Tag Archives: Behind the Curtain

Straight, No Chaser Reader Request: What’s a Healthy Approach to Gaining Weight?

August 17, 2015Diet and Nutrition, Personal Training844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Weight gain, Weight ManagementJeffrey Sterling, MD

If you are even an occasional reader of Straight, No Chaser, you likely never thought you’d see the day when promoting weight gain was the topic of discussion. However, there are multiple medical circumstances for which weight gain is warranted, such as after an illness, in the presence of malnutrition, or during pregnancy. There are still other instances in which you may simply make the choice to gain weight. In either of these cases, you would do well to understand that all weight gain isn’t created equal, and if you’d like to gain weight, you should do so in the healthiest way possible. Just be sure to coordinate any such efforts with your physician. You really want to try to avoid any unnecessary strain on your heart.

To that end, here are 5 quick tips to help you along.

Exercise. The type of exercise (strength training) that increases your muscle will add pounds. It is true that for the same volume, muscle weighs more than fat.
Eat more frequently. Specifically, you should aim for 5-6 small meals per day, and make sure you don’t allow more than 4 hours to pass without eating. Also be sure to eat a healthy snack before going to bed. Remember sleep is the time when your body repairs and replenishes itself. Loading up on nutrients before bedtime will help your muscles grow and stay strong.
Eat a variety of foods. This increases the likelihood you’re eating a nutrient-rich diet. A diet deficient in vitamins and nutrients leads to your body scavenging your muscles for the energy it needs. Make an effort to include whole-grain foods, fruits and vegetables, lean protein sources, nuts and daily products.
Change what and when you drink. Understanding that fluids in general may be appetite suppressants, change your habit of drinking beverages, and consume them at the end of your meal. You would also do well to remove the “empty” calories of sodas with healthier fruit, milk or juice smoothies.
Concentrate and combine. You can accumulate a lot of nutrition (and calories) by choosing foods delivering the same nutritional value in smaller servings. Think of dried fruits as an example. You can also create higher-powered meals by adding items such as nuts, cheeses, granola or potatoes as would be appropriate for any given meal

Remember, the real name of the objective is health, not weight gain or loss. You can be relatively healthier at any body shape or size than you are right now. Just apply a few tried and true principles, and you will be on your way to your personal goals.
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: Dementia – When Brain Health Goes Bad

August 14, 2015Geriatrics/Elderly Care, Mental Health, Neurology844-SMA-TALK, Alzheimer's disease, Behind the Curtain, dementia, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

In case you didn’t pick up on it, the posts regarding brain health served two purposes. The first is to ensure you give yourself the best opportunity to live a healthy, happy mental life. The second is to stave off the point in your life when you develop dementia. In this and the next post on brain health, we focus on dementia, which occurs when the brain becomes a certain type of unhealthy. Alzheimer’s disease is the most common cause of dementia, accounting for approximately 60-80% of cases.
Look at the below chart for a stunning illustration of the scope of dementia.

As opposed to being a single disease, dementia describes a range of symptoms associated with a decline in memory or other mental skills. As such, it’s more helpful to describe functions lost instead of symptoms you may experience. Dementia is associated with a reduced ability to perform routine activities of daily living. It can be associated with significant impairment of other mental functions, including the following:

Memory
Communication and language.
Ability to focus and pay attention
Reasoning and judgment
Visual perception

Practically this could range from problems with remembering appointments or names, engaging in unnecessarily dangerous activities for no reason, or keeping track of items.

Dementia is caused by damage to brain cells. It’s the type of damage that could occur from a poor diet, age-related or other causes of poor blood circulation to the brain (e.g. a stroke). Depending on the involved area of the brain, various levels of loss of function may be seen. Based on the most common patterns and sites of brain damage, the mental deficits described above are those most likely to be seen. It is of note that the center of memory and learning (the hippocampus) is often the first area damaged, which corresponds to those deficits that define early dementia/Alzheimer’s.
My messages to you regarding dementia are pretty simple.

You don’t want it. Dementia is the end of the beginning and the beginning of the end. It is progressive. The symptoms will be more and more pronounced with time.
You need to address it. If you haven’t been forward thinking enough to engage in brain health, know the early signs, and get checked out as soon as possible. The good news is all dementia isn’t Alzheimer’s and could represent a treatable cause. Even when it doesn’t, steps to temporarily improve symptoms can be instituted.

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: Brain Health – Mental Gymnastics to Keep You Vibrant

August 13, 2015General Health and Wellness, Neurology, Health Prevention844-SMA-TALK, Behind the Curtain, brain health, Sleep, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Traumatic brain injuryJeffrey Sterling, MD

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
www.brain.aarp.org
www.luminosity.com
Whatever you choose to do, do something!
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 Chase: Brain Health – Foods and Brain Healthy Habits

August 12, 2015General Health and Wellness844-SMA-TALK, Alzheimer's disease, Behind the Curtain, brain health, dementia, Diabetes, Hypertension, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

I only get asked about this everyday, so let’s review keeping your brain healthy. Unfortunately too often some of you only ask at the point when early dementia or Alzheimer’s disease has begun to develop, but this is another example of an ounce of prevention being worth a pound of cure. Also, these requests often seem to be related to some internet promise of health based on some fad or miracle cure. Remember the Straight, No Chaser dictim: your health won’t be found in a bottle.
In a previous post about how your brain works, we pointed out that your brain consumes a tremendous proportion of the body’s oxygen supply. So to begin the conversation, just remember that a diet promoting good blood flow throughout the body promotes good blood flow to the brain. I wish I could convince you that a baseline level of brain health is just this simple: consume a diet low in fat and cholesterol. If you’re not clogging the arteries in the rest of your body, you won’t be clogging arteries in your brain. The same things you’re doing to avoid diabetes and hypertension will help you here.
As such let’s provide an overview to five basic principles to keep your brain healthy. If you adhere to these, you can save the money you’re spending on ginkgo biloba.

Reduce your fat and cholesterol intake
It’s as simple as already discussed. High intake of these foods promotes a higher risk of Alzheimer’s disease later in life. Try these specific tips.

Use olive oil instead of other saturated fats.
Bake or grill your food instead of frying it.

Eat foods shown to protect and promote brain health
I want to make this simple. If you’re eating dark-skinned fruits and/or vegetables, you’re doing good by your brain. These foods tend to have the highest levels of antioxidants fighting off damage to your brain cells. Here are some specific examples of brain healthy foods. Try working them into your diet.

Fruits – blackberries, blueberries, cherries, oranges, plums, prunes, raisins, raspberries, red grapes and strawberries
Vegetables – alfalfa and Brussels sprouts, beets, broccoli, corn, eggplant, kale, onion, red bell pepper and spinach
Nuts – almonds, pecans and walnuts are a good source of vitamin E, another powerful antioxidant
Fish – halibut, mackerel, salmon, trout and tuna (all contain omega-3 fatty acids, which are brain healthy)

Vitamins
The best way to obtain brain-healthy vitamins is through a brain-healthy diet. Foods strong in vitamins E, C, B12 and folate appear to be important in lowering your risk of developing Alzheimer’s. It should come as no surprise that the foods listed above meet that criteria. You may not know that obtaining vitamins through your food appears to deliver what you need better than taking pills.

Exercise
If you’re keeping your heart strong and pumping blood efficiently throughout your body, your brain is getting its needed supply of oxygen and nutrients. Check this Straight, No Chaser on basic exercise tips.
Be social, Be a lifelong learner
Exercise your brain through social interactions with others, especially those that “stimulate your brain.” The diversity of experience keeps different parts of your brain active, alert, functioning and healthy. Learn a new skill or language. It’s almost as good as starting over!
Another Straight, No Chaser will focus on additional ways for you to engage your brain to keep it working and working well.
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: Brain Health – How Your Brain Works

August 11, 2015General Health and Wellness, Mental Health, Neurology844-SMA-TALK, Alzheimers, Behind the Curtain, brain health, brain stem, cerebellum, cerebral cortex, cerebrum, neurons, Spinal cord, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Everyone at Straight, No Chaser and www.sterlingmedicaladvice.com is into brainpower. This is the first of a series of posts on brain health and brainpower. The purpose of these posts is to give you enough information to optimize, maximize and extend your brain health. Hopefully you’ve learned all this before (no pun intended), and we’re just reorganizing it for you.
The brain really is a fascinating organ; indeed it’s the body’s most powerful (with apologies to the heart; don’t be broken by the news). Despite jokes to the contrary, it only weighs about three pounds in the average person (I’d imagine many of you are inserting your own jokes about your favorite friends here…).

The brain has three major components:

The cerebrum is the area taking up most of the area in your skull. It controls thinking, problem solving, remembering, feeling and movement.
The cerebellum controls coordination and balance from its position in the back of the head, below the cerebrum.
The brain stem is also beneath the cerebrum but is in front of the cerebellum. The brain stem connects the brain to the spinal cord. It controls breathing, blood pressure, digestion and heart – functions you normally don’t have to “think” about (automatic functions).

You may be surprised to know about a quarter of your total blood supply nourishes your brain with each heartbeat. Your network of brain cells consists of billions of cells, and they extract approximately 20% of the oxygen and nutrients being carried by the blood. This amount can increase up to 50% depending on the brain’s level of activity. This is an immediate illustration of why brain health is so vital.

Have you ever wondered why the brain has that wrinkled outer appearance? That area is called the cortex. The cortex roughly resembles a map corresponding to various functions. This area interprets sensations from within your body, and sights, sounds and smells from the outside world. It also helps you form and store memories, generate thoughts, make plans and solve problems. The cortex also controls voluntary movements.

Another common question about the brain relates to the differences between the left and right sides and what that has to do with people who are left handed or right handed. Here’s what is clear about the different halves of the brain.

The left half controls movement of the right side of the body, and the right half controls the left side of the body. Thus if you’re right-handed, you’re likely left-brain dominant.

In most people, the language area is mainly on the left.

All things considered, the adult brain has approximately 100 billion nerve cells, called neurons. Neurons are where the real work of your brain occurs. Via various branches, there are more than 100 trillion connections. This amazing and powerful network is called the neuron forest. This network of neurons is how we know to generate thoughts, feelings and memories. The individual “way stations” where chemicals (neurotransmitters) sent by neurons via electrical charges connect are called synapses. There are dozens of different types of neurotransmitters facilitating different levels of communication within the brain.

Functionally, this level of specificity is important to know at a general level because it sets the table for these additional considerations to be discussed in additional posts:

Good brain health keeps your brain working optimally.
Certain diseases (e.g. Alzheimer’s) destroy neurons and otherwise disrupt both the way electrical charges travel within cells and the activity of neurotransmitters.

This is a simplistic representation of how your brain organizes all the thoughts, activities, memories, skills and knowledge of self we have. Make the commitment to protect your brain. After all, it’s who you are.
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: Does Cuba Hold the Key to Lung Cancer Treatment and Prevention?

August 10, 2015Hematology & Oncology/Blood Disorders/Cancer, Public Health, Respiratory/Lungs, Health Prevention844-SMA-TALK, Behind the Curtain, Cimavax, Lung cancer, oat cell cancer, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

For many, some of the first things that come to mind when you think of Cuba are smoking and cigars. For many others, the one of first things that come to mind when you think of cigars is cancer. As such, lung cancer is the fourth-leading cause of death in Cuba. Given that necessity is often the mother of invention (and given Cuba’s outstanding public health system), it stands to reason that Cuba might be at the forefront when it comes to advancing the search for a cure for cancer.
In the medical news (and in the category of important stuff that’s actually going on but you aren’t paying attention to), is a Cuban-developed lung cancer vaccine called CimaVax. Imagine if you will: a potential powerful deterrent to the most common form of lung cancer may have existed 90 miles off the shores of the US for 25 years but has been unavailable to citizens due to the US-Cuban trade embargo. Sounds like a good enough reason to normalize relations all by itself, you think?

Here’s what we know about CimaVax at this point:

It’s been researched for 25 years in Cuba and Europe.
It’s been available to Cubans since 2011.
It’s been used to treat 5,000 worldwide.
Research, including that published in the US (Journal of Clinical Oncology), has shown CimaVax to be safe, with no significant side effects.
Research has shown it to especially increase survival in study participants younger than 60 years old.

To be clear, CimaVax is not a cure for cancer; what it’s doing is blocking a hormone that causes lung cancer growth. It is thought that this strategy will also prove beneficial in the fight against breast, colorectal, head/neck, ovarian and prostate cancers, so in the field of oncology (study of cancer), this is a really big deal.

What’s next is applying the full scrutiny of the scientific method here in the U.S. What’s possible is within a few years, we may have access to what would unquestionably be one of the biggest tools in the fight against cancer this side of prevention. Here hoping. Sometimes good politics actually do make for great public 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: Extracting Ticks and Preventing Tick Bites

August 7, 2015Infectious Disease, Health Prevention844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Springtime is the beginning of the outdoor season for many. Whether you’re camping, hunting, playing paintball, hiking or engaged in other activities in the woods or tall grass, you need to be alert to the presence of pesky mosquitoes and ticks.
This Straight, No Chaser will discuss prevention and removal of ticks. An additional post will discuss tick-borne diseases.
Tick-borne diseases are seen more often between April and September, because people are more inclined to be outdoors during the warmer months. Preventative activities are necessary whenever you’re outdoors.

Try the following preventative measures:

In general, ticks are found in areas with high grass and in leafy mounds. Avoid these areas, and stay on trails that are well outlined when possible.
Wear clothing that covers as much of your body as practical.
Wear clothing that is pretreated for tick control. These products contain permethrin. Protect your pants, boots and socks. Also treat your tent if you are camping.
If you’re using repellent (which you should), use 20-30% DEET. Apply repellent generously and avoid getting it in the eyes, mouth and hands.

Prevention also includes steps you take once you’re literally out of the woods.

As soon are you arrive home, bathe and/or shower.
View (or have someone else view) your body for ticks. Be sure to check the hair and in body crevices, such as under your arms, within the belly button, armpits and the backs of the knees, the front of the elbows, around the waist and groin, and around the ears.
Once you’ve cared for yourself, check your gear and any pets that accompanied you. Ticks can attach to your pets or other items taken on the retreat, then get on you later. Take the time to look everything over.
Furthermore, once washing your clothes, tumble them in a dryer set on high heat for an hour. This will kill any remaining ticks.

The simplest way to remove a tick that is attached to you is to use tweezers, which should be part of what you take with you when headed to the woods.

Grasp the tick as close to your skin as possible.
Pull upward with steady, even pressure, and do not twist, bend or jerk the tick.
If you break off the tick’s mouth and leave it in the skin, go back and take out the individual parts with tweezers. If you are unsuccessful, do not dig into the skin. Do the best you can to clean the area; the skin will heal.
After removing whichever part of the tick you can, use soap and water, alcohol or and iodine scrub to clean the area of the tick bite.

Avoid and ignore folk tales that involve doing anything to the tick other than extracting it. Without going into details, using paint or fire doesn’t help and can make matters worse.
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: Avoiding Mosquito-Bourne Diseases

August 6, 2015Infectious Disease, Health Prevention844-SMA-TALK, Behind the Curtain, Conditions and Diseases, dengue fever, japanese b encephalitis, malaria, mosquito, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, west nile virus, yellow feverJeffrey Sterling, MD

Sometimes things occur so frequently that you become sensitized to the real danger they present. This thought occurred to me when I saw Bill Gates talking about efforts to eliminate the various threats posed by mosquitoes. Yes, mosquitoes.

Including the damage humans inflict on each other during times of war, mosquitoes are responsible for more human suffering than any other organism on earth. Well over one million humans die every year from diseases transmitted by mosquitoes, and with worldwide travel having increased as it has, the risk is greater than ever. Even if you don’t know the diseases caused by mosquitos, you may have heard of them.

Malaria

West Nile virus

Dengue fever

Yellow fever

Japanese B encephalitis

Getting into the specifics of these various diseases is beyond the scope of this particular post. What I’d like for you to appreciate is this list comprises various diseases with deadly consequences.
Furthermore, you’re not defenseless. There are steps you can take to lessen your risks. In the interest in making this manageable, I’m going to focus on the “Ds of mosquito prevention”, because as is the case with most things, prevention is more effective than attempting to cure a disease once it is obtained.

Dusk and Dawn: Try to steer your activity away from the times when mosquitoes are most active.
Drain: Get rid of standing water around your home. This is where mosquitoes will lay eggs.
Dress: During those times when mosquitoes are most active, wear clothing that covers as much of your skin as practical.
DEET: Use mosquito repellent. Repellents containing up to 30% DEET are effective. Additionally, picaridin, oil of lemon eucalyptus and IR3535 are effective, according to the Center for Disease Control and Prevention (CDC).

Here are a few other simple tips.

Cover doors and windows with screens to keep mosquitoes from entering your home.
Keep infants indoors or use mosquito netting over carriers.
If you have a water garden, stock it with mosquito-eating fish, such as gambusia, goldfish, guppies or minnows.
If you’re traveling, be aware of peak exposure times and places, and schedule around these times if possible. Avoid outbreaks.

Being just a bit more sensitive to the risks mosquitoes pose could be an important component of your overall health strategy. Be smart, and be healthy.

Straight, No Chaser: Your Guide to Fighting Childhood Obesity (Works for Adults, Too!)

August 5, 2015Diet and Nutrition, Pediatrics/Kids Health, Health Prevention844-SMA-TALK, Behind the Curtain, childhood obesity, Diet (nutrition), Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Would you start your child on a fad diet? Of course not. Combating obesity means consistently applying principles that bear fruit (and include fruits over time). So you have an overweight child and want to do better to protect his or her health. Today on Straight, No Chaser, we discuss tips to promote better habits and health. You may want to keep this list. Of course it starts with you. Be careful! You may discover these tips work for you as well.

Things for the parents to do

Understand that this process involves many individuals (e.g., you, your physicians, dieticians, psychologists – even your personal healthcare consultants). None of you should be expected to do this alone. Ask for help.
Appreciate that you are the message. Your words are not enough. You are your children’s role model. They will aspire to look and be like you. Protect your own health.
Don’t isolate your child. Get the entire family involved in developing healthy eating and physical activity habits.
Don’t mentally punish your child. If they are led to believe they did something wrong or disappointed you, they could adopt dangerous behavior to compensate or punish themselves. Be supportive and positive.

Healthier eating habits

General conditions

Make healthy choices easy and unhealthy ones more difficult. Put nutritious foods where they are easy to see, and keep high-calorie foods out of sight. It takes multiple servings for anyone’s tastes to get used to new foods. Stick with it!
Figure out how to avoid fast food. When you do go, choose the healthier options, such as salads with low-fat dressing.
Plan special healthy meals and eat together as a family. Make it an adventure, and make it fun and rewarding.
Don’t use unhealthy foods as a reward when encouraging kids to eat. Promising dessert to a child for eating vegetables, for example, sends the message that vegetables are less valuable than dessert.
Don’t make your child clean his or her plate. This promotes overeating.
Learn to limit eating to specific meal and snack times. At other times, the kitchen is “closed.”
Avoid large portions. Start with small servings, and let your child ask for more if he or she is still hungry.

Limit the bad

Avoid any fats that are solid at room temperature (e.g., butter and lard)
Avoid foods that are high in calories, sugar and salt (e.g., sugary drinks, candy, chips, cookies and French fries)
Avoid refined grains (white flour, rice and pasta)

Add the good

Introduce fruits, vegetables, nuts and seeds and whole grains (e.g., brown rice). Don’t worry. They’ll eat them if that’s the option you’re providing.
Use fat-free or low-fat milk and milk products or substitutes (e.g., soy beverages)
Offer your child water or low-fat milk instead of fruit juice
Serve lean meats, poultry, seafood, beans and peas, soy products and eggs

Control the snacking

Go with air-popped popcorn without butter
Gradually train your kids to like fresh, frozen, dried, or canned fruit served plain or with low-fat yogurt
Gradually train your kids to like fresh vegetables like baby carrots, cucumber, zucchini or tomatoes
Snack on low-sugar, whole-grain cereal with low-fat or fat-free milk or a milk substitute fortified with calcium and vitamin D

Stay physically active

Kids need about 60 minutes of physical activity a day. Several short 5-10 minute periods of activity throughout the day are as effective as one 60-minute session. If you are starting from scratch, start from where you are and build up to the 60 minutes target. It only works if you stay diligent.
General considerations:

Be the message! Show your child that physical activity is fun, and demonstrate how you enjoy it. Have family activities that include being physically active, such as a walk.
Encourage participation in organized sports or classes, such as basketball, dance or soccer.
If sports don’t work, other fun activities include dancing to music, playing tag, jumping rope or riding a bike.
Assign active chores such as making the beds, sweeping/raking or vacuuming.

Activities that kids choose to do on their own are often best. Try these – and play with your kids. You need to be active, too!

Catching and throwing
Climbing on a jungle gym or climbing wall
Dancing
Jumping rope
Playing hopscotch
Riding a bike
Shooting baskets

Cut back on inactive time spent watching TV or on the computer or hand-held device.

Limit screen time to no more than two hours per day.
Substitute these relatively inactive activities with stimulating ones such as acting out books or stories or doing a family art project.
When watching TV, get up and move during TV commercials. By all means, discourage “couch-potato” activity of snacking when sitting in front of the TV.

I know this is a lot, but your kids are worth it, as are you. These actions are habits, not just actions. Work over time to incorporate as many as possible into your family’s routine, and I promise you’ll see the difference.
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.

Straight, No Chaser: Childhood Obesity

August 4, 2015Cardiology/Heart, Diet and Nutrition, General Health and Wellness, Pediatrics/Kids Health844-SMA-TALK, Behind the Curtain, Obesity, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Here’s the thing. Adults have control over and choices about how to live their lives. In the overwhelming majority of cases, children do not. Yet, in the overwhelming majority of cases, adults have control over their children’s health.

Amazingly, approximately one of every three children between the ages of five to 11 is either overweight or obese. It’s not too late. If you’re looking across the breakfast table at a child that’s overweight or obese, please take the time to learn about childhood obesity, the consequences of allowing it to continue and the proactive steps you can take to ward off those consequences. Read on.
If by chance you’re thinking that you have no idea if your child is obese or just looks that way because everyone else in the family looks that way (is “genetically predisposed”), perhaps the first step is to get a better understanding of normal vs. abnormal.

No matter you perceptions of how “good” or “healthy” it may look, normal is less a function of appearance than a reflection of your heart and other organs’ abilities to perform their tasks. Using the heart as an example (and admittedly being overly simplistic), it is a muscular pump serving the purpose of moving blood around the body, delivering oxygen and nutrients to the cells of your various organs. The more weight it has to pump against, the harder the task becomes, and the heart will eventually increase the pressure to compensate (i.e., develop high blood pressure). The sooner this process starts, the more at-risk you are for the consequences of the development of high blood pressure and other conditions (including cancer) down the road. Beside high blood pressure, other health issues associated with childhood obesity include the following:

Breathing problems
Joint problems
Diabetes
High cholesterol

It is important to acknowledge that “big” is not always unhealthy. The amount of body fat changes with age and based on where children are in their growth curve. A physician will take these things into consideration when you have your child evaluated for clinical obesity. On the other hand, please understand the social pressures children may face at school from being overweight. If they perceive a problem to exist, one does.
In the next Straight, No Chaser, we will discuss in detail what you can do to help children who are obese. To no one’s surprise, a heavy dose of healthy eating and physical activity will be on the prescription. As a prelude to that conversation, I will suggest that you should not be placing a child on a diet without a physician’s order. Healthy eating habits will be the way to go.

Overall, just remember that either the positive or negative habits children learn are likely to last a lifetime. As a parent, you will be best positioned to guide children along the appropriate path.
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.

Straight, No Chaser: A Personal Testimony of Health Empowerment

August 3, 2015Public Health, Health Prevention844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Straight, No Chaser often offers guest commentary; it’s helpful to hear complimentary perspectives on all sorts of matters. That said, what matters most is our ongoing goal of health empowerment. We want you to feel that you have the information you need to live your life to its fullest. I hope we get that right more times than not. To that end, today we turn over this space to a reader of both Straight, No Chaser and Behind the Curtain: A Peek at Life from within the ER Enjoy, and we’d love to hear your stories. Regarding this one, I couldn’t have said it any better.
Personal anecdote:
I Just came from “Behind The Curtain.” It was more than I expected and everything you promised and intended. A clear picture of who you are in life will be clearly reflected in the X-ray of your transition/death.
I am not surprised how well written the book is, the order of presentation, nor the vast territory covered, but I was truly enamored with your ability to provide minimal detail while painting a complete picture…not a simple (or easy) art.
My take away… “Our medical conditions are most often traceable and are the consequences of our actions. That’s not the same as saying illness is your fault, but your health is your responsibility. Empower yourself with knowledge…”
I am overweight because I consume more calories than I burn (fundamentally, correct). The difference between right and wrong is typically an easy distinction (for most anyway), but the decision/difference in choosing between right and wrong demands acknowledgement, desire and discipline. Because I’ve been what I refer to as “spoiled” (you know – want what I want, when I want it) my entire life, I have not exercised (literally nor figuratively) the discipline necessary to manage my weight. Thus, technically, I’m over weight because I haven’t exercised the necessary discipline.
It’s understandable that we don’t know what we don’t know, but it’s idiotic to not use (or capitalize on) what you do know. Thank you! Thank you! Thank you! In hopes of staying from Behind the Curtain, I have made a decision to choose what I want most, over what I want now. After all, isn’t that what discipline is?
Lastly, two things, during your brief presentation at the book signing you stated “this book isn’t going to make me rich…” I would add…” But it can (hopefully) enrich the quality of life or dignity of death. And that is priceless!”
Excellent job, J Sterling! Excellent! Secondly, unless your goal is to do things differently, May I suggest signing the title page vs the inside cover.
That’s it! That all!
One more “last thing…” I too, almost lost my mother, in a nutshell: had a colonoscopy (@Cook County), the tech ripped/punctured her intestines (presumably unknowingingly), next day there was pain and more pain, she passed out, and paramedics had difficulty with resuscitation and moving an obese patient, creating further delay… We arrived at University of Chicago with a Code Blue… The doctors think it’s a miracle they get a pulse and heartbeat because they believe it’s a ruptured aorta The cardiologist goes in, nope, it’s a ruptured intestine, and they’ve got to get a different teams of doctors…. After a three month stay (and more drama and trauma), she heads to RIC for a 6 week rehabilitation journey…only to return a week later vomiting liquid w/blood (I can’t even recall that diagnosis). Five years later the hell raiser is still traveling the world – raising hell! But only due to God’s grace.
Love is the capacity to connect, forever! Love always.
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.

Straight, No Chaser: Spice Drugs aka Herbal High aka Synthetic Marijuana

July 31, 2015Public Health, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, herbal high, marijuana, spice drugs, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

So have you ever wondered why incense seems to relax you so? In our ongoing effort to keep you up to date with the latest drug teens may be using, today’s topic introduces “Spice” aka “herbal high.” Simply put, spice products are an effort to create a legal synthetic marijuana. You may be thinking: “Why wouldn’t they just find some marijuana?” Let’s pose and answer at some questions related to the topic.
How does this work? These drugs are synthetic cannabinoid receptor agonists, meaning these chemical compounds interact (fit into) the receptors where cannabis does, producing similar effects.

So it is the same as marijuana? No. The substances affect other parts of the body than cannabinoid receptors, which is how side effects and other symptoms are produced.
What types of symptoms are produced? Clinical symptoms are variable, but in a majority of cases, altered mental status and rapid heart beats occur, along with the typical high one gets from marijuana. Most patients normalize after 2-4 hours, assuming additional quantities aren’t inhaled. Additional symptoms described have included seizures, hallucinations, anxiety and very vivid dreams.
Is this as safe as marijuana? No. Many of these drugs are much more potent than the active substance in marijuana (delta-9-tetrahydrocannabinol – THC), therefore, the psychoactive dose may be much less. Given that marijuana and these substances aren’t some for effect per se, but habitually and recreationally, the potential for toxic inhalations is more significant. Furthermore, these substances are associated with addiction syndromes and withdrawal symptoms.
Do they show up on drug screens? No, not currently. Therein lies part of the attraction.

How do people obtain these substances? Therein lies more danger. If you’re in the know, you’re in the know. If you’re not, you could be playing with fire (no pun intended). These substances are easily obtainable legally, including on the Internet. The packaging usually refers to the content as herbal incense and “not for human consumption.” Many of these drugs are much more potent than delta-9-tetrahydrocannabinol (THC), therefore, the psychoactive dose may be < 1 mg.^[1,2]
But they’re legal? To be clear, selling and possession of these substances is illegal in the U.S. The Drug Enforcement Agency (DEA) and the US Department of Health and Human Services (DHHS) are currently determining if and how these entities will be permanently controlled in the United States.
The Straight, No Chaser recommendation is to find a way to get high on sunshine.
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.

Straight, No Chaser in the News: Your Doctor May Already Be a Nurse

July 30, 2015General Health and Wellness, Public Health844-SMA-TALK, Behind the Curtain, Nurse practitioner, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

I doubt you’ll hear this perspective anywhere else anytime soon, but there are some very interesting developments in health care underway, and you weren’t supposed to hear about them by design. By way of introduction, a few decades ago, physicians abdicated the ownership and preeminent leadership role in healthcare, leaving the industry to the business minds of HMOs. During these early days, non-physician corporations actually owning medical practices and developing practice parameters were outlawed as to ensure that sufficient protections would remain in place for autonomous (and presumably honorable) medical practice.  The combination of for profit hospitals and the advent of contract medical practice management groups (particularly in emergency medicine, hospitalist medicine and radiology) combined to erode away at the corporate practice of medicine laws to where even though the laws are still on the books, suits to enforce it are now routinely defeated. Today, in addition to emergency room physicians, radiologists, surgeons, hospitalists, and anesthesiologists are more likely to be employees than owners of a practice.
In recent times, health care costs have skyrocketed to 17% of our economy, while 50 million Americans went without insurance. Meanwhile, the combination of a shortage of primary care physicians and for-profit entities’ desire to cut costs has led to the development and proliferation of alternative, less costly methods of paying individuals to provide health care. Most notably, this has included the development of advance practice nurses (e.g. nurse practitioners and nurse anesthetists – instead of family doctors and anesthesiologists). Similar interest in cost savings has led to nurses assuming senior managerial positions in hospitals instead of MBA-type executives.
It is against this backdrop that the Patient Protection and Affordable Care Act (aka ‘Obamacare’) passed, seeking to infuse 30 million more paying patients into the primary care arena. With ongoing physician shortages unable to meet this demand, and with there being downward cost pressure on salaries due to the goals of the ACA and desires of corporations, it’s reasonable to predict that we will see a dramatic increase in primary care nurse practitioners (NPs) and physician assistants (PAs), which will lead to further abandonment of primary care as a physician specialty.

Meanwhile, nurses have stepped up to fill the void. In addition to the ongoing advancement of Nurse Practitioners, nurses have successfully lobbied for and created a new provider entity: ‘The Doctorate in Nursing Practice’. It is important to note that NPs and PAs can successfully treat about 85% of the things physicians routinely see. Quality concerns aside, it is an important public health consideration that additional healthcare professionals and health options are being established to fill the need of care for tens of millions of individuals more likely to use the healthcare system.
Meanwhile, regarding your doctors, a conceivable end result is physicians are being marginalized in virtually every aspect of health care. It is easy to see a future in health care 25 years from now where cost concerns have been addressed by nurses having replaced physicians in more specialties than just primary care and anesthesia, and nurses have more control of the hospital apparatus than physicians. Physicians remain oblivious to what’s happening under their noses and an insufficient interest in contributing to healthcare solutions in the ways nurses have. The Straight, No Chaser perspective is given the large segments of society that continue not to have access to care (even with implementation of the Affordable Care Act, it is estimated that 20 million American still won’t have insurance), new innovative options to address these needs are welcome and have a place in the system. What’s next is for society to ensure that this transition occurs with appropriate quality controls and public education.
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.

Straight, No Chaser: Frequently Asked Questions About Your Sore Throat

July 29, 2015Head/Eyes/Ears/Nose/Throat, Infectious Disease844-SMA-TALK, Behind the Curtain, laryngitis, pharyngitis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, tonsillitisJeffrey Sterling, MD

Sore throats. So common. So simple. So sore. So much time wasted in emergency rooms only to get nothing for them… Here are a group of frequently asked questions to help you sort out the whys and what next considerations for you and your family.
How do I catch a sore throat?
You only “catch” them when the cause is an infection. Routine measures such as regular hand washing, covering your mouth when sneezing or coughing and keeping your hands out of your mouth go a long way to protecting you from infectious causes of sore throats.

Is a sore throat the same thing as tonsillitis?
Tonsillitis is one of many causes of sore throats. Causes can include infections, smoking, allergies and trauma to the back of your throat. Yes, bad singing can hurt more than someone else’s ears.
So what do I need to know about tonsillitis?
First you should know what and where the tonsils are. Besides being preferred landing spots for ice cream, the tonsils are the tissue located on both sides of the back of your mouth, as highlighted in the picture above. Tonsils are a common site for infection.
How is tonsillitis treated?
The treatment of sore throats in general is based on the cause. Tonsillitis can be caused by either bacterial or viral infections. Viruses do not respond to antibiotics, whereas bacteria do. Tonsillectomies are not needed in most people with tonsillitis. If you get severe tonsillitis often enough, or if you’re having breathing problems, you doctor may consider it.

Is strep throat the same as tonsillitis?
No. Strep throat is a sore throat caused by a specific type of bacteria (Streptococcus).

What is mono?
Mononucleosis (aka mono, the kissing disease) is a viral infection that causes sore throat. One clue that is very suggestive of the presence of mono is gland swelling in the back of your neck, as noted in the above picture.
Are sore throats dangerous?
It depends on the cause. If untreated, strep throat can result in dangerous disease of the kidney (called glomerulonephritis) or the joints and heart (called rheumatic fever). The complications of mononucleosis can be more serious that the disease, including splenic enlargement and rupture, as well as hepatitis (inflammation to the liver).
How does my doctor determine the cause of my sore throat?
Some physicians rely on clinical signs and symptoms. Others will obtain a throat culture or a rapid strep test. These tests are especially important if the decision is being made not to treat, because of the complications mentioned for untreated strep throat. Regarding mono, diagnosis may be confirmed with a blood test.
How are sore throats treated?
If your sore throat is caused by bacteria, you will receive an antibiotic. If it’s caused by a virus, you won’t. Antibiotics are ineffective against viruses. Just as occurs with other viruses such as the common cold, sore throats caused by viruses will go away on their own in 7-10 days.
Regarding specific treatment considerations:

If you have strep throat, your doctor will need to know if you’re allergic to penicillin.
No one under age 18 should take aspirin. Acetaminophen (e.g., Tylenol) or ibuprofen (e.g., Motrin, Advil) or naproxen (e.g., Aleve) can be given for relief of pain and/or fever.
If allergies are the cause of the sore throat, avoiding the causes is the most important consideration. Additional medicine for symptom relief is available.
Yes, gargling with warm salt water is effective. Place one teaspoon of salt in eight ounces of water.
Sucking on hard candy, throat lozenges, ice cream or frozen foods (e.g., popsicles) can help.
Drink plenty of fluids, warm or cool.
A humidifier is helpful for easing scratchy throats.

Straight, No Chaser: Suicide and Suicide Risks in College Students

July 28, 2015General Health and Wellness844-SMA-TALK, Behind the Curtain, Bipolar disorder, Death, Disorders, Gia Allemand, health, List of causes of death by rate, Major depressive disorder, mental-health, Molecular Psychiatry, Religion, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Suicidal ideation, Suicide, Suicide preventionJeffrey Sterling, MD

I just 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.

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.

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.

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.
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.

Straight, No Chaser: Healthy Eating Tips

July 27, 2015Diet and Nutrition, General Health and Wellness, Public Health844-SMA-TALK, Behind the Curtain, diet and nutrition, healthy eating plate, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

If you want to eat healthy, you really must learn about and try to eat in accordance with the Healthy Eating Plate. It doesn’t get more complicated that that, and you shouldn’t attempt to make it much more complicated.
Today, I’m going to speak on recommendations from the U.S. Department of Agriculture Center for Nutrition Policy and Promotion, which I’m building upon for your success. These bakers’ dozen of tips represent simple, easy-to-do tasks to keep your meals healthy.
1. Eat at home. This accomplishes so many things. If you eat at home, you know exactly what you’re eating. That quality control is important, and it allows you to both save money and get creative in your pursuit of health.
2. If possible, take the cooking out of your hands. Those of you with less self-discipline would do well to simply express your healthy desires to your loved one. Give her or him directions on your health goals and eat what’s brough to you.
3. Use a smaller plate. This act with help you with portion control. If you’re one of those who must finish your plate, this will help prevent you from overeating.
4. Stop eating when you’re full. The body actually is trying to tell you when you’re hungry and when you’re not. Try to overcome that voice in your head that tells you “finish your plate.” Calorie control is the vital component of health.

5. Make half your plate colorful fruits and vegetables. If you just remember dark green, red and orange colors and consistently full of nutrients and healthy, you’ll do well. Think of tomatoes, sweet potatoes and broccoli as examples.
6. Eat slowly. Even if you’re not chewing each morsel 20-25 times before swallowing, learning to savor your food will improve your eating experience and promote a sense of fullness and satisfaction with smaller portions. No, it won’t necessary make you want even more.
7. Lean. Protein. Limit your red meat. Learn to appreciate lean meats, such as chicken, turkey and seafood. Beans and tofu are also excellent protein sources. When you do eat beef and/or pork, ask for lean cuts.
8. Seafood, not see (more) food. Make it your main course at least twice a week.

9. Whole grains. Just say the words and look for the words. When you’re buying breads, look for 100% whole grain. At a restaurant? Specifically ask for whole grains in your breadbasket. You cannot assume your breads are whole grain otherwise.
10. Avoid the extra fat. There’s no good in eating healthy if you cover the goodness with heavy sauces, gravies, syrups or salad dressings. Ask if low fat, low-calorie alternatives exist.
11. Got dairy? Learn to move beyond whole milk. Fat-free, low-fat, soy or almond milks (or yogurt without a daily drink) are all better options and provide the same amount of calcium and other nutrients without all the fat and calories.
12. Satisfy your sweet tooth in a different way. Learn to enjoy a fruit cocktail, yogurt parfait, baked apples or other healthy options as your dessert. All you’re really wanting is a dab of sugar anyway!
13. Learn variety; build your choices. Have you ever tried mango, kiwi, lentils or kale? If so, did you give up after the first taste? Many healthy foods need to be prepared to your liking. Think seasonings and preparation. Get creative!
Whatever you do, fast food is not the option. Invest a touch of time into these very simple tips and undo the bad luck to be found if most of your diets.
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.

Straight, No Chaser: Book Excerpt – Behind the Curtain

July 24, 2015General Health and Wellness, Public Health844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Today is Launch Day for Behind the Curtain: A Peek at Life from within the ER! That means you’ll see it at bookstores and can get it on your Kindle – and Amazon, iTunes and Barnes & Noble will start delivering your preorders. Thank you to all of you who have already purchased it from JeffreySterlingBooks.com, read it and have given us great feedback.
Today I think about my partners in this crazy journey of mine – especially my nurses and techs. Whenever I meet a nurse (especially an emergency nurse), I go out of my way to say thank you, and I do so again today. On this day, let me honor them by sharing an excerpt from Behind the Curtain! Thanks for your support!

Say My Name! Screaming Nurses

I love nurses. Always have. Always will. Nursing has always prided itself on being “the caring profession,” and knowing the things they are made to do for patients, that is certainly true. The amount of humility and compassion it takes to perform their job is substantial. Nurses also care for doctors (especially the ones they like!), and the smart doctors take care of their nurses at every opportunity. I became a much better physician once I learned to trust and listen to my nurses. Even when they’re wrong or off-base about the specifics of a case, they are usually right about something significant being in play. The vast majority of nurses I have worked with clinically are true professionals. They are interested in patient care and are devoted to making me and my medical practice successful. They have allowed me to teach them and show them how to recognize danger signs and things I have expressed that could be important. That helps them communicate things back to me.
In general, my nurses end up with very similar traits. They ask questions and make suggestions. They know when it’s OK to drag me by the collar into a room! And then there is the screaming.
As a physician, you can learn to loathe your name. I’m sure there were days when I heard “Dr. Sterling” over a thousand times. It is always a special treat to have five people conversing with me simultaneously. That said, the nurses always knew how to get my attention.

There was the “Dr. Sterling,” as in “You really aren’t paying attention.”
There was the “Dr. Sterling,” as in “Stop, and listen to me.”
There was the “Dr. Sterling,” as in “Please don’t make me do that!”
There was the “Dr. Sterling,” as in “I don’t care if you haven’t eaten, I have a question.”

However, those were the stern voices. There were also the screams.

“Dr. Sterling”—sing-song, as in “One of your inappropriately flirty patients is here!”
“Dr. Sterling”—annoyed, as in “Where are you hiding?”
“Dr. Sterling”—pleading, as in “When are you going to do what I asked you to do? We need to get this patient out of here!”
“Dr. Sterling”—afraid, as in “Someone’s trying to die!”

One day, I heard a scream that I had never heard before, and I’m sad to say I have heard it several times since. The shriek sounded like my nurse was in danger. I rushed to the room and slung open the curtain. There stood my nurse, almost in tears. She was standing there like someone had just thrown a bucket of water on her….
For the exciting conclusion to the story, you’ll have to read the book!

Straight, No Chaser: Ask An Author – Behind the Curtain with Dr. Jeffrey Sterling

July 23, 2015General Health and Wellness844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

It’s a day before I get to experience the feeling of walking past my book in a bookstore (nationwide wherever books are sold) and readjusting it so it appears more prominently… I want to take this opportunity to thank my publishers and agency at Brown Books in Dallas for the robust and enthusiastic embrace of my effort with Behind the Curtain: A Peek at Life from within the ER. I know several authors. I say that with a degree of reverence. They embrace writing with a passion and perform with layers and levels of complexity that is beyond skilled or mere creativity. With Behind the Curtain, I fancied myself being a story-teller, a communicator and simply someone sharing experiences as part of an ongoing attempt to improve the lives of those within my reach. When asking my friends at Brown Books (if you’re an aspiring author, you’d do well to contact them) what made one an “author” instead of just being a “writer,” I found the answer fascinating. It appears that I’ve been an author for a few years. Authoring is about getting the public to engage in the ideas and stories you share. I am very pleased that Straight, No Chaser has compelled hundreds of thousands of you to examine aspects of how you live your lives and your approach to health and wellbeing. Behind the Curtain will definitely do that but in a much more entertaining manner!
Here are some questions and answers about the book from The Agency at Brown Books.

ASK AN AUTHOR: BEHIND THE CURTAIN WITH DR. JEFFREY STERLING
A servant-leader in healthcare, Dr. Sterling is a national and international advisor, entrepreneur, physician, consultant, speaker, and author, and he specializes in public health, consumer healthcare education and prevention, hospital and provider administration, global healthcare and business infrastructural development, and pharmacoeconomics. As the founder of Sterling Initiatives, LLC, and Sterling Medical Advice, he holds dual roles as the president and CEO of both organizations and also helms company subsidiaries including SMA Health Library, SMA LiveChat, Sterling Medical Wellness, and 844-SMA-TALK.
Additionally, the MD and MPH empowers anyone, anywhere to become better stewards of their own care through his blog Straight, No Chaser, where he shares daily, in-depth information and solutions with more than 32,000 digital followers. Now, Dr. Sterling is expanding his publishing channel with the 2015 launch of his debut title, Behind the Curtain, on July 24. Revealing and unflinching, his new release offers an unfiltered look inside the real-life traumas and triumphs that define emergency medicine, and today, he’s giving fans an exclusive peek at the experiences that inspired his first book.
What motivated you to write Behind the Curtain? “Throughout my career, I’ve been reminded time and again that most of us spend our lives in denial about who we are, what we do, and our susceptibility to the consequences of what we do. I wrote Behind the Curtain to hold a mirror to the public. In the ER, people tend to reveal their truest self, not the representative ‘character’ they present in polite company, and I hope that this book illustrates that we’re not as uniform as we pretend to be – and that we’re not as invincible as our often oblivious actions would suggest.”
What was the most significant question you sought to answer in writing your first book? “I wanted to address many of the significant feelings and questions my patients struggled with, like ‘Am I the only one who feels this way? Am I the only one who does this?’ The answer is always a resounding ‘no.’ We live in an amazingly diverse world, and it’s unfortunate that people feel as if their choices aren’t able to be more freely expressed. We’d do better to empower folks’ choices with information to support their decisions.”
What do you want your readers to take away from Behind the Curtain? “That life is meant to be lived and enjoyed, and it is best done so by making educated decisions in advance of bad things happening.”
Head to JeffreySterlingBooks.com to order your copy of Behind the Curtain and submit your RSVP for coast-to-coast book launch events! For more from Dr. Sterling, tap into his Straight, No Chaser vlog series, Health Basics/8 Ways to Stay out the ER, and to discover his pioneering healthcare initiatives, please visit JeffreySterlingMD.com and connect with him on Facebook and Twitter. #####
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. Preorder your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com.

Straight, No Chaser Vlog: Cancer, The Big C

July 22, 2015General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

https://youtu.be/fOeuqHaMEFI

As part of the launch of http://www.jeffreysterlingbooks.com and Behind the Curtain: A Peek at Life from within the ER, the Straight, No Chaser vlog (video blog) series presents “health care basics” to keep you safe, healthy and out of the emergency room. Today’s Straight, No Chaser focuses on Cancer, the Big C. Early detection is paramount. Learn to take CAUTION with cancer.
In the meantime, if you’d like to read Behind the Curtain ahead of its national launch, we are now shipping orders made exclusively on www.jeffreysterlingbooks.com!
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. Preorder your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com.

Straight, No Chaser: The Kirkus Review of Behind the Curtain

July 21, 2015General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Kirkus Reviews, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

It’s launch week for Dr. Sterling’s first book, Behind the Curtain, and that gives us the opportunity to reinforce themes important to you and your health. In this example it allows us to show you objectively what your life resembles as you stand before a physician. As you know, we prefer our information and advice Straight, No Chaser. Apparently, many of you appreciate straight talk as well. We also know from time to time that different voices help communicate messages that we want to express to you. Along those lines we present to you the Kirkus Review of Behind the Curtain: A Peek at Life from within the ER. Founded in 1933, Kirkus has been an authoritative voice in book discovery for 80 years. Kirkus Reviews magazine gives industry professionals a sneak peek at the most notable books being published weeks before they’re released. When the books become available for purchase, Kirkus serves the book reviews to consumers in a weekly email newsletter and on Kirkus.com, giving readers unbiased, critical recommendations they can trust. Here is the Kirkus Review of Behind the Curtain in total.

KIRKUS REVIEW

Drawing on over 20 years of experience in emergency medicine, debut author Sterling presents alternately humorous and sobering stories of the “controlled chaos” of a hospital emergency room.
In these wry, short essays, the author strikes an appropriate balance between serious warnings and diverting stories. In one, he tells of a nurse who was murdered in the office below his, proving that a hospital can be a risky environment; in others, though, he provides plenty of laughs. Many pieces tread a fine line between being comical and raunchy; for example, the author writes of finding a potato up a patient’s anus and of treating a four-hour erection. He uses a mix of the past and present tense to re-create the immediacy of climactic moments. Snappy conversations—such as one that he has with macho young men who assume that they’re invincible against sexually transmitted diseases—reflect his no-nonsense attitude toward patient responsibility: “It’s my job to treat, not to judge, but sometimes it’s very difficult,” Sterling admits. Too many cases, he notes, result from reckless behavior involving overeating, alcohol, drugs, or careless driving. For instance, he describes one drag-racing fatality with three inches shaved off his skull and a man who drank window-washing fluid and suffered permanent visual damage. Even the most tragic, cautionary tales can still hold a grain of hope, though. In one of the strongest anecdotes, “Extracting Life from Death,” he writes of a woman, nine months pregnant, who got into a high-speed crash while not wearing a seatbelt. She was dead on arrival at the hospital, but Sterling delivered her baby girl alive. The book proves to be as informative as it is entertaining, thanks to its reader-friendly tactics: unfamiliar terms appear in italics, connections are made between similar cases, and bullet-pointed lists detail procedures and treatment options. Taken together, they’ll provide laymen with a way through what Sterling calls the “never-ending alphabet soup of protocols.” A gripping step-by-step narration of a cricothyrotomy (which involves making an incision in the throat to create an airway) is a highlight: “Gain control of the windpipe with one hand. Let’s go. Stab incision with only the tip of the scalpel.” Two messages come through clearly in this collection: knowledge is power, and it’s better to be safe than sorry.
Accessible and often amusing medical anecdotes. (End review)

If you’d like to read Behind the Curtain ahead of its national launch on Friday, we are now shipping orders made exclusively on www.jeffreysterlingbooks.com! E-books and other means of obtaining the book will be available for delivery through Amazon, iTunes, Barnes and Nobles and multiple other national outlets on Friday, June 24th.
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, follow us on Twitter at @asksterlingmd and at Instagram at @jsterlingmd.

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