Category Archives: Respiratory/Lungs

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

pe awareness

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

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

dvt derrick_20thomas_20-_20vert_2091

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

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

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

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

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

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

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

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

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

pe lung

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

Pulmonary Embolism_large

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

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

PEs can cause any or all of the following.

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

pe sudden death

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

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

pe awareness

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

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

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

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

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

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

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

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Filed under Cardiology/Heart, Respiratory/Lungs

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

dvt

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

DVT_clot_illustration

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

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

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

Deep-Vein-Thrombosis-Homeopathic

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

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

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

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

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

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

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

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

Straight, No Chaser: What Will You Do If Your Baby Starts Choking?

infchokingcons

We’ve previously discussed how to address choking in adults. Today, we address the twin horrors of needing to save a baby’s life (those younger than 12 months old) from choking and how to help yourself if no one else is around to help.

In case you didn’t realize it, infants haven’t had time to accumulate enough disease and toxins to have heart attacks in the way adults do. When they are in a life-threatening situation, it’s far more likely to be from a respiratory cause, such as choking. Infants and young children are exploring their world and seemingly will place most anything near or in their mouths. Too often this leads to choking. Please keep this in mind if you’re ever faced with an infant in danger.

In discussing how to help a child in danger, let’s focus on two considerations: how to assess the situation and how to act.

It is vital to assess these situations accurately. There are important splits in treatment algorithms based on your assessment.

Simply put, the first thing you want to do is determine the infant’s level of responsiveness. For the purposes of this discussion, let’s assume we’re discussing conscious choking.

If an infant is suddenly unable to cough or cry, it’s a reasonable to assume that something may be blocking the airway.

  • When this is the case, help will be needed getting the object out.

If an infant is coughing or gagging, it’s likely that the airway may be partially blocked.

  • Coughing is actually the most effective way to dislodge an object, so you shouldn’t interfere in this setting.

If an infant is somewhat responsive in the context of a recent insect bite, bee sting or other possible allergic exposure, the throat could be closing because of an allergic reaction.

  • When this is the case, you are facing a potential life-threatening emergency. Call 911 immediately.

Infant Choking

When you’ve made your assessment, your next step (unless you’re performing CPR, calling 911 or the child is still coughing) is to try to assist in getting the object out. Think “back blows, chest thrusts, repeat unless the infant gets unconscious.” Yes, that was meant to be a jingle.

backblow

Back blows:

  • Hold the infant face up on one forearm, and hold the back of his head with the hand.
  • Stabilize the infant’s front with your opposite hand and forearm.
  • Flip the infant face down so that he’s now in the control of the other forearm. Use your thumb and fingers to stabilize the jaw while flipping. Lower your arm onto your thigh; now the baby’s head will be lower than his chest.
  • Using the heel of your hand, deliver five firm back blows between the infant’s shoulder blades in an effort to dislodge the object. Maintain head and neck support by firmly holding his jaw between your thumb and forefinger.
  • Finally, place the hand that had been delivering the back blows on the back of the baby’s head with your arm along his back. Carefully, turn him over while keeping your other hand and forearm on his front.
  • If you have dislodged the object and the infant is responsive and/or coughing, you are done. Otherwise, proceed to chest thrusts.

chestthrust

Chest thrusts

  • Use your thumb and fingers to hold his jaw while sandwiching him between your forearms to support his head and neck. Lower your arm that is supporting his back onto your opposite thigh, still keeping the baby’s head lower than the rest of his body.
  • Place the pads of two or three fingers in the center of the baby’s chest, just below an imaginary line running between his nipples. To do a chest thrust, push straight down on the chest about 1 1/2 inches. Then allow the chest to come back to its normal position.
  • Do five chest thrusts. Keep your fingers in contact with the baby’s breastbone. The chest thrusts should be smooth, not jerky.

Repeat

Continue alternating five back blows and chest thrusts until the object is forced out, the infant starts to cough forcefully, cry, breathe on his own or becomes unconscious. If he’s coughing, allow him to do so.

fingersweep

If the infant becomes unconscious

If a choking infant becomes unconscious, you should proceed to modified CPR as follows:

  • Open his mouth. If you can see an object, remove it with your little finger.
  • Give two rescue breaths. If you don’t see the chest rise, tilt his head and try two rescue breaths again.

 If his chest still doesn’t rise, do 30 chest compressions.
  • Check the mouth again, looking for an object. Remove it if seen.
  • Repeat the cycle with rescue breaths and chest compressions until help arrives.

Regardless of the outcome, the infant will need prompt medical attention.

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: What Will You Do If You See Someone Choking?

choking1

So … what would you do if someone around you starting choking. Or if they choked, then lost consciousness? What would you do if you choked and no one else was around? Don’t you think you should know? Read on …

First things first. You’ve all heard of the Heimlich maneuver, even if you don’t know how to do it. My job today is to make this easy for you. My first task will be to pass on the physician’s mantra of “Do No Harm.” To that end, let’s start with things you shouldn’t do.

  • If the person is able to speak, don’t interfere.
  • If the person is coughing and still has a normal level of awareness, don’t interfere.
  • If the person is able to breathe in and out without excessive difficulty, don’t interfere.
  • If the person is conscious, don’t place anything in his/her mouth trying to extract an object.

Next, let’s review a few quick points to help you understand what could be going on.

  • Choking is occurring because something is blocking the airway (aka windpipe).
  • Choking is dangerous because complete blockage will prevent oxygen from circulating thorough the body.
  • Choking is deadly because without oxygen, permanent brain damage will likely occur in four to six minutes.

Partial blockage isn’t the same as complete blockage. The body has protective reflexes to deal with blockage. That’s what coughing is. Once blockage has become complete, you’re facing a life-threatening emergency, and the risks of doing something outweigh the risks of doing nothing.

choking

It’s not that difficult to know if someone’s choking; they’re likely grabbing their throat. You would do well to know what it looks like if someone has already choked or is choking but can’t use his/her hands. Here are some clues:

  • Coughing may be increasingly weaker.
  • They likely will exhibit difficulty breathing.
  • They may be unable to speak.
  • Their skin may have a bluish or purplish color.
  • You may hear high-pitched musical sounds while they’re breathing.
  • They may have blacked out (from the blockage).

heimlich

Here are universally accepted steps to the Heimlich maneuver (in someone not obese or pregnant):

  • Ask the person, “Are you choking?”
  • Then ask them to speak. If they can speak or are vigorously coughing, you watch and wait. If not, proceed.
  • Standing behind the person, wrap your arms around his/her waist.
  • Placing your thumb just above the belly button (navel), make a fist with one hand.
  • Grasp the fist with your other hand.
  • Thrust your fist quickly, upward and inward.
  • Repeat until the person either loses consciousness or the object is dislodged.

If the person is obese or pregnant, wrap your arms around the chest, not the abdomen. Place your fist between the nipples on the middle of the breastbone, and make firm thrusts back toward you.

If the person loses consciousness, there are four steps you must take.

  1. If you see something blocking the airway, try to remove it.
  2. Lower the person to the floor, preferably on his/her side until you start CPR or if vomiting starts.
  3. Have someone call 911.
  4. Begin CPR.

Of course, prevention is key. Take care to chew your food slowly and thoroughly.

Here are three more tips for those most at risk:

  • Children: Keep them away from small objects that can be placed in their mouths.
  • Elderly: Make sure their dentures fit appropriately.
  • Adults: Limit alcohol intake around the time of eating.

In an upcoming Straight, No Chaser, we’ll also add a post for you regarding how to handle yourself and infants (less than one year old) if choking.

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

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

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

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

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Filed under Cardiology/Heart, General Health and Wellness, Respiratory/Lungs

Straight, No Chaser: Cigar Smoking

cigar-and-golf

It’s the latest, greatest, coolest past-time.  Endorsed and practiced by celebrities the world over, cigar smoking has clearly and successfully marketed itself as a convenience of the successful.  Even the notion that the ‘best’ cigars are forbidden fruit (i.e. come from Cuba) adds to the allure if and when you’re able to wrap your lips around one.  I wasn’t surprised, but it’s worth noting that beyond the success stories received from those of you who have successfully stopped cigarette smoking, the next set of questions involved whether cigar smoking is a safe alternative.

Since you have little old me taking on an $8 billion a year industry and the wrath of the very passionate, I have no recourse but to arm myself with some data – cold, hard facts.

  • 49% of all cigars sold are large cigars.  A single large cigar contains as much tobacco as an entire pack of cigarettes.
  • Cigar use is on the rise, with over 13 million people identifying as current users.
  • 15% of male students in grades 9-12 are current users.
  • African-Americans have the highest rate of cigar smoking (among ethnicities/races), with a 7.7% user rate.

You want to know the effects of cigar smoking?  Let’s cut to the chase.

mouth_cancer_cr

Here are the five “SURGEON GENERAL WARNING” text-only labels, one of which must be displayed on all cigar packaging and advertisements.  This is done on a rotating basis.

  1. Cigar Smoking Can Cause Cancers Of The Mouth and Throat, Even if You Do Not Inhale.
  2. Cigar Smoking Can Cause Lung Cancer and Heart Disease.
  3. Tobacco Use Increases the Risk of Infertility, Stillbirth and Low Birth Weight.
  4. Cigars Are Not A Safe Alternative To Cigarettes.
  5. Tobacco Smoke Increases The Risk of Lung Cancer And Heart Disease, Even In Nonsmokers. 

Beyond what the Surgeon General requires, here are some additional facts:

  • All tobacco smoke contains more than 60 chemicals that can cause cancer, and cigar smoke is no exception.
  • Regular cigar smoking increases your risk for the following cancers: lung, esophagus, larynx (your voice box), and oral cavity (lips, tongue, mouth and throat).
  • Cigar smoking is linked to gum disease and tooth decay and loss.
  • In addition to lung cancer, heavy cigar smoking increases the risk for emphysema and chronic bronchitis.

Fidel-Castro-smoking-ciga-001

The bottom line?

Cigar smoking is not a safe alternative to cigarette smoking.

There is no level of cigar smoking that does not pose health risks.

As always, it’s not my chore to convince you to do or not to do; freedom of choice is a beautiful thing.  That said, be advised that if you read this blog, you will be an informed consumer.

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: The Frustration of Acute Bronchitis

bronchitis

Imagine what it looks like when someone gets hit in the jaw. There’s the redness, swelling from excess fluid in the area, warmth and pain. Those are the components of inflammation. Now imagine those symptoms in your lungs as you’re trying to breathe and deliver oxygen to the rest of your body. Off the top of my head, I can’t think of a more frustrating diagnosis than bronchitis for both patients and physicians alike. I’ll get into the reasons for that soon enough, but a bit of explanation is definitely in order.

bronchitis1

Bronchitis is inflammation of a portion of the airways (the bronchi). Far and away, bronchitis is seen in smokers and after a viral, upper airway infection (e.g., a cold, the flu). In that last statement I slipped in two words that create the frustration regarding this condition: viral and smokers. There’s still more to come on what that means for you.

bronchitis-treatment-mammqctr

Everyone reading this has suffered from bronchitis at some point, and, based on what’s already been said, it’s easy to figure out what the symptoms would be. The inflammation of your airways leads to a cough, shortness of breath, chest discomfort, a mild fever and fatigue. If you have asthma, you’re likely to start wheezing. Another major source of frustration is even after the bronchitis has gone away or been treated, the cough stays around for up to an additional four weeks. This gives many the impression that they’re still sick, and leads them to demand that the doctor do something to “fix it.”

coughing-up-blood

There are a few more problems dealing with or treating acute bronchitis.

  • Bronchitis is actually the most common cause of coughing up blood. Coughing up blood or producing blood-tinged mucus tends to make people anxious, and they often start thinking of things like cancer. That train of thought makes some people want to take every test possible to rule out cancer, “just to be sure.” Now your physician knows better and isn’t going to do that unless you have additional symptoms or tell a story more consistent with cancer. That often leads to a lot of frustration and sometimes anger.

bronchitis smokers-lungs_1

  • Bronchitis is most often caused by smokers who don’t stop smoking even while they’re suffering. It is a very tense conversation (from both sides) when you return to the ER five days after being seen and diagnosed with bronchitis, and you’re complaining because you’re not better. Folks, even if your physician puts out the fire, if you continue to relight the match, it’ll continue to blaze.

bronchitis abx

  • Bronchitis is not pneumonia, which is an infection of the lungs. In most cases where bronchitis has an infectious cause, that cause is a virus. Viruses do not respond to antibiotics. Your physician understands that you’re sick. Just because you’re sick and coughing, that doesn’t mean you need antibiotics or that antibiotics will cure you. Inappropriate antibiotic use is not without long-term complications that you should want to avoid. In most cases, assuming you remove the source of inflammation (e.g., cigarette or cigar smoke, dust, allergens), your symptoms will improve on their own within a week, and all you need is supportive therapy such as cough, fever and pain medicines along with fluids and rest. You must also practice good hygiene to avoid spreading any viruses that may be causing the bronchitis.
  • What complicates this is when your weakened state and continued exposure to whatever is causing the inflammation allows a bacterial infection to land on top of your bronchitis. Ask your physician if it’s possible that this is what is going on. S/he will know how to proceed, including potentially using antibiotics.

bronchitis and cigarettes

  • In a majority of cases, a diagnosis of bronchitis will be a big source of frustration for patients because, from the physician’s standpoint, bronchitis is an easily diagnosed condition due to an obvious cause (such as a cold or cigarette smoking). As such, your physician is likely not to order a lot—or any—tests. Now from the patient’s standpoint, don’t you just hate going to the physician’s office or ER when you’re sick and “nothing” gets done? Well, especially in an ER setting, tests are not used to make diagnoses. They’re meant to be ordered if the results will change the management of the condition or might lead to a change in what is done with you (e.g., admit you to the hospital). Most often, that’s just not going to be the case with bronchitis. Now if after 3–5 days symptoms haven’t improved, you’ve stopped smoking and the mucus you’re coughing up looks a certain way, there’s plenty that will be done differently in most cases.

Please don’t take any of this to mean that you shouldn’t be seen for bronchitis. My effort today is to temper your expectations and help you appreciate what your physician is looking for and thinking. Here are some specific signs and symptoms to look for when you’re suffering from acute bronchitis that indicates a level of seriousness warranting prompt attention:

  • You have a documented high fever or have had a documented fever for more than three days.
  • You have greenish or bloody mucus, or you are coughing up only blood.
  • You have shaking chills.
  • You have chest pain or shortness of breath.
  • You have heart or lung disease (such as asthma or COPD/emphysema).

Over time, bronchitis can become chronic if the source of the inflammation isn’t removed. If you find yourself with ongoing symptoms for over three months, you will fall into a different category known as chronic bronchitis. Your physician will need to address additional considerations for you.

So often patients with bronchitis are looking for a “quick fix.” As is often the case, that fix is to be found in prevention. In this case, good hygiene and avoidance of smoke and other lung irritants can save you a lot of the shortness of breath and chest pain associated with bronchitis (pun intended).

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: COPD

COPDer

November is COPD Awareness Month. You already know a lot about COPD without realizing it or even having to think about it. You’ve seen patients walking around with the oxygen tanks or tubes in their noses. However, that’s just the extreme. COPD is the third or fourth leading cause of death in the US depending on the source, with millions of individuals diagnosed. You also know COPD and cancers are why your doctors always warn you against smoking in any form. You know smoking is the leading cause of this. This Straight, No Chaser provides a brief overview of COPD and answers some key questions.

emphysema

What Is COPD?

Chronic obstructive pulmonary disease is a lung disease that makes it hard to breathe and advances in severity over time.

Appreciate that air goes from your mouth or nose through the windpipe (trachea) through several branches of airways, eventually connecting to blood vessels meant to carry oxygen to the organs of your body. These same blood vessels drop off waste gas known as carbon dioxide, which we exhale with each breath out. In COPD, less air flows in and out of the airways because of one or more of the following:

  • The airways and air sacs lose their elasticity. Elasticity is the stretchiness your lungs need to fill up with and push out air. In COPD, these sacs act less like a balloon and more like a lead pipe.
  • The airways make more mucus than usual, which clog them and make breathing more difficult. The inflammation caused by smoke and other irritants produce mucus. It’s not a good thing when instead of breathing air, you’re attempting to breathe a smoke-filled swamp of snot-like material.
  • The walls of the airways become thick and inflamed. Over time, inflammation can cause permanent changes in the walls of the airways to compensate for the environment you’ve created.
  • The walls between many of the air sacs are destroyed. Ongoing inflammation overwhelms the body’s ability to repair itself, and eventually sheets of tissue in your airways are destroyed beyond repair, providing you with less tissue to exchange oxygen from the lungs to the blood vessels that carry oxygen through the body.

COPD

What causes COPD? 

Cigarette smoking is far and away the leading cause of COPD. Most of those with COPD are current or former smokers. Heredity, childhood respiratory infections, and long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust may contribute to or cause COPD.

COPD pix

I’ve been told I have bronchitis. Is that the same thing?

There’s acute bronchitis, and there’s chronic bronchitis. In the US, COPD refers to two separate but similar conditions, emphysema and chronic bronchitis; most with COPD have both conditions. Now if you have acute bronchitis, it means something (like and likely cigarette smoke) is currently inflaming your airways. Over time this can permanently damage the airways and produce an ongoing state of inflammation – chronic bronchitis – with airway wall thickening and increased mucus production within the lungs. Let the smoker beware.

How is this different from emphysema?

In emphysema, the walls between many of the air sacs are damaged, losing their shape and elasticity. This damage also can destroy the walls of the air sacs, leading to fewer, larger and less efficient air sacs instead of many more efficient tiny ones. If this happens, the amount of gas exchange in the lungs is reduced, meaning you’re not getting enough oxygen in you and enough carbon dioxide out of you.

copd sx

What are some symptoms of COPD?

COPD can cause coughing with mucus production, wheezing, shortness of breath, chest tightness, decreased ability to exert yourself and walk around. Even more symptoms may develop as a result of inadequate oxygen supply and inadequate carbon dioxide disposal.

How can I know if I have COPD?

One big problem with COPD is many have the disease and don’t know it until it starts becoming quite advanced. It’s safe to assume that if you’re a smoker and have difficulty breathing, you’re experiencing changes to your airways that aren’t in your best interest. You are advised to get evaluated. You are best advised to remove yourself from the source of the inflammation (in other words, stop smoking).

How does COPD affect my life?

For starters, it shortens it. It also markedly increases your cancer risk. At some point all the damage and changes to your lungs is going to cause some abnormality. Given this is the area you use to breathe, deliver oxygen to your organs and eliminate toxins from your body, all manners of things can go wrong, and they often do. COPD is a chronic, progressive disease. You may or may not pick up on the slow creep of diminishing ability to perform routine activities, or maybe you’ll just attribute them to aging (COPD occurs most often in middle-aged to elderly individuals). Once severe enough, COPD may prevent you from doing even basic activities like walking, breathing without difficulty, or taking care of yourself.

What’s the cure for this? 

Here’s the frightening part: we’re talking about irreversible lung tissue change and destruction. Once layers of your airways have been ripped out (figuratively), they aren’t coming back. The damage is done. Prevention is your best defense.

COPD treatment-chart

So how is it treated?

There is no real treatment without removing the trigger feeding the ongoing inflammation. In other words, you’ll have to stop smoking to attempt to arrest the progression. Additional measures involve support.

  • Supplemental oxygen may be needed to deliver enough oxygen to the tissues as an effort to combat the destruction and inflammation of tissue meant to facilitate oxygen exchange.
  • Medicines to reduce the inflammation and mucus may be prescribed.
  • Medicines to better open the airways past the clogging caused by inflammation and mucus may be prescribed.

Your physician will discuss these and other options. The truth is COPD has no cure. Once you’re discovered to have COPD, efforts switch to slowing the progression and implementing measures to improve the quality of your life within the parameters defined by the advancement of your disease.

Here is a short video from the National Institutes of 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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Straight, No Chaser: Lung Health – Know The Signs of Danger

I would suggest you should be in complete awe of your lungs. Did you know you take over 20,000 breaths a day? Your lungs bring air into your body and eliminates waste (carbon dioxide) when you exhale. The lungs transfer oxygen into the bloodstream and launches it throughout body’s cells as life-sustaining fuel. This Straight, No Chaser skips ahead in the process of lung function to discuss the relevance of everyday symptoms you experience as signals of danger.

If you have any of these warning signs or symptoms, discuss them with your physician as soon as possible.

chronic cough

Chronic Cough – In this definition, chronic means the cough has been present for at least a month.  This is an important early symptom and should not be ignored – smokers, that means you.

shortness-of-breath

Shortness of Breath – To be clear: you expect to be short of breath after you exercise or otherwise exert yourself. The shortness of breath that should be particularly concerning doesn’t go away after exercising or occurs after little or no exertion. The feeling that it is hard to breathe in or out is also a warning sign and is also indicative of respiratory illness.

mucus asthma

Chronic Mucus Production – Mucus (aka sputum or phlegm) is produced by the airways as a defense response to infections or irritants.  Ongoing production for more than a month could indicate lung disease.

wheezing

Wheezing – Wheezing is often described as noisy or musical breathing and is a sign that something blocking your lungs’ airways or making them too narrow, such as a physical obstruction, inflammation or increased mucus production.

coughing-up-blood

Coughing up Blood – If you are coughing up blood, the blood may be coming from your lungs or higher up in your respiratory tract. It is a sign of a health problem.

chest-pain chronic

Chronic Chest Pain – Chest pain lasting more than a month should be taken as a warning sign. Lung involvement is more likely if it is associated with worsening while breathing or coughing.

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: Great American Smokeout – Quick Tips to START Smoking Cessation

great-american-smokeout

The Great American Smokeout is a great time to get serious about smoking cessation. Don’t wait to make it a New Year’s resolution. Do it now. Can’t do it now? Do it Monday. In fact, do it every Monday. It’s a fight. If you fall down, start it back up again. It’s the fight of your life (or should I say for your life)!

Try all of these tips to help you:

  • If you decide to quit after your current (last) pack, throw away one cigarette for every one you smoke.
  • Count (figuratively or literally) all the money you’re saving by not smoking.
  • Throw away (not give away) all cigarettes, cigars, matches, lighters, humidors, cigar cutters and anything else you associate with smoking. You’ll realize how sad it is if and when you find yourself rummaging through the garbage to get a fix.
  • Tell everyone (loudly) that you’ve quit. Empower them to help and hold you accountable. Enlist another smoker friend to go through the journey with you.
  • If you do fall off the wagon, smoke a different cigarette brand. Odds are you won’t like it as much, and that will help combat the natural ease you have with smoking.
  • Contact your physician and ask for help.

smokinghard-yes

Here’s a marvelous best-practices schemata of appropriate interplay between a physician and a patient trying to stop smoking.

smoking cessation As

If your physician and you decide to place you on a patch or otherwise medicate you, follow instructions carefully and precisely.

smokingcessation1

More tips:

  • Practice deep breathing. Part of the euphoria of smoking is nothing more than the physiologic sensations produced by deep inhalations.
  • Keep other things in your mouth. Mints and chewing gum (low-calorie) are great. Brushing your teeth also serves many purposes. Drinking water when you want to smoke will often remove the urge.
  • Make it past the first day. Then make it past the first week.

smoking surgeon general cessation

I personally love the START method, which includes several of the above methods. Let me know if it works for any of you.

S: Set a quit date.

T: Tell your friends, family and associates that you’re quitting, and enlist their help.

A: Anticipate and act on the plan you’ve set and challenges you’ll meet.

R: Remove (trash) cigarettes, cigar and other paraphernalia from your environment.

T: Talk with your physician about options and additional support.

For those of you affected (either first or second-hand), this is huge and important. I really wish you all the best. I welcome any comments or questions.

smoking the end

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, Respiratory/Lungs