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• Full body MRIs cost around $2,500 and are being promoted as the "gold standard" for preventative health without proper medical context
• Unlike established screening tests, these scans haven't been evaluated by medical societies for appropriate use in healthy populations
• 15-30% of diagnostic images have at least one incidental finding, which can lead to unnecessary anxiety and further testing
• The marketing tactics use fear-based messaging about finding cancer early, which might be ethically concerning
• These services create healthcare disparities since they're only accessible to those with financial resources

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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski

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We dive deep into hypoglycemia (low blood sugar), exploring its causes, symptoms, and critical treatment options for patients with diabetes and their loved ones. This episode provides essential knowledge that could potentially save lives in emergency situations.

• Hypoglycemia defined as blood sugar below 70 mg/dL, with severe cases below 54 mg/dL
• Common causes include excess insulin/medication, inadequate food intake, vigorous exercise, irregular eating patterns, and alcohol consumption
• Early symptoms include sweating, trembling, hunger and anxiety, progressing to confusion, unusual behavior, and potentially seizures if untreated
• Hypoglycemia unawareness occurs when individuals don't experience warning symptoms, putting them at serious risk
• The 15-15 rule for treatment: consume 15g of fast-acting carbs, wait 15 minutes, recheck blood sugar
• Emergency glucagon (injection or nasal spray) for severe cases when a person cannot safely consume sugar
• Children may sometimes appear asymptomatic with dangerously low blood sugar levels
• Post-hypoglycemia follow-up with healthcare providers is essential to adjust treatment plans

Share this episode with loved ones who have diabetes or anyone who might benefit from understanding how to recognize and respond to low blood sugar emergencies. Sign up for our email list at our website for notifications and additional written materials, or email us at yourcheckuppod@gmail.com.

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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski

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Managing allergic rhinitis requires realistic expectations and a strategic approach to medication. Though no treatment will completely eliminate symptoms, the right combination of therapies can significantly reduce discomfort and improve quality of life during allergy season.

• Nasal corticosteroid sprays are first-line treatments that reduce inflammation in nasal passages
• Proper technique matters: point spray toward outside of nostril and sniff gently "like smelling a flower"
• Non-sedating antihistamines (Zyrtec, Claritin, Allegra) relieve itching, sneezing, and runny nose without drowsiness
• Nasal antihistamine sprays provide targeted relief and can start working within minutes
• Oral decongestants raise concerns about blood pressure and heart rate increases
• Avoid nasal decongestant sprays (like Afrin) beyond 2-3 days to prevent rebound congestion
• Combination therapies often work better than single medications
• Consider allergen immunotherapy when standard treatments don't provide adequate relief

Thank you for coming back to another episode of Your Checkup. Hopefully you were able to learn something for yourself, a loved one, or an allergic neighbor. Please check out our website, find us on Instagram, send us an email at yourcheckuppod@gmail.com and, most importantly, stay healthy my friends, until next time.

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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski

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Allergic rhinitis affects 20% of people with substantial impact on quality of life, causing symptoms like nasal inflammation, itchy eyes, and post-nasal drip.

• Allergic rhinitis is a nasal reaction to airborne particles causing a histamine response
• Symptoms include itchy nose, watery eyes, sneezing, nasal congestion, and sinus pressure
• Allergens fall into four categories: pollens, insects, animal dander, and molds
• Allergies can be seasonal (specific times of year) or perennial (year-round)
• Trigger avoidance is the first line of defense before medication
• For dust mites, use allergen-impermeable covers and wash bedding weekly in hot water
• Pet allergies are challenging—consider HEPA filters and increased cleaning if removal isn't possible
• Changing pillowcases daily during high symptom periods can significantly reduce exposure
• Controlling humidity below 50% helps with dust mites and mold allergens
• For outdoor allergens, stay inside during peak times and shower before bed

Join us next week for an in-depth conversation about medication options for managing allergic rhinitis.

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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski

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The meteoric rise in demand for weight loss drugs has created widespread shortages, leading to the emergence of compounding pharmacies as an alternative source for these medications.

• Compounding pharmacies create custom medications by combining, mixing, or altering ingredients to meet specific needs
• Unlike FDA-approved medications, compounded drugs don't undergo the same rigorous safety and effectiveness reviews
• Dosing errors with compounded weight loss medications have led to serious adverse events requiring hospitalization
• Confusion between units, milliliters, and milligrams contributes to potentially dangerous dosing mistakes
• Some compounding pharmacies add unproven ingredients like vitamins, L-carnitine, and NAD to their formulations
• The long half-life of these medications (about one week) means overdose symptoms can persist for extended periods
• Pharmaceutical companies have responded with direct-to-consumer models offering FDA-approved versions at reduced prices
• Eli Lilly now offers Zepbound in vial form for approximately $499/month versus $1000+ for pen versions
• Novo Nordisk's NovaCare pharmacy provides direct-to-patient delivery of Wegovy single-dose pens at similar price points

Please talk to your healthcare provider about what option might be right for you, as these medications require careful consideration and proper dosing is essential for safety.

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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
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Summary

In this episode, Ed Delesky, MD, and Nicole Aruffo, RN, discuss the impact of GLP-1 medications on lean body mass and muscle mass during weight loss. They explore definitions of lean body mass and skeletal muscle mass, the effects of weight loss medications on muscle physiology, and strategies to preserve muscle mass through diet and exercise. The conversation emphasizes the importance of understanding muscle quality and the potential risks of sarcopenia, particularly in vulnerable populations. The episode concludes with practical advice for maintaining muscle health while using weight loss medications.

Takeaways

GLP-1 medications can impact muscle mass during weight loss.
Lean body mass includes all tissues except fat.
Skeletal muscle mass is crucial for strength and metabolism.
Different studies show varying impacts of GLP-1 on muscle mass.
Weight loss can lead to reduced resting energy expenditure.
Muscle quality is an important factor in health outcomes.
Sarcopenia may be concern for older adults on weight loss medications.
Increasing protein intake can help preserve muscle mass.
Resistance training is essential for maintaining muscle strength.
Consult your doctor for personalized dietary and exercise advice.

Keywords

weight loss, GLP-1 medications, muscle mass, lean body mass, obesity, health, nutrition, exercise, patient education, diabetes, zepbound, wegovy, ozempic, mounjaro

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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski

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In this episode, Ed Delesky, MD, and Nicole Aruffo, RN, discuss Irritable Bowel Syndrome (IBS), covering its symptoms, causes, diagnosis, and various treatment options. They emphasize the importance of understanding IBS as a common condition affecting a significant portion of the population and provide insights into managing symptoms through dietary changes, stress management, and medical treatments. The conversation aims to educate listeners about IBS and encourage proactive health management.

Takeaways

IBS affects 10-20% of the population.
Symptoms include abdominal pain and changes in bowel habits.
Diagnosis is based on symptoms, not a single test.
Treatment requires a personalized approach.
Dietary changes can significantly impact IBS symptoms.
Stress management is crucial for IBS patients.
Medications can help but do not cure IBS.
Probiotics and herbal remedies lack strong evidence for IBS.
Most people with IBS can lead normal lives.
Understanding IBS empowers patients to manage their health.

Keywords

IBS, irritable bowel syndrome, digestive health, symptoms, treatment, management, gut-brain axis, dietary changes, healthcare, patient education

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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski

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Depression requires a comprehensive treatment approach addressing biological, psychological, and social dimensions for true healing. We explore the three essential components of effective depression management: medication, therapy, and behavioral activation.

• Depression categorized as mild, moderate, or severe, with treatment options varying accordingly
• PHQ-9 questionnaire serves as both diagnostic tool and progress tracker
• SSRIs (like Lexapro, Prozac, and Zoloft) serve as first-line medications with fewer side effects
• Antidepressants typically require six weeks at therapeutic dose to determine effectiveness
• Psychotherapy, especially cognitive behavioral therapy, proven equally effective as medication
• Combined medication and therapy approach provides superior outcomes to either alone
• Psychology Today website offers accessible therapist-finding tool
• Exercise (30-60 minutes, 3x weekly) prescribed as essential treatment component
• Behavioral activation through resuming enjoyable activities crucial for recovery
• Recovery is possible with comprehensive treatment even when motivation is low

Visit psychologytoday.com to find therapists in your area based on specialty, insurance coverage, session format, and more.

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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski