Tag Archives: Conditions and Diseases

Summer Conditions You Should Be Able to Address

Introduction

This Straight, No Chaser post discusses a variety of conditions likely to be present in the summer. A previous post was a guide to avoiding summertime sports injuries. We want you to keep summertime as fun time, so let’s enhance your knowledge of these summer conditions!

Your Guide to Summer Health

Taking a trip? Hiking or camping in the woods? Going to the beach and/or swimming? Golfing in the heat? There are tons of activities and risks that exist in the summer. We’ve got you covered. Read the linked posts here for knowledge on issues you more than likely are having to address as we speak!

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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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Your Guide to Combating Cold Exposure

Introduction

Cold exposure

This Straight, No Chaser addresses various components of cold exposure.

Congratulations! We sincerely hope you and your loved ones have survived the polar vortex and can think straight again. With that being the case, let’s review posts to offer you safety and tips to combat the odd things that accompany cold exposure. Use this post as a guide to obtain whatever additional information you need. Click the links provided for additional blog posts. They offer up-to-date information on various topics related to frostbite, hypothermia and other topics of interest. Also, ask us questions!

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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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In The News: What “Medicare For All” Means and Might Look Like

Introduction

Medicare For All

In the news is a proclamation from no fewer than three prominent candidates for President that they would seek to implement “Medicare For All” as America’s health care system. Let’s go Straight, No Chaser and review what that might mean. Let’s frame the conversation around three frequently expressed concerns. First, let’s remember that no actual proposal exists. Therefore, what Medicare For All may end up looking like is subject to a wide range of possibilities.

“Medicare For All” means socialized medicine.

Actually it doesn’t. If you think it does, you don’t understand the definition of socialized medicine. In an actual socialized medicine paradigm, everything is owned and/or paid for directly by the government. This includes the hospitals, the physicians and everything down to the equipment. That is not what Medicare is. Furthermore, it is not what Medicare For All would be. Medicare is an insurance program and a safety net. Also, it is a means of establishing guidelines and regulations. As such, Medicare For All (MFA) would enroll everyone in the nation under a single health care plan. Medicare would set prices for reimbursement and establish your tax burden.

It is incredibly unlikely that the individual cost of your care would be greater than the current annual burden of insurance. These current costs are just under $11,000/person. Remember, the drive for profits (most notably of insurance companies) would go away. This represents a lot of the current expense of health care. Furthermore, under Medicare For All, you’d get to keep your physician! All physicians would have to accept Medicare because there would only be a single payer. As a result, the lasting criticism about the Affordable Care Act wouldn’t be in play.

Is this good or bad?

One wonders about the public health impact of Medicare For All and a patient’s point of view? Remember, we typically look at these things through the prisms of quality, access and cost. Objectively, you’d have to think there are significant opportunities for improvement. It is worth exploring these opportunities instead of rejecting them out of hand.

  • Quality

Regarding quality, the U.S. currently is not doing a very good job at producing health care outcomes. Our current system is somewhere in the mid-30s when compared with the rest of the world. Furthermore, if you’re one of the 150 million Americans who currently enjoy (or at least prefer) your current insurance arrangement through your employee, take heed. Regarding quality, today’s Medicare isn’t likely to be tomorrow’s Medicare For All product. Medicare has been rather good at compelling specific outcomes. With implementation of a single payer system, convenience and quality would like improve beyond today’s standard.

  • Access

Regarding access, there are still approximately 30 million Americans without any health care. This number is down from approximately 50 million prior to implementation of the Affordable Care Act. So for about 15% of the country who otherwise wouldn’t have insurance, the immediate answer would become MFA is infinitely better than the status quo. Lack of access would be completely eliminated under MFA. This would be especially pleasing to those with pre-existing conditions. The conversation about cost is addressed below as a separate question.

“Medicare For All” means eliminating the current insurance company structure in the United States.

Although Sen. Kamala Harris stated as much as part of her platform, that occurrence doesn’t have to be the case. There is no reason why MFA couldn’t represent a “public option” for everyone. The key here would be the financial part. Let’s assume we allowed private insurance to remain for those wanting to pay for it. That’s possible, even while allowing the public option existed for everyone, whether or not they chose to utilize it. This paradigm would conceivably work.

However, the immediate problem would be both private insurance and MFA would become more expensive. Insurance premiums are largely determined by the number of participants in the system. The more people enrolled in a program allows costs to be pooled and reduced. Furthermore, we would predict that those opting out of MFA would still be required to share the tax burden of MFA. Basically, if you want the new system’s costs to explode, allow it to be something providing care only for the indigent and those otherwise unable to pay for private insurance. So under this scenario, those clamoring for private insurance would likely pay higher premiums to the private insurance company (because of less enrollees) and still having to pay a hefty MFA tax.

“Medicare For All” would bankrupt the country.

Even without doing a financial analysis (which isn’t possible because no actual proposal has been submitted), this has to be a preposterous supposition. To be fair, the United States does spend 17% of its gross national product (GNP) on health care. Disrupting the current system would cause disruption of both the clinical and financial aspects of the health care system – and a large segment of the American economy as a consequence.

On the other hand, the United States is alone in the world in spending 17% of its GNP on health care. The next most expensive system in the world (as measured by percentage of GNP) is France. Amazingly, they spend only approximately 11% of GNP on health care. What this means is there are tremendous efficiencies to be had by reforming the American health care system/industry. These efficiencies would result in tremendous savings.

The necessary next question is “Would you trust the government (or more specifically an expansion of Medicaid) to create those efficiencies and maintain a high quality of medical care and health care outcomes?” Indeed, this could go horribly wrong. However, it could be transformative for an incredible number of Americans. Which of the issues of providing health care to people vs providing profits to the healthcare industry will win? It is on these last two questions that the debate will rage on.

There’s More!

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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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Urinary Tract Infections (UTIs)

Introduction

urinary_tractkids

Ladies, have you ever been told that you get urinary tract infections (aka UTIs or “bladder infections”) because you didn’t wipe front to back instead of back to front? Men, have you ever been told that this could be a sign that your prostate needs to be examined This Straight, No Chaser answers simple questions on urinary tract infections. With over 8 millions cases and 100,000 hospitalizations a year due to these, it’s information you should know. We offer the information in question and answer format.

 Urinary-tract-anatomy

What are urinary tract infections? Are they the same as a bladder infection?

What these questions really ask is “What is the urinary tract?” The body’s drainage system serves to remove excess fluid and bodily waste. It includes the following organs:

  • The kidneys serve to filter blood and produce approximately 1-2 quarts of urine per day as a result of this process.
  • The ureters are tubes extending from the kidneys to the bladder, carrying filtered urine within them.
  • The bladder is the pouch within which you store urine until you’re ready to release it.
  • The urethra is a tube at the bottom of the bladder through which urine gets expelled.

A UTI is an infection anywhere along this path. Infections at different parts of the urinary tract can display different symptoms and have different complications.

What causes a UTI?

Bacteria are the most common cause of UTIs, particularly those that live in the bowel (such as E. coli) and are within or in close proximity to the vagina. Under most circumstances the body is very effective at removing bacteria and other microorganisms from the urinary tract (urinating just washes them out!), but some of us are at increased risk due to diminished defenses or other circumstances in which these microorganisms can grow.

 utianatomy

Why do women get UTIs, and it seems like men don’t?

It is true that women get UTIs about four times more frequently than men, but anyone of any age or sex can be infected. Here are some reasons why.

  • Women have a shorter urethra, which makes it easier for bacteria to reach the bladder.
  • Also, the opening of a woman’s urethra is near the vagina and anus, where bacteria live.
  • Women who use a diaphragm are also more likely to get UTIs than women who use other forms of birth control.
  • The male prostate produces secretions that slow bacterial growth.

Are there other risk factors for UTIs? 

Yes. Others at higher risk for UTIs include the following.

  • those having diabetes or have lowered immune systems
  • those habitually needing a tube to drain their bladder
  • those with urinary tract abnormalities that block the flow of urine
  • those with spinal cord injuries or other nerve damage

Additionally, once a man has a UTI, it’s more likely he’ll have the problem again because the bacteria are extremely difficult to reach once they set up shop in the male prostate.

Are UTIs serious?

Unless you describe the annoying symptoms as serious, most UTIs are not serious. However, UTIs can lead to severe complications if left untreated, including the following:

  • Long lasting or recurrent kidney infections can cause permanent damage and scarring to the kidneys, which can create insufficient kidney function and produce high blood pressure and other problems.
  • Kidney infections can enter the blood stream and become life threatening.

 Urinary-Tract-Infection

What are the signs and symptoms of a UTI?

You should see your physician if you develop any of the following signs or symptoms:

  • A burning sensation with urination
  • Bloody, cloudy, dark or otherwise discolored urine
  • Fever or chills
  • Foul-smelling urine
  • Frequent or urgent need to urinate, regardless of the amount actually expressed
  • Pain in your back or side below the ribs

How are UTIs diagnosed?

UTIs are diagnosed based both on symptoms and a lab test. Many of you have experienced your urine being sent to a lab from the emergency room or your doctor’s office. Based on a combination of symptoms, the presence of bacteria and white blood cells that have accumulated to fight the infection, the diagnosis will be made. If you have frequent infections, infections that don’t respond well to treatment, atypical presentations or are sick enough to be hospitalized, your urine may be cultured in an effort to grow the bacteria causing your symptoms. This allows more precise treatment regimens to be given. In other circumstances, tests may be done to check the normalcy of your urinary tract, including an ultrasound or CT scan. Further details on when and why this would be done is available on www.sterlingmedicaladvice.com.

An additional Straight, No Chaser will discuss prevention and treatment options for UTIs.

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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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Prevention and Treatment of Lead Poisoning

Introduction

This point is about prevention and treatment of lead poisoning.

leadaware

What you need to know about protecting yourself from lead poisoning and its effects is reducible to awareness, baseline testing, prevention and treatment.
We covered what you needed for awareness in the previous Straight, No Chaser.
However your goal really should be prevention via avoidance, as much as is possible. However, to prevent, you must have a level of awareness. Think about these things:

  • Do you have a child in your house between ages 6 months and 3 years old? If so, be reminded that children wander around putting things in their mouths.
  • Are you in an old house, or do you have old plumbing?
  • Do you live near a busy road or near bridges?

lead poisoning gettheleadout21

If you are in a high-risk situation, your ideal level of awareness should include preventive considerations such as getting your home tested and your blood lead level checked. If anyone in the home has been found to have high lead levels, the entire household should be checked.

Prevention

Whatever your level of exposure, you want to engage in preventive strategies to prevent further exposure that could lead to disease. Here are a few quick tips to do so:

  • Avoid dust in your home, because you just never know!
  • Wash everyone’s hands prior to eating.
  • Throw away old painted toys, unless you’re sure lead based paint was not used.
  • Use filters for your water, switch to bottled water for drinking and cooking, and/or let any tap water run for approximately one minute prior to drinking or cooking with it.
  • Avoid storing wines in lead crystal decanters for long periods of time.

lead003

Treatment

If you have been found to have any significant levels of lead in your blood, you have a role in your treatment. If your levels and symptoms are significant enough to be hospitalized, that will occur and you’ll receive medicine that facilitates the removal of lead from the body, called chelating agents. However, in the absence of that, your job likely will be to maintain a healthy diet that includes calcium, iron and Vitamin C, all of which help decrease lead absorption within the body.

lead-poisoning1

Prognosis

As mentioned, you want to avoid lead poisoning. Each year in the United States, approximately 310,000 kids aged 1-5 years old have unsafe levels of lead in their blood. In these children, even mild lead poisoning can have a permanent impact on attention and IQ. Remember, the developing brain is more susceptible to the toxic effects of lead. Those with higher lead levels have a greater risk of long-lasting health problems and must be closely followed because of the potential damage to the brain, nervous system, muscles and other systems. Adults who have had mildly high lead levels often recover without problems, but in general, a complete recovery from chronic lead poisoning may take months to years.

If you suspect you may have lead paint in your house, get advice on safe removal from the U.S. Department of Housing and Urban Development (HUD) at 800-RID-LEAD, or the National Information Center at 800-LEAD-FYI. Another excellent source of information is the National Lead Information Center at (800) 424-5323.

If you suspect you or someone in your family is suffering from the effects of lead, call 911 immediately and/or call 1-800-222-1222 to speak with a local poison control center for further instructions while you await the paramedics to arrive.

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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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Low Back Pain

Introductionlow-back-pain-image

For many, low back pain begins with a slip and subsequently becomes a slippery slope that never seems to end. This Straight, No Chaser will help you understand why you’re having pain.
Lower back pain is a tricky subject for an emergency physician, and it’s seen everyday. In fact, over 40 million Americans suffer from various forms of chronic low back pain. The lower back is a source of many life threatening emergencies, which I’ll discuss in a separate post, but for now, as always let’s give you some information to help prevent and address your routine back problems. Let’s start by understanding what the back’s trying to accomplish and how you help or hinder that process by your actions.
Remember the back is the major weight-bearing apparatus of the body and it connects the upper and lower body. It twists, turns, pulls and bends. It contains many vital nerves and muscles.
lower-back-pain-causes-2

Let’s point at four situations that produce or exacerbate your back pain.

Bad form (born with or otherwise acquired)

  • Spinal problems you were born with can predispose you to and outright cause all manner of back difficulties. Any machine works better if well-built.
  • Obesity puts a significant strain on your back in various ways. Given that most people don’t build up their back muscles, sprains and chronic pain are quite easy when you’re front-loaded. Pregnancy produces a similar strain on your back.

Strains

Have you ever heard that it’s easier to lift with your legs than your back? Well, I’d never think so based on the habits of many patients, but it’s true. The lower extremities are much stronger than your back. One of the problems with back strains is once it gets weak, it gets worse. Muscle spasms, pain, more strains and protruding discs all become more likely.

Fractures

A broken back is no fun. A weakened back bone (vertebrae) may collapse on its own if diseased (e.g. cancer, age, arthritis, infection), it may become fractured or may be injured with significant trauma. Those with osteoporosis have this happen more commonly. These broken bones may compress spinal nerves. You may even get shorter.

Arthritis and Normal Deterioration (aging)

There are other forms of arthritis beside degenerative joint disease (osteoarthritis, which we all get as we age), but the resulting pain, warmth, redness, swelling and limitation in motion all forms lead to reduced function and pain that can continue for the remainder of one’s life.

Here are a few clues to help you hone in on whether your back pain requires emergency attention:

  • Direct blow to your back
  • Fever and new onset back pain
  • Loss of control of your bowel movements or bladder function
  • New onset back pain after age 65
  • Numbness and tingling in both of your legs
  • Nighttime back pain
  • Sudden sexual dysfunction
  • Weakness and/or loss of motion or sensation in your legs
  • Weight loss and new onset back pain
  • Work related back injuries

What can you do to prevent or reduce the pain at home?

  • Learn and practice good posture. Sit when you can. Keep your back straight and shoulders back. When you stand, find something upon which to prop one of your feet, like a stool (think Captain Morgan).

CaptainMorgan

  • Learn the correct way to lift (bend at the knees, not at the back – every time). If you have pain, avoid bending, stretching and reaching if avoidable.
  • Wear low-heeled shoes whenever you can, ladies!
  • Learn how to stretch your back.

LBP exercises

  • Maintain a healthy weight, and exercise to strengthen your abdomen and back (your core)
  • Sleep on your side. Try a pillow between your knees.
  • Walk. Did you know walking is the best (and easiest) exercise for your back?

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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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Treatment of Food Poisoning

Introduction

food-poisoning home remedies

The vomiting, diarrhea, fever, abdominal cramps and all around bad feelings you may get with food poisoning is extremely unpleasant. We’ve previously discussed preventive measures you can take to minimize your risks, but you should also want to know what measures to take in the event you actually develop food poisoning. Of course, with over 250 different illnesses related to various forms of food poisoning, there’s a wide variety of treatment, some of which means to treat the specific disease (and its cause) and others that only treat the symptoms.

The threat

I always tell patients that although the vomiting and diarrhea are dramatic nuisance symptoms, the real concern is the risk of dehydration from these fluid losses. Given the body is approximately two-thirds water, altering that balance can lead to disturbances of many of the body’s functions and increase the risk of more serious infections. Thus the key to treatment is staying ahead of fluid and electrolyte losses that occur. Perhaps you’re wondering “How can I do that if I’m vomiting?”

Here are five very important treatment principles for you to remember.

  • First things first: if you have severe diarrhea, your favorite sports drink is not the cure. The composition of fluids and electrolytes in your stool is different from in your sweat, so these drinks don’t optimally replace your losses.

ORT

  • I want you to become familiar with oral rehydration therapy/solution (ORT). It’s how most of the rest of the world first treats fluid losses from vomiting and diarrhea. You may have heard of Ceralyte, Oralyte or Pedialyte, all of which are examples. ORT represents the best possible fluid for you to take and is readily available without a prescription at your local pharmacy or grocery store.
  • Here’s the deal with staying hydrated: you can’t hold a lot on your stomach. You need to dial back as much as possible so that you can tolerate something. That’s why you sip on chicken soup instead of steak when you’re sick. You’re likely to have more success keeping down teaspoons of fluid at a more frequent interval (say, every few minutes) than trying to chug a lot of fluid all at once. Food-Poison pink
  • Preparations of bismuth subsalicylate (Pepto-Bismol is a common example) can reduce the duration and severity of simple diarrhea.
  • If you have diarrhea and cramps with a fever or bloody stools, you should not take antidiarrheal medication without an evaluation by a physician. Even if they make you feel better, these medicines can make your food poisoning much worse.

Here’s one other point that you should understand as you’re going into your doctor’s office or the emergency room: don’t expect to receive an antibiotic to treat your vomiting and diarrhea. Most of these episodes are caused by viruses, which are self-limited and will resolve within two to three days. Furthermore, viruses don’t respond to antibiotics. In fact, efforts to use antibiotics in many of these cases only contribute to antibiotic resistance later on when you actually need them. Antibiotic resistance is discussed in detail in this Straight, No Chaser post.

Innocent problems

When to Seek Help

Finally, here are symptoms that should prompt you to see your physician.

  • Bloody stools
  • Diarrhea lasting more than 3 days
  • High fever (oral temperature over 101.4 F)
  • Signs of dehydration, such as a decrease in urination, a dry mouth and throat, and dizziness with standing
  • Vomiting with inability to keep down liquids

Follow us!

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

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

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

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Understanding Food Poisoning

Introduction

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. They 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.

Follow us!

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

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

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

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The Holiday Heart Syndrome

Introduction

HHS heart ornament

There’s something about the holiday season and flickering. We’re all aware that Christmas lights are meant to do so, but did you know that your heart is more inclined to flicker and flutter this time of year (sorry, but I’m not talking about mistletoe)? In a previous Straight, No Chaser, we discussed a mental consideration concerning the holiday season: the increased rate and risks of depression, known as The Holiday Blues. Unfortunately, health issues associated with the holidays don’t stop there. There are defined physical risks associated with the holidays as well. The disturbing aspect of today’s topic is you’re not immune to this even if you’re otherwise healthy.
HHS party

The Holiday Heart Syndrome

Holiday heart syndrome is a real condition, and it has been described as such since the 1970s. It’s the result of eating and drinking alcohol too much (with or without excessive caffeine intake and a lack of sleep). Does this sound familiar for this time of year? The combination of these indulgences places an undue level of strain on the heart, which causes the heart to develop an abnormal rhythm, most commonly atrial fibrillation. Interestingly, certain foods, alcohol and caffeine all have direct effects on the heart, and indirectly they can also affect the heart through increase of certain hormones (such as epinephrine) that stimulate the heart.
Curiously, holiday heart syndrome is notable for its occurrence in those without existent heart disease. Still, it can be especially concerning in uncovering existing disease or exacerbating disease in those having it. For example, someone with underlying cardiovascular disease featuring microclots can have such clots dislodge during an episode of atrial fibrillation, causing a stroke.

Prognosis

Fortunately, by far the common course of holiday heart syndrome is benign. The abnormal heart rates will slowly resolve as the levels and effects of alcohol and/or other substances decline. That said, the risk is such that you don’t just want to sleep off an occurrence.
Symptoms are pretty obvious, given that you’d have been eating and drinking to excess. You’d also note that your heart was racing and perhaps pounding, as if it was attempting to jump out of your chest. Heart rates in the 120s are pretty typical for holiday heart syndrome (a normal heart rate is between 70-100 beats per minute). This tidbit is important to know; if your heart rate is higher than this, something more serious could be occurring. Under either circumstance, you need to be evaluated and treated in the emergency room setting with hydration and observation of the heart rhythm and rate.
HHS gift heart

Lessons

The lessons here are pretty straightforward:

  • Holiday heart syndrome suggests that indulgences that occur during the holidays can cause symptoms. By no means does it suggest that these symptoms are restricted to the holidays. Overindulgence in food and drink can cause abnormal heart rhythms at any time. That includes weekends, spring break and birthdays, in addition to holidays.
  • The combination of vodka and the energy drink Red Bull make these symptoms more likely to occur.

What you can do

Following alcohol-related abnormal heart rhythms, it is advisable for patients to avoid significant exertion. Excessive stimulation that raises epinephrine levels can precipitate recurrent and possibly cause more serious episodes. Most patients without underlying heart disease should be able to gradually resume full physical activity over the next few days. Once everything is back to normal, most patients do not require further therapy if they refrain from alcohol use. Patients with underlying heart disease, heart disease that’s discovered during evaluation, or those with severe symptoms on presentation (e.g., blackouts or simultaneous low blood pressure) may be candidates to receive certain heart medications.
HHS santa
At the end of the day, Holiday Heart Syndrome is yet another example of the virtue of enjoying life in moderation. Failure to do so can turn the holidays into the most dangerous time of the year. Cheers!

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Frequently Asked Hypertension Questions

Introduction

In this post, we answer frequently asked hypertension questions.High Blood Pressure Hypertension Questions

High blood pressure (hypertension) is so prevalent and such a consequence of the way we live that you must already have an understanding of some basic principles if you care at all about your health. Feel free to offer your own questions or comments.

How do I know if I have high blood pressure?

You know by the numbers. Consider these defining blood pressure levels.
Normal – Systolic: < 120 mmHg, Diastolic: < 80 mmHg
At risk (pre-hypertension) – Systolic: 120–139 mmHg, Diastolic: 80–89 mmHg
High Systolic – Systolic: 140 mmHg or higher, Diastolic: 90 mmHg or higher
If you don’t already have a diagnosis of hypertension and are anywhere at or above the pre-hypertension stage, get checked by your physician.

But when should I get go to the emergency room for high blood pressure?

I’ll always want to see you if your bottom number (diastolic blood pressure) is at or above 110-115, regardless of whether you appropriately take your medication. Don’t look for symptoms to guide you. High blood pressure is called “the silent killer.”

If I do have high blood pressure, will I be placed on medication?

I really hope not, but honestly, approximately two-thirds of individuals in the U.S. who have high blood pressure are poorly controlled – even on medication. This means medication will be necessary for most. That said, theoretically, medication should be viewed as necessary only when necessary and only when other measures don’t work. You should discuss this with your individual physician and make every effort to improve your diet and exercise regimens. If and when you’re placed on medication, the choice of medication will be based on your age, sex, ethnicity, mobility, existing health profile and other considerations.

hypertension questions

You mentioned I could have a heart attack or stroke from this? How would I know if that’s happening?

Check here for Heart Attack Recognition and here for Stroke Recognition where I discuss signs and symptoms. Remember, time is tissue, meaning you must not delay if you develop these symptoms.

What else can I do?

Be healthy! Don’t smoke. Limit alcohol intake. Lower your stress level. This is only a broken record if you’ve received the message and have implemented the recommendations.

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Preventing and Treating Urinary Tract Infections (UTIs)

Introduction

This post addresses preventing and treating urinary tract infections.

UTIwater

At some point, you’ve got to be on board with the notion that you need to prevent some of the things that ail you. All men who have UTIs are at higher risk for having another one. About one of every five women who have a UTI will have another one. Many women have three or more UTIs a year. This Straight, No Chaser will address preventative and treatment considerations for urinary tract infections. Check back to this Straight, No Chaser for a discussion of the how and why you get UTIs.

Some individuals have unfortunate anatomy, and others have increased risk factors due to diseases (e.g. diabetes) or a lowered immune system. Even in these individuals, improving daily habits and lifestyle choices may help you prevent repeat UTIs. There actually is a fair amount of controversy regarding methods of preventing and treating UTIs. The information I am providing represents the latest consensus information from the U.S. Department of Health and Human Services.

 Cranberries-and-cranberry-juice for urinary tract infections

Fluids

Drinking lots of fluid (preferably water) can help flush bacteria from your system. Unless you have kidney or heart failure, you should try to drink six to eight, 8-ounce glasses a day.
Regarding cranberries and cranberry juice, the jury is still out. This is what we do know: there is a substance in cranberries that assist in preventing bacteria from sticking to the walls of your urinary tract. The ability to attach to the walls of your urinary tract keeps bacteria from being flushed out and allows them to grow and multiply. It seems that the amount of this substance in the typical glass of cranberry juice you’re drinking or serving of cranberries you’re eating is sufficient to completely prevent or treat UTIs. It is more likely that the benefit you’re receiving simply comes from drinking fluids. The bottom line? Drinking cranberry juice isn’t hurting you and may be helpful.

Bathroom Habits

It’s just a good idea to urinate often. Whenever you feel the urge, and it’s convenient, eliminate the waste. Also, make a habit of urinating after sex, as soon as it’s convenient. These steps prevent bacteria from staying in your bladder longer than necessary, preventing the growth that can become a UTI.
It’s true: always wipe from front-to-back after using the toilet. A back-to-front wipe can deliver bacteria straying from the rectum (and inclined to cause a UTI) close enough to your urethral opening to get things started.

utibc

Birth Control

Using a diaphragm or spermicide increases bacteria growth and can lead to UTIs. If you’re not having an issue with this, that’s fine, but if you are, you may want to consider a different form of birth control. Furthermore, unlubricated or spermicidal condoms increase irritation of the vaginal walls, which may help bacteria grow and may lead to transport up the urinary tract. This is yet another reason why lubricated condoms without spermicide or a nonspermicidal lubricant are better options for safe sex.

jeans-weight-gain-200

Clothing

Does wearing cotton underwear and loose-fitting clothes prevent UTIs? Probably not. Does doing so keep the area around the urethra dry? Yes. Nylon underwear and tight-fitting jeans can trap moisture and help bacteria grow. Use this information to your advantage. This is another example of how altering your habits may help and won’t hurt the cause.

 Foley-Catheter

Instrumentation

Whether you’re a patient using a catheter to assist yourself with emptying your bladder, or if you’re placing objects into your genital orifices for other purposes (e.g. sexual stimulation), you should appreciate the risks found in not exercising good hygiene with these objects. The immediate proximity of these objects to your urinary tract certainly increases the risks of UTIs.

Treatment

Treatment is usually straightforward. It’s typically based on eliminating the organisms most likely to be causing the infection. Treatment regimens range from 3 days to more than a week depending on certain considerations. Important factors in this regard include severity, resistance patterns in your area, whether you get frequent UTIs and whether you have certain risks or anatomical abnormalities in your urinary tract. Men should receive a longer course of treatment as a rule due to the involvement of the prostate.
Other treatment considerations involve pain control and plenty of fluids.

If your frequency or severity of UTIs requires as much, you may be referred to a urologist for specialized treatment considerations. However, for most people, this isn’t necessary because treatment is sufficient – and prevention is even easier.

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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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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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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!

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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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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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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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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!

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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