Tag Archives: Emergency department

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!
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: What Should Be in Your Medicine Cabinet

medicine cabinet sick-care-vs-health-care

You’ve all done it. I’ve caught a few of you doing it. Why do you rummage through someone else’s medicine cabinet? Are newer homes even built with medicine cabinets anymore? Oh well… Today, Straight, No Chaser tackles a simple but important question in an ongoing effort to better empower you. For starters, here’s hoping your cabinet doesn’t resemble any of these pictured, but there is a role for medicines in your medicine cabinet.
medicine-cabinet_59x73.5_we
1. What should be in your medicine cabinet? Here’s my top five and why.

  • Aspirin (324 mg).

Aspirin-tablet-300x300

On the day you’re having a heart attack, you’ll want this available to pop in your mouth on the way to the hospital. Of all the intervention done in treating heart attacks, none is better than simply taking an aspirin. It offers a 23% reduction in mortality (death rates) due to a heart attack all by itself.

  • Activated charcoal.

activated charcoal

This one may surprise you. Talk to your physician or pharmacist about this. If someone in your family ever overdoses on a medicine, odds are this is the first medication you’d be given in the emergency room. The sooner it’s onboard, the sooner it can begin detoxifying whatever you took. That said, there are some medications and circumstances when you shouldn’t take it, so get familiar with it by talking with your physician.

  • Antiseptics such as triple antibiotic ointment for cuts, scratches and minor burns.

triple abx

It should be embarrassing for you to spend $1000 going to an emergency room when you could have addressed the problem at home. I guess I should include bandages here as well.

  • A variety pack for colds, including antihistamines (like diphenhydramine, aka benadryl) and cough preparations.

OTCdrugs

As a general rule, give yourself 3-5 days of using OTC preparations for a cold to see if it works or goes away. If not, then it’s certainly appropriate to get additional medical care. I guess I can lump a thermometer in this bullet point.

  • The fifth item would be this number: 800-222-1222, which is the number to the national poison control center.

poisoncontrol

They will address your concerns, route you to your local poison center, advise you on the appropriate use of activated charcoal and help coordinate your care when you go to your emergency department.
Be smart about the items in your home in general and in your medicine cabinet in particular. We’ll continue the theme with the next Straight, No Chaser.
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: Understanding Asthma – Toothpicks and Snot (Part 2 of 2)

asthma_treatments_496958

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.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 
 

Straight, No Chaser: What Should Be in Your Medicine Cabinet

medicine cabinet sick-care-vs-health-care

You’ve all done it. I’ve caught a few of you doing it. Why do you rummage through someone’s else’s medicine cabinet? Are newer homes even built with medicine cabinets anymore? Oh well… Today, Straight, No Chaser tackles a simple but important question in an ongoing effort to better empower you. For starters, here’s hoping your cabinet doesn’t resemble any of these pictured, but there is a role for medicines in your medicine cabinet.
medicine-cabinet_59x73.5_we
1. What should be in your medicine cabinet? Here’s my top five and why.

  • Aspirin (324 mg).

Aspirin-tablet-300x300

On the day you’re having a heart attack, you’ll want this available to pop in your mouth on the way to the hospital. Of all the intervention done in treating heart attacks, none is better than simply taking an aspirin. It offers a 23% reduction in mortality (death rates) due to a heart attack all by itself.

  • Activated charcoal.

activated charcoal

This one may surprise you. Talk to your physician or pharmacist about this. If someone in your family ever overdoses on a medicine, odds are this is the first medication you’d be given in the emergency room. The sooner it’s onboard, the sooner it can begin detoxifying whatever you took. That said, there are some medications and circumstances when you shouldn’t take it, so get familiar with it by talking with your physician.

  • Antiseptics such as triple antibiotic ointment for cuts, scratches and minor burns.

triple abx

It should be embarrassing for you to spend $1000 going to an emergency room when you could have addressed the problem at home. I guess I should include bandages here as well.

  • A variety pack for colds, including antihistamines (like diphenhydramine, aka benadryl) and cough preparations.

OTCdrugs

As a general rule, give yourself 3-5 days of using OTC preparations for a cold to see if it works or goes away. If not, then it’s certainly appropriate to get additional medical care. I guess I can lump a thermometer in this bullet point.

  • The fifth item would be this number: 800-222-1222, which is the number to the national poison control center.

poisoncontrol

They will address your concerns, route you to your local poison center, advise you on the appropriate use of activated charcoal and help coordinate your care when you go to your emergency department.
Be smart about the items in your home in general and in your medicine cabinet in particular. We’ll continue the theme with the next Straight, No Chaser.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 2 of 2)

asthma_treatments_496958

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.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: What Should Be in Your Medicine Cabinet

medicine cabinet sick-care-vs-health-care

You’ve all done it. I’ve caught a few of you doing it. Why do you rummage through someone’s else’s medicine cabinet? Are newer homes even built with medicine cabinets anymore? Oh well… Today, Straight, No Chaser tackles a simple but important question in an ongoing effort to better empower you. For starters, here’s hoping your cabinet doesn’t resemble any of these pictured, but there is a role for medicines in your medicine cabinet.
medicine-cabinet_59x73.5_we
1. What should be in your medicine cabinet? Here’s my top five and why.

  • Aspirin (324 mg).

Aspirin-tablet-300x300

On the day you’re having a heart attack, you’ll want this available to pop in your mouth on the way to the hospital. Of all the intervention done in treating heart attacks, none is better than simply taking an aspirin. It offers a 23% reduction in mortality (death rates) due to a heart attack all by itself.

  • Activated charcoal.

activated charcoal

This one may surprise you. Talk to your physician or pharmacist about this. If someone in your family ever overdoses on a medicine, odds are this is the first medication you’d be given in the emergency room. The sooner it’s onboard, the sooner it can begin detoxifying whatever you took. That said, there are some medications and circumstances when you shouldn’t take it, so get familiar with it by talking with your physician.

  • Antiseptics such as triple antibiotic ointment for cuts, scratches and minor burns.

triple abx

It should be embarrassing for you to spend $1000 going to an emergency room when you could have addressed the problem at home. I guess I should include bandages here as well.

  • A variety pack for colds, including antihistamines (like diphenhydramine, aka benadryl) and cough preparations.

OTCdrugs

As a general rule, give yourself 3-5 days of using OTC preparations for a cold to see if it works or goes away. If not, then it’s certainly appropriate to get additional medical care. I guess I can lump a thermometer in this bullet point.

  • The fifth item would be this number: 800-222-1222, which is number to the national poison control center.

poisoncontrol

They will address your concerns, route you to your local poison center, advise you on the appropriate use of activated charcoal and help coordinate your care when you go to your emergency department.
Be smart about the items in your home in general and in your medicine cabinet in particular. We’ll continue the theme with the next Straight, No Chaser.

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

Straight, No Chaser: Your Rebuttals and Questions about Insomnia

hyperinsomnia

You are certainly an entertaining group behind the scenes. Here are some of your questions on insomnia. Be reminded that should you want to leave me a private question, just go to the Home Page, or type https://jeffreysterlingmd.com into your browser. Here’s five questions from yesterday’s post on insomnia.
1. Aw, hell! You’re telling me I can be dying from something causing insomnia? 

  • It’s way more likely that level of stress you’re displaying is keeping you awake at night.

2. How is it that sex makes you sleepy?

  • When you do exert yourself vigorously, the greater utilization of muscles will deplete glycogen (energy) stores and make you drowsy. Also, it’s well established that certain hormones (e.g. prolactin, GABA and oxytocin) that promote sleep are released after an orgasm.

3. You mentioned tea. A good cup of tea at bedtime helps me sleep.

  • If that works for you, go for it. Some people have paradoxical effects to stimulants (In fact, stimulants are the most common treatment for ADHD – a topic for another day.)

4. What about giving my baby Benadryl?
I’m giving information here, not practicing medicine, so that’s a question for your physician. I will say there are many drugs (most notably those in the anticholingeric class) that have drowsiness as a side effect, and many emergency departments will give Benadryl to adults for that purpose. That said, these medications are not primarily used for drowsiness, and you’ll have to deal with other drug effects (such as the intended purpose for the medication) in addition to any possible drowsiness that occurs.
5. Sex at night keeps me wide awake.
That’s why a lot of you are shy about putting comments in the inbox… Sorry, but the answer to that question was not meant for public consumption.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: What Should Be in Your Medicine Cabinet

medicine cabinet sick-care-vs-health-care

You’ve all done it. I’ve caught a few of you doing it. Why do you rummage through someone’s else’s medicine cabinet? Are newer homes even built with medicine cabinets anymore? Oh well… Today, Straight, No Chaser tackles a simple but important question in an ongoing effort to better empower you. For starters, here’s hoping your cabinet doesn’t resemble any of these pictured, but there is a role for medicines in your medicine cabinet.
medicine-cabinet_59x73.5_we
1. What should be in your medicine cabinet? Here’s my top five and why.

  • Aspirin (324 mg).

Aspirin-tablet-300x300

On the day you’re having a heart attack, you’ll want this available to pop in your mouth on the way to the hospital. Of all the intervention done in treating heart attacks, none is better than simply taking an aspirin. It offers a 23% reduction in mortality (death rates) due to a heart attack all by itself.

  • Activated charcoal.

activated charcoal

This one may surprise you. Talk to your physician or pharmacist about this. If someone in your family ever overdoses on a medicine, odds are this is the first medication you’d be given in the emergency room. The sooner it’s onboard, the sooner it can begin detoxifying whatever you took. That said, there are some medications and circumstances when you shouldn’t take it, so get familiar with it by talking with your physician.

  • Antiseptics such as triple antibiotic ointment for cuts, scratches and minor burns.

triple abx

It should be embarrassing for you to spend $1000 going to an emergency room when you could have addressed the problem at home. I guess I should include bandages here as well.

  • A variety pack for colds, including antihistamines (like diphenhydramine, aka benadryl) and cough preparations.

OTCdrugs

As a general rule, give yourself 3-5 days of using OTC preparations for a cold to see if it works or goes away. If not, then it’s certainly appropriate to get additional medical care. I guess I can lump a thermometer in this bullet point.

  • The fifth item would be this number: 800-222-1222, which is number to the national poison control center.

poisoncontrol

They will address your concerns, route you to your local poison center, advise you on the appropriate use of activated charcoal and help coordinate your care when you go to your emergency department.
Be smart about the items in your home in general and in your medicine cabinet in particular. We’ll continue the theme with the next Straight, No Chaser.
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. Preorder your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com.

Straight, No Chaser: What You Can Do To Manage Hypothermia and Serious Cold Exposure

ShiningJackNicholson-300x225

Is this the most famous illustration of frostbite? Do you remember the movie reference?

I’ll admit that my orientation is different than yours. I’ll argue that your orientation should be closer to mine. What’s the difference, you may ask? I’ve actually seen the consequences of your unfortunate actions, and these consequences occur with a much greater frequency than you may imagine. “An ounce of prevention is worth a pound of cure” isn’t just a catchy quote from Ben Franklin. It’s an “Oops, I should’ve had a V-8 moment” when you’re in front of me, my nurses and big invasive medical treatment options in an emergency room.
Cold exposure is a good example of this. We’ve previously discussed frostbite, but there must be more to the story than frostbite. Frostbite is not a necessary pit stop on the way to very bad things happening due to cold exposure. More importantly, for as bad as frostbite is, there are worse things that can happen to you from cold exposure. This is a relatively important conversation. You need more tools at your disposal than “Just bundle up.” We’ll explore these tools in two parts: basic care and emergency care.
The Basics – Prevention

  • Layers of loose clothing are better. Wear more than one pair of socks, at least until you’re back indoors.
  • Use a hat that actually covers your scalp. (Major heat loss occurs through the scalp.)
  • Use a hat that covers your ears and a scarf that covers your nose. (These areas are prone to frostbite.)
  • Wear mittens. They are better for protecting your fingers than gloves.
  • People greatly underestimate the effect of the combinations of being cold and wet or being exposed to cold and windy conditions. If you have water-resistant, wind-proof options, use them.
  • If you know you’re going to be exposed to the cold for a significant period of time, eat up and rest up beforehand. Avoid alcohol and cigarettes prior to and during such journeys.

Treatment You Can Do If Exposed:

  • Know what symptoms could be a result of hypothermia. Check previous posts for a refresher.
  • Your first step is to call 911, especially if any mental status changes (e.g., confusion) are present. Time is of the essence.
  • Do you know CPR? Refer here for a very easy refresher (you’ll commit it to memory in 2 minutes) of when to use it and how to perform it.
  • Can you get inside? Cover yourself with warm blankets and drink warm (nonalcoholic) fluids if possible. Remove wet and tight clothing (and cover back up with dry ones if possible).
  • You’re stuck outside? You should be thinking about reducing exposure to the cold, the wind and any wetness as much as possible. Don’t forget to provide a layer between the backside and the ground. Prioritize covering the scalp.
  • Think about giving or receiving a hug as a means of warmth. If you have access to warm compresses or towels, preferentially apply to the armpits, groin, neck and chest.

Your take home message is death from hypothermia can be avoided with the knowledge and application of basic fundamental considerations. Even better, you can usually choose to avoid exposure to bitterly cold conditions. I hope you find this information useful and never need to use it.
This is part of a series on medical conditions resulting from cold exposure.

  • Click here for a discussion of frostbite.
  • Click here for a discussion of the symptoms of and risks for hypothermia

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Save a Life, Save a Trip, Save Your Cash!

New Logo

In the last 20+ years of caring for patients in emergency rooms (ERs) in communities all over the country, and in 12 years of healthcare consulting in 36 states and countries, my team and I have had the unique privilege of serving all age groups, genders, and health conditions, from sprains to strains, moans and groans, sniffles and whistles, trauma and the flu.
However, in the ER setting, well over half of the people we see every single day would say they could have saved themselves the trip and the cost “…if I only knew.” Straight, No Chaser has given me the privilege to talk with you in a relaxed environment about urgent and non-urgent issues that concern you. It has been fun for me, especially because you have responded in a way that lets me know that my goal of empowering you with knowledge to make your own healthcare and financial decisions for you and your family is being realized. Because this works for your health and your wallet, I have expanded the service from Straight, No Chaser to http://www.SterlingMedicalAdvice.com. Not only will you have access to thousands of tips, fun facts, and frequently asked questions about the full spectrum of health topics, you will also have access to your own personal healthcare consulting team. That’s right, you can chat 24/7 with experts in medicine as well as fitness, dentistry, nutrition, mental health, pharmacy, and other healthcare entities.
So, when the time comes that you need to make an informed decision for yourself and/or your family member, we’re here for you. If this turns out as we desire, this service will become part of the national healthcare system and may be covered by your current insurance interests or as an employee benefit. Beginning today, November 1 at 12 noon Eastern Daylight Time, join me and hundreds of other healthcare experts who have signed up to turn the tide in our country by putting the power of your health back in your hands and saving you the time and costs of unnecessary visits to the emergency room and pharmacy. A subscription counts as payment toward your deductible (if you have insurance) and equates to less than a third of what Americans pay out-of-pocket EVERY YEAR for ER and doctor visits. Try us, and discover the difference having a team at your fingertips will make in your health. We at SterlingMedicalAdvice.com are looking forward to keeping the knowledge flowing,
Jeffrey Sterling, MD
President and CEO
SterlingMedicalAdvice.com
Your Personal and Immediate 24-Hour HealthCare Consultants

About www.SterlingMedicalAdvice.com: "Why would I need this? I already have insurance!"

gfish

Insurance covers most of the costs of the care you need when you need it. However, did you forget that insurance comes with co-pays and deductibles?

  • Before receiving any insurance benefit, patients pay $1,500 in deductibles on average. The year’s deductible alone is 2½ times the cost of a year’s subscription to SMA.
  • Emergency room (ER) and urgent care facility co-pays average between $50–$150. Patients have an additional responsibility for about 30% of the total cost of the bill (the average ER bill comes to about $1,200/visit; your share comes to about $400). So you’re still paying approximately $500/ER visit, even if you have insurance – and that’s after you’ve exhausted your deductible! Even one ER visit with insurance is more expensive than a year’s subscription to SMA.

One of the main purposes of www.SterlingMedicalAdvice.com is to save you multiple ER visits over the course of a year.
SMA works inside your insurance (included as part of your deductible, for example) to reduce additional yearly expenses. Try us, and experience the difference!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: What Should Be in Your Medicine Cabinet

medicine-cabinet_59x73.5_we
You’ve all done it. I’ve caught a few of you doing it. Why do you rummage through someone’s else’s medicine cabinet? Are newer homes even built with medicine cabinets anymore? Oh well… Today, I’m tackling a simple but important question in an ongoing effort to better empower you.
1. What should be in my medicine cabinet? Here’s my top five and why.

  • Aspirin (324 mg). On the day you’re having a heart attack, you’ll want this available to pop in your mouth on the way to the hospital. Of all the intervention done in treating heart attacks, none is better than simply taking an aspirin. It offers a 23% reduction in mortality due to a heart attack by itself.
  • Activated charcoal. This one may surprise you. Talk to your physician or pharmacist about this. If someone in your family ever overdoses on a medicine, odds are this is the first medication you’d be given in the emergency room. The sooner it’s onboard, the sooner it can begin detoxifying whatever you took. That said, there are some medications and circumstances when you shouldn’t take it, so get familiar with it by talking with your physician.
  • Antiseptics such as triple antibiotic ointment for cuts, scratches and minor burns. It should be embarrassing for you to spend $1000 going to an emergency room when you could have addressed the problem at home. I guess I should include bandages here as well.
  • A variety pack for colds, including antihistamines (like diphenhydramine, aka benadryl) and cough preparations. As a general rule, give yourself 3-5 days of using OTC preparations for a cold to see if it works or goes away. If not, then it’s certainly appropriate to get additional medical care. I guess I can lump a thermometer in this bullet point.
  • The fifth item would be this number: 800-222-1222, which is number to the national poison control center. They will address your concerns, route you to your local poison center and help coordinate your care when you go to your emergency department.

Straight, No Chaser: Emergency Room Adventures – Trampoline Trauma

trampolines
So I’m back in the emergency room with a little girl who looks like her forearm is going to fall off the rest of her upper extremity.
People love trampolines. Yet somehow the only time I seem to hear the word trampoline is when someone’s been hurt. I’m not the only one who’d vaporize them on site. The American Academy of Pediatrics recommends that trampolines never be used at home or in outdoor playgrounds because these injuries include head and neck contusions, fractures, strains and sprains, among other injuries.

So my patient had a (posteriorly) dislocated elbow, meaning she fell off the trampoline, landing on the back of the extended upper arm, pushing the upper arm bone (the humerus) in front of the elbow and forearm. This is how that looks.

posterior1

So for the joy of bouncing on a trampoline, the child had to be put asleep so the elbow could be replaced into the appropriate position. This procedure is fraught with potential for complications, including a broken bone on the way back, as well as damage to the local nerves and arteries (brachial artery, median and ulnar nerves), which can become entrapped during the effort to relocate the bone into the elbow joint. Some limitation in fully bending the arm up and down (flexion and extension) is common after a dislocation, especially if prompt orthopedic and physical therapy follow-up isn’t obtained. This really is a high price to pay for the privilege of bouncing up and down.
So if you’re going to allow your kids to play on a trampoline, here are two tips shown to reduce injuries.

  • Find one of those nets that enclose the trampoline, and make sure the frame and hooks are completely covered with padding. This is meant to protect against getting impaled, scratched or thrown from the trampoline.
  • Keep the trampoline away from anything else, including trees and rocks. This works even better if the trampoline is enclosed as previously mentioned.

Think back to the little girl I had to care for and consider whether this predictable event (complete with the mental stress of being in a loud emergency room in pain, getting an IV started and being put to sleep) was worth the effort. As per routine, an ounce of prevention…
I welcome your questions or comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: How I Know If Your Ankle is Broken Without X-Rays – The Ottawa Ankle Rules

Ottawa-ankle-rules
There are medical secrets, and there are tips.  Then there are initiatives that help the public better understand what’s going on, like the big initiatives on heart attacks and strokes.  I wonder why there’s never been a push to teach the public how to better deal with strains and sprains.  The cumulative radiation exposure and the expense of coming to the emergency room are sufficiently high enough that we should want patients not to expect as many unwarranted x-rays as you end up receiving.  Truthfully, the overwhelming majority of ankle sprains (consistently estimated at 85%) don’t have associated fractures.  The initial research done in developing what are known as the Ottawa Ankle Rules demonstrated a complete absence of ankle fractures in the absence of certain exam findings.
An ankle X-ray is only required if any of the following are present (Doctor version).

  • Inability to bear weight for four steps (both immediately and in the emergency room);
  • Bony tenderness along the posterior edge of the distal 6 cm (almost 3 inches) of either the lateral or medial malleolus;
  • Point tenderness over the proximal base of the 5th metatarsal; or
  • Point tenderness over the navicular bone.

Now that was the medical terminology (I bet you thought I’d lost it for a second!).  Here’s the same information translated for you.

  • Inability to bear weight for four steps (both immediately and in the emergency room);
  • Bony tenderness along the back of those big bones sticking out of either side of your ankle (A and B in the diagram above);
  • Point tenderness right about the middle of your foot down from your pinky toe (C in the diagram); or
  • Point tenderness over top of the middle of your foot (D in the diagram).

These rules aren’t applied to those under 18, intoxicated or otherwise distracted, say from another injury.
What does this mean?

  • More than a third of ankle x-rays can be eliminated by applying these rules, saving you money and radiation exposure.
  • If you find your physician asking you if you’d like to not have an x-ray done, you know this is what s/he’s thinking.  Several major studies showed application of these rules had a 100% sensitivity.  In other words, you don’t need the x-ray.
  • All of you playing with your ankles have made me smile.

What this doesn’t mean for you…

  • You can play doctor at home.

Finally, don’t forget about RICE, remember?  That’s how you treat your ankle sprain.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your Rebuttals and Questions about Insomnia

You are certainly an entertaining group behind the scenes. Here are some of your questions on insomnia. Be reminded that should you want to leave me a private question, just go to the Home Page, or type https://jeffreysterlingmd.com into your browser. Here’s five questions from this morning’s post on insomnia.
1. Aw, hell! You’re telling me I can be dying from something causing insomnia?

  • It’s way more likely that level of stress you’re displaying is keeping you awake at night.

2. How is it that sex makes you sleepy?

  • When you do exert yourself vigorously, the greater utilization of muscles will deplete glycogen (energy) stores and make you drowsy. Also, it’s well established that certain hormones (e.g. prolactin, GABA and oxytocin) that promote sleep are released after an orgasm.

3. You mentioned tea. A good cup of tea at bedtime helps me sleep.

  • If that works for you, go for it. Some people have paradoxical effects to stimulants (In fact, stimulants are the most common treatment for ADHD – a topic for another day.)

4. What about giving my baby Benadryl?
I’m giving information here, not practicing medicine, so that’s a question for your physician. I will say there are many drugs (most notably those in the anticholingeric class) that have drowsiness as a side effect, and many emergency departments will give Benadryl to adults for that purpose. That said, these medications are not primarily used for drowsiness, and you’ll have to deal with other drug effects (such as the intended purpose for the medication) in addition to any possible drowsiness that occurs.
5. Sex at night keeps me wide awake.
That’s why a lot of you are shy about putting comments in the inbox… Sorry, but the answer to that question was not meant for public consumption.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: When (Not) to Visit the ER

copay
I’ve spent a lot of time discussing the life threats that should prompt you to rush to the Emergency Room.  Today, I’m going to give you some factual information that could save you some time and a lot of money and keep you out of the ER.  There are so many misconceptions about the appropriate use of an ER.  Let’s address five points you should consider before you come to see me or my colleagues.  The message is not meant to be disrespectful to you and your families, but it’s just straight talk, and remember, the most important consideration is if you ever feel yourself (or your family) to be in harm’s way, don’t even think about it, get to the ER, and we’ll sort it out for you.
1)   Your expectations are sometimes completely unrealistic about the appropriate use of the ER.  One of the most expensive and inefficient healthcare laws on the books is the Prudent Layperson, which places in the hands of the public the right to go to an ER if one ‘believes’ an emergency exists.  Of course, the result of this is 80% of ER presentations represent things that could have been seen elsewhere for a fraction of the cost (mostly strains and sprains, bumps and bruises, sniffles and coughs – none of which usually requires an ER visit).  Admit it.  Your family sometimes uses the ER as a convenience because we’ll see you quicker than your doctor and can do certain tests quicker.  That doesn’t make it right and certainly doesn’t make it cheap.  But it sure makes for good business.
2)   The ER is not a clinic or a take out restaurant, regardless of what you think or need.  The ER’s notoriety as the ‘facility of last resort’ doesn’t mean we’re a substitute for seeing your doctor.  We rule out life-threats.  We’re not necessarily trying to diagnose the issues you’ve had for 3 years.  We don’t have the equipment or inclination to diagnose chronic disease.  It’s called an emergency department and is a specialty just as much as Surgery, Obstetrics or anything else.  We understand if you leave with some degree of dissatisfaction when we don’t address the reasons you came that were not life-threatening and/or emergent, and your complaining doesn’t impose a different standard of care onto us.   All to which you are entitled on an ER visit (as spelled out in the EMTALA law) is a medical screening exam, which is still going to be expensive.  All this accomplishes is the ER doc determining that you really aren’t trying to die at this moment.  Just because you think you need an x-ray doesn’t mean we’re going to order one.  We’re practicing medicine, not taking orders.  I’m not doing a spinal tap on your child because you saw a news report on encephalitis when you don’t have the symptoms (and as a rule, that analogy fits whenever you say the words “Can you do…xxx…just to be sure?” to an ER physician).  We do care.  We will go the extra mile for you and accommodate you – within reason.
3)   The ER is the most expensive portal of entry into the healthcare system by design.  Controlled for the same typical presentations, the average cost for an ER visit is $1020, and the average cost for the same in an office setting is $140.  The government sets prices, not hospitals or physicians.  Hospitals are able to charge more for any presentation because the infrastructure and operating costs of hospitals are massive compared with your doctor’s office.  In fact, hospitals charge a facility fee of several hundred dollars just for you walking through the door, in addition to everything else.  Insurance companies also attempt to discourage this by charging you higher co-pays for your ‘bad behavior’ ($50-150 upfront) to be seen in the ER instead of your doctor’s office, and in some instances, they require pre-authorization.
4)   The ER, hospital and the medical care system in general in this country is not about charity (or health care for that matter).  The US system is capitalistic by design, and has been very successful at that, capturing 1/6th of the US Gross Domestic Product.  We spend $2 trillion a year on medical care, fully one out of every six dollars spent in this country.  It’s probably the very best place to conduct business in this country.  Your occasionally irrational fears are costing you money.  And this is how hospital bills have been the #1 cause of personal bankruptcy in the US.  Just because you’re not paying upfront doesn’t mean the hospital won’t be tenaciously coming after you for payment.
5)   About 80% of disease takes care of itself if you’re patient.  The body is able to fight off most disease.  Nearly all of your creature comfort symptoms can be addressed by over the counter preparations.  Stop letting your fears be played upon.  Use the internet and other resources available to you, and smartly (i.e. selectively) decide when you need to come to the ER.   And please call your primary physician first.
Doctors, nurses and pharmacists are still the best advocates you have left in the system, and we love taking care of you.  Virtually every survey this century shows that the aforementioned medical professionals are the most trusted in the United States, with teachers occasionally in the mix.  The ethics of healthcare providers offer a nice cover for the sometimes questionable (but legally permissible) behavior of insurance companies, pharmaceutical companies and for-profit hospitals, who all too often are all about the profit margin.  The business of American medicine in the 21st century is business first and medical care second.  I’ve told you time and again that diet, exercise, moderation and ounces of prevention preclude all manners of disease.  Take care of yourself, lest you’ll become one of the many for whom medical care expenses destroy personal finances.
If you have any questions, comments or financial horror stories to share, I’m all ears.

Straight, No Chaser: Orthopedics Quick Tips – Learn How to Fall – The FOOSH injury

colles1
We use a lot a acronyms in the Emergency Room, many of which can’t be repeated in polite company.  Orthopedics and Trauma seem to lend themselves to a few.  There’s GTSBOOM (got the stuff beat out of me, which is an all too common occurrence) and there’s FOOSH.  FOOSH stands for ‘fell on outstretched hand’.
I bring this up because you need to learn how to fall.  FOOSH injuries predictably cause fractures of the distal radius and ulnar (the two bones of the forearm), usually down by the wrist.  These injuries are incredibly common and avoidable.  The most notable injury is the Colles fracture, which is a distal radius fracture.  You’ll know you have it after a fall when your wrist assumes the typical ‘dinner-fork deformity’.
colles-fracture1
So next time you fall, try to make it a glancing blow and avoid placing the full weight of your body on those wrists.  Try to land and roll when you hit – but be extra careful to avoid bumping your head by doing this.  If you get this right, it could save you 6 weeks in a splint, cast or in some cases a trip to the operating room.

Straight, No Chaser: Back From the Dead (aka The One Piece of Medical Equipment I Wish You Had in Your House)

Have you ever heard of an AED (automated external defibrillator)? Well, you’re about to. We’ve promoted CPR (cardiopulmonary resuscitation) a ton over the years, but recent recommendations place added emphasis on trying to literally shock patients back into consciousness. Thus, let’s start at the literal end of life, when you actually have a chance to save a life.
There are a couple of abnormal heart rhythms that suggest death is imminent. They’re called ventricular fibrillation (V-Fib) and pulseless ventricular tachycardia (V-tach). In these conditions, the heart is more or less quivering (V-Fib) or pumping too fast (V-tach) instead of giving off an optimal forceful beat. Effective beats pump blood (containing oxygen and nutrients) around the body you need to not only function, but to survive. Now, those two bad rhythms I just mentioned are unsustainable indefinitely, because without effective blood flow, vital organs such as the brain, lungs and ultimately the heart itself will give out within minutes, and that’s why you go ‘flat-line’ (aka asystole, aka dead, or soon to be). Even if you do survive, every minute these organs are starved of blood leads to damage that could be irreparable.
AEDs are designed to shock/stimulate the heart out of these deadly rhythms and back into an effective pumping state when possible (AEDs do not work for asystole, the flat-line rhythm.). The beauty of these machines is they are simple (and have been proven to be useable by untrained 6th graders), small/portable and if you pay attention, they’re all over the place. And even better: all AEDs used in the US talk to you and tell you what to do! My goal for you is simple: even if you can’t have one, know about them so you will think to use them if the opportunity presents.
Here are some frequently asked questions and answers regarding usage:
1) How do you connect it? AEDs have pads that need to be placed on the chest while staying attached to the machine. Instructions embedded on the machine will show you exactly where.
2) How does it know what to do? AEDs will detect the heart’s underlying rhythm and inform you if a shock is needed. Some machines will deliver it automatically; others will require you to press a button.
3) Are there limitations based on age? AEDs may safely be used on children and used by children. Appropriately sized pads must be used for kids.
4) Can I be sued for using this if the person dies? Users are protected by Good Samaritan Laws in case something (else) bad happens.
5) Should I own one? How expensive is it? I’d recommend one if you can easily afford it. I’d also recommend incurring the expense if you have a high-risk profile for heart disease and potentially fatal heart rhythms. This should be discussed with your physician. I paid $300 for mine, but you can pay up to $1100 for no good reason.
6) How long is it good for? You must be sure to stay up to date on the expiration dates on the components, most importantly the battery.
7) What should I do if the victim gets ‘back to normal’ after using an AED? Still call 911 and get to the Emergency Department for further investigation.
Of course the biggest question is “Do they work?” I’ll reference a study that reviewed effectiveness over two years of usage in Chicago’s Heart Start program, in which 22 individuals developed potentially fatal abnormal rhythms. 18 of these people met criteria to be treated by an AED. Of these 18, 11 survived. Of these eleven, bystanders with no prior training treated six.
I have an AED in my house and transport it in my family’s car because after all, I’m the one most likely to need it and benefit from it anyway (and I could shock myself, assuming I was still conscious). If it’s within your means, consider doing the same. It’s all about giving you the best opportunity to survive.

Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (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:

  • 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.

  • 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.

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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress