Tag Archives: Behind the Curtain

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cerebrovascular System (Your Brain)

September 11, 2015General Health and Wellness, Neurology, Health Prevention844-SMA-TALK, Behind the Curtain, Blood vessel, Brain, Cerebrovascular disease, Conditions and Diseases, health, Neurological Disorders, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, Transient ischemic attackJeffrey Sterling, MD

Last but not least, in the first 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.

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.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cardiopulmonary (Heart and Lung) System

September 10, 2015Cardiology/Heart, General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Chronic bronchitis, Chronic obstructive pulmonary disease, Circulatory system, COPD, Disease, Lung, Pulmonary alveolus, Respiratory system, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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.

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.

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.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Genital System

September 9, 2015General Health and Wellness, Genital/Urinary, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, health, Human sexual activity, K-Y Jelly, Masturbation, Sex education, Sex organ, Sexual intercourse, Sexuality, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

The third part of this Straight, No Chaser series on aging 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 on either sex. As before, I’m going to go through changes – challenges – solutions. I welcome any questions or comments.

And now to today’s post.
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.
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).
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Musculoskeletal System

September 8, 2015General Health and Wellness, Health Prevention, Musculoskeletal System844-SMA-TALK, Adipose tissue, Behind the Curtain, Fitness, health, Muscle, Myocyte, Physical exercise, Skeletal striated muscle, Stem cell, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Weight lossJeffrey Sterling, MD

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’.

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:

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.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Life Begins (to End) at 40 (Unless It Doesn’t) – The Skin

September 7, 2015General Health and Wellness, Skin/Dermatology, Health Prevention844-SMA-TALK, Beauty, Behind the Curtain, Cosmetics, health, Herpes zoster, Human skin, Skin, Skin Care, Skin neoplasm, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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.

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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Tattoo Removal

September 4, 2015Skin/Dermatology844-SMA-TALK, Behind the Curtain, dermabrasion, excision, Laser tattoo removal, salabrasion, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

You may find it interesting that people have been obtaining tattoos throughout recorded history. You may also find it interesting that of those getting tattoos, approximately half will have those tattoos removed. This Straight, No Chaser discusses how that’s done through laser removal. I’ll also address the question that’s most likely to be burning through your brain (no pun intended).
First, it’s important to offer a warning – not about this post, but about your skin. One would think you’d be extremely cautious about anything that disfigures or otherwise marks your skin. I would respectfully advise you to think long and hard about the decision either to obtain or remove a tattoo. Too often, these decisions are made on a whim, either emotionally or based on financial considerations. It is not uncommon to see such patients in the emergency room with cellulitis or keloids.

To get started, let’s get an understanding of what’s being accomplished. Understanding this will assist you in the decision to proceed with laser or other forms of tattoo removal. The various colors of your tattoos consider of simple pigments. Lasers are absorbed by these pigments, which results in their being broken up. This theoretically should leave your skin to show through the previously tattooed area. It’s important to appreciate that different pigments absorb different laser wavelengths. Black pigments absorb all laser wavelengths and thus are easiest to remove. Alternatively, tattoos with more colors are more difficult to treat. Laser tattoo removal performed by a dermatologist or cosmetic surgeon represents a level of expertise that further distinguishes laser tattoo removal from other methods.

Regarding the effectiveness of laser tattoo removal, it gets the job done. It gets it done in those who previously tried other treatments, methods or remedies, as long as the tattoos aren’t complicated by significant scarring from those earlier efforts. Laser removal typically takes between two and four treatments, although this varies based on several considerations, such as skin color, pigment/color variety in the tattoos, patient age and size of the tattoo. These considerations can result in additional treatments being necessary.
Regarding the procedure, most don’t require anesthesia (numbing medicine), but those that do may receive a topical skin cream or injection at the site. This often helps for the portion of the procedure during which the skin is being tested (to determine the needed amount of energy for the laser). The treatments are often described as similar to feeling a rubber band snap against the skin. Another more painful description is feeling the equivalent of a grease splatter. After the treatments, topical antibiotic cream and sunblock will be given, and an ice pack will typically be applied to the bandaged area.
Laser tattoo removal has minimal side effects, although a few are possible, including the following:

Infection
Incomplete pigment removal
Hypopigmentation (the treated skin becomes paler than the surrounding skin)
Hyperpigmentation (the treated skin becomes darker than the surrounding skin)
Permanent scarring

So, to your question: “What about the shop corner tattoo removal shops?”

I’ll respond to this question without getting overly clinical. There are multiple forms of tattoo removal that have been shown to be effective. There is one – laser tattoo removal – that clearly gives you the best likelihood of a satisfactory result and the lowest probability of significant side effects. There’s also no question that this method is the most expensive. For completeness sake, here are some additional methods of tattoo removal.

Dermabrasion: This removes superficial skin layers (those containing the pigment) with a rapidly moving tool.
Excision: This is surgical removal (i.e. cutting) of the affected skin.
Salabrasion: This uses gauze pads saturated with a salt solution to erode, scrape or wear away the tattooed area by friction.

Getting your tattoo removed by one of these methods could result in a good outcome. It’s just more likely not to, and more likely to result in scarring or other side effects. There’s a choice to be made. Just realize this is your skin (and often your outward appearance) that’s at risk here.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Hot Tub and Barbershop Folliculitis

September 3, 2015Skin/Dermatology844-SMA-TALK, Behind the Curtain, Folliculitis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Follulicitis. You know it well as hot tub rash, barber bumps, ingrown hairs and many other names. The first thing you need to know is the ‘itis’ means inflammation, and the follicle is the pouch from which your hair grows. Any inflammation of that area is folliculitis. You’ll typically see white-headed pimples with or without itching, pain and redness. So what? Let’s quickly run through causes, problems, prevention and treatment.

Causes

It’s usually caused by microorganisms (usually bacteria, including Staph and others, but also yeast, fungi and viruses may do the same).
Blocking skin pores will also get you there (think heavy application of make-up or oils, or heavy sweating in tight spandex-type clothing).
External irritation can be a cause (think long-term topical steroid use, tight clothing, untreated scratches or lacerations, improperly chlorinated hot tubs, whirlpools or swimming pools).

Problems
It’s inflammation that most commonly is an infection. The irritation can progress to a skin infection (cellulitis) and/or a boil (abscess). These can range from annoyances to ‘not-fun’ to outright problematic, particularly if you’re diabetic, have HIV or otherwise have a compromised immune system.

Prevention
I’m just going to give you a list of healthy hygiene tips that will serve you well in many circumstances, including prevention of folliculitis.

Use antimicrobial soap.
Don’t share towels, and avoid using the same towel multiple times (Sorry, hotel chains!).
Shower immediately after getting out of the swimming pool, whirlpool or hot tub.
Don’t shave (and avoid otherwise irritating) areas where razor bumps exist.
Be moderate with application of lotions, makeups and other moisturizers.

Treatment
Most cases of folliculitis, whether an inflammation or an infection, resolve in 1-2 weeks, assuming you don’t further irritate it to the point where a substantial skin infection sets in. Consider the following a treatment progression for the overwhelming majority of cases; cases more severe (or any you may be concerned with) require consultation with your individual physician.

Warm compresses (clean, hot towels) to the area do a world of good.
Wash with antimicrobial soap, and consider using medicated shampoo, particularly if the discomfort is on the scalp and/or beard.
Your physician may consider topical or oral antibiotics if the situation warrants or worsens. That means you need to be alert for spreading of the bumps, fever, drainage or worsening of pain, swelling or redness.

Straight, No Chaser: Keloids

September 2, 2015Skin/Dermatology844-SMA-TALK, Behind the Curtain, keloids, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Have you ever seen a keloid? Do you suffer from keloids? Do you know someone with them and wonder what’s occurring? Here are some answers.
Some people, more commonly African-Americans, Asians, Latinos and those with a family history of keloids, suffer from abnormal skin growths. These growths typically occur during one’s skin healing after an injury. Keloids are simply overgrowths of scar tissue.

The problem is keloids can be quite scary and scary-appearing. In severe instances, keloids can not only occur after an injury but also after any insult to the skin. This can include severe injuries such as burns, lacerations, surgical scars or trauma, but it can also result from simple insults such as acne, chickenpox, scratches or puncture wounds (such as seen with medication administration, vaccines or ear-piercing).

Keloids can be quite scary in their appearance. At first glance, they are often confused with cancerous skin growth. They take on multiple appearances and colors, and they are often tender and easily irritated. They are not easy to disguise. In fact, sun exposure may cause ongoing tanning to the area, making the deformity even more pronounced. Therefore, it’s important to cover keloids and use sunblock over the involved area when exposed to the sun for the first six months after development of one (or up to 18 months in children).
There’s an unfortunate “Catch-22” with keloids. Once formed, they often don’t need to be treated unless you want to reduce the size or have other cosmetic concerns. Many of the variety of treatment options used to treat keloids can actually cause a larger one to form, particular if it involves cutting or other irritation to the skin. However, in many cases, treatment is quite successful.

Here are some of the various treatments available for keloids. Discuss these options with your physician or Sterling Medical Advice expert consultant if you are considering having modifications to existing keloids.

Cryotherapy (freezing the area)
Injection of steroids
Laser therapy
Radiation therapy
Silicone gel or patches
Surgical reduction or removal

Sterling Medical Advice and 844-SMA-TALK Land in Japan!

September 1, 2015Public Health, Health Prevention844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

For Immediate Release.
September, 1^st 2015 –Fort Worth, TX, Chicago, IL., Tokyo, Japan.
Sterling Initiatives, LLC, Sterling Medical Advice and 844-SMA-TALK would like to announce the partnership of JEAP Peacemind and the Sterling Medical Advice platform.
JEAP Peacemind is an international Employee Assistance Program (EAP) provider overseeing health and other benefits for tens of thousands of employees around the world.

Today, Sterling Medical Advice and SMA TALK become the health information and advice vendor for JEAP Peacemind’s English-speaking employees around the world. SMA-TALK’s call center will provide health services 24 hours a day, 7 days a week. Sterling Medical Advice will also offer wellness and referral services.
If your business or corporation’s EAP program needs a healthcare partner, Sterling Medical Advice is available around the clock and around the world. Contact us at 844-ADVICE3 (866) 238-4233 for more information on this or other services. For individuals desiring immediate health information or advice, feel free to call 844-SMA-TALK (844) 762-8255.

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Straight, No Chaser: Should I Take a Daily Aspirin?

September 1, 2015Cardiology/Heart, Medical Treatment, Health Prevention844-SMA-TALK, Aspirin, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

So… I’m stuck on a desert island, and I’m allowed to take two medications. I’m pretty sure aspirin is going to be one of them. This begs the question “Who should take a daily aspirin?” The answer is actually easy: anyone and only anyone whose physician recommends it. The better question is when will your physician recommend it? In yesterday’s Straight, No Chaser, we reviewed the expanding use of aspirin. That was the “why” of it all. Today we look at the “how” and “when.”
The benefits of aspirin in reducing heart attack risk have been known and well described for quite a while now, and you should check this list to see if you’d benefit from taking a daily aspirin. Truth be told, it’s of such importance that if you’re of a certain age, you should have this conversation with your physician at your next physical exam. Here’s a partial list that will get you a daily aspirin or very strongly considered for one.

If you’ve previously had a heart attack
If you’ve had a coronary artery stent or surgery
If you’ve previously had a stroke (caused by a blood clot) or TIA (transient ischemia attack, aka ‘mini-stroke’).
You’re a male over 50.
You’re a female over 60.
You have a bad risk factor profile (i.e. You smoke, have diabetes, high blood pressure or high cholesterol levels, are overweight, don’t exercise or have a personal or family history of heart disease)

The above list actually isn’t exhaustive but is sufficient for most individuals’ ability to remember to start a conversation with their physician. These considerations will be measured against others that would suggest you shouldn’t be taking a daily aspirin (e.g. allergy, bleeding ulcers, a bleeding disorder or if you’re taking certain other medications).
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Aspirin – It's Not Just for Heart Attacks Anymore

August 31, 2015Cardiology/Heart, General Health and Wellness, Health Prevention844-SMA-TALK, Aspirin, Behind the Curtain, Digestive Tract Cancer, heart attack, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, StrokeJeffrey Sterling, MD

…not that it ever was! Aspirin has been known to be a pain reliever for thousands of years. Let’s take a brief look at the additional qualities that should make aspirin one of the meds you’d want to have if stranded on a deserted island.
Heart attacks: Many doctors routinely prescribe a daily aspirin to help prevent heart attacks. In fact, the research was so good that a Nobel Prize in medicine was awarded to those discovering that aspirin prevents the clot formation that leads to heart attacks. It has been estimated by the American Heart Association that up to 10,000 American lives would be saved every year if an aspirin (325 mg) was taken at the first signs of a heart attack. However, it is important to note that the US Food and Drug Administration (FDA) updated its recommendations to state daily use of aspirin should only be in those instances in which individuals already have cardiovascular disease, due to aspirin’s side effect profile.
Strokes: Aspirin has the same preventive effects on stroke development as it does for heart attacks, and daily preventive medicine is now part of many lives for that reason.
Cancer prevention: Aspirin appears to have preventative benefits for certain digestive cancers. Just this week, research published in the Annals of Internal Medicine finds that daily aspirin use at recommended levels for at least five years was associated with a 27% less likelihood of developing colorectal cancer. Additional evidence is strong for presentation of esophageal and stomach cancers, but outside of the digestive tract, conclusive evidence hasn’t presented of yet.
So if you’ve been told to take a daily aspirin to reduce your risk of a heart attack because you likely fell into one a high-risk category, here are some logistical considerations about what to do.

1) Is there a better time of day to take an aspirin?
Recent data suggests that most heart attacks occur early in the morning. The best time to take an aspirin is relatively soon before you have that heart attack. However, since your heart doesn’t give you a heart attack alarm clock (and many of us aren’t especially mindful of heart attack recognition), the best move would seem to be to take an aspirin before going to bed, and recent research supports that an aspirin taken before going to bed offers the most protection from a heart attack. There are limitations to doing this (e.g. taking aspirin on an empty stomach if you have a history of ulcers may not prove to be the most pleasant thing), and you should discuss such timing with your physician.
2) Is there a better dose of aspirin to take?
That’s a question your physician will answer and is dependent on your personal situation. That said, doses as low as 75-81 mg have been shown to be effective. You may be placed on any dose up to 325 mg/day. It really is important to take an aspirin dose recommended by your physician for this consideration.
3) Is it better to chew or swallow an aspirin?
Chewing an aspirin is the quickest way to achieve effective blood levels. In case you were thinking about taking an Alka-Seltzer (which contains aspirin), that’s also good – but it’s just not as good as chewing an aspirin.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Beeting Back High Blood Pressure and Poor Blood Flow to the Brain

August 28, 2015Cardiology/Heart, Detoxification, Diet and Nutrition, General Health and Wellness844-SMA-TALK, Antioxidant, beet juice, beetroot juice, Behind the Curtain, high blood pressure, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, superfoodJeffrey Sterling, MD

Writing this makes me feel like your mother telling you to eat your spinach, but that’s another conversation. We’ve been talking a lot lately about brain health, and we’re always into improving your baseline health through actions such as lowering your blood pressure. Today’s Straight, No Chaser offers you a challenge that doesn’t involve dumping ice on your head.
In my mind, I’ve reduced much of life to having good blood flow, allowing for delivery of oxygen and other nutrients to essential parts of your body. Much of our performance in various ways is related to just that. To that end, if you’d like to include your blood flow to your brain, consider adding a bit of beet juice into your life.

No, not Beetlejuice…

Yes, that’s better.

Beet juice contains substances known as nitrates, which when metabolized within the body (into nitrites) relax blood vessels and promote better blood flow. Better blood flow equals better oxygenation and delivery of nutrition throughout your body, notably your brain. This blood flow activity isn’t just theoretical. Brain scans and MRIs taken shortly after and even a day after ingesting 8 ounces of beet root juice decisively demonstrate better blood flow and brain activity. This stuff works, and it’s natural!
The good news isn’t just limited to your brain. Beet juice has long been known as a powerful detoxifier, which your liver appreciates. It is a great source of antioxidants, which helps your entire body. Also, appreciate that beet juice has been shown to lower your blood pressure. Recall that blood pressure is a measure of the force the heart needs to pump blood throughout your body. We’re better off with a lower pressure, which is a sign of a more efficiently performing heart. Beet juice is a simple way to reduce your blood pressure by about 10 points.
Here are a final few fun facts for your consideration:

Beet juice is even better than eating cooked beets.
One to two cups a day is sufficient to get the desired health benefits.
Be advised that drinking beet juice may change your urine and bowel movements to a reddish color. This does not represent a danger.

Here’s to your health. Now beet it!
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser In The News: Murders in Virginia, Depression and Violence

August 27, 2015Mental Health, Trauma844-SMA-TALK, Behind the Curtain, Depression, mental-health, murder, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, SuicideJeffrey Sterling, MD

In the news are the horrific live, on-air murders of a television personality and a cameraman. This brings up the relationship between mental health, depression, violent crimes and suicide. Let’s review a few facts on the topic.

The number of clinically depressed individuals involved in a violent crime is actually small (3.7% of men and 0.5% of women in a recently published study).
That said, the number of clinically depressed individuals involved in a violent crime is above average. Studies have found that the depressed are up to three times more likely to be convicted of a violent crime (1.2% of men and 0.2% of women in the general population).

How can these findings be explained? There are two pretty important considerations.

Depression itself is associated with apathy, guilt, hopelessness and sadness. These are human conditions that can lead one to take actions that would normally not be done and also to do them in a way that wouldn’t normally be done (e.g. more recklessly). Violence certainly is included in the scope of actions such individuals consider under these circumstances.
The percentages noted above relate to associations and are not meant to imply that depression causes violence. There is a difference between rates of performing crimes, getting caught performing crimes and getting convicted performing crimes. There are multiple associations found in those more likely to be diagnosed as clinically depressed (e.g. poverty and other components of a lower socioeconomic status) that independently render one less likely to perform well in the criminal justice system.

So what is the relevance of these facts in the current setting?
Let’s stop pretending it’s not the case that certain conditions exist that amount to a powder keg. Feelings of hopelessness and helplessness in the setting of either mental illness or other conditions (e.g. extreme poverty) explain many actions and societal ills. The better course of action (other than heartfelt mourning) is to be proactive and address conditions that produce these outcomes. It is not sufficient to explain away these conditions by ascribing them to poor mental health. Our societies must better appreciate that in many instances, “poor mental health” is a result of our environment and life circumstances, and are not simply a genetically imposed state of being. Let’s provide better support to those easily identified as being in need, and let’s better combat societal ills that have clearly been identified as risk enhancers for depression, other mental illness and violent crimes.
We offer condolences to all affected in this and many other similar tragedies.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser In The News: Omega-3 Supplements Do Not Protect Against Dementia

August 26, 2015Cardiology/Heart, Diet and Nutrition844-SMA-TALK, Behind the Curtain, Omega-3 fatty acid, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Today’s Straight, No Chaser continues our ongoing conversation about your health not being found in a (supplement) bottle. In the news is new research reaffirming that taking omega-3 supplements do not appear to protect the brain from dementia and other forms of cognitive decline. Meanwhile, data continues to mount challenging the previously held views that omega-3 supplements protect the heart in ways previous thought, and that these supplements do not prevent macular degeneration of the eyes. These most recent findings related to cognitive decline come from the National Institutes of Health (NIH), where researchers followed 4,000 at risk individuals over a five-year period.

Omega-3s are the fatty acids found most abundantly in fish. The original notion that these fatty acids were particularly good for you came from studies noting the superior health status of hunter-gatherer societies that heavily relied on diets including fish. The importance and urgency of these findings are found in the fact that Alzheimer’s disease remains the most common cause of dementia. In the U.S. alone, it affects over 5.1 million Americans age 65 and older. With demographics being what they are, the number of those affected is expected to triple in the next 40 years.

It is important to note that these findings speak to supplements, not to intake of foods naturally rich in omega-3s, such as fish and flax seeds. Continue to enjoy the benefits of healthy eating and exercise, which in the example of regularly consuming fish, absolutely includes lower rates of cardiovascular (heart) disease, macular degeneration of the eye and possibly dementia.

There are two additional salient points to be made, based on these new studies.

Health is a habit, and you shouldn’t expect to find a cure for what ills you in supplements. The value of what occurs naturally again and again has been shown less able to be transferred into supplements.
Health is a result, and it’s best secured by establishing a lifetime of healthy habits. Over time, you will either benefit or suffer from the way you live your life. Start those healthy habits as soon as you can for maximal benefit.

Straight, No Chaser: Implementing a Healthy Happy Hour in Pieces

August 25, 2015General Health and Wellness844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

At Straight, No Chaser, we talk a lot about the intersection of health and happiness. In fact the roads run together for as far as the eyes can see. Have you ever thought about whether and how much of a priority having good health is? What would you be willing to invest in your health? 10% of your day? 5%? I’m here to tell you that if you make an investment of 1 hour per day into your health – about 5% of your day – you’ll be amazed at what you can do. Let your healthy hour provide you with a lifetime of happy hours – and the drinks are on us (but they’ll be water). It only takes an hour a day three times a week to provide you with measurable, effective levels of fitness and weight loss.
There are a myriad of routines you can accomplish in an hour based on your existing fitness level and goals. I’m not even suggesting that you need to do an hour straight; in terms of cardiovascular activity; 30 minutes of that gets the job done. Adding some stretching and weight training to that routine will turn you into a lean, mean fighting machine. Some of you are disciplined enough to take that hour at the beginning or end of the day and get it done. We’ve discussed the best way to exercise previously. Others of you … not so much. Finding an hour is like finding a pot of gold. For you, the better course of action is to get what you can when you can.
We previously talked about invisible health as a means of letting your healthy habits produce benefits for you. Let’s add a few active measures you can take throughout the day that will add up to produce healthy results. It has been established that multiple blocks of 10-15 minutes of exercise several times a week can produce demonstrable improvements in aerobic fitness, strength, flexibility, muscular endurance and overall health. You’ve got to lose the “all-or-nothing” mindset! Assuming your lifestyle doesn’t allow you to get your Healthy Happy Hour accomplished in one block, here are some tips for you to accomplish it in parts:

At home

Whenever you have to walk, walk extra. Do you have to walk the dogs? Pick up the mail or newspaper? Turn on the sprinklers? Take out the trash? Use that as the starting point, and keep on walking. Time it so you walk five minutes past your chore. Then turn around and walk back home.
Do jumping jacks like no one’s watching. Whenever you have a break, and you’re waiting, make it happen. Building up to five to 10 minutes of this is a great aerobic exercise. If you get bored and want to mix it up, jog in place.
Do you have that one 30 minutes TV program you watch everyday when it’s just your time? Watch it while you’re on a treadmill or exercise bike. Forget about Level 10 at the beginning. Just get on it, develop the habit, and let the progress come on its own. No, you can’t eat while you’re exercising!

At work

Walk, walk, walk. Walk to work if it’s feasible. Walk around the building before you go into work. Walk the stairs to your office. If you work on the twentieth floor, walk a few flights, then take the elevator. Walk to lunch. You should be sensing a theme here.
Stretch, stretch, stretch. I’d bet you have dozens of opportunities to stand and stretch your core, your neck and your calves. Do it whenever you think about it. Do it at the top of the hour, every hour. Just do it.

On the road

Your first step is to pack your gym shoes. Not doing so wipes out a ton of possibilities.
If you’re driving a long distance, break up the trip with a brisk walk at the rest stop or when stopping for gas. This will also keep you mentally sharp, which you’ll need to be on the road.
At the airport, forget the moving walkways and the trains between terminals. They’re too easy.
At the hotel, get a room on a high level and walk up and down the stairs. If you’re really good, run up and down the stairs. If you’re great, run up and down the stairs two at a time!

Now if this all seems like a lot to you, it’s not. These are just a series of habits that get you to that Healthy Happy Hour of exercise each day. It won’t take long before you realize that it’s not much ado at all. Yet, you’ll still enjoy the benefits.
In case you’re a couch potato, Straight, No Chaser has a special prescription for you. Stay tuned.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser In The News: A "Smart Drug" That's Actually Safe and Effective

August 24, 2015General Health and Wellness844-SMA-TALK, Behind the Curtain, modafinil, Ritalin, smart drug, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

When I hear medical news that’s too good to be true, it usually is. However science evolves, and new discoveries must be evaluated. Typically my first thought is “consider the source.” More often that not, the credibility of a claim is highly correlated with the credentials of the individual making it and/or the source publishing it. Another very important consideration is “does the discovery or proposed mechanism of action make sense in the context of what we know about anatomy, physiology and science?”

To that end, review of 24 existing studies on the topic and research at Harvard University and Oxford Universities have concluded that a safe and effective “smart drug” exists. This drug is named modafinil, and it is currently used for treatment of narcolepsy (a brain disorder that causes affected individuals to suddenly and uncontrollably fall asleep at inopportune times). You may have heard of “smart drugs” in the past, within the context of students using medications to enhance performance on tests – but this conversation goes beyond that use. This Straight, No Chaser will frame the conversation in “question and answer” form for your review. This is fascinating stuff!

1. How does this drug work on the brain? The prevailing (and admittedly oversimplified) thoughts are that modafinil may increase blood flow to specific sections of the brain that control attention and learning, and it may enhance activity in areas of the brain that manage memory, problem-solving and reasoning skills. At this point specific effects on a cellular level are not well understood.

2. What does this drug do to make one “smarter?” The data is pretty clear that modafinil can enhance attention, improve decision-making abilities, improve learning, improve problem-solving capacity and make certain individuals think more creatively. Research has also shown that modafinil’s effect were even more pronounced the long and more complex the task, and it made completing tasks more pleasurable.

3. Has this drug been used in this context before now? Modafinil is licensed and prescribed in the UK as Provigil and has been used since 2002, although it is not prescribed as a “smart pill.” Surveys in respected journals note that 44% of those seeking drugs to improve focus prefer modafinil.

4. Is this drug safe? Answering these types of questions is typically what makes physicians start equivocating, but the answer appears to be yes. In the context of short-term use, modafinil has very few side effects and no demonstrated addictive qualities. Importantly, the drug appears to have miminal effect on mood. It is acknowledged that ongoing information is needed regarding long-term use and its effects. Regarding negative effects, one study in the review showed those already deemed “creative” saw a small drop in that creativity, but this was not a consistent finding.

5. Does it work in both healthy and unhealthy people? Modafinil appears to be safe and effective in health and unhealthy individuals.

6. How does this compare to other “smart drugs” like Ritalin? Other drugs have a much more pronounced side effect profile than modafinil, meaning modafinil appears to be an overall safer drug.

7. Is this drug available? It’s available for use in narcolepsy but not in the context of improving performance. There really are two considerations. It would be difficult at best to obtain permission to conduct a research examining the long-term effects on the brain of such a drug; this presents a serious ethical dilemma. Similarly another ethical question is whether healthy individuals should be allowed to have access to a drug that improves performance when no problems exist? The manufacturer has indicated that they will not pursue license for modafinil in this context.

Stay tuned. I’m sure there will be much more to come on the topic. In the meantime, the smart choice would be to guard your overall health.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Your Teens Are Healthier Than You!

August 21, 2015General Health and Wellness844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, teen healthJeffrey Sterling, MD

Your teens are healthier than you. From the department of good health news – on some very important measures, somehow it seems as if our youth have actually received and read the memo on health. According a recent survey from the Centers for Disease Control and Prevention (CDC), several measures of health have improved significantly in the teen population – with a few important exceptions.

These improvements include the following.

Cigarette smoking. Cigarette smoking among U.S. high school students has reached an all time low. Teen smoking is down to 15.7%. It was just over 15 years ago (in 1997) that the rate was 36.4%. Unfortunately, this still translates to 2.7 million high school students who smoke.
Armed trauma. The proportion of students threatened or injured with a gun, knife or other weapon on school property has dropped to 6.9%, from a peak of 9.2% in 2003. In the presence of so many school shootings, a ray of hope exists.
Fist fights. The proportion of students involved in fist fights was reported at 25%, which is down from 42% in 1991. The number of students having had a fight at school within the last year sits at 8%, which is down from 16%.
Soda consumption. 27% of teens had at least one soda daily, down from 34% in 2007.
TV viewing. 32% watched three daily hours of TV, down from 43% in 1999.
Other: Overall, teens are drinking less alcohol and are having less sex with more birth control use by females.

And now, the not so good news…

Condom use: Condom use is declining among the sexually active, being reported at 59%, down from a peak of 63% in 2003. Remember, HIV and other sexually transmitted diseases/infections haven’t gone away at all; we’ve just gotten better in controlling them. Now is not the time to get comfortable.
Texting and driving: 41% of those who drove admitted to texting or e-mailing while driving. This is bad anyway you look at it.
Cigar and other forms of smoking: Cigars are now as popular as cigarettes with high school boys. Cigars were smoked by 23% of 12th grade boys in the month before the survey. Smokeless tobacco use hasn’t changed since 1999, holding at about 8%. Other surveys have shown increases in e-cigarette and hookah use.
Computer time: 41% of teens report using a computer for non-school reasons at least three hours a day, up from 22% in 2003. Apparently this is where the TV time has gone.

What this really means is (wait for it!) your teens are educable. Discuss these topics with them and why it’s important to make healthy decisions. Of course it helps if you model the behavior.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Distracted Driving

August 20, 2015Trauma, Health Prevention844-SMA-TALK, Behind the Curtain, Distracted driving, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

I find lawmakers fascinating. For example, when states fail to pass distracted driving laws in the name of “freedom,” aren’t they basically signing off on Darwinism (i.e. survival of the fittest)? It’s as if they’re saying “well you’re free to do it, but if you’re dumb enough to get hurt, that’s on you.” Of course that ignores the fact that innocent bystanders are affected. Would you believe that more than 1,000 people are injured and almost 10 people die every day in the U.S. due to distracted drivers? Of course you would, because virtually every individual who reads this has engaged in one distracted driving behavior or another at some point.

Driving is difficult. Unfortunately, it’s not always simply our actions that lead to motor vehicle crashes. These crashes often involve more than one vehicle, and sometimes a drunk, distracted or otherwise impaired driver hits another car, the driver of which may be completely at attention. Thus, driving without distractions is about giving yourself the best opportunity to react to the conditions around you.

The Center for Disease Control and Prevention (CDC) categorizes distracting driving into three main types:

Cognitive: taking your mind off of driving
Manual: taking your hands off the wheel
Visual: taking your eyes off the road

I know it seems like virtually anything you do in a car, from having a conversation to sipping on a drink qualifies, and in the event that seems a bit overbearing, remember you don’t get to see the consequences of all the bad decisions that lead to various death and other calamities that show up in an emergency room. If nothing else, today, I’d like for you to especially consider eliminating texting while driving because it combines all three of the above forms of distraction.

Here is additional data provided by the CDC.

In 2011, 3,331 people were killed in crashes involving a distracted driver, compared to 3,267 in 2010. An additional, 387,000 people were injured in motor vehicle crashes involving a distracted driver in 2011, compared to 416,000 people injured in 2010.1
In 2010, nearly one in five crashes (18%) in which someone was injured involved distracted driving.
69% of drivers in the United States ages 18-64 reported that they had talked on their cell phone while driving within the 30 days before they were surveyed.
In Europe, this percentage ranged from 21% in the United Kingdom to 59% in Portugal.
31% of U.S. drivers ages 18-64 reported that they had read or sent text messages or email messages while driving at least once within the 30 days before they were surveyed.
In Europe, this percentage ranged from 15% in Spain to 31% in Portugal.

Many states are banning texting while driving, or using graduated driver licensing systems for teen drivers to help raise awareness about the dangers of distracted driving and to keep it from occurring. That said, at the end of the day, this isn’t going to be legislated away. Even you will or won’t reduce your individual risk, and that can be done in some very specific ways.

While driving, place your phone out of reach, or just cut it off.
While a passenger, be assertive in preventing the driver from engaging in distracted activities.

It’s up to you. The life you save may be your own. I’ll text you later.
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, Sterling Initiatives, LLC. 2013-2015

Female Libido Enhancing Pill

August 19, 2015Genital/Urinary, Obstetrics and Gynecology844-SMA-TALK, Addyi, Behind the Curtain, flibanserin, hypoactive sexual desire disorder, low libido, sildenafil, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, ViagraJeffrey Sterling, MD

Introduction

This post is about the female libido-enhancing pill flibanserin, branded as Addyi.

It was barely two months ago that Straight, No Chaser forecasted approval for the first medication meant to address less than optimal sexual desire in females. Given the approval of Flibanserin, which should hit the market by Oct. 17 under the brand name Addyi, it’s time to revisit the discussion.

A Female Viagra? She-agra?

The first thought that comes to mind is hmm…. The idea of a female counterpart of Viagra and other erectile dysfunction drugs has been bantered about for quite a while. After all, according to the medical literature, at some point, approximately 10% and up to one-third of women may suffer from hypoactive sexual desire disorder (HSDD). (HSDD is the actual term for premenopausal women with diminished or absent sexual desire. This is also known as “low libido in women”). Should I note that Viagra earned its maker more than $1.6 billion dollars last year?

If you think this through, the issue existing with women shouldn’t be exactly the same as exists with men. After all, men are treated for erectile dysfunction, and after all, women don’t have penises. Furthermore, the condition in women speaks to diminished desire, not diminished ability as in seen in men. The situations aren’t exactly analogous, thus you would think the solution wouldn’t be as simple as giving women a drug used for erectile dysfunction.

Flibanserin – A Female Libido-Enhacing Pill

And so, the drug flibanserin has been fully approved by the FDA for treating hypoactive sexual desire disorder. Note: this is not the same drug as Viagra (sildenafil), Again, it’s important to immediately point out that this is a different medication. In fact, it’s a drug that acts on the central nervous system and is in the same category of pharmaceuticals as antidepressants.

Any of you suffering from depression and taking antidepressants may have paused at that last sentence. Here’s a word of caution to those legitimately suffering. The FDA rejected this same drug twice within the last five years. It had been presumed that this was based on its (lack of) merits. Most of the reasons this medication hadn’t been approved prior to now were related to the associated side effects (often a deterrent to compliance with antidepressants), which include episodic low blood pressure, fainting, and fatigue.

Questions continue to exist on interactions with alcohol or birth control pills. The specific challenge in finally getting approval was largely based on getting a better handle on the side effect profile and on weighing the side effects vs. the benefits.

What decision should you make?

This has been discussed in Straight, No Chaser (and is echoed by many sex therapists and behavioral psychologists). The cure for such conditions is not likely to be found in a bottle. As exists in this example, when conditions are mental instead of physical or physiological in nature, the solution may need to also be mental. It is fair to say this drug is riding a wave based on a combination of existing lack of options in women’s health, politics and the sincere desire to provide solutions to women in need.

That is not the same as saying this drug is definitely the solution for hypoactive sexual desire disorder in women. Still, the drug has been studied in more than 11,000 women. It performed better than a placebo by all measures examined. Specifically, women in clinical trials of the drug experienced two to three “satisfying sexual events” per month before joining the trial. An FDA analysis showed they had 0.5 to 1 more such event per month with flibanserin, when compared with a placebo. That’s a fact, and that gets a drug approved. Just remember: just because a drug is approved doesn’t mean in will work in you. It also doesn’t mean it’s safe for you to take. Discuss this with your physician.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering 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 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.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Straight Outta Health – The Health Risks of Urban vs. Rural Living

August 18, 2015General Health and Wellness, Public Health844-SMA-TALK, Behind the Curtain, Public Health, Rural health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Straight Outta Compton, Urban healthJeffrey Sterling, MD

The amazing success of the movie Straight Outta Compton has focused attention on the consequences of living in inner city America. Among these consequences are adverse effects on one’s health, and yes, these effects go beyond the risks of trauma. To extend the scenario globally, it is an amazing fact that for the first time in human history, it is estimated that more people worldwide live in urban areas than in rural ones. In today’s Straight, No Chaser, we evaluate a few health facts that speak to the relative value of city vs. country living.
It is important to understand that some considerations are more reflective of socioeconomic status than urban vs. rural dwelling. Notably, poverty is a cause of poor health and limits access to health prevention and medical care, regardless of the location of one’s home. There are strong correlations between lower income and higher death rates (mortality) across the board. Poverty, not urban living per se, increases the likelihood of encountering violence, increases the likelihood of experiencing violence and child abuse.

More specific to inner-city urban living, in 1997 the American College of Physicians identified specific health problems most commonly associated with US inner cities, labeling this disadvantage as an “urban health penalty.” They included the following:

Drug abuse
HIV infection
Teenage pregnancy
Violence

Simply put, addressing this set of issues requires addressing the root causes of poverty. It is also of note that access to care presents as significant problems in both urban and rural communities, but for different reasons. Rural communities are likely to have access considerations due to geographic and physician shortages, and urban communities are more likely to have barriers prevent accessing available resources.

There are defined differences in health and health risks, based on living in the city vs. a rural location. For example, those that live in cities:

Actually have less of a risk of becoming obese;
Are less likely to die of an accident;
Are more likely to be lactose tolerant.
Are more likely to develop asthma, have allergies and suffer from dry eyes;
Are more likely to have better TB resistance;
Have a much lower risk of suicide;
Have troubled circadian rhythms and disturbed sleep; and
Report a more pleasant and healthy old age.

Finally it is worth noting that inner city environments produce specific public health threats. These include the following:

Homelessness,
Increased availability of illicit drugs,
Increased spread of HIV infection and treatment-resistant tuberculosis
Presence of higher concentration of certain types of pollutants, such as carbon monoxide and molds.

At the end of the day, these risks may or may not result in health problems for you individually. It is important for you to be aware of the risks in order to limit your exposure. Be empowered, not crippled, by this information. Hopefully that will keep you straight outta an emergency room.
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.
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Copyright, Sterling Initiatives, LLC. 2013-2015

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