Tag Archives: Centers for Disease Control and Prevention

Straight, No Chaser: Traumatic Brain Injuries (Concussion), Part II

concussionboxing_facial__4_

Your son is a star in Friday Night Lights (actually football, not the TV show) and has been concussed.  Amazingly, the most common question I get asked is not “Will he be ok?”, but “When will he be able to get back on the field?” My answer, coming out the ER, is never going to be less than two weeks, and I won’t be the one who provides medical clearance.  It’ll either be your family doctor or preferably, a neurologist.  Don’t just take my word for it.  Consider the following Quick Tips from the Center for Disease Control and Preventions.
CDC’s Discharge Instructions

  • You may experience a range of symptoms over the next few days, such as difficulty concentrating, dizziness or trouble falling asleep.  These symptoms can be part of the normal healing process, and most go away over time without any treatment.
  • Return immediately to the ED if you have worsening or severe headache, lose consciousness, increased vomiting, increasing confusion, seizures, numbness or any symptom that concerns you, your family, or friends.
  • Tell a family member or friend about your head injury and ask them to help monitor you for more serious symptoms.  Get plenty of rest and sleep, and return gradually and slowly to your usually routines.  Don’t drink alcohol.  Avoid activities that are physically demanding or require a lot of concentration.
  • If you don’t feel better after a week, see a doctor who has experience treating brain injuries.
  • Don’t return to sports before talking to your doctor.  A repeat blow to your head-before your brain has time to heal-can be very dangerous and may slow recovery or increase the chance for long-term problems.

Finally, there are two particularly impactful consequences about which you should be aware.

Impact-Syndrome616x314new

  • The ‘second impact syndrome’ is irreversible brain injury triggered by a fairly routine second head impact after a prior concussion.  You must take the time off needed for the brain to heal.  I care more about your child’s mental future than the upcoming playoff game.
  • The ‘post-concussive syndrome’ represents long-term neurologic and psychologic consequences of the head injury.  It includes such symptoms as inability to sleep, irritability, inability to concentrate, headache, dizziness and anxiety.

Post Concussion Syndrome 3D cube Word Cloud Concept with great terms such as brain, injury, trauma and more.
There are no definitive treatments for concussions other than prevention of an additional injury, and that fact should be chilling to you.  Be mindful of the risks involved in choosing to engage in activities putting the brain at risk.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Bacterial Vaginosis – No, That’s Not a STD

BV1

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always be respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

bv anyone

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier
Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.
Doctor: Ok. Let’s examine you…

bv thrush

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different part of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

bv causes

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real.  We even have a real thing call a ‘whiff test’ as part of making the diagnosis.
The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome.  There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.
So this couple gets ‘off the hook’, even though they may decide to start using condoms.  Next we will focus on the risks of various sexual activities. Stay tuned.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

The Rapid Explosion of Autism Diagnoses – A Good or Bad Thing?

Introduction

In this post, we discuss autism diagnoses and look and the recent jump in frequency.

autism awareness and autism diagnoses

The Fear Associated with Autism

Regarding autism, it is a condition that strikes fear into the heart of many, not just because of the condition itself. It’s the lack of knowledge about the condition. It is the uncertainty about whether a newborn child will be affected just because we’re having children at older ages. It’s the possibility that common environmental exposures could be contributing to the increase in the condition.

autism-in-toddlers

I’m going to approach this two-part series on autism in reverse order. Instead of simply discussing the basics about autism, I’m going to discuss the recent increases in autism rates. It is very important that you read past the headlines on this. Hopefully you’ll come to a better understanding.

The Uptick in Autism Diagnoses

In March of 2012 (the most recently updated dataset), the Centers for Disease Control and Prevention (CDC) estimated that one of 88 eight-years-olds would have one of the various forms of autism spectrum disorder. Another CDC study that was just released reveals that autism rates now affect one of every 68 eight-year-old children. This is a 30% increase in just two years!

Many of you are aware of some of the controversial claims about possible causes of autism. Regardless of the believability of unproven claims, it is entirely probable that some good has come from shining a spotlight on autism. It is without question that the enhanced attention has resulted in more attention being paid to children with suggestive symptoms. This recent trend in more aggressive diagnoses is resulting in more attention being given to those in need with better outcomes over the long haul.

Is There a Cure?

There is no cure for autism. This may be true and depressing, but it doesn’t have to be. Generally, interventions tend to focus on eliminating symptoms and producing desired outcomes (such as those that will increase independent living and functioning). Coordination of strategies is important, so the use of multiple professionals working as a team is common. The good news is, for many children, symptoms improve with early treatment and with age.  Those with one of the forms of autism will usually continue to need services and supports throughout their lives, but many are able to work successfully and live independently or within a supportive environment. Also, please note: The earlier the diagnosis is made and treatment is started, the better one’s outcome is likely to be.

I have just understated a point that I will take a few words to revisit. There is no cure for autism. Please don’t fall prey to claims of therapies and interventions that promise a quick fix. These claims are invariably are not supported by scientific studies. They are acting on your hopes and preying on your fears. The details of treatment strategies are further discussed at www.sterlingmedicaladvice.com.

The next post will focus on the diagnosis and symptoms of autism.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering 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 books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

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

Copyright ©2013- 2019 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

healthweek

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.
public health
In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Top10AchievementsPH

  1. Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
  2. Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
  3. Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
  4. Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
  5. Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
  6. Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
  7. Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
  8. Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
  9. Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
  10. Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

Public_Health_Ounce

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Alcoholism and Alcohol-Related Deaths Are on the Rise

alcoholaddictionchains

Does it seem that alcoholism isn’t discussed much anymore, or is it that the public health community has focused more on overdose deaths from heroin and prescription painkillers of late? In the news is reason that should change. According to the Centers for Disease Control and Prevention, alcoholism and the deaths related to it are on the rise. Consider the sum total of the following statistics:

alcohol_risk

  • Alcohol is killing Americans at a rate higher than at any time in the last 35 years. In 2014, there were 9.6 deaths from alcohol-induced causes per 100,000 people, representing an increase of 37% since 2002.
  • Last year, more than 30,700 Americans died from causes directly related to alcohol (e.g. alcohol poisoning and cirrhosis).
  • In 2014, more people died from alcohol-induced causes (30,722) than from overdoses of prescription painkillers and heroin combined (28,647).

alcoholrisedeaths

In reality, the annual number of deaths directly or indirectly caused by alcohol is closer to 90,000, as the official count of alcohol-induced fatalities excludes deaths from drunk driving, other accidents, and homicides committed under the influence of alcohol.
Where do you fit in this equation? Here’s the deal: 30% of American adults don’t drink at all. Another 30% consume less than one drink per week (on average). On the other hand, the top 10% of American adults (approximately 24 million people) consume an average of 74 drinks per week, or a little more than 10 drinks per day. The heaviest drinkers are at the greatest risk for the alcohol-induced causes of death.

alcohol abuse

An easy way to minimize your risk, assuming you’re going to drink, is to restrict your alcohol intake at any one time to 2 drinks per day. The especially good news is that level – defined as moderate alcohol consumption – is actually associated with a decreased risk of mortality.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Food Poisoning (Foodborne Illness)

FoodPoisoning

We make a decision with everything we place into our mouths. We also exhibit a large amount of trust that the food we eat is safe. Most of the time that’s true, but unfortunately sometimes it’s not. Here are some questions and answers to understanding the scope of food poisoning.
How frequent is food poisoning?
According to 2011 data from the U.S. Centers for Disease Control and Prevention (CDC), every year in the U.S. approximately 1 in 6 Americans (almost 50 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

food poisoning

What causes food poisoning?
Over 250 different foodborne diseases have been described, most of which are infections. The most common foodborne illnesses are caused by norovirus and by the bacteria SalmonellaClostridium perfringens, and CampylobacterStaph Aureus (yes, that Staph) is another prominent but less common cause of food poisoning. Poisonous chemicals or other harmful substances can cause foodborne diseases if present in food.
What are the most common symptoms of food poisoning?
Even though there are many different foodborne diseases, they share a commonality of entering your system through your gastrointestinal tract. As a result, the first symptoms are caused and expressed from there and typically include nausea, vomiting, diarrhea and abdominal cramps.

foodpoisoning traceback_900px

Why do foodborne diseases seem to occur in outbreaks?
Actually, the overwhelming majority of cases of food poisoning don’t occur in outbreaks, but of course you wouldn’t know that because having diarrhea is not something people typically will tell you… When outbreaks occur, it’s because a group of people happened to eat the same contaminated item. This would explain how instances of groups of friends or strangers could have been involved. Contaminations that occur closest to the food supply’s distribution result in the widest outbreaks. Look at the above picture. If contaminated food from the producer makes it all the way through the distribution chain, individuals in multiple states could end up with the same infection.

   foodpoisoningfoodsimage

What foods are most associated with foodborne illness?

  • Foods that mingle the products of many individual animals: Raw milk, pooled raw eggs and ground beef have increased risk because contamination in any one of the multiple animals involved can contaminate the entire mixture.
  • Raw foods of animal origin: Foods such as meat, poultry, shellfish, eggs and unpasteurized milk are the most likely foods to be contaminated.
  • Raw fruits and vegetables: Washing reduces but doesn’t eliminate pre-existing contamination, such as that occurring from the fresh manure that fertilizes vegetables. Furthermore, water itself may be contaminated.
  • Shellfish: Because “filter-feeding” shellfish strain microorganisms from the sea over many months, they are particularly likely to be contaminated if there are any in the seawater.

An additional Straight, No Chaser will discuss treatment options. Refer to this post for preventative tips.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser In the News: Zika Virus Update

zika pregnancy-button

The Zika virus continues to be in the news, especially regarding its effects on newborns. According to the Centers for Disease Control and Prevention (CDC), the number of pregnant women in the United States reported to have the Zika virus has increased from 48 to 157. Unfortunately and more importantly, that has now translated in up to a dozen babies or fetuses who have already suffered the consequences of Zika infection, with the obvious possibility of more to come. The most notable consequence is the condition known as microcephaly, representing a reduction in the size of the skull and the brain, causing developmental delays and defects.

zika-x

Here’s one simple point for you to know. Not a single person is known to have contracted Zika from a mosquito bite in the U.S. The CDC has been clear in two specific warnings:

  • Do not travel to countries where Zika is endemic
  • Wear condoms when engaged in sexual intercourse with male who have traveled to such an area (Zika can be passed on through sperm).

Your travel to these areas pose specific risks even if you’re not a female of childbearing age. Such travel increases the risk of being infected without showing symptoms, spreading the disease and contributing to a worldwide expansion of the Zika virus. In fact the World Health Organizations notes that Zika virus is now poised to invade Africa, having spread to the African nation of Cabo Verde (Cape Verde). Your actions pose risks to others. 
Review this Straight, No Chaser for a refresher on transmission, symptoms and complications of the Zika Virus.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Bacterial Vaginosis – No, That’s Not a STD

BV1

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

bv anyone

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier
Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.
Doctor: Ok. Let’s examine you…

bv thrush

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different part of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

bv causes

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real.  We even have a real thing call a ‘whiff test’ as part of making the diagnosis.
The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome.  There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.
So this couple gets ‘off the hook’, even though they may decide to start using condoms.  Next we will focus on the risks of various sexual activities. Stay tuned.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Rapid Explosion of Autism Diagnoses – A Good or Bad Thing?

autism-hands

Sometimes it’s really good to be a physician, especially when it comes to care of children. Just yesterday I saved myself a few thousands of dollars in costs by being able to address a situation at home. I can recall two instances in which poorly qualified, non-physician professionals tried to label my children with specific diagnoses. After my then three-year-old son defended himself from a child trying to take a toy from him, one consulting counselor suggested that I pay $200/hour to get him help for his “aggressive tendencies.” (His “symptoms” remarkably disappeared when I removed him from the environment.) When my otherwise normal daughter displayed signs of delaying speaking, another “professional” immediately wanted to label her autistic. In case you’re wondering, I’m not the guy who marches into everyone’s office and announces that I’m a physician. It’s much more interesting to observe the difference in the first and second conversations (you know, the one after they discover you know something…).
Regarding autism, it is a condition that strikes fear into the heart of many, not just because of the condition itself. It’s the lack of knowledge about the condition. It’s the uncertainty about whether a newborn child will be affected just because we’re having children at older ages. It’s the possibility that common environmental exposures could be contributing to the increase in the condition.

autism-in-toddlers

I’m going to approach this two-part series on autism in reverse order. Instead of simply discussing the basics about autism, I’m going to discuss the recent increases in autism rates. It is very important that you read past the headlines on this. Hopefully you’ll come to a better understanding.
In March of 2012, the Centers for Disease Control and Prevention (CDC) estimated that one of 88 eight-years-olds would have one of the various forms of autism spectrum disorder. Another CDC study that was just released reveals that autism rates now affect one of every 68 eight-year-old children. This is a 30% increase in just two years!
Many of you are aware of some of the controversial claims about possible causes of autism. Regardless of the believability of unproven claims, it is entirely probable that some good has come from shining a spotlight on autism. It is without question that the enhanced attention has resulted in more attention being paid to children with suggestive symptoms. This recent trend in more aggressive diagnoses is resulting in more attention being given to those in need with better outcomes over the long haul.
There is no cure for autism. This may be true and depressing, but it doesn’t have to be. Generally, interventions tend to focus on eliminating symptoms and producing desired outcomes (such as those that will increase independent living and functioning). Coordination of strategies is important, so the use of multiple professionals working as a team is common. The good news is, for many children, symptoms improve with early treatment and with age.  Those with one of the forms of autism will usually continue to need services and supports throughout their lives, but many are able to work successfully and live independently or within a supportive environment. Also, please note: The earlier the diagnosis is made and treatment is started, the better one’s outcome is likely to be.
I have just understated a point that I will take a few words to revisit. There is no cure for autism. Please don’t fall prey to claims of therapies and interventions that promise a quick fix. These claims are invariably are not supported by scientific studies. They are acting on your hopes and preying on your fears. The details of treatment strategies are further discussed at www.sterlingmedicaladvice.com.
The next post will focus on the diagnosis and symptoms of autism.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

healthweek

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.
public health
In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Top10AchievementsPH

  1. Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
  2. Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
  3. Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
  4. Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
  5. Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
  6. Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
  7. Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
  8. Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
  9. Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
  10. Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

Public_Health_Ounce

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Alcoholism and Alcohol-Related Deaths Are on the Rise

alcoholaddictionchains

Does it seem that alcoholism isn’t discussed much anymore, or is it that the public health community has focused more on overdose deaths from heroin and prescription painkillers of late? In the news is reason that should change. According to the Centers for Disease Control and Prevention, alcoholism and the deaths related to it are on the rise. Consider the sum total of the following statistics:

alcohol_risk

  • Alcohol is killing Americans at a rate higher than at any time in the last 35 years. In 2014, there were 9.6 deaths from alcohol-induced causes per 100,000 people, representing an increase of 37% since 2002.
  • Last year, more than 30,700 Americans died from causes directly related to alcohol (e.g. alcohol poisoning and cirrhosis).
  • In 2014, more people died from alcohol-induced causes (30,722) than from overdoses of prescription painkillers and heroin combined (28,647).

alcoholrisedeaths

In reality, the annual number of deaths directly or indirectly caused by alcohol is closer to 90,000, as the official count of alcohol-induced fatalities excludes deaths from drunk driving, other accidents, and homicides committed under the influence of alcohol.
Where do you fit in this equation? Here’s the deal: 30% of American adults don’t drink at all. Another 30% consume less than one drink per week (on average). On the other hand, the top 10% of American adults (approximately 24 million people) consume an average of 74 drinks per week, or a little more than 10 drinks per day. The heaviest drinkers are at the greatest risk for the alcohol-induced causes of death.

alcohol abuse

An easy way to minimize your risk, assuming you’re going to drink, is to restrict your alcohol intake at any one time to 2 drinks per day. The especially good news is that level – defined as moderate alcohol consumption – is actually associated with a decreased risk of mortality.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Food Poisoning (Foodborne Illness)

FoodPoisoning

We make a decision with everything we place into our mouths. We also exhibit a large amount of trust that the food we eat is safe. Most of the time that’s true, but unfortunately sometimes it’s not. Here are some questions and answers to understanding the scope of food poisoning.
How frequent is food poisoning?
According to 2011 data from the U.S. Centers for Disease Control and Prevention (CDC), every year in the U.S. approximately 1 in 6 Americans (almost 50 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

food poisoning

What causes food poisoning?
Over 250 different foodborne diseases have been described, most of which are infections. The most common foodborne illnesses are caused by norovirus and by the bacteria SalmonellaClostridium perfringens, and CampylobacterStaph Aureus (yes, that Staph) is another prominent but less common cause of food poisoning. Poisonous chemicals or other harmful substances can cause foodborne diseases if present in food.
What are the most common symptoms of food poisoning?
Even though there are many different foodborne diseases, they share a commonality of entering your system through your gastrointestinal tract. As a result, the first symptoms are caused and expressed from there and typically include nausea, vomiting, diarrhea and abdominal cramps.

foodpoisoning traceback_900px

Why do foodborne diseases seem to occur in outbreaks?
Actually, the overwhelming majority of cases of food poisoning don’t occur in outbreaks, but of course you wouldn’t know that because having diarrhea is not something people typically will tell you… When outbreaks occur, it’s because a group of people happened to eat the same contaminated item. This would explain how instances of groups of friends or strangers could have been involved. Contaminations that occur closest to the food supply’s distribution result in the widest outbreaks. Look at the above picture. If contaminated food from the producer makes it all the way through the distribution chain, individuals in multiple states could end up with the same infection.

   foodpoisoningfoodsimage

What foods are most associated with foodborne illness?

  • Foods that mingle the products of many individual animals: Raw milk, pooled raw eggs and ground beef have increased risk because contamination in any one of the multiple animals involved can contaminate the entire mixture.
  • Raw foods of animal origin: Foods such as meat, poultry, shellfish, eggs and unpasteurized milk are the most likely foods to be contaminated.
  • Raw fruits and vegetables: Washing reduces but doesn’t eliminate pre-existing contamination, such as that occurring from the fresh manure that fertilizes vegetables. Furthermore, water itself may be contaminated.
  • Shellfish: Because “filter-feeding” shellfish strain microorganisms from the sea over many months, they are particularly likely to be contaminated if there are any in the seawater.

An additional Straight, No Chaser will discuss treatment options. Refer to this post for preventative tips.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes 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: Flu Myths and Questions

Flu season ahead
Every year 36,000 people die and over 200,000 are hospitalized each year due to the flu—in the U.S. alone. If you’re not getting a vaccine every year, you are subjecting yourself to a significantly higher risk and allowing fears and myths to get the better of you. Knowledge is power. Learn the facts.
Does the flu shot give you the flu?
No, no, no. The influenza vaccine cannot cause flu illness. There are vaccines that involve the delivery of live virus, including mumps, measles, rubella, chicken pox and polio. Influenza is not in that category. Flu shots are made either with ‘inactivated’ vaccine viruses that are not infectious or they contain no flu vaccine viruses at all (and instead have recombinant particles that serve to stimulate your immune system).
The most common side effects from the influenza shot are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur. These symptoms are among the same symptoms you see with influenza, so it’s easy to confuse them as flu symptoms. They are not.
Controlled medical studies have been performed on humans in which some people received flu shots and others received shots containing salt water. There were no differences in symptoms other than increased redness and soreness at the injection site for those receiving influenza vaccine. The flu shot does not give you the flu.
flu-shot-myth
I swear I’ve gotten the flu right after getting the flu shot! How is that possible if I can’t get the flu from the flu shot?
I always remind people that the flu vaccine does an even better job of preventing you from dying from the flu than it does in preventing you from catching the flu (and it does that at a 70–90% rate).  It primes your immune system to better fight off the influenza virus when you’re exposed to it.
There are several reasons why someone still might get a flu-like illness after being vaccinated against the flu:

  • Influenza is just one group of respiratory viruses. There are many other viruses that cause similar symptoms including the common cold, which is also most commonly seen during “flu season.” The flu vaccine only protects against influenza, so any other infection timed correctly can give you similar symptoms.
  • When you get immunized against influenza, it takes the body up to two weeks to obtain the desired level of protection. There is nothing preventing you from having been infected before or during the period immediately before immunity sets in. Such an occurrence will result in your obtaining the flu despite being vaccinated.
  • An additional reason why some people may experience flu-like symptoms despite getting vaccinated is that they may have been exposed to a strain of influenza that is different from the viruses against which the vaccine is designed to protect. The ability of a flu vaccine to protect a person depends largely on the match between the viruses selected to make the vaccine and those causing illness among the population that same year.
  • It is also the case that the flu vaccine doesn’t always provide adequate protection against the flu. This is more likely to occur among people who have weakened immune systems or people age 65 and older. Even if the vaccine is 90% effect, some individuals will contact the flu despite having been vaccinated.

Please don’t get the wrong message from this section. These explanations are the exceptions, not the rule. In the overwhelming number of cases, the influenza vaccine does an excellent job of protecting against and prevent disease from the influenza virus.
Is it better to get the flu than the flu vaccine?
No. Influenza causes tens of thousands of deaths every year. If you have asthma, diabetes, heart disease or are especially young or old, you are placing yourself at significant risk by not getting vaccinated. Even if you aren’t in one of the above categories and are otherwise healthy, a flu infection can cause serious complications, including hospitalization or death.

flu-vaccine-facts-myths

Why do I need a flu vaccine every year?
The Center for Disease Control and Prevention (CDC) recommends a yearly flu vaccine for just about everyone six months and older. Once vaccinated, your immune protection decreases over time. These boosters are scheduled and dosed to help you maintain the best level of protection against influenza. Additionally, the virus mutates (changes) every year, so what you were covered for this year may not apply next year.
You can make a decision not to get vaccinated, but frankly, that’s accepts a risk that you flies in the face of a reasonable risk/benefit analysis, and you would be doing so in the face of the solid consensus of medical evidence and research. You should seriously question the motives or knowledge of someone who suggests that you should not get vaccinate for influenza, particularly if they profess to be involved in healthcare. Get vaccinated.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes 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: Traumatic Brain Injuries (Concussion), Part II

concussionboxing_facial__4_

Your son is a star in Friday Night Lights (actually football, not the TV show) and has been concussed.  Amazingly, the most common question I get asked is not “Will he be ok?”, but “When will he be able to get back on the field?” My answer, coming out the ER, is never going to be less than two weeks, and I won’t be the one who provides medical clearance.  It’ll either be your family doctor or preferably, a neurologist.  Don’t just take my word for it.  Consider the following Quick Tips from the Center for Disease Control and Preventions.
CDC’s Discharge Instructions

  • You may experience a range of symptoms over the next few days, such as difficulty concentrating, dizziness or trouble falling asleep.  These symptoms can be part of the normal healing process, and most go away over time without any treatment.
  • Return immediately to the ED if you have worsening or severe headache, lose consciousness, increased vomiting, increasing confusion, seizures, numbness or any symptom that concerns you, your family, or friends.
  • Tell a family member or friend about your head injury and ask them to help monitor you for more serious symptoms.  Get plenty of rest and sleep, and return gradually and slowly to your usually routines.  Don’t drink alcohol.  Avoid activities that are physically demanding or require a lot of concentration.
  • If you don’t feel better after a week, see a doctor who has experience treating brain injuries.
  • Don’t return to sports before talking to your doctor.  A repeat blow to your head-before your brain has time to heal-can be very dangerous and may slow recovery or increase the chance for long-term problems.

Finally, there are two particularly impactful consequences about which you should be aware.

Impact-Syndrome616x314new

  • The ‘second impact syndrome’ is irreversible brain injury triggered by a fairly routine second head impact after a prior concussion.  You must take the time off needed for the brain to heal.  I care more about your child’s mental future than the upcoming playoff game.
  • The ‘post-concussive syndrome’ represents long-term neurologic and psychologic consequences of the head injury.  It includes such symptoms as inability to sleep, irritability, inability to concentrate, headache, dizziness and anxiety.

Post Concussion Syndrome 3D cube Word Cloud Concept with great terms such as brain, injury, trauma and more.
There are no definitive treatments for concussions other than prevention of an additional injury, and that fact should be chilling to you.  Be mindful of the risks involved in choosing to engage in activities putting the brain at 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, AmazonBarnes 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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: The Rapid Explosion of Autism Diagnoses – A Good or Bad Thing?

autism-hands

Sometimes it’s really good to be a physician, especially when it comes to care of children. Just yesterday I saved myself a few thousands of dollars in costs by being able to address a situation at home. I can recall two instances in which poorly qualified, non-physician professionals tried to label my children with specific diagnoses. After my then three-year-old son defended himself from a child trying to take a toy from him, one consulting counselor suggested that I pay $200/hour to get him help for his “aggressive tendencies.” (His “symptoms” remarkably disappeared when I removed him from the environment.) When my otherwise normal daughter displayed signs of delaying speaking, another “professional” immediately wanted to label her autistic. In case you’re wondering, I’m not the guy who marches into everyone’s office and announces that I’m a physician. It’s much more interesting to observe the difference in the first and second conversations (you know, the one after they discover you know something…).
Regarding autism, it is a condition that strikes fear into the heart of many, not just because of the condition itself. It’s the lack of knowledge about the condition. It’s the uncertainty about whether a newborn child will be affected just because we’re having children at older ages. It’s the possibility that common environmental exposures could be contributing to the increase in the condition.

autism-in-toddlers

I’m going to approach this two-part series on autism in reverse order. Instead of simply discussing the basics about autism, I’m going to discuss the recent increases in autism rates. It is very important that you read past the headlines on this. Hopefully you’ll come to a better understanding.
In March of 2012, the Centers for Disease Control and Prevention (CDC) estimated that one of 88 eight-years-olds would have one of the various forms of autism spectrum disorder. Another CDC study that was just released reveals that autism rates now affect one of every 68 eight-year-old children. This is a 30% increase in just two years!
Many of you are aware of some of the controversial claims about possible causes of autism. Regardless of the believability of unproven claims, it is entirely probable that some good has come from shining a spotlight on autism. It is without question that the enhanced attention has resulted in more attention being paid to children with suggestive symptoms. This recent trend in more aggressive diagnoses is resulting in more attention being given to those in need with better outcomes over the long haul.
There is no cure for autism. This may be true and depressing, but it doesn’t have to be. Generally, interventions tend to focus on eliminating symptoms and producing desired outcomes (such as those that will increase independent living and functioning). Coordination of strategies is important, so the use of multiple professionals working as a team is common. The good news is, for many children, symptoms improve with early treatment and with age.  Those with one of the forms of autism will usually continue to need services and supports throughout their lives, but many are able to work successfully and live independently or within a supportive environment. Also, please note: The earlier the diagnosis is made and treatment is started, the better one’s outcome is likely to be.
I have just understated a point that I will take a few words to revisit. There is no cure for autism. Please don’t fall prey to claims of therapies and interventions that promise a quick fix. These claims are invariably are not supported by scientific studies. They are acting on your hopes and preying on your fears. The details of treatment strategies are further discussed at www.sterlingmedicaladvice.com.
The next post will focus on the diagnosis and symptoms of autism.
This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd. Please like and share our blog with your family and friends. We’re here for you 24/7 with immediate, personalized information and advice. Call your Personal Healthcare Consultant at 1-844-SMA-TALK or login tohttp://www.SterlingMedicalAdvice.com.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

healthweek

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.
public health
In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Top10AchievementsPH

  1. Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
  2. Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
  3. Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
  4. Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
  5. Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
  6. Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
  7. Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
  8. Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
  9. Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
  10. Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

Public_Health_Ounce

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser In The News: 2015 Influenza Update and Supplemental Means of Protection

flu prevention honey

Snatched from the headlines and the American Medical Association:

From The Centers for Disease Control and Prevention (CDC): “Flu sending US seniors to the hospital in highest rate in a decade.”
From The CBS Evening News (1/30, lead story, 2:25, Pelley): “The CDC said that the flu season in much of the country appears to have peaked.” However, “the flu is now widespread in all but six states and it’s sending Americans 65 and older to the hospital at the highest rate in at least a decade.”
From The NBC Nightly News (1/31, story 3, 0:25, Williams): The high number of hospitalizations is “…being blamed on this particularly nasty strain of flu this year and a vaccine that, sadly, has proven only about 23 percent effective.”
From The Associated Press (1/31, Stobbe): Approximately “…198 out of every 100,000 people 65 and older have been hospitalized with flu-related illness this flu season. That’s roughly 86,000, according to the CDC.”
From Bloomberg News (1/31, Cortez): “The annual outbreak, already in its 10th week, has extended beyond the lower bound of a normal flu season and isn’t showing signs of easing,” said Lyn Finelli, chief of surveillance and outbreak response at the CDC. In a telephone interview, she explained, “‘While the flu may have peaked in many areas of the country, there is a surge in other areas, including New England, the Northeast and the West Coast.”
From Medscape (1/31, Lowes): The CDC “issued a letter to clinicians urging them to treat patients promptly with antiviral drugs when they suspect influenza, without any confirmatory testing.” That letter, cosigned by leaders of the American Medical Association, the American Academy of Family Physicians, and other professional societies, noted that influenza activity across the nation remains high overall and is likely to continue for weeks.” The letter discussed “the potential of antiviral drugs to reduce influenza symptoms, prevent serious complications, and keep high-risk patients out of the hospital.”

fluchild

The influenza vaccine doesn’t necessary prevent you from getting “the flu.” It’s a mixture of what is predicted to be the most common strains for the upcoming year. As noted, this year the influenza strains causing infections are so varied that this year’s vaccine is approximately 23% effective. Does that mean you shouldn’t get it? That’s not the message at all. The influenza vaccine does a very good job of preventing you for dying from “the flu,” and as noted above, certain populations are having an especially difficult time. Be reminded that there were approximately 35,000 deaths from influenza last year alone.

Print

So you ask, what can we do in the face of a less than optimally performing vaccine? This Straight, No Chaser reviews some of the better options left for you to engage in preventive strategies. It is always the case that an ounce of prevention is better than a pound of cure.

flu treatment options

The best way to avoid the flu is prevention. Consider utilizing these healthy habits before you ever get exposed:

  • Wash your hands frequently with warm soapy water. You know when they’re dirty. Most certainly wash your hands before you use them to eat or put anything else in your mouth.
  • If you can’t wash your hands, use an alcohol-based hand sanitizer.
  • If your hands are dirty and neither soap nor sanitizer is available, still rinse and dry your hands with warm water if you can.
  • Use disinfectant to clean surfaces.
  • Avoid unnecessarily touching your eyes, nose, or mouth.
  • Politely limit close contact with people who are ill, coughing and sneezing.
  • When coughing or sneezing use the bend of your elbow or a facial tissue to help cover your nose and mouth. Learn to avoid coughing or sneezing into your hands.
  • When you become sick, stay home. It’s the proper thing to do to avoid spreading your infection to others.

Vitamin-C

Vitamin C, echinacea and zinc have long been touted to prevent colds and influenza. There are no studies confirming or refuting this claim. Despite assurances that these and other herbal medicines are safe alternatives because they’re “natural”, the active ingredients in them are the same as found in certain prescription medicines. Thus they too may interact with other medications and worsen certain medical conditions. Given this, you should discuss your use of supplements with your physician or pharmacist prior to use.

Flu prevention take 3

Another level of defense for you involves use of certain antiviral prescription medications. If you are exposed to someone (e.g. a family member) with influenza, and especially if you begin having flu-like symptoms, immediately contact your physician to discuss taking medicines to prevent catching the flu. Such medications include Tamiflu® (generic name: oseltamivir), Relenza® (generic name: zanamivir), Flumadine® (generic name: rimantadine) and Symmetrel® (generic name: amantadine). If you make the request more than 24-48 hours after the onset of symptoms, you likely won’t be given the medication, since it isn’t likely to be effective outside of this timeframe.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Updated Circumcision Recommendations, Risks and Benefits

Circumcision prevalence

This past week, the Centers for Disease Control and Prevention (CDC) released new draft recommendations for healthcare providers on parental and patient counseling on the decision on whether to circumcise. This Straight, No Chaser reviews those recommendations and the logic behind it. It is of note that these recommendations are a step away from prevailing medical thought.

As a medical professional, circumcision has long been one of those things that has made me go hmmm…. If your religious beliefs include this as a ritual or ceremony, fine. I get it, and I have no criticism at all. No disrespect is intended. Otherwise, circumcision has largely been a procedure looking for an indication. Quick, tell me what other elective surgical procedure or harmful activity of any type is allowed on children, much less newborns? While I’m waiting for you to think about an answer that doesn’t exist, let’s recap the procedure and the medical logic behind it.

screamingbaby

As you know (and many men are painfully aware – pun intended), circumcision is the surgical removal of the skin over the glans (tip) of the penis. Over the last 30 years, the rate of males receiving the procedure has dropped from 64.5% to 58.3%, according to the National Center for Health Statistics. Worldwide about 30% of males are circumcised, and of those receiving it, the religious influence is largely present. 69% of those being circumcised are Muslim and 1% are Jewish (Circumcision is part of religious rituals in both religions).

circumcision hiv risks

Let’s cut to the chase (no pun intended): Here are the best arguments for circumcision.

  • It helps prevent certain infections (e.g. yeast and UTIs – which most males aren’t especially prone to anyway).
  • The cells of the inner surface of the foreskin may provide an optimal target for the HIV virus (This is theoretical and not conclusively decided in the medical literature. In any event, this is NOT the same as saying uncircumcised males do or are more likely to contract HIV.). Even more importantly, this is NOT the same as saying uncircumcised males fail to be sufficiently protecting by use of condoms and other means of safe sex.
  • Circumcised males have a lower rate of penile cancer (which is very low under any circumstances).

Now, there are emergency indications for circumcision, but that really isn’t the topic of discussion here. The one I’ve had to address (twice in twenty years) is an inability to readjust a foreskin that too tightly adhered to the shaft of the penis (paraphimosis). Obviously, that’s a medical emergency and not something frequently seen enough to justify universal circumcision any more than a much higher rate of appendicitis would warrant universal and elective removal of everyone’s appendix.

circumcision table

Here are criticisms of the decision to have circumcision.

  • Any surgical procedure has complications, and that should be taken seriously. That said, the complication rate for circumcision is very small and includes bleeding infection and pain.
  • Circumcision is a violation of a child’s body and is unnecessary and disfiguring. The foreskin might not be cut the appropriate length, might not heal properly and may require addition surgery because the remaining foreskin incorrectly attaches to the end of the penile shaft.

Honestly, both the risks and benefits are quite overstated, with exceptions for certain parts of the world with exceedingly high HIV rates. Circumcision doesn’t appear to be a medically necessary procedure, but it isn’t an especially dangerous one. Interestingly, the American Academy of Pediatrics’ latest comment on circumcision is that the benefits of circumcision outweigh the risks, which stops short of recommending routine circumcision for all. Even that equivocal smacks of conflict of interest, given who’s performing the procedure at a significant cost to the consumer. Again, this appears to be a procedure looking for an indication – but…
The CDC appears to be going agains the grain with its latest comments. Their new message is pretty clear: the benefits of the procedure — including reducing one’s risk of acquiring HIV, herpes virus, and human papillomavirus — outweigh the harms. They even go as far as to suggest that adolescents and adult males consider the procedure. Of course, it must be said that the CDC’s focus is on the prevention and control of disease, as opposed to the American Academy of Pediatrics, whose focus is children and their health. This is a subtle yet important decision while likely has played out in the extra consideration given by the CDC.
If I was having this conversation in Africa, where the sexually transmitted infection rate is substantially higher and can be significantly reduced by circumcision, I’m sure I’d be more firmly on board with circumcision. If my Jewish or Muslim friends and colleagues were asking my medical advice on the safety of getting the procedure done as part of their religious ceremonies, we’d be having a different conversation. However, we’re not, and for the population in general, it’s safe to say that – various preferences (for various reasons) aside – there’s no compelling reason to recommend circumcision on all newborn males. It just feels like a recommendation to do so is giving in to the notion that we can’t be trusted to have safe sex.

circumcision questions

The CDC officials emphasize that the choice is still left to patients, the document suggests the parents of newborn boys, as well as heterosexually active men of all ages, be told about those benefits, which is reasonable but somewhat leading. If you’re a parent of a newborn, and I tell you there’s a small risk of HIV, HPV and penile cancer in your child if they don’t get circumcised, am I really giving you a choice or burdening you with guilt?
And that’s medical straight talk. Oh, and guys – sorry about the lead picture. That wasn’t a good day.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and www.sterlingmedicaladvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Bacterial Vaginosis – No, That's Not a STD

BV1

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

bv anyone

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier
Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.
Doctor: Ok. Let’s examine you…

bv thrush

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different part of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

bv causes

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real.  We even have a real thing call a ‘whiff test’ as part of making the diagnosis.
The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome.  There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.
So this couple gets ‘off the hook’, even though they may decide to start using condoms.  Next we will focus on the risks of various sexual activities. Stay tuned.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Understanding Food Poisoning (Foodborne Illness)

FoodPoisoning

We make a decision with everything we place into our mouths. We also exhibit a large amount of trust that the food we eat is safe. Most of the time that’s true, but unfortunately sometimes it’s not. Here are some questions and answers to understanding the scope of food poisoning.
How frequent is food poisoning?
According to 2011 data from the U.S. Centers for Disease Control and Prevention (CDC), every year in the U.S. approximately 1 in 6 Americans (almost 50 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

food poisoning

What causes food poisoning?
Over 250 different foodborne diseases have been described, most of which are infections. The most common foodborne illnesses are caused by norovirus and by the bacteria Salmonella, Clostridium perfringens, and Campylobacter. Staph Aureus (yes, that Staph) is another prominent but less common cause of food poisoning. Poisonous chemicals or other harmful substances can cause foodborne diseases if present in food.
What are the most common symptoms of food poisoning?
Even though there are many different foodborne diseases, they share a commonality of entering your system through your gastrointestinal tract. As a result, the first symptoms are caused and expressed from there and typically include nausea, vomiting, diarrhea and abdominal cramps.

foodpoisoning traceback_900px

Why do foodborne diseases seem to occur in outbreaks?
Actually, the overwhelming majority of cases of food poisoning don’t occur in outbreaks, but of course you wouldn’t know that because having diarrhea is not something people typically will tell you… When outbreaks occur, it’s because a group of people happened to eat the same contaminated item. This would explain how instances of groups of friends or strangers could have been involved. Contaminations that occur closest to the food supply’s distribution result in the widest outbreaks. Look at the above picture. If contaminated food from the producer makes it all the way through the distribution chain, individuals in multiple states could end up with the same infection.

   foodpoisoningfoodsimage

What foods are most associated with foodborne illness?

  • Foods that mingle the products of many individual animals: Raw milk, pooled raw eggs and ground beef have increased risk because contamination in any one of the multiple animals involved can contaminate the entire mixture.
  • Raw foods of animal origin: Foods such as meat, poultry, shellfish, eggs and unpasteurized milk are the most likely foods to be contaminated.
  • Raw fruits and vegetables: Washing reduces but doesn’t eliminate pre-existing contamination, such as that occurring from the fresh manure that fertilizes vegetables. Furthermore, water itself may be contaminated.
  • Shellfish: Because “filter-feeding” shellfish strain microorganisms from the sea over many months, they are particularly likely to be contaminated if there are any in the seawater.

An additional Straight, No Chaser will discuss treatment options. Refer to this post for preventative tips.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Page 2 of 3
1 2 3