By : Robert J . Casañas , M . D .
Buenos dias Dr ., Se está hablando mucho de la ADN . Tengo una amiga que me dice que cierto lab me hace el estudio de mi ADN para personalizar mis vitaminas y tambien cremas para la piel . Que usted me puede decir sobre esto ?
-Sara Morell :: Houston , Texas
Q D
Querida Sara :
Existen pruebas geneticas basadas en ciertos grupos de enzimas que pueden ser de utilidad para reconocer las peculiaridades fisiologicas de cada individuo . ( las llamadas citocromo P450 , por ejemplo . o CHIPS , o SNPM ’ s ).
Teniendo en cuenta la eficacia de ciertas enzimas , se pudiera dirigir cualquier efecto teraputico sofisticado con mas facilidad . Aun asi , no se puede sustituir un buen historial medico y un examen fisico , conjunto con quizas ciertas pruebas de laboratorio que van mas alla de lo que usan los medicuchos de cada dia , PERO QUE NO TIENEN QUE NECESARIAMANTE INCLUIR SU ADN COMPLETO .
ADEMÁS , si se hacen esas pruebas cromosomicas , hay que tener cuidado que estas compañias de seguro de vida o medico no les pongan sus garras encima , o puede ser usted estigmatizada con alto riesgo el resto de sus dias . No estaria de mas decir , que estos mismos negocitos que ofrece cada dia todas esta pruebas y productos extravagantes ( o “ cutting edge ”), puede que tengan vinculos con estas maquinas de dinero , las compañias de seguro ( o el el gobierno ).
La piel es una entidad bastante compleja y no se puede facilmente reducir a una prueba unica ( no importa lo avanzado ) y lo mismo con suplementos . En mi practica yo recomiendo cierta sustancias , basadas en el historial de familia y del paciente y un buen examen . Al cabo de varias semanas , yo obtengo niveles sanguineos de estos compuestos para saber si se han absorbido adecuadamente , etc .
Acuerdese también que una prueba genetica es una prueba estatica y hay que definir bien el ambiente donde ese ADN se encuentra , es decir ; lo que vendrian a ser su misma entidad emocional y espiritual , lo que come , y donde se desarrolla . Los cuales determinan como se manifiestan esos genes .
En sumario : Hay que saber usar la tecnologia de manera objetiva y no con fines comerciales y hay que encontrar medicos que hagan medicina avanzada ( llamada Funcional o Wellness o Integrativa ) y no quedar en manos de medicuchos de HMO o marginalmente al dia de todos estos avances .
No se puede fiar ya en ninguna agencia federal que pretende proteger al publico , ni el FDA , Medical State Boards . EPA . SEC , FTC , FEMA . etc etc .
Aprenda a discriminar entre toda esa propaganda y exceso de informacion de Internet y busquese un medico activista que represente su individualidad y respete su dignidad y que sirva mas bien de asesor o “ coach ” medico personal .
Dear Doctor , For bumps on head , a lump of skin grew into a bump on top of my friend ’ s head on top of the skull . To remove that , what will happen and what would be the approximate cost and down time ?
-Jerry :: Orlando , Fl
Dear “ bumps on head ”: What it would entail would depend on the presumptive ( preliminary ) diagnosis . If it is firm and well rooted and is part of the bony structure , it may entail an operating room removal and may be extensive . In such cases , it is a good idea to ultrasound it or CT scan it prior to removal to see how deep in the bone it goes . And then of course , send the tissue off for microscopic analysis ( a biopsy ) to see whether it is malignant or not .
Having said that , bumps such as you describe are rarely malignant and most probably it is a sebaceous cyst ( a pocket of skin oil ) or scar tissue or fibrosed skin tag . Feeling it , knowing the size , how deep it is rooted , whether it is soft and pliable , and the age of the patient would all be important to detail exactly what approach one might take and therefore what “ downtime ” is involved . Family history is important as well . One would need to know other seemingly unassociated symptoms elsewhere ( such as an immune system problem or a fungal infection ), of which the bump is really a harbinger or a causal association . One would want to make sure that your clotting system works adequately as well .
A simple removal would consist of applying a numbing cream an hour before a small needle injection of a numbing solution is injected superficially into the scalp and a deft and precise cut is made five minutes later with a small scalpel . Burning it off would not be recommended due to the size and the fact that you want a definitive diagnosis under the microscope and need to protect the specimen . You would need to keep in mind that we need to protect the hair structures so the hair grows back later . It may also involve shaving the surface .
Time involved would be about thirty minutes altogether ; the incision process itself however would be five or six minutes .
I would be willing to extend you a courtesy visit for consultation and “ eyeball ” and tactile diagnosis if you ’ d like . I could tell you then what would be involved and set it up for you . I wouldn ’ t fret but I would pursue something definitive ( say in the next three or four weeks ) if it seems to have grown in a matter of only a few weeks .
A simple removal and follow up would not cost over $ 300 . Biopsy expense ( the pathologist physician specialist looking at the tissue under a microscope ) may be $ 40 to $ 50 .
Call me if you would like to see me ; otherwise , best of luck to you . Hope the preceding is of some help .
Dr . Robert Casañas Dr . Casañas is a Board Certified Internist and Board Certified Pain Management specialist . Dr . Casañas practices out of two offices , Unicorn Medical Office in West Tampa and Lunasol Institute in Westchase . Submit your question for Dr . Casañas by emailing him at AskElDoctor @ thelatinvillage . com or contact him directly at ( 813 ) 855-6530