Tag Archives: Straight No Chaser

Cervical Health Awareness Month

January 14, 2019Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, CDC, Centers for Disease Control and Prevention, Cervical cancer, HPV, Human papillomavirus, Pap smear, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

January is Cervical Health Awareness Month. To that end, The Center for Disease Control and Prevention (CDC) boldly proclaims “No woman should die of cervical cancer.” Yes, that is actually possible!

This post has a rather simple message. Cervical cancer is entirely preventable. Furthermore, it can be cured when discovered and treated early.

Quick Tips

Here are some quick tips to help you check this off of your list of concerns.

Every child should get vaccinated at age 11 or 12. Even if you’ve reached age 26 and haven’t been vaccinated, you should discuss options with your physician.
Get screened, starting at age 21. This is the most important thing you can do to help prevent cervical cancer.

The Pap test (or smear) should be performed regularly at age 21. It looks for precancerous changes to the cervix that identify the need for early treatment. In many cases a normal test will eliminate the need for another test for the next three years, but your physician will discuss your individual circumstances in this regard.
The HPV test looks for the virus that is now known to be the cause of cervical cancer. Furthermore, human papillomavirus (HPV) is sexually transmitted. The HPV test can be done at the same time as the Pap test from the same examination.

Hopefully knowing these simple tools will convince you to focus on preventing and managing your cervical health. This is a public health success story in that cervical cancer could be eliminated if everyone followed the above steps. The rest is up to you.

Read these!

This additional Straight, No Chaser post discusses the prevention strategy that could eliminate in total cervical cancer. Read it for details.
This Straight, No Chaser post shares news regarding the success of the vaccine in reducing the rates of HPV infection and cervical cancer. Read it for details.

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

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

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Straight No Chaser’s Guide to Completing New Year’s Resolutions

January 7, 2019General Health and Wellness844-SMA-TALK, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This Straight, No Chaser post is a guide to help you completing your New Year’s resolutions!

You call them New Year’s resolutions. We call it getting your health (and life) on a higher plane! Most resolutions involve healthy eating, exercise routines, smoking cessation and stress reduction. None of these endeavors are easy. All too often, they involve starts and stops with failure before success. It seems that the take-home messages are pretty clear.

People choose these endeavors because they are the basics to preventing many illnesses and diseases and to enjoying a healthy life.
Pursuing these efforts involves a lifestyle change. Quick fixes just won’t get it done, no matter how sexy or well-marketed the fad or gimmick is.
Many of you had some success in the efforts you’re pursuing. Understand that difficulty, frustration and occasional setbacks are often part of the process. Fortunately, these setbacks don’t necessary define failure. Furthermore, they shouldn’t cause you to give up the pursuit of better health.

Specific Strategies

If you’re serious about turning your resolutions into completed actions, consider employing some tried and true strategies.

Engage others such as friends and family in your quest. Let them know your goal. Empower them to support you and hold you accountable. Encourage them to join you.
Plan your strategy. Write it down. Have benchmarks, check-ins and intermittent goals. These lofty goals can’t just be a passing fancy. These are difficult tasks and require a certain amount of serious planning on the front end and diligence along the way.
Reward yourself. This effort can’t just be a chore and something that makes you miserable. This is a big deal and should be treated as such. Plan to celebrate your success, and make it a nice enough reward that its pursuit is worth the efforts you’re going through!

Your final take-home message is one we hope you realize by now. You don’t have to pursue these efforts alone. Your medical team should be engaged to help you in these endeavors as needed. However, if and when they aren’t, you have an additional team available to you 24/7 at www.jeffreysterlingmd.com and 844-SMA-TALK. We wish you the best in your pursuit of better health. Happy 2019!

Specific Blogs for Completing Your New Year’s Resolutions

From previous posts, here’s your guide to successfully completing your New Year’s Resolutions. Click the links!

1 – The Benefits of Exercise and Other Physical Activity
2 – Here are Steps for You to Take – Get Active!
3 – Do You Even Know How to Eat Healthy?
4 – Diet and Nutrition Tips
5 – Smoking Cessation
6 – Here’s How You Stop Smoking
7 – Why Stress Kills and Stress Management Saves Lives
8 – Your Personal Stress Management Plan

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The 72 Hours Life Approach to Implementing New Year’s Resolutions

January 3, 2019Personal Training, Health Prevention844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

It’s the beginning of the year and time for implementing your New Year’s Resolutions! You’ve probably been reflective and have done inventory on major parts of your life, including work, finances, family, relationships and health. That makes it the perfect time to adopt The 72 Hours Life to what you’re doing!

Here are four principles to apply to whatever you’ve chosen to do.

Make firm decisions about what you actually want to accomplish

As the saying goes, if you don’t plan on going anywhere, then you’ll end up nowhere. Another way of saying this is we slot ourselves into levels and areas of success. Choices have consequences. Think through your goals and your choices. Understand what that means for the rest of your life. Learn to choose wisely. Then proceed happily, enjoying the journey and looking forward to the destination.

Learn what’s necessary to accomplish your goal

You wouldn’t travel without a flight itinerary. Why would you expect to arrive at your destination without a plan? These days, the mystery of accomplishment has largely disappeared. You have access to resources and to help. Take advantage of everything at your disposal. Why would you try to do anything alone? Now, be careful. You want paths that represent best practices and proven success. All advice isn’t constructive. Similarly, every plan isn’t the most efficient choice. When figuring out how to accomplish your goal, be focused on your success and mindful of how to avoid obstacles. Trial and error or learning from your mistakes isn’t what you’re after here. You want success!

Proceed with the end in mind

When it comes to obtaining goals and productivity, implementation is everything. No matter how good the plan, if it’s not executed well, the goal likely won’t be accomplished. Once you’ve defined the outcome and obtained the resources, focus on the plan. If you’ve done the work in constructing the plan, you’ll have minimized the need for mid-course corrections. Every step along the way, continue asking yourself how your actions are contributing to your desired outcomes.

Stay the course

Unfortunately, life’s journey tends not to involve straight lines. You must have and retain confidence in your chosen outcomes, your plan and your ability to implement. If and when you get temporarily knocked off your target, don’t lose faith in yourself or lose the desire to obtain your goal. More often than not, ultimate success is lost as a result of us closing doors in our own faces without knowing how close to winning we may actually be!

Think through how these four principles apply to your personal, professional, health and financial pursuits. If you do this, I have no doubt that you’ll be a lot more efficient and effective in not only accomplishing any New Year’s resolutions but in creating a better approach to life in general.

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Welcome to The 72 Hours Life! Join our productivity community at www.72HoursLife.com. You can obtain Dr. Sterling’s best seller There Are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life at www.72HoursLife.com, Amazon, Barnes & Noble or wherever books are sold. Also look for The 72 Hours in a Day Workbook: 72 Days to the 72 Hours Life at these same outlets.

Introducing the New 2019 Straight No Chaser: Happy New Year!

January 1, 2019General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

Welcome to the new 2019 Straight, No Chaser: our seventh year! We hope you’ve enjoyed our over two thousand blogs and vlogs, and thank you to the millions of you that have read our posts. In fact, many of you have shared the ways we have directly impacted (and saved) your lives.

2019

For 2019, we are switching formats. You will notice the following differences:

As a rule we will always post once a week on Monday.
The weekly blog will generally serve as a guide that include links to multiple blogs around a central topic. We will align these topics with national health observances.
We will occasionally offer additional blogs during the week based on occurrences in the news.
You will see occasional special guest blogs featuring content experts across medicine, mental health and public health.
All of our blogs will focus on action items you can time to directly improve your life.

We welcome your blog suggestions, questions, feedback and input (if you’d like to become a contributor)! You still have access to any topic of your choosing by just typing a word in the search engine, located in the upper right part of your screen.

We greatly appreciate your support. We think you’ll find the 2019 Straight, No Chaser to be the most impactful version yet. Happy New Year!

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Ask your Sterling Medical Advice 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!

Driving Under the Influence (DUI) & New Year’s Eve

December 31, 2018Toxicology/Drugs, Trauma, Health Prevention844-SMA-TALK, Behind the Curtain, drinking and driving, impaired driving, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This post is about driving under the influence (DUI) of alcohol and other illicit substances.

Celebrating New Year’s Eve? As I am known to say, risks represent incidences of occurrences. Of all days during the year, today you must act to lower your risk of a fatal motor vehicle crash due to alcohol or drugs. Remember, it’s not just your behavior that places you at risk. In addition, the others with whom you’ll be sharing the road will require your full attention and alertness.

Please recall that alcohol is a central nervous system depressant. For instance, it slows down brain function, including reaction time, information-processing skills and hand-eye coordination. This affects judgment, concentration, comprehension, sight and coordination. As a result, you’re much more likely to crash a car if you’ve been using any type of drug.

DUI Facts

You’d do well to know a few FACTS about driving under the influence of alcohol or other drugs (Courtesy of National Council on Alcoholism and Drug Dependence).

Approximately 30 people a day die from motor vehicle crashes in which a driver was under the influence of alcohol. This is about one death every 51 minutes.
An estimated 32% of fatal car crashes involve an intoxicated driver or pedestrian.
Car crashes are the leading cause of death for teens. Unfortunately, about a quarter of those crashes involve an underage drinking driver.
3,952 fatally injured drivers tested positive for drug involvement.
Over 1.2 million drivers are arrested annually for driving under the influence of alcohol or narcotics.
On average, two in three people will be involved in a drunk driving crash in their lifetime.

Tonight is not the night for debate. All of the above facts will become magnified tonight. Driving under the influence is a crime. Therefore, you know the police will be monitoring the roads. Avoid driving if you can. If you are driving, don’t drink, use marijuana, alcohol or any other drugs. The life you save may be your own. I hope to see you safe and healthy in the New Year.

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Eliminating Alcohol from the Body

December 30, 2018Detoxification, Toxicology/DrugsAlcohol, Alcohol intoxication, Behind the Curtain, Binge drinking, Designated driver, health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This Straight, No Chaser post is about eliminating alcohol from the body.

We get questions from you all the time. In preparation for New Year’s Eve, here’s an example: “How can I eliminate alcohol from the body quicker if I get drunk?”

It’s a frequent misconception that there are a ton of remedies you can take to help you eliminate alcohol quicker or get less drunk. Alcohol is eliminated by a process called zero-order kinetics. In other words, alcohol is eliminated from the body at fixed amount per hour. Nothing you do is going to make you less intoxicated (referral to the legal definition of how much you have in your system). This includes coating your stomach, eating (including a cheese tray) or drinking coffee.

This being said, being less dehydrated does help the blood alcohol concentration. Also, drinking coffee or another stimulant can counter the depressant effects of alcohol and may make you feel more alert. However, my best advice for you is to sleep it off. Of course, if you’re intoxicated to the point that you need medical attention, doing so should be your immediate action.

Bonus question: “Does vomiting help?”

Vomiting is only of value in eliminating alcohol that hasn’t yet been absorbed into the bloodstream. Once alcohol is in your system, it is eliminated as discussed.

For further details on the initiatives listed above, please visit Straight, No Chaser at www.jeffreysterlingmd.com and type any desired topic into the search engine.

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Your Hygiene and Risk for Illness

December 23, 2018General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, Gastroenteritis, Hand sanitizer, handwashing, Influenza, MRSA, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

The Straight, No Chaser post looks at the relationship between your hygiene and illness.

There are things you know, there are things you know but don’t really know, and there are still other things that you think you know that you don’t know at all. When it comes to colds and influenza (both or which are simple to understand, prevent and treat), all of the above apply.

Are you sickly or do you get colds more frequently than others? Respectfully, a big part of that is because you have habits that put you at risk. Common things happen commonly.

Of course this is not an actual photo, but it’s a good depiction of what’s happening. Simply put, most of the day, your hands are pretty disgusting. You handle money that’s been handed hundreds if not thousands of times and never cleaned. You grab handles and door knobs all day long. You’re coughing and sneezing throughout the day, spewing germs into the air to be inhaled by others. And you spend time in the restroom. Your unclean hands contribute to many ailments, including colds, influenza, conjunctivitis (pink eye) and gastroenteritis (vomiting and diarrhea) and skin infections.

Lower Your Risk

The important points are simple things you can do to lower your risk for infections. First, you have to stop assuming you know more than you do about basic hygiene and allow yourself to start practicing better habits. For example …

When you sneeze, do you sneeze into your hands or into the air around you? Please learn the habit covering your mouth and nose when you sneeze or cough by sneezing/coughing into your elbow and not your hands.
How often do you wash your hands? You must wash every time you begin to cook, before you eat, after you use the rest room, before you change a diaper and before you apply any topical medicine.
Have you ever noticed how much you keep your hands on parts of you that can become infected by doing so? Keep your hands out of your eyes, mouth and nose, and stop picking at your skin!

Yes, you wash your hands, but do you do so effectively and when you need to? Hand washing must be the easiest and most effective ways to prevent disease. Let’s start with this: from now on, whatever you do to clean your hands, do it for twenty seconds. Of course, antimicrobial soap and water are what we all learned to do way back when. It works! If that’s not available, use hand sanitizers or disposable hand wipes. It that’s not available, just rinse your hands! Be sure to rub your hands vigorously during the process as if you’re trying to get someone off of your hands, because you are!

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Urinary Tract Infections (UTIs)

November 25, 2018Genital/Urinary, Infectious Disease844-SMA-TALK, Behind the Curtain, Conditions and Diseases, cystogram, cystography, E. coli, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, urinary tract infections, UTIsJeffrey Sterling, MD

Introduction

Ladies, have you ever been told that you get urinary tract infections (aka UTIs or “bladder infections”) because you didn’t wipe front to back instead of back to front? Men, have you ever been told that this could be a sign that your prostate needs to be examined This Straight, No Chaser answers simple questions on urinary tract infections. With over 8 millions cases and 100,000 hospitalizations a year due to these, it’s information you should know. We offer the information in question and answer format.

What are urinary tract infections? Are they the same as a bladder infection?

What these questions really ask is “What is the urinary tract?” The body’s drainage system serves to remove excess fluid and bodily waste. It includes the following organs:

The kidneys serve to filter blood and produce approximately 1-2 quarts of urine per day as a result of this process.
The ureters are tubes extending from the kidneys to the bladder, carrying filtered urine within them.
The bladder is the pouch within which you store urine until you’re ready to release it.
The urethra is a tube at the bottom of the bladder through which urine gets expelled.

A UTI is an infection anywhere along this path. Infections at different parts of the urinary tract can display different symptoms and have different complications.

What causes a UTI?

Bacteria are the most common cause of UTIs, particularly those that live in the bowel (such as E. coli) and are within or in close proximity to the vagina. Under most circumstances the body is very effective at removing bacteria and other microorganisms from the urinary tract (urinating just washes them out!), but some of us are at increased risk due to diminished defenses or other circumstances in which these microorganisms can grow.

Why do women get UTIs, and it seems like men don’t?

It is true that women get UTIs about four times more frequently than men, but anyone of any age or sex can be infected. Here are some reasons why.

Women have a shorter urethra, which makes it easier for bacteria to reach the bladder.
Also, the opening of a woman’s urethra is near the vagina and anus, where bacteria live.
Women who use a diaphragm are also more likely to get UTIs than women who use other forms of birth control.
The male prostate produces secretions that slow bacterial growth.

Are there other risk factors for UTIs?

Yes. Others at higher risk for UTIs include the following.

those having diabetes or have lowered immune systems
those habitually needing a tube to drain their bladder
those with urinary tract abnormalities that block the flow of urine
those with spinal cord injuries or other nerve damage

Additionally, once a man has a UTI, it’s more likely he’ll have the problem again because the bacteria are extremely difficult to reach once they set up shop in the male prostate.

Are UTIs serious?

Unless you describe the annoying symptoms as serious, most UTIs are not serious. However, UTIs can lead to severe complications if left untreated, including the following:

Long lasting or recurrent kidney infections can cause permanent damage and scarring to the kidneys, which can create insufficient kidney function and produce high blood pressure and other problems.
Kidney infections can enter the blood stream and become life threatening.

What are the signs and symptoms of a UTI?

You should see your physician if you develop any of the following signs or symptoms:

A burning sensation with urination
Bloody, cloudy, dark or otherwise discolored urine
Fever or chills
Foul-smelling urine
Frequent or urgent need to urinate, regardless of the amount actually expressed
Pain in your back or side below the ribs

How are UTIs diagnosed?

UTIs are diagnosed based both on symptoms and a lab test. Many of you have experienced your urine being sent to a lab from the emergency room or your doctor’s office. Based on a combination of symptoms, the presence of bacteria and white blood cells that have accumulated to fight the infection, the diagnosis will be made. If you have frequent infections, infections that don’t respond well to treatment, atypical presentations or are sick enough to be hospitalized, your urine may be cultured in an effort to grow the bacteria causing your symptoms. This allows more precise treatment regimens to be given. In other circumstances, tests may be done to check the normalcy of your urinary tract, including an ultrasound or CT scan. Further details on when and why this would be done is available on www.sterlingmedicaladvice.com.

An additional Straight, No Chaser will discuss prevention and treatment options for UTIs.

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Prevention and Treatment of Lead Poisoning

December 27, 2018Detoxification, Environmental, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, Conditions and Diseases, lead poisoning, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This point is about prevention and treatment of lead poisoning.

What you need to know about protecting yourself from lead poisoning and its effects is reducible to awareness, baseline testing, prevention and treatment.
We covered what you needed for awareness in the previous Straight, No Chaser.
However your goal really should be prevention via avoidance, as much as is possible. However, to prevent, you must have a level of awareness. Think about these things:

Do you have a child in your house between ages 6 months and 3 years old? If so, be reminded that children wander around putting things in their mouths.
Are you in an old house, or do you have old plumbing?
Do you live near a busy road or near bridges?

If you are in a high-risk situation, your ideal level of awareness should include preventive considerations such as getting your home tested and your blood lead level checked. If anyone in the home has been found to have high lead levels, the entire household should be checked.

Prevention

Whatever your level of exposure, you want to engage in preventive strategies to prevent further exposure that could lead to disease. Here are a few quick tips to do so:

Avoid dust in your home, because you just never know!
Wash everyone’s hands prior to eating.
Throw away old painted toys, unless you’re sure lead based paint was not used.
Use filters for your water, switch to bottled water for drinking and cooking, and/or let any tap water run for approximately one minute prior to drinking or cooking with it.
Avoid storing wines in lead crystal decanters for long periods of time.

Treatment

If you have been found to have any significant levels of lead in your blood, you have a role in your treatment. If your levels and symptoms are significant enough to be hospitalized, that will occur and you’ll receive medicine that facilitates the removal of lead from the body, called chelating agents. However, in the absence of that, your job likely will be to maintain a healthy diet that includes calcium, iron and Vitamin C, all of which help decrease lead absorption within the body.

Prognosis

As mentioned, you want to avoid lead poisoning. Each year in the United States, approximately 310,000 kids aged 1-5 years old have unsafe levels of lead in their blood. In these children, even mild lead poisoning can have a permanent impact on attention and IQ. Remember, the developing brain is more susceptible to the toxic effects of lead. Those with higher lead levels have a greater risk of long-lasting health problems and must be closely followed because of the potential damage to the brain, nervous system, muscles and other systems. Adults who have had mildly high lead levels often recover without problems, but in general, a complete recovery from chronic lead poisoning may take months to years.

If you suspect you may have lead paint in your house, get advice on safe removal from the U.S. Department of Housing and Urban Development (HUD) at 800-RID-LEAD, or the National Information Center at 800-LEAD-FYI. Another excellent source of information is the National Lead Information Center at (800) 424-5323.

If you suspect you or someone in your family is suffering from the effects of lead, call 911 immediately and/or call 1-800-222-1222 to speak with a local poison control center for further instructions while you await the paramedics to arrive.

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Frequently Asked Questions About Lead Poisoning

December 26, 2018Neurology, Pediatrics/Kids Health, Public Health, Skin/Dermatology, Toxicology/Drugs, Health Prevention, Musculoskeletal System844-SMA-TALK, Behind the Curtain, mental-health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

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

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

What is lead poisoning? Why is it dangerous?

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

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

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

Most common exposures

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

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

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

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

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

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

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

Early Symptoms

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

Longer Term Health Problems

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

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

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Colorectal Cancer Screening via Colonoscopy

January 24, 2019Gastrointestinal, General Health and Wellness, Hematology & Oncology/Blood Disorders/Cancer, Health Prevention844-SMA-TALK, Behind the Curtain, Colon, colonoscopy, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This post is about the screening colonoscopy.

Two previous Straight, No Chaser posts have highlighted recommended screening examinations for men and women between ages 40-64. In today’s post, I want to pay special attention to one examination in particular. The screening colonoscopy seems to generate large amounts of fear (and homophobia).

Colon cancer is the second most common cause of cancer in the United States after lung cancer (stop smoking!). As previously noted in the post on recommended screenings, everyone should have a screening colonoscopy at least by age 50. Certain groups of individuals, such as African-Americans and those with positive family history for colon cancer should have the test done earlier. Simply put, colonoscopy is definitive in screening and diagnosing colorectal cancer. Furthermore, it is one of the most successful ways to both prevent and treat early cancer.

How a colonoscopy is done

First, you have to do a bowel prep. Over a few days, you’ll eliminate certain foods (e.g. corn, nuts) from your diet. Next, you’ll progress to an all liquid diet. This will be followed by taking a few doses of a very strong laxative to completely clean out the contents of your intestines (those of you looking for a good detox should be so lucky). I actually lost 3.5 pounds doing this.

The exam involves using a tube (colonoscope) to view your digestive tissue from your rectum all the way up the large intestine (approximately 5 feet). It includes cleaning away and suction stool that blocks the view, direct visualization of the intestines and real-time removal of suspicious tissue (e.g. polyps) that could be cancerous or early signs of cancer. You may or may not choose to be sedated (put to sleep) during this. Of course, my medical curiosity was such that I wanted to see everything on the screen in real time, so I went without any medications, and yes, I lived to tell the story: the level of discomfort never got higher than a 3 on a scale of 1-10.

A few words about colorectal cancer

The point here is simple and straightforward: Most people in whom colon cancer is found and treated early will not only be alive 5 years later, but many will live a normal life span. On the other hand, when it’s not, colorectal cancer is very dangerous because it often doesn’t cause noticeable signs or symptoms until the cancer is advanced and much more difficult to treat. The screening colonoscopy gives you the best chance to know where you stand.

Your risks

So this isn’t that complicated. The following conditions are associated with advanced risk.

Advanced age
African-American
Positive family history for colon cancer or inflammatory intestinal conditions
Live a sedentary lifestyle
You have a low-fiber, high-fat diet

Here are a few words about your diet. You should know that according to the American Institute for Cancer Research, just 1.7 ounces of processed meats consumed daily (equivalent to less than two strips of bacon) roughly increase a person’s risk for colorectal cancer by 21 percent. More definitely, no amount of processed meat is considered safe for consumption.

Thankfully, my colonoscopy was perfectly normal: I keep telling you diet is 75% of health (unless you’re either lucky or unlucky in your genetic makeup)! The actual colonoscopy took just over 10 minutes, and I won’t have to go through this for another 10 years. Isn’t that investment of time worth giving yourself the best chance for a clean bill of colon and rectal health?

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Lactose Intolerance – It’s Explosive!

December 22, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Calcium, Dairy, Dairy product, Hispanic, Lactose, Lactose intolerance, Milk, Native Americans, Pinto beans, Small intestine, Soy milk, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, Turnip greensJeffrey Sterling, MD

Introduction

So I’m at dinner with a group of friends, and somehow the topic gets to lactose intolerance. For 15 minutes. They were really into it. At dinner! You know what it is. Everyone seemingly knows someone who has it, even if (hopefully) you aren’t reminded of it too often. Lactose intolerance is a state where you simply have difficulty digesting lactose (one of the sugars we consume, most notably in milk and other dairy products) because of a deficiency in the enzyme that breaks it down, called lactase. Lactose intolerance occurs more often in Black, Asian, Hispanic and Native Americans, but that doesn’t mean your body read that book.

So by now you may be thinking “What is there to discuss besides the odoriferous emanations produced?” (In case you didn’t get the reference that’s from an old Right Guard commercial featuring Charles Barkley.) Well, the biggest concern from a health standpoint is to ensure you’re still getting enough calcium to keep your bones strong and enough Vitamin D.

Here are 3 sets of practical facts to help you get through it all.

If you have lactose intolerance, that doesn’t mean you’re allergic to dairy products.

This is an important distinction. There’s nothing immediately life-threatening about the ingestion of dairy products if you’re lactose intolerant, as there might be if you were allergic. Just be aware of the cramping, bloating, flatulence, nausea, vomiting, diarrhea and gas that may ensue.

If you’re lactose intolerant, that doesn’t mean you can’t necessarily have any dairy or won’t ever be able to have dairy.

Lactose intolerance occurs in many shades of grey. Some people get worse with age; others get better as they learn to work around it. Some develop lactose intolerance at birth, others later in life, and others develop it after injury or surgery to the small intestine (which is where lactase is normally produced). Some can ingest small amounts of certain products without symptoms. In the privacy of your own surroundings, you should discover for yourself if you’re affected every time you have dairy or whether or not only large amounts of certain products cause symptoms (e.g. Try not to eat the entire gallon of ice cream.). You should also gauge your response to dairy after taking various lactase-containing supplements.

If you’re lactose intolerant, you still can get adequate calcium. Here’s a few suggestions.

Soy and rice products have exploded (in a different way) on the market. Consider soy milk, soybeans and tofu.
Many juice, bread and cereal makers have taken to providing calcium.
Some fruits and veggies are great sources. Consider broccoli, collard and turnip greens, kale, okra, pinto beans, rhubarb, and spinach. Oranges are a good source of calcium.
Other great foods include almonds, salmon, sardines and tuna.

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Differing Effects of Medications in the Elderly

December 21, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Drug, Drug interaction, Drugs and Medications, health, Mental Health, Old age, Pharmaceutical drug, Pharmacy, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This Straight, No Chaser addresses the differing effects of medications in the elderly.

The elderly are living longer and more productively. Part of being able to do so is by maintaining an understanding of how your actions affect you. As you’d believe, one common action of many of the elderly is taking medications. You should be aware that medications have changing effects with aging. Also, you should be aware that there are many different reasons for that fact.

It’s the physiology

First of all, changes in our physiology due to aging make the effects of drugs less predictable and consistent than in younger people. A slower metabolism, increases in body fat and alterations in the function of the kidney and liver (major mechanisms for drug elimination) have important ramifications for what ingested substances will do. Thus, the elderly require more stringent monitoring of drug levels and effects, and you may find that your physician needs to adjust medication doses. This same consideration explains why side effects are more common among the elderly.

Be reminded the presence of other diseases brings additional effects and challenges. Just as with one’s own relatively diminished function, disease imposes the same type of changes onto the body. This can speed the presence of side effects and toxicity as well as adjust the effective dose of a medication.

Drug Interactions

Have you ever seen the individual with a small ‘army’ of medications? Think about it. The more medications one takes, the more likely drug interactions will ensue and changes in effectiveness in any single medication may occur. This effect incrementally increases with each additional drug one takes. Similarly, the more medications one is taking, the most likely one is to make a mistake in taking the correct medication at the right time. Now consider your independently living parents or grandparents. The elderly often are more prone to make these types of errors.

What can you do about this? Get organized, and get help! Those daily medication containers are good solutions to incorrectly dosing medications. If you’re especially organized, a log is great—not necessarily for you, but for the physician that will be trying to figure out why you’re dizzy or have an altered mental status if and when that occurs.
Talk with each doctor you see or a pharmacist about what to expect from the combination of medications you take; it can make your lives a lot less complicated.

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Taking Vitamins and Mineral Supplements

December 19, 2018Diet and Nutrition, General Health and Wellness, Toxicology/Drugs, Health Prevention844-SMA-TALK, Annals of Internal Medicine, Behind the Curtain, Big Bang Theory, CBS, Edgar Miller, Johns Hopkins School of Medicine, Multivitamin, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, VitaminJeffrey Sterling, MD

Introduction

This Straight, No Chaser discusses the use of vitamins and mineral supplements.

If any of you are familiar with the hit comedy The Big Bang Theory on CBS, you may recall this scene from one of the first episodes featuring the genius, physicist and would-be Noble Prize winner and the ditzy, would-be actress:

http://www.youtube.com/watch?v=m0Eo7ju54aY

Sheldon (as Penny selects vitamin supplements): Oh boy.
Penny: What now?
Sheldon: Well, there’s some value to taking a multivitamin, but the human body can only absorb so much, what you’re buying here are the ingredients for very expensive urine.
Penny: Well, maybe that’s what I was going for.
Sheldon: Well then you’ll want some manganese.

The Prevailing Medical View on Widespread Use of Supplements

My views on these things have migrated over the years, and although I’ll share it with you, I still defer to the standard of care on medical matters. That standard is based on an editorial from the prominent medical journal Annals of Internal Medicine. In short, the findings of the editorial, based on a review of relevant recent literature and covering approximately half a million individuals are that taking supplements and multivitamins to prevent chronic diseases is a complete waste of money. Pointedly, the title of the editorial is “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.” In other words, the vast majority of uses of vitamins and minerals are unwarranted and constitute a waste of your well earned dollars.

Here are a few points that reflect the prevailing opinion on supplements.

Physicians have every reason to embrace improvements in medicines and technology when they exist and no reason to shoot down them down when they’re effective. If there was evidence of widespread supplement use, you’d be hearing about it from your physicians.
Your individual opinions, anecdotes and personal experience do not constitute medical fact. Just because you felt better or believe your memory seemed to have improved after taking a certain pill doesn’t mean the cause of your improvement was the pill.
There is a phenomenon called the placebo effect that explains more than you’re willing to admit. It’s more or less “the power of positive thinking.” The placebo effect is a measurable, observable, or felt improvement in health or behavior not attributable to an administered medication or invasive treatment. Even though placebos are not active medicines, they seem to have an effect in about 1 out of 3 patients. This is thought to represent the body mobilizing to address the concern for which you decided to take the pill. In this example, vitamins aren’t placebos because they actually have an effect on the body. However, the improvements you’re experiencing aren’t directly attributable to those pills.

But you love them…

More than half of all adults in the United States take a multivitamin and/or additional supplements, including those touted to prevent cancer, heart disease and boost memory.
“The (vitamin and supplement) industry is based on anecdote, people saying ‘I take this, and it makes me feel better,’ said Dr. Edgar Miller, professor of medicine and epidemiology at Johns Hopkins University School of Medicine and co-author of the editorial. ”It’s perpetuated. But when you put it to the test, there’s no evidence of benefit in the long term. It can’t prevent mortality, stroke or heart attack.”

The vitamin and supplement industry rakes in nearly $12 billion annually, according to the researchers, with multivitamins its most popular product.

Try Diet Instead Unless Told Otherwise

With that, allow me to again extol the virtues of a good diet.

Most everything you’re looking for in a bottle can be obtained by a healthy diet. This is especially true with generous servings of fruits and vegetables.
It is a fair point to make that a large number of us do not engage in a healthy diet, so much so that a multivitamin would be beneficial. Of course, that begs the question “If someone is not compliant with the direction to eat health foods, why would you presume they’d be compliant taking a multivitamin daily?” These pills are not inexpensive. Your better course of action is in spending that money on healthier food choices.
It is appropriate to note that if you are suffering from a nutritional deficiency, you will benefit from a vitamin supplement. Of course, the deficiency would have diagnosed by your physician, and the supplement would have been recommended by your physician. Short of that, in most cases, you’re allowing your fears to be played upon.

Finally, and this is where I’ve migrated, if you simply have the money to spread (or burn as the case may be), and you choose to view supplement use as akin to an insurance policy, there’s usually no harm (medically speaking) to your doing so. I am an advocate of your taking any positive step forward for your health. I just wish you’d do so in an evidenced-based manner. This would be in your best medical – and financial – interests.

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Questions About Genetically Engineered Foods (GMOs)

December 17, 2018Diet and Nutrition, Public Health844-SMA-TALK, Behind the Curtain, bioengineered foods, Food and Drug Administration, GMO, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This post discusses and answers frequently asked questions about genetically engineered foods (GMOs).

Have you ever bred an animal, say a dog? Have you ever taken a vitamin or supplement? Of course you have, so let’s start the conversation there. Imagine you live in a world with shortages of food or fresh water, a diminished food supply, an inability to maintain the freshness of food, or have local conditions that require an abundant need for use of pesticides? What if your food supply could become a vehicle for delivery of vaccines or other medications? These are the arguments used to support the use of genetically engineered foods (aka bioengineered foods, aka GMOs), because all of these conditions exist in large parts of the world.

Even if you didn’t previously understand the logic for the use of genetically engineered foods, you’ve been using them for a long period of time if you live in the U.S. Upwards of 70% of processed foods on US grocery store shelves contain a genetically modified ingredient. If you’re eating corn (or anything with high-fructose corn syrup, such as cereals, sodas or snacks), potatoes, soybeans, squash or tomatoes, you’re likely eating food that has been genetically altered.

Let’s review frequently asked questions.

What are GMOs?

The actual question should be “What are genetically engineered foods?” These foods have genes from other organisms (plants, animals or microorganisms) inserted into their genetic codes, introducing new traits to the affected foods once grown. GMO is short for genetically modified organisms.

Why would anyone want to do this?

There are many great reasons to want to do this. In fact, we have a long history of breeding. Dogs came from wolves. Long-stemmed roses are a result of breeding. Unfortunately, natural processes of doing this can take thousands of years. Science has evolved to the point that genetically desirable traits can be extracted from one source and placed into another.

So what would the benefits of doing this be?

Since you’re selecting (i.e. genetically engineering) what you want your food to be, you can create many different benefits. Here’s a list of some of those.

Ability to use food as medicine or vaccines
Faster growing (plants and animals)
Increased desirability of traits (e.g. less fat absorbent even when fried)
Increased food supply
Less need for water, fertilizer and pesticides
Less susceptible to pests and diseases
Longer shelf life
More drought tolerant
More nutritious
Tastier

What are the potential risks?

Let’s start by pointing out that the risks are theoretical. Perhaps “concerns” would be a better descriptor. The nature of concerns generally revolves around the notion that scientists may prove unable to control the science, and some genetic changes can end up different than planned and harmful. In some conceived scenarios, modified organisms could produce extinction of naturally occurring organisms, with resultant adverse effects on the environment (that requires a certain existing balance). Other risks could include cross-communication of allergies and antibiotic resistance (e.g. you could exhibit a peanut allergy while eating a tomato).

Is this why many speak out against it?

It’s hard to say. There are several reasons cited against GMOs, some of which are political, others of that are scientific and still others that could be ethical or religious.

You may be aware that the 28 countries of the European Union (EU) have banned GMOs. Why, you might ask? The official line is organically produced food is healthier and closer to nature, so it has to be better!
You should also be aware that the US dominates the world bioengineered food market. As such, if GMOs become the natural order of things, there is a certain reality other countries would have to accept when it comes to trade.
A different theoretical concern is a public health concern that we can’t afford the risk of creating any potential adverse effects to the environment, our food supply or to our health.
Still other fears center around the thought that farmers could be rendered irrelevant with these mass produced foods.

Are they safe?

I’ve mentioned “theoretical” on a few occasions. To be fair, there currently have been no adverse effects (to a medical or scientific certainty) demonstrated from using genetically engineered foods. To this point, GMOs have avoided significant regulation from the Food and Drug Administration (FDA), largely because the ice cream looks and tastes the same, and despite the craze toward organic foods, doesn’t appear to cause any harm. That said, no one is suggesting that either sufficient research has been done or that the long-term effects have been determined.

Disclosure Issues

Another question asks why consumers aren’t simply informed as to whether the products they purchase are GMO products. Labeling would address that issue, but to this point the FDA hasn’t felt the need to do so and views a requirement to do so as punitive without cause. This lack of transparency is causing quite of a bit of concern, but I’d remind you that you don’t know (and usually don’t want to know) how most of your food supply is created (something about not wanting to know how the sausage is made comes to mind).

The bottom line is, at this point genetically engineered foods are regarded as safe. There are no reports of illness or injury due to consumption of these foods. You can rest assured that more research on the matter will be forthcoming. You’ve already been using them and would find it extremely difficult to avoid them in the US, even if you tried. The decision to avoid them at this point is either based on fear, politics or dissatisfaction with the level of scientific evidence supporting what is being seen in real time. The issue of labeling genetically modified foods as such is still an ongoing battle.

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Low Back Pain

December 18, 2018Neurology, Orthopedics/Bones, Musculoskeletal System844-SMA-TALK, Behind the Curtain, Conditions and Diseases, low back pain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

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.

Let’s point at four situations that produce or exacerbate your back pain.

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.

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.

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.

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).

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.

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?

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How to Avoid the Most Frequent Causes of Death

December 16, 2018General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, accidents, Asthma, Behind the Curtain, Cancer, COPD, Heart disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This Straight, No Chaser reviews the most frequent causes of death and how to avoid them.

It is interesting and curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Here are some words to the wise: common things happen commonly. I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.

The Five Most Frequent Causes of Death

According to the Centers for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2016. I’ve also included the number of annual deaths per condition; click on the heading for those blogs.

Heart disease: 635,260
Cancer: 598,038
Accidents (unintentional injuries): 161,374
Chronic lower respiratory diseases: 154,596 (e.g., asthma, COPD, emphysema, chronic bronchitis)
Stroke (cerebrovascular diseases): 142,142

Heart disease

Learn early recognition of heart attacks.

Stop smoking and exposing yourself to second-hand smoke.
Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

Cancer

Get screened! Early detection is the key to survival.

Don’t use tobacco in any form.
Eat more fruits and vegetables and less red meat.
Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
Limit alcohol intake to one to two drinks/day (women and men, respectively).

Accidents

Secure your surroundings!

Learn CPR.
Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
Stop all distracted driving (drinking, cell phone use, eating, etc.).
If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
Install smoke and carbon monoxide detectors in your home.

Chronic lower respiratory diseases

Asthma and COPD can take your breath away.

Stop smoking and exposing yourself to second-hand smoke.
Get your home tested for radon.
Follow workplace guidelines for workplace exposures to particles known to cause cancer.

Stroke

Learn early detection.

Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
Control your cholesterol.
Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
Control your weight through diet and exercise, which is bundled in each of the first three considerations.

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard if you’re actually trying.

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Sexually Transmitted Infections Vlog

December 15, 2018General Health and Wellness, Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This is a Straight, No Chaser Sexually Transmitted Infections vlog.

The Straight, No Chaser vlog series presents “health care basics” to keep you safe, healthy and out of the emergency room. If you’ve been a regular or even an infrequent follower of Straight, No Chaser, you know we’ve had a lot to say on sexually transmitted infections (diseases). Today we revisit the topic because out of sight is not out of mind when it comes to these. So give us two minutes of your time, and let’s see if you’re up to speed with your healthy habits! Happy Holidays!

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Fiber and Weight Loss

December 14, 2018Diet and Nutrition, General Health and Wellness844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

Here’s a vlog to discuss the special relationship between fiber and weight loss!

Here’s a sterlingmedicaladvice.com “health care basic.” All week, we’re switching to a vlog format to give you tips to keep you safe, healthy and out of the emergency room. So grab a seat, give us two minutes of your time, and let’s see if you’re on track with your healthy habits! Happy Holidays!

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Treatment of Food Poisoning

December 13, 2018Diet and Nutrition, Gastrointestinal, Infectious Disease844-SMA-TALK, Behind the Curtain, ceralyte, Conditions and Diseases, food poisoning, Gastroenteritis, Oral rehydration therapy, oralyte, pedialyte, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

The vomiting, diarrhea, fever, abdominal cramps and all around bad feelings you may get with food poisoning is extremely unpleasant. We’ve previously discussed preventive measures you can take to minimize your risks, but you should also want to know what measures to take in the event you actually develop food poisoning. Of course, with over 250 different illnesses related to various forms of food poisoning, there’s a wide variety of treatment, some of which means to treat the specific disease (and its cause) and others that only treat the symptoms.

The threat

I always tell patients that although the vomiting and diarrhea are dramatic nuisance symptoms, the real concern is the risk of dehydration from these fluid losses. Given the body is approximately two-thirds water, altering that balance can lead to disturbances of many of the body’s functions and increase the risk of more serious infections. Thus the key to treatment is staying ahead of fluid and electrolyte losses that occur. Perhaps you’re wondering “How can I do that if I’m vomiting?”

Here are five very important treatment principles for you to remember.

First things first: if you have severe diarrhea, your favorite sports drink is not the cure. The composition of fluids and electrolytes in your stool is different from in your sweat, so these drinks don’t optimally replace your losses.

I want you to become familiar with oral rehydration therapy/solution (ORT). It’s how most of the rest of the world first treats fluid losses from vomiting and diarrhea. You may have heard of Ceralyte, Oralyte or Pedialyte, all of which are examples. ORT represents the best possible fluid for you to take and is readily available without a prescription at your local pharmacy or grocery store.
Here’s the deal with staying hydrated: you can’t hold a lot on your stomach. You need to dial back as much as possible so that you can tolerate something. That’s why you sip on chicken soup instead of steak when you’re sick. You’re likely to have more success keeping down teaspoons of fluid at a more frequent interval (say, every few minutes) than trying to chug a lot of fluid all at once.
Preparations of bismuth subsalicylate (Pepto-Bismol is a common example) can reduce the duration and severity of simple diarrhea.
If you have diarrhea and cramps with a fever or bloody stools, you should not take antidiarrheal medication without an evaluation by a physician. Even if they make you feel better, these medicines can make your food poisoning much worse.

Here’s one other point that you should understand as you’re going into your doctor’s office or the emergency room: don’t expect to receive an antibiotic to treat your vomiting and diarrhea. Most of these episodes are caused by viruses, which are self-limited and will resolve within two to three days. Furthermore, viruses don’t respond to antibiotics. In fact, efforts to use antibiotics in many of these cases only contribute to antibiotic resistance later on when you actually need them. Antibiotic resistance is discussed in detail in this Straight, No Chaser post.

When to Seek Help

Finally, here are symptoms that should prompt you to see your physician.

Bloody stools
Diarrhea lasting more than 3 days
High fever (oral temperature over 101.4 F)
Signs of dehydration, such as a decrease in urination, a dry mouth and throat, and dizziness with standing
Vomiting with inability to keep down liquids

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