and collaboration can be provided to all members. Wonder Medicine is healthcare that performs at the same level you do. Join today and become exceptional!
Thanks,
Bill Brandenburg, MD
-
Missing episodes?
-
Holiday Season
October 31 â January 2nd
Halloween to New Years
- Tough time of year
- Loved ones, memories of past loved ones, relationships gone bad, events, obligations, good memories, bad memories, and even trauma.
- Can be the best time of the year or a time of pain.
- Take care of yourself, set an example for loved ones, and double down on pro-longevity behaviors during this holiday season.
Remember
Longevity = Health over a lifetime
By striving for longevity you must become the best, most-high performing version of yourself right now.
Ok so 4 tips. Plus two very important bonus tips at the very end that you will not want to miss!
See Wonder Medicine Blog for complete post at: https://www.wondermedicine.com/wonder-medicine-blog -
Benjamin Franklin: âSearch others for their virtues, thy self for thy vicesâ
- Poor Richards Almanac
The best way to maximize longevity in 2023 is not a drug, supplement, or other high tech therapeutic; its Lifestyle medicine.
Wonder Medicine specializes in the translation of longevity technologies into clinical practice. This includes things like rapamycin, exosomes, and metformin. But we would be misguiding you if we did not focus, first and foremost, on lifestyle.
What is Lifestyle Medicine?
Per the American College of Preventative Medicine: Lifestyle medicine is a medical approach that uses evidence-based behavioral interventions to prevent, treat and manage chronic disease.
I would take this a step further even. For me, Lifestyle includes:
1. Thoughts
2. Behaviors
3. Environment
4. The People Around Us
With environment being particularly relevant and underappreciated in most medical settings. These 4 things drive both health and un-health. By optimizing these four things, a person can greatly extend both lifespan and health span.
Focusing on behaviors alone, will not be enough. This may be why conventional medicine downplays lifestyle changes. If you only address behaviors, changes donât happen, and as such, the strategy fails.
But this is a shame because lifestyle changes are the only definitively proven way to extend the length of human life in 2023. From epidemiological studies, it appears that people who live a healthy lifestyle can add approximately twelve years to their life (range: 5-15 years).
Death at 88 instead of 76 years, most often accompanied by contraction of morbidity.
For the full post check out the Wonder Medicine Blog Available at: https://www.wondermedicine.com/wonder-medicine-blog -
Dia de Los Muertos and Longevity
The day of the Dead. What can the dead and this Mexican cultural holiday teach us about longevity?
Is there more to the story than candy, spooky witches, monsters, tricks, and treats. Let's find out
What is day of the Dead?
- A holiday most often celebrated on Nov 1st or 2nd.
- Its strongest traditions and ties are to the Mexican culture.
- On Dia de los Muertos, people remember and honor their past loved ones.
- Representations of human skulls, marigold flowers, home alters with pictures of passed loved ones, pan de Muertos (the sharing of alimentacion or ânourishmentâ), are the hallmarks of this day.
- The roots are debated, but this tradition may date back to Aztecs society.
- Dia de los Muertos brings families and communities together, celebrates life, and death.
- I encourage you to Celebrate this magical holiday, Dia de los Muertos, along with all the fun and spookiness of Halloween, and depending on your beliefs, along with Christian traditions of All hallows eve (all Saints Day and All souls day â that actually has a similar message that just isnât really practiced in my experience)
See complete blog post at: https://www.wondermedicine.com/wonder-medicine-blog -
The 6 BIG Benefits of Longevity
Be a victim or conquer longevity. You must choose!
Longevity
- Longevity Definition: Long existence or service
- Human longevity relates to both existence (remaining alive) and service (remaining useful).
- I strive for nothing less than long existence and long service for both my patients and myself
My favorite part of Avatar II, Way of the Water:
- âTeach them our ways so they donât have to deal with the shame of being uselessâ
- It blows my mind how many people are ok with being useless to society in 2023
My hospitalized elderly patient: âKeep me alive docâ
Me: âwhat makes you want to keep livingâ
Patient: âI have grandkidsâ
- But these people cannot watch their grandkids because their health is too poor. In fact, they need assistance even to perform activities of daily living (ADL)
- Like avatars of the sea, I would find this inability to contribute meaningfully: shameful.
- Being useful is about more than just pride. It is about service to the community.
- Service is what life is all about. If you are unhappy with your life, I suspect this is huge part of the problem.
Longevity is the Key
- By striving for longevity you are forced to become the best version of yourself right now.
- The best version of you, right now, will be able to live, thrive, and serve the longest.
- As such longevity, or as we call here, the Full Scope, is your best vehicle for health, extreme productivity, and service both now and in the future
See Wonder Medicine blog for complete show notes. -
Live to 100: Secrets of the Blue Zones
- 2023 Netflix documentary, 4 episodes
- Based on the 2008 book: âThe Blue Zones: Lessons for Living Longer from People Whoâve Lived the Longest.â
- By Dan Buettner, Journalist, National Geographic Explorer, New York Times Best Seller
What is a Blue Zone
- Geographic location where peopleâs life expectancies are much much higher than in other parts of the world
- A much higher percent of people live to 100 years of age than other areas. 4x more people than in the USA.
Original 5 Blue Zones
- Started with Gianni Pes and Michael Poulain's 2004 paper: Identification of a geographic area characterized by extreme longevity in the Sardinia Island.
- Dan Buettner read this and then established 4 more Blue Zones with the help of epidemiologists (bluezones.com)
- SARDINA, ITALY
- OKINAWA, JAPAN
- NICOYA, COSTA RICA
- ICARIA, GREECE
- LOMA LINDA, CALIFORNIA, USA
4x more likely to live to 100 than in the US. Life expectancies > 85 years, apposed to 76 years in the US.
Dan Buettnerâs Theory on Why People in Blue Zones Live Longer
- CONNECT (INVEST IN RELATIONSHIPS MORE. KEEP FAMILY AROUND MORE, FRIENDS)
- OULOOK (DAILY RITUALS, FAITH, SHOW UP, PURPOSE VOCABULARY)
- MOVE NATURALLY, (GARDEN, WORK, WALK everywhere, sit on the floor),
- EAT WISELY (WHOLE FOODS, HEAVY PRODUCE, WINE, MODERATION)
According to the US CIA, Singapore has the second highest life expectancy at birth in the world at 86.5 years (second to Monaco, 89.6 year average life expectancy, < 1 sq mile in the French Riviera, < 40k residents, tax haven, wealthiest location in the world, high performers flock to Monaco)
SINGAPORE
- Island in SE Asia. 2nd highest population density of any country in the world, globalized, one of four main languages is English. 283 square miles. 5.5 million residents.
- 80% of people own CARS in the US. 11% of people own CARS in SINGAPORE, PUBLIC TRANSIT USED BY HALF THE POPULATION EVERY DAY. Build in natural scapes in cities, good city planning with lots of walkways, < 10% obesity, Low healthcare costs (in spite of living longer)
- KEEP OLDER FAMILY MEMBERS OUT OF CARE HOMES - (NEEDS TO BE EARNED, HARDER IN THE USA per below)
Singapore Physician Philosophy and how to live a long time.
Why do you like being a doctor?
1) TREAT A PATIENT, FEEL JOY (enjoy the process)
What advice would you give someone who wants to live a long time?
2) WORK HARD EVERYDAY, BE HONEST, HUMBLE (get to work)
- Work hard and enjoy the process. No wonder the people in Singapore are living longerâŠ..their doctors are giving much better advice and generally enjoying their job as a physician.
-
We all have weaknesses.
These weaknesses will eventually limit your life and longevity tremendously.
Train these weaknesses out and become the best version of yourself.
See full notes at:
https://www.wondermedicine.com/wonder-medicine-blog -
Blog post about this podcast available at: https://www.wondermedicine.com/wonder-medicine-blog
Three Things to improve your longevity today.1. Exercise
- Stop pretending to care about longevity or health if you are not exercising
- Bodies in motion stay in motion, bodies that stop, soon stop forever
- Plus the best way to keep your brain health and prevent dementia is to exercise regularly.
- Build your bank account of muscle and movement reserve
- Your job is not exercise. Walking is not enough unless your are elderly. But even then you should be strength training as well
- Dynamic movements through big ranges of motion always better. Donât limit yourself
- Be results driven. Measure strength, VO2 max, and other objective metrics.
- Avoid injury by starting slow and progressing slow, injuries are killers as we get older.
- Learn how to fall
- Focus on Eccentric strength as well as concentric, stop dropping the weights.
- You will only be is strong as your weakest component and this will be your Achilles heal when you age, so stop ignoring it and fix it. Stop skipping leg day
- If you would talk to our exercise physiologist, Callie, ditch the chair
2. Sleep
- Give yourself 8 protected every night. Donât stress if you cant sleep the whole 8 hours
- Living a healthy lifestyle will improve sleep. Do more during the day. Think and move more, vigorous exercise and light exposure early in the day can really help
- Give your kids more time, particularly in the morning
- Avoid z drugs, benzos, alcohol
- Cannabis, makes you wake up more groggy, less REM sleep, people often require more sleep to feel the same amount rested
3. Perseverance with positivity
- I have asked every person above 90 I have taken care of their secret to longevity. I am over 300 people at this point. 90+ percent of the time they either say âkeep movingâ or âstay positive.
- Toughen up, life is hard
- Work, retirement is a killer, work gives people meaning and keeps the brain active.
- Force yourself to do hard things that are uncomfortable, cold plunge.
- Lean into all your weakness always
- Donât give up.
-
Death is coming for you, me, and all of this.
If you seek Longevity, stop avoiding this, assess your risks, and make a plan.
Blog post about this podcast available at: https://www.wondermedicine.com/wonder-medicine-blog
How to assess death- What are my current medical problems, risks, and exposures. Advanced diagnostics and biomarkers can help with this. But just asking some simple questions like:
a. What medical problems do I have?
b. How is my current level of fitness and where will it likely be in the final 1 to 2 decades of my life on my current trajectory.
c. What do my behaviors put me at risk of dying from (e.g. smoking tobacco or junk food addiction = multiple forms of cancer.
d. What environmental risks am I exposed to (e.g. polluted air = COPD and lung cancer)- How have genetically related family members have died. These people share your genetics and often times your environment. They are a window into your own mortality.
a. What things have killed my 1st and 2nd degree relatives?
b. At what age did these problems begin and at what age did they result in death.
c. Do I have a genetic predisposition to certain medical problems?- What things am I most worried about regarding death. People have strong intuitions that when trained can be incredibly accurate. Intuition is simply your brain analyzing a huge amount of data and coming to a conclusion that seems as if it came from a higher knowledge or being. The brain is a powerful supercomputer. If program members are worried about something, I am worried too, full stop. Granted, if someone is worried about everything due to severe anxiety they are essentially worried about nothing. If you goal is everything, it will in fact become nothing by default.
-
Overview
- new 10-to-20-minute podcast every Monday
- the science, philosophies, and actional information around health, longevity, and performance
- meant to help listeners become the highest performing individual possible
- Increase your lifespan, healthspan, and view your life through the full scope
See a blog about this episode at: https://www.wondermedicine.com/wonder-medicine-blog
Disclaimer- Free content, no adds, no junk, just the facts
- This podcast does not create a provider patient relationship between the listener and the full scope team.
- This podcast is not intended to treat, diagnose, or cure your personal medical problem.
- If you want professional medical advice, check out Wonder Medicines Longevity and Performance ProgramShare, rate, and review us
-
Summary
Phosphocreatine is a molecule that can recharge ADP into ATP. This provides energy to skeletal muscle and the brain. Dietary and supplemental creatine can raise the bodies stores of phosphocreatine, providing additional energy. In this podcast, we discuss creatine, what is is, how it works, why it is useful, and how to supplement it.
Morbidity and Mortality
After age 30, most people loose around 5% of their muscle mass per decade. Six million people in the United States are diagnosed with Alzheimerâs dementia and this number is increasing every year. As such, preserving muscle and brain function are cornerstone of all anti-aging strategies.
Story
Creatine was first discovered in muscle in 1832. For over 100 years, it has been known that supplementing creatine increases phosphocreatine levels in skeletal muscle. Since the early 1990s, creatine has been marked as a dietary supplement. The use of creatine has become extremely popular over the last 3 decades and its potential benefits to cognitive and nerve function have only recently been explored/discovered.
Key Points
1. Creatine is a small amino acid like, nitrogenous molecule found in skeletal muscle and the brain.
2. Creatine is phosphorylated to phosphocreatine by creatine kinase. Phosphocreatine can then transfer a phosphate to ADP, making ATP. ATP is a molecule that is the main source of energy for the body.
3. Improved strength, bone health, cognitive function, recovery from TBI, heart health, and improvements in triglyceride are often seen with creatine supplementation.
4. Supplementing 5 to 10g of creatine a day should be considered in many individuals, including non-athletes. Creatine has an excellent track record for safety, but possible side effects will be discussed.
5. Muscle cramps are common when taking creatine. Stay hydrated and consume adequate salt. Be careful not to overuse your muscles or injure yourself when taking creatine.
References
- Forbes SC, Cordingley DM, Cornish SM, Gualano B, Roschel H, Ostojic SM, Rawson ES, Roy BD, Prokopidis K, Giannos P, Candow DG. Effects of Creatine Supplementation on Brain Function and Health. Nutrients. 2022
- Creatine. Wikipedia.
- de Souza E Silva A, Pertille A, Reis Barbosa CG, Aparecida de Oliveira Silva J, de Jesus DV, Ribeiro AGSV, Baganha RJ, de Oliveira JJ. Effects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis. J Ren Nutr. 2019
- Aguiar AF, Januario RS, Junior RP, et al. Long-term creatine supplementation improves muscular performance during resistance training in older women. Eur J Appl Physiol. 2013
- Chilibeck PD, Chrusch MJ, Chad KE, Shawn Davison K, Burke DG. Creatine monohydrate and resistance training increase bone mineral content and density in older men. J Nutr Health Aging. 2005
- Groeneveld GJ, Beijer C, Veldink JH, Kalmijn S, Wokke JH, van den Berg LH. Few adverse effects of long-term creatine supplementation in a placebo-controlled trial. Int J Sports Med. 2005
Share, rate, and review us
-
Summary
Metabolic syndrome is a medical condition characterized by unhealthy and markedly deranged metabolism. Over 50% of United States adults have metabolic syndrome and another 40% are at risk of developing it (90% of US adults!). Metabolic syndrome is the great killer of our time, a global pandemic, and the leading risk factor for most all major chronic diseases.
Story
Chronic diseases are contagious. This is because thoughts and behaviors are contagious. As fast food companies, ultra-processed food, soda and other sugar sweetened beverages, and the American lifestyle spreads around the globe, so too does metabolic syndrome.Key Points
1 Metabolic syndrome is both caused by and can be cured by the way a person lives their life (behaviors).
2. Insulin resistance, unhealthy cholesterol, high blood pressure, and weight gain are symptoms of metabolic syndrome.
3. The risk of multiple chronic diseases including diabetes, heart attacks, strokes, and even cancer is increased in those with metabolic syndrome.
4. Avoiding ultra-processed foods, exercising regularly, sleeping adequately, and managing stress are the best ways to prevent and treat metabolic syndrome.
References
-https://www.nhlbi.nih.gov/health/metabolic-syndrome/diagnosis
- Lustig, Robert. Metabolical: The Lure and Lies of Processed Food, Nutrition, and Modern Medicine. Harper Wave, 2021.
- Saklayen MG. The Global Epidemic of the
Metabolic Syndrome. Curr Hypertens Rep. 2018- Lemieux I, Després J-P. Metabolic Syndrome:
Past, Present and Future. Nutrients. 2020- Shi TH, Wang B, Natarajan S. The Influence of
Metabolic Syndrome in Predicting Mortality Risk Among US Adults: Importance of
Metabolic Syndrome Even in Adults With Normal Weight. Prev Chronic Dis. 2020.- https://www.heart.org/en/health-topics/metabolic-syndrome/symptoms-and-diagnosis-of-metabolic-syndrome
Share, rate, and review us
-
Summary
What is your plan for medical care as you get older? Most people donât know. While 87% of people say they want to die at home, just under half of people do. In this episode we discuss goals of care, comfort care, palliative care, hospice, code status and more.
Morbidity and Mortality
Medical errors are the 3rd leading cause of death in the United States (sorry healthcare teamâŠits true). As people get older, sicker, and frailer, their chances of being hurt by healthcare increase dramatically. At some point for everyone, the benefits of aggressive medical care are outweighed by the risks.
Story
In 1900 the average life expectancy in the United States was 47.3 years. By 2019, life expectancy had increased to 78.8 years. This was largely due to public health measures like clean water, lifesaving antibiotics, and vaccines. However, life expectancy is now trending down-ward.
Key Points
1. Comfort care is when the main goal of care is personâs quality of life
2. Palliative care is a medical discipline that helps people cope mentally, physically, and spiritually with severe illness. People on aggressive medical and comfort care can utilize palliative care.
3. Code Status concerns a patientâs wishes when they are dead. It has nothing to do with their medical care while alive.
4. Hospice is a program centered around comfort care for those persons expected to live < 6 months. It is under-utilized and our current medical incentives push people away from it.
References
- Connor SR, Pyenson B, Fitch K, Spence C, Iwasaki K. Comparing hospice and nonhospice patient survival among patients who die within a three-year window. J Pain Symptom Manage. 2007 Mar;33(3):238-46.
- https://hospicefoundation.org/Hospice-Care/Hospice-Services
- Hughes MT, Smith TJ. The growth of palliative care in the United States. Annu Rev Public Health. 2014;35:459-75. doi: 10.1146/annurev-publhealth-032013-182406. PMID: 24641562.
- Gomes, B., Calanzani, N., Gysels, M. et al. Heterogeneity and changes in preferences for dying at home: a systematic review. BMC Palliat Care 12, 7 (2013)
- Adair T
- Who dies where? Estimating the percentage of deaths that occur at home
- BMJ Global Health 2021
- QuickStats: Percentage of Deaths, by Place of Death â National Vital Statistics System, United States, 2000â2018. MMWR Morb Mortal Wkly Rep 2020
- Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016
- Google searches and numerous sites describing âcomfort careâ, âpalliative careâ, âEnd of life careâ
Share, rate, and review us
-
Sycamore is a physician staffing and independent locums company that encourages physicians to run their career like a business. Price transparency, low fees, direct contracts, and aligned incentives set Sycamore Health apart from other physician staffing companies. In this interview, I discuss medicine, health, business, and more with Sycamore CEO, Larson Hicks.
This episode covers my thoughts and opinions on several different topics.
Please enjoy. More medical knowledge episodes coming soon!
Thanks again,Bill Brandenburg, MD
Share, rate, and review us
-
Alcohol Withdrawal, Part 2
Summary
Drinking alcohol (specifically ethanol) on a regular basis leads to alcohol dependence. When alcohol dependent persons stop drinking, they experience withdrawal. Withdrawal from alcohol is very dangerous and should be managed aggressively in order to prevent long term complications and death. This podcast will teach you the ins and outs of recognizing and managing alcohol withdrawal both in the inpatient and outpatient setting.
Morbidity and Mortality
Almost 100,000 people die every year from ETOH abuse in the United States alone. It is not known how many people die a year from alcohol withdrawal. If delirium tremons develops, it is estimated that about 25% of people will die without treatment.
Story
Ever drink too much at night and then wake up suddenly at 5am feeling wide awake? Ever feel inner tension, agitation, or heart palpitations after a long party weekend with friends? If so, you have experienced symptoms of alcohol withdrawal.
Key Points
1. Tachycardia, tachypnea, hypertension, hyperthermia, tremors, anxiety, and GI upset are the hallmarks of alcohol withdrawal.
2. Severe symptoms may include hallucinations, delirium, seizures, and death
3. Vitamin and electrolyte repletion are critical for sick alcohol dependent patients.
4. Aggressively treating withdrawal by slowly coming off alcohol or using medications like barbiturates, benzodiazepines, and other CNS depressants can be lifesaving. Use medication liberally in this setting!
References
-Saitz M, Mayo-Smith MF, Redmond HA, Bernard DR, Calkins DR. Individualized treatment for alcohol withdrawal. A randomized double-blind controlled trial. JAMA 1994
- Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015
- https://www.who.int/news-room/fact-sheets/detail/alcohol
- Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal.
- In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/
- Nisavic M, Nejad SH, Isenberg BM, Bajwa EK, Currier P, Wallace PM, Velmahos G, Wilens T. Use of Phenobarbital in Alcohol Withdrawal Management - A Retrospective Comparison Study of Phenobarbital and Benzodiazepines for Acute Alcohol Withdrawal Management in General Medical Patients. Psychosomatics. 2019
- Wikipedia, alcohol withdrawal syndrome
- Personal experience treating ETOH withdrawal in the inpatient and outpatient setting
Share, rate, and review us
-
Summary
Drinking alcohol (specifically ethanol) on a regular basis leads to alcohol dependence. When alcohol dependent persons stop drinking, they experience withdrawal. Withdrawal from alcohol is very dangerous and should be managed aggressively in order to prevent long term complications and death. This podcast will teach you the ins and outs of recognizing and managing alcohol withdrawal both in the inpatient and outpatient setting.
Morbidity and Mortality
Almost 100,000 people die every year from ETOH abuse in the United States alone. It is not known how many people die a year from alcohol withdrawal. If delirium tremons develops, it is estimated that about 25% of people will die without treatment.
Story
Ever drink too much at night and then wake up suddenly at 5am feeling wide awake? Ever feel inner tension, agitation, or heart palpitations after a long party weekend with friends? If so, you have experienced symptoms of alcohol withdrawal.
Key Points
1. Tachycardia, tachypnea, hypertension, hyperthermia, tremors, anxiety, and GI upset are the hallmarks of alcohol withdrawal.
2. Severe symptoms may include hallucinations, delirium, seizures, and death
3. Vitamin and electrolyte repletion are critical for sick alcohol dependent patients.
4. Aggressively treating withdrawal by slowly coming off alcohol or using medications like barbiturates, benzodiazepines, and other CNS depressants can be lifesaving. Use medication liberally in this setting!
References
-Saitz M, Mayo-Smith MF, Redmond HA, Bernard DR, Calkins DR. Individualized treatment for alcohol withdrawal. A randomized double-blind controlled trial. JAMA 1994
- Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015
- https://www.who.int/news-room/fact-sheets/detail/alcohol
- Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal.
- In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/
- Nisavic M, Nejad SH, Isenberg BM, Bajwa EK, Currier P, Wallace PM, Velmahos G, Wilens T. Use of Phenobarbital in Alcohol Withdrawal Management - A Retrospective Comparison Study of Phenobarbital and Benzodiazepines for Acute Alcohol Withdrawal Management in General Medical Patients. Psychosomatics. 2019
- Wikipedia, alcohol withdrawal syndrome
- Personal experience treating ETOH withdrawal in the inpatient and outpatient setting
Share, rate, and review us
-
This is a conversation I had with Justin Cotton, host of the Policy not Politics podcast. It does not contain any medical knowledge. But it is a thought provoking conversations about my opinions regarding healthcare policy. Please enjoy. This will be the final episode of Full Scope season 2. I am going to take a hiatus for a couple of months in order to focus on Wander Medicine Clinic and Old Dougs Plaza. Full Scope will return with a season 3 though! Thanks for listening.
Share, rate, and review us
-
Summary
Sleep is the most important thing a person can do for themself. Getting 8 hours of quality sleep equals better cognition (thinking), better body function, less disease, and a longer lifespan.
Morbidity and Mortality
At least 20% of automobile accidents have been linked to sleep deprivation. Teenagers that start school earlier get lower test scores than those who start later. Doctors make more errors and kill more people when sleep deprived. Without sleep, a person will die.
Other Animals
All known animals sleep. Some bats sleep almost 20 hours a day, while giraffes sleep < 2 hours a day. Birds and marine mammals can sleep half of their brain at a time.
Key Points
1. Sleep is a physiologic state that consists of various stages including light sleep, deep sleep, and REM sleep.
2. Most all people need > 7 hours of sleep a night to function optimally. Many of us are functioning sub-optimally and undermining our longevity through a lack of sleep.
3. Many medical diseases effect sleep. Being unhealthy appears to be both a cause of bad sleep as well as an effect of getting suboptimal sleep.
4. Improving sleep starts with improving lifestyle. Paying attention to light exposure is also very important. Grounding, cognitive behavioral therapy, certain types of sound, and sleep hygiene can also be useful. Many supplements can be helpful as well. Medications should be used as a last resort to help with sleep.
References
- Walker, Matthew. Why We Sleep; Unlocking the Power of Sleep and Dreams. Scribner. 2017
- Troynikov O, Watson CG, Nawaz N. Sleep environments and sleep physiology: A review. J Therm Biol. 2018
- Lowe CJ, Safati A, Hall PA. The neurocognitive consequences of sleep restriction: A meta-analytic review. Neurosci Biobehav Rev. 2017
- Owens JA, Weiss MR. Insufficient sleep in adolescents: causes and consequences. Minerva Pediatr. 2017
- https://courses.drhyman.com/sleep-course-own
- Getting a Good Nightâs Sleep. NIH. https://www.nia.nih.gov/health/good-nights-sleep
- Brain Basics: Understanding sleep. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep
- Stages of Sleep. https://www.sleepfoundation.org/how-sleep-works/stages-of-sleep
- How much do animals sleep. https://faculty.washington.edu/chudler/chasleep.html
- https://www.nih.gov/news-events/nih-research-matters/gene-identified-people-who-need-little-sleep
Share, rate, and review us
-
Summary
Sleep is the most important thing a person can do for themself. Getting 8 hours of quality sleep equals better cognition, better body function, less disease, and a longer lifespan.
Morbidity and Mortality
Atleast 20% of automobile accidents have been linked to sleep deprivation. Teenagers that start school earlier get lower test scores than those who start later. Doctors make more errors and kill more people when sleep deprived. Without sleep, a person will die.
Story
All known animals sleep. Some bats sleep almost 20 hours a day, while giraffes sleep < 2 hours a day. Birds and marine mammals can sleep half of their brain at a time.
Key Points
1. Sleep is a physiologic state that consists of various stages including light sleep, deep sleep, and REM sleep.
2. Most all people need > 7 hours of sleep a night to function optimally. Many of us are functioning sub-optimally and undermining our longevity through a lack of sleep.
3. Many medical diseases effect sleep. Being unhealthy appear to be both a cause for bad sleep as well as an effect of getting suboptimal sleep.
4. Improving sleep starts with improving lifestyle. Paying attention to light exposure is also very important. Grounding, cognitive behavioral therapy, certain types of sound, and sleep hygiene can also be useful. Many supplements can be helpful as well. Medications should be used only as a last resort to help with sleep.
References
- Walker, Matthew. Why We Sleep; Unlocking the Power of Sleep and Dreams. Scribner. 2017
- Troynikov O, Watson CG, Nawaz N. Sleep environments and sleep physiology: A review. J Therm Biol. 2018
- Lowe CJ, Safati A, Hall PA. The neurocognitive consequences of sleep restriction: A meta-analytic review. Neurosci Biobehav Rev. 2017
- Owens JA, Weiss MR. Insufficient sleep in adolescents: causes and consequences. Minerva Pediatr. 2017
- https://courses.drhyman.com/sleep-course-own
- Getting a Good Nightâs Sleep. NIH. https://www.nia.nih.gov/health/good-nights-sleep
- Brain Basics: Understanding sleep. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep
- Stages of Sleep. https://www.sleepfoundation.org/how-sleep-works/stages-of-sleep
- How much do animals sleep. https://faculty.washington.edu/chudler/chasleep.html
- https://www.nih.gov/news-events/nih-research-matters/gene-identified-people-who-need-little-sleep
Share, rate, and review us
- Show more
