Category Archives: Cardiology/Heart

Straight, No Chaser: Stroke Awareness Month

American-Stroke-Month-1-

This content of this post is so simple yet important that it really warrants taking up space in a few of your brain’s cells. Most of us know someone who has suffered from a stroke. With recent improvements in treatment, it’s really unfortunate when debilitating consequences occur simply because signs and symptoms weren’t recognized and/or brought in for treatment soon enough.

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 mnemonic 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.”

strokerecogThink 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 if possible for the best chance of recovery. Important treatment options are available within the first several hours of symptom onset that are otherwise unavailable.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Cardiology/Heart, General Health and Wellness

Straight, No Chaser: The Health Benefits of Red Wine

It’s the start of a new week, and we’re coming off a lot of Straight, No Chaser posts on alcohol, so let’s just address some questions you’ve asked about the benefits of alcohol.

So alcohol is good for me now (especially after all those other blog posts)?

red-wine-health-benefits

Red wine has been known to provide specific health benefits for at least 10 years now. Of course, you have to interact with it in a certain way to receive these benefits. More on that in a bit, but yes, moderate alcohol consumption (especially red wine) does have a direct, beneficial effect on the heart.

Can you be more specific?

red-wine-and-heart-health

Ok. The skin and seeds of red grapes contain substances called flavonoids. Flavonoids reduce bad cholesterol (LDL) production, increase good cholesterol (HDL) production and reduce blood clotting, all of which are significant risks leading to many instances of heart disease. Each of these actions by flavonoids independently reduce the risk of heart disease.

Ok. So how much wine should I be drinking per day? 

If you’re drinking “for the health benefits,” a four-ounce serving is generally what’s recommended for women, and 4-8 ounces works for men. Higher levels of daily consumption than this introduce health risks that offset any benefits.

Is this true for all wines?

redwine-ecg

Unfortunately, not to the same extent. Here are two simple (and admittedly overly simplistic) rules regarding the number of healthy flavonoids in wine.

  • Red wines are better than whites.
  • Bitter red wines are better than sweet wines.

The best red wines have been found to be Cabernet Sauvignon, Petit Syrah and Pinot Noir.

So should I start drinking if I don’t already?

red-wine-ink-heart

Probably not. Most drinkers don’t have the discipline to limit their consumption to just one 4-8 ounce serving of red wine a day, and alcohol comes with too many other health risks to offset the benefits of not drinking at all. This is especially true in those with existing health conditions such as hypertension, pancreatitis, depression, high cholesterol/triglycerides or congestive heart failure. Besides, grape juice has been shown to offer the same benefits!

Enjoy your week, just remember (as I always say): good health isn’t found at the bottom of a bottle!

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Cardiology/Heart, Health Prevention, Toxicology/Drugs

Straight, No Chaser: Expiration Dates on Food, Medicines and Cosmetics

expired-medication-by-HazPhotos

We’re all faced with the decision. When you’re sick, have you ever rummaged through the medicine cabinet and discovered an old prescription? Perhaps you wanted to wear your extra special makeup and discovered the expiration date has passed. Or perhaps you came back from out-of-town, and reached into the refrigerator to cook your favorite meat and discovered it’s a few days past the expiration date.

No lectures today. Let’s engage in some straight talk and answer the questions you have.

 Expiration_Date

1. Why do foods have an expiration date?

Expiration dates provide an assertion of a guarantee of freshness, assuming the absence of other considerations. In other words, expiration dates are meant to suggest “best quality.”

2. Why do some stores sell foods beyond their expiration date?

Because they can. The U.S. Food and Drug Administration (FDA) does not require the coordination of expiration dates with assertions of safety (or lack of safety).

3. So is it safe or not safe to eat foods beyond their expiration date?

This is where things get tricky. The problem with “bad food” is contamination to the extent where sufficient bacteria are present to cause an infection. An expiration date is only a rough measure of that. If you leave food unrefrigerated or exposed to heat, it will go bad well before the expiration date. Even after the expiration date, sufficient bacteria may or may not be present to cause problems, but it becomes more likely as time passes.

4. Are there different considerations for different foods?

Use this list as a quick reference.

  • Countertop food (e.g., bakery goods containing custards, meat, vegetables, or frostings made of cream cheese, whipped cream, or eggs) should be kept refrigerated. Others not containing these (e.g., breads, muffins) can be kept at room temperature for a few days, but watch for mold that will develop over time.
  • Unprocessed pantry foods (e.g., cereal, dry beans, grains, mixes, nuts and pastas) should be good up to a year if unopened. Once opened they must be stored in air-tight containers.
  • Processed pantry foods (e.g., canned foods, cake mixes, crackers, dried foods) are safe until opened. Discard cans that are cracked, bulging or squirt liquid when opened.
  • Refrigerated foods (e.g., milk, chicken) may have both sell-by and use-by dates. Although generally safe to eat after both dates, the risk of problems is higher, so check for odor, discoloration or a bad flavor.
  • Freezer foods, according to the FDA, are safe indefinitely as long as they haven’t partially thawed. In this example, the sell-by and use-by dates apply to quality and retained nutritional value. For best results, if you’re going to freeze, do so early.

cosmexpdate

5. So cosmetics expire? I’ve never noticed an expiration date.

The FDA doesn’t require cosmetic manufacturers to print expiration dates on the labels of cosmetic products, but they do have the responsibility to determine shelf life for products, as part of their responsibility to substantiate product safety. The issue isn’t “expiration” as much as increasing risk for infections (of the eyes in particular).

6. For how long can I safely use cosmetics?

The better question is what increases the risk when using cosmetics. Here are some guidelines:

  • Manufacturers usually recommend discarding mascara two to six months after purchase.
  • If mascara becomes dry, discard it. Do not attempt to prolong its usefulness by adding water or saliva. Doing so will introduce bacteria into the product and onto your eyes when applied.
  • If you have an eye infection, stop using all eye-area cosmetics and discard those you were using when the infection occurred. Seek medical attention.
  • “All-natural” (i.e., plant-derived cosmetics) are more likely to have a shorter shelf life and to be conducive to bacterial growth with subsequent infection.
  • Poorly stored (e.g., exposed to high temperatures, previously opened) cosmetics may deteriorate before the expiration date. Conversely, those stored under optimal conditions may be acceptable long after the expiration date has been reached.
  • Sharing makeup increases the risk of contamination. A good example of this are the “testers” commonly found at department store cosmetic counters. If you feel you must test a cosmetic before purchasing it, apply it with a new, unused applicator, such as a fresh cotton swab.

expdatemedicine-19

7. What happens after a medication expiration date?

When it comes to antibiotics, I hope you never find out. You should always take your medications as prescribed, which generally means until all pills are gone. The medication date actually is more of a “freshness” (actually, safety and potency) consideration than a danger warning. However, in the wrong patient, a medicine that has less than the 100% guarantee of its needed strength, as the expiration date represents, could have fatal results. The expiration date doesn’t really indicate a point at which the medication is no longer effective or has become unsafe to use, with significant exceptions (e.g., tetracycline, nitroglycerin, insulin, and liquid antibiotics).

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Cardiology/Heart, General Health and Wellness, Health Prevention

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

medicine cabinet sick-care-vs-health-care

You’ve all done it. I’ve caught a few of you doing it. Why do you rummage through someone else’s medicine cabinet? Are newer homes even built with medicine cabinets anymore? Oh well… Today, Straight, No Chaser tackles a simple but important question in an ongoing effort to better empower you. For starters, here’s hoping your cabinet doesn’t resemble any of these pictured, but there is a role for medicines in your medicine cabinet.

medicine-cabinet_59x73.5_we

1. What should be in your medicine cabinet? Here’s my top five and why.

  • Aspirin (324 mg).

Aspirin-tablet-300x300

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 (death rates) due to a heart attack all by itself.

  • Activated charcoal.

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.

triple abx

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.

OTCdrugs

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 the number to the national poison control center.

poisoncontrol

They will address your concerns, route you to your local poison center, advise you on the appropriate use of activated charcoal and help coordinate your care when you go to your emergency department.

Be smart about the items in your home in general and in your medicine cabinet in particular. We’ll continue the theme with the next Straight, No Chaser.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Cardiology/Heart, Detoxification, General Health and Wellness

Straight, No Chaser: Why Are Athletes At Such Risk For Pulmonary Embolus?

pe awareness

Let’s begin today’s Straight, No Chaser by being sure not to overstate the case. All things being equal, young healthy individuals and superbly conditioned athletes have diminished risks for diseases across the board. However, all things aren’t equal. The nature of being a professional athlete and many of the tasks associated with being a professional athlete have resulted in some very high-profile cases of pulmonary emboli (PE).

  • Former NBA star Jerome Kersey of the Portland Trailblazers died in 2015 from a PE.dvt kersey_600x600
  • NBA stars Chris Bosh of the Miami Heat and Mirza Teletovic of the Brooklyn Nets were diagnosed with pulmonary emboli and missed most of the 2016 season.Miami Heat Media DayNBA: Brooklyn Nets at Toronto Raptors
  • Former NFL star of the Kansas City Chiefs Derrick Thomas died from a PE in 1989.

dvt derrick_20thomas_20-_20vert_2091

  • Tennis superstar Serena Williams lost a year of her prime (and nearly her life) from a PE in 2010.dvt serena-williams
  • Cleveland Cavaliers center Anderson Varejao suffered a similar health scare during the 2012-13 season.dvt AndersonVarejaoCavs120312

Straight, No Chaser has previously discussed deep vein thrombosis (DVT) and pulmonary embolism. It’s the risks that bear paying attention to; athletes and their activities increase the susceptibility to DVTs and PEs.

  • Driving or flying long distances. Athletes scan the globe competing. Any activity requiring you to be inactive for greater than four hours increases the risk of developing a DVT. That risk increases the longer one remains inactive.
  • Dehydration. The advent of sports and rehydration drinks has reduced this risk, but one should appreciate that with the amount of perspiration occurring during athletic events, the risk of dehydration is present. Dehydration can directly lead to increasing the thickness of blood, which makes the development of clots more likely.
  • Hormones. Those taking birth control pills that contain estrogen have an increased risk of DVTs and PEs.
  • Immobilization: Any injury, cast or brace that results in immobility will allow your blood to pool and increase your risk of a DVT or PE.
  • Injuries. Any injury to a vein or a severe muscle injury can increase the risk for developing DVT.
  • Surgeries: Surgeries combine a few independent risks for DVTs, such as immobilization, the risks of dehydration and injuries to vein.

All things considered, professional athletes remain young and healthy. The occasional occurrence of these life-threatening conditions serves as a warning for us all to be aware of the risks. If world-class athletes are subject to the above risks, then the rest of us certainly are. Be informed and take appropriate precautions.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Cardiology/Heart, Respiratory/Lungs

Straight, No Chaser: Pulmonary Embolus (A Blood Clot in the Lungs)

pe lung

When I was a young, wide-eyed medical student, I learned that in a large number of cases, when people died from unexplained cases, the autopsies would often show the patient died from a pulmonary embolus. Of course this immediately sent the message that this condition gets missed a lot and is often deadly when missed. In fact, although estimates suggest these conditions affect 300,000 to 600,000 people in the United States, the exact number of people affected by DVT (deep venous thrombosis, discussed in this Straight, No Chaser) and PE isn’t known due to how often these conditions go undiscovered.

Pulmonary Embolism_large

The problem is pretty straightforward. Your blood flows throughout the body, delivering oxygen and nutrients to your organs and tissues. This is necessary for normal function. If there’s a disruption in your blood flood, there will be problems. A pulmonary embolism (PE) is a sudden blockage in one or more lung arteries. This typically occurs by a clot that travels through the bloodstream to the lungs from elsewhere in the body (usually the legs, thighs or pelvis), which then gets lodged in the small arteries of the lung.

Pulmonary embolism is a serious, life threatening condition. Basically, if your blood flood through the lungs is blocked, the rest of your blood will be deprived of oxygen.

PEs can cause any or all of the following.

  • Permanent damage to the lung
  • Damage to other organs in your body from not getting enough oxygen
  • Death

pe sudden death

The risk of death from PEs should not be underestimated. If left untreated approximately 30% of those with PEs will die. Imagine the horror we’d express if we were exposed to an infection that killed 3 of every 10 individuals affected, and the risk was as great as is presented by the frequency of DVTs and PEs.

A particular problem with PEs is our general inclination toward waiting for diseases to appear and then seek treatment, instead of being proactive and pursuing prevention. Half of those with PEs will have no symptoms. Thus if you have risks factors or wait until you have been told you have clots in your legs to start reducing your risk, your exposure is much more dramatic.

pe awareness

If you do have symptoms of a PE, they can include the following: shortness of breath, chest pain or coughing up blood; these symptoms may appear suddenly and severely. Symptoms of a DVT/blood clot (e.g. in your legs) include warmth, swelling, pain, tenderness and redness.

The goal of treatment is to break up the clots and to prevent other clots from forming – this is not the same as dissolving the clots, which is a very aggressive and risky step only taken in certain specific, immediately life-threatening situations. The good news is that a prompt diagnosis and proper treatment can save lives and help prevent the complications of PE. Unfortunately, such success is not guaranteed once a PE develops.

The next Straight, No Chaser will look at the unique risks athletes have that place them at risk for blood clots and PEs.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Cardiology/Heart, Respiratory/Lungs

Straight, No Chaser: Blood Clots in Your Legs – Deep Venous Thrombosis (DVT)

dvt

If you’re a sports fan, you’re likely aware of the death of a 52-year-old former star of the NBA’s Portland Trailblazers, Jerome Kersey, followed two days after by the discovery of the same condition in a current star of the NBA’s Miami Heat, Chris Bosh. You may also recall tennis superstar Serena Williams’ career was once placed on hold for a year. The condition from which they all suffered was pulmonary embolus (blood clots in the lungs). Straight, No Chaser will discuss those in the next two posts, but today we will address the condition that most often precedes the development of clots in the lungs.

DVT_clot_illustration

A blood clot represents a blockage of a blood vessel somewhere in the body, usually the lower extremities (legs and thighs), the lungs (pulmonary embolus) or the brain (a stroke). Today we’ll discuss the variety that occurs in the lower extremities, which are generally referred to as deep venous thrombosis (DVTs). In case you’re thinking that a clot in the leg doesn’t sound as bad as a clot in the lungs or the head, you’re correct – until you understand that DVTs break off and travel to other body sites, leading to blockage elsewhere (This is called embolism.).

Today’s challenges are to appreciate the risks of developing DVTs and the symptoms. Risk factors include the following:

  • Birth control pills or other estrogen use (this combined with cigarette smoking pushes the risk even higher)
  • Cancer
  • Cigarette smoking
  • Family history of blood clots
  • Obesity
  • Prolonged immobilization
  • Recent pelvic or leg fracture
  • Recent surgery (most often the pelvis or lower extremities)
  • Recent travel involving long periods of sitting
  • Certain medical conditions, most notably lupus

Deep-Vein-Thrombosis-Homeopathic

Symptoms most commonly are in one leg or the other and reflect the fact that the vein is being blocked. These include pain, swelling, redness and warmth. The above picture is not typical. The presentation is usually much more subtle.

Diagnosis and treatment are relatively straightforward as long as they occur in time (meaning before the clots have broken off). Diagnosis is usually accomplished by an ultrasound of the lower extremities; once discovered, you’ll be placed on blood thinners. It’s important to know that blood thinners prevent the formation of new clots. They do not dissolve existing clots. That’s usually not necessary, as many DVTs simply dissolve. If it doesn’t, DVTs that embolize are life-threatening (more so from the pelvis and thigh than the legs). Unfortunately pulmonary emboli are among the most missed medical diagnoses and causes of death.

Try to manage your controllable risk factors, and be aware – especially when you’re dealing with a risk factor that you can’t control (like surgery).

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

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Filed under Cardiology/Heart, Hematology & Oncology/Blood Disorders/Cancer, Respiratory/Lungs