health care – Page 5 – Go Retire Psychiatrist

Cribbage Could Help Preserve Your Brain Health!

I just saw an article that working on your cognitive skills might make you less susceptible to dementia. There are some websites that help you, but I think some, like BrainHQ, could cost you money.

On the other hand, there is some evidence that playing card games can help protect your brain. I think cribbage could be one of them, although it’s tough to find specific studies on it.

I checked around and found a few studies about how playing games like solitaire and hearts could help keep you sharp. On the other hand, when I was a young man, I worked on a land survey crew. We played hearts over lunch hour and when it rained. I consistently lost.

But for the last several years, Sena and I have regularly played cribbage, a card game that calls for some math skills, concentration, attentiveness, and strategy.

The one problem I see with picking cribbage as one of your main sources of cognitive stimulation is that many people see it has an old person’s game. They should try playing cribbage with someone who really knows how to play.

Cribbage players tend to be older; many tend to be over 50. The American Cribbage Congress (ACC) is the major organization for cribbage and they hold lots of tournaments, both local (called grass roots clubs) and national. They always welcome new and younger players. In general, you need to be able to play a game in 15 minutes in tournaments.

We have tried to finish a cribbage game in 15 minutes, but we can’t seem to do it in less than 20 minutes. I always know when Sena wants to play. She like to use the automatic card shuffler (I like to shuffle manually) and whenever I hear the card shuffling machine (which is loud enough to hear from all over the house), I know it’s time for a game!

Walking the Clear Creek Trail Today

Took a quick hike on the Clear Creek Trail this afternoon. Last week, my step counter logged about 5 miles or so when I walked out to the mall. I paid dearly for that; I could barely limp around the house for a day and a half. Today, I got about 7,500 steps which now gives me an average of about 10,850 steps over the last week. But I burned only 30 calories per day over the last month. Walking 10,000 steps usually burns 300-500 calories.

Not good if I’m going to get rid of a belly which could threaten to qualify me to play Santa Claus at the mall—eventually (I’m exaggerating—a little). The web tells me I have to burn 3,500 calories by exercise to lose a pound or 500 calories per day over a week.

One incentive to walk more frequently (at least until the snow flies) is to walk where I can see interesting scenes in nature, like today. I’m pretty sure I saw a downy woodpecker because it was pretty small, which distinguishes it from a hairy woodpecker—otherwise they look a lot alike. And I caught a chipmunk trying to hide from me.

On the other hand, I saw an article indicating that you could get good results from working out 2 days a week. They always quote a study, which in this case was published in the open access journal Obesity. It says that a weekend warrior can get the same results at losing belly fat as those slogging away every day. Maybe.

I’m not a weekend warrior. In fact, lately I’m a peacenik when it comes to exercise. I’d rather sit on a bench than bench press.

CDC ACIP Highlights on Covid 19 Vaccine

There was a lot to digest in today’s CDC ACIP meeting on Covid-19 vaccines. I missed the morning sessions but managed to see a few of the afternoon presentations.

The presentation by Dr. Retsef Levi, PhD, MIT, ACIP Work Group Chair, the Covid -19 Vaccine Discussion Framing Work Group (WG) was basically pretty critical of the Covid-19 vaccines in general.

The opposing reply to this (favorable to vaccines) was put together by University of Iowa’s Dr. Stanley Perlman, Dr. H. Bernstein, and Dr. M. Miglis, Additional Workgroup Considerations in Covid-19 Vaccination Policy and Practice.

For a change, I listened to the Public Comment section. I usually have not paid attention to them because most of the speakers were opposed to vaccines. Today was different. All of them were strongly supportive of vaccines.

There is a bottom line to this. I watched the voting session, which was very interesting. There were 4 voting questions. I had to take pictures of them because they were not included in the on-line schedule. It was easily the most interesting session of the afternoon, at least for me.

Voting question 1: all but one member voted “yes,” the committee chair Kulldorff voted “no.”

Voting question 2: one member suggested striking this one, but they voted anyway. What’s worrisome is that it was split between the yes and no votes; only the chair, Kulldorff, could break it and he voted “no.” Looks like common sense won; otherwise it would have made access very difficult.

Voting question 3: The video lost audio for a long time, but eventually it turned out that the votes were “yes” unanimously on the assumption that pharmacists counted as “health care providers.”

Voting question 4: The votes were all “yes,” mainly because they decided that pharmacists could make this work. One member questioned the wording which suggested that you needed to talk to your doctor about getting the vaccine because of the wording “shared clinical decision-making.” They glossed over it.

It looks like access to the Covid-19 vaccine will remain mostly open for now.

Comments on CDC ACIP Meeting Today

There are updates to the CDC ACIP meetings posted now. It looks like the anticipated votes on the MMRV and Hepatitis B vaccines are posted.

Public Comments on Upcoming CDC ACIP Meeting Posted

I have just noticed that there are over 5,000 comments posted on the comments section of regulations.gov in the section entitled Meeting of the Advisory Committee on Immunization Practices-September 2025.

The link to the comment section is on the CDC ACIP meeting announcement web page, “Written Public Comments.”

This is the first time I’ve seen a written comment section like this for the meetings. I think it gives people a sense of what health care professionals and others think about how things are going with the current approach to preventive medicine at the CDC.

Upcoming CDC ACIP September Meeting on MMVR & Covid-19 Vaccines

The upcoming meeting on the MMVR and Covid-19 vaccines will include voting on the MMVR and Covid-19 vaccines. Usually, the committee posts the actual voting questions, which so far I have not seen on the meeting agenda. I’ll be looking for them in the next couple of days.

Here is the link to the Center for Infectious Disease and Policy (CIDRAP) at the University of Minnesota article which bears directly on the meeting topics.

CDC ACIP Meeting Agenda Posted

I just noticed that the CDC ACIP draft agenda for upcoming meeting on September 18th and 19th has been posted. There will be votes on the MMRV, Hepatitis B, and Covid-19 vaccines.

University of Iowa Physician Wins Lasker Award!

How about some good news? This just in, University of Iowa Physician-Scientist, Dr. Michael Welsh, wins the 2025 Lasker Award for his research on cystic fibrosis.

His work and the work of two other researchers with whom he’ll share the award set the stage for the development of new drugs which saves the lives of those who suffer from cystic fibrosis.

I learned from the article that the cystic fibrosis gene was discovered in 1989; I was a second-year medical student then. Since then, the development of new treatments has meant that many people who died in early adulthood now can live into their 80s.

Congratulations to Dr. Welsh and colleagues!

Rounding@Iowa Podcast: “When to Suspect Atypical Recreational Substances”

There’s a new podcast in town from The University of Iowa Health Care and the title is “When to Suspect Atypical Recreational Substances.”

89: Tick-borne Illnesses – Rounding@IOWA

Join Dr. Clancy, Dr. Appenheimer & Dr. Barker as they discuss prevention, diagnosis and treatment of various tick-borne illnesses. CME Credit Available: https://uiowa.cloud-cme.com/course/courseoverview?eid=82296 Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Ben Appenheimer, MD Clinical Associate Professor of Internal Medicine-Infectious Diseases Assistant Director, Infectious Diseases Fellowship Program Associate Clinical Director, Infectious Diseases Co-Medical Director, TelePrEP, University of Iowa Health Care University of Iowa Carver College of Medicine Jason Barker, MD Associate Professor of Internal Medicine-Infectious Diseases University of Iowa Carver College of Medicine Financial Disclosures: Dr. Gerard Clancy, his guests, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 1.0 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 1.0 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. JA0000310-0000-26-038-H01 Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.)

This is a fascinating topic and the discussion ran for close to an hour, which is longer than usual because there’s a lot to say about it. The substances include a lot of chemicals that are not illegal and, in some cases, easily available in convenience stores and gas stations. In fact, the name for one of them is gas station heroin, which is tianeptine, approved in other countries as an antidepressant.

The discussion also included substantial information (or maybe better said, lack of enough information) about bath salts (usually cathinones), kratom, and something I’ve never even heard of: diamond shruumz (chocolate bars which can contain various substances not limited to psilocin). Remember that guy who chewed the face off of somebody in Miami in 2012? That was attributed to intoxication with bath salts.

This is way beyond the 1970s stuff like window pane or blotter (LSD) and pot. Many people end up in emergency rooms for evaluation of what looks like poisoning from multiple drugs. The stickler is the possibility that they got poisoned from something bought at a convenience store. Often it’s difficult to tell what the person ingested.

One of the takeaways from this podcast is that, whenever possible, try to get a history from the patient. They might just tell you what you need to know.

Got Vaccines Today!

Sena and I got our latest updated seasonal Covid-19 and flu vaccines today. Manpower was low at Walgreens so we ended up sitting for about an hour, but otherwise this was a routine trip. We’re thankful.

We noticed there were a few people waiting—mostly our age. No word up yet on the CDC ACIP site about the Sept. 18-19 meeting as far as an agenda, speakers, or slides.