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Doctor Kevin Most joined the show this morning as he does each week. Today we talked about vertigo in hopes to better understand Jason Day’s collapse during the US Open. Jason Day isn’t the only athlete who has this reoccurring “awful” problem, so we turned to Doctor Most for answers. As he always does… he provided the answers in this podcast, and you can read more from Doc Most below!

VERTIGO

Benign positional vertigo – it is a common illness that can be concerning and scary.  Vertigo is one of the worst feelings you can have. People are concerned if this is caused by one of many possible illnesses, many are concerned about brain tumors or other issues.  For anyone who has had Vertigo , they know it is an awful feeling..
Balance is a really cool thing ,  how can a blind person walk?  They are able to because the body still has signals sent from the feet to the brain and the inner ear sending messages to the brain letting the brain know the position of the body. Pretty cool.
Others notes: Hey just a few things in the news that people may appreciate, we could also talk about the need for balance with children and activity during the summer. Some kids are playing sports 100% of the time and have no time to have fun, other kids are doing video games and no activity and they need some activity, sports, team building.

Telehealth-  You are probably seeing a lot of advertising for tele health companies.  Recent changes in Illinois law allow for patients to be offered treatment for minor illness on line. Treatment via a computer or smart phone is going to explode soon. There are many companies now looking at delivering healthcare via a video access to a doctor. The companies are going to treat the minor illnesses that are often treated in the primary care office.
Some pharmacies are looking into providing this service as well, including Walgreens.  The way it works is you would log in on line with the service and provide your demographic information including billing information. Many of these companies are not going to bill insurance and may just work on the consultation fee being at the level of what your office co pay would be.
You will see more and more of these companies popping up. Is it the way of the future, time will tell. Will the patient be OK with the doctor seeing them via a computer? Soon we will have technology that the patient will attach at home to their computer that will allow the doctor to listen to heart sounds, lung sounds and see the throat and ear drum. Test kits from the pharmacy that give us the information we need.
How will patients accept this? Unclear, the millennials may embrace it. The Mom in the middle of the night may try it. Some patients are going to want the hands on exam and interaction, others will look for the convenience  for routine illnesses.
This will definitely make an impact on the cost of care. No need for an office, nurses, supplies etc.
Appendicitis treatment-   A study published in JAMA this week suggests that some adult patients with  on complicated appendicitis may be able to be treated with antibiotics for 10 days and no surgery.  The study looked at 256 adult individuals from Finland, who were given antibiotics and did not receive surgery, they tracked these patients for a year. At the end of a year 186 of the 256 had not ultimately needed surgery. The patients this may work for are patients without an abccess or perforation of the appendix. This study was done in Finland where socialized medicine is in place. The treatment here in the US is still appendectomy, removal of the appendix.  We are probably not risk takers as we want the appendix removed before it ruptures. The decision is made by the surgeon here after reviewing the CT scan, lab work and a review of the physical exam.
Currently we have CT scans which can give us a very accurate diagnosis in most cases. The CT allows us to have an accurate diagnosis and start antibiotics before and during surgery. This study has shown that many of the cases are not emergencies and could actually wait before surgery is performed. Many patients want to know why surgery is not done right away. The surgeon will make that decision.
The results and discussion of this is  coming with some disagreement and concerns in the medical field. Ideally a diagnosis of an appendicitis is made by the surgeon with all the data and exam results available to him or her.  At that time a decision to do surgery is made between the patient and the physician. We hope it does not get to the point where a decision is made by someone other than the physician and patient.