Paging Dr. Frischer: Food defects


While enjoying a bowl of cereal I noticed something suspicious floating in the bowl. Of course, that was the end of that bowl of cereal; I tossed it down the drain. It was probably nothing, but it got me wondering: what in the world was in there?

Nobody wants to find insect parts, rat hairs, mouse poop or maggots in their food. However, the Food and Drug Administration allows low levels of those unsavory items to be present in our food. In fact, the FDA considers this to be natural and unavoidable.

Most of us have never heard of the FDA Defect Levels Handbook. This is (I hope!) the most disgusting government publication in existence. For more than 100 food items, from allspice to wheat flour, this booklet spells out the maximum allowable levels of “defects” that are permissible before the agency considers the food to be unacceptable. It actually spells out just how much mold, rot, parasites, bugs, and other contaminants are allowed in our food.

The handbook puts it this way: “The FDA set these action levels because it is economically impractical to grow, harvest or process raw products that are totally free of nonhazardous, naturally occurring, unavoidable defects.”

Given the large amount of food that is produced daily in the United States, it is unrealistic to think that some outside materials won’t make their way into the finished product. When grain is harvested, it is inevitable that there will be a bug in there somewhere. After harvest, when it is being processed at a factory, or being stored, or in transit, there might be a mouse, and therefore…mouse poop. These “defects” exist in the environment where foods come from, and it is just impractical and too expensive to remove every little bit if it does not actually pose a threat to our health.

If it’s at all reassuring, do note that food-processing systems are far cleaner, more effective and more efficient than ever before.

The motivation for setting limits is to utilize this inevitable contamination as an indicator of whether there is something dangerously wrong. One mouse hair in food will not harm us, but many hairs may be evidence of an infestation at the factory. Along with an infestation may be bacteria, viruses, or other harmful microorganisms.

Consider these examples of FDA limits:

  • · A 16-ounce box of pasta may contain no more than nine rodent hairs.

  • · Perhaps there are dark specks in your cornmeal. Maybe they’re just cornmeal, but the FDA’s action levels do allow for up to 13 “fragments” of rodent excreta in a 24-ounce container.

  • · The government permits three maggots in a 28-ounce can of tomatoes.

  • · A 16-ounce jar of peanut butter may contain up to 136 insect fragments and four rodent hairs.

  • · Beer drinkers take note: there is a limit of 2,500 aphids for every 10 grams of hops.

  • · Tiny bugs such as aphids, thrips, or mites may come in from the field with the broccoli. The limit is 60 creatures per 100 grams – or 204 in a 12-ounce bag of frozen broccoli.

  • · 6% of potato chips may contain rot. However, only 5% of prunes can be moldy, decomposed, or insect-infested.

  • · 15 ounces of golden raisins may contain no more than 40 milligrams of sand and grit…as well as 65 fly eggs.

  • · Mushrooms can contain up to 20 maggots per can.

  • · The cranberry sauce accompanying your Thanksgiving turkey may contain an average of 15% mold filaments.

Honestly, after perusing this FDA handbook, I thought twice about ever eating again. These imperfections sound disgusting.

The good news is that the FDA reassures us that these allowable imperfections present no health hazards. Although the FDA has established these acceptable defect levels, and can take action if a food exceeds those levels, the amounts actually found are much lower. In fact, most food companies set their own quality standards at far stricter levels than these FDA limits.

Note that today’s column does not address intrinsically harmful food contaminants such as pesticides, metals or environmental chemicals, but “merely” defects in food quality. Keep this in mind as you consume your next grasshopper leg.

Bon appétit!

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

Paging Dr. Frischer: Ginger

Ginger has long been one of my mother’s favorite foods. Birthday presents that contain it in one form or another are always a hit. In addition to its unique flavor, however, ginger has some amazing properties.

Ginger is native to warmer parts of Asia, including China, Japan, and India. Its use for health-related purposes comes up in ancient Sanskrit, Chinese, Greek, Roman, and Arabic texts. Dried ginger has been used for thousands of years to treat stomachaches, diarrhea, and nausea.

Scientific analysis shows that ginger contains hundreds of components and metabolites, some of which do appear to contribute to health and healing. Of these, the gingerols and shogaols have been most extensively researched. The most common current medical uses for ginger include:

  • Digestion - The phenolic compounds in ginger help relieve gastrointestinal (GI) irritation, stimulate the production of saliva and bile, and suppress gastric contractions as food and fluids move through the digestive tract. Ginger also stimulates the pancreatic enzymes.

  • Nausea - Chewing raw ginger, drinking ginger tea, or consuming it as lozenges or candies is a common remedy for nausea, especially during cancer treatment or after surgery. Taking ginger for motion sickness often reduces feelings of nausea (but does not appear to prevent vomiting). Ginger in low doses is safe to use for nausea during pregnancy.

  • Cold and flu relief - Drinking ginger tea with lemon and honey helps to treat a cough. It also acts as a diaphoretic (it promotes sweating), which helps the body to rid itself of fevers and toxins.

  • Pain relief – Some studies have shown that daily ginger supplementation reduces exercise-induced muscle pain. It’s also been found to alleviate menstrual pain.

  • Osteoarthritis inflammation - Ginger has been found to be modestly effective and reasonably safe when used for this type of inflammation.

There are, of course, many additional claims of ginger’s benefits, and studies are ongoing.

As with any herb or medication, use precaution and moderation. When ginger is used as a spice, it is considered safe. For some, however, ginger can cause abdominal pain, diarrhea, and gas. It is recommended that those with gallbladder disease use caution because it may increase the flow of bile. There is some concern about taking ginger with anticoagulants (such as warfarin).

If you enjoy the taste of ginger, by all means consume it and enjoy. If you also get therapeutic benefits from it, please indulge. My mother would certainly approve.

Paging Dr. Frischer: Colon cancer screenings


By Dr. Alan Frischer

When my patients turn 50, I routinely recommend that they have a colonoscopy to screen for colorectal cancer. Not surprisingly, my generous offer is sometimes rejected. Patients express concern over drinking the prep, having general anesthesia, or undergoing the procedure itself.
This fact has not escaped the medical field, and new recommendations have been issued. Various highly respected organizations, including the American Cancer Society and the US Multi-Society Task Force, currently issue guidelines on colorectal cancer screening. All recommend routine screening for colorectal cancer and polyps, usually starting at age 50 and continuing until about the age of 75. 

What is colorectal cancer? It’s a disease in which abnormal cells in the colon or rectum divide uncontrollably, forming a malignant tumor. Most begin as a polyp, a growth in the tissue that lines the inner surface of the colon or rectum. Polyps are common in those over 50, and the vast majority of them are not cancerous.

However, the type of polyp known as an adenoma has a higher risk of becoming a cancer. Aside from skin cancer, which is the most common but rarely fatal form of cancer, colorectal cancer is the third most common cancer (following prostate and lung in men, and breast and lung in women).

Death rates are declining due to more screening and to a reduction in risk factors, such as a decrease in cigarette smoking. Other risk factors include a family history of colorectal cancer or a familial polyposis condition, inherited Lynch syndrome, older age, excessive alcohol use, obesity, lack of physical activity, inflammatory bowel diseases like ulcerative colitis and Crohn’s disease, and possibly diet. 
There are several screening tests developed to help detect colorectal cancer early, when it may be more treatable. In fact, screening can act as a form of cancer prevention as well: some tests detect precancerous polyps, which can be removed.

The standard test continues to be the colonoscopy. The rectum and entire colon are examined with a colonoscope, a flexible lighted tube with a lens for viewing and a tool for removing any abnormal growths. A thorough cleansing of the entire colon is necessary before this test, which is done by drinking large amounts of a laxative prep solution. Sedation is necessary. 

An alternative visualization test is the sigmoidoscopy. This uses a shorter scope that can only view the rectum and the sigmoid colon, which is about one-third of the entire colon. It takes less time, and sedation is usually not necessary, but any cancers beyond the sigmoid colon may be missed. 

There are a few other methods used for visualizing the colon, including computed tomographic (CT) colonography and double contrast barium enemas. The colonography is rarely done because it is expensive and still requires follow up with a regular colonoscopy if polyps are found. The barium enema is also seldom used, as it is less sensitive in detecting small polyps and cancers. 

Other tests mainly detect cancer (but not polyps) and are less invasive, using stool samples to detect the presence of blood. Two of these tests are approved by the FDA: the FOBT (Fecal Occult Blood Test), and the FIT (Fecal Immunochemical Test). Note, however, that there are other reasons why blood might be in the stool, so this is by no means a definitive test for cancer. If positive, it still needs to be followed by colonoscopy and possibly endoscopy. 

Cologuard is a new stool DNA test, approved by the FDA. It detects tiny amounts of blood in stool, similar to the FIT test, as well as nine DNA biomarkers that have been found in colorectal cancer and precancerous advanced adenomas. So, this test can detect some forms of precancerous growths. Of course, any positive test will yet again lead to a colonoscopy. An increasing number of insurance companies, including Medicare, are now covering this test.

Which test is right for you? The standard colonoscopy is still the gold standard. It allows the doctor to view the rectum and the entire colon, and a biopsy can be taken during the test. The disadvantages are that it can still miss some small polyps, flat or depressed growths, and even cancers.

The quality of the results depends on a thorough cleansing of the colon, as well as the skill and patience of the gastroenterologist. A liquid diet, prep, and sedation are necessary. Someone needs to accompany the patient to and from the procedure, and the patient may need to miss a day of work. 

In June of 2017 the US Multi-Society Task Force on Colorectal Cancer issued updated screening recommendations. The most effective choices are:

•    Colonoscopy every ten years, or
•    Annual FIT / FOBT

Less effective choices, but better than doing nothing, are:

•    CT colonography every five years, or
•    FIT or fecal DNA every three years, or  
•    Flexible sigmoidoscopy every five-ten years 

My bottom line? It is absolutely critical that we all select a screening test, and be re-tested on a regular basis. I urge everyone between 50 and 75 to be screened for colorectal cancer, because this is a common cancer and one that can often be treated or prevented.

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

Alternative Medicine: What are Etheric Cords?

By Marcela Arrieta

Etheric what! That’s one of many words used to describe the connections linking a person to the other. 

To a person who can see energy, these cords look similar to a water hose. Interlacing two people. Inside the water-hose-like  structure, energies of love, compassion, etc., flow between people. But it’s not all lovey-dovey. On our not-so-great days, the predominant energies consist of the icky-like textures of anger, bitterness, etc.

The question we should be asking is: why are these etheric cords so important and why do they exist? The best way to describe a positive-filled cord is that of the bond between a mother and child. It’s said women tend to have a heightened sixth sense. 

Somehow we intuitively pick up on the needs and wants of a baby who can’t speak. Part of this “knowing” emanates from the etheric cord bonding mother and child. It’s flooded with incalculable love and compassion. Making mom ultra sensitive to the higher energy frequencies shared through the cord. 

The opposite is true. When a cord by majority is filled with negative energy it becomes toxic and we feel it through the emotions of anger, resentment, inability to forgive, etc. 

This energy if left untreated has the possibility of being harmful. What is conveyed through this cord is one of the reason why we find ourselves continuously thinking and judging that person who did us wrong. In reality we are contributing to this energy. What happens when you add fuel to fire? The fire will continue to burn. 

I’ll share two simple yet effective techniques. 

To pump additional positive and loving energy into an already loving etheric cord simply imagine a water-hose like structure bonding you and the other person. Picture in your minds eye filling this cord with tremendous amounts of light-pink light. Hold this thought up-to 3 minutes. Repeat as often with anyone!

How do you transform a negative spewing cord into one of joy and love? Simple! Follow the same instructions given in the above exercise. With the following added step: practice forgiveness towards the person who hurt you, it may even be towards oneself. 

Have a question regarding this article or maybe you’d like to suggest a topic? Write to me at: Next article we will talk about intuition.

Marcela Arrieta is an alternative modality practitioner with over five years of experience in this field. She is also an entrepreneur who resides in Downey. She can be reached at

Paging Dr. Frischer: Kissing

I recently wrote about the health benefits of hugging, and I now feel motivated to move along to kissing. No worries; this is a family-oriented column, and I will change course for my next column.

Let’s explore the popular field of philematology.

Is kissing good for our health? I was fortunate to run in the Boston Marathon again this year. Halfway into the 26.2-mile race, runners pass by Wellesley College. As you can imagine, by mile 13 it is definitely time for a boost. 

For over 100 years, the Wellesley College women have had an enormous cheering section for the runners. Not only do they scream and cheer, but some hold signs like

“Come over and kiss me!” 

Keeping in mind that there are about 30,000 runners in the race, how would you like to be, say, the 100th person to kiss that wonderfully supportive Wellesley student? In this case, kissing is clearly not good for your health.

Since by one calculation, the average person may spend 20,000 minutes kissing in a lifetime, let’s move on to the many health benefits of kissing.

Serotonin, dopamine and oxytocin:  Kissing, like hugging, causes the release of these “feel good” hormones. Kissing appears to activate the areas of the brain linked to reward and addiction. Serotonin elevates mood and can help spark obsessive thoughts about a partner. 

Dopamine is involved in craving and desire. Oxytocin brings calm, relaxation, and bonding.
Cortisol: Cortisol is known as the “stress hormone.” Levels decrease in both men and women after kissing. It’s relaxing!

Epinephrine: Kissing can cause epinephrine levels to rise, which leads to a reduction in the levels of the bad cholesterol LDL.

Sebum: Lips are densely packed with sensory neurons, which are stimulated by touch. When we kiss, glands release sebum, which mixes with our saliva. 

Researchers suggest that swapping sebum may help us to subconsciously assess the health and hormonal conditions of a partner before committing to sex or long-term involvement.

There are likely additional chemical cues that help us size up potential mates.

Calories: A kiss may burn 8 to 16 calories. Still, let’s not plan on replacing our next workout.

Immune system: Kissing appears to boost the immune system and to reduce skin and nasal allergies. It raises the level of immunoglobulin A (IgA), which helps to fight off invading organisms, and reduces the level of immunoglobulin E (IgE), which stimulates allergic responses. Perhaps this helps us to explain why those who report frequent sexual activity take fewer sick days. 

Also, note that more than 700 types of bacteria have been found in the human mouth, and no two people have the same makeup of oral germs. Exchanging saliva introduces new bacteria, which helps to build immunity. When we kiss for more than 10 seconds, some 80 million bacteria can transfer between our partner and us. Many of these bacteria are helpful in balancing and regulating our immune system.

Teeth: Kissing leads to more saliva production, which helps to re-mineralize teeth and protect them from acid, resulting in fewer cavities. Saliva also helps to keep away plaque.

Heart disease: Kissing that leads to sexual activity may reduce the risk of developing heart disease due to its relaxation effects, ability to lower cortisol levels, raise oxytocin levels, dilate blood vessels, slow the heart rate, and lower blood pressure.

Pain: Kissing appears to reduce pain from a variety of causes, including migraines, menstrual cramps, and generalized arthritis pain, due to blood vessel dilation and the release of endorphins. Perhaps “Not tonight Honey, I have a headache,” should change to: “Honey, I have a headache. Come over and kiss me!”

Testosterone: A man’s saliva contains testosterone, and through kissing, it can be introduced into a partner’s mouth, where it is absorbed through the mucous membranes. Testosterone increases sex drive in both men and women, and may increase a woman’s arousal and the likelihood that she will engage in reproductive behavior.

Financial success: One study found that men who received a passionate kiss before they left for work earned more money. I suspect that the kiss represented a happy home life, a confident person, better self-esteem, and so many other factors that may contribute to financial success.

Kissing and hugging are forms of affection that not only have primal biological roots and procreational purposes, but can also have a very positive impact on our health. It’s easy to conclude that they offer the promise of a longer, healthier, and more enjoyable life. 

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

Alternative Medicine: Why do we meditate?

By Marcela Arrieta

Meditation is a form of prayer. Universal and encompassing of people from multiple religious beliefs. It promotes optimal wellness in all areas of life. 

Study-after-study it has been recorded that mediation aids with the reduction of stress, improved focus, lower blood pressure and an overall well-being of body, emotions, mind and spirit. 

So why are these benefits achieved at a greater pace than with prayer? There is one differentiating factor which we’ll speak of next. 

The majority of religious institutions if not all classify prayer as a form of conveying our physical, emotional, mental and spiritual needs to a greater force, creator, God, universe etc. 

SEE ALSO: Using the Human Energy Field to Improve Health

Usually characterized as a one-way stream of communication. I was brought up catholic and after prayer we’d say, “it’s in the God’s hands now”. Then, we’d go about our daily routine. 

Thinking very little of what we asked God for nonetheless doing anything to make our requests a reality.

With meditation a two-way form of communication is applied. The first factor is incorporating prayer, which is communicating our needs and wants. 

The second factor is holding a space of awareness during your meditation. During this heightened state of awareness we’re able to perceive an immediate response to the prayer(s).

This response is what I like to call the guru within us. All of the answers and solutions to my prayers are one meditation session away! Awakening from meditation I usually have a clear view of what needs to be done in order to achieve the results I’ve prayed for. 

When I first began to meditate several years ago it took some practice to achieve a state of stillness and prolonged awareness. 

The second challenge was training the mind and all my senses to register and validate those signals coming from above. The human body has a fairly primitive mind whose only purpose is to survive. 

It doesn’t yet understand or register higher frequencies generated through meditation. This is why constant practice in meditation will train the mind working to register these frequencies. 

I’ve learned that religion is exclusive, but spirituality is inclusive. 

SEE ALSO: Paging Dr. Frischer - Blood Transfusions 

I’ve meditated among Muslims, Hindus, Buddhists, Catholics and Christians to name a few. We come together as One human race with the ultimate goal of becoming a better person, achieving an overall state of wellness that benefits every person, being and earth.

Regardless of your chosen belief structure anyone can learn to meditate. 

There are many forms of it but personally I’ve found that sitting in a quiet and clean space definitely amplified the results. 

There is a wonderful meditation workshop offered at Downey Yoga. It’s wonderful for all levels of meditation practice.

Here’s a little exercise to get you started:

-Find that quiet and clean space. 

-Preferably sit up with your spine straight, but you can also lay down. 

-Put your hands on your knees with the palms facing up if your sitting. If laying down place your arms to your side. 

-Gently inhale and exhale as you put your awareness on your heart center - known as the heart chakra. 

-Move that awareness upwards to the top of your head - crown chakra. 
At this moment convey your prayer (wants and needs). Continue to focus on your breathing and the heart and crown chakras. 

SEE ALSO: Shared Stories: A Retreat for the Body and Soul

Silently ask to be shown how to accomplish these wants and needs. Allow these images to simply come through. Each time silently asking to be shown more until you have the answer(s) you seek. 

All you have to do to train the mind and senses each time you meditate is silently say, “thank you” after every response you receive regarding your questions. That simple!

Have a question regarding this article or maybe you’d like to suggest a topic? Write to me at: Next article we will talk about Etheric Cords.

Marcela Arrieta is an alternative modality practitioner with over five years of experience in this field. She is also an entrepreneur who resides in Downey. She can be reached at

Paging Dr. Frischer: Tetanus

A young woman recently saw me for a physical. 

While reviewing her immunizations, I asked her when her last tetanus vaccination was. She answered with a blank stare. 

This lack of awareness is due to the incredible success of vaccination efforts in the United States. The incidence of tetanus has been reduced dramatically, although it is far more common in other countries.

Tetanus is a life-threatening but preventable disease caused by the toxin of Clostridium tetani. This common bacterium is found in soil, dust, and animal feces.

Tetanus has been documented at least as far back as the fifth century. In 1889, the tetanus toxin was first isolated from a human. The first vaccine was finally developed in 1924, and was used during World War II.

In the United States, reported tetanus cases since 1947 have declined by 95%, and deaths by 99%. From 2001 through 2008 there were only 233 cases of tetanus, in total! 

SEE ALSO: Using the Human Energy Field to Improve Health

Overall, tetanus has about a 13% fatality rate. Those with diabetes, or those who abuse IV drugs are at a higher risk.

What does the disease look like? Often referred to as lockjaw, it causes a painful tightening of the muscles and stiffness of the jaw, neck and abdomen. 

It can lead to the jaw “locking” (trismus) so that it’s difficult to open the mouth or to swallow. 

There may be body spasms that last for several minutes, seizures, fevers, sweating, elevated blood pressure, and a rapid heart rate. 

Doctors diagnose tetanus by examining the patient and looking for its signs and symptoms. 

There are no hospital lab tests to diagnose it. Symptoms can appear anytime from a few days to several weeks after the bacteria enter the body.

How do we get tetanus? We’ve all heard that stepping on a rusty nail can cause it. 

But it is also caused when the bacteria penetrate through any open wound, including a puncture, gunshot, compound fracture, burn, surgery, injection drug use, animal or insect bite, body piercing, infected foot ulcer, dental infection, or any other break in the skin.

Who should get a tetanus booster? Babies receive the TDaP (tetanus, diphtheria and pertussis) vaccine in a series of five doses between the ages of two months and four-six years. 

SEE ALSO: Paging Dr. Frischer - Blood Transfusions

At around 11 or 12, a child should get a booster. After that, a Td (tetanus and diphtheria) booster is recommended every 10 years. If you are an adult and were not vaccinated as a child, you will likely start with a three-vaccine series of Td (or TDaP if needed). If you have never been vaccinated and you suffer a wound, you would want to have the tetanus vaccine administered within 48 hours. 

Adults who will be spending time with infants under the age of one may need the TDaP vaccine as a one-time booster. 

This is for the benefit of the younger, more at-risk population. If you plan to travel internationally, particularly to a developing country where tetanus might be common, you should ensure that your immunity is current.

Who should *not* get the vaccine? Those who have had a life-threatening or allergic reaction to it, or are moderately or severely ill should not get the tetanus vaccine. 

Those with a neurologic disease like epilepsy, who have had Guillain-Barre Syndrome, or are pregnant, should consult with their doctor first.

SEE ALSO: Shared Stories: A Retreat for the Body and Soul

The number of tetanus cases reported each year continues to decline, but tetanus remains a very rare but life-threatening disease in the United States. 

Be sure to stay up to date with your Td vaccination; especially if you are 65 or older, or suffer from a chronic disease.

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

Paging Dr. Frischer: Blood Transfusions

Joe, my dear friend from back in my medical school days, was a hemophiliac. He was frequently a recipient of blood transfusions. Many of us know someone who has needed a blood transfusion. 

Perhaps they had a disease, like Joe, or were in an accident, or became dangerously anemic. 

Perhaps they had the luxury to choose whether or not to have a blood transfusion, or perhaps they faced an emergency life or death situation requiring an immediate transfusion. 
What are the benefits and risks?

In 1628, a British physician discovered that blood circulates throughout the body. The first successful blood transfusion occurred in England in 1665 when one dog received the blood from another.

Finally in 1818, a British obstetrician performed the first successful transfusion of human blood to a patient, to treat postpartum hemorrhage.

A patient may receive a blood transfusion when they have lost blood from a trauma, have had surgery with blood loss, lost blood due to an ulcer, or has a disease that causes a shortage of red blood cells. 

An *autologous* red blood cell transfusion is when a donor’s own blood is used for them at a later date, usually before a planned surgery.

A blood transfusion can save a life. It replenishes the body’s red blood cells, which reduces the symptoms of anemia, such as light-headedness, fatigue, weakness, and shortness of breath; and in the case of heart patients, even angina or a heart attack. 

New guidelines recommend that red blood cell transfusions be considered when the hemoglobin level drops to about seven or eight, depending on the age and general health of a patient, and depending on whether there is active bleeding. 

If it is not an emergency, the blood will be typed and crossed in order to make a proper match and avoid possible serious complications. 

In an emergency where time is of the essence, a patient will receive the universal donor blood type, O Negative. Even O Negative blood can lead to serious reactions, but is the best for an emergency.

However, blood transfusions are not completely without risk:

■ Incompatible blood can possibly cause an anaphylactic reaction or hemolytic anemia. 
Serious safeguards are in place to prevent this, such as type and cross procedures and multiple staff verification of bags. Medication can be given before a transfusion to reduce risk.

■ It’s possible for pathogens to be introduced into the blood stream, leading to infections. 
Fortunately, this risk has diminished dramatically over time – for example, the Mayo Clinic lists the odds of developing HIV at around one in every two million transfusions (less likely than being killed by lightning); the risk of hepatitis C at approximately one in 1.5 million transfusions, and the risk of getting hepatitis B at about one in 300,000 transfusions.

■ Bacterial infections are possible but rare.

Jehovah’s Witnesses may oppose blood transfusions on religious grounds. Refusing the possibility of a transfusion may lead to the refusal of a surgeon to conduct a surgery. 
Today, Jehovah’s Witnesses have a Hospital Liaison Committee to address legal or moral conflicts.

My friend and classmate Joe’s story ended tragically. Our medical school was in San Francisco, and the time was the early 1980’s. AIDS was just being identified, and he became one of its earliest victims. 

Had he received those blood products today, they would have been effectively tested for the AIDS virus, and even with hemophilia, he could possibly still be with us today.

Blood transfusions are an extremely valuable, life-saving, and safe treatment. The Red Cross provides about 40% of the blood used for transfusions, and I urge everyone to donate blood.

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

Paging Dr. Frischer: Ancient Practices

I love practicing medicine in 2017. There are so many more options at our disposal then there were even 10 or 20 years ago. It is interesting, however, just how many old or even ancient practices are still in use. Are they medical myths, barbaric treatments, or is there a modern rationale to support them?

Maggots can consume dead and infected tissue, which allows wounds to heal. Maggots have been used for healing since antiquity. In more recent centuries, military surgeons have observed and documented that soldiers who remained on the battlefield healed more quickly when flies laid eggs in their wounds. In 2004, the FDA allowed maggots to be marketed for medical use on slowly healing wounds like diabetic foot ulcers and bedsores, chronic leg ulcers, post-surgical wounds and acute burns. This therapy has actually experienced newfound popularity due to growing antibiotic resistance.

Not long ago I wrote of a dear friend who swears by leech therapy for her arthritic knee. Leeches are worms with teeth to cut into flesh, and suckers to feed on blood. Since ancient times, leeches were used for bloodletting. The FDA has approved the use of medical leeches for venous congestion, a condition where blood pools in a particular area of the body, and the veins aren’t capable of returning it to the heart. This might happen after a surgery to reattach a finger or ear, or after major reconstructive surgery. Leeches are also currently being used to numb pain, reduce swelling, and keep blood flowing.

Are you aware that bloodletting is still performed? It is not done with leeches, and certainly isn’t used for the wide range of diseases that it once was. It is, however, used for hemochromatosis, a condition where the blood contains excess iron. Too much iron can be toxic to the liver, heart, pancreas and joints. Bloodletting is performed by inserting a needle into a vein and drawing out a pint or more of blood, once or twice per week, over several months.

Would you consider allowing yourself to be stung by a bee in order to use the venom to heal? Apitherapy refers to a number of bee therapies, including bee venom, honey, pollen, and royal jelly. It’s thousands of years old, depicted in ancient rock art and practiced in ancient Egypt, Greece (Hippocrates wrote of it), and China. It’s now being used by some to treat arthritis, immune system dysfunction, multiple sclerosis, hay fever, ALS, shingles, gout, tendonitis, bursitis, infectious diseases, wound healing, burns, fractures, and even cancer. Do note that apitherapy gets mixed reviews in the scientific literature, and clearly more and better-controlled studies are called for. Further, there are potential risks to these therapies that may outweigh any benefits.

The great novel and movie One Flew Over the Cuckoo’s Nest horribly featured ECT (electroconvulsive therapy). Developed in the 1930’s, ECT passes electrical currents through the brain. It is actually still used for those with treatment-resistant depression, but is now administered under general anesthesia. ECT affects brain chemicals and nerve cells, and can alter mood, sleep, memory and appetite.

Trepanation is the oldest known surgical procedure, dating back to the Stone Age. A hole was made in the skull, with the belief that this would rid the patient of the evil spirits felt to cause illness, or to treat headaches, epilepsy, head injuries and infections. Today, neurosurgeons perform a form of trepanation for very different reasons. A small hole is drilled into the skull in order to treat epidural and subdural hematomas, or for surgical access for other procedures, such as intracranial pressure monitoring.

Lastly, let’s move to the subject of stool. The concept of transplanting stool dates back to 4th century China. Doctors gave a healthy person’s dried or fermented stool to a patient who was suffering from diarrhea, vomiting, fever or constipation. Today this is known as fecal microbiota transplantation (FMT). FMT directly transfers stool from healthy donors to the stomach or small intestine of the patient. The goal is to introduce a new mix of bacteria to restore a healthy microbial balance in the gut for those with recurring Clostridium difficile (C. diff) infections.

Some treatments have indeed withstood the test of time. Still, don’t expect to find maggots, leeches, bees, or stool in my black bag…yet.

Paging Dr. Frischer: Jet lag

Whether you’re a frequent flyer or have taken a one-time trip to a faraway location, you have likely experienced jet lag. Upon your arrival and/or return, perhaps you suffered headache, lethargy, fatigue, insomnia, irritability, mild depression, difficulty concentrating, loss of appetite, confusion, dizziness, or even diarrhea or constipation.

Jet lag is a very modern problem. The term came into use when the use of jet aircraft became common. Travel by propeller-driven aircraft, ship, or train was too slow to cause such a thing. When we rapidly change time zones, our body’s circadian rhythms are slow to adjust to the new schedule.

Jet lag, also known as desynchronosis, or circadian dysrhythmia, can have a major affect on sleep and alertness. Distance alone is not a factor in jet lag – for example, a flight from Greenland to very distant Argentina would cover many miles, but fall within the same time zone. But when we travel east to west or west to east, our body still feels that it remained in the original time zone. Our natural patterns for eating, sleeping, hormone regulation, body temperature, and other functions no longer correspond to the new environment.

The speed at which the body adjusts to the new schedule depends on the person, as well as on the direction of travel. Travelling east is usually more difficult than travelling west because the body clock must be advanced, which tends to be more difficult than delaying it. Most of us have a circadian rhythm that is longer than 24 hours, so lengthening a day is easier than shortening it.

Some people may require several days or more to adjust to a new time zone, while others experience little trouble. What can we do to minimize jet lag?

•    Plan for the new time zone by adjusting your sleep and wake habits for several days prior to the trip: get up and go to bed earlier prior to an eastbound trip, and later for a westbound trip.

•    Try to select a flight that arrives in the early evening. If you must nap during that day, do so in the early afternoon, and for less than two hours.

•    Change your watch to reflect the new time zone as soon as you board the plane. Avoid alcohol and caffeine at least three to four hours before your new bedtime.

•    Airplane cabins have low humidity levels. Avoiding dehydration by drinking extra water during the flight.


Upon arrival at your destination:

•    Make an effort to stay awake until the local bedtime.

•    Avoid heavy exercise close to the new bedtime.

•    Consider using earplugs and a sleep mask to help dampen noise and block out light, in order to stay asleep.

•    Time your meals with local mealtimes, and avoid heavy meals for the first few days.

•    Set two alarms, or request two wake-up calls, in case you miss the first one.

•    Spend time in the daylight to help regulate your biologic clock.

What about the use of sleep aids to combat jet lag? While pills don’t resolve the biological imbalance, they may help to manage in the short-term. Test out a new medication prior to the trip, so that you won’t be surprised by an unexpected negative reaction, or by the lack of a positive response. Many find that melatonin or Benadryl helps to get a better night’s sleep (and, of course, that caffeine helps to stay awake).

Jet lag is generally temporary and usually does not require treatment. Symptoms should improve within a few days, but can last longer. If you travel frequently, you may wish to speak to your doctor about medication or other strategies. Bon Voyage!