Tag Archives: Behind the Curtain

Straight, No Chaser: Food Allergies

Diet and Nutrition, Endocrine/Metabolic, Environmental, Hematology & Oncology/Blood Disorders/Cancer, , , , , , ,

This week’s Straight, No Chaser posts will focus on your food. Today, we begin with food allergies, which sound like a cruel trick or something out of a horror movie, but unfortunately, they’re all too real. We’ve discussed seasonal allergies and allergic reactions before, but food allergies warrant addressing additional questions you’ve had.

 food.allergies.101.cnn.640x480

Why do I get allergies anyway?
Food and other types of allergies result from your body mistaking harmless substances for potential threats. The resulting immune response is an attempt to defeat that threat. You are caught in the crossfire, and you exhibit symptoms as a result.
Why do I get allergies to foods I’ve eaten before without a problem?
In many instances, the first time you’re exposed to a certain new food, your body is only primed, and you won’t experience symptoms. A subsequent exposure will prompt the full allergic response.
Is there a way to know if I’m at risk?
Food allergies are more likely in those who have a family history of allergies, asthma or eczema. Take a minute today and ask your parents if they have any allergies to foods or medicines. It’s good to be aware.
How do I know my symptoms are an allergic reaction?
We’ll discuss symptoms shortly, but one big clue is the timing of symptoms. Allergic reactions due to food take place within minutes to a few hours after exposure. It’s not as important for you to know the symptoms as to realize that you’re not well and that evaluation is needed.

 food allergy sx

So what are the symptoms?
Let’s start with the life-threatening considerations. If you have any shortness of breath, mental status changes (e.g. confusion, severe dizziness) or sensation that your throat is closing, get to an emergency room as soon as possible. Other symptoms may include the following.

  • Itching or swelling of your mouth or the tissues between your mouth and throat
  • Hives, wheals, or an eruption of your eczema
  • Abdominal pain or cramping
  • Nausea, vomiting or diarrhea
  • Drop in your blood pressure

food allergy touch
Can you get food allergies from touching foods?
Yes. As an example, those with peanut allergies can have an allergic reaction from breathing in peanut residue, touching peanuts or using skin products that contain peanuts.

 food-allergies

Which foods are most likely to cause allergies?
Here is a partial list of foods commonly causing food allergies.

  • Cow’s mik
  • Eggs
  • Fish/shellfish
  • Peanuts/tree nuts
  • Soy
  • Wheat

Cow’s milk? Is that the same as lactose intolerance? 
No. That’s a different consideration and an upcoming post.
What about treatment?
That’s tomorrow’s post. Obviously knowledge and avoidance are key.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Infection Prevention

General Health and Wellness, Infectious Disease, Health Prevention, , , ,

sneeze_in_arm

There are things you know, there are things you know but don’t really know, and there are still other things that you think you know that you don’t know at all. When it comes to colds and influenza (both or which are simple to understand, prevent and treat), all of the above apply.
Are you sickly or do you get colds more frequently than others? Respectfully, a big part of that is because you have habits that put you at risk. Common things happen commonly.

germs-on-hands

Of course this is not an actual photo, but it’s a good depiction of what’s happening. Simply put, most of the day, your hands are pretty disgusting. You handle money that’s been handed hundreds if not thousands of times and never cleaned. You grab handles and door knobs all day long. You cough and sneeze throughout the day, spewing germs into the air to be inhaled by others. And you spend time in the restroom. Your unclean hands contribute to many ailments, including colds, influenza, conjunctivitis (pink eye) and gastroenteritis (vomiting and diarrhea) and skin infections.
The important points are there are simple things you can do to lower your risk for infections. First, you have to stop assuming you know more than you do about basic hygiene and allow yourself to start practicing better habits. For example …

  • When you sneeze, do you sneeze into your hands or into the air around you? Please learn the habit covering your mouth and nose when you sneeze or cough by sneezing/coughing into your elbow and not your hands.
  • How often do you wash your hands? You must wash every time you begin to cook, before you eat, after you use the rest room, before you change a diaper and before you apply any topical medicine.
  • Have you ever noticed how much you keep your hands on parts of you that can become infected by doing so? Keep your hands out of your eyes, mouth and nose, and stop picking at your skin!

handwashing2

Yes, you wash your hands, but do you do so effectively and when you need to? Hand washing must be the easiest and most effective ways to prevent disease. Let’s start with this: from now on, whatever you do to clean your hands, do it for twenty seconds. Of course, antimicrobial soap and water are what we all learned to do way back when. It works! If that’s not available, use hand sanitizers or disposable hand wipes. It that’s not available, just rinse your hands! Be sure to rub your hands vigorously during the process as if you’re trying to get someone off of your hands, because you are!

sneeze

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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 Most Frequent Causes of Death and How to Avoid Them

General Health and Wellness, , , , , , , , , ,

early-death-pair

It is interesting and curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.
According to the Centers for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

  • Heart disease (e.g., heart attack): 597,689
  • Cancer (all cases): 574,743
  • Chronic lower respiratory diseases (e.g., asthma, COPD, emphysema, chronic bronchitis): 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Please get screened! Early detection is the key to survival.

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

COPDer

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog

Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard if you’re actually trying.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Depression – How to Avoid It, When to Get Help

Mental Health, , , , , , , ,
depression
This is the third post in a series on depression and suicide. In our first post, we focused on the magnitude of  clinical depression and suicide. In the second post, we provided tools for depression self-awareness. In this post we provide tips for you to address depression and an inclination toward suicide. Remember that 844-SMA-TALK and www.sterlingmedicaladvice.com provides crisis mental health services for those in need.
suicide-stay-informed-stay-connected
As a physician, I’m not willing to advise you on how to ‘care’ for yourself at home if you’re clinically depressed.  I can discuss how to avoid depression (to the extent possible) and what warning signs should prompt emergent access to care.  If you’re good at accomplishing the items listed below, you have less of a chance of being unhappy and clinically depressed.

  • Avoid alcohol and other mood-altering drugs.
  • Eat healthily.
  • Exercise regularly.
  • Get enough sleep.
  • Remove yourself from negativity, including your choices in friends, mates and work environments.
  • Surround yourself with positivity, including your choices in friends, mates and work environments (Please note this is a different consideration than the previous bullet point.).
  • Learn how to relax and where to go to relax (These considerations include such things as yoga, meditation and your religion/spirituality, not the business end of a bottle or drug use.).

suicide HELP_Logo_Master
Look out for these potential warning signs for suicide: Remember that approximately 30% of suicides are preceded by the individual declaring intent.  Be alert for the following additional considerations:

  • Increasing levels of depression, withdrawal, reckless behavior, alcohol and other drug use, and/or desperation.
  • Notice activity that could be a prelude to a suicide attempt, such as obtaining knives, firearms or large quantities of medication.
  • Changing one’s will and settling one’s life affairs in the midst of depression
  • Ongoing comments about lack of worth and desire to end it all.

Suicide-Lifeline
The following considerations should prompt an immediate visit to an emergency room or other treatment facility.

  • You have a compelling, overwhelming feeling that you want to hurt yourself, with or without an actual plan.
  • You have a compelling, overwhelming feeling that you want to hurt someone else, with or without an actual plan.
  • You hear voices or see things or people who are not there.
  • You find yourself crying often and uncontrollably for no apparent cause.
  • Your depression has affected your activities of daily living (work, school, consistent forms of recreation or family life) for longer than 2 weeks.
  • You think your current medications are affecting you abnormally and are possibly contributing to making you feel depressed.
  • You have been told or believe that you should cut back on drinking or other drug use.

I wish you and your loved ones all the best in avoiding and/or dealing with this disastrous condition.  I welcome any comments, thoughts or questions.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Are You Depressed and/or Suicidal?

Mental Health, , , , , , ,

In our first post on clinical depression and suicide, we looked at the scope of the disease, and in the next post we will provide tips for you to address depression and an inclination toward suicide. In this post, we carefully tread onto your tendencies that may clue you into the need for help. Remember that 844-SMA-TALK and http://www.sterlingmedicaladvice.com provides crisis mental health services for those in need.

areudepressed
I have a strong distaste for do-it-yourself websites that want to ‘screen’ you for depression.  Folks, if you’re wondering whether you’re clinically depressed, you don’t need validation from some makeshift online questionnaire.  That said, if you’d like to learn something, go ahead and find one.  More importantly, seek assistance immediately from a qualified counselor or therapist.  They do wonderful work and can get through to you before you get to yourself.  Instead of a quiz, I will simply give you common signs and symptoms consistent with the diagnosis.  Note the progression in the symptoms.  The bottom line is: odds are, you already know if you need help.  Yes, there are different depression syndromes; I’m not getting into that.  You and a psychiatrist or therapist can sort that out.  Don’t be reassured by a quiz when you already know better.
suicide counseling pix
You may be depressed if…

  • You feel sad, hopeless, empty, or numb to the point where you wallow in these emotions, and they dominate your existence.
  • You have a loss of interest in your normal activities of daily living.  It’s not just that you don’t enjoy things.  You don’t even want to be bothered with them.  You don’t want sex.  You don’t enjoy your friends.  You don’t want recreation.  You can’t eat.  You can’t sleep, or you can’t stop sleeping.  You can’t breathe (because of your crippling anxiety).  You might actually be depressed if you have these symptoms and didn’t get the ideas from listening to the lyrics of a Toni Braxton song.
  • You find yourself exceedingly irritable and/or anxious. These feelings are explosive and over the top.  You’re waiting, ready and looking for a reason to embrace gloom, doom or anger.
  • You have difficulty moving forward and making decisions. This occurs for many reasons.  Your attention may be shot.  Your interests aren’t there.  You’re overwhelmed.  Stuck in a rut is not only where you are, it’s where you want to be.
  • You feel worthless and blame yourself for any and everything.  Again, these feelings are explosive, dramatic and over the top.
  • You have thoughts of death and suicide. This is where things get beyond scary.  You may simply have a passive wishing that things would end and a belief that your friends, family and the rest of the world would be ‘better off’ without you.  You may have fleeting voices that aren’t your own suggesting or commanding suicide as an option.  You may see visions of people telling you to harm yourself.  You may have an active plan.  When depression gets to this point, nothing good is going to happen without intervention.  Never allow someone to make such comments and then pretend as if they were insincere.

suicide-sign-hand-SS
Now consider these most common precipitants for suicide:

  • Problems with one’s intimate partner
  • Problems with one’s physical health
  • Problems with one’s job
  • Problems with one’s finances

You will have a lot better chance getting someone help at a warning stage than preventing someone from doing something once they have a weapon in their hands.  Approximately 30% of suicides result after the individual has expressed an intent to do so.  Listen up…  Take the signs of depression and any expressed thoughts of suicide seriously.
I welcome your comments, thoughts or questions.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Suicide Data – Understand the Threat

Mental Health, Public Health, , , , , , , , , , , , , , , , ,

suicidemap
There are amazing, shocking and saddening facts about suicide.  It is equally amazing that we aren’t discussing this as an epidemic.  Consider the following information provided by the Centers for Disease Control and Prevention:
There were an average of 105 suicides a day in the U.S. (over 38,000 for 2010).
An estimated 8.3 million adults reported having suicidal thoughts in the past year.
Suicide is the third leading cause of death among those aged 15-24, the second among those aged 25-34, the fourth among those aged 35-54, and the eighth among persons aged 55-64.
For those committing suicide:

  • 33.3% tested positive for alcohol.
  • 23% tested positive for antidepressants.
  • 20.8% tested positive for opiates (such as heroin and prescription pain killers).
  • There is one suicide for every 25 attempts.

Females are more likely than males to have had suicidal thoughts, but suicide among males is four times higher than among females (in other words, females think about it and try more often, but males complete the act more often.).
Among Native Americans aged 15-34, suicide is the second leading cause of death, fully 2.5 times higher than the national average.

stop_suicide

There are some topics that aren’t amenable to Blogs.  Depression and suicide are among them.  They can’t be done justice.  What I can try to do is break components of the conversation into bite size pieces and give you information to work with.  I’ll do this in three parts.  Above, I’ve shown you the magnitude of suicide.  In the next post, I will help you understand what clinical depression looks like, then finally, I’ll review some Quick Tips to help you prevent falling into the deepest levels of depression and to help you know when immediate attention is required.  Just remember: this isn’t the type of depression that involves having a bad day.  I’m talking about when your downward mood interferes with your activities of daily living.  I’m describing depression that introduces suicide and homicide as an option.  If you don’t read these for yourself, read them for knowledge.  Someone you know may be affected.
I welcome any questions, comments or thoughts.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Tips to Deal with Depression and The Holiday Blues

General Health and Wellness, Mental Health, , , , , , , , , ,
Holiday_Depression-300x199
I don’t mean to bring anyone down during what is supposed to be the ‘most wonderful time of the year,’ but in reality there are many people hurting. For some, life’s tragedies happen this time of year the same as they might any other time. For others, this may have already happened, and this time of year is a permanent reminder of an unfortunate experience. For others still who struggle with depression, anxiety and mental illness all year, the holiday season can exacerbate these feelings and may make holidays especially long, depressing and potentially dangerous times.
Today’s Straight, No Chaser is not meant to drag you into the dumps but to empower you with tips to assist you in the event this is a difficult time for you. By the way, I’m extremely thankful that you’ve chosen to give me moments of your day and life. I take that gift seriously and hope you continue to find it a worthwhile use of your time.
HolidayDepression
Here’s five tips for your holiday mental health:

  1. Remove yourself from stressful environments and avoid situations you know will create conflict, mental duress and/or danger. I can not emphasize this enough. If you put yourself in a bad situation, you can not be surprised when bad things happen.’
  2. Find support. Specifically, have ‘go-to’ friends and family that provide you comforting support. There’s a time and place for tough love, but in the midst of depression or suicidal ideation, ‘buck up’ is not good advice. Know where your support lies and be sure (in advance) that it will be accessible if you need it.
  3. Find success and happiness where it is. During the holidays, people tend to lament what isn’t. That’s not a formula for success. Yes, all of your family may not be around, but celebrating happy memories with the ones you can often fills the room with the joyous presence of loved ones not around. Enjoy the pleasures and successes you do have access to, whether big or small. Focusing on the positive keep you positive.
  4. If you’re struggling, admit it.  You already know you’re hurting. Often the first step to getting past it is acknowledging it. Once done, then you can put coping mechanisms in place to address your feelings.
  5. Avoid holiday activities that will create post-holiday angst. This applies to eating, drinking, shopping and personal interactions. Some use the holiday as an excuse to overindulge as if the consequences won’t be there afterwards. Reread #1 above.

BBKING_SU_C_^_SUNDAY
Know when you need professional help. If your support system doesn’t sufficiently address your needs, and you’re feeling severely depressed, can’t function or are suicidal or homicidal, find a physician or mental health professional ASAP. Of course, you can always contact your SterlingMedicalAdvice.com expert. If you type mental health, depression or other keywords into the search bar above, you can access many other Straight, No Chaser blogs on behavioral health concerns that may provide you the support you need. I wish you all the best today and throughout the year, and hopefully the picture above will reflect the only type of blues you’ll have to deal with this year.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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 © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: X-Ray Safety

General Health and Wellness, Health Prevention, , , , , , ,

the.incredible.hulk.033108

After the question of “Can I get an x-ray,” the next most common question I get (which should be the first) regarding x-rays is “Do I need this x-ray?” The answer is not just based on the presence or absence of a medical indication but the medical indication relative to the risk. I’ll provide examples of that consideration shortly. The point of this Straight, No Chaser is to get you to more frequently think of the risks of irradiating your body parts. After all, inappropriate doses of radiation have a much greater chance of contributing to cancer than turning you into a superhero.
Let’s start by getting this off the table: x-rays are safe when used appropriately and with care during each case. Radiologists and x-ray technologists are trained to toe the line between inadequate production of x-rays and overexposure such that patients are placed at risk. Additionally, your physicians consider the risk-benefit ratio with each study ordered. This is why instances exist when your physician (especially emergency physicians) may advise against having x-rays done.

X-Ray-Microwave-Sign-OCI-6685-SPANISH_600

What exactly are the risks of x-rays and other medical imaging studies?
It’s about the risks of radiation and the potential contribution to cancer. You accept these risks everyday. Some of you tan, play golf, surf and otherwise expose yourself to the sun. It’s the cumulative exposure that poses risks, and these risks are miniscule. That said, there are circumstances in which the risks become pronounced, such as irradiation during pregnancy, in children or due to dye materials (called contrast media) such as barium or iodine used to enhance development of the film during special x-ray studies.
In some people, the injection of a contrast medium can cause the following side effects:

  • A feeling of warmth or flushing
  • A metallic taste in the mouth
  • Hives
  • Itching
  • Lightheadedness
  • Nausea
  • Severely low blood pressure and shock (anaphylaxis, due to an allergic reaction)
  • Cardiac arrest

How much radiation is involved in these studies?
The radiation exposure from one chest x-ray is roughly equivalent to the amount of radiation exposure you obtain from natural surroundings in 10 days.

 Preg_xray-on-candysporks

Aren’t x-rays dangerous during pregnancy?
One of the rules of emergency medicine is we don’t focus on potential side effects when confronted with a defined life threat. The issue of the effect of x-rays on an unborn fetus is secondary to the need to treat the mother. In other words, the best way to protect the fetus is to protect the mother. Even so, the theoretical risk exists, and your physician will take steps to minimize the risk if possible. This may occur by choosing another test (such as an ultrasound) that doesn’t involve radiation. The vast majority of medical x-rays do not pose a critical risk to a developing child. In fact, x-rays of the head, arms, legs and chest do not usually expose the baby directly to radiation.
Regarding standard x-ray examinations of the abdomen, they are not likely to pose a serious risk to the child. Some abdominal and pelvic studies such as CT, nuclear medicine scans and interventional radiologic studies deliver greater amounts of radiation to a developing pregnancy.

 xray pregnant

What can I do to minimize risks?
I’ll offer two simple recommendations that will help reduce your risk. In both of these instances, alternative evaluation and treatment options might be available that can provide the desired level of care.

  • Work with your physician in obtaining x-rays. The instances when you receive x-rays when your physician suggests they are not necessary are not in your best interest.
  • Inform the radiologist that you are or might be pregnant.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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 © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: X-Ray Basics

General Health and Wellness, Health Prevention, , , ,

parent_xray

“C’mon, Doc. I just want to be sure!” If I’ve heard it once, I’ve heard it a million times. You love x-rays. They’re cool, and they sometimes tell you what’s wrong. How much do you know about them? What should you know about the different types of tests done? What about the risks? This Straight, No Chaser explores the how and why of different radiologic studies.

 xrayphotoshop

How do x-rays work?
X-rays are forms of radiant energy that pass through the part of the body being examined. While doing so, a special film or monitor allows a radiologist to view pictures of internal structures.

 xrfb

What are x-rays used for?
X-rays have other uses than determining whether you have broken bones. There are many other uses, including the following:

  • Chest x-rays help in evaluating punctured lungs, the presence of pneumonia or lung masses (e.g. abscesses or cancer), heart size, shape and abnormal content (e.g. calcium deposits).
  • Abdominal x-rays help identify punctures of various organs, the presence of blocked intestines (bowel obstructions), hernias, constipation and many other conditions.
  • X-rays also identify bones that have been dislocated (moved from the normal location in a joint) or suffer from arthritis or infection, and they can often detect foreign objects. X-rays can confirm the placement of tubes your physician has placed (e.g. breathing tubes, tubes through the nose or penis or special IV tubes) and facilitate certain medical procedures.

cat scan

I’ve heard CT scans are just fancy x-rays. Is this true?

That’s overly simplistic but not entirely inaccurate. CT scans do involve the passage of a fan-shaped beam around the area in question, produce higher quality images than regular x-rays. This also involves more radiation.

 c-arm_fluoroscopy

What is fluoroscopy?
An easy way to understand radiology is to call it “screening.” In this example, the x-ray beams are being viewed in real-time via a moving picture on a TV screen. This type of study can be especially important for the identification and removal of foreign objects in the skin or for looking at the stomach and intestine.

 Ultrasound-Overview

Are ultrasounds and MRIs also x-rays?
No. Although x-rays are used as a generic term by many in the lay population, these procedures are different and would be better called radiologic or medical imaging studies. Ultrasounds and MRIs (magnetic resonance imaging) don’t use x-rays, so they are safer. Many are familiar with the use of ultrasounds in pregnancy, but they are helpful in many situations, including trauma, identification of gallstones, the presence of abscesses and many other scenarios. MRIs growing in popularity because of its superiority in identification of many conditions, particularly neurologic concerns. However, its limited availability is a problem.

nukemed

What about nuclear medicine studies?
In this type of study, radioactive materials called isotopes are injected into a vein, swallowed or inhaled. These isotopes concentrate in a specific area (body organ or tissue) when the emissions (known as gamma rays) are detected by a special camera. These emissions present a picture of the affected area.

cat_scan leopard

What else do I need to know? Why is my doctor always refusing to order x-rays?
In the hands of a good physician, these tests confirm diagnoses, not make them. In many instances, a good examination eliminates the need for x-rays. An example of this concept has been previously discussed in a Straight, No Chaser post on ankle x-rays. Also remember that for injuries, x-rays look at bones. Your muscle spasm, ligament and tendon injuries won’t show up on an x-ray, so it’s a waste of time and money to do the test.
The rest of the story is about safety. These x-rays, gamma rays and radioactive isotopes bring risk. Although they won’t turn you into the Incredible Hulk, your physician is considering your lifetime exposure and risk. Avoiding unnecessary x-rays is a key part of that. This risk will be discussed in greater detail in another post.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Stroke Recognition

Neurology, Health Prevention, , , , , , , , ,

strokerecog

This content of this post is so simple yet important that it really warrants taking up space in a few of your brain’s cells. Most of us know someone who has suffered from a stroke. With recent improvements in treatment, it’s really unfortunate when debilitating consequences occur simply because signs and symptoms weren’t recognized and/or brought in for treatment soon enough.
Let’s talk about strokes, aka Cerebral Vascular Accidents (CVA) and Transient Ischemic Attacks (TIA), and specifically about recognition and treatment. If you don’t remember anything else here, commit the mnemonic FAST to memory. (Details follow.)
A stroke (CVA) is an insult to some part of your brain, usually due to an inability of the blood supply to deliver needed oxygen and nutrients to that part of the brain. The brain actually approximates a “body map,” so depending on what part of your brain is affected, different parts of your body will be predictably affected. Technically, a stroke isn’t a stroke until the symptoms have been there for more than 24 hours; until then and/or if the symptoms reverse within that timeframe, the same scenario is called a TIA or a “mini-stroke.”
Think FAST, Act Faster
Here’s how the layperson can recognize a possible stroke:

  • Face: Ask the affected person to show you his/her teeth (or gums). In a stroke the face often droops or is otherwise noticeably different.
  • Arms: Ask the person to lift and extend the arms so the elbows are at eye level. In a stroke one side will often be weak and drift downward.
  • Speech: Ask the person to say any sentence to you. In a stroke the speech will slur or otherwise be abnormal.
  • Time: If any of the above occur, it’s recommended that you call 911 immediately, but if it’s my family, I’m getting in a car and going to the nearest MAJOR medical center—not the nearest hospital, which is where the ambulance will take you. There are important differences in hospitals when it comes to stroke treatment (which you won’t know offhand), because some are designated stroke centers and others are not. Friends, this is not the situation where you should wait hours or overnight to see if things get better. Time is (brain) tissue.

It is VERY important that you act on any of the above symptoms (F-A-S) within three (3) hours of symptom onset if possible for the best chance of recovery. Important treatment options are available within the first several hours of symptom onset that are otherwise unavailable.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Heart Attack Recognition – Time is Tissue

Cardiology/Heart, General Health and Wellness, Health Prevention, , , , , , , ,

 MIrecog

Heart Attacks. Myocardial Infarctions. Acute Coronary Syndromes. Coronary Artery Disease. Unstable Angina. There are many names to describe one main phenomenon. Heart attacks are the most common manifestation of heart disease, the #1 cause of death in the United States. Today’s post is to heighten your sensitivity to risk factors and symptoms of a heart attack, because we’ve gotten very good at treating them—especially if you get to us in time.
Risk Factors
Who’s at risk of having a heart attack? If any of the following considerations look or sound like you, you should be especially sensitive to the symptoms I describe below. Please understand these are the rules. I also see the exceptions nearly every day.

  • Age: especially men over 45 and women over 55
  • Cocaine or amphetamine (meth) use
  • Family history of heart attacks: sibling, parents, or grandparents if their heart attacks occurred by age 65
  • High blood pressure: higher risk with obesity, smoking, diabetes, or high cholesterol.
  • High cholesterol or triglyceride levels
  • Obesity/inactivity: especially due to associations with high blood pressure, diabetes, and high cholesterol
  • Smoking: including prolonged exposure to second-hand smoke

Again, if you have any of the above risk factors, your symptoms are more likely to be attributable to a heart attack. You may still have a heart attack without any of these risks.
Symptoms
How do you know if you’re having a heart attack? There’s no one-answer-fits-all response (like using FAST for strokes, which we’ll discuss in the next post). Heart attack pain comes in many varieties and is usually associated with other symptoms. What you should be aware of are the pain patterns that should prompt you to get evaluated. These may include the following:

  • Chest discomfort like pressure (something sitting on your chest), squeezing, fullness, indigestion, or just pain
  • Radiation of chest discomfort or just pain in other areas, such as one or both arms, the back, neck, jaw, or stomach.
  • Shortness of breath
  • Nausea or vomiting
  • Breaking out in a sweat
  • Racing, fluttering, or forceful beating of the heart
  • Lightheadedness up to or including blacking out

Again, you may have all of these symptoms or none of these symptoms in the face of a heart attack. We evaluate you based on the combination of your risk factors and your symptoms.
Bottom Line 1: If you have risks, symptoms and/or concerns, I’d much rather give you good news and education than give your family condolences. Get evaluated.
Bottom Line 2: I’m not discussing specific treatment options today (that’s for a future post), but remember two things:

  • Time is tissue, so the sooner you get to the Emergency Room, the more treatment options we have and the better your outcome is likely to be. This is not the disease to think, “It’ll just go away.” We can do our absolute best for you if you get to us within three hours of the start of your symptoms.
  • If and when something like this happens to me, the first thing I’m doing on my way the hospital is taking an aspirin.

As per routine, the combination of adequate prevention and prompt symptom recognition are key. I hope you share this with your families, especially those at immediate risk.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Questions About High Blood Pressure (Hypertension)

Cardiology/Heart, , , , , , ,

High-Blood-Pressure

These days everyone is running around getting their blood pressure checked at the local pharmacy. Many times that raises more questions than answers. What are you supposed to do with those numbers? High blood pressure (hypertension) is so prevalent and such a consequence of the way we live that you must already have an understanding of some basic principles if you care at all about your health. Feel free to offer your own questions or comments.

1. How do I know if I have high blood pressure? 
You know by the numbers. Consider these defining blood pressure levels.
Normal – Systolic: < 120 mmHg, Diastolic: < 80 mmHg
At risk (pre-hypertension) – Systolic: 120–139 mmHg, Diastolic: 80–89 mmHg
High Systolic – Systolic: 140 mmHg or higher, Diastolic: 90 mmHg or higher
If you don’t already have a diagnosis of hypertension and are anywhere at or above the pre-hypertension stage, get checked by your physician.
2. But when should I get go to the emergency room for high blood pressure?
I’ll always want to see you if your bottom number (diastolic blood pressure) is at or above 110-115, regardless of whether you appropriately take your medication. Don’t look for symptoms to guide you. High blood pressure is called “the silent killer.”
3. If I do have high blood pressure, will I be placed on medication?
I really hope not, but honestly, approximately two-thirds of individuals in the U.S. who have high blood pressure are poorly controlled – even on medication. This means medication will be necessary for most. That said, theoretically, medication should be viewed as necessary only when necessary and only when other measures don’t work. You should discuss this with your individual physician and make every effort to improve your diet and exercise regimens. If and when you’re placed on medication, the choice of medication will be based on your age, sex, ethnicity, mobility, existing health profile and other considerations.
4. You mentioned I could have a heart attack or stroke from this? How would I know if that’s happening?
Straight, No Chaser will have upcoming posts on heart attack and stroke recognition. where we will discuss signs and symptoms. Remember, time is tissue, meaning you must not delay if you develop these symptoms.
5. What else can I do?
Be healthy! Don’t smoke. Limit alcohol intake. Lower your stress level. This is only a broken record if you’ve received the message and have implemented the recommendations.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Diabetes Basics and the Importance of Education

General Health and Wellness, , , , , , , , ,

diabetesed

Diabetes is a disease in which education is vital. For a diabetic, knowing the disease well allows him or her to better prevent long-term consequences of the disease. It also allows the diabetic to make real-time adjustments when sick or otherwise  in danger acutely. In Straight, No Chaser, we’ve provided a series of posts meant to empower diabetics (and you can review any or all of them via the search box on the right). Remember, it all should start with a basic understanding of the disease.
We eat, and the process of digestion is for the purpose of converting food into glucose (sugar) that’s used by our body for energy. The blood delivers the glucose to different organs of the body where the cells take it up for use. In order for that process to work, an organ that’s part of the digestive tract called the pancreas has to produce a hormone called insulin. Insulin facilitates the glucose getting from the blood to inside the cells. Diabetes is a disease where insulin isn’t being made by the pancreas or isn’t working optimally.
Now think about what happens when you’re not getting sugar into your cells. It’s as if you’re starving (because physiologically, you might as well be). You get symptoms such as weight loss, hunger, fatigue and excessive thirst. Because your cells don’t have energy, they aren’t functioning well. In fact, blood and nerve vessels lose significant function, resulting in significant vision loss and lack of sensitivity in your extremities. Anyone who’s been a diabetic for about 10 years know this because you’re wearing glasses and because you’ve lost a fair amount of sensation, especially in your feet. There are other symptoms that are variations of the same theme, including excessive urination, dry skin, increased infection rate and slower healing from those infections – all due to poor function of your blood vessels.
Sometimes diabetes is a disease that happens to you because of unlucky genetics (or simply a family history). Other times it is a disease that you find. Risk factors for developing diabetes includes obesity, older age, and physical inactivity. Gestational diabetes (i.e. that occurring during pregnancy) is an entirely different conversation.

diabetes-treadmill

Let’s take a moment to discuss prevention and treatment. There are different types of diabetes, but the risk of one form of diabetes in particular can be reduced by – you guessed it – diet and exercise. In fact, diet, exercise and medications are the three legs of the diabetes treatment stool regardless of type. Some patients require regular insulin injections and others require pills. Still others who are successful with diet and exercise are able to markedly reduce, and in some instances eliminate medications.
If you’re a diabetic, make an investment in your education. It could not only save your legs or eyes, but it may just save your life. I welcome your questions and comments.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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.

Straight, No Chaser: Splinters

Skin/Dermatology, Trauma, , , , , , ,

Splintersjack

Ah, splinters. You know them, you hate them. Honestly, it’s frustrating for me to see you in an emergency room with a splinter in most cases because one of the first things that cross my mind is, “You’re spending a lot of money for such a simple thing.” Now here at Straight, No Chaser, 844-SMA-TALK and www.sterlingmedicaladvice.com we don’t practice medicine. We give you information and advice. That said, we can provide you with tried and true tips on a variety of tried and true methods to deal with splinters, and we can share with you what’s likely to happen when you show up to an emergency room or urgent care facility.

 Splinter

First, let’s diffuse your anxiety about these little slithers of wood, glass or metal. Unlike gunshot wounds that lodge up against vital organs, these little things typically stay just below the upper skin layer. You’ll be ok. Pain and anxiety and likely the worst symptoms you’ll have. Here are some general tips if you’re trying to remove splinters.

  • No matter how you try, thorough wash your hands before you start and the area of injury after you finish. There’s not much worse than adding an infection to that injury.
  • If you have a magnifying glass, use it.
  • Try to extract the splinter in the same direction (angle) it entered.
  • Don’t squeeze the splinter in an effort to get it out. You’re more likely to break it or drive it further into the skin.
  • If you do get it out, apply antibiotic ointment and allow it to heal without a bandage (unless you’re going to get the area dirty relatively soon).

In general, here’s when you when you should be seeking prompt medical attention.

  • The splinter is near or in your eye.
  • The splinter is causing significant bleeding.
  • The splinter is too deep for you to make an effort.
  • The splinter has broken into many fragments.
  • There is associated pus or other drainage.

 splintertweezer

Here’s a few methods used to try to remove splinters.

  • If you can identify the tip, perhaps the simplest thing to do is to grab the splinter with tweezers. (This is true at any point with all the methods.) Soak the tip of the tweezers in rubbing alcohol prior to using them.
  • If you can identify the tip but can’t get at it, if you have access to a sterile needle or can sterilize a needle (e.g., soak it in rubbing alcohol), you can use the pin to open up the skin at the area where the splinter went it until the tip is exposed. Then proceed with tweezers.
  • Ask your pharmacist if s/he has black drawing salve (i.e., ichthammol ointment). This non-prescription remedy has been known to be successful in coaxing splinters out of hiding. Place it on the area, attach an adhesive bandage and take the bandage off a day later. If redness or pus develops in the meantime, get medical attention.
  • Sticky tape is a variety of the same theme as the black drawing salve, except you can place it on and pull it off immediately. Be sure to pull off the tape in the direction the splinter entered the skin. Packaging tape works especially well for fiberglass splinters.

 splinterbakingsoda

Here are three other described methods that deserve special commentary.

  • Glue can be applied to the area and allowed to harden. With any luck, when you pull off the hardened glue, the splinter will come out with it.
  • Placing a raw, cut potato slice onto the splinter has been known to draw out splinters after a few minutes. This method is best used when you’re in the mood for French fries.
  • Applying baking soda paste to the skin at the point of entry has also been described as a solution. This method causes the skin to swell, theoretically expelling the splinter.

The particular concern with these last three methods (and all methods) is the risk of infection. Placing foreign objects into an opening in the skin isn’t the best measure and shouldn’t be done without taking appropriate precautions or in the presence of other options. Of course, you always have the option to wear gloves and take other safety measures to prevent obtaining splinters, including not poking your face through a door splintered by your axe a la Jack Nicholson’s The Shining character. Good luck!
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Sexual Deviances and Perversions (Paraphilias)

Mental Health, , , , , , , , , , , , ,

paraphilias_01

This is a serious conversation that I won’t sensationalize or joke about. The mental health disorders known as paraphilias (commonly referred to as sexual deviancies or perversions) represent a disturbing level of dysfunction that has devastating consequences for victims. This Straight, No Chaser will provide an overview of these disorders as categorized by the Diagnostic and Statistical Manual of Mental Disorders (DSM).
First, here’s a working definition from the DSM: paraphilias involving recurrent fantasies, urges or behaviors of a sexual nature that center on children, non-humans (animals, objects or materials), or harming others or one’s self. That definition isn’t especially difficult to understand, but what is more difficult to appreciate is these deviants (and often predators) suffer from mental illness and aren’t just “bad people.” What’s especially difficult for society to reconcile is when and if treatment is more appropriate than punishment.
Here’s a list of recognized sexual deviancy disorders, which will be individually discussed in future posts. It is important to note that some of these behaviors occur in the general population in certain circumstances (e.g., between consenting adults) and only are defined as mental disorders when the activity becomes a compulsion, interfering with normal function and/or behavior.
paraphilia exhibitionism
Exhibitionism: the compulsion to display one’s sexual organs to strangers. This compulsion increases until relieved by the act of exposure.
paraphilia shoe fetish
Fetishism: the habit of having sexual energies fixated on an object. Typical objects include garments such as shoes or underwear or may involve materials such as leather or rubber. The objects of fetishes often are required to achieve orgasm.
paraphiliaFrotteurism
Frotteurism: the compulsion to rub ones self against strangers others in a sexual manner. This compulsion increases until relieved by the act.
Paraphilia Pedophiles
Pedophilia: the act of a sexually mature adult fantasizing about or engaging in sexual behavior with children who haven’t achieved puberty.
paraphilia sadomasochism
Sadism and Masochism: the habit of engaging in sexual encounters where the focus is on causing (sadism) or receiving (masochism) physical and emotional pain, embarrassment and humiliation.
paraphilia transvestism
Transvestism: (aka cross-dressing) the habit of an otherwise “normal” heterosexual male having fantasies about and/or dressing in woman’s clothing, which is usually sexually arousing.
paraphilia voyeurism
Voyeurism: the compulsion to fantasize about and/or actually spy on an unsuspecting person in the act of undressing (aka being a “peeping tom”) as part of a person’s sexual routine.
The DSM also includes a Not-Otherwise-Specified category of paraphilias, including such actions as a chronic preoccupation with making obscene telephone calls, relating sexually to only a part of another’s body, dead people, animals, feces and urine.
Sexual perversions generate many different emotions in victims and the general public. Perhaps Job One is to be conscious of your surroundings and the situations in which you place yourself. Although in most instances you can’t control the inclinations or prevent the actions of others, you can control the choices you make that increase or decrease your risk of becoming a victim of a sexual deviant.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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.

Straight, No Chaser: Personality Disorder Screening Quiz – Now It’s Your Turn!

Mental Health, , , , ,

personality-disorder-types

It’s been an interesting week of responses from you on the series of personality disorders. The most common comment was a request for an ability to test oneself. I’ll provide that information to you, but beforehand, here are the links to the other Straight No Chaser posts on personality disorders.

  • Introduction: Understanding Personality Disorders
  • Cluster A: Paranoid, Schizoid and Schizotypal Personality Disorders
  • Cluster B: Narcissistic, Histrionic, Antisocial and Borderline Personality Disorders
  • Cluster C: Obsessive-Compulsive, Avoidant and Dependent Personality Disorders

We need a disclaimer here. The link to this personality quiz states pretty clearly that it’s for entertainment purposes only. The results will provide you with a trend, not a diagnosis. It’s a good way to reinforce the information from the previous posts and to learn a little bit more about yourself. In case you were wondering, I scored Doctor Personality Disorder.
ilovemyself
Here’s the link to the quiz:
http://www.helloquizzy.com/tests/the-personality-disorder-test-5
I welcome any feedback or questions you have about the topic or the quiz. I think it’s safe to say that most of you should have fun with this quiz.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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.

Straight, No Chaser: Obsessive-Compulsive, Avoidant and Dependent Personality Disorders

Mental Health, , , , , , ,

Cluster C PD

The final group of personality disorders we will review involves excessive fears expressed through thoughts or behaviors. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder. Collectively these comprise the Class C Personality Disorders. Let’s review symptoms of each.
PD avoidant
Avoidant personality disorder: think of the shy, hypersensitive loner

  • Social inhibition, timidity and isolation (e.g. avoiding new activities or meeting strangers)
  • Abnormal fear of disapproval, embarrassment or ridicule
  • Avoidance of work and social activities that require interpersonal contact
  • Constant feelings of inadequacy, inferiority or unattractiveness
  • Extreme shyness in social situations and personal relationships
  • Hypersensitivity to criticism or rejection

Dependent_Personality_Disorder-3 
Dependent personality disorder: you’re happy or sad based entirely on others’ treatment of you

  • Difficulty disagreeing with others due to excessive fears of disapproval
  • Excessive dependence on others, feels the need to be taken care of, and is submissive and clingy
  • Fears having to care or provide for one’s self
  • Inadequate self-confidence, requiring excessive advice and reassurance from others, even with small decisions
  • Inadequate self-confidence such that one has difficulty starting or doing projects on own
  • Tolerance of poor or abusive treatment
  • Urgent need to start a new relationship when one has ended

 control-freak
Obsessive-compulsive personality disorder: think overly preoccupied with control and order

  • Desire to be in control of people, tasks and situations with an inability to delegate
  • Extreme perfectionism, resulting in dysfunction and distress when perfection is not achieved (e.g. inability to finish a project because standards of perfection aren’t met)
  • Inability to discard previously held broken or worthless objects
  • Inflexibility about morality, ethics or values
  • Neglect of friends, family and enjoyable activities because of excessive commitment to work or a project
  • Preoccupation with details, orderliness and rules
  • Rigid and stubborn
  • Tight, miserly control over budgeting and spending money

It is important to note that obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder (OCD). OCD is a type of anxiety disorder.
It is important to remember that everyone can exhibit some of these personality traits now and again. That said, when these patterns of behavior interfere with one’s activities of daily living, lend a hand. Get help.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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.

Straight, No Chaser: Narcissistic, Histrionic, Antisocial and Borderline Personality Disorders

Mental Health, , , , , , , ,

Again, I need to start with a disclaimer, lest all the armchair psychiatrists out there start diagnosing everyone you know. The Cluster B personality disorders are defined by drama, erratic and emotional behaviors. They include narcissistic personality disorder, historynic personality disorder, antisocial personality disorder and borderline personality disorder. This group of patients is defined by overly emotional or predictable behavior. Remember that symptoms aren’t enough; some degree of social dysfunction must also be present for these diagnoses to be made.

antisocial
 
Antisocial personality disorder: think of a dangerous habit of manipulating, exploiting, or violating the rights of others. Typical symptoms will include some of the following.

  • Aggressive, violent and/or criminal behavior
  • Disregard for others’ needs, feelings and safety
  • Disregard for the safety of self or others
  • Disregard and violation of others’ rights
  • Excessively and repeatedly irresponsible
  • Impulsive behavior with lack of remorse
  • Habitual deceit, lying, stealing and cheating
  • Recurring problems with the law

borderline 
Borderline personality disorder: think of ongoing patterns of unstable emotions that result in impulsive actions and chaotic relationships.

  • Frequent and explosive bouts of anger
  • Impulsive and risky behavior (e.g. habitual gambling, binge eating, unsafe sex)
  • Intense fear of being alone or abandoned
  • Ongoing feelings of emptiness
  • Paranoid worsened by stress
  • Unstable or fragile self-image
  • Unstable and intense relationships
  • Up and down moods, often as a reaction to interpersonal stress
  • Suicidal thoughts, threats and behaviors

 histrionic
Histrionic personality disorder: think of overly dramatic and emotional actions meant to draw attention to oneselves.

  • Constantly seeking and demanding attention
  • Easily influenced by others and believes relationships are closer than they are
  • Excessively concerned with physical appearance
  • Excessively emotional, dramatic or sexually provocative to gain attention
  • Speaks dramatically with strong opinions, but few facts or details to back them up
  • Shallow, rapidly changing emotions

 narcis3
Narcissistic personality disorder: think of an excessive sense of self-importance and self-preoccupation with a lack of empathy for others

  • Arrogance
  • Envy of others or belief that others envy you
  • Exaggeration of achievements or talents
  • Unreasonable expectations of constant praise, admiration, favors and advantages
  • Fantasies about power, success and attractiveness
  • Inability to recognize others’ needs and feelings
  • Unfounded belief that you’re special and more important than others

It is important to remember that everyone can exhibit some of these personality traits now and again. That said, when these patterns of behavior interfere with one’s activities of daily living, lend a hand. Get help.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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.

Straight, No Chaser: Paranoid, Schizoid and Schizotypal Personality Disorders

Mental Health, , , , , , ,

Cluster A

I’d imagine that if you’re reading this, it’s not necessarily because the topic is interesting but because you may be wondering if these are applicable to someone you know. Whereas it’s important to get friends and family to help if needed, do resist the urge to practice armchair psychology. Although the idea of a personality disorder is something that may lead to playful banter, they can be quite serious. In this Straight, No Chaser, we discuss the disorders that involve odd, eccentric thinking or behavior: paranoid, schizoid and schizotypal personality disorders, with a particular focus on paranoid personality disorder. Collectively, they are known as Cluster A personality disorders. It is important to note that those with personality disorders do not have psychosis. As is the case throughout personality disorders, a single cause is unknown, but a mix of genetic predisposition and environmental triggers appears to play roles.
parano4
Paranoid personality disorder is more common in men and families with psychotic disorders. As you might suspect, these individuals have a long history of distrust and suspicion, which can lead to social isolation and poor functioning. Relationships, school, work and other activities may be compromised. Other symptoms may include the following:

  • Constant feeling of being in danger
  • Unjustified belief that others have hidden motives and are trying to harm, deceive or exploit
  • Unjustified suspicion of the loyalty or trustworthiness of others
  • Hesitant to confide in others due to unreasonable fear that others will use the information against you
  • Perception of innocent remarks or unthreatening situations as personal insults or attacks
  • Angry or hostile reaction to perceived slights or insults, with a tendency to hold grudges
  • Unjustified, recurrent suspicion that spouse or sexual partner is unfaithful
  • Inability to work together with others
  • Detachment and social isolation
  • Lack of insight that feelings are unjustified

Treatment is difficult because people with this condition are often very suspicious of doctors. Medications and behavioral (talk) therapy can often be effective; reducing paranoia and limiting its impact on the person’s daily functioning.
The other disorders in Cluster A are schizoid and schizotypal personality disorders. Other considerations (causes, treatments) are similar, but here are some of the defining symptoms of each.
schizoid
Schizoid personality disorder: Think of an excessively flat personality

  • Appearance of indifference to others
  • Inability to take pleasure in activities or accomplishments
  • Inability to pick up on social cues
  • Little emotional expression
  • Little interest in sex or interpersonal relationships

 schizotypal
Schizotypal personality disorder – Think of abnormal thoughts and activities

  • Belief that incidents or events have hidden messages meant specifically for you
  • Belief that you can influence people and events with your thoughts (aka magical thinking)
  • Inappropriately indifferent responses to others
  • Inappropriate or flat emotions
  • Lack of comfort with close relationships
  • Odd perceptual experiences (e.g. hearing a voice say your name)
  • Social anxiety

Remember, it’s not enough to have some symptoms. A level of social dysfunction is necessary to establish a diagnosis.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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: Understanding Personality Disorders

Mental Health, , , , ,

personality-disorder

Mental health really is taken for granted. Your ability to cope and exist within your environment is a fundamental determinant of your quality of life. Psychoses are severe, unhealthy and debilitating mental disorders that are likely to take you beyond normal function. Personality disorders are mental disorders that create limitations in your ability to interact with your world and all within it. These patterns of behaving, thinking and functioning lead to difficulties perceiving and responding appropriately.
PDThis series of Straight, No Chaser posts will review the three categories of personality disorders (known as clusters) and treatment options. These categories of disorders were developed based on similar traits and symptoms. They are not mutually exclusive, and an individual can suffer from more than one disorder at a time.
Today, we want you to come to an understanding of what puts you at risk and when any type of personality or mental disorder requires medical intervention. It is a medical fact that you are not likely to maintain a steady state of functioning with these disorders, as they tend to progress and become worse without intervention. We hope these posts provide insight into human behavior and allow you to obtain any help you or a loved one may need.
nature vs nuture
It’s fair to say that society shapes behavioral norms and judges behavior based on one’s adherence to those norms. Thus your environment has a large role in the determination of normalcy vs. abnormal behavior. That said, there are objective standards for behavioral deviancy. You should be especially sensitive of deviancy during childhood, as this is when personality develops. That said, your personality is a result of the interaction between genetic considerations passed by parents (i.e. your temperament) and how your environment embraces, molds and enhances your genetic inclinations. What that means in simple terms is you may be prone to certain behaviors (even abnormal personality disorders) from birth, but it likely requires circumstances and/or events in your life to stimulate their development and expression. Anger
Beyond the interaction of genetic and environment, a precise cause of personality disorders isn’t known. However, we can identify certain factors that increase the risk of developing or triggering personality disorders.

  • Family history of mental illness, including personality disorders
  • Low level of education and lower social and economic status
  • Verbal, physical or sexual abuse during childhood
  • Neglect or an unstable or chaotic family life during childhood
  • Being diagnosed with childhood conduct disorder
  • Variations in brain chemistry and structure

When should you see a physician for a possible personality disorder? The short answer is always. If you have any signs or symptoms of a personality disorder, see your doctor, mental health provider or other health care professional. It’s better to have been evaluated and found normal than to have needed an evaluation and not have obtained it.
If you or a loved one is having personality disorder-type issues, here are considerations you’ll want to have addressed.

  • What can I do to help myself?
  • What type of personality disorder might I have?
  • How do you treat my type of personality disorder?
  • Will talk therapy (psychotherapy) help?
  • Are there medications that might help?
  • How long will I need to take medication?
  • What are the major side effects of the medication you’re recommending?
  • How long will treatment take?
  • How does my support system become empowered to best help me?
  • What other support is available?

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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 © 2015 · Sterling Initiatives, LLC · Powered by WordPress
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