J. Bruce Williams, M.D.J. Bruce Williams, M.D.
- Accepting Children: No
- Accepting New Patients: Yes
- Accepting Medicare: Yes
- Accepting Medicaid/DSHS: No
Contact this office for accepted insurance plans.Additional Information:
University Of Oregon Health ScienceResidency
Hennepin County Medical CenterBoard Certifications
Internal MedicineAdditional Information:
I think I can say a few things about medicine. First, it’s never been easy to be a doctor taking care of real people. My great grandfather set up practice in Appalachia, far from any urban center, and using ether and the most crude of instruments, set about bringing the beginnings of the surgical era to backwoods Kentucky. He carried a pistol to defend himself from angry family members if things got out of hand.
Second, the rate of change induced by scientific discovery, is far from slowing, and in fact, seems to be accelerating. My father’s career in particular, spanning the era of specialization, witnessed the fruits of research from the National Institutes of Health in the first decades after World War 2. Broad scientific developments drove the discovery of hundreds of new medicines and the specialists who could understand and prescribe them. Lifespans have ...
I have been asked many times about toenail fungus and how to treat it. It is a common condition and distressing to look at, at least from the patient's perspective. There are theories abound as to the cause or causes, and I've heard of treatments from tea-tree oil soaks to surgery, but the really bedeviling part about this affliction is the generally high likelihood of recurrence no matter what you do. The medications and some of the other treatments available seem to work for a time, only to fail later on. But there may be a solution.
A curious observation is that exercise...
“I don’t get it! Everytime I come to your office my blood pressure is high. It’s never like that anywhere else!”
“White Coat Hypertension” is very common and affects many people, even those who feel at ease with their physician. But whether your blood pressure is low or high at the doctor’s office, if you’ve been told you might have hypertension, you are likely to find yourself at home, or in a grocery or drug store with your arm in a cuff trying to figure out if your blood pressure is reasonable. A key to successful self-measurement is knowing the proper technique.
The big studies of blood pressure in the population upon which we base all our definitions of normal and high values were careful to take their measurements in a standardized way. The patient should avoid coffee, tea, nicotine, and other stimulants for at least 30 minutes prior to the test. She should sit quietly for a full 10 minutes reading or softly conversing before measurement. Even reaching across the table to pull the BP cuff near is to be avoided. (Get the machinery next to you when you first sit down.) Use an upper arm cuff. Forearm and finger devices are not reliable. Feet should be flat on the floor, clothing comfortable, and a bare arm may be needed for some machines. Two or three measurements a few minutes apart may be averaged.
A few caveats to mention: if one arm is higher than the other, you have to go by the higher side. Humans have a natural ‘diurnal’ variation, with most of us having a little higher blood pressure in the morning compared with later in the day. Blood pressure rises with physical and mental exertion and takes some time to come down, so don’t expect a resting value if you’ve not been at rest for 10 minutes or more.
Blood pressure is dynamic and always changing. The majority of values should be in a good range; your physician can help you determine if your numbers are in the range you need for optimal health.
“Darn! My inhaler is out and I am going to have to call today, a Sunday, to get a refill…”
Spring is here! And that means asthma season is back, and with the nicer weather, pollen counts are high. Flowers are wonderful and the trees beautiful, but if you are like me, some of those plants have your number. The beautiful smells come with itchy eyes, sneezes, and for some, a serious amount of wheezing.
Patients are reaching for their inhalers more often, and sometimes getting into serious respiratory trouble, especially if their medication is running short. Inhalers are expensive, too, and so using them optimally is both financially and healthfully important.
Fortunately, a couple of tricks can really help maximize an asthma spray’s value.
The medication comes out fast and hard when you squeeze the canister, and it can be difficult to time your breath to inhale the dose well, plus with the energy of the release being so high, a lot of misted drug can zoom right out of your mouth. The trick is to use a ‘spacer’, and the simplest is a rolled up piece of paper, to about a one inch diameter. Tuck the sprayer in the far end, wrap your lips around the outside of the other end, and take your leisure squeezing and breathing! The tube holds the mist in place for a few seconds, letting you better coordinate your inhalation and improve substantially the amount of drug you get to where it is needed.
The second tip is to use a steroid inhaler daily if you need your rescue inhaler more than a few times a week. The rescue inhaler will become less effective the more you use it if you don’t directly treat the inflammation of the allergic response in your bronchial tubes with a low dose of cortisone type medication. The dose of the latter is small and will not cause harm to the rest of your system if used according to directions, but it will keep your rescue medication most beneficial!
“Did my stress cause this rash?!”
A patient recently asked this question half-jokingly, but as we talked further about his life circumstances, he came to the answer of his own question. Issues between him and a loved one came tumbling out, his persistent unhappiness with the present state of affairs made it clear that yes, very much so, his stress is playing a role in his rash.
How can this be possible? And if it is true, that our mental states can give rise to very straightforwardly visible physical maladies, how are we to respond?
The interplay of our minds and bodies runs deep. The more time I spend in the practice of medicine, the more amazed I am at the powerful effects that run back and forth between the two poles of our being, the physical and the mental aspects of our selves. Physical events, such as broken bones, strokes, and degenerative disease strike ...
Edmonds, WA 98026