Tidbits with Tropical Storm/Hurricane Nicole Rolling In

November tropical weather systems, either storms or hurricanes, are a rarity for south Floridians including this grizzled veteran who has spent 45 years in this area.

My office has been in the same location since 2003 but this is at least the third ownership group (landlord) we have worked with. The building and grounds are well maintained. For reasons unclear to me, when NOAA issued a hurricane warning for Boca Raton yesterday at 2 p.m., the building management insisted we vacate the building by 4 p.m. so they could prepare for the storm. I have gone through multiple hurricanes as a tenant in this building, so I know just how long it takes to prepare the building for a storm. There are no shutters to install. There is no impact glass in the office building. The storm was not projected to arrive until sometime the next day.

Nonetheless we rescheduled our last patients, sent some home early and sent our wonderful staff home at 3:45 to comply. The storm still has not fully arrived and, thankfully when it does, it will not bring hurricane force winds or tornados to the area. I now have all this extra time on my hands to catch up on reading journal articles. None of the topics truly warranted a full blog so I thought I would give you a quick smorgasbord synopsis.

  1. A small study suggested that if you perform physical exercise 30-60 minutes prior to your flu shot or COVID-19 booster shot you get an enhanced immune system response.
  2. Drinking 2-5 cups a day of coffee probably reduces cardiac arrhythmia, cardiac events and cerebrovascular events. Ground coffee with caffeine seems more effective than decaf and instant coffee.
  3. The new guidelines for vaccinating adults against community acquired pneumonia are about as clear as mud. If you turned 65 and received Prevnar 13 followed a year later by Pneumovax 23 you are probably complete. If you only received Prevnar 13 please go to your pharmacy and get a PCV 20 vaccine to complete the series. There was much disagreement on giving boosters to seniors five years after completing the vaccine series. If this confuses you all well then welcome to the club.
  4. Screening for colorectal cancer with an office based flexible sigmoidoscopy saves lives. Screening with a traditional colonoscopy is even better at getting a look at the left and right colon. Any controversy created by a recent colorectal cancer study needs to be ignored. If you are 45 you need a screening colonoscopy. If your study is normal, then you will be retested in 7-10 years. In the future, tests such as Cologuard and fecal immune globulin may permit other safe means of evaluation and screening in low-risk patients.
  5. There are some new and safe treatments for acute migraine headaches and prevention of migraine headaches. These include injectable monoclonal antibodies and receptor site inhibitors. Avoiding triggers of these headaches. Tylenol, non-steroidal anti-inflammatory drugs and triptans remain the main options for treating migraines but new and better therapies are now available.
  6. Bebtelovimab, the monoclonal antibody infused to prevent COVID-19 from progressing to severe disease requiring hospitalization may not cover some of the newer Omicron variants. It is currently still recommended by the CDC in all 50 states and is the product administered at our local hospital. That may change in the next few weeks.

Hope you enjoyed this poo-poo platter of medical knowledge. Call me if you have any questions.

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