Tag Archives: Asthma

Straight, No Chaser: Asthma Basics – (Part 2 of 2)

As we move into discussing asthma treatment, remember that asthmatics die at an alarming rate.  I mentioned yesterday (and it bears repeating) that death rates have increased over 50% in the last few decades.  If you’re an asthmatic, avoid taking care of yourself at your own peril.  Your next asthma attack could be your last.
The other thing to remember is that asthma is a reversible disease – until it’s not.  At some point (beginning somewhere around age 35 or so), the ongoing inflammation and damage to the lungs will create some irreversible changes, and then the situation’s completely different, possibly predisposing asthmatics to other conditions such as chronic bronchitis, COPD (chronic obstructive pulmonary disease) and lung cancer.  This simply reiterates the importance of identifying and removing those triggers.
Given that, let’s talk about asthma control as treatment.  Consider the following quick tips you might use to help you reduce or virtually eliminate asthma attacks:

asthmatriggers

  • Avoid cigarette smoke (including second hand smoke) like the plague!
  • Avoid long haired animals, especially cats.
  • Avoid shaggy carpets, window treatments or other household fixtures that retain dust.
  • If you’re spraying any kind of aerosol, if it’s allergy season, if you’re handling trash, or if you react to cold weather, wear a mask while you’re doing it.  It’s better to not look cool for a few moments than to have to look at an emergency room for a few hours or a hospital room for a few days.
  • Be careful to avoid colds and the flu.  Get that flu shot yearly.

If and when all of this fails, and you’re actually in the midst of an asthma attack, treatment options primarily center around two types of medications.

AsthmaHispanic

  • Short (and quick) acting bronchodilators (e.g. albuterol, ventolin, proventil, xopenex, alupent, maxair) functionally serve as props (‘toothpicks’, no not real ones, and don’t try to use toothpicks at home) to keep the airways open against the onslaught of mucous buildup inside the lungs combined with other inflammatory changes trying to clog the airways.  These medications do not treat the underlying condition.  They only buy you time and attempt to keep the airways open for…
  • Steroids (e.g. prednisone, prelone, orapred, solumedrol, decadron – none of which are the muscle building kind) are the mainstay of acute asthma treatment, as they combat the inflammatory reaction and other changes that cause the asthma attack.  One can functionally think of steroids as a dump truck moving in to scoop the snot out of the airways.  The only issue with the steroids is they take 2-4 hours to start working, so you have to both get them on board as early as possible while continuing to use the bronchodilators to stem the tide until the steroids kick in.

asthma-inhaler-techniques-15-638
If you are not successful in avoiding those triggers over the long term, you may need to be placed on ‘controller’ medications at home, which include lower doses of long-acting bronchodilators and steroids.
So in summary, the best treatment of asthma is management of its causes.  Avoid the triggers, thus reducing your acute attacks.  Become educated about signs of an attack.  When needed, get help sooner rather than later.  And always keep an inhaler on you.  It could be the difference between life and death.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Asthma Basics – (Part 1 of 2)

asthmaBasics-enHD-AR1

Asthma concerns me. I’ve had many close friends and family suffer with the disease. In fact, a very good friend died of an attack while in medical school, because he didn’t have his inhaler with him. In other words, this is somewhat personal. I’ve probably given more lectures on asthma than any other topic over the years, and I can say without hesitation that relative to how much we know about its prevention and treatment, I can’t think of another disease where we under perform as much as with asthma management. According to data from the National Institutes of Health, over the last few decades the death rate has increased by over 55%. The prevalence rate has increased by 75%, and among African-Americans the hospitalization rate has increased over 35%. The good news is asthma can be controlled and effectively treated. In this primer, we’ll discuss quick tips to improve the health of the asthmatic in your life.
The encouraging thing about asthma is that if you understand what causes it, you understand how to treat it. Here’s what you need to know about what causes asthma. For the purposes of discussion I am simplifying matters for general consumption.
asthma

  • Asthma is a result of certain triggers, causing inflammation to your airways over a long period of time with the occurrence of attacks (intermittent exacerbations). These triggers can be thought of as allergens. Examples of these triggers include cigarette smoke, dust, aerosols, cold air, long-haired animals (especially cats), seasonal pollens, and exercise (in some).
  • These triggers create a state of inflammation and hyperresponsiveness in the lungs, leading to the excessive production of mucus within the lungs’ various airway branches. If bad enough this will lead to complete obstruction of the airways. In other words you’ll stop breathing, and you will die without assistance and/or reversal.
  • Exacerbation of asthma include breathlessness, chest tightness, coughing, and wheezing. Basically, because you have the functional equivalent of snot in your lungs, your airways are narrowed, and you’re having difficulty breathing. After all, it’s harder to breathe snot than air. Now imagine how your lungs feel when you’re adding cigarette smoke to that mix.

Asthma Symptoms Word Circle Concept with great terms such as coughing wheezing and more.
Let’s get logical. Asthma management is theoretically straightforward if you can pull it off. Prevention is treatment. I used to describe this as “Kill the Cat.” (This blog neither supports, advocates, nor is responsible for the harming of any animals resulting from this information.) In short, if you identify the triggers that precipitate your asthma attacks and then remove yourself from that environment, you will dramatically reduce, if not eliminate, your attacks. This is often described (incorrectly) in kids as “growing out of their asthma.” No one grows out of it, and you don’t cure asthma; asthmatics just stop having attacks because they’re not around the triggers.
In Part II, we discuss asthma management. In case you’re wondering, that’s where the toothpicks come in.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Tips to Limit Your Risk of Contracting The Most Deadly Diseases

early-death-pair

It is interesting and, even more, curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.

Health_hazards

According to the Center for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Cancer warrants a special comment to get screened! Early detection is the key to survival!

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

asthmarisk

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog
Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

risk

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Tips to Limit Your Risk of Contracting The Most Deadly Diseases

early-death-pair

It is interesting and, even more, curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.

Health_hazards

According to the Center for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Cancer warrants a special comment to get screened! Early detection is the key to survival!

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

asthmarisk

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog
Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

risk

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 2 of 2)

asthma_treatments_496958

As we move into discussing asthma treatment, remember that asthmatics die at an alarming rate.  I mentioned yesterday (and it bears repeating) that death rates have increased over 50% in the last few decades.  If you’re an asthmatic, avoid taking care of yourself at your own peril.  Your next asthma attack could be your last.
The other thing to remember is that asthma is a reversible disease – until it’s not.  At some point (beginning somewhere around age 35 or so), the ongoing inflammation and damage to the lungs will create some irreversible changes, and then the situation’s completely different, possibly predisposing asthmatics to other conditions such as chronic bronchitis, COPD (chronic obstructive pulmonary disease) and lung cancer.  This simply reiterates the importance of identifying and removing those triggers.
Given that, let’s talk about asthma control as treatment.  Consider the following quick tips you might use to help you reduce or virtually eliminate asthma attacks:

asthmatriggers

  • Avoid cigarette smoke (including second hand smoke) like the plague!
  • Avoid long haired animals, especially cats.
  • Avoid shaggy carpets, window treatments or other household fixtures that retain dust.
  • If you’re spraying any kind of aerosol, if it’s allergy season, if you’re handling trash, or if you react to cold weather, wear a mask while you’re doing it.  It’s better to not look cool for a few moments than to have to look at an emergency room for a few hours or a hospital room for a few days.
  • Be careful to avoid colds and the flu.  Get that flu shot yearly.

If and when all of this fails, and you’re actually in the midst of an asthma attack, treatment options primarily center around two types of medications.

AsthmaHispanic

  • Short (and quick) acting bronchodilators (e.g. albuterol, ventolin, proventil, xopenex, alupent, maxair) functionally serve as props (‘toothpicks’, no not real ones, and don’t try to use toothpicks at home) to keep the airways open against the onslaught of mucous buildup inside the lungs combined with other inflammatory changes trying to clog the airways.  These medications do not treat the underlying condition.  They only buy you time and attempt to keep the airways open for…
  • Steroids (e.g. prednisone, prelone, orapred, solumedrol, decadron – none of which are the muscle building kind) are the mainstay of acute asthma treatment, as they combat the inflammatory reaction and other changes that cause the asthma attack.  One can functionally think of steroids as a dump truck moving in to scoop the snot out of the airways.  The only issue with the steroids is they take 2-4 hours to start working, so you have to both get them on board as early as possible while continuing to use the bronchodilators to stem the tide until the steroids kick in.

asthma-inhaler-techniques-15-638
If you are not successful in avoiding those triggers over the long term, you may need to be placed on ‘controller’ medications at home, which include lower doses of long-acting bronchodilators and steroids.
So in summary, the best treatment of asthma is management of its causes.  Avoid the triggers, thus reducing your acute attacks.  Become educated about signs of an attack.  When needed, get help sooner rather than later.  And always keep an inhaler on you.  It could be the difference between life and death.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 
 

Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 1 of 2)

asthmaBasics-enHD-AR1

Asthma concerns me. I’ve had many close friends and family suffer with the disease. In fact, a very good friend died of an attack while in medical school, because he didn’t have his inhaler with him. In other words, this is somewhat personal. I’ve probably given more lectures on asthma than any other topic over the years, and I can say without hesitation that relative to how much we know about its prevention and treatment, I can’t think of another disease where we underperform as much as with asthma management. According to data from the National Institutes of Health, over the last few decades the death rate has increased by over 55%. The prevalence rate has increased by 75%, and among African-Americans the hospitalization rate has increased over 35%. The good news is asthma can be controlled and effectively treated. In this primer, we’ll discuss quick tips to improve the health of the asthmatic in your life.
The encouraging thing about asthma is that if you understand what causes it, you understand how to treat it. Here’s what you need to know about what causes asthma. For the purposes of discussion I am simplifying matters for general consumption.
asthma

  • Asthma is a result of certain triggers, causing inflammation to your airways over a long period of time with the occurrence of attacks (intermittent exacerbations). These triggers can be thought of as allergens. Examples of these triggers include cigarette smoke, dust, aerosols, cold air, long-haired animals (especially cats), seasonal pollens, and exercise (in some).
  • These triggers create a state of inflammation and hyperresponsiveness in the lungs, leading to the excessive production of mucus within the lungs’ various airway branches. If bad enough this will lead to complete obstruction of the airways. In other words you’ll stop breathing, and you will die without assistance and/or reversal.
  • Exacerbation of asthma include breathlessness, chest tightness, coughing, and wheezing. Basically, because you have the functional equivalent of snot in your lungs, your airways are narrowed, and you’re having difficulty breathing. After all, it’s harder to breathe snot than air. Now imagine how your lungs feel when you’re adding cigarette smoke to that mix.

Asthma Symptoms Word Circle Concept with great terms such as coughing wheezing and more.
Let’s get logical. Asthma management is theoretically straightforward if you can pull it off. Prevention is treatment. I used to describe this as “Kill the Cat.” (This blog neither supports, advocates, nor is responsible for the harming of any animals resulting from this information.) In short, if you identify the triggers that precipitate your asthma attacks and then remove yourself from that environment, you will dramatically reduce, if not eliminate, your attacks. This is often described (incorrectly) in kids as “growing out of their asthma.” No one grows out of it, and you don’t cure asthma; asthmatics just stop having attacks because they’re not around the triggers.
In Part II, we discuss asthma management. In case you’re wondering, that’s where the toothpicks come in.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

From the SterlingMedicalAdvice.com Health Library: “My Doctor Said I Was a High-Risk Asthmatic. What Does That Mean?”

asthmarisk

If you have an asthmatic in your life, it’s important to know that asthmatics die.  The risk of death is higher in certain asthmatics. If you or your loved one is in this subset of asthmatics, you really must be diligent in avoiding those triggers that cause asthma attacks. You must also be attentive and consistent in taking your ‘controller’ medicines.
These circumstances define a high risk asthmatic:

  • A history of sudden severe asthma attacks
  • Prior need to be intubated (placed on a respiratory aka breathing machine)
  • Prior admission to a hospital ICU (intensive care unit)
  • Greater than one admission or two ER visits in the past year
  • An ER visit within the last month
  • Needing to use two or more inhalers per month
  • Current or recent oral steroid use
  • Illicit drug use
  • Concomitant cardiopulmonary or psychosocial disease

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Tips to Limit Your Risk of Contracting The Most Deadly Diseases

early-death-pair

It is interesting and, even more, curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.

Health_hazards

According to the Center for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Cancer warrants a special comment to get screened! Early detection is the key to survival!

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

asthmarisk

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog
Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

risk

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 2 of 2)

asthma_treatments_496958

As we move into discussing asthma treatment, remember that asthmatics die at an alarming rate.  I mentioned yesterday (and it bears repeating) that death rates have increased over 50% in the last few decades.  If you’re an asthmatic, avoid taking care of yourself at your own peril.  Your next asthma attack could be your last.
The other thing to remember is that asthma is a reversible disease – until it’s not.  At some point (beginning somewhere around age 35 or so), the ongoing inflammation and damage to the lungs will create some irreversible changes, and then the situation’s completely different, possibly predisposing asthmatics to other conditions such as chronic bronchitis, COPD (chronic obstructive pulmonary disease) and lung cancer.  This simply reiterates the importance of identifying and removing those triggers.
Given that, let’s talk about asthma control as treatment.  Consider the following quick tips you might use to help you reduce or virtually eliminate asthma attacks:

asthmatriggers

  • Avoid cigarette smoke (including second hand smoke) like the plague!
  • Avoid long haired animals, especially cats.
  • Avoid shaggy carpets, window treatments or other household fixtures that retain dust.
  • If you’re spraying any kind of aerosol, if it’s allergy season, if you’re handling trash, or if you react to cold weather, wear a mask while you’re doing it.  It’s better to not look cool for a few moments than to have to look at an emergency room for a few hours or a hospital room for a few days.
  • Be careful to avoid colds and the flu.  Get that flu shot yearly.

If and when all of this fails, and you’re actually in the midst of an asthma attack, treatment options primarily center around two types of medications.

AsthmaHispanic

  • Short (and quick) acting bronchodilators (e.g. albuterol, ventolin, proventil, xopenex, alupent, maxair) functionally serve as props (‘toothpicks’, no not real ones, and don’t try to use toothpicks at home) to keep the airways open against the onslaught of mucous buildup inside the lungs combined with other inflammatory changes trying to clog the airways.  These medications do not treat the underlying condition.  They only buy you time and attempt to keep the airways open for…
  • Steroids (e.g. prednisone, prelone, orapred, solumedrol, decadron – none of which are the muscle building kind) are the mainstay of acute asthma treatment, as they combat the inflammatory reaction and other changes that cause the asthma attack.  One can functionally think of steroids as a dump truck moving in to scoop the snot out of the airways.  The only issue with the steroids is they take 2-4 hours to start working, so you have to both get them on board as early as possible while continuing to use the bronchodilators to stem the tide until the steroids kick in.

asthma-inhaler-techniques-15-638
If you are not successful in avoiding those triggers over the long term, you may need to be placed on ‘controller’ medications at home, which include lower doses of long-acting bronchodilators and steroids.
So in summary, the best treatment of asthma is management of its causes.  Avoid the triggers, thus reducing your acute attacks.  Become educated about signs of an attack.  When needed, get help sooner rather than later.  And always keep an inhaler on you.  It could be the difference between life and death.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress
 

From the SterlingMedicalAdvice.com Health Library: “My Doctor Said I Was a High-Risk Asthmatic. What Does That Mean?”

asthmarisk

If you have an asthmatic in your life, it’s important to know that asthmatics die.  The risk of death is higher in certain asthmatics. If you or your loved one is in this subset of asthmatics, you really must be diligent in avoiding those triggers that cause asthma attacks. You must also be attentive and consistent in taking your ‘controller’ medicines.
These circumstances define a high risk asthmatic:

  • A history of sudden severe asthma attacks
  • Prior need to be intubated (placed on a respiratory aka breathing machine)
  • Prior admission to a hospital ICU (intensive care unit)
  • Greater than one admission or two ER visits in the past year
  • An ER visit within the last month
  • Needing to use two or more inhalers per month
  • Current or recent oral steroid use
  • Illicit drug use
  • Concomitant cardiopulmonary or psychosocial disease

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 1 of 2)

 

asthmaBasics-enHD-AR1

Asthma concerns me. I’ve had many close friends and family suffer with the disease. In fact, a very good friend died of an attack while in medical school, because he didn’t have his inhaler with him. In other words, this is somewhat personal. I’ve probably given more lectures on asthma than any other topic over the years, and I can say without hesitation that relative to how much we know about its prevention and treatment, I can’t think of another disease where we underperform as much as with asthma management. According to data from the National Institutes of Health, over the last few decades the death rate has increased by over 55%. The prevalence rate has increased by 75%, and among African-Americans the hospitalization rate has increased over 35%. The good news is asthma can be controlled and effectively treated. In this primer, we’ll discuss quick tips to improve the health of the asthmatic in your life.
The encouraging thing about asthma is that if you understand what causes it, you understand how to treat it. Here’s what you need to know about what causes asthma. For the purposes of discussion I am simplifying matters for general consumption.
asthma

  • Asthma is a result of certain triggers, causing inflammation to your airways over a long period of time with the occurrence of attacks (intermittent exacerbations). These triggers can be thought of as allergens. Examples of these triggers include cigarette smoke, dust, aerosols, cold air, long-haired animals (especially cats), seasonal pollens, and exercise (in some).
  • These triggers create a state of inflammation and hyperresponsiveness in the lungs, leading to the excessive production of mucus within the lungs’ various airway branches. If bad enough this will lead to complete obstruction of the airways. In other words you’ll stop breathing, and you will die without assistance and/or reversal.
  • Exacerbations of asthma include breathlessness, chest tightness, coughing, and wheezing. Basically, because you have the functional equivalent of snot in your lungs, your airways are narrowed, and you’re having difficulty breathing. After all, it’s harder to breathe snot than air. Now imagine how your lungs feel when you’re adding cigarette smoke to that mix.

Asthma Symptoms Word Circle Concept with great terms such as coughing wheezing and more.
Let’s get logical. Asthma management is theoretically straightforward if you can pull it off. Prevention is treatment. I used to describe this as “Kill the Cat.” (This blog neither supports, advocates, nor is responsible for the harming of any animals resulting from this information.) In short, if you identify the triggers that precipitate your asthma attacks and then remove yourself from that environment, you will dramatically reduce, if not eliminate, your attacks. This is often described (incorrectly) in kids as “growing out of their asthma.” No one grows out of it, and you don’t cure asthma; asthmatics just stop having attacks because they’re not around the triggers.
In Part II, we discuss asthma management. In case you’re wondering, that’s where the toothpicks come in.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Most Frequent Causes of Death and How to Avoid Them

early-death-pair

It is interesting and curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.
According to the Centers for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

  • Heart disease (e.g., heart attack): 597,689
  • Cancer (all cases): 574,743
  • Chronic lower respiratory diseases (e.g., asthmaCOPDemphysemachronic bronchitis): 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Please get screened! Early detection is the key to survival.

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

COPDer

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog

Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokeslearn CPRget screened for cancer and learn how to survive car crashes. It’s not that hard if you’re actually trying.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Tips to Limit Your Risk of Contracting The Most Deadly Diseases

early-death-pair

It is interesting and, even more, curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.

Health_hazards

According to the Center for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

  • Heart disease (e.g., heart attack): 597,689
  • Cancer (all cases): 574,743
  • Chronic lower respiratory diseases (e.g., asthma, COPD, emphysema, chronic bronchitis): 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Cancer warrants a special comment to get screened! Early detection is the key to survival!

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

asthmarisk

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog
Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

risk

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Most Frequent Causes of Death and How to Avoid Them

early-death-pair

It is interesting and curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.
According to the Centers for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

  • Heart disease (e.g., heart attack): 597,689
  • Cancer (all cases): 574,743
  • Chronic lower respiratory diseases (e.g., asthma, COPD, emphysema, chronic bronchitis): 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Please get screened! Early detection is the key to survival.

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

COPDer

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog

Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard if you’re actually trying.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Tips to Limit Your Risk of Contracting The Most Deadly Diseases

early-death-pair

It is interesting and, even more, curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.
According to the Center for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

  • Heart disease (e.g., heart attack): 597,689
  • Cancer (all cases): 574,743
  • Chronic lower respiratory diseases (e.g., asthma, COPD, emphysema, chronic bronchitis): 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Cancer warrants a special comment to get screened! Early detection is the key to survival!

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

asthmarisk

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog
Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: When the Patient Knows Better

drptnt2

So … your friendly neighborhood ER physician chats with a patient.

Client: “Doc, I’m sick. I need my asthma medicine. I need steroids, an inhaler and some antibiotics.”
Expert: “Oh really. How do you know that?”
Client: “Oh, I get the same thing this time every year.”
Expert: “Hmm. Same time every year, huh? Would you mind telling me your symptoms first?”
Client: “Cough, chest tightness, wheezing. I’m telling you. Same thing every year.”
Expert: “Have you gotten your flu shot this year?”
Client: “I haven’t had the flu shot since 2005, but I’m going to get it in January. But this is my asthma! C’mon, Doc. I just need my antibiotics and my asthma medicine.”
Expert: “There’s an adage in medicine that has been proven true a million times over. A physician that treats himself has a fool for a patient. Now, if physicians won’t treat themselves …”
If I’ve heard it once, I’ve heard it a million times.

  • “I know my body.”
  • “I’ve had the exact thing before.”
  • “I read it on the Internet.”
  • “I had a friend with the same thing.”
  • “I just want to make sure.”
  • “Well you have to do something, don’t you?”

Medicine is a science. By that, I mean a real science made of facts—not opinions, educated guesses or perspectives. There are seemingly a million paraprofessionals and incredibly intelligent people on the periphery of healthcare who have what we describe as an “experience base.” That means they “know” it because they’ve seen it or just read it. That is completely different than a knowledge base. Physicians have completed between seven and 10 years after undergrad learning, understanding and mastering the human body. What does that mean to you? Basically, the methodology for practicing medicine is not the linear A+B=C (i.e., “I have this symptom, therefore it must be this disease”).
Yes, this applies to you. Even you, dear “I know my body better than you do” reader. When you tell your physician that you’ve seen or experienced something before, you’re basically suggesting your sample size of one defines the entire universe of medicine. Even as it applies to you, the body is a wondrously complex creation with many, many variables affecting a single breath or heartbeat.
So, when your physician is telling you something different than what you believe or expect to hear about your condition, it’s not that s/he isn’t listening to you. It’s that s/he has listened to you and has come to a different determination. That’s why physicians have the power to write prescriptions, and you (and even pharmacists) don’t.
Of course, none of this is to say that your input isn’t valuable. It is valuable, and that’s why the physician asks you the questions. This is not even to say that physicians don’t make mistakes. This is to challenge you to allow the conversation to occur. Ask your own questions. Demand an explanation from your caregiver. Insist on being part of the care team and a partner in your treatment plan. Learn what to look for, what you can do at home and what should prompt additional measures. If you are stuck on a course of treatment before the conversation occurs, it is just as pointless as if a physician refuses to listen to your concerns.
Cut your physicians some slack. Many of you get so frustrated and outright angry when you don’t get your way. Physician’s offices and emergency rooms are not grocery stores. It’s not as if docs own the pharmaceutical company or the hospital. They’re just trying to care for you as best they can. As much as physicians love to provide satisfaction to patients, caring for you appropriately is of a higher order. Many of you understand this, and as such physicians continue to have among the highest rating of “trust” among professionals. It’s a privilege to take care of patients. The overwhelming majority of us still understand that fact.
Postscript: It was the flu.
PPS: A little advice from a friendly online SMA expert might have saved her the trip to the ER.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
 

From the Health Library of SterlingMedicalAdvice.com: "My doctor said I was a high-risk asthmatic. What does that mean?"

asthmarisk

If you have an asthmatic in your life, it’s important to know that asthmatics die.  The risk of death is higher in certain asthmatics. If you or your loved one is in this subset of asthmatics, you really must be diligent in avoiding those triggers that cause asthma attacks. You must also be attentive and consistent in taking your ‘controller’ medicines.
These circumstances define a high risk asthmatic:

  • A history of sudden severe asthma attacks
  • Prior need to be intubated (placed on a respiratory aka breathing machine)
  • Prior admission to a hospital ICU (intensive care unit)
  • Greater than one admission or two ER visits in the past year
  • An ER visit within the last month
  • Needing to use two or more inhalers per month
  • Current or recent oral steroid use
  • Illicit drug use
  • Concomitant cardiopulmonary or psychosocial disease

For more on asthma from Straight, No Chaser, click here and here.

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Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 1 of 2)

asthma
Asthma concerns me. I’ve had many close friends and family suffer with the disease. In fact, a very good friend died of an attack while in medical school, because he didn’t have his inhaler with him. In other words, this is somewhat personal. I’ve probably given more lectures on asthma than any other topic over the years, and I can say without hesitation that relative to how much we know about its prevention and treatment, I can’t think of another disease where we underperform as much as with asthma management. According to data from the National Institutes of Health, over the last few decades the death rate has increased by over 55%. The prevalence rate has increased by 75%, and among African-Americans the hospitalization rate has increased over 35%. The good news is asthma can be controlled and effectively treated. In this primer, we’ll discuss quick tips to improve the health of the asthmatic in your life.
The encouraging thing about asthma is that if you understand what causes it, you understand how to treat it. Here’s what you need to know about what causes asthma. For the purposes of discussion I am simplifying matters for general consumption.

  • Asthma is a result of certain triggers, causing inflammation to your airways over a long period of time with the occurrence of attacks (intermittent exacerbations). These triggers can be thought of as allergens. Examples of these triggers include cigarette smoke, dust, aerosols, cold air, long-haired animals (especially cats), seasonal pollens, and exercise (in some).
  • These triggers create a state of inflammation and hyperresponsiveness in the lungs, leading to the excessive production of mucus within the lungs’ various airway branches. If bad enough this will lead to complete obstruction of the airways. In other words you’ll stop breathing, and you will die without assistance and/or reversal.
  • Exacerbations of asthma include breathlessness, chest tightness, coughing, and wheezing. Basically, because you have the functional equivalent of snot in your lungs, your airways are narrowed, and you’re having difficulty breathing. After all, it’s harder to breathe snot than air. Now imagine how your lungs feel when you’re adding cigarette smoke to that mix.

Let’s get logical. Asthma management is theoretically straightforward if you can pull it off. Prevention is treatment. I used to describe this as “Kill the Cat.” (This blog neither supports, advocates, nor is responsible for the harming of any animals resulting from this information.) In short, if you identify the triggers that precipitate your asthma attacks and then remove yourself from that environment, you will dramatically reduce, if not eliminate, your attacks. This is often described (incorrectly) in kids as “growing out of their asthma.” No one grows out of it, and you don’t cure asthma; asthmatics just stop having attacks because they’re not around the triggers.
In Part II, we discuss asthma management. In case you’re wondering, that’s where the toothpicks come in.
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Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 2 of 2)

As we move into discussing asthma treatment, remember that asthmatics die at an alarming rate.  I mentioned yesterday (and it bears repeating) that death rates have increased over 50% in the last few decades.  If you’re an asthmatic, avoid taking care of yourself at your own peril.  Your next asthma attack could be your last.
The other thing to remember is that asthma is a reversible disease – until it’s not.  At some point (beginning somewhere around age 35 or so), the ongoing inflammation and damage to the lungs will create some irreversible changes, and then the situation’s completely different, possibly predisposing asthmatics to other conditions such as chronic bronchitis, COPD (chronic obstructive pulmonary disease) and lung cancer.  This simply reiterates the importance of identifying and removing those triggers.
Given that, let’s talk about asthma control as treatment.  Consider the following quick tips you might use to help you reduce or virtually eliminate asthma attacks:

  • Avoid cigarette smoke (including second hand smoke) like the plague!
  • Avoid long haired animals, especially cats.
  • Avoid shaggy carpets, window treatments or other household fixtures that retain dust.
  • If you’re spraying any kind of aerosol, if it’s allergy season, if you’re handling trash, or if you react to cold weather, wear a mask while you’re doing it.  It’s better to not look cool for a few moments than to have to look at an emergency room for a few hours or a hospital room for a few days.
  • Be careful to avoid colds and the flu.  Get that flu shot yearly.

If and when all of this fails, and you’re actually in the midst of an asthma attack, treatment options primarily center around two types of medications.

  • Short (and quick) acting bronchodilators (e.g. albuterol, ventolin, proventil, xopenex, alupent, maxair) functionally serve as props (‘toothpicks’, no not real ones, and don’t try to use toothpicks at home) to keep the airways open against the onslaught of mucous buildup inside the lungs combined with other inflammatory changes trying to clog the airways.  These medications do not treat the underlying condition.  They only buy you time and attempt to keep the airways open for…
  • Steroids (e.g. prednisone, prelone, orapred, solumedrol, decadron – none of which are the muscle building kind) are the mainstay of acute asthma treatment, as they combat the inflammatory reaction and other changes that cause the asthma attack.  One can functionally think of steroids as a dump truck moving in to scoop the snot out of the airways.  The only issue with the steroids is they take 2-4 hours to start working, so you have to both get them on board as early as possible while continuing to use the bronchodilators to stem the tide until the steroids kick in.

If you are not successful in avoiding those triggers over the long term, you may need to be placed on ‘controller’ medications at home, which include lower doses of long-acting bronchodilators and steroids.
So in summary, the best treatment of asthma is management of its causes.  Avoid the triggers, thus reducing your acute attacks.  Become educated about signs of an attack.  When needed, get help sooner rather than later.  And always keep an inhaler on you.  It could be the difference between life and death.
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