Tag Archives: health

Straight, No Chaser: A Solution to the Upcoming Healthcare Crisis and the Affordable Care Act

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Many of you have heard or seen me discuss various aspects of the Patient Protection and Affordable Care Act.  This ambitious effort seeks to maintain the current level of quality that exists (via maintaining the same insurance coverage for those individuals that already have it), while adding approximately 30 million individuals to the insurance rolls while not increasing overall system costs.
Have you noticed that one part of the conversation that doesn’t seem to occur is “Who’s going to take care of these 30 million new individuals? Also, what about the other 20 million that still won’t have insurance?” The twin deterrents of co-pays and deductibles will eventually be stiffened to curtail over- and inappropriate utilization of the emergency room for both the newly insured and the uninsured voucher recipients (Besides, who wants to deal with the long wait times both in your physician’s office and the ER, soon to be even worse with all the newly insured?). Similarly, you would presume that armies of new physicians are being trained to meet this growth in the newly insured, but that simply isn’t the case. Additional options to address this influx will be necessary. Prominent among these options will be those providing better education and greater empowerment of patients to direct their own care.
Sterling Medical Advice (SMA) is a national public health initiative that provides a solution to these issues by the introduction of 24/7 online personal healthcare consulting, featuring physicians and other care professionals covering the entire spectrum of medicine and healthcare. Consultations will be personalized and immediately available to those in need around the clock.
“What’s that, and when might you use it?” Here are a few examples.

  • You need advice regarding an immediate medical concern
  • You need general information about your medical condition
  • You need immediate information about your prescription
  • You are experiencing symptoms and want to know why
  • You want to learn more information about a medical condition that is part of your family history
  • You want additional details on your upcoming medical procedure
  • You need advice regarding the best care option for addressing a medical concern (e.g., emergency room vs. urgent care vs. scheduling an appointment with your primary care physician)
  • You want a second opinion on your new diagnosis
  • You want a second opinion on your new treatment plan
  • You need additional information about what to expect from a newly diagnosed condition

Sterling Medical Advice will improve public health outcomes while reducing healthcare costs for individuals, families and businesses and the healthcare system at large. Personal healthcare consulting will create a better-educated and empowered population and will become an additional component to the American health care system without compromising quality.
To find out more about Sterling Medical Advice, visit www.sterlingmedicaladvice.com, and thanks for following Straight, No Chaser.

Straight, No Chaser: Revisiting the Affordable Care Act – How You or Your Employer Can Save Up to 50% of HealthCare Costs

affordable-care-copy1

Politics aside, I’m not so sure why business owners are focusing on the angst of implementation of the Affordable Care Act instead of the opportunities to save.
Consider the following from the Small Business Association website: “The Affordable Care Act (ACA) creates new incentives for employers to promote wellness among employees by creating supportive, healthier work environments and encouraging employees to take advantage of workplace wellness programs. Health-contingent wellness programs generally require employees to meet a specific standard related to their health, e.g., decreased tobacco use or lowered cholesterol levels. Under the ACA rules that take effect on January 1, 2014, employer rewards will increase from a 20–30% refund of their healthcare coverage costs for employing health-contingent programs, up to 50% for programs designed to prevent or reduce tobacco use.”
Subscribing to www.sterlingmedicaladvice.com as an employee benefit will save companies up to half of the insurance costs they are already paying for their employees.  These savings can occur at a cost of less than 10% of current costs of insurance! For more information about the final rules’ flexibility in eligible wellness programs, visit www.dol.gov/ebsa.  Have your employee assistance program administrator contact us at 1-866-ADVICE3 (238-4233) or email us at sales@sterlingmedicaladvice.com.

Looking to cut your ACA tax in half? Sign up with SMA, reduce absenteeism, win the appreciation of your employees, and save a bundle.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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From the Health Library of SterlingMedicalAdvice.com: "How can I get alcohol out of my system quicker?"

alcoholic-intoxication

It’s a frequent misconception that there are a ton of remedies you can take to help you eliminate alcohol quicker or get less drunk. Alcohol is eliminated by what’s called zero-order kinetics. This process means that a fixed amount of alcohol is eliminated from the body at a time. Nothing you’re doing, including coating your stomach, eating (including a cheese tray) or drinking coffee is going to make you less intoxicated (referral to the legal definition of how much you have in your system). Now being less dehydrated helps the blood alcohol concentration, and drinking coffee (which is a stimulant and can counter the depressant effects of alcohol) may make you feel more alert, but my best remedy for you is to sleep it off (unless you’re intoxicated to the point that you need medical attention).
Bonus question: “Does vomiting help?”
Vomiting is only of value in eliminating alcohol that hasn’t yet been absorbed into the bloodstream.  Once the alcohol is in your system, it needs to be eliminated as discussed.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

From the Health Library of SterlingMedicalAdvice.com: What is high cholesterol?

fatchol-718351

Hypercholesterolemia (aka high cholesterol), is a condition in which your blood cholesterol level is higher than normal. High cholesterol by itself has no symptoms. Unfortunately, over time, cholesterol may stick to the inside of blood vessels, resulting in clogged arteries, heart disease, and stroke. Many of you are familiar with the many different factors that can lead to high cholesterol, including a high-fat diet, lack of exercise, heredity and excess weight.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Heads Up! Concussions – Traumatic Brain Injuries, Part I

concussion-football

The really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing, or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame, and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.
A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes, ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia. (It’s important to note that not all blows to the head result in a TBI.) For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contribute to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.
Healthcare professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

  • Thinking/remembering
  • Physical
  • Emotional/mood
  • Sleep

Red Flags
Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

  • Any difficulty waking
  • Any loss of consciousness, confusion, or significant agitation
  • One pupil (the black part in the middle of the eye) larger than the other
  • Loss of ability to identify people, places, the date, or self
  • Loss of motion or sensation, weakness, numbness or loss of coordination
  • Persistent, worsening headache
  • Repeated vomiting
  • Slurred speech or difficulty with expression
  • Seizures
  • Kids will not stop crying and cannot be consoled
  • Kids will not nurse or eat

Click here for Part II, in which we discuss complications and treatment options.
Click here for Part III, in which a neurologist adds his thoughts.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

From the Health Library of SterlingMedicalAdvice.com: Are there herbal therapies for anxiety disorder?

Kava-Home-Page3

Yes. Two herbal treatments for anxiety disorders that I’ll mention now include kava kava (also called kava) and valerian.
Kava has been used to relieve anxiety and improve sleep, but it appears to increase the effects of alcohol, so do not drink when taking it. Typical doses of 200 to 250 mg per day are considered safe and effective, but you must follow pharmacist or physician’s directions when considering usage. Kava use has also shown some links to liver toxicity, so the U.S. Food and Drug Administration (FDA) has issued warning regarding its use.
Valerian is a mild sedative with milder side effects than Kava. Valerian’s side effects are reported to be minimal when used at the recommended dose of 300 to 500 mg per day.
Be reminded that the effectiveness of these and most herbs have not been proven by medical research, and benefits have not been directly compared to those of prescription drugs.
 
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Keys to Mental (Un)Health and (Un)Happiness

Mental Health

Everyone has thoughts about the keys to happiness, but we can objectify the conversation and identify what’s most likely to make you unhappy and lead to depression. You may find this hard to believe, but outside of medical causes of psychiatric illness and factors outside of your control, there are actually three choices we make that most commonly adversely impact your happiness and good mental health. Take it for what you will, but the data is what it is. Stay away from these circumstances, and you’re less likely to be unhappy. Sometimes it’s about addition by subtraction.
Health Problems: People who are sick or have significant illness in their families generally aren’t happy. Although this may seem obvious and perhaps unfair, given that some illnesses and conditions are inherited or occur haphazardly, be mindful of the things you can control. Of course, this gets to the negative effects of obesity and smoking. More so than any other health-related activities/conditions, these will eventually lead to deteriorating health and subsequent unhappiness.
Job Problems: You don’t have enough to do with your time? Yep, an idle mind is the Devil’s workshop, as the saying goes. It should be pointed out that neither too much work nor the wrong type of work (i.e., low job satisfaction) seems to promote happiness. On average, people change careers seven times during their lifetimes. It’s often due to a search for happiness and actually is a good thing to do to avoid being stuck in a bad situation. Follow the job you love, and you’re more likely to be both happy and successful.
Relationship Problems: You make bad relationship choices? Well there’s one specific choice that is shown to be most likely to reduce your happiness—choosing a neurotic partner. What’s neurotic? For one particularly disruptive example, think about the so-called Drama Queen/King. A neurotic partner responds emotionally to events that wouldn’t affect most people, and their reactions tend to be more intense than normal. They’re more likely to interpret minor frustrations as hopelessly difficult. Their negative emotional reactions persist for unusually long periods of time. In short, if you want to be really unhappy, become attached to such a person. They will negatively affect your world, keeping you embroiled in drama and unhappiness, no matter how good the financial, physical, or other parts of your relationship.
Now your results may vary but probably won’t. I’m not make judgements, just sharing the data. Life choices have consequences. Choose wisely!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

From the Health Library of SterlingMedicalAdvice.com: "Is It OK to Take Leftover Antibiotics to Treat a Current Infection?"

oldabx
 
You should never use any leftover antibiotics to treat a current infection. The various antibiotics that are available are effective only against specific bacteria, so do not assume that the old medication will take care of your current infection. Your physician should determine the cause of your infection and prescribe appropriate treatment.
It also is important to note that any time your doctor prescribes an antibiotic, you should take all the medicine you are given on the schedule your doctor provides—even when you start to feel better. Unless your doctor tells you to discontinue the antibiotic, you should not have any left over. Not finishing the prescription means some bacteria could survive and possibly come back even stronger. The surviving bacteria can then become resistant to the antibiotic, make the infection worse, and make it harder to treat.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Quick Tip – Caring for Your Ankle Sprain

Ankle-High-sprain-2791
If you decide not to come to the Emergency Room for your ankle sprain, just think about the mnemonic “RICE.” (This works for any other soft tissue sprain, such as the wrist.)
Rest
The longer you stay off of it, the quicker it will heal. The more you try to use it, the longer your recovery will take and the greater the risk of aggravating the injury.
Ice
Apply ice for 15–20 minutes every hour over the first 24 hours. That will help keep the swelling and pain down. However, please keep a towel between the ice pack and your skin.
Compression/Crutches
Use an ace wrap for comfort and to help with the swelling. Use crutches to help stay off that ankle.
Elevation
This is about the only time I’ll tell you it’s ok to be a couch potato. Keep your leg elevated on the bed or on the couch at or above the level of your chest. That’ll help to keep the swelling down.
If you go to the ER, we’ll do the same for you, unless you have a fracture somewhere, in which case we’ll splint or cast you instead giving you the ace wrap. Stay safe.
 
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

How Can I Prevent Acne?

Introduction

This Straight, No Chaser answers the simple question “How can I prevent acne?”

prevent acneWhat to Do

You can prevent pimples by keeping your face clean and your hands away from your face. Use any good cleanser or soap to gently wash the affected area two to three times daily. You treat most cases of mild acne with over-the-counter lotions or creams containing salicylic acid and benzoyl peroxide. You can also try dietary or herbal products like arnica, zinc, and tea tree oil.

If herbal or over-the-counter products do not work, a doctor may recommend a prescription medicine that can be applied to the skin or taken orally. If you have more than 10 blemishes on one side of your face or they are deep, painful and swollen, you should see a doctor. People over the age of 25 with acne may also need a doctor’s care for acne.

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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!

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Straight, No Chaser: A Quick Tip for When You're Feeling Bugged…

earbug
 
Quite a few of you had the same question after Friday’s post on objects in the ears, nose and throat:
What about insects that get in the ear, particularly when you are asleep? It’s pretty horrifying to think of some cockroach or other disgusting thing scratching around that close to your brain! What you don’t want to do is something that will irritate the critter to the point of puncturing your eardrum. Beyond freaking out, your next step should be pretty simple.
At home, consider doing what we do. If you have mineral oil, put a few drops in the ear. It’s the quickest and safest way to kill what’s in there. However, don’t delay coming to the local ER, urgent care facility or your doctor’s office. Any damage caused still needs to be evaluated.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: That Doesn't Belong There, Little Johnny!

jingle bell
Let’s talk about our kids and the things they put inside themselves. Pediatric foreign body ingestion/insertion is a common emergency room presentation. Maybe it’s just part of them exploring their world. In fact, I recall getting a pearl in my ear and a dime in my nostril as a child; maybe I wanted to start saving at a young age… Bottom line: kids get in trouble. And it’s not always their fault. Families sometimes leave things lying around the house. Children may be fed something they can’t handle. Then there’s always the older sibling putting stuff in them…
More than 100,000 cases of accidental pediatric foreign body ingestion occur each year. I’m going to address the three main orifices where things are placed and let you know the dangers, potential solutions and what to expect if and when you show up in the emergency room. Yep, three different holes, because different types of insertions occur, each with their own risks. I guess they figure if there’s a hole, something needs to go in it.
Ears:
What Happens: Kids will put anything that will fit in their ears, but the problems arise when something either gets stuck or breaks off in an ear. This can include such things as a cotton swab, food, a toy (a bead, something waxy, or something pointy) or whatever else they get their hands on. This poses a significant risk of infection, bleeding and possible rupture of the eardrum, which can lead to an entirely new set of complications.
What You Need to Know: Regardless as to the nature of the item, removal of the item is going to be very dramatic. At home, you should be very conservative in your efforts to get anything out of a child’s ear. Blind efforts may lead to pushing the item further back on the eardrum, possibly rupturing it, or jabbing it into the ear canal, causing damage and potentially setting up an infection. Such efforts usually make it even more difficult for health professionals to get at it once you come to the ER or your doctor’s office.
What happens in the ER: Drama. Depending on the size, shape and depth of the object, tools to flush it out, suck it out, scoop it out or pick it out may be used. There is no guarantee of success, and if the object is unable to be easily retrieved (without an unacceptable risk of further ear damage), the child may either be put to sleep to make the process easier, or you may be referred to an ears, nose and throat specialist.
Nose:
What Happens: Somehow kids think that because of the shape of the nostrils, round things just belong in there. Those smooth pearls, beads, marbles and kernels fit just right.
What You Need to Know: The particular danger with items placed in the nose is they can become dislodged into the airway and choke the child. You should be mindful of this as you try to get that object out yourself. One strategy that you might safely try (assuming no blood or significant pain or other apparent injury exists) is to ‘blow your child a kiss’. Put your mouth around the kids mouth and give a big puff. Sometimes this will pop the object out of the nostril! More easily, if the child is big enough to blow his/her nose, try that while occluding the unaffected nostril.
What Will Happen in the ER: We may try the same things described above. We may also use a piece of equipment called an Ambu-bag to deliver that same type of puff. If that doesn’t work, we have additional means to enter the nose and try to remove the object. The most important consideration is to protect the child’s airway.
Throat to the Stomach or Lower Airway:
What Happens and What You Need to Know: More foreign object ingestions and aspirations (passage down the airway) occur in children younger than 3 years than in other age groups, although they do occur in all ages. Even relatively immobile infants may get something inappropriate in their mouths despite not being able crawl or pick up objects and put them in the mouth. Their relative inability to chew, coupled with faster breathing rates increases the odds of objects entering the windpipe instead of the food pipe. We see simple things such as nuts, raisins, coins, magnets, seeds, foods (e.g. hot dogs and grapes), as well as toys, pins, batteries, balloons, bones and many other items. Your pediatrician has likely advised you to avoid giving certain foods until the child is at least 5 years old.
Objects that have entered or passed through the throat will leave a sensation that something is still in the throat, particularly if it scratched something on the way down. Objects in the airways run the risk of partial or complete obstruction of different parts of the airway. This can be immediately life-threatening if severe enough obstruction has occurred. There’s no guesswork here; the child will be having difficulty breathing, coughing, gasping and likely turning blue.
What Will Happen in the ER:
Management of swallowed or aspirated foreign body depends on the size of both the object and child and the object’s location.
1) If it’s in the stomach or beyond: unless there are multiple sharp objects that suggest something’s been perforated, little will be done, and you’ll be instructed to wait and watch for it in the stool.
2) If it’s in the airway, this is an emergency, and a lung specialist will need to get the object out with a special scope.
3) If it’s in the food pipe but not yet in the stomach or beyond, what’s done will depend on the size and location. Esophageal foreign bodies (that is, those in the food pipe) generally require early removal by a specialist because of their potential to cause respiratory problems (by manual pressure onto the windpipe) and complications to the esophagus itself (scratches, burns or even rupture). Most notably, ingestion of those annoying button batteries, and their lodging in the esophagus require urgent removal even if no symptoms are present because of an unacceptably high risk of complications. Sharp foreign bodies (except for single straight pins) are especially dangerous and prone to complications and most likely will also need to be removed.
So, after all that, is there any wonder why we ask you to child-proof your home? The dangers are real, and the drama of an ER visit for these things is avoidable and worth being diligent at home. Have a great, safe, healthy and happy weekend.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: That Doesn't Belong There, Little Johnny

jingle bell

Let’s talk about our kids and the things they put inside themselves. Pediatric foreign body ingestion/insertion is a common emergency room presentation. Maybe it’s just part of them exploring their world. In fact, I recall getting a pearl in my ear and a dime in my nostril as a child; maybe I wanted to start saving at a young age… Bottom line: kids get in trouble. And it’s not always their fault. Families sometimes leave things lying around the house. Children may be fed something they can’t handle. Then there’s always the older sibling putting stuff in them…
More than 100,000 cases of accidental pediatric foreign body ingestion occur each year. I’m going to address the three main orifices where things are placed and let you know the dangers, potential solutions and what to expect if and when you show up in the emergency room. Yep, three different holes, because different types of insertions occur, each with their own risks. I guess they figure if there’s a hole, something needs to go in it.
Ears:
What Happens: Kids will put anything that will fit in their ears, but the problems arise when something either gets stuck or breaks off in an ear. This can include such things as a cotton swab, food, a toy (a bead, something waxy, or something pointy) or whatever else they get their hands on. This poses a significant risk of infection, bleeding and possible rupture of the eardrum, which can lead to an entirely new set of complications.
What You Need to Know: Regardless as to the nature of the item, removal of the item is going to be very dramatic. At home, you should be very conservative in your efforts to get anything out of a child’s ear. Blind efforts may lead to pushing the item further back on the eardrum, possibly rupturing it, or jabbing it into the ear canal, causing damage and potentially setting up an infection. Such efforts usually make it even more difficult for health professionals to get at it once you come to the ER or your doctor’s office.
What happens in the ER: Drama. Depending on the size, shape and depth of the object, tools to flush it out, suck it out, scoop it out or pick it out may be used. There is no guarantee of success, and if the object is unable to be easily retrieved (without an unacceptable risk of further ear damage), the child may either be put to sleep to make the process easier, or you may be referred to an ears, nose and throat specialist.
Nose:
What Happens: Somehow kids think that because of the shape of the nostrils, round things just belong in there. Those smooth pearls, beads, marbles and kernels fit just right.
What You Need to Know: The particular danger with items placed in the nose is they can become dislodged into the airway and choke the child. You should be mindful of this as you try to get that object out yourself. One strategy that you might safely try (assuming no blood or significant pain or other apparent injury exists) is to ‘blow your child a kiss’. Put your mouth around the kids mouth and give a big puff. Sometimes this will pop the object out of the nostril! More easily, if the child is big enough to blow his/her nose, try that while occluding the unaffected nostril.
What Will Happen in the ER: We may try the same things described above. We may also use a piece of equipment called an Ambu-bag to deliver that same type of puff. If that doesn’t work, we have additional means to enter the nose and try to remove the object. The most important consideration is to protect the child’s airway.
Throat to the Stomach or Lower Airway:
What Happens and What You Need to Know: More foreign object ingestions and aspirations (passage down the airway) occur in children younger than 3 years than in other age groups, although they do occur in all ages. Even relatively immobile infants may get something inappropriate in their mouths despite not being able crawl or pick up objects and put them in the mouth. Their relative inability to chew, coupled with faster breathing rates increases the odds of objects entering the windpipe instead of the food pipe. We see simple things such as nuts, raisins, coins, magnets, seeds, foods (e.g. hot dogs and grapes), as well as toys, pins, batteries, balloons, bones and many other items. Your pediatrician has likely advised you to avoid giving certain foods until the child is at least 5 years old.
Objects that have entered or passed through the throat will leave a sensation that something is still in the throat, particularly if it scratched something on the way down. Objects in the airways run the risk of partial or complete obstruction of different parts of the airway. This can be immediately life-threatening if severe enough obstruction has occurred. There’s no guesswork here; the child will be having difficulty breathing, coughing, gasping and likely turning blue.
What Will Happen in the ER:
Management of swallowed or aspirated foreign body depends on the size of both the object and child and the object’s location.
1) If it’s in the stomach or beyond: unless there are multiple sharp objects that suggest something’s been perforated, little will be done, and you’ll be instructed to wait and watch for it in the stool.
2) If it’s in the airway, this is an emergency, and a lung specialist will need to get the object out with a special scope.
3) If it’s in the food pipe but not yet in the stomach or beyond, what’s done will depend on the size and location. Esophageal foreign bodies (that is, those in the food pipe) generally require early removal by a specialist because of their potential to cause respiratory problems (by manual pressure onto the windpipe) and complications to the esophagus itself (scratches, burns or even rupture). Most notably, ingestion of those annoying button batteries, and their lodging in the esophagus require urgent removal even if no symptoms are present because of an unacceptably high risk of complications. Sharp foreign bodies (except for single straight pins) are especially dangerous and prone to complications and most likely will also need to be removed.
So, after all that, is there any wonder why we ask you to child-proof your home? The dangers are real, and the drama of an ER visit for these things is avoidable and worth being diligent at home. Have a great, safe, healthy and happy weekend.

From the Health Library of SterlingMedicalAdvice.com: “What are some warning signs of mental illness?”

mental health

Symptoms of mental illness vary, but immediate and drastic changes in mood, thinking, and/or behaviors are common indicators. Should any such symptoms develop, seek medical attention immediately.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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“What should I look for as an indicator of poor mental health in children?”

Introduction

Today’s questions related to mental health in children.

“What should I look for in my child as an indicator of mental health issues?”

mental health in children
Today’s question is simple. The answer certainly is not. Be aware of changes in your child’s emotional, behavioral, and/or mental functioning. Remember that children often express sadness and feelings of depression in the form of anger, through outbursts, tantrums, etc. If the symptoms persist for more than a month, seek evaluation from your child’s doctor or a mental health professional. Sooner is better than later.

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Straight, No Chaser: Understanding Asthma – Toothpicks and Snot (Part 1 of 2)

asthma
Asthma concerns me. I’ve had many close friends and family suffer with the disease. In fact, a very good friend died of an attack while in medical school, because he didn’t have his inhaler with him. In other words, this is somewhat personal. I’ve probably given more lectures on asthma than any other topic over the years, and I can say without hesitation that relative to how much we know about its prevention and treatment, I can’t think of another disease where we underperform as much as with asthma management. According to data from the National Institutes of Health, over the last few decades the death rate has increased by over 55%. The prevalence rate has increased by 75%, and among African-Americans the hospitalization rate has increased over 35%. The good news is asthma can be controlled and effectively treated. In this primer, we’ll discuss quick tips to improve the health of the asthmatic in your life.
The encouraging thing about asthma is that if you understand what causes it, you understand how to treat it. Here’s what you need to know about what causes asthma. For the purposes of discussion I am simplifying matters for general consumption.

  • Asthma is a result of certain triggers, causing inflammation to your airways over a long period of time with the occurrence of attacks (intermittent exacerbations). These triggers can be thought of as allergens. Examples of these triggers include cigarette smoke, dust, aerosols, cold air, long-haired animals (especially cats), seasonal pollens, and exercise (in some).
  • These triggers create a state of inflammation and hyperresponsiveness in the lungs, leading to the excessive production of mucus within the lungs’ various airway branches. If bad enough this will lead to complete obstruction of the airways. In other words you’ll stop breathing, and you will die without assistance and/or reversal.
  • Exacerbations of asthma include breathlessness, chest tightness, coughing, and wheezing. Basically, because you have the functional equivalent of snot in your lungs, your airways are narrowed, and you’re having difficulty breathing. After all, it’s harder to breathe snot than air. Now imagine how your lungs feel when you’re adding cigarette smoke to that mix.

Let’s get logical. Asthma management is theoretically straightforward if you can pull it off. Prevention is treatment. I used to describe this as “Kill the Cat.” (This blog neither supports, advocates, nor is responsible for the harming of any animals resulting from this information.) In short, if you identify the triggers that precipitate your asthma attacks and then remove yourself from that environment, you will dramatically reduce, if not eliminate, your attacks. This is often described (incorrectly) in kids as “growing out of their asthma.” No one grows out of it, and you don’t cure asthma; asthmatics just stop having attacks because they’re not around the triggers.
In Part II, we discuss asthma management. In case you’re wondering, that’s where the toothpicks come in.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About www.SterlingMedicalAdvice.com: How Do I Use It?

that_looks_cool_but_how_do_i_use_it
Starting November 1st, www.SterlingMedicalAdvice.com will offer three separate options for your use.

  • When you have a healthcare question or concern, log into www.SterlingMedicalAdvice.com and chat with your SMA expert consultant. Your dynamic and experienced online SMA team, representing over 15 different medical and healthcare specialties, is at your service around the clock.
  • If you have a specific question on a general topic, log into www.SterlingMedicalAdvice.com and view the thousands of questions in our database, compiled by our expert consultants. You’ll likely find the answer you seek.
  • If you desire more rounded information on a specific topic, log into www.SterlingMedicalAdvice.com and read the healthcare blog Straight, No Chaser. Hundreds of posts covering a wide variety of topics are available to educate and inform you.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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From the Health Library of SterlingMedicalAdvice.com: “Is there really a way to eat what you want and still lose weight?”

calorie table
In all honesty, if you are staying within the daily calorie intake range, then yes, it’s possible. That said, foods that are bad for weight loss cause your blood sugar levels to rise and drop quickly, making you hungry. Of course, if you are craving more food, you are going to take in excessive calories and gain weight. That’s why eating nutritious foods will help you lose the weight and keep it off.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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From the Health Library of SterlingMedicalAdvice.com: "Why Is It So Hard to Lose This 'Last' 5-10 Pounds?"

find the best way to lose weight and tips
It may be that your body has reached its ‘desired’ weight – its effective, genetic set point.  Reaching this level is relatively less painful than getting past it, but your body’s idea of an ‘effective’ weight won’t necessarily correspond to your personally desired level of leanness. Women in particular tend to achieve healthy homeostasis at higher body fat levels. Breaking through plateaus can be hard enough, but plateaus ordained by the body can seem to be impossible. It’s probably going to take some serious tinkering with carbs, calories, activity levels, sleep and stress. If everything else is on point and accounted for, you may be looking at healthy homeostasis (a biological balance). Then the question becomes “Do you want to mess with a good thing”. If so, stay the course; just don’t expect results as rapidly.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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From the Health Library of SterlingMedicalAdvice.com: How Do I Cope?

coping
What should I do if I’m having a hard time coping with recent changes in my life?
Adjusting to change or coping with a recent traumatic event is a difficult process and can lead to some of the same symptoms as mental illness if left unaddressed. Short-term treatment is often very effective to help prevent long-term distress, especially when you seek help sooner than later. Difficulty coping with change is normal, and talking with a professional to help make a healthy transition does not indicate you have a mental illness.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some 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, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

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