EXPERT
Dr. Amy Chai, MD
Internist
Dr. Amy Chai is an internist practicing in Waterbury, CT. Dr. Chai specializes in the medical treatment of adults. Internists can act as a primary physician or a consultant to a primary physician. They manage both common and rare diseases. Dr. Chai provides comprehensive care and manages treatment with surgeons as well. Internists establish long-term relationships with their patients and incorporate disease prevention and mental health care into their practice. Dr. Chai has specialized training in obesity management and opioid addiction treatment.
39 years
Experience
Dr. Amy Chai, MD
- Waterbury, CT
- The Johns Hopkins University
- Accepting new patients
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Can a hernia problem be fixed without a surgery?
A hernia cannot be "fixed" (repaired) without surgery. In some cases, if the hernia is not causing any symptoms, there may be the option to simply watch and wait--delaying surgery READ MORE
A hernia cannot be "fixed" (repaired) without surgery. In some cases, if the hernia is not causing any symptoms, there may be the option to simply watch and wait--delaying surgery to see if symptoms develop over time. (Typically, symptoms will develop even if the hernia is not causing any symptoms when it is diagnosed). It is always appropriate to see a surgeon if your doctor discovers a hernia. The surgeon will explain all of your options.
What is stomach atrophy?
It sounds like you must mean “atrophic gastritis” and you can look up this term online. It is related to inflammation of the stomach to where the stomach doesn’t absorb certain READ MORE
It sounds like you must mean “atrophic gastritis” and you can look up this term online. It is related to inflammation of the stomach to where the stomach doesn’t absorb certain things as well and gets a little bit Fibrotic (like scarred). Sometimes it is caused by your own body’s immune system and sometimes it is caused by infection with a bacteria called H pylori.
Is lupus cancer or not?
Lupus is NOT CANCER. Lupus is an autoimmune disease. "Auto" means "self." Auto immunity is an immune reaction against yourself. Lupus is where your body makes antibodies (the same READ MORE
Lupus is NOT CANCER. Lupus is an autoimmune disease. "Auto" means "self." Auto immunity is an immune reaction against yourself. Lupus is where your body makes antibodies (the same antibodies that fight off infections) against itself. As you can imagine, it is not a great idea for the body's immune system to attack itself. This can cause problems ranging from MILD (such as a rash) to SEVERE (such as kidney failure). Some people with lupus do not have too many problems and they do fine with the medications that are used to calm down the body's natural immune response. HOWEVER, some people with lupus seem to have constant problems and flare-ups. So, the disease can be either mild or serious. It is typically treated by a rheumatologist. Rheumatologists treat a lot of immune type of diseases such as rheumatoid arthritis and lupus. So, to answer your question, NO, lupus is NOT cancer at all.
Help, I'm struggling with ceoliac disease.
Am I understanding correctly? You were purchasing your food at the pharmacy? If so, that might explain why you are struggling with your food choices. There are so many delicious READ MORE
Am I understanding correctly? You were purchasing your food at the pharmacy? If so, that might explain why you are struggling with your food choices. There are so many delicious gluten-free options available, I will list a few of the most popular brands for you if you do not like preparing your own gluten-free foods. There is Amy's Kitchen, Bob's Red Mill, Udi's, Schar, and Glutino, to name a few. For beers, we like Omission brand. To prepare your own gluten free recipes, simply purchase gluten free flour and prepare your own muffins, pancakes, scones, or cookies. There are many recipes online that you can discover. Of course, creating Asian dishes with steamed rice or rice noodles is my personal favorite way to eat gluten-free. Also, baked potato is gluten free and healthy instead of bread. I would definitely NEVER purchase food from a pharmacy! There are so many good gluten-free choices at the normal grocery store or online.
Good luck!
Good luck!
How are you cleared for surgery in a blood clot risk assessment?
“If you are doing unnecessary surgery, you better do it damn well.” The plastics people are extremely risk averse because their surgeries are a cash business, not a life saving READ MORE
“If you are doing unnecessary surgery, you better do it damn well.” The plastics people are extremely risk averse because their surgeries are a cash business, not a life saving necessity. That being said, you may have other risk factors for blood clots. I am sure you are not taking standard oral contraceptives (because they are contraindicated in migraine) and it is unlikely you are a smoker. Those are two major risk factors for blood clot. Other risk factors are obesity and venous insufficiency in the legs. You do not have a personal or family history of clotting disorder, so those would be the things I would look for if I were doing a pre op exam. I assume you do not have any other major health problems like afib or kidney disease. Yes, it is true that migraine WITH AURA increases your risk of a blood clot to about double compared to a woman your age without migraine with aura. However, It is a low number, and doubling a low number is still a low number. And that is for clots “in general” I am not aware of percent risk that is specific to “perioperative risk” related to migraine. So generally, I would simply make the surgeon aware of that and suggest careful management and suggest proactive preventive measures. However, it is not me doing your procedure. If the surgeon wishes to cover his bases with a hematology consult, it is reasonable to ask for one. In any case, you are at higher risk of blood clot, but so are a lot of people who get surgeries. I am pretty sure the hematologist would agree that you do have increased risk. The hematologist can also check for Factor V Leiden, which might also confer risk, not sure of the exact number. I would ask the surgeon what the standard clotting risk is for his particular surgery, then double it. There is not a cut and dried predictive risk calculation for you that I am aware of. Maybe the hematologist could do a better estimate. But ultimately, you will need to choose the level of risk that you personally feel comfortable with. People with migraines, a fib, cancer, smoking, obesity, etc do get surgeries all the time. I personally have migraine with aura and have been under the knife a few times. There is always risk, sometimes it is hard to quantify.
Is fish oil good for heart health?
Prescription “fish oils” can be beneficial if you have elevated triglycerides. The most important thing for you to do is to have your lipids (cholesterol and triglycerides) checked. READ MORE
Prescription “fish oils” can be beneficial if you have elevated triglycerides. The most important thing for you to do is to have your lipids (cholesterol and triglycerides) checked. You should also have your blood pressure checked regularly, and get a physical exam with a baseline EKG. It would be helpful to know WHY other family members had heart problems. Was it due to an abnormal rhythm? Was it due to a structural defect? Was it due to high cholesterol? These thing can be familial. One example is “long QT syndrome” which can cause sudden death due to abnormal rhythm. Of course it would be useless to threat that with “fish oil” since fish oil primarily is prescribed for high triglycerides, not abnormal heart rhythms. I do not routinely recommend fish oil, though having a diet with a couple of servings of a fatty fish each week would be good. I suggest avoiding smoking (or any drugs including marijuana which increases heart attacks) eating a lower carb diet with fish and whole grains, maintain a healthy weight, exercise regularly, and go to your doctor to be evaluated for your personal risk profile.
Are snoring and sleep apnea the same thing?
It is possible to have snoring without having sleep apnea. Snoring is vibration in the back of your throat due to air moving past. Sleep apnea is when there are actually episodes READ MORE
It is possible to have snoring without having sleep apnea. Snoring is vibration in the back of your throat due to air moving past. Sleep apnea is when there are actually episodes of 1-APNEA (when breathing stops completely, typically due to throat tissues blocking the airway completely) and/or 2-HYPOPNEA (where the throat is closing off enough for the oxygen level to drop during your sleep). Sleep apnea is usually caused due to the throat tissues blocking the airway. Loud snoring is usually the first clue that the throat is getting blocked off during sleep. Other symptoms include a "snort" that wakes you up, headaches in the morning, and feeling tired during the day. Most people with sleep apnea do not realize that they have sleep apnea. Usually, a family member notices the snoring and "snorting" or "gagging" episodes during sleep. ALSO, it is possible to have "central" sleep apnea, where the brain simply forgets to breathe while you are sleeping. Any sort of sleep apnea is dangerous and can cause serious health problems. The only way to know whether loud snoring is due to sleep apnea is to get it checked with a sleep study. They do have sleep study monitors that you can take home and "wear" overnight in your own bed if there is a low chance that you have apnea. This is much simpler than getting the study where you have to sleep overnight at the facility.
Why do I have bad pain?
If you have abdominal pain and bleeding you certainly ought to be seen right away. It would be reasonable to go directly to the emergency department.
What symptoms should I look out for to have my thryroid checked?
Low thyroid can cause many symptoms, such as weight gain, constipation, dry skin, and cold intolerance. It is worth checking your thyroid function if you gain weight. However, READ MORE
Low thyroid can cause many symptoms, such as weight gain, constipation, dry skin, and cold intolerance. It is worth checking your thyroid function if you gain weight. However, there are many causes of weight gain, including chronic stress, shift work, inadequate sleep, and certain medications. Many doctors are poorly educated about weight management, it is not as simple as calories. It is likely that most people have several reasons for weight gain. Discuss this with your doctor.
Pulled a muscle in my groin. What should I do for pain?
You need to first be certain that you do indeed have a groin pull. A visit to an urgent care will help if you are unsure. Other causes of pain in the groin include problems such READ MORE
You need to first be certain that you do indeed have a groin pull. A visit to an urgent care will help if you are unsure. Other causes of pain in the groin include problems such as hernias and problems with the hip joint. A typical groin pull is helped by over the counter pain remedies such as ibuprofen (assuming there is no medical reason not to take such medications) physical therapy, and gentle range of motion stretches. Of course rest and avoiding strenuous activity will help it heal faster.
What else can I do to see a specialist ASAP?
I think that there is a good chance that repletion of your iron stores with iron infusion will resolve or at least improve your fatigue and restless legs. This is a chronic problem READ MORE
I think that there is a good chance that repletion of your iron stores with iron infusion will resolve or at least improve your fatigue and restless legs. This is a chronic problem and if your hemoglobin is normal, it is not likely that waiting until next month will cause physical harm, though I do suggest calling your PCP to see if the appointment can be bumped up. I think it is also important to consider why you might have problems with low iron stores. Have you been checked for celiac disease (gluten intolerance)? Another potential cause of poor iron absorption is chronic use of proton pump inhibitors (your acid medication). It might be reasonable to try to treat GERD with strict diet and a wedge pillow instead of chronic use of high doses of omeprazole. Also, make sure to disclose all supplements used. Some can be toxic, especially in higher doses. It is completely possible that your sleep study showing REM sleep disorder could be related to restless legs and caused by iron deficiency. In this case, klonopin might be tapered off. Benzodiazepines can worsen GERD and can have a lethal
withdrawal syndrome, including seizures if you take them long term or at high doses or both. Celiac disease can also cause GERD and seizures. Interestingly, common viral infections such as chicken pox can actually trigger immune responses that cause celiac (gluten intolerance). So, you might be right about that detail. So the common denominator here is potentially celiac disease and/or omeprazole. I do strongly suggest finding a good gastroenterologist. These are simply my random thoughts and are not meant to constitute medical advice.
withdrawal syndrome, including seizures if you take them long term or at high doses or both. Celiac disease can also cause GERD and seizures. Interestingly, common viral infections such as chicken pox can actually trigger immune responses that cause celiac (gluten intolerance). So, you might be right about that detail. So the common denominator here is potentially celiac disease and/or omeprazole. I do strongly suggest finding a good gastroenterologist. These are simply my random thoughts and are not meant to constitute medical advice.
Is Xanax addictive?
You are correct. Xanax is not the first choice drug to use for sleep or anxiety, unless it is for a very limited time frame or for only occasional use. Sometimes I will prescribe READ MORE
You are correct. Xanax is not the first choice drug to use for sleep or anxiety, unless it is for a very limited time frame or for only occasional use. Sometimes I will prescribe a "few" xanax for people who have a lot of anxiety, so that they can have a sense of control and know that if they "really" have a need, they can use one. I will also use this technique for short term high stress events, such as a death in the family. The other disorder for which benzos are appropriate is panic disorder. Panic disorder is not the same thing as anxiety disorder. So drugs like xanax are fine in limited amounts for limited times. They are too addictive to use for long term anxiety or insomnia.
For anxiety, it is often appropriate to use a combination of "antidepressant" medications and cognitive behavioral therapy. (sertraline or duloxetine are commonly used) There are a number of phone apps that help with anxiety, such as B2R (developed for the VA) and Pacifica. Combining appropriate treatments for anxiety with good sleep hygiene would be my initial approach to treating the insomnia caused by anxiety. Best of luck
For anxiety, it is often appropriate to use a combination of "antidepressant" medications and cognitive behavioral therapy. (sertraline or duloxetine are commonly used) There are a number of phone apps that help with anxiety, such as B2R (developed for the VA) and Pacifica. Combining appropriate treatments for anxiety with good sleep hygiene would be my initial approach to treating the insomnia caused by anxiety. Best of luck
Can weight loss help me get rid of my diabetes?
It is possible to put type 2 diabetes "in remission" with weight loss. In fact, there was a trial in the UK that showed that this is indeed possible. However, to be realistic, READ MORE
It is possible to put type 2 diabetes "in remission" with weight loss. In fact, there was a trial in the UK that showed that this is indeed possible.
However, to be realistic, it is also important to note that most people who lose 5-10% of their body weight do regain it rather quickly. This is not due to a lack of willpower, rather it is due to the body's reaction to the weight loss. The body tries to protect a "biological set point" of weight, and has many dirty tricks in store for you (such as pumping out hunger hormones) when you lose weight.
Often times, people need to remain on weight loss drugs long term to maintain the lower weight. It is a conundrum. You must think in terms of resetting your body's weight set point.
I encourage you to exercise as much as possible, and to limit carbs as much as possible. Also, I would suggest avoiding "weight gaining" diabetic medications such as sulfonureas (like glyburide) and insulins. The newer medications such as ozempic might be a good choice for weight loss. I would also stay on the metformin.
If you are able to simply use diet and exercise, that would be wonderful, though you would be in the minority of people who are actually able to do that. Best of luck.
However, to be realistic, it is also important to note that most people who lose 5-10% of their body weight do regain it rather quickly. This is not due to a lack of willpower, rather it is due to the body's reaction to the weight loss. The body tries to protect a "biological set point" of weight, and has many dirty tricks in store for you (such as pumping out hunger hormones) when you lose weight.
Often times, people need to remain on weight loss drugs long term to maintain the lower weight. It is a conundrum. You must think in terms of resetting your body's weight set point.
I encourage you to exercise as much as possible, and to limit carbs as much as possible. Also, I would suggest avoiding "weight gaining" diabetic medications such as sulfonureas (like glyburide) and insulins. The newer medications such as ozempic might be a good choice for weight loss. I would also stay on the metformin.
If you are able to simply use diet and exercise, that would be wonderful, though you would be in the minority of people who are actually able to do that. Best of luck.
How can one clear out a stuffed ear?
Cleaning ears with Qtips is not a good idea. In fact, cleaning your ears with a cotton swab may CAUSE the impaction (hardening and sticking) of earwax in the ear canal. The first READ MORE
Cleaning ears with Qtips is not a good idea. In fact, cleaning your ears with a cotton swab may CAUSE the impaction (hardening and sticking) of earwax in the ear canal. The first recommendation I have is to avoid using the cotton swab. If your wax remains impacted, then using an over-the-counter ear drop for wax removal would be the next step. If that fails, you
should go to your primary care doctor to get the "waterpik" treatment. Typically, we use a gentle pulse of water to flush out the ear wax. Once the wax is removed, simply use a washcloth as normal, but avoid cotton swabs.
should go to your primary care doctor to get the "waterpik" treatment. Typically, we use a gentle pulse of water to flush out the ear wax. Once the wax is removed, simply use a washcloth as normal, but avoid cotton swabs.
Who is at risk of getting COPD?
Everyone who smokes is at risk for developing Chronic Obstructive Pulmonary Disease, or COPD. The more cigarettes that you smoke over time, the greater the likelihood of developing READ MORE
Everyone who smokes is at risk for developing Chronic Obstructive Pulmonary Disease, or COPD. The more cigarettes that you smoke over time, the greater the likelihood of developing COPD. Air pollution, second hand smoke, and exposure to other airborne particles such as cooking smoke can also cause COPD. You are correct to be concerned about a family history of COPD. Some people have genetic factors that place them at greater risk of developing COPD. So if family members have COPD, there is a good chance that you are more susceptible to the damage caused by smoke. It is also likely that if your parents smoked, you have had a lot of exposure to "second hand" smoke as a child. Less commonly, there is a genetic abnormality called alpha 1 antitrypsin deficiency that, when present, can cause lung and liver disease even without exposure to toxins. To prevent yourself from developing COPD, or to prevent your existing COPD from getting worse, it is critically important to stop smoking. Chantix is a medication that has shown a lot of efficacy for smoking cessation. Other options include a medication called bupropion (Wellbutrin) and nicotine replacement patches and gum. Of course, "cold turkey" is also a good way to go. The physical addiction to nicotine goes away after only two weeks of withdrawal. You might be grouchy for a couple of weeks, though. After the first two weeks, keeping away from cigarettes usually means finding another activity to do with your hands or your mouth, such as chewing gum or using a fidget spinner. It is also important to get support from family and friends so they can keep you on the right track.
Good luck, you can do it.
Good luck, you can do it.
Why do my feet swell up by evening?
Foot swelling is called, "dependent edema" in medical language. Edema is the buildup of fluid in body tissues. Fluid often builds up in the feet and legs because gravity causes READ MORE
Foot swelling is called, "dependent edema" in medical language. Edema is the buildup of fluid in body tissues. Fluid often builds up in the feet and legs because gravity causes fluid to flow to the lowest point in the body. That is why elevating the feet and legs (above the level of the heart if possible) will make edema better, and standing up will make it worse. Typically, leg swelling is least bothersome in the morning. This is because the feet are the same level as the rest of the body while you are asleep in bed, allowing the fluid to spread equally in the body. Then, after being awake and walking around all day, gravity causes the fluid to pool in the lowest body part, your feet. To relieve the discomfort of edema, you can elevate your legs and wear compression stockings. However, when you have edema you should never simply ignore it. Even though foot swelling is common and is often caused by a minor problem, edema can also be a symptom of a serious problem with the kidney, the liver, or the heart. Your doctor will need to do some blood tests, a urine test, and a physical exam if you have a new problem with edema. It is important to get checked out to make sure that you do not have a medical problem causing the swelling.
Can natural foods help in improving my platelet count?
There are two main causes for dropping platelet count: 1-The bone marrow is not making enough platelets; or 2-The body is destroying platelets too fast. Low platelets is a serious READ MORE
There are two main causes for dropping platelet count: 1-The bone marrow is not making enough platelets; or 2-The body is destroying platelets too fast. Low platelets is a serious problem and should be evaluated by your doctor. Your doctor might look for some causes of decreased bone marrow production, such as low vitamin B12, folate, and iron, or bone marrow diseases such as myelodysplasia or aplastic anemia. Your doctor might look for some causes of platelet destruction such as viral illnesses, spleen disorders, autoimmune problems, or blood clotting disorders. There is no natural food or food supplement that helps platelets. The only thing that helps platelets is to diagnose the cause and treat the cause. Please see your doctor to evaluate this.
Is it safe to take the c1 pill with blood pressure medication?
By C1, I assume that you mean "clonazepam" or some other street benzo. I am going to assume that you are calling it c1 because you purchased it from a "friend" and it was not prescribed READ MORE
By C1, I assume that you mean "clonazepam" or some other street benzo. I am going to assume that you are calling it c1 because you purchased it from a "friend" and it was not prescribed to you. Your doctor has no idea what a c1 is because that is not what we call it. Your doctor also doesn't know what a zbar or a blue football is. The only reason I know is because I run a methadone clinic. I absolutely would NEVER take medication that was purchased from the internet or a friend. NEVER. The reason is the People's Republic of China. They are great counterfeiters. However, they don't care about you. They will put God knows what and press it into a pill and sell it. You could die. It could be laced with a synthetic fentanyl product. People have dropped from counterfeit pills. You have no idea what is in that pill. Your doctor can tell you if the medication that he/she prescribed has an interaction with your blood pressure pills. If the doctor who prescribed the medications are different doctors, you should inform the primary care doctor of your new medication, and ask your pharmacist to check for any drug interactions. It is great that you are being proactive and checking prior to starting a new drug, that is very smart!
I am unable to eat well these days. Could it be related to my liver condition?
The medical term for loss of appetite is called, "anorexia." It is very common to suffer from anorexia when you have hepatitis. If the anorexia is simply due to the hepatitis, READ MORE
The medical term for loss of appetite is called, "anorexia." It is very common to suffer from anorexia when you have hepatitis. If the anorexia is simply due to the hepatitis, it should improve as the illness resolves. However, it is not a good idea to "assume" that you know the cause of any given medical symptom. It is important to bring up your loss of appetite with your doctor, so you can work together to develop a strategy to determine the cause and treatment. Your doctor might want to order additional tests.