Tag Archives: Conditions and Diseases

Straight, No Chaser: Questions About High Blood Pressure (Hypertension)

High-Blood-Pressure

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?

Check here for Heart Attack Recognition and here for Stroke Recognition where I 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.

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

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

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

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

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Filed under Cardiology/Heart, Health Prevention

Straight, No Chaser: Questions About Color Blindness

Have you ever found yourself at school, work or elsewhere and discovered that you were wearing different colored socks or pants than you’d thought? If so, you may be experiencing color blindness.

 colorblindness

A person with color deficiency may not be able to see the number 5 among the dots in this picture.

What are the main symptoms?

Classic color blindness involves difficulty in seeing colors and the brightness of colors, coupled with an inability to differentiate between shades and other variations of similar colors. Usually the perception of red and green or blue and yellow are affected. There can be a lot of variation in symptoms, ranging from mild to complete and including greater or lesser difficulty in bright or dim light.

color_blind_12

Why does it occur?

In the back of your eyes, you have two different types of cells affecting your ability to detect light. One of these is called cone cells; these detect color. Of these, there are three types: those that detect red, green and blue. Our brain perceives color based on degrees of input from these cells. Any absence or malfunction in these cells can produce color blindness. It stands to reason (and is true) that different degrees of color blindness could result from the extent of malfunction to these cells.

Who is at risk?

  • Most people with color blindness are born with it.
  • One of 10 males has some form of color blindness.
  • Women seldom suffer from color blindness, but those that do are likely to pass it to their sons.
  • Color blindness is more common among those of Northern European heritage.
  • Certain drugs, most notably plaquenil (a drug used to treat rheumatoid arthritis) can cause color blindness.
  • Certain medical conditions, including Alzheimer’s, Parkinson’s, alcoholism, glaucoma, leukemia and sickle anemia increase the risk of acquiring color blindness.

Are there other symptoms?

Except in the most severe form, color blindness does not affect the sharpness of vision. In rare instances one may experience poor vision, light sensitivity, involuntary rapid eye movement and visualization of everything as shades of gray. These symptoms aren’t likely to occur suddenly, so you’d have ample opportunity to see an ophthalmologist (eye doctor) prior to this level of malfunction.

Contact_Lens_for_Color_Blindness

What can be done about it?

There is no cure for color blindness, although acquired forms are best addressed by treating the underlying source. You may be given special eyewear that improves color detection.

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

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

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

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

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Filed under Ophthalmology/Eyes

Straight, No Chaser: Questions about “Lazy Eye” (Amblyopia)

lazy eye

We all get concerned when it comes to things that damage or put our vision in danger. As such, you should be aware of the most common condition causing visual problems in children. You know it as lazy eye, but the medical term is amblyopia. This occurs in approximately 2 to 3 of every 100 children. Unfortunately, the issue isn’t just its occurrence in children but its persistence into adulthood. Amblyopia is also the most common cause of visual impairment among young and middle-aged adults affecting one eye.

Here are some questions and answers of concern. These may help you understand some terms your ophthalmologist (eye doctor) or optometrist uses with you.

lazyeyetmac 

What exactly is lazy eye?

Amblyopia (aka lazy eye) is the condition that exists when the vision of one eye is reduced due to that eye not working appropriately with the brain. The brain adjusts by favoring the other eye.

Let’s get medical for a moment. Appropriate eye function requires accurate interaction between the eyes and the portions of the brain necessary for vision. Each eye focuses light on the retina, which is located in the back of the eye. Cells within the retina stimulate nerve signals that travel along the optic (eye) nerves to the brain, which interpret and responds to these signals.

Lazy Eye Baby

What are some common causes of this?

As noted, the correct function and interaction between the eyes and brain are necessary. Many things can go wrong along the way, all of which serve to cause unclear focusing. Here are some examples.

strabismus-wall-eyes

  • Strabismus: misalignment of the eyes

cataracts

  • Cataracts: clouding of the front part of the eye

Child

  • Nearsightedness (myopia; better focus on closer objects) results from the eye being too long from front to back.

Child Playing at Water's Edge

  • Farsightedness (hyperopia; better focus on objects at a distance) results from the eye being too short from front to back.

astigmatism

  • Astigmatism: condition associated with irregularly shaped eyes; produces difficulty focusing on both near and far objects

 Eye-Patch1

How is lazy eye treated?

Most of the focus on treating amblyopia involves catching it early and treating the child. It is during this time that the eye, the brain and the connections between them are developing, and the opportunity for improvement is greatest. Generally speaking, treatment involves forcing the child to use the eye with weaker vision. There are two common ways to treat lazy eye:

  • PatchingPlacing an adhesive patch on the stronger eye for weeks to months forces the brain/eye apparatus to use the affected eye. This stimulates more complete development of the needed areas in the brain and eye.
  • AtropineUsing this eye medication causes blurring in the strong eye, forcing use of the affected eye. This works as well as patching.

 

eye-ptosis

Is this the same as eye drooping or lid lag?

No. “Lazy” eyelids (aka ptosis) are not the same as malfunctioning eyes. Lazy eye refers to the latter. That said, the two are not mutually exclusive.

Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

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

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

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Filed under Ophthalmology/Eyes

Straight, No Chaser: Low Blood Sugar (Hypoglycemia)

hypoglycemia1

In a previous post, I provided an overview of diabetes. Everyone knows about diabetes, and most understand how dangerous diabetes is over the long-term. However, as an emergency physician, I’m more concerned with what will kill you immediately, and on that front, low blood glucose (sugar) is usually much more concerning. I want you to know up front that a low enough blood glucose will kill you – now. As we say in the ER, a high glucose level will hurt you and may kill you, but a glucose level that goes to zero means ‘Cancel Christmas’.

Therefore I will start with a simple statement. Any diabetic (or individual known to have low glucose levels) with altered mental status needs to be given juice or if they can handle it, some soft food to chew on. If they’re in the midst of a high sugar reaction, it won’t make much of a difference, but if that glucose level was zero, you’ve just saved a life. Now let’s briefly discuss symptoms and causes.

hypoglycemia-enhd-ar1

Low glucose levels can present many different ways including dizziness, jitteriness, numbness, tingling, blackouts, seizures and other symptoms. However, it’s usually the confusion or other change in mental status that’s most predominant and concerning. Just remember, this is not something about which you should wait around to see if it gets better.

Regarding causes, unintentional overdosing of insulin or oral medication (particular the sulfonylureas class of medicines) are especially concerning and common. Sometimes a family member, particularly a child, may take such a medicine to disastrous effects. Beyond that, heavy alcohol consumption on an empty stomach is another common cause due to its effects on the liver (Alcohol locks glucose stores in the liver, preventing release to the blood; as a result you have less to use.).

Other causes are more exotic and fortunately less common; they will be evaluated upon arrival to the hospital when a rapid response isn’t seen with simple administration of glucose. Dysfunction of certain organs (the adrenal and pituitary glands, the liver due to hepatitis, or tumors of the pancreas – the organ that produces the insulin that drives glucose into your cells – can cause problems with regulating either glucose itself or insulin. These conditions can drive your blood glucose dangerously low.

So, the causes are varied, but the message is simple. Be careful with insulin administration, remember to check those blood sugar levels and act promptly in the face of mental status changes. Usually I note that time is tissue, but in this example, you’ll run out of time before your tissues are damaged.

Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

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

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Filed under Endocrine/Metabolic

Straight, No Chaser: Diabetes Basics and the Importance of Education

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.

Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

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

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

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Filed under Diet and Nutrition, Endocrine/Metabolic, Health Prevention

Straight, No Chaser: Tetanus (Lockjaw)

tetanusjoker

If there could possibly be anything cool about tetanus, it’s that the overwhelming majority of us have never seen it and never will. At first thought, that could seem odd because if you ever end up in an emergency room with a cut or scratch, you’re sure to hear about it. Those two facts are reconciled by knowing there is an incredibly effective vaccine for tetanus, necessary because tetanus is an incredibly dangerous disease. As a result of vaccination, tetanus just doesn’t happen much anymore. Over approximately the last 20 years, less than 30 cases a year have been reported in the United States – nearly all in those either never vaccinated or those not up to date with their tetanus booster shots.

Here are some questions about tetanus to help you understand while this mostly invisible disease is still a major concern.

tetanusdirt

What causes tetanus? 

Tetanus is an infection caused by bacteria named Clostridium tetani. These bacteria are virtually everywhere in the environment, most notably in soil, dust and manure.

tetanusprone

How do I catch tetanus? 

Tetanus is contracted through your skin, usually via cuts or punctures by contaminated objects. Burns and crush wounds also are prone to delivering tetanus. You catch it primarily if you’re not immunized, and you receive a tetanus-prone wound.

Is tetanus contagious? 

Tetanus doesn’t spread between individuals.

tetanusnewbie

What are the symptoms of tetanus? 

If you’re old enough, you’ve probably heard of lockjaw, which is a nickname for tetanus and describes the muscle spasms of the jaw that occur and prevent opening of the mouth. Other symptoms include muscle stiffness and spasms, jaw cramping and trouble swallowing. Seizures, headaches, fever, sweating, high blood pressure and a fast heart rate are other common symptoms.

Severe cases of tetanus can produce devastating complications, including fractures, pneumonia, blood clots, involuntary contractions of the vocal cords and breathing difficulties. Up to 20% of cases cause death.

Tetanusvax

If I got immunized as a child, am I safe?

Full tetanus immunization requires lifelong booster shots every ten years after having received the primary immunization series as a child.

Tetanus

How will I know if I get tetanus? 

Your physician will have to make the diagnosis based on your clinical signs and symptoms. There is no quick test available to confirm the disease.

What will happen if I get diagnosed with tetanus?
Regarding treatment, it’s aggressive and includes hospitalization, further immunization, antibiotics and addressing the wound and developing symptoms. Treating tetanus is a race against the clock, and the disease is life threatening.

jack-nicholson-joker

What’s with the picture of the Joker?

The grimace on his face was modeled after the symptom of tetanus known as rictus sardonicus (roughly translated as scornful laughter), as illustrated in the pictures above of those infected. It’s not a grin or a cry. In tetanus, the sufferer’s face is locked in a painful and often sinister pose that resembles a smile. It results from the spasms causing lockjaw.

 

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

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

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

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

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Filed under General Health and Wellness, Infectious Disease, Neurology, Skin/Dermatology

Straight, No Chaser In The News: New Public Health Consequences & Lessons from Puerto Rico – Leptospirosis

This is a post on a public health matter, not a political one. Please appreciate the difference. Three weeks after Hurricaine Maria rendered the nearly 3.5 million US citizens living in Puerto Rico without normal living conditions, there has been a sudden uptick – a tripling, actually – in the death count. Oddly, the major cause of this surge is not from the over 100 individuals who still remain unaccounted for after all this time. This situation is an illustration of the fundamental roles of government in a society and the consequences that occur when those roles are abdicated or aren’t performed competently.

You may not know that for most of recorded history, diarrhea and dehydration was the world’s number one cause of death. As a public health consideration, the ability to purify water has saved more lives than any other initiative, including antibiotics, immunizations and medical procedures. The situation in Puerto Rico is a stark reminder of what it looks like when citizens don’t have access to clean water; in up to a third of the Puerto Rican population, there still is no access to water, prompting them to drink from local streams and whatever other sources they can access.

The issue here is a disease called leptospirosis. Leptospirosis is a particularly nasty disease that is not uncommon in tropical locations and tends to show up after huge rainfalls. The disease is notable for being spread by drinking water contaminated by animal urine, especially rodents (rats) and even domestic pets that may have gotten into the native water. Symptoms sound like it’s a serious disease; they may include headache, vomiting, high fever, and jaundice (yellow pigmentation). The disease can include liver failure, kidney failure, bleeding from the lungs and infections of the brain. Death rates from this disease alone can reach thirty percent (30%). This is a horrible disease to have and a horrible way to die, even before considering that prevention – simply meaning access to fresh water – is the best cure.

Given that many deadly infectious diseases, including leptospirosis and a host of presumably upcoming mosquito-borne illnesses, can take several weeks to incubate and cause symptoms of a disease, one can assume things will get worse before they get better. In the meantime, there are at approximately 19,000 federal, civilian and military personnel assisting Puerto Rico. Can someone take the time to spread out some water, penicillin and doxycycline, which by the way only costs $1/day?

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

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

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

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

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Filed under Infectious Disease, Public Health