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Straight, No Chaser: When Alcohol Becomes Toxic – Or Deadly

alctox

Ok. We now know the teams playing in the Super Bowl. Maybe you’ve already begun planning the party or have identified where you’ll be watching. Well, forewarned is forearmed. It’s not my intention to spoil the “buzz” of Super Bowl Sunday, but allow me to provide some liquor for thought. Most everyone knows the effects of getting drunk. What most seem to forget is that alcohol has a continuum of effects that isn’t restricted to becoming “buzzed,” intoxicated or just drunk. Alcohol poisoning also includes effects such as coma and death.
Some of you may be reflecting on the times when you felt most intoxicated. Perhaps it was a college event, a New Year’s Eve party or a sports event (or all of the above). Your first take home message of the day is alcohol poisoning isn’t about how you feel. It’s simply about the concentration of alcohol in your blood and the effects that amount of alcohol will have on your system. This is commonly described as BAC – blood alcohol content.
As BAC increases, so do the effects of alcohol. Let’s quantify the amount of alcohol that is associated with danger, how symptoms progress with alcohol poisoning and the different BAC levels that are associated with danger.
Amount
We’re talking about acute alcohol toxicity and poisoning. This is typically brought on via a large intake of alcohol (e.g., binge drinking). Bingeing is generally regarded as at least four to five drinks (for women and men, respectively) within two hours. This level of drinking will raise your BAC into the “legally drunk” level and increase the risk of adverse consequences. Such amounts can overwhelm the body’s metabolism and elimination of alcohol from the blood.  When this occurs, further alcohol intake will rapidly increase BAC and impair bodily functions, most notably those of the brain.
Note the following chart, which gives a rough estimate of the general effects of different amounts of alcohol based on your weight. It is very important to realize that weight, age, sex and other considerations play into the individual effects of alcohol on you.

bac

Symptoms of Alcohol Poisoning
Alcohol poisoning occurs when there is so much alcohol in the bloodstream that it is able to affect and shut down areas of the brain controlling basic life-support functions (i.e., breathing, heart rate, and regulation of your core temperature). Symptoms of alcohol poisoning include confusion, difficulty breathing and remaining conscious, vomiting, seizures, slowed heart rate, clammy skin, dulled responses, such as no gag reflex (which prevents choking) and an extremely low body temperature.
BAC can continue to rise even when a person is unconscious. Alcohol in the stomach and intestine continues to enter the bloodstream and circulate throughout the body. This makes “sleeping it off” a very dangerous proposition, and you should not assume one will be better by doing so. Alcohol is a depressant to the brain. Among its activities is dulling the gag reflex. Coupling that with alcohol’s irritant effects on the stomach, a person who drinks to the point of passing out is in danger of choking on vomit, which in turn could lead to death by asphyxiation (inadequate oxygenation). Even survival can leave a victim of an alcohol overdose with brain damage.
Effects
The following charts approximate the BACs that occur with varying numbers of drinks. Let’s continue to think about binge drinking, focusing on the following male/female charts after one hour of drinking. Although there is individual variation in the clinical effects of the number of drinking one may have, the clinical effects of alcohol are rather consistent at various BACs. These levels eventually reach a point of toxicity known as alcohol poisoning. This designation is particularly meaningful in that it reflects the level at which the level of alcohol in the blood begins to shut down areas of the brain controlling basic life-support functions (i.e., breathing, heart rate, and regulation of core temperature).
Male BAC
BAC Female
Clinical Effects at Various BACs
This next section is at a level of specificity that you won’t remember, but I want to go through the detail to demonstrate the increasing dangers seen with increasing levels of intoxication. Don’t be lulled into comfort by the lower levels. Even small levels of alcohol in the system affect judgment and coordination. Increased amounts affect the body and mind more dramatically, leading to the ability to kill.
The following effects of different levels of BAC are approximations. Individual reactions vary, sometimes widely.

  • BAC .02 percent to .04 percent
    This level tends to produce mild relaxation, loosened inhibitions and some lightheadedness. Prevailing moods may intensify.
  • BAC .05 percent to .07 percent 
    This level tends to intensification and exaggeration of emotions and behavior. Euphoria may begin, and a feeling of relation and warmth may overcome you.
  • BAC .08 percent to .09 percent
    At this level you’re losing an ability to accurate assess your level of functioning. You may have slurred speech, impaired motor skills and a degree of imbalance. Your sense of seeing and hearing clearly are diminished, and your reduced judgment often leads to continued drinking when this would actually be a good time to stop. This level corresponds to a diminished ability to evaluate sexual situations.
  • BAC .10 percent to .12 percent
    At this level you’re clearly suffering. You have diminished motor skills, coordination, balance, judgment and memory. Emotions become even more exaggerated at both extremes. Some people become loud, aggressive or belligerent, and others may seem depressed. This BAC level also corresponds to when men may have trouble getting an erection.
  • BAC .14 percent to .17 percent
    At this level euphoria may give way to unpleasant feelings. You have difficulty talking, walking or even standing up. Your judgment and perception are severely impaired. You may become more aggressive and are at increased risk of accidentally injuring yourself or others. A blackout may occur at this level.
  • BAC .20 percent
    At this point, neurologic effects are present. You may feel confused, dazed or otherwise disoriented and may need help to stand up or walk. If you are injured, you probably won’t realize it because you won’t feel pain, and if you do realize it, you may be inclined not to do anything about it. At this point you may experience nausea and start vomiting. Your gag reflex is impaired, so you could choke if you throw up. Since blackouts are likely at this level, you may not remember any of this.
  • BAC .25 percent
    At this point, all mental, physical and sensory functions are severely impaired. You’re emotionally numb. There’s an increased risk of death due to asphyxiation (inadequate oxygen) caused by choking on vomit and of seriously injuring yourself by falling or other accidents.
  • BAC .30 percent
    You’re probably in a stupor. You have little comprehension of where you are or what’s really going on around you. You may suddenly pass out and be difficult to awaken.
  • BAC .35 percent
    This blood alcohol concentration is similar to the physical effects of surgical anesthesia. You may stop breathing.
  • BAC .40 percent to .50 percent
    You are probably in a coma. The nerve centers controlling your heartbeat and respiration are slowing down, and it’s a miracle if you survive.

Let’s bring things full circle. Someone weighing 100 pounds who has consumed 9-10 drinks in less than an hour is at risk of death. Here’s how. The term “lethal dose” (LD) is used to describe the blood concentration that produces death from drugs (in this case, alcohol) in half the population. Most authorities agree that BACs in the 0.40 percent to 0.50 percent range meet the requirement. That percent is an average, not an absolute standard. Fatal overdoses from alcohol at BACs lower than 0.40 percent have been documented, as have cases of survivors at BACs higher than 0.50 percent. If you refer to the above chart correlating number of drinks, weight and BAC levels, you can now figure out how dangerous different numbers of drinks can be.
Here’s a final take home message for you. Alcohol poisoning is a life-threatening condition and requires immediate medical attention. You don’t have time for cold showers, hot coffee or walking. Not only will these not reverse the effects of alcohol overdose, but they could actually make things worse.
Feel free to contact your SMA expert consultant with any questions you have on this topic.
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The ER ISN'T as Sexy as You Think!

clooney

Yes, ER docs are the best. However, here’s my free advice for the day. Skip the ER trip if you can.

You won’t find Clooney in the ER. What you will find is a longer wait and higher cost than you want or often need. Did you know the average cost of an ER visit nationally is over $1300? Did you know hospital bills are the number one cause of personal bankruptcies? That’s not sexy.

Avoid unnecessary doctor/ER visits when you register at SterlingMedicalAdvice.com or call 844-SMA-TALK. SHARE us with your friends and family, please. Thank you.
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Straight, No Chaser: So What Do I Need to Know About the Prostate?

Continuing in our review of topics of Men’s Health, today we explore the prostate. There are generally five questions people ask me about the prostate, so let’s take the time to address them. These topics are individually discussed in detail at www.sterlingmedicaladvice.com.

1. What is the prostate?

prostate

The prostate is a male-only organ located in front of the rectum and under the bladder. It surrounds the urethra, which is the tube through which urine flows on its way out of the penis. Understanding this anatomy helps one understand the nature of problems that arise related to the prostate. The prostate is part of the male reproductive system. It’s a gland that contributes to the fluid (seminal fluid) that carries sperm out of the body (i.e., semen).
2. Doesn’t it get infected?

Prostatitis

Prostatitis is the presence inflammation or infection of the prostate gland. It has many different causes. When an infection with bacteria causes prostatitis, it is called bacterial prostatitis. Bacterial prostatitis can be a particularly long-lasting infection, requiring antibiotics to treat.

  • Acute bacterial prostatitis is an infection that produces signs and symptoms rapidly.
  • Chronic bacterial prostatitis is an infection that lasts for at least three months.

3. Why does the prostate get large?

BPH

A condition known as benign prostatic hypertrophy (BPH) occurs in men as they age. As a general rule, 50% of men have it by age 50, and 80% have it by age 80. The prostate normally is only the size of a walnut. When BPH occurs, the prostate has enlarged to a point where it may press upon the urethra, disrupting the normal flow of urine, preventing normal emptying. It is important to understand that the growth seen in BPH is not cancer.
4. What’s the relationship between the prostate and sex?
When people ask me this question, they have one of two concerns.

  • Some medical studies have drawn a relationship between a higher frequency of ejaculations and a lower risk of prostate cancer. This trend is not currently considered definitive; to be clear there is no conclusive evidence that the risk of prostate cancer is reduced by frequent ejaculation.
  • The male equivalent of a “G-spot” is described as being near the prostate.

5. Is prostate cancer deadly?

Prostate-cancer-risk

Prostate cancer is usually slow growing, but may occasionally be aggressive. Cancerous prostate cells may break off and spread to other parts of the body, particularly the bones and lymph nodes. Prostate cancer usually is seen in men after 50 and even when discovered often doesn’t require especially aggressive management.
Your bottom line? You especially need a prostate exam and other considerations yearly after age 50.
Feel free to contact your SMA expert consultant with any questions you have on this topic.
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Baby's Sick? Contact SterlingMedicalAdvice.com

baby with stethoscope

When you contact SterlingMedicalAdvice.com or 844-SMA-TALK, you’ll receive advice immediately from expert consultants who have spent decades caring for children and who are still dedicating their careers to doing so. Statistically speaking, more often than not you can avoid taking the baby out of the house at all.
Avoid unnecessary doctor/ER visits. Register at SterlingMedicalAdvice.com or call 844-SMA-TALK. Then SHARE us with your friends and family, please. Thank you.
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Straight, No Chaser: Maintain Healthy Testosterone Levels Without Replacement Therapy

Testerone2

Male virility is a fascinating topic medically. It is truly an example of how confidence and mental fortitude (or the absence thereof) can directly translate into physical performance. Thus, it doesn’t come as a surprise when TV ads seek to sew seeds of doubt into you. (“Don’t perform like you used to? Maybe it’s Low-T! Here’s a miracle pill!”)
As mentioned in the previous post, many factors control testosterone, most notably a natural drop associated with aging.  In fact, your levels are considered normal until about age 30, then you lose approximately 1% per year until you reach a state by age 70 where you’re expected to be clinically below normal – and that’s just due to the age-related considerations. Factors you can control affect not only your sexual health but your physical and mental health, too. These include appropriately managing your diet, exercise, sleep and stress. Let’s look at the effect each has on maintenance of healthy testosterone levels.
Diet:

testostdietfruit

It will forever be true that what you place in your mouth either strengthens you or slowly poisons you. Here’s a quick list of foods that are specifically good for boosting your testosterone levels.

  • Bananas – Banana are rich in B vitamins, which are needed to manufacture testosterone.
  • Brazil nuts – It’s the magnesium contained within that increases testosterone.
  • Chicken liver – It’s the zinc! Zinc increases testosterone levels.
  • Cruciferous vegetables – Broccoli, cabbage and cauliflower help eliminate the hormone estrogen from the body, which increases testosterone. Choosing these healthy foods also helps weight loss, which in turn increases testosterone production.
  • Eggs – It’s really about the vitamin D contained within eggs; vitamin D deficiency has been shown to correlate with higher estrogen levels and lower testosterone levels.
  • Garlic (as part of a high protein diet) – This combination increases testosterone production.
  • Oysters – It’s the zinc! Zinc increases testosterone.
  • Pineapples – It’s the magnesium contained within that increases testosterone.
  • Pumpkin seeds – It’s the zinc! Zinc increases testosterone.

Here’s the other dietary consideration for you: In general, most anything you eat that adds to your level of obesity will result in lowered testosterone levels. Number one on that list is processed sugar—think fructose, meaning soda/pop, fruit juices. The relationship between diet and testosterone is way more intricate than this, but if you incorporate the steps just mentioned, you will see a difference in your overall health and sexual health.
Exercise:

testosteroneexercise

I will limit this part of the discussion to two manageable considerations.

  • If you’re overweight, you are more likely to have low testosterone levels. Globally losing weight will work to your advantage. Check these Straight, No Chaser posts to address obesity and weight loss.
  • Intense strength training also boosts testosterone levels. When strength training to boost testosterone, you’ll want to increase the weight, lower your number of reps and slow down the motion on each rep. Also try to work a large number of muscles, as occurs with dead lifts or squats.

Stress Management:

testostress

When you’re under a significant stress, your body releases high levels of the stress hormone cortisol. Cortisol blocks the effects of testosterone. Over the longterm, stress chronically blocks the effects of testosterone, producing all of the undesired symptoms that accompany that state.
You know to how reduce your stress. Here are techniques shown to be effective in this setting.

  • Deep breathing
  • Laughter
  • Meditation
  • Positive visualization
  • Prayer
  • Yoga

Sleep:

testostsleep

Here’s something you likely didn’t know. Testosterone is only produced by your testes at night. Even more impressive production coincides at a specific point in the sleep cycle immediately before REM (rapid-eye movement) sleep. This production and replenishment is most complete in men getting at least eight hours of sleep/night. Conversely, testosterone levels are significantly lower in those receiving less than six hours of sleep/night. Note this is total sleep at night, not consecutive hours of sleep (assuming you are able to rapidly fall back asleep). Get your sleep!
These are very important considerations. As is the case with many conditions, your health is not going to be found in a medicine bottle. The fundamentals of taking care of yourself are your best course of action for longevity and health. This is especially important in the management of low testosterone, given that testosterone therapy has serious side effects and increases risks for certain conditions, including signaling the body to stop producing its own testosterone and the following:

  • Acne
  • Prostate enlargement
  • Prostate cancer
  • Reduction in sperm production
  • Sleep apnea

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.
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ER as Quick Fix: I Get It!

ER

Knowing there’s an ER nearby creates peace of mind. You can get immediate and effective care when something goes terribly wrong. So it makes sense that you’d run over just in case something has gone terribly wrong—early detection being key to battling certain illnesses.
HOWEVER, every headache isn’t cancer; every stomach ache isn’t a ruptured appendix. Some symptoms don’t require any treatment at all. Yes, sometimes it is better to be safe than sorry, but popping over to the ER to visit and chat with a physician is very expensive and time consuming.
That’s why we’ve developed SterlingMedicalAdvice.com. We’d like to provide you that same level of comfort, using the same experts you’d see in the ER or doctor’s office—for a fraction of the cost and with no waiting.
Avoid unnecessary doctor/ER visits. Register at SterlingMedicalAdvice.com or call 844-SMA-TALK. Then SHARE us with your friends and family, please. Thank you.
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.

Straight, No Chaser: The Specter of Low Testosterone

low-testosterone-treatment

Are you someone who had never heard of Low-T until recent commercials starting telling you that you weren’t normal? Let’s review what all the fuss is about.
As most people know, testosterone is the most important male sex hormone that in many ways and for many defines “manhood,” contributing to the following:

  • Changes of puberty, including deepening of your voice
  • Production of pubic, facial and body hair
  • Production of sperm
  • Facilitation of sex drive
  • Maintenance of bone health, which assists growth

Low-T-In-Men-Tucson

In case you were wondering, this is what “male menopause” looks like.
Certain parts of the brain (hypothalamus and pituitary gland) signal how much testosterone needs to be produced. Most production occurs in the testes.
The symptoms of low testosterone are predictable. Symptoms include a reduction in sex drive, erections and sperm count. Men may also see an enlargement of their breasts. Additional symptoms (over the long-term) may include smaller testes, less energy, mood changes, loss of muscle size and strength, and weakened bones.

low-testosterone

The aging process normally reduces sex drive, sperm count and frequency of erections. Aging also reduces testosterone such that clinically low testosterone levels invariably occur by age 70. The presence of these two independent facts can make it confusing to know if these symptoms are simply part of the aging process or might be attributable to a disease in the areas that either produce or regulate testosterone. In other words, although a natural age-related reduction in testosterone level is normal, it may or may not be the cause of lower sex drive.

testostgraph_men

Low testosterone in the absence of aging really is thought to be more of a sign of disease than a disease unto itself. The primary goal is to ensure than none of the more serious causes of low testosterone are present. Some of the more serious causes and considerations leading to low testosterone include injury, infection or cancer to the testes, radiation therapy or chemotherapy, hormonal disorders such as pituitary gland tumors or diseases, liver and kidney disease, diabetes, HIV/AIDS, obesity, certain genetic disorders and use of opiates (pain-killers).
Based on the cause and your health status, you may be prescribed testosterone replacement therapy. Testosterone replacement may occur via periodic injections, skin patches/gels, skin pellets or tablets that stick to the gums.
Testosterone replacement is not like taking a pill for an erection. These are hormones and come with long-term risks, the most notable being prostate cancer. Therefore, those males with prostate or breast cancer aren’t candidates for testosterone replacement therapy. Other side effects of testosterone replacement therapy include acne, breast enlargement, fluid buildup in the legs, ankles and feet, increased red blood cell count, prostate enlargement and sleep apnea.
Here are groups with significant enough risks from testosterone replacement therapy that they require monitoring if treated this way:

  • African-American men
  • Men over 40 years of age who have close relatives with prostate cancer
  • All men over 50 years of age

So what should you do with this information?

  • Understand that certain age-related changes occur naturally and don’t represent disease.
  • Understand that the premature presence of these symptoms could represent disease and need to be evaluated.
  • Understand that a desire to avoid the symptoms associated with low testosterone is best done with routine health measures (diet and exercise) that help the body function and maintain healthy levels of testosterone naturally.
  • Understand that a decision to seek treatment for these symptoms isn’t as simple as getting a pill or a patch. Hormonal treatment has real and serious associated side effects and risks and should only be done with the consultation and consent of your physician and endocrinologist (hormone specialist).

hrt

Feel free to contact your SMA expert consultant for any questions you may 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.
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You Work Hard for Your Money. We Work Hard to Save It.

gold coins

Why waste it?

  • co-pays
  • deductibles
  • facilities fees
  • transportation and parking
  • time off work

Avoid unnecessary doctor/ER visits. Call your personalized expert consultants to work with you on the most cost effective means of addressing your healthcare concerns. Register at SterlingMedicalAdvice.com or call 844-SMA-TALK. Then SHARE us with your friends and family, please. Thank you.
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.

Straight, No Chaser: The Top 50 Things I've Learned in 50 Years on Earth Related to Health (Part II)

50

I could muse on my observations on human nature forever. I’ve been very fortunate to have had this front row seat to life’s quirks and nuances. You can go here for the first 25 items on my list. Thanks for being a part of this.
26. In an emergency room, the physicians spend at least as much time treating your fears as they do any medical issues that exist.
27. You can do anything you choose. Physicians aren’t the morality police, so don’t ask any doctor to justify your bad decisions. We provide information, then treat. Judging you really isn’t our thing.
28. For every person that brags about how the bullet was less an inch away from doing something really bad, I can point to a hundred people from whom the bullet was on target. Avoid a gunfight.
29. There is nowhere on your body where a burning sensation is meant to feel good. Contrary to popular belief, a “hunk of burning love” is not a good thing.
30. You have less control and margin for error than you think regarding your bad habits. Usually it’s not if something bad will happen; it’s when.
31. Proof that love is blind is offered every time you see a mother grab a newborn covered in all that childbirth.
32. Want to see your future health? Look at your immediate family. They’re the ones who will either be cooking and caring for your or stressing you out and sending you to an early grave. I bet you already know … and don’t forget to look in the mirror!
33. People overuse the ER because it’s convenient and for most people doesn’t cost anything. They’ll stop when something more convenient is made available or when the ER is made less available.
34. Not being able to breathe appears to be the most terrifying way to die. Smokers, you’ve been warned.
35. If you’re one of those still driving a car without a seat beat or a motorcycle without a helmet, you can’t be surprised when it happens.
36. Delivering a child into the world is still the most amazing thing I’ve done in an emergency room.
37. Nothing matches the look on a patient’s face when you explain that you’re going to stick a needle directly into his penis and extract blood in order to reduce his erection that won’t otherwise go down. Quick! Look in the mirror! That’s the look.
38. If you brag to me that “I haven’t seen a doctor in 40 years, and I’m just doing fine,” I fear for what is about to be discovered.
39. I’ve never had a patient who told me, “I’m going to die today” make it out of the emergency room. Don’t ever say those words to a doctor.
40. People ask me what the oddest thing I’ve ever done to a patient. Cracking their chest open to massage or manually repair a heart is pretty high on the list.
41. No one’s “happiest day of my life” was on a day when they were sick. Stay healthy, and enjoy more happy days.
42. Ladies, it’s true. Men are much less tolerant of pain than women.
43.  Nothing combines physical, mental and spiritual trauma like being sexually assaulted. No one recovers from rape. At best, they develop sufficient coping mechanisms to deal with it.
44. Proof that we’re still only animals is found in people who punch walls.
45. I suspect drug addiction wouldn’t be nearly as devastating if people didn’t allow denial to prevent them from dealing with it for so long.
46. The hardest part of my job is keeping a straight face. If you were doing this, 90% of the time you’d either be laughing, crying or screaming.
47. Your infants are a lot more resilient than you believe they are.
48. When the time comes, most people are much more ready to die than their family members are for them to die.
49. What do I know that you don’t? I’ve seen the story of how your bad habits end. More importantly, I’ve also seen how happy older, healthy people are. If you could see how consistently true that is, you’d be motivated to straighten up and fly right.
50. Medical miracles really do happen. In your time of need, don’t ever stop believing. Or praying.
Feel free to contact your SMA expert consultant with any questions you have on any 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.
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The Price of a Pill, The Price of Peace of Mind

Pharma cash

Do you know how much over-the-counter pain medicine costs as line items on your ER bill? Have you ever heard of the $12 Tylenol? Snoop around on the Internet and see how much you will save in pharmaceuticals alone by avoiding unnecessary ER visits.
Chat 24/7 with your personal healthcare consultant about your pharmaceuticals questions through your Sterling Advice Plus subscription and for advice on whether you really should have a physician examine you.
Register at SterlingMedicalAdvice.com or call 844-SMA-TALK. Then SHARE us with your friends and family, please. Thank you.
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.
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Straight, No Chaser: The Top 50 Things I've Learned in 50 Years on Earth Related to Health (Part I)

50-Golden-XSmall

Thank you for your indulgence, because today I’m going to deviate from the regular routine and share some life lessons. This took a while to figure out, but here’s a list of things about which I’m absolutely certain. Special thanks go out to the 50,000 patients I’ve cared for over the years for also being my teachers.

  1. If you’re happy in your personal life, your health improves.
  2. The biggest head scratcher of human nature? Pumping smoke and toxins into the part of your body you use to clean and nourish the rest of your body (I mean smoking) is the oddest thing I know that people willingly do to themselves …
  3. … except willingly infecting multiple partners with communicable disease. (Wear condoms!)
  4. I saw a recent episode of the TV program The Blacklist where a vigilante doled out punishment to child, elderly and spousal abusers by reproducing the same acts on the perpetrators of the crimes. Kinda makes you think… I’m not advocating violence, but abusers of all types are a special brand of inhumane.
  5. I’ll never understand why people don’t wash their hands after using the restroom. See it all the time. Folks, that’s why most of you have diarrhea.
  6. Wealthy people look like healthy people even when they’re sick … unless they’re drug addicts.
  7. Fear is why healthcare costs so much.
  8. Somehow people allow fear to prevent them from using preventative measures, but it doesn’t prevent them from engaging in risky behaviors.
  9. Most alcohol tastes so much worse than I once thought.
  10. The death of a spouse is truly the biggest risk factor for one’s death. (This is actually a true medical fact.)
  11. Water tastes so much better than I thought.
  12. 99% of the times in my life that I’ve heard the word trampoline, it has involved someone with a broken bone or other injury.
  13. Diabetics really are dealt a bad hand. I can’t imagine why anyone would eat themselves into becoming one.
  14. We are nowhere near as horrified as we should be about people who are depressed enough to take their own lives.
  15. Anything that comes out of your body that’s colored is bad (and that includes feces and urine, which are meant to be colored).
  16. A happy day is a healthy day.
  17. Estimates say that 25% of women presenting to an emergency room are victims of abuse. That estimate is probably low.
  18. I actually think I can now tell the difference in whether the food I’m eating is healthy or toxic.
  19. There’s something fundamentally wrong when someone with a concussion is allowed to continue getting hit in the head. Ever. Again.
  20. Birthing and raising a special needs child makes you appreciate the value of health.
  21. Most people prefer happiness to health.
  22. Most people seemingly would prefer to die quickly instead of suffering the medical consequences of how they’ve lived their lives.
  23. One’s health habits provide you a lot of insight into a person’s character and personality.
  24. I’m really lucky to have been a physician. It helps to be able to differentiate between the nonsense and science. I’d hate to have to depend on actors for my health information.
  25. Aging while still being healthy is delightful.

Feel free to contact your SMA expert consultant with any questions you have on any 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.
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Pain in the Tooth?

Dental advice

Did I mention that you can consult with dental experts through your Sterling Advice Plus subscription? Reach out to your expert consultants about that toothache, dental abscess, whether that tooth that fell out can be put back in, what to do about that erupting molar tooth, or whatever other issue you have. We’re standing by waiting to help.

Register at SterlingMedicalAdvice.com or call 844-SMA-TALK. Connect with your personal healthcare consultants 24/7. Then SHARE us with your friends and family, please. Thank you.
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: How's Your Dental Hygiene?

teethfalse

If you ignore your teeth, they’ll go away.

Working in an emergency department is interesting for many different reasons. One thing in particular I’ve noticed over the years is how oblivious some people are to their smiles—especially their teeth. We see it all: loose teeth, missing teeth, broken teeth, infected teeth, sensitive teeth, erupted wisdom teeth, gingivitis, bad breath, dental infections (especially abscesses), things stuck in the teeth, mouth cancer, yeast infections, rashes inside the mouth and other conditions. The mouth is the gateway to the body. Through it, you introduce many substances that can infect or otherwise damage you. Clinically, the appearance of your mouth, gums and teeth are often a direct statement about how well you care for the rest of your body.
You would think dental hygiene is an especially difficult proposition, but it’s actually quite simple. According to the American Dental Association (ADA), all you really need to commit to good dental hygiene is less than five minutes at a time, at least twice a day. Surely that’s not too much to ask of yourself for yourself, is it?
Let’s identify three sets of conditions you should be prepared to address with your activities. Each measure contains simple tips and habits you should employ to keep your smile making the right kind of introduction.
1. Prevention and self-maintenance

toothbrush

Brushing and flossing keep your gums and teeth healthy by removing plaque and food particles that can serve as a source for infection and tooth decay. Here are your essentials.

  • Brush for two minutes at a time.
  • Brush at least twice a day and preferably after each meal.
  • Flossing is important. There are particles that collect under the gums and between the teeth that your toothbrush can’t reach.

Avoid the stainers. Tobacco products (e.g., cigarettes, chewing tobacco and cigars), excessive red wine and coffee contain a high quantity of very strong chemicals that stain and damage your teeth. Cranberry and grape juices also may stain teeth if consumed in excess. Besides cosmetic considerations, the staining isn’t the problem as much as fact that the chemicals causing the staining are also damaging your teeth and gums.
2. Prevention and professional maintenance
Do you have a dentist?

  • Regular dental checkups are very important for the ongoing maintenance of your teeth and the early identification of dental problems—before excessively expensive and painful options are needed.
  • Dental exams provide an opportunity for identification of several medical conditions and diseases whose symptoms can appear in the oral cavity (mouth).

3. Recognizing possible dental emergencies

dentalers

It is simultaneously understandable and befuddling that patients go without dental care as long as they do. By the time they come to the ER, invariably, some of these symptoms have been present and were ignored. If you’re experiencing the following symptoms, you’d do well to see the dentist early, before you end up in the ER.

  • Your teeth have become sensitive to hot or cold stimuli.
  • Your gums are swollen and/or they bleed with brushing, flossing or eating.
  • You have continually bad breath or bad taste in your mouth.
  • You have difficulty chewing or swallowing.
  • You have pain or swelling in your mouth, face or neck.
  • You have spots or a sore that doesn’t look or feel right in your mouth and it isn’t going away.
  • Your jaw sometimes pops or is painful when opening and closing, chewing or when you first wake up.
  • You have an uneven bite.
  • Your mouth is becoming unexplainably drier than normal.
  • You have a medical condition such as diabetes, cardiovascular disease, eating disorder or are HIV positive with new dental problems.
  • You are undergoing medical treatment such as radiation, chemotherapy or hormone replacement therapy with new dental problems.

Upcoming Straight, No Chaser posts will evaluate individual dental emergencies.
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.
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You May Be One of the Fortunate Ones

Wait-time-clock

If you’re wondering if you’ll be the sickest patient in the ER waiting room who will go to the front of the line, register at SterlingMedicalAdvice.com or call 844-SMA-TALK to find out. Connect with your personal healthcare consultants 24/7. You may be one of the fortunate ones who can avoid the trip, the wait and the expense with some immediate advice from a medical expert.
Then SHARE us with your friends and family, please. Thank you.
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.
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Straight, No Chaser: Fat Burn vs. Cardio – How Do I Best Exercise?

fat crying

You’re working out. Congratulations! But do you know what you’re doing?

If you’ve ever been to a gym, perhaps on an elliptical, a treadmill or stationary bike, perhaps you’ve seen a table like this. (You may want to click the pictures and tables to enlarge them.)

 target-heart-zone

Your target heart rate zone points to a range of health and fitness benefits based on how much energy you exert during your workout. With that in mind, let’s discuss two of the settings you’re likely to see on your exercise equipment: fat burn and cardio.

fatburn_vs_cardio-400x300

It’s best to view your workouts as achieving incremental benefits. Any physical activity burns calories. Calories are units of energy, and you burn energy to lose weight. If you burn enough calories (relatively to how many you take in), you will lose weight. (We’ve discussed that previously here.)
Now your body has different ways of storing energy. Depending on how intensely you exercise, you will preferentially attack different energy stores. The important point is that different levels of activity and exercise progressively take you from burning calories to burning fat to improving your heart’s conditioning.

  • Fat burn: A lot of the confusion among those starting to exercise is found in the seemingly intuitive notion that people exercise because they want to “lose fat” rather than also thinking about “burning carbs” or “conditioning the heart.” In the hierarchy of expending energy, the body actually burns a higher percentage of fat relative to carbohydrates at lower levels of exertion. Lighter workouts afford the body a greater level of oxygen, which is needed to burn fat most efficiently. This level of exercise corresponds to reaching approximately 65% of your average maximum heart rate.
  • Cardio: When your exercise level reaches approximately 80-85% of your maximum heart rate, you’re in cardio mode, which means you’re working at a level sufficient to strengthen your heart and cardiovascular system. This level of exercise also best improves your blood pressure and lowers your cholesterol levels. In the grand scheme of things, cardiovascular fitness is much more important than fat burning. It’s important to note that at the higher levels of exercise, you don’t lose any of the benefits obtained at the lower levels of exercise.

heart_rate_chart

So let’s clear any confusion regarding fat burning, weight loss and exercise. When you exercise in cardio mode, you exhaust your oxygen stores to the point where you aren’t as efficient in burning fat, although you are still doing so. In cardio mode, you switch to preferentially burning carbohydrates, which doesn’t require the same oxygen levels as fat to be utilized for energy. This point is illustrated in the following table.
fatcalburn
If weight loss is your goal, you will absolutely burn more calories (and more fat) in cardio mode than fat burning mode. Fat burning mode points to the intensity level needed to start the fat burning process. For the most comprehensive workout, incrementally increase your workouts until you can perform in the cardio mode, because what you care about is the total number of calories, not the percentage of fat burned. And yes, you’ll still look better burning more calories than focuses on burning a higher percentage of fat relative to carbs.
Finally, as a measure of health, know your target resting heart rate. Where you fall in that range is a decent measure of your level of fitness.

Resting-HR-Table

Don’t forget to consult your physician before you begin an exercise routine. 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.
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How Long Are You In For?

ERwaitingroom

I know this bunch personally, and they were in their early 20s when they checked in at the ER.

At a few of the hospitals at which I’ve worked, people knew to bring both a bag lunch and snack in anticipation of the long wait. Of course, in many instances, there were then told that they were ok. Don’t you hate that? Call us next time. What do you have to lose?

Lose the wait. Register at SterlingMedicalAdvice.com or call 844-SMA-TALK. Connect with your personal healthcare consultants 24/7. Then SHARE us with your friends and family, please. Thank you.
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: Dehydration—When You're Too Dry to Cry

Dehydration

Dehydration is one of those topics that illustrates the adage “a little knowledge is a dangerous thing”— except I would adjust that to suggest a little of the wrong type of knowledge is dangerous. Hopefully in this post we’ll provide you with enough information to recognize and act on dehydration when it becomes significant or severe, because the first thing you should know is dehydration can be a life-threatening emergency. In fact dehydration due to diarrheal diseases remains the one of the topic five causes of death in the world.
Simply put, you’re dehydrated when your body is lacking in the amount of fluids it needs. This can occur from losing fluid (as occurs with excessive vomiting, diarrhea, sweating, urination or other losses), from insufficient fluid intake (as occurs with nausea, a loss of appetite, eating disorders, etc.) or from a combination of both.
Let’s approach the rest of the conversation simply by answering seven commonly asks questions.
1.  Who’s at risk/what places me at risk?
Infants, children, the elderly and the ill are at particular risk for dehydration. Children simply have lower fluid amounts and similar losses proportionately cause greater effects. All of these groups share the habit of a more rapid utilization and/or turnover of fluids, requiring higher intake.
2.  How can I prevent dehydration?
This is relatively easy. Drink plenty of fluids every day and even more when exercising or losing fluids (e.g., menstruating, sweating or hot days, exercising or suffering from vomiting or diarrhea).
3.  How can I recognize when I’m dehydrated?
You will do a good job of preventing dehydration if you learn the early signs, including those less severe items listed in the lead picture. You will do an even better job if you don’t wait until signs develop to begin rehydration. Specifically, sipping fluids is generally recommended for anyone with vomiting, diarrhea or a febrile illness.
4.  When should I treat possible dehydration?
Here are a few scenarios that should prompt treatment.

  • There is less frequent wetting of diapers in children and urination in those older.
  • There is a relative absence/reduction of saliva and/or tears.
  • In infants, the eyes or the soft spot on the top of the head (the fontanelles) may be sunken.
  • You’re having diarrhea and/or vomiting, particularly when you seemingly can’t keep any food down.

Dehybaby

5.  How can I treat my dehydration?
Here are some key points for you to understand.

  • IV fluids may be necessary for moderate to severe dehydration. However, IV fluids are not necessary to treat most cases of dehydration; in fact, IVs are rarely used to treat dehydration in the rest of the world outside of the U.S.
  • You will do much better treating dehydration if you sip instead of guzzle. If you’re vomiting and your stomach is “upset,” you likely will precipitate more vomiting if you take in large amounts of fluids at a time. Think in terms of teaspoons or syringes of fluid.
  • You may have heard that electrolyte solutions aren’t the best for rehydrating yourself. That point has value when discussing diarrhea, but all things considered, electrolyte solutions and “freezer pops” are very effective, because water replacement without electrolytes isn’t the most effective means of correcting dehydration.
  • The next time you’re at your local pharmacy, ask the pharmacist to show you some rehydration solutions. These are especially effective.

6.  When do I need to see a physician for dehydration?
You or your loved one may be in the midst of a life-threatening condition if you’re light-headed, confused, dizzy, lethargic or have blacked out. This should prompt a 911 call or an immediate visit to the emergency room.
There are multiple other symptoms that should prompt you to contact your physician. Here are some of them, in addition to those listed in the previous questions.

  • You are sick and can’t keep down fluids, even when you’re sipping.
  • Vomiting has continued for more than 24 hours in an adult or more than 12 hours in a child.
  • Diarrhea has continued for more than five days.
  • You have bloody stools or vomit.
  • You notice an abnormally fast heartbeat.
  • Your infant has dry skin that sags back into position slowly when pinched up into a fold.
  • You or your child has little or no urine output for eight hours.
  • You notice irritability or less activity in your infant or child.

7.  What’s the worst that can happen?
Dehydration can lead to death and other severe disturbances, including coma, brain damage, seizures, and shock. Just understand that if you think you could be dehydrated, you should be drinking fluids.
Remember: dehydration is something seemingly simple that can go horrible wrong if unattended. The better news is when you do enact preventive and early treatment measures, outcomes are generally very good. Feel free to refer to this information when the need arises. You can always contact your SMA expert consultant at www.sterlingmedicaladvice.com or 844-SMA-TALK for any questions you have on this or any other 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.
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Psychiatric Patients Wait

ED-Psych-Wait-Time-Graph

This graph is worth a billion words. What I’d like to point to is that care of psychiatric patients is just one of the factors that adds to U.S. emergency rooms’ reality: They’re bursting at the seams.
Why not avoid the trip to the ER if you can? Register at SterlingMedicalAdvice.com or call 844-SMA-TALK. Connect with your personal healthcare consultants 24/7. Then SHARE us with your friends and family, please. Thank you.
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

The Straight, No Chaser Guide to Completing Your New Year's Resolutions

New-Year-Resolutions

We’ve spent the last week addressing your health-related New Year’s resolutions involving healthy eating, exercise routines, smoking cessation and stress reduction. None of these endeavors is easy, and they often involve starts and stops with failure before success. It seems that the take-home messages are pretty clear.

  • People choose these endeavors because they are the basics to preventing many illnesses and diseases and to enjoying a healthy life.
  • Pursuing these efforts involves a lifestyle change. Quick fixes just won’t get it done, no matter how sexy or well-marketed the fad or gimmick is.
  • Many have succeeded in the efforts you’re pursuing. Understand that difficulty, frustration and occasional setbacks are often part of the process but don’t necessary define failure and shouldn’t cause you to give up the pursuit of better health.

If you’re serious about turning your resolutions into completed actions, consider employing some tried and true strategies.

  • Engage others such as friends and family in your quest. Let them know of your goal. Empower them to support you and hold you accountable. Encourage them to join you.
  • Plan your strategy. Write it down. Have benchmarks, check-ins and intermittent goals. These lofty goals can’t just be a passing fancy. These are difficult tasks and require a certain amount of serious planning on the front end and diligence along the way.
  • Reward yourself. This effort can’t just be a chore and something that makes you miserable. This is a big deal and should be treated as such. Plan to celebrate your success, and make it a nice enough reward that its pursuit is worth the efforts you’re going through!

Your final take-home message is one we hope you realize by now. You don’t have to pursue these efforts alone. Your physician’s team should be engaged to help you in these endeavors as needed, but if and when they aren’t, you have an additional team available to you 24/7 at www.sterlingmedicaladvice.com and 844-SMA-TALK.  We wish you the best in your pursuit of better health. Happy 2014!
From this week’s posts, here’s your guide to successfully completing your New Year’s Resolutions.
1 – Straight, No Chaser: The Benefits of Exercise and Other Physical Activity
2 – Straight, No Chaser: Here are Steps for You to Take – Get Active!
3 – Straight, No Chaser: Do You Even Know How to Eat Healthy?
4 – Straight, No Chaser: Diet and Nutrition Tips
5 – Straight, No Chaser: Smoking Cessation
6 – Straight, No Chaser: Here’s How You Stop Smoking—Quick Tips to S.T.A.R.T.
7 – Straight, No Chaser: Pass The Stress Test
8 – Straight No Chaser: Your Stress Management Plan
Feel free to ask your SMA expert consultant any questions you may 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. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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By The Way

Pay Here

By the way, how much did that unnecessary ER trip cost you? On average, that would be about 40 times more than a phone call to 844-SMA-TALK or a monthly subscription to www.sterlingmedicaladvice.com. Our mission is to give you information you need to help you avoid the time and expense of that visit when it isn’t needed.

Register at SterlingMedicalAdvice.com or call 844-SMA-TALK. Connect with your personal healthcare consultants 24/7. Then SHARE us with your friends and family, please. Thank you.

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.
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