Tag Archives: United States

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

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

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

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

Alpha-Phi-Alpha-Ice-Cold-shirthypotherm1

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

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

DO NOT

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

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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

HIV-AIDS-21

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

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

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

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

How does one get AIDS?
AIDS is a progression of HIV into its later stages and occurs after one’s immune system is severely damaged. You don’t “get AIDS” as much as HIV progresses to AIDS in certain circumstances. Many of us recall that HIV could progress in this way to AIDS in a matter of a few years a few decades ago. Fortunately, with the development of specialized medications in the 1990s, people with HIV are living much longer with HIV before they develop AIDS.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight, No Chaser: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

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I deal with disease and death everyday as an Emergency Physician, and it’s dehumanizing on many levels. Imaging having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.

  • Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
  • Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
  • Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

  • Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
  • Women are more likely to develop PTSD than men.
  • Mental illness may abnormally shape responses to traumatic events.
  • There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
  • The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

  • A predisposition toward optimism
  • The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
  • A mental orientation that you “performed well” in the face of the danger
  • A mental orientation of learning from the experience instead of allowing the experience to define you
  • Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.

  • Check here for a discussion of the diagnosis and treatment of PTSD.
  • Check here for a discussion of the effects of PTSD on children.
  • Check here for a discussion of the effects of PTSD on communities after mass trauma.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight, No Chaser: When Eating Goes Wrong, Part II – Bulimia

Bulimia…-nerviosa-1bulimia

If you read Part I of this conversation on eating disorders (anorexia nervosa), you will recall that eating disorders are a mix of an abnormal body image combined with abnormal behaviors that lead to medical consequences.
The ‘Bizz-Buzz’ of bulimia nervosa is ‘binge-purge.’ What that means is bulimics engage in frequent episodes of eating excessive amounts of food (bingeing) followed by one of several methods of eliminating what was just ingested (purging). This methods include forced vomiting (most common), use of diuretics or laxatives, fasting or excessive exercise. It is important to note that the bulimic feels a lack of control over these episodes.
Bulimia is an especially dangerous disease because it usually occurs in secret, and victims are able to hide it. This means symptoms will typically be further along when discovered. Bulimics usually manage to maintain a normal or healthy weight despite their behavior and may appear to be the person who ‘never gains weight’ despite ‘eating like a horse.’ This is a key differentiator between bulimia and anorexia. Otherwise, the two diseases do share some of the same psychological pathology, including the fear of weight gain and the unhappiness with physical appearance.
Treatment considerations for bulimia are similar to those for other eating disorders. A combination of psychotherapy, reestablishment of normal nutritional intake and medications usually leads to marked improvement. Again, the particular challenge with bulimics is discovering the condition in the first place. As with anorexia nervosa, treatment for bulimia nervosa often involves a combination of options and depends upon the needs of the individual. Medications may include antidepressants, such as fluoxetine (Prozac), if the patient also has depression or anxiety.
Let’s recap by revisiting where we started with our conversation on anorexia. Our society doesn’t do the job it should in promoting a normal image of health. The typically promoted American ideal of beauty sets standards that lead many to pursue unrealistic means of meeting that ideal. In the setting of an actual American population that is obese by medical standards, this becomes even more of a problem. The levels of stress, anxiety and depression resulting from this reality sometimes leads to eating disorders. Remember, eating disorders aren’t just habits. They are life-threatening conditions. If you or a loved one is suffering, please seek help immediately.
Post-script: If you’re wondering about the lead picture of the teeth, you’re viewing the effects of all that regurgitated acid on the enamel layer of your teeth.  I know. It’s not your best look.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight, No Chaser: Bye-Bye, Trans Fats

Toxic-Trans-Fat

In news you can use: the Food and Drug Administration has decided to eliminate trans fats from the American diet. What does this mean? Why should you care? Read on…
Substances known as trans fats, trans fatty acids or partially hydrogenated oils serve the purpose of making liquid vegetable oils more solid. You know and love them because they make food taste good. It’s largely why some of you love and crave foods that are deep fried. What types of foods am I describing? Think about French fries, pizza, pies, doughnuts, pastries, microwave popcorn, cookies and popcorn creamer. Are you using stick margarine? Not for long! Enjoy it while it lasts – or better yet, don’t.
Trans fats raise your bad (LDL) cholesterol levels and lower your good (HDL) cholesterol levels. Eating trans fats increases your risk of developing heart disease and stroke. It’s also associated with a higher risk of developing type 2 diabetes.
This move will eliminate 20,000 heart attacks and 7,000 deaths due to heart disease per year. However,  you know what won’t die? Your taste buds. Options always exist, and food manufacturers will find healthier ways to make food just as tasty as it has always been. By the way, you can do the same even now with just a little effort.
Before you start thinking about whether you can ingest trans fats in moderation, the answer is no. Trans fats occur in sufficient amounts naturally that you’re already eating the limits of what would be acceptable. Adding industrially made trans fats simply adds to your risk of disease and avoidable death.
Now if we can only get you to exercise…
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Straight, No Chaser: Save a Life, Save a Trip, Save Your Cash!

New Logo

In the last 20+ years of caring for patients in emergency rooms (ERs) in communities all over the country, and in 12 years of healthcare consulting in 36 states and countries, my team and I have had the unique privilege of serving all age groups, genders, and health conditions, from sprains to strains, moans and groans, sniffles and whistles, trauma and the flu.
However, in the ER setting, well over half of the people we see every single day would say they could have saved themselves the trip and the cost “…if I only knew.” Straight, No Chaser has given me the privilege to talk with you in a relaxed environment about urgent and non-urgent issues that concern you. It has been fun for me, especially because you have responded in a way that lets me know that my goal of empowering you with knowledge to make your own healthcare and financial decisions for you and your family is being realized. Because this works for your health and your wallet, I have expanded the service from Straight, No Chaser to http://www.SterlingMedicalAdvice.com. Not only will you have access to thousands of tips, fun facts, and frequently asked questions about the full spectrum of health topics, you will also have access to your own personal healthcare consulting team. That’s right, you can chat 24/7 with experts in medicine as well as fitness, dentistry, nutrition, mental health, pharmacy, and other healthcare entities.
So, when the time comes that you need to make an informed decision for yourself and/or your family member, we’re here for you. If this turns out as we desire, this service will become part of the national healthcare system and may be covered by your current insurance interests or as an employee benefit. Beginning today, November 1 at 12 noon Eastern Daylight Time, join me and hundreds of other healthcare experts who have signed up to turn the tide in our country by putting the power of your health back in your hands and saving you the time and costs of unnecessary visits to the emergency room and pharmacy. A subscription counts as payment toward your deductible (if you have insurance) and equates to less than a third of what Americans pay out-of-pocket EVERY YEAR for ER and doctor visits. Try us, and discover the difference having a team at your fingertips will make in your health. We at SterlingMedicalAdvice.com are looking forward to keeping the knowledge flowing,
Jeffrey Sterling, MD
President and CEO
SterlingMedicalAdvice.com
Your Personal and Immediate 24-Hour HealthCare Consultants

Straight, No Chaser: A Solution to the Upcoming Healthcare Crisis and the Affordable Care Act

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Many of you have heard or seen me discuss various aspects of the Patient Protection and Affordable Care Act.  This ambitious effort seeks to maintain the current level of quality that exists (via maintaining the same insurance coverage for those individuals that already have it), while adding approximately 30 million individuals to the insurance rolls while not increasing overall system costs.
Have you noticed that one part of the conversation that doesn’t seem to occur is “Who’s going to take care of these 30 million new individuals? Also, what about the other 20 million that still won’t have insurance?” The twin deterrents of co-pays and deductibles will eventually be stiffened to curtail over- and inappropriate utilization of the emergency room for both the newly insured and the uninsured voucher recipients (Besides, who wants to deal with the long wait times both in your physician’s office and the ER, soon to be even worse with all the newly insured?). Similarly, you would presume that armies of new physicians are being trained to meet this growth in the newly insured, but that simply isn’t the case. Additional options to address this influx will be necessary. Prominent among these options will be those providing better education and greater empowerment of patients to direct their own care.
Sterling Medical Advice (SMA) is a national public health initiative that provides a solution to these issues by the introduction of 24/7 online personal healthcare consulting, featuring physicians and other care professionals covering the entire spectrum of medicine and healthcare. Consultations will be personalized and immediately available to those in need around the clock.
“What’s that, and when might you use it?” Here are a few examples.

  • You need advice regarding an immediate medical concern
  • You need general information about your medical condition
  • You need immediate information about your prescription
  • You are experiencing symptoms and want to know why
  • You want to learn more information about a medical condition that is part of your family history
  • You want additional details on your upcoming medical procedure
  • You need advice regarding the best care option for addressing a medical concern (e.g., emergency room vs. urgent care vs. scheduling an appointment with your primary care physician)
  • You want a second opinion on your new diagnosis
  • You want a second opinion on your new treatment plan
  • You need additional information about what to expect from a newly diagnosed condition

Sterling Medical Advice will improve public health outcomes while reducing healthcare costs for individuals, families and businesses and the healthcare system at large. Personal healthcare consulting will create a better-educated and empowered population and will become an additional component to the American health care system without compromising quality.
To find out more about Sterling Medical Advice, visit www.sterlingmedicaladvice.com, and thanks for following Straight, No Chaser.

Straight, No Chaser: Revisiting the Affordable Care Act – How You or Your Employer Can Save Up to 50% of HealthCare Costs

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Politics aside, I’m not so sure why business owners are focusing on the angst of implementation of the Affordable Care Act instead of the opportunities to save.
Consider the following from the Small Business Association website: “The Affordable Care Act (ACA) creates new incentives for employers to promote wellness among employees by creating supportive, healthier work environments and encouraging employees to take advantage of workplace wellness programs. Health-contingent wellness programs generally require employees to meet a specific standard related to their health, e.g., decreased tobacco use or lowered cholesterol levels. Under the ACA rules that take effect on January 1, 2014, employer rewards will increase from a 20–30% refund of their healthcare coverage costs for employing health-contingent programs, up to 50% for programs designed to prevent or reduce tobacco use.”
Subscribing to www.sterlingmedicaladvice.com as an employee benefit will save companies up to half of the insurance costs they are already paying for their employees.  These savings can occur at a cost of less than 10% of current costs of insurance! For more information about the final rules’ flexibility in eligible wellness programs, visit www.dol.gov/ebsa.  Have your employee assistance program administrator contact us at 1-866-ADVICE3 (238-4233) or email us at sales@sterlingmedicaladvice.com.

Looking to cut your ACA tax in half? Sign up with SMA, reduce absenteeism, win the appreciation of your employees, and save a bundle.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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Straight, No Chaser: Heads Up! Concussions – Traumatic Brain Injuries, Part I

concussion-football

The really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing, or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame, and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.
A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes, ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia. (It’s important to note that not all blows to the head result in a TBI.) For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contribute to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.
Healthcare professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

  • Thinking/remembering
  • Physical
  • Emotional/mood
  • Sleep

Red Flags
Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

  • Any difficulty waking
  • Any loss of consciousness, confusion, or significant agitation
  • One pupil (the black part in the middle of the eye) larger than the other
  • Loss of ability to identify people, places, the date, or self
  • Loss of motion or sensation, weakness, numbness or loss of coordination
  • Persistent, worsening headache
  • Repeated vomiting
  • Slurred speech or difficulty with expression
  • Seizures
  • Kids will not stop crying and cannot be consoled
  • Kids will not nurse or eat

Click here for Part II, in which we discuss complications and treatment options.
Click here for Part III, in which a neurologist adds his thoughts.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Heads Up! Traumatic Brain Injuries (Concussions), Part I

concussion-football
Human Shark Week continues with a discussion about concussions.  The really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.
A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia (It’s important to note that not all blows to the head result in a TBI.). For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contributes to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.
Health care professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

  • Thinking/remembering
  • Physical
  • Emotional/mood
  • Sleep

Red Flags:
Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

  • Any difficulty being awakened
  • Any loss of consciousness, confusion or significant agitation
  • Have one pupil (the black part in the middle of the eye) larger than the other
  • Loss of ability to recognize people, places or inability to identify the date or themselves
  • Loss of motion or sensation, weakness, numbness or loss of coordination
  • Persistent, worsening headache
  • Repeated vomiting.
  • Slurred speech or difficulty with expression
  • Seizures
  • Kids will not stop crying and cannot be consoled
  • Kids will not nurse or eat

This afternoon, in Part II, we will discuss complications and treatment options.

Straight, No Chaser: Quick Tip – Caring for Your Ankle Sprain

Ankle-High-sprain-2791
If you decide not to come to the Emergency Room for your ankle sprain, just think about the mnemonic “RICE.” (This works for any other soft tissue sprain, such as the wrist.)
Rest
The longer you stay off of it, the quicker it will heal. The more you try to use it, the longer your recovery will take and the greater the risk of aggravating the injury.
Ice
Apply ice for 15–20 minutes every hour over the first 24 hours. That will help keep the swelling and pain down. However, please keep a towel between the ice pack and your skin.
Compression/Crutches
Use an ace wrap for comfort and to help with the swelling. Use crutches to help stay off that ankle.
Elevation
This is about the only time I’ll tell you it’s ok to be a couch potato. Keep your leg elevated on the bed or on the couch at or above the level of your chest. That’ll help to keep the swelling down.
If you go to the ER, we’ll do the same for you, unless you have a fracture somewhere, in which case we’ll splint or cast you instead giving you the ace wrap. Stay safe.
 
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: That Doesn't Belong There, Little Johnny!

jingle bell
Let’s talk about our kids and the things they put inside themselves. Pediatric foreign body ingestion/insertion is a common emergency room presentation. Maybe it’s just part of them exploring their world. In fact, I recall getting a pearl in my ear and a dime in my nostril as a child; maybe I wanted to start saving at a young age… Bottom line: kids get in trouble. And it’s not always their fault. Families sometimes leave things lying around the house. Children may be fed something they can’t handle. Then there’s always the older sibling putting stuff in them…
More than 100,000 cases of accidental pediatric foreign body ingestion occur each year. I’m going to address the three main orifices where things are placed and let you know the dangers, potential solutions and what to expect if and when you show up in the emergency room. Yep, three different holes, because different types of insertions occur, each with their own risks. I guess they figure if there’s a hole, something needs to go in it.
Ears:
What Happens: Kids will put anything that will fit in their ears, but the problems arise when something either gets stuck or breaks off in an ear. This can include such things as a cotton swab, food, a toy (a bead, something waxy, or something pointy) or whatever else they get their hands on. This poses a significant risk of infection, bleeding and possible rupture of the eardrum, which can lead to an entirely new set of complications.
What You Need to Know: Regardless as to the nature of the item, removal of the item is going to be very dramatic. At home, you should be very conservative in your efforts to get anything out of a child’s ear. Blind efforts may lead to pushing the item further back on the eardrum, possibly rupturing it, or jabbing it into the ear canal, causing damage and potentially setting up an infection. Such efforts usually make it even more difficult for health professionals to get at it once you come to the ER or your doctor’s office.
What happens in the ER: Drama. Depending on the size, shape and depth of the object, tools to flush it out, suck it out, scoop it out or pick it out may be used. There is no guarantee of success, and if the object is unable to be easily retrieved (without an unacceptable risk of further ear damage), the child may either be put to sleep to make the process easier, or you may be referred to an ears, nose and throat specialist.
Nose:
What Happens: Somehow kids think that because of the shape of the nostrils, round things just belong in there. Those smooth pearls, beads, marbles and kernels fit just right.
What You Need to Know: The particular danger with items placed in the nose is they can become dislodged into the airway and choke the child. You should be mindful of this as you try to get that object out yourself. One strategy that you might safely try (assuming no blood or significant pain or other apparent injury exists) is to ‘blow your child a kiss’. Put your mouth around the kids mouth and give a big puff. Sometimes this will pop the object out of the nostril! More easily, if the child is big enough to blow his/her nose, try that while occluding the unaffected nostril.
What Will Happen in the ER: We may try the same things described above. We may also use a piece of equipment called an Ambu-bag to deliver that same type of puff. If that doesn’t work, we have additional means to enter the nose and try to remove the object. The most important consideration is to protect the child’s airway.
Throat to the Stomach or Lower Airway:
What Happens and What You Need to Know: More foreign object ingestions and aspirations (passage down the airway) occur in children younger than 3 years than in other age groups, although they do occur in all ages. Even relatively immobile infants may get something inappropriate in their mouths despite not being able crawl or pick up objects and put them in the mouth. Their relative inability to chew, coupled with faster breathing rates increases the odds of objects entering the windpipe instead of the food pipe. We see simple things such as nuts, raisins, coins, magnets, seeds, foods (e.g. hot dogs and grapes), as well as toys, pins, batteries, balloons, bones and many other items. Your pediatrician has likely advised you to avoid giving certain foods until the child is at least 5 years old.
Objects that have entered or passed through the throat will leave a sensation that something is still in the throat, particularly if it scratched something on the way down. Objects in the airways run the risk of partial or complete obstruction of different parts of the airway. This can be immediately life-threatening if severe enough obstruction has occurred. There’s no guesswork here; the child will be having difficulty breathing, coughing, gasping and likely turning blue.
What Will Happen in the ER:
Management of swallowed or aspirated foreign body depends on the size of both the object and child and the object’s location.
1) If it’s in the stomach or beyond: unless there are multiple sharp objects that suggest something’s been perforated, little will be done, and you’ll be instructed to wait and watch for it in the stool.
2) If it’s in the airway, this is an emergency, and a lung specialist will need to get the object out with a special scope.
3) If it’s in the food pipe but not yet in the stomach or beyond, what’s done will depend on the size and location. Esophageal foreign bodies (that is, those in the food pipe) generally require early removal by a specialist because of their potential to cause respiratory problems (by manual pressure onto the windpipe) and complications to the esophagus itself (scratches, burns or even rupture). Most notably, ingestion of those annoying button batteries, and their lodging in the esophagus require urgent removal even if no symptoms are present because of an unacceptably high risk of complications. Sharp foreign bodies (except for single straight pins) are especially dangerous and prone to complications and most likely will also need to be removed.
So, after all that, is there any wonder why we ask you to child-proof your home? The dangers are real, and the drama of an ER visit for these things is avoidable and worth being diligent at home. Have a great, safe, healthy and happy weekend.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: That Doesn't Belong There, Little Johnny

jingle bell

Let’s talk about our kids and the things they put inside themselves. Pediatric foreign body ingestion/insertion is a common emergency room presentation. Maybe it’s just part of them exploring their world. In fact, I recall getting a pearl in my ear and a dime in my nostril as a child; maybe I wanted to start saving at a young age… Bottom line: kids get in trouble. And it’s not always their fault. Families sometimes leave things lying around the house. Children may be fed something they can’t handle. Then there’s always the older sibling putting stuff in them…
More than 100,000 cases of accidental pediatric foreign body ingestion occur each year. I’m going to address the three main orifices where things are placed and let you know the dangers, potential solutions and what to expect if and when you show up in the emergency room. Yep, three different holes, because different types of insertions occur, each with their own risks. I guess they figure if there’s a hole, something needs to go in it.
Ears:
What Happens: Kids will put anything that will fit in their ears, but the problems arise when something either gets stuck or breaks off in an ear. This can include such things as a cotton swab, food, a toy (a bead, something waxy, or something pointy) or whatever else they get their hands on. This poses a significant risk of infection, bleeding and possible rupture of the eardrum, which can lead to an entirely new set of complications.
What You Need to Know: Regardless as to the nature of the item, removal of the item is going to be very dramatic. At home, you should be very conservative in your efforts to get anything out of a child’s ear. Blind efforts may lead to pushing the item further back on the eardrum, possibly rupturing it, or jabbing it into the ear canal, causing damage and potentially setting up an infection. Such efforts usually make it even more difficult for health professionals to get at it once you come to the ER or your doctor’s office.
What happens in the ER: Drama. Depending on the size, shape and depth of the object, tools to flush it out, suck it out, scoop it out or pick it out may be used. There is no guarantee of success, and if the object is unable to be easily retrieved (without an unacceptable risk of further ear damage), the child may either be put to sleep to make the process easier, or you may be referred to an ears, nose and throat specialist.
Nose:
What Happens: Somehow kids think that because of the shape of the nostrils, round things just belong in there. Those smooth pearls, beads, marbles and kernels fit just right.
What You Need to Know: The particular danger with items placed in the nose is they can become dislodged into the airway and choke the child. You should be mindful of this as you try to get that object out yourself. One strategy that you might safely try (assuming no blood or significant pain or other apparent injury exists) is to ‘blow your child a kiss’. Put your mouth around the kids mouth and give a big puff. Sometimes this will pop the object out of the nostril! More easily, if the child is big enough to blow his/her nose, try that while occluding the unaffected nostril.
What Will Happen in the ER: We may try the same things described above. We may also use a piece of equipment called an Ambu-bag to deliver that same type of puff. If that doesn’t work, we have additional means to enter the nose and try to remove the object. The most important consideration is to protect the child’s airway.
Throat to the Stomach or Lower Airway:
What Happens and What You Need to Know: More foreign object ingestions and aspirations (passage down the airway) occur in children younger than 3 years than in other age groups, although they do occur in all ages. Even relatively immobile infants may get something inappropriate in their mouths despite not being able crawl or pick up objects and put them in the mouth. Their relative inability to chew, coupled with faster breathing rates increases the odds of objects entering the windpipe instead of the food pipe. We see simple things such as nuts, raisins, coins, magnets, seeds, foods (e.g. hot dogs and grapes), as well as toys, pins, batteries, balloons, bones and many other items. Your pediatrician has likely advised you to avoid giving certain foods until the child is at least 5 years old.
Objects that have entered or passed through the throat will leave a sensation that something is still in the throat, particularly if it scratched something on the way down. Objects in the airways run the risk of partial or complete obstruction of different parts of the airway. This can be immediately life-threatening if severe enough obstruction has occurred. There’s no guesswork here; the child will be having difficulty breathing, coughing, gasping and likely turning blue.
What Will Happen in the ER:
Management of swallowed or aspirated foreign body depends on the size of both the object and child and the object’s location.
1) If it’s in the stomach or beyond: unless there are multiple sharp objects that suggest something’s been perforated, little will be done, and you’ll be instructed to wait and watch for it in the stool.
2) If it’s in the airway, this is an emergency, and a lung specialist will need to get the object out with a special scope.
3) If it’s in the food pipe but not yet in the stomach or beyond, what’s done will depend on the size and location. Esophageal foreign bodies (that is, those in the food pipe) generally require early removal by a specialist because of their potential to cause respiratory problems (by manual pressure onto the windpipe) and complications to the esophagus itself (scratches, burns or even rupture). Most notably, ingestion of those annoying button batteries, and their lodging in the esophagus require urgent removal even if no symptoms are present because of an unacceptably high risk of complications. Sharp foreign bodies (except for single straight pins) are especially dangerous and prone to complications and most likely will also need to be removed.
So, after all that, is there any wonder why we ask you to child-proof your home? The dangers are real, and the drama of an ER visit for these things is avoidable and worth being diligent at home. Have a great, safe, healthy and happy weekend.

Straight, No Chaser: The Reach of Breast Cancer and Your Risk Factors

breastcancerincidence

Even as a physician, I am left to think about the horror of being a woman with a lifetime risk of acquiring breast cancer that’s 1 in 8. The only thing I can think of off-hand and relate to similarly is the risk for trauma being an inner-city minority kid. This risk of breast cancer is compounded by the reality that there is no way to prevent it. Thus, it must be emphasized early and often: risk factor identification and reduction, coupled with early evaluation, detection and treatment are absolutely vital.
Breast cancer is the second most common cancer contracted by American women (after skin cancer), and it is the second most common cause of death from cancer (after lung cancer). More than a quarter of a million new cases will be diagnosed in women yearly, and approximately 40,000 women will die from complications of breast cancer annually (that’s over 100 deaths every day).
In the event the previous information seemed like too much gloom and doom, understand that the tide has been stemmed. After more than two decades of increase, rates of new cases of breast cancer began dropping in 2000 and have stabilized.  This is largely thought to be due to declining rates of post-menopausal hormone use in response to results from major research projects. As you may know, such hormone use has been shown to increase the risk of both breast cancer and heart disease.
Speaking of risks, I don’t especially like this part of the conversation because it always comes across as if everything is a risk factor, and there are still controversies about what is or isn’t a risk. As a result, patients end up confused and paralyzed into inaction. Therefore, I’ll mention just enough for you to understand and work with; if you have specific questions on what you’ve heard that I haven’t already addressed in the breast cancer myth posts (Parts I and II), feel free to ask.
There are risk factors you can’t change, like aging, family history and being a woman. Having these risk factors simply means you need to be more diligent in performing self exams and seeking early care for suspicious findings.  Now, there are other risk factors you can minimize. Oral contraceptive use, postmenopausal hormonal therapy, choosing not to breast feed, alcohol use and obesity are all risk factors for breast cancer that are under your control.
The bottom line is your risk factors don’t cause cancer, and the absence of risk factors doesn’t ensure you won’t have breast cancer. For example, men contract breast cancer as well. What it all comes down to is you must be diligent in performing exams and getting evaluated and treated if something abnormal is discovered. We’ll discuss some of that next.
I welcome your questions and comments.
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Straight, No Chaser: (El)even More Myths Regarding Breast Cancer

Breast-Cancer-Myths2

Continuing from the earlier post with additional myths, well because you have so many questions!  In fact, I’m doubling up on what you received earlier in Part I of Breast Cancer Myths.  

6. “Breast cancer is preventable.”

  • Unfortunately, this is not true.  All of our efforts are geared toward lowering risks, early detection and effective treatment.

7. The risk of breast cancer isn’t affected by obesity.

  • Not true. The risk is particularly increased in post-menopausal women with weight gain.

8. African-American women have an increased risk due to hair straighteners and relaxers.

  • This myth was taken head on and debunked by the National Cancer Institute in a large 2007 study including women with significant use over a 20-year period.

9. Caffeine causes breast cancer.

  • Not according to the evidence. There’s even evidence suggesting a benefit, but the data on this is just as inconclusive as that suggesting a link to breast cancer.

10. Mammograms increase breast cancer risk due to the radiation load.

  • The risks of radiation are so relatively insignificant that they’re mentioned as an afterthought compared to the benefits received from early and frequent evaluation.

11. “Tight clothes and underwire bras will make me get breast cancer.”

  • Not true. Neither has any connection to breast cancer.

12. “I was told small breasts give me less of a chance of having cancer!”

  • Not true. Larger breasts are sometimes more difficult to evaluate, but that’s not the same as saying the risk of cancer is increased in women with larger breasts.

13. “These lumps I have are ok because I’m breastfeeding.”

  • The fact you can discover normal changes in your breast tissue doesn’t mean that all lumps discovered while breastfeeding are normal. Get evaluated.

14. “Deodorant and tanning cause breast cancer, don’t they?”

  • No. Cell phones don’t either. Tanning does increase the risk of skin cancer, but that’s a topic for another day.

15. “I heard having a baby when I’m older increases my risk of breast cancer.”

  • Well, not just any baby, but having one’s first baby later in life is a significant consideration. Women who give birth for the first time after age 35 are 40 percent more likely to get breast cancer than women who have their first child before age 20.

16. “Breast cancer is a death sentence.”

  • Most women survive breast cancer. Give yourself the best opportunity to do so by reducing your risks, learning the principles of early detection and getting prompt treatment if ever diagnosed. We’ll focus on these considerations in the next posts.

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Straight, No Chaser: Five Myths Surrounding Breast Cancer

bustingthemyths

Before I get into the details of what you need to know about breast cancer, it’s important to clear the table of some of the persistent myths and fears that exist. The disease is tough enough as it is without the fear factor impeding our ability to fight back. Please be patient with me here. If you find these myths ridiculous, then good for you, as it indicates that you’re informed on the matter. Just understand that these are real questions that other physicians and I hear often. Remember, knowledge is power.
1. “If a family member of mine has breast cancer, that means I’ll get it too.”

  • It is only true to say that women who have a family history of breast cancer have a higher risk of developing it. Overall, only approximately 10% of women diagnosed with breast cancer have a family cancer, and most women with breast cancer have no family history. In other words, a family member with breast cancer isn’t a life sentence for you, and it shouldn’t stop your efforts to lower your other risks and focus on early detection and treatment.

2. “All lumps in my breast are breast cancer.”

  • There are two important points for you to remember. First, any persistent change in the breast or armpit (axilla) should not be ignored. Remember, I will be stressing the importance of early evaluation for the purposes of detection. That said, only a small percentage of breast changes represent cancer (about 80% of lumps are benign). The really good news is if you learn and perform consistent breast exams, you will detect these changes earlier than anyone else and very often early enough to make a difference.

3. “Men don’t get breast cancer.”

  • Unfortunately, I know this not to be the case within my family. Annually, there are over 400 breast cancer deaths among men from over 2000 new cases being diagnosed. Men should pay attention just as women do because unfortunately, in part due to the delayed detection, the death rate of breast cancer in men is higher than in women.

4. “I heard breast implants cause cancer.”

  • No. There’s no increased risk with breast implants and breast cancer. However, you can legitimately say implants sometimes obscure the view of possible cancer on a mammogram.

5. “The risk of breast cancer is always 1 in 8.”

  • Actually it’s 1 in 8 during a woman’s lifetime. The important distinction is the risk increases as one ages, from 1 in 233 in a woman’s 30s up to 1 in 8 across the board by age 85.

Check back this afternoon for even more breast cancer facts and myths busted.
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Straight, No Chaser: What Would You Do If Your Tongue Suddenly Swelled? Learn About Angioedema

Angioedema_250xAngioedema-5angioedema

Here at Straight, No Chaser, we want you to know how to prevent disease and injury because that’s a lot easier than the alternative. However, if and when the time comes, you should also have a few tools in your arsenal to stave off a life-threatening situation. One of the more scary examples of needing help is acute swelling of your tongue, sometimes so much so that your airway appears as if it will be blocked.
The most common cause of acute tongue, lip or throat swelling is called angioedema. This is an allergic reaction and occurs in two varieties.

  • A life-threatening allergic reaction (anaphylaxis) sometimes occurs shortly after an exposure to substance such as medicine, bee or other insect stings or food. It can throw your entire body into a state of shock, including involvement of multiple parts of the body. This can include massive tongue swelling, wheezing, low blood pressure resulting in blackouts and, of course, the rash typified by hives (urticaria).
  • Sometimes lip, tongue and/or throat swelling may be the only symptoms.  This is more typical of a delayed reaction to certain medications, such as types of blood pressure medications (ACE inhibitors and calcium channel blockers), estrogen and the class of pain medication called NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen)

With any luck, you would already know you’re at risk for this condition, and your physician may have prompted you to wear a medical alert bracelet or necklace. In these cases, your physician may have also given you medicines and instruction on how to take them in the event you feel as if your tongue is swelling and/or your throat is closing. These medicines would include epinephrine for injection, steroids and antihistamines such as Benadryl. As you dial 911 (my recommendation) or make your way to the nearest hospital, taking any or all of these medications could be life-saving. By the way, those are the among the same medicines you’ll be treated with upon arrival to the emergency room. In severe cases, you may need to be intubated (i.e. have a breathing tube placed) to maintain some opening of the airway.
If the swelling is (or assumed to be) due to any form of medication, symptoms will improve a few days after stopping it. If the swelling in this instance becomes severe enough, treatment may resemble that of the life-threatening variety.
There are few things better than cheating death. If you’re at risk, carry that injectable epinephrine (e.g. an Epi-pen). If you’re affected, take some Benadryl and/or steroids if you’ve been taught what dose to take, and most importantly, don’t wait to see if things improve. Get evaluated, get treated and get better!
I welcome your questions and comments.
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Straight, No Chaser: What Should NOT Be in Your Medicine Cabinet

medicine-cabinets

Ever notice that people run straight to the medicine cabinet to do harm to themselves or others? I want you to know the harder the effort is to obtain items to hurt oneself, the less likely one is to follow through on the notion. On another related note, here’s a quick not-so-fun-but-interesting fact. One of the differences between America and say, certain European countries is the oversized influence of corporations in the States. Why am I talking about that on a medical blog? Read on. If you can’t tell where I’m going with this, you’ll get it pretty quickly.

Here’s my top five items I want you to take out your medicine cabinets and lock up.

1. Any jumbo sized container of any medication. Think about two of the most common over the counter (OTC) medications used for suicide attempts: acetaminophen (Tylenol) and salicylate (aspirin). One thing they have in common is you can buy what amounts to a tub-full of it at your local superstore in the United States. They should call these things ‘suicide quantities’, because often those in the midst of a suicide attempt will grab and swallow whatever is convenient. Many different medications will hurt you if you take enough; Tylenol and aspirin certainly fit that bill. Observing that (and additional considerations after the deaths due to the lacing of Tylenol with cyanide back in 1983), the Brits decided to not only pass a law limiting quantities, but certain medications that are high-frequency and high-risk for suicide use are now mandatorily dispensed in those annoying containers that you have to pop through the plastic container. Needless to say, observed suicide rates by medication rates plummeted as a result. Wonder why that hasn’t been implemented in the good ol’ USA?

2. Have teens in your house? Lock up the Robitussin and NyQuil. Dextromethorphan is the active ingredient in over 100 OTC cold and cough preparations. Teens use these to get high, folks. To make matters worse, they are addictive, and if taken with alcohol or other drugs, they can kill you. Then there’s ‘purple drank’ (yes, that’s how it’s spelled), in which these cough syrups containing codeine and promethazine (Benadryl) are mixed with drinks such as Sprite or Mountain Dew.

3. Have any sexual performance medications? This is part of a category of medicines called ‘medicines that can kill someone with just one pill’. That usually refers to kids or the elderly, but remember that those sexual enhancement drugs are medicines that lower your blood pressure. In the wrong person and in the wrong dose, taking such medicine – whether intentionally or accidentally – could be the last thing someone does.

3. Any narcotic. Need I say more? Remember, you do have people rummaging through your cabinets on occasion!

4. Any sharps. That includes sewing pins, needles, etc.

5. Any medication with an expiration date. The medication date actually is more of a ‘freshness’ consideration than a danger warning. However, in the wrong patient, a medicine that has less than the 100% guarantee of its needed strength that the expiration date represents could be fatal. Play it safe and get a new prescription.

There’s a lot more that could be added to this list, but I like keeping things manageable for you.  Please childproof all your cabinets, and use childproof caps on your medications. I welcome your questions or comments.

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Straight, No Chaser: What Should Be in Your Medicine Cabinet

medicine-cabinet_59x73.5_we
You’ve all done it. I’ve caught a few of you doing it. Why do you rummage through someone’s else’s medicine cabinet? Are newer homes even built with medicine cabinets anymore? Oh well… Today, I’m tackling a simple but important question in an ongoing effort to better empower you.
1. What should be in my medicine cabinet? Here’s my top five and why.

  • Aspirin (324 mg). On the day you’re having a heart attack, you’ll want this available to pop in your mouth on the way to the hospital. Of all the intervention done in treating heart attacks, none is better than simply taking an aspirin. It offers a 23% reduction in mortality due to a heart attack by itself.
  • Activated charcoal. This one may surprise you. Talk to your physician or pharmacist about this. If someone in your family ever overdoses on a medicine, odds are this is the first medication you’d be given in the emergency room. The sooner it’s onboard, the sooner it can begin detoxifying whatever you took. That said, there are some medications and circumstances when you shouldn’t take it, so get familiar with it by talking with your physician.
  • Antiseptics such as triple antibiotic ointment for cuts, scratches and minor burns. It should be embarrassing for you to spend $1000 going to an emergency room when you could have addressed the problem at home. I guess I should include bandages here as well.
  • A variety pack for colds, including antihistamines (like diphenhydramine, aka benadryl) and cough preparations. As a general rule, give yourself 3-5 days of using OTC preparations for a cold to see if it works or goes away. If not, then it’s certainly appropriate to get additional medical care. I guess I can lump a thermometer in this bullet point.
  • The fifth item would be this number: 800-222-1222, which is number to the national poison control center. They will address your concerns, route you to your local poison center and help coordinate your care when you go to your emergency department.
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