Tag Archives: Straight No Chaser (composition)

From the Health Library of SterlingMedicalAdvice.com: “Does eating yogurt with probiotics help weight loss?”

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

2probiotics

According to the available medical literature, if you eat yogurt with probiotics before or after you eat, it will break down all the fat you have ingested. This does retard weight gain!
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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Straight, No Chaser: Mass Trauma Alert – When Disaster Strikes

Public Health, Trauma, Health Prevention, , , , , , , , , , , , , , ,

tornado
If you’ve become a regular reader of Straight, No Chaser (thank you!), you will note the recurring theme of prevention. There’s often just not enough time to act in the midst of a life-threatening emergency. Today, I’m just asking you to put together a simple contingency, emergency supplies kit for whatever disaster may befall you and your family. Should you ever need it, I suspect you’ll be glad you did. The disaster you’re preparing for could last hours or more than a few days. Depending on where you live, it could be a hurricane, tornado, blizzard, or wildfire. Or maybe you’ve just become trapped inside your home; maybe you’re trapped outside your home, and your children are trapped at home. You might not have access to food, water, or electricity. With preparation of emergency water, food, and a disaster supplies kit, you can provide for and protect your entire family.
Without getting precise or complicated, it’s a very good idea to assemble a basic collection of items in the event of any emergency or disaster. All of this should sound basic and obvious, but, unless assembled and at the ready, you might not be able to access what you need. It would be good to strategically place kits at home, work, and/or car. Also consider any unique health and medical needs of your family, and include these in your kit. Store at least a 3-day supply, and if at all possible, up to a 2-week supply that will cover each member of your family. Don’t forget to consider your pets. Here’s a list of essentials. Use it to customize and develop your kit.

  • Water—one gallon per person, per day. This is a must. Think one half-gallon for drinking and another for food preparation and hygiene. If you are unable to store this much, store as much as you can without making your kit too difficult to maneuver. You can conserve water and energy of water by reducing activity and staying cool.
  • Food—non­perishable, easy to prepare items (Don’t forget the can opener.)
  • First aid kit
  • Medications (7­-day supply) and any supplies needed to administer them
  • Flashlight
  • Battery­ powered radio (will last longer than the charge on your smartphone)
  • Cell phone with chargers
  • Extra batteries for everything
  • Multi­purpose tool
  • Sanitation and personal hygiene items
  • Copies of personal documents (birth certificates, insurance policies, medication list and pertinent medical information, proof of address, deed/lease to home, passports, etc.) with family and emergency contact information
  • Extra cash
  • Emergency blankets and towels
  • Area maps
  • Extra house and car keys
  • Protective masks
  • Rain gear
  • Work gloves
  • Tools/supplies for securing your home
  • Extra clothing, hat, and sturdy shoes
  • Duct tape
  • Something to cut with (scissors, pocket knife)
  • Household liquid bleach
  • Entertainment items and other creature comfort items to help maintain your sanity

Pack the items in easy-to-carry containers, label the containers clearly, and store them where they would be easily accessible. Rollable trash containers and backpacks are very good for this purpose. In a disaster situation, you may need access to your disaster supplies kit quickly—whether you are sheltering at home or evacuating.
So there you have it. I’ve tried to be basic. Much more detailed information is available, and I’d suggest you tailor your kit to what types of disasters are most likely in your area. Take an hour and do this. Without a good disaster plan and kit, the disaster itself will only be the first wave of trauma to hit.
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: How Do I Use It?

General Health and Wellness, , , , , , ,

that_looks_cool_but_how_do_i_use_it
Starting November 1st, www.SterlingMedicalAdvice.com will offer three separate options for your use.

  • When you have a healthcare question or concern, log into www.SterlingMedicalAdvice.com and chat with your SMA expert consultant. Your dynamic and experienced online SMA team, representing over 15 different medical and healthcare specialties, is at your service around the clock.
  • If you have a specific question on a general topic, log into www.SterlingMedicalAdvice.com and view the thousands of questions in our database, compiled by our expert consultants. You’ll likely find the answer you seek.
  • If you desire more rounded information on a specific topic, log into www.SterlingMedicalAdvice.com and read the healthcare blog Straight, No Chaser. Hundreds of posts covering a wide variety of topics are available to educate and inform you.

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: What Would You Do If Your Tongue Suddenly Swelled? Learn About Angioedema

Head/Eyes/Ears/Nose/Throat, Health Prevention, , , , , , , , , , ,

Angioedema_250xAngioedema-5angioedema

Here at Straight, No Chaser, we want you to know how to prevent disease and injury because that’s a lot easier than the alternative. However, if and when the time comes, you should also have a few tools in your arsenal to stave off a life-threatening situation. One of the more scary examples of needing help is acute swelling of your tongue, sometimes so much so that your airway appears as if it will be blocked.
The most common cause of acute tongue, lip or throat swelling is called angioedema. This is an allergic reaction and occurs in two varieties.

  • A life-threatening allergic reaction (anaphylaxis) sometimes occurs shortly after an exposure to substance such as medicine, bee or other insect stings or food. It can throw your entire body into a state of shock, including involvement of multiple parts of the body. This can include massive tongue swelling, wheezing, low blood pressure resulting in blackouts and, of course, the rash typified by hives (urticaria).
  • Sometimes lip, tongue and/or throat swelling may be the only symptoms.  This is more typical of a delayed reaction to certain medications, such as types of blood pressure medications (ACE inhibitors and calcium channel blockers), estrogen and the class of pain medication called NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen)

With any luck, you would already know you’re at risk for this condition, and your physician may have prompted you to wear a medical alert bracelet or necklace. In these cases, your physician may have also given you medicines and instruction on how to take them in the event you feel as if your tongue is swelling and/or your throat is closing. These medicines would include epinephrine for injection, steroids and antihistamines such as Benadryl. As you dial 911 (my recommendation) or make your way to the nearest hospital, taking any or all of these medications could be life-saving. By the way, those are the among the same medicines you’ll be treated with upon arrival to the emergency room. In severe cases, you may need to be intubated (i.e. have a breathing tube placed) to maintain some opening of the airway.
If the swelling is (or assumed to be) due to any form of medication, symptoms will improve a few days after stopping it. If the swelling in this instance becomes severe enough, treatment may resemble that of the life-threatening variety.
There are few things better than cheating death. If you’re at risk, carry that injectable epinephrine (e.g. an Epi-pen). If you’re affected, take some Benadryl and/or steroids if you’ve been taught what dose to take, and most importantly, don’t wait to see if things improve. Get evaluated, get treated and get better!
I welcome your questions and comments.
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Straight, No Chaser: The Sexually Transmitted Disease Summary and The Week In Review, Sept. 29th, 2013

Infectious Disease, The Week In Review, , , , , , , , , , , ,

in-case-you-missed-it

Based on your responses to the pictures posted this week, I should have renamed the blog, Scared Straight, No Chaser. The irony of it all is without exception, those pictures were very typical representations of the various sexually transmitted infections (STIs). Some of you didn’t like it, but I do appreciate that large numbers of you read it all. I hope you learned a lot and even more importantly were moved into (in)action. In case you missed anything:

On Sunday, we began the week with a look at bacterial vaginosis (BV), which may be associated with sex but is not an STI. It’s important for women to take an active effort to learn their bodies and the effects various activities have. Remember, BV is easily treated, but it’s always fair to take the opportunity to ensure that STIs aren’t also present.

On Monday, we reviewed the most common bacterial STI, chlamydia. Chlamydia is a really typical disease in that it’s contagious, easily transmitted and has substantial complications if not treated.

On Tuesday, we reviewed gonorrhea, which very often occurs in tandem with Chlamydia. Like chlamydia, it’s contagious, easily transmitted and has substantial complications if not treated. Think of gonorrhea when copious discharge is present, and don’t forget this includes the eyes, throat and joints.

On Wednesday, we reviewed the various stages of syphilis. This easily treatable yet very dangerous disease has the nasty habits of mimicking many other disease and spontaneously disappearing – which is not the same as it being cured. Instead, it progresses to more harmful stages if not identified and treated. Remember the association of syphilis with rashes involving the palms and soles.

On Thursday, we reviewed the treatment of syphilis. It is so important to understand how easily this is treated, so get checked. We also reviewed the story of the Tuskegee Experiment of Untreated Syphilis and how that (unethically) led to the knowledge we have about syphilis and the mandatory protections now in place for humans participating in medical experiments.

On Friday, we reviewed herpes. Many were shocked to learn these groups of small blisters (vesicles) can be found wherever an infection occurs, including the fingers, eyes and mouth. Think of herpes when you get a painful genital ulcer, and get checked ASAP.

On Saturday, we discussed the cauliflower ear, a too common, very preventable and apparently sought after (by certain athletes) condition seen in those with trauma to the ear. The trauma results in the accumulation of blood and clots, which damages and deforms the ear into its prototypical appearance. This leads to a life of pain and deformity.

Here are three final considerations on sexually transmitted infections.

1. They all tend to coexist. Your exposure to one places you at risk for acquiring others, including HIV/AIDS. What you don’t know can hurt you; in fact it can kill you.

2. Remember that until your partner is treated, you’re not treated.

3. Most of these diseases lead to conditions that physiologically make acquiring HIV/AIDS more likely. I didn’t discuss HIV/AIDS this week because it’s involved enough that it is its own topic with several different considerations. We’ll address these another time.

If you’re not prudent enough to practice safe sex, please be diligent enough to get tested and treated based on any suspicion. Even better – do both. The life you save will be your own.

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Straight, No Chaser: Syphilis Prevention, Treatment and the Tuskegee Experience

Genital/Urinary, Medical Treatment, Obstetrics and Gynecology, Public Health, Health Prevention, , , , , , , , , , , , , , , ,

tuskegee syphilis4
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.
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.

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.
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Straight, No Chaser Editorial: The Future of Medicine – Nurses are Stepping Up to the Plate

Public Health, , , , , , , ,

Nursing1
I doubt you’ll hear this perspective anywhere else anytime soon, but there are some very interesting developments in health care underway. By way of introduction, a few decades ago, physicians abdicated the ownership and preeminent leadership role in healthcare, leaving the industry to the business minds of HMOs. During these early days, non-physician corporations actually owning medical practices and developing practice parameters were outlawed as to ensure that sufficient protections would remain in place for autonomous (and presumably honorable) medical practice. 
The combination of for profit hospitals and the advent of contract medical practice management groups (particularly in emergency medicine, hospitalist medicine and radiology) combined to erode away at the corporate practice of medicine laws to where even though the laws are still on the books, suits to enforce it are now routinely defeated. Today, in addition to emergency room physicians, radiologists, surgeons, hospitalists, and anesthesiologists are more likely to be employees than owners of a practice.
In recent times, health care costs have skyrocketed to 17% of our economy, while 50 million Americans went without insurance. Meanwhile, the combination of a shortage of primary care physicians and for-profit entities’ desire to cut costs has led to the development and proliferation of alternative, less costly methods of paying individuals to provide health care. Most notably, this has included the development of advance practice nurses (e.g. nurse practitioners and nurse anesthetists – instead of family doctors and anesthesiologists). Similar interest in cost savings has led to nurses assuming senior managerial positions in hospitals instead of MBA-type executives.
It is against this backdrop that the Patient Protection and Affordable Care Act (aka ‘Obamacare’) passed, seeking to infuse 30 million more paying patients into the primary care arena. With ongoing physician shortages unable to meet this demand, and with there being downward cost pressure on salaries due to the goals of the ACA and desires of corporations, it’s reasonable to predict that we will see a dramatic increase in primary care nurse practitioners (NPs) and physician assistants (PAs), which will lead to further abandonment of primary care as a physician specialty.
Meanwhile, nurses have stepped up to fill the void.  In addition to the ongoing advancement of Nurse Practitioners, nurses have successfully lobbied for and created a new provider entity: ‘The Doctorate in Nursing Practice’. It is important to note that NPs and PAs can successfully treat about 85% of the things physicians routinely see. Quality concerns aside, it is an important public health consideration that additional healthcare professionals and health options are being established to fill the need of care for tens of millions of individuals more likely to use the healthcare system.
Meanwhile, regarding your doctors, a conceivable end result is physicians are being marginalized in virtually every aspect of health care. It is easy to see a future in health care 25 years from now where cost concerns have been addressed by nurses having replaced physicians in more specialties than just primary care and anesthesia, and nurses have more control of the hospital apparatus than physicians. Physicians remain oblivious to what’s happening under their noses and an insufficient interest in contributing to healthcare solutions in the ways nurses have. The Straight, No Chaser perspective is given the large segments of society that continue not to have access to care (even with implementation of the Affordable Care Act, it is estimated that 20 million American still won’t have insurance), new innovative options to address these needs are welcome and have a place in the system. What’s next is for society to ensure that this transition occurs with appropriate quality controls and public education.
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Straight, No Chaser: High Blood Pressure

Cardiology/Heart, General Health and Wellness, Health Prevention, , , , , , , , , ,

bp_chartbloodpressure
High blood pressure is called the silent killer. It’s common for me to see someone who thought they were ‘fine’ drop dead from its effects, never knowing it was about to happen and not having been aware of the warning signs and risk factors.
In lay terms, your heart is just a muscular pump pushing blood (containing oxygen and nutrients) around the body keeping stuff alive. The more you poison that pump (by ingesting unhealthy foods and inhaling other toxins) and strain the muscle by adding weight and clogging its vessels so it has to pump against more force (by being obese, not exercising and engaging in other unhealthy behaviors), the more likely that muscle is to strain until it gives out. Once it does, blood isn’t delivering what’s needed to your vital organs, and that’s when bad stuff happens.
The vital organs in question and those bad effects include the following:
• The heart itself (no blood flow and no oxygen = heart attack; when the heart’s not strong enough to pump blood around the body = congestive heart failure)
• The blood vessels, especially the heart’s main offshoot, the aorta (too much strain = aneurysm, an outpouching from the main tubular system, stealing valuable blood from the rest of the body)
• The brain (no blood flow and no oxygen = stroke; aneursyms also occur in the brain)
• The kidneys (not enough blood flow or adequate enough function to clear the toxins from the kidney = renal failure)
• The eyes (poor blood flow and/or diseased eye blood vessels leads to vision loss)
Bottom line: The heart is a muscle best thought of as a machine. Here’s three easy things you can do to reduce your risks.
• Get off your butt. Any exercise helps to get your heart pumping and blood flowing; strive for 20” three times a week at the very least.
• Close your mouth. Everything in moderation is cool, but introduce some fruits and vegetables into your life.
• Lose the salt shaker. At least taste your food first. It’s likely the food was already prepared with salt.
Did I mention stop smoking? Any questions?
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Straight, No Chaser – The Week In Review

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

weekinreview
I hope this was another week of good health for you.  Let’s review how Straight, No Chaser tried to contribute to your health and wellness.  Don’t forget to click on any of the underlined topics for links to the original posts.
On Sunday, we reviewed eye emergencies.  Don’t forget that even transient vision loss could be a stroke in progress, and certain causes of vision loss have a limited window of time in which treatment must occur.  Act quickly!  By the way, I didn’t mention this information that occurs more commonly than you’d think: If you ever have eye discharge so copious that it seems like you’re tearing pus, this is probably gonorrhea.  Get it treated, lest you could lose an eye.  Now that I have your attention…
On Monday, we reviewed syncope (aka fainting) in two parts, talking about the entity (click here) and the life-threatening conditions associated with faints.  You’re way too cavalier with faints; please get them evaluated.  Faints can either be the result of significant disease or can secondarily produce significant head and neck injuries from the falls.  Stop going to the bathroom (with all the hard stuff in there) when you’re feeling dizzy.  That’s not a good place to black out!
On Tuesday, we discussed suicide and depression in-depth, reviewing demographic information, information for your self-assessment, and tips on how to recognize when help is needed (and how you can avoid depression).  I’m pleased that you’ve made these topics the most read topics yet, and I sincerely hope this information helps some of you.
On Wednesday, we reviewed the overuse of the emergency room, which will become a major theme of this blog.  Those creature comfort visits are 8 times more expensive than the same visits done at a primary care physician’s office.  In Texas, the average ER cost is $1020.  Just because you’re not necessarily paying up front doesn’t mean the hospital won’t ensure you’ll pay eventually.  Remember, hospital bills are the #1 cause of personal bankruptcy in the U.S.  Straight, No Chaser was created to point you toward better options.  Stick around, and we’ll get you there.  Wednesday also brought a review of vomiting and diarrhea (viral gastroenteritis).  Learn about oral rehydration therapy.  Viral gastroenteritis is a good example of something that feels really… bad but is usually self-limited and will go away on its own, as long as you stay hydrated.
On Thursday, we reviewed end of life decision-making.  I know this struck home for a lot of you, bringing back not so fond memories.  That said, you must begin to think about how you want to be treated in your last days.  There are many tragedies during this time that tear families apart.  Use the tools discussed on the post on living wills, power of attorney designations and DNR considerations to make sure your interests are the only consideration being addressed when the time comes.
On Friday, we seemed to prick a nerve or two (no pun intended) discussing circumcision.  If nothing else, be an educated consumer.  Even now, considerations are perhaps best summed up by the posture of the American Academy of Pediatrics, which declines to recommend routine circumcisions for all newborns but notes that if you are inclined to get the procedure (which should be a big if), the benefits outweigh the risks.  Friday afternoon, we reviewed hearing loss and the damage the activities of daily living produce.  This is a pretty good example of how we take our health for granted.  Just a little bit of protection and prevention over the first 40 years of your life will make a big difference later on.
Saturday, we discussed two different types of sounds that come out of you.  First, we discussed snoring (which is always annoying but never boring) and gave you some Quick Tips to overcome it.  We also discussed hiccups, which everyone gets at some point, but no one ever wants.  We also gave you Quick Tips on hiccup cures here.  Remember those ABCDEs!
We continue to listen to your comments and feedback, and over the next few months, some major changes will be occurring.  Please continue to forward your topic requests.  I promise I’ll get to them all eventually.  Maybe I’ll start doing reader submission posts.  As we continue to grow, your support, referrals and follows are much appreciated.  Have a happy and healthy week.
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Straight, No Chaser: End of Life Decision Making

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

AdvanceDirective
Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.” I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. Please understand that at any age your life could be at risk, you could die, and you could need someone comply with decisions; as such, you need to be protected now. You’re much more protected having declared your interests and desires than not. Read on.
Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and, subsequently, with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions that can be covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

  • Do you care to be intubated? The use of breathing tubes to either protect your airway or breathe for you when you’re unable to is a big deal. The decision to accept or forego this might be an immediately life-prolonging or life-ending decision.
  • Do you care to have advanced cardiac life support in the event that your heart either stops or is unstable? As with intubation, there’s an immediacy to this decision that’s better addressed in a moment of quiet reflection than in the emotion of crisis.
  • Do you want transfusions of blood or other blood products? Some religions have strong declarations on the topic. If you haven’t made your decision not to receive blood known in a legal document and you are unable to express that decision in a life or death situation, physicians will try to save your life with an infusion. They will not adhere to your choice, because they won’t know what it is. That doesn’t have to happen.
  • Do you want “every possible thing done for you,” or might there be a limit in the face of perceived medical futility (i.e., minimal chance of any success)? Basically, this question gets at whether you’d like to go in peace or in a blaze of resuscitative glory and heroic effort.
  • If you’re in the midst of a terminal illness and/or are comatose with no perceptible chance of recovery, will you want medicines and treatments (such as dialysis to remove toxins from your body) to ease pain and suffering or will you want to be allowed to expire?
  • Will you want the medical staff to feed you if you can’t feed yourself?
  • Will you want to donate your organs?

As you can see, these are serious questions to consider, and I’d hope you’d agree they are worthy of conversation well in advance of a tragedy. In my next post, I’ll discuss some related logistical considerations around end-of–life care and decision-making. I hope this has gotten you to thinking and planning on having important conversations.

Straight, No Chaser: This is Specifically For the Faint of Heart

Cardiology/Heart, Medical Treatment, Neurology, Health Prevention, , , , , , , , , , , , ,

faint
Don’t faints seem mysterious?  It’s as if your computer crashed and had to reboot.  Although we never seemingly figure out why computers are so crazy, fainting (syncope) is reducible to a common denominator: something causes a decrease in blood flow to your brain.  Recall that oxygen and other needed nutrients are carried in blood, so even a temporary stoppage or shortage of blood flow shuts things down.  Now extrapolate that to strokes and comas, which are often due to serious and prolonged causes of blockage to the blood vessels supplying the brain.  This is a prime example of why good blood flow and good health are so important.  The brain is a highly efficient, oxygen and energy-guzzling organ.  Shut it down for even a few seconds, and bad things start to happen.  Consider fainting a warning sign.
I’m going to start by offering some Quick Tips to help if you find yourself around someone who has fainted.  Then, I will get into the weeds of why these things happen for those interested.  I’m doing this so you can check these and determine where your risks may be.

  • Call 911.  Make sure the person is still breathing and has a pulse.  If not, start CPR.
  • Loosen clothing, especially around the neck.
  • Elevate the legs above the level of the chest.
  • If the fainter vomited, turn him/her to the side to help avoid choking and food going down the airway (aspiration).
  • A diabetic may have been given instructions to eat or drink something if s/he feels as if s/he is going to faint.  If you know this, a faint would be a good time to administer any glucose gel or supplies advised by a physician.  Prompt treatment of low blood sugar reactions is a life-saver.  Discuss and coordinate how you can perform this effort on behalf of your friends and family with their physicians.
  • If it’s possible that the faint is part of some heat emergency (heat exhaustion or heat stroke), follow these steps to save a life (click here).

Actually, faints are caused by all kinds of medical problems.  I list a few notable causes below, but whether the front end difficulty is with the heart pumping, the nerves conducting, or the content of oxygen or energy being delivered, the end result is the same.

  • Decreased nerve tone (vasovagal syncope): This is the most common cause of faints, and contrary to what you might think, it happens more often in kids and young adults than in the elderly.  Understand that your nerves actually regulate blood flow (analogous to a train conductor telling the heart to speed up or pump harder or not).  Changes in nerve tone can result in errant signals being sent, transiently resulting in low flow.
  • Diseases and conditions that affect the nervous system and/or ability to regulate blood pressure: Alcoholism, dehydration, diabetes and malnutrition are conditions that may depress the nervous system.  Alternatively, coughing, having a bowel movement (especially if straining) and urination may abnormally stimulate the system.  In the elderly and those bedridden, simply standing can cause fainting due to difficulty regulating blood pressure.  In this case, standing causes a sharp drop in blood pressure.
  • Anemia: A deficiency in blood cells can lead to a deficiency in oxygen delivery to the brain.
  • Arrhythmias (irregular heart beats): Inefficiency in your heartbeat leads to unstable delivery of blood to the brain.
  • Low blood sugar (hypoglycemia): Low energy states can deplete the body of what it needs to operate effectively, leading to low blood flow.
  • Medications (especially those treating high blood pressure): anything that lowers the heart’s ability to vigorously pump blood around the body can leave the brain inadequately supplied, leading to a blackout.  Let’s include illicit drugs and alcohol in this category.
  • Panic attacks: Hyperventilation caused by anxiety and panic upset the balance between oxygen and carbon dioxide in the brain, which can lead to fainting spells.
  • Seizures: Here’s a chicken and egg scenario.  A prolonged faint can lead to a seizure, and seizures lead to periods of unconsciousness, during and after the seizure.  The lack of oxygen is a common denominator.

Straight, No Chaser: Do You Drink Too Much?

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

drinks
It’s one of those Straight, No Chaser (literally) days.  I haven’t addressed substance abuse much yet (and you know I will), but the problems with most intoxicating substances revolve around the same consideration.  You had the most incredible time and got the most incredible high the first time, and you spend the rest of your life chasing the joy of that first buzz, which for most drugs you’ll never get.  The difference with alcohol abuse is that alcohol is legal and comparatively inexpensive, so you get to keep trying without much fuss (or at least initially).
Let’s set the stage by standardizing some terms:

  • Alcohol intoxication: You’re drunk and under the influence of alcohol.
  • Alcohol abuse: Your drinking habits are unhealthy, resulting in bad consequences (e.g. at work, in your relationships, with the law).
  • Alcohol dependency: You’re physically and/or mentally addicted to alcohol.  You crave liquor and seemingly can’t do without it.  Dependency involves withdrawal symptoms when alcohol is not in your system.  These symptoms may include anxiety, nausea, sweating, jitteriness, shakes and even withdrawal seizures.

Alcoholism is a chronic disease.  Unfortunately, some of us start with a predisposition based on genes and strong influences based on family and cultural considerations.  It is so much more than either a lack of willpower or an inability to quit.  This disease has a predictable course and defined effects on various parts of the body, leading to specific means of death if unaddressed.  Because I’m Straight, No Chaser, I’m not going to deal with the subjective thoughts you offer about whether or not you can ‘handle your liquor’ or whether you believe ‘you can stop anytime you want’.  I’m going to give you some medical data that defines when you’re doing damage to your body.  It’s actually pretty simple.
Are you this guy or gal (keep in mind a standard drink is defined as one 12 ounce can of beer, 1 glass of wine or 1 mixed drink)?

  • Women having more than 3 drinks at one time or more than 7 drinks a week.
  • Men having more than 4 drinks at one time or more than 14 drinks a week.

If so, you’re causing damage.  We’ll get into the specifics at another time.
That’s damage.  Let’s discuss dependency.  Consider the possibility that you may be dependent on alcohol if you have any of these problems over the course of a year:

  • While you’re drinking, you can’t quit or control how much you drink.
  • You have tried to quit drinking or to cut back the amount you drink but can’t.
  • You need to drink more to get a previous effect (This is called ‘tolerance’.).
  • You have withdrawal symptoms (discussed earlier) when you stop.
  • You spend a lot of your time either drinking, recovering from drinking, or giving up other activities so you can drink.
  • You continue to drink even though it harms your relationships and causes physical problems.

So What?
No one is giving up alcohol by reading this, I’m sure.  I haven’t even touched to the harsh realities of alcoholism (yet).  Alcohol is part of the American social fabric.  We live, celebrate and commemorate milestones with it.  It’s glamorized throughout society.  It’s constitutionally approved.  I appreciate that.  In moderation, it’s a good time.  Just understand that it’s not a free ride.  The danger is in the insidious nature of this disease, meaning issues may creep up on you before you ever know what’s about to hit you.  Then we’re having a completely different conversation.
I look forward to any questions or thoughts on the topic.
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