Dr. Paul Waytz
speaker
98 appearances
1 recordings
1 series
first heard Jun 2024
last heard Jun 2024
Dr. Paul Waytz’s voice in public audio — every appearance, attributed to the second.
Trend
recordings per month · last 12 monthsNo recordings in the last 12 months.Older appearances are listed below; set an alert to hear about the next one.
Appearances
He stopped the medication and within a month had an attack that brought this guy to tears. I mean, this was a professional football player who's, you know, been beat up and strung up and all this kind of stuff. He was in tears because he was in so much pain. So if there's gout and it's a treatable condition and in 2024 people, we shouldn't be seeing the amount of gout that we do.
Yeah. So the typical symptoms is very abrupt onset, pain, severe pain, redness, warmth, and swelling, usually in the big toe. However, and so people say, oh, it's in the big toe. 30% of initial attacks of gout are more than one joint. which throws some people off because they say, well, you've got three joints, it can't be gout. Or it's not the toe, it's the ankle and the knee.
The way to prove that, and this sounds barbaric, is you put a needle in a joint and you take a little fluid out. And you look at it under the microscope. And with very easy techniques, you can identify those crystals. And then you say, aha, I've made the diagnosis. I'm going to reduce the inflammation with one drug.
And then I'm going to put you on another drug that doesn't fight inflammation, but lowers the uric acid in your system. The interesting thing, Clarence, is that say somebody comes in with an attack of gout. in their knee and you prove the diagnosis.
I can guarantee you, almost guarantee you, that if I put a needle in a wrist that's not even symptomatic, I would find some uric acid crystals because that process has been going on for years. Wow.
Yeah, it's because we're making uric acid on a daily basis. Okay. And you can lower it, but once you stop the drug, the processes that created that the elevation of the uric acid will just go right back to where they were. And again, we talk about diet and this and that and the other thing. A lot of it's genetic. The most part is genetic. So you're going to have it.
And so here's another interesting story. The ancient Greek physicians recognized that gout would occur. And you can find gout in mummies, you know, so it's been going on. And the treatment at the time was to go chew on willow bark. Willow bark has acetylsalicylic acid in it, which is the basis of aspirin.
And if you take enough aspirin or if, I mean, usually low doses of aspirin can aggravate gout, but if you take a lot of it, that will reduce the inflammation. So we, that was recognized, you know, many centuries ago.
And that was the 1860s. I think Napoleon had gout. I think some of the czars had gout. And there's talk about wars that were either won or lost because somebody had gout or, you know, and they couldn't show up.
Exactly.
Exactly.
Okay. So lupus is an autoimmune disease that generally affects women 10 times more than men. So you're correct there. And like with rheumatoid arthritis that primarily involves the joints, you can get joint involvement with lupus, but generally speaking, you have other organ systems involved, such as the skin. The lining of the lungs, the lining of the heart. So you have multiple symptoms.
You have joint pain. You have chest pain. You have shortness of breath. The bad thing with lupus, the really bad thing, is I think the statistics are, let's just say, a good proportion, over 50%, will have kidney problems. That the inflammation attacks the kidney, which causes kidney failure.
And there are several different kinds of kidney failure such that you really need to recognize what's going on. So part of a lupus evaluation includes looking at a urine specimen and doing blood tests that look at kidney function. Lupus can affect the brain. It can affect not only the lining of the heart, but the heart itself. It can affect other blood vessels.
So it is potentially a life-threatening disease. Whereas rheumatoid arthritis tends to not be life-threatening, but chronic in pain, you can have life-threatening issues. And just like rheumatoid arthritis, it's a disease of young people, especially young women, women between the ages of 20 and 40. Wow. Wow. Wow. So, all right.
Yeah, yeah. The yes, overuse can certainly lead to more wear and tear arthritis. And again, it's about the idea of pounding that cartilage in the knee or hips or shoulders with people, whatever they're doing, torquing or lifting weights and this type of thing that you're putting an unusual amount of force into. Cartilage is made to absorb a certain amount of force.
If you overdo it for too long, then that's going to create some problem there. So that nice cushioning of the cart that the cartilage provides falters. And then it sets off, you know, a process that then includes inflammation that just aggravates the process. Now people said, well, does running or does running cause or not cause arthritis of the knees?
And there have been studies that looked at marathon runners over years. And early studies suggested that it doesn't, that running doesn't, you know, marathon running. Now, you have to factor in a couple of things. You have to really look at more than a few years after as time goes on, so maybe 10, 15, 20 years. And that data still doesn't exist in clear fashion yet.
The other thing is marathon runners tend to be very athletic, so they're not overweight and they're taking good care of themselves and they're eating properly, this type of thing. So it can be multifactorial. The other thing is that a prior injury someplace, so say you, I don't know, fell down some stairs when you were a kid and you had a bad knee, that is a precursor
to running, aggravating the knee problem. So if there's something underlying going on, then you're gonna have issues. So overuse can certainly lead to wear and tear arthritis, but we're talking decades down the line, we're talking decades. Now, let me just, you know, I love stories. There were autopsy studies of Korean War casualties.
Showing 41–60 of 98 · page 3 of 5
← Previous
Next →