Tag Archives: health

Straight, No Chaser: Quick Tips for the Drowning Victim

Medical Treatment, Trauma, Health Prevention, , , , , , ,

Drowning_safety_children_CPSC

  1. If the victim is still conscious, attempt to hand him something that can be used to pull him from the water. If you’re out of handing distance, throw either a floatable object or something he can hold onto and with which he can be pulled to safety.
  2. If the victim has fallen into solid ice, and you have enough individuals, consider forming a human rope, with each individual interconnected and at least two individuals safely connected back on firm land.
  3. The victim should be removed from the water at the earliest opportunity. Forego inclination to perform chest compressions or rescue breathing in the water.
  4. If possible, remove the victim from the water as flat (horizontal) as possible. You want to make every effort to avoid damage to the neck throughout this entire process (This actually would be additional injury to the neck; there’s a fair chance such an injury has already occurred.).
  5. Once victims are out of the water, NEVER assume death unless you’re a qualified medical professional. Begin CPR, as described in yesterday’s post (Click here to review.).
  6. If the victim has an altered mental status, check the airway for foreign material and vomitus. Use your fingers to sweep away any material visible between the mouth and throat.
  7. The Heimlich maneuver (abdominal thrusting) is not effective in removing swallowed water. Don’t waste valuable time with it.
  8. If you’ve successfully saved a drowning victim, don’t bother taking off wet clothes. It’s not worth the possible agitation to the neck, and recent medical thought suggests that cooling after certain likely types of cardiac arrest is especially beneficial in reducing brain injury and death. This consideration is much more important than any benefit to be gained from warming the patient. Sounds weird, but it’s the truth.

Regarding the lead picture, yes it’s true that one can drown in inches of water. Infant safety means keeping them at arm’s length while they’re in the water.

Straight, No Chaser: Cocaine Myth Busters – Facts and Fiction

Medical Treatment, Toxicology/Drugs, Health Prevention, , , , , , , ,

cocaine whitney-houstonbias

Whitney was right. Crack is whack, and coke’s no joke.

There has to be a better way to chase The Glamorous Life.

Debunking myths about cocaine use

1.    “Cocaine isn’t addictive.”

  • This is just wrong.  Cocaine produces an incredibly powerful psychological dependency, and people will chase the experience of that first high to their deathbeds.  As tolerance to the previous doses develops, it takes increasingly high doses to get similar effects as before, and the risk of overdosing becomes incrementally higher.  Let me be clear.  No set number of cocaine doses accurately determines the development of either a physical or psychological addiction.  That first dose could be the one.

2.    “Cocaine is safe if I only use it once or only use it from time to time.”

  • What you’re discounting is that cocaine use is very much a game of Russian Roulette.  A single dose can cause death in many ways, including heart attacks, abnormal heart rhythms and rupture, strokes, sudden kidney failure, and rupture of your nasal passages.  A bad cocaine high could be the last thing you ever do.  Learn the story of Len Bias, pictured above, just to name one example.

3.    “As long as I’m not using crack cocaine, it’s clean and safe.”

  • If you are looking at the relative merits of smoking, inhaling or injecting drugs, you’ve already missed the point.  That said, people tend to confuse ‘clean drug’ with the ‘upscale’ nature of those who snort cocaine, as opposed to the more negative ‘dirty’ stereotypes of the individuals using crack cocaine.  It’s the same drug, folks.  In fact, snorting cocaine leaves you just as sweaty, irritable and prone to hallucinations as crack users.  The subsequent addiction and pursuit of an even higher high will lead to many a rich, ‘clean’ individual eventually resembling the most stereotypically downtrodden crack user.  There’s nothing ‘clean’ about someone walking around with ulcerated, bleeding or perforated nasal passages.

4.    “Cocaine doesn’t produce a hangover or residual effects.”

  • This is frankly ridiculous.  Cocaine acts by producing a massive release of internal substances that rev you up and produce a powerful euphoria.  When you’ve depleted your body of all these hormones, there’s nowhere else to go but down.  Where do you think the term crash came from?  Fatigue, depression and some degree of mental instability, including suicidal tendencies, are not only common but should be expected.  Other residual effects include insomnia, weight loss, paranoia, anxiety, and aggressive behavior.  The downward spiral of a cocaine user is all too predictable.  The lifestyle changes and risky behavior pattern of cocaine users, including enhanced exposure to HIV, hepatitis and other easily transmittable deadly disease must be included as residual effects of cocaine use.

5.    “Cocaine is a great sex drug.”

  • I hold disdain for educational efforts that aren’t truthful, and in this case, too often such efforts make suggestions that any cocaine user knows not to be true.  A large part of the mystique of cocaine is to be found in the fact that users find it an exotic enhancer of sexual activity.  Cocaine opens blood vessels, which in the case of the penis, facilitates the blood flow that produces and sustains an erection.  Recall, however, that I mentioned that cocaine use is playing Russian Roulette.  One big (no pun intended) problem with using cocaine to stimulate erections is you may not be able to finish what you start.  In other words, that “contact your doctor if you have an erection that lasts more than 4 hours” disclaimer should have originated with cocaine, except for the fact that its use is illegal.  And if you ever do get this side effect, when you arrive to see me or my colleagues, we’ll be there with very large needles needing to be inserted into your penis to manually extract the blood.  That’s not a good day for you.

The answer to the naiveté about cocaine is the same.  It is an extremely powerful and dangerous drug with physical and psychological effects that can linger long past the high. If anyone’s reading this that’s a cocaine user, and you’ve never had any of these problems, learn the medical meaning of physiological tolerance.  As you become acclimated to the effects of cocaine, and the propensity to use more drug to get the same effects rise, the more likely these phenomena will happen to you.  Also recall that a single dose, even in the absence of any past such reaction, can produce any of the adverse effects I’ve described.
If you know someone on cocaine, be as aggressive as you can to get them off of it before it’s too late.  Counseling works.

Straight, No Chaser: The Battle of Antioxidants and Free Radicals

Health Prevention, , , , , , , , , , , ,

Antioxidants
We engage in a lot of fads and off the wall activity to pursue health instead of following tried and true principles of basic science. One thing that I wish didn’t fit that trend is use of supplemental antioxidants. Before talking about using antioxidants, allow me to discuss why they’re necessary.
Free radicals are like the Tasmanian Devil. These molecules are byproducts of many activities that create cell damage. Think about cigarette smoke, trauma (even vigorous exercise), excessive heat and sunlight (and its radiation), to name a few examples. The process of creating and releasing these molecules is called oxidation. The key point is free radicals are unstable and too many of them lead to a process called oxidative stress. This process is implicated in the development of many illnesses, including Alzheimer’s disease, cancer, cataracts and other eye diseases, cardiovascular diseases, diabetes and Parkinson’s disease.
Antioxidants are substances that prevent or delay cell damage caused by free radicals. Antioxidants may be natural or artificial (e.g. man-made). The healthy diets we’re always asking you to eat (e.g. those high in fruits and vegetables) contain lots of antioxidants; in fact this has a lot to do with why we believe they’re good for us. Of course, now you can get many forms of antioxidants in pills. That’s where things get a little less certain.
Logically, you’d think that if some antioxidants are good, a lot would be better, and they would really be effective against free radicals. Furthermore, you’d think a convenient and efficient way of doing this would be putting a lot of antioxidants in a pill. Unfortunately, medical science (including over 100,000 people studied) has shown this not to be as simplistic as our logic would have us believe. I can’t say this any simpler. Antioxidant supplements have not been shown to be helpful in preventing disease. In fact, high-dose supplementation has been shown to have harmful effects, including increasing the risks of lung and prostate cancer. In short, our body doesn’t function in as linear a manner as we would like to think.
Here’s your take home message: We have yet proven that we’re able to cheat Mother Nature. You will not find your health in a bottle. Diet and exercise remain the champions of the battle of pursuing good health. Get your antioxidants the old fashioned way – in your fruits and veggies. Here’s a nice chart for your reference.
Top-Antioxidants

Straight, No Chaser: When Allergies Strike

Medical Treatment, Skin/Dermatology, Health Prevention, , , , , , , , , , ,

allergy
Bee stings.  Medication reactions.  Food allergies.  Latex.  Animals.  Dust.  Cosmetics.  What do these things have in common?  You get allergic to them, and in differing degrees, they make you come to me huffing and puffing and puffy and thinking about not breathing anymore.
The basis of allergies is that your body is trying to defend you from infections.  Sometimes our defense mechanisms are ‘inaccurate’, and the body overreacts to what normally might be harmless substances by producing a system wide reaction (antibodies) to certain triggers (allergens).  This overreaction leads to our bodies fighting a war that isn’t meant to be fought.  That manifests itself clinically by some subset of itchy rashes (wheals, urticaria or angioedema), shortness of breath, nausea, vomiting and other systemic systems.  Again, it’s important to note that this can be both a systemic overreaction or just a local reaction.
One question I commonly get asked is “Why I am allergic to this now?”  In other words, sometimes allergies occur after the initial exposure to seafood or peanuts, or maybe you had been stung by a bee in the past.  That occurs because the first allergic exposure doesn’t always cause a visible reaction.  However, it will sensitize the body such that you’re mobilized for subsequent exposures and will be prepared to ‘unload both barrels’ if it’s needed.  Unfortunately, this reaction can be itself life-threatening.  This life-threatening response is called anaphylaxis, and you’ll know it because more than one organ system of your body (heart palpations, breathing difficulties, gastric upset, itchy skin rashes, dizziness as your body goes into shock, etc.).
Although allergic reactions are more likely to occur in those with conditions like asthma, eczema, allergic rhinitis, seasonal allergies, and sleep apnea, to be clear, the acute allergic reaction is a different animal than seasonal allergies.  If you have any sensation that you’re short of breath, your throat feels like it’s closing, you have any dizziness or altered mental status, palpitations, or if the rash is diffuse and spreading, please get to your closest emergency room.  I wouldn’t be upset if you took the recommended dose of Benadryl along the way.
Final tip: Those of you who’ve suffered any type of allergic reaction to medication, food, animals, etc. should ask your physician about the utility of carrying an epipen, benadryl or steroids in the event of an emergency.  If your risk profile warrants it, any or all of these could prove life saving.  However, these medicines aren’t without risk, so you shouldn’t take any of them unless recommended by your physician.

Straight, No Chaser: Ulcers – I Can’t Believe You Ate the Whole Thing…

Gastrointestinal, Medical Treatment, Health Prevention, , , , , , , ,

ulcers
Peptic ulcer disease (PUD) has an increasing incidence in the general population and particularly so in the elderly, due to a liberal use of NSAIDs (non-steroidal anti-inflammatory agents, such as ibuprofen, aspirin, naproxen).  These painful sores in the lining of the stomach or first part of the small intestine make for many a bad day (and night).  That ulcer is the end result of an imbalance between digestive fluids in the stomach and duodenum.
What you didn’t know is a bacterial is responsible for most cases.  I’ll come back to that.
You’re predisposed to PUD if you smoke or drink, use NSAIDs or take steroids.
Complications abound.  PUD is actually the #1 cause of abdominal organ rupture.  Other complications include bleeding and obstructions (that you’ll recognize as nausea and vomiting to accompany the pain).
Here we go again with prevention.  If you don’t want an ulcer, or if you want your ulcer to be better, stop the habits that produce it.  I’m talking about smoking, drinking alcohol and taking the pain pills.  Let me be clear: ALL patients with peptic ulcer disease should stop smoking, stop drinking alcohol and avoid NSAIDs.
Severe ulcers are treated with surgery or by endoscopy (which is also the method of diagnosing ulcers – this involves placing a tube down your throat to directly visualize the areas and possibly repairing damage if it’s amenable to that).
Less severe ulcers may be treated with various medications called proton pump inhibitors.  You’ll recognize these acid reducers by names such as aciphex, nexium, prevacid, prilosec and protonix.  If you are discovered to have an infection, antibiotic combinations can be given for one to two weeks for the involved bacteria (Helicobacter pylori) in addition to the proton pump inhibitors.  None of these will address the situation if you don’t make those lifestyle adjustments.
Questions or comments?

Straight, No Chaser: Emergency Room Adventures – The Risk of Rabies

Infectious Disease, Medical Treatment, Health Prevention, , , , , , , , , ,

Rabiesdog
You can’t make this stuff up.   It’s another busy night in the ER, and back-to-back patients come in, not related but dealing with the same issue.  One’s a child bitten over the eye by a family dog with no shots.  The next is a teenager attacked by a possum, which he decided to kick in the mouth, and of course he ends up being bitten.  Both of these situations hold a certain risk of rabies exposure.
Rabies is a viral disease transmitted to humans through the bite (or scratch) of an infected animal.  It infects the central nervous system, initially producing a multitude of symptoms that resemble the flu (fatigue, headaches, fever, malaise) and then progressing to exotic symptoms (including fear of water, increase in saliva, hallucinations, confusion and partial paralysis) culminating in death within days.
There is no cure for rabies once symptoms appear, so prevention is critical.
Animals that are especially likely to transmit rabies include bats (the most common culprit in the U.S.), foxes, raccoons, skunks and most other carnivores.
rabies1

  • Bites from these animals are regarded as rabid unless proven otherwise by lab tests.  These animals must be killed and tested as soon as possible.

Animals that have been reported to transmit rabies include dogs, cats and ferrets.

  • If bitten from these animals, and it appears rabid, treatment must begin immediately.
  • If the biting animal appears healthy and can be observed for 10 days, then do so, but the animal must be euthanized at the first sign of rabies.

Others bites to consider include bites from rodents (woodchucks, beavers and smaller rodents), rabbits and hares, which almost never require post-exposure prophylaxis unless the area is a high rabies exposure area.  In these instances decisions will be made in consultation with local public health officials.
So what should you do if bitten?

  • Remember, there will be no immediate symptoms, so you can’t trust that you’re ok just because you’re feeling ok.
  • Make every effort to secure the animal.
  • Even if the animal isn’t available, go to the nearest emergency room as soon as possible after contact with a suspect animal.

What can you expect?

  • Vigorous wound cleaning
  • Assessment for and possible administration of two different types of vaccinations.  These regimens can prevent the onset of rabies in virtually 100% of cases, one of which needs to be administered in five separate doses over a month’s time.
  • Additional vaccination for tetanus, if appropriate
  • Antibiotics if appropriate.

Remember, rabies is a fatal disease.  It is meant to be avoided, but if you can’t avoid it, you need to get assessed as rapidly as possible.  I hope this information helps you make correct decisions if you’re ever confronted with a rabies prone animal, and for goodness’ sake, please get any house pets all appropriate vaccines.

Straight, No Chaser: Quick Tips for The Newborn Addition to Your Family

Pediatrics/Kids Health, Health Prevention, , , , , , , , , ,

Cute-Newborn-Black-Baby-Girl-Picture
You’re excited. You have a newborn, or maybe you’re a new grandparent caring for the baby for the first time. I get more ‘deer in the headlight’ looks from these folks than perhaps any others. Here’s some Quick Tips for you new parents and family members:

  1. Your child doesn’t have a fully developed immune system yet and won’t until s/he begins receiving immunizations. This is a major reason why breastfeeding is so heavily recommended. Mothers transfer levels of immunity to the baby through this process. It’s not just about bonding.
  2. Your baby is spitting up? Welcome to the club! As long as s/he is gaining weight and is comfortable, there’s not much cause for concern. It’s likely a measure of eating too much and/or too quickly. Acid reflux and or gastroesophageal reflux occurs in about ½ of infants. Again, the baby needs time to have its protective mechanisms fully develop. Speaking of breastfeeding, here’s some more food for thought (no pun intended). Kids who aren’t being breastfed tend to spit up more. Expect it.
  3. I know this is hard and perhaps impractical in many instances, but hold off on multiple family visits for the first month while that immune system is maturing. Exposing them to dozens of relatives is a pretty good way to get a sick baby. Unfortunately, during those first 30 days, babies don’t confine illnesses very well, and even a little cold or ear infection can rapidly spread throughout the body. This could lead to meningitis and someone like me having to perform a lumbar puncture (i.e. spinal tap) on your newborn.
  4. Colic drives parents crazy! Crying newborns obviously are trying to tell you something, and maybe it’s as simple as wanting to be fed, but here’s an important tip for you: check under the diaper. There are multiple issues that present there. Here are three of them:
    1. Anal fissure – hard stools can cause a scratch near the anal opening. Fissures are painful, and whenever stool passes by or anything touches that area, it’s going to hurt! There may be blood associated with this as well; perhaps you’ll notice it on the diaper or streaking along the stool.
    2. Diaper rash – rashes can cause inflammation and infection. They are irritating and painful. New parents must be diligent in getting wet and/or stooled diapers changed with appropriate frequency. After all, wouldn’t you yell if you had to keep that stuff in your undergarments?
    3. Loose hairs – You’d be surprised how often I see loose hairs wrapped around a newborn or infant’s penis, doing it’s best to choke it off. I’m not joking. If the child isn’t circumcised, be sure to retract the foreskin to check and allow look over the testes. This could be dangerous.

I mean no disrespect when I say this, but call your primary doctor before bringing your colicky newborn to the ER during those first 30 days of life. The main reason I say this is for your further protection. The ER is where a lot of bad microorganisms live, and although we never mind seeing you, we want to coordinate when it’s appropriate for you to have to expose your baby to the environment.

Straight, No Chaser: The Week In Review and Your Take Home Messages

The Week In Review, , , , , , ,

?????
Well, it was a busy week. Let’s look at what you may have missed.
On Sunday, we started with reviewing the important of National Minority Organ Donor Awareness Month. Over 56% of people on the national organ transplant waiting list are minorities. Consider checking in at http://organdonor.gov/becomingdonor/stateregistries.html.
On Monday, we reviewed human bites, which involve any lesion caused by your teeth that breaks the skin. These range from over aggressive hickeys to the Mike Tyson variety to lesions caused by punching someone in the teeth. We posted your FAQs separately here. My bottom line is you need to get evaluated every bite (that breaks the skin) every time.
On Tuesday, we reviewed alcohol intoxication, abuse and dependency and gave you the tools to assess that all important question: Do You Drink Too Much? We included a special Alcohol Facts and Fiction post for your consideration. In case you were wondering, that beer belly isn’t from your beer and is the least of your worries, either from the alcohol or the belly sides of the equation.
On Wednesday, we went Back to the Future in discussing low back pain and identified life-threatening conditions associated with low back pain. Remember to lift with your knees instead of your back, and beware of night-time back pain or loss of motion, sensation, bowel and/or bladder control. You probably heard the word Cauda Equina for the first time.
On Thursday, we discussed spider bites, focusing on the Black Widow and Brown Recluse spiders. Do you remember what a volcano lesion is? We also discussed shingles and answered a lot of questions about the chickenpox and shingles vaccines. The Straight, No Chaser recommendation is to get them (the vaccines, not the diseases)!
On Friday, we busted a few myths about migraine headaches and discussed life-threatening conditions associated with headaches. I want you to remember the association between migraines, heart attacks and strokes. Review the list of ‘headache plus’ symptoms to prompt you to get immediately evaluated.
On Saturday, we taught you how to fall. Do you remember what FOOSH stands for? We also reviewed the causes and treatment of ingrown toenails. Sometimes the simplest advice is the best. Stop biting your toenails!
Thanks to all of you who have filled out the Straight, No Chaser survey. I hope you’re seeing improvements to your satisfaction. The Week in Review post is a direct result of your feedback. We have 500 followers now in a month, which isn’t bad for a blog on a topic that can be a boring as health and medicine. Thanks for your support and continued feedback.
Jeffrey E. Sterling, MD

Straight, No Chaser: Quick Tips – Rashes on Your Palms and Soles – Pay Attention!

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

In the world of rashes, there aren’t an abundance of rashes that appear on the palms and soles.  However, there are a few of note, so here’s some Quick Tips to point you in the right direction.
There’s actually an entity called hand, foot and mouth disease, commonly seen in children and caused by the Coxsackie A virus.  It’s rather benign.
Hand-Foot-and-Mouth-Disease-3hand-foot-mouth-disease1hand-foot-mouth
If you’ve spent any time in the woods of the Southeastern U.S. (usually between April and September), you may recall being bitten by a tick (which will transmit an infection from a bacteria named Rickettsia Rickettsii).  If you contract Rocky Mountain Spotted Fever (yes, it’s misnamed – the Rocky Mountains aren’t in the Southeastern U.S.), your rash may look like this.
RMSFRMSFfeet
If you’re a child with five or more days of fever, pink eye, dryness in the mouth, big lymph nodes in the neck and this rash, your physician should consider Kawasaki’s disease.  This is caused by an inflammation of blood vessels, and demographically, it is seen more often in those of Asian descent.
kawasaki
Sometimes in Kawasaki’s disease, the tongue may look like a strawberry.
Kawasaki2
And yes, secondary syphilis presents with rashes on the palms and soles.  The real take home message is this.  Primary syphilis is so overlooked (because the initial genital lesion is painless and may come and go without much announcement), the development of rashes on the hands and feet may be the first time you get diagnosed.  Trust me, you want to get treated before tertiary syphilis develops.  Here’s what that rash looks like.
2ndsyphilis2ndarysyphilis
The long and short of it, is if you or a loved one develop a rash on the palms and/or soles, get it evaluated.

Straight, No Chaser: Find Something Better to Chew On! Ingrown Toenails

Skin/Dermatology, , , , , , ,

ingrown_toenail

The overwhelming majority of cases of ingrown toenails I see come from people chewing on their toenails.  So the really, really Quick Tip is keep your feet out of your mouth.  If only it was that simple.

Ingrown toenails themselves aren’t the problem.  The resulting skin infection and pain are what bring you in to see me.  Remember that the ingrown toenail is caused by the nail burrowing into the skin of the toe instead of growing out and over it.  I’ve always found it interesting that people wait so long for such things, but in this instance, if you are going to wait, there actually are things you can do to potentially make it better.  You’ll know you need to do this if you have a red, swollen, painful toe and especially short toenails.

  • Soak your feet two-three times a day for 15 minutes at a time.
  • Attempt to lift the nail by placing cotton or dental floss under the toenail after you soak.  The goal is to get that nail corner above the skin.
  • Wear open-toed shoes.  This is not the time when you’d want to have any pressure on your toes.
  • Place a topical antibiotic on the area.

Have you ever seen a bad ingrown toenail get removed?  If you have, you’ll likely agree that it’s a deterrent to having another one.  Treatment usually involves lots of local anesthesia (i.e. needles) and partial manual removal of the toenail.  It’s not a good day when this has to happen.

So, you can avoid this fate.  Just follow a few simple steps to avoid it in the first place.

  • Don’t bite your nails.  As discussed in the human bites blog post, you’ve just added really bad bacterial to the mix for when the infection occurs.
  • Don’t cut your toenail so short that you can’t see some of the white tips.  Be sure to let the corners extend past the skin.
  • Don’t wear excessively tight shoes that literally smash your toes onto themselves.

Here’s a final note: if you’re diabetic or otherwise immunocompromised, these infections can spread rapidly and extend into the bone – these infections are very serious.  In some cases this has led to amputated toes.  If an ingrown toenail happens to you, I’d suggest getting seen sooner rather than later.

Straight, No Chaser: Orthopedics Quick Tips – Learn How to Fall – The FOOSH injury

Orthopedics/Bones, , , , , , ,

colles1
We use a lot a acronyms in the Emergency Room, many of which can’t be repeated in polite company.  Orthopedics and Trauma seem to lend themselves to a few.  There’s GTSBOOM (got the stuff beat out of me, which is an all too common occurrence) and there’s FOOSH.  FOOSH stands for ‘fell on outstretched hand’.
I bring this up because you need to learn how to fall.  FOOSH injuries predictably cause fractures of the distal radius and ulnar (the two bones of the forearm), usually down by the wrist.  These injuries are incredibly common and avoidable.  The most notable injury is the Colles fracture, which is a distal radius fracture.  You’ll know you have it after a fall when your wrist assumes the typical ‘dinner-fork deformity’.
colles-fracture1
So next time you fall, try to make it a glancing blow and avoid placing the full weight of your body on those wrists.  Try to land and roll when you hit – but be extra careful to avoid bumping your head by doing this.  If you get this right, it could save you 6 weeks in a splint, cast or in some cases a trip to the operating room.

Straight, No Chaser: When That Headache is More Serious Than a Migraine

Health Prevention, , , , , , , , , ,

Brain-Aneurysm-Prognosis-Factors
All headaches are not created equal.  Earlier we discussed migraines, but there’s a lot more to headaches than those.  In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we still aren’t thinking about migraines as the first consideration.  It’s all about the life-threats.  The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms.
Secondary headaches are those related to some other illness or condition that produces headaches as a symptom.  These are much more common causes of headaches than migraines.  They’re even more important because they could represent life-threatening conditions.  So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and ‘brain-freeze’ (Yes, ‘ice-cream headaches’ really are a thing!), and point you to some conditions about which you should be concerned (I’m intentionally leaving out many especially uncommon and otherwise esoteric conditions.  I wouldn’t want to encourage any hypochondriacs out there.).

 unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid hemorrhage: and other intracranial hemorrhages

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight.

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms you may have that may suggest your headache is different enough to get evaluated for a possible life-threat.

Consider this a ‘headache plus this symptom = go to the emergency room’ list

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)

Straight No Chaser: Myth Busters Edition – Migraine Headaches Fact vs. Fiction

Medical Treatment, Health Prevention, , , , , , , , , , , , , , ,

headache

There are 30 million migraine sufferers in the U.S. alone.  Women are thrice as likely to have them, but both sexes have to address the issues raised by them.  Here are some important facts regarding migraines and myths surrounding them, based on questions I’ve actually been asked.  And yes, regarding the lead picture, I refuse to say she’s lion.

Myth #1: I can’t help if I get migraines.  They’re hereditary, right?

There are a few things about being predisposed to having migraines I want you to know.

  • If you have one parent with migraines, there’s a 50% chance you’ll have them.
  • If both your parents have migraines, there’s a 75% chance you also will.
  • 4 of 5 migraine sufferers have a relative with migraines.

These facts represent a predisposition.  In order to have migraines, you must have triggers that will set off the migraine.  That’s a vital consideration in your effort to prevent, reduce and effectively treat your migraines.

Myth #2: This is a woman’s disease.  They stress out more and are more emotional.  That’s why they get headaches.

It is true that there is a strong hormonal component to migraines, particularly regarding estrogen and progesterone.  In fact, the incidence of migraines between the sexes is pretty equal until puberty.  Migraines are increased during pre-menstruation, when hormone levels are high.  Menopause may ease migraines.    All of this said, men still get migraines as well because of the presence of other triggers.  It certainly does not appear to be true that women suffer stress at a disproportionate rate sufficient to claim it as more of a trigger in women than in men.  Both sexes’ stress responses include release of substances that expands blood vessels, causing migraines.

Myth #3: My migraines won’t get any easier as I get older.

Along the same lines as Myth #2, diminished hormone production that accompanies aging may help explain how most migraine sufferers have less frequent and less intense migraines after age 40.  Because of hormonal fluctuations during perimenopause, this reduction may not be seen.

  • Most people who get migraines have fewer headaches and their headaches aren’t as strong once they hit 40. However, this may not be the case for women going through perimenopause. If hormones are a trigger for a woman’s migraines, then she could have more headaches during the period around menopause.

Myth #4: Once I’m diagnosed with migraines, only narcotics will help.

First of all, trigger identification and prevention is vital.  Migraine trigger management and treatment is a topic unto itself, but I’d like to point out a few important considerations.

  • Think triggers first and last.  The list of triggers includes foods (think chocolate, alcohol, aged cheese and caffeine; results vary with the individual), cold, stress, smoking and certain medications.  Alterations in mealtimes, exercise and sleep patterns must be monitored as well, these tend to exacerbate migraines.  Migraine sufferers are advised to maintain a headache log to identify triggers as things occur.
  • A special comment about caffeine: It helps some people, but for others it’s a migraine trigger, particularly if you’re a heavy user.  If you don’t drink many caffeinated beverages, one may help if you’re having a less than severe migraine.  If you’re taking enough in to create a caffeine dependency, overnight withdrawal may be enough to trigger a morning migraine.

Patients must become their own experts on how and when you use different medications.

  • I hope you and your primary care physician have discussed and have you focusing on your abortive medications.  These medicines can stop further progression of migraines if used early enough at the first sign of a migraine.
  • Painkillers have consequences.  As tolerance to and dependence on narcotics develop, withdrawal symptoms become more prominent.  Rebound headaches are a major component of these symptoms.  That’s a vicious cycle that doesn’t have a happy ending.  It’s important to note that your health care professionals do appreciate there is a difference between being drug seeking and drug dependent.

Myth #5: Migraines really don’t cause problems beyond the headaches, right?

Wrong.  If you have migraines, take special care to ensure you have a healthy heart and a low risk for strokes.  Refer to the Straight, No Chaser archives (or just type in the search engine to the right) for information on stroke recognition and heart attack recognition.  If you’re a female and have migraines with aura (certain warning symptoms that precede you migraine like nausea, dizziness, light sensitivity, and seeing zig-zag lines), your heart attack risk climbs by over 90% and your stroke risk more than doubles (increases by up to 108%).  The presence of migraines without aura also raises the risk of heart attack and stroke but by lesser amounts.

As per routine at Straight, No Chaser, the message is simple, but execution is key. Prevention is protection, and knowledge is power.  Check back this afternoon for life threatening causes of headaches, and feel free to send questions and comments.  Take good care.

Straight, No Chaser: Can You Get Chicken Pox Twice? Emergency Room Adventures: Introducing Shingles

Medical Treatment, Health Prevention, , , , , , , , , , , , ,

shingles
It’s another interesting night in the ER.  My nurses are hounding me because there’s a patient with a rash, and they don’t know what it is.  They’re so good that they rarely get stumped, and they get excited when they are.  The patient had a pretty impressive cluster of little blisters called vesicles (see the picture above) under one eye with significant reddening of the skin under the cluster.  Unknown to them, their problem with this patient is she’s African-American.  Many healthcare professionals have difficulty identifying common rashes in dark-skinned individuals.
I wonder if any of you haven’t had chickenpox.  That’s a question that never would have been asked a few decades ago.  Chickenpox is caused by the Varicella Zoster virus, which is one of the Herpes viruses (No not that one; we’ll discuss that next week.).  Repeat infections or reactivation of the virus that went dormant inside of you causes shingles.  When I was younger, no one ever got shingles because no one got chickenpox twice.  Chickenpox was something you got as a child, and when you contracted it, everyone in the neighborhood would bring the kids by so everyone could get it and be done with it.  The first case of shingles I actually remember seeing was during residency in a HIV+ patient who actually died from it (Herpes Zoster pneumonia; I was told it happened to the elderly or patients with lowered immunity).
Then an odd thing happened.  A chickenpox vaccine came out.  Chickenpox started being seen in older individuals, because all the kids were immunized, and the loss of the ‘herd immunity’ phenomenon allowed some individuals to sneak by without getting chickenpox as a child, only to develop it at an older age.  Then shingles started being seen more often.
The shingles rash is classically a group of lesions stretched around a single dermatome (an area of skin corresponding to the distribution a specific nerve root), usually in the abdomen or back, but seen with some frequency on the face and involving the nose and around the eyes.  Infection begins with general nonspecific symptoms like headache, light sensitivity, pain, itching and burning in the area a few days before the rash appears.  The pain should be emphasized, as it can last for a year after the rash (which typically lasts for 2-4 weeks).  Amazingly 30 out of 100 Americans will now develop this illness at some point in their lives.
Anyone who has had chickenpox may get shingles. However, you can now get a shingles vaccine, which serves two purposes: it may prevent shingles, but if it doesn’t it can make the episode less painful.  If you’re 50, you can get vaccinated, and it can cut the risk of contracting shingles in half.  Please discuss this with your physician.  If you’re eligible, you’ll thank me; if you don’t get vaccinated and contract shingles, you’ll wish you had.
Quick Tips:

  • If you have never had chickenpox and have never gotten the chickenpox vaccine, avoid contact with people who have shingles or chickenpox. Fluid from blisters in both conditions is contagious and can cause chickenpox in these groups.
  • If you have shingles, avoid close contact with people until after the rash blisters heal.
  • Certain people are at heightened risk from chickenpox and shingles, including anyone pregnant, elderly, ill or with a diminished immune system.

I welcome your questions, comments or stories.  For the sports fans out there, this pictorial trivia question shouldn’t be hard to answer?  Who’s this famous manager pictured here with shingles?
larussashingles

Straight, No Chaser: When That Back Pain is the Least of Your Problems

Neurology, Orthopedics/Bones, , , , , , , , , ,

Emergency
Back pain hurts, but there are various causes of that pain that will kill or cripple you.  Here’s some information on some diseases that present with back pain representing life-threats.  Be advised that as an Emergency Physician, my initial orientation is more toward ruling out the life-threatening consideration than making a definitive diagnosis, which comes afterwards.  Forewarned is forearmed.
Let’s start where we left off on the last post and identify what I was talking about….
Here are a few clues to help you hone in on whether your back pain requires emergency attention.  Remember pain and pathology (serious disease) are two different considerations.  I’m describing medical emergencies here and admittedly being overly simplistic.

  • Direct blow to your back:  Think Fracture
    • The trauma literature suggests that most motor vehicle collisions don’t have enough direct force to break your back.  It’s suggested that the force of a baseball bat is needed to break something in your back if you were previously healthy.  That said, the consequences of fracture are such that direct back trauma from a fall or other direct blow are such that you should at least be evaluated.
  • Fever and new onset back pain: Think Spinal Epidural Abscess
    • A spinal epidural abscess is a ‘pus pocket’ (i.e. infection) that collects between the spinal cord’s outer covering and the bones.  It can result from a recent back surgery, a back boil, a bony spinal infection (vertebral osteomyelitis), from IV drug abuse, or as part of an infection otherwise delivered from the blood.  Antibiotics for about a month and/or surgery may be required.
  • Loss of control of your bowel movements or bladder: Think Cauda Equina Syndrome (CES)
    • There are many neurologic causes of low back pain, but the ones associated with ‘hard’ neurologic findings represent true medical emergencies.  CES is caused by something compressing on the spinal nerve roots, like a ruptured lumbar disk, a tumor, infection, bleeding or fracture or various birth defects.  This could lead to loss of bowel and bladder control and possibly permanent paralysis of your legs.  Again, there are several other causes of these symptoms, but for the purposes of this blog, get evaluated quickly, and let us figure out whether this or something else is going on.
  • New onset back pain after age 65: Think Cancer
    • There are several considerations in play when it comes to back pain in the elderly, including fractures and arthritis, but the life-threatening consideration I’m focusing on is cancer.  The spine is a common place for cancer cells to metastasize; in fact approximately 70% of patients with metastatic cancer will have spinal involvement.  Given that only about 10% of these patients tend to be initially symptomatic, it’s imperative that you get evaluated if symptoms present.  It could represent a significant advancement of disease.
  • Numbness and tingling in both of your legs: see Cauda Equina Syndrome above
  • Night-time back pain: Think Metastatic Cancer.
    • Bone pain at night in a patient previously diagnosed with cancer is the most ominous symptom in patient with metastatic cancer.
  • Sudden sexual dysfunction: See Cauda Equina Syndrome above
  • Weakness and/or loss of motion or sensation in your legs: See Cauda Equina Syndrome above
  • Unexplained new weight loss and new onset back pain: Think Cancer
    • There are a few considerations here, but I’m focusing on the life threatening consideration and working backwards from there.
  • Work-related back injuries
    • This isn’t as much a life-threatening consideration as it is a limb and career-threatening one.  Given the degree of disability that is work-related and the need to continue working at the same level of productivity required to keep your job, it’s a pretty good idea to have incremental changes in symptoms and function assessed.  Ignoring symptoms when they occur can lead to failure to qualify for worker’s compensation, not to mention it places you at risk for worsening injuries and ongoing disability.

Other diseases present with back pain, including kidney stones and infection, pancreatitis and certain ruptured abdominal organs.  I’d like to make special mention of the latter, which may include abdominal aortic aneurysms and ectopic pregnancies, both of which I’ll address in the future.  The take home consideration here is to use these cues to know when to get rapidly evaluated.  Even though people use the Emergency Room for seemingly everything these days, knowing when time is of the essence for true emergencies is a life-saver.

Straight, No Chaser: Back Pain to The Future

Neurology, Orthopedics/Bones, , , , , , ,

lower-back-pain-causes-2
Over 40 million Americans suffer from various forms of chronic low back pain. We must work really hard.
Lower back pain is a tricky subject for an emergency physician. The lower back is a source of many life threatening emergencies, which I’ll discuss in a separate post, but for now, as always let’s give you some information to help prevent and address your routine back problems. Let’s start by understanding what the back’s trying to accomplish and how you help or hinder that process by your actions.
Remember the back is the major weight-bearing apparatus of the body and it connects the upper and lower body. It twists, turns, pulls and bends. It contains many vital nerves and muscles.
Let’s point at four situations that produce or exacerbate your back pain:
1. Bad form (born with or otherwise acquired):

  • Spinal problems you were born with can predispose you to and outright cause all manner of back difficulties. Any machine works better if well-built.
  • Obesity puts a significant strain on your back in various ways. Given that most people don’t build up their back muscles, sprains and chronic pain are quite easy when you’re front-loaded. Pregnancy produces a similar strain on your back.

2. Strains
Have you ever heard that it’s easier to lift with your legs than your back? Well, I’d never think so based on the habits of many patients, but it’s true. The lower extremities are much stronger than your back. One of the problems with back strains is once it gets weak, it gets worse. Muscle spasms, pain, more strains and protruding discs all become more likely.
3. Fractures
A broken back is no fun. A weakened back bone (vertebrae) may collapse on its own if diseased (e.g. cancer, age, arthritis, infection), it may become fractured or may be injured with significant trauma. Those with osteoporosis have this happen more commonly. These broken bones may compress spinal nerves. You may even get shorter.
4. Arthritis and Normal Deterioration (aging)
There are other forms of arthritis beside degenerative joint disease (osteoarthritis, which we all get as we age), but the resulting pain, warmth, redness, swelling and limitation in motion all forms lead to reduced function and pain that can continue for the remainder of one’s life.
Here are a few clues to help you hone in on whether your back pain requires emergency attention:

  • Direct blow to your back
  • Fever and new onset back pain
  • Loss of control of your bowel movements or bladder function
  • New onset back pain after age 65
  • Numbness and tingling in both of your legs
  • Nighttime back pain
  • Sudden sexual dysfunction
  • Weakness and/or loss of motion or sensation in your legs
  • Weight loss and new onset back pain
  • Work related back injuries

What can you do to prevent or reduce the pain at home?

  • Learn and practice good posture. Sit when you can. Keep your back straight and shoulders back. When you stand, find something upon which to prop one of your feet, like a stool (think Captain Morgan).

CaptainMorgan

  • Learn the correct way to lift (bend at the knees, not at the back – every time). If you have pain, avoid bending, stretching and reaching if avoidable.
  • Wear low-heeled shoes whenever you can, ladies!
  • Learn how to stretch your back.

LBP exercises

  • Maintain a healthy weight, and exercise to strengthen your abdomen and back (your core)
  • Sleep on your side. Try a pillow between your knees.
  • Walk. Did you know walking is the best (and easiest) exercise for your back?

I’ll be back later (no pun intended) with your questions and more.

Straight, No Chaser: Do You Drink Too Much?

Health Prevention, , , , , , , , , ,

drinks
It’s one of those Straight, No Chaser (literally) days.  I haven’t addressed substance abuse much yet (and you know I will), but the problems with most intoxicating substances revolve around the same consideration.  You had the most incredible time and got the most incredible high the first time, and you spend the rest of your life chasing the joy of that first buzz, which for most drugs you’ll never get.  The difference with alcohol abuse is that alcohol is legal and comparatively inexpensive, so you get to keep trying without much fuss (or at least initially).
Let’s set the stage by standardizing some terms:

  • Alcohol intoxication: You’re drunk and under the influence of alcohol.
  • Alcohol abuse: Your drinking habits are unhealthy, resulting in bad consequences (e.g. at work, in your relationships, with the law).
  • Alcohol dependency: You’re physically and/or mentally addicted to alcohol.  You crave liquor and seemingly can’t do without it.  Dependency involves withdrawal symptoms when alcohol is not in your system.  These symptoms may include anxiety, nausea, sweating, jitteriness, shakes and even withdrawal seizures.

Alcoholism is a chronic disease.  Unfortunately, some of us start with a predisposition based on genes and strong influences based on family and cultural considerations.  It is so much more than either a lack of willpower or an inability to quit.  This disease has a predictable course and defined effects on various parts of the body, leading to specific means of death if unaddressed.  Because I’m Straight, No Chaser, I’m not going to deal with the subjective thoughts you offer about whether or not you can ‘handle your liquor’ or whether you believe ‘you can stop anytime you want’.  I’m going to give you some medical data that defines when you’re doing damage to your body.  It’s actually pretty simple.
Are you this guy or gal (keep in mind a standard drink is defined as one 12 ounce can of beer, 1 glass of wine or 1 mixed drink)?

  • Women having more than 3 drinks at one time or more than 7 drinks a week.
  • Men having more than 4 drinks at one time or more than 14 drinks a week.

If so, you’re causing damage.  We’ll get into the specifics at another time.
That’s damage.  Let’s discuss dependency.  Consider the possibility that you may be dependent on alcohol if you have any of these problems over the course of a year:

  • While you’re drinking, you can’t quit or control how much you drink.
  • You have tried to quit drinking or to cut back the amount you drink but can’t.
  • You need to drink more to get a previous effect (This is called ‘tolerance’.).
  • You have withdrawal symptoms (discussed earlier) when you stop.
  • You spend a lot of your time either drinking, recovering from drinking, or giving up other activities so you can drink.
  • You continue to drink even though it harms your relationships and causes physical problems.

So What?
No one is giving up alcohol by reading this, I’m sure.  I haven’t even touched to the harsh realities of alcoholism (yet).  Alcohol is part of the American social fabric.  We live, celebrate and commemorate milestones with it.  It’s glamorized throughout society.  It’s constitutionally approved.  I appreciate that.  In moderation, it’s a good time.  Just understand that it’s not a free ride.  The danger is in the insidious nature of this disease, meaning issues may creep up on you before you ever know what’s about to hit you.  Then we’re having a completely different conversation.
I look forward to any questions or thoughts on the topic.
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Straight, No Chaser: Your Questions about Human Bites

Medical Treatment, , , , , , , , , , , , , , , ,

dracula_bites_kim_kardashian_by_the_mind_controller-d5jh3ix
It seems that you found today’s post, well… biting.  Here’s your questions and answers about human bites:
1)   If human bites are so dangerous, why do women love Dracula so much?

  • Seriously?  Let’s just ascribe it to the neck being an erogenous zone and move on…

2)   What’s a Boxer’s Fracture?

  • A boxer’s fracture is a misnomer because boxers don’t get them.  This describes a fracture at the base of the small finger (5th metacarpal), often caused from poor form throwing a punch.  If you take one hand and move the pinky finger portion of the palm (the metacarpal bone), you’ll notice how movable it is (i.e. unstable) compared with the same efforts on the index and middle fingers at the level of the palm, which is what should deliver the blow.  A boxer’s fracture and a human bite together makes for a very bad day.

3)   Is a human’s mouth really dirtier than a goat’s mouth?

  • It’s correct to say the bacteria in a human’s mouth cause more disease.

4)   Is a bite the same as a puncture wound?

  • The difference between a puncture wound and a laceration is you can identify the bottom (base) of the wound in a laceration, and you can’t in a puncture wound.  Regarding bites: cats, snakes and the aforementioned Dracula are more likely to cause puncture wounds.  Puncture wounds may or may not be caused by a bite (e.g. knife wounds are punctures).

5)   I received a bite and didn’t get stitched up.  Why?

  • This could be for several reasons.  Puncture wounds don’t receive stitches because you don’t want to seal off the infection.  That’s a really good way to develop an abscess.
  • Sometimes we will opt for ‘delayed closure’, waiting 3-5 days to ensure no infection has occurred before placing stitches.
  • It’s really about the risk/benefit ratio.  A laceration to a face is more likely to be repaired because of the risk of disfigurement and scarring, plus the face is a relatively low infection area anyway.

6)   Why didn’t Dracula ever get Hepatitis or HIV?

  • Even though Dracula’s the undead, one would think he’d be the world’s single greatest transmitter of both HIV and the blood transmitted forms of Hepatitis.  HIV is viable for awhile in dead tissue, but it can’t multiply, which would explain why Dracula doesn’t show signs of the diseases.  On that note, I’m done.

Straight No Chaser: Human Bites

Medical Treatment, Health Prevention, , , , , , , , , , , , , , ,

tysonbite
I have had weird experiences with humans biting humans, as have most physicians. There are several different types of human bites, which can range from harmless to surgically serious, but as an emergency physician knowing the dangers of the bacteria inhabiting your mouth, I tend to assume the worst until proven otherwise. Your first Quick Tip is to do the same.
Maybe it’s where I’m located, but I tend to see way more ‘fight bites’ than anything else; these specifically refer to someone getting hit in the mouth. It’s always interesting to see the guy who ‘won’ the fight being the one who has to come in for medical treatment. He will have cut his hand on someone’s tooth and really doesn’t think much of it. He just wants the laceration sewn. Little does he realize how concentrated all of the structures (tendons, blood vessels, muscles and bones) are in the hand. He also doesn’t know that they’re confined to a very limited space, and seeding an infection in that space makes things really bad really quick. These guys are very dangerous because they tend to deny ever getting into the fight, ascribing the injury to something else (like punching a tree) – at least until I ask him why a tooth is inside his hand.
Then there’s the “Yes, I was bitten” variety, including activity where the teeth engaged the victim instead of the fist engaging a tooth. Think of the above Tyson vs. Holyfield bite as an example. Sometimes parts get bitten off (fingers, nose, ears and other unmentionables)! Children sometimes need to learn to stop biting as a behavior. Biting is sometimes seen in sexual assault, physical abuse and in self-mutilating behavior or with mentally handicapped individuals.
A third type is the ‘We love too much!’ variety. These may include hickeys (that actually break the skin), folks biting off their hangnails, and individuals who create skin infections by biting their toenails and fingernails. Yes, it happens more than you’d think.
The commonality to all of these scenarios is saliva found its way through the skin. Because of the virulence of those bacteria contained within, an infection will be forthcoming. You’ll know soon enough when the redness, warmth, tenderness and possibly pus from the wound and fever develop.
The easy recommendation to make is anytime a wound involving someone’s mouth breaks your skin, you need to be evaluated. Some wounds are much more dangerous than others. Teeth get dislodged into wounds, hand tendons get cut, bones get broken, and serious infections develop, and in fact these bites require immunization for tetanus. Bottom line: there’s no reason not to get evaluated if you develop those signs of infection I mentioned, if any injury to your hand occurs, or if any breakage of your skin has occurred. You’ll need antibiotics and wound cleaning in all probability, with a tetanus shot if you’re not up to date. If you’re unlucky, you may end up in the operating room.
So here’s your duty if you haven’t successfully avoided the bite:
1) At home, only clean the open wound by running water over the area. Avoid the home remedies, peroxide, alcohol and anything else that burns. You’re making things worse for yourself (those agents cause skin damage more than they’re ‘cleaning’ the area).
2) Apply ice – never directly to the wound, but in a towel. Use for 15 minutes off then 15 minutes on.
3) Retrieve any displaced skin tissue, place it in a bag of cold water, place that bag on ice, and bring it with you. We’ll decide if it’s salvageable.
4) Get in to be evaluated. Be forthcoming about whether or not it was a bite.

Straight, No Chaser: National Minority Organ Donor Awareness Month

Health Prevention, , , , , , ,

Organ-donor-shortage-001
August is National Minority Donor Awareness Month, which brings attention to the more than 118,000 people nationwide waiting for lifesaving organ transplants. Of the these men, women and children listed on the national organ transplant waiting list, 56% are minorities. People of most races and ethnicities in the U.S. donate in proportion to their representation in the population. Minorities are disproportionately affected by illnesses, like high blood pressure and diabetes, which can lead to end-stage renal disease and the need for dialysis or a kidney transplant.  This contributes to a disproportionately higher number of minority patients on the national organ transplant waiting list.
Here’s a representation of waiting list candidates by ethnicity:

  • Caucasians: 43.7%
  • African-Americans: 29.6%
  • Hispanics/Latinos: 18.4%
  • Asians: 6.7%
  • Native Americans and Alaska Natives: 1%
  • Native Hawaiians and other Pacific Islanders: 0.5%
  • Multiracial: 0.5%

In 2012, 11,309 minority patients received organ transplants; while there were 2,762 minority deceased donors and 1,711 minority living donors. The wait is long and, sadly, 18 people die every day because the transplant they desperately needed did not come in time.  These facts make the need for more donors from ethnic minority groups critical.  However, minority organ donation often lags due to misinformation about the need and process.
Learn The Facts (most information provided by U.S. Department of Health and Human Services)
These facts may help you better understand organ, eye, and tissue donation:

  • Fact: Regardless of age or medical history, anyone can sign up to be a donor. The transplant team will determine at an individual’s time of death whether donation is possible.
  • Fact: Most major religions in the United States support organ donation and consider donation as the final act of love and generosity toward others.
  • Fact: If you are sick or injured and admitted to a hospital, the number one priority is to save your life.  Hospitals simply are not in the business of allowing patients to die to harvest their organs.
  • Fact: When matching donor organs to recipients, the computerized matching system considers issues such as the severity of illness, blood type, time spent waiting, other important medical information, and geographic location. The recipient’s financial or celebrity status or race does not figure in.
  • Fact: An open casket funeral is usually possible for organ, eye, and tissue donors. Through the entire donation process, the body is treated with care, respect, and dignity.
  • Fact: There is no cost to donors or their families for organ or tissue donation.
  • Fact: Every state provides access to a donor registry where its residents can indicate their donation decision.
  • Fact: Federal law prohibits buying and selling organs in the U.S. Violators are punishable by prison sentences and fines.
  • Fact: People can recover from comas, but not brain death. Coma and brain death are not the same. Brain death is final.

In order to sign up to be on the donor registry, or to receive more information, visit http://organdonor.gov/becomingdonor/stateregistries.html.
Meet the challenge.  Address the need.

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