Category Archives: Medical Treatment

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: Your Guide to Fighting Childhood Obesity (Works for Adults, Too!)

Would you start your child on a fad diet? Of course not. Combating obesity means consistently applying principles that bear fruit (and include fruits over time). So you have an overweight child and want to do better to protect his or her health. Today on Straight, No Chaser, we  discuss tips to promote better habits and health. You may want to keep this list. Of course it starts with you. Be careful! You may discover these tips work for you as well.

Things for the parents to do

parents-kids-obesity

  • Understand that this process involves many individuals (e.g., you, your physicians, dieticians, psychologists – even your personal healthcare consultants). None of you should be expected to do this alone. Ask for help.
  • Appreciate that you are the message. Your words are not enough. You are your children’s role model. They will aspire to look and be like you. Protect your own health.
  • Don’t isolate your child. Get the entire family involved in developing healthy eating and physical activity habits.
  • Don’t mentally punish your child. If they are led to believe they did something wrong or disappointed you, they could adopt dangerous behavior to compensate or punish themselves. Be supportive and positive.

Healthier eating habits

kids-healthy-eating

General conditions

  • Make healthy choices easy and unhealthy ones more difficult. Put nutritious foods where they are easy to see, and keep high-calorie foods out of sight. It takes multiple servings for anyone’s tastes to get used to new foods. Stick with it!
  • Figure out how to avoid fast food. When you do go, choose the healthier options, such as salads with low-fat dressing.
  • Plan special healthy meals and eat together as a family. Make it an adventure, and make it fun and rewarding.
  • Don’t use unhealthy foods as a reward when encouraging kids to eat. Promising dessert to a child for eating vegetables, for example, sends the message that vegetables are less valuable than dessert.
  • Don’t make your child clean his or her plate. This promotes overeating.
  • Learn to limit eating to specific meal and snack times. At other times, the kitchen is “closed.”
  • Avoid large portions. Start with small servings, and let your child ask for more if he or she is still hungry.

Limit the bad

  • Avoid any fats that are solid at room temperature (e.g., butter and lard)
  • Avoid foods that are high in calories, sugar and salt (e.g., sugary drinks, candy, chips, cookies and French fries)
  • Avoid refined grains (white flour, rice and pasta)

Add the good

  • Introduce fruits, vegetables, nuts and seeds and whole grains (e.g., brown rice). Don’t worry. They’ll eat them if that’s the option you’re providing.
  • Use fat-free or low-fat milk and milk products or substitutes (e.g., soy beverages)
  • Offer your child water or low-fat milk instead of fruit juice
  • Serve lean meats, poultry, seafood, beans and peas, soy products and eggs

Control the snacking

  • Go with air-popped popcorn without butter
  • Gradually train your kids to like fresh, frozen, dried, or canned fruit served plain or with low-fat yogurt
  • Gradually train your kids to like fresh vegetables like baby carrots, cucumber, zucchini or tomatoes
  • Snack on low-sugar, whole-grain cereal with low-fat or fat-free milk or a milk substitute fortified with calcium and vitamin D

Stay physically active

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Kids need about 60 minutes of physical activity a day. Several short 5-10 minute periods of activity throughout the day are as effective as one 60-minute session. If you are starting from scratch, start from where you are and build up to the 60 minutes target. It only works if you stay diligent.

General considerations:

  • Be the message! Show your child that physical activity is fun, and demonstrate how you enjoy it. Have family activities that include being physically active, such as a walk.
  • Encourage participation in organized sports or classes, such as basketball, dance or soccer.
  • If sports don’t work, other fun activities include dancing to music, playing tag, jumping rope or riding a bike.
  • Assign active chores such as making the beds, sweeping/raking or vacuuming.

Activities that kids choose to do on their own are often best. Try these – and play with your kids. You need to be active, too!

  • Catching and throwing
  • Climbing on a jungle gym or climbing wall
  • Dancing
  • Jumping rope
  • Playing hopscotch
  • Riding a bike
  • Shooting baskets

Cut back on inactive time spent watching TV or on the computer or hand-held device.

  • Limit screen time to no more than two hours per day.
  • Substitute these relatively inactive activities with stimulating ones such as acting out books or stories or doing a family art project.
  • When watching TV, get up and move during TV commercials. By all means, discourage “couch-potato” activity of snacking when sitting in front of the TV.

I know this is a lot, but your kids are worth it, as are you. These actions are habits, not just actions. Work over time to incorporate as many as possible into your family’s routine, and I promise you’ll see the difference.

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 Diet and Nutrition, Health Prevention, Medical Treatment, Pediatrics/Kids Health

Straight, No Chaser: The Treatment of Erectile Dysfunction

Well, here’s what many of you’ve been awaiting.  Assuming the preventative efforts I mentioned didn’t work for you, there are several different treatment approaches. If there’s an underlying medical cause, then treatment of that cause is not only a good way to relieve erectile dysfunction (ED), but it’s a good way to get healthy and avoid other complications from the primary disease. Today, I’ll review different treatment strategies your primary care physician or urologist may discuss or recommend to you for treatment.

The medications

A first consideration is to be wary of (any) medications via mail order. The same level of testing, scrutiny and quality control just doesn’t exist to the same degree as do medications obtained through a pharmacy. Reports abound of people receiving expired or weak formulations of the pills, as well as fake or hazardous substitutes of the pills they thought they were receiving. Engage at your own risk.

Now, regarding those medications you know all too well by name and brand (e.g. Levitra, Cialis and Viagra), there’s no special ‘magic’ to them. They all are variations of the same theme, physiologically relaxing muscles in the penis, resulting in increased blood flow to it.  Unfortunately, that’s not the entire story with these medications.  ED medications all lower blood pressure throughout the body, and that increased blood to the penis is coming at the expense of decreased blood flow elsewhere (This is called a ‘steal syndrome’.).  If you’re otherwise unhealthy, and your redirecting blood that was needed in the heart or brain, you could end up with a heart attack or stroke while taking these meds.  Therefore, this leads to two very important cautions regarding ED meds.  You shouldn’t start them without discussing with a physician first (to determine “…if you’re healthy enough to have sex”, as the commercials say), and secondly, don’t keep the fact that you’re taking them a secret (to your significant other, and especially to any physician you come across if you’re sick).  These medications could be the cause of whatever medical issue has you in an emergency room. They could also be contributors to life-threatening adverse effects if you’re being treated for something else with a medication that interacts with the ED med you’re taking but didn’t bother to mention to the emergency physician.  This is why ED medications generally aren’t given to men also on medications for high blood pressure, an enlarged prostate, blood thinners or certain other heart diseases (e.g. angina).

There are actually even more intricate medications used to treat ED.  Taking testosterone injections is an increasing means of addressing low hormone levels.  Additional injections directly into the penis or inserting a suppository into the penis itself are additional, effective treatment methods.  You’d be given these options by your urologist if necessary.

The counseling

If your ED is due  to anxiety, stress or other psychologically generated reasons, psychotherapy (possibly with your partner) may be of incredible assistance.  If you pursue this option, you and your partner must be prepared to be patient and to work through a variety of issues and possible approaches.

Surgery and additional methods

  • If you’ve ever seen an Austin Powers movie, you’re familiar with (well at least the jokes about) penis pumps.  These are real things, and involve placing a hollow tube over the penis and creating a vacuum to pull blood to the penis via a pump.  A tension ring is placed about the base of the penis to maintain the erection during intercourse.
  • Actual vascular surgery to repair damaged arteries may be indicated in certain cases.
  • Penile implants are an additional option.  Inflatable rods are placed into the sides of the penis.  These rods are simply inflated when needed.

Penile-Prosthesis-300x168

If you think some of this is a bit much, it may or may not be, depending on if you’re the one suffering.  As I usually conclude, prevention would have been a much better course of action.  Hopefully if that’s not the case, you’ve understood the information provided well enough to have an informed conversation with your physician.  Good luck, and I welcome your comments and/or questions.

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, Medical Treatment

Straight, No Chaser: So… You Skipped Your Period? Let’s Discuss Secondary Amenorrhea

missed-periods-300x205

It happens all the time, but one thing that makes both men and women anxious is a missed menstrual period. Everyone’s always worried about being pregnant (and you should be).

amenorrhea

While a missed menstrual period is the defining feature of early pregnancy, it can be due to a number of other factors and conditions.

Skipped periods are a fact of life. Doctors use the term amenorrhea—primary and secondary amenorrhea—to describe the absence of menstruation.

Primary amenorrhea, which is very rare, is when a female has not yet started her monthly periods, though she is older than age 15 and has otherwise completed puberty. We discuss primary amenorrhea over at www.sterlingmedicaladvice.com.

Secondary amenorrhea, which is much more common, is the absence of periods in a previously menstruating woman. Periods may be irregular, with the woman skipping periods for the first few years after she begins menstruating and during perimenopause (the time preceding menopause). However, when the lapse in regular periods last for over six months, it is called secondary amenorrhea. (This designation does not pertain to post-menopausal, pregnant or breast-feeding women.)

Let’s jump right into the risk factors and causes. There are many, and these conditions tend to interfere with the balance and levels of the body’s sex hormones.

Risk factors

You are more likely to have amenorrhea when the following factors are present:

  • Excessive exercise
  • Significant, sudden weight loss (e.g., gastric bypass, extreme diets)
  • Obesity
  • Severe anxiety or emotional distress
  • Very low body fat (less than 15% – 17%)

Other possible causes include the following:

  • Brain tumors (e.g., pituitary tumors)
  • Cancer/chemotherapy treatment
  • Dilatation and curettage (D&C)
  • Drugs used to treat schizophrenia or psychosis
  • Overactive thyroid gland
  • Polycystic ovarian syndrome
  • Reduced function of the ovaries
  • Severe pelvic infections
  • Use of hormone shots (e.g., Depo-provera) and the six-month period after cessation of these shots

Of course, you’re going to get evaluated, and the first question will be whether or not you are pregnant. The good news is for secondary amenorrhea (and even more so for skipped periods), simply addressing the underlying cause resolves the situation in most cases. However, don’t take it lightly. Get evaluated if you have concerns. Of course, you can feel free to contact your SMA expert consultant with any questions you have.

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 Endocrine/Metabolic, Medical Treatment, Obstetrics and Gynecology

Straight, No Chaser: Lowering Your Risk of Being Sexually Assaulted

rapestop

Rape occurs in many different situations. Although the stereotype involves a stranger pulling a victim into a dark, isolated place, more common situations involve being assaulted in the home environment by someone known or by a date. These days rapes occur with victims unable to resist and without memory of the assault.

To begin this conversation of how to lower your risk of sexual assault, remember this first:

Never leave your drink unattended, whether on a date or at a club or other social event.

daterapedrugs

This is the second entry in a Straight, No Chaser series on sexual assault (aka sexual violence, rape).

  • Check this Straight, No Chaser, which addresses the definition and scope of sexual assault, including actions to take if you’re a victim of sexual assault or an attempted sexual assault.
  • Another post will discuss concrete physical and mental consequences of sexual assault.
  • Another post will discuss signs of sexual assault in children.

For the many of you who are victims of rape and sexual assault, you are never at fault, no matter where or how it happens. Your mental health moving forward is largely dependent on when and how completely you accept this fact.

rapeprevention

How can I lower my risk of sexual assault?
This information is modified from the U.S. Department of Health and Human Services (DHHS), the Center for Disease Control and Prevention (CDC) and the National Crime Prevention Council. Here are actions you can take to lower your risk of sexual assault. Being prepared to recognize signs and take action is not the same as living in fear or being paranoid. Forewarned is forearmed.

In general
• First and foremost, be aware of your surroundings. Learn to survey your environment as a prelude to avoiding dangerous situations.
• If any circumstance presents that makes you feel uncomfortable, leave. Hone and trust your instincts.
• Be assertive about your personal space. Make it clear that there are limits that are not to be violated. Your first concern shouldn’t be how these boundaries make you look, but your safety.
• Carry your preferred method of protection. Be skilled in your choice and avoid options that can easily be used against you.

At home
• Lock your doors and your windows, even if you’re gone for just a few minutes. The appearance of unforced entry only confuses matters if you’re trying to prosecute an attacker.
• Never prop open self-locking doors.
• Use door guards, including security door chains and partial door stops.
• Never open your door without knowing who is on the other side. Use the door’s peephole to view your visitors.

Out and about
• Walk with confidence. This promotes strength.
• When it comes to using alcohol, know your limits and stick to them.
• Avoid isolated areas such as underground garages, offices after business hours and apartment laundry rooms, especially if you’re alone.
• Avoid walking or jogging alone, especially at night. Vary your route and routine. Exercise and rest in well-traveled, well-lit areas.

Near your car
• Lock your car, even if you’ll only be gone for a few moments. You don’t want to return to find someone hiding in your back seat.
• Have your key ready to use before you reach your car.
• Get a key with an alarm button. Make sure the battery is always strong and the alarm functioning.
• Watch your car keys and don’t put your name and address on the key ring.
• Park in brightly lit areas that are away from wooded or other areas that could easily disguise danger.
• Drive on well-traveled roads and maintain high levels of fuel in your car. Keep your doors and windows locked while driving.
• Fuel your vehicle during the day.
• Never pick up a hitchhiker.
• If you experience car trouble, stay in your vehicle and call for help on your cellular phone. If you don’t have a phone, put the hood up, lock the doors and place banners in scattered sites that say, “Help. Call police.”

date_rape_psa_photo

Prevention in these matters is the smart thing to do. Your best chance to avoid sexual assault is to avoid being places in which a higher risk of assault exists.

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 Genital/Urinary, Medical Treatment, Mental Health, Trauma

Straight, No Chaser: Quick Tips – Learn the ABCDEs of Hiccups

hiccups-enHD-AR1

Three question sets on hiccups of all things

Why do I get hiccups?

You get hiccups because everyone gets them.  You get them because basically you’ve agitated your main breathing muscle (You have one on both sides, between the chest and abdominal cavities.).  Something’s caused it to spasm, which produces a reflex vocal cord closure.  That sound you hear is the reflex air going down your windpipe.  Here’s some of those ‘somethings’…

You smoke too much.

You’re overstressed.

You’re agitating your stomach.

  • You eat too much too quickly.
  • You drink too much.
  • You swallow too much air.
  • You alternative between hot and cold foods too quickly.

Are hiccups ever serious?

Absolutely.  In fact, hiccups can go on for more than 48 hours.  In these instances, you need to get evaluated.  Several things can cause this, but I’ll be particularly worried about your nerves and nervous system.

hiccup-460_1215860c

What about all those hiccup cures?

Some things never hurt to try.  What you’re actually trying to accomplish through multiple variations of the same theme is to increase your carbon dioxide level (the gas you exhale in breathing), which tends to stop the hiccups.  Here’s a few oldies but goodies – think ABCDE.

  • Achoo!  Sneeze even if you don’t need to.  It may additionally stimulate the diaphragm out of hiccupping.
  • Breathe into a paper bag for 30-60 seconds.
  • Count to 10 while holding your breath.
  • Drink a cold glass of water – fast (Notice you’re holding your breath while doing this, and no, you don’t need a pencil in your mouth.).
  • Eat a teaspoon of sugar or honey.

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 Medical Treatment, Neurology

Straight, No Chaser: Should I Take a Daily Aspirin?

heart aspirin

So… I’m stuck on a desert island, and I’m allowed to take two medications. I’m pretty sure aspirin is going to be one of them. This begs the question “Who should take a daily aspirin?” The answer is actually easy: anyone and only anyone whose physician recommends it. The better question is when will your physician recommend it? In yesterday’s Straight, No Chaser, we reviewed the expanding use of aspirin. That was the “why” of it all. Today we look at the “how” and “when.”

The benefits of aspirin in reducing heart attack risk have been known and well described for quite a while now, and you should check this list to see if you’d benefit from taking a daily aspirin. Truth be told, it’s of such importance that if you’re of a certain age, you should have this conversation with your physician at your next physical exam. Here’s a partial list that will get you a daily aspirin or very strongly considered for one.

  • If you’ve previously had a heart attack
  • If you’ve had a coronary artery stent or surgery
  • If you’ve previously had a stroke (caused by a blood clot) or TIA (transient ischemia attack, aka ‘mini-stroke’).
  • You’re a male over 50.
  • You’re a female over 60.
  • You have a bad risk factor profile (i.e. You smoke, have diabetes, high blood pressure or high cholesterol levels, are overweight, don’t exercise or have a personal or family history of heart disease)

The above list actually isn’t exhaustive but is sufficient for most individuals’  ability to remember to start a conversation with their physician.  These considerations will be measured against others that would suggest you shouldn’t be taking a daily aspirin (e.g. allergy, bleeding ulcers, a bleeding disorder or if you’re taking certain other medications).

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, Health Prevention, Medical Treatment

Straight, No Chaser: End of Life Decision Making

end-of-life_tcm7-91616

Having this conversation when death is staring you or a loved one in the face is not the most ideal situation. Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.”

I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. It needs to sink in: at any age your life could be at risk, and at any age you could die. When your life is threatened, if you have specific desires, you’ll need someone comply with decisions. It could happen today. You need to be protected now. You’re much more protected having declared your interests and desires than not. Read on.

AdvanceDirective

Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and subsequently with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions that can be covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

  • Do you care to be intubated? The use of breathing tubes to either protect your airway or breathe for you when you’re unable to is a big deal. The decision to accept or forego this might be an immediately life-prolonging or life-ending decision.
  • Do you care to have advanced cardiac life support in the event that your heart either stops or is unstable? As with intubation, there’s an immediacy to this decision that’s better addressed in a moment of quiet reflection than in the emotion of crisis.
  • Do you want transfusions of blood or other blood products? Some religions have strong declarations on the topic. If you haven’t made your decision not to receive blood known in a legal document, and you are unable to express that decision in a life or death situation, physicians will try to save your life with an infusion. They will not adhere to your choice, because they won’t know what it is. That scenario doesn’t have to happen.
  • Do you want “every possible thing done for you,” or might there be a limit in the face of perceived medical futility (i.e., minimal chance of any success)? Basically, this question gets at whether you’d like to go in peace or in a blaze of resuscitative glory and heroic effort.
    • If you’re in the midst of a terminal illness and/or are comatose with no perceptible chance of recovery, will you want medicines and treatments (such as dialysis to remove toxins from your body) to ease pain and suffering, or will you want to be allowed to die?
    • Will you want the medical staff to feed you if you can’t feed yourself?
    • Will you want to donate your organs?

endoflifedeath

As you can see, these are serious questions to consider, and I’d hope you’d agree they are worthy of conversation well in advance of a tragedy. In my next post, I’ll discuss some related logistical considerations around end-of–life care and decision-making. I hope this has gotten you to thinking and planning on having important conversations.

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 General Health and Wellness, Health Prevention, Medical Treatment

Straight, No Chaser: Treatment of Acid Reflux (Gastroesophageal Reflux Disease)

acid-reflux-400x400

If you experience heartburn two times a week or more, you may have gastroesophageal reflux disease (GERD). Because there are significant differences in the severity of GERD, you should know when varying forms of treatment may be necessary. This Straight, No Chaser focuses on treatment of mild symptoms. For discussion of more severe GERD, visit www.sterlingmedicaladvice.com or discuss the options listed below with your healthcare provider.

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Mild symptoms As is the case for many diseases, simple dietary changes away from foods that increase acid producing and reflux symptoms often can be sufficient. As a reminder, such foods include alcohol, caffeine, chocolate, fatty foods and peppermint. With mild symptoms, over the counter medications such as antacids or antihistamines might be all that’s needed. Additional considerations such as the following have been shown to be helpful in some people with mild reflux and is worth the effort.

  • avoiding large meals
  • avoiding late meals
  • avoiding tight-fitting clothing
  • elevating the head of your bed six to eight inches
  • increasing the chewing of gum or use of oral lozenges (this is related to saliva production, which can neutralize acid)
  • quitting smoking (smoking actually reduces saliva production)
  • weight loss

acid_reflux_treatment

If and when medicines are used for mild symptoms, there are two classes of medicines used.

  • Antacids — Antacids such as Maalox, Myalanta and Tums are commonly used for short-term relief of acid reflux. The frustration you may have experienced in taking them is related to the fact that these medicines only neutralize stomach acid very briefly after each dose.
  • Histamine antagonists (aka antihistamines) — These medicines, including cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac), reduce acid production in the stomach and are often helpful as a first line effort.

Moderate to severe symptoms — For patients with moderate, severe or refractory symptoms of acid reflux, or for those with complications of gastroesophageal reflux disease, different treatment options must be used.

  • Proton pump inhibitors (PPIs) — This class of prescription medicine is stronger and more effective than the histamine antagonists listed above. When these are necessary, it typically takes an eight-week course of treatment to optimize dosing and produce the best results that can be achieved.
  • Surgical treatment — When PPIs are ineffective, surgical options such as strengthening the lower esophageal sphincter and repairing any hiatus hernias (conditions in which the stomach partially slips through the diaphragm into the chest, facilitating more escape of acid into the esophagus) may be necessary.

There’s a lot you can do to avoid taking medicines and needing surgery. Make those better choices and live a healthier, happier life!

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, Medical Treatment

Straight, No Chaser: Breast Cancer Treatment Options

breast cancer treatment remedies

The next to last post in this series on breast cancer is on management. Of course, there is no universal treatment of ‘breast cancer’; everything is based on the specific type of breast cancer and the extent of progression upon diagnosis. Management usually involves a team approach in order to balance multiple considerations, which often leads to different treatment modalities being used together.

Breast-Cancer-Treatment-Diagram1

My goal today is to offer an understanding for the different components of treatment, not to get into the nuances of individual treatment regimens. I certainly recommend you engage your personal physician and resources such as the Center for Disease Control and Prevention and the American Cancer Society, which will provide you with any and all additional details you may desire.

Breast cancer is treated in several ways, including surgery, chemotherapy, hormonal therapy, biologic therapy, and radiation. Let’s review the basics of each.

breast cancer treatment sx

  • Surgery: Under certain circumstances, the cancer has only advanced to a level where it can be surgically removed. Surgical options include cutting out the area affected by the cancer (a lumpectomy), removing the entire breast (a mastectomy), and/or removing the areas where the cancer will drain and spread to other parts of the body (lymph node biopsy/resection). Of course, options aren’t actually quite this simple. Efforts to spare skin and tissue and to retain a cosmetic appearance are important considerations. Sometimes decisions to remove the other breast is made if the risk of breast cancer in that breast is sufficiently high. Additional surgical considerations include breast reconstruction after surgery, which may include one’s own tissue or a synthetic breast implant. These are options to be discussed with a plastic surgeon prior to breast cancer surgery.

BREAST CANCER TREATMENT chemo

  • Chemotherapy: Chemotherapy is the use of medication to kill or reduce the cancer. Chemotherapy may be given via an IV (into the veins) or by pills. Chemotherapy may be given before surgery to reduce tumor size, after surgery or with other therapy to reduce the risk of recurrence, or as a primary treatment option.

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  • Radiotherapy (radiation therapy): High energy rays can be aimed at the cancer cells in an effort to kill them. Alternatively, radioactive material can be placed in the body.

breast cancer treatment hormonal tx

  • Hormonal therapy: As mentioned in this post, certain cancer cells are stimulated by hormones to grow. Hormonal therapy blocks cancer cells from getting the specific hormones that assist growth. Different drugs in this class act in a variety of different ways, both direct and indirect, with the same end result of diminishing the ability of hormones to stimulate tumor growth. Yes, this treatment option would be better named hormonal blocking therapy. Hormonal therapy also can be used as a primary treatment option or after other treatment options to reduce the chance of recurrence.
  • Biological therapy: Biological therapy serves to boost the body’s immune system to better help it fight the cancer. It also is of assistance in addressing immune-reducing side effects other cancer treatments may create.
  • Targeted drugs: An additional treatment modality is the use of targeted drugs, which attack specific abnormalities within cancer cells. The most notable example of such an abnormality is the presence of a human growth factor receptor 2 (HER2), a protein that helps breast cancer cells grow and survive..

Complications and side effects of breast cancer treatment are plentiful, and they vary based on the treatment given. Surgery carries a risk of bleeding and infection. Risks of radiation therapy include fatigue and a red, sunburn-like rash where the radiation is aimed. Breast tissue may be altered in texture and may appear swollen. Rarely, damage to the heart or lungs may occur. Common side effects of chemotherapy include hair loss, nausea, vomiting, fatigue and an increased risk of developing infection. Rare side effects can include premature menopause, damage to the heart and kidneys, nerve damage, and, very rarely, blood cell cancer.

breast cancer treatment decision making team

The teams of medical, radiological and surgical cancer specialists who treat breast and other cancers do phenomenal work. Do your part in reducing your risks and engaging in practices (breast self-exam and mammograms) that allow for early detection. Remember, the days of increasing rates of breast cancer are behind us, and breast cancer survivors abound, with approximately 2.8 million survivors in the US. You now have the tools to be included in those numbers should (heaven forbid) you find yourself afflicted by breast cancer.

breast cancer survivor

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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

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Filed under Hematology & Oncology/Blood Disorders/Cancer, Medical Treatment, Obstetrics and Gynecology