Category Archives: General Health and Wellness

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

stdstudSTD1in25

As an emergency physician, my first consideration is to eliminate life threats.  Along the way, I cure disease and provide a ton of information.  With all of these efforts, I provide a heavy dose of tough love and straight talk meant to empower (and hopefully never belittle).  This is heavy on my mind because this week we’ll be discussing sex – not the pleasant aspects, but those instances when something has gone wrong as a result of sex.

std-statistics-worldwide-infographic

I’ve been on the receiving end of hundreds (more likely thousands) of couples coming in, usually one dragging the other by the ear, attempting to determine if “something’s going on”, and yes, more than a few relationships have left the emergency room dissolved after such conversations.  I would like to have the beginning of such a conversation with you much in the way that I might have with one of these couples.  This is a very appropriate prelude to a conversation about sexuality transmitted infections (aka STIs aka STDs).

Patient: I have a foul smell coming from my vagina.  I know he’s doing something!

Doctor: Can you tell me what it smells like?  Is there any vaginal discharge, rash or other lesions that you’re seeing?

Male partner (who would have been better off saying nothing): It smells like fish!

Patient (after shooting eye lasers at her partner): I am not having sex with anyone but him, so I know he did something!

Male partner: Doc, I’m not doing anything.  She’s the only one I’m with, and I don’t have any symptoms.

Doctor: So each of you only has each other as a partner?

Couple: <nods yes>

Doctor: Would you bet your lives on it?

Couple: <Stunned silence>

Doctor: Well that’s exactly what you’re doing every time you’re having unprotected sex.  Now about that discharge…

This upcoming week we are going to address several of most common and/or most important STIs out there for you to know about.

std red-carpet-celebrities-with-stds

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss.  In this case, what you don’t know can kill you.  No matter what you think about how ‘good’ it is, it’s not worth risking your life over.  Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.

If you’re sexually active, you really should follow this series. There’s going to be a lot covered. Might I suggest you cover it as well?

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

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

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

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

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Straight, No Chaser: Healthcare Disparities

Disparities

In large part, this blog exists to inform individuals of all backgrounds about the risks that lead to abnormal health outcomes. Our hope is that once you discover the risks, you’ll be sufficiently equipped and incentivized to take the simple steps provided to improve your health.

Disparities are abnormal outcomes of a different variety. Disparities in healthcare lead to premature development of disease and death. The culprits are often insufficient access to care, culture barriers, habits and even discriminatory practices. It is critical for all involved, i.e., individuals, healthcare planners and practitioners, to understand these causes so that everyone can adjust habits and apply resources to combat this health hazard affecting both individuals and communities.

For the last 25 years of my career, I’ve had the unfortunate privilege of addressing this topic in national forums, including before the National Urban League, before the National Medical Association, recently, in the NAACP’s The Crisis magazine and in Straight, No Chaser to extent that our service provides you with the information that can make a difference in your lives. Unfortunately for some, it’s almost never that easy.

 disparities_infant-mortality

As a statement of fact, according to the Center for Disease Control and Prevention (CDC) Health Disparities & Inequalities Report 
of 2013, African-Americans suffer global health disparities that result in the following outcomes.

  • Life expectancy: In 2011, the average American could expect to live 78.7 years. The average African-American could only expect to live 75.3 years, compared with 78.8 years for the average White American.
  • Death rates: In 2009, African-Americans had the highest death rates from homicide among all racial and ethnic populations. Rates among African-American males were the highest for males across all age groups.
  • Infant mortality rates: In 2008, infants of African-American women had the highest death rate among American infants with a rate more than twice as high as infants of white women.

 disparitydm

The following disparities were also reported:

  • Heart disease and stroke: In 2009, African-Americans had the largest death rates from heart disease and stroke compared with other racial and ethnic populations, with disparities across all age groups younger than 85 years of age.
  • High blood pressure: From 2007-2010, the prevalence of hypertension was among adults aged 65 years and older, African-American adults, US-born adults, adults with less than a college education, adults who received public health insurance (18-64 years old) and those with diabetes, obesity or a disability compared with their counterparts. The percentages of African-Americans and Hispanics who had control of high blood pressure were lower compared to white adults.
  • Obesity: From 2007-2010, the prevalence of obesity among adults was highest among African-American women compared with white and Mexican American women and men. Obesity prevalence among African-American adults was the largest compared to other race ethnicity groups.
  • Diabetes: In 2010, the prevalence of diabetes among African-American adults was nearly twice as large as that for white adults.
  • Activity limitations caused by chronic conditions: From 1999-2008, the number of years of expected life free of activity limitations caused by chronic conditions is disproportionately higher for African-American adults than whites.
  • Periodontitis: In 2009-2010, the prevalence of periodontitis (a form of dental disease) was greatest among African-American and Mexican American adults compared with white adults.
  • HIV: In 2010, African-American adults had the largest HIV infection rate compared with rates among other racial and ethnic populations. Prescribed HIV treatment among African-American adults living with HIV was less than among white adults.
  • Access to care: In 2010, Hispanic and African-American adults aged 18-64 years had larger percentages without health insurance compared with white and Asian/Pacific Islander counterparts.
  • Colorectal cancer: In 2008, African-Americans had the largest incidence and death rates from colorectal cancer of all racial and ethnic populations despite similar colorectal screening rates compared to white adults.
  • Influenza vaccination: During the 2010-11 influenza season, influenza vaccination coverage was similar for African-American and white children aged six months to 17 years but lower among African-American adults compared with white adults.
  • Socioeconomic factors: In 2011, similar to other minority adults aged 25 years or older, a larger percentage of African-American adults did not complete high school compared with white adults. A larger percentage of African-American adults also lived below the poverty level and were unemployed (adults aged 18-64 years) compared with white adults of the same age.

disparityuninsured

Identifying disparities is a good start. However, to reduce them it is necessary to identify and implement solutions, both individually and institutionally. To this end, we will explore best practices in future Straight, No Chaser posts. Feel free to ask any questions you have on this topic.

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

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

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

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

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Straight, No Chaser In The News: The Cleveland Murder, African Americans and Mental Health

In the news is a simply horrific, seemingly random murder in Cleveland that was posted to Facebook. Today’s Straight, No Chaser seeks to review a central aspect of the crime: the alleged perpetrator of the crime appears to be suffering from mental health issues, and he claimed to have lost “everything” due to gambling.

Straight, No Chaser has recently reviewed gambling addiction in the following post: Problem Gambling

There also is a fair amount of discussion, if not surprise, that the alleged perpetrator of the crimes was an African-American male, given that a “mental breakdown” appears to have been in play (which, medically speaking is a dubious consideration). Things have changed. There was a time when mental health disorders were not thought to be “much” of an issue in the African-American community (apologies to all historically affected). Over the years, this notion has led to mental illness being dramatically undiagnosed and undertreated in this segment of the population. However, as this data from the U.S. Department of Health and Human Services, Office of Minority Health (DHHS/OMH) points out, that is a misperception at best.

Regarding mental health and African-Americans

  • African-Americans are 10% more likely to report having serious psychological distress than Non-Hispanic whites.
  • The death rate from suicide for African-American men was more than four times greater than for African-American women, in 2014.
  • However, the suicide rate for African-Americans is 70% lower than that of the non-Hispanic white population.

As these things go, there’s a relative consideration and an absolute consideration, and it’s true that more than one thing can be true at a time. As noted, African-Americans commit suicide at a significantly lower rate than others within the general population. However, it is also true that African-Americans have a significantly higher level of psychological distress. As such, a report from the U.S. Surgeon General found that from 1980 – 1995, the suicide rate among African-Americans ages 10 to 14 increased 233%, as compared to 120% of non-Hispanic whites.

Also, I would be remiss if I didn’t point out the strong correlation between poverty and mental health. Also from the DHHS/OMH:

  • Poverty level affects mental health status. African-Americans living below the poverty level, as compared to those over twice the poverty level, are 3 times more likely to report psychological distress.

All of this is to say, mental health concerns among African-Americans should be taken as seriously as they are in every other segment of society and not dismissed as something to be absorbed by the individual. Remove the stigma. Get people the help they need before a crisis occurs.

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

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

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

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

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Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

healthweek

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.

public health

In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Top10AchievementsPH

  1. Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
  2. Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
  3. Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
  4. Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
  5. Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
  6. Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
  7. Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
  8. Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
  9. Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
  10. Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

Public_Health_Ounce

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.

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

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

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

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Straight, No Chaser: The Emotional Signs of Child Abuse

child-abuse report

In a previous Straight, No Chaser, we provided a pictorial demonstration of the physical signs of child abuse. Unfortunately for many, the emotional signs are even more dangerous. It’s important for you to be able to recognize the subtle emotional cues that could represent a high-risk situation for a child. Too often people take a laissez-faire approach to “abnormally acting” children. Your raising and reporting concerns could save lives.

One very important consideration is that reporting abnormal situations isn’t the same as making accusations. It’s better to think of it as establishing a path for whatever type of help is needed. To that end, today’s post will share information provided by the U.S. Department of Health and Human Services to help you recognize when a child may be in danger. Pay attention because it could be your child that is affected, and it’s not always true that what doesn’t kill you will make you stronger.

child abuse emotional

The Child

• Shows sudden changes in behavior or school performance

• Has not received help for physical or medical problems brought to the parents’ attention

• Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes

• Is always watchful, as though preparing for something bad to happen

• Lacks adult supervision

• Is overly compliant, passive, or withdrawn

• Comes to school or other activities early, stays late and does not want to go home

• Is reluctant to be around a particular person

• Discloses maltreatment

child abuse emotional no excuse

The Parent

• Denies the existence of—or blames the child for—the child’s problems in school or at home

• Asks teachers or other caregivers to use harsh physical discipline if the child misbehaves

• Sees the child as entirely bad, worthless or burdensome

• Demands a level of physical or academic performance the child cannot achieve

• Looks primarily to the child for care, attention, and satisfaction of the parent’s emotional needs

• Shows little concern for the child

child abuse emotional tears

The Parent and Child

• Rarely touch or look at each other

• Consider their relationship entirely negative

• State that they do not like each other

The above list may not be all the signs of abuse or neglect. It is important to pay attention to other behaviors that may seem unusual or concerning. In addition to these signs and symptoms, Child Welfare Information Gateway provides information on the risk factors and perpetrators of child abuse and neglect fatalities:  https://www.childwelfare.gov/topics/can/

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Signs of Physical Abuse

Consider the possibility of physical abuse when the child …

• Has unexplained burns, bites, bruises, broken bones or black eyes

• Has fading bruises or other marks noticeable after an absence from school

• Seems frightened of the parents and protests or cries when it is time to go home

• Shrinks at the approach of adults

• Reports injury by a parent or another adult caregiver

• Abuses animals or pets

Emotional-Child-Abuse

Consider the possibility of physical abuse when the parent or other adult caregiver …

• Offers conflicting, unconvincing or no explanation for the child’s injury, or provides an explanation that is not consistent with the injury

• Describes the child as “evil” or in some other very negative way

• Uses harsh physical discipline with the child

• Has a history of abuse as a child

• Has a history of abusing animals or pets

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

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

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 General Health and Wellness, Mental Health, Pediatrics/Kids Health, Trauma

Straight, No Chaser: The Physical Signs of Child Abuse

abuse-emotional-child-96_2

Given how often this topic is in the news, we must continue to drill certain points home. This Straight, No Chaser provides visual examples of the consequences of child abuse. A child’s body doesn’t care if the wounds were meant to injure or just to punish. The long term effects aren’t limited by family traditions of similar behavior. We need an army to protect children against child abuse. A separate post will discuss the mental signs and consequences of abuse, but to start with, I’d like to help you recognize physical signs I tend to look for to potentially identify victims of abuse.

Symptoms include:

  • Black eyes

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  • Broken bones that are unusual and unexplained
  • Bruise marks or lashes shaped like hands, fingers, or objects (such as a belt)

child abuse whip marks arm

  • Bruises in areas where normal childhood activities would not usually result in bruising

BRUISES-MISSED-ABUSE

  • Bite marks

child abuse bite marks

  • Bulging soft spot (fontanelle) or separations in an infant’s skull

childabusefontanelle

  • Burn marks, usually seen on the hands, arms, or buttocks

childabusebuttock

  • Choke marks around the neck
  • Cigarette burns on exposed areas or on the genitals

child abuse burns

  • Circular marks around the wrists or ankles (signs of twisting or tying up)
  • Unexplained unconsciousness in an infant

If you ever see such things in children, be suspicious, be involved and get help. There are always ‘explanations’ for why things happen to children, but they too frequently seem to defy logic. Of course you can call 911 or the Childhelp National Child Abuse Hotline (1-800-4-A-CHILD). You could save a life.

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

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

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

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Straight, No Chaser: National Doctor’s Day!

doctors-day-logo1

National Doctors’ Day is held every March 30th in the U.S. It celebrates the contribution of physicians who serve our country by caring for citizens. The first Doctor’s Day observance was March 30, 1933 in Georgia, where Eudora Brown Almond, wife of Dr. Charles B. Almond, decided to set aside a day to honor physicians. This first observance included the mailing greeting cards and placing flowers on graves of deceased doctors.

On March 30, 1958, a Resolution Commemorating Doctors’ Day was adopted by the United States House of Representatives. In 1990, legislation was introduced in the House and Senate to establish a national Doctor’s Day. Following overwhelming approval by the United States Senate and the House of Representatives, on October 30, 1990, President George Bush signed S.J. RES. #366 (which became Public Law 101-473) designating March 30th as “National Doctor’s Day.”

doctors-day-logo

So whether or not your like or use your doctor as much as you should, and especially because your physicians typically aren’t into ego gratification about their careers, might I suggest the best way of honoring your physician on National Doctor’s Day is to follow that last piece of medical advice you received. Because (and this is speaking personally) the best gift you probably could give me is showing that my efforts actually are making a positive impact on your live. Here’s to your health!

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

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

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 General Health and Wellness, Public Health