Dr. Rex L. Mahnensmith

Yes. Acupuncture is safe for diabetic patients. The needle insertion site must be clean. The needle is single-use only.

It is important to have this checked by your healthcare provider. Its exact location is important. Its relationship to the thyroid or lymph node is important.

Special testing is required. EKG. Echocardiogram. Blood testing. Then therapy will be specific to the etiologies and pathophysiological changes. Midodrine is helpful and can benefit you. Other remedies aim at heart and inflammation.

The serum creatinine value indicates very substantial kidney functions. As long as the serum creatinine does not increase month by month or year by year, your functions are very good. Lisinopril protects kidneys. Your bladder function will be adversely affected by hydromorphone which slows bladder emptying.

The activity requires an extra evaluation by physical therapy exam to determine the functional capacity.

Chronic obstructive pulmonary disease evolves from inhaled irritants. The irritants provoke bronchial mucus secretion and bronchial cellular thickening. Then chronic bronchitis becomes established with tightness and narrowing of pulmonary bronchi and branch bronchioles. Inhaled airflow is thereby constricted. Air trapping may occur in alveoli. The common irritants are tobacco smoke, factory fumes and dust, coal mine dust, and mold allergens. Exposure and inhalation over extended periods of time are variables. And an individual’s response will vary from person to person depending upon intensity and repetition.

This is quite variable. The time can be years and years and years. Many years possible. Support matters. In-person support. Nutrition support. Vitamin support. Brain nutrient support. Rest and activity support. Safety assurances. Help and helpers. Safe home. Safe living. Clinical specialist support with specific medications help. Talking. Music. Walking. All help.

Your symptoms and questions and concerns indicate a definite need for additional testing. Gastric irritation that is sufficient to cause ongoing heartburn and epigastric upset and pain itself indicates inflammation within the lining of your stomach and likely your lower esophagus. The root cause is gastric acid. Gastric acid secretion is essential for food digestion. Yet it can cause erosion in the stomach lining. The resulting gastritis may be superficial or deeper and creating ulcers. Ulcers require remediation which includes diet changes and acid reduction. Then of extreme importance, chronic gastritis is often associated with gastric mucosal infection with Helicobacter pylori. Helicobacter pylori bacteria are common. Their presence perpetrates and perpetuates ulcerative erosions and gastritis. And ongoing infection leads to cancer changes in the stomach lining. The presence of Helicobacter can be detected by endoscopy and by specific breath testing at a special laboratory. A biopsy is very good at detection. If present double antibiotic plus omeprazole twice daily for 10-14 days is essential with follow-up retests. And chronic acid reflux into the esophagus can lead to ulcer formation in the lower esophagus and this too can become cancerous. So specialist testing is essential.

The likely consequence of the rupture and repair surgery are some internal adhesions and small spaces of scar tissue surrounding small spaces. The tissue may have some ongoing breakdown over time. And spleen loss renders a person prone to infection.

It does take longer than one week for sinus infections and inflammation and ear infections and inflammation to resolve. An antihistamine tablet daily and corticosteroid nasal spray daily.

Request an order for blood cultures.

Yes. The canister will say Children's.

Clotrimazole topical cream works well for children’s toe fungus applied twice daily for four weeks. Approved for children over 3 years old. Topical Vicks Vapo Rub helps eliminate toenail fungus also applied each night.

Yes. The liver enzyme elevations are mild and reversible. A liver ultrasound is warranted to assess the texture of the liver. One consideration is alcohol-induced liver enzyme elevation. A second consideration is fatty liver from carbohydrate and fatty acid storage. Both are reversible. A liver biopsy is not essential. A hematologist can provide expert advice.

Your concern is reasonable. Omeprazole can cause kidney injury as allergic interstitial nephritis. It is a common cause of allergic interstitial nephritis worldwide. It is appropriate to substitute famodipine.

Several factors and variables influence sperm counts. Zinc is important for prostate health and testicular health but all factors need to be adjusted and remedied.

Good question. Maintain healthy body weight. Maintain normal blood pressure. Maintain normal glucose. Maintain normal cholesterol and triglycerides. Exercise regularly. Avoid sugar intake and animal fats. Take omega three and astaxanthin. Take Polyphenol powders daily. Take magnesium supplements daily.

Colitis responds to corticosteroids and other immune suppressant medications. Each requires expert advice and dosing and monitoring. Diet adjustments are essential too. Probiotics are essential too.

Liver inflammation with hepatitis A resolves. Liver inflammation from NASH most often resolves after diet changes of glucose and fructose restrictions and fat restrictions and total calorie restrictions and 15 percent weight loss.

Go to the emergency room.