Category Archives: Neurology

Straight, No Chaser: Lou Gehrig’s Disease (aka Amyotrophic Lateral Sclerosis)

ALS icebucketchallenge

There’s no longer an ice bucket challenge, but the disease known as Lou Gehrig’s disease still is around. However, I have to ask… Do you have any idea what the disease is? In the overwhelming likelihood that you do not, this Straight, No Chaser is going to provide you with a few facts about ALS, so you can at least know why you were getting all wet. ALS is actually a very complicated disease for the layperson to understand (and it’s even worse for the 12,000 or so Americans with definitive diagnosis), so I’ll break it down in five questions.

 ALS Lou

What is ALS? 

The medical description of ALS is a progressive neurodegenerative disease that affects those nerve cells in the brain and in the spinal cord that control voluntary muscle movement and power. Decomposing that medical jargon, this disease

1) creates a dysfunction of certain areas of the brain and nervous system and the associated nerves and muscles controlled by them,

2) worsens over time, and

3) it often culminates in irreversible deterioration and loss of function in the affected organs or tissues.

 als hawking

So what’s the dysfunction?

Remember that the brain controls the activities of the rest of the body. If nerve cells in the brain and spinal cord are dying, your functions associated with those cells go away. In ALS, based on the type of cells affected (motor neurons), what is affected results in a loss of the ability of the brain to initiate and control muscle movement.

Does ALS involve all muscles?

No. There are organs and tissues of the body (most notably the heart and digestive system) that aren’t under voluntary control. These areas are spared from the effects of ALS.

 ALS symptoms

What are the symptoms?

Since the brain can’t control those muscles under your voluntary control, symptoms are somewhat predictable and include the following.

  • Early symptoms often include increasing and widespread muscle weakness. This can include the arms and legs and also those muscles allowing you to speak, swallow and breath.
  • Additional symptoms include thinning of the arms and legs resulting from lack of muscle use.
  • Eventually, paralysis can occur. Paralysis of muscles involved with swallowing and breathing can lead to a rapid death.

What’s the treatment for ALS?

There is no cure for ALS. There is also no treatment that halts or reverses progression. However, there is a drug named riluzole that modestly slows the progress of ALS. The remainder of treatment efforts involves providing episodic relief of symptoms.

This is why your contributions are of value. There is ongoing research that is promising. Even if you didn’t take the ice bucket challenge, you can still make a difference. Go to www.alsa.org  to learn more.

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 Neurology

Straight, No Chaser: Do’s and Don’ts of Treating Electrical Injuries

In a previous Straight, No Chaser, we discussed the “what” of electrical injuries and lightning. In this post, we discuss the “what-to-do” and “what-not-to-do” if and when you find yourself shocked or caring for someone else who was.

Let’s begin with prevention. It is easier for you to avoid a hazardous situation than to have to deal with it while injured. Let’s start with the children.

 electrical-outlet-child-proof

  • Talk to your children about electricity. Review hazardous and safe behaviors.
  • Use child safety plugs in all electrical outlets. This shouldn’t come as a surprise to anyone anymore.
  • Take the next step and keep all electrical cords out of children’s reach.
  • Keep children away from electrical devices, especially those plugged in.
  • Intermittently check electrical cords, and make sure they aren’t cut or split with loose, exposed wiring visible and accessible.
  • Take the extra step of reading and following manufacturer’s safety instructions when using electrical appliances. Learning the right places to plug live wires on the fly is not the best idea.
  • Stay away from electrical devices while wet. This includes touching faucets or pipes while using them. Take the time to take the extra step.
  • Learn where the power boxes are in your house. If you ever need to turn them off, the first step is knowing the correct location for them.

Lineman_Rescue

Now, let’s review steps NOT to take if you’re electrocuted or near someone who was.

  • Don’t touch someone still in contact with the source of the electricity. The body is an excellent conductor of electrical current, and you’ll become part of the link.
  • Not only should you not touch, you shouldn’t even get close. Stay at least 20 feet (about three to four body lengths) away from someone being electrocuted until the power is turned off. The high-voltage current of power lines can dance their way onto you if given the opportunity.
  • Regardless of the distance, don’t try to rescue someone near an active high-voltage power line.
  • Don’t play doctor. If the power does get shut off, don’t move the victim. You’re likely to cause more harm than good. The force associated with electrical injuries often cause injuries, including to the head or spine. The exception to this would be the presence of a fire or the risk of an explosion.
  • Don’t play doctor, part two: Forget what you’ve heard. Please don’t slather the burns with butter or apply ice, ointment or any other medications. In fact, avoid placing any type of adhesive dressing or big bulky dressings. Your best move is to spend that time on the phone with emergency medical services.
  • You’re still not a doctor! Avoid the urge to break open burn blisters or peel off dead skin. Sometimes don’t-do-something-just-stand-there is the best course of action.

Ok, you really want to do something to help? Here are safe, reasonable steps to take. 

  • First things first: Ensure your own safety, whether from the electricity, any fire or possibility of an explosion. If there’s any water on the floor while this is occurring get out while you can.

shut off powerbox

  • Take advantage of your being smart enough to have learned how to cut off the power and do so. I’d recommend working backwards in this order: turn off the circuit breakers, remove the fuse from the fuse box, and unplug the cord. Remember, appliances can still allow for electrical current flow even in the off position. Simply cutting it off might neither be safe nor effective.
  • Call your local emergency medical service number (e.g., 911) at the first safe opportunity.

electrocution1

  • If the current can’t be turned off, and you determine it is safe to do so, find something made of rubber or another non-conducting material, such as a broom, chair or rug to push the person away from the source of the current. Don’t even think about using metal or something wet. Whenever you’re doing whatever you’re doing, stand on something rubber.
  • Do you know CPR? You may need it here. If the victim is no longer near the source of electricity, take needed steps. One very simple yet effective step is to raise the legs about the level of the heart. Again, avoid movement of the head, neck or lower spine.
  • If the person has a burn, remove any clothing that comes off easily without disturbing the rest of the body. Rinse any burns in cool running water until the pain subsides, and if possible give first aid. Do not go to great lengths here. The ambulance is likely to arrive before you get to do much here.
  • Stay with the victim until medical assistance arrives, unless the situation demands a quit exit.

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 General Health and Wellness, Musculoskeletal System, Neurology, Trauma

Straight, No Chaser: When Your Headache is Life-Threatening

Brain-Aneurysm-Prognosis-Factors

All headaches are not created equal. Earlier we discussed migraines, but there’s a lot more to headaches than those. In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we aren’t thinking about migraines first. The ER is all about the life-threats.

The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms. In other words, alcohol, cocaine and cigarettes increase  your risk for life-threatening causes of headaches.

Secondary headaches are those related to some other illness or condition that produces headaches as a symptom. These are much more common causes of headaches than migraines. They’re even more important because they could represent life-threatening conditions. So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and “brain-freeze.” (Yes, “ice-cream headaches” are a real thing!) Today we’ll point you to some conditions about which you should be concerned. (I’m intentionally leaving out especially uncommon ones and otherwise esoteric conditions. I wouldn’t want to encourage any hypochondriacs out there.)

  • AVM (arteriovenous malformation): an abnormal formation of blood vessels inside your brain
  • Concussions and post-concussive syndrome
  • Brain aneurysm: a ballooning of one of your brain’s arteries that can steal blood away from needed areas

unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning: from breathing exhaust fumes
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid and other intracranial hemorrhage: bleeding inside various parts of the brain

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms that may suggest your headache is different enough to get evaluated for a possible life-threat.

Consider this a “headache plus this symptom = go to the emergency room” list.

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)
  • Worse headache of your 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 Neurology

Straight, No Chaser: Migraine Headaches Questions and Answers

migraine-enhd-ar1

There are 30 million migraine sufferers in the U.S. alone.  Women are three times as likely to have them, but both sexes have to address the issues raised by them.  Here are some important facts regarding migraines and myths surrounding them, based on questions I’ve actually been asked.  And yes, regarding the lead picture, I refuse to say she’s lion.

Myth #1: I can’t help if I get migraines.  They’re hereditary, right?

There are a few things about being predisposed to having migraines I want you to know.

  • If you have one parent with migraines, there’s a 50% chance you’ll have them.
  • If both your parents have migraines, there’s a 75% chance you also will.
  • 4 of 5 migraine sufferers have a relative with migraines.

These facts represent a predisposition.  In order to have migraines, you must have triggers that will set off the migraine.  That’s a vital consideration in your effort to prevent, reduce and effectively treat your migraines.

headache

Myth #2: This is a woman’s disease.  They stress out more and are more emotional.  That’s why they get headaches.

It is true that there is a strong hormonal component to migraines, particularly regarding estrogen and progesterone.  In fact, the incidence of migraines between the sexes is pretty equal until puberty.  Migraines are increased during pre-menstruation, when hormone levels are high.  Menopause may ease migraines. All of this said, men still get migraines as well because of the presence of other triggers.  It certainly does not appear to be true that women suffer stress at a disproportionate rate sufficient to claim it as more of a trigger in women than in men.  Both sexes’ stress responses include release of substances that expands blood vessels, causing migraines.

Myth #3: My migraines won’t get any easier as I get older.

Along the same lines as Myth #2, diminished hormone production that accompanies aging may help explain how most migraine sufferers have less frequent and less intense migraines after age 40.  Because of hormonal fluctuations during perimenopause, this reduction may not be seen.

  • Most people who get migraines have fewer headaches, and their headaches aren’t as strong once they hit 40. However, this may not be the case for women going through perimenopause. If hormones are a trigger for a woman’s migraines, then she could have more headaches during the period around menopause.

migraine-black-female-300x168

Myth #4: Once I’m diagnosed with migraines, only narcotics will help.

First of all, trigger identification and prevention is vital.  Migraine trigger management and treatment is a topic unto itself, but I’d like to point out a few important considerations.

  • Think triggers first and last.  The list of triggers includes foods (think chocolate, alcohol, aged cheese and caffeine; results vary with the individual), cold, stress, smoking and certain medications.  Alterations in mealtimes, exercise and sleep patterns must be monitored as well, these tend to exacerbate migraines.  Migraine sufferers are advised to maintain a headache log to identify triggers as things occur.
  • A special comment about caffeine: It helps some people, but for others it’s a migraine trigger, particularly if you’re a heavy user.  If you don’t drink many caffeinated beverages, one may help if you’re having a less than severe migraine.  If you’re taking enough in to create a caffeine dependency, overnight withdrawal may be enough to trigger a morning migraine.

Patients must become their own experts on how and when you use different medications.

  • I hope you and your primary care physician have discussed and have you focusing on your abortive medications.  These medicines can stop progression of migraines if used early enough, like at the first sign of a migraine.
  • Painkillers have consequences.  As tolerance to and dependence on narcotics develop, withdrawal symptoms become more prominent.  Rebound headaches are a major component of these symptoms.  That’s a vicious cycle that doesn’t have a happy ending.  It’s important to note that your health care professionals do appreciate there is a difference between being drug seeking and drug dependent.

migraine acute or chronic headache symptoms need for painkiller or prevention therapy
Myth #5: Migraines really don’t cause problems beyond the headaches, right?

Wrong.  If you have migraines, take special care to ensure you have a healthy heart and a low risk for strokes.  Refer to the Straight, No Chaser archives (or just type in the search engine to the right) for information on stroke recognition and heart attack recognition.  If you are female and have migraines with aura (certain warning symptoms that precede you migraine like nausea, dizziness, light sensitivity and seeing zig-zag lines), your heart attack risk climbs by over 90% and your stroke risk more than doubles (increases by up to 108%).  The presence of migraines without aura also raises the risk of heart attack and stroke but by lesser amounts.

The message is simple, but execution is key. Prevention is protection, and knowledge is power.  Check back; the next Straight, No Chaser addresses life threatening causes of headaches, and feel free to send questions and comments.  Take good care.

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 Neurology

Straight, No Chaser: Heat Illnesses Awareness (Heat Exhaustion, Heat Cramps, Heat Stroke)

heatawarenessday-logo

Heat Awareness Day occurs the last Friday in May instead of the first weekend in July because prevention is better than cure. Once the rains calm down across America, it’s predictable what will happen next: heat, more heat and all heat, and you’d better be ready. The way things work, we just have to deal with it. Unlike when the weather is cold, and you can just add layers, when it’s extremely hot, it seems unescapable. So we sweat, get fatigued and even cramp up. Surprisingly there appears not to be much thought given to the notion that heat cramps are an early sign of a life threatening condition, even though many of us have had loved ones die from heat related illnesses.

When a loved one dies, families often ask “Is there something I could have done?” Usually I give you information. Today’s Straight, No Chaser will  give you information and power to act if needed. There are several varieties of heat-related illness, and you would do well to be aware of them, because you can make a difference if someone’s suffering in the heat.

heat-sickness-signs

For starters, I really want you to become mindful of Heat Stress, which is the earliest complex of problems arising from excessive heat exposure. Heat stress is that strain and discomfort you get (usually during outdoor exertional activity) that reminds you that you’d be better off inside (assuming it’s cooler inside). You may notice such symptoms as cramping, a prickly-type rash, swelling and a sensation that you want to lose consciousness. If you must remain outdoors due to work, or choose to (playing sports or enjoying the sun), hydration means everything. It really is true that in some instances if you’re not actively urinating, you’re not drinking enough fluid. (This is the level at which LeBron James was suffering(NBA finals 2014), and it really does beg the question as to why he was allowed to suffer on the sidelines instead of being taken to the locker room, iced down and given intravenous fluids.)

Ok, so you’ve ignored both me and your body, and you’re still outdoors, not rehydrating enough. Heat exhaustion may occur next, and it’s defined by ongoing body salt and fluid losses. Now you’re feeling faint, thirsty, anxious, weak, dizzy, you want to vomit and may have a headache, and your body temperature starts to climb. I see a lot of these patients, usually because once you get wobbly, your employers or co-workers are getting concerned, which is good, because at this point, you are actually in danger.

heatstroke2.1206

Or maybe you didn’t come to see me when you had the chance, and you’ve collapsed outdoors, to be found and brought in. This is Heat Stroke, and is defined by changes in your mental status, increases in your temperature and disruption of your bodily functions, including a loss of ability to sweat and a loss of your kidney and liver’s abilities to detoxify your body the way they normally do.

Well, in case you’re feeling good about yourself because you’re too smart to exert yourself outdoors, all I’ve been describing is ‘Exertional’ Heat Stroke. The more deadly form of heat related illness is ‘Classic’ Heat Stroke. This is the type that captures the headlines every year in places like Chicago, New Orleans, Miami and Houston. Classic Heat Stroke is seen in those with underlying disease, bad habits or the elderly. I’m talking about the obese, alcoholics, meth and/or cocaine users, folks with thyroid or heart disease or on certain medications like diuretics or beta-blockers. These folks can get the same symptoms simply by not being able to escape the heat. They may actually just be sitting around in a less than optimally air-conditioned home.

So that’s what you’re up against. And yes, many people die from this. By the way, you’re not protected from the heat related illness just because you’re in shape. Let’s end with 2 tips (one for prevention and the other for assessment and treatment) to help you Beat the Heat.

heat_stroke_prevention

1) Take special caution during the following conditions

  1. 95 degrees is high risk, regardless of the humidity
  2. 85 degrees and 60% or above humidity
  3. 75 degrees and 90% or above humidity

heat_maintips

Here, you want to remove yourself from that environment. You need to keep plenty of fluids around. You need to visit an environment where there’s adequate air conditioning. Dress very lightly.

2) If symptoms of heat related illness short of mental status changes occur, think “Check, Call, Care, Cool”

  1. Check – look for those signs and symptoms I mentioned earlier
  2. Call – call 911 immediately. Better to have it and not need it than need it and not have it.
  3. Care – Lie in a cool place, elevate the legs, place cool, wet towels on the body (especially in the armpits and groin), and drink cool fluids. If mental status changes occur, or if the heart or lungs appear to give out, cool by any means necessary while waiting for the ambulance. This could include ice bath, ice packs, fans or cold water, but don’t drown someone trying to put them in a tub of water if you can’t handle them. Don’t forget to remove those layers of clothing.

Please be mindful that it is hotter in July, and unfortunately lives are lost every year to the heat. That said, it doesn’t have to be July for you to get a heat-related illness. If you can’t avoid the exposure, at least have a plan for managing the heat and acting on any mishaps. The life you save may be your own.

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 Endocrine/Metabolic, Health Prevention, Neurology

Straight, No Chaser: Bell’s Palsy

bellsPalsy-enHD-AR1

We’ve spent some time focusing on stroke recognition, but today we focus on a condition that often gets confused with a stroke. Bell’s palsy is a paralysis of the facial nerve, caused by inflammation or other irritation to the nerve.  This paralysis causes muscle weakness in one side of the face.

Patients often find themselves unable to close one of the eyelids or wrinkle one side of the forehead/face.  The eyes may become dry due to inability to blink.  One side of the mouth may drool and droop.  The sense of taste may change.  Sounds may become louder, and headache may develop.

Bell’s palsy is treated with steroids and artificial tears.

The prognosis for individuals with Bell’s palsy is generally very good.  The extent of nerve damage determines the extent of recovery.  Improvement is gradual and recovery times vary.  With or without treatment, most individuals begin to get better within 2 weeks after the initial onset of symptoms and most recover completely, returning to normal inside of 3-6 months.  For some, the symptoms may last longer, and in a few cases, the symptoms may never completely disappear.

bellspalsy

By the way, in case you’re wondering about the picture, the right side of the picture (the left side of the patient’s face) is the side affected.  He can neither wrinkle his forehead nor close his eye, both of which are functions of the cranial nerve.  And no, this is not a stroke.

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 Head/Eyes/Ears/Nose/Throat, Neurology

Straight, No Chaser Vlog: Stroke – How to Save a Life

The Straight, No Chaser vlog (video blog) series presents “health care basics” to keep you safe, healthy and out of the emergency room. Today’s topic is stroke (cerebrovascular accidents). Please take 60 seconds to learn how to save a life. It may even be your own.

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 Health Prevention, Neurology

Straight, No Chaser: About Stuttering

stuttering

How do you respond when you hear someone stutter? Are you a stutterer, and if so, how do you handle it? Let’s answer 7 frequency asked questions to facilitate some understanding (and hopefully compassion) about stuttering.

What is stuttering?

Simply put, stuttering is a communication disorder, notable for what’s called disfluencies. These disruptions in speech flow may or may not hinder ability to speak and understand others. There are typically three types of difficulties with the effort to speak in stuttering:

  • Abnormal stoppages (no sounds produced)
  • Prolongations: (“llllllike this”)
  • Repetitions: “li-li-like this”

Why do people stutter?

Causes and/or development of stuttering is typically attributable to four factors:

  • Genetics/family history (approximately 60% will have another stutterer in the family)
  • Child development (those other over developmental delays or speech/language disorders are more likely to stutter)
  • Neurophysiology (stutterers have been shown to have actual differences in how their brains process language and speech from those who do not)
  • Behavioral considerations (faster-paced lifestyles with high expectations seem to contribute to stuttering)

Stuttering

Who is more likely to stutter?

Approximately 5% of children go through a stuttering phase that lasts at least six months (About 75% with recover, especially with early intervention).

How many people are affected?

More than 70 million people worldwide stutter (approximately 1% of people). Males stutter more often than females with about a 4:1 ratio among stutterers.

stuttering FAQ1

Is stuttering part of a psychological disorder?

No. Stutterers are no more likely to have psychological disorders than non-stutterers.

When should I seek help for stuttering?

Whenever the need is felt. As with most health matters, there’s no harm in early evaluation. However, if stuttering persists beyond 3 to 6 months or is somehow disabling socially or impeding the ability to communicate, help should be obtained as soon as possible.

How is stuttering treated?

First off, there are no miracle cures, so don’t fall for any scams suggesting otherwise. Successful treatment involves enlisting a speech-language pathologist. Most treatment programs are designed to teach specific skills or behaviors that lead to improved speaking, such as controlling the rate at which a stutterer speaks.

There are many great organizations that provide assistance, such as The American Speech-Language-Hearing Association, the National Stuttering Association, Stuttering Foundation of America.

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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Straight, No Chaser: Prevention and Treatment of Carpal Tunnel Syndrome

carpel-tunnel-relief-

If you have carpel tunnel syndrome (CTS) or are at significant risk for developing it, you really should learn strategies to either prevent, limit progression or treat the condition. Of course, once you develop it, you’ll be more focused on treatment. Fortunately, very good options exist for all of these, and that’s what we’ll be reviewing in today’s Straight, No Chaser. Feel free to review this previous post on carpal tunnel syndrome, discussing its causes and risk factors.

carpal-tunnel-at-work prevention

How can carpal tunnel syndrome be prevented in the workplace?

Here are activities you should employ if you’re at risk for CTS. Your employer (through employee health services or even without such an entity) can develop an ergonomics program. This involves adapting the workplace (e.g. conditions and job demands) to the capability and needs of workers to complete assigned tasks. Components of ergonomics may include the following.

  • Redesign of workstations, tools and tool handles, and tasks to enable the wrist to maintain a natural position during work
  • Frequent rest breaks
  • Job rotation among workers
  • On-the-job conditioning
  • Stretching exercises
  • Use of splints to keep your wrists straight
  • Use of correct posture and wrist position
  • Wearing fingerless gloves to keep your hands warm and flexible

carpal tunnel syndrome keyboard

Of course if you have high-risk conditions such as obesity, arthritis or diabetes, you will do well to manage these conditions. Doing so will lessen the risk of subsequent development or worsening of CTS.

How is carpal tunnel syndrome treated?

In this post, we will address general, drug and surgical treatments. More detailed treatment considerations are covered at www.sterlingmedicaladvice.com.

Carpal-Tunnel-Syndrome-ice

General

  • Treatments for CTS should begin as early as possible and under a doctor’s direction.
  • Underlying causes such as diabetes or arthritis should be treated first.
  • Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending.
  • If there is inflammation, applying cool packs can help reduce swelling.

Carpal-tunnel-wrist-bracing

Drugs

  • In special circumstances, various drugs can ease the pain and swelling associated with CTS. Nonsteroidal anti-inflammatory drugs (e.g. aspirin, ibuprofen, and other nonprescription pain relievers) may ease symptoms that have been present for a short time or have been caused by strenuous activity.
  • Other drugs occasionally used include diuretics (“water pills”), meant to decrease swelling. Corticosteroids (such as prednisone) or the drug lidocaine can be injected directly into the wrist or taken by mouth (in the case of prednisone) to relieve pressure on the median nerve and provide immediate, temporary relief to persons with mild or intermittent symptoms. (Caution: persons with diabetes and those who may be predisposed to diabetes should note that prolonged use of corticosteroids can make it difficult to regulate insulin levels. Additionally, some studies show that vitamin B6 (pyridoxine) supplements may ease the symptoms of carpal tunnel syndrome.

carpel-tunnel-syndrome-eagle-arms-cow-face-arms-open-the-shoulder-stretch-your-hands-the-idea-girl-says-youtube

Exercise and Alternative Therapies

  • Stretching and strengthening exercises can be helpful in people whose symptoms have abated. These exercises may be supervised by a physical therapist trained to use exercises to treat physical impairments, or an occupational therapist, who is trained in evaluating people with physical impairments and helping them build skills to improve their health and well-being.
  • Acupuncture and chiropractic care have benefited some patients but their effectiveness remains unproven. An exception is yoga, which has been shown to reduce pain and improve grip strength among patients with carpal tunnel syndrome.

carpal-tunnel-surgery

Surgery

  • Carpal tunnel release is one of the most common surgical procedures in the United States. Generally recommended if symptoms last for 6 months, surgery involves cutting the band of tissue around the wrist to reduce pressure on the median nerve. Surgery is done under local anesthesia and does not require an overnight hospital stay.
  • Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take months. Complications may include infection, nerve damage, stiffness, and pain at the scar. Occasionally the wrist loses strength because the carpal ligament is cut. Patients should undergo physical therapy after surgery to restore wrist strength. Some patients may need to adjust job duties or even change jobs after recovery from surgery.
  • Recurrence of carpal tunnel syndrome following treatment is rare. The majority of patients recover completely.

If you focus on the prevention strategies, the need for surgery will be lessened, and treatments will be guided by your physician. Your first job should be to discuss the safety of your work environment and ensure you’re doing what’s needed to minimize your risk.

 

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

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

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

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

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Straight, No Chaser: Carpal Tunnel Syndrome

carpal tunnel

Do you spend much time typing at work? Are you a construction worker who operates a jack hammer? Do you have arthritis that affects your wrist? Do you have occasional or constant numbness or tingling in your hand or wrist or pain that shoots up your wrist into your arm? If so I’d hope that you’ve had at least a passing conversation about carpal tunnel syndrome (CTS), a fairly common condition associated with work activities. CTS is part of a class of disorders called entrapment neuropathies.

Let’s review CTS by addressing common questions about the syndrome.

Carpal-tunnel-syndrome-picture

What is carpal tunnel syndrome?

CTS is basically a squeezing of the nerve (median nerve) that extends from the forearm to the palm; the pressure on the nerve occurs at the level of the wrist. The carpal tunnel is an area at the base of the hand (on the side of the thumb) that houses tendons and the median nerve. Because it is such a small space, irritation such as that which occurs from inflammation or injury can compress and/or pinch the median nerve.

carpel-tunnel-relief-

What are the causes of CTS?

Your anatomy sets the table for CTS in some cases. Some individuals simply are predisposed to CTS because of a smaller carpel tunnel. Beyond this, conditions that cause injury to the wrist and result in swelling are likely culprits; that said, in some cases no cause is identified. Known causes and/or contributors include the following.

  • Development of a cyst or tumor in the canal
  • Fluid retention during pregnancy or menopause
  • Fracture or sprain
  • Hypothyroidism
  • Overactivity of the pituitary gland
  • Repeated use of vibrating hand tools
  • Rheumatoid arthritis
  • Work stress

Interestingly and contrary to the popular narrative, there is little clinical data to prove that repetitive and forceful movements of the hand and wrist during work or leisure activities can cause CTS. However, it does stand to reason that if you have CTS, these activities can exacerbate the situation.

carpal tunnel syndrome sx

What are the symptoms of carpal tunnel syndrome?

Symptoms are easy to figure out if you view your nerve as electrical conductors of various signals caused by stimulation. Frequent burning, tingling, or itching starts gradually, as does numbness in the palm of the hand and the fingers, especially the thumb, index and middle fingers. Symptoms may begin at work or during the night (if you sleep with your wrists cupped). Other symptoms may include a sensation of hand swelling without visual evidence, hand tingling that progressively worsens throughout the day and decreased grip strength. Over time, some untreated patients may lose the ability to distinguish between hot and cold sensations by touch. Symptoms are usually first seen in the dominant hand.

Who is at risk of developing carpal tunnel syndrome?

  • Women are three times more likely than men to develop CTS.
  • Diabetics or those with other disorders directly affect the body’s nerves are more susceptible to nerve compression.
  • CTS usually occurs only in adults.
  • CTS is especially common in those performing assembly line work , such as manufacturing, sewing, finishing, cleaning and packing (e.g. meat, poultry, or fish). In fact, CTS is three times more common among assemblers than among data-entry personnel.

The next Straight, No Chaser will address prevention and treatment of carpal tunnel syndrome.

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 Neurology, Occupational Health, Orthopedics/Bones