Tag Archives: Sterling

Straight, No Chaser: How to Survive a Motor Vehicle Collision

July 10, 2017Trauma844-SMA-TALK, Head-on collision, Seat belt, Sterling, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, Traffic collisionJeffrey Sterling, MD

As you drive the expressways of some cities, you can now see signs displaying how many traffic deaths have occurred during the year. I’m sure the purpose of these announcements is to keep drivers alert to the real dangers of driving and to remind us to drive safely. We discussed the magnitude of motor vehicles crashes (they’re not accidents) in the last Straight, No Chaser. However, when prevention hasn’t kept you out of harm’s way, what you do next can make a world of difference. Here are 10 quick tips to keep you upright.
If you see an accident happening in front of you …

1) Move away from the steering wheel/dashboard. That airbag will be coming at you at approximately 200 MPH. It can cause burns and other injuries on its own. You want both hands on the wheel as loose as possible during impact.
2) If possible, angle the car for a glancing blow. Try to avoid the head-on collision, especially with the bigger object. Similarly, the ‘T-bone’ side impact collision is especially dangerous, as the car is structurally weaker on the side, and the side is closer to passengers.
3) Slow down as best you can, but also try to control your deceleration. The faster the impact, the worse the damage will be.
4) If there’s time and you haven’t already, get that seat belt on.
5) If there’s time, get any potential projectile from where it may strike you. That’s off the seat, dashboard and cup holders. Hot coffee in your face or being slashed by your phone won’t feel good.
After the crash …

6) Call emergency medical services as your first move after a crash.
7) If you have any neck pain, as best you can, do not move. Period.
8) If you are pregnant, get onto your left side while you wait.
9) After a crash, switch off your engine, do not smoke, and stop anyone else from smoking. You will not be in a position to put out any fire you start and if flammables are in either car, you could be setting up an explosion.
10) Do not attempt to remove injured people from a vehicle yourself; leave that to the paramedics. You could be aggravating a neck (spinal) injury that is not obvious at that point.
It bears repeating: the best way to survive car crashes is not to be involved in one.
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.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Curse of the Weekend Warrior – Achilles Tendon Rupture

July 8, 2017Orthopedics/Bones, Sports Medicine, Trauma, Musculoskeletal SystemAchilles, Facebook, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Tendon, There are 72 Hours in a Day, Twitter, WordPressJeffrey Sterling, MD

The Achilles tendon connects the muscles at the back of the calf to the heel. The formula for damage is pretty simple and consistent. As you age your tendons tend to stiffen and shrink. As you age you change from the fine-tuned wannabe athlete most of us were to a recreational player, and we overextend ourselves. Others of us, in making a comeback (or just rushing to train for something like a 5K run), try to go from zero (0) to 60 way too soon. In either scenario, that overextension causes the tendon to tear or snap. You’ll recognize it immediately by the sound (pop) and the inability to walk/stand on your toes, which results from the lack of connection from the calf to the heel. (You need to point your foot downward to walk, which is where the Achilles comes in.) Other common occurrences of Achilles tendon rupture include falling from a height and landing on your feet or stepping into a sizeable hole.

Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.
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.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: How to Survive a Motor Vehicle Collision

July 10, 2016Trauma844-SMA-TALK, Head-on collision, Seat belt, Sterling, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Traffic collisionJeffrey Sterling, MD

6) Call emergency medical services as your first move after a crash.
7) If you have any neck pain, as best you can, do not move. Period.
8) If you are pregnant, get onto your left side while you wait.
9) After a crash, switch off your engine, do not smoke, and stop anyone else from smoking. You will not be in a position to put out any fire you start and if flammables are in either car, you could be setting up an explosion.
10) Do not attempt to remove injured people from a vehicle yourself; leave that to the paramedics. You could be aggravating a neck (spinal) injury that is not obvious at that point.
It bears repeating: the best way to survive car crashes is not to be involved in one.
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: The Curse of the Weekend Warrior – Achilles Tendon Rupture

July 8, 2016Orthopedics/Bones, Sports Medicine, Trauma, Musculoskeletal SystemAchilles, Facebook, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Tendon, Twitter, WordPressJeffrey Sterling, MD

Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.
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: Syphilis Prevention, Treatment and the Tuskegee Experience

April 30, 2016Infectious Disease, Medical Treatment, Public HealthAfrican American, Behind the Curtain, health, Human papillomavirus, Limited liability company, Monogamy, Penicillin, Powered, Sexual partner, Sexuality, Sexually transmitted disease, Sterling, Straight No Chaser (composition), Syphilis, Tuskegee, United States, United States Public Health ServiceJeffrey Sterling, MD

Introduction

Syphilis should be a word derived from something meaning horrible. In an earlier post, we reviewed the rather horrific progression of the symptoms of syphilis. An additionally horrible consideration is that treatment is so very easy once identified. Of course, that’s not the most horrific aspect of the disease. Read on.

Looking back retrospectively, advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. However, as discussed in the post discussing the symptoms of syphilis, remember that treating syphilis at any point can prevent the most severe complications that lead to death. Which brings us to Tuskegee – and keep in mind this is Straight, No Chaser.

The Tuskegee Experiments

In the early 1930s, the US Public Health Service working with the Tuskegee Institute in Alabama began a study to evaluate the effectiveness of current treatments for syphilis, which at the time, were thought to be at least as bad as the disease. The study was conducted on 600 Black men, who were convinced to participate in the study with the promise of free medical exams, meals and money for burial, ‘if’ it was necessary.

The study was initially meant to last 6 months, but at some point a governmental decision was made to continue the study and observe the natural progression of syphilis until all subjects died of the disease, with a commitment obtained from the subjects that they would be autopsied ‘if’ they died. There were several problems with this decision.

None of the patients participated under informed consent. They believed they were being treated as opposed to being observed and having medicine withheld while they were being allowed to die. In other words, the subjects were not aware of the purpose of the study.
Penicillin was established as a true, rapidly effective treatment for syphilis and the standard of care by 1947. The study continued 25 years beyond this treatment option being available.
Efforts by concerned individuals failed to end the study for 5 years prior to a whistleblower going to the press in 1972. The study was ended in a day.

Aftermath

The aftermath of the study includes the following:

Reparations averaging a mere $15,000 per individual were given ($9M total) as well as a formal apology, delivered by President Clinton. Yep, the victims received the equivalent of $15,000 per person on average for 40 years of carrying syphilis 25 years after there was a known cure, after infecting wives and unborn children in several documented cases.
Strict requirements for protocols for human study (i.e. Institutional Review Boards) were implemented for the first time.

It shouldn’t surprise anyone that many African-Americans remain distrustful of governmental public health efforts to this day; for many, this study continues to be the reason while vaccination isn’t optimally taken advantage of (e.g. HPV) and why organ donation rates are so relatively low in the African-American community. Even though this posture contributes to the adverse health outcomes that exist in the African-American community, it isn’t hard to see why the fear and distrust exists.

Let’s bring this full circle. When it comes to syphilis, prevention is best, and full treatment is available. At the very least, I certainly can say you’ve been warned. Folks have given their lives to make your warning possible. I welcome your questions and comments.

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.

Straight, No Chaser: Your Questions About Gunshot and Stab Wounds

November 3, 2013TraumaFacebook, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Thoracic wall, Twitter, WordPressJeffrey Sterling, MD

Your Top Five Questions:
1. Why don’t we remove the bullets every time?
Removing bullets may cause more damage than leaving them in the body. Sometimes it’s 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 his or her life?
That describes either a cricothyrotomy or a tracheostomy, and it’s not “slitting” the throat as much as it is 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 might cause so much 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.
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: SterlingMedicalAdvice.com is LIVE! That means it's time for Giveaways!

November 1, 2013General Health and WellnessAdvice, Business, Healthcare, Healthcare Management, Sterling, Sterling Medical Advice, SterlingMedicalAdvice.comJeffrey Sterling, MD

Everyone loves freebies. So do we. To commemorate our launch, SterlingMedicalAdvice.com is going to sweeten the pot for you. Never mind the fact that our cost per month for a Sterling Advice Plus plan is only 4% the cost of a single ER visit and 3% the average cost of your monthly individual insurance premium.
We’ve already announced that those of you who enroll in an annual plan will get 13 months for the price of twelve. We figured that was great, but we knew we could do better. So…
If you join either our Sterling Advice family plan or Advice Plus family plan, we will add an additional month! That’s right, enroll today in one of these two plans, and your next payment will be Jan. 1, 2015 – 14 months for the price of 12. That’s a lot of peace of mind.
All of that said, we believe under any plan you choose, once you join SterlingMedicalAdvice.com, we’ll establish a relationship that will serve you and your family for a lifetime. Try us and enjoy the difference personalized, immediate 24-hour healthcare consulting can make in your life.

About SterlingMedicalAdvice.com: "How do I sign up?"

October 30, 2013General Health and WellnessFacebook, Limited liability company, Powered, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Twitter, WordPressJeffrey Sterling, MD

Anytime starting noon EDT (and 11 am CDT) on Nov. 1st, you may go to www.sterlingmedicaladvice.com to join. It’s very easy to do. Give yourself about 15″. Have your personal health information, including medications and past medical history available. You will only have to provide this information once, and it will be invaluable in allowing our expert consultants to give you the very best information and advice.

Remember, if you sign up for a year’s plan, you get 13 months for the price of 12!

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.

About SterlingMedicalAdvice.com: "How will my health information be protected?"

October 28, 2013Health PreventionFacebook, Health Insurance Portability and Accountability Act, Insurance, Limited liability company, Powered, Sterling, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser (composition), Twitter, WordPressJeffrey Sterling, MD

www.SterlingMedicalAdvice.com’s website is completely compliant with HIPPA guidelines and regulations, meaning the highest level of security is protecting our site and your information! No information will ever be released without your explicit direction to do so, even if your physician or insurance company requests it without your permission. Remember, if you keep your health information updated on SterlingMedicalAdvice.com, you will have a readily retrievable folder of your information at your disposal. Try us and enjoy the difference personal healthcare consulting makes.
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

About SterlingMedicalAdvice.com: How will the expert consultants know anything about me?

October 27, 2013General Health and Wellness, Health PreventionFacebook, Limited liability company, Powered, Sterling, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser (composition), Twitter, WordPressJeffrey Sterling, MD

When you sign up at www.SterlingMedicalAdvice.com, you provide a medical history that becomes a permanent part of your record. The information you give us during each chat will also be filed in your record. Your SMA consultant will access your updated information every time you log in for a new chat. Your information is personalized, and your service is immediate. Try us, and experience personal healthcare consulting!
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: Human Bites

October 27, 2013Infectious Disease, Skin/DermatologyFacebook, Infection, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser, Twitter, WordPress, WoundJeffrey Sterling, MD

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

About SterlingMedicalAdvice.com: Are there limits to how often I can use the site?

October 26, 2013General Health and WellnessFacebook, Limited liability company, Powered, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Twitter, WordPressJeffrey Sterling, MD

You can reach your SMA consultants 24 hours a day, seven days a week. The following interactions are included in your subscription.

	STERLING ADVICE^®		STERLING ADVICE PLUS^®
	Individual	Family	Individual	Family
Real-time consults	3	10	5	15
Email communications	5	15	10	30
Additional contacts	$10 per	$10 per	$10 per	$10 per
Access to online library	Unlimited	Unlimited	Unlimited	Unlimited
Access to health blog	Unlimited	Unlimited	Unlimited	Unlimited

Straight, No Chaser: The Curse of the Weekend Warrior – Achilles Tendon Rupture

October 25, 2013Orthopedics/Bones, Sports MedicineAchilles, Facebook, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Tendon, Twitter, WordPressJeffrey Sterling, MD

In high school I led the league in stolen bases, and in college my cohorts and I loved inventing ever more creative ways to dunk a basketball. Apparently, my calf muscles worked well. Somehow at a certain age, I quit those competitive sports cold turkey, partially because I knew an Achilles rupture was lurking out there somewhere.
The Achilles tendon connects the muscles at the back of the calf to the heel. The formula for damage is pretty simple and consistent. As you age your tendons tend to stiffen and shrink. As you age you change from the fine-tuned wannabe athlete most of us were to a recreational player, and we overextend ourselves. Others of us, in making a comeback (or just rushing to train for something like a 5K run), try to go from zero (0) to 60 way too soon. In either scenario, that overextension causes the tendon to tear or snap. You’ll recognize it immediately by the sound (pop) and the inability to walk/stand on your toes, which results from the lack of connection from the calf to the heel. (You need to point your foot downward to walk, which is where the Achilles comes in.) Other common occurrances of Achilles tendon rupture include falling from a height and landing on your feet or stepping into a sizeable hole.
Besides being an older guy (or gal, but it’s about five times more common in men) trying to reclaim past glory, steroids and certain antibiotics (flouroquinolones, examples of which are Levafloxacin, aka Levaquin, and Ciprofloxacin, aka Cipro) weaken the tendons enough to predispose you to this injury.
Depending on your age and preexisting health status, you will have surgical and/or nonsurgical options available to you to repair the tendon. Nonsurgical treatment involves a specific type of walking boot or cast, and surgery is more likely when the tear is complete. You’ll need extensive rehabilitation and strengthening of the muscle around the repaired tendon to avoid reinjury. Don’t expect to return to your previous level of strength and activity for four to six months.
So what’s your take home message? Once again, know where opportunities for prevention are. Given how important it is to maintain physical activity as you age, it’s important to remind you to learn how to stretch and maintain musculature so you don’t injure yourself while trying to exercise. Don’t engage in more strenuous activities until and unless you’ve built up to the level where you’re prepared to do so. Achilles injuries occur most often when you’re trying to do too much too soon. Also, be mindful of slippery surfaces; that slide acts the same as an attempt to accelerate too rapidly.

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

About SterlingMedicalAdvice.com: "Can I get services for my family?"

October 24, 2013General Health and WellnessFacebook, Limited liability company, Powered, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Twitter, WordPressJeffrey Sterling, MD

Yes! SMA offers individual and family plans for both STERLING ADVICE^® and STERLING ADVICE PLUS^®.
The STERLING ADVICE^®plan offers you information and advice on all medical disclipines, and the STERLING ADVICE PLUS^®plan adds on ancillary care considerations, including mental health, dentistry, pharmacy, nutrition and personal training. Subscribe to either plan, and cover your whole family, including children up to age 26.
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

About www.SterlingMedicalAdvice.com: What if I'm not satisfied with the advice I receive?

October 23, 2013General Health and WellnessFacebook, Limited liability company, Powered, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Twitter, WordPressJeffrey Sterling, MD

www.SterlingMedicalAdvice offers a 100% satisfaction guarantee! If your SMA consultant is unclear in addressing your health concern or does not answer your questions adequately, you can talk with another consultant free of charge. We love your feedback. Try us and experience the difference!
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.
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About www.SterlingMedicalAdvice.com: What If I Need Prescriptions?

October 22, 2013General Health and WellnessDrug interaction, Facebook, Limited liability company, Powered, Sterling, Sterling Medical Advice, Straight No Chaser (composition), Twitter, WordPressJeffrey Sterling, MD

SterlingMedicalAdvice.com consultants may advise you on medications you have and are likely to receive based on your condition. They may advise you of important drug side effects, interactions and dosing considerations. However, you will need to obtain prescriptions from your physician when needed. The expert consultants of SterlingMedicalAdvice.com do not prescribe medications, because SMA is a medical information and advice service, not a medical practice.
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.
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When is SterlingMedicalAdvice.com Available?

October 21, 2013General Health and WellnessFacebook, Limited liability company, Powered, Sterling, Straight No Chaser (composition), Superior mesenteric artery, Twitter, WordPressJeffrey Sterling, MD

SMA will be available to subscribers 24 hours a day, seven days a week, starting on November 1, 2013. If you have an immediate need or possible emergency, you can receive instant information and advice. If you have a need for general information, you can review our vast Question Bank 24/7. If you have a need for general information from a specialist, we will get you information within minutes!
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

About www.SterlingMedicalAdvice.com: What's the Cost for the SterlingMedicalAdvice.com subscription?

October 20, 2013General Health and WellnessFacebook, Limited liability company, Nonprofit organization, Sterling, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser (composition), Twitter, WordPressJeffrey Sterling, MD

See the monthly costs below. When you purchase a full year’s subscription, you receive an additional month FREE! Additional plans are available for businesses and non-profit organizations; ask your employer about adding SterlingMedicalAdvice.com as an employee benefit!

*STERLING ADVICE*®		*STERLING ADVICE PLUS*®
Individual	Family	Individual	Family
$29.99	$89	$49.99	$149

Straight, No Chaser: A Quick Tip for When You're Feeling Bugged…

October 20, 2013Head/Eyes/Ears/Nose/Throat, Skin/DermatologyDisease, Facebook, health, Limited liability company, Sterling, Sterling Medical Advice, Straight No Chaser, Twitter, WordPressJeffrey Sterling, MD

Quite a few of you had the same question after Friday’s post on objects in the ears, nose and throat:
What about insects that get in the ear, particularly when you are asleep? It’s pretty horrifying to think of some cockroach or other disgusting thing scratching around that close to your brain! What you don’t want to do is something that will irritate the critter to the point of puncturing your eardrum. Beyond freaking out, your next step should be pretty simple.
At home, consider doing what we do. If you have mineral oil, put a few drops in the ear. It’s the quickest and safest way to kill what’s in there. However, don’t delay coming to the local ER, urgent care facility or your doctor’s office. Any damage caused still needs to be evaluated.
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: Learn the Physical Signs of Child Abuse

October 20, 2013Pediatrics/Kids Health, TraumaChildhelp, Facebook, Friends, Limited liability company, Sterling, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Twitter, WordPressJeffrey Sterling, MD

Given how often this topic is in the news, we need an army to protect children against child abuse. I will intermittently be discussing various forms of abuse, but to start with, I’d like to help you recognize physical signs I tend to look for to potentially identify victims of abuse.
Symptoms include:

Black eyes

Broken bones that are unusual and unexplained
Bruise marks or lashes shaped like hands, fingers, or objects (such as a belt)

Bruises in areas where normal childhood activities would not usually result in bruising

Bite marks

Bulging soft spot (fontanelle) or separations in an infant’s skull

Burn marks, usually seen on the hands, arms, or buttocks

Choke marks around the neck
Cigarette burns on exposed areas or on the genitals

Circular marks around the wrists or ankles (signs of twisting or tying up)
Unexplained unconsciousness in an infant

If you ever see such things in children, be suspicious, be involved and get help. There are always ‘explanations’ for why things happen to children, but they too frequently seem to defy logic. Of course you can call 911 or the Childhelp National Child Abuse Hotline (1-800-4-A-CHILD). You could save a life.
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.
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