Dr. Mark Steven Bromson, M.D.

In matters like these, without knowing all the facts, it is difficult to give you a definitive opinion. Nevertheless, according to your e-mail, you have had the same physician for 28 years, and even there is was a falling out, unless there was something egregious, it is best to simply move on.

In regards to finding another physician, the first step is finding physicians on your insurance plan (assuming you have insurance.) Once you have choices, it is best to try to get some recommendations, which isn’t always easy. The best recommendations are generally from friends or other physicians. Online ratings are occasionally useful, but I generally recommend taking them with a grain of salt, as they are not a representative sample.

The definitive way of diagnosing a fungal infection on a toe is to do a culture or a biopsy; however, that is often not necessary. If you are talking about a fungal skin infection, in most cases you can simply treat it empirically with over-the-counter anti-fungal medications, and it will usually respond. If you are talking about a nail infection, if it is minor you can do the same thing, but if it is more established, then you will require a biopsy/culture and prescription medication

Generally, this is something that could be handled by a primary care physician or a gastroenterologist (GI doctor). He would only need to go to an ER if he was having massive diarrhea, high fevers, or having other significant symptoms. Alternatively, he could go to an urgent care center.

There are a lot of foods that are rich in vitamin B-12, including seafood, milk and dairy products, beef, chicken, etc. These foods include clams, tuna, trout, salmon, mackerel, sardines, oysters, mussels, haddock, crab, yogurt, milk and dairy products, eggs, chicken, turkey, liver, kidneys, beef, fortified cereals, fortified nutritional yeast, fortified nondairy milk, fortified tofu, and the list goes on.

However, while it is good to get Vitamin B12 in the diet, I would suggest that your father also take vitamins that contain the recommended daily allowance of Vitamin B-12 to make sure that he is getting enough.

Yes, both of these are know side effects of Zoloft. Common side effects of Zoloft include: diarrhea, dizziness, drowsiness, dyspepsia, fatigue, insomnia, loose stools, nausea, tremor, headache, paresthesia, anorexia, decreased libido, delayed ejaculation, diaphoresis, ejaculation failure, and xerostomia. Other side effects include: abdominal pain, agitation, pain, vomiting, anxiety, hypouricemia, and malaise.

I would recommend that you follow-up with the prescribing physician to see if there are other alternatives.

It is quite possible that you have varicose vein, based both upon your description, and the fact that they are quite common. Unless you are having significant symptoms, varicose veins usually don’t require medical care; however, I would show them to your primary care physician at your next checkup. If they are more of a cosmetic issue, then there are plenty of clinics specializing in eliminating them.

Hyperthyroidism may have an effect on hair color. Most people with hyperthyroidism notice thinning or fragility of the hair, but occasionally an increased appearance of gray hairs can also occur. With proper treatment of the hyperthyroidism, the changes can be reversed. While some patients may find that they gray will resolve completely, many will still have some residual gray hairs although it should be improved. However, it needs to be emphasized that gray hair is generally an inherited trait, and by age 50, 50% of the population will have 50% gray hair, so it is possible that the color changes are unrelated. Nevertheless, no matter what the cause, the hyperthyroidism needs to be treated.

Aspirin can cause upset stomach, heartburn and GI bleeding. Your grandfather should stop taking the medication and see his primary care physician. There are other medications that he can take for his arthritis.

Most healthy women in their 30's will not require calcium supplementation, although there are situations where calcium may not be adequately absorbed in the body. The calcium level in your blood is not an accurate reflection of the calcium in your bones. You should ask your doctor exactly why he/she recommended calcium for you.

The treatment should not vary between an MD and a DO for this illness.

Unless she has any open wounds, soap and water is fine.