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San Francisco Bay Area Forest Fire Smoke Avoidance

November 14, 2018

  • Stay indoors as much as possible
  • Avoid outdoor activity when the air quality is poor. Check it on AirNow:  cfpub.epa.gov/airnow.
  • Keep windows and doors closed.  
  • If you have air conditioning, put it on maximum recirculate to keep from drawing in outdoor air.
  • When driving, put air conditioning on maximum recirculate as well.  
  • Obtain a home air purifier with a CARBON filter, which adsorbs gases like smoke and fumes. 
  • Wear a N95 or P100 rated mask outdoors. Sold in pharmacies. 

Supplements:  "You pay your money, you take your chances."

September 1, 2018

Americans consume large amounts of "dietary supplements" available  from almost any retail outlet, including gas-stations and pharmacies' store-sections. However supplement production and sale is unregulated.  Almost no one is watching out for consumers by studying the safety and effectiveness of these products. The FDA's consumer updates address the caveats about dietary supplements HERE .  

​Where's The Pollen Coming From?

March 5, 2018

It is March, one of the heaviest months for allergies with symptoms like sneezing, itchy red eyes, wheezing.  It's natural to think that yellow acacia trees are the cause.  But acacia and other flowering plants use bees to cross-fertilize and have larger waxy pollen grains.  Unless you have close exposure these grains won't be inhaled.


The showy acacia above isn't spreading allergy, but the large Monterey Cypress behind it is releasing about one gallon of pollen per week.  It just isn't as obvious about it.

Do You Really Need Distilled Water to Prepare Saline Sinus Rinses?​ - YES!

 January 2018

From the FDA Website:

for use as a nasal rinse because it’s not adequately filtered or treated. Some tap water contains low levels of organisms — such as bacteria and protozoa, including amoebas — that may be safe to swallow because stomach acid kills them. But in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections. They can even be fatal in some rare cases, according to the Centers for Disease Control and Prevention (CDC).

What Types of Water Are Safe to Use?

Distilled or sterile water, which you can buy in stores. The label will state “distilled” or “sterile.”
Boiled and cooled tap water — boiled for 3 to 5 minutes, then cooled until it is lukewarm. Previously boiled water can be stored in a clean, closed container for use within 24 hours.
Water passed through a filter designed to trap potentially infectious organisms. CDC has information on selecting these filters.

Mistaken Reasons for Declining the "Flu Shot" Influenza Vaccine

A few patients are reluctant to receive the Influenza Vaccine 2014-15

because they've heard that only 40% of this year's influenza virus strains can be prevented with the shots.  However, preventing 40% is still highly desirable and the risk of the vaccine is minimal.  So, please have yourself vaccinated to prevent you and others from getting 


Others who decline the shot say "I got the flu shot but I got the flu anyway." They report "stomach flu" symptoms of vomiting and diarrhea. "Stomach flu" has no relation to Influenza. We use the term as a shortcut to say "gastroenteritis."  Developing the GI disease is not prevented by the respiratory Influenza vaccine.  

Grand Rounds: Medical Effects of Mold Exposure California Pacific Medical Center, San Francisco

This video below shows my July 15, 2014 lecture on the actual effects of mold exposure, as well as several medical myths surrounding it.    I was recovering from laryngitis & vocal quality was poor. Mold (Fungus) arises as a concern for many patients visiting an allergist.  Unfortunately, many false dangers are promoted by unqualified “experts.”  While living in damp or moldy conditions is associated with more respiratory symptoms, cause-and-effect has not been established.  Furthermore, the literature often does not distinguish between exposure to dampness vs. exposure to mold. A common unfounded health fear is that of Stachybotrys, misleadingly referred to as “Black Mold.” Most fungi (molds) which produce a colored pigment can grow as a black colony under specific environmental conditions.  Black colored mold is not necessarily Stachybotrys. Indeed, inhaling Stachybotrys is not detrimental. Stachybotrys must be eaten to cause poisoning, such as in contaminated foodstuffs.