Tag Archives: Benadryl

Straight, No Chaser: Don’t Let the Bedbugs Bite!

bed-bugs-101-chalkboard

There’s nothing pleasant in talking about bedbugs, but’s it is even worse to have to deal with them, so let’s get you some information to help you prevent and address these bug bites.

bed-bugs-chart

Bedbugs are everything you don’t want them to be. They’re parasites found all over the world, living only to feed on the blood of humans and other animals while you sleep. They’re excellent at hiding, and they do so all day. They only come out every week or so to feed, and when that doesn’t work, they don’t mind so much. They can go over a year between meals. Here’s a not-so-pleasant fact. If you have them, they live within eight feet of where you sleep, but they are willing to travel over 100 feet to get to you.
Let’s discuss your major concerns about bed bugs.

bed-bug

How do I prevent having them?

  • Keep a tidy environment so there are fewer places for bedbugs to hide.
  • Routinely check your furniture, drapes and curtains.
  • Use a protective cover for your mattress, box springs and pillows, and frequently check it for holes.
  • When on the road, don’t place your luggage on the floor (use a luggage rack if available). Inspect your mattress, looking for bugs, blood stains or droppings.
  • When returning from a trip, unpack directly into the washing machine. Learn to check your travel bags.

If bitten, what type of symptoms will I have?

  • You’ll itch, and you’ll discover bite marks (These may not appear for a week or two after the bite. Why you might ask? The bite actually injects an anesthetic into you that prevents you from immediately realizing you were bitten.). Symptoms vary pretty widely between individuals, from some having no reaction to others having severe allergic reactions.

Do bedbugs spread disease?

  • At least it can be said that bedbugs don’t transmit other diseases.

What treatment do I need for bedbug bites?

  • Treatment is symptomatic and involves controlling the itching. Diphenhydramine (branded as Benadryl®) is usually effective for this, as are over the counter topic corticosteroids. You should be careful about scratching your skin, as you can cause infections. If you develop redness, swelling, pain, ongoing itching or develop pus from the bite site, you should seek medical attention.

How do I get rid of bed bugs?

  • Once you discover you are exposed to bedbugs, you will need to wash and dry your clothes and bed sheets at very high temperatures.
  • If you aren’t using protective covers for your mattress, box springs and pillows, you will need to do so.
  • Insecticide spraying is effective in treating infestations.

Bedbgs

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

Straight, No Chaser: Don’t Let the Bedbugs Bite!

bed-bugs-101-chalkboard

There’s nothing pleasant in talking about bedbugs, but’s it is even worse to have to deal with them, so let’s get you some information to help you prevent and address these bug bites.

bed-bugs-chart

Bedbugs are everything you don’t want them to be. They’re parasites found all over the world, living only to feed on the blood of humans and other animals while you sleep. They’re excellent at hiding, and they do so all day. They only come out every week or so to feed, and when that doesn’t work, they don’t mind so much. They can go over a year between meals. Here’s a not-so-pleasant fact. If you have them, they live within eight feet of where you sleep, but they are willing to travel over 100 feet to get to you.
Let’s discuss your major concerns about bed bugs.

bed-bug

How do I prevent having them?

  • Keep a tidy environment so there are fewer places for bedbugs to hide.
  • Routinely check your furniture, drapes and curtains.
  • Use a protective cover for your mattress, box springs and pillows, and frequently check it for holes.
  • When on the road, don’t place your luggage on the floor (use a luggage rack if available). Inspect your mattress, looking for bugs, blood stains or droppings.
  • When returning from a trip, unpack directly into the washing machine. Learn to check your travel bags.

If bitten, what type of symptoms will I have?

  • You’ll itch, and you’ll discover bite marks (These may not appear for a week or two after the bite. Why you might ask? The bite actually injects an anesthetic into you that prevents you from immediately realizing you were bitten.). Symptoms vary pretty widely between individuals, from some having no reaction to others having severe allergic reactions.

Do bedbugs spread disease?

  • At least it can be said that bedbugs don’t transmit other diseases.

What treatment do I need for bedbug bites?

  • Treatment is symptomatic and involves controlling the itching. Diphenhydramine (branded as Benadryl®) is usually effective for this, as are over the counter topic corticosteroids. You should be careful about scratching your skin, as you can cause infections. If you develop redness, swelling, pain, ongoing itching or develop pus from the bite site, you should seek medical attention.

How do I get rid of bed bugs?

  • Once you discover you are exposed to bedbugs, you will need to wash and dry your clothes and bed sheets at very high temperatures.
  • If you aren’t using protective covers for your mattress, box springs and pillows, you will need to do so.
  • Insecticide spraying is effective in treating infestations.

Bedbgs

Keep in mind that bed bugs are often an acquired habit. When you’re at a hotel or a guest in someone’s home, be mindful to check everything you bring back home!
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Don’t Let the Bedbugs Bite!

bed-bugs-101-chalkboard

There’s nothing pleasant in talking about bedbugs, but’s it is even worse to have to deal with them, so let’s get you some information to help you prevent and address these bug bites.

bed-bugs-chart

Bedbugs are everything you don’t want them to be. They’re parasites found all over the world, living only to feed on the blood of humans and other animals while you sleep. They’re excellent at hiding, and they do so all day. They only come out every week or so to feed, and when that doesn’t work, they don’t mind so much. They can go over a year between meals. Here’s a not-so-pleasant fact. If you have them, they live within eight feet of where you sleep, but they are willing to travel over 100 feet to get to you.
Let’s discuss your major concerns about bed bugs.

bed-bug

How do I prevent having them?

  • Keep a tidy environment so there are fewer places for bedbugs to hide.
  • Routinely check your furniture, drapes and curtains.
  • Use a protective cover for your mattress, box springs and pillows, and frequently check it for holes.
  • When on the road, don’t place your luggage on the floor (use a luggage rack if available). Inspect your mattress, looking for bugs, blood stains or droppings.
  • When returning from a trip, unpack directly into the washing machine. Learn to check your travel bags.

If bitten, what type of symptoms will I have?

  • You’ll itch, and you’ll discover bite marks (These may not appear for a week or two after the bite. Why you might ask? The bite actually injects an anesthetic into you that prevents you from immediately realizing you were bitten.). Symptoms vary pretty widely between individuals, from some having no reaction to others having severe allergic reactions.

Do bedbugs spread disease?

  • At least it can be said that bedbugs don’t transmit other diseases.

What treatment do I need for bedbug bites?

  • Treatment is symptomatic and involves controlling the itching. Diphenhydramine (branded as Benadryl®) is usually effective for this, as are over the counter topic corticosteroids. You should be careful about scratching your skin, as you can cause infections. If you develop redness, swelling, pain, ongoing itching or develop pus from the bite site, you should seek medical attention.

How do I get rid of bed bugs?

  • Once you discover you are exposed to bedbugs, you will need to wash and dry your clothes and bed sheets at very high temperatures.
  • If you aren’t using protective covers for your mattress, box springs and pillows, you will need to do so.
  • Insecticide spraying is effective in treating infestations.

Bedbgs

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

Straight, No Chaser: Your Rebuttals and Questions about Insomnia

hyperinsomnia

You are certainly an entertaining group behind the scenes. Here are some of your questions on insomnia. Be reminded that should you want to leave me a private question, just go to the Home Page, or type https://jeffreysterlingmd.com into your browser. Here’s five questions from yesterday’s post on insomnia.
1. Aw, hell! You’re telling me I can be dying from something causing insomnia? 

  • It’s way more likely that level of stress you’re displaying is keeping you awake at night.

2. How is it that sex makes you sleepy?

  • When you do exert yourself vigorously, the greater utilization of muscles will deplete glycogen (energy) stores and make you drowsy. Also, it’s well established that certain hormones (e.g. prolactin, GABA and oxytocin) that promote sleep are released after an orgasm.

3. You mentioned tea. A good cup of tea at bedtime helps me sleep.

  • If that works for you, go for it. Some people have paradoxical effects to stimulants (In fact, stimulants are the most common treatment for ADHD – a topic for another day.)

4. What about giving my baby Benadryl?
I’m giving information here, not practicing medicine, so that’s a question for your physician. I will say there are many drugs (most notably those in the anticholingeric class) that have drowsiness as a side effect, and many emergency departments will give Benadryl to adults for that purpose. That said, these medications are not primarily used for drowsiness, and you’ll have to deal with other drug effects (such as the intended purpose for the medication) in addition to any possible drowsiness that occurs.
5. Sex at night keeps me wide awake.
That’s why a lot of you are shy about putting comments in the inbox… Sorry, but the answer to that question was not meant for public consumption.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Allergies – Friend or Foe?

allergyseason

Bee stings. Medication reactions. Food allergies. Latex. Animals. Dust. Cosmetics. What do these things have in common? You get allergic to them, and in differing degrees they make you come to the emergency room or your physician’s office huffing and puffing and puffy and sometimes thinking about not breathing anymore.

allergy

The basis of allergies is that your body is trying to defend you from infections. Sometimes our defense mechanisms are “indiscriminate,” and the body overreacts to what normally might be harmless substances by producing a system wide reaction, producing antibodies to certain triggers (allergens). This overreaction amounts to our bodies fighting a war that doesn’t need to be fought. That manifests itself clinically by some subset of itchy rashes (called wheals, urticaria or angioedema), shortness of breath, nausea, vomiting and other body-wide systems. Again, it’s important to note that this can be both a systemic overreaction or just a local reaction.
One question I commonly get asked is “Why am I allergic to this now?” In other words, sometimes allergies occur after the initial exposure to seafood or peanuts, or maybe you had been stung by a bee in the past without incident. That occurs because the first allergic exposure doesn’t always cause a visible reaction. However, it will sensitize the body such that you’re mobilized for subsequent exposures and will be prepared to “unload both barrels” if it’s needed. Unfortunately, this reaction can be life-threatening. This life-threatening response is called anaphylaxis, and you’ll know it because more than one organ system of your body will be affected. For example, you may have pounding or racing heartbeats, breathing difficulties, intestinal upset, itchy skin rashes and/or dizziness as your body goes into shock.

allergiesintro

Although allergic reactions are more likely to occur in those with conditions like asthma, eczema, allergic rhinitis, seasonal allergies, and sleep apnea, to be clear, the acute allergic reaction is a different animal than seasonal allergies. If you have any sensation that you’re short of breath, your throat feels like it’s closing, you have any dizziness or altered mental status, palpitations, or if the rash is diffuse and spreading, please get to your closest emergency room. I wouldn’t be upset if you took the recommended dose of Benadryl (generic name: diphenhydramine) along the way.
Final tip: Those of you who’ve suffered any type of allergic reaction to medication, food, animals, etc., should ask your physician about the utility of carrying an epipen, benadryl or steroids to be taken in the event of an emergency. If your risk profile warrants it, any or all of these could prove life saving. However, these medicines aren’t without risk, so you shouldn’t take any of them unless recommended by your physician.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Don't Let the Bedbugs Bite!

bed-bugs-101-chalkboard

There’s nothing pleasant in talking about bedbugs, but’s it is even worse to have to deal with them, so let’s get you some information to help you prevent and address these bug bites.

bed-bugs-chart

Bedbugs are everything you don’t want them to be. They’re parasites found all over the world, living only to feed on the blood of humans and other animals while you sleep. They’re excellent at hiding, and they do so all day. They only come out every week or so to feed, and when that doesn’t work, they don’t mind so much. They can go over a year between meals. Here’s a not-so-pleasant fact. If you have them, they live within eight feet of where you sleep, but they are willing to travel over 100 feet to get to you.
Let’s discuss your major concerns about bed bugs.

bed-bug

How do I prevent having them?

  • Keep a tidy environment so there are fewer places for bedbugs to hide.
  • Routinely check your furniture, drapes and curtains.
  • Use a protective cover for your mattress, box springs and pillows, and frequently check it for holes.
  • When on the road, don’t place your luggage on the floor (use a luggage rack if available). Inspect your mattress, looking for bugs, blood stains or droppings.
  • When returning from a trip, unpack directly into the washing machine. Learn to check your travel bags.

If bitten, what type of symptoms will I have?

  • You’ll itch, and you’ll discover bite marks (These may not appear for a week or two after the bite. Why you might ask? The bite actually injects an anesthetic into you that prevents you from immediately realizing you were bitten.). Symptoms vary pretty widely between individuals, from some having no reaction to others having severe allergic reactions.

Do bedbugs spread disease?

  • At least it can be said that bedbugs don’t transmit other diseases.

What treatment do I need for bedbug bites?

  • Treatment is symptomatic and involves controlling the itching. Diphenhydramine (branded as Benadryl®) is usually effective for this, as are over the counter topic corticosteroids. You should be careful about scratching your skin, as you can cause infections. If you develop redness, swelling, pain, ongoing itching or develop pus from the bite site, you should seek medical attention.

How do I get rid of bed bugs?

  • Once you discover you are exposed to bedbugs, you will need to wash and dry your clothes and bed sheets at very high temperatures.
  • If you aren’t using protective covers for your mattress, box springs and pillows, you will need to do so.
  • Insecticide spraying is effective in treating infestations.

Bedbgs

Keep in mind that bed bugs are often an acquired habit. When you’re at a hotel or a guest in someone’s home, be mindful to check everything you bring back home!

Straight, No Chaser: When Good Drugs Do Bad—Drug Interactions

three-feet-green-iguana-walking-on-the-beach-of-costa-rica

“Be sure to let your doctor know if you grow a third foot.”
Ok, well maybe that is about the only side effect you haven’t heard at the end of one of those commercials that seem to spend half of its time describing the side effects. If you pay attention to a pharmaceutical commercial, though, you’ll appreciate that even though medicines do a world of good, sometimes they cause significant problems. Those problems can become sped up or magnified by the effects of taking several drugs at a time. Alternatively, combinations of medications may make one or more of the drugs less effective. Regarding the medicines you’re taking, you should be clear if drug interactions can be minor and insignificant or serious and  life-threatening. Let’s review the various types of drug interactions.
drug-interactions
Drug/drug interactions: Two or more different drugs taken together may interact and cause an unwanted effect or change how the drug acts in the body. Here are some common examples:

  • An individual who already takes a sedative (e.g., sleeping pill) to help combat insomnia develops an exacerbation of their seasonal allergies. To treat the allergies, they decide to take an over-the-counter (OTC) antihistamine (like diphenhydramine, branded as Benadryl). Diphenhydramine also may cause drowsiness, so the combination of the medications may pose a danger to the person, especially if s/he is operating heavy machinery, such as driving a car.
  • Caffeine (which is a drug) in everyday foods—such as coffee and chocolate—also can interact with certain other drugs. In fact, caffeine is known to interact with over 80 different drugs, including about a dozen with which it produces serious effects. These include commonly used medications like aspirin, ciprofloxacin (branded as Cipro), guafenesin (the generic name for your favorite cough medicines) and diazepam (branded as Valium).
  • Nicotine (another drug) in tobacco products can interact with other medications, especially nicotine-replacement products. So if you’re taking medicine to help with your smoking cessation efforts, and you’re still smoking, you’re making the problem worse!

Drug/food interactions: If you’re a fan of grapefruit or chocolate, then it’s likely that your physician has cautioned you on drug/food interactions. These occur when certain foods or beverages interfere with the metabolism of certain medications. In the example of grapefruit, it’s known to interfere with metabolism of medications used to lower cholesterol levels (called statins). This can lead to adverse drug effects and actual liver damage. Other examples are to be found in the many foods (e.g., red wine, aged cheese) that affect the antidepressant class of drugs known as MAO inhibitors.
Drug/condition interactions: You see these all the time. Many different medication instructions warn you not to take them if you have certain medical conditions, as the medications may make the medical condition worse. Prominent examples include over-the-counter cold, cough and flu remedies that advise you not to take if you have heart disease or high blood pressure. Also if you have kidney or liver disease, any medicine that gets metabolized via one of those routes may have difficulty and delays in getting metabolized and excreted, leading to longer than desired activity of the given drug.
Drug/alcohol interactions: This is actually a subcategory of the drug/drug interaction because alcohol is a drug. It deserves special mention because drinking alcohol while taking certain medications can cause adverse effects related to the additive effects of alcohol and various drugs. Any medication involving the central nervous system or one’s mental state would likely be worsened by alcohol.
The best way to guard against these concerns is to discuss any new medications with your physician or pharmacist prior to taking them. Be smart about medicines you’re putting in your body and don’t be cavalier about them; the wrong combinations can turn a medicine into a toxin.
One final note: don’t be lulled into complacency by herbal preparations as some form of replacement. Herbals are still medicines and work via the same active ingredient as the pharmaceutical drug they’re replacing. As such, they are subject to cause the same types of problems listed above. Even more concerning is that as a class, comparatively less research has been done on herbals. Therefore, the full extent of side effects and drug interactions is not defined. Not knowing the full extend of an herbal medicine’s side effect profile isn’t the same as saying the herbal doesn’t have side effects, and you shouldn’t interpret things that way.
Feel free to contact your SMA expert consultant for any questions you may have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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

Straight, No Chaser: What Should NOT Be in Your Medicine Cabinet

medicine-cabinets

Ever notice that people run straight to the medicine cabinet to do harm to themselves or others? I want you to know the harder the effort is to obtain items to hurt oneself, the less likely one is to follow through on the notion. On another related note, here’s a quick not-so-fun-but-interesting fact. One of the differences between America and say, certain European countries is the oversized influence of corporations in the States. Why am I talking about that on a medical blog? Read on. If you can’t tell where I’m going with this, you’ll get it pretty quickly.

Here’s my top five items I want you to take out your medicine cabinets and lock up.

1. Any jumbo sized container of any medication. Think about two of the most common over the counter (OTC) medications used for suicide attempts: acetaminophen (Tylenol) and salicylate (aspirin). One thing they have in common is you can buy what amounts to a tub-full of it at your local superstore in the United States. They should call these things ‘suicide quantities’, because often those in the midst of a suicide attempt will grab and swallow whatever is convenient. Many different medications will hurt you if you take enough; Tylenol and aspirin certainly fit that bill. Observing that (and additional considerations after the deaths due to the lacing of Tylenol with cyanide back in 1983), the Brits decided to not only pass a law limiting quantities, but certain medications that are high-frequency and high-risk for suicide use are now mandatorily dispensed in those annoying containers that you have to pop through the plastic container. Needless to say, observed suicide rates by medication rates plummeted as a result. Wonder why that hasn’t been implemented in the good ol’ USA?

2. Have teens in your house? Lock up the Robitussin and NyQuil. Dextromethorphan is the active ingredient in over 100 OTC cold and cough preparations. Teens use these to get high, folks. To make matters worse, they are addictive, and if taken with alcohol or other drugs, they can kill you. Then there’s ‘purple drank’ (yes, that’s how it’s spelled), in which these cough syrups containing codeine and promethazine (Benadryl) are mixed with drinks such as Sprite or Mountain Dew.

3. Have any sexual performance medications? This is part of a category of medicines called ‘medicines that can kill someone with just one pill’. That usually refers to kids or the elderly, but remember that those sexual enhancement drugs are medicines that lower your blood pressure. In the wrong person and in the wrong dose, taking such medicine – whether intentionally or accidentally – could be the last thing someone does.

3. Any narcotic. Need I say more? Remember, you do have people rummaging through your cabinets on occasion!

4. Any sharps. That includes sewing pins, needles, etc.

5. Any medication with an expiration date. The medication date actually is more of a ‘freshness’ consideration than a danger warning. However, in the wrong patient, a medicine that has less than the 100% guarantee of its needed strength that the expiration date represents could be fatal. Play it safe and get a new prescription.

There’s a lot more that could be added to this list, but I like keeping things manageable for you.  Please childproof all your cabinets, and use childproof caps on your medications. I welcome your questions or comments.

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

Straight, No Chaser: What's that Rash? Eczema and Psoriasis

Rashes are very frustrating for patients.  They itch, burn, get infected, aren’t pleasant to look at and never go away rapidly enough. Another problem is no one ever seems to know what they are at first, and that causes a big problem because you’re concerned immediately (as you should be) when the rash appears. Unfortunately, in the early stages, most rashes are indistinguishable. In many cases, in order to diagnose them, you’d have to let them evolve and bloom into whatever they’re trying to become, but who has time for that? I remember in medical school, the prevailing wisdom was “If it’s wet, dry it (powder), if it’s dry, wet it (creams, lotions and ointments), and give everybody steroids.” Well, don’t try that at home without your physician’s direction because it’s not universally true, but it sure does seem like hydrocortisone has a lot to do with treating rashes.
Today, I’d like to review two common chronic conditions defined by rashes, and later I’ll do the same with acute presentations of rashes. The thing about eczema and psoriasis is we should know it when we see it, and so should you. By the way, dermatitis is the general term for skin inflammations, and eczema and psoriasis both fall under this category. As such, they have a lot in common, including basic underlying mechanisms (irritation), treatment considerations and a knack at raising frustration levels.
eczema
Eczema (aka atopic dermatitis, which is the most common form of eczema) is a red, dry itchy rash that really is just an inflammatory reaction. If you let it linger, it can become cracked, infected and develop a leather-like consistency. It’s said that you’d develop eczema just by scratching or rubbing your skin long enough, because it’s the damage to the skin that causes the inflammatory reaction that defines eczema. This is why eczema is notoriously called “the itch that rashes”. You’re more likely to have it if you have asthma, have fever or tendencies toward food allergies (or other allergies), but you can get it with pretty much any significant skin irritation. It’s not contagious, but it does run in families.
psoriasis
Psoriasis is another chronic skin condition that is easily recognized. As noted above, that thick scaly, silvery skin (called plaques) results from an overgrowth of skin cells. As with eczema, this condition is a result of inflammation to the skin, in this instance caused by an overreaction of your immune system speeding up the production of skin cells. Psoriatic lesions are most often seen on the elbows, knees and scalp; it can also involve the back, hand and feet (including the nails). Psoriasis tends to flare-up then go into remission, but during those flare-ups, it is very uncomfortable and unsightly.
These are both ‘dry’ rashes, so treatment involves moisturizers, changing habits to include mild soaps, loose fitting clothing, moderate temperature showers (to avoid drying the skin), and when necessary, antihistamines (like Benadryl) and topical steroid creams (like hydrocortisone). Use any medications after consultation with your physician, who may prescribe more exotic treatments such as medications to calm or suppress the body’s immune response or ultraviolet light therapy. Your job is to identify and avoid the irritants that cause the inflammatory reaction (e.g. sweating, scratching, tight-fitting clothing and anything that dries you out). It’s important for you to get these addressed early before the appearance becomes too bothersome for you.
I welcome any questions or comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your Rebuttals and Questions about Insomnia

You are certainly an entertaining group behind the scenes. Here are some of your questions on insomnia. Be reminded that should you want to leave me a private question, just go to the Home Page, or type https://jeffreysterlingmd.com into your browser. Here’s five questions from this morning’s post on insomnia.
1. Aw, hell! You’re telling me I can be dying from something causing insomnia?

  • It’s way more likely that level of stress you’re displaying is keeping you awake at night.

2. How is it that sex makes you sleepy?

  • When you do exert yourself vigorously, the greater utilization of muscles will deplete glycogen (energy) stores and make you drowsy. Also, it’s well established that certain hormones (e.g. prolactin, GABA and oxytocin) that promote sleep are released after an orgasm.

3. You mentioned tea. A good cup of tea at bedtime helps me sleep.

  • If that works for you, go for it. Some people have paradoxical effects to stimulants (In fact, stimulants are the most common treatment for ADHD – a topic for another day.)

4. What about giving my baby Benadryl?
I’m giving information here, not practicing medicine, so that’s a question for your physician. I will say there are many drugs (most notably those in the anticholingeric class) that have drowsiness as a side effect, and many emergency departments will give Benadryl to adults for that purpose. That said, these medications are not primarily used for drowsiness, and you’ll have to deal with other drug effects (such as the intended purpose for the medication) in addition to any possible drowsiness that occurs.
5. Sex at night keeps me wide awake.
That’s why a lot of you are shy about putting comments in the inbox… Sorry, but the answer to that question was not meant for public consumption.
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Straight, No Chaser: When Allergies Strike

allergy
Bee stings.  Medication reactions.  Food allergies.  Latex.  Animals.  Dust.  Cosmetics.  What do these things have in common?  You get allergic to them, and in differing degrees, they make you come to me huffing and puffing and puffy and thinking about not breathing anymore.
The basis of allergies is that your body is trying to defend you from infections.  Sometimes our defense mechanisms are ‘inaccurate’, and the body overreacts to what normally might be harmless substances by producing a system wide reaction (antibodies) to certain triggers (allergens).  This overreaction leads to our bodies fighting a war that isn’t meant to be fought.  That manifests itself clinically by some subset of itchy rashes (wheals, urticaria or angioedema), shortness of breath, nausea, vomiting and other systemic systems.  Again, it’s important to note that this can be both a systemic overreaction or just a local reaction.
One question I commonly get asked is “Why I am allergic to this now?”  In other words, sometimes allergies occur after the initial exposure to seafood or peanuts, or maybe you had been stung by a bee in the past.  That occurs because the first allergic exposure doesn’t always cause a visible reaction.  However, it will sensitize the body such that you’re mobilized for subsequent exposures and will be prepared to ‘unload both barrels’ if it’s needed.  Unfortunately, this reaction can be itself life-threatening.  This life-threatening response is called anaphylaxis, and you’ll know it because more than one organ system of your body (heart palpations, breathing difficulties, gastric upset, itchy skin rashes, dizziness as your body goes into shock, etc.).
Although allergic reactions are more likely to occur in those with conditions like asthma, eczema, allergic rhinitis, seasonal allergies, and sleep apnea, to be clear, the acute allergic reaction is a different animal than seasonal allergies.  If you have any sensation that you’re short of breath, your throat feels like it’s closing, you have any dizziness or altered mental status, palpitations, or if the rash is diffuse and spreading, please get to your closest emergency room.  I wouldn’t be upset if you took the recommended dose of Benadryl along the way.
Final tip: Those of you who’ve suffered any type of allergic reaction to medication, food, animals, etc. should ask your physician about the utility of carrying an epipen, benadryl or steroids in the event of an emergency.  If your risk profile warrants it, any or all of these could prove life saving.  However, these medicines aren’t without risk, so you shouldn’t take any of them unless recommended by your physician.