Tag Archives: Behind the Curtain

Concussions, Part I

tbi basics

It’s probably not a coincidence that National Traumatic Brain Injury Awareness Month occurs at the same time as the onset of the NFL season in the U.S. However, it’s also important to appreciate that traumatic brain injuries (TBIs) don’t only occur in the setting of professional sports. Regarding sports, the really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing, or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame, and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.

concussion

A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes, ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia. (It’s important to note that not all blows to the head result in a TBI.) For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contribute to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.

tbi traumatic-brain-injury-chart

Healthcare professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

  • Thinking/remembering
  • Physical
  • Emotional/mood
  • Sleep

tbi brain-injury-awareness

Red Flags
Here’s what you need to know today. Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

  • Any difficulty waking
  • Any loss of consciousness, confusion, or significant agitation
  • One pupil (the black part in the middle of the eye) larger than the other
  • Loss of ability to identify people, places, the date, or self
  • Loss of motion or sensation, weakness, numbness or loss of coordination
  • Persistent, worsening headache
  • Repeated vomiting
  • Slurred speech or difficulty with expression
  • Seizures
  • Kids will not stop crying and cannot be consoled
  • Kids will not nurse or eat

We’ll continue the conversation about concussions in part two.
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, 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!
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The Other Side of 40 – The Cerebrovascular System (Your Brain) – Changes, Challenges, Solutions

brain-alive

Last but not least, in the last part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
brainaging
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.

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, 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 SNC! 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.
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The Other Side of 40 – The Cardiopulmonary (Heart and Lungs) System – Changes, Challenges, Solutions

The fourth part of this series looks at your heart and lungs.

And now to today’s post.

One thing the heart and lung share in common is, left to their own devices, they could function normally for much longer than typically ends up occurring. It’s important to discuss because heart disease is the most common cause of death in people 65 and over, and it is also the most frequent cause of activity limitations. Let’s quickly review changes, challenges and solutions.

agingheart
Heart Changes: Coronary artery disease increases as your activity declines. Blockages accumulate on the inside of your arteries, and they harden as they lose their elasticity. Both of these factors resulting in lessened blood flow. High blood pressure increases with age, independently and as a result of this.
aginglungs
Lung Changes: The air sacs, airways, and tissues lose elasticity and become more rigid with age. In general however, serious disease notwithstanding, the respiratory system can serve one well throughout a very long life. However, if you’re a smoker or have lung disease (e.g. asthma, COPD), the reversible damage to the lungs starts becoming irreversible about age 35. At that time, you in effect begin tearing out useful lung tissue, which diminishes your respiratory capacity and sets you up for chronic bronchitis and cancer, as the body attempts to repair this damage and does so incorrectly.
Challenges: In the absence of structural disease or continuing to expose yourself to toxins (e.g. cigarettes), the effects of these changes on our health status need not be severe. The social implications of the effects of normal changes due to aging often would not hamper reasonable normal functioning. The real challenge is to avoid inhaling toxins that will harm you (duh, right?).
Solutions: This is much simpler than you’d think and mostly involves prevention. The biological changes can be greatly diminished and held off by a regular, strenuous exercise regimen that causes deep breathing and elevation of your heart rate over a period of time and by avoidance of toxins, especially cigarette smoke and fatty foods. Your heart and lungs are well situated for the long haul in the absence of bad genes and bad habits.

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, 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 SNC! 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.
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Straight, No Chaser: The Other Side of 40 – The Genital System – Changes, Challenges, Solutions

sexaging
The third part of this series is about your genital system after 40. There’s a lot here both for the ladies and the gentlemen, but everyone should want to know all the information provided. As before, I’m going to go through changes – challenges – solutions. I welcome any questions or comments.
Prologue: Sex is good for your long-term genital and mental health. I can’t think of a better, more sexy application of the truism ‘knowledge is power’. Men, feel free to discuss this with your ladies. Ladies, I promise you I’m not being biased here (wink).
Changes: Allow me to start with the most important point: sexuality is not truly an issue of aging as much as it is more an issue of education, psychological response and health. However some changes specific to the genital system do occur with aging. In men, the prostate may enlarge (does so in 50% of men at age 50), potentially causing frequent and urgent needs to urinate and difficultly holding urine. However, more changes occur in women than in men. In women, the uterus shrinks, and several changes occur in the vagina, resulting in decreased lubrication and elasticity being lost.
repro
Challenges: The challenges here are interesting ones. Simple rules to better genital health – Women: Stay sexually active! Men: Be confident in your sexual stamina! It is important to understand that the changes that occur in the genital system are not as related to age as they are to one’s sense of sexuality. The physical changes in the genital system should be non-problematic, especially if sex has been occurring without long periods of abstinence.
Venus Challenges: On the female side, the physical changes all can be dealt with if the woman has maintained some regular level of sexual activity. Yes, genital responses to stimulation slow gradually in both men and women, but you can have normal sexual relations at any age, as long as you are healthy. If after the age of about 40, a woman abstains from intercourse for prolonged periods (such as 3 to 5 years) the ability to secrete lubricating fluids, and much of the elasticity of the vagina are permanently lost.
Mars Challenges: On the male side, a particularly annoying challenge for some men with prostate enlargement is to avoid self-wetting. The even greater challenge is (not believing, but) ‘knowing’ your sexual prowess and stamina are still intact, particularly if dealing with an intimidating female partner (e.g. better conditioned, more adventurous or perhaps younger). For males, premature ejaculation and impotence are dramatically reduced in men when they become legitimately confident in their sexual skills set. Work on that! Women, feed your men confidence! It will come back to you!
Venus Solutions: Masturbation can effectively help to maintain female capabilities to provide lubrication and elasticity, especially if object insertion is included. Since most research shows that less than 50% of women practice object insertion during masturbation, these women who also abstain from intercourse lose some vaginal elasticity, even with regular masturbation. In the event that the woman has been sexually abstinent for a period of 3 to 5 years or more, the use of K-Y Jelly or some other non-alcoholic, non-petroleum lubricant specifically designed for compatibility with the chemistry of the vagina may sufficiently reduce discomfort in sexual intercourse.
Mars Solutions: Remember that most sexual problems are social/psychological problems, and they occur at all ages. Men: work on learning what’s necessary to give you confidence, and better performance will follow. For some it’s a certain partner, for others it’s a pill. Do not underestimate this point: if you’re otherwise healthy, that enhances your ability to perform sexually! It’s all about blood flow anyway.
Solutions Epilogue: The main solution to age-related issues of the genitalia are all within your reach (no pun intended): it’s all about activity, especially continued regular sexual activity, exercise, good nutrition and other healthy habits.
Post-script: Petroleum products such as baby oil and vaseline must never be put in or on the vagina, as they will upset the pH balance of the vagina, making it susceptible to yeast infections and other problems like BV (bacterial vaginosis).

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!
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Straight, No Chaser: The Other Side of 40 – The Musculoskeletal System – Changes, Challenges, Solutions

The second part of this series on how your body changes with age is about your muscles. This section combined with the previous skin section explains why you wrinkle. As before, I’m going to go through system – changes – challenges – solutions. If you’re keeping score, especially focus on the take home messages within solutions. I welcome any questions or comments.
Changes: Did you know that muscle cells are unable to replace themselves once they are formed? Therefore, muscle cell loss is permanent. Plus, muscular response gradually slows with age. That said, the loss of muscular capabilities over time is by far the result of cell loss due to inactivity. As muscle cells are lost, weakness and slowness increase. Plus, some of you don’t exercise at all, or as much/vigorously as you used to, so you’re not building up anything new.
Challenges: The effects of these changes on our health status are mostly due to the fact that the muscles are the main tools for effecting strong circulation throughout the body (i.e. muscular contraction pushes blood around). As the muscles become smaller, including the muscles in the face, and as fat tissue accumulates, including in the face, the entire appearance changes to that of an older person, with all the ramifications described in the post on the description of skin changes with aging. In addition, as muscle fibers decrease, weaken, and slow, it becomes increasingly difficult to keep up with younger people, who may make allowances, but who may also become avoidant. Your recognition of this creates a vicious cycle, and you eventually settle into ‘being old’.
Physical Therapist Working with Patient
Solutions: In two words – exercise & activity. A well designed, consistently followed exercise program addressing both strength and response is indispensable for the maintenance of muscle cells, and of good health over time. A personal trainer is a pretty good idea after a certain age. You neither need to under nor overdo your weight lifting regimen. In any event, move those muscles as much as you can, whether via walking, yoga, running or sex. Being a couch potato is never a good thing.
Post-scripts:

elderly-couple-stretching

  • Another thing that very few of us do is stretch. Those old muscles are tight, and the tendons/ligaments are short and ready to pop. You really must stretch before your weekend warrior events or most any big exertional activity. That’s a big part of why yoga promotes longevity.
  • Fortunately, the main muscles of the heart and the diaphragm (your breathing muscle) do not lose muscle fibers with age because they are continually active. Yet, your heart and lungs have their own problems besides the muscles. That topic is forthcoming. All that said, be mindful that through ongoing exercise and training, you can stem the tide on these changes.

Young is as young does.

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.
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Straight, No Chaser: The Other Side of 40 -The Skin – Changes, Challenges, Solutions

September is Healthy Aging Month. A big part of healthy aging is prior healthy living, particularly as you reach the age at which your unhealthy habits begin to catch up with you or otherwise naturally aging processes begin to demonstrate themselves emphatically. Being on the other side of 40 is an exercise in self-reflection and understanding of limitations previously not existent. I’m still pushing the rock up the mountain, but I’ve seen the challenges of maintaining and continuing to advance. This is a lot to digest, so I’m going to go through five different body systems this week in a simple way: system – changes – challenges – solutions. If you’re keeping score, especially focus on the take home messages within solutions. And don’t be depressed! Forewarned is forearmed. Take action! I welcome any questions or comments.

Part 1/5: Your Skin

Changes: As the skin ages, blood flow to the skin is decreased, and nerve endings are lost or become less sensitive. As a result, the skin loses some of its effectiveness as a protector against bacteria, as an insulator, as a heat/cold regulator, and as a sensory receptor. These losses cause wrinkling, loss of elasticity, freedom of movement, and expression are inhibited. The slowing of circulation results in slower healing. The loss of color is also seen, as the hair becomes gray.
Challenges: The skin generally functions well throughout life though, and most changes in the skin due to aging are not life threatening. Most of the damaging changes in the skin are cosmetic. The drying and thinning result in sagging and wrinkling, the hair becomes sparser and gray or white, and the fingernails become rigid, tend to yellow, and are prone to splitting. Skin disorders more common in the aging skin include enhanced itching, thickening in patches, skin cancer, ulcers/pressure sores, and herpes zoster (shingles). These effects bring social implications based on a significant cultural tendency toward ageism. One’s social life becomes more limited as younger people view elders as “not fun”, “slow”, “grumpy”, less desirable as friends and sexual partners, and so on. These views spill into the workplace or what might be a potential workplace, as one who looks “old” is not considered as having ‘much’ to offer.
Solutions: Two words: hydrate and moisturize. Avoid excessive exposure to the sun, maintain moisture in the skin, provide adequate nutrition so that the skin can be maintained and repaired, and get regular exercise to maintain circulation in the skin. Sounds simple, but we really fail to adhere to this consideration. Many of these changes can be delayed for very long periods of time.
Post-Script: I would be remiss if I didn’t point out that those of you of all races and ethnicities must be diligent in getting rapidly growing or changing moles evaluated. It is an untruth that Blacks and Browns don’t get skin cancer.
Post-Post-Script: Ever imagine what effect holding a cigarette up to your face for decades has?  Here’s a depiction.

agesmoke

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.
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Straight, No Chaser: Arthritis – Response to Reader Question

 knucklescrack

 

Does joint cracking cause Arthrtis?

I actually understand the question. You would think all that snap, knuckle and pop would represent bad things happening to your bones, and over time, it could cause damage to the joints. Fortunately this isn’t what is happening.
Basically manipulation of the joint space when you’re attempting to crack your knuckles or other joints creates a vacuum within the (synovial) fluid that bathes the joint. The air within that vacuum can result in the characteristic popping sounds you hear when further manipulation occurs, disrupting that air pocket. In other instances, popping sounds from the joints can be the result of the snapping of tendons. This latter consideration is more likely as you age, with narrowing of joint spaces and stiffening of tendons that already occur.

knucklespop

Here’s what you need to be concerned about: pain when your knuckles pop. Generally, the absence of pain suggests that you’re not harming anything of note. Conversely, the presence of pain suggests a problem potentially exists that requires evaluation. These problems could represent the following:

  • Arthritis
  • Bursitis: inflammation of the small, fluid-filled sac that cushions bone as they move across other moving body parts, such as muscles, skin or tendons
  • Tendonitis: inflammation of the tissue that connects muscle to bone

knucklepop

So regarding the question of does cracking your knuckles cause arthritis, it’s a pretty simple “no.” With any luck, you’ll just have to wait to age for that to happen!

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.
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Straight, No Chaser: Arthritis – Prevention & Treatment

arthritis

The thing about treating arthritis is you’d better do it. If you’re not lucky enough to have a form that readily responds to treatment or if you didn’t get early treatment, your arthritis will progress and create an incrementally worse situation for you. Given that we’re discussing arthritis, we’re talking loss of mobility somewhere, maybe in your legs or hands, and pain.
The goal of treatment is to reduce pain, improve function, and prevent further joint damage. The underlying cause often cannot be cured.
Treatment considerations for arthritis fall into three general categories: lifestyle changes, medication and surgery. Let’s review each.
arthritisrx
Lifestyle
The best time to enact lifestyle changes is before you’re struggling to return to normalcy. Exercise is a lifelong habit that will improve the quality and extend the quantity of your life. For starters, exercise maintains and improves muscle tone. It also strengths your bones and cartilage. This will reduce pain, fatigue and stiffness over the long-term.
Exercise should include a tolerable level of aerobic activity, flexibility exercises to sustain your range of motion and strength training to maintain and improve your muscle tone. Physical therapy is another component; massage, heat and ice application, splints and other treatments are important in maintaining blood flow, mobility and positioning as stiffness and deformity increase over time.
Medication
Using medication for arthritis is a very delicate act. Many if not most arthritics are aging and may have other medical issues. Medications in these settings have risks for side effects and drug interactions, including kidney, liver and heart damage, stroke, ulcers and bleeding. Any medications should be coordinated with your physician. Typical over-the-counter (OTC) medical regimens begin with acetaminophen, then move to NSAIDs (non-steroidal anti-inflammatory agents such as ibuprofen, aspirin or naproxen).
When OTCs don’t work, your doctor may prescribe medicines, including steroids and other medications called biologics, immunosuppressants and DMARDs (disease-modifying anti-rheumatic drugs). These drugs all are effective in certain patients but can have serious side effects.

arthritis surgery

Surgery
Surgery is an option if and when other therapies haven’t worked and if the patient is healthy enough to have it. There are two primary options. Arthroplasty rebuilds the joint, and joint replacement starts from scratch.
Let’s start back where I’ll always hope you start: prevention. Here are some lifestyle change tips for holding off the onset of arthritis or slowing down its advance.

  • If you are overweight, do what you can to slim down. Weight loss significantly reduces joint pain in the legs and feet.
  • Eat a healthy diet full of fruits and vegetables. Among other things, a rich supply of vitamin E yields benefits you’ll need. Also eat foods rich in omega-3 fatty acids (e.g., salmon, mackerel, herring, flaxseed, canola oil, soybeans and soybean oil, pumpkin seeds, and walnuts).
  • Sleeping eight to 10 hours a night and taking naps during the day can help you both prevent and recover from flare-ups more quickly.
  • Avoid staying in one position for too long.
  • Try stress-reducing activities, such as meditation, yoga or tai chi.
  • Avoid positions or movements that place extra stress on your sore joints.
  • Change your home to make activities easier (e.g., grab bars in the shower, the tub, and near the toilet).
  • Consider capsaicin cream over your painful joints. Typically expect improvement after three to seven days if it’s going to help.

Old Man With Walking Stick Showing Aged 3d Character

If and when you develop arthritis, it’s going to be a tough time. Get ahead of the challenge and take care of yourself in advance. Feel free to ask questions or leave comments.

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: Arthritis – Symptoms & Causes

OA

Arthritis is one of a few different “inevitable” diseases humans have.  Today we’re discussing one form of Arthritis, specifically, degenerative joint disease (osteoarthritis). For this conversation, the inevitability of arthritis is based in the gradual wear and tear on your joints. It seems our design includes an expiration date on our joints. By now, you’re likely wondering why. The answer is in the definition.
osteoarthritisArthritis is inflammation of one or more of your joints.

  • Inflammation is a process of some form of attack to an area, producing symptoms that usually include redness, swelling, warmth and pain.
  • A joint is the area where two bones meet.

It stands to reason that when regular use becomes wear and tear, ongoing inflammation ensues, the structure of your bones and joints changes and function decreases. This is why you see decreased movement and deformities in the involved joints of arthritics.
What I just described was a reasonable description of osteoarthritis, the most common form of arthritis, but in fact there are over 100 different types of arthritis. Given its importance in helping you understand and treat yourself and/or your loved one with arthritis, let’s review the common and distinguishing mechanisms.
cartilage

Arthritis involves the breakdown of cartilage, which is the tissue coating the ends of two bones at a joint. Its purpose is to keep the bones in place and moving smoothly. When cartilage is damaged, the bones rub together. This damage results in pain, swelling, stiffness, warmth and redness—inflammation.
The causes of this inflammation are broad but typically center on four mechanisms:

  • The aging process itself causes sufficient wear and tear on the body, including bones and cartilage, such that the joints will suffer. This represents the most common form of arthritis: degenerative joint disease, aka osteoarthritis.
  • When you break bones, especially near a joint, the resulting damage and/or insufficient healing will expedite the development of arthritis.
  • When you develop certain infections, they can occur in the bones/joints or target those areas. This also can lead to arthritis.
  • The body’s immune system sometimes mistakenly views certain parts of the body as foreign. When this occurs, it will attack healthy tissue, including bones and cartilage. These conditions are known as autoimmune disorders, and they cause inflammation and can lead to acute and chronic arthritis.

OA

You’ve heard of many different forms of arthritis. If you know anyone with any of the following diseases, they likely have arthritis as part of (if not the predominant feature of) the disease.

  • Ankylosing spondylitis
  • Gonococcal (i.e., due to gonorrhea) arthritis and other arthritis due to other bacterial infections
  • Gout
  • Juvenile rheumatoid arthritis (in children) and rheumatoid arthritis (in adults)
  • Psoriatic arthritis
  • Reactive arthritis (Reiter syndrome)
  • Scleroderma
  • Systemic lupus erythematosus (SLE)

The inflammation and other symptoms usually go away if you can find and treat the cause. If it doesn’t go away, or if it goes untreated, chronic arthritis will develop.
Here are the various conversations you should have with your physician regarding arthritis:

  • “I have a family history of arthritis. Should I be concerned?”
  • “I have a newly swollen joint but didn’t strain or sprain anything.”
  • “All of a sudden my joint (or joints) have really started hurting.”
  • “My skin in my (knee, elbow or other joint) is very hot and very red.”
  • “I have arthritis, and now I’m having problems moving my joint.”
  • “I have arthritis, and the swelling is much worse.”
  • “I have arthritis, and my pain has lasted more than three days.”
  • “I have arthritis, and I have developed a fever plus my joints are really aching.”
  • “I have arthritis, and I seem to be losing weight.”

Next, I’ll discuss general treatment of arthritis and tips you can use to help yourself or your loved one with arthritis. I welcome any questions or comments you may have on this topic.

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.
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Straight, No Chaser: Cholesterol – What you should know.

cholerestor awareness month

Most people know just enough about cholesterol to be able to do something about it should they choose. Still, seventy-one million American adults have abnormally high cholesterol, but only one-third of that total has the condition appropriately managed. In observance of National Cholesterol Education Month, consider getting your cholesterol screened. Why, you might ask? A high blood cholesterol level is one of the main risk factors for heart disease and stroke—two leading causes of death and two diseases that can strike without warning. If you’re serious about being healthy, you have to consider maintaining normal cholesterol levels. This Straight, No Chaser answers some frequently asked questions about cholesterol and tells you what you need to know, what you need to do and how that can make a difference in your lives.
Just what is cholesterol?
cholesterol label
Cholesterol is a waxy, fat-like substance that your body needs to strengthen cell membranes and form steroids the body uses. Dietary cholesterol is mainly derived from animal fats.
How does cholesterol affect my health?

cholesterol MI CVA

When you have too much cholesterol in your blood, it can build up on the walls of your arteries and form blockages.

  • Blockage of arteries that supply the heart itself can lead to heart disease, including a heart attack.
  • Blockage of arteries that supply the brain can cause a stroke.
  • Blockage of arteries that supply the legs can cause peripheral artery disease.

Aren’t there different types of cholesterol? Is this important?

cholesterol hdl ldl

You will commonly hear of two types of cholesterol: LDL (the “bad” cholesterol) and HDL (the “good” cholesterol).

  • LDL cholesterol contributes to thick, hard substance known as plaque. Plaque can stiffen and clog arteries, resulting in reduced blood supply to the artery’s destination. This is called atherosclerosis and explains much of how hearts attack, strokes and peripheral artery disease develop.
  • HDL cholesterol helps remove LDL cholesterol from the arteries and carries it to the liver for elimination from the body. As such, it is protective against heart attacks and strokes; low HDL levels have been shown to increase the risk of heart disease.
  • It stands to reason that you want to maintain relatively higher HDL levels and lower LDL levels.

How do I lower the bad cholesterol?

Cholesterol-Education-Month-480x330

It’s all about diet, exercise and better choices (or if you like A-B-C, try “Avoid tobacco, Be more active, Choose good nutrition.”

  • Eating a healthy diet. If you remember to associate the word “saturated” with the word “fat”, remember this becomes easy. Saturated fats and trans fats tend to raise “bad” cholesterol levels (known as LDL), so avoid these. Polyunsaturated fats can actually lower blood cholesterol levels. Additionally, eating fiber also can help lower cholesterol (in addition to keeping your bowel movement more regular).
  • Exercising regularly. The Surgeon General recommends that adults engage in moderate-intensity exercise for 2 hours and 30 minutes every week. Check this Straight, No Chaser for what moderate-intensity exercise is.
  • Maintaining a healthy weight. Losing weight and keeping it off is likely to lower your cholesterol level. Being overweight or obese brings with it a strong probability that your cholesterol levels are elevated.
  • Not smoking. If you smoke, quit as soon as possible.

If your physician deems it necessary, cholesterol-lowering medications can be prescribed, but this is not a reasonable first approach.
cholesterol types
How do I increase the good cholesterol?

  • Exercising regularly (see above) is the single best way to increase your good (HDL) cholesterol levels. Moderate to vigorous aerobic exercise (e.g. via five 30-minute sessions each week) can increase HDL 5-10%
  • Lose weight: If you’re overweight or obese any amount of weight loss will help.
  • Stop smoking: Your HDL levels will increase by up to 20% after you quit smoking.
  • Eat healthy foods: Avoid trans fats and highly refined carbohydrates (e.g. white-flour products).
  • Consider medications: Specifically, niacin is the most effective HDL-raising medication available. If you’re obtaining it over-the-counter, please consult your physician or SterlingMedicalAdvice.com expert consultant regarding appropriate usage.

Do I need to get checked?

cholesterol-level

It’s a great idea for you to know your baseline cholesterol level. Get it checked. You will likely be advised to have more frequent checks if you are discovered to have any of the following:

  • Your total cholesterol is 200 mg/dL or higher.
  • You are a man older than age 45 or a woman older than age 50 it’s a must, although The National Cholesterol Education Program recommends that adults aged 20 years or older have their cholesterol checked every 5 years.
  • Your HDL cholesterol is lower than 40 mg/dL.
  • You have other risk factors for heart disease and stroke.

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.
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Straight, No Chaser: Lowering Your Risk for Infection

sneeze_in_arm

There are things you know, there are things you know but don’t really know, and there are still other things that you think you know that you don’t know at all. When it comes to colds and influenza (both or which are simple to understand, prevent and treat), all of the above apply.
Are you sickly or do you get colds more frequently than others? Respectfully, a big part of that is because you have habits that put you at risk. Common things happen commonly.

germs-on-hands

Of course this is not an actual photo, but it’s a good depiction of what’s happening. Simply put, most of the day, your hands are pretty disgusting. You handle money that’s been handed hundreds if not thousands of times and never cleaned. You grab handles and door knobs all day long. You cough and sneeze throughout the day, spewing germs into the air to be inhaled by others. And you spend time in the restroom. Your unclean hands contribute to many ailments, including colds, influenza, conjunctivitis (pink eye) and gastroenteritis (vomiting and diarrhea) and skin infections.
The important points are there are simple things you can do to lower your risk for infections. First, you have to stop assuming you know more than you do about basic hygiene and allow yourself to start practicing better habits. For example …

  • When you sneeze, do you sneeze into your hands or into the air around you? Please learn the habit covering your mouth and nose when you sneeze or cough by sneezing/coughing into your elbow and not your hands.
  • How often do you wash your hands? You must wash every time you begin to cook, before you eat, after you use the rest room, before you change a diaper and before you apply any topical medicine.
  • Have you ever noticed how much you keep your hands on parts of you that can become infected by doing so? Keep your hands out of your eyes, mouth and nose, and stop picking at your skin!

handwashing2

Yes, you wash your hands, but do you do so effectively and when you need to? Hand washing must be the easiest and most effective way to prevent disease. Let’s start with this: from now on, whatever you do to clean your hands, do it for twenty seconds. Of course, antimicrobial soap and water are what we all learned to do way back when. It works! If that’s not available, use hand sanitizer or disposable hand wipes. If that’s not available, just rinse your hands! Be sure to rub your hands vigorously during the process as if you’re trying to get someone off of your hands, because you are!

sneeze

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.
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Straight, No Chaser: Suicide – Crisis on Campus

Crisis_300x300

I  had the privilege of spending time at my alma mater addressing issues on behalf of students and mental health services. Among many other things discussed, I was shocked by the extent to which college suicides have become present on college campuses. I wonder when things changed. Isn’t college supposed to be the “best four years of your life?” It really doesn’t take much though to appreciate how this becomes the case.

PreventingSuicide2ndPageTop

Suicide is the second leading cause of death among college-age students in the United States and the third leading cause among those aged 15-24. There are approximately 1,100 deaths by suicide occurring in this age group each year. A recent study from Johns Hopkins and the University of Maryland went in-depth in surveying and analyzing why students may have thoughts on suicide. Here is a summary of some of the study’s findings:

  • 12% of those studied admitted that they had thought of committing suicide.
  • Of this group of 12%, approximately 25% of them said they had those thoughts repeatedly.
  • Depression and lack of social support appeared to be major factors contributing to thoughts of suicide.

depression_suicide_stats
If you actually think about it, college brings together a lot of risks for suicide.

  • Late adolescence and early adulthood represents the period of highest risk of developing a major psychiatric disorder.
  • The academic environment can be a stress-producing inferno for some, who may find themselves overwhelmed and feeling lost and as if they have nowhere to turn.
  • For many, the college experience represents the first time many are away from home and/or completely detached from the family and friends they’ve had their entire lives. Unless and until a sufficient new social network is established, levels of isolation can be overwhelming.
  • Even among those with social networks, the academic failure and any social rejection that may occur could be perceived by students as having life-long consequences, so much so that hopelessness and thoughts of suicide could set into a young adult’s mind.

Suicide-Rates-Among-College-Students

Practically, how might you consider the risk in any one individual? The presence of any of these risk factors should prompt implementation of a support system to counter feelings of suicide.

  • It shouldn’t be difficult to appreciate how the lack of social support is one of the most powerful predictors of persistent suicidal thoughts. Someone who expresses or has feelings of being unappreciated, unloved and uninvolved with family and friends should be considered at risk – even in the absence of any other risk factors.
  • A history of clinically diagnosed depression or other psychiatric diagnoses
  • The exposure to domestic violence (either witnessing or having been abused) in childhood
  • Having a mother with a history of clinical depression

There are many Straight, No Chaser posts that address suicide prevention, diagnosis and treatment.

Feel free to use the search box on the right for additional information.If you are a college student or a family member of a college student, you would do well to review your college’s support system and learn about services and support available for those in need of mental/behavioral health services. College should represent the beginning of one’s adult life, not the place where it ends.
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.
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Straight, No Chaser: What is MRSA? Causes, Prevention & Treatments

One of the things that’s changed a lot from when I first started practicing medicine is people show up every day to the emergency room for mosquito and spider bites.  The local news has done a number on you, as now everyone is afraid of MRSA.
Methicillin-resistant Staph Aureus (MRSA) is a bacterial infection that’s resistant to the penicillin family of drugs that we used for decades to treat many infections. Staph Aureus itself is a bacteria akin to flipping a light switch.  Normally, it resides within us (approximately 30% of us have it in our nostrils but only 2% of us carry the MRSA variety), not causing any problems, but it is also the source of many dangerous and life-threatening illnesses if it enters your bloodstream.
Over the last 50 years of treating Staph infections, resistance to many different antibiotics has occurred, meaning that when a serious infection occurs, it’s potentially very harmful.  The emphasis there should be on potentially.  Most MRSA infections are community-acquired skin infections that resemble a spider or other insect bite but are still mild and are treatable with different antibiotics than historically used.  Regular Staph and MRSA infections are even more likely to occur in those institutionalized (i.e. in hospitals, nursing homes, etc.) and have tubes and wounds.  Consider and discuss the risk with your physician when you see someone on a breathing device, a urinary catheter, needing gauze for surgical wounds or on feeding tubes.  Amazingly, MRSA causes approximately 60% of hospital-acquired Staph infections now.
My primary goal today is to inform you of what you need to know to prevent obtaining these infections and when to be especially diligent in seeking treatment.  It’s really a simple task of maintaining hygiene.  Just prevent that ‘light-switch’ from flipping to the on position and most times you’ll be ok.
1.  Staph is everywhere.  You can best protect yourself by simply practicing good hygiene.  Wash your hands early and often.
2. MRSA is spread by contact. Don’t be so quick to feel and squeeze on someone’s (or your own) boil.  Wash your hands before and after such contact.  Don’t share towels or razors.
3.  Keep any cuts, scratches, nicks or scrapes covered until healed.
If you do see or develop signs of a skin infection (redness, warmth, tenderness, pain and possibly discharge from the wound site), it’s worth contacting your physician to see if s/he’d like to start antibiotics or drain a possible abscess.
So… don’t be afraid, be smart.  Prevention is key.

Hand_Washing_MRSA

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.
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Straight, No Chaser: Questions About Abscesses (Boils)

Whether you call them boils, pus pockets or abscesses, they hurt. Abscesses are infections that localize and collect pus beneath the skin. Although previous Straight, No Chaser posts have addressed MRSA, this one will highlight your frequently asked questions about abscesses.

 abscess1

Why do I get an abscess?
Something causes an injury or sufficient irritation to your skin to allow bacteria to enter, and/or your lowered immunity can’t adequately fight back. Examples of circumstances causing skin infections that can develop into abscesses include ingrown hairs (folliculitis), insect bites and IV drug use. You are at increased risk for developing an abscess if you have diabetes, are obese, use IV drugs, have a weakened immune system or have an untreated skin infection (cellulitis).

 Abscess2

What causes abscesses?
Bacteria such as Staphylococcus aureus (Staph) and Streptococcus are common causes of abscesses. I’ll remind you that MRSA stands for methicillin-resistant Staph Aureus; this is an indication that traditionally used antibiotics don’t work against this particular strain of bacteria. MRSA should be a reminder of the dangers of inappropriate antibiotic use.

 abscess3

How do I know if I have an abscess?
Trust me. You’ll know. Typically you’ll develop a skin infection first, which could simply include pus-filled bumps that worsen to become red, warm, swollen and tender. You may develop a fever, and you will have a significant amount of pain.
Can I treat these at home?
Generally not unless you’re a physician or have access to one at home… What you can do is prevent them. Stop picking at your skin; in fact, learn to keep your hands off your skin. Use clean equipment (e.g. razors, clippers) if you shave hair from your skin.
In terms of treating abscesses at home, it is not advisable for you to attempt to cut yourself or otherwise deal with these once one has formed. Abscesses often have deep tracks under the skin that need to be explored. Whatever you’re doing to delay getting evaluated is increasing the risk that things will worsen.

abscess i&D abscess gauze

So how are abscesses treated?
There are two approaches to treating abscesses: “from the inside out” and “from the outside in.”

  • From the inside out refers to receiving antibiotics. Most abscess do respond promptly to antibiotics if you don’t wait too long to get them treated.
  • From the outside in refers to a procedure called incision and drainage (I & D). You’ll recognize this as your physician having to cut open the abscess, clean the area out and place gauze in the wound for a few days. Doing this in most cases eliminates the need to also take antibiotics. Unfortunately, I & Ds often must be done on higher risk abscesses, and in some instances, it’s necessary to have it done by a surgeon.

When should I see a doctor for one of these?
These generally aren’t getting better on their own. In particular, if you have one of the risk factors previously mentioned (diabetes, IV drug use, obesity, decreased immunity), the abscess is on or near your genitalia, is spreading fast or is extremely painful, you should be seen sooner rather than later.

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.
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Straight, No Chaser: Recommendations for Early Detection of Prostate Cancer

prostate-to-do-2

Every so often, controversies regarding medical treatment recommendations get in the news and seemingly only serve to confuse the public. Every blog, article or research paper is a single entity that may or may not adjust the body and weight of evidence on a given topic. Even most well-done research articles do not completely change the standard of care for medical practice. Prostate cancer screening is a great example. At the end of it all, controversies aren’t as important as the consensus recommendations that emerge from medical and public health professionals tasked with reviewing such information.
In this Straight, No Chaser, we will review the latest (2016) recommendations from the American Cancer Society (ACS) for early detection of prostate cancer. Remember, when you hear dissenting views, consider the source and balance that against the formal recommendations of ACS.
In an earlier Straight, No Chaser, several questions regarding prostate cancer were addressed. However, there is one additional question that is important to review.
Does Everyone With Prostate Cancer Get Treated?


prostate screening risks benefits

This is the source of controversies regarding screening of prostate cancer. Most men diagnosed with prostate cancer do not die from the disease. I mentioned previously that 30,000 men with prostate cancer die of the disease every year. However, over 3 million men in the U.S. are currently living with a diagnosis of prostate cancer. Based on these statistics, the question then becomes…

Why Do All Men Need to Be Screened For Prostate Cancer?
A certain stream of logic asks why screening is necessary if most of those who are diagnosed don’t die. Many treatments (e.g. surgery, medications, radiation) have additional risks that could be avoided if interventions were avoided. Similarly, some have taken to asking if any screening program is necessary. The view here is information is empowering. It’s always better to have information regarding the state of your health. Working with your medical team and family, the correct decisions about next steps can be made. This option is only available if you know what’s happening with your health.
How Does Screening Occur?

prostate exam

There are two tests commonly used to screen for prostate cancer.

  • A digital rectal exam (DRE) is when a doctor inserts a gloved, lubricated finger into the rectum and estimates the size of the prostate and assesses it for lumps or other abnormalities.
  • The prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate, and PSA blood levels can be higher in men who have prostate cancer. Unfortunately the PSA level isn’t specific for prostate cancer, as it can be elevated in other conditions that affect the prostate such as age, race, certain medications or medical procedures, prostate enlargement or infection.

So What Are The Current Recommendations for screening?

prostate cancer screening guidelines

The American Cancer Society (ACS) recommends that men get to decide if they want to be screened, based on a recommendation from their physician and having received information about the risks, benefits and uncertainties surrounding screening. In other words, we don’t even talk about screening anymore; now it’s “Who should have a conversation with their physician about getting screened?”

  • If you’re age 50 and have an average risk of prostate cancer and are expected to live at least 10 more years. Because prostate cancer grows slowly, if your life expectancy is less than 10 years, you wouldn’t benefit from screening or treatment for prostate cancer.
  • If you’re age 45 for men and are at high risk of developing prostate cancer. This includes African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
  • If you’re age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

Among these groups, when the decision is made to screen, those men will be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.
Assuming no prostate cancer is found as a result of screening, the need for future screenings depends on the results of the PSA blood test:

  • Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years.
  • Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher.

Even after a decision about testing has been made, the discussion about the pros and cons of testing should be repeated as new information about the benefits and risks of testing becomes available. Further discussions are also needed to take into account changes in the patient’s health, values, and preferences. Please at least have the conversation with your physician.

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.
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Straight, No Chaser: Facts About Prostate Cancer – 2018 Update

prostate-cancer_medium

Men (and those who care for men – meaning everyone) should be knowledgeable about prostate cancer. I don’t mean physician-level knowledgeable, but there are just a few facts that you should know that are meaningful. We’ll cover those in this Straight, No Chaser.
Aside from skin cancer, prostate cancer is the most common cancer among men in the U.S. It is also one of the leading causes of cancer death among men of all races. According to the National Cancer Institute, in 2018, there will be over 164,6900 new cases and well over 29, 430 deaths (13% increase from 2017) from prostate cancer. Approximately 11.2% of men will be diagnosed with prostate cancer at some point during their lifetime. Here are some prostate cancer basics.
Prostate NormalCancer
What’s the prostate exactly?
The location and function of the prostate was covered in this previous post.
Who’s at risk for prostate cancer?

  • Age: This is simple. The older you are, the greater your risk of developing prostate cancer.
  • Race: Prostate cancer is more common in certain racial and ethnic groups.
  • Genetics: Your risk is increased, which is not the same as saying you’ll develop it if a family member has. This risk is twice to three times more likely if you have a father, brother or son who has had prostate cancer.

prostate cancer symptoms-of-prostate-cancer-c77ttmeb

What are the symptoms of prostate cancer?
It is of interest that a wide variety of presentations exists in those later diagnosed with prostate cancer. Some men don’t have symptoms (meaning it’s discovered on screening examinations), and other men present with several symptoms, which may include the following.

  • Blood in the urine or semen
  • Difficulty completely emptying the bladder
  • Difficulty starting urination
  • Frequent urination (especially at night)
  • Pain in the back, hips, or pelvis that doesn’t go away
  • Pain or burning during urination
  • Painful ejaculation
  • Weak or interrupted flow of urine

Prostate-Cancer-Treatment

How Is Prostate Cancer Treated?
See the above chart for more detailed information. Optimally, treatment for prostate cancer should take into account

  • Your age and expected life span with and without treatment
  • Other health conditions you have
  • The severity (i.e. stage and grade) of your cancer
  • Your feelings (and your physician’s medical opinion) about the need to treat the cancer
  • The likelihood that treatment will cure your cancer or provide some other measure of benefit
  • Possible side effects from treatment

Different types of established treatments are available for prostate cancer, including the following:

  • Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms. This is known as active surveillance.
  • Surgery to remove the prostate and or surrounding tissue. This surgery is called a prostatectomy.
  • Radiation therapy with high-energy rays to kill the cancer..
  • Hormone therapy perhaps could be named “hormone blocking therapy,” because these medicines blocks cancer cells from getting the hormones they need to grow.

The next Straight, No Chaser will provide an update on prostate cancer screening recommendations.

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
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: Questions About the Prostate

prostate-sticker

This is Prostate Cancer Awareness month, and as such, this Straight, No Chaser explores the prostate (no pun intended). Prostate cancer and screening will be addressed in an additional post. There are generally five questions people ask about the prostate, so let’s take the time to address them. These topics are individually discussed in detail at www.sterlingmedicaladvice.com.

1. What is the prostate?

prostate

The prostate is a male-only organ located in front of the rectum and under the bladder. It surrounds the urethra, which is the tube through which urine flows on its way out of the penis. Understanding this anatomy helps one understand the nature of problems that arise related to the prostate. Importantly, the prostate is part of the male reproductive system. It’s a gland that contributes to the fluid (seminal fluid) that carries sperm out of the body (i.e., semen).
2. Doesn’t it get infected?

Prostatitis

Prostatitis is either inflammation or infection of the prostate gland. It has many different causes. When an infection with bacteria causes prostatitis, it is called bacterial prostatitis. Bacterial prostatitis can be a particularly long-lasting infection, requiring antibiotics to treat.

  • Acute bacterial prostatitis is an infection that produces signs and symptoms rapidly.
  • Chronic bacterial prostatitis is an infection that lasts for at least three months.

3. Why does the prostate get large?

BPH

A condition known as benign prostatic hypertrophy (BPH) occurs in men as they age. As a general rule, 50% of men have it by age 50, and 80% have it by age 80. The prostate normally is only the size of a walnut. When BPH occurs, the prostate has enlarged to a point where it may press upon the urethra, disrupting the normal flow of urine, preventing normal emptying. It is important to understand that the growth seen in BPH is not cancer.
4. What’s the relationship between the prostate and sex?
When people ask me this question, they have one of two concerns.

  • Some medical studies have drawn a relationship between a higher frequency of ejaculations and a lower risk of prostate cancer. This trend is not currently considered definitive; to be clear there is no conclusive evidence that the risk of prostate cancer is reduced by frequent ejaculation.
  • The male equivalent of a “G-spot” is described as being near the prostate.

5. Is prostate cancer deadly?

Prostate-cancer-risk

Prostate cancer is usually slow-growing, but may occasionally be aggressive. Cancerous prostate cells may break off and spread to other parts of the body, particularly the bones and lymph nodes. Prostate cancer usually is seen in men after 50 and even when discovered often doesn’t require especially aggressive management.

Your bottom line?

You especially need a prostate exam and other considerations yearly after age 50.

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 for Treating & Preventing Gas

So… you have problems with gas. What are you to do? Well, given that gas production is a natural occurrence, it’s not like you’re going to eliminate having gas (no pun intended). If you read the previous post on what produces belching and flatus, you should have a good idea as to why different things affect you the way they do. Understanding this directly leads into how you can prevent, reduce and treat untoward gas production.

gas-bloating

I’ll make this simple. If you want to reduce the amount of gas you produce, think of these three considerations within your reach. If these efforts prove ineffective, your physician may prescribe medicine, but this should not be the initial consideration.
Adjust your diet

  • If you recall the variety of foods that produce gas or simply remember foods high in carbohydrates produce more gas than foods high in fat or protein, that’s a start. Unfortunately this requires thought and balance. Many healthy foods produce gas (e.g. fruits, vegetables and whole grains). You don’t want to create an unhealthy diet in pursuit of convenience. Be reminded that while fat does not cause gas to the extent that carbohydrates do, limiting high-fat foods can still help reduce bloating and discomfort. Less fat in the diet helps the stomach empty faster. This allows gases to move more quickly through the digestive system.
  • If you believe or know yourself to be lactose intolerant, simple avoidance of dairy products will improve your situation.

chewing gum

Change how you eat

  • Your eating habits play a role in this. For example, if you are a fast eater, you’re likely gulping down air. Slow it down, and chew more thoroughly.
  • Think about how you chew. Do you keep your mouth open? If so, that involves swallowing more air. Now think about those people who habitually chew gum or hard candies with their mouths open. These are habits easily altered.
  • Keep your dentures or dental plates adjusted so they fit. The constant production of air pockets in those loose spaces can get transmitted down your digestive track as you chew. A little attention in this direction can lead to a lot less gas. Check with your dentist.

gas-x

Over-the-counter (OTC) treatments
You know certain OTC medicines well. It’s reasonable for you to know what they’re doing.

  • Beano (alpha-galactosidase) is a digestive aid. It helps the body digest the sugar contained within beans and many vegetables. It doesn’t affect gas production from lactose or fiber.
  • Mylanta, Maalox or Gas-X (simethicone) also can relieve bloating and abdominal pain or discomfort caused by gas. These products don’t affect gas production but do increase the rate of gas elimination. Thus, even when it seems as if one of these is not producing immediate relief, it’s likely helping.
  • Lactase tablets or drops can help people with lactose intolerance digest milk and milk products to reduce gas production. Lactose intolerance is discussed in detail in another Straight, No Chaser post.

Here’s a final word of caution. Gas pain may not be due to simple considerations. Those who burp frequently can have gastroesophageal reflux disease (GERD). Cardiac disease can present with gas pain. Irritable bowel syndrome (IBS) can be a reason why you’re more sensitive to gas pain. There are many other examples.
Remember: if these tips aren’t effective in improving your gas discomfort, please consider getting evaluated.

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: The Gas You Pass-Eructation (Belching) and Flatus (The Other One)

Belching

It seems like Straight, No Chaser is unafraid to address any topic! Here’s one of those conversations that everyone wants to have but rarely does. Gas is a natural phenomenon. That’s a given. However, all of us probably want to and would benefit from knowing why it’s happening and what can be done to minimize those odoriferous emanations from above and below. Here are some frequently asked questions on the gas you pass.

flatus 

What is gas?
Gas is a byproduct of the digestive process or of your swallowing air. It’s some combination of oxygen, carbon dioxide, hydrogen, nitrogen and methane gases. Remember the digestive tract extends from your mouth to your anus, so depending on where the gas is produced, the gas may be expressed from either end of you through burps or flatus.
Why would I swallow air?
Everyone swallows a small amount of air when eating and drinking. The amount of air swallowed increases when people eat or drink too fast, chew gum or suck or hard candy, drink carbonated beverages, smoke or wear loose-fitting dentures.

 belching cows

Why does gas have that smell?
Flatus (gas passed through the anus) may contain small amounts of sulfur. Flatus that contains more sulfur gasses has more odor.

Why do I produce so much gas? 

  • Passing gas is normal. In fact, the average person does so about 15-20 times a day. Many things can cause you to produce more, including eating a lot of carbohydrates (e.g. sugars, starches, fibers). The upper parts of the digestive system (stomach and small intestines) are as effective as the lower intestines as breaking down carbohydrates. When the lower intestines do so, gases including hydrogen, carbon dioxide, methane gas or hydrogen sulfide (a sulfur gas – as mentioned, methane and sulfur as more noticeably smelly gases). This isn’t as much of an issue with fat and protein based diets.
  • Constipation also results in increased amounts of methane production.
  • Conditions that disrupt the digestive system can have the same effect. Examples include diabetes and Crohn’s disease.

 flatulence foodsflatusbeans

Can you give examples of foods that are carbohydrates and cause gas?
There’s wide variation between individuals in how foods are digested. As an example, consider the effect of being lactose intolerant. Some foods that may cause gas include

  • fruits such as pears, apples, and peaches
  • vegetables such as broccoli, cauliflower, cabbage, Brussels sprouts, onions, mushrooms, artichokes, and asparagus
  • whole grains such as whole wheat and bran
  • sodas; fruit drinks, especially apple juice and pear juice; and other drinks that contain high-fructose corn syrup, a sweetener made from corn
  • beans
  • milk and milk products such as cheese, ice cream, and yogurt
    • packaged foods—such as bread, cereal, and salad dressing—that contain small amounts of lactose, a sugar found in milk and foods made with milk
  • sugar-free candies and gums that contain sugar alcohols such as sorbitol, mannitol, and xylitol

 belching1

What are the symptoms of gas?
In addition to burping and passing gas, bloating and abdominal discomfort are common.
When should I be seen for gas?
It’s easy to be distracted by what you believe to be simple gas pains. If your symptoms are new or different (especially if you’re above age 40), or if your gas symptoms are accompanied by diarrhea, constipation or weight loss, you should get evaluated. Of course, severe pain seems to be the most common prompt for an evaluation.

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 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

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