Andropause

Andropause Dr. Alvin B. Lin is a double board certified physician affiliated with the University of Nevada School of Medicine, a Fellow of the American Academy of Family Physicians and is President-Elect of the Nevada Academy of Family Physicians.

Andropause is the lay term for male menopause. The phrase is not recognized by traditional medicine but is used widely in anti-aging & age management circles. The common definition involves a constellation of clinical symptoms typically associated with middle-age men and is thought to be due to low or insufficient levels of testosterone. Some studies and many case studies report tremendous benefit

Andropause is the lay term for male menopause. The phrase is not recognized by traditional medicine but is used widely in anti-aging & age management circles. The common definition involves a constellation of clinical symptoms typically associated with middle-age men and is thought to be due to low or insufficient levels of testosterone. Some studies and many case studies report tremendous benefit

Another @bmj_latest #XmasBMJ classic pokes fun #EvidenceBasedMedicine: Parachute use doesn’t prevent death when jumping ...
12/14/2018
Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial

Another @bmj_latest #XmasBMJ classic pokes fun #EvidenceBasedMedicine: Parachute use doesn’t prevent death when jumping from aircraft: PArticipation in RAndomized trials Compromised by widely Held beliefs aboUt lack of Treatment Equipoise (PARACHUTE) trial http://ow.ly/bPCa30mZlI3

Objective To determine if using a parachute prevents death or major traumatic injury when jumping from an aircraft. Design Randomized controlled trial. Setting Private or commercial aircraft between September 2017 and August 2018. Participants 92 aircraft passengers aged 18 and over were screened fo...

New AAFP #ChoosingWisely recommendations re #PelvicExam #PapSmear, #Diabetes #insulin, screening for #Herpes & Testicula...
12/03/2018
AAFP ADDS 5 NEW “CHOOSING WISELY” RECOMMENDATIONS

New AAFP #ChoosingWisely recommendations re #PelvicExam #PapSmear, #Diabetes #insulin, screening for #Herpes & TesticularCancer plus when (not) to transfuse #anemia http://ow.ly/ruyZ30mPmhA This is #FamilyMedicine

The American Academy of Family Physicians (AAFP) has added 5 new recommendations to its Choosing Wisely list, http://www.choosingwisely.org/societies/american-academy-of-family-physicians/, which highlights medical tests, treatments, and procedures that may be unnecessary and should prompt discussio...

11/29/2018

Here’s another good one: #Medicare secondary insurance processed bill/invoice on 7/24/18 and just sent me $10.23 for $130 worth of services provided 12/3/17 (that’s right, almost a year ago!). How does #SoloPractice #FamilyMedicine continue to survive in this environment? AAFP

11/29/2018

To add injury to insult, CMSGov decided that my March 2018 $120 service as #FamilyDoc #Geriatrician was really only worth $39 so they only had to pay $31. Thank goodness for that $8 from the secondary insurance! How does any other company stay in business under these conditions

11/29/2018

I just finished my 2nd year in #SoloPractice as a #FamilyDoc limited to home-bound residents who receive #Medicare. I billed CMSGov $120 back in March for services rendered & just received a check for $7.90 from supplemental insurance!!! Really?!?! Imagine any other business...

This is known as #OstrichBehavior #StickYourHeadInTheSand b/c you don't want to face your #mortality w/your #FamilyDoc h...
11/28/2018
Older Adults’ Preferences for Discussing Long-Term Life Expectancy: Results From a National Survey

This is known as #OstrichBehavior #StickYourHeadInTheSand b/c you don't want to face your #mortality w/your #FamilyDoc http://ow.ly/Fz8C30mM4Vs If we don't know your #HealthcareGoals then how can we best help you? Esp when you don't want to die in an institution #LifeExpectancy

PURPOSE Clinical practice guidelines recommend incorporating long-term life expectancy to inform a number of decisions in primary care. We aimed to examine older adults’ preferences for discussing life expectancy in a national sample.

Please remember that just b/c something is #natural doesn't make it #safe #NaturalIsntAlwaysSafe #PoisonOak & #PoisonIvy...
11/27/2018
FDA Warns of High Levels of Heavy Metals in Kratom

Please remember that just b/c something is #natural doesn't make it #safe #NaturalIsntAlwaysSafe #PoisonOak & #PoisonIvy are natural but I wouldn't want to wipe it over my body! Now U.S. FDA finding #HeavyMetals in #kratom http://ow.ly/umDH30mM3oA

FDA scientists have found heavy metals including lead and nickel at levels not considered safe for human consumption in some kratom products.

New recommendations for #FamilyDoc #FamilyPhysician to screen for excessive aka unhealthy #alcohol use just promulgated ...
11/14/2018
USPSTF Recommendation: Screening and Interventions for Unhealthy Alcohol Use

New recommendations for #FamilyDoc #FamilyPhysician to screen for excessive aka unhealthy #alcohol use just promulgated by US Preventive Services Task Force #USPSTF https://jamanetwork.com/journals/jama/fullarticle/2714537 Big thanks to Forbes for summary http://fortune.com/2018/11/13/new-guidelines-doctors-adults-alcohol/

This 2018 Recommendation Statement from the US Preventive Services Task Force recommends screening for unhealthy alcohol use in primary care settings in adults, including pregnant women, and providing brief behavioral counseling to reduce unhealthy alcohol use (B recommendation) and concludes that.....

Ever wonder what’s causing #burnout in your #FamilyDoc? Set aside some time to read Atul Gawande essay on how #computers...
11/06/2018
Why Doctors Hate Their Computers

Ever wonder what’s causing #burnout in your #FamilyDoc? Set aside some time to read Atul Gawande essay on how #computers #ElectronicMedicalRecords have altered patient & physician relationship and added #WorkAfterHours http://ow.ly/Xnn530mw8A7 #FamilyMedicine #HealthIsPrimary

Digitization promises to make medical care easier and more efficient. But are screens coming between doctors and patients?

#TrickOrTreat? Scientists link #appendix to #Parkinsons #ParkinsonsDisease Makes you go 🤔 Future generations may one day...
11/01/2018
The vermiform appendix impacts the risk of developing Parkinson’s disease

#TrickOrTreat? Scientists link #appendix to #Parkinsons #ParkinsonsDisease Makes you go 🤔 Future generations may one day consider early prophylactic #appendectomy http://ow.ly/74VJ30msySi

Misfolded α-synuclein is a pathological hallmark of Parkinson’s disease (PD). Killinger et al . now report that the human appendix contains an abundance of misfolded α-synuclein and that removal of the appendix decreased the risk of developing PD. The appendix of both PD cases and healthy indivi...

#Diabetes #medication #canaglifozin (#SGLT2inhibitor) approved by U.S. FDA to reduce risk of #HeartAttack #stroke or #de...
11/01/2018
Canagliflozin (Invokana) Gets FDA Nod for CV Protection

#Diabetes #medication #canaglifozin (#SGLT2inhibitor) approved by U.S. FDA to reduce risk of #HeartAttack #stroke or #death due to a cardiovascular cause http://ow.ly/890E30msdDO #Empagliflozin already approved to reduce risk of CV mortality; #Liraglutide, too, has similar benefits

The SGLT2 inhibitor is the first oral diabetes medication approved to reduce the risk of cardiovascular events in patients with type 2 diabetes and heart disease.

I’m getting #StressedOut reading this study on negative effect of #stress: “Higher #cortisol associated with worse memor...
10/29/2018
Circulating cortisol and cognitive and structural brain measures

I’m getting #StressedOut reading this study on negative effect of #stress: “Higher #cortisol associated with worse memory & visual perception, as well as lower total cerebral brain, occipital & frontal lobar gray matter volumes” http://n.neurology.org/content/early/2018/10/24/WNL.0000000000006549

Objective To assess the association of early morning serum cortisol with cognitive performance and brain structural integrity in community-dwelling young and middle-aged adults without dementia. Methods We evaluated dementia-free Framingham Heart Study (generation 3) participants (mean age 48.5 year...

Here’s lay version that explains recent study linking #stress (via #cortisol) to worse memory, organization, visual perc...
10/29/2018
"Stress Hormone" Cortisol Linked to Early Toll on Thinking Ability

Here’s lay version that explains recent study linking #stress (via #cortisol) to worse memory, organization, visual perception and attention plus precursors to brain changes linked to #Alzheimers disease and other #dementia #dementias https://www.scientificamerican.com/article/ldquo-stress-hormone-rdquo-cortisol-linked-to-early-toll-on-thinking-ability/

Brain changes, visible on scans, are also associated with Alzheimer’s precursors

10/28/2018

Sad commentary that 11 of 20 questions in #WomensHeath & #MaternityCare in Med-Challenger #FamilyMedicine board exam prep dealt with #SexualAssault #NoMeansNo Inability to decline is not same as consent!

10/26/2018

Using Med-Challenger to study for American Board of Family Medicine #FamilyMedicine board exam. Just ran thru Infectious Disease chapter exam and got 5 questions on #rabies🤔 Is it that common to warrant devoting 25% of quiz? 🤷‍♂️

10/22/2018

I mentioned #xyosted during my presentation on #hypogonadism (#LowTestosterone) last wk at #AAFPFMX. It’s U.S. FDA approved #testosterone in a once weekly subcutaneous autoinject form. Or ask your #FamilyPhysician #FamilyDoc about less expensive off-label options.

#CaveatEmptor #BuyerBeware U.S. FDA points out many #DietarySupplements (esp those for #SexualEnhancement, #WeightLoss, ...
10/18/2018
Unapproved Pharmaceutical Ingredients in Dietary Supplements Associated With FDA Warnings

#CaveatEmptor #BuyerBeware U.S. FDA points out many #DietarySupplements (esp those for #SexualEnhancement, #WeightLoss, or #MuscleBuilding) contaminated w/active but undeclared #medications https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2706496

This quality improvement study examines trends across adulterated dietary supplements, containing unapproved ingredients, associated with US Food and Drug Administration (FDA) warnings.

Bought a drink for a colleague but much of it ended up on my car😱. Shout out & big thanks to Starbucks Coffee barista (E...
10/18/2018

Bought a drink for a colleague but much of it ended up on my car😱. Shout out & big thanks to Starbucks Coffee barista (Eastern & Coronado Center) who volunteered to remake drink when I went back in to clean up #DontDrinkAndDrive #YoureSupposedToDrinkItNotSpillIt 🤦‍♂️

Big shout out & thanks to AAFP staff for making #AAFPFMX another uplifting & educational success! Couldn’t do it w/o all...
10/13/2018

Big shout out & thanks to AAFP staff for making #AAFPFMX another uplifting & educational success! Couldn’t do it w/o all your hard work! #FamilyMedicine #FamilyPhysician #FMrevolution #HealthIsPrimary #HealthHasNoZipCode

‪Bigger room, smaller crowd for 2nd presentation on #Hypogonadism #LowTestosterone ‬but at least I got to where I was su...
10/13/2018

‪Bigger room, smaller crowd for 2nd presentation on #Hypogonadism #LowTestosterone ‬but at least I got to where I was supposed to be on time! #AAFPFMX AAFP

Oops! Talk about nervous! Showed to wrong room & got mic’d up but couldn’t find my #anticoagulation presentation😳Luckily...
10/13/2018

Oops! Talk about nervous! Showed to wrong room & got mic’d up but couldn’t find my #anticoagulation presentation😳Luckily I was only off by 20 rooms🤦‍♂️ #AAFPFMX #amateur

Just finished my presentation on #anticoagulation at AAFP #AAFPFMX only to find U.S. FDA just today approved #rivaroxaba...
10/12/2018

Just finished my presentation on #anticoagulation at AAFP #AAFPFMX only to find U.S. FDA just today approved #rivaroxaban plus ASA for use in chronic CAD or PAD https://www.medscape.com/viewarticle/903344 Guess I better update tomorrow’s talk🤦‍♂️

Wow! You like me! You really like me! No tomatoes or rotten eggs before start of today’s #hypogonadism #LowTestosterone ...
10/12/2018

Wow! You like me! You really like me! No tomatoes or rotten eggs before start of today’s #hypogonadism #LowTestosterone presentation at AAFP #AAFPFMX

#HealthHasNoZipCode #AAFPFMX #FamilyMedicine #FamilyPhysician #FMrevolution #HealthIsPrimary
10/10/2018

#HealthHasNoZipCode #AAFPFMX #FamilyMedicine #FamilyPhysician #FMrevolution #HealthIsPrimary

Thanks AAFP for having me present to #FamilyDoc colleagues at #ChronicConditions course on #stroke #Alzheimers #dementia...
09/27/2018

Thanks AAFP for having me present to #FamilyDoc colleagues at #ChronicConditions course on #stroke #Alzheimers #dementia #HighRiskMedicationUse in our #elderly #MakeHealthPrimary It’s barely 3AM PT - full day of #FamilyMedicine as soon as I land!

Just answered: "Female 70+ Have CVD and a Stroke a year ago .My GP changed Blood pressure tablets from Quinapril 40mg mo...
08/10/2017
Female 70+ Have CVD and a Stroke a year ago .My GP changed Blood pressure tablets from Quinapril 40mg morning and 20mg evening to Ramitril 5mg once a day (equivalent to 20mg of Quinapril)the max ramitril dose is 10mg =40mg Quinapril .Dose is too...

Just answered: "Female 70+ Have CVD and a Stroke a year ago .My GP changed Blood pressure tablets from Quinapril 40mg morning and 20m..." See answer on #HealthTap

Get help from Dr. Lin now: https://www.healthtap.com/AlvinBLin

Dr. Lin responded: Hypertension. Best way to determine appropriate dose and/or combination of blood pressure lowering medications is to monitor your BP regularly....

Just answered: "Took a fall directly on my kneecap  4  days ago the pain and stiffness is getting worse each day. I'm 74...
06/23/2017
Took a fall directly on my kneecap 4 days ago the pain and stiffness is getting worse each day. I'm 74 years old.. Should I get it xrayed ? - Answered by top doctors on HealthTap

Just answered: "Took a fall directly on my kneecap 4 days ago the pain and stiffness is getting worse each day. I'm 74 years old.. ..." See answer on #HealthTap

Get help from Dr. Lin now: https://www.healthtap.com/AlvinBLin

Dr. Lin responded: Yes. Worsening pain/stiffness dictates further evaluation after fall/injury/trauma. See your Family Doc or Geriatrician. Or go to Urgent Care. Ask fo...

Just answered: "Too skinny, want to firm up muscles; just retired from sedentary job?" See answer on #HealthTap  Get hel...
06/23/2017
Too skinny, want to firm up muscles; just retired from sedentary job? - Answered by top doctors on HealthTap

Just answered: "Too skinny, want to firm up muscles; just retired from sedentary job?" See answer on #HealthTap

Get help from Dr. Lin now: https://www.healthtap.com/AlvinBLin

Dr. Lin responded: Exercise. Congratulations on your retirement and your decision to improve your health! Start by reviewing your dietary choices. You know what's healthy: fruits, veggies, non-processed foods, lean proteins. Avoid

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