Tag Archives: There are 72 Hours in a Day

Straight, No Chaser: Amnesia and Severe Memory Loss

July 15, 2017General Health and Wellness, Geriatrics/Elderly Care, Mental Health, Neurology844-SMA-TALK, amnesia, Conditions and Diseases, memory loss, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

In a previous post, we discussed forgetfulness and mild memory loss. We’ve also discussed Alzheimer’s disease and dementia. If you noticed and remember (no pun intended), we didn’t discuss amnesia. Amnesia is unusual memory loss. Normal aging does not lead to dramatic memory loss. This is qualitatively different.
It is normal to have forgetfulness associated with the aging process. Many of us will notice learning new information requires more time and seems more difficult.

This is not the memory loss of amnesia. In amnesia, you’ll likely not remember new occurrences and/or some past memories. You may forget recent or new events (or periods of time). You may forget memories within an event and compensate by creating “new memories” (this is called confabulation). You may have difficulty forming new memories or learning new information. Interestingly, amnesia may be transient, otherwise temporary or permanent.
Allow me to reiterate. Amnesia is not part of a normal aging process but is part of a disease in one or severe areas of the brain responsible for creating, storing and retrieving memories. If you see or think you are experiencing this level of symptoms, you need to get medically evaluated.

Courtesy of the National Institutes of Health, here is a partial list of causes of memory loss. Many of these causes have Straight, No Chaser posts related to them. If you have questions, type the topic into the search box for more information or feel free to ask your www.sterlingmedicaladvice.com or 844-SMA-TALK expert consultant any questions you may have.

Alcohol or use of illicit drugs
Not enough oxygen to the brain (heart stopped, stopped breathing, complications from anesthesia)
Brain growths (caused by tumors or infection)
Brain infections such as Lyme disease, syphilis, or HIV/AIDS
Brain surgery, such as surgery to treat seizure disorders
Cancer treatments, such as brain radiation, bone marrow transplant, or after chemotherapy
Certain medications
Certain types of seizures
Dementia
Depression, bipolar disorder, or schizophrenia when symptoms have not been well controlled
Dissociative disorder (not being able to remember a major, traumatic event; the memory loss may be short-term or long-term)
Drugs such as barbiturates or benzodiazepines
Electroconvulsive therapy (especially if it is long-term)
Encephalitis of any type (infection, autoimmune disease, chemical/drug induced; this is inflammation of a certain part of the brain)
Epilepsy that is not well controlled with medications
Head trauma or injury
Heart bypass surgery
Illness that results in the loss of, or damage to, nerve cells (this is called neurodegenerative illness), such as Parkinson’s disease, Huntington’s disease, or multiple sclerosis
Long-term alcohol abuse
Migraine headache
Mild head injury or concussion
Nutritional problems (vitamin deficiencies such as low vitamin B12)
Permanent damage or injuries to the brain
Transient global amnesia
Transient ischemic attack (TIA)

Finally, if you are supporting an individual with such challenges at home, you already know they need a lot of attention and support. Here are a few tips to assist.

Show familiar objects, music, or photos.
Get in the habit of writing things down. Write down when the person should take any medication. Write down any important tasks needing to be completed.
Show patience with the situation and avoid the tendency toward anger and frustration.
When it gets to the point to when help is needed completing the activities of daily living, or safety or nutrition is a concern, you may want to incrementally consider home health care, then extended care facilities, such as an assisted living facility or a nursing home.

Your job is to remember to be attentive to changes in your or your loved ones’ behavior. The earlier you get assistance, the better one’s quality of life will remain.
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: Brain Health – Mental Gymnastics to Keep You Vibrant

July 14, 2017General Health and Wellness, Mental Health, Neurology, Health Prevention844-SMA-TALK, Behind the Curtain, brain health, Sleep, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, Traumatic brain injuryJeffrey Sterling, MD

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
http://www.aarp.org/health/brain-health/
www.luminosity.com
Whatever you choose to do, do something!
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: Brain Health – Foods and Brain Healthy Habits

July 13, 2017General Health and Wellness, Mental Health, Neurology844-SMA-TALK, Alzheimer's disease, Behind the Curtain, brain health, dementia, Diabetes, Hypertension, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

I only get asked about this everyday, so let’s review keeping your brain healthy. Unfortunately too often some of you only ask at the point when early dementia or Alzheimer’s disease has begun to develop, but this is another example of an ounce of prevention being worth a pound of cure. Also, these requests often seem to be related to some internet promise of health based on some fad or miracle cure. Remember the Straight, No Chaser dictum: your health won’t be found in a bottle.
In a previous post about how your brain works, we pointed out that your brain consumes a tremendous proportion of the body’s oxygen supply. So to begin the conversation, just remember that a diet promoting good blood flow throughout the body promotes good blood flow to the brain. I wish I could convince you that a baseline level of brain health is just this simple: consume a diet low in fat and cholesterol. If you’re not clogging the arteries in the rest of your body, you won’t be clogging arteries in your brain. The same things you’re doing to avoid diabetes and hypertension will help you here.
As such let’s provide an overview to five basic principles to keep your brain healthy. If you adhere to these, you can save the money you’re spending on ginkgo biloba.

Reduce your fat and cholesterol intake
It’s as simple as already discussed. High intake of these foods promotes a higher risk of Alzheimer’s disease later in life. Try these specific tips.

Use olive oil instead of other saturated fats.
Bake or grill your food instead of frying it.

Eat foods shown to protect and promote brain health
I want to make this simple. If you’re eating dark-skinned fruits and/or vegetables, you’re being good to your brain. These foods tend to have the highest levels of antioxidants fighting off damage to your brain cells. Here are some specific examples of brain healthy foods. Try working them into your diet.

Fruits – blackberries, blueberries, cherries, oranges, plums, prunes, raisins, raspberries, red grapes and strawberries
Vegetables – alfalfa and Brussels sprouts, beets, broccoli, corn, eggplant, kale, onion, red bell pepper and spinach
Nuts – almonds, pecans and walnuts are a good source of vitamin E, another powerful antioxidant
Fish – halibut, mackerel, salmon, trout and tuna (all contain omega-3 fatty acids, which are brain healthy)

Vitamins
The best way to obtain brain-healthy vitamins is through a brain-healthy diet. Foods strong in vitamins E, C, B12 and folate appear to be important in lowering your risk of developing Alzheimer’s. It should come as no surprise that the foods listed above meet that criteria. You may not know that obtaining vitamins through your food appears to deliver what you need better than taking pills.

Exercise
If you’re keeping your heart strong and pumping blood efficiently throughout your body, your brain is getting its needed supply of oxygen and nutrients. Check this Straight, No Chaser on basic exercise tips.
Be social, Be a lifelong learner
Exercise your brain through social interactions with others, especially those that “stimulate your brain.” The diversity of experience keeps different parts of your brain active, alert, functioning and healthy. Learn a new skill or language. It’s almost as good as starting over!
Another Straight, No Chaser will focus on additional ways for you to engage your brain to keep it working and working well.
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: Brain Health – How Your Brain Works

July 12, 2017General Health and Wellness, Mental Health, Neurology844-SMA-TALK, Alzheimers, Behind the Curtain, brain health, brain stem, cerebellum, cerebral cortex, cerebrum, neurons, Spinal cord, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Everyone at Straight, No Chaser and www.sterlingmedicaladvice.com is into brainpower. This is the first of a series of posts on brain health and brainpower. The purpose of these posts is to give you enough information to optimize, maximize and extend your brain health. Hopefully you’ve learned all this before (no pun intended), and we’re just reorganizing it for you.
The brain really is a fascinating organ; indeed it’s the body’s most powerful (with apologies to the heart; don’t be broken by the news). Despite jokes to the contrary, it only weighs about three pounds in the average person (I’d imagine many of you are inserting your own jokes about your favorite friends here…).

The brain has three major components:

The cerebrum is the area taking up most of the area in your skull. It controls thinking, problem solving, remembering, feeling and movement.
The cerebellum controls coordination and balance from its position in the back of the head, below the cerebrum.
The brain stem is also beneath the cerebrum but is in front of the cerebellum. The brain stem connects the brain to the spinal cord. It controls breathing, blood pressure, digestion and heart – functions you normally don’t have to “think” about (automatic functions).

You may be surprised to know about a quarter of your total blood supply nourishes your brain with each heartbeat. Your network of brain cells consists of billions of cells, and they extract approximately 20% of the oxygen and nutrients being carried by the blood. This amount can increase up to 50% depending on the brain’s level of activity. This is an immediate illustration of why brain health is so vital.

Have you ever wondered why the brain has that wrinkled outer appearance? That area is called the cortex. The cortex roughly resembles a map corresponding to various functions. This area interprets sensations from within your body, and sights, sounds and smells from the outside world. It also helps you form and store memories, generate thoughts, make plans and solve problems. The cortex also controls voluntary movements.

Another common question about the brain relates to the differences between the left and right sides and what that has to do with people who are left-handed or right-handed. Here’s what is clear about the different halves of the brain.

The left half controls movement of the right side of the body, and the right half controls the left side of the body. Thus if you’re right-handed, you’re likely left-brain dominant.

In most people, the language area is mainly on the left.

All things considered, the adult brain has approximately 100 billion nerve cells, called neurons. Neurons are where the real work of your brain occurs. Via various branches, there are more than 100 trillion connections. This amazing and powerful network is called the neuron forest. This network of neurons is how we know to generate thoughts, feelings and memories. The individual “way stations” where chemicals (neurotransmitters) sent by neurons via electrical charges connect are called synapses. There are dozens of different types of neurotransmitters facilitating different levels of communication within the brain.

Functionally, this level of specificity is important to know at a general level because it sets the table for these additional considerations to be discussed in additional posts:

Good brain health keeps your brain working optimally.
Certain diseases (e.g. Alzheimer’s) destroy neurons and otherwise disrupt both the way electrical charges travel within cells and the activity of neurotransmitters.

This is a simplistic representation of how your brain organizes all the thoughts, activities, memories, skills and knowledge of self we have. Make the commitment to protect your brain. After all, it’s who you are.
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: Questions You Should Ask When You Have a Laceration

July 11, 2017Skin/Dermatology, Trauma844-SMA-TALK, Behind the Curtain, dermabond, lacerations, skin staples, Sterling Medical Advice, SterlingMedicalAdvice.com, stitches, Straight No Chaser, There are 72 Hours in a Day, wound dehissence, wound infectionJeffrey Sterling, MD

I wonder if any of us avoid lacerations over the course of our lives. It seems that everyone I know or every patient I have cared for has a scar and a story to accompany it. Fortunately, it’s not as simple (or complicated) as going to the emergency room and getting stitches when a cut (laceration) occurs. Today’s Straight, No Chaser offers you simple facts and questions to ask your physician when you find yourself or someone else you’re caring for needing care for a laceration. Believe me, you want to know the correct questions to ask, and you want to have an understanding of expected outcomes.
When should I deal with these cuts at home?
Remember that a laceration is a manual breakdown of the body’s most basic defense against toxins and other agents entering your body. This creates a significant risk for subsequent infection. In most cases it is advisable to get a laceration at least evaluated, which doesn’t mean you’ll necessarily need stitches.
Are there things I can do at home to help?
We now know that tap water is as effective as the saline used in hospital or clinic settings to clean wounds. If you’re at home, copious rinsing of the wounds with warm water followed by applying clean wrappings is a good idea.
Are there things I shouldn’t do at home in an attempt to help?
Detergents, hydrogen peroxide and povidone-iodine solutions should be avoided, as they can damage the integrity of the skin.
How long after a cut can I get stitches?
This depend on the location of the wound, your health and factors such as mechanism, contamination and risk for subsequent infection. As a rule, you should get lacerations evaluated within 12 hours after the injury. Under all circumstances you should be seen within 24 hours after an injury.
What happens if I come in too late to get stitches?
Depending on circumstances, your physician has additional options that can reduce the infection risk and optimize the cosmetic outcome. Some older wounds may be loosely closed, followed by a definitive repair in a few days if all goes well (i.e. no signs of infection in the interim). Other wounds may be packed with protective gauze as an alternative. Still others will simply need to heal on its own. Your physician can discuss when and why each option is preferable.

Will I always need stitches?
No. Sometimes what appears to be a cut is actually a scratch. Other times, lacerations can or need to be repaired with other options, such as steri-strips (a version of medical taping), tissue adhesive (you call it medical glue) or staples.

What’s the glue that’s being used?
In many circumstances, tissue adhesives not only can be used but should be used. Tissue adhesives have similar results as sutures in cosmetic results (i.e. appearance), breakdown rates, and infection risk. That said, some types of wounds, some situations and some locations prevent the use of tissue adhesives. Ask your physician if a tissue adhesive is a reasonable option.
Can I just use some form of glue at home?
No. It’s not the same, and if you try using some commercial glue, paste or needle and thread on your cuts at home, you’re asking for a ferocious infection in a few days.
Will I always need a shot for my numbing medicine?
No. Ask your physician if a topical medicine option is appropriate, especially in children or those otherwise wanting to avoid needles.

How long do stitches stay in?
Here are some guidelines based on the location of the laceration.

Face	Three to five days
Scalp	Seven to 10 days
Arms	Seven to 10 days
Trunk	10 to 14 days
Legs	10 to 14 days
Hands or feet	10 to 14 days
Palms or soles	14 to 21 days

How do I care for myself after the cut has been fixed?
Follow-up for repaired lacerations is pretty similar regardless of the method used to repair. Consider the following.

Keep the wound clean and dry using a protective dressing for at least 24 hours after the repair, unless tissue adhesive was used, in which case no dressing should be applied.
An antibiotic or white petrolatum ointment can be applied daily to wounds not repaired with tissue adhesives. That’s right, white petroleum ointments are just as effective as antibiotic preparations.
If you’re received a tissue adhesive, you must avoid white petroleum or antibiotic ointments over the wound site, as these can dissolve the tissue adhesive, causing the wound to break open.

Anything else?
Even if you’re not asked, you should always ask if you need a tetanus vaccine after a laceration. The answer will always be yes if it’s been more than 10 years since your last immunization, and in selected cases it will be indicated if it’s been more than 5 years.
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 to Survive a Motor Vehicle Collision

July 10, 2017Trauma844-SMA-TALK, Head-on collision, Seat belt, Sterling, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, Traffic collisionJeffrey Sterling, MD

As you drive the expressways of some cities, you can now see signs displaying how many traffic deaths have occurred during the year. I’m sure the purpose of these announcements is to keep drivers alert to the real dangers of driving and to remind us to drive safely. We discussed the magnitude of motor vehicles crashes (they’re not accidents) in the last Straight, No Chaser. However, when prevention hasn’t kept you out of harm’s way, what you do next can make a world of difference. Here are 10 quick tips to keep you upright.
If you see an accident happening in front of you …

1) Move away from the steering wheel/dashboard. That airbag will be coming at you at approximately 200 MPH. It can cause burns and other injuries on its own. You want both hands on the wheel as loose as possible during impact.
2) If possible, angle the car for a glancing blow. Try to avoid the head-on collision, especially with the bigger object. Similarly, the ‘T-bone’ side impact collision is especially dangerous, as the car is structurally weaker on the side, and the side is closer to passengers.
3) Slow down as best you can, but also try to control your deceleration. The faster the impact, the worse the damage will be.
4) If there’s time and you haven’t already, get that seat belt on.
5) If there’s time, get any potential projectile from where it may strike you. That’s off the seat, dashboard and cup holders. Hot coffee in your face or being slashed by your phone won’t feel good.
After the crash …

6) Call emergency medical services as your first move after a crash.
7) If you have any neck pain, as best you can, do not move. Period.
8) If you are pregnant, get onto your left side while you wait.
9) After a crash, switch off your engine, do not smoke, and stop anyone else from smoking. You will not be in a position to put out any fire you start and if flammables are in either car, you could be setting up an explosion.
10) Do not attempt to remove injured people from a vehicle yourself; leave that to the paramedics. You could be aggravating a neck (spinal) injury that is not obvious at that point.
It bears repeating: the best way to survive car crashes is not to be involved in one.
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: Motor Vehicle Crashes – Risky Behaviors, Injuries and Prevention

July 9, 2017Trauma844-SMA-TALK, motor vehicle collision, motor vehicle crashes, MVA, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, TraumaJeffrey Sterling, MD

‘Tis not our task to preach but to inform. Maybe you think you’ve heard it all before, but let me lay it all out for you so you can truly be an informed consumer. Forewarned is forearmed. There’s a reason you hear so much about drinking or texting and driving, wearing seat belts/helmets and speeding. If there was such a thing as Human Shark Week, the biggest and baddest predator in the trauma world would be motor vehicle crashes.
Motor vehicle collisions are the single leading cause of death among those between ages 5-34 in the US. More than 2.4 million adult drivers and passengers were treated in ERs as the result of being injured in motor vehicle crashes in 2015 (an average of 6,693 persons included per day). Traffic fatalities increased by 7 percent from 2014 to 2015 (up to 35,092) in the United States; that’s 96 deaths per day. Let’s lay this out simply and review the risks, the consequences and preventative efforts you should be taking.
Risky Behavior:

Danger is enhanced by various distractions and inadequate protection. The mistake people make is not understanding that much of the danger is outside of your control – other drivers. If you’re impaired or distracted, you can’t respond effectively. I’ve seen it all.

Drinking while driving – Stop it with the “I can handle my liquor” nonsense. Someone dies every hour from drinking while driving. It’s not just drunk driving, it’s impaired driving. Your senses are altered and ability to respond diminished at any level of alcohol consumption and is incrementally more so with more consumption.
Texting while driving
Eating while driving
Reading while driving
Doing your hair/shaving/makeup while driving
Kissing and other sexual activities while driving
Motorcycle driving/riding without a helmet
Letting your children drive without a license and/or formal training: it’s all too true. Teens are most at risk for accidents and being impaired/distracted/drunk while driving.
Letting your children ride in the front of the car
Not wearing seat belts (the biggest mistake of them all)

Injuries:

I’ve seen nearly every conceivable injury from motor vehicle collisions. It doesn’t take as much effort as you’d think to have a very bad life after a crash. Consider the following possible going head to toe (and yes, the list is abbreviated)…

Traumatic Brain Injury, including intracranial bleeds, strokes, seizures, concussions, herniation and death…
Neck Injury, including fractures, strains, pinched nerves, temporary and permanent loss of motion/sensation in your extremities…
Chest wall bruising, heart and lung bruising, collapsed lungs, stab wounds to the heart and lungs, ruptured heart vessels…
Abdominal injuries, including contusions to and rupture of the liver, spleen, pancreas, diaphragm and intestines…
Genital, urinary and pelvic injuries, including the kidneys and multiple fractures…
Nervous, psychologic and musculoskeletal system injuries, including contusions, life-threatening fractures and dislocations, paralysis, facial disfigurement and other scarring, post-traumatic stress syndrome and long term pain syndromes.

Prevention:

Seat belt use reduces serious injuries and deaths in crashes by 50%. Air bags provide added protection but are not a substitute for seat belts in a crash.
Wear a seat belt every time, every trip.
Seat all kids under 12 in the back seat.
Seat backseat passengers in the middle (it’s the safest spot in the car)
Regarding any function on a smartphone, if you can’t be hands free, it can wait. If you must use your hands, pull over.
Remember designated drivers? Yes, that’s still a thing.
If you’re on a motorcycle, wear a helmet, every time, every trip.
Protect your teen. No license, no vehicle. Consider driving school.

Impaired and distracted driving will cause you harm; it’s not an “if it’ll happen” situation, it’s “when it happens.” Please consider the points I’ve mentioned and the lives of passengers/other drivers when deciding how you handle your vehicle. Good luck on the road.
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 Curse of the Weekend Warrior – Achilles Tendon Rupture

July 8, 2017Orthopedics/Bones, Sports Medicine, Trauma, Musculoskeletal SystemAchilles, Facebook, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Tendon, There are 72 Hours in a Day, Twitter, WordPressJeffrey Sterling, MD

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

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

Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: The Role of Gunshot Wounds in a Nation at War with Itself

July 7, 2017Trauma844-SMA-TALK, Behind the Curtain, Gunshots, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Apparently there is going to be an ongoing need to address this… Somewhere in the midst of reconciling the parts of me that are physician, public health professional and African-American male, I realized that I don’t have the luxury to simply review the medical aspects of gunshot wounds. As an African-American, I have lived my entire life learning and having it reinforced that I and others of my kind are a misunderstanding or inappropriate interaction away from becoming a statistic (and not just via the police). As a physician I get to treat, and as a public health professional I get to report and fashion broad solutions to various challenges, but as an African-American, I get to live a certain reality that for me began when my father died from a so-called “random gunshot” wound when I was a small child.

The trauma inflicted by a gunshot wound is not theoretical. It is a medical lie that such a thing as a warning shot exists, if indeed a bullet enters your body. Penetrating injuries to virtually all areas of the body (brain, neck, chest, back, abdomen, groin, extremities) can be fatal. Gunshot wounds have several ways of injuring you, including the direct damage to tissue, indirect damage from the shock waves and direct damage from fragments (of the bullet or bone). When you shoot someone, you have factored in a possibility that the wound you inflict could be fatal. Police officers shooting individuals are aiming at areas correlating with defined statistic probabilities of death, none of which is zero. Those trained in firearm use make choices: shooting to kill instead of to subdue is a deadly choice among other options. No one should ever be allowed to claim otherwise.

We live in a country that is without debate the most violent country on earth, both outside of and within all parts of our borders. From the individual’s rights to bear militia levels of arms to the police’s increasing position as military units, from the contradictions of allowing both “Open Carry” and “Stand Your Ground,” we are spiraling toward an inevitable conclusion. Stop being so deficient of attention about what’s happening before our eyes, and think and ask what the inevitable conclusion of all of this is going to be.
Regardless of your political persuasion, there are issues to be addressed. Although the news of the day isn’t pointed in this direction, the extent of this mad has begun to envelope children as well.

Consider the following facts from the Children’s Defense fund,

Approximately 2900 children and teens died from guns in the US in both 2008 and 2009. (Does anyone think the numbers have declined since then?) That’s one child or teen every 3 hours. That’s eight children or teens every day. That’s 55 children or teens every week for two years. What is our country’s response to this? What are you specifically doing to contribute to a solution to this?
Young Blacks are being exterminated by gunshot wounds in this country. Black children and teens accounted for 45% of all child and teen deaths in those years, while only accounting for 15% of the total child population. Are you just going to read this statement passively without wondering about and contributing to a solution?
Black males 15-19 were eight times as likely as White males of the same age and two-and-a-half times as likely as their Hispanic peers to be killed in a gun homicide in 2009. In fact, gun homicide is the leading cause of death among Black teens ages 15-19 in 2008-2009.
The most recent analysis of data from industrialized nations shows that 87% of the children under age 15 killed by guns in these nations lived in the U.S. The homicide rate in the U.S. for teens and young adults ages 15-24 was 42.7 times higher than the combined rate for all other nations.
In spite of all this, in absolute numbers more White than Black children and teens have died from gun violence since data started being collected.

Using more recently available data, the Centers for Disease Control and Prevention lists the number of firearm-induced deaths in 2013 as 11,068. This accounted for over 68% of all murders in the U.S. last year.

What is it going to take to get the American public and leaders to stand up to protect the lives and safety of children over the lobbies of gun owners and sellers? America can walk and chew gum at the same time. We can fashion reasonable safety measures and restrictions that will save lives while working within the framework of current interpretations of the Constitution by the Supreme Court. This will not occur without pressure from the populace.
Martin Luther King, Jr had two famous and related quotes that are relevant and applicable here.

“Our lives begin to end the day we become silent about things that matter.”
“In the end, we will remember not the words of our enemies, but the silence of our friends.”

If you are not willing to take specific actions to eradicate the challenges facing us, that makes your condolences somewhat hollow after tragedies have occurred. It is past time to get involved in whatever way you can or choose. The life you save may be your own.
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: Total Knee Replacement Surgery

July 6, 2017Orthopedics/Bones, Sports Medicine844-SMA-TALK, arthroplasty, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, total knee replacementJeffrey Sterling, MD

When you’re a the big game, whether it’s football, basketball, soccer or otherwise, it’s likely you’re watching a group that includes someone who may require joint replacement surgery over the course of his life.
Can you believe that over half of a million total knee replacement (TKR) surgeries are performed a year?
As we age or experience knee injury, the progression of limitations on us imposed by arthritis and other diseases of the knee-joint can become too much to bear. Persistent pain and limited range of motion can make each step an exercise in physical and mental agony.
Risks for TKR include having osteoarthritis, infection, obesity, being younger than 55 years old and being male.

TKR involves removal of damaged bone and other tissue (e.g., cartilage) from the knee joint and creation and placement of a new joint (a prosthesis) made of plastic and/or metal. Most TKRs are successful, with approximately 90 percent of patients experiencing rapid and signficant pain reduction and improved joint function.
Of course, many of you have heard about complications of joint replacement surgeries, and TKR also comes with risks. Scarring, blood clots and infections may occur, but in the hands of a competent orthopedic surgeon, these risks pale in comparison to the benefits that the otherwise healthy individual will receive. Recovery involves a brief post-surgery hospitalization, followed by treatment in a rehabilitation facility and a couple of months of physical therapy (PT).
PT is especially important, because with it you’re setting your future bar. You need to work to whatever limits you want to reach, and you need to get started right away. Once the knee stiffens post-surgery, you won’t be able to get back what you’ve lost. Your post-surgery life and use of your knee will be a direct result of how hard and how much you work that knee during rehabilitation.
Recovery involves mental and physical considerations. Physically, you’re likely not going to be engaged in high-impact sports anymore (or even running for that matter, although this is a case-by-case consideration) because of the risks of loosening the prosthesis and requiring revision surgery. Riding a bike and other activities involving flexibility will be possible.
Mentally, TKR is not a fountain of youth, and you have to wrap your brain around that fact. You must define quality of life through the loss of pain and improved mobility.

Prosthesis are expected to last at least 15-20 years, and that level of longevity should give you a new lease on life. If you find yourself or your loved ones in severe pain from arthritis or other knee pain, ask your physician what circumstances may lead to the need for a TKR. You can certainly discuss the matter further with your SMA expert consultant.
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: Avoiding Summertime Sports Injuries

July 5, 2017Sports Medicine, Trauma, Musculoskeletal System844-SMA-TALK, Achilles tendon, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

It’s not just kids that get injured in the summer having fun. Those of you weekend warriors, recreational and actual athletes are very much at risk also. Now, professional athletes are at risk for injuries for different reasons than weekend warriors. Although accidents happen to everyone, poor conditioning and training, propensities not to stretch or warm up, relatively poorer playing conditions, and use of inferior equipment (or lack of use of any at all) make your adventures a little more risky. Straight, No Chaser has reviewed many common sports injuries. Links to some are listed below, and others you can read up on just by typing what you’re looking for into the search box on the right.
The most common sports injuries include the following conditions.

Sprains and strains, particularly ankle sprains
Knee injuries
Bruises (contusions) and other muscle injuries
Achilles tendon injuries
Rotator cuff injuries
Fractures
Dislocations

Of course, the most common aren’t all the rage. Everyone’s concerned about concussions. Here’s a Straight, No Chaser review of concussions.
The weekend warrior is too often engaged in a testosterone fest and doesn’t listen to his body. If you get hurt, stop. If you don’t listen to your body, someone more serious could be on the verge of happening.

Here are some tips to help you avoid sports injuries.

Always warm up, regardless of the sport. It’s especially helpful to stretch the Achilles tendon, hamstring and quadriceps areas and hold the positions without a bouncing motion.
Avoid bending knees past 90 degrees.
Avoid twisting knees. This is best done by keeping your feet as flat as possible during stretches and running.
If you’re jumping, land with your knees bent.
Cool down following vigorous sports. You want your heart rate to come down gradually.
Wear properly fitting shoes. You can avoid stress fractures and sprains by wearing shoes that provide shock absorption and stability.
Avoid running on hard surfaces like asphalt and concrete. It’s preferable to run on softer, flat surfaces. Appreciate that running uphill may increase the stress on the Achilles tendon and the leg itself.
Know when to stop.

We’ve discussed the RICE method of treating strains and sprains in the past. Make a habit of this for even minor ankle, knee, wrist, elbow and shoulder sprains. It helps with pain and swelling, and it also speeds recovery.
Whether you’re enjoying the Big Game or just your game, it’s good to know what you’re looking to avoid. Don’t let a sports injury sneak up behind you. If you are in need of information or advice, contact your personal healthcare consultants at 844-SMA-TALK or www.sterlingmedicaladvice.com. Have a great day, and enjoy the game.

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: Fireworks Safety

July 3, 2017Environmental, Trauma844-SMA-TALK, Behind the Curtain, firecrackers, fireworks, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

For many, the Fourth of July is a time of celebration, happiness and creation of good family memories. In the emergency room it’s one of the two worst days to have to work (excluding any Friday the 13ths that occur during a full moon…). I’d bet it’s even worse for firefighters, as over 50,000 fires are caused each year as a result of using fireworks. The presence of fireworks, grills, alcohol, driving and other hazardous activities make for an eventful day filled with many different types of trauma and drama, including the following:

Burns
Eye injuries
Finger/hand lacerations and amputations
Motor vehicle collisions

That said, this isn’t about us; it’s about you. Let’s take advantage of this opportunity to provide you with some safety tips to prevent injuries and enjoy your holiday. Yes, some of these may sound simplistic, but failure to follow these tips are the reasons people end up in emergency rooms.

Tip #1 is to leave the fireworks to the professionals. If you want to enjoy a fireworks celebration, attend a public display. Your biggest risk here will be getting stuck in traffic.
If you like fireworks, get the legal kind. You can always identify legal fireworks by their being labeled with the manufacturer’s name and address. Also don’t try to make your own fireworks. Doesn’t that just sound like a formula for disaster?
Speaking of disasters, if you are going to use fireworks, don’t drink alcohol until everything’s done. Think about it. Alcohol + fire + explosives by design aren’t meant to have a happy ending.
Store your animals. They will become spooked by the fireworks and can have their hearing damaged by the blasts or otherwise hurt themselves escaping.

If you allow fireworks in the home, don’t allow use by kids – or do so at your own risk. Did you know that sparklers, which many parents allow as a “safer” alternative to firecrackers, can get as hot as 1,800 degrees Fahrenheit?
Keep any fireworks outdoors, and keep a water supply nearby. These things cause fires.
Here’s a common mistake: do not light fireworks while holding. This is how your hands get burned or fingers get blown off.
Wear eye shields when using fireworks. Folks have lost vision and eyes playing with fireworks.
Do not keep fireworks in your pocket, as the friction can ignite them.
Never point fireworks at anything other than the sky or an open space. Buildings can catch on fire, and individuals will be injured.

Do not light fireworks in glass or metal containers. They explode and end up stuck in people.
Only attempt to light one firework at a time.
Never attempt to relight a dud. If it ends up not being a dud, it can fire unpredictably. If you have a dud, soak it in water for twenty minutes before attempting to discard it.
In fact, soak all fireworks in water prior to trashing them.
Do not allow kids to pick up fireworks after an event. You and they don’t know if any are still active.
Finally, remember that fireworks are not legal everywhere. You’re rather check and be safe then be fined or arrested if your activity is discovered.

To be complete, here are some tips in the unfortunate event that an injury occurs as a result of fireworks.

Go to the closest major medical center immediately. This is an example of “time is tissue.” Don’t dally at home, and I’d recommend not even stopping at the closest emergency room. In the example when your eye or limb is at risk, you’re going to want to be at a trauma and/or burn center.
If an eye injury occurs as a result of fireworks, don’t rub or otherwise touch it. You’re more likely to cause additional damage than do anything constructive. Along the same line, don’t spend the time attempting to flush your eyes. Grab a shield or anything that can be used to protect the eye, and get to the emergency room. If you have sustained this injury, your eye is at risk.
If a minor burn occurs as a result of fireworks, remove clothing, and avoid ice. If you have access to water while waiting for an ambulance, run cool (not cold) water over the burn.

Happy Fourth of July, and I hope you feel that way at day’s end.
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: Kids Summer Fun Gone Wrong – Trampoline & Hover Board Trauma

July 2, 2017Pediatrics/Kids Health, Trauma844-SMA-TALK, Behind the Curtain, Hover boards, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, TrampolineJeffrey Sterling, MD

With this long holiday weekend upon us, let me share a story…. It starts with me back in the emergency room with a little girl who looks like her forearm is going to fall off the rest of her upper extremity.
People love trampolines and more recently, hover boards. Yet somehow the only time I seem to hear the word trampoline is when someone’s been hurt. I’m not the only one who’d vaporize them on site. The American Academy of Pediatrics recommends that trampolines never be used at home or in outdoor playgrounds, because associated injuries include head and neck contusions, fractures, strains and sprains, among other injuries.

So my patient had a (posteriorly) dislocated elbow, meaning she fell off the trampoline, landing on the back of the extended upper arm, pushing the upper arm bone (the humerus) in front of the elbow and forearm. This is how that looks (yes, the ball is supposed to fit into the socket). You are similarly at risk from falls from our newfangled hover boards.

So for the joy of bouncing on a trampoline, the child had to be put asleep so the elbow could be replaced into the appropriate position. This procedure is fraught with potential for complications, including a broken bone on the way back, as well as damage to the local nerves and arteries (brachial artery, median and ulnar nerves), which can become entrapped during the effort to relocate the bone into the elbow joint. Some limitation in fully bending the arm up and down (flexion and extension) is common after a dislocation, especially without prompt orthopedic and physical therapy follow-up. This really is a high price to pay for the privilege of bouncing up and down.
So if you’re going to allow your kids to play on a trampoline, here are three tips shown to reduce injuries:

Find one of those nets that encloses the trampoline to prevent a child from being thrown from the trampoline.
Make sure the frame and hooks are completely covered with padding to prevent a child from getting impaled or scratched.
Keep the trampoline away from anything else, including trees and rocks. This works even better if the trampoline is enclosed as previously mentioned.

Think back to the little girl I had to care for and consider whether this predictable event (complete with the mental stress of being in a loud emergency room in pain, getting an IV needle and being put to sleep) was worth the effort. As per routine, an ounce of prevention…
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: Dehydration – When You’re Too Dry to Cry

July 1, 2017Environmental, General Health and Wellness844-SMA-TALK, Behind the Curtain, dehydration, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

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. In this Straight, No Chaser, 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 asked questions.
1. Who’s at risk/what places me at risk?

Infants, children, the elderly and the ill are at particular risk for dehydration (and add yourself if you work outdoors during hot summer months). Children simply have lower fluid amounts than adults, and fluid losses is kids proportionately cause greater effects. All the above risk groups share the habit of a more rapid utilization and/or turnover of fluids, requiring higher fluid 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 on hot days, exercising or if you’re 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 above 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.

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, but in fact water replacement without electrolytes isn’t what you want to attempt ideally. All things considered, electrolyte solutions and “freezer pops” are very effective for basic considerations of addressing hydration.
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.
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 Questions About Gunshots and Stab Wounds

June 30, 2017Trauma844-SMA-TALK, Behind the Curtain, Conditions and Diseases, Gunshots, Stab wounds, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

There has been a lot going on the news this entire year related to trauma, particularly gunshot wounds. This Straight, No Chaser answers your questions related to penetrating injuries from bullets and stabs.

Your Top Five Questions

1. Why don’t we remove the bullets every time?

Removing bullets may cause more damage than leaving them in the body. Sometimes it’s not worth the effort.
2. What’s with the tubes that go in the chest?

Chest tubes are used to treat a pneumothorax (a collapsed lung). The problem is there’s air in the space between the lung and the chest wall. This can interfere with normal breathing and may be life threatening. The tubes go through the chest wall to release the air from that space, thus allowing re-expansion of the lungs.
3. Why would doctors ever need to slit someone’s throat to save his or her life?

That describes either a cricothyrotomy or a tracheostomy, and it’s not “slitting” the throat as much as it is creating an opening in the airway to permit airflow. This is usually necessary because of some airway obstruction at the upper throat (foreign body in the throat, etc.) with an inability to clear it. This procedure is only done to save a life.
4. Why would you die from a wound to the thigh?
Fractures of certain bones and laceration of certain blood vessels might cause so much blood loss that you could bleed to death. Infection and blood clots are additional considerations that could be life-threatening. We’ll spare you the pictures.
5. What about gunshot or stab wounds to someone pregnant?
Penetrating trauma to the abdomen is typically less fatal to the mother than to a fetus because the fetus is literally acting as a shield. In the event any wound has placed the mother’s life at risk or the mother has died from the wound, under certain extreme circumstances, an emergency C-section may be performed to save the baby.
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!
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Straight, No Chaser: Penetrating Trauma (Gunshot and Stab Wounds)

June 29, 2017Trauma844-SMA-TALK, Gun shot wounds, Gunshots, Penetrating Trauma, Stab Wound, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Penetrating trauma (PT) is of such magnitude in this country that it is nearly impossible to do it justice in short form. This is primarily a medical blog, and as such I’ll defer addressing the politics of it all. The fact remains that gunshot and stab wounds take an astounding toll on human life in the U.S, with over 16,000 homicides annually (approximately 45 deaths every day). The ramifications of these wounds encompass much more than medical considerations, but I’ll devote this space to discussing basics of penetrating trauma.

What Happens
By design, intentional stab and gunshot wounds aim to kill. Any area of the body can be shot or stabbed. Unintentional injuries are also a source of common emergency room presentations. Major ERs and Trauma Centers are known within the industry as the “knife and gun clubs.”
Penetrating injuries to virtually all areas (brain, neck, chest, back, abdomen, groin, extremities) can be fatal. Gunshot wounds have several ways of injuring you, including the direct damage to tissue, indirect damage from the shock waves and direct damage from fragments (of the bullet or bone).

PT that reaches blood vessels can cause fatal bleeding. In the abdomen, the liver is the most commonly injured organ because of its large size. It can bleed enough to cause shock and death.
PT that reaches the spinal cord can cause paralysis and death.
PT to the brain can cause all manners of dysfunction, including loss of speech, motion, sensation, bodily functions, paralysis and death.
PT to the chest can cause puncture, rupture and/or loss of lung and heart function, leading to a pretty rapid death.

Be reminded that although both gunshot wounds and stab wounds involve penetration and may puncture your internal organs, gunshots are more prone to deeper penetration with higher energy and may create exit wounds, causing damage throughout its course.
What You Can Do
Here are the things you must consider after becoming a victim of penetrating trauma.

Get to safety. Perpetrators of penetrating trauma mean to hurt you and often mean for you to be dead. They may be looking to finish the job. I’ve been involved in many scenarios where individuals came to the ER to do just that.
Once you’re safe,immediately call 911 regardless of how you feel. You may be in shock and your body will fight feverishly to normalize how you feel – right up until you crash. In other words, you can’t trust how you feel. Another vital consideration about getting medical attention rapidly is what we call “The Golden Hour.” The opportunity to address many of the truly life threatening considerations in penetrating trauma is best done within the first 60 minutes of the injury.
Once you’re safe, apply pressure (clean towels) to any bleeding sites. Cover yourself with blankets as needed to preserve heat.
Avoid movement. Gunshot wounds are associated with spinal cord injuries, so movement could be dangerous.

What You Should Expect
Treatment of penetrating trauma is very dramatic and necessarily regimented due to the early lack of knowledge of the depth and location of injuries. As such, assessment and treatment protocols generally are in place for the region of the body penetrated. The first consideration is always ensuring that the patient’s Airway is intact, Breathing is still ongoing, and Circulation (blood flow) is sufficient (The “ABCs” of Trauma management). After that, use of x-rays, CT scans and other radiologic modalities to identify the location and extent of injuries will be employed based on the stability of the patient. Sometimes immediate surgical intervention is needed.
This is another situation where prevention is the best course of action. Avoiding injuries when possible should go without saying but often does not. Gun safety for gun owners is crucial to avoid unintentional injuries. Attention to detail is very important when handling guns and knives. Unintentional injuries tend to occur when handlers of these weapons get too comfortable. Unfortunately, once penetrating trauma has occurred, it seems like a game of chance. For every person who is told, “If that bullet was one more inch to the right, you’d be paralyzed (or dead),” another family has to be told to make arrangements. Unfortunately, my father was the victim of a random fatal gunshot wound when I was six years old, so I know that story all too well.
If you remember anything from this blog post, remember time is of the essence. Get your loved one to us inside of ‘The Golden Hour” to give the best chance of a good outcome.
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: Understanding an Actual Conservative Point of View on Healthcare

June 28, 2017General Health and Wellness, Public Health844-SMA-TALK, Affordable Care Act, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

I am not attempting to speak for any group as much as I am hoping to enlighten those needing it regarding how others could seemingly vote for or support what appears to be in their “best interest” when it comes to health care.
For starters, not all Americans share the same value system. In as much as the citizenry has responsibility for our healthcare (via insurance payments, deductibles and co-pays that total thousands of dollars a year on average), it is properly described as a commodity. Among people with relatively scarce resources, consider these two scenarios:

Some people have higher priorities in their lives than healthcare. People who feel this way would love to spend those extra thousands of dollars on food, better education or whatever they choose. A government-mandated healthcare system prevents them from making decisions on how they spend their own money. Yes the assumption here is that they’ll never get sick, but many people are willing to accept the consequences of their choices.
Some people would rather manage their own healthcare. Many people do so successfully. In fact, insurance itself is largely based on the notion that you pay into the system more than you get back when you’re young and statistically don’t need healthcare (especially if you’re young and male), only to receive more than you pay into the system when you’re older and invariably going to need more healthcare. Again, there is a large group of Americans willing to accept responsibility for their own healthcare and/or health actions, if that means they can forego spending thousands of dollars into a healthcare system they largely don’t use, or if the option existed to buy healthcare on an as needed basis.

Next, there actually are legitimate concerns (that everyone seems afraid to discuss) about the cost of healthcare. If I told you there actually is $800 million dollars (roughly the amount slated for cuts to Medicare) of fat in the system, would you listen or just reflexively assume someone was trying to kill Grandma? Allow me to explain, but it’s important to point out that looking for efficiencies and savings in the system is not the same as justifying cuts to essential services as an excuse for tax cuts for the wealthy.

The amount of cash in the US healthcare system approximates $3 trillion and is over 17% of the gross domestic product (would you believe it was only 5% in 1960?). This comes to almost $10,000/year for every person in the country. It is estimated that the country that is next on the list of highest percentage of its GNP spent on healthcare is France, at about 11%. Yes, now is when I remind you that the US healthcare system historically has been ranked in the mid-thirties regarding best healthcare systems. So with that in mind, don’t tell me this great country can’t build a better system. Here are just three considerations about which those on both the left and right should be able to agree are problems.

Clinical inefficiency. Simply put, an ounce of prevention is worth a pound of cure. Using the ED instead of a family doctor’s office for the same presentation costs about eight times more. Also, eliminating the system of incentives for defensive medicine (meant to avoid lawsuits) would alone save almost $50 billion/year, according to the Harvard School of Public Health. In all, clinic waste accounting for 14% of health care spending, over $420 billion dollars.
Administrative complexity: This is so easy you should question the motives of those who haven’t brought this to pass. According to the Harvard Business School, fully 9% (about $270 billion a year) is wasted on inefficiencies in medical billing, collections, compliance and oversight. It’s the paper pushers.
Insurance companies: The next time someone whines about woe-is-me insurance companies, remind them that the companies participating in Medicare Advantage plans received about $170 billion, just from the government in 2015! Look at the below graph to see how well they all are doing. Have your stocks increased 1000% since 2009? The current model of paying insurance companies so much money is neither producing good outcomes for patients nor payers. Those on the left should be furious that better health isn’t included as a result of the thousands of dollars spent, and those on the right should be furious that the current system does not offer sufficient competition or transparency that could generate downward price pressure. Even more onerous, the various subsidies given to insurance companies are simply forms of corporate welfare, as multiple companies make tens of billions of dollars in profit each year.

So…next time someone talks about raising premiums on us, let’s ask about getting a better return on our investment.

If I may, here’s five simple components of what an actual compassionate conservative (i.e. even more so than Obamacare) plan would look like.

Freedom to opt out of healthcare insurance, with the caveat that one either participates in an “essential coverage plan,” or maintains a certain amount of financial liquidity (e.g. a health saving account) to pay for a year’s worth of projected costs based on actuarial tables. “Essential coverage” includes preventive medicine, critical care, maternal care, mental health and ongoing coverage of preexisting conditions – otherwise, it’s not really insurance.
Enhancement of competition, including the ability for insurance companies to compete across state lines as well as the items discussed in the next two bullet points.
Freedom for citizens to opt-in to a government option. Why, you ask, would this work for conservatives? Well, it’s about choice, and here’s an option. Also, the government option is the surest way to create downward price pressure.
Transparency in healthcare services pricing. As an example, if this existed, consumers would be able to decide for themselves if they wanted to pay for an MRI vs a CT scan vs an x-ray vs nothing for a knee sprain. Much has been made about the effects of price transparency on the cost of lasik surgery.
Dramatic savings earned by elimination of clinical waste and the resultant high costs of care, including the practice of defensive medicine and awarding of excessive medical malpractice rewards. Implementation of best practices in administrative processes, and ongoing crackdown on healthcare fraud and abuse (the Harvard Business School identifies these components as contributing to 40% of the costs of healthcare).

If a system was being proposed built on the above considerations by those on the right side of the political aisle, it would form the basis of an actual conservation and would result in even more cost savings, because there is in fact more than enough money already in the system to provide whatever services are needed. Imagine if you will that the US spent the same percentage of its GDP on healthcare as the second most generous nation on earth (France at 11%). That would represent a trillion dollars in savings, and remember: France provides universal healthcare with better healthcare outcomes.
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: Sickle Cell Disease/Anemia

June 27, 2017Hematology & Oncology/Blood Disorders/Cancer844-SMA-TALK, Behind the Curtain, Hemoglobin, Sickle Cell Anemia, Sickle Cell Disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

I don’t type this post with any amount of joy. Can you imagine an existence in which your blood cells are deformed to the extent to which they resemble pointy knives poking at you? That’s a grotesque oversimplification, but it does capture the essence of those suffering from today’s topic. World Sickle Cell Day was earlier this month, seeking a heightened awareness of Sickle Cell Disease. Here are some answers to basic questions meant to provide you information about the disease.

What Is Sickle Cell Disease (SCD)?

Sickle cell disease is a group of disorders of the red blood cells (RBCs). The RBCs have abnormal hemoglobin (the protein responsible for carrying oxygen throughout your bodies to nourish various tissues).

How do I get Sickle Cell Disease?

The conditions defining SCD are inherited. It is not a disorder you can individually obtain from interacting with someone affected (i.e. it is not contagious). In order to inherit SCD, you must receive abnormal genes from both parents. Sickle cell anemia is more common in certain ethnic groups, including those of African descent, Hispanic Americans from Central and South America, and those of Middle Eastern, Asian, Indian, and Mediterranean descent. One in twelve African-Americans carries a sickle cell gene.

Is this the same as Sickle Cell Anemia?

In sickle cell disease, a form of hemoglobin known as hemoglobin S is formed through inheritance from one parent. If the genes passed down from both parents create hemoglobin S (a designated known as hemoglobin SS), the resulting condition is known as sickle cell anemia (SCA). SCA is the most common and severe form of SCD. It should be noted that other forms of sickle cell disease exist, representing other combinations of hemoglobin and relatively different amounts of hemoglobin S. These include the following:

Hemoglobin SS
Hemoglobin SC
Hemoglobin Sβ0 thalassemia
Hemoglobin Sβ+ thalassemia
Hemoglobin SD
Hemoglobin SE

What does it mean if I have Sickle Cell Disease?

The problem is simple and relatively easily understood. Red blood cells (RBCs) carry oxygen from your lungs to tissues around the body. Normally hemoglobin is disc-shaped and quite able to deform in ways allowing it to maneuver throughout the body in its quest to deliver oxygen. If the hemoglobin is deformed, it is less able or unable to carry oxygen. If you can’t carry oxygen, it’s not getting delivered to your organs and tissues. If it’s not getting delivered, there are consequences.

Why do I get symptoms? What symptoms would I get if I had SCD?

It’s all about the lack of oxygen. The pain results from the equivalent of your body screaming from its absence. These pain crises are sudden, severe and often unrelenting, requiring ER visits and dramatic doses of medicine to reverse symptoms. These crises can occur anywhere such as the brain or lungs, but are typically seen in joints.
Symptoms may result from the rupture of these deformed cells (hemolysis). Sickle cells only last 10-20 days, compared to a normal lifespan of 90-120 days for normal cells. The lack of effective RBCs in your body is what’s known as anemia. Those of you who bleed monthly or otherwise have conditions affecting red blood cells recognize all too well the fatigue and energy loss associated with low RBC levels. Furthermore, the abnormally shaped cells themselves (in combination with the relative lack of oxygen delivery) can damage organs, most notably including the spleen but also including the brain, eyes, lungs, liver, heart, kidneys, penis, joints, bones, or skin.

How is SCD treated?

On a relative scale, there’s much better news than existed a generation or two ago. In the US, back in 1973 the average lifespan of a patient with SCD was only 14 years old; today it is approximately 40-60 years. SCD produces a life-long illness. Today, stem cell transplantation of those cells producing normal red blood cells (called hematopoietic stem cell transplantation or HSCT) represents a cure for those that can obtain it. The rate limiting consideration for many is most sicklers are either too old or don’t have an appropriate healthy genetic match to receive a successful transplant.
In the absence of a cure, for most patients, management involves regular healthy measures and regular medical care to prevent complications Special attention is given to maintaining hydration, appropriate blood cell counts and pain management when needed.
A truly unfortunate part of the disease is the relative lack of compassion offered to sufferers. These patients live a life of pain and go through life treated as drug-seekers in a way we never see others treated (e.g. those with cancer or Lupus, for example). Most have had surgery before they reached age 10. Patients with sickle cell anemia suffer from a decreased life expectancy. If you’ve made it to this point in the post, consider yourself aware. I hope you care enough to lend a hand when needed.
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: Do’s and Don’ts of Treating Electrical Injuries

June 26, 2017General Health and Wellness, Neurology, Trauma, Musculoskeletal System844-SMA-TALK, Behind the Curtain, electrical injury, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

In a previous Straight, No Chaser, we discussed the “what” of electrical injuries and lightning. In this post, we discuss the “what-to-do” and “what-not-to-do” if and when you find yourself shocked or caring for someone else who was.
Let’s begin with prevention. It is easier for you to avoid a hazardous situation than to have to deal with it while injured. Let’s start with the children.

Talk to your children about electricity. Review hazardous and safe behaviors.
Use child safety plugs in all electrical outlets. This shouldn’t come as a surprise to anyone anymore.
Take the next step and keep all electrical cords out of children’s reach.
Keep children away from electrical devices, especially those plugged in.
Intermittently check electrical cords, and make sure they aren’t cut or split with loose, exposed wiring visible and accessible.
Take the extra step of reading and following manufacturer’s safety instructions when using electrical appliances. Learning the right places to plug live wires on the fly is not the best idea.
Stay away from electrical devices while wet. This includes touching faucets or pipes while using them. Take the time to take the extra step.
Learn where the power boxes are in your house. If you ever need to turn them off, the first step is knowing the correct location for them.

Now, let’s review steps NOT to take if you’re electrocuted or near someone who was.

Don’t touch someone still in contact with the source of the electricity. The body is an excellent conductor of electrical current, and you’ll become part of the link.
Not only should you not touch, you shouldn’t even get close. Stay at least 20 feet (about three to four body lengths) away from someone being electrocuted until the power is turned off. The high-voltage current of power lines can dance their way onto you if given the opportunity.
Regardless of the distance, don’t try to rescue someone near an active high-voltage power line.
Don’t play doctor. If the power does get shut off, don’t move the victim. You’re likely to cause more harm than good. The force associated with electrical injuries often cause injuries, including to the head or spine. The exception to this would be the presence of a fire or the risk of an explosion.
Don’t play doctor, part two: Forget what you’ve heard. Please don’t slather the burns with butter or apply ice, ointment or any other medications. In fact, avoid placing any type of adhesive dressing or big bulky dressings. Your best move is to spend that time on the phone with emergency medical services.
You’re still not a doctor! Avoid the urge to break open burn blisters or peel off dead skin. Sometimes don’t-do-something-just-stand-there is the best course of action.

Ok, you really want to do something to help? Here are safe, reasonable steps to take.

First things first: Ensure your own safety, whether from the electricity, any fire or possibility of an explosion. If there’s any water on the floor while this is occurring get out while you can.

Take advantage of your being smart enough to have learned how to cut off the power and do so. I’d recommend working backwards in this order: turn off the circuit breakers, remove the fuse from the fuse box, and unplug the cord. Remember, appliances can still allow for electrical current flow even in the off position. Simply cutting it off might neither be safe nor effective.
Call your local emergency medical service number (e.g., 911) at the first safe opportunity.

If the current can’t be turned off, and you determine it is safe to do so, find something made of rubber or another non-conducting material, such as a broom, chair or rug to push the person away from the source of the current. Don’t even think about using metal or something wet. Whenever you’re doing whatever you’re doing, stand on something rubber.
Do you know CPR? You may need it here. If the victim is no longer near the source of electricity, take needed steps. One very simple yet effective step is to raise the legs about the level of the heart. Again, avoid movement of the head, neck or lower spine.
If the person has a burn, remove any clothing that comes off easily without disturbing the rest of the body. Rinse any burns in cool running water until the pain subsides, and if possible give first aid. Do not go to great lengths here. The ambulance is likely to arrive before you get to do much here.
Stay with the victim until medical assistance arrives, unless the situation demands a quit exit.
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: Electrical Injuries and Lightning Strikes

June 25, 2017General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Conditions and Diseases, electrical injury, lightning strikes, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

As I watch lightning lighting up the sky, it makes me wonder if anyone out there is unlucky enough to be getting struck. The annual probability of being struck by lightning is approximately 1 in 280,000, which is a lot more frequent than makes me comfortable. Today’s Straight, No Chaser addresses concerns and frequently asked questions on electrical injuries.
Why is getting shocked a big deal?
The human body conducts electricity very well, meaning when an external current is attached to us, it runs through the body with ease. This provides a lot of opportunity to cause damage. That damage in the wrong place can kill.
How does getting shocked cause damage?
There are three different paths by which electrical current (“getting shocked”) can cause damage.

On the way in and out, electrical current is likely to cause burns to the skin (thermal burns, aka entry and exit wounds).
An electrical current can cause destruction to several tissues, including muscles and nerves.
As electrical currents reach the heart, they can be disruptive to the heart’s electrical current, even causing it to stop.

What are some common causes of electrical injuries?
The dangers are all around you and in many instances occur because you don’t respect the power and danger of the electricity you use.

If you have a job involving machinery or working with electricity, you can’t afford to get comfortable, because that’s when mistakes and injuries occur.

If you have electrical outlets that aren’t childproofed, then it stands to reason that eventually someone might place a metal object into that outlet, receiving a shock – or worse.

If you have electrical appliances with worn, frayed and exposed wiring and you come in contact with the wire while it’s plugged in, you will be shocked.

You live near a high-voltage power line? Beware of flashing electric arcs, which are looking for somewhere to land.

Thunder and lightning outside? Don’t be the golfer or other nature-lover wielding metal or otherwise unnecessarily exposing yourself to a rather large bolt. When you hear the thunder, the lightning is closer than you may think, relatively speaking.

What are the types of injuries I may receive?
Symptoms related to electrical injuries are numerous and varied. Here are a few examples.

Burns are common. The skin is likely to be pierced and burned on the way in and on the way out, producing “exit wounds” from the burn. Additionally, your sweat can be converted to steam and produce burns that way. Children who bite something with an active electrical current can receive a burn to the lip and experience delayed yet significant bleeding from the lip.

The parts of the body that rely heavily on electric current are likely to be involved and damaged. This means you may experience the symptoms of a heart attack, an irregular heartbeat, numbness and tingling in your arms or legs from nerve damage or abnormal contractions of your muscles, which you’ll perceive as spasms and pain.
Similar effects on the brain may produce seizures and/or altered mental status.
The blast caused by an electrical injury can rupture a lung or your eardrums. Lung failure, shortness of breath and difficulty hearing may result.
The jolt caused by an electrical injury can sufficiently throw you such that secondary injuries can occur, including broken bones.
Combinations of the above mechanisms can produce additional symptoms such as headache, visual disturbances and problems swallowing.
Death may occur. Fortunately, even with the “ultimate” electrical injury (a lightning strike), 90% of victims still survive.

A separate Straight, No Chaser will address treatment and prevention considerations related to electrical injuries. In the meantime, look before you get shocked.

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