From the Doctor’s Chair

Every week Dr. Hopkin will be sharing his wealth of information about the medicine world with you.



I wanted to get a MOST IMPORTANT ANNOUNCEMENT out to our dear patients and friends.
After almost 10 months of manning the clinic alone, I am immeasurably pleased (you have no idea….) to announce that HELP IS ARRIVING!!! Her name is Jamie Gudmunson. She was an ER nurse for 6 years before she took her training to become a Nurse Practitioner (NP). Many of you have already met her because she rotated here a total of about 4 out of the last 15 months. She just passed her Boards with flying colors and we are only waiting now for her Idaho license to arrive before she starts. Jamie is married and has two children, a boy and a girl. Her husband, Cody, is a Freemont County Sheriff’s Deputy. They make their home in St. Anthony and are, hence, here to stay! Of course, I am deliriously happy to have her join me. (it is just beyond words).

Jamie is a new NP grad, but she has been taking care of sick and injured patients for nearly 10 years. I have worked with her for many months. I feel really fortunate to find her. She is personable, pleasant, and she is a whole lot cuter than I am. But there is a tangible difference between Jamie and most health care providers I have known.

She cares.

After a visit with her you will know that Jamie signed on for the entire package when she went into medicine. She didn’t sign up for the money or the fame (I mean, look who she is working with, doh!?). She clearly wants to help people. And you will know that. Watch how long she listens to you, and how hard she works to meet your needs. Notice how kind she is to your children who aren’t being seen. Pay attention to how she makes you feel about your humanity while you are here. You will leave feeling cared for in every way.

Primary care providers working for Intermountain Health Care in Utah are now given 10 minutes to complete each patient visit before they must move on. In California, Kaiser Health Care family docs are limited to 7 minutes before a light and an alarm go off signaling them to move to the next room. There are offices in this town (Rexburg) where, if you are on Medicaid insurance, you will only be seen for one problem per visit. If you have 3 complaints, you will be seen for each one on 3 different days.

Those of you who call our office home already know that we do things differently at Upper Valley Family Practice and Urgent Care. You are treated like family. We listen and we care.

Please accept my invitation to make your next appointment with Jamie Gudmunson, our new provider. She and I see health care the same way. Reach out and give her a try. You will realize that you are not losing your favorite doctor; you are simply making a new friend!

Call us for your health care needs. We are open 8 AM to 8 PM, Monday through Saturday. We will even call you back after hours if you need. In every way that we can we will show you that we care.

Cold Sores Got You Down?

Cold Sore Remedies | Upper Valley Family Practice & Urgent Care | Rexburg, ID

If the above picture looks like something you have seen in the mirror before, then this message is for YOU!
This is herpes labialis, commonly called a “cold sore”. Saying it can slow down the social life of a BYU-I single is the understatement of the year! Just try getting a date to the dance with an eruption like this on your lip! Plus, it is also painful and an unwelcome two week distraction in our already busy lives.

It is caused by herpes hominis 1 or “herpes” as it is commonly referred to (with loathing and aversion). Most of us acquire it by kissing someone who is unknowingly shedding the virus before a new volcano appears on their lips. (Or the less romantic version of sharing a soft drink from the same straw). If we have a slight break in our skin, then, voilá!, we have also been marked for life! Forever more we can be subject to intermittent eruptions at that same spot preceded by 2-3 days of stinging, itching, or burning, followed by 2 weeks of social isolation as though we had leprosy….
You will hear about this or that topical treatment (abreva, prevasure, orajel, grasshopper urine) that promises to magically shorten the course of this nightmare down to two weeks (that’s right, the same time as if you did nothing).
But there really IS an inexpensive prescription medicine that can shorten, or even prevent these attacks from occurring. It is called Acyclovir, and it has been around treating herpes infections since I was in residency 30 years ago. Back then we were treating newborn infants seriously ill with herpetic encephalitis whose mothers had their herpes in their nether regions. Acyclovir is also available as a topical, but it is nowhere near as effective that way as it is orally. It comes as a liquid for children and as capsules for those of “pill-swallowing age”. If you start the medicine when the eruption starts, you will cut the 2 weeks down to 1 week. If, however, you start it with the first sign of tingling, itching, or burning (before the blister), you may well abort the attack altogether! So the goal is to have the medicine already on-hand for that 10 PM discovery of, “Oh crap, I think I have another outbreak of the ‘lip plague’ coming on!!” If you have it to take right then, you may still be able to talk some cute date into going with you to the prom!!

For this, and for ALL other health care needs you and your family may have, please come to Upper Valley Family Practice and Urgent Care. We are open 6 days of the week, 8AM to 8PM. We approach the little things (like cold sores when there is no outbreak) and the big things (like herpes labialis TWO DAYS BEFORE YOUR WEDDING!!!!) with information, humor, and professionalism. We are here to help you and your families get through the joys and vicissitudes of life with a smile on your face!

Call 356-8883 for your appointment!

Weight loss

So here are two good questions for anyone who wants to lose weight!! (and who doesn’t??)
Which is more detrimental to weight loss, carbs or fats?
Which produces more weight loss, dieting or exercise?
Who hasn’t asked themselves these questions before? Someone, you say? Yeah, well are they still BREATHING??
(I doubt it…). They ARE good questions. So here goes!
So which group, carbs or fats, is more harmful to losing weight? It is the carbs, hands down.
When I was in medical school we learned that there are 9 kcals/gr of fat and only 4 kcals/gr of carbs. So carbs are better, right? Nope. Refined carbs (white bread, white rice, potato, and SUGAR COATED BREAKFAST CEREALS or anything like them) produce a surge in insulin when we consume them. The insulin quickly drives those calories into fat cells where they become stored energy (medical speak for FAT!). As the calories leave the blood stream this way, receptors tell our brains that our blood sugar is low and that we need to eat again, sooner than we would if we had consumed fat. This leads to cyclic, more rapid eating and increased fat deposition. And good bye to the bikini for another summer!!
So are all carbs bad? No. But the more refined they are (sugar is the most refined carb), the worse they are. White rice is worse than wild rice, white bread worse than heavy, whole grain bread, etc. And if you will couple even the good carbs with a protein, that will blunt that insulin spike and stave off that hunger response longer. This needn’t be meat or cheese. Cooked beans or legumes of any kind are a better choice. That is why most of the third world eats beans and rice (a nonfat protein and a carb). Or celery with some peanut butter in the groove—another good choice.
And the question of dieting vs. exercise?? In general you will lose 75-80% of your weight by changing your eating patterns and another 20-25% by exercising. (Actually I always counted on 5-10% from re-programming my home scales….but don’t tell my doctor…). And the exercise that is best is aerobic (walking, biking, swimming, jumping rope—that which gets your heart pumping and your breathing increased).
Of course, balance and common sense is still most important. Vegetable fats (oils) may not have any carbs or cholesterol, but I wouldn’t drink it regularly as a beverage and expect to be thin. I used to have an old Hermann cartoon that showed a male patient in a hospital bed who is casted head to toe—just his beady eyes visible—arm and one leg in a trapeze apparatus over the bed. Standing beside the bed is a doctor holding a clip board and telling the patient:
         “Your insurance is denying all coverage on this accident because of a pre-existing condition, Mr. Smith. They say you were already an idiot before you rollerbladed backwards down the freeway at rush hour!”
I have lots of medical textbooks, but Hermann is my last authority!
If Hermann, common sense, and easily explained, useful information sounds like Medical care the way you would like it, then call us (356-8883) and get in, and let’s talk!
There is a lot more where the Hermann joke came from….
Your doctor appointment is waiting….!

Preventative Care

I don’t know if any of you have noticed this, but about 80% of my blogs are about preventative health care rather than acute treatment of illness, which to me is like observing that the Idaho summer sky is blue—rather obvious, you know? That is just the way I think. But most health care is not that way. Most American medical care is NOT preventative (think coronary artery disease, oncology, surgery, urgent care, etc.). Haunting statistics have proved for a generation that we Americans spend 90% of all health care dollars on 10% of those receiving health care—on the late complications of almost entirely preventable diseases. These would include diabetes (eating poorly, obesity), heart disease (eating poorly, obesity, sedentary lifestyle), and cancer (smoking, obesity, high fat/low fiber diets). Another haunting and disgusting statistic is that physicians are paid well for surgeries and procedures and very poorly for preventative care. That is a big part of why American health care is so screwed up. We have all seen those internet postings of candid photos of “Walmart Customers” in varying degrees of overweight, under covered grossness. (Yech!) Bariatric surgeons, cardiovascular surgeons, cancer surgeons, see those postings and see future business! My wife just returned from a once-in-a-lifetime trip to France. She loved it, just loved it. One of her observations, however, is that the typical Frenchman is thin—no obesity there. But don’t worry about the French taking over the world; everyone over there smokes too! Okinawa, Japan, has been studied for over 50 years because it has the highest concentration of centenarians in the world. These people just know how to live well. What do they do?? They exercise individually (more yoga, less competitive sports), they are passionate about their family vegetable gardens, they eat fish and seaweeds, they stay thin, their culture discourages a high stress, competitive lifestyle, and smoking is minimal. They meditate; they are spiritual but not outwardly religious. They value art and poetry (think Mr. Miyagi’s bonsai trees). And they outlive us by an average of over twenty years!
We all probably think we know how any doctor would advise us to live. Eat healthy, living as “close to the ground” as circumstances allow. Avoid processed and hormone-added foods. Stay thin, exercise, sleep, choose less stress, relax/meditate more and compete less. Surround yourself with emotional support (family, neighbors, support groups like church or civic organizations). Stay employed, seeking that ill-defined balance between a comfortable income and excess stress. In Idaho, nearly all of us are vitamin D deficient and need supplementation. We should focus less on lowering our cholesterol and more on lowering our inflammation. We should actively seek out our nutritional deficiencies when we become perennially tired or depress (rather than have our doctor put us on Prozac). We should focus on gut health much more than we do. We should use much fewer antibiotics. We physicians should go back much more to the basics of normal human physiology to understand and treat most diseases; we should rely much less on the recommendations of the large Pharmaceutical Industry whose primary purpose is to market to us very expensive new drugs. (Big secret: 50% of all medical education in this country is financed by Big Pharma, and these companies are wealthier by far than the state budgets of Idaho, Montana, and Wyoming put together!).
I am very much into prevention, as you can see. And I am suspicious of the present medical establishment in general. “Follow the money” is still the best way to understand large systems like the Medical-Industrial Complex, the Military-Industrial Complex, or even the Federal Government itself. If you want to see inside our current messed-up medical system, get on YouTube and watch “Escape Fire”, a documentary about the upside down provision of health care in America. It will open your eyes.
And if you want to practice preventative health care, really, then make an appointment (356-8883) and let us begin to change your life and your future. Feeling good does not have to be just a memory! We can test it and we can fix it, and do so naturally!
Your appointment with the doctor is waiting!