October Newsletter
October, 2022
Welcome to the October newsletter. This newsletter aims to provide information and analysis of timely topics from recent articles published in the medical literature. I hope you find this information useful and helpful in your health journey. If you have comments or questions, please let us know. I hope you enjoy these articles!
-----

There have been a lot of viruses going around. After over 2.5 years of hearing about nothing but covid other viruses are back. I get a weekly chart of viruses being detected in the region and right now rhinovirus/enterovirus, RSV, adenovirus, and parainfluenza viruses are running 10:1 over covid. So why are people getting so sick from these common cold viruses? The measures used over this period also limited the spread of other viruses. Additionally, when covid surged it knocked out all the other viruses. What we are experiencing now is an "immunity gap". We have always had regular patterns of respiratory viruses such as RSV and influenza. We have been seeing viruses popping up at unusual times. RSV is usually a late fall/early winter virus, but we have been seeing cases in the summer. Kids typically get this before age 2 and will get it multiple times. What we are seeing now is a group of children who didn't get it when they normally would have and it is hitting them hard. It is similar for adults. We are commonly exposed to several cold viruses throughout the year. Not all will make us sick but our immune system is challenged by them. We also develop immunity over time, even with mild or asymptomatic infections. Many of us have not been exposed like we normally are so when we do get a respiratory virus, it is hitting us hard. Over time, we suspect the viruses will return to their usual times and we will return to small exposures over time and multiple infections building back our immunity. Until then, it may be a bit rough. The upcoming flu season is a mystery. We haven't had one since early 2020. If you are susceptible to the flu, I would encourage a flu shot. I normally wait to give these until late November but I am hedging my bets and starting now as it could be an early season.

-----
To Scope or Not To Scope
Does colonoscopy reduce colon cancer deaths? This article has gotten a lot of traction in the media and I have gotten questions regarding it. Headlines state “Colonoscopies have a lower-than-expected benefit in preventing colon cancer (18% reduction), with no reduction in colon cancer mortality.” When I first read this, I was surprised so I went to the paper itself to get more information. Why did the authors find only an 18% reduction in preventing colon cancer and no reduction in deaths? This doesn’t seem right, and it isn’t…

 
Why We Get Brain Fatigue
Many of us have experienced cognitive or decision fatigue. We have that feeling late in the day that we don’t want to make more decisions or we find we make better decisions earlier and our decisions are not as good late in the day. We tend to make more mistakes and take longer to make decisions after we have done a lot of cognitive tasks. Why does our brain get tired? 
‌
Muscle Head
Last month we discussed how strength training is associated with lower mortality. This month we are looking at the relationship between muscle mass and cognition and the possible mechanisms by which physical inactivity can lead to physical and cognitive decline and how we can combat this decline. 
To Your Health...
Thank you for taking the time to read through this newsletter. We hope you have found this information useful. Feel free to pass this on to anyone you think would benefit from this newsletter.

Mark Niedfeldt, M.D.


Old-fashioned medicine with 21st Century convenience and technology