Tag Archives: CDC

Challenges and Guidelines for Returning to School

Introduction

This Straight, No Chaser looks at challenges and guidelines for returning to school. First, here are two questions for your consideration. What would happen if all college students were asked to take a gap year during the 2020-21 academic year? Is that a better or worse scenario than accepting the risk of sending kids and young adults back to mass gatherings in the midst of a pandemic?

How Can We Come to the Right Decision?

Somewhere in between Notre Dame announcing a return to school schedule and Oxford University deciding that all of this academic year’s classes will be done online is where most schools will end up. However, what’s the right decision for you and your family? Colleges and universities are rather expensive. The college experience, inclusive of athletics, club activities, fraternities and sororities, is an important part of the equation. Most of that will be (should be) gone for the upcoming academic year. Even efforts to create a sense of normalcy are fraught with risk. Doesn’t the entire “go back to school thing” include a massive assumption that the pandemic environment will improve by the fall moving into the winter? Where is the evidence for that? Are you willing to accept that risk? At what financial cost? Aren’t schools about the easiest way you can imagine to rapidly extend and expand an infectious disease? Keep in mind that the presence of just one case will likely cause any given school to again shutter its doors. Remember, the issue isn’t that the students are at advanced risk for death. The issue is teachers, support staff and family members within proximity of commuter students may be.

CDC Guidelines for Returning to School

Even so, in acknowledging America’s ill-advised rush to return to normal, the CDC has put forth a list of 11 guidelines, all of which must be met before a school should even consider reopening.

Items to first consider

  • Will reopening be consistent with state and local orders?
  • Can the school protect children and employees at higher risk for severe illness?
  • Can students and employees be screened upon arrival for symptoms and history of exposure?

Are recommended health and safety actions in place?

  • Are capabilities for healthy hygiene practice in place?
  • Has the school intensified cleaning, disinfection and ventilation?
  • Are social distancing measures feasible and implemented?
  • Are employees trained on health and safety protocols?
  • Have measures for ongoing monitoring but put in place?
  • Are procedures to check signs and symptoms of students and employees on a daily basis in place?

Are procedures to have the sick stay at home in place?

  • Is there a regular communication strategy to engage students, employees, families and local authorities in place?
  • Are monitoring and student leave policies in place as needed?
  • Are coordination and communication strategies in place with local health authorities?

What to Do?

See, this is a high bar to reach, and it should be. Implementing these guidelines will be a Herculean task for any school, much less for all schools. It is foreseeable that the better course of action leans toward an emphasis on the educational component of school and less on the social component. Accordingly, the best reopening strategies will focus more on at a distance learning components than the more familiar in person scenarios. The very last thing any of us needs is a national panic based on a reemergence of the disease, based on seeding at schools and colleges. COVID-19 doesn’t care about your frustration or other priorities. Remember, the most likely of the optimistic scenarios is that a COVID-19 vaccine will be available during the summer of 2021. Until then, our actions will most likely worsen the situation, resulting in additional lives lost. Choices have consequences. Choose wisely.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
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CDC COVID-19 Update

Introduction

This Straight, No Chaser offers this week’s CDC COVID-19 Update.

Weekly Highlights

  • Nationally, the percentage of laboratory specimens testing positive for SARS-CoV-2 was similar but slightly decreased, compared to last week.
  • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline. They are now below baseline nationally and in many regions of the country. They remain elevated in the northeast and northwest.
    • The decrease in the percentage of people presenting for care with influenza-like illness (ILI) and coronavirus-like illness (CLI) may be due to a decline in COVID-19 illness. Reported levels of activity may be decreasing because of widespread adoption of social distancing efforts and changes in healthcare seeking behavior.
    • Little influenza virus activity has been reported in recent weeks.
  • The overall cumulative COVID-19 associated hospitalization rate is 40.4 per 100,000, with the highest rates in people 65 years and older (131.6 per 100,000) and 50-64 years (63.7 per 100,000).
    • Hospitalization rates for COVID-19 in adults (18-64 years) are higher than hospitalization rates for influenza at comparable time points during the past 5 influenza seasons.
    • For people 65 years and older, current COVID-19 hospitalization rates are similar to those observed during comparable time points during recent high severity influenza seasons.
    • For children (0-17 years), COVID-19 hospitalization rates are much lower than influenza hospitalization rates during recent influenza seasons.

More Data

  • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 23.6% during week 16 to 14.6% during week 17 which is still significantly above baseline. This is the second week of decline in this indicator, but the percentage remains high compared with any influenza season. The percentage may change as additional death certificates for deaths during recent weeks are processed.
  • Declines in some key indicators used to track COVID-19 from one week to the next could change as additional data are received but also may be a result of widespread social distancing measures.

All of this points out that things are still quite deadly but are slightly improving. Stay safe.

Need Personal Protective Equipment (PPE)?

Are you a first responder? Does your job make you one of the first exposed? Courtesy of SI Medical Supply, you have an option to provide masks, gloves, hand sanitizer, disinfectant wipes and no-touch thermometers for your family and loved ones. Importantly, getting these product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) for masks at www.jeffreysterlingmd.com or 844-724-7754. Other items are preorders with an expected delivery date of May 8th. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share! Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders! Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.
 
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The COVID-19 Endgame You Want to Avoid

Introduction

This Straight, No Chaser asks you to think about the COVID-19 endgame.

Remember the notion that COVID-19 will disappear with the warm weather? It’s a pretty embarrassing misapplication of logic and another illustration that correlation is not causation. The virus lives inside of us, and you’ll recall that our temperatures approximate 98.6 degrees, right? This virus doesn’t live and die based on a temperature-based light switch that you turn on and off, so please stop it with that line of rationale.

What’s important and more appropriate to state is there is a respiratory season in which certain diseases (e.g. influenza and COVID-19) are more common. The baseline of these diseases resets during the non-respiratory season. They then reemerge in the fall, often with mutations and new strains having developed. This is not the same as a disease being eradicated by warm weather. Please appreciate the difference.

Reopening is Reexposing

The backdrop of the current situation with COVID-19 is certain parts of the country are “reopening” to at-risk behavior. Let’s be clear. What we’re doing is reexposing the population. We are not declaring victory or giving the “all-clear” sign here. Based on what we know, this reexposure will maintain COVID-19 in the population at a higher baseline than would have otherwise occurred with sufficient stay-at-home and social distancing efforts.

Here’s the problem. When the next respiratory season begins, the curve will be launching from a higher baseline. Ideally, the number of cases year to year would resemble a series of curves. Instead, we are placing ourselves at risk for propulsion from the equivalent of a higher rung of a ladder. As infectious diseases go, this would allow a more trampoline-like effect than a gradual ascent.

As if that’s not enough, the CDC is now suggesting that the next launch of COVID-19 will occur in tandem with the launch of influenza. In other words, the next respiratory season will see us battling both diseases from the beginning of respiratory season.

All of this is to say our willful disregard of the past efforts we’ve made to defeat COVID-19 are quite dangerous. We aren’t close to being done or successful. We see states like Georgia, Tennessee and South Carolina rushing to reopen/reexpose outside of the federal COVID-19 Task Force’s recommendations. These choices will have consequences. Remember, there still is neither an effective vaccine nor an approved medical regimen. Just as was the case months ago, the future is predictable and foreseeable. What happens next is based on what we do now. Choose wisely, America. We really don’t want to do this again next year.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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The Rationale for Not Using Hydroxychloroquine and Azithromycin to Treat COVID-19

Introduction

Before looking at the rationale against the use of hydroxychloroquine and azithromycin to treat COVID-19, think about what’s being asked here. There are two option. The first is you’re potentially asking for a patient requiring critical care to benefit from a miracle cure. The second is you’re asking for an antiparasitic medication with a dangerous side effect profile to work in preventing the spread of an especially virulent virus in patients who mostly recover on their own. It’s as if the cards were stacked at the beginning of the conversation. In case you haven’t done so, review the previous post on the rationale for using hydroxychloroquine and azithromycin.

There’s a difference between hope and false hope. To quote Dr. Fauci’s comments on physicians and persons endorsing this combination without evidence, “We don’t operate on how you feel. We operate on what evidence is, and data is…we’ve got to be careful that we don’t make that majestic leap to assume that this is a knockout drug.”

Meanwhile, President Donald Trump, in his self-described capacity as a cheerleader, has notably encouraged using these drugs, saying “What do you have to lose?” Well, physician don’t operate that cavalierly with your lives. We operate under the mantra “Do No Harm.” Let use these opposing premises as the starting point for a review of the arguments against the proposed uses of hydroxychloroquine in treating COVID-19.

The Research

There really are four topics that constitute the arguments (“evidence” if you will) for use of hydroxychloroquine in treating COVID-19. Let’s review them.

Small studies performed on laboratory cell cultures

A Chinese study demonstrated that hydroxychloroquine prevented proliferation of the COVID-19 in a lab setting. Anyone who has ever taken a high school science course should recall the difference between in vitro and in vivo. What happens in a petri dish is a long way away from having the same effect on and having benefits in living beings. Furthermore, efforts specifically meant to replicate the lab (in vitro) success have not been successful. Per the academic journal Antiviral Research: “Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.” Simply put, the drug has shown no benefit when tested on any animal in clinical studies.

Comments of Chinese Health Officials

Chinese health officials assert “chloroquine might improve the success rate of treatment, shorten hospital stay and improve patient outcome.” That sounds good, but this Chinese consensus statement provided no data to support the assertion. For example, one such paper was titled “Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies.” It cites as its primary source an audio recording of a news briefing from the State Council of China. That’s propaganda, not science.

The French Study

A single French study that suggested the combination of hydroxychloroquine and azithromycin was effective against COVID-19. (This is the study Trump references in his tweets.) The study’s conclusion states “hydroxychloroquine is efficient in clearing viral nasopharyngeal carriage of [the novel coronavirus] in COVID-19 patients in only three to six days, in most patients.”

This paper has been criticized widely. Here are some of the cited concerns.

The study contained 20 people, thus lacking the statistic power to make extrapolations of the data that supporters have made. Also, this study was published without underground the peer review process that subjects these things to medical scrutiny.

This was not a double-blinded study. The doctors and the patients were aware of patients’ group status within the study. This is a failure by itself. Also, only a quarter of the placebo patients actually had their viral load measured! So how was the conclusion of reducing nasopharyngeal COVID-19 quantified? By the way, even if “clearing of the virus” occurred, that doesn’t necessary equate to “better clinical outcomes.” There is no suggestion one set of individuals fared better than the other.

Furthermore, six (a pretty substantial proportion) of the patients from the group who had been receiving the drug quit the trial. Three of them ended up in intensive care. One died. These likely were failures of the drug to work against the virus, but this data wasn’t considered or reported as such in the results.

Dr. Vladamir Zelenko’s 699 Patients

Many are enamored with Dr. Vladamir Zelenko’s claims that he has treated 699 patients successfully with hydroxychloroquine and azithromycin (with zinc). Here’s all you need to know to analyze his efforts. Zelenko’s claims are exactly that: claims. He has published no data. He has described no study design. There has been no analysis reported. His anecdotes are not close to being scientific proof.

Pushback

In fact, there has been an actual controlled clinical trial from China that showed no statistical differences in health outcomes between a control group and patients who received hydroxychloroquine after seven days. However, because of its small size, it also can not be deemed conclusive.

Still, and in case you didn’t know, the preponderance of evidence (or lack thereof) has compelled the Centers for Disease Control and Prevention to pull back its guidance for hydroxychloroquine usage for COVID-19. It no longer offers recommendations for its dosage. Also, the CDC has also deleted all information on those aforementioned early studies of the drug from its website. Its “off-label” use for emergencies is left to the discretion of individual physicians. It is of note that multiple prominent institutions, such as Northwestern Memorial Hospital in Chicago, have declined to offer it.

Summary

What this all means is, at best, “the absence of evidence isn’t evidence of absence.” It is indisputable that the research thus far is below the medical and scientific standard. However, because of some of the theoretically plausible benefits and the actual absence of any meaningful data, the drugs are worthy of undergoing the scrutiny of the scientific method of research. And thus, legitimate clinical studies have begun.

It is unfortunate that the attention paid to hydroxychloroquine and azithromycin (and their unfounded positioning as miracle drugs) could be distracting from other possible solutions. It certainly is a distraction from the need to focus on wider testing and preventive strategies. What has also been lost in the fervor is the combination of hydroxychloroquine and azithromycin could be dangerous for individuals, particularly those with some heart conditions. However, you will note that looking at side effects wasn’t even necessary to demonstrate the use of these medicines is premature at best. In the spirit of “do no harm,” let’s finish back with Dr. Fauci, who was asked if he would take the drug if he were stricken with the virus. His response? “Only if it were part of a clinical trial.”

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Order are now at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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African American COVID-19 Outcomes are Disproportionately Bad

Introduction

Very few states have been collecting COVID-19 demographic data based on race. When you look at the data, it’s apparent why some may not wish to be confronted with that information. We’ve already discussed how African Americans are set up for horrific outcomes due to this pandemic. African Americans fit the high-risk profile in numbers disproportionate to the greater population. They have increased incidences of diabetes, chronic heart disease, chronic lung disease and HIV. As you may be aware, along with being elderly and having other causes of lower immunity, these conditions constitute the most significant risk factors for poorer outcomes with COVID-19 infection.

African Americans are also subject to poorer outcomes due to social determinants of disease. In each of the major considerations: impediments in accessing care, having equal quality of care, and baseline economic status allowing the navigation of costs of care, African Americans are less well off than the general population.

African American COVID-19 Outcomes in Selected Locations

Here are a few data points that show just how dangerously and disproportionately COVID-19 is affecting the afro-descendent community.

  • In Chicago’s Cook County, African American residents make up 23% of the population. Unfortunately, they account for 58% of the COVID-19 deaths. According to data from the Cook County Medical Examiner’s office, half of the deceased lived in Chicago. Furthermore, the majority of African American COVID-19 patients who died had underlying health conditions, including respiratory problems and diabetes. Eighty-one percent had hypertension (high blood pressure), diabetes or both.
  • However, it’s not just an issue in Chicago. Statewide, the number of African American residents throughout with COVID-19 is also disproportionately high. African Americans account for 38 percent of the confirmed cases in Illinois while only being 14% of the population. The state has not released a racial breakdown for deaths, although Illinois is one of the few states that keeps COVID-19 data with a racial breakdown. 
  • As of April 2nd, African Americans were almost half of Milwaukee County’s 945 cases. They were 81% of its 27 deaths. Milwaukee County’s population is 26% black. 
  • According to the Michigan Department of Health and Human Services, as of April 2nd, African Americans made up 35% of the state’s overall confirmed cases. They accounted for 40% of Michigan’s 417 deaths related to COVID-19. In Michigan, the state’s population is 14% black.
  • Louisiana has not published case breakdowns by race, but 40% of the state’s deaths have happened in Orleans Parish, where the majority of residents are black. New Orleans has emerged as one of the nation’s hotspots for COVID-19.

Other Examples of Disparities

  • Other concerns have been expressed without the data to precisely quantify them. Disproportionality in African American having access to tests with the same systems have been reported. Temporary COVID-19 treatment facilities have tended not to go up in areas accessible to African American communities. The $2 trillion stimuli bill was passed after stripping affirmative action guidelines promoting fairing in the business procurement process, making it less able for Black businesses to get opportunities to fund and fashion culturally specific solutions. The explosion in unemployment also disproportionately affected African Americans. These social determinants of health matter.

The concept of a perfect storm ignores the fact that there’s nothing perfect about it to its recipients. A certain degree of willness ignorance about public health challenges tends to exist at the onset of major catastrophes. Let’s not allow that to define the experience of African Americans during this already devastating pandemic. It’s long been said that when White Americans catch a cold, Black American get pneumonia. Given the devastation occurring across America, let’s be mindful of the still disproportionate effects that occur in this demographic.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being accepted at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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The CDC Recommends Facial Masks for the Public

Need Facial Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being accepted at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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COVID-19 Update, Actions and Next Steps

Introduction

This Straight, No Chaser addresses the latest on COVID-19 and discusses actions and next steps.

Number of Cases

The United States is now contracting 40% of the new cases of COVID-19 worldwide. As of this morning, there have been 428,220 cases and 19,101 deaths around the world. In the US, there have now been 55,330 confirmed cases and 804 deaths. That is more American than have died in the Afghanistan war in the last 8 years. Even if that was a hard stop, it would be horrific. But it’s only the end of the beginning.

You should reflect on the fact that we’ve only been dealing with this a short time. The next three weeks will be horrific. #PrayForNY #CaliforniaYoureNext #IllinoisKeepFighting

The Trajectory

Look at this chart of the disease trajectory. It’s not a curve. It’s a straight line. The curve has not yet bent. Cases are doubling every three days. This is not a game or a casual happenstance. This is science and medicine. Any individual’s (even the President’s) exhortations about their opinions or wishes about when and how this will end means next to nothing. Even if you’ve never heard of it, epidemiology is a branch of medicine addressing the incidence, distribution, and possible control of diseases and other factors relating to health. In other words, this is foreseeable and predictable. It could have been controllable much sooner. It is yet to be determined when it will be controlled.

Now look at this chart. Most US states are actually on the same trajectory. It’s not just New York. If anything, NY is the canary in the coal mine. Forewarned should be forearmed.

What’s Next: Actions and Next Steps

The next three weeks are going to be scary to many and deadly for a lot of Americans. The state of New York’s health care system is about to become overrun as if hit by a tsunami. As much as can be illustrated, the depictions of the numbers of people about to die will be shocking. However, it was still foreseeable. Predictable. Controllable.

And still, it can get worst. There are two sides to #FlattenTheCurve. You must still continue with the need to #StayAtHome. You must engage in vigorous, frequent hand washing. Cough or sneeze into your elbow. Keep your hands away from your eyes, nose and mouth. Sanitize items before and after you touch them. Stay six feet away from others. Avoid gathering of any size, and certainly more than ten people.

Regarding the other side of #FlattenTheCurve, it is not politics to ask the government to engage in public health best practices. We need widespread testing of symptomatic and high risk patients to identify the infected instead of just the seriously sick. #WhereAreTheTests We need to quarantine the infected. We need enforced isolation and treatment of the sick. #WhereAreTheSupplies We need to implement the Defense Protection Act today.

Ongoing half measures, stops and starts and variations from the standard continue to propel the disease forward. It pains me to opine that we have neither seen quick nor decisive action, often due to efforts to weigh other national considerations, including the economy. Pandemics don’t work that way. The best chance for these peripheral considerations to be addressed as soon as possible is to fully address the disease as soon as possible.

Thank you to my colleagues across health care and other essential services for continuing to put your lives on the line to combat this disease. Now, more than ever, health empowerment needs to be your mantra. When our system falls short (or even when it doesn’t), ultimately the responsibility for your health falls in your hands. Please take the actions and next steps recommended. Act as if you already have the disease and don’t want to transmit it.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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Actual Criteria for Coronavirus Testing

Introduction

Do you have any idea about the actual criteria for coronavirus testing? Even if you don’t want to know, if you’re talking or visiting a physician, you should be aware of what’s being used to determine (under current recommendations) your eligibility. This Straight, No Chaser presents an active set of criteria for your review.

Meanwhile, the need to expand coronavirus testing criteria and to expand the availability of tests continues. Let your voices be heard. #WhereAreTheTests

Whom Should Physicians Test for COVID-19?

Physicians may test any patient with symptoms consistent with COVID-19. Examples of these typically include fever, cough and shortness of breath. As commercial testing becomes even more increasingly accessible, expect criteria to expand.

However, the following patients should be prioritized for testing:

  • Critically ill patients receiving ICU-level care with unexplained viral pneumonia or respiratory failure. This is regardless of travel history or close contact with suspected or confirmed COVD-19 patients. This is meant to inform decisions about infection control and investigational therapeutics.
  • Any persons with fever (subjective or confirmed) and/or symptoms of a lower respiratory tract illness and a history of close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset. This includes all residents of a long-term care facility that have had a laboratory-confirmed COVID-19 case.
    1. “Close contact” is defined as being within approximately six feet of a COVID-19 case for a prolonged period. A prolonged period equals more than about 10 minutes per current public health contact-tracing practice. It also includes those having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).
    2. Here’s when physicians and other health care personnel (e.g., nurses and administrative staff) should be tested. Testing may be considered if there has been exposure to a person with suspected COVID-19 even without laboratory confirmation. Even mild signs and symptoms (e.g., sore throat) of COVID-19 should be evaluated among potentially exposed health care personnel. This is warranted given their extensive and close contact with vulnerable patients in health care settings.
  • Any symptomatic individuals with a history of travel within 14 days of symptom onset to geographic regions where sustained community transmission has been identified.
  • Any symptomatic individuals who may be at higher risk of poor outcomes. These include those who are ≥ 65 years of age, immunosuppressed, or have high-risk chronic medical conditions (e.g., diabetes, heart disease, chronic lung disease, chronic kidney disease).
  • Individuals with fever and/or symptoms of a lower respiratory tract illness who are critical to pandemic response. These include health care personnel, public health officials, and other essential leaders.

Whom should physicians NOT test for COVID-19?

  • Asymptomatic individuals are not recommended to be tested for COVID-19, regardless of exposure history.
  • If an alternative diagnosis can be determined (e.g., rapid strep, rapid flu, BioFire viral panel), a clinical determination can be made that a COVID-19 test is not necessary. This is especially true if there is not yet community transmission of the disease in your area.
  • CDC recommends that mildly ill patients should be encouraged to stay home. You should contact your physician by phone for guidance about clinical management. If telemedicine is available and determines that symptoms are mild, patient’s should be referred to a mobile testing site if available. Otherwise, your doctor may elect to test you at the end of the day in the office away from other patients. This can protect staff and other patients and preserves the use of personal protective equipment.  

You would do well to print this out. Use it as a guide to determine if your symptoms meet criteria for coronavirus testing under current guidelines. Use it to insist on testing if you meet criteria. #KnowledgeIsPower #KnowledgeIsHealth

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Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

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A Challenge to Prevent Alhzeimer’s Disease

Introduction

Prevent Alzheimer's Disease

Who wouldn’t want to prevent Alzheimer’s Disease? We’ve done a few challenges in this space. However, remember that we’re never as interested in the activity as we are the accomplishment. In other words, the best challenges aren’t as concerned with the exercise as the underlying health benefit. We’re not doing a formal challenge today, but I do want to give you five simple tips. If you accept the challenge of implementing them into your habits, they will dramatically reduce the risk of Alzheimer’s Disease and dementia.

This is an overly simplistic presentation with the goal of giving you achievable tasks toward holding off Alzheimer’s Disease.

Let’s Prevent Alzheimer’s Disease

Prevent Alzheimer's Disease

To be clear: there is presently no cure for Alzheimer’s. Therefore, the effort to prevent Alzheimer’s Disease is as good as it gets. We’ve discussed it at length in this space, and we offer links to better understand it. What we want you to know today is incorporation of a series of healthy lifestyle habits can offer a 60% lower risk of developing Alzheimer’s Disease than those practicing one or none of these habits. Simply put, according to multiple medical studies, the more healthy habits you adopt, the lower your risk will be of cognition decline.

Here’s the list:

  • Regular exercise (moderate to vigorous for at least 150 minutes a week)
  • Cognitive stimulation (engaging in later-in-life “brain exercise” activities)
  • Eating a brain-healthy diet
  • Not smoking
  • Light to moderate alcohol consumption

Regarding diet, the brain healthy diet is made of leafy green vegetables, nuts, poultry, beans and olive oil. It avoids red meat, sweet and fried foods (similar to the MIND diet).

Alzheimer’s is the sixth leading cause of death, according to the CDC (Centers for Disease Control and Prevention). It is the most common form of dementia. These interventions lower your risk regardless of any generic risk.

Wait, There’s More!

Click on the below links for any and all of these Straight, No Chaser posts on Alzheimer’s Disease.

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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, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

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September is Pain Awareness Month

Introduction

This Straight, No Chaser acknowledges that September is Pain Awareness Month.

Pain Awareness Month

In the midst of all the conversation about the national opioid epidemic, many of those suffering from acute and chronic pain are finding themselves lost in the struggle. Better public education regarding expectations, beliefs, and understanding about pain are all important. Additional measures include professional education and training for better, comprehensive, and integrated pain management.

The Scope of Ongoing Pain

Recent reports on chronic pain estimate that chronic pain affects approximately 50 million U.S. adults. Furthermore, high-impact chronic pain (i.e., interfering with work or life most days or every day) affects approximately 20 million U.S. adults. Are you part of this statistic?

Better Pain Awareness Strategies

Pain Relievers and Drug Overdose Deaths

More than even, patients need to be educated about expectations and consequences of accepting different forms of treatment for pain management. Start with understanding that even as your pain is real, it doesn’t necessarily require narcotics. Also, appreciate that the use of narcotics come with risks and consequences.

Better Pain Management Strategies

Pain Awareness Month

Understand that physicians are balancing competing concerns. Your treatment for pain involves more than just the dispensing of narcotics.

In fact there are national strategies emerging.

Better pain management is also a major element in addressing the current opioid crisis. Additional information is available  from the US Department of Health and Human Services here.

Wait, There’s More

Read these additional Straight, No Chaser posts to round out your knowledge during Pain Awareness Month.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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Prostate Cancer Awareness for 2019

Introduction

This post is for Prostate Cancer Awareness Month. We offer answers to a few questions and additional resources. The first is this video from the Center for Disease Control and Prevention (CDC) about whether you should get tested for prostate cancer.

Basic Facts

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

Who’s at risk for prostate cancer?

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

What are the symptoms of prostate cancer?

prostate cancer symptoms

It is of interest that a wide variety of presentations exists in those later diagnosed with prostate cancer. Some men don’t have symptoms. In these cases, prostate cancer is discovered on screening examinations. Other men present with several symptoms, often including the following.

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

What Is Prostate Cancer Screening?

Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancer early that may spread if not treated.

There is no standard test to screen for prostate cancer. Here are two tests that are commonly used to screen for prostate cancer.

  • A blood test called a prostate specific antigen (PSA) test. PSA is a substance your prostate makes. This test measures the level of PSA in your blood. Your PSA level may be high if you have prostate cancer and for many other reasons, such as having an enlarged prostate, a prostate infection, or taking certain medicines.
  • Digital rectal examination, when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer.

How Is Prostate Cancer Treated?

Prostate-Cancer-Treatment

See the above chart for more detailed information. Optimally, treatment for prostate cancer should take into account

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

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

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

There’s More!

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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

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Overview of the American Drug Overdose Epidemic

Introduction

This Straight, No Chaser guide loses at the drug overdose epidemic in the United States.

drug overdose epidemic deaths

Drug overdose deaths continue to increase in the United States. Deaths from drug overdose are up among both men and women, all races, and adults of nearly all ages. Two out of three drug overdose deaths involve an opioid. Opioids are substances that work in the nervous system of the body or in specific receptors in the brain to reduce the intensity of pain. Overdose deaths from opioids, including prescription opioids, heroin, and synthetic opioids (such as fentanyl) have increased almost six times since 1999.

Data on the Drug Overdose Epidemic

70,237 drug overdose deaths occurred in the United States in 2017. This is an increase of nearly 10% from 2016. Opioids are currently the main driver of drug overdose deaths. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths), and 36% of those deaths involved prescription opioids. Deaths from prescription opioids totaled over 17,000 deaths in 2017, equivalent to approximately 46 deaths per day. For various reasons this is thought to be a undercounting of the scope of the problem.

In 2017, the states with the highest rates of death due to drug overdose were West Virginia (57.8 per 100,000), Ohio (46.3 per 100,000), Pennsylvania (44.3 per 100,000), the District of Columbia (44.0 per 100,000), and Kentucky (37.2 per 100,000). This chart is a graphic representation of states with increases in deaths due to drug overdose.

drug overdose epidemic

There’s More!

Read these Straight, No Chaser posts for details and discussion on various types of drug abuse.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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

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National Minority Health Month

National Minority Health Month – Get Active!

Introduction

Diverse hands stacked on top of one another

April is National Minority Health Month. In this Straight, No Chaser post, we discuss what you can do to get active and stay healthy. Thank you to the Center for Disease Control and Prevention (CDC) and the Office of Minority Health (OMH) for providing this valuable information.

“Without health and long life, all else fails.”
– Dr. Booker T. Washington

Dr. Booker T. Washington recognized that health is the key to progress and equity in all other things. Accordingly, he proposed the observance of “National Negro Health Week” in April 1915. He called on local health departments, schools, churches, businesses, professional associations and the most influential organizations in the African-American community to “pull together” and “unite… in one great National Health Movement.” That observance grew into what is today a month-long initiative: National Minority Health Month. This effort seeks to advance health equity across the country on behalf of all racial and ethnic minorities.

In this post, we will focus on the contribution of physical activity. It is one of the best things people can do to improve their health. In general, too few Americans get the recommended amount of daily activity. In fact, only 1 in 4 adults and 1 in 5 high school students fully meet physical activity guidelines for aerobic and muscle-strengthening activities. These numbers are even lower among adults in some racial and ethnic minority populations.

Physical activity promotes health and reduces the risk of chronic diseases. Importantly, these conditions are often more common and more severe among racial and ethnic minority groups. Physical activity also fosters normal growth and development in children. Also, it improves mental health and can make people feel, function and sleep better.

How much physical activity do I need?

The Physical Activity Guidelines for Americans standards outline the amounts and types of physical activity needed to maintain or improve overall health. It also points the way forward to reducing the risk of chronic disease. The guidelines recommend that each week, adults get at least 150 minutes of moderate intensity aerobic activity. Examples of this level include something as simple as a brisk walk that makes your heart beat faster. There are many ways to get this amount. How about a 22-minute walk each day? Could you do a 30-minute walk five days a week? Every little bit counts.

How much physical activity do children need?

Preschool-aged children should do physical activity every day throughout the day. This is important for healthy growth and development. Starting at age 6, children should participate in at least 60 minutes of moderate-to-vigorous intensity physical activity daily. Remember: children imitate adults. You can start them by adding physical activity to your own daily routine. Encourage your child to join you!

How can communities help people stay active?

Communities can create easy and safe options for physical activity. These can help every American be more active where they live, learn, work, and play. The Racial and Ethnic Approaches to Community Health (REACH) program is a CDC program that focuses on reducing chronic disease for specific racial and ethnic groups. The program spams urban, rural, and tribal communities with high disease burden across the United States. REACH has demonstrated that locally based and culturally tailored efforts can be effective in closing health gaps.

How can I help people become more physically active?

National Minority Health Month logo

 

This year’s National Minority Health Month theme this year is “Active and Healthy”. You can advance health equity by sharing why physical activity matters and the benefits of physical activity. The Physical Activity Guidelines for Americans outline the amounts and types of physical activity needed to maintain or improve overall health. It also shows how to reduce the risk of chronic disease. Additionally, the Move Your Way campaign provides resources to help further explain the Physical Activity Guidelines for Americans. Share and embrace this information. Furthermore, in your own life, be the message!

There’s More!

Visit these Straight, No Chaser posts for more information on minority health during National Minority Health Month.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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

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National Child Abuse Awareness Month

Child Abuse Prevention and Awareness

Introduction

April is Child Abuse Prevention Month (and Neglect Prevention Month). Therefore, Straight, No Chaser, with the guidance of the Centers for Disease Control and Prevention, is offering up information and resources. Let’s increase you knowledge and offer better protection for the children you love. Children and families thrive when they have access to safe, stable, nurturing relationships and environments. Make a point of learning how to prevent child abuse and neglect before it begins!

Child Abuse Prevention

Father hugging child and smiling

Facts about Child Abuse and Neglect

Child abuse and neglect are significant public health problems in the United States:

  • In 2017, an estimated 1,720 children died from abuse and neglect.
  • Also, about 674,000 children were identified as victims of child abuse or neglect by child protective service agencies in 2017.
  • Furthermore, an estimated one in four children have experienced abuse or neglect at some point in their lives.

Child Abuse and Neglect Are Preventable

child abuse prevention and awareness

Children’s lives are shaped by their experiences, including what happens in their environment and the types of relationships they have with parents, teachers, and other caregivers. Children who experience abuse, neglect, and other adverse childhood experiences (ACEs) are also at increased risk for negative health consequences and certain chronic diseases as adults. Safe, stable, nurturing relationships and environments are essential to preventing child abuse and neglect. Additionally, policies and programs that are supportive of children and families can help prevent such abuse and neglect.

Resources for Prevention

national child abuse prevention month

CDC works to prevent child abuse and neglect before it begins.

Visit CDC’s VetoViolence website for free violence prevention trainings, tools, and resources.

There’s More!

Visit these Straight, No Chaser posts for more information on Child Abuse

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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

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Cervical Health Awareness Month

Introduction

cervical health awareness month

January is Cervical Health Awareness Month. To that end, The Center for Disease Control and Prevention (CDC) boldly proclaims “No woman should die of cervical cancer.” Yes, that is actually possible!

This post has a rather simple message. Cervical cancer is entirely preventable. Furthermore, it can be cured when discovered and treated early.

Quick Tips

Here are some quick tips to help you check this off of your list of concerns.

  • Every child should get vaccinated at age 11 or 12. Even if you’ve reached age 26 and haven’t been vaccinated, you should discuss options with your physician.
  • Get screened, starting at age 21. This is the most important thing you can do to help prevent cervical cancer.

pap smear

  • The Pap test (or smear) should be performed regularly at age 21. It looks for precancerous changes to the cervix that identify the need for early treatment. In many cases a normal test will eliminate the need for another test for the next three years, but your physician will discuss your individual circumstances in this regard.
  • The HPV test looks for the virus that is now known to be the cause of cervical cancer. Furthermore, human papillomavirus (HPV) is sexually transmitted. The HPV test can be done at the same time as the Pap test from the same examination.

Hopefully knowing these simple tools will convince you to focus on preventing and managing your cervical health. This is a public health success story in that cervical cancer could be eliminated if everyone followed the above steps. The rest is up to you.

Read these!

  • This additional Straight, No Chaser post discusses the prevention strategy that could eliminate in total cervical cancer. Read it for details.
  • This Straight, No Chaser post shares news regarding the success of the vaccine in reducing the rates of HPV infection and cervical cancer. Read it for details.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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

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Flu Myths and Questions

Introduction

This Straight, No Chaser addresses flu myths and address a few frequently asked questions.Flu season aheadEvery year 36,000 people die and over 200,000 are hospitalized each year due to the flu—in the U.S. alone. If you’re not getting a vaccine every year, you are subjecting yourself to a significantly higher risk and allowing fears and myths to get the better of you. Knowledge is power. Learn the facts.

Does the flu shot give you the flu?

No, no, no. The influenza vaccine cannot cause flu illness. There are vaccines that involve the delivery of live virus, including mumps, measles, rubella, chicken pox and polio. Influenza is not in that category. Flu shots are made in one of two ways. They can be made with ‘inactivated’ vaccine viruses that are not infectious. Alternatively, they contain no flu vaccine viruses at all (and instead have recombinant particles that serve to stimulate your immune system).

The most common side effects from the influenza vaccines are pretty minor things. This include soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur. These symptoms are among the same symptoms you see with influenza, so it’s easy to confuse them as flu symptoms. They are not.

Controlled medical studies have been performed on humans in which some people received flu shots and others received shots containing salt water. There were no differences in symptoms other than increased redness and soreness at the injection site for those receiving influenza vaccine. The flu shot does not give you the flu.
flu myths

I swear I’ve gotten the flu right after getting the flu shot! How is that possible if I can’t get the flu from the flu shot?

I always remind people that the flu vaccine does an even better job of preventing you from dying from the flu than it does in preventing you from catching the flu (and it does that at a 70–90% rate).  It primes your immune system to better fight off the influenza virus when you’re exposed to it.

There are several reasons why someone still might get a flu-like illness after being vaccinated against the flu:

  • Influenza is just one group of respiratory viruses. Many other viruses cause similar symptoms. Most notable of these is the common cold, which is also most frequently seen during “flu season.” The flu vaccine only protects against influenza. Any other infection timed correctly can give you similar symptoms.
  • When you get immunized against influenza, it takes the body up to two weeks to obtain the desired level of protection. There is nothing preventing you from having been infected before or during the period immediately before immunity sets in. Such an occurrence will result in your obtaining the flu despite being vaccinated.

Two More Reasons!

  • An additional reason why some people may experience flu-like symptoms despite getting vaccinated is that they may have been exposed to a strain of influenza that is different from the viruses against which the vaccine is designed to protect. The ability of a flu vaccine to protect a person depends largely on the match between the viruses selected to make the vaccine and those causing illness among the population that same year.
  • It is also the case that the flu vaccine doesn’t always provide adequate protection against the flu. This is more likely to occur among people who have weakened immune systems or people age 65 and older. Even if the vaccine is 90% effect, some individuals will contact the flu despite having been vaccinated.

Please don’t get the wrong message from this section. These explanations are the exceptions, not the rule. In the overwhelming number of cases, the influenza vaccine does an excellent job of protecting against and prevent disease from the influenza virus.

Is it better to get the flu than the flu vaccine?

No. Influenza causes tens of thousands of deaths every year. If you have asthma, diabetes, heart disease or are especially young or old, you are placing yourself at significant risk by not getting vaccinated. Even if you aren’t in one of the above categories and are otherwise healthy, a flu infection can cause serious complications, including hospitalization or death.

flu-vaccine-facts-myths

Why do I need a flu vaccine every year?

The Center for Disease Control and Prevention (CDC) recommends a yearly flu vaccine for just about everyone six months and older. Once vaccinated, your immune protection decreases over time. These boosters are scheduled and dosed to help you maintain the best level of protection against influenza. Additionally, the virus mutates (changes) every year. This means what covers you this year may not apply next year.

You can make a decision not to get vaccinated. However, that flies in the face of any reasonable risk/benefit analysis. Also, not getting vaccinated runs against the solid consensus of medical evidence and research. The evidence is so one-sided toward the benefit of getting immunized that you should seriously question the motives or knowledge of someone who suggests that you should not get vaccinate for influenza. This is especially true for those involved in healthcare. Get vaccinated.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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

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Your Questions About E-Cigarettes (Vaping)

Let’s talk about using E-cigarettes, aka vaping. Here are five questions you commonly ask.

What is vaping, and how is it different from smoking cigarettes?

E-cigarettes are battery-operated devices that typically resemble a pen or cigarette. They enable smokers to get their “nicotine fix” without being exposed to all the other chemicals contained within regular cigarettes. E-cigarettes have chambers in which you place liquid nicotine with additional ingredients and flavorings. Heating the liquid turns the liquid into vapor. This is why the name “vaping” is applied when one uses an e-cigarette.

Is vaping safe?

On an absolute scale, the answer is no. On a relative scale, the answer is likely “safer than regular cigarettes.” Simply put, nicotine is addictive, and it produces withdrawal symptoms and cravings. Nicotine causes several other problems of note. It exacerbates problems for those with heart disease and causes damage to blood vessels. Also, nicotine harms the developing brains of kids and could affect memory and attention. Pregnant women or those attempting to become pregnant must avoid nicotine exposure, because nicotine clearly causes damage to unborn babies. E-cigarettes do not remove all the chemicals found in cigarettes; formaldehyde and other cancer-inducing products are still present.

Is vaping safer than smoking cigarettes?

The basis for e-cigarettes being safer than regular cigarettes is the production of toxins with burning that occurs when smoking cigarettes. Vaping doesn’t reach the threshold of burning, so the thousands of chemicals found in cigarettes don’t produce the same effect. A safe estimate of the relative safety of e-cigarettes compared to regular cigarettes would be that vaping is about 75% safer than smoking cigarettes, but it bears repeating: neither is safe. Fortunately, the risks of second-hand vaping are very low, according to currently research.

Is vaping effective at getting people to stop smoking cigarettes?

The American Heart Association recommends that e-cigarettes should only be used as a last-ditch effort toward quitting cigarette smoking. Unfortunately, most of the e-cigarette use in the US occurs in addition to cigarette use, as opposed to replacing cigarette use.

How is vaping affecting childhood smoking? Does it lead kids to smoke?

One commonly expressed concern is that kids who start vaping may continue as smokers throughout life. The concern arises due to the many kid-friendly flavors in e-cigarettes.

The journal Pediatrics published a study in 2016 showing a six-fold increase in cigarette use in those who used e-cigarettes compared to those who did not. A 2015 study produced in the Journal of the American Medical Association showed a similar finding. Yet, the overall trend of childhood smoking remains encouraging. Data from the CDC show that while use of e-cigarettes went up to 24% in 2015, cigarette smoking dropped to a historic low — to just under 11%.

Click here for information about hookahs!

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, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

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

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Concussion, Part II

concussionboxing_facial__4_

Your son is a star in Friday Night Lights (actually football, not the TV show) and has been concussed.  Amazingly, the most common question I get asked is not “Will he be ok?”, but “When will he be able to get back on the field?” My answer, coming out the ER, is never going to be less than two weeks, and I won’t be the one who provides medical clearance.  It’ll either be your family doctor or preferably, a neurologist.  Don’t just take my word for it.  Consider the following Quick Tips from the Center for Disease Control and Preventions.
CDC’s Discharge Instructions

  • You may experience a range of symptoms over the next few days, such as difficulty concentrating, dizziness or trouble falling asleep.  These symptoms can be part of the normal healing process, and most go away over time without any treatment.
  • Return immediately to the ED if you have worsening or severe headache, lose consciousness, increased vomiting, increasing confusion, seizures, numbness or any symptom that concerns you, your family, or friends.
  • Tell a family member or friend about your head injury and ask them to help monitor you for more serious symptoms.  Get plenty of rest and sleep, and return gradually and slowly to your usually routines.  Don’t drink alcohol.  Avoid activities that are physically demanding or require a lot of concentration.
  • If you don’t feel better after a week, see a doctor who has experience treating brain injuries.
  • Don’t return to sports before talking to your doctor.  A repeat blow to your head-before your brain has time to heal-can be very dangerous and may slow recovery or increase the chance for long-term problems.

Finally, there are two particularly impactful consequences about which you should be aware.

Impact-Syndrome616x314new

  • The ‘second impact syndrome’ is irreversible brain injury triggered by a fairly routine second head impact after a prior concussion.  You must take the time off needed for the brain to heal.  I care more about your child’s mental future than the upcoming playoff game.
  • The ‘post-concussive syndrome’ represents long-term neurologic and psychologic consequences of the head injury.  It includes such symptoms as inability to sleep, irritability, inability to concentrate, headache, dizziness and anxiety.

Post Concussion Syndrome 3D cube Word Cloud Concept with great terms such as brain, injury, trauma and more.
There are no definitive treatments for concussions other than prevention of an additional injury, and that fact should be chilling to you.  Be mindful of the risks involved in choosing to engage in activities putting the brain at risk.

Feel free to ask your SMA expert consultant any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber,  we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following SNC! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Alcoholism and Alcohol-Related Deaths Are on the Rise

Introduction

This Straight, No Chaser post reviews the rate of rise of alcohol-related deaths.

alcoholaddictionchains

Does it seem that alcoholism isn’t discussed much anymore, or is it that the public health community has focused more on overdose deaths from heroin and prescription painkillers of late? According to the Centers for Disease Control and Prevention, alcoholism and the deaths related to it are on the rise.

Alcohol-related deaths

Consider the sum total of the following statistics:

alcohol_risk

  • Alcohol is killing Americans at a rate higher than at any time in the last 35 years. In 2015, there were 10.3 thousand deaths from alcohol-induced causes per 100,000 people, representing an increase of 47% since 2002.
  • During 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths (31 percent of overall driving fatalities).
  • In 2014, more people died from alcohol-induced causes (30,722) than from overdoses of prescription painkillers and heroin combined (28,647).

alcohol-related deaths

In reality, the annual number of deaths directly or indirectly caused by alcohol is closer to 90,000, as the official count of alcohol-induced fatalities excludes deaths from drunk driving, other accidents, and homicides committed under the influence of alcohol. This makes alcohol related deaths the 3rd leading cause of preventable deaths in the United States.

Where do you fit in this equation? Here’s the deal: 30% of American adults don’t drink at all. Another 30% consume less than one drink per week (on average). On the other hand, the top 10% of American adults (approximately 24 million people) consume an average of 74 drinks per week, or a little more than 10 drinks per day. The heaviest drinkers are at the greatest risk for the alcohol-induced causes of death.

alcohol abuse

An easy way to minimize your risk, assuming you’re going to drink, is to restrict your alcohol intake at any one time to 2 drinks per day. The especially good news is that level – defined as moderate alcohol consumption – is actually associated with a decreased risk of mortality.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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

Copyright © 2019 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Cervical Health Awareness

cervical_health_awareness_month

January is Cervical Health Awareness Month, and to that end, The Center for Disease Control and Prevention (CDC) boldly proclaims “No woman should die of cervical cancer.”
It’s cervical health month in the United States, and this point has a rather simple message: Cervical cancer is highly preventable and can be cured when discovered and treatment early. Here are some quick tips to help you check this off of your list of concerns.

  • Every child should get vaccinated at age 11 or 12. Even if you’ve reached age 26 and haven’t been vaccinated, you should discuss options with your physician.
  • The most important thing you can do to help prevent cervical cancer is to get screened regularly starting at age 21.

pap smear

  • The Pap test (or smear) should be performed regularly at age 21. It looks for precancerous changes to the cervix that identify the need for early treatment. In many cases a normal test will eliminate the need for another test for the next three years, but your physician will discuss your individual circumstances in this regard.
  • The HPV test looks for the virus that is now known to be the cause of cervical cancer. Furthermore, human papillomavirus (HPV) is sexually transmitted. The HPV test can be done at the same time as the Pap test from the same examination.

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

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