Morning everyone!

 

Welcome to another edition of the Doctor’s Note, where we talk about what’s on our minds when it comes to your health. 

 

I’m coming to you today with another update on Covid-19. 

 

This Doctor’s Note might be my most important article to date. Please share it. 

 

We’ve been dealing with the COVID-19 pandemic for 8 months here, and at Performance Medicine we have treated a few hundred cases. Most all of them being outpatient by telemedicine. 

 

We’ve all known people who have had it. I’ve had a few family members do great with it. But there are people who are getting really sick from this. 

 

As I write this there have been 8 million cases in the United States, and around 220,000 deaths. 

 

It’s everywhere right now. It’s certainly here in east Tennessee where I live. 

 

I think there’s even more positive cases out there than we know about. I believe this to be true because of how bad the testing has been. 

 

Why has it affected the United States more than other countries? This is the question that needs to be asked more. Our healthcare system is one of the most advanced in the world with the most money, and yet we’re doing worse with COVID-19 than most third world countries on the mortality list. 

 

I think there’s a few reasons for this. I think a lot of it is because we are an obese country, and we’ve also been slow to adapt to things we should have been doing already. Plus, we live in a free country. We can’t force people to do things like some of these Communist countries, thank God. Our bureaucracy makes it hard for things to get done, because everyone is worried about legalities. And you’ve seen how politics have affected this. 

 

Many people who have symptoms are going to the Urgent Care or the ER to get tested. And if you have a positive test, they say go home and ride it out. Take some Tylenol or cough medicine. And if you get worse go to the hospital. 

 

That’s just not a good answer for this thing. 

 

We now know that early outpatient treatment is the answer. You can’t wait two weeks until you have to go to the hospital to start treatment. If you wait until you’re short of breath and in the hospital, your chances of dying are so much greater than if we had treated this disease early. 

 

I’ve treated a lot of this early, and I know it works. 

 

I think that some of the reason you’re seeing conflicting reports about whether certain drugs work or don’t work is because the studies are being done too late. They are doing these studies on people who are already in the hospital, maybe even on ventilators. Of course some of these medications aren’t working then. 

 

But they’ve proven that it works early. 

 

For example, Hydroxychloroquine has proven that it works early, and you have to use it early. Studies show that it may not work if you’re sick and in the hospital. 

 

What you’re trying to do by treating it early on is prevent the viral replication which causes this cytokine storm and then blood clots to your lungs and heart. 

 

There is a treatment protocol that has been studied extensively by a huge US/Italian coalition type of project. They’ve reviewed over 50,000 studies on different things that may work for this virus. They’ve come up with a protocol.
 
I’ve been using something similar to this very protocol for the last several months now, and I’ve seen it work.  

 

One thing to think about right now if you don’t have COVID-19 is taking your baseline vitamins (Vitamin D which is paramount, Vitamin C, and Zinc). Doing this will go a long way towards prevention of getting Covid-19. 

 

If you’re a healthy individual, you don’t have a lot to worry about. If you are in shape, healthy, and under the age of 50, you may not even know you have had it. Or if they do it’s going to be a very mild illness. Of course, there are outliers. 

 

If you question whether or not you may have it and have some symptoms like a sore throat, dry cough, fever, muscle aches, loss of taste or smell, GI problems, etc., you should get tested.

 

This PCR test is pretty specific, but not very sensitive. So if you have symptoms, there’s a good chance you have COVID-19. As of right now, 30% of the negative tests are false negative. 

 

The key is early treatment and keeping people out of the hospital. The danger in this thing is hospitals getting overwhelmed by sick people. 

 

To all of our providers, doctors and mid-levels, this is a medical emergency of our lifetime. As doctors we took the Hippocratic Oath to do something! The “second front line” can be the most important people in treating this thing. 

 

My dad was an old timey doc and he always told me that if you’re not really sure what to do, do something! Now we know of some things we can do. 

 

Some of those things include the use of High dose Zinc, Hydroxychloroquine (the malaria drug) and Zithromax. These are my first lines of choice. 

 

Hydroxychloroquine is a very safe drug. It’s my “go to” for this thing. It has very low side effects. The only people I wouldn’t use it on are those with prolonged QT intervals. This is a rare thing you may see on an EKG. If you have a history of cardiac arrhythmias, or on certain drugs that may predispose you to this, you may be wary of Hydroxychloroquine.

 

This is why you really need someone who knows what to do for this. There’s very few people I wouldn’t put on Hydroxychloroquine because of medical history. 

 

I also have been using Zithromax, or Doxycycline. You can get on these early to prevent problems like pneumonia, which you can get from Covid. There’s a thing called Covid Pneumonia. It looks horrible on a chest x-ray. You also want to prevent the emboli in your lungs from blood clotting. You always need an antiplatelet drug in there like aspirin, or at times Lovenox. I’m also using home O2 SAT monitors to follow how your lungs are doing. 

 

I’ve even used home oxygen, and nebulized budesonide inhalers.  

 

You also want to look at the course of the disease. If by day 5 you’re not getting better, you need to take note because that’s when you’re in danger of this cytokine storm happening. This inflammatory reaction can set in and kill you. That’s when I may add prednisone. 

 

You really need to look at comorbidities. Morbid obesity is the biggest risk factor I’ve seen besides being very elderly. You also want to be very careful if you have lung disease, cancer, heart disease, hypertension, or diabetes. People with these comorbidities are more at risk for having a real difficult time with Covid. 

 

We treat it early and we use multiple combinations of these medications. 

 

Another medicine I’m starting to use is Ivermectin, which is an antiparasitic drug that’s very safe. With this there are no cardiac arrhythmia possibilities. It’s been used for many decades. 

 

We are learning these things every day from treating it. Another medicine I’m using is called Colchicine. I use this when I can’t use prednisone. It’s something used for gout. 

 

The idea is to not have to send people to the hospital. I’ve only had to do this with one case. With this case the doctors (pulmonologists) treating them in the hospital said that if we hadn’t started them on hydroxychloroquine, steroids, and budesonide they wouldn’t have made it. We started early.
 

Also I tend to use very high doses of vitamins D, C, and Zinc. 

 

In my opinion, no doctor should stand by and do nothing. There are good treatments out there, and you have to hit it early. I’ve been practicing for 35 years, and now is definitely the time to step up because this is something we have not seen before in our lifetimes. 

 

We are recruiting other doctors from other specialties to help jump on this. We can’t wait for a vaccine. We need to treat now. We can’t wait for the CDC, WHO, or the FDA to complete all these studies. That may take years. 
 

So now is the time to step up. 

 

Please share this article. I guarantee you know someone who has COVID-19. 

 

Again, it’s really hard on obese patients, diabetics, and elderly people. It can spread easily and rapidly. 

 

Don’t take it lightly. Treat it early. If you are at risk or have a positive test, call one of my offices. I or one of my Nurse Practitioners or PA’s  will treat you for this over the phone. 

 

We have increased the use of telemedicine, and it’s been great for us and great for patients. 

 

We will monitor you on an outpatient basis, and of course let you know if we think you need to go to the hospital. 

 

 

 

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