Tag Archives: CDC

Alcoholism and Alcohol-Related Deaths Are on the Rise

Toxicology/Drugs, , , , , , , , , ,

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!

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Straight, No Chaser: Cervical Health Awareness

Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health Prevention, , , , , , , , , ,

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.
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Straight, No Chaser: Flu Myths and Questions

General Health and Wellness, , , , , , , , , , , , , , ,

Flu season ahead
Every 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 either with ‘inactivated’ vaccine viruses that are not infectious or 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 shot are 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-shot-myth
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. There are many other viruses that cause similar symptoms including the common cold, which is also most commonly seen during “flu season.” The flu vaccine only protects against influenza, so 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.
  • 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, so what you were covered for this year may not apply next year.
You can make a decision not to get vaccinated, but frankly, that’s accepts a risk that you flies in the face of a reasonable risk/benefit analysis, and you would be doing so in the face of the solid consensus of medical evidence and research. You should seriously question the motives or knowledge of someone who suggests that you should not get vaccinate for influenza, particularly if they profess to be involved in healthcare. Get vaccinated.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Straight, No Chaser: Traumatic Brain Injuries (Concussion), Part II

Neurology, Trauma, , , , , , , , , ,

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 to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Straight, No Chaser: Hoping for Health, Happiness and Healthcare Reform that isn't Sexist On Mother's Day

Obstetrics and Gynecology, Public Health, Health Prevention, , , , , , , , ,

Apologies in advance for this not being the Mother’s Day post you might have expected, but in the current environment, it’s perhaps a more valuable gift than your typical set of platitudes…
There’s something about being a Mother that men clearly don’t get. Even as a physician, I’ve always been fascinated at how seemingly oblivious to their own health women are in pursuit of the care of their children. I’m not just talking about all the infection risks that come from caring for the snotty noses, strep throats, flu and pneumonia that kids get (moms, you do know that stuff is contagious, right?). I’m talking about risks of death. Mother’s Day is as good of a time as any to remind the thirteen men in the US Senate drafting a bill to repeal and replace the Affordable Care Act (aka Obamacare) why this matters.
Did you know that the U.S. has the absolute worst maternal mortality rate (death during childbirth) in the developed world? That’s right (or wrong), we’re #1 in the worst possible way here. According to the World Health Organization, the U.S. was one of a very few countries in which the rates of death for pregnant and new mothers increased in the years between 1990 and 2015. Meanwhile, in the rest of the world, that rate dropped by 44% – nearly half. In 2014 alone, the estimated US maternal mortality rate increased by 26.6%. The sum total here is about three mothers die every single day. In case you were wondering, according to this same data, African-American women are three times as likely to die from pregnancy complications than white women.

Of course, nothing compares to an actual death, but our ongoing national tragedy is compounded by analysis from the CDC Foundation suggesting that approximately 60% of maternal deaths are preventable. In other words, this isn’t just attributable to say, women choosing to have children at more advanced ages, which independently increases the risk of death.

Incredibly, it is against this backdrop that steps are in place to worsen the situation. Remember, death is an absolute and not a factor of your political inclinations. In the American Health Care Act bill just passed in the House of Representatives, here’s a three-pack of considerations that will predictably further increase the maternal mortality rate:

  • Labeling pregnancy as a pre-existing condition
  • Reducing or eliminating coverage for contraception and abortion
  • Removal of funding for Planned Parenthood and other sources of reproductive health

Medicaid pays for approximately one-half of the childbirths in the United States.
This post probably isn’t what you think it is. Given everything happening in the political arena regarding proposed changes in this nation’s provision of health, Mother’s Day is as good of a time as any to remind the 13 men in the US Senate why this matters.
Happy Mother’s Day to everyone. Here’s hoping it’s a healthy one. Let’s all give the additional give of fighting for adequate health care.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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The Rapid Explosion of Autism Diagnoses – A Good or Bad Thing?

Mental Health, Pediatrics/Kids Health, , , , , , , ,

Introduction

In this post, we discuss autism diagnoses and look and the recent jump in frequency.

autism awareness and autism diagnoses

The Fear Associated with Autism

Regarding autism, it is a condition that strikes fear into the heart of many, not just because of the condition itself. It’s the lack of knowledge about the condition. It is the uncertainty about whether a newborn child will be affected just because we’re having children at older ages. It’s the possibility that common environmental exposures could be contributing to the increase in the condition.

autism-in-toddlers

I’m going to approach this two-part series on autism in reverse order. Instead of simply discussing the basics about autism, I’m going to discuss the recent increases in autism rates. It is very important that you read past the headlines on this. Hopefully you’ll come to a better understanding.

The Uptick in Autism Diagnoses

In March of 2012 (the most recently updated dataset), the Centers for Disease Control and Prevention (CDC) estimated that one of 88 eight-years-olds would have one of the various forms of autism spectrum disorder. Another CDC study that was just released reveals that autism rates now affect one of every 68 eight-year-old children. This is a 30% increase in just two years!

Many of you are aware of some of the controversial claims about possible causes of autism. Regardless of the believability of unproven claims, it is entirely probable that some good has come from shining a spotlight on autism. It is without question that the enhanced attention has resulted in more attention being paid to children with suggestive symptoms. This recent trend in more aggressive diagnoses is resulting in more attention being given to those in need with better outcomes over the long haul.

Is There a Cure?

There is no cure for autism. This may be true and depressing, but it doesn’t have to be. Generally, interventions tend to focus on eliminating symptoms and producing desired outcomes (such as those that will increase independent living and functioning). Coordination of strategies is important, so the use of multiple professionals working as a team is common. The good news is, for many children, symptoms improve with early treatment and with age.  Those with one of the forms of autism will usually continue to need services and supports throughout their lives, but many are able to work successfully and live independently or within a supportive environment. Also, please note: The earlier the diagnosis is made and treatment is started, the better one’s outcome is likely to be.

I have just understated a point that I will take a few words to revisit. There is no cure for autism. Please don’t fall prey to claims of therapies and interventions that promise a quick fix. These claims are invariably are not supported by scientific studies. They are acting on your hopes and preying on your fears. The details of treatment strategies are further discussed at www.sterlingmedicaladvice.com.

The next post will focus on the diagnosis and symptoms of autism.

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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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Straight, No Chaser: Cervical Health Awareness

Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health Prevention, , , , , , , , , ,

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.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Alcoholism and Alcohol-Related Deaths Are on the Rise

General Health and Wellness, Public Health, Toxicology/Drugs, , , , , , , ,

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? In the news is reason that should change. According to the Centers for Disease Control and Prevention, alcoholism and the deaths related to it are on the rise. 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 2014, there were 9.6 deaths from alcohol-induced causes per 100,000 people, representing an increase of 37% since 2002.
  • Last year, more than 30,700 Americans died from causes directly related to alcohol (e.g. alcohol poisoning and cirrhosis).
  • In 2014, more people died from alcohol-induced causes (30,722) than from overdoses of prescription painkillers and heroin combined (28,647).

alcoholrisedeaths

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.
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.
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.
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Consequences of Inappropriate Antibiotic Use

General Health and Wellness, Infectious Disease, Respiratory/Lungs, , , , , , , , , , , ,

Introduction

This Straight, No Chaser discusses inappropriate antibiotic use.

inappropriate antibiotic use

Whenever physicians attempt to discuss inappropriate antibiotic use with patients, too often fear replaces logic. These days, antibiotic use is treated as a convenience consideration, regardless if there’s actually a disease present that can be treated by antibiotics. Here are some principles your physician is mindful of when deciding if you actually need antibiotics.

We Want to Treat You!

Significant complications exist from missing any disease. If a heart attack is missed, your heart can rupture, and you can die. When a fracture is missed, you can develop necrosis, arthritis and loss of limb. If pneumonia is missed, you can go into respiratory failure and die. Etc., etc. As an emergency physician, my colleagues and I are more in tune than any other specialty of physicians with the risks and consequences of misdiagnosing critical illness; in fact it’s one of the main components of the speciality.

The point is giving medicine is not based on either fear or treating conditions that have a low probability of existing. Any physician is weighing the value of the information you provide to determine what appropriate management will be; that’s the Art of Medicine, and that will always be left to the individual judgment of your treating physician.

That said, the days of such absolute power by physicians are going the way of the dinosaur. Evidence-based medicine and outcomes-based medicine are here to stay. Multiple guidelines for best practices exist across many medical conditions, including when to order ankle x-rays and not, when to order neck x-rays and not, when to treat various infections and not. What’s new here is identifying opportunities to avoid exposing patients to unnecessary, costly medical interventions. What’s also new is you the patient can be better empowered and knowledgeable about the conditions you have and the care you receive.
abx

Antibiotics Come with Risks!

The risk of inappropriate antibiotic use is more real, more present and more important than practicing defensive medicine. 

There are classes of antibiotics that we can no longer use. I mentioned previously how Staph is resistant to several of the penicillins we’ve used for decades due to resistance, which occurs from overuse and inappropriate use, most frequently seen in treatment of viral illnesses. Yes readers, MRSA stands for methicillin-resistant Staph Aureus, and that’s why it’s known as a ‘super-bug’. Approximately 80% of those ear, nose and throat infections you’re coming to the emergency room for and asking/receiving antibiotics for are viral illness and would be better on their own in 48-72 hours.

Have you heard about what happened to gonorrhea due to inappropriate antibiotic use?

Similarly, treatment of gonorrhea has recently been revised by the Center for Disease Control and Prevention (CDC) because of the emergence of resistance to the medications used against it. Again, this has resulted from overuse and inappropriate use of these medications, largely in treatment of viral illnesses. One of the more powerful antibiotics we had at our disposal (a member of the fluoroquinolone class) just got pulled back from its 15 different indications for usage due to emerging resistance. This particularly powerful entity, instead of being withheld for serious diseases, was being used for urinary tract infections, minor skin and soft tissue illness and other conditions that eventually led to a loss of effectiveness. Why would such things be done? Profits and defensive medicine are two reasons that rapidly come to mind.

This is a lot more serious than just overusing medications. Sepsis occurs when an infection overwhelms the body and isn’t just limited to the local site where the infection originated. It can be so devastating that your body goes into shock, losing its ability to function and deliver blood throughout your body. Initial treatment of real illness suffers when we’re using medications that are less effective because bacteria have had time to mutate or otherwise become resistant due to non-lethal exposures.

getsmart_16_3731609472

The CDC and the American Academy of Pediatrics have consistently promoted this philosophy. It’s been included in JAMA, the Journal of the American Medical Association. Inappropriate antibiotic use has consequences!

Illnesses that Don’t Need Antibiotics

Consider the following lists of conditions that commonly can be treated without antibiotics.

  • Common colds and upper respiratory illnesses, including non-strep pharyngitis
  • Influenza (flu)
  • Most coughs and bronchitis (chest cold with a cough)
  • Many ear infections (also called otitis media)
  • Many skin rashes

To be clear, no one is recommending or promoting inappropriate or less than appropriate treatment of conditions that actually exist. No one is suggesting that anything you read here or anywhere else is more important than the real-time judgement of your physician. Just appreciate that opportunities exist to do the right thing and the wrong thing, and medicine is better with an informed patient.

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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!

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Straight, No Chaser In the News: Zika Virus Update

Infectious Disease, Neurology, Obstetrics and Gynecology, Public Health, Health Prevention, , , , , , , , ,

zika pregnancy-button

The Zika virus continues to be in the news, especially regarding its effects on newborns. According to the Centers for Disease Control and Prevention (CDC), the number of pregnant women in the United States reported to have the Zika virus has increased from 48 to 157. Unfortunately and more importantly, that has now translated in up to a dozen babies or fetuses who have already suffered the consequences of Zika infection, with the obvious possibility of more to come. The most notable consequence is the condition known as microcephaly, representing a reduction in the size of the skull and the brain, causing developmental delays and defects.

zika-x

Here’s one simple point for you to know. Not a single person is known to have contracted Zika from a mosquito bite in the U.S. The CDC has been clear in two specific warnings:

  • Do not travel to countries where Zika is endemic
  • Wear condoms when engaged in sexual intercourse with male who have traveled to such an area (Zika can be passed on through sperm).

Your travel to these areas pose specific risks even if you’re not a female of childbearing age. Such travel increases the risk of being infected without showing symptoms, spreading the disease and contributing to a worldwide expansion of the Zika virus. In fact the World Health Organizations notes that Zika virus is now poised to invade Africa, having spread to the African nation of Cabo Verde (Cape Verde). Your actions pose risks to others. 
Review this Straight, No Chaser for a refresher on transmission, symptoms and complications of the Zika Virus.
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.
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Straight, No Chaser: The Rapid Explosion of Autism Diagnoses – A Good or Bad Thing?

Mental Health, Pediatrics/Kids Health, , , , , , , ,

autism-hands

Sometimes it’s really good to be a physician, especially when it comes to care of children. Just yesterday I saved myself a few thousands of dollars in costs by being able to address a situation at home. I can recall two instances in which poorly qualified, non-physician professionals tried to label my children with specific diagnoses. After my then three-year-old son defended himself from a child trying to take a toy from him, one consulting counselor suggested that I pay $200/hour to get him help for his “aggressive tendencies.” (His “symptoms” remarkably disappeared when I removed him from the environment.) When my otherwise normal daughter displayed signs of delaying speaking, another “professional” immediately wanted to label her autistic. In case you’re wondering, I’m not the guy who marches into everyone’s office and announces that I’m a physician. It’s much more interesting to observe the difference in the first and second conversations (you know, the one after they discover you know something…).
Regarding autism, it is a condition that strikes fear into the heart of many, not just because of the condition itself. It’s the lack of knowledge about the condition. It’s the uncertainty about whether a newborn child will be affected just because we’re having children at older ages. It’s the possibility that common environmental exposures could be contributing to the increase in the condition.

autism-in-toddlers

I’m going to approach this two-part series on autism in reverse order. Instead of simply discussing the basics about autism, I’m going to discuss the recent increases in autism rates. It is very important that you read past the headlines on this. Hopefully you’ll come to a better understanding.
In March of 2012, the Centers for Disease Control and Prevention (CDC) estimated that one of 88 eight-years-olds would have one of the various forms of autism spectrum disorder. Another CDC study that was just released reveals that autism rates now affect one of every 68 eight-year-old children. This is a 30% increase in just two years!
Many of you are aware of some of the controversial claims about possible causes of autism. Regardless of the believability of unproven claims, it is entirely probable that some good has come from shining a spotlight on autism. It is without question that the enhanced attention has resulted in more attention being paid to children with suggestive symptoms. This recent trend in more aggressive diagnoses is resulting in more attention being given to those in need with better outcomes over the long haul.
There is no cure for autism. This may be true and depressing, but it doesn’t have to be. Generally, interventions tend to focus on eliminating symptoms and producing desired outcomes (such as those that will increase independent living and functioning). Coordination of strategies is important, so the use of multiple professionals working as a team is common. The good news is, for many children, symptoms improve with early treatment and with age.  Those with one of the forms of autism will usually continue to need services and supports throughout their lives, but many are able to work successfully and live independently or within a supportive environment. Also, please note: The earlier the diagnosis is made and treatment is started, the better one’s outcome is likely to be.
I have just understated a point that I will take a few words to revisit. There is no cure for autism. Please don’t fall prey to claims of therapies and interventions that promise a quick fix. These claims are invariably are not supported by scientific studies. They are acting on your hopes and preying on your fears. The details of treatment strategies are further discussed at www.sterlingmedicaladvice.com.
The next post will focus on the diagnosis and symptoms of autism.
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.
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Straight, No Chaser: Alcoholism and Alcohol-Related Deaths Are on the Rise

General Health and Wellness, Public Health, Toxicology/Drugs, , , , , , , ,

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? In the news is reason that should change. According to the Centers for Disease Control and Prevention, alcoholism and the deaths related to it are on the rise. 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 2014, there were 9.6 deaths from alcohol-induced causes per 100,000 people, representing an increase of 37% since 2002.
  • Last year, more than 30,700 Americans died from causes directly related to alcohol (e.g. alcohol poisoning and cirrhosis).
  • In 2014, more people died from alcohol-induced causes (30,722) than from overdoses of prescription painkillers and heroin combined (28,647).

alcoholrisedeaths

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.
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.
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.
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Straight, No Chaser: Inappropriate Antibiotic Use

General Health and Wellness, Infectious Disease, Respiratory/Lungs, , , , , , , , , , , ,

antibiotics

Whenever physicians attempt to discuss inappropriate antibiotic use with patients, too often fear replaces logic. These days, antibiotic use is treated as a convenience consideration, regardless if there’s actually a disease present that can be treated by antibiotics. Here are some principles your physician is mindful of when deciding if you actually need antibiotics.
Significant complications exist from missing any disease. If a heart attack is missed, your heart can rupture, and you can die. If a fracture is missed, you can develop necrosis, arthritis and loss of limb. If pneumonia is missed, you can go into respiratory failure and die. Etc., etc. As an emergency physician, my colleagues and I are more in tune than any other specialty of physicians with the risks and consequences of misdiagnosing critical illness; in fact it’s one of the main components of the speciality.
The point is giving medicine is not based on either fear or treating conditions that have a low probability of existing. Any physician is weighing the value of the information you provide to determine what appropriate management will be; that’s the Art of Medicine, and that will always be left to the individual judgment of your treating physician. That said, the days of such absolute power by physicians are going the way of the dinosaur. Evidence-based medicine and outcomes-based medicine are here to stay. Multiple guidelines for best practices exist across many medical conditions, including when to order ankle x-rays and not, when to order neck x-rays and not, when to treat various infections and not. What’s new here is identifying opportunities to avoid exposing patients to unnecessary, costly medical interventions. What’s also new is you the patient can be better empowered and knowledgeable about the conditions you have and the care you receive.
abx
The risk of inappropriate antibiotic use is more real, more present and more important than practicing defensive medicine. There are classes of antibiotics that we can no longer use. I mentioned previously how Staph is resistant to several of the penicillins we’ve used for decades due to resistance, which occurs from overuse and inappropriate use, most frequently seen in treatment of viral illnesses. Yes readers, MRSA stands for methicillin-resistant Staph Aureus, and that’s why it’s known as a ‘super-bug’. Approximately 80% of those ear, nose and throat infections you’re coming to the emergency room for and asking/receiving antibiotics for are viral illness and would be better on their own in 48-72 hours. Similarly, treatment of gonorrhea has recently been revised by the Center for Disease Control and Prevention (CDC) because of the emergence of resistance to the medications used against it. Again, this has resulted from overuse and inappropriate use of these medications, largely in treatment of viral illnesses. One of the more powerful antibiotics we had at our disposal (a member of the fluoroquinolone class) just got pulled back from its 15 different indications for usage due to emerging resistance. This particularly powerful entity, instead of being withheld for serious diseases, was being used for urinary tract infections, minor skin and soft tissue illness and other conditions that eventually led to a loss of effectiveness. Why would such things be done? Profits and defensive medicine are two reasons that rapidly come to mind.
This is a lot more serious than just overusing medications. Sepsis is a condition where an infection overwhelms the body and isn’t just limited to the local site where the infection originated. It can be so devastating that your body goes into shock, losing its ability to function and deliver blood throughout your body. Initial treatment of real illness suffers when we’re using medications that are less effective because bacteria have had time to mutate or otherwise become resistant due to non-lethal exposures.

getsmart_16_3731609472

The CDC and the American Academy of Pediatrics have consistently promoted this philosophy. It’s been included in JAMA, the Journal of the American Medical Association. Inappropriate antibiotic use has consequences!

Consider the following lists of conditions that commonly can be treated without antibiotics.

  • Common colds and upper respiratory illnesses, including non-strep pharyngitis
  • Influenza (flu)
  • Most coughs and bronchitis (chest cold with a cough)
  • Many ear infections (also called otitis media)
  • Many skin rashes

To be clear, no one is recommending or promoting inappropriate or less than appropriate treatment of conditions that actually exist. No one is suggesting that anything you read here or anywhere else is more important than the real-time judgement of your physician. Just appreciate that opportunities exist to do the right thing and the wrong thing, and medicine is better with an informed patient.
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.
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Straight, No Chaser: Cervical Health Awareness

Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health Prevention, , , , , , , , , ,

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.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Flu Myths and Questions

General Health and Wellness, , , , , , , , , , , , , ,

Flu season ahead
Every 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 either with ‘inactivated’ vaccine viruses that are not infectious or 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 shot are 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-shot-myth
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. There are many other viruses that cause similar symptoms including the common cold, which is also most commonly seen during “flu season.” The flu vaccine only protects against influenza, so 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.
  • 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, so what you were covered for this year may not apply next year.
You can make a decision not to get vaccinated, but frankly, that’s accepts a risk that you flies in the face of a reasonable risk/benefit analysis, and you would be doing so in the face of the solid consensus of medical evidence and research. You should seriously question the motives or knowledge of someone who suggests that you should not get vaccinate for influenza, particularly if they profess to be involved in healthcare. Get vaccinated.
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.

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Straight, No Chaser: Traumatic Brain Injuries (Concussion), Part II

Neurology, Trauma, , , , , , , , ,

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.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: The Rapid Explosion of Autism Diagnoses – A Good or Bad Thing?

Mental Health, Pediatrics/Kids Health, , , , , , , ,

autism-hands

Sometimes it’s really good to be a physician, especially when it comes to care of children. Just yesterday I saved myself a few thousands of dollars in costs by being able to address a situation at home. I can recall two instances in which poorly qualified, non-physician professionals tried to label my children with specific diagnoses. After my then three-year-old son defended himself from a child trying to take a toy from him, one consulting counselor suggested that I pay $200/hour to get him help for his “aggressive tendencies.” (His “symptoms” remarkably disappeared when I removed him from the environment.) When my otherwise normal daughter displayed signs of delaying speaking, another “professional” immediately wanted to label her autistic. In case you’re wondering, I’m not the guy who marches into everyone’s office and announces that I’m a physician. It’s much more interesting to observe the difference in the first and second conversations (you know, the one after they discover you know something…).
Regarding autism, it is a condition that strikes fear into the heart of many, not just because of the condition itself. It’s the lack of knowledge about the condition. It’s the uncertainty about whether a newborn child will be affected just because we’re having children at older ages. It’s the possibility that common environmental exposures could be contributing to the increase in the condition.

autism-in-toddlers

I’m going to approach this two-part series on autism in reverse order. Instead of simply discussing the basics about autism, I’m going to discuss the recent increases in autism rates. It is very important that you read past the headlines on this. Hopefully you’ll come to a better understanding.
In March of 2012, the Centers for Disease Control and Prevention (CDC) estimated that one of 88 eight-years-olds would have one of the various forms of autism spectrum disorder. Another CDC study that was just released reveals that autism rates now affect one of every 68 eight-year-old children. This is a 30% increase in just two years!
Many of you are aware of some of the controversial claims about possible causes of autism. Regardless of the believability of unproven claims, it is entirely probable that some good has come from shining a spotlight on autism. It is without question that the enhanced attention has resulted in more attention being paid to children with suggestive symptoms. This recent trend in more aggressive diagnoses is resulting in more attention being given to those in need with better outcomes over the long haul.
There is no cure for autism. This may be true and depressing, but it doesn’t have to be. Generally, interventions tend to focus on eliminating symptoms and producing desired outcomes (such as those that will increase independent living and functioning). Coordination of strategies is important, so the use of multiple professionals working as a team is common. The good news is, for many children, symptoms improve with early treatment and with age.  Those with one of the forms of autism will usually continue to need services and supports throughout their lives, but many are able to work successfully and live independently or within a supportive environment. Also, please note: The earlier the diagnosis is made and treatment is started, the better one’s outcome is likely to be.
I have just understated a point that I will take a few words to revisit. There is no cure for autism. Please don’t fall prey to claims of therapies and interventions that promise a quick fix. These claims are invariably are not supported by scientific studies. They are acting on your hopes and preying on your fears. The details of treatment strategies are further discussed at www.sterlingmedicaladvice.com.
The next post will focus on the diagnosis and symptoms of autism.
This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd. Please like and share our blog with your family and friends. We’re here for you 24/7 with immediate, personalized information and advice. Call your Personal Healthcare Consultant at 1-844-SMA-TALK or login tohttp://www.SterlingMedicalAdvice.com.
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Straight, No Chaser In The News: 2015 Influenza Update and Supplemental Means of Protection

General Health and Wellness, , , , , , , , , , ,

flu prevention honey

Snatched from the headlines and the American Medical Association:

From The Centers for Disease Control and Prevention (CDC): “Flu sending US seniors to the hospital in highest rate in a decade.”
From The CBS Evening News (1/30, lead story, 2:25, Pelley): “The CDC said that the flu season in much of the country appears to have peaked.” However, “the flu is now widespread in all but six states and it’s sending Americans 65 and older to the hospital at the highest rate in at least a decade.”
From The NBC Nightly News (1/31, story 3, 0:25, Williams): The high number of hospitalizations is “…being blamed on this particularly nasty strain of flu this year and a vaccine that, sadly, has proven only about 23 percent effective.”
From The Associated Press (1/31, Stobbe): Approximately “…198 out of every 100,000 people 65 and older have been hospitalized with flu-related illness this flu season. That’s roughly 86,000, according to the CDC.”
From Bloomberg News (1/31, Cortez): “The annual outbreak, already in its 10th week, has extended beyond the lower bound of a normal flu season and isn’t showing signs of easing,” said Lyn Finelli, chief of surveillance and outbreak response at the CDC. In a telephone interview, she explained, “‘While the flu may have peaked in many areas of the country, there is a surge in other areas, including New England, the Northeast and the West Coast.”
From Medscape (1/31, Lowes): The CDC “issued a letter to clinicians urging them to treat patients promptly with antiviral drugs when they suspect influenza, without any confirmatory testing.” That letter, cosigned by leaders of the American Medical Association, the American Academy of Family Physicians, and other professional societies, noted that influenza activity across the nation remains high overall and is likely to continue for weeks.” The letter discussed “the potential of antiviral drugs to reduce influenza symptoms, prevent serious complications, and keep high-risk patients out of the hospital.”

fluchild

The influenza vaccine doesn’t necessary prevent you from getting “the flu.” It’s a mixture of what is predicted to be the most common strains for the upcoming year. As noted, this year the influenza strains causing infections are so varied that this year’s vaccine is approximately 23% effective. Does that mean you shouldn’t get it? That’s not the message at all. The influenza vaccine does a very good job of preventing you for dying from “the flu,” and as noted above, certain populations are having an especially difficult time. Be reminded that there were approximately 35,000 deaths from influenza last year alone.

Print

So you ask, what can we do in the face of a less than optimally performing vaccine? This Straight, No Chaser reviews some of the better options left for you to engage in preventive strategies. It is always the case that an ounce of prevention is better than a pound of cure.

flu treatment options

The best way to avoid the flu is prevention. Consider utilizing these healthy habits before you ever get exposed:

  • Wash your hands frequently with warm soapy water. You know when they’re dirty. Most certainly wash your hands before you use them to eat or put anything else in your mouth.
  • If you can’t wash your hands, use an alcohol-based hand sanitizer.
  • If your hands are dirty and neither soap nor sanitizer is available, still rinse and dry your hands with warm water if you can.
  • Use disinfectant to clean surfaces.
  • Avoid unnecessarily touching your eyes, nose, or mouth.
  • Politely limit close contact with people who are ill, coughing and sneezing.
  • When coughing or sneezing use the bend of your elbow or a facial tissue to help cover your nose and mouth. Learn to avoid coughing or sneezing into your hands.
  • When you become sick, stay home. It’s the proper thing to do to avoid spreading your infection to others.

Vitamin-C

Vitamin C, echinacea and zinc have long been touted to prevent colds and influenza. There are no studies confirming or refuting this claim. Despite assurances that these and other herbal medicines are safe alternatives because they’re “natural”, the active ingredients in them are the same as found in certain prescription medicines. Thus they too may interact with other medications and worsen certain medical conditions. Given this, you should discuss your use of supplements with your physician or pharmacist prior to use.

Flu prevention take 3

Another level of defense for you involves use of certain antiviral prescription medications. If you are exposed to someone (e.g. a family member) with influenza, and especially if you begin having flu-like symptoms, immediately contact your physician to discuss taking medicines to prevent catching the flu. Such medications include Tamiflu® (generic name: oseltamivir), Relenza® (generic name: zanamivir), Flumadine® (generic name: rimantadine) and Symmetrel® (generic name: amantadine). If you make the request more than 24-48 hours after the onset of symptoms, you likely won’t be given the medication, since it isn’t likely to be effective outside of this timeframe.
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.
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Straight, No Chaser: Your Questions About Measles – Could You Recognize It?

Pediatrics/Kids Health, Skin/Dermatology, Health Prevention, , , , , , , ,

health-0326-measles-640x360

The Centers for Disease Control and Prevention (CDC) calls measles, a virus that lives in the nose and throat, the “most deadly of all childhood rash/fever illnesses”. About 90% of those who are not immune will become infected if they come close to an infected person, according to the CDC. An estimated 20 million people worldwide contract measles each year. In the US, the CDC typically expects only 220 cases. Last year there were 644, a nearly two-decade high. Yes, this was due to a marked drop in immunization rates in certain parts of the country.
In discussing the recent measles outbreak, one of the most common responses I received was “So? What’s measles anyway?” It has been that long since measles has been a problem in the United States. Let’s talk about common questions related to measles.
What causes measles? The medical term for measles is rubeola, and it’s caused by a virus.

What are the symptoms I’d see? To the layperson, measles most often presents as a full body rash with cold/flu-like symptoms, such as a fever, cough and runny nose. Your doctor is also looking for red eyes (conjunctivitis) and small reddish spots inside the mouth (known as Koplik’s spots).
Is measles contagious? It’s highly contagious to those not immunized. According to the Center for Disease Control and Prevention, 90% of those not immunized will contract measles if exposed to someone with it.
How is it spread? It’s spread through the air. This means sneezing, coughing and kissing.

Measles-immunization

Why don’t I ever see measles? Measles has been contained in the U.S. since the introduction of the measles vaccine over 50 years ago. It is amazing to think that there are still 20 million cases still occurring around the world annually.
How is measles prevented? Immunization! The immunization is approximately 99% effective in preventing infection in the face of exposure. Infants are generally protected from measles for 6 months after birth due to immunity passed on from their immunized mothers. For most others, the measles vaccine is part of the measles-mumps-rubella immunization (MMR) or measles-mumps-rubella-varicella immunization (MMRV) given at 12 to 15 months of age and again at 4 to 6 years of age. Additional considerations exist in the face of an outbreak.

 measlesvaxsideeffx

What are the side effects of the vaccine? Unless you have an underlying health condition and/or have a reduced immunity, the most common reactions include the following:

  • fever 6-12 days after vaccination (in about 5%-15% of those vaccinated)
  • an incidental (and non-allergic, non-contagious) rash. This goes away on its own and occurs in about 5% of vaccine recipients.

What’s the treatment of measles? Given that measles is a virus, there is no specific medical treatment (as is almost always the case with viruses). Supportive treatment is important and involves fluids and rest for what is expected to be a two-week period. Something like Tylenol or children’s ibuprofen can be given for fever or pain (but never give aspirin to a child).

 measles101

What are the common complications? 30% of cases of measles involve complications. Complications include simpler conditions such as otitis media (those pesky ear infections), croup and diarrhea.
This all sounds pretty benign. Why not just get the disease and avoid the vaccination? Because children can die from measles. Unfortunately, measles also has more serious considerations such as pneumonia (which occurs in approximately 1 of 20 cases) and a serious brain infection called encephalitis (which occurs in approximately 1 of 1000) cases. Measles also causes pregnant women to have miscarriages, premature births or low-birth-weight babies.
How do people die from measles? Pneumonia is the complication most often causing death. For every 1,000 children who acquire measles, 1 or 2 will die.
What’s the Vitamin A connection with measles? Vitamin A has been found to decrease complications and death in those infected with measles. It should be considered, especially in those hospitalized with complications of measles or those who have compromised immune systems and acquire measles.
If I had measles as a child and get exposed to the disease again, am I in danger? No. Surviving a measles infection provides one with life-long immunity. Of course, your take home message is most of this isn’t a consideration if you simply get immunized.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and 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 © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser In the News: Measles Outbreaks and Not Getting Vaccinated

Public Health, Skin/Dermatology, Health Prevention, , , , , , , , , ,

A case of measles was just confirmed in suburban Chicago. Here’s a cautionary tale to those who rely on non-medical sources to guide their health decisions. 

measlesuscases

The measles vaccine became available in 1963. Prior to then, the virus causing measles infected approximately 500,000 Americans a year. On average, this resulted in 500 deaths and 48,000 hospitalizations per year. Universal administration of the measles vaccine in the United States was so effective that measles was officially deemed “eliminated” – meaning there had been no sustained outbreaks in the subsequent 50 years and no homegrown outbreaks since 2000.

By now, most everyone is aware of medically-unfounded controversies related to vaccine administration. The fear-mongering and isolated reports of adverse reactions, the frequency of which fall into statistic insignificance (with all due respect to anyone actually affected), have led to a not insignificant fall in the national immunization rate. Although the premise of herd immunity is meant to shield the population from outbreaks (roughly meaning that if a certain percentage of the population is immunized, then the entire population is virtually immunized), enough people are now exposed that significant occurrences of measles are being seen. Last year, cases of measles were reported in approximately 20 states. This represents the most measles cases in 20 years. The largest outbreak occurred  in Ohio, and a large outbreak notably occurred around Disneyland (which subsequently led to cases in many states across the country).

nonmedical vaccine exemptions

Ninety percent of new cases of measles have been seen among those who have not been vaccinated.

The reasons cited by these individuals for not getting vaccinated include philosophical, religious or other personal reasons for not using vaccines. High rates of nonmedical vaccine exemptions are enough to cause an outbreak. There needs to be an exposure.

vaccine preventable outbreaks

According to the Center for Disease Control and Prevention’s National Center for Immunizations and Respiratory Diseases, the proverbial match that started the flame was exposure to infected travelers. Most notable was a cluster resulting from the Philippines, which experienced an outbreak in October 2013. It appears that unvaccinated Amish missionaries brought back measles while overseas.
This is an example of what would be expected to occur if individuals not immunized are exposed to the disease. Of course those immunized are protected in this same scenario. This is not an example of the cure being more harmful that the disease. Get objective, factual information about your health decisions. Consider the source, the inherent bias and consequences both for your action and inaction. The many diseases for which immunizations are offered are not to be taken lightly. Part of the equation for deciding to implement mass immunization programs involves substantial consequences (including death) resulting from exposure to those not immunized. The choice remains yours. Just remember: You can have your opinions, but you can’t wish them into being medical facts.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and 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.
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