Dr. Rex L. Mahnensmith

There is a clear trend toward the worldwide prevalence of *MTHFR* 677 and COVID‐19 incidence and mortality. Published data exist documenting this observation that disease from COVID may be more severe. HOWEVER, the vaccine is not considered unsafe or contraindicated with MTHFR. The vaccine is considered helpful to prevent COVID in you. Long ago, the polio vaccine was questioned as unsafe, but the actual data with review did not contraindicate any vaccine in the setting of MTHFR -- most importantly, be sure your intake of B vitamins is sufficient and daily and that your intake of FOLIC acid is daily.

Rex

This may be a small, firm cyst; cysts of the epididymis can form; and cysts of spermatic cord can form. Be examined by urologist and by ultrasound.

Rex

There may be minor restriction of lung volumes with a pectus c… the effect varies and depends upon rib cage flexibility and your breathing habits. Work on deep breathing. Expand to the fullest. Hold it. Expire slowly. Repeat fullest expansion. And blow up balloons. Your rib cage capacity can grow and increase with deliberate habits and exercises.

Please present yourself for heart evaluation and lung evaluation. As soon as you can.

Minimally invasive surgery is effective. The goal is resection without nerve trauma.

Your leg will recover over 2-4 weeks; the wound will heal; as the wound heals, be more and more active; numbness will recede slowly.

Rex

You definitely need help. Blood work is essential. The choices are going to an Urgent Care Walk In Center for an exam and blood testing. Or going to an ER. Or calling a physician you have seen to ask for blood testing.

Not uncommon to have chest ache after stent. Let your cardiologist know.

Hello,

I share your concerns and worries. Your intestines are 'irritable' and 'inflamed.' Precisely why is essential to know. And planning remedies centers on the 'why.' Essential studies include:
gastric emptying study; intestinal capsule-scope study; intestinal transit study; CT enterography study; plasma Immunoglobulin IgA level; Immunoglobulin IgE level; colonoscopy if not done; Helicobacter pylori evaluation by Upper Endoscope with biopsy and by Urea Breath Test; serum gastrin level; serum lipase level; liver function tests; food allergy blood test profiles; and then pre-biotic and probiotic capsule intake daily; may need CDIFF test and treatment; may need intestinal antibiotic therapy with xifaxin; may benefit from dicyclomine; diet adjustments to eliminate fats and simple carbs essential also.

Rex

Hi,

- BEST meal plans include plenty of vegetables, and very little sugars and mixed fatty meat - i.e. eating complex carbohydrates, primarily from vegetables, and consuming only very lean nonfat protein foods.
- Foods to eat daily and faithfully include complex carbohydrates such as quinoa, oatmeal, fruits, vegetables, beans, and lentils; lean meats which have no or very little fat; and NO sugar foods or breads or pastas

- DO NOT EAT:
- Pizza, pasta, white bread, muffins, potato, juices, soda, cookies, pastries;
- Fatty meats, such as bacon hamburger sausage fried chicken, pork with fat, beef with fat - carve out all fat from any beef or pork or chicken or turkey - make it super lean always;
- Any saturated fats, which are animal fats, poultry fats, creams, whole milk, ice cream.
- Sodas (regular and diet),
- Refined sugars,
- Processed carbohydrates (breads, cereals, cookies, cakes, most pasta, white polished rice, muffins, bagels)
- Trans fats, high-fat animal products = any visible fat solid at room temperature
- High-fat dairy products = whole milk, ice cream, heavy cream
- High fructose corn <https://www.medicinenet.com/corns/article.htm> syrup = avoid - this is added
- Artificial sweeteners
<https://www.medicinenet.com/artificial_sweeteners/article.htm> = avoid
-Fried foods = avoid all fried foods

- What To eat:
-V8 Fusion Juice - Diet Version - Best Juice
-Skim Milk or Soy Milk or Almond Milk
-Unsweetened Tea or Coffee
-Whole Vegetables
-Whole Fruits with no syrup or juices
-Lean Meats with NO VISIBLE FAT
-Fish NOT FRIED
-Whole Grain: High Fiber Oatmeal, Granola, Whole Rice, Beans, Quinoa

COUNT Calories - and Grams of Carbs - and GRAMS of FATS EACH DAY
- Calorie intake: aim for 1600 kcal per day = NO MORE
- Protein intake: aim for 60 grams per day.
-Fat Intake: Less than 15 grams per day = NO MORE

CREATE MEAL PLANS - PORTION SIZE - FOOD TYPES

COUNT CALORIES, CARB Grams, FAT Grams per MEAL

Keep notes!! A meal plan is essential.

1.20-25 GRAMS OF CARBS
1.Complex Carbs
2.Not Simple Sugar Carbs
3.Minimal Bread/Pasta/Processed Carb
2.10 GRAMS of FATS
1.Plant Fats MOSTLY
3.30-40 GRAMS of PROTEIN
1.Very lean - Eggs, Fish, White Meat
4.Minimize Simple Carbs
5.Minimize Animal Fats
6.Small-Medium Portion Size is Essential:
- The carbohydrates consumed should be low glycemic load and come primarily from vegetables.
- The fat and proteins consumed should primarily come from plant sources - or egg - or fish - or very, very lean meats.

Learn the Glycemic Load of daily foods. Carbohydrates (carbs) are the primary food that raises blood sugar. Glycemic <https://www.medicinenet.com/high_and_low_glycemic_index_foods/article.htm> load indicates how much sugar/glucose is eaten per food!!
- Foods with low glycemic load raise blood sugar modestly and thus are better choices for people with diabetes.
- Carbohydrates can be classified as either:
- Complex carbohydrates - Low Glycemic Load
- Simple sugars - High Glycemic Load -- Avoid

Complex carbohydrates (low glycemic load foods, or foods that are a part of a prevent diabetes plan) are mostly UNPROCESSED - and WHOLE. Examples of complex carbohydrates, or low glycemic load (index) foods include:

- Brown rice
- Whole wheat
- Quinoa
- Steel-cut oatmeal
- Vegetables
- Fruits
- Beans
- Lentils

Whole grains, such as brown rice, quinoa, and oatmeal are good sources of fiber and nutrients; and have a low glycemic load making them good food choices. Processed food labels make it very confusing to understand whole grains. For example, "whole wheat bread" is made in many different ways, and some are not that different from white bread in its blood sugar impact (glycemic load). The same is true for whole grain pasta, it's still pasta. Whole grains raise blood sugar much less. Choose whole grains that are still in their grain form like brown rice and quinoa, or look at the fiber content on the nutrition <https://www.medicinenet.com/nutrition/article.htm> label. For example, a "good" whole grain bread will have 3+ grams of fiber
per slice.Starchy vegetables should not be eaten daily - or regularly

Not compelling to investigate further. It is recovered frequently. GERD can be a risk factor. Smoking is a risk factor. Being around smokers is a risk factor.

These headaches are either focal migraine or vascular cluster headaches. These require preventative management.

The skull of a mature person is firm and solid bone; the scalp is firm, but able to be compressed just a bit; not more than 1-2 mm; the skin of the scalp can be altered by heavy compression; the skull itself though will not be altered.

Rex

This symptom is not unusual. It is pretty common. The lingering cough reflects bronchial and tracheal lining inflammation which will resolve over another two to three weeks. The virus penetrates a bit and incites inflammation there. Then resolution occurs over weeks. To help yourself, deep breathe often. And drink fluids that are thin and easy to swallow. Sometimes we prescribe prednisone to help resolution.

OKAY, hard, constipated stool requires remedies. First, make sure your food intake has 5 servings of fresh fruit and vegetables with natural fiber. Best choices: apples, pears, peaches, prunes, tomatoes, broccoli, asparagus, onion, peppers, and whole-grain, high-fiber oatmeal. Minimize simple sugar foods: doughnuts, white bread, white rice, and potatoes. Minimize animal fats. Be sure you are drinking 8 cups of fluids per day. And be sure you are active: walking is fine. Then, it is helpful and appropriate to take Senna Capsules daily; take 2 each day; it is helpful to have a simple colon cleanse also: can do this with an over-the-counter colon agent.

Rex

Good evening,

The essential remedy is colon cleanse with a product that cleans colons completely. The cleanse agent used pre-colonoscopy is best. Stay hydrated. Then adjust your intake. Prebiotic capsules daily. Probiotic capsules daily. Senna capsule daily. Be sure you have one to two bowel evacuations each day. Minimize simple carbs. Minimize dairy. Minimize animal fat. Best diet is Mediterranean Diet. Minimize soda. No alcohol. Yes, take an acid blocker daily. Whole fruit and whole vegetables are fine. High fiber is best. The basic problem is intestinal overgrowth and stasis and leaky gut syndrome. Get Lectin Shield.

Good evening,

Your ailments are substantial as you describe. The autoimmune ailments are able to be modified and remediated with a combination approach. Plaquenil. Steroids. Immune suppressants. Biologics. And massage therapy and physical therapy help. The multi modal therapy approach is essential.

Yes, the low white blood cell count is a risk factor for infection from any infectious agent. White blood cells include lymphocytes, which are essential in a protective response to viral infections. The result is an impairment in infection defense. An important consideration is "why" are your white blood cells lower than normal. This is essential to discern.

Rex

It is important to get precise and accurate diagnoses. Chlamydia only very rarely infects mouth or lips or eyes. Other agents are more common: mycoplasma, ureaplasma, Herpes, Trichomonas, Enteric Bacteria,GC, and Syphilis can infect urethra plus face tissues. Repeated Smear, culture, DNA probe testing need to be done. And repeat contacts can reinfect.

This is chest wall pain. It is located in your rib cage. The point source is either rib muscle or rib tendon or tendon sheath or inner rib cage pleural membrane. Reason may be either strain or sprain or inflammation. Fracture not likely.