Tag Archives: Conditions and Diseases

Diabetes Basics and the Importance of Education

Introduction

Today we focus on diabetes basics.

diabetes basics treadmill

Diabetes is a disease in which education is vital. For a diabetic, knowing the disease well allows him or her to better prevent long-term consequences of the disease. It also allows the diabetic to make real-time adjustments when sick or otherwise  in danger acutely. In Straight, No Chaser, we’ve provided a series of posts meant to empower diabetics (and you can review any or all of them via the search box on the right). Remember, it all should start with a basic understanding of the disease.

Diabetes Basics

We eat, and the process of digestion is for the purpose of converting food into glucose (sugar) that’s used by our body for energy. The blood delivers the glucose to different organs of the body where the cells take it up for use. In order for that process to work, an organ that’s part of the digestive tract called the pancreas has to produce a hormone called insulin. Insulin facilitates the glucose getting from the blood to inside the cells. Diabetes is a disease where insulin isn’t being made by the pancreas or isn’t working optimally.

Now think about what happens when you’re not getting sugar into your cells. It’s as if you’re starving (because physiologically, you might as well be). You get symptoms such as weight loss, hunger, fatigue and excessive thirst. Because your cells don’t have energy, they aren’t functioning well. In fact, blood and nerve vessels lose significant function, resulting in significant vision loss and lack of sensitivity in your extremities. Anyone who’s been a diabetic for about 10 years know this because you’re wearing glasses and because you’ve lost a fair amount of sensation, especially in your feet. There are other symptoms that are variations of the same theme, including excessive urination, dry skin, increased infection rate and slower healing from those infections – all due to poor function of your blood vessels.

Risk Factors

Sometimes diabetes is a disease that happens to you because of unlucky genetics (or simply a family history). Other times it is a disease that you find. Risk factors for developing diabetes includes obesity, older age, and physical inactivity. Gestational diabetes (i.e. that occurring during pregnancy) is an entirely different conversation.

diabetes-treadmill

Prevention and Treatment

Let’s take a moment to discuss prevention and treatment. There are different types of diabetes, but the risk of one form of diabetes in particular can be reduced by – you guessed it – diet and exercise. In fact, diet, exercise and medications are the three legs of the diabetes treatment stool regardless of type. Some patients require regular insulin injections and others require pills. Still others who are successful with diet and exercise are able to markedly reduce, and in some instances eliminate medications.
If you’re a diabetic, make an investment in your education. It could not only save your legs or eyes, but it may just save your life. I welcome your questions and comments.

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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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Low Blood Sugar – Hypoglycemia

Introduction

Low blood sugar is as dangerous as high blood sugars. They just cause danger in different ways.

hypoglycemia is low blood sugar
In a previous post, I provided an overview of diabetes. Everyone knows about diabetes, and most understand how dangerous diabetes is over the long-term. However, as an emergency physician, I’m more concerned with what will kill you immediately, and on that front, low blood glucose (sugar) is usually much more concerning. I want you to know up front that a low enough blood glucose will kill you – now. As we say in the ER, a high glucose level will hurt you and may kill you, but a glucose level that goes to zero means ‘Cancel Christmas’.

If you’re not sure if it’s low blood sugar or high blood sugar, feed them!

Therefore I will start with a simple statement. Any diabetic (or individual known to have low glucose levels) with altered mental status needs to be given juice, or if they can handle it, some soft food to chew on. If they’re in the midst of a high sugar reaction, it won’t make much of a difference. However, if that glucose level was zero, you’ve just saved a life. Now let’s briefly discuss symptoms and causes.

Symptoms and Causes of Hypoglycemia

hypoglycemia1

Low glucose levels can present many different ways including dizziness, jitteriness, numbness, tingling, blackouts, seizures and other symptoms. However, it’s usually the confusion or other change in mental status that’s most predominant and concerning. Just remember, this is not something about which you should wait around to see if it gets better.

Regarding causes, unintentional overdosing of insulin or oral medication (particular the sulfonylureas class of medicines) are especially concerning and common. Sometimes a family member, particularly a child, may take such a medicine to disastrous effects. Beyond that, heavy alcohol consumption on an empty stomach is another common cause due to its effects on the liver (Alcohol locks glucose stores in the liver, preventing release to the blood; as a result you have less to use.).

Other causes are more exotic and fortunately less common; they will be evaluated upon arrival to the hospital when a rapid response isn’t seen with simple administration of glucose. Dysfunction of certain organs (the adrenal and pituitary glands, the liver due to hepatitis, or tumors of the pancreas – the organ that produces the insulin that drives glucose into your cells – can cause problems with regulating either glucose itself or insulin. These conditions can drive your blood glucose dangerously low.

So, the causes are varied, but the message is simple. Be careful with insulin administration, remember to check those blood sugar levels and act promptly in the face of mental status changes. Usually I note that time is tissue, but in this example, you’ll run out of time before your tissues are damaged.

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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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Questions About Color Blindness

Introduction

Do you suffer from color blindness? Have you ever found yourself at school, work or elsewhere and discovered that you were wearing different colored socks or pants than you thought? If so, the answer may be yes.

 colorblindness


A person with color deficiency may not be able to see the number 5 among the dots in this picture.

What are the main symptoms of color blindness?

Classic color blindness involves difficulty in seeing colors and the brightness of colors, coupled with an inability to differentiate between shades and other variations of similar colors. Usually the perception of red and green or blue and yellow are affected. There can be a lot of variation in symptoms, ranging from mild to complete and including greater or lesser difficulty in bright or dim light.

color_blind_12

Why does color blindness occur?

In the back of your eyes, you have two different types of cells affecting your ability to detect light. One cell type is called cone cells; these detect color. There are three types of cone cells: those that detect red, green and blue. Our brain perceives color based on degrees of input from these cells. Any absence or malfunction in these cells can produce color blindness. It stands to reason (and is true) that different degrees of color blindness could result from the extent of malfunction to these cells.

Who is at risk?

  • Most people with color blindness are born with it.
  • One of 10 males has some form of color blindness.
  • Women seldom suffer from color blindness, but those that do are likely to pass it to their sons.
  • Color blindness is more common among those of Northern European heritage.
  • Certain drugs, most notably plaquenil (a drug used to treat rheumatoid arthritis) can cause color blindness.
  • Certain medical conditions, including Alzheimer’s, Parkinson’s, alcoholism, glaucoma, leukemia and sickle anemia increase the risk of acquiring color blindness.

Are there other symptoms?

Except in the most severe form, color blindness does not affect the sharpness of vision. In rare instances one may experience poor vision, light sensitivity, involuntary rapid eye movement and visualization of everything as shades of gray. These symptoms aren’t likely to occur suddenly, so you’d have ample opportunity to see an ophthalmologist (eye doctor) prior to this level of malfunction.

Contact_Lens_for_Color_Blindness

What is done about it?

Color blindness has no cure. However, treating the underlying cause is the best way to address most forms. Also, you may be given special eye wear that improves color detection.

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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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Questions About Lazy Eye (Amblyopia)

Introduction

lazy eye tracy mcgrady

We all get concerned when it comes to things that damage or put our vision in danger. As such, you should be aware of the most common condition causing visual problems in children. You know it as lazy eye, but the medical term is amblyopia. This occurs in approximately 2 to 3 of every 100 children. Unfortunately, the issue isn’t just its occurrence in children but its persistence into adulthood. Amblyopia is also the most common cause of visual impairment among young and middle-aged adults affecting one eye.

Here are some questions and answers of concern. These may help you understand some terms your ophthalmologist (eye doctor) or optometrist uses with you.

What exactly is lazy eye?

Amblyopia (aka lazy eye) is the condition that exists when the vision of one eye is reduced due to that eye not working appropriately with the brain. The brain adjusts by favoring the other eye.

Let’s get medical for a moment. Appropriate eye function requires accurate interaction between the eyes and the portions of the brain necessary for vision. Each eye focuses light on the retina, which is located in the back of the eye. Cells within the retina stimulate nerve signals that travel along the optic (eye) nerves to the brain, which interpret and responds to these signals.

Lazy Eye Baby

What are some common causes of lazy eye?

As noted, the correct function and interaction between the eyes and brain are necessary. Many things can go wrong along the way, all of which serve to cause unclear focusing. Here are some examples.

strabismus-wall-eyes

  • Strabismus: misalignment of the eyes

cataracts

  • Cataracts: clouding of the front part of the eye

Child

  • Nearsightedness (myopia; better focus on closer objects) results from the eye being too long from front to back.

Child Playing at Water's Edge

  • Farsightedness (hyperopia; better focus on objects at a distance) results from the eye being too short from front to back.

astigmatism

  • Astigmatism: condition associated with irregularly shaped eyes; produces difficulty focusing on both near and far objects

 Eye-Patch1

How is lazy eye treated?

Most of the focus on treating amblyopia involves catching it early and treating the child. It is during this time that the eye, the brain and the connections between them are developing, and the opportunity for improvement is greatest. Generally speaking, treatment involves forcing the child to use the eye with weaker vision. There are two common ways to treat lazy eye:

  • PatchingPlacing an adhesive patch on the stronger eye for weeks to months forces the brain/eye apparatus to use the affected eye. This stimulates more complete development of the needed areas in the brain and eye.
  • AtropineUsing this eye medication causes blurring in the strong eye, forcing use of the affected eye. This works as well as patching.

 

eye-ptosis

Is this the same as eye drooping or lid lag?

No. “Lazy” eyelids (aka ptosis) are not the same as malfunctioning eyes. Lazy eye refers to the latter. That said, the two are not mutually exclusive.

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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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An Introduction to Intersex (aka Hermaphroditism)

Introduction

intersex definition

Today we address the challenges faced by intersex individuals. In the past, the term hermaphrodite was more common, but for many reasons that is no longer the case. In general, intersex speaks to a discrepancy between one’s external appearance and the internal genitals (ovaries and testes).

Let me start by discussing why this is so confusing. We want clarity and easy ways to categorize sexuality. However, the evolution of sexuality is such that there are at least four factors to consider:

  • External appearance
  • Gender identity
  • Internal and external organs
  • Genetics (chromosomes)

Intersex Categories

intersex graphic

There are many ways in which those considerations interact with the others. As a result, a myriad of options and realities for separate individuals exists. To make things easier to understand, It helps to divide intersex into 4 categories.

  • The 46 chromosomes, XX intersex (genetic female constitution). In this example, the external genitals appear male. Excess exposure by the female fetus to male hormones is a typical cause for this condition.
  • The 46 chromosomes, XY intersex (genetic male constitution). In this example, the external genitals are incompletely formed, ambiguous, or even female.
  • True gonadal intersex occurs with both XX and XY chromosomal structure. These individuals must have both ovarian and testicular tissue. This tissue could be joined together, or it could present as one ovary and one testis.
  • Complex or undetermined intersex disorders of sexual development represent many other presentations. In these examples, there are no discrepancies between internal and external genitalia. Many chromosome configurations other than simple 46, XX or XY can produce intersex individuals. Examples include 45, XO (only one X chromosome), and 47, XXY, 47, XXX. In the latter cases, an extra sex chromosome is present. Still, there may be problems with sex hormone levels, overall sexual development, and altered numbers of sex chromosomes.

Future Conversations

This is a very complicated topic, and this introduction and identification of current efforts to classify means to offer a fundamental consideration. Intersex does not represent a “one size fits all” consideration. It also does not present a uniform set of treatment options. A basic level of understanding, empathy and tolerance for what is an anatomic challenge is very important to these individuals. Future Straight, No Chaser posts will address ethical questions, treatment options and mental health challenges faced.

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

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

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

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Your Questions About E-Cigarettes (Vaping)

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

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

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

Is vaping safe?

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

Is vaping safer than smoking cigarettes?

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

Is vaping effective at getting people to stop smoking cigarettes?

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

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

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

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

Click here for information about hookahs!

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

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

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

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Use and Effectiveness of CBD (Cannabidiol) Oil

Let’s talk about cannabidiol (aka CBD) oil. There’s a huge fervor for this, which is understandable given the wave of states having legalized marijuana. CBD oil has become widely accessible. In fact, it’s legal in thirty states, and seventeen others have CBD-specific laws allowing for some use. Still, the rush needs to be tempered with a reality check! Let’s delve into uses and concerns about CBD oil.

How is CBD oil different from marijuana?

CBD oil is an extract from the marijuana (or hemp) plant. Significantly, CBD oil does not contain tetrahydrocannabinol (THC). Importantly, THC is the portion of marijuana that produces intoxication, so you don’t have to worry about being “high” with CBD oil.

How does CBD oil work?

CBD works by tapping into our brain’s endocannabinoid system. This system contains communication chemicals, millions of cannabinoid receptors with which the chemicals interact, and enzymes that synthesize and break them down. Our internal cannabinoids pass messages between the brain, nervous system and immune system. These messages help balance key body functions ranging from mood, sleep, appetite and memory. Additionally, they help coordinate the production of hormones, as well as our growth and development. Our endocannabinoid system is also involved in regulating inflammation, pain perception and immune responses. CBD (an “external” approximation of cannabinoid) interacts with some of your cannabinoid receptors but not others, which speaks to the limits of its effectiveness. CBC oil is taken as a liquid or tincture, a topical ointment or a vape/e-liquid.

For what does CBD oil work?

I am not going to dismiss the benefits (whether placebo or real) that individuals receive after taking CBD oil. However, I will emphasize the difference in what is known and what’s suspected.

  • The only FDA-approved indication for CBD oil is for epilepsy (seizure disorders). Therefore, that means every other suggested use has insufficient medical research to have established a consensus and approval for use by the FDA.
  • CBD oil has not been shown to be conclusively effective against anxiety, sleeplessness and inflammation (particularly of the joints). Unfortunately, the medical research does not yet support these claims.

If I choose to use it anyway, about what should I be concerned?

Your concerns should include the lack of quality control and potential side effects.

  • Research has found that when tested, approximately seven of ten CBD products don’t control the amount of CBD cited on the label. Additionally, about 20% of products actually included THC (the portion of marijuana producing the intoxication). Simply put, the lack of FDA regulation means you have no assurances about what you’re actually taking.
  • Side effects of note include an increase in your liver enzymes (which could reflect damage to the liver) and interactions with other drugs. CBD oil increases the blood level of other anti-seizure drugs. As a result, the potential side effects of these other drugs can become enhanced.

Summary

The sum total is if you take CBD, you shouldn’t be just grabbing it from over the counter. You should be under the care of a physician who is looking at the entirety of your health. You should be considering how and if adding CBD can enhance your health or is safe. As recently as 2017, the Centers for Disease Control and Prevention (CDC) reported fifty-two cases of illness tied to products that were falsely labeled as CBD. Above all, ask yourself: as a consumer, how do you know a product not approved or regulated by the FDA either is what it says it is, works or is safe? Let the buyer beware.

Click here for our post on marijuana facts and fiction.

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

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

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

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Your Questions About Chronic Pain and Management

Questions__Comments Concerns

Chronic pain and its management are complicated topics, both for sufferers and those who care for them. Thank you for your feedback on the previous post and appreciating the spirit in which the information was provided. There were many interesting questions presented, and I’d like to address two topics raised in some detail.

You don’t have to be a drug seeker to be drug addicted.
drptnt2
Here’s a point many chronic pain patients don’t think about that emergency room (ER) staffs have to. Even if you’re not a drug seeker, you can still be physiologically addicted to drugs. Of course your ER physician cares about your mental intent, but s/he has to be cognizant of the possibility or reality that your body might be addicted. One reason this is especially relevant is the development of tolerance, which is an important sign of addiction.

Specifically, tolerance is the phenomenon by which those physiologically addicted to a substance don’t get the same effect by giving what had previously been an effective dose.

So what? This means over time you will require increasing amounts to get an effective amount of relief (i.e. equivalent to previous effects).

So… as a patient suffering from pain, you’re focusing on the fact that you’re not relieved of your pain. Your ER staff is focused on the reality that increasing amounts of certain pain medications (i.e. narcotics) come with increasing amounts of side effects, more notably respiratory depression, meaning a high enough dose can knock out your ability to breath and will kill you. This is a major reason why there are limits as to the amounts and frequency of what will be given to you in an ER setting. Once you’ve been given a certain amount, many physicians will simple stop giving additional amounts regardless as to how you feel – unless we are able to specifically discuss your cases with your primary or pain management physician, who may explain your circumstance and help decide if additionally amounts are needed. This also explains why you’re more likely to get “better” treatment during regular business hours than in the middle of the night; those conversations with other members of the team are important.

The allergy vs. adverse drug reaction question:
Drug-Infographic-Small

In a previous post, I commented on patients equating preference or side effects with allergies, and several readers have asked for clarification (e.g. “Why isn’t that side effect the same as an allergy?). An example that relates to pain is some patients’ preference of various narcotics. For some, morphine routinely makes many people itch. This is an expected side effect and is not the same as an allergic reaction. Morphine also makes some patients feel “bleh,” especially when compared with such medicinal options as Dilaudid or Demerol which are more “happy drugs.”

Even so, these drugs have different effects that would make a physician choose one over the other. For example, morphine is actually a drug of choice for pain exacerbations associated with sickle cell anemia due to its effects at the cellular level, so in many cases, physician will prefer to use morphine despite patient preference. In any event, your job is simply to have the conversation with your physician. Don’t claim an allergy if one doesn’t exist; simply discuss the reasons why one medication seems to work better than the other. You likely will find a much more receptive audience taking this approach.

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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Fibromyalgia – Facts and Controversies

fibromyalgi

Previously, Straight, No Chaser has discussed the frustration of uncertainty some patients have with having symptoms and not being given a diagnosis (much less a cure). Imagine if that uncertainty arose in the context of excruciating pain lasting for what seems like all day. There was a time when this was the case to a much greater extent, and then several medical conditions gained recognition and/or prominence. Some of these include chronic pain syndrome, chronic fatigue syndrome, temporomandibular joint syndrome (TMJ syndrome), endometriosis, inflammatory bowel disorder, vaginismus, vulvodynia and still other conditions. Today we will address one such condition, fibromyalgia.

 Fibromyalgia_pain

The symptoms of fibromyalgia include muscle pain and fatigue. This pain may take one of several typical forms, including headaches, painful menstrual periods and – most interestingly – “tender points.” Tender points are specific places on the body that hurt when you apply pressure. These can occur most anywhere but usually involve the extremities, neck, back, hips and shoulders. Other symptoms include numbness and tingling in your hands and feet, difficulty sleeping and morning stiffness. In some cases a condition called “fibro fog” occurs, in which clouding of thinking and memory occurs. It shouldn’t be a surprise that these other symptoms often result in clinical depression.

Unfortunately, fibromyalgia is a condition, not a disease that we can attach to a specific cause. However, there are several diseases to which fibromyalgia has been linked. In short, many stressful life conditions and events can serve as triggers for this disorder. Some of the more notable conditions and triggers include ankylosing spondylitis (aka spinal arthritis), motor vehicle crashes, rheumatoid arthritis and systemic lupus erythematosus (aka lupus). So many such triggers exists that now over 5 million Americans have been labeled with the diagnosis. Interesting, 80-90% of those so diagnosed are women, most during middle age.

Given the absence of an identified cause, treatment is mostly symptomatic, attempting to address the pain and other things that disrupt one’s activities of daily living. More importantly, once affected, you need to implement the lifestyle changes that have been shown to help, including improving diet, exercise, getting enough sleep, changing one’s work and home environments, and taking medications as prescribed.

I would be remiss if I didn’t address the controversies surrounding fibromyalgia. Given the absence of a defined cause, many patients suffering from fibromyalgia and similar disorders are often perceived to be drug seeking, particularly in emergency departments. It is very frustrating for physicians to care for patients they can’t “fix.” Although drug seeking patients do exist, multiple medical studies have shown that inadequate treatment of pain remains one of the great faux pas of medicine. It is an equal disservice to give in to a patient’s request for pain medication as a routine matter without the benefit of a full evaluation. There are many defined medical conditions that present with pain. More deliberate and vigorous evaluations can not only put a more definitive name to the pain but can lead to better outcomes for those patients.

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 Other Side of 40 – The Cerebrovascular System (Your Brain) – Changes, Challenges, Solutions

brain-alive

Last but not least, in the last part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
brainaging
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.

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: Asthma Basics – (Part 2 of 2)

As we move into discussing asthma treatment, remember that asthmatics die at an alarming rate.  I mentioned yesterday (and it bears repeating) that death rates have increased over 50% in the last few decades.  If you’re an asthmatic, avoid taking care of yourself at your own peril.  Your next asthma attack could be your last.
The other thing to remember is that asthma is a reversible disease – until it’s not.  At some point (beginning somewhere around age 35 or so), the ongoing inflammation and damage to the lungs will create some irreversible changes, and then the situation’s completely different, possibly predisposing asthmatics to other conditions such as chronic bronchitis, COPD (chronic obstructive pulmonary disease) and lung cancer.  This simply reiterates the importance of identifying and removing those triggers.
Given that, let’s talk about asthma control as treatment.  Consider the following quick tips you might use to help you reduce or virtually eliminate asthma attacks:

asthmatriggers

  • Avoid cigarette smoke (including second hand smoke) like the plague!
  • Avoid long haired animals, especially cats.
  • Avoid shaggy carpets, window treatments or other household fixtures that retain dust.
  • If you’re spraying any kind of aerosol, if it’s allergy season, if you’re handling trash, or if you react to cold weather, wear a mask while you’re doing it.  It’s better to not look cool for a few moments than to have to look at an emergency room for a few hours or a hospital room for a few days.
  • Be careful to avoid colds and the flu.  Get that flu shot yearly.

If and when all of this fails, and you’re actually in the midst of an asthma attack, treatment options primarily center around two types of medications.

AsthmaHispanic

  • Short (and quick) acting bronchodilators (e.g. albuterol, ventolin, proventil, xopenex, alupent, maxair) functionally serve as props (‘toothpicks’, no not real ones, and don’t try to use toothpicks at home) to keep the airways open against the onslaught of mucous buildup inside the lungs combined with other inflammatory changes trying to clog the airways.  These medications do not treat the underlying condition.  They only buy you time and attempt to keep the airways open for…
  • Steroids (e.g. prednisone, prelone, orapred, solumedrol, decadron – none of which are the muscle building kind) are the mainstay of acute asthma treatment, as they combat the inflammatory reaction and other changes that cause the asthma attack.  One can functionally think of steroids as a dump truck moving in to scoop the snot out of the airways.  The only issue with the steroids is they take 2-4 hours to start working, so you have to both get them on board as early as possible while continuing to use the bronchodilators to stem the tide until the steroids kick in.

asthma-inhaler-techniques-15-638
If you are not successful in avoiding those triggers over the long term, you may need to be placed on ‘controller’ medications at home, which include lower doses of long-acting bronchodilators and steroids.
So in summary, the best treatment of asthma is management of its causes.  Avoid the triggers, thus reducing your acute attacks.  Become educated about signs of an attack.  When needed, get help sooner rather than later.  And always keep an inhaler on you.  It could be the difference between life and death.

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: Asthma Basics – (Part 1 of 2)

asthmaBasics-enHD-AR1

Asthma concerns me. I’ve had many close friends and family suffer with the disease. In fact, a very good friend died of an attack while in medical school, because he didn’t have his inhaler with him. In other words, this is somewhat personal. I’ve probably given more lectures on asthma than any other topic over the years, and I can say without hesitation that relative to how much we know about its prevention and treatment, I can’t think of another disease where we under perform as much as with asthma management. According to data from the National Institutes of Health, over the last few decades the death rate has increased by over 55%. The prevalence rate has increased by 75%, and among African-Americans the hospitalization rate has increased over 35%. The good news is asthma can be controlled and effectively treated. In this primer, we’ll discuss quick tips to improve the health of the asthmatic in your life.
The encouraging thing about asthma is that if you understand what causes it, you understand how to treat it. Here’s what you need to know about what causes asthma. For the purposes of discussion I am simplifying matters for general consumption.
asthma

  • Asthma is a result of certain triggers, causing inflammation to your airways over a long period of time with the occurrence of attacks (intermittent exacerbations). These triggers can be thought of as allergens. Examples of these triggers include cigarette smoke, dust, aerosols, cold air, long-haired animals (especially cats), seasonal pollens, and exercise (in some).
  • These triggers create a state of inflammation and hyperresponsiveness in the lungs, leading to the excessive production of mucus within the lungs’ various airway branches. If bad enough this will lead to complete obstruction of the airways. In other words you’ll stop breathing, and you will die without assistance and/or reversal.
  • Exacerbation of asthma include breathlessness, chest tightness, coughing, and wheezing. Basically, because you have the functional equivalent of snot in your lungs, your airways are narrowed, and you’re having difficulty breathing. After all, it’s harder to breathe snot than air. Now imagine how your lungs feel when you’re adding cigarette smoke to that mix.

Asthma Symptoms Word Circle Concept with great terms such as coughing wheezing and more.
Let’s get logical. Asthma management is theoretically straightforward if you can pull it off. Prevention is treatment. I used to describe this as “Kill the Cat.” (This blog neither supports, advocates, nor is responsible for the harming of any animals resulting from this information.) In short, if you identify the triggers that precipitate your asthma attacks and then remove yourself from that environment, you will dramatically reduce, if not eliminate, your attacks. This is often described (incorrectly) in kids as “growing out of their asthma.” No one grows out of it, and you don’t cure asthma; asthmatics just stop having attacks because they’re not around the triggers.
In Part II, we discuss asthma management. In case you’re wondering, that’s where the toothpicks come in.

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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From the SterlingMedicalAdvice.com Health Library: “My Doctor Said I Was a High-Risk Asthmatic. What Does That Mean?”

asthmarisk

If you have an asthmatic in your life, it’s important to know that asthmatics die.  The risk of death is higher in certain asthmatics. If you or your loved one is in this subset of asthmatics, you really must be diligent in avoiding those triggers that cause asthma attacks. You must also be attentive and consistent in taking your ‘controller’ medicines.
These circumstances define a high risk asthmatic:

  • A history of sudden severe asthma attacks
  • Prior need to be intubated (placed on a respiratory aka breathing machine)
  • Prior admission to a hospital ICU (intensive care unit)
  • Greater than one admission or two ER visits in the past year
  • An ER visit within the last month
  • Needing to use two or more inhalers per month
  • Current or recent oral steroid use
  • Illicit drug use
  • Concomitant cardiopulmonary or psychosocial disease

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: Five Frequently Asked Questions on Lupus

 

What is lupus? What causes it?

In general terms, lupus is a disease in which your immune system malfunctions and attacks your healthy tissue. This is known as an autoimmune disease. The consequences of lupus are pretty profound because the body’s immune response can be pretty indiscriminate. Lupus can damage your heart, brain, skin, kidneys, lungs, blood vessels, joints and other tissues, meaning it can present in a multitude of ways. This occurs most often in the type known as systemic lupus erythematosus (SLE). The cause is unknown.

Can anyone get lupus? Who is most at risk?

Anyone can get lupus, but certain groups are more at risk, including the following.

  • Women are most at risk.
  • African American women are affected by lupus two to three times more often than Caucasian women.
  • Lupus is also more common in Hispanic, Asian, and Native American women.
  • Black and Hispanic women are more likely to have severe forms of lupus.

 

What are the symptoms of lupus?

Because of the variety of locations that can be affected, lupus can have a wide variety of symptoms in different people. The most common symptoms include joint pain or swelling, muscle pain, fatigue, fever, a red facial rash (aka “butterfly rash”), chest pain with breathing, sun sensitivity, hair loss, eye, leg and gland swelling, and mouth ulcers. The fingers and toes also may tend to become pale or purplish.

Symptoms tend to flare (come and go) and can change in severity and type between attacks, with new symptoms occurring at any time.

How is lupus diagnosed?

The diagnosis of lupus really is often a source of frustration. There’s not a defining diagnostic test, and because it mimics so many other conditions, it can take years for a correct diagnosis to be made. Tests can range to routine blood tests to samples of tissue that looks at suggestive changes under a microscope.

What are the treatments for lupus?

Lupus has no definitive cure. Management focuses on control of the various parts of your body separately affected by the disease. The approach to care involves prevention, prompt treatment and reduction/elimination of long-term damage to the parts of your body (organs) being affected.

Along those lines, treatments also involve two components. The first is to attempt to normalize the immune system, prevent and reduce flare-ups and minimize the pain and other symptoms when flares occur. The second component involves treating the consequences of the organs affected by lupus (e.g. high blood pressure, high cholesterol, infections). In case you were wondering, alternative medicines have not been shown to be effective in treating lupus beyond stress reduction. Given the impact of medications on your immune system, it’s not advisable to add additional medicines to your treatment regimen without coordination with your primary care physician.

As much as anything, those with lupus need to become empowered and active in their management. Routine health activities (diet and exercise) that produce global health benefits, along with stress reduction have often proven to be as important as other components of the care plan. It the best cases, management of lupus is a group activity. Make sure your team is assembled and working in the same direction.

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: Early and Delayed Puberty

AllAboutPuberty

The onset of puberty is an anxious enough time without it being complicated by being early or late. You may be familiar with the changes related to puberty, but you also should know what can cause these changes to be premature or delayed. First we should review some normal benchmarks.
Puberty usually happens between ages 10-14 for girls and ages 12-16 for boys. In girls, breast development is usually the first sign of puberty, followed by growth of pubic and armpit hair, with the onset of menstruation occurring last. In males, enlargement of the penis and testicles is usually the first sign, followed by hair growth, then voice deepening and the development of muscles and facial hair. Both sexes may experience acne and see a two-three year growth spurt during puberty.

precocious puberty

Regarding the onset of puberty, there’s a normal range, and some variations may run in families. Here are some signs that you may need to get early onset of puberty evaluated.

  • Onset of breasts and pubic hair in a girl before age seven-eight
  • Increase in testicle or penis size in a boy before age nine

 delayed pubs

Delayed puberty can also be an issue. Use this range to determine if you should take your child to get evaluated.

  • In girls: no development of breast tissue by age 14 or no menstrual periods for five years after the first appearance of breast tissue
  • In boys: no testicle development by age 14 or development of the males organs isn’t complete within five years of the beginning of their development

“What does all of this mean?” In more instances early or delayed puberty is just that – a variation of normal, with no cause identified. However, there are two groups of potential issues where premature and delayed puberty may not be a normal variant:

  • Nutrition can play a role. Eating certain foods can facilitate early puberty. Alternatively, malnutrition can cause delayed puberty. Abnormalities in hormone levels, bone structure, growth or disturbances within the brain could all have a role. Follow the guidelines above to make sure early or late onset of puberty isn’t a sign of a more serious medical matter.
  • Social consequences can be devastating. Pre-teen and teen years  are when self-esteem and personality are being developed. The ability of loved ones to provide love regardless of physical appearance is important. If early or late puberty is something that runs in your family, share that information with the child. If a medical evaluation or psychological counseling would provide comfort, please don’t delay.

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: When Fainting is Deadly

fainting

1. So can faints be deadly?

Potentially. There are three separate sets of considerations. The brain can’t survive very long without adequate oxygen. Whatever caused that faint, if it continues to deny oxygen to the brain, can lead to seizures, strokes and death. The process that caused the faint could be deadly in and of itself. Such things would include heart attacks, strokes, seizures due to bleeding inside the brain. Significant injuries may occur after the faint. Someone who falls may subsequently suffer a head or neck injury, which could be deadly, independent of the cause of the faint. It’s worth mentioning that it’s an especially odd behavior that people seem to travel to the bathroom when they feel dizzy. All things considered, it’s better to faint in your soft bed or surrounding carpeted floor than on the hard tile of a typical bathroom with even harder sinks, toilets and tubs in close proximity.
2. My doctor always warns me about high blood sugars. You mentioned low blood sugars as a cause of faints. Am I putting myself in danger if I’m taking sugar and my sugar level is already high?
If you know all of that, yes. More often, you know none of that. Here’s the deal. Both a high and low glucose (blood sugar) count can cause altered mental status, fainting and coma. If your glucose level is especially high, say 900, and you drink some orange juice, it won’t make much of a difference. If your glucose level is 0, and you are given some orange juice, your life just got saved. In other words, it’s medically worth the risk if you don’t know what the glucose level is.
3. Can a loved one really take my breath away?
Yes. Overstimulation can lead to syncope in a variety of ways as mentioned previously.
4. What’s with the goats?
If you’re referring to Tennessee fainting goats, they exist. The goats don’t actually faint. When startled, they become stiff to the point of being unable to move their legs. Subsequently, the terrified goats can’t run and just topple over. Here you go.
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: You’re Way Too Comfortable With Fainting

Don’t faints seem mysterious?  It’s as if your computer crashed and had to reboot.  Although we never seemingly figure out why computers are so crazy, fainting (syncope) is reducible to a common denominator: something causes a decrease in blood flow to your brain.  Recall that oxygen and other needed nutrients are carried in blood, so even a temporary stoppage or shortage of blood flow shuts things down.  Now extrapolate that to strokes and comas, which are often due to serious and prolonged causes of blockage to the blood vessels supplying the brain.  This is a prime example of why good blood flow and good health are so important.  The brain is a highly efficient, oxygen and energy-guzzling organ.  Shut it down for even a few seconds, and bad things start to happen.  Consider fainting a warning sign.

I’m going to start by offering some Quick Tips to help if you find yourself around someone who has fainted.  Then, I will get into the weeds of why these things happen for those interested.  I’m doing this so you can check these and determine where your risks may be.

  • Call 911.  Make sure the person is still breathing and has a pulse.  If not, start CPR.
  • Loosen clothing, especially around the neck.
  • Elevate the legs above the level of the chest.
  • If the fainter vomited, turn him/her to the side to help avoid choking and food going down the airway (aspiration).
  • A diabetic may have been given instructions to eat or drink something if s/he feels as if s/he is going to faint.  If you know this, a faint would be a good time to administer any glucose gel or supplies advised by a physician.  Prompt treatment of low blood sugar reactions is a life-saver.  Discuss and coordinate how you can perform this effort on behalf of your friends and family with their physicians.
  • If it’s possible that the faint is part of some heat emergency (heat exhaustion or heat stroke).

Actually, faints are caused by all kinds of medical problems.  I list a few notable causes below, but whether the front end difficulty is with the heart pumping, the nerves conducting, or the content of oxygen or energy being delivered, the end result is the same.

  • Decreased nerve tone (vasovagal syncope): This is the most common cause of faints, and contrary to what you might think, it happens more often in kids and young adults than in the elderly.  Understand that your nerves actually regulate blood flow (analogous to a train conductor telling the heart to speed up or pump harder or not).  Changes in nerve tone can result in errant signals being sent, transiently resulting in low flow.
  • Diseases and conditions that affect the nervous system and/or ability to regulate blood pressure: Alcoholism, dehydration, diabetes and malnutrition are conditions that may depress the nervous system.  Alternatively, coughing, having a bowel movement (especially if straining) and urination may abnormally stimulate the system.  In the elderly and those bedridden, simply standing can cause fainting due to difficulty regulating blood pressure.  In this case, standing causes a sharp drop in blood pressure.
  • Anemia: A deficiency in blood cells can lead to a deficiency in oxygen delivery to the brain.
  • Arrhythmias (irregular heart beats): Inefficiency in your heartbeat leads to unstable delivery of blood to the brain.
  • Low blood sugar (hypoglycemia): Low energy states can deplete the body of what it needs to operate effectively, leading to low blood flow.
  • Medications (especially those treating high blood pressure): anything that lowers the heart’s ability to vigorously pump blood around the body can leave the brain inadequately supplied, leading to a blackout.  Let’s include illicit drugs and alcohol in this category.
  • Panic attacks: Hyperventilation caused by anxiety and panic upset the balance between oxygen and carbon dioxide in the brain, which can lead to fainting spells.
  • Seizures: Here’s a chicken and egg scenario.  A prolonged faint can lead to a seizure, and seizures lead to periods of unconsciousness, during and after the seizure.  The lack of oxygen is a common denominator.

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: Avoiding Mosquito-Bourne Diseases

Mosqbite

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

 mosquito

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

 Mosquite-BorneDiseases

Malaria

West Nile virus

Dengue fever

Yellow fever

Japanese B encephalitis

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

 mosquito_borne_diseases

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

mosquito

Here are a few other simple tips.

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

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

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: Stop, The Life You Save May Be Your Own – Snake Bites

snakes-on-a-plane
So you’ve been snake bitten.  What will you do next?
First things first.  Stay calm.  Call 911.  Realize that most snake bites are non-venomous (A really quick tip regarding the likelihood of a venomous snake: most have triangular heads.).  Here’s 10 additional steps to take while waiting for your help to arrive.
5 Things To Do

  1. Protect yourself.  Get out of the snake’s striking distance.  It should be trying to get away from you as well.
  2. Lie down.  Keep the wound below the level of the heart.
  3. Be still.  Activity simply facilitates spreading of any venom present.
  4. Cover the wound with a loose, clean dressing.  Immobilize the extremity if possible.
  5. Remove all restrictive clothing and jewelry from the area, because the area will swell.

5 Things Not to Do

  1. Try to suck out venom.
  2. Try to cut out the area bitten.
  3. Apply any constrictive dressings.
  4. Apply any cold or ice packs to the wound site.
  5. Run to help.

MORNINGSTAR

If you’re lucky enough to have a snake bite kit, you’ll simply follow those instructions, which are a modified version of the instructions I’ve just given.
You will need to be seen by a health care provider for consideration of the following:

  • Anti-venom may be needed.
  • Tetanus immunization may be needed.
  • Appropriate wound cleaning will be needed.
  • Antibiotics for skin infection may be needed.
  • Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
    Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
    Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
    Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your Questions About Human Bites

jaws

The votes are in, and it appears that Jaws (from James Bond fame) found the previous post, well… biting.  Here’s your questions and answers about human bites:
1)   If human bites are so dangerous, why do women love Dracula so much?

  • Seriously?  Let’s just ascribe it to the neck being an erogenous zone and move on…

2)   What’s a Boxer’s Fracture?

fight bite

  • A boxer’s fracture is a misnomer because boxers don’t get them.  This describes a fracture at the base of the small finger (5th metacarpal), often caused from poor form throwing a punch.  If you take one hand and move the pinky finger portion of the palm (the metacarpal bone), you’ll notice how movable it is (i.e. unstable) compared with the same efforts on the index and middle fingers at the level of the palm, which is what should deliver the blow.  A boxer’s fracture and a human bite together makes for a very bad day.

3)   Is a human’s mouth really dirtier than a goat’s mouth?

goat lip

  • It’s correct to say the bacteria in a human’s mouth cause more disease.

4)   Is a bite the same as a puncture wound

  • The difference between a puncture wound and a laceration is you can identify the bottom (base) of the wound in a laceration, and you can’t in a puncture wound.  Regarding bites: cats, snakes and the aforementioned Dracula are more likely to cause puncture wounds.  Puncture wounds may or may not be caused by a bite (e.g. knife wounds are punctures).

human-reflex-bite

5)   I received a bite and didn’t get stitched up.  Why?

  • This could be for several reasons.  Puncture wounds don’t receive stitches because you don’t want to seal off the infection.  That’s a really good way to develop an abscess.
  • Sometimes we will opt for ‘delayed closure’, waiting 3-5 days to ensure no infection has occurred before placing stitches.
  • It’s really about the risk/benefit ratio.  A laceration to a face is more likely to be repaired because of the risk of disfigurement and scarring, plus the face is a relatively low infection area anyway.

6)   Why didn’t Dracula ever get Hepatitis or HIV?
dracula_bites_kim_kardashian_by_the_mind_controller-d5jh3ix

  • Even though Dracula’s the undead, one would think he’d be the world’s single greatest transmitter of both HIV and the blood transmitted forms of Hepatitis.  HIV is viable for a while in dead tissue, but it can’t multiply, which would explain why Dracula doesn’t show signs of the diseases.  On that note, I’m done.

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

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