Tag Archives: Sterling Medical Advice

Straight, No Chaser: Fifteen Tips to Care for Diabetic Skin

Endocrine/Metabolic, Health Prevention, , , , , , , , , ,

DiabeticskindmgangreneDiabetic Foot

In this previous post, we discussed the frailty of the diabetic skin and discussed how that sets one up for skin infections, abscesses, ulcers, amputations and even death. Your best defense from these set of illnesses and tragedies is knowledge, prevention and prompt action.  Here are some concern steps you can take to better care for the diabetic in your life. In the event you know a diabetic who appears healthy, I want you to pay special attention to him/her. Diabetes is a chronic and insidious disease. These changes occur over years, and your challenge is to slow the process down as long as possible.
If you have diabetes, these tips may help prevent skin damage and infections:

  1. Do the best to can to control your blood glucose levels. The more out of control it is, the most damage it causes.
  2. You must check your feet every single day for the rest of your life. Diabetes develop decreased sensitivity to their feet. It is extremely common to step on a sharp object and not realize that you’ve done so. A splinter or nail is an excellent medium for an infection.
  3. Eat fruits and vegetables. Your skin needs all the nourishment it can get.
  4. Develop better hygiene. Wash and dry your skin often and thoroughly; this will keep you less exposed to infections.
  5. Make a point of keeping your groin, armpits and other areas prone to heavy sweat dry. Those moist areas in particular are most prone to becoming infected. Talcum powder is a good choice to use.
  6. Stay hydrated. It’s an uphill battle with the frequent urination and high blood sugar (glucose) levels. Dehydration causes your skin to be more brittle and prone to infections.
  7. Stay moisturized! Apply lotion early and often, especially after baths. Note those dry, cracked feet and get ahead of that happening if possible.
  8. Remember: if you’re diabetic, at some point your hands will retain sensation longer than your finger. It’s common to see scald injuries from stepping in water hot enough to burn you without you feeling it initially. Check the water with your hands before stepping into a tub.
  9. Use a milder, less irritating soaps that include moisturizer. Speaking of tubs, avoid bubble baths. Sorry.
  10. Consider investing in a humidifier to prevent skin drying, especially in dry or cold climates.
  11. Always take any skin wounds seriously, especially those on your feet. Avoid placing alcohol on any of your wounds.
  12. Invest in some sterile gauze. If you develop a scratch or other wound, control the wound with it after cleaning.
  13. Limit your self-help to cleaning and gauze wrapping. Only place topical antibiotics or take antibiotics for a skin infection under your physician’s supervision.
  14. Always ask your physician to check your skin during an examination and ask him/her to teach you what to look for.
  15. Immediately consult your physician or access the local emergency room if you have a burn, scratch, abscess (boil) or laceration that seems serious.

Feel free to contact your SMA expert consultant if you have any questions on this topic.
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Straight, No Chaser: The Skin Problems of Diabetics, Part 1

Endocrine/Metabolic, Health Prevention, , , , , , , , , , ,

diabetes_foot_problems_s12_ulcers

If you are diabetic or caring for a diabetic, one of the things you’ve likely noticed is that the skin doesn’t always seem to look, feel or perform normally. Perhaps the first thing I’d want you to know as a means of understanding what’s going on is this combination of facts: the skin is the body’s largest organ and diabetics have issues with blood flow. Given all the area needing blood flow, it stands to reason that diabetics invariably would have skin problems.
On a practical level, appreciate that infections are the most common cause of death in diabetics. Even a small cut or scratch in this population can lead to loss of a limb if unrecognized and left untreated. Unfortunately, amputations among diabetics  happens all too often. Is it preventable? With 100% confidence, yes. You can sufficiently reduce your risk of this ever happening. That said, there’s a reality that approximately 1/3 of all diabetes will have some type of skin problem, ranging from eczema and other localized itching problems to infections, abscesses, and gangrene.
By now you are likely wondering two things: How does this happen, and how can I prevent/help this?
First, diabetics suffer from frequent and excessive urination from those high blood glucose levels. This can lead to dehydration. Dehydrated skin is dry, red and has a waxy appearance. It becomes cracked, itchy, easily injured, harder to heal and easier to infect. Remember how diabetics have problems with poor blood circulation? That reduces the bodies’ ability to fight infections. So the first course of action for diabetics (beyond understanding the risks) is to be diligent in preventing infection.
I will dedicate a separate post to give you all the knowledge you need to prevent diabetic cuts, scratches and skin infections or to have them treated. In the meantime, the same rules apply to diabetics as they do to everyone else: an ounce of prevention is worth a pound of care. Diet and exercise can stave off the day when you’re fighting for your life because of a diabetic foot ulcer.
Click here for an explanation of basic facts about diabetes.
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.

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Straight, No Chaser: "…Stop Wasting Money on Vitamins and Mineral Supplements."

Diet and Nutrition, General Health and Wellness, Toxicology/Drugs, Health Prevention, , , , , , , , , ,

placebo
If any of you are familiar with the hit comedy The Big Bang Theory on CBS, you may recall this scene from one of the first episodes featuring the genius, physicist and would-be Noble Prize winner and the ditzy, would-be actress:
http://www.youtube.com/watch?v=m0Eo7ju54aY

  • Sheldon (as Penny selects vitamin supplements): Oh boy.
  • Penny: What now?
  • Sheldon: Well, there’s some value to taking a multivitamin, but the human body can only absorb so much, what you’re buying here are the ingredients for very expensive urine.
  • Penny: Well, maybe that’s what I was going for.
  • Sheldon: Well then you’ll want some manganese.
  • Vitamins have been all over the news the last few days, based on an editorial published in this week’s edition of the prominent medical journal Annals of Internal Medicine. In short, the findings of the editorial, based on a review of relevant recent literature and covering approximately half a million individuals are that taking supplements and multivitamins to prevent chronic diseases is a complete waste of money. In fact, the title of the editorial is “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.”
    And with that folks, let us declare today a Straight, No Chaser kind of day. I’m going to make this real simple.
  • Point #1: I’m a physician and a scientist. Physicians have every reason to embrace improvements in medicines and technology when they exist and no reason to shoot down them down when they’re effective. If it worked, we’d tell you.
  • Point #2: Opinions, anecdotes and personal experience do not constitute medical fact. Just because you felt better or believe your memory improved after taking a certain pill doesn’t mean the cause of your improvement was the pill.
  • Point #3: There is a phenomenon called the placebo effect that explains more than you’re willing to admit.
  • The placebo effect is a measurable, observable, or felt improvement in health or behavior not attributable to a medication or invasive treatment that has been administered. Even though placebos are not active medicines, they seem to have an effect in about 1 out of 3 patients. This is thought to represent the body mobilizing to address the concern for which you decided to take the pill. In this example, vitamins aren’t placebos because they actually have an effect on the body; however, the improvements you’re experiences aren’t directly attributable to those pills.
    More than half of all adults in the United States take a multivitamin and/or additional supplements, including those touted to prevent cancer, heart disease and boost memory.
    “The (vitamin and supplement) industry is based on anecdote, people saying ‘I take this, and it makes me feel better,’ said Dr. Edgar Miller, professor of medicine and epidemiology at Johns Hopkins University School of Medicine and co-author of the editorial. ”It’s perpetuated. But when you put it to the test, there’s no evidence of benefit in the long term. It can’t prevent mortality, stroke or heart attack.”
    The vitamin and supplement industry rakes in nearly $12 billion annually, according to the researchers, with multivitamins its most popular product.
    With that, allow me to again extol the virtues of a good diet.
  • Point #4: Most everything you’re looking for in a bottle can be obtained by a healthy diet, especially generous in servings of fruits and vegetables.
  • It is a fair point to make that a large number of us do not engage in a healthy diet, so much so that a multivitamin would be beneficial. Of course, that begs the question “If someone is not compliant with the direction to eat health foods, why would you presume they’d be compliant taking a multivitamin daily?” These pills are not inexpensive. Your better course of action is in spending that money on healthier food choices.
  • Point #5: It is an appropriate point to make that if you are suffering from a nutritional deficiency, you will benefit from a vitamin supplement.
  • Of course, the deficiency would have diagnosed by your physician, and the supplement would have been recommended by your physician. Short of that, in most cases, you’re allowing your fears to be played upon.

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Straight, No Chaser: Sleep Apnea

Sleep, , , , , , , , , ,

apnea111

We’ve discussed many components of sleep and sleep disorders. A very common condition that many of you are walking around with undiagnosed is sleep apnea.  Sleep apnea is a common, recurring sleeping disorder in which your breathing temporarily pauses during your sleep. Have you ever awakened and felt as if you were choking or coughing? We may be talking to you.
The pauses of sleep apnea range in frequency and severity. They can last seconds or minutes. They may occur about 30 times in an hour.
Let’s pause there. I just told you that many of you are suffering from a disorder in which you stop breathing while asleep. Think about what that means.
Physiologically, if you’re not breathing while you’re asleep, your body will adjust. If you are in a stage of deep sleep, you’ll be kicked into light sleep, which is a lesser quality of sleep, and your body won’t be as replenished as it would otherwise. Your body will be less rested as a result, and you will suffer throughout the day.
Sleep apnea is most commonly due to some level of obstruction—obstructive sleep apnea. Do you have a large tongue or big tonsils? Are you overweight? Are you a big snorer? We may be talking to you. That snoring may be the sound of air moving past some obstruction. By the way, obstructive sleep apnea occurs more often in overweight  people, but it can occur in anyone.

sleep-apnea

Now to the “So What?” of the conversation. This is about the quality of your life. Sleep apnea is about insufficient quantity and quality of sleep. It’s about excessive daytime sleepiness. It’s about recurring episodes of inadequate levels of air resulting from the breathing difficulty. These facts have consequences. Refer to the lead picture above for an illustration of the various types of symptoms and problems that are associated with sleep apnea. Sleep apnea also brings risks for the following conditions and diseases if left untreated.

  • Diabetes
  • Heart attacks
  • Heart failure
  • High blood pressure
  • Irregular heartbeats (arrhythmias)
  • Obesity
  • Strokes

Sleep apnea is easy and hard to diagnose at the same time. Many of you are suffering with it unsuspectingly as we speak. The person you sleep with may have expressed concern about your snoring or choking while you sleep. If so, get checked.
Sleep apnea once diagnosed is treatable with some combination of lifestyle changes, breathing devices and mouthpieces. Surgery is used in some cases.
We’ve reviewed many components of sleep and sleep disorders. Be mindful that sleep is your body’s time to rest and recover from the day’s activity. Any disruption in its ability to do that does not bode well for you over the long term. If your sleeping habits are problematic for you, you really should get evaluated. Getting this situation addressed can dramatically improve the quality of your life.
Finally, review the attached video for an illustration of what’s happening during sleep apnea. Excuse the scary music!
http://www.youtube.com/watch?v=Wm-TZ-dO_rQ
This discussion has focused on obstructive sleep apnea and not the less common form, central sleep apnea. The symptoms are similar, so if you have the other condition, it would be determined by your physician.
This post is part of a Straight, No Chaser series on sleep and sleep disorders.

  • Click here for a discussion of normal sleep and how much you need a day.
  • Click here and click here for discussions about insomnia.
  • Click here for a discussion of night terrors.
  • Click here for a discussion of hypersomnia (excessive sleepiness).
  • Click here for a discussion of narcolepsy (sleep attacks).

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.

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Straight, No Chaser: The Risks and Benefits of Coffee

Diet and Nutrition, General Health and Wellness, , , , , , , , , ,

pros-and-cons-of-coffee-consumption-infographic

Today, I come to praise coffee, not to bury it—and I don’t even drink it. Here’s the point: Coffee is a reasonably healthy beverage choice. The problem with coffee appears to be what you do to it! More about that in a moment. I’d like to review recent findings from a massive study on coffee and health from the Harvard School of Public Health. (Go Crimson!)
Those of you who’ve made a big deal of reducing your coffee intake as a means of improving your health would be much better off focusing on better eating and exercise habits, and on smoking and alcohol cessation. Regarding coffee specifically, it’s important to state that any discussion of the risks and benefits of coffee are in reference to black coffee. If you’re guzzling high calorie coffee products with lots of sugar, whipped cream, caramel and other additives that increase calories and fat, you’ve migrated to an entirely different conversation, and that one isn’t so pleasant.
Coffee has beneficial health effects, including the following:

  • It may protect against Type 2 diabetes.
  • It may protect against Parkinson’s disease.
  • It may protect against liver cirrhosis and liver cancer.
  • People who regularly drink coffee actually have a somewhat lower risk of death from heart disease than those who rarely drink coffee.

The “problem with coffee” is more about what you do while you’re drinking coffee.

  • Drinking coffee often occurs while smoking cigarettes, and if you’re a smoker you’re not getting any health benefits from pretty much anything associated with that activity.
  • People who drink coffee are less likely to exercise and use dietary supplements, and they tend to have a less healthy diet.
  • The weight of evidence on whether coffee increases the risk of heart disease or certain cancers is clearly leaning toward suggesting the negative ramifications are associated with the other habits of coffee drinkers and not the coffee consumption itself.
  • As mentioned earlier and to further the last point, adding syrups, sugars and milks can increase the caloric intake high enough that regular consumption may lead to weight gain and increase your risk for Type 2 diabetes.

What about tea? Chinese data is different than US data. US research has not shown the type of benefits of tea that Chinese research has. It is thought that this is likely due to US tea drinkers consuming weaker varieties of tea, and they tend to drink less of it. (The Chinese studies feature approximately a liter a day of Oolong tea.)
Here are some bottom line considerations:

  • Drinking as much as up to six cups a day of black coffee is not associated with increased risk of death from any cause, including death from cancer or cardiovascular disease.
  • If you are a pregnant female, have difficulty controlling diabetes or high blood pressure, or if coffee gives you tremors or palpitations, you may wish to avoid it.
  • You should brew coffee with a paper filter, to remove a substance that causes increases in LDL cholesterol.
  • Coffee likely has health benefits, but more research needs to be done to definitively state the extent of those benefits.
  • The health benefits of coffee are likely neutralized or overrun by unhealthy substances added to coffee and associated unhealthy habits of coffee drinkers.

Maybe coffee is another of those instances in which Straight, No Chaser is best!
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.

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Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

Sleep, , , , , , , , , ,

sleep_cycle_graph_1

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes a lot of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two stages, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after sleeping and waking up at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.
How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation.
Additional Straight, No Chaser Blogs have addressed several of the sleep disorders.

  • Click here and click here for discussions about insomnia.
  • Click here for a discussion of night terrors.
  • Click here for a discussion of hypersomnia (excessive sleepiness).
  • Click here for a discussion of narcolepsy (sleep attacks).
  • Check back for a discussion of sleep apnea.

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.

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Straight, No Chaser: Narcolepsy – The Sleep Attack

Sleep, , , , , , , , ,

narcolepsy

This is part of a series on sleep disorders.

  • Click here and click here for discussions about insomnia.
  • Click here for a discussion of night terrors.
  • Click here for a discussion of hypersomnia (excessive sleepiness).
  • Check back for a discussion of sleep apnea.

When you hear about narcolepsy, it’s usually in the context of some joke, but it’s a horrifying condition. Looking at the lead picture, imagining blacking out while driving a car.  A diagnosis of narcolepsy should prompt certain lifestyle changes.

To better understand this condition, let’s look at certain truths of narcolepsy.

Narcolepsy doesn’t happen just because you’re tired.

Narcolepsy is a brain disorder. The part of your brain that regulates your cycle of being awake vs. being asleep is disturbed. The drop attack is not fading into sleep. It is an irresistible shut down. Now, narcoleptics do suffer from severe sleepiness throughout the day, but the sleep attacks aren’t predictable based on how tired one is.

Narcoleptics have severe disruptions of the activities of daily living.

Just remembering that this is a drop attack will help you appreciate the danger of narcolepsy. It can occur at any time during any activity. The unpredictability of the condition renders it very dangerous to the sufferer, and it makes performing at work, at school, in social and in many other settings very difficult.

Narcoleptics are likely suffering from other sleep disorders.

Understand that narcolepsy is a disruption of the sleep/wake cycle. That disturbance can manifest in other ways, including poor sleep quality and frequent nighttime waking. However, narcoleptics do not tend to spend more total time asleep during the day than unaffected individuals.

In addition to the sleep attacks, the main symptoms are excessive daytime sleepiness and cataplexy.

Cataplexy is a sudden voluntary muscle loss while one is still awake—the horror before the horror, if you will. Individuals feel limp and/or unable to move. Other symptoms may include hallucinations and an extension of the cataplexy to outright paralysis before and after the episode. Now the drop attacks themselves typically last seconds to minutes and result in a temporary feeling of refreshment before the sleepiness phenomenon reoccurs.

There’s no special rhyme or reason to who suffers from narcolepsy.

Narcolepsy occurs the world around and in men and women at a roughly equal rate. It typically occurs in children through young adulthood, but it can occur at any age. Surprisingly, it often is underdiagnosed. Don’t let that happen to you. With any form of a blackout or sleep attack, please get evaluated and be sure to ask if the episode could have been narcolepsy.

Check back for a discussion of causes, diagnosis and treatment of narcolepsy.

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: Why Are You So Sleepy?

Sleep, , , , , , , , ,

hyperinsomnia

This is part of a series on sleep disorders.

  • Click here and click here for discussions about insomnia.
  • Click here for a discussion of night terrors.
  • Check back for discussions of narcolepsy and sleep apnea.

Are you one of those individuals who is always tired and sleepy? You take iron, you exercise and you’re getting sleep at night. However, you’re still tired? What’s that about?
Hypersomnia (i.e., excessive sleepiness) is characterized by prolonged nighttime sleep and/or recurrent bouts of excessive daytime sleepiness or prolonged nighttime sleep. This is not the variety of sleepiness due to physical or mental exhaustion or insufficient sleep at night.  Hypersomnia makes you want to nap repeatedly during the day. Ironically, even if you do take a nap or even after you sleep overnight, you’re still fatigued.
The functional importance of this is somewhat obvious. Hypersomnia interrupts your life, your work, your ability to normally interact with others. Symptoms are what you might expect from someone not getting enough sleep. Here’s a typical list:

  • restlessness
  • anxiety and irritation
  • decreased energy
  • slow thinking
  • slow speech
  • loss of appetite
  • hallucinations
  • memory difficulty
  • loss the ability to function in family, social, occupational, or other settings

Hypersomnia is difficult. It takes time to realize you’re affected beyond just regular fatigue. It’s also difficult to pin down the cause. Consider the following potential groups of causes:

  • Physical causes may include damage to the brain (e.g., from head trauma) or spinal cord, or from a tumor.
  • Medical and mental/behavioral health causes may include obesity, seizure disorder (epilepsy), encephalitis, multiple sclerosis and other sleep disorders (e.g., sleep apnea, nacolepsy).
  • Mental/behavioral health causes may include depression, drug or alcohol use.
  • Medications or medication withdrawal may cause hypersomnia.

Unfortunately, treatment is symptomatic and often requires some degree of trial and error. For some individuals, stimulants, antidepressants and other psychoactive medications are effective. For others, behavioral changes appear to be more effective.
Any disruption in the quality or amount of sleep warrant investigation. Discuss your concerns with your physician if you have the opportunity. You always have the option of discussing with your SterlingMedicalAdvice.com expert consultant.
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.

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

Environmental, Health Prevention, , , , , , , ,

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.

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Straight, No Chaser: Hypothermia (Low Body Temperature)

Environmental, , , , , , , , ,

hypothermia

This is part of a series on cold-related medical disorders.

  • To review the Do’s and Don’ts of Frostbite, click here.

Hypothermia is low body temperature. It’s not the “Oh, it’s cold outside” type of cold, but it is the “Oh, your life is in danger!” variety. Medically, hypothermia is a core body temperature below 95 °F (35 °C), and it can be produced by either an absolute cold exposure or sufficient heat loss beyond the body’s ability to generate a response.

What you want to know about hypothermia is the conditions and risks that set you up for it. Anyone can get hypothermia if you’re exposed to bad enough conditions, including the following:

  • Being outside without sufficient clothing in cold conditions
  • Being outside with wet clothing in cold and windy conditions
  • Excessive exertion or insufficient food or fluids while in cold and/or windy conditions
  • Excessive cold water exposure (e.g. immersion while ice fishing or boating)

Persons most likely to get hypothermic include the very old or young and those who are chronically ill or malnourished. Persons of normal health can get hypothermia if excessively fatigued or under the influence of alcohol or other drugs.
Typical symptoms of hypothermia include weakness, drowsiness, confusion and lack of coordination. Skin becomes cold, pale and frostbitten. Shivering becomes obvious and uncontrollable. Eventually, the heart and breathing rates will slow, and mental ability will progressively fade. Ultimately, the body can go into shock, and the heart and brain can cease functioning. Prolonged exposure will result in death if untreated.
For now I will leave you with the following considerations.

  • If you find someone in the cold who is not responding, don’t assume s/he’s dead.
  • Placing someone in direct heat, such as is given via a heating pad or lamp, or in hot water is not the approach and should not be done.
  • Do not give alcohol to someone exposed to extreme cold.

In the next post in this series we will discuss treatment and prevention strategies for extreme cold exposure.
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Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

Mental Health, Trauma, , , , , , , , , ,

masstrauma nairobi shootings

This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack or the effects of war, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures should include the following.

  • Getting medically evaluated and to a safe place
  • Securing food and water
  • Contacting loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

Unfortunately, some just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid”. This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Click here for a related Straight, No Chaser on Mass Trauma, and here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
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What's the difference between phenylephrine and pseudoephedrine?

Toxicology/Drugs, , , , , , , , , ,

sudafed

Unlike many things, this is a distinction with a difference, and one you should know. Both pseudoephedrine and phenylephrine are decongestants used to treat nasal congestion due to colds and allergies and other upper respiratory tract nuisances. The issue is pseudoephedrine can be made into methamphetamine. As a result, the U.S. Senate passed a bill restricting its sale. Pseudoephedrine products can still be purchased in limited quantities, but certain restrictions and other requirements are in place. In some states this includes requiring a prescription.
Regarding the difference between the two drugs, no studies have been done to confirm whether these two decongestants are equally effective, so we’re left to look at the chemical effects to judge.
There are some differences in the way the drugs are absorbed by the body:

  • The intestines will absorb only about 1/3 of the amount of phenylephrine in one tablet, while pseudoephedrine is 100% absorbed.
  • Phenylephrine’s effects do not last as long as those of pseudoephedrine. As a result, phenylephrine needs to be taken every four hours, while pseudoephedrine can be taken every four to six hours.

If you are considering trying either medication, discuss it with your physician or SMA consultant first. People with certain medical conditions such as diabetes, heart disease, high blood pressure, and overactive thyroid should not take products containing either of these ingredients. Also, people taking propranolol or certain antidepressants should avoid using these products.
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.

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Straight, No Chaser: Do medications work differently in older people?

Geriatrics/Elderly Care, , , , , , , , , ,

geriatrics_clip_image

The elderly are living longer and more productively. Part of being able to do so is by maintaining an understanding of how your actions  affect you. One common action of many of the elderly is taking medications. You should be aware that medications have changing effects with aging, and there are many different reasons for that fact.
First of all, changes in our physiology due to aging make the effects of drugs less predictable and consistent than in younger people. A slower metabolism, increases in body fat and alterations in the function of the kidney and liver (major mechanisms for drug elimination) have important ramifications for what ingested substances will do. Thus, the elderly require more stringent monitoring of drug levels and effects, and you may find that your physician needs to adjust medication doses. This same consideration explains why side effects are more common among the elderly.
Be reminded the presence of other diseases brings additional effects and challenges. Just as with one’s own relatively diminished function, disease imposes the same type of changes onto the body. This can speed the presence of side effects and toxicity as well as adjust the effective dose of a medication.
Have you ever seen the individual with a small ‘army’ of medications? Think about it. The more medications one takes, the more likely drug interactions will ensue and changes in effectiveness in any single medication may occur. This effect incrementally increases with each additional drug one takes. Similarly, the more medications one is taking, the most likely one is to make a mistake in taking the correct medication at the right time. Now consider your independently living parents or grandparents. The elderly often are more prone to make these types of errors.
What can you do about this? Get organized, and get help! Those daily medication containers are good solutions to incorrectly dosing medications. If you’re especially organized, a log is great—not necessarily for you, but for the physician that will be trying to figure out why you’re dizzy or have an altered mental status if and when that occurs.
Talk with each doctor you see or a pharmacist about what to expect from the combination of medications you take; it can make your lives a lot less complicated.
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Straight, No Chaser: The Effects of PTSD on Children

Mental Health, Pediatrics/Kids Health, Public Health, , , , , , , , , ,

PTSD-And-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
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.

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Straight, No Chaser: The Do's and Don't of Treating Frostbite

Environmental, , , , , , , , , ,

Alpha-Phi-Alpha-Ice-Cold-shirthypotherm1

There’s a cold front coming. You can’t avoid the exposure. Some of you will end up cold as ice (and twice as nice?). Would you really know what to do if you caught frostbite? I thought not, and the bad news is some of your instinctive tendencies are exactly what you ought not to do in this situation. Here are some do’s and don’ts if you ever find yourself or a loved one in this particularly precarious position.
The Do’s
A lot of this depends on the circumstances.

  • Give warm fluids if possible.
  • If the person is wet, remove wet clothing.
  • If s/he is wearing tight clothing, remove whatever’s constricting.
  • Move to as warm of a climate as feasible; if not possible, then shelter the person from the cold. Avoid movement of the frostbitten parts to the extent possible.
  • Gently separate affected fingers and toes, and if you can, wrap them loosely in sterile dressing.
  • If you have transportation, get to an emergency room as soon as possible.
  • If immediate care or transportation is not available, soak the affected areas in warm (preferably circulating and never hot) water. Alternatively, place warm coverings to affected areas for up to 30 minutes at a time. If skin is soft and feeling returns, you’ve done a good job.
    • Be mindful that burning pain and swelling will occur during rewarming.
  • Apply dry, loose and preferably sterile dressings to the frostbitten areas. Keep frostbitten fingers or toes separated with dressings.
  • Delay rewarming if you are not in an area safe from the risk of refreezing. Refreezing of thawed extremities is even more dangerous than the initial freeze.  

DO NOT

  • Rub or massage the frostbitten area.
  • Peel or pop any blisters that may be present.
  • Use dry heat, such as from a hair dryer, a radiation, heating pad, electric blanket or campfire. These heat source may be ok to keep the rest of you warm (particularly your core), but this type of direct heat can further damage frostbitten tissue.
  • Rewarm until you can be sure it can stay thawed.
  • Smoke or drink alcohol during recovery. These activities can interfere with blood circulation and cause additional problems.

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Straight, No Chaser: Your HIV and STD Risks from Sexual Activities Other Than Intercourse

Genital/Urinary, Infectious Disease, Obstetrics and Gynecology, Health Prevention, , , , , , , , , ,

sexual-risk-factors-2

Today, your sexual IQ goes up, and hopefully your risk for sexually transmitted infections (STIs), including HIV, goes down.
This is the fifth and last post in a series on HIV and AIDS.

  • For an explanation of what AIDS is, click here.
  • For an explanation of how HIV is contracted, click here.
  • For an explanation of the signs and symptoms of HIV/AIDS, click here.
  • For an explanation of the risk of contracting HIV from specific acts of sexual intercourse, click here.

Here are some terms you should understand.
Rimming: oral-anal contact
Fingering: digital sexual stimulation

Now let’s review.

Performing Oral Sex On A Man

  • You can get HIV by performing oral sex on your male partner. The risk is not as pronounced as it is with unprotected vaginal or anal sex, but oral sex clearly is a mode of transmitting HIV.
  • You are also at risk for getting other sexually transmitted infections (STIs), including herpes, syphilis, chlamydia and gonorrhea.
  • Using condoms during oral sex reduces the risk of contracting HIV and other STIs.
  • Your risk of contracting HIV from oral sex is reduced if your male partner does not ejaculate in your mouth.
  • Your risk of contracting HIV from oral sex is reduced if you do not have open sores or cuts in your mouth.

Receiving Oral Sex If You Are A Man

  • The risk of contracting HIV is less with receiving oral sex than many other sexual activities, but it is still present.
  • Your risk of contracting HIV from receiving oral sex is reduced if you do not have open sores or cuts on your penis.
  • Oral sex also presents a risk of contracting other STIs, most notably herpes.

Performing Oral Sex On A Woman

  • Significant levels of HIV have been found in vaginal secretions, so there is a risk of contracting HIV from this activity, although the risk is not a great with other sexual activities.
  • It is also possible to contract other STIs from performing oral sex on a woman.
  • There are effective barriers you can use to protect yourself from contact with your partner’s vaginal fluids. You can  use dental dams or non-microwaveable plastic wrap to protect against HIV and other STIs. (According to the Centers for Disease Control and Prevention, plastic wrap that can be microwaved will not protect you—viruses are small enough to pass through that type of wrap.)

Receiving Oral Sex If You Are A Woman

  • The risk for contracting HIV while receiving oral sex is significantly lower than for unprotected vaginal sex, but it is still present.
  • It is also possible to contract other STIs while receiving oral sex.
  • There are effective barriers you can use (cut-open unlubricated condom, dental dam, or non-microwaveable plastic wrap) over your vulva to protect yourself from STIs.

Oral-Anal Contact (Rimming)

  • The risk of contracting HIV by rimming is very low but comes with a high risk of transmitting hepatitis A and B, parasites, and other bacteria to the partner who is doing the rimming.
  • You should use a barrier method (cut-open unlubricated condom, dental dam, or non-microwaveable plastic wrap) over the anus to protect against infection.

Digital Stimulation (Fingering)

  • There is a very small risk of getting HIV from fingering your partner if you have cuts or sores on your fingers and your partner has cuts or sores in the rectum or vagina.
  • The use medical-grade gloves and water-based lubricants can during fingering eliminates this risk.

If you have any additional questions, please feel free to ask questions or provide comments. I cannot more highly endorse the websites at cdc.gov and the US Department of Health and Human Services.
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Straight, No Chaser: Your HIV and STD Risks From Specific Acts of Sexual Intercourse

Genital/Urinary, Infectious Disease, Obstetrics and Gynecology, , , , , , , , , , , ,

stirisks

Let’s be clear that we’re explicitly discussing the types of sexual behaviors that will lead to transmitting HIV and other sexually transmitted infections (STIs). Over the next two days, we will run the gamut of sexual behavior and its implications.
This is the fourth in an ongoing series on HIV and AIDS.

  • For an explanation of what AIDS is, click here.
  • For an explanation of how HIV is contracted, click here.
  • For an explanation of the signs and symptoms of HIV/AIDS, click here.

What I hope to accomplish here is to identify those activities that place you at significant risk for contracting HIV and other sexually transmitted infections  (STIs). The take-home message is you really should identify your partner’s health status before you begin sexual activity.
Today we will focus on four types of sexual activity and discuss the risks of each. Let’s start with some terminology.

  • Receptive sex risks speak to risks to the receiver.
  • Insertive sex risks speak to risks to the giver.
  • Bottoming is a way of describing receptive anal sex.
  • Topping is a way of describing insertive anal sex.

Now, let’s review.

Receptive Vaginal Sex

  • Vaginal sex without a condom is a high-risk behavior for HIV infection.
  • HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
  • If you currently have an STI or vaginal infection, your risk for contracting/transmitting HIV is increased because your tissue will be inflamed. This has nothing to do with the presence or absence of symptoms.
  • Female condoms protect HIV infection if used correctly. However, the risk still exists for any area exposed and infected (in the presence of an open sore or bleeding, for example).
  • Barrier birth control methods (such as diaphragms, IUDs and cervical caps) DO NOT protect against STIs or HIV infection. If infected semen or sperm contracts inflamed or otherwise injured vaginal tissue, the risk of transmission/contraction is present.
  • Birth control pills do not protect against HIV or other STIs.

Insertive Vaginal Sex

  • HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
  • Condom use is a critical means of protection against STIs that are present without obvious symptoms. Use condoms with a water-based lubricant every time you have insertive vaginal sex to prevent STIs, including HIV.

Receptive Anal Sex (Bottoming)

  • Bottoming without a condom provides the highest risk for contracting HIV, more so than any other sexual behavior.
  • HIV has been identified in pre-ejaculatory semen. “Pulling out” prior to ejaculation may not decrease your risk.
  • Rectal douching before anal sex can increase your HIV risk. Douching irritates the rectal tissue and can make you more receptive to contracting HIV. Soap and water in a non-abrasive manner are adequate means of cleanliness.
  • If bottoming, you will best minimize the risk of transmitting HIV and other STIs by always using a water-based lubricant with a latex, polyurethane, or polyisoprene condom. This will help to minimize irritation to the rectum during sex and subsequent transmission.

Insertive Anal Sex (Topping)

  • Topping without a condom is a high-risk behavior for transmission of HIV and other STIs. An infection may be present. If small sores, scratches or tears are also present, they would provide a ready path of entry and transmission of HIV.
  • Similarly, those same lesions in your partners rectum could harbor infected cells in blood, feces or other fluid, which, when contacted, could infect you through your penis.

Check back for the next post in this series on HIV/AIDS. It will focus on HIV and STD risks from sexual activities other than intercourse.
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Straight, No Chaser: What are the Symptoms of HIV and AIDS?

Infectious Disease, , , , , , , , , ,

This is the third in an ongoing series on HIV and AIDS.

  • For an explanation of what AIDS is, click here.
  • For an explanation of how HIV is contracted, click here.

The National Institutes of Health has a nice method of categorizing HIV signs and symptoms, which I’ll replicate here. There are several take home messages, and I’ll use the pictures to communicate them.

HIV signs-symptoms-2
HIV Positive Without Symptoms
Many people who are HIV-positive do not have symptoms of HIV infection, and symptoms only evolve as their condition deteriorates toward AIDS (Acquired Immunodeficiency Syndrome). Sometimes people living with HIV go through periods of being sick and then feel fine.
HIV signs-symptoms2
Signs and Symptoms of Early HIV
As early as two–four weeks after exposure to HIV (but sometimes as far out as three months later), people can experience an acute illness, often described as “the worst flu ever.” This is called acute retrovirus syndrome (ARS) or primary HIV infection. This represents the body’s natural response to HIV infection. During primary HIV infection, there are higher levels of virus circulating in the blood, which means that people can more easily transmit the virus to others.
Symptoms resemble a flu-like syndrome, including fever, chills, nights sweats, muscle aches and fatigue. Other symptoms may include a rash, sore throat, swollen lymph nodes and ulcers in mouth. It is important to state that not everyone gets ARS when they become infected with HIV.
hiv-and-aids ss3
Signs and Symptoms of Chronic or Latent Phase HIV
After the initial infection and seroconversion, the virus becomes less active in the body, although it is still present. During this period, many people do not have any symptoms of HIV infection. This period is called the ‘chronic’ or ‘latency’ phase. This period can last up to 10 years—sometimes longer.

HIV opportunistic-infections-4

Signs and Symptoms of AIDS
While the virus itself can sometimes cause people to feel sick, most of the severe symptoms and illnesses of HIV disease come from the opportunistic infections that attack the infected individual’s compromised immune system.
When HIV infection progresses to AIDS, many people begin to suffer from fatigue, diarrhea, nausea, vomiting, fever, chills, night sweats, and even wasting syndrome at late stages.
Unless symptoms are discovered late, HIV/AIDS is much better being diagnosed early based on risk factors and exposures. That said, use the knowledge provided to prompt evaluation and testing.
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We're in the Giving Mood: Free Subscriptions to SterlingMedicalAdvice.com

Uncategorized, , , , , , , ,

New Logo

Ok, we’ve lost it, and we’re giving it away for FREE! We’re so excited about SterlingMedicalAdvice.com that we’re giving it away for the month of December! If you like us on Facebook or follow us on Twitter at @asksterlingmd or follow the Straight, No Chaser blog at www.jeffreysterlingmd.com you can then go to www.SterlingMedicalAdvice.com and receive a free December subscription to our service (you will receive a SterlingAdviceSM plan).
Try it for free, and experience the difference personalized healthcare consulting can make in your family’s life. Thank for your support, and Happy Holidays.
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.

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Straight, No Chaser: How Do You Contract HIV/AIDS?

Genital/Urinary, Infectious Disease, , , , , , , , , , ,

HIV-AIDS-21

Today is World AIDS day. This isn’t 1983. The mystery of how HIV infection is contracted has come and gone. You need to be knowledgable to be empowered.
This is the first blog in an ongoing series on HIV and AIDS.

  • For an explanation of what AIDS is, click here.
  • For an explanation of the signs and symptoms of HIV/AIDS is, click here.

First, let’s address a simple principle. The HIV virus can live and reproduce in high levels in blood other body fluids, including breast milk, rectal mucus, semen (and pre-semen) and vaginal fluids. If any of those fluids are infected and are transmitted to another’s body, that individual can become infected with HIV. In special circumstances (such as healthcare workers), individuals may become exposed to other areas that may contain high levels of HIV, including amniotic fluid (in pregnancy women), cerebrospinal fluid (from the brain and spinal cord) and synovial fluid (from various joints).
Now please take a moment and look at the lead picture. In addition to those circumstances listed, you should know that fluids such as feces, nasal fluid, saliva, sweat, tears, urine or vomit don’t by themselves contain high enough levels to transmit HIV. However, if those fluids are mixed with blood and you have contact with both fluids, you may become infected via these routes.
HIV is transmitted through body fluids in very specific ways:

  • During anal, oral or vaginal sex: When you have anal, oral, or vaginal sex with a partner, you will have contact with your partner’s body fluids in areas very likely to be high in HIV viral load if your partner is infected. HIV gets transmitted in these instances through small breaks in the surfaces of the mouth, penis, rectum, vagina or vulva. One of the reasons HIV infection rates are higher in individuals with herpes and syphilis is because those diseases cause open sores, creating additional opportunities for HIV-infected body fluids to enter the body.
  • During pregnancy, childbirth or breastfeeding: Babies have constant contact with their mother’s potentially infected body fluids. Means of transmitting HIV from mother to child include through amniotic fluid, blood and infected breast milk.
  • As a result of injection drug use: Injecting drugs puts you in contact with blood. If those needles and their contents are contaminated, you can be directly delivering HIV into your bloodstream.
  • As a result of occupational exposure: Healthcare workers must be constantly diligent against this method of transmission. Risks of HIV transmission to healthcare workers occur through blood transferred from needlesticks and cuts, and less commonly through contact of infected body fluids splashed into the eyes, mouth or into an open sore or cut.
  • As a result of a blood transfusion or organ transplant: Fortunately, these days, this is very rare given the stringency of screening requirements in the United States, but it is possible to transmit HIV through blood transfusions or organ transplants from infected donors.

How does one get AIDS?
AIDS is a progression of HIV into its later stages and occurs after one’s immune system is severely damaged. You don’t “get AIDS” as much as HIV progresses to AIDS in certain circumstances. Many of us recall that HIV could progress in this way to AIDS in a matter of a few years a few decades ago. Fortunately, with the development of specialized medications in the 1990s, people with HIV are living much longer with HIV before they develop AIDS.
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