Medicine For People!

November 2017

smartphones
By Senado Federal - Fotos produzidas pelo Senado, CC BY 2.0, Link

Smartphone Tricks

Table of Contents

  • Rashes
  • Dr Google
  • A Second Set of Ears
  • Apps for Better Health
  • Smartphone Moderation

Smartphone Tricks

Jonah had moved here from Portland and needed help with his emphysema. The inhaled corticosteroid that had been adequate for many years wasn’t cutting it any more, even at the highest dose. He had to stop halfway up the stairs to catch his breath before continuing. Sleep was a challenge. Even just cooking was difficult.

We ran through the list of medications that might be helpful.

"Ipratropium?" I queried.

He studied his smartphone. "Nope. That one gave me terrible headaches."

"Salmeterol?"

Again he looked at his phone. "I got dizzy."

"Montelukast?"

Once again he checked his phone. This medicine he had not tried.

I was pleasantly surprised to learn that Jonah used his phone to keep notes of every medication he had tried, how much it cost, whether his insurance had covered it or not, and how well it had worked for him. These notes proved to be of great benefit to our work together. Three different physicians had prescribed for him. Each prescription meant a physician’s visit and fee. We didn’t have to request records from the other physicians, then plow through hundreds of pages searching for any mention of ipratropium, salmeterol, or montelukast and all their synonyms. We were able to avoid unnecessary trials of things that hadn’t worked before.

In one fairly brief visit we were able to focus on the logical next step for improving his symptoms.

Rashes

These two rashes appear to be similar.

Impetigo
By CNX OpenStax (https://cnx.org/contents/5CvTdmJL@4.4) [CC BY 4.0 (http://creativecommons.org/licenses/by/4.0)], via Wikimedia Commons

Herpes
Public Domain, Link

 

However, the first is impetigo (a staph or strep infection), while the second shows the mid-phase of a herpes simplex outbreak.

Treatment is very different for each. But in only a few days, these rashes often become indistinguishable.

When you have a rash or unusual growth on your skin, take a photograph with your smartphone. If there is not a lip, eye, or other marker in the photograph that shows the size of the rash, put a coin or ruler next to it before you take the picture.

Such photographs can be very helpful to your physician!

Dr. Google

While I have a pretty big encyclopedia in my head, there are a few misprints. In addition to that memorized encyclopedia, I have access to some excellent guidelines that give me in-depth and up-to-date information about most health issues. Nonetheless, it’s a big and ever-changing world, and I am never surprised when people tell me something I hadn’t known before.

If you have found something on Google you wish to bring to my attention, please do. In that process, usually both of us learn something. Don’t be shy to consult Dr. Google and, if you need to, ask me for a second opinion.

One caveat: it will come as no surprise to you that there’s a lot of misinformation out there. Be wary of sites that make all kinds of claims for a new (or ancient) cure, especially if they promise that the cure will fix everything from cancer to diabetes to wrinkles. Investigate who is behind the site, and be even more skeptical if the site also sells the cure. If the site says that something is "clinically proven," they should supply the reference for the clinical study.

A good place to start is the free PubMed resource of the National Institutes of Health. Use it to look up the latest studies on the condition you’re researching, or whether a particular treatment actually works: https://www.ncbi.nlm.nih.gov/pubmed.

A Second Set of Ears

A friend or loved one is often useful in our consultation room to help you ask questions and remember the answers. But they might not be always available. In that case, let your smartphone be that second set of ears. Most physicians are quite comfortable with you recording the consultation, either for your own use or to supplement your answers to your spouse’s interrogation of you on your return home!

Apps for Better Health

There are so many applications that count steps that I won’t recommend a particular one. But I do recommend using them. They help give you an objective record of your activity. How many steps should you aim for each day? That goal will vary depending upon your age, state of health, and general conditioning. But you know the bottom line: more is better. Several apps monitor your sleep. Sleep Cycle is my favorite. It gives you an illustration on awakening of how deeply you have slept. As every sleep specialist knows, we are poor judges of how much sleep we get. Our smartphones are more objective! [i]

Smartphone Moderation

Just as we can eat too much, talk too much, gamble too much, or drink too much, we can also use our smartphones too much. It’s a useful tool, but don’t make it the center of your life.

Endnotes

[i] Of course, no smartphone app can substitute for a more comprehensive sleep study whether done by a dedicated laboratory or specialized home monitoring device.

Thanks to Jody Bower for her invaluable help editing this newsletter.

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Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington.