A&M Internal Medicine
Dr. Marc Wiener handles all common medical problems, and he has special expertise in a number of medical areas.
Here are examples of Dr. Wiener’s approach to some medical issues:
Sinusitis High Cholesterol and Heart Disease Asthma
Diabetes Hypertension (High Blood Pressure) Depression
  Menopause and Osteoporosis
Sinusitis:
A general name for a large variety of symptom complexes. Although the term can indicate either inflammation or infection, it is helpful to use the term “sinus infection” to differentiate the sinusitis-type presentation from the more severe condition which will require antibiotics. And since patients with sinusitis (without actual infection) will feel better on antibiotics, it becomes extremely important to try to differentiate the two conditions. Typical causes can include viral (i.e. colds), allergies, irritants and medications (especially birth-control pills).
Diabetes:
A wide range of conditions all related to an imbalance between the amount of calories ingested and the ability of one’s body to remove the glucose from the blood. New medications allow for longer periods of time before needing insulin. New types of insulin, and new strategies of dosing, allow for optimal control for a wider range of patients. It is essential to keep tight control of diabetes in order to minimize the chance of the devastating complications, such as: blindness, kidney failure, heart disease and amputations.
High Cholesterol and Heart Disease:
Prevention and treatment are entwined for this set of problems related to plaque build-up in the heart arteries. As good as medications are these days, diet and exercise must still be optimized! And the false sense of security that a normal stress test might bring must be tempered by the understanding of what might occur in the future for an individual patient who has a specific set of risk factors. A good long-term patient-physician relationship lies at the cornerstone of excellent health, especially when dealing with these issues.
Hypertension (High Blood Pressure):
Called the “silent killer” for a reason! All too often under-treated, but some patients are over treated due to an excessive reliance on in-office blood pressure measurements. It becomes essential to fit the medication to the individual. No patient should have to live with ongoing side-effects from a daily medication because there now exist enough different blood pressure medications to allow any patient to find ones which are both effective and free of side effects.
Menopause and Osteoporosis:
At a time when women's health issues are in a rapid state of flux, the most important thing to do is to treat each woman as an individual. Even though some women can still benefit from hormone replacement therapy (HRT), the risks must be understood and balanced against whatever rewards that HRT provides. It is no longer sufficient to simply put everyone on Prempro and send them on their way. And with new forms of osteoporosis treatment coming out each month, the treatment plan must be updated at regular intervals, based on the bone density tests and the current management options.
Asthma:
Much more common than people might imagine, many people with allergies also have occasional asthma. Since asthma is a condition primarily associated with airway inflammation, the most important aspects of treatment must focus on reducing the inflammation. And few medical conditions see as much benefit from patient education as is the case with asthma.
Depression:
Probably the most under-diagnosed condition there is. The key factors for proper diagnosis of depression are a strong patient-physician relationship, an ability for the patient to have the time to really explain what is going on with them, and the willingness to actually entertain the possibility of the diagnosis. Fortunately there are many anti-depressant medications which provide great benefit to the patient with depression, and which can be prescribed by primary care physicians.