Category Archives: Infectious Disease

Straight, No Chaser: Animal Bites

cat_scratch

We love our pets, and animals in general. Is there one about which a movie hasn’t been made? In most cases they are sources of entertainment, if not love. Unfortunately, they are still animals, and on occasions instincts kick in. When this occurs, we find ourselves in danger. Today’s post reviews the dangers of various animal bites.

dogbite

Bow-Wow Ows

Dogs bite almost five million people yearly, resulting in 800,000 visits to a healthcare provider. Injuries are highest for kids between ages five and nine.

Most dog bites are to the upper extremities. (Imagine yourself reaching out, petting or slapping a dog.) However, in kids most injuries are to the head and neck. (They’re smaller.) Here are some tips to avoid getting bitten.

  • If you’re considering bringing a dog into your family, remember that dogs or dog breeds with histories of aggression are inappropriate in households with children. (I’m talking to you, pit bull owner.) Also, spend time with a dog before committing. If your kids are afraid of any individual dog, hold off. That fear may create cues the dog will pick up on and create a self-fulfilling prophecy. Spaying/neutering a dog actually reduces aggressive tenderness (no puns necessary).
  • Once you’ve acquired a pet dog, please never leave infants or young children alone with the dog.
  • Train your dogs, focusing on submissive behaviors. Do not wrestle or otherwise become overly aggressive with your dog. If your dog develops aggressive tendencies, either get better training or remove the pet from the household before it’s too late.
  • Don’t disturb your pet if sleeping, eating or caring for puppies. Also, avoid staring down your or any dog.
  • Do not approach an unfamiliar dog.
  • Regarding dogs you don’t know, don’t pet any new dog without allowing it to see your hand and smell you beforehand. Do not run away screaming from a dog; in fact, if you’re approached by an unfamiliar dog, your best move is to remain motionless. If you trip or fall over, roll into a ball and lie still.

cats bite fingers-gray cat

Mee-Ow Ows

In general, cat bites and scratches are much worse than dog bites. Cat bites and scratches are more of the puncture wound variety, seeding and walling off very infectious bacteria deep inside of you, which then grow and cause infections. (Dog bites are more of the ripping, tearing variety, which poses different problems, but they aren’t as dangerous from an infectious disease standpoint.) Cat bites cause skin and blood infections. You’ll know this by warmth, redness, pain and pus from the wound site. Below is a depiction of an infected cat bite wound.

catbite14x6web

Fever may also be present if the infection is severe enough, and yes, cat bites can be fatal if untreated. You may have heard of “cat-scratch fever.” It’s a real phenomenon. Forget the lead picture; here’s a real picture of cat-scratch fever.

catscratch adenitis

All bite wounds should immediately be washed under high pressure running water, but you want to avoid any scrubbing. Applying pressure to bleeding wounds is important. Time is also important. Both cat and dog bites need to get evaluated. Expect to receive antibiotics in the vast majority of cases. Some bites will require stitches; others will not. That’s a decision for the medical professionals. Treatment may include tetanus and rabies vaccines. Get in and be seen, especially with cat bites/scratches, which can cause loss of life and limb if not dealt with rapidly and effectively.

dog-not-biting

By the way, since this is my blog, I’ll just say stop it with letting your dogs lick you and kiss you in the mouth. That’s just nasty (and that’s medically speaking). Don’t you know where their mouths have been?

shark-attack-792816

The Big Yow Wow! Ow

Shark bites are the things of legends, thanks to movies like Jaws and The Deep Blue Sea, which gives the impression that sharks are serial human killers. In fact, there are about 100 shark attacks worldwide yearly, with about 15-20% of attacks being fatal. I doubt that most Straight, No Chaser readers will be shark bait anytime soon, but the first thing I will mention that’s important to know is unlike other attacks by potential predators, playing possum doesn’t work with sharks. Fight back and fight dirty, attacking the eyes and gills. Apparently, sharks like easy food. In case you’ve ever wondered, sharks aren’t biting you because they’re hungry but because they’re curious. They don’t encounter humans often and similar to how a baby puts about anything in its mouth, sharks will take an “exploratory bite.” The typical human who swims frequently enough to be in shark infested waters isn’t obese enough to keep sharks’ interest and be a focus of their diets, particularly with so many other options. The other curiosity about sharks is after that first nibble, they tend to back off and wait for prey to die before returning for the kill. They don’t seem to like fighting wounded and aggressive victims. Rather lazy, I’d say.

The real danger in shark bites is the amputation. Single bites of arms and legs can cause enough blood loss and subsequent infection to kill you, just like any other amputation. Obviously a bite to your skull, chest or abdomen can kill instantly. Treatment primarily involves aggressive fluid resuscitation and other life-supportive measures, along with assessment of infection risk with antibiotics as necessary.

human bite

The Most Dangerous Animal of Them All

Yesterday’s blog on human bites is important; it’s that frequent and important. For now, understanding that the human mouth is especially dirty and dangerous should hold you over. (Yes, it gets a lot worse than the above picture.) In the meantime, pay attention to your household pets and use the tips mentioned to avoid infection.

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 Infectious Disease, Skin/Dermatology

Straight, No Chaser: Your Questions About Human Bites

jaws

The votes are in, and it appears that Jaws (from James Bond fame) found the previous post, well… biting.  Here’s your questions and answers about human bites:

1)   If human bites are so dangerous, why do women love Dracula so much?

  • Seriously?  Let’s just ascribe it to the neck being an erogenous zone and move on…

2)   What’s a Boxer’s Fracture?

fight bite

  • A boxer’s fracture is a misnomer because boxers don’t get them.  This describes a fracture at the base of the small finger (5th metacarpal), often caused from poor form throwing a punch.  If you take one hand and move the pinky finger portion of the palm (the metacarpal bone), you’ll notice how movable it is (i.e. unstable) compared with the same efforts on the index and middle fingers at the level of the palm, which is what should deliver the blow.  A boxer’s fracture and a human bite together makes for a very bad day.

3)   Is a human’s mouth really dirtier than a goat’s mouth?

goat lip

  • It’s correct to say the bacteria in a human’s mouth cause more disease.

4)   Is a bite the same as a puncture wound

  • The difference between a puncture wound and a laceration is you can identify the bottom (base) of the wound in a laceration, and you can’t in a puncture wound.  Regarding bites: cats, snakes and the aforementioned Dracula are more likely to cause puncture wounds.  Puncture wounds may or may not be caused by a bite (e.g. knife wounds are punctures).

human-reflex-bite

5)   I received a bite and didn’t get stitched up.  Why?

  • This could be for several reasons.  Puncture wounds don’t receive stitches because you don’t want to seal off the infection.  That’s a really good way to develop an abscess.
  • Sometimes we will opt for ‘delayed closure’, waiting 3-5 days to ensure no infection has occurred before placing stitches.
  • It’s really about the risk/benefit ratio.  A laceration to a face is more likely to be repaired because of the risk of disfigurement and scarring, plus the face is a relatively low infection area anyway.

6)   Why didn’t Dracula ever get Hepatitis or HIV?

dracula_bites_kim_kardashian_by_the_mind_controller-d5jh3ix

  • Even though Dracula’s the undead, one would think he’d be the world’s single greatest transmitter of both HIV and the blood transmitted forms of Hepatitis.  HIV is viable for a while in dead tissue, but it can’t multiply, which would explain why Dracula doesn’t show signs of the diseases.  On that note, I’m done.

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 Infectious Disease, Medical Treatment, Skin/Dermatology

Straight, No Chaser: Human Bites

fight-bite

I have had weird experiences with humans biting humans, as have most physicians. There are several different types of human bites, which can range from harmless to surgically serious. However, as an emergency physician, knowing the dangers of the bacteria inhabiting your mouth, I tend to assume the worst until proven otherwise. Your first quick tip is to do the same.

fight bite infected

Maybe it’s where I’m located, but I tend to see way more “fight bites” than anything else; these specifically refer to someone getting hit in the mouth. It’s always interesting to see the guy who “won” the fight being the one who has to come in for medical treatment. He cut his hand on someone’s tooth and really doesn’t think much of it. He just wants the laceration sewn. Little does he realize, the structures in the hand (tendons, blood vessels, muscles, and bones) are highly concentrated. He also doesn’t know that they are confined to a very limited space and seeding an infection in that tight space makes things really bad really quick. This guy is very dangerous because he tends to deny ever getting into the fight, ascribing the injury to something else (like punching a tree)—at least until I ask him why a tooth is inside his hand.

tysonbite

Then there’s the “Yes, he bit me” variety, where the teeth were the aggressor that engaged the victim instead of the fist engaging the tooth. Think of the Tyson vs. Holyfield bite as an example. Sometimes parts get bitten off (fingers, nose, ears, and other unmentionables)! Children, as another example, sometimes bite and need to learn to stop that behavior. Biting is sometimes seen in sexual assault, physical abuse, self-mutilation, or with mentally handicapped individuals.

human-vampires-bite--large-msg-135111099475

A third type is the ‘We love too much!’ variety of bites. These may include hickeys that actually break the skin. Other examples of “friendly” bites are folks biting off their hangnails, fingernails, and toenails and create skin infections. Yes, it happens more than you’d think, and no, you don’t have to be a vampire.

The commonality to all of these scenarios is saliva that found its way through the skin. Because of the virulence of the bacteria contained within the saliva, an infection will be forthcoming. You’ll know soon enough when the redness, warmth, tenderness, fever, and possible pus from the wound develop.

The easy recommendation to make is anytime a wound involving someone’s mouth breaks your skin, get evaluated. Some wounds are much more dangerous than others. Teeth get dislodged into wounds, hand tendons get cut, bones get broken, and serious infections develop. In fact, these bites require immunization for tetanus.

Bottom line: There’s no reason not to get evaluated if you develop those signs of infection, if any injury to your hand occurs, or if any breakage of your skin has occurred. You’ll need antibiotics and wound cleaning in all probability, with a tetanus shot if you’re not up to date. If you’re unlucky, you may end up in the operating room.

human-bite

So here’s your duty if you haven’t successfully avoided the bite:

1) At home, only clean the open wound by running water over the area. Avoid the home remedies like peroxide, alcohol, and anything else that burns. Those agents make things worse by damaging the skin more than they “clean” the area.

2) Apply ice—never directly to the wound—but in a towel. Use for 15 minutes on and then 15 minutes off.

3) Retrieve any displaced skin tissue, place it in a bag of cold water, place that bag on ice, and bring it with you. We’ll decide if it’s salvageable.

4) Get in to be evaluated. Be forthcoming about whether or not it was a bite.

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 Infectious Disease, Skin/Dermatology

Straight, No Chaser: Don’t Let the Bedbugs Bite!

bed-bugs-101-chalkboard

There’s nothing pleasant in talking about bedbugs, but’s it is even worse to have to deal with them, so let’s get you some information to help you prevent and address these bug bites.

bed-bugs-chart

Bedbugs are everything you don’t want them to be. They’re parasites found all over the world, living only to feed on the blood of humans and other animals while you sleep. They’re excellent at hiding, and they do so all day. They only come out every week or so to feed, and when that doesn’t work, they don’t mind so much. They can go over a year between meals. Here’s a not-so-pleasant fact. If you have them, they live within eight feet of where you sleep, but they are willing to travel over 100 feet to get to you.

Let’s discuss your major concerns about bed bugs.

bed-bug

How do I prevent having them?

  • Keep a tidy environment so there are fewer places for bedbugs to hide.
  • Routinely check your furniture, drapes and curtains.
  • Use a protective cover for your mattress, box springs and pillows, and frequently check it for holes.
  • When on the road, don’t place your luggage on the floor (use a luggage rack if available). Inspect your mattress, looking for bugs, blood stains or droppings.
  • When returning from a trip, unpack directly into the washing machine. Learn to check your travel bags.

If bitten, what type of symptoms will I have?

  • You’ll itch, and you’ll discover bite marks (These may not appear for a week or two after the bite. Why you might ask? The bite actually injects an anesthetic into you that prevents you from immediately realizing you were bitten.). Symptoms vary pretty widely between individuals, from some having no reaction to others having severe allergic reactions.

Do bedbugs spread disease?

  • At least it can be said that bedbugs don’t transmit other diseases.

What treatment do I need for bedbug bites?

  • Treatment is symptomatic and involves controlling the itching. Diphenhydramine (branded as Benadryl®) is usually effective for this, as are over the counter topic corticosteroids. You should be careful about scratching your skin, as you can cause infections. If you develop redness, swelling, pain, ongoing itching or develop pus from the bite site, you should seek medical attention.

How do I get rid of bed bugs?

  • Once you discover you are exposed to bedbugs, you will need to wash and dry your clothes and bed sheets at very high temperatures.
  • If you aren’t using protective covers for your mattress, box springs and pillows, you will need to do so.
  • Insecticide spraying is effective in treating infestations.

Bedbgs

Keep in mind that bed bugs are often an acquired habit. When you’re at a hotel or a guest in someone’s home, be mindful to check everything you bring back home!

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 Infectious Disease

Straight, No Chaser: Travelers’ Diarrhea

diarrheaemergency

This is the time of year in the U.S. when you wished you were somewhere else. (Hawaii, Africa, Australia or Mexico for a nice cruise, anyone?) Unfortunately, sometimes when you travel, you get more than you hoped.

“Montezuma’s Revenge” is often the punchline of a joke in the U.S., but travelers’ diarrhea (TD) is a serious concern. It is the most common illness contracted by travelers, affecting approximately 10 million people per year. Individuals visiting the U.S. can suffer from it as well. That’s a clue as to what’s actually occurring with TD.

TD is typically a response to an infection by a strain of bacteria known as E. coli, specifically, a strain that produces a toxin that affects the intestines. This is the case approximately 80% of the time. Parasites sometimes figure prominently in the illness. The risk and primary source of this infection is food or water that is contaminated with feces. Note that most any disturbance in the bacterial balance of the intestines can cause disruptions in the digestive system, leading to diarrhea.

travelers-diarrhea-risk-map

Although anyone can contract TD, destinations and personal characteristics can markedly increase that risk.

  • Higher risk destinations include developing countries in Africa, Asia, Latin America and the Middle East.
  • Those individuals at higher risk include the immunocompromised, diabetics, young adults, those with inflammatory bowel disease and those taking antacids or medicines known as H-2 blockers.

TD is straightforward. Symptoms include watery diarrhea and cramps. A mild fever may or may not be present.

So, what are you supposed to do to prevent TD? This stuff is miserable! Here are a few tips and pointers for you:

  • Avoid street vendors.
  • Avoid raw or undercooked foods (especially meats and seafood).
  • Avoid raw fruits and vegetables (unless you peel them).
  • Wash your hands!
  • Taking antibiotics in advance (prophylactically) is not recommended, because they can increase your susceptibility to resistant organisms and side effects.
  • Bismuth subsalicylate (two ounces or two tablespoons four times daily) reduces the incidence of TD. Speak to your physician or SMA expert consultant about the risks and indications of taking bismuth subsalicylate. By the way, you know bismuth subsalicylate as pepto-bismol or kaopectate.

And now, a few words about treatment. Here are a few considerations about which you should be aware.

  • TD is usually mild and will run its course without medication. In other words, you’re likely to be just fine.
  • The most important consideration is to ensure adequate hydration. Clear fluids are key.
  • You may need antibiotics if symptoms progress to include fever, bloody stools, nausea, vomiting and severe cramps. Drugs typically include ciprofloxacin and norfloxacin. Previously used drugs such as trimethoprim-sulfamethoxazole and doxycycline aren’t recommended anymore because of the high resistance rate.
  • Bismuth subsalicylate may also be used as treatment (in addition to its role in prevention).
  • A  special word about anti-motility (anti-diarrhea) medications: There are some benefits to using these agents, but there are also significant risks. You should not take these medications without understanding the risks and how they may affect you based on your existing health profile. This topic is discussed in greater detail at www.sterlingmedicaladvice.com, and you certainly can discuss this further with your SMA personal healthcare consultant.

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

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

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

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

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Filed under Gastrointestinal, General Health and Wellness, Health Prevention, Infectious Disease, Public Health

Straight, No Chaser: Step on a Nail? What Happens Next?

StepOnNail

What would you do if you stepped on a nail? What if the nail was rusty? Does it make a difference if you were wearing shoes? Is stepping on a nail dangerous? Why does everyone pronounce tetanus “teknus?” For the answers to these questions (well maybe not the last one) and more, read the rest of this Straight, No Chaser!

It’s an interesting thing that so many nails are allowed to stay on the ground until they become rusty. One would think either they’d be picked up or that you wouldn’t be walking around barefooted in unknown areas. We’ve discussed puncture wounds previously, and stepping on a nail is an example of a puncture wound. However, there are some important considerations that make it worthwhile to discuss.

 footnail

What should you do if you step on a nail?

Assuming the nail isn’t stuck in your feet, clean your foot vigorously. If the nail is superficially struck in your foot, it’s likely you will have reflexively yanked it out. That’s ok as long as the wound isn’t significantly bleeding at the time.

It’s prudent that you call your physician for next instructions, but in most cases you’ll be directed to come to the emergency room.

 foot_nail-350

What’s the issue?

There is no one issue. There are several potentially significant consequences of stepping on a nail.

  • If the skin was sliced instead of punctured, that’s a laceration, which will need to be addressed.
  • It makes a huge difference if you were wearing shoes or not, and not in the way you might think. Stepping on a rusty nail is a much more dangerous proposition if you did so while wearing rubber soles. One of the more dangerous bacteria we have to deal with (named Pseudomonas) thrives in rubber. The puncture from grass or ground through the sole of a rubber shoe into your foot may plant this bacteria superficially or deeply into your foot, causing one (or several) of many different types of infections.
  • Rusty nails can produce tetanus, which is almost always fatal. This is why you get immunized at least every decade for this disease. You wouldn’t want your worse enemy to suffer a death from tetanus (at least I’d hope not).

 foot infection from nail

What kind of infections can you get from this?

Skin infections are common after puncture wounds involving nails, and can include the following:

  • Cellulitis – a straightforward infection of the skin
  • Abscesses – those walled-off “pus pockets” that sometimes require incision and drainage to make it go away
  • Osteomyelitis – the bones deeper into the foot can actually become chipped and/or infected as well

These are significant wounds, especially if rubber soles are involved, and they may even require surgery to clean the area. In some instances (especially when you have certain risk factors) skin ulcerations (breakdown of the skin) can occur, making severe infection more likely. In some of these instances, foot amputation is necessary.

In addition to wearing rubber-soled shoes at the time of the injury, these other conditions place you at risk for a worse outcome.

  • Cancer
  • Diabetes
  • Malnutrition
  • Reduced immunity
  • Smoking history

The infections associated with nail-induced puncture wounds are potentially serious and hard to treat. Patients sometimes end up hospitalized with weeks and sometimes months of treatment with antibiotics.

In case you think the take home message is it’s better not to wear shoes or sandals when walking through the house, grass or sand, you’re partially correct. My best advice to you is look before you weep.

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

Comments Off on Straight, No Chaser: Step on a Nail? What Happens Next?

Filed under General Health and Wellness, Infectious Disease, Orthopedics/Bones

Straight, No Chaser: Living With An Incurable Sexually Transmitted Infection

STD living well

You’ve requested it, and it’s only fair. We’ve spent a lot of time discussing sexually transmitted diseases and infections (STDs, STIs). It’s reasonable to discuss living with an STD. The first point to appreciate is most STDs can be treated; that’s been discussed at length in several previous posts. Next you should understand that those that can’t be treated don’t represent a death sentence. STDs are simply diseases. To be clear you will need to make adjustments to your life, and this Straight, No Chaser will discuss those.

Even if you were irresponsible in acquiring an STD, you must learn to be responsible in managing it once it’s known that you have an incurable STD such as HPV or HIV/AIDS. Refer back to the Straight, No Chaser Comprehensive Safe Sex Guide for details.

std incurable

There are important differences between managing different diseases. Putting HIV/AIDS aside momentarily, consider the following general considerations regarding herpes or HPV.

  • You can live a mostly normal life with these conditions. Unless you’re in the midst of a herpes outbreak or are showing the warts of HPV, you will appear normal. Every other positive attribute you possess will still be intact. Use that positivity to help you through.
  • It’s only fair and reasonable to have a conversation with existing and/or new sexual partners about your condition. You and your partner should meet with your physician to discuss risks and possibilities. You will want this information to make informed decisions about what you choose to do moving forward.
  • If you are showing symptoms or in the midst of an outbreak, you should avoid any sexual activity.
  • Unless you’re in the midst of an outbreak, you can have sex. Remember that these STDs can be transmitted even in the absence of symptoms, so please protect yourself and your partner.

A really reasonable way to think about having sex with an incurable STD is to think about kissing someone with a cold or the flu. You could still do it, but you’re likely to be at risk. When the symptoms aren’t there, your partner could still be a carrier of the disease and could still give you the disease. Your better course of action is to wait until all symptoms are gone and then still be careful.

std living facts

You have to simultaneously appreciate that your life will be approximately normal, even as you’ve had a significant change. Even as you get about living the rest of your life, you should be aware of risks that can cause an outbreak.

  • Of course intercourse is a very risky activity. Couples who have been exposed to one STD are likely to have been exposed to multiple. You don’t want to “ping-pong” diseases between you and your partner. Follow the recommended guidelines for having and avoiding sex based on your symptoms.
  • Surgery, trauma or any cause of a reduced immune system can produce an outbreak. If you’re diabetic, on steroids, have lupus or other conditions that affect the immune system, have a conversation with your physician.

STD living

At some point, you’ll get over the guilt and shame associated with having an untreatable STD and start focusing on the rest of your life. Be sure to live that life so it’s not causing more damage along the way; out of sight can’t be out of mind with an incurable STD. Be especially mindful of your risks of giving your partner your disease, both from specific acts of intercourse and from other sexual activities besides intercourse. Remember, these diseases all affect more than sex; managing these diseases is managing your health.

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 Genital/Urinary, Infectious Disease, Obstetrics and Gynecology

Straight, No Chaser: STDs – Treatment of Pubic Lice (Crabs)

pubic lice treatment comb

There’s no dishonor in needing help. A pubic lice infestation is one of many types of conditions that can lead to a complete disruption of your life. These are full-time parasites whose mission is to multiply and inhabit you. If you get infected and either don’t know what to do or incompletely/incorrectly treat these infections, you’ll be in for a long and unpleasant co-existence with pubic lice. Today’s Straight, No Chaser addresses treatment considerations regarding pubic lice and is modified from recommendations from the Centers for Disease Control and Prevention. Non-treatment-related information on pubic lice is available in this post.

Lice-killing over-the-counter products containing 1% permethrin or pyrethrins and piperonyl butoxide can be used to treat pubic (“crab”) lice. These medications are safe and effective when used according to instructions. It never hurts to discuss this with the pharmacist while you’re there or with your SterlingMedicalAdvice.com expert consultant from home.

It is important to appreciate that there are two separate considerations in treating pubic lice: 1) treatment of lice actually in the pubic area and 2) treatment of lice on the eyebrows and/or eyelashes.

public lice rx statement

Steps for genital pubic lice treatment:

  • Wash the infested area and towel dry. Set the towel aside, as it will need to be specially cleaned.
  • Thoroughly saturate the pubic hair and other infested areas with lice medication. Leave the medication on your hair for the time recommended in the instructions. After waiting the recommended time, promptly remove it.
  • Even at this point, most nits (eggs) will still be attached to hair shafts. Nits may be removed with fingernails or by using a fine-toothed comb.
  • Put on clean underwear and clothing.
  • To kill any lice or nits remaining on clothing, towels, or bedding, machine-wash and machine-dry those items used during the two-three days before treatment. Use hot water (at least 130°F) and the hot dryer cycle.
  • Items that cannot be laundered can be dry-cleaned or stored in a sealed plastic bag for two weeks.
  • All sex partners from within the previous month should be informed that they are at risk for infestation and should be treated.
  • Sexual contact must be avoided until all sexual partners have been treated and reevaluated to rule out persistent infestation.
  • Repeat treatment in nine to 10 days if live lice or nits are still found.
  • Persons with pubic lice should be evaluated for other sexually transmitted diseases (STDs).

Steps for treatment of lice and nits found on eyebrows or eyelashes:

  • The lice medications used for the genital region should not be used near the eyes.
  • If only a few live lice and nits are present, it may be possible to remove these with fingernails or a nit comb.
  • If additional treatment is needed for lice or nits on the eyelashes, careful application of ophthalmic-grade petrolatum ointment (only available by prescription) on the eyelid margins two to four times a day for 10 days is effective. Regular petrolatum such as Vaseline should not be used, because it can irritate the eyes.

Your physician knows what medications work for treatment of pubic lice, but I do want you to make a note regarding one medicine: lindane shampoo. This medicine is effective but has a bad risk profile. It can be toxic to the brain and central nervous system and is most notably associated with the development of seizures. Because of this, lindane is not a first-line medication and should be restricted to instances in which other medications didn’t work or aren’t tolerated. Lindane is not to be given to anyone under 110 pounds (e.g., children), those with a history of seizures, women who are pregnant or breast-feeding, the elderly or those with sores and/or irritated skin in the areas to be treated.

The point about pubic lice is the same as with any sexually transmitted infection. Your best course is to avoid contracting it. If obtained, your best course is to come clean (no pun intended) and get aggressive with treatment and notification of your sexual partners. Pretending it will go away or that it can’t happen to you is a dangerous prescription that I won’t co-sign.

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 Genital/Urinary, Infectious Disease

Straight, No Chaser: STDs – Pubic Lice (Crabs)

Unfortunately, there’s no pleasant way around this topic. I hope the topic doesn’t make you crabby.

public lice_01

There is a story of legend in the medical community regarding the trends to start waxing or shaving pubic hair. It involves crabs (pubic lice). Back in the 1920s, when the clear preference for appearance involved a full “bush,” this was often accompanied with the frequent presence of pubic lice, particularly in the brothels of Las Vegas. Women took to shaving in an effort to relieve themselves from the presence of the lice. However, the newly shaved appearance apparently wasn’t good for business; as a result, these women began wearing pubic toupees.

So why am I telling this story? The toupees were made of beaver hair. That’s the origin of that terminology, in case you didn’t know… On to common questions about pubic lice.

 pubic-lice-hair

What are pubic lice? Pubic lice (aka crabs) a parasitic insects found in the genital and pubic areas of humans.

 pubiclicevsheadlice

Where are pubic lice found? By definition, pubic lice are predominantly found in the genital and pubic areas in one’s hair. However, pubic lice have also been found in other areas of the body with coarse hair, such as the armpits, beard, eyebrows, eyelashes, legs and mustache. In fact, pubic lice on the eyebrows or eyelashes of children are regarded as a prompt to search for sexual abuse. It also is of note that lice on the scalp are head lice, which is a different consideration than pubic lice.

Whom do pubic lice infect? Anyone and everyone seem to be affected. Pubic lice are seen all over the world across all races, classes and ethnicities. Pubic lice are not seen in animals. Pubic lice are most commonly seen in adults, are considered to be a sexually transmitted disease (infection, aka STD or STI) and should prompt a search for other STDs. There have been occasional cases spread through contact with articles such as bed linens, clothing or towels, but this is extremely rare. Lice can’t live away from the warmth of a human body very long, and their feet don’t allow for walking on or attaching to smooth surfaces, so they generally are limited to staying on their hosts.

Can I get public lice by sitting on a toilet? This commonly expressed concern is quite overstated. As noted, lice can’t live away from the warmth of a human body very long, and their feet don’t allow for walking on or attaching to smooth surfaces, so they generally are limited to staying on their hosts.

 pubicLice

What do pubic lice look like? Pubic lice have three forms: the egg (also called a nit), the nymph, and the adult.

  • Nit: Nits are lice eggs. When seen, they are usually found firmly attached to the hair shaft. They are oval and usually yellow to white. Pubic nits hatch in about 6–10 days.
  • Nymph: The nymph is a young, immature louse that just hatched from the nit. Pubic lice nymphs take about 2–3 weeks after hatching to mature into adults capable of reproducing. To live, a nymph must feed on blood.
  • Adult: The adult pubic louse resembles a miniature crab. Pubic lice have six legs; their two front legs are very large and look like the pincher claws of a crab. Pubic lice are tan to grayish-white in color. Females are usually larger than males. In case you’re thinking that doesn’t matter to those infected, it should because females lay eggs, continuing the cycle that causes human discomfort. To live, lice must feed on blood. If the louse falls off a person, it dies within 1–2 days. 

What are the signs and symptoms of pubic lice? The symptoms of pubic lice infestation include genital itching, visible lice eggs (nits) or visible crawling lice.

Pubic-lice

How is a pubic lice infestation diagnosed? The diagnosis of pubic lice is simply made by visualizing a louse or nit (egg) in the pubic hair or elsewhere. It is more common to need a magnifying glass to identify lice or eggs.

How are pubic lice treated? We will go into the treatment of pubic lice in some detail in an additional Straight, No Chaser. It’s too important to simply give a quick answer on this.

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

Comments Off on Straight, No Chaser: STDs – Pubic Lice (Crabs)

Filed under Genital/Urinary, Infectious Disease, Obstetrics and Gynecology

Straight, No Chaser: What To Do If You Suspect a Sexually Transmitted Disease (STD)

It’s been a long and productive sex week here at Straight, No Chaser. We’ve run the gamut of common sexually transmitted infections (STIs) and other genital conditions, and links to many are included within this post. However, many of you have rightfully asked a simple question: “What happens if and when I contract a STI?” This and the next post will look at three scenarios around contracting, managing and living with a STIs.

 STD1 tellapartner

What you should do immediately if you suspect you or your partner has a sexually transmitted infection

  • You first job is to stop the denial. STIs don’t go away on their own. Well, actually herpes does, but it’s more accurate to say it goes into hiding, waiting to return another day. At the first suggestion of any abnormality (e.g. vaginal/penile discharge, the presence of bumps, a rash, warts or ulcers, itching or burning when you urinate, or abnormal smells, etc.), get evaluated. This clearly is an example of it’s better to have it (an evaluation) and not need it than to need it and not have it. STIs cause consequences, including PID (pelvic inflammatory disease), birth defects and any increased incidence of cancer. HPV even causes cancer, and without vaccination, virtually 100% of the sexually active population will obtain it at some point in life.

STD1 women-infertile

  • You must get all your sexual partners evaluated and treated. Ping pong is not just a sport. You getting treated without all of your partners doing so as well is pointless. Even your asymptomatic partners can be carriers of the disease. Sorry folks, but guys are much more likely not to have symptoms even if infected. Don’t let that fact change the reality of who needs to be told and treated (or who could have caused the infection). Not telling your female partners about STIs can have devastating consequences.

std1 hiv

  • You should make a commitment to wearing condoms. Either get over the subjective difference in how sexual intercourse feels with and without condoms, or get more creative to adjust for the difference. The issues are common things happen commonly, and the best predictor of future behavior is past behavior. If you have had a STI, you’re more likely to have others in the future. It’s more likely to be in your social network, and you may be the one who is a carrier (of herpes, for example). Given that STIs “hang out” together like a gang (meaning the same individuals infected with one STI are the ones most likely to have others), you want to avoid contract some of the incurable STIs, such as herpes, HIV or HPV.

 std1 testing

What we will do if you suspect you have a STI

  • When you come to your physician’s office or the emergency room with the possibility that a STI exists, or you know you’ve been exposed to one, you will be treated. This is not a situation in which we wait to treat some of the more common conditions, such as gonorrhea or chlamydia. Because of the community, dealing with STIs is more of a “treat now, ask questions later” situation. Besides, many individuals are carriers without the presences of symptoms (particularly those with herpes). I must restate: this is neither the time to be bashful or in denial. If it’s syphilis that’s in question, say so. If you have sufficient symptoms, your medical team will figure it out, but it’s better for you if you already know what the likely culprit is.
  • You should not be offended by the questions you will be asked. Physicians are in the treatment business, not the judging business. Expect to have frank conversations about your sexual habits and preferences, with and without your partner(s) present.

std1 hpv-vaccine

  • If a definitive diagnosis is made for certain conditions (e.g. gonorrheachlamydiasyphilis or PID), you will be treated prior to leaving the emergency room unless you have allergies preventing the use of certain medicines. There are two particular considerations for you after you’ve been treated for a curable STI in an office or ER setting, both regarding your resuming sexual activity. First, if cultures were drawn, you should wait to begin sex until after these results have returned. The cultures will clarify exactly which diseases you have and which antibiotics work against them. Normally this would have been an issue, but antibiotic-resistant gonorrhea is a real thing. Additionally, you should wait to begin sex until all of your current partners have also been treated and cleared. You can and will become reinfected from all STIs on more than one occasion.

The final post in this series discusses managing the presence of an incurable sexually transmitted infection.

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

Comments Off on Straight, No Chaser: What To Do If You Suspect a Sexually Transmitted Disease (STD)

Filed under Geriatrics/Elderly Care, Health Prevention, Infectious Disease, Obstetrics and Gynecology