Tag Archives: Centers for Disease Control and Prevention

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!

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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!

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Straight, No Chaser: Your Questions on Treatment of Fire Related Injuries

firevictim
Questions, you’ve got questions (Why are you so shy about posting them?).  Here we go.  Today, your focus is on the aftermath and treatment of fire related injury.

1)   What does carbon monoxide poisoning look like?

  • Carbon Monoxide (CO) poisoning is very dangerous because the gas is colorless and odorless.  You should suspect that you’re feeling its effect when you’re feeling like you have the flu after perhaps being in a contained area with a motor running or after a fire.  Headache is the most common symptom, and you may also feel nauseated, with malaise (feeling ‘blah’) and fatigue also being common symptoms.

2)   How are the burns treated?

  • Burns cause serious illness.  The thermal component can cause direct damage to your airway.  The toxins contained within (carbon monoxide and cyanide) can kill you independent of any other consideration.  Burns are especially prone to infection, so you don’t want significant skin burns exposed to everything outside of a burnt house while you’re waiting for the ambulance.
  • The burns will be treated according to the severity.  A lot of intravenous fluid, pain management, clear blister removal and infection control will be in order.  Especially serious burns may require a burn unit and skin grafting.

3)   What can I do to treat while waiting for the ambulance?

  • Keep calm, and keep them calm.
  • Be prepared to start CPR if necessary.
  • If any injuries have occurred to the head and neck, lay the person down and don’t move them.
  • Cover any bleeding areas, and apply enough pressure to stop external bleeding.
  • If you have a clean sheet, wrap the person in it.

4)   I know someone who says she was intubated (i.e. had a ‘breathing tube’ placed), and they were feeling fine after a fire.  Why would this have been done?

  • It’s hard to comment on the management of individual cases sight unseen, but most likely soot or burning was noted somewhere inside the airway (e.g. the mouth, nose or oral cavity).  Intubation would have been done to protect and secure the airway before in collapses.  If you wait until the last possible moment, it could be too late.

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: Bacterial Vaginosis – No, That’s Not a STD

BV1

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always be respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

bv anyone

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier
Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.
Doctor: Ok. Let’s examine you…

bv thrush

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different parts of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

bv causes

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real.  We even have a real thing call a ‘whiff test’ as part of making the diagnosis.
The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome.  There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.
So this couple gets ‘off the hook’, even though they may decide to start using condoms.  Next we will focus on the risks of various sexual activities. Stay tuned.
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: Public Health Has Saved More Lives Than Medical Care

healthweek

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physician, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.
public health
In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Top10AchievementsPH

  1. Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
  2. Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
  3. Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
  4. Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
  5. Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
  6. Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
  7. Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
  8. Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
  9. Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
  10. Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

Public_Health_Ounce

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
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: Alcoholism and Alcohol-Related Deaths Are on the Rise

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. 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.
  • In 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).

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. 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.
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: 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.
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Straight, No Chaser: Understanding Food Poisoning (Foodborne Illness)

FoodPoisoning

We make a decision with everything we place into our mouths. We also exhibit a large amount of trust that the food we eat is safe. Most of the time that’s true, but unfortunately sometimes it’s not. Here are some questions and answers to understanding the scope of food poisoning.
How frequent is food poisoning?
According to 2011 data from the U.S. Centers for Disease Control and Prevention (CDC), every year in the U.S. approximately 1 in 6 Americans (almost 50 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

food poisoning

What causes food poisoning?
Over 250 different foodborne diseases have been described, most of which are infections. The most common foodborne illnesses are caused by norovirus and by the bacteria SalmonellaClostridium perfringens, and CampylobacterStaph Aureus (yes, that Staph) is another prominent but less common cause of food poisoning. Poisonous chemicals or other harmful substances can cause foodborne diseases if present in food.
What are the most common symptoms of food poisoning?
Even though there are many different foodborne diseases, they share a commonality of entering your system through your gastrointestinal tract. As a result, the first symptoms are caused and expressed from there and typically include nausea, vomiting, diarrhea and abdominal cramps.

foodpoisoning traceback_900px

Why do foodborne diseases seem to occur in outbreaks?
Actually, the overwhelming majority of cases of food poisoning don’t occur in outbreaks, but of course you wouldn’t know that because having diarrhea is not something people typically will tell you… When outbreaks occur, it’s because a group of people happened to eat the same contaminated item. This would explain how instances of groups of friends or strangers could have been involved. Contamination that occur closest to the food supply’s distribution result in the widest outbreaks. Look at the above picture. If contaminated food from the producer makes it all the way through the distribution chain, individuals in multiple states could end up with the same infection.

   foodpoisoningfoodsimage

What foods are most associated with foodborne illness?

  • Foods that mingle the products of many individual animals: Raw milk, pooled raw eggs and ground beef have increased risk because contamination in any one of the multiple animals involved can contaminate the entire mixture.
  • Raw foods of animal origin: Foods such as meat, poultry, shellfish, eggs and unpasteurized milk are the most likely foods to be contaminated.
  • Raw fruits and vegetables: Washing reduces but doesn’t eliminate pre-existing contamination, such as that occurring from the fresh manure that fertilizes vegetables. Furthermore, water itself may be contaminated.
  • Shellfish: Because “filter-feeding” shellfish strain microorganisms from the sea over many months, they are particularly likely to be contaminated if there are any in the seawater.

An additional Straight, No Chaser will discuss treatment options. Refer to this post for preventative tips.
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

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!
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

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!
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: Bacterial Vaginosis – No, That’s Not a STD

BV1

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always be respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

bv anyone

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier
Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.
Doctor: Ok. Let’s examine you…

bv thrush

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different part of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

bv causes

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real.  We even have a real thing call a ‘whiff test’ as part of making the diagnosis.
The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome.  There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.
So this couple gets ‘off the hook’, even though they may decide to start using condoms.  Next we will focus on the risks of various sexual activities. Stay tuned.
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: The Rapid Explosion of Autism Diagnoses – A Good or Bad Thing?

autism-hands

Sometimes it’s really good to be a physician, especially when it comes to care of children. On multiple occasions I’ve saved 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 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.
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.
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: Public Health Has Saved More Lives Than Medical Care

healthweek

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.
public health
In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Top10AchievementsPH

  1. Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
  2. Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
  3. Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
  4. Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
  5. Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
  6. Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
  7. Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
  8. Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
  9. Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
  10. Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

Public_Health_Ounce

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
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

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: Understanding Food Poisoning (Foodborne Illness)

FoodPoisoning

We make a decision with everything we place into our mouths. We also exhibit a large amount of trust that the food we eat is safe. Most of the time that’s true, but unfortunately sometimes it’s not. Here are some questions and answers to understanding the scope of food poisoning.
How frequent is food poisoning?
According to 2011 data from the U.S. Centers for Disease Control and Prevention (CDC), every year in the U.S. approximately 1 in 6 Americans (almost 50 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

food poisoning

What causes food poisoning?
Over 250 different foodborne diseases have been described, most of which are infections. The most common foodborne illnesses are caused by norovirus and by the bacteria SalmonellaClostridium perfringens, and CampylobacterStaph Aureus (yes, that Staph) is another prominent but less common cause of food poisoning. Poisonous chemicals or other harmful substances can cause foodborne diseases if present in food.
What are the most common symptoms of food poisoning?
Even though there are many different foodborne diseases, they share a commonality of entering your system through your gastrointestinal tract. As a result, the first symptoms are caused and expressed from there and typically include nausea, vomiting, diarrhea and abdominal cramps.

foodpoisoning traceback_900px

Why do foodborne diseases seem to occur in outbreaks?
Actually, the overwhelming majority of cases of food poisoning don’t occur in outbreaks, but of course you wouldn’t know that because having diarrhea is not something people typically will tell you… When outbreaks occur, it’s because a group of people happened to eat the same contaminated item. This would explain how instances of groups of friends or strangers could have been involved. Contaminations that occur closest to the food supply’s distribution result in the widest outbreaks. Look at the above picture. If contaminated food from the producer makes it all the way through the distribution chain, individuals in multiple states could end up with the same infection.

   foodpoisoningfoodsimage

What foods are most associated with foodborne illness?

  • Foods that mingle the products of many individual animals: Raw milk, pooled raw eggs and ground beef have increased risk because contamination in any one of the multiple animals involved can contaminate the entire mixture.
  • Raw foods of animal origin: Foods such as meat, poultry, shellfish, eggs and unpasteurized milk are the most likely foods to be contaminated.
  • Raw fruits and vegetables: Washing reduces but doesn’t eliminate pre-existing contamination, such as that occurring from the fresh manure that fertilizes vegetables. Furthermore, water itself may be contaminated.
  • Shellfish: Because “filter-feeding” shellfish strain microorganisms from the sea over many months, they are particularly likely to be contaminated if there are any in the seawater.

An additional Straight, No Chaser will discuss treatment options. Refer to this post for preventative tips.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser In the News: Zika Virus Update

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.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Bacterial Vaginosis – No, That’s Not a STD

BV1

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

bv anyone

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier
Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.
Doctor: Ok. Let’s examine you…

bv thrush

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different part of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

bv causes

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real.  We even have a real thing call a ‘whiff test’ as part of making the diagnosis.
The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome.  There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.
So this couple gets ‘off the hook’, even though they may decide to start using condoms.  Next we will focus on the risks of various sexual activities. Stay tuned.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

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

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: Public Health Has Saved More Lives Than Medical Care

healthweek

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.
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In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

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  1. Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
  2. Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
  3. Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
  4. Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
  5. Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
  6. Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
  7. Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
  8. Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
  9. Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
  10. Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

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These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
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

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:

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  • 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).

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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.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

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