Tag Archives: Facebook

Straight, No Chaser: Quick Tips for the Diabetic in Your Life

November 4, 2017Endocrine/Metabolic, Health Prevention844-SMA-TALK, Behind the Curtain, Blood sugar, Diabetes mellitus, Facebook, Limited liability company, Sterling Medical Advice, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Per your requests, we occasionally feature quick tips for healthy living. Here’s an important example.

If you have diabetics in your life, here are three things they should do everyday.

1) Check their feet. Diabetics have decreased sensation in their extremities. It is very typical for them to step on nails, glass, or otherwise cause injuries that go unnoticed, because they don’t have sufficient sensitivity. Next thing you know, they have an infection and then a foot ulcer, and that’s a common path to amputated toes or the entire foot.
2) Keep soft candy or juice at all times. If they ever experience mental status changes, feed them. Altered mental status can be due to high or low blood sugars. If you treat a high sugar level with more sugar, it’s not a big deal, relatively speaking; if you treat a blood sugar level that was zero, you just saved a life.
3) Have them touch the water with their hands before they shower or bathe. The hands of diabetics remain sensitive to pain longer than the feet, so touching with the hands first helps avoid injuries. The decreased sensitivity of the feet leads to burns, which leads to infections, which leads to amputations.

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: The Curse of the Weekend Warrior – Achilles Tendon Rupture

July 8, 2017Orthopedics/Bones, Sports Medicine, Trauma, Musculoskeletal SystemAchilles, Facebook, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Tendon, There are 72 Hours in a Day, Twitter, WordPressJeffrey Sterling, MD

In high school I led the league in stolen bases, and in college my cohorts and I loved inventing ever more creative ways to dunk a basketball. Apparently, my calf muscles worked well. Somehow at a certain age, I quit those competitive sports cold turkey, partially because I knew an Achilles rupture was lurking out there somewhere.

The Achilles tendon connects the muscles at the back of the calf to the heel. The formula for damage is pretty simple and consistent. As you age your tendons tend to stiffen and shrink. As you age you change from the fine-tuned wannabe athlete most of us were to a recreational player, and we overextend ourselves. Others of us, in making a comeback (or just rushing to train for something like a 5K run), try to go from zero (0) to 60 way too soon. In either scenario, that overextension causes the tendon to tear or snap. You’ll recognize it immediately by the sound (pop) and the inability to walk/stand on your toes, which results from the lack of connection from the calf to the heel. (You need to point your foot downward to walk, which is where the Achilles comes in.) Other common occurrences of Achilles tendon rupture include falling from a height and landing on your feet or stepping into a sizeable hole.

Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: The Effects of PTSD on Children

May 31, 2017Mental Health, Pediatrics/Kids HealthBehind the Curtain, Facebook, health, mental-health, Posttraumatic stress disorder, Psychological trauma, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This is part of a series on post-traumatic stress disorder (PTSD).

For a review of PTSD signs, symptoms and those at risk, click here.
For a review of PTSD diagnosis and treatment, click here.

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

Clinginess
Bedwetting
Cessation of speech
Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
Think about these things when your children have been victims of bullying, abandonment or assault. You have to think about PTSD in order to recognize help may be needed. It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
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: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

May 29, 2017Mental HealthBehind the Curtain, Facebook, health, Posttraumatic stress disorder, Psychological trauma, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, Twitter, United StatesJeffrey Sterling, MD

Memorial Day serves to honor our fallen heroes. Part of that involves caring for our soldiers still with us. Understanding and acknowledging the mental components of their suffering remains a vital and underachieved need. Our soldiers disproportionately suffer from several mental disorders, notably, post-traumatic stress disorder. Today’s post begins a review of post-traumatic stress disorder (PTSD). We thank all of our veterans for their service.
I’ve dealt with disease and death everyday as an Emergency Physician, and it has been dehumanizing on many levels. Imagine having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.

Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
Women are more likely to develop PTSD than men.
Mental illness may abnormally shape responses to traumatic events.
There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

A predisposition toward optimism
The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
A mental orientation that you “performed well” in the face of the danger
A mental orientation of learning from the experience instead of allowing the experience to define you
Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.
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: Alcohol Abuse and Alcoholism

April 11, 2017Toxicology/DrugsAlcohol, Alcohol abuse, Alcoholism, Behind the Curtain, Drink, Facebook, National Institutes of Health, Physical dependence, Self-esteem, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Substance abuse, WithdrawalJeffrey Sterling, MD

With all the focus of late on other forms of drug use and abuse (e.g., methamphetamine, marijuana, opiates), alcohol abuse seems to be lacking the attention it deserves. Fully one in six people in the United States has a drinking problem. In this segment of the Straight, No Chaser series on alcohol, we will explore problem drinking.
“Problem drinking” is a way of describing alcohol intake that causes problems with your functioning. Alcohol abuse is an episode or continued excessive alcohol consumption that causes problems with your daily living activities, such as family or job responsibilities. Of course, a single episode of alcohol abuse can cost you your life if you’re an impaired driver who runs into a tree or some other calamity befalls you.

Alcoholism is alcohol dependence, which is composed of two separate considerations:

Physical addiction to a drug is defined by tolerance and withdrawal symptoms. Tolerance is when you become acclimated to the same dose of drug, meaning, in this case, the same amount of liquor no longer gives you the same buzz. Withdrawal symptoms occur when you experience effects from no longer having the drug in your system.
Mental addiction to alcohol is illustrated by its increasingly prominent role in your life. Your life becomes centered around the pursuit and consumption of alcohol. It creates problems with your physical, mental and social health, controlling your life and relationships.

Many of you ask if alcoholism is hereditary. Hereditary means a specific thing medically, so the answer is no. However, we believe genes play a role and increase the risk of alcoholism. It is most likely that genetics “load the gun,” but environment “pulls the trigger.”

Regarding environment, there’s no fixed equation to if and when you’ll become dependent, but there is a correlation with certain activity and an increased risk. Consider the following activities as suggestive of a significant risk for development alcoholism:

Men who have 15 or more drinks a week (One drink is either a 12-ounce bottle of beer, a 5-ounce glass of wine or a 1.5 ounce shot of liquor.)
Women who have 12 or more drinks a week
Anyone who has five or more drinks at a time at least once a week
Anyone who has a parent with alcoholism

Here are some less hard signs, but these situations also have been shown to increase risk, according to the National Institutes of Health:

You are a young adult under peer pressure
You have a behavioral health disorder such as depression, bipolar disorder, anxiety disorders, or schizophrenia
You have easy access to alcohol
You have low self-esteem
You have problems with relationships
You live a stressful lifestyle
You live in a culture in which alcohol use is more common and accepted

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.
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From the Health Library of SterlingMedicalAdvice.com: “Why would my doctor tell me not to take a decongestant?”

March 28, 2017General Health and Wellness, Head/Eyes/Ears/Nose/ThroatBehind the Curtain, Decongestant, Decongestants, Facebook, FAQ, health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser (composition), Twitter, Upper respiratory tract infectionsJeffrey Sterling, MD

As you struggle from allergies season, the lede is a reasonable question, here is its answer.
Based on how ubiquitous cold and flu remedies are, you would think they were the safest medications known to man. That’s actually not the case and in some instances can be quite far from the truth. The reason for this is simple. Decongestants work by manipulating blood vessels. Specifically, they narrow nasal blood vessels, creating more room for air flow and mucous drainage while reducing swelling and other effects of inflammation. This is a major part of how you treat upper respiratory viral infections like colds and the flu; antibiotics don’t work against viruses.
Unfortunately, if you have certain medical issues, you should not take decongestants. Here’s a list of situations that can make it dangerous to take decongestants:

Allergies to pseudo-ephedrine
Children under age 4
Diabetes
Glaucoma
High blood pressure
Heart disease
Kidney disease
Prostate disease
Pregnant
Breast feeding women
Thyroid disease

So … even if it’s an over the counter preparation, if you’re not sure, head over to the pharmacist before you make that purchase at the store. Of course, you can always connect with your SterlingMedicalAdvice.com consultant as well.
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: When Eating Goes Wrong, Part II – Bulimia

February 17, 2017Diet and Nutrition, Gastrointestinal, Mental HealthAnorexia nervosa, Behind the Curtain, Bulimia nervosa, Eating disorder, Facebook, Psychopathology, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

If you read Part I of this conversation on eating disorders (anorexia nervosa), you will recall that eating disorders are a mix of an abnormal body image combined with abnormal behaviors that lead to medical consequences. Today’s Straight, No Chaser is on bulimia, yet another dangerous eating disorder.
The ‘Bizz-Buzz’ of bulimia nervosa is ‘binge-purge.’ What that means is bulimics engage in frequent episodes of eating excessive amounts of food (bingeing) followed by one of several methods of eliminating what was just ingested (purging). This methods include forced vomiting (most common), use of diuretics or laxatives, fasting or excessive exercise. It is important to note that the bulimic feels a lack of control over these episodes.

Bulimia is an especially dangerous disease because it usually occurs in secret, and victims are able to hide it. This means symptoms will typically be further along when discovered. Bulimics usually manage to maintain a normal or healthy weight despite their behavior and may appear to be the person who ‘never gains weight’ despite ‘eating like a horse.’ This is a key differentiator between bulimia and anorexia. Otherwise, the two diseases do share some of the same psychological pathology, including the fear of weight gain and the unhappiness with physical appearance.
Treatment considerations for bulimia are similar to those for other eating disorders. A combination of psychotherapy, reestablishment of normal nutritional intake and medications usually leads to marked improvement. Again, the particular challenge with bulimics is discovering the condition in the first place. As with anorexia nervosa, treatment for bulimia nervosa often involves a combination of options and depends upon the needs of the individual. Medications may include antidepressants, such as fluoxetine (Prozac), if the patient also has depression or anxiety.
Let’s recap by revisiting where we started with our conversation on anorexia. Our society doesn’t do the job it should in promoting a normal image of health. The typically promoted American ideal of beauty sets standards that lead many to pursue unrealistic means of meeting that ideal. In the setting of an actual American population that is obese by medical standards, this becomes even more of a problem. The levels of stress, anxiety and depression resulting from this reality sometimes leads to eating disorders. Remember, eating disorders aren’t just habits. They are life-threatening conditions. If you or a loved one is suffering, please seek help immediately.

Post-script: If you’re wondering about the above picture of the teeth, you’re viewing the effects of all that regurgitated acid on the enamel layer of your teeth. I know. It’s not your best look.
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: Why You Get Grey Hair

January 30, 2017General Health and Wellness, Skin/DermatologyBehind the Curtain, Facebook, grey hair, Hair follicle, Human hair color, Melanin, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This is a lot simpler than people make it. Gray hair is a happenstance of life. At the end of the day, genetic, racial and chemical considerations determine when you go gray. Let’s briefly look at each and dispel a myth or two along the way.
Chemical: Your hair consists of two parts, a shaft (the visible part above the skin line) and the root (the portion located below the surface). The root contains hair follicles, which contain color-producing cells called melanin (yes, the same melanin that contributes to skin color). Any disruption in melanin production or damage to the hair follicles, such as folliculitis and especially the normal effects of aging, can cause graying. This graying may be physiologic and timely, or it can be premature. An additional consideration to graying can be the physiologic build up of hydrogen peroxide. This naturally occurring chemical actually bleaches the hair.
Racial: Bet you didn’t know that on average, different racial and ethnic groups go gray at different rates. Whites start graying in their mid-30s. Asians begin graying in their late 30s. African-Americans seem to begin graying in their mid to late 40s. Most people will have noticeable and significant graying by age 50.

Genetic: Simply put, graying is predetermined based on your genetic composition. You should already have a good idea if and when you’re going gray by looking at your parents and grandparents.

And now… two questions rolled into one.

Doesn’t stress make you gray? Isn’t that why Presidents go gray while in office?

Presidents go gray in office because they’re at the age when people go gray while in office.
The stress you’re thinking of (‘freaking out’) isn’t the same as physiologic stress, which is a disruption of the body’s normal functions. Such biological stresses can cause disruption of any bodily function. This is why so much confusion exists around ‘stress’. When scientists or your physicians are describing the effects of stress, it’s much deeper than your anxiety attack, which isn’t going to turn you gray overnight.

Straight, No Chaser: Quick Tips for the Diabetic in Your Life

November 8, 2016Endocrine/Metabolic, Skin/Dermatology, Health Prevention844-SMA-TALK, Behind the Curtain, Blood sugar, Diabetes mellitus, Facebook, Limited liability company, Sterling Medical Advice, Straight No ChaserJeffrey Sterling, MD

Per your requests, we occasionally feature quick tips for healthy living. Here’s an important example.

If you have diabetics in your life, here are three things they should do everyday.

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 Curse of the Weekend Warrior – Achilles Tendon Rupture

July 8, 2016Orthopedics/Bones, Sports Medicine, Trauma, Musculoskeletal SystemAchilles, Facebook, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Tendon, Twitter, WordPressJeffrey Sterling, MD

Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.
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 Effects of PTSD on Children

June 1, 2016Mental Health, Pediatrics/Kids HealthBehind the Curtain, Facebook, health, mental-health, Posttraumatic stress disorder, Psychological trauma, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This is part of a series on post-traumatic stress disorder (PTSD).

For a review of PTSD signs, symptoms and those at risk, click here.
For a review of PTSD diagnosis and treatment, click here.

Clinginess
Bedwetting
Cessation of speech
Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
Think about these things when your children have been victims of bullying, abandonment or assault. You have to think about PTSD in order to recognize help may be needed. It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
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: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

May 30, 2016Mental HealthBehind the Curtain, Facebook, health, Posttraumatic stress disorder, Psychological trauma, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Twitter, United StatesJeffrey Sterling, MD

Memorial Day serves to honor our fallen heroes. Part of that involves caring for our soldiers still with us. Understanding and acknowledging the mental components of their suffering remains a vital and underachieved need. Our soldiers disproportionately suffer from several mental disorders, notably, post-traumatic stress disorder. Today’s post begins a review of post-traumatic stress disorder (PTSD). We thank all of our veterans for their service.
I’ve dealt with disease and death everyday as an Emergency Physician, and it has been dehumanizing on many levels. Imaging having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.

Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
Women are more likely to develop PTSD than men.
Mental illness may abnormally shape responses to traumatic events.
There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

A predisposition toward optimism
The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
A mental orientation that you “performed well” in the face of the danger
A mental orientation of learning from the experience instead of allowing the experience to define you
Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.
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: Alcohol Abuse and Alcoholism

April 3, 2016Toxicology/DrugsAlcohol, Alcohol abuse, Alcoholism, Behind the Curtain, Drink, Facebook, National Institutes of Health, Physical dependence, Self-esteem, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Substance abuse, WithdrawalJeffrey Sterling, MD

With all the focus of late on other forms of drug use and abuse (e.g., methamphetamine, marijuana), alcohol abuse seems to be lacking the attention it deserves. Fully one in six people in the United States has a drinking problem. In this segment of the Straight, No Chaser series on alcohol, we will explore problem drinking.
“Problem drinking” is a way of describing alcohol intake that causes problems with your functioning. Alcohol abuse is an episode or continued excessive alcohol consumption that causes problems with your daily living activities, such as family or job responsibilities. Of course, a single episode of alcohol abuse can cost you your life if you’re an impaired driver who runs into a tree or some other calamity befalls you.

Alcoholism is alcohol dependence, which is composed of two separate considerations:

Physical addiction to a drug is defined by tolerance and withdrawal symptoms. Tolerance is when you become acclimated to the same dose of drug, meaning, in this case, the same amount of liquor no longer gives you the same buzz. Withdrawal symptoms occur when you experience effects from no longer having the drug in your system.
Mental addiction to alcohol is illustrated by its increasingly prominent role in your life. Your life becomes centered around the pursuit and consumption of alcohol. It creates problems with your physical, mental and social health, controlling your life and relationships.

Men who have 15 or more drinks a week (One drink is either a 12-ounce bottle of beer, a 5-ounce glass of wine or a 1.5 ounce shot of liquor.)
Women who have 12 or more drinks a week
Anyone who has five or more drinks at a time at least once a week
Anyone who has a parent with alcoholism

Here are some less hard signs, but these situations also have been shown to increase risk, according to the National Institutes of Health:

You are a young adult under peer pressure
You have a behavioral health disorder such as depression, bipolar disorder, anxiety disorders, or schizophrenia
You have easy access to alcohol
You have low self-esteem
You have problems with relationships
You live a stressful lifestyle
You live in a culture in which alcohol use is more common and accepted

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

From the Health Library of SterlingMedicalAdvice.com: “Why would my doctor tell me not to take a decongestant?”

March 30, 2016General Health and Wellness, Head/Eyes/Ears/Nose/ThroatBehind the Curtain, Decongestant, Decongestants, Facebook, FAQ, health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser (composition), Twitter, Upper respiratory tract infectionsJeffrey Sterling, MD

As you struggle from allergies season, the lede is a reasonable question, here is its answer.
Based on how ubiquitous cold and flu remedies are, you would think they were the safest medications known to man. That’s actually not the case and in some instances can be quite far from the truth. The reason for this is simple. Decongestants work by manipulating blood vessels. Specifically, they narrow nasal blood vessels, creating more room for air flow and mucous drainage while reducing swelling and other effects of inflammation. This is a major part of how you treat upper respiratory viral infections like colds and the flu; antibiotics don’t work against viruses.
Unfortunately, if you have certain medical issues, you should not take decongestants. Here’s a list situations that can make it dangerous to take decongestants:

Allergies to pseudo-ephedrine
Children under age 4
Diabetes
Glaucoma
High blood pressure
Heart disease
Kidney disease
Prostate disease
Pregnant
Breast feeding women
Thyroid disease

So … even if it’s an over the counter preparation, if you’re not sure, head over to the pharmacist before you make that purchase at the store. Of course, you can always connect with your SterlingMedicalAdvice.com consultant as well.
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: When Eating Goes Wrong, Part II – Bulimia

February 26, 2016Diet and Nutrition, Gastrointestinal, Mental HealthAnorexia nervosa, Behind the Curtain, Bulimia nervosa, Eating disorder, Facebook, Psychopathology, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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: Why You Get Grey Hair

February 23, 2016General Health and Wellness, Skin/DermatologyBehind the Curtain, Facebook, grey hair, Hair follicle, Human hair color, Melanin, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

And now… two questions rolled into one.

Doesn’t stress make you gray? Isn’t that why Presidents go gray while in office?

Presidents go gray in office because they’re at the age when people go gray while in office.
The stress you’re thinking of (‘freaking out’) isn’t the same as physiologic stress, which is a disruption of the body’s normal functions. Such biological stresses can cause disruption of any bodily function. This is why so much confusion exists around ‘stress’. When scientists or your physicians are describing the effects of stress, it’s much deeper than your anxiety attack, which isn’t going to turn you gray overnight.

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 Effects of PTSD on Children

May 6, 2015Mental Health, Pediatrics/Kids HealthFacebook, health, mental-health, Posttraumatic stress disorder, Psychological trauma, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Twitter, WordPressJeffrey Sterling, MD

This is part of a series on post-traumatic stress disorder (PTSD).

For a review of PTSD signs, symptoms and those at risk, click here.
For a review of PTSD diagnosis and treatment, click here.

Clinginess
Bedwetting
Cessation of speech
Acting out the scary event

Straight, No Chaser: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

May 4, 2015General Health and Wellness, Mental HealthFacebook, health, Posttraumatic stress disorder, Psychological trauma, PTSD, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Twitter, United StatesJeffrey Sterling, MD

This is Mental Health Awareness Month. Straight, No Chaser has done multiple posts on depression and suicide, the components of health and happiness, and many other mental health topics. It’s important that you appreciate the ways events in your life and even the way you live your life impact you over the long term. I deal with disease and death everyday as an Emergency Physician, and it’s dehumanizing on many levels. Imaging having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.

Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
Women are more likely to develop PTSD than men.
Mental illness may abnormally shape responses to traumatic events.
There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

A predisposition toward optimism
The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
A mental orientation that you “performed well” in the face of the danger
A mental orientation of learning from the experience instead of allowing the experience to define you
Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.
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: Alcohol Abuse and Alcoholism

April 7, 2015Toxicology/DrugsAlcohol, Alcohol abuse, Alcoholism, Drink, Facebook, National Institutes of Health, Physical dependence, Self-esteem, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Substance abuse, United States, Withdrawal, WordPressJeffrey Sterling, MD

Alcoholism is alcohol dependence, which is comprised of two separate considerations:

Physical addiction to a drug is defined by tolerance and withdrawal symptoms. Tolerance is when you become acclimated to the same dose of drug, meaning, in this case, the same amount of liquor no longer gives you the same buzz. Withdrawal symptoms occur when you experience effects from no longer having the drug in your system.
Mental addiction to alcohol is illustrated by its increasingly prominent role in your life. Your life becomes centered around the pursuit and consumption of alcohol. It creates problems with your physical, mental and social health, controlling your life and relationships.

Men who have 15 or more drinks a week (One drink is either a 12-ounce bottle of beer, a 5-ounce glass of wine or a 1.5 ounce shot of liquor.)
Women who have 12 or more drinks a week
Anyone who has five or more drinks at a time at least once a week
Anyone who has a parent with alcoholism

Here are some less hard signs, but these situations also have been shown to increase risk, according to the National Institutes of Health:

You are a young adult under peer pressure
You have a behavioral health disorder such as depression, bipolar disorder, anxiety disorders, or schizophrenia
You have easy access to alcohol
You have low self-esteem
You have problems with relationships
You live a stressful lifestyle
You live in a culture in which alcohol use is more common and accepted

Feel free to contact your SMA expert consultant if you have any questions on this topic.
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. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: When Eating Goes Wrong, Part II – Bulimia

March 12, 2015Diet and Nutrition, Gastrointestinal, Mental HealthAnorexia nervosa, Bulimia nervosa, Eating disorder, Facebook, Psychopathology, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Twitter, United States, WordPressJeffrey Sterling, MD

Post-script: If you’re wondering about the above picture of the teeth, you’re viewing the effects of all that regurgitated acid on the enamel layer of your teeth. I know. It’s not your best look.
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.

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