Tag Archives: mental-health

The Other Upcoming Pandemic

Introduction

This Straight, No Chaser looks at mental health as an equivalent of an upcoming pandemic.

The general American population (and perhaps the world in differing amounts) is about to get a up close look at what is known as social determinants of health. With another 5.2 million Americans filing for unemployment (raising the number to over 22 million over the last four weeks), we are reaching a critical mass of economic hardship. As a result, someone (everyone) needs to prepare for the mental health ramifications of this.

Mental Health Challenges

Here are some predictable scenarios, each with mental health consequences:

• Depressions (and even suicide rates) will explode.
• Individuals prone to post-traumatic stress will have flare ups. Also, others will develop an equivalent of it.
• Americans will be forced to choose between food and medicine. Unfortunately, others won’t have either as an option and will become ill (and die) as a result.
• We will become angry. Anger will be expressed; in some cases rightfully so, and it will be displaced inappropriately. Predictably, we have already begun to see demonstrations.
• In some instances, there will be violence. This will range from domestic violence to outward expressions. Sadly, everyone’s fuse is shortening.

How Will You Cope?

There’s so much more, but you should get the point. The question, of course, is how will you cope with the upcoming pandemic of mental health issues? Do you have the means, inclination and access to get help? Let’s start with self-help measures you can take. From there, just being mindful that these issues will be arising may convince you to get help when you need it. Also take the time to look after those you care for. Actually engage people in conversations about their mental health. For years, I’ve told patients that when I asked them how they were doing, it wasn’t a pleasantry but an actual inquiry. Care enough to do the same. We’re all in this together. When things “return to normal,” maybe show a little empathy for those for whom this has always been their normal.

Straight, No Chaser Posts on Mental Health

Stress Management

Developing a Stress Management Plan

Post-Traumatic Stress Syndrome in Communities

Depression: How to Avoid it and When to Get Help

Suicide Risks and Prevention

How to Escape a Domestic Violence Situation

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled (without shipping delays!) at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

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Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

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Domestic Violence Awareness Month

Introduction

Domestic Violence

October is Domestic Violence Awareness Month, although it doesn’t take a break during other months. Are you concerned about domestic violence? Probably, you should be. You are not alone. Domestic violence (DV) occurs in every culture and society. Also, it occurs in all age groups and in men and women. DV occurs in all races, income levels and religions. Likewise, it occurs in heterosexual and homosexual relationships. Furthermore, it is estimated that one in four women and one in nine men will be victims of DV at some point in their lives. That’s right. As a result, many (if not most) emergency rooms now screen every single woman for domestic violence. Therefore, you need to know the signs of danger and what you can do to get help.

A Simple Definition of Domestic Violence

Domestic violence is the abuse that one person with control in a household inflicts on another. Perpetrators can include parents or other caregivers, siblings, spouses or intimate partners. DV reveals itself in several forms, including sexual (e.g., rape), physical (e.g., biting, hitting, kicking) and mental abuse (e.g., constant criticisms or threats, limiting ability to lead otherwise normal lives). These forms tend to center around abnormal control of an aspect of another’s life. Even more, the level of mental control is such that victims of DV often internalize the activity as normal. They also assign fault to themselves and/or accept responsibility for the abuse.

Domestic violence is a crime in all 50 states of the U.S.

First of all, it is a crime.

Above all, victims do not cause abuse and are not responsible for it.

national domestic violence hotline

Domestic Violence Awareness and Mental Health

Domestic violence has consistent adverse effects on mental health.

  • Children suffering from domestic violence often display developmental delays and aggressive behavior. Also, they have difficulty performing in school and tend to have low self-esteem. Furthermore, they are at greater risk for being diagnosed with a psychiatric disorder.
  • Domestic violence increases the diagnoses of anxiety disorder, depression, panic attacks and post-traumatic stress disorder. It is also associated with an increase in substance abuse.
  • DV increases the incidence of psychotic episodes, suicide attempts and homelessness. Its presence also slows recovery from those suffering from other mental illness.
  • DV increases the risk of retaliatory violence against the perpetrators.

Please … contact us if you’re in need of support. Our expert crisis counselors are here for you, 24/7. 1-844-724-7754 or www.SterlingMedicalAdvice.com. You don’t have to “endure with dignity.”

There’s More!

Read these additional Straight, No Chaser posts as part of Domestic Violence Awareness Month.

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

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

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Frequently Asked Questions About Lead Poisoning

Introduction

lead_poisoning1

Medically speaking, it really wasn’t long ago when dozens of cases of lead poisoning in Flint, Michigan occurred. Of course, this was a result of elevated levels of lead in the city’s drinking water supply. This followed inadequate preventive treatment of the water supply, which is a necessary step in the provision of public health. The water had become contaminated from aging pipes in the Flint river, which became relevant after the city switched its water supply from Detroit sources in 2014. It’s hard to fathom that the number of poisonings was so high the city declared a state of emergency. It’s even harder to accept the suboptimal response that occurred to the emergency.

In case you’re wondering, yes, this could happen to you. If you read on, we’ll tell you how to minimize your exposure. Let’s review some frequently asked questions.

What is lead poisoning? Why is it dangerous?

Lead is a chemical element (“mineral”) that is quite poisonous in humans. Swallowing or breathing lead dust can cause major health problems, both immediately (with a very high exposure), or more commonly, over time with ongoing exposures to low levels. The particular concern is in exposure to children. As is the case with head injuries or most any other type of insult to a developing child’s brain and nervous system, a significant risk to one’s mental development occurs apoteksv.se. The younger the child, the more dangerous the exposure is; the highest risks are in the unborn.

lead

How does one get poisoned? What are the risk factors?

Lead used to be very common in gasoline and house paint in the U.S., but lead based paint was banned in 1978. It is estimated that approximately 4 million Americans are still significantly exposed to potentially toxic levels of lead, because lead basically is everywhere, including old house paint, new toys, dust, dirt and gasoline. Children living in cities with older houses are more likely to have high levels of lead.

Most common exposures

Here’s a quick list of lead exposures (there are many other potential exposures):

  • Homes, toys and furniture painted in the US before 1978 and any toys made outside the US (no, the paint doesn’t have to be peeling);
  • Plumbing, pipes, faucets and the water flowing through them;
  • Soil contaminated by car exhaust (think near expressways or busy streets) or house paint scrapings (think old abandoned buildings); and
  • Storage batteries

Take these exposures seriously, because lead exposure comes from swallowing, touching and/or breathing objects containing lead particles. Once in the body and bloodstream, it spread, causing damage throughout. Two notable areas of concern are the effects of lead on blood cells (causing anemia) and on bones (preventing healthy, strong teeth and bone function due to reducing the absorption of calcium.

Lead-Poisoning

How does lead poisoning get identified? What are the signs and symptoms?

Lead poisoning can affect many different parts of the body, and symptoms can range from nothing obvious to dramatic mental impairment. Symptoms are more prominent as blood lead levels get higher.

Lead is much more harmful to children than adults because it can affect children’s developing nerves and brains. The younger the child, the more harmful lead can be. Unborn children are the most vulnerable.

It’s important to reiterate that many with lead poisoning won’t have signs of illness early on. If you believe your environment poses a risk, you should ask to be checked. Symptoms are often nonspecific, but if you can remember groupings of symptoms, you’d be on the right track.

Early Symptoms

  • Behavioral problems may exist such as irritability, difficulty concentrating, sluggishness or fatigue.
  • Digestive tract problems may exist, such as loss of appetite, a metallic taste in one’s mouth, weight loss, nausea, vomiting, constipation and/or abdominal pain.
  • Neurologic problems may exist, such as headaches, muscle and joint weakness or pain, seizures.
  • Pale skin from anemia is also often a prominent finding.

Longer Term Health Problems

  • damage to the nervous system (such as poor muscle coordination, speech and language problems), kidneys, and/or hearing
  • decreased bone and muscle growth
  • developmental delay

The next Straight, No Chaser will address prevention and treatment strategies.

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

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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Challenges to Your Mental Health and Happiness

Introduction

Mental-health

You all have challenges to your mental health and happiness. We are mindful that there are as many of you unsuccessful as there are successful in navigating these challenges. Everyone has thoughts about the keys to happiness, but we can objectify the conversation! Let’s identify what is most likely to make you unhappy and lead to depression. You may find this hard to believe, but outside of medical causes of psychiatric illness and factors outside of your control, there are actually three choices we make that most commonly adversely impact your happiness and good mental health. Take it as you will, but the data is quite clear. Stay away from these circumstances, and you’re less likely to be unhappy. Sometimes mental health is achieved via addition by subtraction.

Health Problems

HealthIssues

People who are sick or have significant illness in their families generally aren’t happy. Although this may seem obvious and perhaps unfair, given that some illnesses and conditions are inherited or occur haphazardly, be mindful of the things you can control. Of course, this gets to the negative effects of obesity and smoking. More so than any other health-related activities/conditions, these will eventually lead to deteriorating health and subsequent unhappiness.

Job Problemsneed-job

You don’t have enough to do with your time? As the saying goes, an idle mind is the Devil’s workshop. It should be pointed out that neither too much work nor the wrong type of work (i.e., low job satisfaction) seems to promote either happiness or solid mental health. On average, people change careers seven times during their lifetimes. It’s often due to a search for happiness and actually is a good thing to do to avoid being stuck in a bad situation. Follow the job you love, and you’re more likely to be both happy and successful.

Relationship Problems

You make bad relationship choices? Well there’s one specific choice that is shown to be most likely to reduce your happiness—choosing a neurotic partner. What’s neurotic? For one particularly disruptive example, think about the so-called Drama Queen/King. A neurotic partner responds emotionally to events that wouldn’t affect most people, and their reactions tend to be more intense than normal. They’re more likely to interpret minor frustrations as hopelessly difficult. Their negative emotional reactions persist for unusually long periods of time. In short, if you want to be really unhappy, become attached to such a person. They will negatively affect your world, keeping you embroiled in drama and unhappiness, no matter how good the financial, physical, or other parts of your relationship.
Mental Health
Now your results may vary but probably won’t. I’m not make judgements, just sharing the data. Your life choices have consequences as related to your mental health. Choose wisely!

Click here for more on avoiding depression.

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

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Please share our page with your friends on WordPress! Like us on Facebook SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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Suicide Risks on College Campuses

Introduction

This post looks at suicide risks on college campuses.

Crisis_300x300

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

PreventingSuicide2ndPageTop

Suicide Data

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

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

depression_suicide_statsRisks for Suicide at College

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

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

Suicide-Rates-Among-College-Students

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

  • It shouldn’t be difficult to appreciate how the lack of social support is one of the most powerful predictors of persistent suicidal thoughts. Appreciate that someone expressing or having feelings of being unappreciated, unloved and uninvolved with family and friends should be considered at risk. Unfortunately, this is true even in the absence of any other risk factors.
  • Those with a history of clinically diagnosed depression or other psychiatric diagnoses are at significant risk.
  • Also, risk exist in those with exposure to domestic violence (either witnessing or having been abused) in childhood.
  • Finally, having a mother with a history of clinical depression also increases the risk of suicide in students.

There are many Straight, No Chaser posts that address suicide prevention, diagnosis and treatment.

Follow us!

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

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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Self Assessment for Signs of Early Dementia or Alzheimer’s

Introduction

This post offers tools for self assessment for signs of early dementia or Alzheimer’s disease.

Alzheimer's and Dementia

Each of us has elderly family members for whom we may be concerned about their memory or other possible signs of dementia. You don’t have to stand by powerless and let them dwindle away. Early detection of dementia gives the best chance for a higher quality during the rest of one’s life. Isn’t that how we’d all want our loved ones to spend their golden days? This Straight, No Chaser post adapts information provided by the Alzheimer’s Association. Any positive responses can suggest an issue warranting further investigation. The goal here is straightforward. If any concerns arises after completing this, you should print out the sheet, and take it to your physician, requesting an evaluation.
early dementia or alzheimer's

Self Assessment Questions

_____ 1. Memory loss that disrupts daily life.

One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Other signs include forgetting important dates or events; asking for the same information over and over; relying on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. Typical age-related changes involve sometimes forget names or appointments, especially if you remember them later.

_____ 2. Challenges in planning or solving problems.

Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. Typical age-related changes include making an occasional error when balancing a checkbook.

_____ 3. Difficulty completing familiar tasks at home, at work or at leisure.

People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. Typical age-related changes include occasionally needing help to use the settings on a microwave or to record a television show.

_____ 4. Confusion with time or place.

People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. Typical age-related changes include occasionally getting confused about the day of the week, especially if s/he figures it out later.

_____ 5. Trouble understanding visual images and spatial relationships.

For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not recognize their own reflection. Typical age-related changes of vision changes are related to cataracts and do not indicate Alzheimer’s.

_____ 6. New problems with words in speaking or writing.

People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a watch a “hand clock”). Typical age-related changes involve sometimes having trouble finding the right word.

_____ 7. Misplacing things and losing the ability to retrace steps.

A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. It’s more typical to displace things from time to time, such as a pair of glasses or the remote control.

_____ 8. Decreased or poor judgment.

People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. It’s less concerning for anyone of any age to make a bad decision once in a while.

_____ 9. Withdrawal from work or social activities.

A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. It’s more typical for anyone of any age to sometimes feel weary of work, family and social obligations.

_____ 10. Changes in mood and personality.

The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. It’s more typical for people as they age to develop very specific ways of doing things and to become irritable when a routine is disrupted.
It is worth restating: early diagnosis provides the best opportunities for treatment, support and future planning. For more information, call the Alzheimer’s Association at 800.272.3900 or your SterlingMedicalAdvice.com expert consultants.

Follow us!

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

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright ©2013- 2019 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Self-Assessment for Signs of Early Dementia or Alzheimer’s

Dementia Not Human

Each of us has elderly family members for whom we may be concerned about their memory or other possible signs of dementia. You don’t have to stand by powerless and let them dwindle away. Early detection of dementia gives the best chance for a higher quality during the rest of one’s life. Isn’t that how we’d all want our loved ones to spend their golden days? This Straight, No Chaser post adapts information provided by the Alzheimer’s Association. Any positive responses can suggest an issue warranting further investigation. The goal here is straightforward. If any concerns arises after completing this, you should print out the sheet, and take it to your physician, requesting an evaluation.
dementia loss
_____ 1. Memory loss that disrupts daily life. One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Other signs include forgetting important dates or events; asking for the same information over and over; relying on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. Typical age-related changes involve sometimes forgetting names or appointments, especially if you remember them later.
_____ 2. Challenges in planning or solving problems. Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. Typical age-related changes include making an occasional error when balancing a checkbook.
_____ 3. Difficulty completing familiar tasks at home, at work or at leisure. People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. Typical age-related changes include occasionally needing help to use the settings on a microwave or to record a television show.
_____ 4. Confusion with time or place. People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. Typical age-related changes include occasionally getting confused about the day of the week, especially if s/he figures it out later.
_____ 5. Trouble understanding visual images and spatial relationships. For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not recognize their own reflection. Typical age-related changes of vision changes are related to cataracts and do not indicate Alzheimer’s.
_____ 6. New problems with words in speaking or writing. People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a watch a “hand clock”). Typical age-related changes involve sometimes having trouble finding the right word.
_____ 7. Misplacing things and losing the ability to retrace steps. A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. It’s more typical to displace things from time to time, such as a pair of glasses or the remote control.
_____ 8. Decreased or poor judgment. People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. It’s less concerning for anyone of any age to make a bad decision once in a while.
_____ 9. Withdrawal from work or social activities. A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. It’s more typical for anyone of any age to sometimes feel weary of work, family and social obligations.
_____ 10. Changes in mood and personality. The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. It’s more typical for people as they age to develop very specific ways of doing things and to become irritable when a routine is disrupted.
It is worth restating: early diagnosis provides the best opportunities for treatment, support and future planning. For more information, call the Alzheimer’s Association at 800.272.3900 or your SterlingMedicalAdvice.com expert consultants.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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The Effects of PTSD on Children

Introduction

This post discusses the effects of PTSD on children.

PTSD-on-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

ptsd in children

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

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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: Post-Traumatic Stress Disorder – Signs, Symptoms and Those at Risk

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Memorial Day serves to honor our fallen heroes. Part of that involves caring for our soldiers still with us. Understanding and acknowledging the mental components of their suffering remains a vital and underachieved need. Our soldiers disproportionately suffer from several mental disorders, notably, post-traumatic stress disorder. Today’s post begins a review of post-traumatic stress disorder (PTSD). We thank all of our veterans for their service.
I’ve dealt with disease and death everyday as an Emergency Physician, and it has been dehumanizing on many levels. Imagine having to pronounce someone dead despite giving your version of a superhuman effort to resuscitate them and then having to deliver the news to a family deep in prayer and holding on to strings of hope. Oh yeah, and then you immediately get to return to a room filled with patients and families oblivious to anything you’re dealing with as an individual, who are completely immersed in their personal situations and often complaining because “you took too long.” Imagine the lives of morticians or cemetery workers, having to stare at and feel the remains of the dead all day everyday. Imagine the lives of those habitually raped or viciously beaten by a loved one as a child. And, of course, there are the soldiers. Over 7.5 million Americans are thought to be suffering from post-traumatic stress disorder (PTSD), approximately one in every 40 individuals.
Traumatic and post-traumatic stress are not only able to affect your reality, but to adjust your reality. The body’s normal “fight-or-flight” response to danger or extremely stressful situations can evolve into abnormalities in your behavior if you are continually immersed in these environments. One such as the emergency physician may become desensitized and/or empowered to address situations that would make otherwise normal individuals recoil, or one may become overly sensitive, hyper-stressed and prone to a fight response to lesser stimuli—or no stimuli at all.
There are three categories of symptoms of PTSD, which are easily remembered by thinking of a hyperactive “fight-or-flight” response: reliving traumatic experiences, avoiding circumstances or situations that remind one of the experience, and reacting out of hyperarousal to stimuli suggestive of the experience.
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  • Reliving can involve flashbacks, scary thoughts and nightmares. Victims have been known to actually re-experience the physical and mental episodes, complete with palpitations, sweating, jitteriness and severe anxiety. Such experiences can become incapacitating.
  • Avoidance is in many ways the opposite end of the “fight or flight” syndrome. In this example, avoidance isn’t just being proactive and staying away from reminders of the experience, but it can escalate to loss of emotions or even recollection of the event. This isn’t a strategic decision; it’s a defense mechanism gone haywire. As an example, imagine the near-drowning victim who refuses to even sit on the beach.
  • Hyperarousal leads one to be on edge, sensitive and prone to overreact. In contrast to the other two symptoms listed, hyperarousal tends to be a constant state of being. PTSD victims with hyperarousal describe themselves as easily angered and always stressed.

Many if not most of us will experience traumatic events in our lives sufficient enough to cause tremendous stress. There are circumstances that enhance the risk of developing PTSD.

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  • Childhood trauma is especially dangerous in that the developing brain can respond “appropriately” in coding for abnormal circumstances and exposures. Subsequent trauma can trigger PTSD-quality responses.
  • Women are more likely to develop PTSD than men.
  • Mental illness may abnormally shape responses to traumatic events.
  • There is some evidence that susceptibility to the disorder may run in families. Individual differences in the brain or genes may predispose an individual.
  • The relative absence of social support and a functional network is a severe risk.

Conversely, if you have strong coping mechanisms, you may be able to lower your risk for developing PTSD after trauma. Consider the following protective factors:

  • A predisposition toward optimism
  • The ability and inclination to seek out support from others, ranging from friends, family and/or an active support group
  • A mental orientation that you “performed well” in the face of the danger
  • A mental orientation of learning from the experience instead of allowing the experience to define you
  • Sufficient mental fortitude to be able to carry on in the face of the symptoms (fear, anxiety) that follow the event

The presence of these “resilience factors” does not suggest that those suffering from PTSD are lacking in any way; it suggests the best opportunities for you to avoid succumbing to the enormous pressures that exist.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Straight, No Chaser In the News: Lead Poisoning

lead_poisoning1

In the news is the story of dozens of cases of lead poisoning in Flint, Michigan, resulting from elevated levels of lead in the city’s drinking water supply. This followed inadequate preventive treatment of the water supply, a necessary step in the provision of public health. It appears that the water had become contaminated from aging pipes in the Flint river, which became relevant after the city switched its water supply from Detroit sources in 2014. The number of poisonings has been so high the city has declared a state of emergency. In case you’re wondering, yes this could happen to you, but if you read on, we’ll tell you how to minimize your exposure.
What is lead poisoning? Why is it dangerous?
Lead is a chemical element (“mineral”) that is quite poisonous in humans. Swallowing or breathing lead dust can cause major health problems, both immediately (with a very high exposure), or more commonly, over time with ongoing exposures to low levels. The particular concern is in exposure to children. As is the case with head injuries or most any other type of insult to a developing child’s brain and nervous system, a significant risk to one’s mental development occurs. The younger the child, the more dangerous the exposure is; the highest risks are in the unborn.

lead

How does one get poisoned? What are the risk factors?
Lead used to be very common in gasoline and house paint in the U.S., but lead based paint was banned in 1978. It is estimated that approximately 4 million Americans are still significantly exposed to potentially toxic levels of lead, because lead basically is everywhere, including old house paint, new toys, dust, dirt and gasoline. Children living in cities with older houses are more likely to have high levels of lead.
Here’s a quick list of lead exposures (there are many other potential exposures):

  • Homes, toys and furniture painted in the US before 1978 and any toys made outside the US (no, the paint doesn’t have to be peeling);
  • Plumbing, pipes, faucets and the water flowing through them;
  • Soil contaminated by car exhaust (think near expressways or busy streets) or house paint scrapings (think old abandoned buildings); and
  • Storage batteries

Take these exposures seriously, because lead exposure comes from swallowing, touching and/or breathing objects containing lead particles. Once in the body and bloodstream, it spread, causing damage throughout. Two notable areas of concern are the effects of lead on blood cells (causing anemia) and on bones (preventing healthy, strong teeth and bone function due to reducing the absorption of calcium.

Lead-Poisoning

How does lead poisoning get identified? What are the signs and symptoms?
Lead poisoning can affect many different parts of the body, and symptoms can range from nothing obvious to dramatic mental impairment. Symptoms are more prominent as blood lead levels get higher.
Lead is much more harmful to children than adults because it can affect children’s developing nerves and brains. The younger the child, the more harmful lead can be. Unborn children are the most vulnerable.
It’s important to reiterate that many with lead poisoning won’t have signs of illness early on. If you believe your environment poses a risk, you should ask to be checked. Symptoms are often nonspecific, but if you can remember groupings of symptoms, you’d be on the right track. Consider the following:

  • Behavioral problems may exist such as irritability, difficulty concentrating, sluggishness or fatigue.
  • Digestive tract problems may exist, such as loss of appetite, a metallic taste in one’s mouth, weight loss, nausea, vomiting, constipation and/or abdominal pain.
  • Neurologic problems may exist, such as headaches, muscle and joint weakness or pain, seizures.
  • Pale skin from anemia is also often a prominent finding.

Over the longer term, health problems include the following:

  • damage to the nervous system (such as poor muscle coordination, speech and language problems), kidneys, and/or hearing
  • decreased bone and muscle growth
  • developmental delay

The next Straight, No Chaser will address prevention and treatment strategies.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Straight, No Chaser: Suicide and Suicide Risks in College Students

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

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

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

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

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

Suicide-Rates-Among-College-Students

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

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

There are many Straight, No Chaser posts that address suicide prevention, diagnosis and treatment. Feel free to use the search box on the right for additional information.If you are a college student or a family member of a college student, you would do well to review your college’s support system and learn about services and support available for those in need of mental/behavioral health services. College should represent the beginning of one’s adult life, not the place where it ends.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Straight, No Chaser: Self-Assessment for Signs of Early Dementia or Alzheimer’s

Dementia Not Human

Each of us has elderly family members for whom we may be concerned about their memory or other possible signs of dementia. You don’t have to stand by powerless and let them dwindle away. Early detection of dementia gives the best chance for a higher quality during the rest of one’s life. Isn’t that how we’d all want our loved ones to spend their golden days? This Straight, No Chaser post adapts information provided by the Alzheimer’s Association. Any positive responses can suggest an issue warranting further investigation. The goal here is straightforward. If any concerns arises after completing this, you should print out the sheet, and take it to your physician, requesting an evaluation.
dementia loss
_____ 1. Memory loss that disrupts daily life. One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Other signs include forgetting important dates or events; asking for the same information over and over; relying on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. Typical age-related changes involve sometimes forget names or appointments, especially if you remember them later.
_____ 2. Challenges in planning or solving problems. Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. Typical age-related changes include making an occasional error when balancing a checkbook.
_____ 3. Difficulty completing familiar tasks at home, at work or at leisure.People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. Typical age-related changes include occasionally needing help to use the settings on a microwave or to record a television show.
_____ 4. Confusion with time or place. People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. Typical age-related changes include occasionally getting confused about the day of the week, especially if s/he figures it out later.
_____ 5. Trouble understanding visual images and spatial relationships. For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not recognize their own reflection. Typical age-related changes of vision changes are related to cataracts and do not indicate Alzheimer’s.
_____ 6. New problems with words in speaking or writing. People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a watch a “hand clock”). Typical age-related changes involve sometimes having trouble finding the right word.
_____ 7. Misplacing things and losing the ability to retrace steps. A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. It’s more typical to displace things from time to time, such as a pair of glasses or the remote control.
_____ 8. Decreased or poor judgment. People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. It’s less concerning for anyone of any age to make a bad decision once in a while.
_____ 9. Withdrawal from work or social activities. A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. It’s more typical for anyone of any age to sometimes feel weary of work, family and social obligations.
_____ 10. Changes in mood and personality. The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. It’s more typical for people as they age to develop very specific ways of doing things and to become irritable when a routine is disrupted.
It is worth restating: early diagnosis provides the best opportunities for treatment, support and future planning. For more information, call the Alzheimer’s Association at 800.272.3900 or your SterlingMedicalAdvice.comexpert consultants.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Life, Death and Grief

stages-of-grief
It’s never easy discussing death. Bereavement is the state of mourning and sadness we endure after the death of a loved one. Grief is that process we endure, either in anticipation of death or in bereavement. Humans have been shown to systematically show grief in a predictable way. This Kubler-Ross model famously describes the response of those dying.

  • Denial, accompanied with simultaneous emotional numbness
  • Anger over the loss
  • Bargaining, as if the possibility of staying alive exists
  • Depression and intense mourning
  • Acceptance

The real point of bringing up the grieving process is to point out that the loss of a loved one is an extremely dangerous time for those left behind. In fact, the death of a spouse is the single highest risk factor for one’s own death. I’m sure many of us can think back to an elderly couple who died months apart.
The period of bereavement is a time when people need to come together, provide support and take care of each other. It’s very important that you and your loved ones know that the emotions you will experience are universal and normal. Try to keep that in mind when the time comes. Be reminded that normal grief can last over a year. Don’t feel abnormal because of the difficulties you may be having moving on. It’s healthy to work through your pain.
Common psychological thought describe four trajectories we take in bereavement.

  • Resilience – the attempt to ‘stay strong’ through it all
  • Recovery – evolution toward a healthy honoring and appreciation of the life of the lost
  • Chronic dysfunction – the unfortunate circumstance of being stuck in the mourning process such that it cripples your existence
  • Delayed grief or trauma – the subsequent release and expression of those suppressed emotions

Grief is to be considered a necessary and healthy part of a recovery process that we should learn to embrace. Here’s hoping you find the path to celebrating the lives of your loved ones when they’ve made the final transition.
I welcome any questions you may have.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Mass Trauma, Community Stress and Post-Traumatic Stress Disorder

masstrauma nairobi shootings

If you’ve been following the Straight, No Chaser series on post-traumatic stress disorder, it may have occurred to you that episodes that some might be able to handle when taken in isolation can have dramatically different psychological effects on others. It gives one pause and a cause to reflect on recent episodes in the news locally and abroad through a different prism.
This is the fourth in a series on Post-Traumatic Stress Disorder (PTSD).

  • For an introduction to PTSD, including signs, symptoms and those at risk, click here.
  • For a discussion of the diagnosis and treatment of PTSD, click here.
  • For a discussion of the effects of PTSD in children, click here.

ptsddisasters

When entire communities are affected by a mass trauma such as a natural disaster, a terrorist attack, the effects of war or even a seemingly senseless death within the community, many can develop signs of post-traumatic stress disorder (PTSD). In these instances, symptoms tend to develop in the first few weeks after the episode. This is a normal, expected and shared community response to serious trauma. Fortunately, when communities suffer trauma, resources are more likely to become readily available, which allows many to experience a lessening of symptoms over time.
In the immediate timeframe of the event, vital measures for physical and mental wellbeing should include the following.

  • Getting medically evaluated and to a safe place
  • Securing food and water
  • Contacting loved ones or friends
  • Learning what is being done to help and either provide or receive help as needed

A woman cries while sitting on a road amid the destroyed city of Natori, Miyagi Prefecture in northern Japan March 13, 2011, after a massive earthquake and tsunami that are feared to have killed more than 10,000 people. Picture taken March 13, 2011. REUTERS/Asahi Shimbun (JAPAN - Tags: DISASTER ENVIRONMENT) JAPAN OUT. NO COMMERCIAL OR EDITORIAL SALES IN JAPAN. FOR EDITORIAL USE ONLY. NOT FOR SALE FOR MARKETING OR ADVERTISING CAMPAIGNS
Unfortunately, some individuals just do not get better on their own. Although most people tend to improve with time after a community disaster, it is not uncommon for some to become more distressed and to exhibit more symptoms of PTSD, depression, and other mental health conditions. There are so many variables in play based on the type of disaster that occurred. Some people are effective at rebuilding their lives if the available resources are appropriate for the type of effect it had on them personally, but others may experience ongoing stress from loss of jobs and schools, trouble paying bills, finding housing, and getting healthcare. These types of stressors compound the effects of the disaster and may delay recovery in those affected by PTSD.
Many in the public health communities are embracing a comprehensive version of mass trauma “psychological first aid.” This complement to medical and financial resources is meant to fill existing voids in post-community disaster care delivery. Otherwise treatment approaches are generally similar to treatment of other forms of PTSD.
At the end of it all, disasters are just that. It would be a good thing for you and your family to be aware of the types of community disasters you may be exposed to and prepare before you ever need help. Having emergency numbers and other resources on your person at all times can be the difference between life and death when seconds count. Here’s hoping you either never need such assistance or you’re prepared enough during a disaster to make it through ok.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: The Effects of PTSD on Children

PTSD-And-Children

This is part of a series on post-traumatic stress disorder (PTSD).

  • For a review of PTSD signs, symptoms and those at risk, click here.
  • For a review of PTSD diagnosis and treatment, click here.

ptsd kids

Children are exposed to the same stimuli that creates post-traumatic stress disorder (PTSD), including physical abuse, sexual assault and the effects of war, but they may have different responses and  symptoms than adults. Symptoms unique to children typically involve developmental regression and may include the following:

  • Clinginess
  • Bedwetting
  • Cessation of speech
  • Acting out the scary event

Teens may become disruptive, disrespectful, or destructive, and they may express guilt or engage in revenge.
Think about these things when your children have been victims of bullying, abandonment or assault. You have to think about PTSD in order to recognize help may be needed. It is very important to get counseling for children that have experienced a traumatic event. The effects may be subtle but could be devastating and long-lasting.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Do Medications Work Differently in Older People?

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The elderly are living longer and more productively. Part of being able to do so is by maintaining an understanding of how your actions  affect you. One common action of many of the elderly is taking medications. You should be aware that medications have changing effects with aging, and there are many different reasons for that fact.
First of all, changes in our physiology due to aging make the effects of drugs less predictable and consistent than in younger people. A slower metabolism, increases in body fat and alterations in the function of the kidney and liver (major mechanisms for drug elimination) have important ramifications for what ingested substances will do. Thus, the elderly require more stringent monitoring of drug levels and effects, and you may find that your physician needs to adjust medication doses. This same consideration explains why side effects are more common among the elderly.
Be reminded the presence of other diseases brings additional effects and challenges. Just as with one’s own relatively diminished function, disease imposes the same type of changes onto the body. This can speed the presence of side effects and toxicity as well as adjust the effective dose of a medication.

medmngt

Have you ever seen the individual with a small ‘army’ of medications? Think about it. The more medications one takes, the more likely drug interactions will ensue and changes in effectiveness in any single medication may occur. This effect incrementally increases with each additional drug one takes. Similarly, the more medications one is taking, the most likely one is to make a mistake in taking the correct medication at the right time. Now consider your independently living parents or grandparents. The elderly often are more prone to make these types of errors.
What can you do about this? Get organized, and get help! Those daily medication containers are good solutions to incorrectly dosing medications. If you’re especially organized, a log is great—not necessarily for you, but for the physician that will be trying to figure out why you’re dizzy or have an altered mental status if and when that occurs.
Talk with each doctor you see or a pharmacist about what to expect from the combination of medications you take; it can make your lives a lot less complicated.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: When Eating Goes Wrong, Part I – Anorexia

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Simply put, our society doesn’t do the job it should in promoting a normal image of health at either end of the body size spectrum. The typically promoted American ideal of beauty sets standards that lead many to pursue unrealistic means of meeting that ideal. In the setting of an actual American population that is disproportionately obese by medical standards, this becomes even more of a problem, as individuals give up on realistic goals and settle into unhealthy eating habits that lead to disease due to obesity.
Most people are aware of two eating disorders (on the low side that is; obesity is another conversation): anorexia and bulimia. It is important to note that eating disorders are real medical and mental diseases. It is equally important to understand that they can be treated. It is vitally important to understand that when left untreated these disorders lead to a much higher incidence of death than in those without these conditions. These diseases cause severe disturbances in one’s diet, so much so that individuals spiral out of control toward severe disease and death in many instances. Sufferers of eating disorders often have a distorted self-image and ongoing concerns about weight and appearance. (This is as true for those pathologically overweight and in denial as it is for those pathologically underweight.)
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Today’s Straight, No Chaser discusses anorexia. Anorexia nervosa is an eating disorder with nearly a 20 times greater likelihood of death that those in the general population of a similar age. Why, you ask? Simply put, anorexics are suffering the consequences of starving themselves. Anorexics have a maniacal and relentless pursuit of thinness, even in the face of being extremely thin. They couple an unwillingness to maintain a healthy weight with an intense fear of gaining weight. They possess a distorted view of their bodies and severely restrict their eating in response. They are obsessed.
Other symptoms and habits of anorexics include a lack of menstruation (among females, though men suffer from anorexia, too), binge-eating followed by extreme dieting and excessive exercise, misuse of diuretics, laxatives, enema and diet medications. The medical manifestations of anorexia are serious and can include osteoporosis or osteopenia (bone thinning), anemia, brittle hair and nails, dry skin, infertility, chronically low blood pressure, lethargy and fatigue, and heart and brain damage. It’s worth noting again that people die from anorexia. It is a disorder to be taken seriously.
The key components of treating eating disorders in general are stopping the behavior, reducing excessive exercise and maintaining or establishing adequate nutrition. The pursuit of adequate nutrition is vital enough that when patients develop dehydration and chemical imbalances (i.e., electrolyte abnormalities), they need hospitalization to correct deficiencies.
Specific management of anorexia involves addressing the psychological issues related to the eating disorder, obtaining a healthy weight, and consuming sufficient nutrition. This may involve various forms of behavioral therapy and medication. Regarding medication use, although some (such as antipsychotics or antidepressants) have been effective in addressing issues related to anorexia such as depression and anxiety, no medication has been proven effective in reversing weight loss and promoting weight gain back to a healthy/normal level. Similarly, behavioral therapy has been shown to assist in addressing the roots causes of anorexia but insufficient in addressing the medical issues that the disease contributed to or caused. Ultimately, it appears that a combination of medications, other medical interventions and behavioral therapy is the most effective course. As is the case with most illnesses, the earlier treatment is initiated, the better the outcome tends to be.
Please maintain a sufficient sensitivity toward those with anorexia. It’s a life-threatening condition, not the punch line of a joke about someone’s appearance.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Let’s Boost Your Metabolism

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It would be improper for me to have dragged you through the mud for three days and depressed you into thinking you can’t improve your situation. Hopefully, you’re not feeling that way. You should now have a better understanding of how the body works, how to count calories and how to compare yourself to a baseline for health. What left is giving your body a leg up on your efforts. Yep, I’m talking about boosting your metabolism. Any of you that have been with me for a while know that means I’m not promoting something you’ll find in a bottle, although there are many good supplements that can assist in that effort. I’ll refer you to your (or my) favorite personal trainer for those considerations. As always, I want to offer you the tools to be self-empowered. To that end, here’s five Quick Tips to boost your metabolism. Why five? Because five is easier to implement than six. Once you get these five down, let me know, and we can get a bit more intricate.

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1. Eat smaller meals, and eat more frequently. It’s true. More meals more often is better, but only if they’re smaller. Calorie counting is still a major part of the equation. The point of more frequent meals is preventing the body from going into starvation mode, which slows your metabolism as the body attempts to conserve energy. If you do this, you’ll discover those meals are smaller and you will get closer to eat more appropriate portions than we typically do. Also, make those in-between meals healthy choices like a handful of fruits or nuts.
2. Prime your pump. Remember, it’s all about your heart’s ability to efficiently move blood around the body anyway. The healthier your heart is, the better your metabolism will be. You need aerobic exercise that increases your heart rate for 20-30 minutes at a time. Learn your target heart rate for your age, and exercise to get into that range. Your metabolism will better approximate that of a fine tuned machine rather than a sputtering old car.
3. Weight train. This is very simple. The more muscular you are, the more calories you will burn, especially relative to someone of the same weight who is obese. Not only will you become a finer calorie-burning machine, in this case you actually will look better! Add weight training to your exercise regimen.
4. Choose the fish (and not the fried variety). Fish oil contains substances called omega-3 fatty acids (EPA, DHA) which increases levels of fat-burning enzymes and decreases levels of fat storing enzymes. Daily ingestion has been shown to help by approximately 400 calories a day.
5. Enlist a personal trainer. Everyone needs help and motivation. Some of us need a lot of help and a lot of motivation. We also need expertise. There’s nothing more frustrating than working hard yet not seeing any results because you’re working incorrectly. A good trainer can put you on the path, supervise your regimen, and hold your hand through the process. The minutia of age, sex and body habitus considerations that also play a role in this can be managed by a good trainer. Your ideal trainer will have knowledge of nutrition, wellness and supplements that are tailored to your specific considerations. This will get your metabolism revved up!
By the way, if you’re into green tea, caffeine or spicy/hot peppers, enjoy them for their other benefits, but don’t expect them to contribute significantly to your efforts to improve your metabolism. At least that’s what the consensus in the medical literature points out.

metabolism rev up

Finally: yes, it’s true that metabolism naturally slows with age (starting as early as age 25); everyone has heard that fact. However, here’s what you don’t usually hear: that’s not inevitable and is more a result of your becoming less physically active than just aging. That demonstrates the need for you to be even more diligent in your efforts. Good luck, and I welcome your questions and comments.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Healthy, Sustainable Weight Loss – Let’s Get Started

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How to Lose Weight, and What is Healthy Weight Loss (AKA, How Much, How Soon and How)?
Let’s start with the How. Commercial voice: “You should contact your physician before starting any weight loss routine”. We ended things on the last post talking about the caloric balance equation, which (simplified) means you need to get off your derriere, and close your mouth. Without getting too technical, to lose weight, 1 pound equals 3,500 calories, so your net caloric intake must be cut by at least 500 calories per day to lose a pound a week. Here are some Quick Tips to cut calories (and I will not be discussing any of the popular diets or medical remedies (with one exception in the next post); you can see your physician or nutritionist about those. Besides, guess what? Most of you don’t need a fad diet. Keep it simple. And…more importantly, you should be more concerned with healthy regimens that help you keep the weight off, not drastic efforts that have proven to have quick short-term but unsustainable long-term outcomes).

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1) Work out: If you can sprint, do so. If you can’t, jog. If you can’t jog, walk. I like working out while watching sports, because my heart’s pumping anyway. Weight training at the same time is even better. Once you hit a good exercise regimen, your metabolism will improve, making weight loss that much easier.  By the way, the next post is on metabolism; stay tuned.
2) Hungry?  Start counting calories.  Use this standard to determine what your daily calorie intake should be.  Meal plan so you don’t exceed that level.  Remember the caloric equation to lose weight: Amount expended minus the amount eaten should be 500 calories a day.  In the next post, I’ll give you a Quick Tip for an extra 400 calories a day you can lose.

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3) Still hungry? Try brushing your teeth. Don’t laugh. It actually works. And it gives you nice teeth. Otherwise try drinking water or chewing calorie-free gum. All these are nice, simple inexpensive appetite suppressants.
How Soon? It’s natural for anyone trying to lose weight to want to lose it very quickly. But evidence shows that people who lose weight gradually and steadily (about 1-2 pounds per week) are more successful at keeping weight off. Healthy weight loss isn’t just about a “diet” or “program”. It’s about an ongoing lifestyle that includes long-term changes in daily eating and exercise habits. Think health instead of weight, and the weight will improve.

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How Much? If you were my patient (but you’re not!), I’d tell you to forget about ideal body weight and BMI – for now. Focus on a modest weight loss, like 5-10% of your current weight. Even this success will improve your blood pressure, cholesterol and blood sugar levels. Once you accomplish that goal, do it again. So even if the overall goal seems large, see it as a journey rather than just a final destination. Seek to learn new eating and physical activity habits that will help you live a healthier lifestyle. These habits may help you maintain your weight loss over time. To that end, I love healthy challenges. Try a 30-day water instead of pop (soda)/coffee, etc. challenge, or even better, give yourself a 30-day ‘fruit for dessert challenge’ or ‘salad of your choice for lunch’ challenge. When that’s done, immediately do it again.  Learn to integrate healthy habits into your quest to lose weight, and you’ll increase the odds of having sustainable weight lost. At the end of the day, it’s been well established that those who maintained a significant weight loss report improvements in not only their physical health, but also their energy levels, physical mobility, general mood, and self-confidence. Good luck, and check back for the next post on how to fine-tune your metabolism!

find the best way to lose weight and tips

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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight

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Earlier, we identified the differences between a ‘normal’ weight and being overweight and/or obese. Today’s goal is to help you understand specific risks of carrying extra weight.  We’ll also set the table for losing weight by discussing why weight gain occurs.  It bears repeating that none of this has anything to do with the perception of one’s physical attractiveness.
Let’s focus on three considerations.
1. What are the health risks?
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As body weight increases, so does the risk for several different medical conditions and illnesses, including the following:
• Arthritis
• Cancers (breast, endometrial, and colon)
• Diabetes
• Gynecological problems (abnormal periods, infertility)
• Heart disease (heart attacks, heart failure, hardening of the arteries)
• High cholesterol
• Liver and gallbladder disease (gallstones)
• Sleep apnea and other respiratory problems
• Stroke
In the event that these risks are just words on a page, learning a little bit about some of them might provide the motivation needed to avoid them.
2. What is a realistic goal for weight loss?  What’s the balance between family predisposition and the foods I eat?

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No matter what I tell you today, it’s unlikely to turn you into a supermodel. The goal (independent of your consultation with your own health care provider) is to get you to optimize your situation based on the things you can control. Yes, genetic factors do play a role in obesity, but beyond that you are more than able to close your mouth and get off your…couch. You are able to limit your fat and caloric intake and put down the salt shaker. Yes, genetics count, but behavior and environmental (culture, socioeconomic status) consideration play at least as much of a role. These latter considerations can even jumpstart your metabolism beyond your genetic predisposition.
3. Why do I gain weight if I’m still active?

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The most simple way to answer this is that weight gain occurs from an energy imbalance.  You’re taking in too many calories, and/or you’re not engaging in enough physical activity. It’s an equation, and the weight gain occurs when you’re on the wrong side of the equation. It’s not much more complicated than this. Either do less of the eating, more of the activity, or both.  I mentioned in a previous post on caloric counting that you must have an excess of 500 more calories expended than you ingest daily every day for a week just to lose one pound.  It takes work.  This is the simple answer as to why fad diets don’t work long-term.  You can’t cheat the equation.  The moment you stop being diligent, you’re headed in the wrong direction.  Your weight loss plan must include lifestyle changes for the long-term.
In the next post, we’ll identify some very simple methods to combat obesity based on the information provided to this point.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

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