Tag Archives: health

Straight, No Chaser: Tips to Deal with Depression and The Holiday Blues

Mental Health, , , , , , , , ,

 Holiday_Depression-300x199

I don’t mean to bring anyone down during what is supposed to be the ‘most wonderful time of the year’, but in reality there are many people hurting. For some, life’s tragedies happen this time of year the same as they might any other time. For others, this may have already happened, and this time of year is a permanent reminder of an unfortunate experience. For others still who struggle with depression, anxiety and mental illness all year, the holiday season can exacerbate these feelings and may make holidays especially long, depressing and potentially dangerous times.
Today’s Straight, No Chaser is not meant to drag you into the dumps but to empower you with tips to assist you in the event this is a difficult time for you. By the way, I’m extremely thankful that you’ve chosen to give me moments of your day and life. I take that gift seriously and hope you continue to find it a worthwhile use of your time.
HolidayDepression
Here’s five tips for your holiday mental health:

  1. Remove yourself from stressful environments and avoid situations you know will create conflict, mental duress and/or danger. I can not emphasize this enough. If you put yourself in a bad situation, you can not be surprised when bad things happen.’
  2. Find support. Specifically, have ‘go-to’ friends and family that provide you comforting support. There’s a time and place for tough love, but in the midst of depression or suicidal ideation, ‘buck up’ is not good advice. Know where your support lies and be sure (in advance) that it will be accessible if you need it.
  3. Find success and happiness where it is. During the holidays, people tend to lament what isn’t. That’s not a formula for success. Yes, all of your family may not be around, but celebrating happy memories with the ones you can often fills the room with the joyous presence of loved ones not around. Enjoy the pleasures and successes you do have access to, whether big or small. Focusing on the positive keep you positive.
  4. If you’re struggling, admit it.  You already know you’re hurting. Often the first step to getting past it is acknowledging it. Once done, then you can put coping mechanisms in place to address your feelings.
  5. Avoid holiday activities that will create post-holiday angst. This applies to eating, drinking, shopping and personal interactions. Some use the holiday as an excuse to overindulge as if the consequences won’t be there afterwards. Reread #1 above.

BBKING_SU_C_^_SUNDAY

Know when you need professional help. If your support system doesn’t sufficiently address your needs, and you’re feeling severely depressed, can’t function or are suicidal or homicidal, find a physician or mental health professional ASAP. Of course, you can always contact your SterlingMedicalAdvice.com expert. If you type mental health, depression or other keywords into the search bar above, you can access many other Straight, No Chaser blogs on behavioral health concerns that may provide you the support you need. I wish you all the best today and throughout the year, and hopefully the picture above will reflect the only type of blues you’ll have to deal with this year.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight, No Chaser: STDs – Syphilis, The Great Mimicker

Genital/Urinary, Infectious Disease, Obstetrics and Gynecology, , , , , , , , , , ,

Today, Straight, No Chaser will present two phrases that you may not have previously heard: The Great Mimicker and MSM, and that means we’re discussing what has historically been a devastating disease: syphilis. Historically, syphilis really is the most important sexually transmitted disease (For what it’s worth, it’s thought that Columbus’ crew spread the disease between the Americas and Europe.). The great mimicker nickname as applied to syphilis exists because syphilis has many general symptoms that resemble and are often confused with other diseases. MSM points to the fact that treatment in the early stages is so complete that syphilis had been rapidly in decline – until it’s reemergence in a specific population. It is estimated that well over 60% of reported early stage cases of syphilis occurs in men who have sex with men (MSM).
In this review, I want to specifically address the symptoms, which are impressively and dramatically different depending on the stage.
syphilis1
Stage I – Primary Syphilis: Primary syphilis usually presents with the presence of a single, painless sore (a chancre), located wherever it was contracted. As pictured above, the head (glans) of the penis is a typical site. The sore disappears in 3-6 weeks (with or without treatment), and if treatment wasn’t received, the disease progresses. Herein lies the problems. Because it’s painless, you ignore it, perhaps thinking it was a friction sore, or you never gave it much of a thought. Because it went away on its own, you forget about it, thinking that it got better. So sad, so wrong…
syphilis2Syphilis-hands
Stage II – Secondary Syphilis: When syphilis returns days to weeks (more typically) after the primary infection, it does so quite dramatically. Rashes can appear everywhere, including across your back (as noted above) and chest to on your palms and soles, in your mouth, groin, vagina, anus, or armpits. The rash could be warts (condyloma lata) or flat. You should be scared, but you might not be because… the rash and the other symptoms again will disappear on its own. Despite what you may think intuitively, you really don’t want that to happen.
Latent Syphilis: Dormant syphilis can stay that way for decades after secondary syphilis has occurred. What you don’t know can hurt you. Syphilis can be transmitted during the earlier portion of latent phases, including to an unborn child.
Syphilis3
Tertiary Syphilis: Late stage syphilis is a disturbing thing to see (and obviously experience). The disease can result in death, causing damage to the brain, heart, liver, bones, joints, eyes, the nervous system and blood vessels. Before it kills you, it can result in blindness, paralysis, dementia and loss of motor control. If you don’t know how the research discovering all of this was conducted, for now I’ll just say it was one of the most shameful acts of medical history. I’ll blog on it later. The individuals in the above picture were alive when these pictures were taken, by the way.
A special note: The microorganism causing syphilis is rather aggressive, so much so that it can be transmitted by oral, anal or genital sexual contact. By oral, I also mean kissing. Pay attention to those oral sores. Furthermore, syphilis gets transmitted from mother to unborn child. This is a devastating occurrence – if untreated, a child may be born prematurely, with low birth weight or even stillborn. If untreated, once born, a child may suffer deafness, seizures and cataracts before death.
Prevention and Treatment Considerations: Advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. Remember that treating syphilis at any point can prevent the most severe complications that lead to death.
For a historical lesson on what happens with untreated syphilis, review this Straight, No Chaser post on The Tuskegee Experiments.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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Straight, No Chaser: Bacterial Vaginosis – No, That's Not a STD

Genital/Urinary, Obstetrics and Gynecology, Health Prevention, , , , , , , , , , , , , ,

BV1

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

bv anyone

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier…
Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.
Doctor: Ok. Let’s examine you…

bv thrush

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different part of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

bv causes

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real.  We even have a real thing call a ‘whiff test’ as part of making the diagnosis.
The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome.  There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.
So this couple gets ‘off the hook’, even though they may decide to start using condoms.  Next we will focus on the risks of various sexual activities. Stay tuned.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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Straight, No Chaser: Pain Awareness Month and Your Chronic Pain

General Health and Wellness, , , , , , , , , , , , , , ,

Print

 
The notion of a pain awareness month is an odd thing; probably even more so to those suffering from chronic pain. Typically the idea with these periods of recognizing diseases and conditions is to create sensitivity among the general public toward one’s condition. In this and the next Straight, No Chaser, we will not only do that but will build upon that and provide those sufferers of chronic pain some better tools to make those emergency room visits more productive.
chronic-pain
I’d begin by asking you to get more in touch with your “you sensitivity” and learn to differentiate between different types of pain. It’s important for you to know the difference.

  • Clearly there’s acute pain from injury. You break a jaw or twist an ankle, you’re going to hurt.
  • There’s acute exacerbations of pain from disease. You have sickle cell anemia? Cancer? Lupus? Sciatica or other low back pain? Arthritis? Migraines? You will have acute flare ups.

Then there’s chronic pain. Remember, sometimes pain happens without injury or disease. Pain is simply a signal communicated from your body to you through your brain. Acute pain is normal and is meant to alert you to somehow protect yourself or get help. Chronic pain is different. Those signals coming from your nervous system can be sporadic or haphazard, and they may be more reflective of dysfunction within the nervous system than a disease or injury. It can even be psychogenic (due to matters of your mind). Regardless of the cause, chronic pain is well, a pain.
There are many established conditions that cause chronic pain, such as the following:

chronicpain-circle3
Maybe the point of this post isn’t to tell those of you who suffer from chronic pain things you don’t already know as much as it is to organize your thoughts and approach to your pain. After all, it’s not like there are cures for chronic pain besides eliminating the underlying condition (which reminds me to remind you not to fall for the many medical scams promising instant and permanent relief to these medical conditions). The first step really is to help you appreciate the need for becoming better sensitized to your condition. Many patients with chronic pain suffer horrible outcomes because they become desensitized to pain, learn to ignore it, and misinterpret a new, unrelated pain condition (maybe with a few similarities), failing to get evaluated before it is too late.
If you suffer from chronic pain, it’s key to know the things you can do to improve your quality of life. Strengthening your mind to reduce stress and avoid fixating on your medical condition is very important. Learning to relax actually is treatment; your body has pain-reducing chemicals, including those that directly treat pain and promote healing, and others that prevent release of internal pain producers. Find someone with whom you can discuss relaxation and stress reduction.
chronicpain2
Engage the fight to get better within your physical limitations.

  • Exercise remains key. Depending on your situation, walking, running, biking and/or swimming can dramatically improve your situation. Be advised that the extremes (not exercising at all or doing so too much) can actually worsen the situation.
  • Stretching and strengthening similarly produce benefits to those with chronic pain. This should sound like a good reason to become involved with a personal trainer or have a physical therapist.
  • Regular sleep and avoidance of nicotine (stop smoking!) will also help.

Your physician may discuss multiple other possible treatment modalities, such as the following:

  • Acupuncture
  • Behavioral therapy can reduce your pain and decrease your stress through methods that help you relax, such as meditation, tai chi, and yoga. Give it a try. It works for many people.
  • Brain stimulation therapy
  • Local electrical stimulation
  • Occupational therapy teaches you how to perform routine activities of daily living in a way that reduces your pain and/or avoids reinjuring yourself.
  • Osteopathic manipulation therapy (OMT)
  • Psychotherapy

Regarding medication, for many people use of medication (especially narcotics) becomes a crutch and a slippery slope. Over the counter medications such as acetaminophen and ibuprofen are quite effective for many causes of pain. Use of narcotics should be measured and part of an overall plan, not a tool for a quick fix or to get you out of your doctor’s face. It is part of reality that even if you are not a drug-seeking patient, with enough exposure to narcotics you will develop tolerance (less effectiveness at the same dose) and become addicted. You should want to avoid this fate.
The pain, mental duress and reduction in quality of life associated with chronic pain can be lessened with you learning how to approach and understand your pain, taking appropriate steps to reduce things you do to exacerbate the pain, increasing the things you do to lessen the pain, and working with your health care team to provide you with appropriate support and treatment. We at http://www.SterlingMedicalAdvice.com and 844-SMA-TALK are here to support your efforts. We welcome your questions.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Chronic Pain

General Health and Wellness, Neurology, Musculoskeletal System, , , , , , , , , , , , , , ,

chronic-pain

If I could talk to you about pain (oh wait, I can), I’d begin by asking you to get more in touch with your “you sensitivity” and learn to differentiate between different types of pain. It’s important for you to know the difference.

  • Clearly there’s acute pain from injury. You break a jaw or twist an ankle, you’re going to hurt.
  • There’s acute exacerbations of pain from disease. You have sickle cell anemia? Cancer? Lupus? Sciatica or other low back pain? Arthritis? Migraines? You will have acute flare ups.

Then there’s chronic pain. Remember, sometimes pain happens without injury or disease. Pain is simply a signal communicated from your body to you through your brain. Acute pain is normal and is meant to alert you to somehow protect yourself or get help. Chronic pain is different. Those signals coming from your nervous system can be sporadic or haphazard, and they may be more reflective of dysfunction within the nervous system than a disease or injury. It can even be psychogenic (due to matters of your mind). Regardless of the cause, chronic pain is well, a pain.
There are many established conditions that cause chronic pain, such as the following:

 chronicpain-circle3

Maybe the point of this post isn’t to tell those of you who suffer from chronic pain things you don’t already know as much as it is to organize your thoughts and approach to your pain. After all, it’s not like there are cures for chronic pain besides eliminating the underlying condition (which reminds me to remind you not to fall for the many medical scams promising instant and permanent relief to these medical conditions). The first step really is to help you appreciate the need for becoming better sensitized to your condition. Many patients with chronic pain suffer horrible outcomes because they become desensitized to pain, learn to ignore it, and misinterpret a new, unrelated pain condition (maybe with a few similarities), failing to get evaluated before it is too late.
If you suffer from chronic pain, it’s key to know the things you can do to improve your quality of life. Strengthening your mind to reduce stress and avoid fixating on your medical condition is very important. Learning to relax actually is treatment; your body has pain-reducing chemicals, including those that directly treat pain and promote healing, and others that prevent release of internal pain producers. Find someone with whom you can discuss relaxation and stress reduction.

 chronicpain2

Engage the fight to get better within your physical limitations.

  • Exercise remains key. Depending on your situation, walking, running, biking and/or swimming can dramatically improve your situation. Be advised that the extremes (not exercising at all or doing so too much) can actually worsen the situation.
  • Stretching and strengthening similarly produce benefits to those with chronic pain. This should sound like a good reason to become involved with a personal training or have a physical therapist.
  • Regular sleep and avoidance of nicotine (stop smoking!) will also help.

Your physician may discuss multiple other possible treatment modalities, such as the following:

  • Acupuncture
  • Behavioral therapy can reduce your pain and decrease your stress through methods that help you relax, such as meditation, tai chi, and yoga. Give it a try. It works for many people.
  • Brain stimulation therapy
  • Local electrical stimulation
  • Occupational therapy teaches you how to perform routine activities of daily living in a way that reduces your pain and/or avoids reinjuring yourself.
  • Osteopathic manipulation therapy (OMT)
  • Psychotherapy

Regarding medication, for many people use of medication (especially narcotics) becomes a crutch and a slippery slope. Over the counter medications such as acetaminophen and ibuprofen are quite effective for many causes of pain. Use of narcotics should be measured and part of an overall plan, not a tool for a quick fix or to get you out of your doctor’s face. It is part of reality that even if you are not a drug-seeking patient, with enough exposure to narcotics you will develop tolerance (less effectiveness at the same dose) and become addicted. You should want to avoid this fate.
The pain, mental duress and reduction in quality of life associated with chronic pain can be lessened with you learning how to approach and understand your pain, taking appropriate steps to reduce things you do to exacerbate the pain, increasing the things you do to lessen the pain, and working with your health care team to provide you with appropriate support and treatment. We at www.SterlingMedicalAdvice.com and 844-SMA-TALK are here to support your efforts. We welcome your questions.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight No Chaser In The News: Your Teens Have Healthier Habits Than You

General Health and Wellness, Public Health, Health Prevention, , , , , , ,

teenagers1

Your teens are healthier than you. From the department of good health news – on some very important measures, somehow it seems as if our youth have actually received and read the memo on health. According a recent survey from the Centers for Disease Control and Prevention (CDC), several measures of health have improved significantly in the teen population – with a few important exceptions.

teenhealth

These improvements include the following.

  • Cigarette smoking. Cigarette smoking among U.S. high school students has reached an all time low. Teen smoking is down to 15.7%. It was just over 15 years ago (in 1997) that the rate was 36.4%. Unfortunately, this still translates to 2.7 million high school students who smoke.
  • Armed trauma. The proportion of students threatened or injured with a gun, knife or other weapon on school property has dropped to 6.9%, from a peak of 9.2% in 2003. In the presence of so many school shootings, a ray of hope exists.
  • Fist fights. The proportion of students involved in fist fights was reported at 25%, which is down from 42% in 1991. The number of students having had a fight at school within the last year sits at 8%, which is down from 16%.
  • Soda consumption. 27% of teens had at least one soda daily, down from 34% in 2007.
  • TV viewing. 32% watched three daily hours of TV, down from 43% in 1999.
  • Other: Overall, teens are drinking less alcohol and are having less sex with more birth control use by females.

And now, the not so good news…

  • Condom use: Condom use is declining among the sexually active, being reported at 59%, down from a peak of 63% in 2003. Remember, HIV and other sexually transmitted diseases/infections haven’t gone away at all; we’ve just gotten better in controlling them. Now is not the time to get comfortable.
  • Texting and driving: 41% of those who drove admitted to texting or e-mailing while driving. This is bad anyway you look at it.
  • Cigar and other forms of smoking: Cigars are now as popular as cigarettes with high school boys. Cigars were smoked by 23% of 12th grade boys in the month before the survey. Smokeless tobacco use hasn’t changed since 1999, holding at about 8%. Other surveys have shown increases in e-cigarette and hookah use.
  • Computer time: 41% of teens report using a computer for non-school reasons at least three hours a day, up from 22% in 2003. Apparently this is where the TV time has gone.

What this really means is (wait for it!) your teens are educable. Discuss these topics with them and why it’s important to make healthy decisions. Of course it helps if you model the behavior.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: New Findings and Other Vaccine News

Infectious Disease, Public Health, Health Prevention, , , , , , , , , , , ,

Introduction

This Straight, No Chaser provides vaccine news of interest.

If this doesn’t convince you, nothing will. You’ll want to read until the end.

The most recent edition of the medical journal Pediatrics this week publishes the results of three new studies that individually are convincing and together are definitive. This really isn’t news; the public health and medical communities have been speaking with one voice on this for nearly a century. However, given all the recent misinformation disseminated, it’s important to continue to drive home the point that vaccines save lives.
Let’s summarize the three studies.

rotavirus vax

Rotavirus

Rotavirus was once an extremely common cause of infant diarrhea, causing hospitalization and even death due to diarrhea and dehydration. A rotavirus vaccine was developed. According to a study conducted by the U.S. Centers for Disease Control and Prevention (CDC), based on previous usage rates, during the first four years of vaccine use, more than 176,000 hospitalizations, 242,000 emergency department visits, and 1.1 million doctor’s visits among children under 5 were prevented, saving approximately $925 million in the U.S.

chickenpoxvaccine

Chickenpox

Chickenpox actually kills, especially adults and those with compromised immune systems. Prior to development of the chicken pox vaccine, approximately 11,000 people were hospitalized a year in the United States from chickenpox. According to a study performed by the Kaiser Permanente Vaccine Study Center, in the fifteen year period between 1994 and 2009, the chickenpox vaccine slashed the number of hospitalizations by 90%, across all age groups.

measlesvax

Measles

The recent measles outbreak has previously been discussed in Straight, No Chaser, but a 2011 outbreak was highlighted in detail in Pediatrics, and yes, the study speaks to the consequences of going without immunization. The CDC is clear that current measles outbreaks are due to parents withholding vaccines from their children, and this review could be the proverbial Exhibit A. The Minnesota Department of Health identified an outbreak infecting 21 people, with an average age of 1-year-old and whose parents in the community had largely withheld the measles vaccine. About 67% of those infected were hospitalized, mostly due to breathing complications and dehydration.

An interesting post-script to the findings in Minnesota directly involves the source of widespread misinformation about the measles vaccine (actually the measles-mumps-rubella vaccine; they’re all given together). The author of a discredited 1998 research paper that is the source of the alleged link between vaccines and autism had visited this community approximately four times, convincing many residents to go without the measles vaccine. This author, Andrew Wakefield, actually lost his right to practice medicine in England, and the journal that published his study retracted the paper linking autism and vaccines. However, you probably hadn’t heard that part of the story, and the autism-vaccine link continues in mythology via the internet and ill-informed “advocates.”

Diseases and Vaccines

The story of diseases and vaccines is actually pretty linear and historically consistent.

  • There were a series of infectious diseases that once wreaked havoc on society, often killing mass numbers of humans.
  • Vaccines were developed to prevent infections (and their complications) from these microorganisms.
  • Mass vaccinations markedly reduced (and actually eliminated in some examples) the rate of contracting these diseases to where we take for granted the danger of the actual disease (discussing what it was like in the US when polio was a common disease would be an interesting conversation to have with your grandparents if you can).
  • Certain segments of society opt out of getting immunized over fear of the vaccine.
  • At some point when the vaccination rate drops below a certain percentage, the diseases return in those not immunized.

I welcome your questions. Discuss your legitimate concerns with your physician or experts personal healthcare consultants such as we offer at 844-SMA-TALK and www.sterlingmedicaladvice.com. Protect your families. Without exception, if a vaccine exists, you should fear the disease more than the vaccine.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

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Straight, No Chaser: Your Questions About Measles (Rubeola)

General Health and Wellness, Infectious Disease, Pediatrics/Kids Health, , , , , , , , , , , , ,

measles

In discussing the recent measles outbreak, the most common response I received was “So? What’s measles anyway?” It has been that long since measles has been a problem in the United States. Let’s talk about common questions related to measles.
What causes measles? The medical term for measles is rubeola, and it’s caused by a virus.

 measleskoplik

What are the symptoms I’d see? To the layperson, measles most often presents as a full body rash with cold/flu-like symptoms, such as a fever, cough and runny nose. Your doctor is also looking for red eyes (conjunctivitis) and small reddish spots inside the mouth (known as Koplik’s spots).
Is measles contagious? It’s highly contagious to those not immunized. According to the Center for Disease Control and Prevention, 90% of those not immunized will contract measles if exposed to someone with it.
How is it spread? It’s spread through the air. This means sneezing, coughing and kissing.

Measles-immunization

Why don’t I ever see measles? Measles has been contained in the U.S. since the introduction of the measles vaccine over 50 years ago. It is amazing to think that there are still 20 million cases still occurring around the world annually.
How is measles prevented? Immunization! Infants are generally protected from measles for 6 months after birth due to immunity passed on from their immunized mothers. For most others, the measles vaccine is part of the measles-mumps-rubella immunization (MMR) or measles-mumps-rubella-varicella immunization (MMRV) given at 12 to 15 months of age and again at 4 to 6 years of age. Additional considerations exist in the face of an outbreak.

 measlesvaxsideeffx

What are the side effects of the vaccine? Unless you have an underlying health condition and/or have a reduced immunity, the most common reactions include the following:

  • fever 6-12 days after vaccination (in about 5%-15% of those vaccinated)
  • an incidental (and non-allergic, non-contagious) rash. This goes away on its own and occurs in about 5% of vaccine recipients.

What’s the treatment of measles? Given that measles is a virus, there is no specific medical treatment (as is almost always the case with viruses). Supportive treatment is important and involves fluids and rest for what is expected to be a two-week period. Something like Tylenol or children’s ibuprofen can be given for fever or pain (but never give aspirin to a child).

 measles101

What are the common complications? 30% of cases of measles involve complications. Complications include simpler conditions such as otitis media (those pesky ear infections), croup and diarrhea.
This all sounds pretty benign. Why not just get the disease and avoid the vaccination? Because children can die from measles. Unfortunately, measles also has more serious considerations such as pneumonia (which occurs in approximately 1 of 20 cases) and a serious brain infection called encephalitis (which occurs in approximately 1 of 1000) cases. Measles also causes pregnant women to have miscarriages, premature births or low-birth-weight babies.
How do people die from measles? Pneumonia is the complication most often causing death. For every 1,000 children who acquire measles, 1 or 2 will die.
What’s the Vitamin A connection with measles? Vitamin A has been found to decrease complications and death in those infected with measles. It should be considered, especially in those hospitalized with complications of measles or those who have compromised immune systems and acquire measles.
If I had measles as a child and get exposed to the disease again, am I in danger? No. Surviving a measles infection provides one with life-long immunity. Of course, your take home message is most of this isn’t a consideration if you simply get immunized.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd. Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

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

General Health and Wellness, , , , , , , ,

diabetesed

Diabetes is a disease in which education is vital. For a diabetic, knowing the disease well allows him or her to better prevent long-term consequences of the disease. It also allows the diabetic to make real-time adjustments when sick or otherwise  in danger acutely. In Straight, No Chaser, we’ve provided a series of posts meant to empower diabetics (and you can review any or all of them via the search box on the right). Remember, it all should start with a basic understanding of the disease.
We eat, and the process of digestion is for the purpose of converting food into glucose (sugar) that’s used by our body for energy. The blood delivers the glucose to different organs of the body where the cells take it up for use. In order for that process to work, an organ that’s part of the digestive tract called the pancreas has to produce a hormone called insulin. Insulin facilitates the glucose getting from the blood to inside the cells. Diabetes is a disease where insulin isn’t being made by the pancreas or isn’t working optimally.
Now think about what happens when you’re not getting sugar into your cells. It’s as if you’re starving (because physiologically, you might as well be). You get symptoms such as weight loss, hunger, fatigue and excessive thirst. Because your cells don’t have energy, they aren’t functioning well. In fact, blood and nerve vessels lose significant function, resulting in significant vision loss and lack of sensitivity in your extremities. Anyone who’s been a diabetic for about 10 years know this because you’re wearing glasses and because you’ve lost a fair amount of sensation, especially in your feet. There are other symptoms that are variations of the same theme, including excessive urination, dry skin, increased infection rate and slower healing from those infections – all due to poor function of your blood vessels.
Sometimes diabetes is a disease that happens to you because of unlucky genetics (or simply a family history). Other times it is a disease that you find. Risk factors for developing diabetes includes obesity, older age, and physical inactivity. Gestational diabetes (i.e. that occurring during pregnancy) is an entirely different conversation.

diabetes-treadmill

Let’s take a moment to discuss prevention and treatment. There are different types of diabetes, but the risk of one form of diabetes in particular can be reduced by – you guessed it – diet and exercise. In fact, diet, exercise and medications are the three legs of the diabetes treatment stool regardless of type. Some patients require regular insulin injections and others require pills. Still others who are successful with diet and exercise are able to markedly reduce, and in some instances eliminate medications.
If you’re a diabetic, make an investment in your education. It could not only save your legs or eyes, but it may just save your life. I welcome your questions and comments.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: Quick Workouts for the Couch Potato

General Health and Wellness, , , ,

Warning: This post includes adorable animal exercise pictures.

couch-potato

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.

beer cat

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).

exercize cat[5]

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.

chair_standchair-stand1

  • 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 dip

  • 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.

couch crunchpuppycrunches

  • 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.

catstretch

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

couch_potato_cat

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!

bear on couch

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

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Straight, No Chaser: Invisible Health – Developing New Habits

General Health and Wellness, , , ,

healthy-habits

Good habits are just as addictive as bad habits, but they’re much more positively rewarding.

The easiest way to change your life is to change your life. But how? When it comes to health, sometimes it can seem like work. For many, the idea of exercise is a big to do. You have to pack. You have to drive. You have to shower. Who has time for all of that? Dieting is just as bad, it seems. Do I need to go find a special store? It always takes time to cook a special meal. It seems like work to count calories! I don’t like the taste of this or that…
Well, at Straight, No Chaser, we want to introduce you to Invisible Health. Today, we offer you a series of ten simple tips (and one admittedly not so easy one) that will promote your health without all the fuss (although we fully endorse the fuss and know that over time, it’s not a fuss). Feel free to expand the list. More importantly, implement the list. You’ll be amazed how just a few minor modifications in regular activities can produce large improvements in your health. Everything is relative. Don’t just sit there. Do something!

no-negative-self-talk

One thing you’ll notice about these tips is you’re producing health benefits without the active grind of “working out ” or “dieting.” We just want you to develop some new habits or increase the frequency of some things you may already be doing.

  • Take a walk. You’re exercising and didn’t know it. Walk the stairs. Take a walk in the park with your loved one. Walk while you talk with your kid. Regular walkers have less heart attacks and strokes, better sex lives and less stress. Walking improves your immune system and reduces all manners of unhealthy cravings. It’s easy. Just do it.
  • Learn to like to dance. Hear your favorite song? Go for it. Have a child? Teach them and dance with them! I’ll bet while you’re having fun, you’re breaking a sweat, losing calories and getting your heart pumping without the worry of reps or time spent.
  • Are you hungry and about to shove something unhealthy in your mouth? Drink a glass of water. Your body needs it. The majority of you don’t drink nearly enough water. Learn to appreciate water. Have you heard that you need eight glasses of water a day? You’ll never get there by sipping on a hot beverage. It’s refreshing and replenishing, plus it makes your body function optimally. Besides, if you’re drinking water, you’re not drinking high calorie, sugar-laden soft drinks. Speaking of which…
  • Stop. Drinking. Sodas. Today. I’d bet the easiest “diet” many of you could go on would be just eliminating soda. Even without doing anything else you’d lower your risk of diabetes and high blood pressure, and you would start losing weight. One can delivers 150 calories. Any amount of water is zero calories.
  • Still hungry and still looking at that donut? Go brush your teeth. You probably don’t brush enough anyway, and brushing and flossing intermittently throughout the day provide numerous health benefits as well as serve as suppressing your appetite in a simple way.
  • Wack some weeds. Getting in your yard and doing most any kind of cleaning is going to be beneficial to your health. Stop riding your lawnmower. Walk! Pull some weeds (with both hands), rake some leaves, plant some flowers or sod some grass. You’re burning several hundred calories an hour!
  • Stand for something. If you think about it, you spend a lot of time sitting during the day. Could you perform a lot of what you’re doing standing or moving? Give it a try. Just develop the habit of getting up and moving around intermittently. For example, learn to pace while you’re on the phone. It’s activity, and you probably need more of it.

Healthyapple

  • Snack healthy. Find a favorite fruit. Eat a handful of nuts. A handful of carrots or almonds, a few slices of an apple or a bowl of grapes is an infinitely better approach to those cravings. Lose the potato chips and the empty calories. This is both addition by subtraction and addition by addition!
  • Play! Have a kid of any age? Throw the football around. Shag fly balls with each other. Shoot some hoops. You’ll love the benefits to your heart and lungs. Plus, it’ll keep your brain sharp.
  • Find a healthy friend. Having a companion with whom you share your health aspirations gives you a much better chance of success across the board, as opposed to that friend of yours that you just get together with to eat or drink. It’s true in health as well. You’re probably the average of the five people you most hang around!
  • Stop smoking. You didn’t really think I would leave smoking off the list, did you? Speaking of invisible health, the more invisible smoking is, the better. I don’t care how you do it, just do it. Every cigarette is costing you about seven minutes of your life. In one fell swoop, eliminating cigarettes from your life will produce as many benefits as most anything else you’ll do.

Healthy-Lifestyle

Give it a try. See how many of these 10 tips you can incorporate into your life. I’d love to get some feedback on your journey.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

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Straight, No Chaser: Insomnia – You are Not Getting Sleepy…

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

hypnosis

Talking about insomnia makes me, well, tired. You know what the problem is. You either can’t fall asleep or you can’t stay asleep. You’re tired when you wake and throughout the day. Lack of sleep saps your energy and your productivity.

Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle. There are so many mental factors that can disrupt your ability to sleep.

insomnia

Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).

hyperinsomnia

The thing is, whether acute, intermittent or chronic, any type of insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember: If it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might try. In fact, consider this my Top Ten Tips presented in the order you might consider implementing them.

  • Adhere to good diet and exercise habits, which make your body perform as it should and which will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says “no sleep” like heartburn all night. (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.)
  • Avoid nighttime stimulants (e.g., cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Don’t drink and sleep. Although alcohol is a sedative, it’s also on the “don’t do” list, because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music … or all of them.
  • Set the alarm for the morning. Then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use “white noise” for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born),

Good night and good luck.

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Straight, No Chaser: Toxin and Detoxification Series Summary

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

bigstock_Smiley_ball_sending_message_ab_25677302
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!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: Natural Colon Cleansing (Colonics) as a Means of Detox

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

coloniccolonics

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.

  1. If you wash a car that already has rust on it, you aren’t really fixing anything.
  2. 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.
Call us at 1-844-SMA-TALK or login at www.SterlingMedicalAdvice.com to chat with your expert nutritionists about these matters, especially now that we’re in National Nutrition Month.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: A Look at Detox Diets

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

detox-diet1

Detox-Diet2

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!
Call us at 1-844-SMA-TALK or login at www.SterlingMedicalAdvice.com to chat more.
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Straight, No Chaser: Our World is Filled with Toxins

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

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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.
chemicals-in-cigarettes-arsenic-etc
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 five-part 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.
Call us at 1-844-SMA-TALK or login at www.SterlingMedicalAdvice.com to chat with your expert nutritionists about these matters, especially now that we’re in National Nutrition Month.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: Quick Tips to Detoxify Yourself Naturally

General Health and Wellness, Health Prevention, , , , , , , , , ,

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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:

  1. Diet: think fruits and vegetables, and cut back on refined sugar.
  2. 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.
  3. Exfoliation is a beautiful thing. There are dozens of ways to do it. Find one that works for you.
  4. 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:

  1. Avoid inhaling cigarette and cigar smoke. Duh.
  2. Exercise makes your respiratory machinery more effective and efficient. Go for it.
  3. 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:

  1. 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.
  2. Learn about cranberries. Many of those urinary tract infections are successfully addressed by drinking cranberry juice.
  3. 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:

  1. Increase your water intake. Water makes your entire body function better but also softens your stools, facilitating transport.
  2. Increase your fiber intake. Fiber bulks your stools and makes it easier to expel.
  3. 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.
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Straight, No Chaser: The Horror of Night Terrors

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

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I wonder how many of you have been exposed to night terrors.  These are different than nightmares, which we all know and experience.  In a nightmare, Little Johnny has had a bad dream, maybe thinking there’s a monster under his bed.  He wants to be comforted by you, and he is still upset the next morning.  That’s not what a night terror looks like.
During a night terror, Little Johnny may be sleep walking, or he seems to wake up in the middle of the night and just starts screaming.  He’s really not communicative; he’s just terrified.  These episodes generally last about 15 minutes. Then he goes back to sleep.  The next morning, the child has no recollection of the event.
The cause of night terrors is unknown but they seem to be triggered by emotional stress and lack of sleep.  Febrile illnesses also seem to correlate with the presence of these episodes.
Who gets these?  Children less than age seven, more frequently boys.  These episodes usually stop by age 10.  There often is a family history.
There’s really no testing or treatment for these until they are frequent and prolonged, or unless a secondary injury occurs from all the trashing about.
I bring this to your attention because many parents are aware of this phenomenon and have no idea what to do when it occurs.  My best advice is to ensure that the child is safe during the episode for otherwise stress free children.  You may want to consider medical or psychological screening if the problem worsens.  Sleep well…
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: Spotlight on Health Concerns When Traveling – Vaccines and Illnesses

General Health and Wellness, Health Prevention, , , , , , , , , , ,

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Traveling is exciting, but it presents multiple challenges to your health. To best meet these challenges, preparation is everything.

Travel-health-insurance-for-international-travelers

Before you travel and every time you travel, your surest means of protecting yourself is to confirm you are current on routine vaccines.

  • Your basic vaccines include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine and influenza.
  • Most international travelers will need immunizations to protect you from hepatitis A, polio, and typhoid.
  • Depending on where you’re international travels take you and the duration of your trip, you may need immunizations to protect you from hepatitis B, malaria, rabies and/or yellow fever.

The plane trip itself can be hazardous to your health. I encourage you to review the risks of flying.

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Diseases have different patterns in how they spread and their resistance to medications in different countries. It is important to be aware of prominent diseases affecting the countries you plan to visit, because some may be uncommon in your home country. For Americans traveling abroad, such diseases include the following:

  • HIV/AIDS 
  • Malaria: an infectious disease caused by a parasite, which invades the blood cells. It is notable for the presence of high fever, shaking chills, low blood count and a flu-like set of symptoms.
  • Pandemic/avian flu (aka as the bird flu): an infectious disease in birds caused by a virus that can spread to humans
  • Travelers’ diarrhea –  the most common disease acquired by travelers.
  • Tuberculosis: an infectious disease involving the lungs, able to spread throughout the body

I strongly recommend that you develop a habit of checking the CDC travel site every time you prepare to travel internationally, including those of you coming from abroad into the United States. Detailed information on these diseases is available clicking the links, checking the search engine and at www.sterlingmedicaladvice.com.
Feel free to contact your SMA expert consultant with any questions you have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: The Medical Issues You Encounter While Flying

General Health and Wellness, , , , , , , , , ,

SAMC logo color 1
I’ve probably been engaged twenty times on airplanes to provide medical assistance. My favorite incident was when four doctors (and a nurse) simultaneously jumped to assistance as if everyone was some type of superhero. Of course, I wouldn’t be telling the story if I didn’t end up being the last man standing (due to my status as the emergency physician among the group – and yes, the patient was ok). Consider this your handy to do and to don’t if and when you’re traveling by air. You never know!
There are four quick considerations I’d like to share:
Blood clots: Flights (and especially the long ones) increase your risk for deep venous thrombosis (DVTs). You can reduce this risk by frequently bending and rotating your ankles, drinking water whenever the opportunity presents and getting up intermittently to walk. Prevention is also important – this is why traveling while in the latter stages of pregnancy is especially problematic and why near-term women aren’t allowed to travel (and you thought it only had to do with early deliveries!).
Headaches and earaches: Air in your body (lungs, intestines, sinuses and eardrums, to name a few) expand when your plane ascends and contracts upon descent. The squeeze on descent is actually more frequent of an issue than gases expanding on ascent, but both situations present problems. In addition to exacerbating migraines, your eardrums can rupture from the squeeze. Of course, adults address this by holding their noses and blowing, thus ‘popping’ their ears (actually this equalizes the pressure on both sides of the eardrum, returning things back to normal). Kids suffer just as much as adults, but the younger ones aren’t able to release the pressure as easily. Thus, it’s true that you should allow them to chew or suck on something during descent. The passenger sitting next to you will thank you.
Fainting: Fainting is a common occurrence on flights for many reasons. Faints and other mental status changes due to hypoglycemia are the most common episodes I’ve personally encountered on flights. My best advice here is to stay hydrated (This will help you prevent faints and problems with DVTs.) and if you’re diabetic, eat during the flight. Low sugar reactions are scary in the air, and the pilots are always wondering if they’ll need to do an emergency landing.
Respiratory disease: This is an important consideration because the potential for bad outcomes are heightened. Those with asthma, blood clots in the lungs (pulmonary emboli) and COPD (chronic obstructive pulmonary disease aka chronic bronchitis and emphysema) need to discuss traveling with their physicians. The high altitude of flights results in thinner air, drier air and increasing viscosity of your blood, which can affect patients suffering from the conditions mentioned. A ruptured lung in a patient with bad COPD is a formula for disaster.
In short, fly smart and fly healthy. An airplane is a horrible place to be in harm’s way. And that doesn’t even include snakes on a plane.
snakes-on-a-plane
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