Talk to your doctor about COVID-19

I am asking you to make your personal physician your first line source for understanding the SARS-CoV-2 virus and the available vaccines.

On September 9, 2021, President Biden addressed the nation from the White House briefing room, sharing

where we are in the battle against COVID-19, the progress we’ve made, and the work we have left to do.

His remarks outlined a series of executives orders and recommendations which have been met with controversy; I will briefly list them but there was one that I think no one can disagree with. He asked the nation’s family physicians, and I am one, to talk to our patients about the vaccine.

I’m already doing that and I think most primary care doctors are. But I think he should have taken it one step further, and that is to ask Americans to

Talk to your doctor about COVID-19

a female physician talking to a male patient
photo from the LIGHTSTOCK.COM collection (affiliate link)

Like most of you, I am on social media, not just professionally but personally, and I have been appalled when people I know pass around information that is unverified, unreferenced, contrary to science, inflammatory, conspiratorial, and sometimes just plain nonsense.

I absolutely support anyone’s right to have an opinion and share it, but labeling opinion as truth when it may or may not be true is irresponsible. And I somewhat agree with Mr. Biden when he said ” These pandemic politics, as I refer to, are making people sick, causing unvaccinated people to die. “

So I am asking you to make your personal physician your first line source for understanding the SARS-CoV-2 virus and the available vaccines.

Your doctor may not be an expert on the pandemic; we are all working overtime to keep ourselves informed and still take care of the myriad of other health conditons our patients bring to us. But the advantage is your doctor knows you, and any medical decision ultimately boils down to what you and they decide working together, it’s called “shared decision making.”

What if your doctor recommends against the vaccine? That’s possible because I know there are some medical professionals who have taken the minority opinion on the safety of the vaccine. I do not understand their position; some of the high profile ones are known for consistently taking a stance against mainstream medicine. If that’s the case for you, I encourage you to ask why they lack confidence in the vaccine and what would it take for them to change their minds. Ultimately, the choice one way or the other is yours, so be sure it is a truly informed choice.

Michael Munger, M.D., consults a patient at his medical office in Overland Park, Kan.
Photo compliments of American Academy of Family Physicians

Biden’s plan

You’ve probably read or heard it in the news by now, but here is an outline of his major points.

Large employers, those with 100 or more employees, should require vaccination or weekly testing

Vaccination required for all federal employees and contractors

Vaccine required in all healthcare facilities that are paid by Medicare and Medicaid, and all federally funded educational facilities like HeadStart

Large venues such as sports or concerts to require vaccination or negative test for entrance by patrons

Home tests available at cost at Amazon, Walmart, and Kroger

Federal funding for testing at schools and salary protection for teachers who protect children

Continue mask requirements on interstate travel, and in federal buildings

Calling on the states’ governors to support viral mitagation measures in schools

President Biden Visits NIH Vaccine Research Center
NIH immunologist Dr. Kizzmekia Corbett speaks to President Joe Biden about the fundamental research that contributed to the development of the Moderna and Pfizer COVID-19 vaccines when the President visited NIH’s Vaccine Research Center on February 11, 2021. Credit: NIH/Chiachi Chang

Here is my previous review of President Biden’s original plan to deal with the pandemic as he took office in January 2021.

2021-National Strategy for the COVID-19 Response and Pandemic Preparedness

President Biden, Vice President Harris, and their science and healthcare teams have developed a plan with 7 goals to end this pandemic and prevent others. You can read the entire 200 page report at the link. Here is a list of the 7 goals with a few of the points of each goal.

1. Restore trust with the American people.
  • establishes a federal COVID-19 response team to coordinate efforts
  • regular public briefings led by science experts
  • track and make data available to the public by the CDC
Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center (EOC) to coordinate with the World Health Organization (WHO), federal, state and local public health partners, and clinicians in response to the coronavirus disease 2019 (COVID-19) outbreak. CDC is closely monitoring the situation and working 24/7 to provide updates.
Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center (EOC) to coordinate with the World Health Organization (WHO), federal, state and local public health partners, and clinicians in response to the coronavirus disease 2019 (COVID-19) outbreak. CDC is closely monitoring the situation and working 24/7 to provide updates credit James Gathany, public domain
2.Mount a safe, effective, and comprehensive vaccination campaign.
  • increase the production of vaccines
  • give states clearer projections on vaccine availability
  • partner with states to create more vaccine centers
  • launch a national campaign to educate and encourage Americans on vaccine
3. Mitigate spread through expanding masking, testing, data, treatments,health care workforce, and clear public health standards.
  • asking Americans to wear masks for 100 days (note-this adds to any state or local recommendations or mandates on mask use)
  • require masks on public transportation
  • the CDC develop guidelines to help schools and businesses to reopen
  • create programs to develop new treatments for COVID-19
cloth facial coverings to prevent transmission of COVID-19
Mask use required on airplanes, trains, and other public transportation
4.Immediately expand emergency relief and exercise the Defence Production Act.
  • increase emergency funding to the states for pandemic costs, including for PPE and use of National Guard
  • invoke the Defense Production Act to increase the supply of PPE, and testing and vaccination supplies
5. Safely reopen schools, businesses, and travel while protecting workers.
  • develop a national strategy to reopen most schools within 100 days
  • federal agencies to issue updated guidance on protection for workers
  • asks Congress to provide financial aid to schools, universities, and daycares (cost in the billions)
a girl with a large backpack, walking to a school bus
6. Protect those most at risk and advance equity, including across racial, ethnic and rural/urban lines.
  • establishes an equity task force to address disparities based on race, ethnicity, and geography
  • create a U.S. Public Health Workforce to help with testing and vaccinations in their communities
Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved [date graphic was accessed], from https://health.gov/healthypeople/objectives-and-data/social-determinants-health
7. Restore U.S. leadership globally and build better preparedness for future threats.
  • rejoin the World Health Organization
  • increase humanitarian aid and support efforts to fight COVID-19 around the world
  • asks for Congressional support to establish a national center to prepare for future biological threats
2 bandaids crossed on a world globe
photo from the Lightstock collection (affiliate link)

Exploring the HEART of health

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

By following this blog, you’ll know when I post additional pieces reviewing the COVID-19 pandemic as well as other topics that explore the HEART of health.

2 oval plates with words "thank you"

Dr. Aletha

Watercress and kidney stones; what’s the connection?

Oxalate is a waste product of the body’s metabolism but is also found in many foods including peanuts, rhubarb, spinach, beets, Swiss chard, chocolate, sweet potatoes- and watercress.

Despite the name, I didn’t plan to write a blog about watercress; it’s more of a play on words using my family name and a description of watercress -unique, tangy, nutritious, multifaceted-to name a blog about health.

But peoplesearching the web for information about watercress find this blog and the most common questions they need answered include

  1. Does watercress cause kidney stones?
  2. Can I eat watercress if I’ve had kidney stones?
  3. Does watercress cure kidney stones?
Big rocks on a grassy slope
These are stones. Kidney stones are called renal calculi.

What are kidney stones?

Stones, or urinary tract calculi, don’t usually cause symptoms as long as they stay in the kidney. But if they migrate down into the ureter, the tiny tube that connects the kidneys to the bladder, trouble begins. As the stones try to wiggle their way down the narrow passageway, spasms of pain result; and the bigger the stone the worse.

kidneys and urinary system graphic
The urinary tract- kidney, ureters and bladder

Fortunately, most stones less than 10 mm, or about 3/8 of an inch, eventually pass into the bladder and out the body through the urethra. Some get stuck and must be removed. Occasionally, large stones can block the kidney, leading to infection. But , once you have had a stone, you want to prevent another.

What causes kidney stones and why care about oxalate?

We know what substances cause most stones- chemicals that normally pass through the urine but  sometimes build up, harden and form into tiny rock-like structures called calculi. Calcium causes 95% of calculi, while the other 5% are made of uric acid, struvite, or cystine.

Calcium can’t travel out of the body alone, it needs a companion, either phosphate or oxalate. So people who have too much oxalate in their blood are at risk of calcium oxalate stones, the most common type- either from

Watercress and oxalate

Oxalate is a chemical composed of carbon-C and oxygen-O molecules. It combines with other elements to form salts, one of which is calcium oxalate.

Oxalate is a waste product of the body’s metabolism but is also found in many foods including fruits and vegetables, nuts and seeds, grains, legumes, and even chocolate and tea. Some examples of foods that have high levels of oxalate include peanuts, rhubarb, spinach, beets, Swiss chard, chocolate, sweet potatoes- and watercress.

So to answer the questions-
  1. No watercress itself does not cause kidney stones, but the calcium and oxalate in watercress does.
  2. It depends. If you did not have a calcium oxalate stone and are not prone to that type, you should be able to eat watercress with no worries. If you have had multiple calcium oxalate stones, especially if they were large and required surgery, you probably will want to avoid any oxalate containing foods at all.
  3. Not exactly, but the calcium in watercress binds oxalate , removing it from the body in the urine. So there is less oxalate to make more stones.

How to limit intake of oxalate rich foods.

If you do choose to avoid high oxalate foods, this chart from the National Kidney Foundation will help you choose the right foods.

Other ways to prevent kidney stones

Drink enough water to produce 2-2.5 quarts/liters of urine every day.

A high fluid, preferably water, intake can prevent build up of these stone causing chemicals. At least 2 quarts/liters daily is recommended, more if one does heavy physical activity , sports, or lives in a hot climate.

Limit the amount of sodium, salt, in the diet.

Since the majority of stones contain calcium, it might make sense to limit calcium. But the kidneys spend more time filtering sodium; so with less sodium, more calcium can  be flushed away and so it’s not making stones.  Here are 5 tips to reduce salt intake from WebMD.

Limit intake of certain animal proteins.

High purine foods can cause the less common uric acid stones. To prevent uric acid stones, cut down on high-purine foods such as red meat, organ meats, beer/alcoholic beverages, meat-based gravies, sardines, anchovies and shellfish.

a basket filled with fruits and vegetables
a LIGHTSTOCK.COM image, an affiliate link for stock photos and other media
Eat a whole foods, plant based diet.

Although watercress and other greens contain oxalate, it’s probably not necessary to avoid them entirely; they also are a good source of calcium which attaches to the oxalate, removing both from the body. Moderate amounts with adequate fluid intake should be safe, unless your doctor tells your otherwise.

  • Follow a healthy diet plan that has mostly vegetables and fruits, whole grains, and low-fat dairy products.
  • Limit sugar-sweetened foods and drinks, especially those that have high fructose corn syrup.
  • Limit alcohol because it can increase uric acid levels in the blood and avoid short term diets for the same reason.
  • Drink beverages with lime and lemon juice.

This information is current as of the publication date; it is general medical information that helps doctors and patients make decisions about what is right for them. Medical recommendations and practice changes as we learn new things. If you deal with any of these issues , please discuss with your doctor before taking any action.

Explore further

This was a simple explanation about kidney stones but you can get more detailed info at these links.

the National Kidney Foundation

Watch a brief video about kidney stones from MedlinePlus .

Explore the causes of excess oxalate in detail, especially the rare genetic causes, at the Oxalosis and Hyperoxaluria Foundation.

Doe and Faun White-tailed deer drinking at a farm pond in Stanly Co., NC on Aug. 19, 2000.
Doe and Faun White-tailed deer drinking at a farm pond in Stanly Co., NC on Aug. 19, 2000. copyright Daniel E. Wray

I don’t know if deer get kidney stones, but if so, they are doing the right thing. I like this photo from the LIGHTSTOCK.COM collection. (affiliate link)

exploring the HEART of health

Thank you for joining me to explore the HEART of health. I hope you’ve learned something new about kidney stones; I hope you never have one! Please contact me about topics you want to read about.

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

Dr. Aletha