Tag Archives: Behind the Curtain

Straight, No Chaser: Animal Bites

cat_scratch

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

dogbite

Bow-Wow Ows

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

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

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

cats bite fingers-gray cat

Mee-Ow Ows

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

catbite14x6web

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

catscratch adenitis

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

dog-not-biting

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

shark-attack-792816

The Big Yow Wow! Ow

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

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

human bite

The Most Dangerous Animal of Them All

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

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

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

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

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

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Filed under Infectious Disease, Skin/Dermatology

Straight, No Chaser: Your Questions About Human Bites

jaws

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

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

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

2)   What’s a Boxer’s Fracture?

fight bite

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

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

goat lip

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

4)   Is a bite the same as a puncture wound

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

human-reflex-bite

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

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

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

dracula_bites_kim_kardashian_by_the_mind_controller-d5jh3ix

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

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

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

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

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

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Filed under Infectious Disease, Medical Treatment, Skin/Dermatology

Straight, No Chaser: Human Bites

fight-bite

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

fight bite infected

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

tysonbite

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

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

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

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

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

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

human-bite

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

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

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

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

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

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

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

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

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

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Filed under Infectious Disease, Skin/Dermatology

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

bed-bugs-101-chalkboard

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

bed-bugs-chart

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

Let’s discuss your major concerns about bed bugs.

bed-bug

How do I prevent having them?

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

If bitten, what type of symptoms will I have?

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

Do bedbugs spread disease?

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

What treatment do I need for bedbug bites?

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

How do I get rid of bed bugs?

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

Bedbgs

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

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

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

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

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

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Filed under Infectious Disease

Straight, No Chaser: 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: Questions You Should Ask When You Have a Laceration

laceration

I wonder if any of us avoid lacerations over the course of our lives. It seems that everyone I know or every patient I have cared for has a scar and a story to accompany it. Fortunately, it’s not as simple (or complicated) as going to the emergency room and getting stitches when a cut (laceration) occurs. Today’s Straight, No Chaser offers you simple facts and questions to ask your physician when you find yourself or someone else you’re caring for needing care for a laceration. Believe me, you want to know the correct questions to ask, and you want to have an understanding of expected outcomes.

When should I deal with these cuts at home?

Remember that a laceration is a manual breakdown of the body’s most basic defense against toxins and other agents entering your body. This creates a significant risk for subsequent infection. In most cases it is advisable to get a laceration at least evaluated, which doesn’t mean you’ll necessarily need stitches.

Are there things I can do at home to help?

We now know that tap water is as effective as the saline used in hospital or clinic settings to clean wounds. If you’re at home, copious rinsing of the wounds with warm water followed by applying clean wrappings is a good idea.

Are there things I shouldn’t do at home in an attempt to help?

Detergents, hydrogen peroxide and povidone-iodine solutions should be avoided, as they can damage the integrity of the skin.

How long after a cut can I get stitches?

This depends on the location of the wound, your health and factors such as mechanism, contamination and risk for subsequent infection. As a rule, you should get lacerations evaluated within 12 hours after the injury. Under all circumstances you should be seen within 24 hours after an injury.

What happens if I come in too late to get stitches?

Depending on circumstances, your physician has additional options that can reduce the infection risk and optimize the cosmetic outcome. Some older wounds may be loosely closed, followed by a definitive repair in a few days if all goes well (i.e. no signs of infection in the interim). Other wounds may be packed with protective gauze as an alternative. Still others will simply need to heal on its own. Your physician can discuss when and why each option is preferable.

lac repair with staples

Will I always need stitches?

No. Sometimes what appears to be a cut is actually a scratch. Other times, lacerations can or need to be repaired with other options, such as steri-strips (a version of medical taping), tissue adhesive (you call it medical glue) or staples.

laceration_chin dermabond_chinlac0

What’s the glue that’s being used? 

In many circumstances, tissue adhesives not only can be used but should be used. Tissue adhesives have similar results as sutures in cosmetic results (i.e. appearance), breakdown rates, and infection risk. That said, some types of wounds, some situations and some locations prevent the use of tissue adhesives. Ask your physician if a tissue adhesive is a reasonable option.

Can I just use some form of glue at home?

No. It’s not the same, and if you try using some commercial glue, paste or needle and thread on your cuts at home, you’re asking for a ferocious infection in a few days.

Will I always need a shot for my numbing medicine?

No. Ask your physician if a topical medicine option is appropriate, especially in children or those otherwise wanting to avoid needles.

stitches

How long do stitches stay in?

Here are some guidelines based on the location of the laceration.

Face Three to five days
Scalp Seven to 10 days
Arms Seven to 10 days
Trunk 10 to 14 days
Legs 10 to 14 days
Hands or feet 10 to 14 days
Palms or soles 14 to 21 days

How do I care for myself after the cut has been fixed?

Follow-up for repaired lacerations is pretty similar regardless of the method used to repair. Consider the following.

  • Keep the wound clean and dry using a protective dressing for at least 24 hours after the repair, unless tissue adhesive was used, in which case no dressing should be applied.
  • An antibiotic or white petrolatum ointment can be applied daily to wounds not repaired with tissue adhesives. That’s right, white petroleum ointments are just as effective as antibiotic preparations.
  • If you’ve received a tissue adhesive, you must avoid white petroleum or antibiotic ointments over the wound site, as these can dissolve the tissue adhesive, causing the wound to break open.

Anything else?

Even if you’re not asked, you should always ask if you need a tetanus vaccine after a laceration. The answer will always be yes if it’s been more than 10 years since your last immunization, and in selected cases it will be indicated if it’s been more than 5 years.

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 Skin/Dermatology, Trauma

Straight, No Chaser: How to Survive a Motor Vehicle Collision

 

As you drive the expressways of some cities, you can now see signs displaying how many traffic deaths have occurred during the year. I’m sure the purpose of these announcements is to keep drivers alert to the real dangers of driving and to remind us to drive safely. We discussed the magnitude of motor vehicles crashes (they’re not accidents) in the last Straight, No Chaser. However, when prevention hasn’t kept you out of harm’s way, what you do next can make a world of difference. Here are 10 quick tips to keep you upright.

If you see an accident happening in front of you …

Whitetail deer jumping a fence into a roadway.

1) Move away from the steering wheel/dashboard. That airbag will be coming at you at approximately 200 MPH. It can cause burns and other injuries on its own. You want both hands on the wheel as loose as possible during impact.

2) If possible, angle the car for a glancing blow. Try to avoid the head-on collision, especially with the bigger object. Similarly, the ‘T-bone’ side impact collision is especially dangerous, as the car is structurally weaker on the side, and the side is closer to passengers.

3) Slow down as best you can, but also try to control your deceleration. The faster the impact, the worse the damage will be.

4) If there’s time and you haven’t already, get that seat belt on.

5) If there’s time, get any potential projectile from where it may strike you. That’s off the seat, dashboard and cup holders. Hot coffee in your face or being slashed by your phone won’t feel good.

After the crash …

mvc1

6) Call emergency medical services as your first move after a crash.

7) If you have any neck pain, as best you can, do not move. Period.

8) If you are pregnant, get onto your left side while you wait.

9) After a crash, switch off your engine, do not smoke, and stop anyone else from smoking. You will not be in a position to put out any fire you start and if flammables are in either car, you could be setting up an explosion.

10) Do not attempt to remove injured people from a vehicle yourself; leave that to the paramedics. You could be aggravating a neck (spinal) injury that is not obvious at that point.

It bears repeating: the best way to survive car crashes is not to be involved in one.

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 Trauma

Straight, No Chaser: Motor Vehicle Crashes – Risky Behaviors, Injuries and Prevention

 

Image result for fatal motor crashes per day 2017

‘Tis not our task to preach but to inform. Maybe you think you’ve heard it all before, but let me lay it all out for you so you can truly be an informed consumer. Forewarned is forearmed. There’s a reason you hear so much about drinking or texting and driving, wearing seat belts/helmets and speeding. If there was such a thing as Human Shark Week, the biggest and baddest predator in the trauma world would be motor vehicle crashes.

Motor vehicle collisions are the single leading cause of death among those between ages 5-34 in the US. More than 4.26 million adult drivers and passengers were treated in ERs as the result of being injured in motor vehicle crashes in 2016.. Traffic fatalities increased by 6 percent from 2015 to 2016 (up to 40,200) in the United States (102 people per day). Let’s lay this out simply and review the risks, the consequences and preventative efforts you should be taking.

Risky Behavior:

Image result for us car injuries 2017Danger is enhanced by various distractions and inadequate protection. The mistake people make is not understanding that much of the danger is outside of your control – other drivers. If you’re impaired or distracted, you can’t respond effectively. I’ve seen it all.

  1. Drinking while driving – Stop it with the “I can handle my liquor” nonsense. Someone dies every hour from drinking while driving. It’s not just drunk driving, it’s impaired driving. Your senses are altered and ability to respond diminished at any level of alcohol consumption and is incrementally more so with more consumption.
  2. Texting while driving
  3. Eating while driving
  4. Reading while driving
  5. Doing your hair/shaving/makeup while driving
  6. Kissing and other sexual activities while driving
  7. Motorcycle driving/riding without a helmet
  8. Letting your children drive without a license and/or formal training: it’s all too true. Teens are most at risk for accidents and being impaired/distracted/drunk while driving.
  9. Letting your children ride in the front of the car
  10. Not wearing seat belts (the biggest mistake of them all)

Injuries:

I’ve seen nearly every conceivable injury from motor vehicle collisions. It doesn’t take as much effort as you’d think to have a very bad life after a crash.  Consider the following possible going head to toe (and yes, the list is abbreviated)…

  • Traumatic Brain Injury, including intracranial bleeds, strokes, seizures, concussions, herniation and death…
  • Neck Injury, including fractures, strains, pinched nerves, temporary and permanent loss of motion/sensation in your extremities…
  • Chest wall bruising, heart and lung bruising, collapsed lungs, stab wounds to the heart and lungs, ruptured heart vessels…
  • Abdominal injuries, including contusions to and rupture of the liver, spleen, pancreas, diaphragm and intestines…
  • Genital, urinary and pelvic injuries, including the kidneys and multiple fractures…
  • Nervous, psychologic and musculoskeletal system injuries, including contusions, life-threatening fractures and dislocations, paralysis, facial disfigurement and other scarring, post-traumatic stress syndrome and long term pain syndromes.

Prevention:

MVC-Utilization of Safety Equipment Among Those Injured in a Motor Vehicle Crash

  1. Seat belt use reduces serious injuries and deaths in crashes by 50%. Air bags provide added protection but are not a substitute for seat belts in a crash.
  2. Wear a seat belt every time, every trip.
  3. Seat all kids under 12 in the back seat.
  4. Seat backseat passengers in the middle (it’s the safest spot in the car)
  5. Regarding any function on a smartphone, if you can’t be hands free, it can wait. If you must use your hands, pull over.
  6. Remember designated drivers?  Yes, that’s still a thing.
  7. If you’re on a motorcycle, wear a helmet, every time, every trip.
  8. Protect your teen.  No license, no vehicle.  Consider driving school.

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Impaired and distracted driving will cause you harm; it’s not an “if it’ll happen” situation, it’s “when it happens.” Please consider the points I’ve mentioned and the lives of passengers/other drivers when deciding how you handle your vehicle.  Good luck on the road.

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: Total Knee Replacement Surgery

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When you’re at the big game, whether it’s football, basketball, soccer or otherwise, it’s likely you’re watching a group that includes someone who may require joint replacement surgery over the course of his life.

Can you believe that over half of a million total knee replacement (TKR) surgeries are performed a year?

As we age or experience knee injury, the progression of limitations on us imposed by arthritis and other diseases of the knee-joint can become too much to bear. Persistent pain and limited range of motion can make each step an exercise in physical and mental agony.

Risks for TKR include having osteoarthritis, infection, obesity, being younger than 55 years old and being male.

TKR2

TKR involves removal of damaged bone and other tissue (e.g., cartilage) from the knee joint and creation and placement of a new joint (a prosthesis) made of plastic and/or metal. Most TKRs are successful, with approximately 90 percent of patients experiencing rapid and signficant pain reduction and improved joint function.

Of course, many of you have heard about complications of joint replacement surgeries, and TKR also comes with risks. Scarring, blood clots and infections may occur, but in the hands of a competent orthopedic surgeon, these risks pale in comparison to the benefits that the otherwise healthy individual will receive. Recovery involves a brief post-surgery hospitalization, followed by treatment in a rehabilitation facility and a couple of months of physical therapy (PT).

PT is especially important, because with it you’re setting your future bar. You need to work to whatever limits you want to reach, and you need to get started right away. Once the knee stiffens post-surgery, you won’t be able to get back what you’ve lost. Your post-surgery life and use of your knee will be a direct result of how hard and how much you work that knee during rehabilitation.

Recovery involves mental and physical considerations. Physically, you’re likely not going to be engaged in high-impact sports anymore (or even running for that matter, although this is a case-by-case consideration) because of the risks of loosening the prosthesis and requiring revision surgery. Riding a bike and other activities involving flexibility will be possible.

Mentally, TKR is not a fountain of youth, and you have to wrap your brain around that fact. You must define quality of life through the loss of pain and improved mobility.

TKR

Prosthesis are expected to last at least 15-20 years, and that level of longevity should give you a new lease on life. If you find yourself or your loved ones in severe pain from arthritis or other knee pain, ask your physician what circumstances may lead to the need for a TKR. You can certainly discuss the matter further with your SMA expert consultant.

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

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

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

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

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Filed under Orthopedics/Bones, Sports Medicine

Straight, No Chaser: The Role of Gunshot Wounds in a Nation at War with Itself

gunviolence

Apparently there is going to be an ongoing need to address this… Somewhere in the midst of reconciling the parts of me that are physician, public health professional and African-American male, I realized that I don’t have the luxury to simply review the medical aspects of gunshot wounds. As an African-American, I have lived my entire life learning and having it reinforced that I and others of my kind are a misunderstanding or inappropriate interaction away from becoming a statistic (and not just via the police). As a physician I get to treat, and as a public health professional I get to report and fashion broad solutions to various challenges, but as an African-American, I get to live a certain reality that for me began when my father died from a so-called “random gunshot” wound when I was a small child.

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The trauma inflicted by a gunshot wound is not theoretical. It is a medical lie that such a thing as a warning shot exists, if indeed a bullet enters your body. Penetrating injuries to virtually all areas of the body (brain, neck, chest, back, abdomen, groin, extremities) can be fatal. Gunshot wounds have several ways of injuring you, including the direct damage to tissue, indirect damage from the shock waves and direct damage from fragments (of the bullet or bone). When you shoot someone, you have factored in a possibility that the wound you inflict could be fatal. Police officers shooting individuals are aiming at areas correlating with defined statistic probabilities of death, none of which is zero. Those trained in firearm use make choices: shooting to kill instead of to subdue is a deadly choice among other options. No one should ever be allowed to claim otherwise.

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We live in a country that is without debate the most violent country on earth, both outside of and within all parts of our borders. From the individual’s rights to bear militia levels of arms to the police’s increasing position as military units, from the contradictions of allowing both “Open Carry” and “Stand Your Ground,” we are spiraling toward an inevitable conclusion. Stop being so deficient of attention about what’s happening before our eyes, and think and ask what the inevitable conclusion of all of this is going to be.

Regardless of your political persuasion, there are issues to be addressed. Although the news of the day isn’t pointed in this direction, the extent of this madness has begun to envelope children as well.

gun-violence

Consider the following facts from the Children’s Defense fund,

  • 7,768 children and teens were killed with a gun during 2013-2015. That’s enough to fill 388 classrooms of 20 children. 2,799 were killed in 2015 alone.
  • Young Blacks are being exterminated by gunshot wounds in this country.  Black children and teens accounted for 14% of the total child population while each day in America 8  children or teens are killed with a gun; black children and teens account for 3 of those daily deaths. Are you just going to read this statement passively without wondering about and contributing to a solution?
  • Gun violence remains the leading cause of death for Black children and teens.  In 2015, 9.5 out of every 1,000 Black children and teens were killed with a gun; a rate four times higher than the rate for White children and teens (2.5 per 1,000). A Black child or teen was killed with a gun every 7 hours and 25 minutes.
  • Since 1963, the number of children and teens killed by guns on American soil was more than three times higher than the number of U.S. soldiers killed by hostiles in wars abroad. Nearly 180,000 children and teens dies from guns in the U.S. between 1963-2015.

Using more recently available data, the Centers for Disease Control and Prevention lists the number of firearm-induced deaths in 2015 as 36,252.

GunViolenceend

What is it going to take to get the American public and leaders to stand up to protect the lives and safety of children over the lobbies of gun owners and sellers? America can walk and chew gum at the same time. We can fashion reasonable safety measures and restrictions that will save lives while working within the framework of current interpretations of the Constitution by the Supreme Court. This will not occur without pressure from the populace.

Martin Luther King, Jr had two famous and related quotes that are relevant and applicable here.

  • “Our lives begin to end the day we become silent about things that matter.”
  • “In the end, we will remember not the words of our enemies, but the silence of our friends.”

If you are not willing to take specific actions to eradicate the challenges facing us, that makes your condolences somewhat hollow after tragedies have occurred. It is past time to get involved in whatever way you can or choose. 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.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPres

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Filed under Trauma