Tag Archives: health

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

September 22, 2016General Health and Wellness, Pediatrics/Kids Health, Health PreventionBaby, Behind the Curtain, breastfeed, Breastfeeding, Children, Clothing, Family, Gastroesophageal reflux disease, health, Home, Infant, ShoppingJeffrey Sterling, MD

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:

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.
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.
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.
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.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cerebrovascular System (Your Brain)

September 9, 2016General Health and Wellness, Mental Health, Neurology, Health Prevention844-SMA-TALK, Behind the Curtain, Blood vessel, Brain, Cerebrovascular disease, Conditions and Diseases, health, Neurological Disorders, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, Transient ischemic attackJeffrey Sterling, MD

Last but not least, in the first part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.

Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Genital System

September 7, 2016General Health and Wellness, Genital/Urinary, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, health, Human sexual activity, K-Y Jelly, Masturbation, Sex education, Sex organ, Sexual intercourse, Sexuality, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

The third part of this series is about your genital system after 40. There’s a lot here both for the ladies and the gentlemen, but everyone should want to know all the information provided. As before, I’m going to go through changes – challenges – solutions. I welcome any questions or comments.
Prologue: Sex is good for your long-term genital and mental health. I can’t think of a better, more sexy application of the truism ‘knowledge is power’. Men, feel free to discuss this with your ladies. Ladies, I promise you I’m not being biased here (wink).
Changes: Allow me to start with the most important point: sexuality is not truly an issue of aging as much as it is more an issue of education, psychological response and health. However some changes specific to the genital system do occur with aging. In men, the prostate may enlarge (does so in 50% of men at age 50), potentially causing frequent and urgent needs to urinate and difficultly holding urine. However, more changes occur in women than in men. In women, the uterus shrinks, and several changes occur in the vagina, resulting in decreased lubrication and elasticity being lost.

Challenges: The challenges here are interesting ones. Simple rules to better genital health – Women: Stay sexually active! Men: Be confident in your sexual stamina! It is important to understand that the changes that occur in the genital system are not as related to age as they are to one’s sense of sexuality. The physical changes in the genital system should be non-problematic, especially if sex has been occurring without long periods of abstinence.
Venus Challenges: On the female side, the physical changes all can be dealt with if the woman has maintained some regular level of sexual activity. Yes, genital responses to stimulation slow gradually in both men and women, but you can have normal sexual relations at any age, as long as you are healthy. If after the age of about 40, a woman abstains from intercourse for prolonged periods (such as 3 to 5 years) the ability to secrete lubricating fluids, and much of the elasticity of the vagina are permanently lost.
Mars Challenges: On the male side, a particularly annoying challenge for some men with prostate enlargement is to avoid self-wetting. The even greater challenge is (not believing, but) ‘knowing’ your sexual prowess and stamina are still intact, particularly if dealing with an intimidating female partner (e.g. better conditioned, more adventurous or perhaps younger). For males, premature ejaculation and impotence are dramatically reduced in men when they become legitimately confident in their sexual skills set. Work on that! Women, feed your men confidence! It will come back to you!
Venus Solutions: Masturbation can effectively help to maintain female capabilities to provide lubrication and elasticity, especially if object insertion is included. Since most research shows that less than 50% of women practice object insertion during masturbation, these women who also abstain from intercourse lose some vaginal elasticity, even with regular masturbation. In the event that the woman has been sexually abstinent for a period of 3 to 5 years or more, the use of K-Y Jelly or some other non-alcoholic, non-petroleum lubricant specifically designed for compatibility with the chemistry of the vagina may sufficiently reduce discomfort in sexual intercourse.
Mars Solutions: Remember that most sexual problems are social/psychological problems, and they occur at all ages. Men: work on learning what’s necessary to give you confidence, and better performance will follow. For some it’s a certain partner, for others it’s a pill. Do not underestimate this point: if you’re otherwise healthy, that enhances your ability to perform sexually! It’s all about blood flow anyway.
Solutions Epilogue: The main solution to age-related issues of the genitalia are all within your reach (no pun intended): it’s all about activity, especially continued regular sexual activity, exercise, good nutrition and other healthy habits.
Post-script: Petroleum products such as baby oil and vaseline must never be put in or on the vagina, as they will upset the pH balance of the vagina, making it susceptible to yeast infections and other problems like BV (bacterial vaginosis).
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Musculoskeletal System

September 6, 2016General Health and Wellness, Health Prevention, Musculoskeletal System844-SMA-TALK, Adipose tissue, Behind the Curtain, Fitness, health, Muscle, Myocyte, Physical exercise, Skeletal striated muscle, Stem cell, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Weight lossJeffrey Sterling, MD

The second part of this series on how your body changes with age is about your muscles. This section combined with the previous skin section explains why you wrinkle. As before, I’m going to go through system – changes – challenges – solutions. If you’re keeping score, especially focus on the take home messages within solutions. I welcome any questions or comments.
Changes: Did you know that muscle cells are unable to replace themselves once they are formed? Therefore, muscle cell loss is permanent. Plus, muscular response gradually slows with age. That said, the loss of muscular capabilities over time is by far the result of cell loss due to inactivity. As muscle cells are lost, weakness and slowness increase. Plus, some of you don’t exercise at all, or as much/vigorously as you used to, so you’re not building up anything new.
Challenges: The effects of these changes on our health status are mostly due to the fact that the muscles are the main tools for effecting strong circulation throughout the body (i.e. muscular contraction pushes blood around). As the muscles become smaller, including the muscles in the face, and as fat tissue accumulates, including in the face, the entire appearance changes to that of an older person, with all the ramifications described in the post on the description of skin changes with aging. In addition, as muscle fibers decrease, weaken, and slow, it becomes increasingly difficult to keep up with younger people, who may make allowances, but who may also become avoidant. Your recognition of this creates a vicious cycle, and you eventually settle into ‘being old’.

Solutions: In two words – exercise & activity. A well designed, consistently followed exercise program addressing both strength and response is indispensable for the maintenance of muscle cells, and of good health over time. A personal trainer is a pretty good idea after a certain age. You neither need to under nor overdo your weight lifting regimen. In any event, move those muscles as much as you can, whether via walking, yoga, running or sex. Being a couch potato is never a good thing.
Post-scripts:

Another thing that very few of us do is stretch. Those old muscles are tight, and the tendons/ligaments are short and ready to pop. You really must stretch before your weekend warrior events or most any big exertional activity. That’s a big part of why yoga promotes longevity.
Fortunately, the main muscles of the heart and the diaphragm (your breathing muscle) do not lose muscle fibers with age because they are continually active. Yet, your heart and lungs have their own problems besides the muscles. That topic is forthcoming. All that said, be mindful that through ongoing exercise and training, you can stem the tide on these changes.

Young is as young does.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Life Begins (to End) at 40 (Unless It Doesn’t) – The Skin

September 5, 2016General Health and Wellness, Skin/Dermatology, Health Prevention844-SMA-TALK, Beauty, Behind the Curtain, Cosmetics, health, Herpes zoster, Human skin, Skin, Skin Care, Skin neoplasm, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

We have a natural inclination to think about our mortality as we approach and pass 40 years old. A big part of healthy aging is prior healthy living, particularly as you reach the age at which your unhealthy habits begin to catch up with you or otherwise naturally aging processes begin to demonstrate themselves emphatically. Being on the other side of 40 is an exercise in self-reflection and understanding of limitations previously not existent. I’m still pushing the rock up the mountain, but I’ve seen the challenges of maintaining and continuing to advance. This is a lot to digest, so I’m going to go through five different body systems this week in a simple way: system – changes – challenges – solutions. If you’re keeping score, especially focus on the take home messages within solutions. And don’t be depressed! Forewarned is forearmed. Take action! I welcome any questions or comments.

Part 1/5: Your Skin

Changes: As the skin ages, blood flow to the skin is decreased, and nerve endings are lost or become less sensitive. As a result, the skin loses some of its effectiveness as a protector against bacteria, as an insulator, as a heat/cold regulator, and as a sensory receptor. These losses cause wrinkling, loss of elasticity, freedom of movement, and expression are inhibited. The slowing of circulation results in slower healing. The loss of color is also seen, as the hair becomes gray.
Challenges: The skin generally functions well throughout life though, and most changes in the skin due to aging are not life threatening. Most of the damaging changes in the skin are cosmetic. The drying and thinning result in sagging and wrinkling, the hair becomes sparser and gray or white, and the fingernails become rigid, tend to yellow, and are prone to splitting. Skin disorders more common in the aging skin include enhanced itching, thickening in patches, skin cancer, ulcers/pressure sores, and herpes zoster (shingles). These effects bring social implications based on a significant cultural tendency toward ageism. One’s social life becomes more limited as younger people view elders as “not fun”, “slow”, “grumpy”, less desirable as friends and sexual partners, and so on. These views spill into the workplace or what might be a potential workplace, as one who looks “old” is not considered as having ‘much’ to offer.
Solutions: Two words: hydrate and moisturize. Avoid excessive exposure to the sun, maintain moisture in the skin, provide adequate nutrition so that the skin can be maintained and repaired, and get regular exercise to maintain circulation in the skin. Sounds simple, but we really fail to adhere to this consideration. Many of these changes can be delayed for very long periods of time.
Post-Script: I would be remiss if I didn’t point out that those of you of all races and ethnicities must be diligent in getting rapidly growing or changing moles evaluated. It is an untruth that Blacks and Browns don’t get skin cancer.
Post-Post-Script: Ever imagine what effect holding a cigarette up to your face for decades has? Here’s a depiction.

Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Suicide and Suicide Risks in College Students

August 31, 2016General Health and Wellness, Mental Health844-SMA-TALK, Behind the Curtain, Bipolar disorder, Death, Disorders, Gia Allemand, health, List of causes of death by rate, Major depressive disorder, mental-health, Molecular Psychiatry, Religion, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Suicidal ideation, Suicide, Suicide preventionJeffrey Sterling, MD

I just had the privilege of spending time at my alma mater addressing issues on behalf of students and mental health services. Among many other things discussed, I was shocked by the extent to which college suicides have become present on college campuses. I wonder when things changed. Isn’t college supposed to be the “best four years of your life?” It really doesn’t take much though to appreciate how this becomes the case.

Suicide is the second leading cause of death among college-age students in the United States and the third leading cause among those aged 15-24. There are approximately 1,100 deaths by suicide occurring in this age group each year. A recent study from Johns Hopkins and the University of Maryland went in-depth in surveying and analyzing why students may have thoughts on suicide. Here is a summary of some of the study’s findings:

12% of those studied admitted that they had thought of committing suicide.
Of this group of 12%, approximately 25% of them said they had those thoughts repeatedly.
Depression and lack of social support appeared to be major factors contributing to thoughts of suicide.

If you actually think about it, college brings together a lot of risks for suicide.

Late adolescence and early adulthood represents the period of highest risk of developing a major psychiatric disorder.
The academic environment can be a stress-producing inferno for some, who may find themselves overwhelmed and feeling lost and as if they have nowhere to turn.
For many, the college experience represents the first time many are away from home and/or completely detached from the family and friends they’ve had their entire lives. Unless and until a sufficient new social network is established, levels of isolation can be overwhelming.
Even among those with social networks, the academic failure and any social rejection that may occur could be perceived by students as having life-long consequences, so much so that hopelessness and thoughts of suicide could set into a young adult’s mind.

Practically, how might you consider the risk in any one individual? The presence of any of these risk factors should prompt implementation of a support system to counter feelings of suicide.

It shouldn’t be difficult to appreciate how the lack of social support is one of the most powerful predictors of persistent suicidal thoughts. Someone who expresses or has feelings of being unappreciated, unloved and uninvolved with family and friends should be considered at risk – even in the absence of any other risk factors.
A history of clinically diagnosed depression or other psychiatric diagnoses
The exposure to domestic violence (either witnessing or having been abused) in childhood
Having a mother with a history of clinical depression

There are many Straight, No Chaser posts that address suicide prevention, diagnosis and treatment. Feel free to use the search box on the right for additional information.If you are a college student or a family member of a college student, you would do well to review your college’s support system and learn about services and support available for those in need of mental/behavioral health services. College should represent the beginning of one’s adult life, not the place where it ends.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Quick Workouts for the Couch Potato

August 30, 2016General Health and Wellness844-SMA-TALK, Behind the Curtain, exercise, health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Warning: This post includes adorable animal exercise pictures.

Hey you! Yes, you: the ones about to enjoying the return of the NFL; the ones who have spent the last 3 months on the couch. Let’s turn your couch time into something (relatively) healthy. Now, if you’re reading this, you may be asking “How can anything about being a couch potato be healthy?” Actually it’s not, so if you’re committed to being a couch implant, good luck with that, and I’ll see you in the ER down the road. However, if you are simply spending time on the couch, and you may be interested in multitasking, this read’s for you.

I think I figured this out about 20 years ago. TV commercials are usually very annoying. In many instances, they are a waste of time and just beg you to do something else. Why not get in a workout? That’s right, in our ongoing effort to get you to move, we point your attention to the three minutes between the scenes of your favorite shows. Do something for your benefit (and I don’t mean go grab a beer and chips).

Here is a quick list of activities and exercises that you can do during commercial breaks. Mix and match these into a routine that suits your purposes. If it’s too much for you, consider turning off the TV and reading a book! Of course, be sure you’re healthy enough to engage in exercise before starting any regimen.

Push ups: Drop and do 10 push ups or 10 sit ups for every commercial. Once you’ve done it, break until the commercial starts. Or…
Jumping jacks: After your push ups, do jumping jacks until the start of the next commercial, then go back to the push ups.
Stairs: Rush up and down a flight of stairs.
Knee lifts: You don’t have stairs? Practice knee lifts during the commercials. Stand up and alternate bringing your right elbow down to meet your left knee and switch. Build up to doing this for the length of a commercial.

Windmills: Extend your arms to the side and make circular motions from your shoulders. See if you can build up to doing this for an entire commercial.
Punches: Place your arms in front of you and simulate using a punching bag.

Couch/armchair stands: Sit on the edge of the couch or chair with your feet shoulder-width apart. Fold your arms across your chest or leave them hanging at the side if you need to for balance. Stand while pressing into the floor with your feet, tensing your butt muscles as you rise. Keep your back straight and your abdominal muscles tight. Hold the position for a five count, then slowly lower yourself. Before you touch the couch, stand up again. Build your endurance with this; you should be able to go for a full commercial. These couch/armchair stands will help develop the buttocks and the front portion of your thighs.

Chair dips: Start by sitting on the edge of your couch or chair. Place your hands on either side of you. Move your feet and slide out so that your butt is off the couch, and bend your knees to a 90-degree angle. Bend your elbows so they are pointing behind you. Lower yourself as far as comfortable. Hold the position for a three to five count (build up to five), then slowly press up again. Repeat as you can; build up your stamina. Try to do these for an entire commercial. Armchair dips are great for the backs of your arms.

Leg-up Couch Crunches: Want a quick abdominal workout? While on your couch (or floor if the couch is too soft), lie on your back with your knees bent. Lift your feet up on one end, and keep your hands behind your head. Pressing your lower back into the couch, slowly lift your head, shoulders and upper back off the couch. Hold for a three to five count (build up to five), then slowly lower. Repeat, building up to the length of a commercial.

Don’t forget to work some stretching into your routine!

And if your team doesn’t win, don’t be angry. Just meditate the disappointment away…

I would be remiss if I didn’t point out how important it is for you to avoid to habitual consumption of empty calories that typically occurs during idle TV watching. Remember, your diet is actually about 75% of your issue. Stop poisoning yourself by what you eat!

Feel free to ask any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Toxin and Detoxification Series Summary

August 25, 2016Medical Treatment, Health Prevention844-SMA-TALK, Behind the Curtain, Defecation, Detoxification, health, Intestine, Normal number, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Toxin, Weight lossJeffrey Sterling, MD

I want to thank you for all the positive responses to the series of posts on toxins and detoxification. You have shared many personal stories and asked many great questions. I guess I’ll continue to accept your being shy (especially on these topics) about asking personal questions publicly, but keep contacting me here. To that end, I’ll summarize by sharing some of your thoughts and making a few final comments.
You can’t escape toxins, but you can pretty easily reduce your exposure to them. For the things you can control, “everything in moderation” is a pretty good rule of thumb for most, except for cigarette smoke into your lungs. That just needs to stop.
Your body does a great job of detoxification through the lungs, kidneys, liver, intestines and skin. This process is retarded by age and the effects of toxins on these systems.
There are a lot of fad diets and questionable methods of detoxifying. Most have risks that should make you cautious. None are more effective than tuning your body to do its best work. Furthermore, these methods are invariably more effective in the short-term than the long-term.
Now, to some of your questions.
1. So are you saying bowel movements are good enough to detox the intestines?
Until and unless your bad habits catch up with you, yes. Consider the ways the large intestines (the colon) handle toxins.

If healthy, the colon sheds old cells about every three days, preventing a buildup of harmful material. It regenerates new healthy cells in their place. It’s lining includes mucus membranes that can keep toxic substances from reentering the blood and tissues.
You have “natural” bacteria that reside in the colon. They actually detoxify food wastes for you. (One of the potential issues of colon cleansing is the removal of these bacteria.)
The liver’s main function is to neutralize toxins.
Your bowel movements remove waste and toxins from you. Although the number of bowel movements vary between individuals, your body (if healthy) is able to regulate when you defecate based on your needs.
Increasing the number of bowel movements doesn’t improve weight loss. That’s because the body absorbs most calories before they reach the large intestine.

Nothing in a colonic or juice fast will match this level of effectiveness. Spend your efforts keeping your body healthy. Increase your fiber, water, fruit and vegetable intake. Lower or eliminate the intake of red meat, cigarettes and alcohol. There’s your detox program all day long.
2. So what’s the verdict on the detox diets and colon cleansing?
Consult with your physician. I’d imagine that using the diets as a starting point for lifestyle changes would be endorsed. I’d doubt that any fad diet would be endorsed.
3. You said tap water is no longer good? Should I exclusively drink bottled water?
Actually filtered water is even better.
4. Are you suggesting I stop wearing makeup?
You’re beautiful just the way you are.
5. Have you ever had a colonic?
Yes, and it made me feel dirty. (Was that serious, or a joke?)
6. I’d never do that.
Actually, you will. (Well, almost.) Many men over 50 will have a colonoscopy to evaluate for the possibility of colon cancer at some point. If and when you get that, you’ll get your colon cleanse solution one to two days before the procedure and maybe an enema in addition. At least you’ll be under the care of a physician, and you’ll get a sedative first!
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Natural Colon Cleansing (Colonics) as a Means of Detox

August 24, 2016Medical Treatment, Toxicology/Drugs, Health Prevention844-SMA-TALK, Behind the Curtain, Colon, Colon cleansing, Detoxification, Food and Drug Administration, health, Intestine, Irrigation, Medical procedure, medicine, SterlingMedicalAdvice.com, Straight No Chaser, ToxinJeffrey Sterling, MD

C’mon. Be honest. You knew we’d end up here (no pun intended). Isn’t colonic cleansing one of those things that makes you wonder who the Greek guy was who first thought of this centuries ago? Perhaps even more interesting would be talking to the first guy who volunteered for this … I promise to (try to) do (most of) the rest of this post with a straight (no chaser) face.
What Is It? Colon cleansing is done primarily via two methods.

You can take supplements by mouth that will stimulate expulsion of the contents of your intestines.
You can have a tube inserted through your rectum to irrigate your intestines.

Why Do It? Allow me to set the table by explaining the premise for colonic cleansing. It’s actually a pretty simple and linear train of thought.

You have toxins in your intestines from undigested food.
Over time, those toxins can get reabsorbed back into your blood and cause damage to your organs (as previously discussed here).
You’d like to get rid of the toxins by flushing and irrigating them out of your system.

Proponents of colonic cleansing claim potential benefits such as weight loss, improved immunity and mental outlook and reduction of the risk of colon cancer.
The Methods
Oral colon cleansing (through supplements, oral laxatives, or enzymes) and colonic irrigation (through inserting of a tube) are variations of the same theme. Oral cleansing stimulates massive contractions of your intestines with subsequent massive bowel movements. (Think of the effects of Draino – and please don’t try taking any Draino and say I told you to; it’s just an analogy.)
Colonic cleansing involves placement of a tube through the rectum into the colon and irrigating the colon with several gallons of the chosen solution (sometimes including herbs, enzymes, caffeine or probiotics) until the contents are clear, suggesting the stool has been removed (like a high power wash or enema – again please don’t do that at home…).
At the end of either process, all we can say for sure is that you will have a lot less stool in your intestines.
The Risks
I love the phrases “Natural doesn’t necessarily mean safe” and “Safe doesn’t necessarily mean effective.” They especially come to mind when I see the phrase “natural colon cleansing.” Colonic cleanses, even if effective, are risky. Keep in mind the following.

The U.S. Food and Drug Administration (FDA) does not regulate these colonic procedures. Don’t ask me why, but that means that nothing about the procedure has been quality checked in the same way medicines and medical procedures have to be. To be fair, there is a massive case history of these procedures being done safely in the overwhelming number of cases.
If you decided to get a colonic, you may be receiving one from someone who’s not licensed, depending on the state or country. I can’t believe I’m saying this, but ask to see credentials before you allow someone to give you a colonic … and please speak with your primary care physician about options.
Consider the fact that this is a medical procedure. Even in the hands of the best therapists, things go wrong. If and when something happens, will the therapist be able to address the issue? Ask your therapist what will happen if you have an allergic reaction to any solutions being used.
Other risks include dehydration and electrolyte imbalance, infection, rupture of the intestines and depletion of probiotics. (You may recall that in my previous post that I discussed that the intestines have toxin-repellent mechanisms already in place. Probiotics are part of that internal process.)

You should not be undergoing colonics without your physician’s approval under any circumstance and not even then if you suffer from any of the following:

Any lower digestive tract tumor (cancer)
Any recent surgery, especially of the intestines
Specific digestive tract conditions, such as Crohn’s disease, ulcerative colitis, diverticulosis or diverticulitis
Bad hemorrhoids (as opposed to the good ones)
Significant heart, lung or kidney disease (You will be receiving a medical procedure in a place not equipped to deal with emergencies should one occur, and no one can tell you that one won’t happen while you’re on the business end of a rectal tube.)

Does it work?
I can make the following comments with complete confidence and no equivocation.

There has been very little medical research on the benefit of colonic cleansing. Therefore, any global claims of benefit, include those listed above, are unjustified when placed against the standard by which the medical community judges these things. It is very unlikely that will ever change, as I don’t exactly foresee a sufficient number of research subjects lining up (or backing up) for a randomized, double-blinded study anytime soon … That’s not to say it doesn’t work, and there is a theoretical basis for why it would work. It’s just that sufficient medical evidence that it works hasn’t been put forth.
I know individuals (and not just the colonic hydrotherapists/hygienists who are obviously incentivized to promote the procedure) who swear they feel better getting this done. Of course, this could be attributable to a placebo effect. Alternatively, here’s something that proponents of colonics don’t seem to discuss that is quite reasonable. There are specific medical ailments related to the nervous system (which has several trigger points in the intestines) that are improved by relieving constipation; clearly colonics do that. Perhaps proponents don’t want to see the procedure reduced to a complex way to provide an enema.
I know there are natural methods of cleansing that are at least as effective as colonics. I’ve discussed these here.

So what does all this mean? Given the last bullet point above, the issue can be addressed with either of two analogies.

If you wash a car that already has rust on it, you aren’t really fixing anything.
If you repair a car that still functions as new, you aren’t really improving anything. I’m all for maintenance, but when you’re discussing the body, if you take care of it, it sustains itself rather well.

In my “toxin summary post” tomorrow, I will answer your questions on the entire toxin and detoxification series and add a few final thoughts.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: A Look at Detox Diets

August 23, 2016Medical Treatment, Toxicology/Drugs, Health Prevention844-SMA-TALK, Behind the Curtain, Detoxification, Detoxification (alternative medicine), Diet, Disease, health, Master Cleanse, Shopping, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Support Groups, Toxin, Weight lossJeffrey Sterling, MD

Everyone who talks to me about detox is motivated and sincere about making an improvement in his or her health. Therefore, it’s important that they be shown respect and encouraged. However, some of these same individuals exhibit a level of desperation that is counterproductive and leaves them subject to fads and scams that are doomed to long-term failure. The first question I ask is “Are you trying to improve your health or weight?” These are often separate considerations. Of course, I’m hoping they answer, “Both.” Interestingly, that happens less often than you might think. Next, I’ll ask if they’re engaged in some basic, fundamental activity (click here), which is rarely the case. Once people discover the latest, greatest thing, they tend to lock in on it and just have to go for it. So be it.

So… today and tomorrow, I’m going to discuss two very common “quick-fix” approaches to detoxification. Let’s start with the “detox diet.” For the purposes of this discussion, all detox diets are variations of the same theme. I hope this doesn’t disappoint you or come off as dismissive, but the point of the matter is that from a medical standpoint, these actions are reducible to a set of physiologic actions that either produce biological effects or don’t. Giving a car a new coat of paint doesn’t make it an airplane. Similarly, taking a quick detox diet doesn’t make you healthy if you return to the same conditions that produced your pathology in the first place. Folks, it really should occur to you that given the rates of obesity and disease that exist, if these diets really worked, the pharmaceutical and medical communities would be all over them because of their potential for profit (and of course the potential for good…). Here’s what detox diets do and don’t accomplish.

The Premise: Going on a diet for a few weeks can clear your body of toxins, which will improve your health.
The Short Term Effects: Proponents of detox diets often claim or note the following during the diet:

Weight loss
More energy
Better mental focus

The Long Term Effects: Proponents of detox diets often make the following claims about the benefits of the diets:

Health promotion
Prevention of new diseases
Cure of chronic diseases

What’s Really Happening: Have you ever heard that correlation is not causation? If you engage in any activity involving backing away from fats, drinking more water, taking in less sugar and processed food, eliminating alcohol and caffeine, and taking in more fruits and vegetables, you’ll feel better! In fact, I’m all for it. Refer to this blog post where I give you details on how to naturally, healthily and sustainably do this.
Now, here’s the question. Is your detox diet just a two to four-week “challenge,” or is it the launching pad for a set of lifestyle changes? The problem is that people use these diets with their better principles, but they usually don’t sustain them. In fact, the diets themselves generally are not sustainable because they’re too restrictive. If you tried sustaining some of these diets, you’d end up hospitalized. You’re much better off applying fundamental principles that will slowly and steadily improve your health and also help you lose weight. By the way, those long-term claims have been roundly and routinely debunked by the medical community, which has every incentive to want to discover new ways to treat disease.
Precautions and Risks

Before starting any diet, you need to discuss what you’re trying to accomplish with your physician. I’d venture a bet that most would not approve one of these diets, especially if you suffer from any chronic illness, especially diabetes, mental illness, moderate to severe (and poorly controlled) high blood pressure or cardiac disease. They also won’t approve it if you’re pregnant or at the extremes of age.
Based on the components of these diets, you are introducing certain specific risks. These include vomiting, diarrhea and dehydration, electrolyte loss and imbalance and disruption of the function of your digestive system.

Let’s finish with two pointed questions and answers.
1. Should I go on a detox diet? I encourage almost any activity that motivates you to improve your health and has been shown to improve your health. If you want to naturally detox, apply these principals as the basis for a lifestyle change. As your body recovers, your natural detoxification system will take over and do just fine (assuming you are otherwise healthy).
2. I quick-flush my system with a diet every few months. Is this healthy? It depends on what you’re doing as a “quick-flush” and even more so, what you’re doing in-between. Focus on enhancing your natural detoxification system. I can’t say that a one-time or intermittent initiative to kick things off would be a terrible thing — if you stay with the program. In the best case scenario, it’s like going to get a dental cleaning every six months. You’ll still have decaying teeth and disease if that’s the only thing you’re doing. On the other hand, if you’re brushing and flossing every day, then the six-month check up is quick (and in this case, maybe superfluous). I’m much more concerned with you sustaining a healthy approach toward the desired goal.
Next up, and the last in this series on detoxification will be a look at colonics. Until then, bottoms up!
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Our World is Filled with Toxins

August 22, 2016Toxicology/Drugs, Health Prevention844-SMA-TALK, Behind the Curtain, Detoxification, Drinking water, Erin Brockovich, Government, health, High-fructose corn syrup, Kidney, Liver, Lung, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, ToxinJeffrey Sterling, MD

You can’t escape all toxins, but you can certainly minimize your exposure to them. A handy way to classify them involves reminding you of the organ systems that help us detoxify and how, over time, toxins fight and sometimes win the battle against our defenses. In the interest of space, I’m going to give you the names of several chemicals that you may want to know about and should be wary of using, without giving you details on their individual effects. If you have questions about any of them specifically, call me at 1-844-SMA-TALK.
Lungs
The toxins: We are fighting what we breathe and inhale. Air pollution includes levels of carbon monoxide and methane. Exhaust fumes, factory emissions, first and second-hand smoke all contain substances damaging to our lungs. Did someone mention cigarettes? Tobacco smoke has been fascinating to me. The idea that we would introduce smoke into the very area we use to deliver oxygen to our entire body is one of the most curious actions of humans. Look at this diagram of the toxins found in cigarettes.

The effects: The lungs are impressively effective at handling toxins up to a certain point and up to a certain age (approximately 35 years old). At that point what had been reversible airway damage begins to not only change the structure of lung tissue, but it results in lung tissue loss that does not get repaired. It’s as if when you run your hands through your hair, you discover that you’re pulling out large clumps of it. Of course, the problem is that this isn’t your hair, but the lung tissue that you need to breathe. The list of diseases contributed to, exacerbated by or caused by toxins is long, including COPD (emphysema, chronic bronchitis), asthma exacerbations, asbestosis and lung cancer.
Skin:
The toxins: Do you trust your skin products – you know, mascara, styling gel, tanning oil, soaps and body washes, shampoos, hair sprays, shaving creams, cologne and lotions, just to name a few? Toxic chemicals you’re commonly absorbing through your skin include propylene glycol, parabens, glycerin, triethanolamine and sodium lauryl sulfate.
The effects: You thought acne and the occasional allergic reaction were bad? This group’s collective effects includes respiratory, immune system and skin toxicants and known throat carcinogens. I’d suggest you become more conscious of what you’re using and seek organic options when available.
Kidneys
The toxins: The water we drink seems to get worse with time. Does anyone remember when tap water was “just fine?” Now our drinking water is liable to contain ammonia, chlorine, bleach and other toxic substances. An entire movie (Erin Brockovich) was made over the issue of toxins in drinking water. You may recall that the kidneys bear the burden of the actual elimination of urine. They need to maintain excellent health to perform this function.
The effects: The consequences of the kidney’s inability to perform can be so dramatic that dialysis (which is basically manual, external filtering of your blood once the kidneys go into failure) becomes necessary. Prior to that, toxins “gumming up” the kidneys can be left free to create havoc in other parts of the body.
Gastrointestinal system (particularly your liver and intestines)
The toxins: The food you eat is toxic. To be clear, usually I’m asking you to eat healthily. Today, that’s still true, but it’s not the only issue. I’m pointing out that your food contains actual toxins, including food additives and dyes, pesticides on your non-organic fruits, aspartame, MSG, hormones, high fructose corn syrup, sugar, mercury, bisphenols, and alcohol. Did someone mention alcohol? Alcohol is directly toxic to the liver.
The effects: I’m just going to focus on the alcohol. Alcohol produces conditions known as fatty liver, alcoholic hepatitis and cirrhosis. Chronic, excessive alcohol use is the single most important cause of illness and death from liver disease in the U.S. Moderation or abstention is the order of the day, my friends. Liver transplants are very hard to come by.
The purpose of this is not to paralyze you into inactivity but to stimulate you into action. Between now and tomorrow, when you read the fourth post in this toxins series, I’d suggest you review this post about natural detoxification. Compare that to some of the other options I’ll be discussing later. I’d recommend an ounce of prevention.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Quick Tips to Detoxify Yourself Naturally

August 21, 2016Detoxification, General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Blood pressure, Cranberry juice, Detoxification, health, Hypertension, Kidney, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Texas, Toxin, Urinary tract infection, Water supply network, Weight lossJeffrey Sterling, MD

Here are 3-4 Quick Tips for each of the organs involved in naturally detoxifying you; I’ve limited what I’m giving you to do in the effort to make this manageable for you. I don’t think you’ll find anything here beyond your ability to implement into your routine. If you incorporate the items listed below, you’ll be well on your way to a healthier life.
Quick tips to naturally detox your skin:

Diet: think fruits and vegetables, and cut back on refined sugar.
Sweat: You know I prefer you exercise, but if you’re healthy enough, the sauna works too. Or you can just move to Texas in the summer.
Exfoliation is a beautiful thing. There are dozens of ways to do it. Find one that works for you.
Hydrate and moisturize. You spend too much time in the sun and lose too much water from your skin not to replenish (You get a bonus tip because your skin is such an important detox organ.).

Quick tips to naturally detox your lungs:

Avoid inhaling cigarette and cigar smoke. Duh.
Exercise makes your respiratory machinery more effective and efficient. Go for it.
Learn to deep breathe. Take it in from your belly. Learn to breathe slowly and deeply. Yoga is a great complement to this.

Quick tips to naturally detox your kidneys:

It’s all about fluids. Remember that your body is over 60% water, and you have to stay hydrated and keep flushing. I’ve discussed this previously but remember to get in at least 64 ounces of fluids a day.
Learn about cranberries. Many of those urinary tract infections are successfully addressed by drinking cranberry juice.
Remember that diabetes and high blood pressure are the most common causes of kidney disease. You want to detox your kidneys? Control your blood pressure and avoid/control diabetes.

Quick Tips to naturally detox your liver and intestines:

Increase your water intake. Water makes your entire body function better but also softens your stools, facilitating transport.
Increase your fiber intake. Fiber bulks your stools and makes it easier to expel.
Decrease your alcohol intake. As everyone knows, alcohol will sufficiently damage your kidneys to the point where your body will be unable to eliminate many toxins. Liver disease is a very unpleasant experience and way to die.

It bears repeating: if all of this sound fundamental, it’s because it is. You have the ability to help yourself if you consistently apply basic health and wellness principles. You can do this.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Natural Methods of Detoxification

August 19, 2016Detoxification, General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Body, Colon cleansing, Detoxification, Detoxification (alternative medicine), Diet, Disease, Government, health, Human gastrointestinal tract, Intestine, Kidney, Liver, Master Cleanse, Shopping, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Support Groups, Texas, Toxin, Weight lossJeffrey Sterling, MD

It seems that at least once a week I get asked to comment on colonics, detox diets, juice fasts, etc. It seems to me that these are all rather extreme places to start. How about we just talk about the threats that exist, how to avoid them, how to understand the natural detoxification process and how to optimize it?
On some level, our body is at constant war with our surroundings. We are finely tuned machines (until we’re not). We are well designed and equipped to filter the air we breathe and the food we eat, and to repel external poisons from penetrating our bodies. That’s a very good thing, because toxins are everywhere. We eat and drink them. We inhale, absorb and ingest them. Usually we do these things unwittingly, but for various reasons, a good number of us do these things intentionally. By definition, toxins have harmful effects on our bodies. Buildups of these substances can cause damage and eventually death.
In the first part of this five-part review of toxins and how they affect us, I want to point out how the body is equipped to combat and eliminate toxins – until and unless we poison it. In the second part, I’ll offer Quick Tips to enhance your ability to naturally detoxify. In the third part, I’ll discuss what and where the toxins are that we must combat. In the fourth and fifth parts, I’ll discuss some of the exotic (or should that be esoteric?) methods promoted to detoxify the body.
Let’s start not by talking about toxins, but by discussing how the body protects you. There are four areas in particular to review: the skin, the lungs, the kidneys and the gastrointestinal tract (particularly your liver and intestines).
Skin: The skin is actually the body’s largest organ, and it’s the largest organ of elimination. It is in constant contact with the environment and is our primary barrier against disease, keeping out microorganisms, dusts, pollens and other substances with no good intentions. The constant battle leaves your skin’s pores clogged, subject to infection, lacerations, and premature aging.
Lungs: The lungs are the vessels of life, bringing oxygen into the body to supply the needs of all your organs and systems. However, have you looked at the atmosphere lately? Smog’s everywhere, not to mention allergens and cigarette and cigar smoke. If the air you’re breathing is poisoning the lungs themselves, your ability to keep poisons out of you and exhale away carbon dioxide incrementally become diminished to disastrous effect.
Kidneys: Your kidneys are one of the two primary ways you visibly eliminate waste. Consider them the blood’s strainer. You really should learn to watch your urine. It tells a story about your health. If your urine is not clear to light yellow, something’s going on. If you come to me with cloudy, straw-colored, bloody, pink, or brown urine, those all tell me about different medical conditions you could be experiencing.
Your liver and intestines: Now we’re looking at your stools. Consider that if you were ideally healthy, you’d have a bowel movement with the same frequency with which you ate. At the other end of the spectrum (no pun intended), you could be constipated, or your bowels could be obstructed. You have bacteria that live in your intestines that also help naturally detoxify wastes, but that only works as intended if you continue to have stools. The more contact time your body’s intended waste has with your intestinal tract, the more of it that will be absorbed. Fortunately, the intestines have additional barriers in its membranes that fight against toxins reentering the body. Your liver serves a vital function in detoxifying many directly poisonous substances. It uses its natural chemicals to facilitate excretion of toxins by the kidneys.
Most everything you think you know about extrinsic supplemental ways to detoxify are poor substitutes for what a healthy body will achieve. If you focused on your health and fitness, you could rest assured that your body would protect you, and you could also save a ton of money avoiding all those fad diets and other ‘previously secret’ methods of detoxification.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Contact Dermatitis, Diaper Rash, Poison Ivy and the Like

August 6, 2016Skin/Dermatology, Health Prevention844-SMA-TALK, Allergic contact dermatitis, Allergy, Atopic dermatitis, Behind the Curtain, Citrus, Contact dermatitis, Dermatitis, health, Irritation, Latex, Rash, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Urushiol-induced contact dermatitisJeffrey Sterling, MD

Let’s pick up where we left off. In our discussion of eczema and psoriasis, we described the common theme of underlying inflammation manifesting in rashes of different appearances. The theme continues today, with the difference being overlying inflammation. Contact dermatitis (dermatitis = skin inflammation) results from some external entity becoming a nuisance to your skin and generating a response in the form of a rash. You know this in many different forms (shown in the pictures below) – think about those old nickel coated watches, piercings gone bad (piercings also cause actual infections, which is a different consideration), clothing (below is a picture of contact dermatitis caused by flip-flop slippers), poison ivy and diaper rash. I bet the lead picture, which seems like a brand of a butterfly necklace pendant, as well as the following pictures look familiar to many of you.

These rashes are examples of allergic contact dermatitis. Your immune system is generating a response because it believes it is under attack by whatever has touched you. The way the body defends itself leads to release of various chemicals (most notably histamines) that cause the rash. The reason I picked the illustration of the diaper rash is to remind you that the rash actually is in the distribution of the diaper (not just under it), meaning that it may be the diaper that’s the culprit. In other words, don’t just zone in on feces and urine as the problem. Allergic contact dermatitis can occur from – well, anything you’re allergic to, but it’s commonly associated with latex, fruit peels (especially citrus), lotions, perfumes and other topical substances applied to the skin.
When we discussed eczema earlier, we were describing irritant contact dermatitis, which occurs because something damages the skin (remember eczema is called “the itch that rashes”). Imagine that you’ve sensitized and damaged your eczematous skin by scratching away at it and then place something irritating on it. That’s what this is. The longer the new irritant stays on the already damaged skin, the worse the inflammation is, and the more violent the rash appears.
So let’s get to the bottom line: the name of the game is avoidance (as in poison ivy, latex or other known irritants), prompt recognition and removal of irritants, and symptomatic treatment. If you come in contact with a substance that burns or rashes immediately, remove the object or get away from it, and then wash the affected area with mild soap and moderate water. Consider oral histamines (e.g. benadryl) and a mild OTC hydrocortisone ointment. If the rash isn’t better within a few days, or if you ever feel short of breath or as if your throat is closing, contact your physician or the local emergency room immediately for evaluation. Unless you have an underlying condition like eczema or psoriasis, contact dermatitis should resolve within 2-4 weeks with this approach to management.
So in closing, remember: it’s not just the more you itch, the more you scratch. It’s also the more you scratch, the more you itch. Break the cycle.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Your Questions About Human Bites

July 26, 2016Infectious Disease, Medical Treatment, Skin/Dermatology844-SMA-TALK, Behind the Curtain, Bite, Bite marks, Bites and Stings, Boxer's fracture, cat bite, Conditions and Diseases, Dracula, health, human bite, Infection, laceration repair, metacarpal bone, pinky finger, puncture wound, Snake bite, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Wound, Wounds and InjuriesJeffrey Sterling, MD

The votes are in, and it appears that Jaws (from James Bond fame) found the previous 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 (5^th 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.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Human Bites

July 25, 2016Infectious Disease, Skin/Dermatology844-SMA-TALK, Behind the Curtain, Bite, Bites and Stings, Biting, Cellulitis, Conditions and Diseases, Hangnails, health, human bite, Infection, Mike Tyson, Open wound, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Tetanus shot, Wound, Wounds and InjuriesJeffrey Sterling, MD

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. However, 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 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, the structures in the hand (tendons, blood vessels, muscles, and bones) are highly concentrated. He also doesn’t know that they are confined to a very limited space and seeding an infection in that tight space makes things really bad really quick. This guy is very dangerous because he tends 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, he bit me” variety, where the teeth were the aggressor that engaged the victim instead of the fist engaging the tooth. Think of the Tyson vs. Holyfield bite as an example. Sometimes parts get bitten off (fingers, nose, ears, and other unmentionables)! Children, as another example, sometimes bite and need to learn to stop that behavior. Biting is sometimes seen in sexual assault, physical abuse, self-mutilation, or with mentally handicapped individuals.

A third type is the ‘We love too much!’ variety of bites. These may include hickeys that actually break the skin. Other examples of “friendly” bites are folks biting off their hangnails, fingernails, and toenails and create skin infections. Yes, it happens more than you’d think, and no, you don’t have to be a vampire.
The commonality to all of these scenarios is saliva that found its way through the skin. Because of the virulence of the bacteria contained within the saliva, an infection will be forthcoming. You’ll know soon enough when the redness, warmth, tenderness, fever, and possible pus from the wound develop.
The easy recommendation to make is anytime a wound involving someone’s mouth breaks your skin, get 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. 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, 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 like peroxide, alcohol, and anything else that burns. Those agents make things worse by damaging the skin more than they “clean” the area.
2) Apply ice—never directly to the wound—but in a towel. Use for 15 minutes on and then 15 minutes off.
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.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Stop, The Life You Save May Be Your Own – Snake Bites

July 24, 2016General Health and Wellness844-SMA-TALK, Antivenom, Behind the Curtain, Conditions and Diseases, health, health care provider, postaday, Rattlesnake, Snake, snake bit, snake bites, Snakebite, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, triangular heads, Venomous snake, Wound, wound cleaningJeffrey Sterling, MD

So you’ve been snake bitten. What will you do next?
First things first. Stay calm. Call 911. Realize that most snake bites are non-venomous (A really quick tip regarding the likelihood of a venomous snake: most have triangular heads.). Here’s 10 additional steps to take while waiting for your help to arrive.
5 Things To Do

Protect yourself. Get out of the snake’s striking distance. It should be trying to get away from you as well.
Lie down. Keep the wound below the level of the heart.
Be still. Activity simply facilitates spreading of any venom present.
Cover the wound with a loose, clean dressing. Immobilize the extremity if possible.
Remove all restrictive clothing and jewelry from the area, because the area will swell.

5 Things Not to Do

Try to suck out venom.
Try to cut out the area bitten.
Apply any constrictive dressings.
Apply any cold or ice packs to the wound site.
Run to help.

If you’re lucky enough to have a snake bite kit, you’ll simply follow those instructions, which are a modified version of the instructions I’ve just given.
You will need to be seen by a health care provider for consideration of the following:

Anti-venom may be needed.
Tetanus immunization may be needed.
Appropriate wound cleaning will be needed.
Antibiotics for skin infection may be needed.

Straight, No Chaser: The Treatment of Erectile Dysfunction

June 26, 2016Genital/Urinary, Medical Treatment844-SMA-TALK, Austin Powers, Behind the Curtain, Blood, Erectile dysfunction, health, Limited liability company, Penis, Pharmaceutical drug, Physician, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Urology, ViagraJeffrey Sterling, MD

Well, here’s what many of you’ve been awaiting. Assuming the preventative efforts I mentioned didn’t work for you, there are several different treatment approaches. If there’s an underlying medical cause, then treatment of that cause is not only a good way to relieve erectile dysfunction (ED), but it’s a good way to get healthy and avoid other complications from the primary disease. Today, I’ll review different treatment strategies your primary care physician or urologist may discuss or recommend to you for treatment.
The medications
A first consideration is to be wary of (any) medications via mail order. The same level of testing, scrutiny and quality control just doesn’t exist to the same degree as do medications obtained through a pharmacy. Reports abound of people receiving expired or weak formulations of the pills, as well as fake or hazardous substitutes of the pills they thought they were receiving. Engage at your own risk.
Now, regarding those medications you know all too well by name and brand (e.g. Levitra, Cialis and Viagra), there’s no special ‘magic’ to them. They all are variations of the same theme, physiologically relaxing muscles in the penis, resulting in increased blood flow to it. Unfortunately, that’s not the entire story with these medications. ED medications all lower blood pressure throughout the body, and that increased blood to the penis is coming at the expense of decreased blood flow elsewhere (This is called a ‘steal syndrome’.). If you’re otherwise unhealthy, and your redirecting blood that was needed in the heart or brain, you could end up with a heart attack or stroke while taking these meds. Therefore, this leads to two very important cautions regarding ED meds. You shouldn’t start them without discussing with a physician first (to determine “…if you’re healthy enough to have sex”, as the commercials say), and secondly, don’t keep the fact that you’re taking them a secret (to your significant other, and especially to any physician you come across if you’re sick). These medications could be the cause of whatever medical issue has you in an emergency room. They could also be contributors to life-threatening adverse effects if you’re being treated for something else with a medication that interacts with the ED med you’re taking but didn’t bother to mention to the emergency physician. This is why ED medications generally aren’t given to men also on medications for high blood pressure, an enlarged prostate, blood thinners or certain other heart diseases (e.g. angina).
There are actually even more intricate medications used to treat ED. Taking testosterone injections is an increasing means of addressing low hormone levels. Additional injections directly into the penis or inserting a suppository into the penis itself are additional, effective treatment methods. You’d be given these options by your urologist if necessary.
The counseling
If your ED is due to anxiety, stress or other psychologically generated reasons, psychotherapy (possibly with your partner) may be of incredible assistance. If you pursue this option, you and your partner must be prepared to be patient and to work through a variety of issues and possible approaches.
Surgery and additional methods

If you’ve ever seen an Austin Powers movie, you’re familiar with (well at least the jokes about) penis pumps. These are real things, and involve placing a hollow tube over the penis and creating a vacuum to pull blood to the penis via a pump. A tension ring is placed about the base of the penis to maintain the erection during intercourse.
Actual vascular surgery to repair damaged arteries may be indicated in certain cases.
Penile implants are an additional option. Inflatable rods are placed into the sides of the penis. These rods are simply inflated when needed.

If you think some of this is a bit much, it may or may not be, depending on if you’re the one suffering. As I usually conclude, prevention would have been a much better course of action. Hopefully if that’s not the case, you’ve understood the information provided well enough to have an informed conversation with your physician. Good luck, and I welcome your comments and/or questions.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Erectile Dysfunction, Part Two – Causes

June 25, 2016General Health and Wellness, Genital/UrinaryBehind the Curtain, Conditions and Diseases, Erectile dysfunction, health, Hypercholesterolemia, Men's Health, Substance abuse, Western pattern dietJeffrey Sterling, MD

In my last post on erectile dysfunction (ED), I gave a simplistic way to understand and address it. However, the truth of the matter is the overwhelming majority of cases of ED are not related to stress or other psychological issues. First, some sense of ‘reasonable’, expected performance should be established, especially as one ages (as discussed here). Beyond that, you should know that approximately 90% of ED cases involve an underlying medical concern, including, but not limited to, the following:

Diabetes

High blood pressure

Changes/disease to your blood vessels

Low testosterone

Kidney disease

Smoking

Alcohol and Drug abuse

Obesity and High cholesterol

Effects of your medications

Therefore, today’s message is simple and brief, but I’d suggest it’s probably more important than you have previously thought. You should consult your physician if and when you or your partner’s sexual performance becomes an issue. You may actually discover something that will not only save his performance, but his life.
Finally, in the next post we will review the wide variety of treatment options for ED.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Erectile Dysfunction, Part One

June 24, 2016General Health and Wellness, Genital/UrinaryBehind the Curtain, Conditions and Diseases, Erectile dysfunction, Erection, health, Heart disease, Impotence, Men's Health, Western pattern dietJeffrey Sterling, MD

It seems appropriate to follow-up a post on age-related changes in your genitourinary system with a discussion on erectile dysfunction (ED). The nature of the topic is such that I’m going to approach this in two different ways. Today, I’ll give you a functional, overly simplistic view of ED and tomorrow, I’ll look at it from more of a clinical orientation, because there really are nuances involved. So keep in mind the lead picture. There are many medical and psychological issues that can lead to problems having erections. I’ll get into that more tomorrow.
In many ways, your health is related to the quality of your blood flow, both in quantity (successful circulation to tissues) and quality (relative absence of toxins we ingest and deliver throughout). This is true for the brain (mental health, absence of strokes), the heart (stamina, absence of heart disease/attacks), and your penis (sexual function, lack of impotence), as well as every other organ.

Excluding truly medical considerations, the two surest ways I know to be a sexual stud (without implants or being of a certain age) are to have a legitimately healthy ego (psychologic health) and more importantly, to be in good physical shape and otherwise healthy. However, for now, given that an erection simply results from strong blood flow to the penis, your overall health better enables that process (the first time as well as if you want multiple contiguous encounters). Everything being equal, the best way for a guy to be able to have sex for whatever you define as a ‘sufficient’ period of time (besides being of a certain young age) is to maintain good cardiovascular health by spending that physician-recommended 20-30″ or more at a time on a treadmill, bike, running, etc.

Drugs like Viagra, Cialis, etc. are really nothing more than drugs that lower blood pressure (and resulting demands by other bodily organs on your blood), such that your penis’ call for an erection is otherwise unimpeded. Sounds good? The risk is varying forms of a ‘steal syndrome’, where that blood isn’t being distributed to your heart and brain, which could result in a heart attack or stroke. That’s why you must “ask your doctor if you’re healthy enough for sex” before using…
Bottom line: practice for good sex and stamina during sex by working out. It’s just another benefit to being healthy.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

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