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Straight, No Chaser: The Curse of the Weekend Warrior – Achilles Tendon Rupture

Kobe

In high school I led the league in stolen bases, and in college my cohorts and I loved inventing ever more creative ways to dunk a basketball. Apparently, my calf muscles worked well. Somehow at a certain age, I quit those competitive sports cold turkey, partially because I knew an Achilles rupture was lurking out there somewhere.
The Achilles tendon connects the muscles at the back of the calf to the heel. The formula for damage is pretty simple and consistent. As you age your tendons tend to stiffen and shrink. As you age you change from the fine-tuned wannabe athlete most of us were to a recreational player, and we overextend ourselves. Others of us, in making a comeback (or just rushing to train for something like a 5K run), try to go from zero (0) to 60 way too soon. In either scenario, that overextension causes the tendon to tear or snap. You’ll recognize it immediately by the sound (pop) and the inability to walk/stand on your toes, which results from the lack of connection from the calf to the heel. (You need to point your foot downward to walk, which is where the Achilles comes in.) Other common occurrances of Achilles tendon rupture include falling from a height and landing on your feet or stepping into a sizeable hole.
Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.
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 WordPres

Straight, No Chaser: The Treatment of Erectile Dysfunction

Well, here’s what many of you’ve been awaiting.  Assuming the preventative efforts I mentioned didn’t work for you, there are several different treatment approaches. If there’s an underlying medical cause, then treatment of that cause is not only a good way to relieve erectile dysfunction (ED), but it’s a good way to get healthy and avoid other complications from the primary disease. Today, I’ll review different treatment strategies your primary care physician or urologist may discuss or recommend to you for treatment.
The medications
A first consideration is to be wary of (any) medications via mail order. The same level of testing, scrutiny and quality control just doesn’t exist to the same degree as do medications obtained through a pharmacy. Reports abound of people receiving expired or weak formulations of the pills, as well as fake or hazardous substitutes of the pills they thought they were receiving. Engage at your own risk.
Now, regarding those medications you know all too well by name and brand (e.g. Levitra, Cialis and Viagra), there’s no special ‘magic’ to them. They all are variations of the same theme, physiologically relaxing muscles in the penis, resulting in increased blood flow to it.  Unfortunately, that’s not the entire story with these medications.  ED medications all lower blood pressure throughout the body, and that increased blood to the penis is coming at the expense of decreased blood flow elsewhere (This is called a ‘steal syndrome’.).  If you’re otherwise unhealthy, and your redirecting blood that was needed in the heart or brain, you could end up with a heart attack or stroke while taking these meds.  Therefore, this leads to two very important cautions regarding ED meds.  You shouldn’t start them without discussing with a physician first (to determine “…if you’re healthy enough to have sex”, as the commercials say), and secondly, don’t keep the fact that you’re taking them a secret (to your significant other, and especially to any physician you come across if you’re sick).  These medications could be the cause of whatever medical issue has you in an emergency room. They could also be contributors to life-threatening adverse effects if you’re being treated for something else with a medication that interacts with the ED med you’re taking but didn’t bother to mention to the emergency physician.  This is why ED medications generally aren’t given to men also on medications for high blood pressure, an enlarged prostate, blood thinners or certain other heart diseases (e.g. angina).
There are actually even more intricate medications used to treat ED.  Taking testosterone injections is an increasing means of addressing low hormone levels.  Additional injections directly into the penis or inserting a suppository into the penis itself are additional, effective treatment methods.  You’d be given these options by your urologist if necessary.
The counseling
If your ED is due  to anxiety, stress or other psychologically generated reasons, psychotherapy (possibly with your partner) may be of incredible assistance.  If you pursue this option, you and your partner must be prepared to be patient and to work through a variety of issues and possible approaches.
Surgery and additional methods

  • If you’ve ever seen an Austin Powers movie, you’re familiar with (well at least the jokes about) penis pumps.  These are real things, and involve placing a hollow tube over the penis and creating a vacuum to pull blood to the penis via a pump.  A tension ring is placed about the base of the penis to maintain the erection during intercourse.
  • Actual vascular surgery to repair damaged arteries may be indicated in certain cases.
  • Penile implants are an additional option.  Inflatable rods are placed into the sides of the penis.  These rods are simply inflated when needed.

Penile-Prosthesis-300x168
If you think some of this is a bit much, it may or may not be, depending on if you’re the one suffering.  As I usually conclude, prevention would have been a much better course of action.  Hopefully if that’s not the case, you’ve understood the information provided well enough to have an informed conversation with your physician.  Good luck, and I welcome your comments and/or questions.
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: Spotlight on Health Concerns When Traveling – Vaccines and Illnesses

globalization_intro

Traveling is exciting, but it presents multiple challenges to your health. To best meet these challenges, preparation is everything.

Travel-health-insurance-for-international-travelers

Before you travel and every time you travel, your surest means of protecting yourself is to confirm you are current on routine vaccines.

  • Your basic vaccines include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine and influenza.
  • Most international travelers will need immunizations to protect you from hepatitis A, polio, and typhoid.
  • Depending on where you’re international travels take you and the duration of your trip, you may need immunizations to protect you from hepatitis B, malaria, rabies and/or yellow fever.

The plane trip itself can be hazardous to your health. I encourage you to review the risks of flying.

international-health-insurance-300x166

Diseases have different patterns in how they spread and their resistance to medications in different countries. It is important to be aware of prominent diseases affecting the countries you plan to visit, because some may be uncommon in your home country. For Americans traveling abroad, such diseases include the following:

  • HIV/AIDS 
  • Malaria: an infectious disease caused by a parasite, which invades the blood cells. It is notable for the presence of high fever, shaking chills, low blood count and a flu-like set of symptoms.
  • Pandemic/avian flu (aka the bird flu): an infectious disease in birds caused by a virus that can spread to humans
  • Travelers’ diarrhea –  the most common disease acquired by travelers.
  • Tuberculosis: an infectious disease involving the lungs, able to spread throughout the body

I strongly recommend that you develop a habit of checking the CDC travel site every time you prepare to travel internationally, including those of you coming from abroad into the United States. Detailed information on these diseases is available by clicking the links, checking the search engine and at www.sterlingmedicaladvice.com.
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: Quick Tips for the Diabetic in Your Life

DM foot ulcer

Per your requests, we occasionally feature quick tips for healthy living. Here’s an important example.

If you have diabetics in your life, here are three things they should do everyday.

1) Check their feet. Diabetics have decreased sensation in their extremities. It is very typical for them to step on nails, glass, or otherwise cause injuries that go unnoticed, because they don’t have sufficient sensitivity. Next thing you know, they have an infection and then a foot ulcer, and that’s a common path to amputated toes or the entire foot.
2) Keep soft candy or juice at all times. If they ever experience mental status changes, feed them. Altered mental status can be due to high or low blood sugars. If you treat a high sugar level with more sugar, it’s not a big deal, relatively speaking; if you treat a blood sugar level that was zero, you just saved a life.
3) Have them touch the water with their hands before they shower or bathe. The hands of diabetics remain sensitive to pain longer than the feet, so touching with the hands first helps avoid injuries. The decreased sensitivity of the feet leads to burns, which leads to infections, which leads to amputations.

diabetes-control-big

 
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Curse of the Weekend Warrior – Achilles Tendon Rupture

Kobe

In high school I led the league in stolen bases, and in college my cohorts and I loved inventing ever more creative ways to dunk a basketball. Apparently, my calf muscles worked well. Somehow at a certain age, I quit those competitive sports cold turkey, partially because I knew an Achilles rupture was lurking out there somewhere.

achilles-tendon-rupture

The Achilles tendon connects the muscles at the back of the calf to the heel. The formula for damage is pretty simple and consistent. As you age your tendons tend to stiffen and shrink. As you age you change from the fine-tuned wannabe athlete most of us were to a recreational player, and we overextend ourselves. Others of us, in making a comeback (or just rushing to train for something like a 5K run), try to go from zero (0) to 60 way too soon. In either scenario, that overextension causes the tendon to tear or snap. You’ll recognize it immediately by the sound (pop) and the inability to walk/stand on your toes, which results from the lack of connection from the calf to the heel. (You need to point your foot downward to walk, which is where the Achilles comes in.) Other common occurrences of Achilles tendon rupture include falling from a height and landing on your feet or stepping into a sizeable hole.

achilles-Figure2

Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Treatment of Erectile Dysfunction

Well, here’s what many of you’ve been awaiting.  Assuming the preventative efforts I mentioned didn’t work for you, there are several different treatment approaches. If there’s an underlying medical cause, then treatment of that cause is not only a good way to relieve erectile dysfunction (ED), but it’s a good way to get healthy and avoid other complications from the primary disease. Today, I’ll review different treatment strategies your primary care physician or urologist may discuss or recommend to you for treatment.
The medications
A first consideration is to be wary of (any) medications via mail order. The same level of testing, scrutiny and quality control just doesn’t exist to the same degree as do medications obtained through a pharmacy. Reports abound of people receiving expired or weak formulations of the pills, as well as fake or hazardous substitutes of the pills they thought they were receiving. Engage at your own risk.
Now, regarding those medications you know all too well by name and brand (e.g. Levitra, Cialis and Viagra), there’s no special ‘magic’ to them. They all are variations of the same theme, physiologically relaxing muscles in the penis, resulting in increased blood flow to it.  Unfortunately, that’s not the entire story with these medications.  ED medications all lower blood pressure throughout the body, and that increased blood to the penis is coming at the expense of decreased blood flow elsewhere (This is called a ‘steal syndrome’.).  If you’re otherwise unhealthy, and your redirecting blood that was needed in the heart or brain, you could end up with a heart attack or stroke while taking these meds.  Therefore, this leads to two very important cautions regarding ED meds.  You shouldn’t start them without discussing with a physician first (to determine “…if you’re healthy enough to have sex”, as the commercials say), and secondly, don’t keep the fact that you’re taking them a secret (to your significant other, and especially to any physician you come across if you’re sick).  These medications could be the cause of whatever medical issue has you in an emergency room. They could also be contributors to life-threatening adverse effects if you’re being treated for something else with a medication that interacts with the ED med you’re taking but didn’t bother to mention to the emergency physician.  This is why ED medications generally aren’t given to men also on medications for high blood pressure, an enlarged prostate, blood thinners or certain other heart diseases (e.g. angina).
There are actually even more intricate medications used to treat ED.  Taking testosterone injections is an increasing means of addressing low hormone levels.  Additional injections directly into the penis or inserting a suppository into the penis itself are additional, effective treatment methods.  You’d be given these options by your urologist if necessary.
The counseling
If your ED is due  to anxiety, stress or other psychologically generated reasons, psychotherapy (possibly with your partner) may be of incredible assistance.  If you pursue this option, you and your partner must be prepared to be patient and to work through a variety of issues and possible approaches.
Surgery and additional methods

  • If you’ve ever seen an Austin Powers movie, you’re familiar with (well at least the jokes about) penis pumps.  These are real things, and involve placing a hollow tube over the penis and creating a vacuum to pull blood to the penis via a pump.  A tension ring is placed about the base of the penis to maintain the erection during intercourse.
  • Actual vascular surgery to repair damaged arteries may be indicated in certain cases.
  • Penile implants are an additional option.  Inflatable rods are placed into the sides of the penis.  These rods are simply inflated when needed.

Penile-Prosthesis-300x168
If you think some of this is a bit much, it may or may not be, depending on if you’re the one suffering.  As I usually conclude, prevention would have been a much better course of action.  Hopefully if that’s not the case, you’ve understood the information provided well enough to have an informed conversation with your physician.  Good luck, and I welcome your comments and/or questions.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Spotlight on Health Concerns When Traveling – Vaccines and Illnesses

globalization_intro

Traveling is exciting, but it presents multiple challenges to your health. To best meet these challenges, preparation is everything.

Travel-health-insurance-for-international-travelers

Before you travel and every time you travel, your surest means of protecting yourself is to confirm you are current on routine vaccines.

  • Your basic vaccines include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine and influenza.
  • Most international travelers will need immunizations to protect you from hepatitis A, polio, and typhoid.
  • Depending on where you’re international travels take you and the duration of your trip, you may need immunizations to protect you from hepatitis B, malaria, rabies and/or yellow fever.

The plane trip itself can be hazardous to your health. I encourage you to review the risks of flying.

international-health-insurance-300x166

Diseases have different patterns in how they spread and their resistance to medications in different countries. It is important to be aware of prominent diseases affecting the countries you plan to visit, because some may be uncommon in your home country. For Americans traveling abroad, such diseases include the following:

  • HIV/AIDS 
  • Malaria: an infectious disease caused by a parasite, which invades the blood cells. It is notable for the presence of high fever, shaking chills, low blood count and a flu-like set of symptoms.
  • Pandemic/avian flu (aka as the bird flu): an infectious disease in birds caused by a virus that can spread to humans
  • Travelers’ diarrhea –  the most common disease acquired by travelers.
  • Tuberculosis: an infectious disease involving the lungs, able to spread throughout the body

I strongly recommend that you develop a habit of checking the CDC travel site every time you prepare to travel internationally, including those of you coming from abroad into the United States. Detailed information on these diseases is available clicking the links, checking the search engine and at www.sterlingmedicaladvice.com.
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: Quick Tips for the Diabetic in Your Life

DM foot ulcer

Per your requests, we occasionally feature quick tips for healthy living. Here’s an important example.

If you have diabetics in your life, here are three things they should do everyday.

1) Check their feet. Diabetics have decreased sensation in their extremities. It is very typical for them to step on nails, glass, or otherwise cause injuries that go unnoticed, because they don’t have sufficient sensitivity. Next thing you know, they have an infection and then a foot ulcer, and that’s a common path to amputated toes or the entire foot.
2) Keep soft candy or juice at all times. If they ever experience mental status changes, feed them. Altered mental status can be due to high or low blood sugars. If you treat a high sugar level with more sugar, it’s not a big deal, relatively speaking; if you treat a blood sugar level that was zero, you just saved a life.
3) Have them touch the water with their hands before they shower or bathe. The hands of diabetics remain sensitive to pain longer than the feet, so touching with the hands first helps avoid injuries. The decreased sensitivity of the feet leads to burns, which leads to infections, which leads to amputations.

diabetes-control-big

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

Straight, No Chaser: The Curse of the Weekend Warrior – Achilles Tendon Rupture

Kobe

In high school I led the league in stolen bases, and in college my cohorts and I loved inventing ever more creative ways to dunk a basketball. Apparently, my calf muscles worked well. Somehow at a certain age, I quit those competitive sports cold turkey, partially because I knew an Achilles rupture was lurking out there somewhere.

achilles-tendon-rupture

The Achilles tendon connects the muscles at the back of the calf to the heel. The formula for damage is pretty simple and consistent. As you age your tendons tend to stiffen and shrink. As you age you change from the fine-tuned wannabe athlete most of us were to a recreational player, and we overextend ourselves. Others of us, in making a comeback (or just rushing to train for something like a 5K run), try to go from zero (0) to 60 way too soon. In either scenario, that overextension causes the tendon to tear or snap. You’ll recognize it immediately by the sound (pop) and the inability to walk/stand on your toes, which results from the lack of connection from the calf to the heel. (You need to point your foot downward to walk, which is where the Achilles comes in.) Other common occurrences of Achilles tendon rupture include falling from a height and landing on your feet or stepping into a sizeable hole.

achilles-Figure2

Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Treatment of Erectile Dysfunction

Penis-Pump-For-Penis-Enlargement-font-b-Erectile-b-font-font-b-Dysfunction-b
Well, here’s what many of you’ve been awaiting.  Assuming the preventative efforts I mentioned didn’t work for you, there are several different treatment approaches. If there’s an underlying medical cause, then treatment of that cause is not only a good way to relieve erectile dysfunction (ED), but it’s a good way to get healthy and avoid other complications from the primary disease. Today, I’ll review different treatment strategies your primary care physician or urologist may discuss or recommend to you for treatment.
The medications
A first consideration is to be wary of (any) medications via mail order. The same level of testing, scrutiny and quality control just doesn’t exist to the same degree as do medications obtained through a pharmacy. Reports abound of people receiving expired or weak formulations of the pills, as well as fake or hazardous substitutes of the pills they thought they were receiving. Engage at your own risk.
Now, regarding those medications you know all too well by name and brand (e.g. Levitra, Cialis and Viagra), there’s no special ‘magic’ to them. They all are variations of the same theme, physiologically relaxing muscles in the penis, resulting in increased blood flow to it.  Unfortunately, that’s not the entire story with these medications.  ED medications all lower blood pressure throughout the body, and that increased blood to the penis is coming at the expense of decreased blood flow elsewhere (This is called a ‘steal syndrome’.).  If you’re otherwise unhealthy, and your redirecting blood that was needed in the heart or brain, you could end up with a heart attack or stroke while taking these meds.  Therefore, this leads to two very important cautions regarding ED meds.  You shouldn’t start them without discussing with a physician first (to determine “…if you’re healthy enough to have sex”, as the commercials say), and secondly, don’t keep the fact that you’re taking them a secret (to your significant other, and especially to any physician you come across if you’re sick).  These medications could be the cause of whatever medical issue has you in an emergency room. They could also be contributors to life-threatening adverse effects if you’re being treated for something else with a medication that interacts with the ED med you’re taking but didn’t bother to mention to the emergency physician.  This is why ED medications generally aren’t given to men also on medications for high blood pressure, an enlarged prostate, blood thinners or certain other heart diseases (e.g. angina).
There are actually even more intricate medications used to treat ED.  Taking testosterone injections is an increasing means of addressing low hormone levels.  Additional injections directly into the penis or inserting a suppository into the penis itself are additional, effective treatment methods.  You’d be given these options by your urologist if necessary.
The counseling
If your ED is due  to anxiety, stress or other psychologically generated reasons, psychotherapy (possibly with your partner) may be of incredible assistance.  If you pursue this option, you and your partner must be prepared to be patient and to work through a variety of issues and possible approaches.
Surgery and additional methods

  • If you’ve ever seen an Austin Powers movie, you’re familiar with (well at least the jokes about) penis pumps.  These are real things, and involve placing a hollow tube over the penis and creating a vacuum to pull blood to the penis via a pump.  A tension ring is placed about the base of the penis to maintain the erection during intercourse.
  • Actual vascular surgery to repair damaged arteries may be indicated in certain cases.
  • Penile implants are an additional option.  Inflatable rods are placed into the sides of the penis.  These rods are simply inflated when needed.

Penile-Prosthesis-300x168
If you think some of this is a bit much, it may or may not be, depending on if you’re the one suffering.  As I usually conclude, prevention would have been a much better course of action.  Hopefully if that’s not the case, you’ve understood the information provided well enough to have an informed conversation with your physician.  Good luck, and I welcome your comments and/or questions.
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: Spotlight on Health Concerns When Traveling – Vaccines and Illnesses

globalization_intro

Traveling is exciting, but it presents multiple challenges to your health. To best meet these challenges, preparation is everything.

Travel-health-insurance-for-international-travelers

Before you travel and every time you travel, your surest means of protecting yourself is to confirm you are current on routine vaccines.

  • Your basic vaccines include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine and influenza.
  • Most international travelers will need immunizations to protect you from hepatitis A, polio, and typhoid.
  • Depending on where you’re international travels take you and the duration of your trip, you may need immunizations to protect you from hepatitis B, malaria, rabies and/or yellow fever.

The plane trip itself can be hazardous to your health. I encourage you to review the risks of flying.

international-health-insurance-300x166

Diseases have different patterns in how they spread and their resistance to medications in different countries. It is important to be aware of prominent diseases affecting the countries you plan to visit, because some may be uncommon in your home country. For Americans traveling abroad, such diseases include the following:

  • HIV/AIDS 
  • Malaria: an infectious disease caused by a parasite, which invades the blood cells. It is notable for the presence of high fever, shaking chills, low blood count and a flu-like set of symptoms.
  • Pandemic/avian flu (aka as the bird flu): an infectious disease in birds caused by a virus that can spread to humans
  • Travelers’ diarrhea –  the most common disease acquired by travelers.
  • Tuberculosis: an infectious disease involving the lungs, able to spread throughout the body

I strongly recommend that you develop a habit of checking the CDC travel site every time you prepare to travel internationally, including those of you coming from abroad into the United States. Detailed information on these diseases is available clicking the links, checking the search engine and at www.sterlingmedicaladvice.com.
Feel free to contact your SMA expert consultant with any questions you have on this topic.
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: Syphilis Prevention, Treatment and the Tuskegee Experience

tuskegeesyphilis4
Syphilis should be a word derived from something meaning horrible. In an earlier post, we reviewed the rather horrific progression of the symptoms of syphilis. An additionally horrible consideration is that treatment is so very easy once identified. Of course, that’s not the most horrific aspect of the disease. Read on.
Looking back retrospectively, advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. However, as discussed in the post discussing the symptoms of syphilis, remember that treating syphilis at any point can prevent the most severe complications that lead to death. Which brings us to Tuskegee – and keep in mind this is Straight, No Chaser.

tuskegee

In the early 1930s, the US Public Health Service working with the Tuskegee Institute in Alabama began a study to evaluate the effectiveness of current treatments for syphilis, which at the time, were thought to be at least as bad as the disease. The study was conducted on 600 Black men, who were convinced to participate in the study with the promise of free medical exams, meals and money for burial, ‘if’ it was necessary.
The study was initially meant to last 6 months, but at some point a governmental decision was made to continue the study and observe the natural progression of syphilis until all subjects died of the disease, with a commitment obtained from the subjects that they would be autopsied ‘if’ they died. There were several problems with this decision.

  • None of the patients participated under informed consent. They believed they were being treated as opposed to being observed and having medicine withheld while they were being allowed to die. In other words, the subjects were not aware of the purpose of the study.
  • Penicillin was established as a true, rapidly effective treatment for syphilis and the standard of care by 1947. The study continued 25 years beyond this treatment option being available.
  • Efforts by concerned individuals failed to end the study for 5 years prior to a whistleblower going to the press in 1972. The study was ended in a day.

The aftermath of the study includes the following:

  • Reparations averaging a mere $15,000 per individual were given ($9M total) as well as a formal apology, delivered by President Clinton. Yep, the victims received the equivalent of $15,000 per person on average for 40 years of carrying syphilis 25 years after there was a known cure, after infecting wives and unborn children in several documented cases.
  • Strict requirements for protocols for human study (i.e. Institutional Review Boards) were implemented for the first time.

It shouldn’t surprise anyone that many African-Americans remain distrustful of governmental public health efforts to this day; for many, this study continues to be the reason while vaccination isn’t optimally taken advantage of (e.g. HPV) and why organ donation rates are so relatively low in the African-American community. Even though this posture contributes to the adverse health outcomes that exist in the African-American community, it isn’t hard to see why the fear and distrust exists.
Let’s bring this full circle. When it comes to syphilis, prevention is best, and full treatment is available. At the very least, I certainly can say you’ve been warned. Folks have given their lives to make your warning possible. I welcome your questions and comments.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Treatment of Erectile Dysfunction

Smiling_BobPenis-Pump-For-Penis-Enlargement-font-b-Erectile-b-font-font-b-Dysfunction-b
Well, here’s what many of you’ve been awaiting.  Assuming the preventative efforts I mentioned didn’t work for you, there are several different treatment approaches. If there’s an underlying medical cause, then treatment of that cause is not only a good way to relieve erectile dysfunction (ED), but it’s a good way to get healthy and avoid other complications from the primary disease. Today, I’ll review different treatment strategies your primary care physician or urologist may discuss or recommend to you for treatment.
The medications
A first consideration is to be wary of (any) medications via mail order. The same level of testing, scrutiny and quality control just doesn’t exist to the same degree as do medications obtained through a pharmacy. Reports abound of people receiving expired or weak formulations of the pills, as well as fake or hazardous substitutes of the pills they thought they were receiving. Engage at your own risk.
Now, regarding those medications you know all too well by name and brand (e.g. Levitra, Cialis and Viagra), there’s no special ‘magic’ to them. They all are variations of the same theme, physiologically relaxing muscles in the penis, resulting in increased blood flow to it.  Unfortunately, that’s not the entire story with these medications.  ED medications all lower blood pressure throughout the body, and that increased blood to the penis is coming at the expense of decreased blood flow elsewhere (This is called a ‘steal syndrome’.).  If you’re otherwise unhealthy, and your redirecting blood that was needed in the heart or brain, you could end up with a heart attack or stroke while taking these meds.  Therefore, this leads to two very important cautions regarding ED meds.  You shouldn’t start them without discussing with a physician first (to determine “…if you’re healthy enough to have sex”, as the commercials say), and secondly, don’t keep the fact that you’re taking them a secret (to your significant other, and especially to any physician you come across if you’re sick).  These medications could be the cause of whatever medical issue has you in an emergency room. They could also be contributors to life-threatening adverse effects if you’re being treated for something else with a medication that interacts with the ED med you’re taking but didn’t bother to mention to the emergency physician.  This is why ED medications generally aren’t given to men also on medications for high blood pressure, an enlarged prostate, blood thinners or certain other heart diseases (e.g. angina).
There are actually even more intricate medications used to treat ED.  Taking testosterone injections is an increasing means of addressing low hormone levels.  Additional injections directly into the penis or inserting a suppository into the penis itself are additional, effective treatment methods.  You’d be given these options by your urologist if necessary.
The counseling
If your ED is due  to anxiety, stress or other psychologically generated reasons, psychotherapy (possibly with your partner) may be of incredible assistance.  If you pursue this option, you and your partner must be prepared to be patient and to work through a variety of issues and possible approaches.
Surgery and additional methods

  • If you’ve ever seen an Austin Powers movie, you’re familiar with (well at least the jokes about) penis pumps.  These are real things, and involve placing a hollow tube over the penis and creating a vacuum to pull blood to the penis via a pump.  A tension ring is placed about the base of the penis to maintain the erection during intercourse.
  • Actual vascular surgery to repair damaged arteries may be indicated in certain cases.
  • Penile implants are an additional option.  Inflatable rods are placed into the sides of the penis.  These rods are simply inflated when needed.

Penile-Prosthesis-300x168
If you think some of this is a bit much, it may or may not be, depending on if you’re the one suffering.  As I usually conclude, prevention would have been a much better course of action.  Hopefully if that’s not the case, you’ve understood the information provided well enough to have an informed conversation with your physician.  Good luck, and I welcome your comments and/or questions.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Spotlight on Health Concerns When Traveling – Vaccines and Illnesses

globalization_intro

Traveling is exciting, but it presents multiple challenges to your health. To best meet these challenges, preparation is everything.

Travel-health-insurance-for-international-travelers

Before you travel and every time you travel, your surest means of protecting yourself is to confirm you are current on routine vaccines.

  • Your basic vaccines include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine and influenza.
  • Most international travelers will need immunizations to protect you from hepatitis A, polio, and typhoid.
  • Depending on where you’re international travels take you and the duration of your trip, you may need immunizations to protect you from hepatitis B, malaria, rabies and/or yellow fever.

The plane trip itself can be hazardous to your health. I encourage you to review the risks of flying.

international-health-insurance-300x166

Diseases have different patterns in how they spread and their resistance to medications in different countries. It is important to be aware of prominent diseases affecting the countries you plan to visit, because some may be uncommon in your home country. For Americans traveling abroad, such diseases include the following:

  • HIV/AIDS 
  • Malaria: an infectious disease caused by a parasite, which invades the blood cells. It is notable for the presence of high fever, shaking chills, low blood count and a flu-like set of symptoms.
  • Pandemic/avian flu (aka as the bird flu): an infectious disease in birds caused by a virus that can spread to humans
  • Travelers’ diarrhea –  the most common disease acquired by travelers.
  • Tuberculosis: an infectious disease involving the lungs, able to spread throughout the body

I strongly recommend that you develop a habit of checking the CDC travel site every time you prepare to travel internationally, including those of you coming from abroad into the United States. Detailed information on these diseases is available clicking the links, checking the search engine and at www.sterlingmedicaladvice.com.
Feel free to contact your SMA expert consultant with any questions you have on this topic.
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, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Medical Issues You Encounter While Flying

SAMC logo color 1
I’ve probably been engaged twenty times on airplanes to provide medical assistance. My favorite incident was when four doctors (and a nurse) simultaneously jumped to assistance as if everyone was some type of superhero. Of course, I wouldn’t be telling the story if I didn’t end up being the last man standing (due to my status as the emergency physician among the group – and yes, the patient was ok). Consider this your handy to do and to don’t if and when you’re traveling by air. You never know!
There are four quick considerations I’d like to share:
Blood clots: Flights (and especially the long ones) increase your risk for deep venous thrombosis (DVTs). You can reduce this risk by frequently bending and rotating your ankles, drinking water whenever the opportunity presents and getting up intermittently to walk. Prevention is also important – this is why traveling while in the latter stages of pregnancy is especially problematic and why near-term women aren’t allowed to travel (and you thought it only had to do with early deliveries!).
Headaches and earaches: Air in your body (lungs, intestines, sinuses and eardrums, to name a few) expand when your plane ascends and contracts upon descent. The squeeze on descent is actually more frequent of an issue than gases expanding on ascent, but both situations present problems. In addition to exacerbating migraines, your eardrums can rupture from the squeeze. Of course, adults address this by holding their noses and blowing, thus ‘popping’ their ears (actually this equalizes the pressure on both sides of the eardrum, returning things back to normal). Kids suffer just as much as adults, but the younger ones aren’t able to release the pressure as easily. Thus, it’s true that you should allow them to chew or suck on something during descent. The passenger sitting next to you will thank you.
FaintingFainting is a common occurrence on flights for many reasons. Faints and other mental status changes due to hypoglycemia are the most common episodes I’ve personally encountered on flights. My best advice here is to stay hydrated (This will help you prevent faints and problems with DVTs.) and if you’re diabetic, eat during the flight. Low sugar reactions are scary in the air, and the pilots are always wondering if they’ll need to do an emergency landing.
Respiratory disease: This is an important consideration because the potential for bad outcomes are heightened. Those with asthma, blood clots in the lungs (pulmonary emboli) and COPD (chronic obstructive pulmonary disease aka chronic bronchitis and emphysema) need to discuss traveling with their physicians. The high altitude of flights results in thinner air, drier air and increasing viscosity of your blood, which can affect patients suffering from the conditions mentioned. A ruptured lung in a patient with bad COPD is a formula for disaster.
In short, fly smart and fly healthy. An airplane is a horrible place to be in harm’s way. And that doesn’t even include snakes on a plane.
snakes-on-a-plane
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your Questions About Gunshot and Stab Wounds

GSW

SW

Your Top Five Questions:
1. Why don’t we remove the bullets every time? 
Removing bullets may cause more damage than leaving them in the body. Sometimes it’s not worth the effort.
2. What’s with the tubes that go in the chest?
Chest tubes are used to treat a pneumothorax (a collapsed lung). The problem is there’s air in the space between the lung and the chest wall. This can interfere with normal breathing and may be life threatening. The tubes go through the chest wall to release the air from that space, thus allowing re-expansion of the lungs.
3. Why would doctors ever need to slit someone’s throat to save his or her life?
That describes either a cricothyrotomy or a tracheostomy, and it’s not “slitting” the throat as much as it is creating an opening in the airway to permit airflow. This is usually necessary because of some airway obstruction at the upper throat (foreign body in the throat, etc.) with an inability to clear it. This procedure is only done to save a life.
4. Why would you die from a wound to the thigh?
Fractures of certain bones and laceration of certain blood vessels might cause so much blood loss that you could bleed to death. Infection and blood clots are additional considerations that could be life-threatening.
5. What about gunshot or stab wounds to someone pregnant?
Penetrating trauma to the abdomen is typically less fatal to the mother than to a fetus because the fetus is literally acting as a shield. In the event any wound has placed the mother’s life at risk or the mother has died from the wound, under certain extreme circumstances, an emergency C-section may be performed to save the baby.
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

About SterlingMedicalAdvice.com: What's Next?

new-logo3.jpg

SterlingMedicalAdvice.com is creating a virtual healthcare universe.  You can look forward to the following offerings.

Nov. 1: The launching of www.SterlingMedicalAdvice.com, including the Sterling Advice plan and the Sterling Advice Plus plan.  The Sterling Advice plan offers you personalized, immediate 24-hour advice and information from physicians and other medical specialists covering all medical specialties. The Sterling Advice Plus plan incorporates the offerings of the Sterling Advice plan and expands it to include pharmacy, mental health, dentistry, nutrition and personal training.

Dec. 1: The launching of SterlingMedicalAdvice.com’s Wellness and Smoking Cessation Programs. These modules will allow you to follow a best-practice program to improve your health over the long-term. This is a perfect addition to your employee benefits program. Employers, take note!

Jan. 1: The launching of SterlingMedicalAdvice.com’s Spanish language platform. All of the offerings of www.SterlingMedicalAdvice.com will be available in multiple languages for multiple audience.
Hablamos español!

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: 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 SterlingMedicalAdvice.com: "I'm already paying too much for insurance as it is! Can I afford SterlingMedicalAdvice.com?"

new-logo3.jpg
100% of your subscription to SterlingMedicalAdvice.com counts toward your healthcare insurance deductible. You’re only using money you have to spend anyway!
Here are a few more ways SMA makes great financial sense.
  • In the overwhelming majority of cases, your insurance contains deductibles of $1000-1500 that you must spend out-of-pocket before your insurance covers any expenses.
  • Your deductible usually covers one to three doctor or emergency room visits. Your www.SterlingMedicalAdvice.com subscription affords you the opportunity have more than TEN TIMES the interactions with multiple health professions for less cost!
  • Your membership with SterlingMedicalAdvice.com works to spare you the wasted time and expense of unnecessary physician and ER visits (which your insurance may or may not cover).
  • If your employer subscribes as a corporate entity, you and your co-workers can receive SterlingMedicalAdvice.com as an employee health benefit at NO COST to you (or your family)! Share this link with your human resources manager TODAY!
  • Buy a year’s subscription and GET A MONTH FREE.
  • Remember, www.SterlingMedicalAdvice.com comes with a 100% satisfaction guarantee!  Try us, and experience the difference convenience, knowledge and empowerment regarding your health makes!

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

About SterlingMedicalAdvice.com: "How do I sign up?"

Anytime starting noon EDT (and 11 am CDT) on Nov. 1st, you may go to www.sterlingmedicaladvice.com to join. It’s very easy to do. Give yourself about 15″. Have your personal health information, including medications and past medical history available. You will only have to provide this information once, and it will be invaluable in allowing our expert consultants to give you the very best information and advice.

Remember, if you sign up for a year’s plan, you get 13 months for the price of 12!

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

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