It may be that your body has reached its ‘desired’ weight – its effective, genetic set point. Reaching this level is relatively less painful than getting past it, but your body’s idea of an ‘effective’ weight won’t necessarily correspond to your personally desired level of leanness. Women in particular tend to achieve healthy homeostasis at higher body fat levels. Breaking through plateaus can be hard enough, but plateaus ordained by the body can seem to be impossible. It’s probably going to take some serious tinkering with carbs, calories, activity levels, sleep and stress. If everything else is on point and accounted for, you may be looking at healthy homeostasis (a biological balance). Then the question becomes “Do you want to mess with a good thing”. If so, stay the course; just don’t expect results as rapidly.
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
All posts by Jeffrey Sterling, MD
From the Health Library of SterlingMedicalAdvice.com: "Why Is It So Hard to Lose This 'Last' 5-10 Pounds?"
What Services Does www.SterlingMedicalAdvice.com offer?
SMA provides quality advice and information through our …
• Medical professionals, representing over 15 medical specialties
• Healthcare specialists, including dentists, mental health professionals, nutritionists, personal trainers, pharmacists and physical therapists
• An extensive online medical library featuring thousands of Frequently Asked Questions and the blog site, Straight, No Chaser
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.
SMA provides quality advice and information through our …
• Medical professionals, representing over 15 medical specialties
• Healthcare specialists, including dentists, mental health professionals, nutritionists, personal trainers, pharmacists and physical therapists
• An extensive online medical library featuring thousands of Frequently Asked Questions and the blog site, Straight, No Chaser
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.
From the Health Library of SterlingMedicalAdvice.com: How Do I Cope?
What should I do if I’m having a hard time coping with recent changes in my life?
Adjusting to change or coping with a recent traumatic event is a difficult process and can lead to some of the same symptoms as mental illness if left unaddressed. Short-term treatment is often very effective to help prevent long-term distress, especially when you seek help sooner than later. Difficulty coping with change is normal, and talking with a professional to help make a healthy transition does not indicate you have a mental illness.
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.
What should I do if I’m having a hard time coping with recent changes in my life?
Adjusting to change or coping with a recent traumatic event is a difficult process and can lead to some of the same symptoms as mental illness if left unaddressed. Short-term treatment is often very effective to help prevent long-term distress, especially when you seek help sooner than later. Difficulty coping with change is normal, and talking with a professional to help make a healthy transition does not indicate you have a mental illness.
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.
Straight, No Chaser: Stroke Recognition
Let’s talk about strokes, aka Cerebral Vascular Accidents (CVA) and Transient Ischemic Attacks (TIA), and specifically about recognition and treatment. If you don’t remember anything else here, commit the mneumonic FAST to memory. (Details follow.)
A stroke (CVA) is an insult to some part of your brain, usually due to an inability of the blood supply to deliver needed oxygen and nutrients to that part of the brain. The brain actually approximates a “body map,” so depending on what part of your brain is affected, different parts of your body will be predictably affected. Technically, a stroke isn’t a stroke until the symptoms have been there for more than 24 hours; until then and/or if the symptoms reverse within that timeframe, the same scenario is called a TIA or a “mini-stroke.”
Think FAST, Act Faster
Here’s how the layperson can recognize a possible stroke:
- Face: Ask the affected person to show you his/her teeth (or gums). In a stroke the face often droops or is otherwise noticeably different.
- Arms: Ask the person to lift and extend the arms so the elbows are at eye level. In a stroke one side will often be weak and drift downward.
- Speech: Ask the person to say any sentence to you. In a stroke the speech will slur or otherwise be abnormal.
- Time: If any of the above occur, it’s recommended that you call 911 immediately, but if it’s my family, I’m getting in a car and going to the nearest MAJOR medical center—not the nearest hospital, which is where the ambulance will take you. There are important differences in hospitals when it comes to stroke treatment (which you won’t know offhand), because some are designated stroke centers and others are not. Friends, this is not the situation where you should wait hours or overnight to see if things get better. Time is (brain) tissue.
It is VERY important that you act on any of the above symptoms (F-A-S) within three (3) hours of symptom onset. Important treatment options are available within the first four and a half (4 ½) hours that are otherwise unavailable.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 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
Let’s talk about strokes, aka Cerebral Vascular Accidents (CVA) and Transient Ischemic Attacks (TIA), and specifically about recognition and treatment. If you don’t remember anything else here, commit the mneumonic FAST to memory. (Details follow.)
A stroke (CVA) is an insult to some part of your brain, usually due to an inability of the blood supply to deliver needed oxygen and nutrients to that part of the brain. The brain actually approximates a “body map,” so depending on what part of your brain is affected, different parts of your body will be predictably affected. Technically, a stroke isn’t a stroke until the symptoms have been there for more than 24 hours; until then and/or if the symptoms reverse within that timeframe, the same scenario is called a TIA or a “mini-stroke.”
Think FAST, Act Faster
Here’s how the layperson can recognize a possible stroke:
- Face: Ask the affected person to show you his/her teeth (or gums). In a stroke the face often droops or is otherwise noticeably different.
- Arms: Ask the person to lift and extend the arms so the elbows are at eye level. In a stroke one side will often be weak and drift downward.
- Speech: Ask the person to say any sentence to you. In a stroke the speech will slur or otherwise be abnormal.
- Time: If any of the above occur, it’s recommended that you call 911 immediately, but if it’s my family, I’m getting in a car and going to the nearest MAJOR medical center—not the nearest hospital, which is where the ambulance will take you. There are important differences in hospitals when it comes to stroke treatment (which you won’t know offhand), because some are designated stroke centers and others are not. Friends, this is not the situation where you should wait hours or overnight to see if things get better. Time is (brain) tissue.
It is VERY important that you act on any of the above symptoms (F-A-S) within three (3) hours of symptom onset. Important treatment options are available within the first four and a half (4 ½) hours that are otherwise unavailable.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 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: The Week In Review, Oct. 13, 2013
I want to take a moment to thank my readers for support Straight, No Chaser and to inform you of a few new developments. The launch of www.SterlingMedicalAdvice.com occurs on Nov. 1st, 2013; you can actually head there now for a sneak peek. Straight, No Chaser was and is designed to provide a taste of what will be available within SterlingMedicalAdvice.com, which will also feature a Frequently Asked Question (FAQ) databank with thousands of pre-answered questions, as well as personalized, immediate, always available interactions with healthcare professionals on your urgent and non-urgent questions. Additional content is currently available on Google+ and Facebook at SterlingMedicalAdvice.com, and on Twitter @asksterlingmd.
Now to the week in review.
On Monday, we discussed angioedema, a condition often presenting with severe swelling of the lips, tongue and throat. This is to be considered a life-threatening emergency prompting immediate medical attention. The risk of the tongue occluding your airway, resulting in an ability to breathe is real.
On Tuesday, we began a series on breast cancer. The first post introduced Breast Cancer Awareness Month and called for more universal awareness.
On Wednesday, we presented two posts (check here and here) listing various myths regarding breast cancer. I’m encouraged that so many of you are aware that men can develop breast cancer as well as women.
On Thursday, we focused on demographic information and discussed risk factors relating to breast cancer. It’s not just being an older women that places you at risk. You can control certain things, such as alcohol intake and obesity.
On Friday, we began the self-empowerment process, giving you tools to self-assess for breast cancer and providing detailed instructions on how to perform the breast self-exam.
On Saturday, we discussed the actual signs, symptoms and long-term prognosis for breast cancer. There are more symptoms to worry about than just lumps. Also remember: the evidence is very clear that your survival rates directly relate to early detection and evaluation.
On Sunday, we discussed breast cancer treatment options. Although breast cancer is scary and deadly in many cases, be encouraged that nearly 3 million survivors are with us in the U.S.
In the next few weeks, we will continue to blog as well as provide additional information from the www.SterlingMedicalAdvice.com FAQ database and still more information about the new service. Thanks for supporting Straight, No Chaser, and be sure to check us out on the social media sites as well.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
I want to take a moment to thank my readers for support Straight, No Chaser and to inform you of a few new developments. The launch of www.SterlingMedicalAdvice.com occurs on Nov. 1st, 2013; you can actually head there now for a sneak peek. Straight, No Chaser was and is designed to provide a taste of what will be available within SterlingMedicalAdvice.com, which will also feature a Frequently Asked Question (FAQ) databank with thousands of pre-answered questions, as well as personalized, immediate, always available interactions with healthcare professionals on your urgent and non-urgent questions. Additional content is currently available on Google+ and Facebook at SterlingMedicalAdvice.com, and on Twitter @asksterlingmd.
Now to the week in review.
On Monday, we discussed angioedema, a condition often presenting with severe swelling of the lips, tongue and throat. This is to be considered a life-threatening emergency prompting immediate medical attention. The risk of the tongue occluding your airway, resulting in an ability to breathe is real.
On Tuesday, we began a series on breast cancer. The first post introduced Breast Cancer Awareness Month and called for more universal awareness.
On Wednesday, we presented two posts (check here and here) listing various myths regarding breast cancer. I’m encouraged that so many of you are aware that men can develop breast cancer as well as women.
On Thursday, we focused on demographic information and discussed risk factors relating to breast cancer. It’s not just being an older women that places you at risk. You can control certain things, such as alcohol intake and obesity.
On Friday, we began the self-empowerment process, giving you tools to self-assess for breast cancer and providing detailed instructions on how to perform the breast self-exam.
On Saturday, we discussed the actual signs, symptoms and long-term prognosis for breast cancer. There are more symptoms to worry about than just lumps. Also remember: the evidence is very clear that your survival rates directly relate to early detection and evaluation.
On Sunday, we discussed breast cancer treatment options. Although breast cancer is scary and deadly in many cases, be encouraged that nearly 3 million survivors are with us in the U.S.
In the next few weeks, we will continue to blog as well as provide additional information from the www.SterlingMedicalAdvice.com FAQ database and still more information about the new service. Thanks for supporting Straight, No Chaser, and be sure to check us out on the social media sites as well.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: Breast Cancer Treatment Options
The last post in this series on breast cancer is on management. Of course, there is no universal treatment of ‘breast cancer’; everything is based on the specific type of breast cancer and the extent of progression upon diagnosis. Management usually involves a team approach in order to balance multiple considerations, which often leads to different treatment modalities being used together.
My goal today is to offer an understanding for the different components of treatment, not to get into the nuances of individual treatment regimens. I certainly recommend you engage your personal physician and resources such as the Center for Disease Control and Prevention and the American Cancer Society, which will provide you with any and all additional details you may desire.
Breast cancer is treated in several ways, including surgery, chemotherapy, hormonal therapy, biologic therapy, and radiation. Let’s review the basics of each.
- Surgery: Under certain circumstances, the cancer has only advanced to a level where it can be surgically removed. Surgical options include cutting out the area affected by the cancer (a lumpectomy), removing the entire breast (a mastectomy), and/or removing the areas where the cancer will drain and spread to other parts of the body (lymph node biopsy/resection). Of course, options aren’t actually quite this simple. Efforts to spare skin and tissue and to retain a cosmetic appearance are important considerations. Sometimes decisions to remove the other breast is made if the risk of breast cancer in that breast is sufficiently high. Additional surgical considerations include breast reconstruction after surgery, which may include one’s own tissue or a synthetic breast implant. These are options to be discussed with a plastic surgeon prior to breast cancer surgery.
- Chemotherapy: Chemotherapy is the use of medication to kill or reduce the cancer. Chemotherapy may be given via an IV (into the veins) or by pills. Chemotherapy may be given before surgery to reduce tumor size, after surgery or with other therapy to reduce the risk of recurrence, or as a primary treatment option.
- Radiotherapy (radiation therapy): High energy rays can be aimed at the cancer cells in an effort to kill them. Alternatively, radioactive material can be placed in the body.
- Hormonal therapy: As mentioned in this post, certain cancer cells are stimulated by hormones to grow. Hormonal therapy blocks cancer cells from getting the specific hormones that assist growth. Different drugs in this class act in a variety of different ways, both direct and indirect, with the same end result of diminishing the ability of hormones to stimulate tumor growth. Yes, this treatment option would be better named hormonal blocking therapy. Hormonal therapy also can be used as a primary treatment option or after other treatment options to reduce the chance of recurrence.
- Biological therapy: Biological therapy serves to boost the body’s immune system to better help it fight the cancer. It also is of assistance in addressing immune-reducing side effects other cancer treatments may create.
- Targeted drugs: An additional treatment modality is the use of targeted drugs, which attack specific abnormalities within cancer cells. The most notable example of such an abnormality is the presence of a human growth factor receptor 2 (HER2), a protein that helps breast cancer cells grow and survive..
Complications and side effects of breast cancer treatment are plentiful, and they vary based on the treatment given. Surgery carries a risk of bleeding and infection. Risks of radiation therapy include fatigue and a red, sunburn-like rash where the radiation is aimed. Breast tissue may be altered in texture and may appear swollen. Rarely, damage to the heart or lungs may occur. Common side effects of chemotherapy include hair loss, nausea, vomiting, fatigue and an increased risk of developing infection. Rare side effects can include premature menopause, damage to the heart and kidneys, nerve damage, and, very rarely, blood cell cancer.
The teams of medical, radiological and surgical cancer specialists who treat breast and other cancers do phenomenal work. Do your part in reducing your risks and engaging in practices (breast self-exam and mammograms) that allow for early detection. Remember, the days of increasing rates of breast cancer are behind us, and breast cancer survivors abound, with approximately 2.8 million survivors in the US. You now have the tools to be included in those numbers should (heaven forbid) you find yourself afflicted by breast cancer.
I welcome your questions and comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
The last post in this series on breast cancer is on management. Of course, there is no universal treatment of ‘breast cancer’; everything is based on the specific type of breast cancer and the extent of progression upon diagnosis. Management usually involves a team approach in order to balance multiple considerations, which often leads to different treatment modalities being used together.
My goal today is to offer an understanding for the different components of treatment, not to get into the nuances of individual treatment regimens. I certainly recommend you engage your personal physician and resources such as the Center for Disease Control and Prevention and the American Cancer Society, which will provide you with any and all additional details you may desire.
Breast cancer is treated in several ways, including surgery, chemotherapy, hormonal therapy, biologic therapy, and radiation. Let’s review the basics of each.
- Surgery: Under certain circumstances, the cancer has only advanced to a level where it can be surgically removed. Surgical options include cutting out the area affected by the cancer (a lumpectomy), removing the entire breast (a mastectomy), and/or removing the areas where the cancer will drain and spread to other parts of the body (lymph node biopsy/resection). Of course, options aren’t actually quite this simple. Efforts to spare skin and tissue and to retain a cosmetic appearance are important considerations. Sometimes decisions to remove the other breast is made if the risk of breast cancer in that breast is sufficiently high. Additional surgical considerations include breast reconstruction after surgery, which may include one’s own tissue or a synthetic breast implant. These are options to be discussed with a plastic surgeon prior to breast cancer surgery.
- Chemotherapy: Chemotherapy is the use of medication to kill or reduce the cancer. Chemotherapy may be given via an IV (into the veins) or by pills. Chemotherapy may be given before surgery to reduce tumor size, after surgery or with other therapy to reduce the risk of recurrence, or as a primary treatment option.
- Radiotherapy (radiation therapy): High energy rays can be aimed at the cancer cells in an effort to kill them. Alternatively, radioactive material can be placed in the body.
- Hormonal therapy: As mentioned in this post, certain cancer cells are stimulated by hormones to grow. Hormonal therapy blocks cancer cells from getting the specific hormones that assist growth. Different drugs in this class act in a variety of different ways, both direct and indirect, with the same end result of diminishing the ability of hormones to stimulate tumor growth. Yes, this treatment option would be better named hormonal blocking therapy. Hormonal therapy also can be used as a primary treatment option or after other treatment options to reduce the chance of recurrence.
- Biological therapy: Biological therapy serves to boost the body’s immune system to better help it fight the cancer. It also is of assistance in addressing immune-reducing side effects other cancer treatments may create.
- Targeted drugs: An additional treatment modality is the use of targeted drugs, which attack specific abnormalities within cancer cells. The most notable example of such an abnormality is the presence of a human growth factor receptor 2 (HER2), a protein that helps breast cancer cells grow and survive..
Complications and side effects of breast cancer treatment are plentiful, and they vary based on the treatment given. Surgery carries a risk of bleeding and infection. Risks of radiation therapy include fatigue and a red, sunburn-like rash where the radiation is aimed. Breast tissue may be altered in texture and may appear swollen. Rarely, damage to the heart or lungs may occur. Common side effects of chemotherapy include hair loss, nausea, vomiting, fatigue and an increased risk of developing infection. Rare side effects can include premature menopause, damage to the heart and kidneys, nerve damage, and, very rarely, blood cell cancer.
The teams of medical, radiological and surgical cancer specialists who treat breast and other cancers do phenomenal work. Do your part in reducing your risks and engaging in practices (breast self-exam and mammograms) that allow for early detection. Remember, the days of increasing rates of breast cancer are behind us, and breast cancer survivors abound, with approximately 2.8 million survivors in the US. You now have the tools to be included in those numbers should (heaven forbid) you find yourself afflicted by breast cancer.
I welcome your questions and comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser (Unless the Chaser is Mouthwash): Halitosis
Let’s talk about bad breath (halitosis). Putting the silliness of someone’s breath odor (or in some cases, oh dear) aside for a second, the overwhelming majority causes of bad breath are relatively simple things and have easy fixes (specifically flossing and brushing, including the tongue), but it could be a sign of a significant medical issue. I would hope the next time you stumble across someone with bad breath, you’d care enough to speak up. You could identify a life threatening disease, such as liver failure or diabetes! For example…
Simple medical issues: have a sore throat or bad teeth (pharyngitis, laryngitis, a dental infection/abscess)? How about reflux? You’ll have halitosis.
You don’t brush and floss? You don’t clean those dentures as much as you should? You’ll get gingivitis, gum decay and an abscess = halitosis (bad breath). How’s your diet? You like onions, garlic, curry, cauliflower or coffee? You smoke or chew tobacco? You drink way too much? You probably have halitosis. Yes, you!
The most important thing is to get to the root of the cause. Take the example of the dental abscess. This infection is found at the bottom of a tooth usually with someone already having gingivitis (inflammation of your gums) and cavities (and yep, is probably a cigarette smoker). It can be treated with penicillin or other antibiotics, but continuing to smoke without getting the cavity closed will continue to cause repeat infections.
At the root of the funk are certain types of mouth-based bacteria not needing oxygen to thrive. These bugs produce odors as part of their metabolizing the ‘goodies’ they’re chewing on in your mouth, and much in the way a cow produces methane gas when it farts… That’s why brushing and flossing are so important. It’s a constant battle to beat back these organisms that live in your mouth.
Sooo… enjoy your day, and remember to take a Tic Tac and a smile. Have a nice weekend!
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Let’s talk about bad breath (halitosis). Putting the silliness of someone’s breath odor (or in some cases, oh dear) aside for a second, the overwhelming majority causes of bad breath are relatively simple things and have easy fixes (specifically flossing and brushing, including the tongue), but it could be a sign of a significant medical issue. I would hope the next time you stumble across someone with bad breath, you’d care enough to speak up. You could identify a life threatening disease, such as liver failure or diabetes! For example…
Simple medical issues: have a sore throat or bad teeth (pharyngitis, laryngitis, a dental infection/abscess)? How about reflux? You’ll have halitosis.
You don’t brush and floss? You don’t clean those dentures as much as you should? You’ll get gingivitis, gum decay and an abscess = halitosis (bad breath). How’s your diet? You like onions, garlic, curry, cauliflower or coffee? You smoke or chew tobacco? You drink way too much? You probably have halitosis. Yes, you!
The most important thing is to get to the root of the cause. Take the example of the dental abscess. This infection is found at the bottom of a tooth usually with someone already having gingivitis (inflammation of your gums) and cavities (and yep, is probably a cigarette smoker). It can be treated with penicillin or other antibiotics, but continuing to smoke without getting the cavity closed will continue to cause repeat infections.
At the root of the funk are certain types of mouth-based bacteria not needing oxygen to thrive. These bugs produce odors as part of their metabolizing the ‘goodies’ they’re chewing on in your mouth, and much in the way a cow produces methane gas when it farts… That’s why brushing and flossing are so important. It’s a constant battle to beat back these organisms that live in your mouth.
Sooo… enjoy your day, and remember to take a Tic Tac and a smile. Have a nice weekend!
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: Signs, Symptoms and Prognosis of Breast Cancer
So, after all we’ve discussed this week, this is what it comes down to: the one in eight lifetime risk has landed at your doorstep. What happens next is very important. The ability to recognize and obtain early treatment for breast cancer (or not) will determine the length and quality of the rest of your life. Remember, most women survive breast cancer; there are approximately 3 million breast cancer survivors in the U.S. That said, also remember that there are about 40,000 annual deaths from breast cancer. The combination of breast self-exams and widespread use of screening mammograms has increased the number of breast cancers found before they cause any symptoms. Unfortunately, many others go undetected because of the limitations or failure to engage those two modalities.
I really want you to become familiar with your bodies (in this instance, your breasts). The most common symptom of breast cancer is a new lump, but you should be in tune with any new change or irregularity, including pain, swelling, redness, irritation, nipple inversion or other irregularity. Remember, breast tissue extends into the armpit (axilla), and you may find swollen and tender lymph nodes in the axilla or near the collarbone (clavicle). My bottom line: you be responsible for diligently assessing any abnormalities, and your healthcare team will determine the cause and if it’s cancer.
One more pitch for early detection: if breast cancer is detected prior to spread to the lymph nodes, the 5-year survival rate (with appropriate treatment) is as high as 98%. If it’s reached the lymph nodes, that drops to approximately 84%, and if it has spread to other body parts (e.g. the lungs, liver and bone – this is called metastatic cancer or carcinoma), the average 5-year survival rate drops to 23%.
This represents a drop in mortality rates by about 25% since 1990. Unfortunately, survivors must live with the uncertainties of possible recurrent cancer and some risk for complications from the treatment itself. That said, recurrences of cancer usually develop within 5 years of treatment. About 25% of recurrences and 50% of new cancers in the opposite breast occur after 5 years.
Many of you have asked about tumor ‘predictors’. I’ll end this post with a look at three considerations, although there are many others:
1. Breast cancer cells may contain binding sites for hormones (estrogen and progesterone). When that’s the case, these cells are called hormone receptor-positive; if not, they’re called hormone receptor negative. When cancer cells are hormone receptor positive, they are responsive to certain medications (such as tamoxifen and others). This improves prognosis. These types of cells also happen to grow more slowly, which also helps. On the other hand, hormone receptor-negative cells only respond to chemotherapy.
2. Tumor markers are proteins released from cancer cells that are able to be identified during the disease. They are notable for demonstrating (or predicting) how aggressive one’s cancer may be. The one I will mention (yes, there are others) is the HER2 marker, which is especially quick-growing and aggressive. The American Cancer Society recommends all newly diagnosed women be tested for this. Fortunately, only 20% women with invasive breast cancer are positive for HER2.
3. Curiously, tumor location within the breast has proven to be an important predictor. Tumors in the middle of the breast are most serious than those toward the outside.
I wish all of you breast cancer survivors or those with family members affected all the best with this. I hope these posts have again pointed out the importance of lowering your risk profile and early detection and treatment. This is another illustration of the shortcomings of our typical approach to health care; relying on medical care is not the same as comprehensive healthcare. The time to engage the fight against breast cancer is not in the midst of advanced disease.
I welcome your comments or questions.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
So, after all we’ve discussed this week, this is what it comes down to: the one in eight lifetime risk has landed at your doorstep. What happens next is very important. The ability to recognize and obtain early treatment for breast cancer (or not) will determine the length and quality of the rest of your life. Remember, most women survive breast cancer; there are approximately 3 million breast cancer survivors in the U.S. That said, also remember that there are about 40,000 annual deaths from breast cancer. The combination of breast self-exams and widespread use of screening mammograms has increased the number of breast cancers found before they cause any symptoms. Unfortunately, many others go undetected because of the limitations or failure to engage those two modalities.
I really want you to become familiar with your bodies (in this instance, your breasts). The most common symptom of breast cancer is a new lump, but you should be in tune with any new change or irregularity, including pain, swelling, redness, irritation, nipple inversion or other irregularity. Remember, breast tissue extends into the armpit (axilla), and you may find swollen and tender lymph nodes in the axilla or near the collarbone (clavicle). My bottom line: you be responsible for diligently assessing any abnormalities, and your healthcare team will determine the cause and if it’s cancer.
One more pitch for early detection: if breast cancer is detected prior to spread to the lymph nodes, the 5-year survival rate (with appropriate treatment) is as high as 98%. If it’s reached the lymph nodes, that drops to approximately 84%, and if it has spread to other body parts (e.g. the lungs, liver and bone – this is called metastatic cancer or carcinoma), the average 5-year survival rate drops to 23%.
This represents a drop in mortality rates by about 25% since 1990. Unfortunately, survivors must live with the uncertainties of possible recurrent cancer and some risk for complications from the treatment itself. That said, recurrences of cancer usually develop within 5 years of treatment. About 25% of recurrences and 50% of new cancers in the opposite breast occur after 5 years.
Many of you have asked about tumor ‘predictors’. I’ll end this post with a look at three considerations, although there are many others:
1. Breast cancer cells may contain binding sites for hormones (estrogen and progesterone). When that’s the case, these cells are called hormone receptor-positive; if not, they’re called hormone receptor negative. When cancer cells are hormone receptor positive, they are responsive to certain medications (such as tamoxifen and others). This improves prognosis. These types of cells also happen to grow more slowly, which also helps. On the other hand, hormone receptor-negative cells only respond to chemotherapy.
2. Tumor markers are proteins released from cancer cells that are able to be identified during the disease. They are notable for demonstrating (or predicting) how aggressive one’s cancer may be. The one I will mention (yes, there are others) is the HER2 marker, which is especially quick-growing and aggressive. The American Cancer Society recommends all newly diagnosed women be tested for this. Fortunately, only 20% women with invasive breast cancer are positive for HER2.
3. Curiously, tumor location within the breast has proven to be an important predictor. Tumors in the middle of the breast are most serious than those toward the outside.
I wish all of you breast cancer survivors or those with family members affected all the best with this. I hope these posts have again pointed out the importance of lowering your risk profile and early detection and treatment. This is another illustration of the shortcomings of our typical approach to health care; relying on medical care is not the same as comprehensive healthcare. The time to engage the fight against breast cancer is not in the midst of advanced disease.
I welcome your comments or questions.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
I really want you to become familiar with your bodies (in this instance, your breasts). The most common symptom of breast cancer is a new lump, but you should be in tune with any new change or irregularity, including pain, swelling, redness, irritation, nipple inversion or other irregularity. Remember, breast tissue extends into the armpit (axilla), and you may find swollen and tender lymph nodes in the axilla or near the collarbone (clavicle). My bottom line: you be responsible for diligently assessing any abnormalities, and your healthcare team will determine the cause and if it’s cancer.
One more pitch for early detection: if breast cancer is detected prior to spread to the lymph nodes, the 5-year survival rate (with appropriate treatment) is as high as 98%. If it’s reached the lymph nodes, that drops to approximately 84%, and if it has spread to other body parts (e.g. the lungs, liver and bone – this is called metastatic cancer or carcinoma), the average 5-year survival rate drops to 23%.
This represents a drop in mortality rates by about 25% since 1990. Unfortunately, survivors must live with the uncertainties of possible recurrent cancer and some risk for complications from the treatment itself. That said, recurrences of cancer usually develop within 5 years of treatment. About 25% of recurrences and 50% of new cancers in the opposite breast occur after 5 years.
Many of you have asked about tumor ‘predictors’. I’ll end this post with a look at three considerations, although there are many others:
1. Breast cancer cells may contain binding sites for hormones (estrogen and progesterone). When that’s the case, these cells are called hormone receptor-positive; if not, they’re called hormone receptor negative. When cancer cells are hormone receptor positive, they are responsive to certain medications (such as tamoxifen and others). This improves prognosis. These types of cells also happen to grow more slowly, which also helps. On the other hand, hormone receptor-negative cells only respond to chemotherapy.
2. Tumor markers are proteins released from cancer cells that are able to be identified during the disease. They are notable for demonstrating (or predicting) how aggressive one’s cancer may be. The one I will mention (yes, there are others) is the HER2 marker, which is especially quick-growing and aggressive. The American Cancer Society recommends all newly diagnosed women be tested for this. Fortunately, only 20% women with invasive breast cancer are positive for HER2.
3. Curiously, tumor location within the breast has proven to be an important predictor. Tumors in the middle of the breast are most serious than those toward the outside.
I wish all of you breast cancer survivors or those with family members affected all the best with this. I hope these posts have again pointed out the importance of lowering your risk profile and early detection and treatment. This is another illustration of the shortcomings of our typical approach to health care; relying on medical care is not the same as comprehensive healthcare. The time to engage the fight against breast cancer is not in the midst of advanced disease.
I welcome your comments or questions.
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Straight, No Chaser: How to Perform the Breast Self-Exam
Beginning in their 20s, women should be aware of the benefits and limitations of breast self-exam (BSE). Women should know how their breasts normally look and feel and report any new breast changes to a health professional as soon as they are found. Finding a breast change does not necessarily mean there is a cancer.
A woman can notice changes by being aware of how her breasts normally look and feel and by feeling her breasts for changes (breast awareness), or by choosing to use a step-by-step approach (with a BSE) and using a specific schedule to examine her breasts.
If you choose to do BSE, the information below is a step-by-step approach for the exam. The best time for a woman to examine her breasts is when they are not tender or swollen. Women who examine their breasts should have their technique reviewed during their periodic health exams by their health care professional.
Women with breast implants can do BSE, too. It may be helpful to have the surgeon help identify the edges of the implant so that you know what you are feeling. There is some thought that the implants push out the breast tissue and may actually make it easier to examine. Women who are pregnant or breastfeeding can also choose to examine their breasts regularly.
It is acceptable for women to choose not to do BSE or to do BSE once in a while. Women who choose not to do BSE should still be aware of the normal look and feel of their breasts and report any changes to their doctor right away.
How to examine your breasts
- Lie down and place your right arm behind your head. The exam is done while lying down, not standing up. This is because when lying down the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue.
- Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.
- Use 3 different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast, but you should tell your doctor if you feel anything else out of the ordinary. If you’re not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.
- Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).
- There is some evidence to suggest that the up-and-down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast, without missing any breast tissue.
- Repeat the exam on your left breast, putting your left arm behind your head and using the finger pads of your right hand to do the exam.
- While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling, or redness or scaliness of the nipple or breast skin. (The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)
- Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it harder to examine.
This procedure for doing breast self-exam is different from some previous recommendations. These changes represent an extensive review of the medical literature and input from an expert advisory group. There is evidence that this position (lying down), the area felt, pattern of coverage of the breast, and use of different amounts of pressure increase a woman’s ability to find abnormal areas.
I need to acknowledge and thank the multiple sources that continue to compile and disseminate information to the public, including the Centers for Disease Control and Prevention, the American Cancer Society and the Susan G. Komen Foundation. I have used these and other sources over the course of the week to integrate my practices and have distilled their information in many cases. I highly recommend them should you need additional or more thorough information. I welcome your questions and comments.
http://www.youtube.com/watch?v=omfbsthDsbc
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Beginning in their 20s, women should be aware of the benefits and limitations of breast self-exam (BSE). Women should know how their breasts normally look and feel and report any new breast changes to a health professional as soon as they are found. Finding a breast change does not necessarily mean there is a cancer.
A woman can notice changes by being aware of how her breasts normally look and feel and by feeling her breasts for changes (breast awareness), or by choosing to use a step-by-step approach (with a BSE) and using a specific schedule to examine her breasts.
If you choose to do BSE, the information below is a step-by-step approach for the exam. The best time for a woman to examine her breasts is when they are not tender or swollen. Women who examine their breasts should have their technique reviewed during their periodic health exams by their health care professional.
Women with breast implants can do BSE, too. It may be helpful to have the surgeon help identify the edges of the implant so that you know what you are feeling. There is some thought that the implants push out the breast tissue and may actually make it easier to examine. Women who are pregnant or breastfeeding can also choose to examine their breasts regularly.
It is acceptable for women to choose not to do BSE or to do BSE once in a while. Women who choose not to do BSE should still be aware of the normal look and feel of their breasts and report any changes to their doctor right away.
How to examine your breasts
- Lie down and place your right arm behind your head. The exam is done while lying down, not standing up. This is because when lying down the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue.
- Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.
- Use 3 different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast, but you should tell your doctor if you feel anything else out of the ordinary. If you’re not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.
- Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).
- There is some evidence to suggest that the up-and-down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast, without missing any breast tissue.
- Repeat the exam on your left breast, putting your left arm behind your head and using the finger pads of your right hand to do the exam.
- While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling, or redness or scaliness of the nipple or breast skin. (The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)
- Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it harder to examine.
This procedure for doing breast self-exam is different from some previous recommendations. These changes represent an extensive review of the medical literature and input from an expert advisory group. There is evidence that this position (lying down), the area felt, pattern of coverage of the breast, and use of different amounts of pressure increase a woman’s ability to find abnormal areas.
I need to acknowledge and thank the multiple sources that continue to compile and disseminate information to the public, including the Centers for Disease Control and Prevention, the American Cancer Society and the Susan G. Komen Foundation. I have used these and other sources over the course of the week to integrate my practices and have distilled their information in many cases. I highly recommend them should you need additional or more thorough information. I welcome your questions and comments.
http://www.youtube.com/watch?v=omfbsthDsbc
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: This is How You Self-Assess For Breast Cancer, Part 1
When I started this point, my first thought was “Why reinvent the wheel? There is a massive amount of information available on the web about breast cancer.” However, as I looked through it all, I was equally amazed at how technical and filled with medical jargon much of it is. I guess that’s why Straight, No Chaser comes in handy! With that in mind, today I’m going to address specific simple steps you should be taking to assess yourself for breast cancer.
1. Reduce your risk factors
- Discuss with your physician balancing the need for birth control with the use of oral contraceptives
- When you are pregnant, breast feed
- Exercise and reduce your obesity
- Limit alcohol intake
- If you’re post-menopausal, discuss with your physician balancing the need for hormone use with your breast cancer risks
2. Get screened
- Learn your body better than anyone else; learn to do breast exams at and after age 20
- Have a clinical breast exam at least every three years starting at age 20, and every year starting at age 40
- Have a mammogram every year starting at age 40 unless your physician places you on a different schedule
3. Know the signs of concern and prompts to see your health care provider
- Lump, hard knot or change in consistency inside the breast or underarm area
- Persistent pain, swelling, warmth, redness or discoloration of the breast
- Change in the size or shape of the breast
- Dimpling, puckering or pulling in of the skin, nipple or other parts of the breast
- Itchy, scaly sore or rash on the nipple
- Nipple discharge that starts suddenly
I welcome your questions and comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
When I started this point, my first thought was “Why reinvent the wheel? There is a massive amount of information available on the web about breast cancer.” However, as I looked through it all, I was equally amazed at how technical and filled with medical jargon much of it is. I guess that’s why Straight, No Chaser comes in handy! With that in mind, today I’m going to address specific simple steps you should be taking to assess yourself for breast cancer.
1. Reduce your risk factors
- Discuss with your physician balancing the need for birth control with the use of oral contraceptives
- When you are pregnant, breast feed
- Exercise and reduce your obesity
- Limit alcohol intake
- If you’re post-menopausal, discuss with your physician balancing the need for hormone use with your breast cancer risks
2. Get screened
- Learn your body better than anyone else; learn to do breast exams at and after age 20
- Have a clinical breast exam at least every three years starting at age 20, and every year starting at age 40
- Have a mammogram every year starting at age 40 unless your physician places you on a different schedule
3. Know the signs of concern and prompts to see your health care provider
- Lump, hard knot or change in consistency inside the breast or underarm area
- Persistent pain, swelling, warmth, redness or discoloration of the breast
- Change in the size or shape of the breast
- Dimpling, puckering or pulling in of the skin, nipple or other parts of the breast
- Itchy, scaly sore or rash on the nipple
- Nipple discharge that starts suddenly
I welcome your questions and comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: The Reach of Breast Cancer and Your Risk Factors
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: (El)even More Myths Regarding Breast Cancer
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: Five Myths Surrounding Breast Cancer
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: October is Breast Cancer Awareness Month
Breast cancer disturbs me deeply, and if it doesn’t affect you as well, you haven’t been paying attention. One in eight women will be diagnosed with breast cancer in their lifetime. It’s more likely than not that every single one of us has been affected by this, either directly or through a friend or family member.
Breast cancer is different. We’ve found the way to eradicate certain cancers and have made remarkable progress on others. Aside from the hereditary component, breast cancer seems so…random, so dehumanizing and so debilitating to so many. Unlike so many of the things I address as an emergency physician, breast cancer isn’t like trauma, STDs and many other conditions, where one is often directly suffering the consequences of their behavior. It is vital that you appreciate the need and value for early detection to give yourself the best possible chance for the best possible outcomes. I’ll be discussing all these considerations in detail throughout the week.
I appreciate the sentiment behind a National Breast Cancer Awareness Month, but if I could offer you anything on this, it would be a plea to be ‘aware’ every month, and use this month as a (re)commitment to take basic steps that will reduce your risk, a charge to maintain steps for early evaluation and a prod to point you toward prompt treatment if and when needed. In fact, those three areas will be the topics of my next few posts. In the meantime, please share this or other information about breast cancer to any and all females in your life. I also hope you choose to engage your family, friends and others in conversations geared to improving breast cancer awareness. Odds are many of them have been or will be affected by breast cancer.
I welcome your comments or questions.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Breast cancer disturbs me deeply, and if it doesn’t affect you as well, you haven’t been paying attention. One in eight women will be diagnosed with breast cancer in their lifetime. It’s more likely than not that every single one of us has been affected by this, either directly or through a friend or family member.
Breast cancer is different. We’ve found the way to eradicate certain cancers and have made remarkable progress on others. Aside from the hereditary component, breast cancer seems so…random, so dehumanizing and so debilitating to so many. Unlike so many of the things I address as an emergency physician, breast cancer isn’t like trauma, STDs and many other conditions, where one is often directly suffering the consequences of their behavior. It is vital that you appreciate the need and value for early detection to give yourself the best possible chance for the best possible outcomes. I’ll be discussing all these considerations in detail throughout the week.
I appreciate the sentiment behind a National Breast Cancer Awareness Month, but if I could offer you anything on this, it would be a plea to be ‘aware’ every month, and use this month as a (re)commitment to take basic steps that will reduce your risk, a charge to maintain steps for early evaluation and a prod to point you toward prompt treatment if and when needed. In fact, those three areas will be the topics of my next few posts. In the meantime, please share this or other information about breast cancer to any and all females in your life. I also hope you choose to engage your family, friends and others in conversations geared to improving breast cancer awareness. Odds are many of them have been or will be affected by breast cancer.
I welcome your comments or questions.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: What Would You Do If Your Tongue Suddenly Swelled? Learn About Angioedema
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: The Week in Review – October 6, 2013
As fall settles in, I’d like to invite my readership to enjoy additional content on Facebook, Twitter and Google+; look for me on Facebook at SterlingMedicalAdvice.com and at Twitter at @asksterlingmd.
On Sunday, we begin the week looking at one possible aspect of trauma from trampolines – elbow dislocation. It is important to be aware of the risks of using trampolines as well as steps you can take to make trampoline use more safe. Also, you must be aware of the severity and high complication rate of elbow dislocations, even with treatment.
On Monday, we took a look at two common rashes: eczema and psoriasis. Did you remember the phrase ‘the itch that rashes’? Be mindful of how important it is to keep those dry rashes moisturized to help avoid cracking, bleeding and infection.
On Tuesday, we joined the conversation on the health exchanges accompanying the Affordable Care Act. While continuing to answer very important questions for you, we also want to point out that regardless as to any initial difficulties anyone is having signing up, benefits don’t begin until January 1st, so there’s plenty of time to get on board.
On Wednesday, we discussed a variety of mechanisms that produce contact dermatitis, including poison ivy/oak and diaper rashes. Be reminded to get treated and not to scratch so much you produce eczema.
On Thursday, we reviewed some items I believe should be in your medicine cabinet. This is a great example of how having knowledge of simple steps you can take can provide tremendous benefit during a critical time.
On Friday, we reviewed some items I believe you should take out of your medicine cabinet and lock up. Here’s another example of taking an ounce of prevention. Maybe you’ll remember what ‘purple drank’ is and be better able to screen the wayward activities of some teens.
On Saturday, we answered some frequently asked questions on contact lenses. Many behaviors involving contacts can have adverse effects, including infections, ulcers and even perforation. Proceed with caution.
Thanks for your continued and steady support of Straight, No Chaser.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
As fall settles in, I’d like to invite my readership to enjoy additional content on Facebook, Twitter and Google+; look for me on Facebook at SterlingMedicalAdvice.com and at Twitter at @asksterlingmd.
On Sunday, we begin the week looking at one possible aspect of trauma from trampolines – elbow dislocation. It is important to be aware of the risks of using trampolines as well as steps you can take to make trampoline use more safe. Also, you must be aware of the severity and high complication rate of elbow dislocations, even with treatment.
On Monday, we took a look at two common rashes: eczema and psoriasis. Did you remember the phrase ‘the itch that rashes’? Be mindful of how important it is to keep those dry rashes moisturized to help avoid cracking, bleeding and infection.
On Tuesday, we joined the conversation on the health exchanges accompanying the Affordable Care Act. While continuing to answer very important questions for you, we also want to point out that regardless as to any initial difficulties anyone is having signing up, benefits don’t begin until January 1st, so there’s plenty of time to get on board.
On Wednesday, we discussed a variety of mechanisms that produce contact dermatitis, including poison ivy/oak and diaper rashes. Be reminded to get treated and not to scratch so much you produce eczema.
On Thursday, we reviewed some items I believe should be in your medicine cabinet. This is a great example of how having knowledge of simple steps you can take can provide tremendous benefit during a critical time.
On Friday, we reviewed some items I believe you should take out of your medicine cabinet and lock up. Here’s another example of taking an ounce of prevention. Maybe you’ll remember what ‘purple drank’ is and be better able to screen the wayward activities of some teens.
On Saturday, we answered some frequently asked questions on contact lenses. Many behaviors involving contacts can have adverse effects, including infections, ulcers and even perforation. Proceed with caution.
Thanks for your continued and steady support of Straight, No Chaser.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: Five Important Questions About Contact Lenses
Question: Which is better: disposable or regular contact lenses?
The development of disposable contact lenses has lessened the risk of various eye problems. This isn’t the same as saying regular lenses aren’t good or even just as good. Daily use (i.e. disposable) contacts don’t require cleaning solutions, which were commonly used for contacts in the past to increase the longevity of them. When you’re next ready for lenses, ask about silicon hydrogel lens. Evidence suggests they are even better for comfort and lower risk for eye problems.
Question: Can I wear my contact lenses when I go swimming?
You can, but you shouldn’t, according to the FDA (Food and Drug Administration). Swimming can cause absorption of chemicals (including chlorine) and bacteria from the water, leading to an eye infection. Additionally, contacts can adhere to the eye after swimming. This can lead to ulceration of parts of the eye (e.g. cornea).
Question: Can I wear my contact lenses while I sleep?
You can use extended wear contacts while you sleep if this has been approved in advance by your optometrist or ophthalmologist; they can be used for up to seven days if recommended as such. Daily wear contacts must be removed prior to sleep – even a nap.
Question: What steps help prevent fungal infections caused by contact lenses?
First, you should understand your risks, which include prior eye damage or a diminished immune system. Fungal infections are a particular concern for those wearing soft contact lens with risk factors. To reduce your risk, be sure to thoroughly wash your hands with soap and water. Be especially careful to avoid lint on your hands before handling your contacts. Avoid extending the use of your contact lens beyond the recommendations of your eye provider. Be sure to keep your lens case clean, and replace the case every 3-6 months. In the unlikely event you’re still using Bausch & Lomb ReNu ® with MoistureLoc® Multi-Purpose Solution, discard it. It’s been recalled due to an increase rate of eye fungal infections.
Question: How do I know if my contact lenses have caused an eye infection?
Be on the lookout for redness, swelling, tearing and/or eye discharge, light sensitivity, blurred vision and pain that doesn’t improve after removal of the contacts. If you have symptoms like this, remove the contacts and get medical assistance.
Remember to pause before inserting anything in your eyes. The consequences of bad decisions can be devastating and irreversible. I welcome your questions or comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Question: Which is better: disposable or regular contact lenses?
The development of disposable contact lenses has lessened the risk of various eye problems. This isn’t the same as saying regular lenses aren’t good or even just as good. Daily use (i.e. disposable) contacts don’t require cleaning solutions, which were commonly used for contacts in the past to increase the longevity of them. When you’re next ready for lenses, ask about silicon hydrogel lens. Evidence suggests they are even better for comfort and lower risk for eye problems.
Question: Can I wear my contact lenses when I go swimming?
You can, but you shouldn’t, according to the FDA (Food and Drug Administration). Swimming can cause absorption of chemicals (including chlorine) and bacteria from the water, leading to an eye infection. Additionally, contacts can adhere to the eye after swimming. This can lead to ulceration of parts of the eye (e.g. cornea).
Question: Can I wear my contact lenses while I sleep?
You can use extended wear contacts while you sleep if this has been approved in advance by your optometrist or ophthalmologist; they can be used for up to seven days if recommended as such. Daily wear contacts must be removed prior to sleep – even a nap.
Question: What steps help prevent fungal infections caused by contact lenses?
First, you should understand your risks, which include prior eye damage or a diminished immune system. Fungal infections are a particular concern for those wearing soft contact lens with risk factors. To reduce your risk, be sure to thoroughly wash your hands with soap and water. Be especially careful to avoid lint on your hands before handling your contacts. Avoid extending the use of your contact lens beyond the recommendations of your eye provider. Be sure to keep your lens case clean, and replace the case every 3-6 months. In the unlikely event you’re still using Bausch & Lomb ReNu ® with MoistureLoc® Multi-Purpose Solution, discard it. It’s been recalled due to an increase rate of eye fungal infections.
Question: How do I know if my contact lenses have caused an eye infection?
Be on the lookout for redness, swelling, tearing and/or eye discharge, light sensitivity, blurred vision and pain that doesn’t improve after removal of the contacts. If you have symptoms like this, remove the contacts and get medical assistance.
Remember to pause before inserting anything in your eyes. The consequences of bad decisions can be devastating and irreversible. I welcome your questions or comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: What Should NOT Be in Your Medicine Cabinet
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
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.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: What Should Be in Your Medicine Cabinet
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.
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.
Straight, No Chaser: Contact Dermatitis, Diaper Rash, Poison Ivy and the Like
Let’s pick up where we left off. In our discussion of eczema and psoriasis, we described the common theme of underlying inflammation manifesting in rashes of different appearances. The theme continues today, with the difference being overlying inflammation. Contact dermatitis (dermatitis = skin inflammation) results from some external entity becoming a nuisance to your skin and generating a response in the form of a rash. You know this in many different forms (shown in the pictures below) – think about those old nickel coated watches, piercings gone bad (piercings also cause actual infections, which is a different consideration), clothing (below is a picture of contact dermatitis caused by flip-flop slippers), poison ivy and diaper rash. I bet the lead picture, which seems like a brand of a butterfly necklace pendant, as well as the following pictures look familiar to many of you.
These rashes are examples of allergic contact dermatitis. Your immune system is generating a response because it believes it is under attack by whatever has touched you. The way the body defends itself leads to release of various chemicals (most notably histamines) that cause the rash. The reason I picked the illustration of the diaper rash is to remind you that the rash actually is in the distribution of the diaper (not just under it), meaning that it may be the diaper that’s the culprit. In other words, don’t just zone in on feces and urine as the problem. Allergic contact dermatitis can occur from – well, anything you’re allergic to, but it’s commonly associated with latex, fruit peels (especially citrus), lotions, perfumes and other topical substances applied to the skin.
When we discussed eczema earlier, we were describing irritant contact dermatitis, which occurs because something damages the skin (remember eczema is called “the itch that rashes”). Imagine that you’ve sensitized and damaged your eczematous skin by scratching away at it and then place something irritating on it. That’s what this is. The longer the new irritant stays on the already damaged skin, the worse the inflammation is, and the more violent the rash appears.
So let’s get to the bottom line: the name of the game is avoidance (as in poison ivy, latex or other known irritants), prompt recognition and removal of irritants, and symptomatic treatment. If you come in contact with a substance that burns or rashes immediately, remove the object or get away from it, and then wash the affected area with mild soap and moderate water. Consider oral histamines (e.g. benadryl) and a mild OTC hydrocortisone ointment. If the rash isn’t better within a few days, or if you ever feel short of breath or as if your throat is closing (as described in greater detail here), contact your physician or the local emergency room immediately for evaluation. Unless you have an underlying condition like eczema or psoriasis, contact dermatitis should resolve within 2-4 weeks with this approach to management.
So in closing, remember: it’s not just the more you itch, the more you scratch. It’s also the more you scratch, the more you itch. Break the cycle.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Let’s pick up where we left off. In our discussion of eczema and psoriasis, we described the common theme of underlying inflammation manifesting in rashes of different appearances. The theme continues today, with the difference being overlying inflammation. Contact dermatitis (dermatitis = skin inflammation) results from some external entity becoming a nuisance to your skin and generating a response in the form of a rash. You know this in many different forms (shown in the pictures below) – think about those old nickel coated watches, piercings gone bad (piercings also cause actual infections, which is a different consideration), clothing (below is a picture of contact dermatitis caused by flip-flop slippers), poison ivy and diaper rash. I bet the lead picture, which seems like a brand of a butterfly necklace pendant, as well as the following pictures look familiar to many of you.
These rashes are examples of allergic contact dermatitis. Your immune system is generating a response because it believes it is under attack by whatever has touched you. The way the body defends itself leads to release of various chemicals (most notably histamines) that cause the rash. The reason I picked the illustration of the diaper rash is to remind you that the rash actually is in the distribution of the diaper (not just under it), meaning that it may be the diaper that’s the culprit. In other words, don’t just zone in on feces and urine as the problem. Allergic contact dermatitis can occur from – well, anything you’re allergic to, but it’s commonly associated with latex, fruit peels (especially citrus), lotions, perfumes and other topical substances applied to the skin.
When we discussed eczema earlier, we were describing irritant contact dermatitis, which occurs because something damages the skin (remember eczema is called “the itch that rashes”). Imagine that you’ve sensitized and damaged your eczematous skin by scratching away at it and then place something irritating on it. That’s what this is. The longer the new irritant stays on the already damaged skin, the worse the inflammation is, and the more violent the rash appears.
So let’s get to the bottom line: the name of the game is avoidance (as in poison ivy, latex or other known irritants), prompt recognition and removal of irritants, and symptomatic treatment. If you come in contact with a substance that burns or rashes immediately, remove the object or get away from it, and then wash the affected area with mild soap and moderate water. Consider oral histamines (e.g. benadryl) and a mild OTC hydrocortisone ointment. If the rash isn’t better within a few days, or if you ever feel short of breath or as if your throat is closing (as described in greater detail here), contact your physician or the local emergency room immediately for evaluation. Unless you have an underlying condition like eczema or psoriasis, contact dermatitis should resolve within 2-4 weeks with this approach to management.
So in closing, remember: it’s not just the more you itch, the more you scratch. It’s also the more you scratch, the more you itch. Break the cycle.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
