Tag Archives: There are 72 Hours in a Day

Straight, No Chaser: Questions About Color Blindness

November 11, 2017Ophthalmology/Eyes844-SMA-TALK, Behind the Curtain, color blindness, color deficiency, Conditions and Diseases, cones, nystagmus, retina, rods, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Have you ever found yourself at school, work or elsewhere and discovered that you were wearing different colored socks or pants than you’d thought? If so, you may be experiencing color blindness.

 
A person with color deficiency may not be able to see the number 5 among the dots in this picture.
What are the main symptoms?
Classic color blindness involves difficulty in seeing colors and the brightness of colors, coupled with an inability to differentiate between shades and other variations of similar colors. Usually the perception of red and green or blue and yellow are affected. There can be a lot of variation in symptoms, ranging from mild to complete and including greater or lesser difficulty in bright or dim light.

Why does it occur?
In the back of your eyes, you have two different types of cells affecting your ability to detect light. One of these is called cone cells; these detect color. Of these, there are three types: those that detect red, green and blue. Our brain perceives color based on degrees of input from these cells. Any absence or malfunction in these cells can produce color blindness. It stands to reason (and is true) that different degrees of color blindness could result from the extent of malfunction to these cells.
Who is at risk?

Most people with color blindness are born with it.
One of 10 males has some form of color blindness.
Women seldom suffer from color blindness, but those that do are likely to pass it to their sons.
Color blindness is more common among those of Northern European heritage.
Certain drugs, most notably plaquenil (a drug used to treat rheumatoid arthritis) can cause color blindness.
Certain medical conditions, including Alzheimer’s, Parkinson’s, alcoholism, glaucoma, leukemia and sickle anemia increase the risk of acquiring color blindness.

Are there other symptoms?
Except in the most severe form, color blindness does not affect the sharpness of vision. In rare instances one may experience poor vision, light sensitivity, involuntary rapid eye movement and visualization of everything as shades of gray. These symptoms aren’t likely to occur suddenly, so you’d have ample opportunity to see an ophthalmologist (eye doctor) prior to this level of malfunction.

What can be done about it?
There is no cure for color blindness, although acquired forms are best addressed by treating the underlying source. You may be given special eyewear that improves color detection.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Questions about "Lazy Eye" (Amblyopia)

November 10, 2017Ophthalmology/Eyes844-SMA-TALK, amblyopia, Behind the Curtain, cataracts, Conditions and Diseases, hyperopia, lazy eye, myopia, ptosis, Sterling Medical Advice, SterlingMedicalAdvice.com, strabismus, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

We all get concerned when it comes to things that damage or put our vision in danger. As such, you should be aware of the most common condition causing visual problems in children. You know it as lazy eye, but the medical term is amblyopia. This occurs in approximately 2 to 3 of every 100 children. Unfortunately, the issue isn’t just its occurrence in children but its persistence into adulthood. Amblyopia is also the most common cause of visual impairment among young and middle-aged adults affecting one eye.
Here are some questions and answers of concern. These may help you understand some terms your ophthalmologist (eye doctor) or optometrist uses with you.

What exactly is lazy eye?
Amblyopia (aka lazy eye) is the condition that exists when the vision of one eye is reduced due to that eye not working appropriately with the brain. The brain adjusts by favoring the other eye.
Let’s get medical for a moment. Appropriate eye function requires accurate interaction between the eyes and the portions of the brain necessary for vision. Each eye focuses light on the retina, which is located in the back of the eye. Cells within the retina stimulate nerve signals that travel along the optic (eye) nerves to the brain, which interpret and responds to these signals.

What are some common causes of this?
As noted, the correct function and interaction between the eyes and brain are necessary. Many things can go wrong along the way, all of which serve to cause unclear focusing. Here are some examples.

Strabismus: misalignment of the eyes

Cataracts: clouding of the front part of the eye

Nearsightedness (myopia; better focus on closer objects) results from the eye being too long from front to back.

Farsightedness (hyperopia; better focus on objects at a distance) results from the eye being too short from front to back.

Astigmatism: condition associated with irregularly shaped eyes; produces difficulty focusing on both near and far objects

How is lazy eye treated?

Most of the focus on treating amblyopia involves catching it early and treating the child. It is during this time that the eye, the brain and the connections between them are developing, and the opportunity for improvement is greatest. Generally speaking, treatment involves forcing the child to use the eye with weaker vision. There are two common ways to treat lazy eye:

Patching: Placing an adhesive patch on the stronger eye for weeks to months forces the brain/eye apparatus to use the affected eye. This stimulates more complete development of the needed areas in the brain and eye.
Atropine: Using this eye medication causes blurring in the strong eye, forcing use of the affected eye. This works as well as patching.

Is this the same as eye drooping or lid lag?

No. “Lazy” eyelids (aka ptosis) are not the same as malfunctioning eyes. Lazy eye refers to the latter. That said, the two are not mutually exclusive.

Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: X-Ray Safety

November 9, 2017General Health and Wellness, Health Prevention844-SMA-TALK, anaphylaxis, Behind the Curtain, contrast media, radiation, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

After the question of “Can I get an x-ray,” the next most common question I get (which should be the first) regarding x-rays is “Do I need this x-ray?” The answer is not just based on the presence or absence of a medical indication but the medical indication relative to the risk. I’ll provide examples of that consideration shortly. The point of this Straight, No Chaser is to get you to more frequently think of the risks of irradiating your body parts. After all, inappropriate doses of radiation have a much greater chance of contributing to cancer than turning you into a superhero.
Let’s start by getting this off the table: x-rays are safe when used appropriately and with care during each case. Radiologists and x-ray technologists are trained to toe the line between inadequate production of x-rays and overexposure such that patients are placed at risk. Additionally, your physicians consider the risk-benefit ratio with each study ordered. This is why instances exist when your physician (especially emergency physicians) may advise against having x-rays done.

What exactly are the risks of x-rays and other medical imaging studies?
It’s about the risks of radiation and the potential contribution to cancer. You accept these risks everyday. Some of you tan, play golf, surf and otherwise expose yourself to the sun. It’s the cumulative exposure that poses risks, and these risks are miniscule. That said, there are circumstances in which the risks become pronounced, such as irradiation during pregnancy, in children or due to dye materials (called contrast media) such as barium or iodine used to enhance development of the film during special x-ray studies.
In some people, the injection of a contrast medium can cause the following side effects:

A feeling of warmth or flushing
A metallic taste in the mouth
Hives
Itching
light-headedness
Nausea
Severely low blood pressure and shock (anaphylaxis, due to an allergic reaction)
Cardiac arrest

How much radiation is involved in these studies?
The radiation exposure from one chest x-ray is roughly equivalent to the amount of radiation exposure you obtain from natural surroundings in 10 days.

Aren’t x-rays dangerous during pregnancy?
One of the rules of emergency medicine is we don’t focus on potential side effects when confronted with a defined life threat. The issue of the effect of x-rays on an unborn fetus is secondary to the need to treat the mother. In other words, the best way to protect the fetus is to protect the mother. Even so, the theoretical risk exists, and your physician will take steps to minimize the risk if possible. This may occur by choosing another test (such as an ultrasound) that doesn’t involve radiation. The vast majority of medical x-rays do not pose a critical risk to a developing child. In fact, x-rays of the head, arms, legs and chest do not usually expose the baby directly to radiation.
Regarding standard x-ray examinations of the abdomen, they are not likely to pose a serious risk to the child. Some abdominal and pelvic studies such as CT, nuclear medicine scans and interventional radiologic studies deliver greater amounts of radiation to a developing pregnancy.

What can I do to minimize risks?
I’ll offer two simple recommendations that will help reduce your risk. In both of these instances, alternative evaluation and treatment options might be available that can provide the desired level of care.

Work with your physician in obtaining x-rays. The instances when you receive x-rays when your physician suggests they are not necessary are not in your best interest.
Inform the radiologist that you are or might be pregnant.

Straight, No Chaser: X-Ray Basics

November 8, 2017General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

“C’mon, Doc. I just want to be sure!” If I’ve heard it once, I’ve heard it a million times. You love x-rays. They’re cool, and they sometimes tell you what’s wrong. How much do you know about them? What should you know about the different types of tests done? What about the risks? This Straight, No Chaser explores the how and why of different radiologic studies.

How do x-rays work?
X-rays are forms of radiant energy that pass through the part of the body being examined. While doing so, a special film or monitor allows a radiologist to view pictures of internal structures.

What are x-rays used for?
X-rays have other uses than determining whether you have broken bones. There are many other uses, including the following:

Chest x-rays help in evaluating punctured lungs, the presence of pneumonia or lung masses (e.g. abscesses or cancer), heart size, shape and abnormal content (e.g. calcium deposits).
Abdominal x-rays help identify punctures of various organs, the presence of blocked intestines (bowel obstructions), hernias, constipation and many other conditions.
X-rays also identify bones that have been dislocated (moved from the normal location in a joint) or suffer from arthritis or infection, and they can often detect foreign objects. X-rays can confirm the placement of tubes your physician has placed (e.g. breathing tubes, tubes through the nose or penis or special IV tubes) and facilitate certain medical procedures.

I’ve heard CT scans are just fancy x-rays. Is this true?

That’s overly simplistic but not entirely inaccurate. CT scans do involve the passage of a fan-shaped beam around the area in question, produce higher quality images than regular x-rays. This also involves more radiation.

What is fluoroscopy?
An easy way to understand radiology is to call it “screening.” In this example, the x-ray beams are being viewed in real-time via a moving picture on a TV screen. This type of study can be especially important for the identification and removal of foreign objects in the skin or for looking at the stomach and intestine.

Are ultrasounds and MRIs also x-rays?
No. Although x-rays are used as a generic term by many in the lay population, these procedures are different and would be better called radiologic or medical imaging studies. Ultrasounds and MRIs (magnetic resonance imaging) don’t use x-rays, so they are safer. Many are familiar with the use of ultrasounds in pregnancy, but they are helpful in many situations, including trauma, identification of gallstones, the presence of abscesses and many other scenarios. MRIs growing in popularity because of its superiority in identification of many conditions, particularly neurologic concerns. However, its limited availability is a problem.

What about nuclear medicine studies?
In this type of study, radioactive materials called isotopes are injected into a vein, swallowed or inhaled. These isotopes concentrate in a specific area (body organ or tissue) when the emissions (known as gamma rays) are detected by a special camera. These emissions present a picture of the affected area.

What else do I need to know? Why is my doctor always refusing to order x-rays?
In the hands of a good physician, these tests confirm diagnoses, not make them. In many instances, a good examination eliminates the need for x-rays. An example of this concept has been previously discussed in a Straight, No Chaser post on ankle x-rays. Also remember that for injuries, x-rays look at bones. Your muscle spasm, ligament and tendon injuries won’t show up on an x-ray, so it’s a waste of time and money to do the test.
The rest of the story is about safety. These x-rays, gamma rays and radioactive isotopes bring risk. Although they won’t turn you into the Incredible Hulk, your physician is considering your lifetime exposure and risk. Avoiding unnecessary x-rays is a key part of that. This risk will be discussed in greater detail in another post.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Low Blood Sugar (Hypoglycemia)

November 7, 2017Endocrine/MetabolicBehind the Curtain, Blood sugar, Conditions and Diseases, Diabetes, Diabetes mellitus, Endocrine Disorders, Glucose, health, Insulin, Pancreas, There are 72 Hours in a DayJeffrey Sterling, MD

In a previous post, I provided an overview of diabetes. Everyone knows about diabetes, and most understand how dangerous diabetes is over the long-term. However, as an emergency physician, I’m more concerned with what will kill you immediately, and on that front, low blood glucose (sugar) is usually much more concerning. I want you to know up front that a low enough blood glucose will kill you – now. As we say in the ER, a high glucose level will hurt you and may kill you, but a glucose level that goes to zero means ‘Cancel Christmas’.
Therefore I will start with a simple statement. Any diabetic (or individual known to have low glucose levels) with altered mental status needs to be given juice or if they can handle it, some soft food to chew on. If they’re in the midst of a high sugar reaction, it won’t make much of a difference, but if that glucose level was zero, you’ve just saved a life. Now let’s briefly discuss symptoms and causes.

Low glucose levels can present many different ways including dizziness, jitteriness, numbness, tingling, blackouts, seizures and other symptoms. However, it’s usually the confusion or other change in mental status that’s most predominant and concerning. Just remember, this is not something about which you should wait around to see if it gets better.
Regarding causes, unintentional overdosing of insulin or oral medication (particular the sulfonylureas class of medicines) are especially concerning and common. Sometimes a family member, particularly a child, may take such a medicine to disastrous effects. Beyond that, heavy alcohol consumption on an empty stomach is another common cause due to its effects on the liver (Alcohol locks glucose stores in the liver, preventing release to the blood; as a result you have less to use.).
Other causes are more exotic and fortunately less common; they will be evaluated upon arrival to the hospital when a rapid response isn’t seen with simple administration of glucose. Dysfunction of certain organs (the adrenal and pituitary glands, the liver due to hepatitis, or tumors of the pancreas – the organ that produces the insulin that drives glucose into your cells – can cause problems with regulating either glucose itself or insulin. These conditions can drive your blood glucose dangerously low.
So, the causes are varied, but the message is simple. Be careful with insulin administration, remember to check those blood sugar levels and act promptly in the face of mental status changes. Usually I note that time is tissue, but in this example, you’ll run out of time before your tissues are damaged.

Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Prevention and Treatment Considerations for Diabetic Eye Conditions

November 6, 2017Endocrine/Metabolic, Ophthalmology/Eyes844-SMA-TALK, Behind the Curtain, cataracts, Diabetes, Diabetic retinopathy, Glaucoma, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Several of you asked about the treatment of the eye conditions resulting from diabetes. This last Straight, No Chaser addressing Diabetes Awareness Month will focus on treatment approaches.
The first point – and one that can’t be overemphasized – is treatment is not a cure. As long as diabetes continues (and especially continues to be uncontrolled), symptoms will progress, and the diabetic-related causes of eye disorders will create ongoing difficulties, even after treatment of past problems has occurred. Thus, the first consideration is to understand steps you can take to prevent or slow the progression of the effects of diabetes on your eyes.
There actually are several preventive measures within your control. Consider implementing these.

Keep your blood glucose and blood pressure as close to normal as you can. This involves dieting, exercising and taking your medication as prescribed.
Have an eye care professional examine your eyes annually – even if your vision is normal, and especially if your vision is normal. If you have good control of your diabetes, your eyes will tell part of that story, and you need to stay ahead of evolving problems. Of course, discovering problems early and getting prompt treatment gives you the best opportunity to maintain normal vision and to prevent advancement to more serious stages. Be proactive and ask your eye care professional to check for signs of cataracts and glaucoma.
If you are diabetic and planning to get pregnant, ask your doctor if you should have an eye exam.
If you are diabetic and pregnant, see an eye care professional during your first 3 months of pregnancy.
Don’t smoke.

Recall that damaged older vessels or fragile new vessels has a propensity to bleed into the eye. This blood interferes with your ability to see normally. This severe, advanced diabetic retinopathy is treated with laser surgery, which helps to shrink the abnormal blood vessels, thus reducing bleeding into the eye. The procedure involves 1,000 to 2,000 laser burns in the area of the retina (the lining in the back of your eye that senses light), causing the abnormal blood vessels to shrink. Even as laser surgery saves much of your sight, patients often notice reduction or loss of side vision, color vision and/or night vision.
If the bleeding is especially severe, you may need a surgical procedure called a vitrectomy. This procedure removes blood from the center of your eye.

These procedures stabilize vision and in some instances may dramatically improve it. Focal laser treatment reduces the risk of vision loss by 50 percent and the risk of blindness by 90 percent. However, laser surgery most often cannot restore vision that has already been lost. That is why finding diabetic retinopathy early should be your most important strategy to prevent vision loss. There are additional medical treatment options emerging meant to replace the need for surgery. If you suffer from diabetic retinopathy, discuss these options with your eye doctor.
Please remember, that although both laser treatments and vitrectomies are very effective in reducing vision loss, they are not cures. Once you have proliferative retinopathy, you always will be at risk for new bleeding. That said, people with progressive diabetic retinopathy have less than a five percent chance of becoming blind within five years of early treatment.

Please use the preventive strategies and understand the treatment options available to you. Failure to do so could be devastating.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Diabetic Retinopathy and Other Eye Problems

November 5, 2017Endocrine/Metabolic, Ophthalmology/Eyes844-SMA-TALK, Behind the Curtain, cataracts, Diabetes, Diabetic retinopathy, Glaucoma, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

As you likely know, diabetics have a large amount of blood glucose (sugar) circulating in their blood. The high level of glucose can cause damage to many cells, including your eyes. If you’re diabetic, your challenge is to learn how to slow down the process. This Straight, No Chaser addresses relatively frequent effects of diabetes on your eyes.
How does diabetes hurt my eyes?
Diabetes has direct (through the effects of high blood glucose) and indirect (through high blood pressure) effects on four parts of your eye: the lining in the back of your eye that senses light (the retina), the jelly-like fluid that fills the back of the eye (the vitreous), the lens (serves to focus light on the retina) and the optic nerve (the main nerve from the eye to the brain).

How can diabetes hurt the retinas of my eyes?

Diabetic retinopathy is the term for the most common eye problem of diabetics. The retinas have tiny blood vessels that are easy to damage and do become damaged by high glucose levels. As retina problems get worse, new blood vessels grow. These new blood vessels are fragile and susceptible to leaking blood into the back of the eye. The leaking blood keeps light from reaching the retina. This can result in a sensation of seeing floating spots or almost total darkness.
Over time, these damaged blood vessels can form scar tissue and pull the retina away from the back of the eye, causing detachment of the retina. A detached retina can cause loss of sight or blindness if you don’t take care of it right away.

How do I know if I have retina damage from diabetes?
You may or may not have any signs of retina damage, but here are the more common signs

blurry or double vision
dark or floating spots
pain or pressure in one or both of your eyes
rings, flashing lights, or blank spots
trouble seeing things out of the corners of your eyes

What other eye problems can happen to people with diabetes?
Cataracts and glaucoma are two other eye disorders that occur at a higher frequency in diabetics.

A cataract is a cloud over the normally clear lens of your eye. Remember, the lens focuses light onto the retina, so the presence of a cataract makes everything you look at seem cloudy. You need surgery to remove the cataract, which replaces the bad lens with a permanent plastic lens.

Glaucoma is a condition resulting from pressure building up in the eye. Eventually, this will damage the optic nerve, which will progressively reduce your vision. Treating glaucoma involves eye drops to lower the pressure in your eyes or surgery for advanced cases.

Of course, you want to know what steps you can take to prevent or slow the occurrences of these eye conditions. These will be discussed in an upcoming Straight, No Chaser.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Quick Tips for the Diabetic in Your Life

November 4, 2017Endocrine/Metabolic, Health Prevention844-SMA-TALK, Behind the Curtain, Blood sugar, Diabetes mellitus, Facebook, Limited liability company, Sterling Medical Advice, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

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

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

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

Straight, No Chaser: Diabetes Basics and the Importance of Education

November 3, 2017Diet and Nutrition, Endocrine/Metabolic, Health Prevention844-SMA-TALK, Behind the Curtain, Conditions and Diseases, Diabetes, Diet, exercise, health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Diabetes is a disease in which education is vital. For a diabetic, knowing the disease well allows him or her to better prevent long-term consequences of the disease. It also allows the diabetic to make real-time adjustments when sick or otherwise in danger acutely. In Straight, No Chaser, we’ve provided a series of posts meant to empower diabetics (and you can review any or all of them via the search box on the right). Remember, it all should start with a basic understanding of the disease.
We eat, and the process of digestion is for the purpose of converting food into glucose (sugar) that’s used by our body for energy. The blood delivers the glucose to different organs of the body where the cells take it up for use. In order for that process to work, an organ that’s part of the digestive tract called the pancreas has to produce a hormone called insulin. Insulin facilitates the glucose getting from the blood to inside the cells. Diabetes is a disease where insulin isn’t being made by the pancreas or isn’t working optimally.
Now think about what happens when you’re not getting sugar into your cells. It’s as if you’re starving (because physiologically, you might as well be). You get symptoms such as weight loss, hunger, fatigue and excessive thirst. Because your cells don’t have energy, they aren’t functioning well. In fact, blood and nerve vessels lose significant function, resulting in significant vision loss and lack of sensitivity in your extremities. Anyone who’s been a diabetic for about 10 years know this because you’re wearing glasses and because you’ve lost a fair amount of sensation, especially in your feet. There are other symptoms that are variations of the same theme, including excessive urination, dry skin, increased infection rate and slower healing from those infections – all due to poor function of your blood vessels.
Sometimes diabetes is a disease that happens to you because of unlucky genetics (or simply a family history). Other times it is a disease that you find. Risk factors for developing diabetes includes obesity, older age, and physical inactivity. Gestational diabetes (i.e. that occurring during pregnancy) is an entirely different conversation.

Let’s take a moment to discuss prevention and treatment. There are different types of diabetes, but the risk of one form of diabetes in particular can be reduced by – you guessed it – diet and exercise. In fact, diet, exercise and medications are the three legs of the diabetes treatment stool regardless of type. Some patients require regular insulin injections and others require pills. Still others who are successful with diet and exercise are able to markedly reduce, and in some instances eliminate medications.
If you’re a diabetic, make an investment in your education. It could not only save your legs or eyes, but it may just save your life. I welcome your questions and comments.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Fifteen Tips to Care for Diabetic Skin, Part 2

November 2, 2017Endocrine/Metabolic, Skin/Dermatology844-SMA-TALK, Behind the Curtain, Diabetes, diabetic foot ulcers, diabetic skin care, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

In the previous Straight, No Chaser, we discussed the frailty of 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 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 you can to control your blood glucose levels. The more out of control it is, the more damage it causes.
2. You must check your feet every single day for the rest of your life. Diabetics 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 includes 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 ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: The Skin Problems of Diabetics, Part 1

November 1, 2017Diet and Nutrition, Endocrine/Metabolic, Infectious Disease, Skin/Dermatology844-SMA-TALK, Amputation, Behind the Curtain, diabetic foot ulcers, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

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.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Treating Halloween Mishaps

October 31, 2017Diet and Nutrition, Toxicology/Drugs, Health Prevention844-SMA-TALK, Behind the Curtain, choking, food poisoning, Halloween, Sprained ankle, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Syncope, There are 72 Hours in a DayJeffrey Sterling, MD

In the previous Straight, No Chaser, we offered you tips for a safe Halloween. However, safety tips are only as good as your inclination to use them. Even when an ounce of prevention is worth a pound of cure, you should still have access to that pound. In this post, we remind you of the treatment measures you may need to employ in the event something untoward happens at that Halloween party or while trick or treating.

Upset stomach? There are two pretty big reasons why this happens.

Eating all those sugary treats can cause all types of problems, including an upset stomach. Ration out the treats, especially the first night. You’d do well to make sure the trick-or-treaters have a generous dinner in advance of the activities.
Have you ever thought of all the different hands that touch the contents of those bags? You’d better be sure to wash hands and any foods prior to ingestion, whether wrapped or unwrapped.
If vomiting and diarrhea ensue from any food poisoning, review the linked Straight, No Chaser for treatment considerations.

Sprained ankle?

It can get pretty exciting out there, and kids can easily get distracted. Falls and ankle sprains can be expected on those sugar-induced sprints to the next house.
Review the linked Straight, No Chaser for treatment considerations.

Faints?

Are those tricks too scary? Did the excitement prove too much to handle?
Review the linked Straight, No Chaser for treatment considerations.

Choking?

You must be mindful that all candies are not appropriate for children. Peanuts and candy corn have a nasty habit of getting lodged in the throats of very young children.
Learn what steps to take in the event this happens. Review the linked Straight, No Chaser for treatment considerations.

Keep in mind that common things happen commonly. The horror tales of legend aren’t likely to be a part of your Halloween, nor are you likely to come across any ghouls, goblins, vampires or zombies unless you come across a Thriller reenactment.
Be safe and have a Happy Halloween!

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Halloween Health Tips

October 30, 2017Diet and Nutrition, Toxicology/Drugs, Health Prevention844-SMA-TALK, Behind the Curtain, Halloween, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Are you taking the young ones trick-or-treating this year? Straight, No Chaserand the Centers for Disease Control and Prevention (CDC) want you to have a safe halloween. Today and tomorrow’s posts will offer safety tips and treatment considerations in the event something goes wrong.

Remember: have a SAFE HALLOWEEN!
Swords, knives, and other costume accessories should be short, soft, and flexible. Objects don’t have to have the consistency of a knife to stab or otherwise impale.
Avoid trick-or-treating alone. Walk in groups or with a trusted adult.
Fasten reflective tape to costumes and bags to help drivers see you.
Examine all treats for choking hazards and tampering before eating them – slow down! Limit the amount of treats you eat.

Hold a flashlight while trick-or-treating to help you see and others see you. Always walk; don’t run from house to house.
Always test make-up in a small area first in case an allergy may be present. Remove it before bedtime to prevent possible skin and eye irritation.
Look both ways before crossing the street, and use crosswalks wherever possible.
Lower your risk for serious eye injury by not wearing decorative contact lenses.
Only walk on sidewalks whenever possible, or on the far edge of the road facing traffic to stay safe.
Wear well-fitting masks, costumes, and shoes. The idea is to avoid blocked vision, trips, and falls.
Eat only factory-wrapped treats, and throw away homemade treats made by strangers.
Enter homes only if you’re with a trusted adult. Only visit well-lit houses. Never accept rides from strangers.
Never walk near lit candles or luminaries. Be sure to wear flame-resistant costumes.

Expecting trick-or-treaters or party guests? Follow these tips to help make the festivities fun and safe for everyone:

Provide healthier treats such as low-calorie treats and drinks. For party guests, offer a variety of fruits, vegetables, and cheeses. Get creative as to keep things festive.
Use party games and trick-or-treat time as an opportunity for participants to get their daily dose of 60 minutes of physical activity.
Be sure walking areas and stairs are well-lit and free of obstacles that could result in falls.
Keep candle-lit jack o’lanterns and luminaries away from doorsteps, walkways, landings, and curtains. Place them on sturdy tables, keep them out of the reach of pets and small children, and never leave them unattended.
Remind drivers to watch out for trick-or-treaters and to drive safely.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Medical Myths, Health Fraud Scams and Your Boogie Men

October 29, 2017General Health and Wellness844-SMA-TALK, Behind the Curtain, health fraud, medical myths, Medical scams, SterlingMedicalAdvice.com, There are 72 Hours in a DayJeffrey Sterling, MD

I feel your frustration everyday. You call me, and you text me. You send me articles and ask my opinion on the newest health claim on the Internet. That’s right, I’m your information and advice guy. Thus, please allow me to offer you some basic principles to help you in your analysis of what you’re reading.
First and foremost, please be careful to appreciate that everything you read (especially on the Internet) isn’t factual. There’s a tremendous amount of misinformation. What’s worse, it’s everywhere. The Internet often provides you just enough information to confuse you, misdirect you, steer you toward someone’s agenda or paralyze you into inactivity.
I see at least 20 posts everyday on the Internet that, because they’re spoken with confidence or certainty, you take them as truth. Without regard to the source, you’re willing to try or do things that if you actually understood some basic anatomy, physiology or chemistry, you’d ignore – especially when tried and true methods (that you aren’t utilizing) are available to you.
This propensity to present opinions and misinformation as facts is part of what’s changed in society. For as scary and odd as it seems while you’re watching, pharmaceutical companies’ commercials are ethical enough to tell you risk factors, side effects and then advise you to discuss the products with your physicians. These Internet articles and sales pitches assert that they, the authors (or salesmen), alone know the truth, and that everyone else, including your government and your physicians are part of some global conspiracy.
Here’s the deal.
Medicine – or at least the way in which physicians treat patients – is largely based on science. The standard of evidenced-based medicine depends on a preponderance of evidence accumulated over multiple studies of a certain caliber (randomized, double-blinded, peer reviewed). New evidence accumulated over multiple studies can cause incremental changes in thinking and treatment strategies. Therefore, your physicians aren’t going off the grid to make recommendations or provide treatment. Safety considerations necessitate proof that the medicines you’re taking or the procedures being done to you aren’t unnecessarily placing you in danger.
You may note that this leaves some room for new discovery, because the last paragraph is not the same as saying that if it hasn’t been researched, it’s not safe. What can be said is the safety and efficacy of certain medicines and procedures can’t be verified, because they haven’t been adequately researched (i.e., the scientific method). This is something often noted about many herbal medications. That’s right: the absence of evidence isn’t always evidence of absence.

Different still is how certain other claims are made. Medical scams and frauds are often perpetrated on the public, and agenda-based fears are presented as if opinions are facts, even in the face of volumes of evidence to the contrary. Claims arguing that immunization will cause the disease from which you’re being protect or that vaccines will cause other conditions such as autism are examples of this.
So, the next time you come across a sensational article that refutes everything that you had previously known or some medical cure than your physician hasn’t shared with you, take a deep breath and ask yourself if it’s possible that you’re being asked to respond to your fears instead of actual medical science.

Now let’s empower you. Here are some tips to help you the next time you’re presented with something alleging to be a miracle cure. Keep in mind that those aiming to perpetrate a scam are attempting to play upon your insecurities. Thus, scams tend to focus on conditions about which you hold fear, including the following:

Obesity, with promises of rapid and sustainable weight loss
Impotence, with the promise of a return to peak sexual performance
Memory loss
Miracle cures for serious diseases such as Alzheimer’s, cancer, diabetes, heart disease and arthritis

Similarly, any product promising the following types of results warrant a conversation with your physician before investing your hard-earned money:

It includes claims that “One product does it all,” alleging to treat multiple diseases.
It involves personal testimonials instead of scientific evidence.
It claims quick fixes for chronic diseases (such as cancer or obesity).
The product is “all natural.” Remember these types of products haven’t been subject to the rigors of medical testing by the FDA and could actually contain dangerous levels of the same active ingredients as in prescription medicines.
It’s a “Miracle cure, Scientific breakthrough, Secret ingredient, New Discovery.” Please pay attention. If a truly innovative cure for a serious disease were discovered, it would be on the front page of the papers and would be the lead story on the news, not the topic of an infomercial or an Internet promotion.
It’s the answer to a conspiracy theory. Claims like “The pharmaceutical industry and the government are working together to hide information about a miracle cure” are always untrue and unfounded. These statements are used to distract consumers from the obvious, common sense questions about the so-called miracle cure.

So lower your stress levels and let the boogiemen go. You’re not going to find a miracle cure in a bottle. Even more importantly, don’t forget that you’re not alone in pursuit of protecting your health. Your healthcare team already knows the variety of medical options available and chooses the best one for you from those choices. You also have access to healthcare information and advice from www.sterlingmedicaladvice.com and 844-SMA-TALK (844-762-8255). You’re not alone in your effort to live a better, healthier life. Keep in mind the years of education your physicians obtained to practice medicine. Let that provide you with confidence and guide you when deciding where to get honest and accurate answers.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Patient Psychology, Expectations and Communication

October 28, 2017General Health and Wellness, Public Health72 Hours Life, 844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

I’ve always found the psychology of patients to be fascinating. Patients who present to emergency rooms most often are consumed with the fear of the unknown and are ultimately focused on the question of “What’s wrong with me, doc?” Of course in the emergency room (ER), we are less focused on what you have and more focused on the life-threatening conditions that you could have. It always seems to be very unsatisfying for patients when a firm diagnosis isn’t made in the ER, which is very ironic because in many cases, you really don’t want to have what we’re looking to find. The next time your ER physician tells you the tests were normal, and you’ll require more testing by your family physician, take that information and run with it. It usually means that you’ve escaped the clutches of the most immediately life-threatening considerations. Remember, we don’t always give good news.
Still, patients fear the unknown. After all, physicians are sometimes wrong. In other instances, your visit to the ER is just a “snapshot” of your condition. In two days you could look completely different. That nonspecific-appearing rash could bloom into full form. That persistent cold or other viral illness could have sufficiently lowered your immunity such that a bacterial infection could have simultaneously developed. It is very unsatisfying when your physician suggests that you’re ok, when you “know” you’re not. After all, that’s why you came to the ER! Don’t just stand there, doc: Do Something!
Of course, the fear hits the highest levels when it involves children. A parent’s intuition about these things is not to be disregarded. For some, “normal” is usually not good enough (meaning it’s not an acceptable answer).

So my question to you is “What are your expectations?” You would do well to take a deep breath, and think about that before you come in to be seen. In my experience, your concerns usually are among the following types.

Is there a clear but unknown illness or injury, and your concern is making sure the doctor gets the treatment right?
Do you “already know what’s going on,” and just want the doctor to do what will make you feel better?
Are you coming in “just to be sure?”
Do you not have a clue what’s going on but just know “something is wrong?”

Each of the above considerations represent an attitude you’re bringing to the table. If you take the time to identify your expectations, you’ll do a better job in convincing your physician that your desired outcome represents the best course of action. Much has been made of physicians who don’t listen. Resolve to do a better job of making your physician hear you. Also do a better job of asking questions, and take the time to hear what is being said back to you.

The discharge interaction is incredibly important. If you’re not listening or understanding your instructions, you’re not only going to be lost and frustrated, but you’re going to be at risk for worsening of your condition. In many instances, even if nothing was discovered, something could be wrong. In other instances your instructions have to do with handling your surrounding environment. If you’re tuned out because you didn’t get your preferred course of treatment, you will less well equipped to handle the conditions that could produce further injury or illness.
Understanding your own psychology going into a physician interaction is a big part of your health. Try it, communicate it and get better soon. This consideration is actually a big part of personal healthcare consulting. Your Sterling Medical Advice expert consultants work to help you flush out expectations and outcomes. Whether or not you do it with us, learn to make this a part of your self-assessment.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: The Day You Get Diagnosed With HIV

October 26, 2017Infectious Disease, Health Prevention844-SMA-TALK, AIDS, Behind the Curtain, HIV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

I’ve had many occasions to tell a patient they were HIV(+). Over the last 20 years of my doing so, that message has changed from a death sentence to the acknowledgement of a chronic disease that will need to be battled for a lifetime. That said, the responses still haven’t changed much. There are differences in those for whom the diagnosis is a complete surprise (such as those who would have received it from a blood transfusion) versus those who suspect they’ve been infected (e.g. through IV drug use or risky sexual practices).
I’d imagine that the response is much like it was for an earlier generation when news was received that they’d contracted “The Big C (Cancer).”

As I walk into the room, the patient is already in complete shock. It’s as if they’re thinking about the error of their ways and simultaneously not thinking at all.
The moment requires finesse. It’s easy to blow in and out of a room and drop this bomb of news; after all, it’s a busy emergency room. However, this is important. This is a moment when someone’s life will irreparably change. It will either be the first day of the rest of their life or the beginning of the end of their life.
Patients tend to want this information in private, although to a physician, this is a big red flag. This isn’t private information. Everyone in his/her life will be affected, and furthermore it’s important to start lining up one’s support from the very beginning. I want the patient to have loved ones around to hear this information if they will consent.
“I need you to pay attention, and stay with me.” I’ll tell them this regardless of the outcome, because the fact that this information is being provided in an ER instead of a primary care physician’s office usually means there is some behavior modification that’s going to be needed regardless of the verdict.
Let’s get this out-of-the-way, because that’s what he or she wants to know. “You’re HIV(+).” Again: “I need you to pay attention, and stay with me.”

There are different topics that need to be discussed.

What it means to be HIV(+).
What it means to have AIDS.
How the rest of one’s life is going to look with and without treatment.
What this will mean to one’s family, friends and other loved ones.
How to give the patient the best opportunity for success.

The conversation can be devastating or empowering. You may find this surprising, but a significant number of patients take this news as a rallying cry. In the same way a smoker is suddenly able to stop smoking cold turkey on the day of a heart attack, newly HIV(+) patients find the strength to stop IV drug abuse and alter other high risk activities.

Here’s a bit of a disclaimer. It’s really not all about friends/family support. Friends and family need to be protected. These are the very people who immediately become at risk once a significant other becomes HIV(+), and they deserve to know they are at risk. In many ways it’s easiest to inform them from the very beginning, and it’s certainly in their best interest to know as soon as possible.

Back to you and your diagnosis: you may have noticed I haven’t given you much time to breathe or grieve. There will be plenty of time for you to experience denial, anger, bargaining, depression and acceptance after you leave the emergency room. In real-time, the virus is here, and the risk for risk management begins immediately, especially given it likely wasn’t being handled previously. The most important purpose of your visit wasn’t the launching of your grieving process but the mobilization of resources to treat you and protect others.
A final point: you really don’t want to go through this. Seeing the utter despair, fear and depression indicates that life at best will be very challenging to live. The steps to minimize your risks are so straightforward. It’s agonizing to see those newly diagnosed mentally retracing their steps, knowing that wearing condoms or not being promiscuous or not engaging in needle use was within their control. Make better choices on the front end. After all, you probably wouldn’t knowingly step in front of a moving truck.

Please get tested.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Your HIV and STD Risks From Sexual Activities Other Than Intercourse

October 25, 2017Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Behind the Curtain, Female condom, HIV, Hiv And Aids, HIV/AIDS, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Today, your sexual IQ goes up, and hopefully your risk for sexually transmitted infections (STIs), including HIV, goes down.
This is the fifth 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.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your HIV and STD Risks From Specific Acts of Sexual Intercourse

October 24, 2017Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Behind the Curtain, Female condom, HIV, Hiv And Aids, HIV/AIDS, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

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.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: What Are The Symptoms of HIV and AIDS?

October 23, 2017Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease844-SMA-TALK, Acquired Immunodeficiency Syndrome, AIDS, HIV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

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 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.

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.

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.

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.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

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

October 22, 2017Genital/Urinary, Infectious DiseaseAIDS, Blood, Blood transfusion, Body fluid, HIV, HIV-AIDS, HIV/AIDS, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

This isn’t 1983. The mystery of how HIV infection is contracted has come and gone. Yet HIV and AIDS awareness are still critical. You need to be knowledgeable to be empowered.

This is the second 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.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

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