Tag Archives: Straight No Chaser

Straight, No Chaser: My Back and Neck Pain Has a Name – Herniated Disks

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It’s quite common for someone to come to me and say, “I have a herniated disk.” I used to ask how they knew, but I came to realize the answer to be unimportant. The pain and relative disability of those suffering from low back pain can be dramatic, both physically and emotionally. Being able to place a name of what’s causing that discomfort is meaningful in and of itself.

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We’ve discussed low back pain (LBP) before on Straight, No Chaser, but herniated disks are special considerations among its causes. A herniated (aka ruptured or slipped) disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine. A common and effective way to understand a spinal disk is to picture a jelly donut, with a softer center captured inside of a tougher exterior. A herniated disk occurs when some of the softer portion protrudes through the exterior. Keep in mind that your spinal column runs from your neck down your lower back, so herniation may occur anywhere along the spine, although the low back is the most common site.Herniated-Disc

Herniated disks may or may not produce symptoms, and you may not even know you have one. Of course, some herniated disks are extremely painful and incapacitating. The problems with herniated disks aren’t just related to the manual eruption of the disk’s contents. You can experience irritation of surrounding nerves, which can produce pain, numbness or weakness in an arm or leg.

The most common signs and symptoms of a herniated disk are relative to the nerves affected by the herniation. Nerves have a distribution (i.e., affected areas of the body) associated with them. The following symptoms can be produced by a herniated disk and will be seen along that distribution.

  • Arm or leg pain Arm and shoulder pain may result from herniated disks in your neck, including pain that radiates down the arm. Certain motions and actions (e.g., coughing, sneezing and neck rotation) may exacerbate your symptoms. If your herniated disk is in your lower back, intense pain may be present in your buttocks, thigh, calf and part of the foot.
  • Numbness or tingling
  • Weakness Similarly, muscles that are served by nerves affected by a herniated disk tend to weaken, and this may cause stumbling and other signs of lessened strength (e.g., decreased ability to lift or hold).

Factors that increase your risk of a herniated disk may include a genetic predisposition, excess weight producing ongoing stress on the apparatus of the back,and various jobs (including those involving heavy or repetitive lifting, bending, twisting, pushing or pulling).

The next post will address treatment options and self-help considerations for herniated disks.

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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Filed under Musculoskeletal System, Orthopedics/Bones

Straight, No Chaser: Low Back Pain

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For many, low back pain begins with a slip and subsequently becomes a slippery slope that never seems to end. This Straight, No Chaser will help you understand why you’re having pain.

Lower back pain is a tricky subject for an emergency physician, and it’s seen everyday. In fact, over 40 million Americans suffer from various forms of chronic low back pain. The lower back is a source of many life threatening emergencies, which I’ll discuss in a separate post, but for now, as always let’s give you some information to help prevent and address your routine back problems. Let’s start by understanding what the back’s trying to accomplish and how you help or hinder that process by your actions.

Remember the back is the major weight-bearing apparatus of the body and it connects the upper and lower body. It twists, turns, pulls and bends. It contains many vital nerves and muscles.

lower-back-pain-causes-2Let’s point at four situations that produce or exacerbate your back pain:

1. Bad form (born with or otherwise acquired):

  • Spinal problems you were born with can predispose you to and outright cause all manner of back difficulties. Any machine works better if well-built.
  • Obesity puts a significant strain on your back in various ways. Given that most people don’t build up their back muscles, sprains and chronic pain are quite easy when you’re front-loaded. Pregnancy produces a similar strain on your back.

2. Strains

Have you ever heard that it’s easier to lift with your legs than your back? Well, I’d never think so based on the habits of many patients, but it’s true. The lower extremities are much stronger than your back. One of the problems with back strains is once it gets weak, it gets worse. Muscle spasms, pain, more strains and protruding discs all become more likely.

3. Fractures

A broken back is no fun. A weakened back bone (vertebrae) may collapse on its own if diseased (e.g. cancer, age, arthritis, infection), it may become fractured or may be injured with significant trauma. Those with osteoporosis have this happen more commonly. These broken bones may compress spinal nerves. You may even get shorter.

4. Arthritis and Normal Deterioration (aging)

There are other forms of arthritis beside degenerative joint disease (osteoarthritis, which we all get as we age), but the resulting pain, warmth, redness, swelling and limitation in motion all forms lead to reduced function and pain that can continue for the remainder of one’s life.

Here are a few clues to help you hone in on whether your back pain requires emergency attention:

  • Direct blow to your back
  • Fever and new onset back pain
  • Loss of control of your bowel movements or bladder function
  • New onset back pain after age 65
  • Numbness and tingling in both of your legs
  • Nighttime back pain
  • Sudden sexual dysfunction
  • Weakness and/or loss of motion or sensation in your legs
  • Weight loss and new onset back pain
  • Work related back injuries

What can you do to prevent or reduce the pain at home?

  • Learn and practice good posture. Sit when you can. Keep your back straight and shoulders back. When you stand, find something upon which to prop one of your feet, like a stool (think Captain Morgan).

CaptainMorgan

  • Learn the correct way to lift (bend at the knees, not at the back – every time). If you have pain, avoid bending, stretching and reaching if avoidable.
  • Wear low-heeled shoes whenever you can, ladies!
  • Learn how to stretch your back.

LBP exercises

  • Maintain a healthy weight, and exercise to strengthen your abdomen and back (your core)
  • Sleep on your side. Try a pillow between your knees.
  • Walk. Did you know walking is the best (and easiest) exercise for your back?

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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Filed under Musculoskeletal System, Neurology, Orthopedics/Bones

Straight, No Chaser: When Eating Goes Wrong, Part II – Bulimia

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If you read Part I of this conversation on eating disorders (anorexia nervosa), you will recall that eating disorders are a mix of an abnormal body image combined with abnormal behaviors that lead to medical consequences. Today’s Straight, No Chaser is on bulimia, yet another dangerous eating disorder.

The ‘Bizz-Buzz’ of bulimia nervosa is ‘binge-purge.’ What that means is bulimics engage in frequent episodes of eating excessive amounts of food (bingeing) followed by one of several methods of eliminating what was just ingested (purging). This methods include forced vomiting (most common), use of diuretics or laxatives, fasting or excessive exercise. It is important to note that the bulimic feels a lack of control over these episodes.

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Bulimia is an especially dangerous disease because it usually occurs in secret, and victims are able to hide it. This means symptoms will typically be further along when discovered. Bulimics usually manage to maintain a normal or healthy weight despite their behavior and may appear to be the person who ‘never gains weight’ despite ‘eating like a horse.’ This is a key differentiator between bulimia and anorexia. Otherwise, the two diseases do share some of the same psychological pathology, including the fear of weight gain and the unhappiness with physical appearance.

Treatment considerations for bulimia are similar to those for other eating disorders. A combination of psychotherapy, reestablishment of normal nutritional intake and medications usually leads to marked improvement. Again, the particular challenge with bulimics is discovering the condition in the first place. As with anorexia nervosa, treatment for bulimia nervosa often involves a combination of options and depends upon the needs of the individual. Medications may include antidepressants, such as fluoxetine (Prozac), if the patient also has depression or anxiety.

Let’s recap by revisiting where we started with our conversation on anorexia. Our society doesn’t do the job it should in promoting a normal image of health. 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 obese by medical standards, this becomes even more of a problem. The levels of stress, anxiety and depression resulting from this reality sometimes leads to eating disorders. Remember, eating disorders aren’t just habits. They are life-threatening conditions. If you or a loved one is suffering, please seek help immediately.

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Post-script: If you’re wondering about the above picture of the teeth, you’re viewing the effects of all that regurgitated acid on the enamel layer of your teeth.  I know. It’s not your best look.

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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Filed under Diet and Nutrition, Gastrointestinal, Mental Health

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.

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Filed under Diet and Nutrition, Mental Health

Straight, No Chaser: Blood Transfusions – Facts About Giving and Receiving

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When was the last time you saved a life? I’m not talking about an Internet game. There are many ways in which your efforts can make a significant difference in the life of someone whose life is at risk. One such instance is donating blood. This Straight, No Chaser reviews the basics of blood transfusion because it’s Patient Blood Management Awareness Week.

You have a greater chance of needing a blood transfusion than you may think.

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Each year, almost 5 million Americans need blood transfusions, meaning 5 million examples of active or potential people in the midst of imminent or potential life-threatening conditions. These can include any of the following:

  • Rapid loss of blood from injuries such as gunshot or stab wounds, motor vehicle collisions or broken bones;
  • Loss of blood during operations;
  • Severe anemia from disease such as cancer, sickle-cell anemia, kidney disease or iron deficiency;
  • Bleeding disorders, such as hemophilia or thrombocytopenia.

Let’s recap why blood is so vital.

donate how_much_blood

Blood carries oxygen and nutrients to the cells of various tissues and organs throughout the body. Failure to have an adequate supply of either oxygen or nutrients causes damage and/or death to the cells affected. You recognize many diseases in which this occurs, including heart attacks and strokes. Blood itself has many components, including red cells, white cells, platelets and plasma. Whole blood contains all of these, but more often transfusions occur via individual parts.

Do you know your blood type?

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On a list of things you should know about yourself, that really ranks high on the list. When seconds count, being able to share that information can make all the difference. The blood used in a transfusion must work with your blood type. If it doesn’t, antibodies (proteins) in your blood attack the new blood and make you sick.

  • Everyone has one of the following blood types: A, B, AB, or O. Also, every person’s blood is either Rh-positive or Rh-negative. So, if you have type A blood, it’s either A positive or A negative; that classification combines the two components that measure incompatibilities between blood.
  • Type O blood is called the universal donor, meaning it’s safe for almost everyone. As such, Type O blood is used for emergencies when there’s no time to test a person’s blood type. Approximately 40 percent of the population has type O blood.
  • People who have type AB blood are called universal recipients, means they can get any type of blood.
  • If you have Rh-positive blood, you can get Rh-positive or Rh-negative blood. But if you have Rh-negative blood, you should only get Rh-negative blood. Rh-negative blood is used for emergencies when there’s no time to test a person’s Rh type.
  • All of this means if you’re AB positive, you’re in a good position to receive donor blood and are relatively less likely to have allergic reactions to blood. Any blood type is good regarding the ability to donate.

Is donated blood safe?

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Blood banks collect, test, and store blood. All donated blood is meticulously screened for viruses, other infectious agents and other factors that could make you sick.

It’s helpful to know that not all transfusions require blood donated from a stranger. If you’re going to have surgery and if it’s surgery that is scheduled months in advance, your doctor may ask whether you would like to donate your own blood for potential use if needed during the surgery. Your blood would be drawn well in advance and stored in a blood bank. Even during surgeries, surgeons try to reduce the amount of blood lost so that fewer transfusions are needed. Sometimes blood lost can be collected and reused for the same patient.

Are there alternatives to blood transfusions?

It’s very interesting that of all the medical advances that have been made, there are still no man-made alternative to human blood. That said, researchers are trying to find ways to make blood. At this point, researchers have developed medicines that may help do the job of some blood parts. For example, some people who have kidney problems take a medicine called erythropoietin, which helps their bodies make more red blood cells. As a result, they may need fewer blood transfusions.

Will you donate blood?

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What this all boils down to is having sufficient blood supplies is vital to hospitals’ ability to take care of patients. Please consider this gift of life. You can easily check your ability to donate by contacting your local hospital or the Red Cross by visiting http://www.redcrossblood.org/give/drive/driveSearch.jsp. Besides, donating blood actually comes with plenty of benefits, including reducing cholesterol, improving circulation, reducing iron buildup and identifying any abnormalities you may have in your blood.

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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Filed under Hematology & Oncology/Blood Disorders/Cancer

Straight, No Chaser: The Health Benefits of Dark Chocolate, aka Happy Valentine’s Day!

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Happy Valentine’s Day! Got Dark Chocolate?

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As you may know if you’re a regular reader, Straight, No Chaser is big on you enjoying life and making healthy choices while doing so. In that spirit, on this day of roses and chocolates, we’re here to share with you the benefits of dark chocolate.

That’s right. Chocolate does have health benefits, but all chocolate is not created equal. If your loved one gives you chocolates today, that’s great (if that’s your thing). If s/he gives you dark chocolate, that’s an extra level of loving!

Straight, No Chaser has previously discussed the health benefits of antioxidants. Here’s the thing: antioxidants are substances that prevent or delay cell damage caused by free radicals. Free radicals are molecules that are byproducts of many activities that create cell damage. Think about cigarette smoke, trauma (even excessively vigorous exercise), excessive heat and sunlight (and its radiation), to name a few examples. The process of creating and releasing these molecules is called oxidation. The key point is free radicals are unstable and too many of them lead to a process called oxidative stress. This process is implicated in the development of many illnesses, including Alzheimer’s disease, cancer, cataracts and other eye diseases, cardiovascular diseases, diabetes and Parkinson’s disease. Antioxidants fight this process; this is why foods rich in antioxidants are called superfoods!

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Here are the known benefits of dark chocolate:

  1. It lowers blood pressure.
  2. It increases the levels of antioxidants, which reduces the incidence of heart disease of other conditions.
  3. It potential slows the onset of many (if not any) disease made likely by increased levels of free radicals. This points to benefits for brain health, slowing aging, cancer prevention and many other conditions.

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Here’s how to enjoy the benefits of dark chocolate:

  1. Remember, it’s dark chocolate (not white chocolate or milk chocolate) that provides these health benefits.
  2. Offset the extra calories you’re ingesting by exercise or otherwise eating less.
  3. Don’t drink milk while enjoying your dark chocolate; it appears to interfere with the body’s absorption of the dark chocolate.
  4. Go for European dark chocolate if available. It’s richer in cocoa phenols (the specific compounds known to lower blood pressure).
  5. Remember that a dark chocolate diet is not a thing! This is you making healthy choices even as you enjoy sweets.

dark-chocolate-health-food-get-fit-in-shape-

So if you’re going to chomp down on a truffle or bon-bon today, make it dark chocolate. And hold the milk. Happy Valentine’s Day!

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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Filed under Cardiology/Heart, Detoxification, Diet and Nutrition, General Health and Wellness, Health Prevention

The Straight, No Chaser Comprehensive Safe Sex Guide

safe-sex-no-regrets

This edition of Straight, No Chaser is a keepsake, whether for your own reference or as a conversation piece/teaching guide for others. I suspect that due to the volume and wealth of information contained within, you’ll refer to this post time and again (or so I hope). For additional information, refer to the U.S. Center for Disease Control and Prevention and/or the National Institutes of Health websites.

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STAYING STD-FREE

The best ways to stay STI free is to confirm it and then avoid it. If you want to reduce your risk of acquiring HIV and other STIs (sexually transmitted infections) through sexual contact, here are your options.

  • Abstain from sex.
  • Be monogamous.
  • Prove both you and your partner(s) are negative. Get yourself and your partner(s) tested, preferably prior to engaging in sexual activity and subsequently every three to six months, especially if you and/or your partner have more than one sexual partner.
  • If and once you establish that you’re STI-free, learn how to use condoms and do so every time you have sex.

A special note about protecting yourself from HIV

HIV can be spread by having unprotected sexual contact with an HIV-positive person. “Unprotected” means any vaginal, anal or oral sex without barrier protection, like a condom or dental dam. Some of the ways to reduce your risk of getting HIV through sexual contact include the following:

  • Don’t have sex. Abstinence is the best way to be certain that you won’t contract HIV. Although HIV is occasionally transmitted in other ways, vaginal, anal and oral sex are the most common ways that HIV is transmitted.
  • Be monogamous. To be clear, this means you are in a sexual relationship with only one person and both of you are having sex only with each other. For the purposes of contracting HIV, sex includes vaginal, oral or anal sexual activity. Monogamy is optimally effective if you also confirm early and often that both you and your partner are not infected with HIV.
  • Get yourself and your sexual partner(s) tested: Knowing your own status is important for both your health and the health of your partner. Talking about your HIV status likely will be difficult and uncomfortable, but it’s important to start the discussion BEFORE you have sex.

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FRANKLY, “DON’T ASK, DON’T TELL” IS JUST DUMB WHEN IT COMES TO STIs.

This is actually quite simple. No excuses. You need to ask your sexual partner(s) and any possible future partners the following questions.

  • Have you been tested for HIV, herpes, gonorrhea, syphilis and/or chlamydia?
  • When was the last time you were tested for HIV, herpes, gonorrhea, syphilis and/or chlamydia?
  • If you’ve been tested, what were the results of your tests?

STDlights

SAFER-SEX ACTIVITIES
These activities carry no risk of HIV transmission:

  • Non-sexual massage
  • Casual or dry kissing
  • Masturbation (without your partner’s body fluids)
  • Frottage—also known as “dry humping” or body-to-body rubbing

You can still contract other STIs, like herpes, HPV, or pubic lice (“crabs”) if you have bare skin-to-skin contact with your partner.

howToUseCondoms

CONDOM USE

Here are two questions for both males and females.

  • Have you ever learned how to safely and appropriately use condoms?
  • Do you use condoms consistently?

To maximally reduce your risk of getting HIV or other STIs, you must use a new condom with every act of vaginal, anal or oral sex. If you don’t use them for oral but do for vaginal and anal, you have still lowered your risk, just not as much as you could have. Also, you must use condoms correctly, as depicted in the above diagram, to appropriately reduce your risk. Learning correct usage also will keep condoms from breaking or slipping off, which reintroduces the risks.

I also want you to understand that all condoms are not created equal. Latex condoms are highly effective against HIV and other STIs. Do you or your partner have a latex allergy? If so, the next safest condom choice is a polyurethane or polyisoprene condom. Just tell your pharmacist at the drug store that you’re allergic to latex, and s/he’ll take it from there. On the other hand, lambskin condoms do NOT protect against HIV. The particle size of the virus allows it to maneuver and slip through lambskin.

Condoms alone have never been enough. Did you know that you should always use a water-based lubricant when you use a condom for either vaginal or anal sex?  I want to restate this: that’s water, not petroleum jelly. Water-based lubricants reduce friction and help keep the condom from breaking. Do NOT use an oil-based lubricant (such as petroleum jelly, hand lotion or cooking oil). Oil-based lubricants can damage condoms, making them less effective.

Both male condoms and female condoms will help protect you against HIV and other STIs. If you’ve learned to enjoy sex with a male condom, you can learn to enjoy it with a female condom or a dental dam. Additionally, there are many of you who have contracted STIs. If you wish to continue to enjoy a variety of sexual activities, learning to use the full range of barrier protection may be a better option for you and your partner than abstaining.

Condoms do not provide 100% protection against all STIs, but you are always safer using a condom than not. You can get certain STIs, like herpes or HPV, from contact with your partner’s bare skin, even if one of you is wearing a condom, but condoms lessen the risk. Take the time to explore and inspect each other if you’re confused or concerned about the possibility of your partner having an STI.

Spermicides only serve the purpose of reducing the risk of becoming pregnant. They are ineffective in preventing contraction of HIV and other STIs. They actually irritate rectal and vaginal walls, in effect increasing the chances of HIV infection, should infected fluids come into contact with these areas.

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ABOUT SEX TOYS

This is pretty straightforward. Using sex toys can be safe, but think of staying clean and “not sharing.”

  • It is important that you use soap and water to clean your toys after each use. If the instructions allow for a stronger disinfectant, you may do so.
  • As a rule, don’t share your toys. The nature of how toys are typically used likely increases the risk of vaginal or anal irritation, which increases the risk for HIV or other STI transmission.
  • If you “must” share your toy with your partner while still trying to be safe, use a condom on the toy before you use it, and change the condom before your partner uses it.

circumcision None Required

CIRCUMCISION
We’ve discussed circumcision at length in Straight, No Chaser. (Click here for a dedicated post on circumcision.) There has been ongoing interest and research over the past few years about circumcision and its effect on preventing HIV infection. The bottom line? In 2007, the World Health Organization reported that male circumcision reduced the transmission of HIV by 60% from women to men in three randomized, controlled studies in Uganda, Kenya, and South Africa.

There is much less available data for men who have sex with men and how circumcision might affect HIV transmission through anal sex. In addition, recent studies show that circumcision does NOT protect women from contracting HIV from male partners.

Let’s be careful in interpreting the results of these findings.

  • Circumcision is only additionally effective when earlier preventative efforts have not been taken. Advocating circumcision is not an appropriate substitute for any of the numerous safety measures and habits previously discussed to reduce one’s risk for HIV and other STIs.
  • Failure to have a circumcision does NOT increase one’s HIV and other STI risk in the presence of appropriate safe-sex activities.

So there you have it. Knowledge is power. We appreciate that this posting was not balanced by the human decisions and passions that come into place with sexual activity. We recommend that you adopt a posture of “safety first” to create that balance! Good luck, and feel free to ask your SMA expert consultant any questions you may have on this topic.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

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