Tag Archives: Lung

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cardiopulmonary (Heart and Lung) System

September 8, 2016Cardiology/Heart, Respiratory/Lungs, Health Prevention844-SMA-TALK, Behind the Curtain, Chronic bronchitis, Chronic obstructive pulmonary disease, Circulatory system, COPD, Disease, Lung, Pulmonary alveolus, Respiratory system, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

The fourth part of this series looks at your heart and lungs.

And now to today’s post.

One thing the heart and lung share in common is, left to their own devices, they could function normally for much longer than typically ends up occurring. It’s important to discuss because heart disease is the most common cause of death in people 65 and over, and it is also the most frequent cause of activity limitations. Let’s quickly review changes, challenges and solutions.

Heart Changes: Coronary artery disease increases as your activity declines. Blockages accumulate on the inside of your arteries, and they harden as they lose their elasticity. Both of these factors resulting in lessened blood flow. High blood pressure increases with age, independently and as a result of this.

Lung Changes: The air sacs, airways, and tissues lose elasticity and become more rigid with age. In general however, serious disease notwithstanding, the respiratory system can serve one well throughout a very long life. However, if you’re a smoker or have lung disease (e.g. asthma, COPD), the reversible damage to the lungs starts becoming irreversible about age 35. At that time, you in effect begin tearing out useful lung tissue, which diminishes your respiratory capacity and sets you up for chronic bronchitis and cancer, as the body attempts to repair this damage and does so incorrectly.
Challenges: In the absence of structural disease or continuing to expose yourself to toxins (e.g. cigarettes), the effects of these changes on our health status need not be severe. The social implications of the effects of normal changes due to aging often would not hamper reasonable normal functioning. The real challenge is to avoid inhaling toxins that will harm you (duh, right?).
Solutions: This is much simpler than you’d think and mostly involves prevention. The biological changes can be greatly diminished and held off by a regular, strenuous exercise regimen that causes deep breathing and elevation of your heart rate over a period of time and by avoidance of toxins, especially cigarette smoke and fatty foods. Your heart and lungs are well situated for the long haul in the absence of bad genes and bad habits.
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.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

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.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Spotlight on Health Concerns When Traveling – Vaccines and Illnesses

June 15, 2016General Health and Wellness, Health Prevention844-SMA-TALK, Chronic obstructive pulmonary disease, Deep vein thrombosis, health, Limited liability company, Lung, Pulmonary embolism, Sterling Medical Advice, Sterling Medical Wellness, SterlingMedicalAdvice.com, Straight No Chaser, ThrombusJeffrey Sterling, MD

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

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.

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.
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: Understanding Asthma – Toothpicks and Snot (Part 1 of 2)

March 24, 2016Respiratory/Lungs, Health Prevention844-SMA-TALK, American College of Allergy Asthma & Immunology, Asthma, Behind the Curtain, Conditions and Diseases, health, Lung, Respiratory Disorders, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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

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

Let’s get logical. Asthma management is theoretically straightforward if you can pull it off. Prevention is treatment. I used to describe this as “Kill the Cat.” (This blog neither supports, advocates, nor is responsible for the harming of any animals resulting from this information.) In short, if you identify the triggers that precipitate your asthma attacks and then remove yourself from that environment, you will dramatically reduce, if not eliminate, your attacks. This is often described (incorrectly) in kids as “growing out of their asthma.” No one grows out of it, and you don’t cure asthma; asthmatics just stop having attacks because they’re not around the triggers.
In Part II, we discuss asthma management. In case you’re wondering, that’s where the toothpicks come in.
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: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cardiopulmonary (Heart and Lung) System

September 10, 2015Cardiology/Heart, General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Chronic bronchitis, Chronic obstructive pulmonary disease, Circulatory system, COPD, Disease, Lung, Pulmonary alveolus, Respiratory system, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

The fourth part of this series looks at your heart and lungs.

And now to today’s post.

Heart Changes: Coronary artery disease increases as your activity declines. Blockages accumulate on the inside of your arteries, and they harden as they lose their elasticity. Both of these factors resulting in lessened blood flow. High blood pressure increases with age, independently and as a result of this.

Lung Changes: The air sacs, airways, and tissues lose elasticity and become more rigid with age. In general however, serious disease notwithstanding, the respiratory system can serve one well throughout a very long life. However, if you’re a smoker or have lung disease (e.g. asthma, COPD), the reversible damage to the lungs starts becoming irreversible about age 35. At that time, you in effect begin tearing out useful lung tissue, which diminishes your respiratory capacity and sets you up for chronic bronchitis and cancer, as the body attempts to repair this damage and does so incorrectly.
Challenges: In the absence of structural disease or continuing to expose yourself to toxins (e.g. cigarettes), the effects of these changes on our health status need not be severe. The social implications of the effects of normal changes due to aging often would not hamper reasonable normal functioning. The real challenge is to avoid inhaling toxins that will harm you (duh, right?).
Solutions: This is much simpler than you’d think and mostly involves prevention. The biological changes can be greatly diminished and held off by a regular, strenuous exercise regimen that causes deep breathing and elevation of your heart rate over a period of time and by avoidance of toxins, especially cigarette smoke and fatty foods. Your heart and lungs are well situated for the long haul in the absence of bad genes and bad habits.
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, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Our World is Filled with Toxins

March 21, 2014Health PreventionDetoxification, Drinking water, Erin Brockovich, Government, health, High-fructose corn syrup, Kidney, Liver, Lung, Toxin, United StatesJeffrey 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 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.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Spotlight on Health Concerns When Traveling – Vaccines and Illnesses

February 16, 2014General Health and Wellness, Health Prevention844-SMA-TALK, Chronic obstructive pulmonary disease, Deep vein thrombosis, health, Limited liability company, Lung, Pulmonary embolism, Sterling Medical Advice, Sterling Medical Wellness, SterlingMedicalAdvice.com, Straight No Chaser, ThrombusJeffrey Sterling, MD

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

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.

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.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Medical Issues You Encounter While Flying

February 15, 2014General Health and Wellness844-SMA-TALK, Chronic obstructive pulmonary disease, Deep vein thrombosis, health, Limited liability company, Lung, Pulmonary embolism, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, ThrombusJeffrey Sterling, MD

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.

Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

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

October 16, 2013Respiratory/Lungs, Health PreventionAmerican College of Allergy Asthma & Immunology, Asthma, Conditions and Diseases, health, Lung, Respiratory DisordersJeffrey Sterling, MD

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

Let’s get logical. Asthma management is theoretically straightforward if you can pull it off. Prevention is treatment. I used to describe this as “Kill the Cat.” (This blog neither supports, advocates, nor is responsible for the harming of any animals resulting from this information.) In short, if you identify the triggers that precipitate your asthma attacks and then remove yourself from that environment, you will dramatically reduce, if not eliminate, your attacks. This is often described (incorrectly) in kids as “growing out of their asthma.” No one grows out of it, and you don’t cure asthma; asthmatics just stop having attacks because they’re not around the triggers.
In Part II, we discuss asthma management. In case you’re wondering, that’s where the toothpicks come in.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Medical Issues You Encounter While Flying

September 20, 2013General Health and Wellness, Health PreventionChronic obstructive pulmonary disease, Deep vein thrombosis, health, Limited liability company, Lung, Pulmonary embolism, Thrombus, WordPressJeffrey Sterling, MD

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 – discussed in detail here). 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.

Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cardiopulmonary (Heart and Lung) System

September 12, 2013Cardiology/Heart, General Health and Wellness, Respiratory/Lungs, Health PreventionChronic bronchitis, Chronic obstructive pulmonary disease, Circulatory system, COPD, Disease, Lung, Pulmonary alveolus, Respiratory systemJeffrey Sterling, MD

The fourth part of this series looks at your heart and lungs. One thing the heart and lung share in common is, left to their own devices, they could function normally for much longer than typically ends up occurring. It’s important to discuss because heart disease is the most common cause of death in people 65 and over, and it is also the most frequent cause of activity limitations. Let’s quickly review changes, challenges and solutions.

Heart Changes: Coronary artery disease increases as your activity declines. Blockages accumulate on the inside of your arteries, and they harden as they lose their elasticity. Both of these factors resulting in lessened blood flow. High blood pressure increases with age, independently and as a result of this.
Lung Changes: The air sacs, airways, and tissues lose elasticity and become more rigid with age. In general however, serious disease notwithstanding, the respiratory system can serve one well throughout a very long life. However, if you’re a smoker or have lung disease (e.g. asthma, COPD), the reversible damage to the lungs starts becoming irreversible about age 35. At that time, you in effect begin tearing out useful lung tissue, which diminishes your respiratory capacity and sets you up for chronic bronchitis and cancer, as the body attempts to repair this damage and does so incorrectly.
Challenges: In the absence of structural disease or continuing to expose yourself to toxins (e.g. cigarettes), the effects of these changes on our health status need not be severe. The social implications of the effects of normal changes due to aging often would not hamper reasonable normal functioning. The real challenge is to avoid inhaling toxins that will harm you (duh, right?).
Solutions: This is much simpler than you’d think and mostly involves prevention. The biological changes can be greatly diminished and held off by a regular, strenuous exercise regimen that causes deep breathing and elevation of your heart rate over a period of time and by avoidance of toxins, especially cigarette smoke and fatty foods. Your heart and lungs are well situated for the long haul in the absence of bad genes and bad habits.
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Straight, No Chaser: Your Questions About Gunshot and Stab Wounds

August 1, 2013Medical Treatment, Skin/Dermatology, Trauma, Health PreventionBallistic trauma, Chest, Government, Gun Shot Wound, Lung, Medical examiner, Penetrating Trauma, Pneumothorax, Stab Wound, United States, WoundJeffrey Sterling, MD

Your Top Five Questions:
1. Why don’t the bullets always get taken out?
Removal of bullet may cause more damage than leaving them in. It’s sometimes not worth the effort.
2. What’s with the tubes that go in the chest?
Chest tubes are used to treat a pneumothorax (a collapsed lung). The problem is there’s air in the space between the lung and the chest wall. This can interfere with normal breathing and may be life threatening. The tubes go through the chest wall to release the air from that space, thus allowing re-expansion of the lungs.
3. Why would doctors ever need to slit someone’s throat to save their lives?
That describes either a cricothyrotomy or a tracheostomy, and it’s not ‘slitting’ the throat as much as it’s creating an opening in the airway to permit airflow. This is usually necessary because of some airway obstruction at the upper throat (foreign body in the throat, etc.) with an inability to clear it. This procedure is only done to save a life.
4. Why would you die from a wound to the thigh?
Fractures of certain bones and laceration of certain blood vessels are potentially associated with enough blood loss that you could bleed to death. Infection and blood clots are additional considerations that could be life-threatening.
5. What about gunshot or stab wounds to someone pregnant?
Penetrating trauma to the abdomen is typically less fatal to the mother than to a fetus because the fetus is literally acting as a shield. In the event any wound has placed the mother’s life at risk or the mother has died from the wound, under certain extreme circumstances, an emergency C-section may be performed to save the baby.