Tag Archives: Straight No Chaser

Understanding Food Poisoning

December 12, 2018Detoxification, Gastrointestinal844-SMA-TALK, Behind the Curtain, Campylobacter, Centers for Disease Control and Prevention, Conditions and Diseases, E. coli, Food and Drug Administration, food poisoning, foodborne illness, Staph, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, vibrio, YersiniaJeffrey Sterling, MD

Introduction

We make a decision with everything we place into our mouths. We also exhibit a large amount of trust that the food we eat is safe. Most of the time that’s true, but unfortunately sometimes it’s not. Here are some questions and answers to understanding the scope of food poisoning.

How frequent is food poisoning?

According to 2011 data from the U.S. Centers for Disease Control and Prevention (CDC), every year in the U.S. approximately 1 in 6 Americans (almost 50 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

What causes food poisoning?

Over 250 different foodborne diseases have been described, most of which are infections. The most common foodborne illnesses are caused by norovirus and by the bacteria Salmonella, Clostridium perfringens, and Campylobacter. Staph Aureus (yes, that Staph) is another prominent but less common cause of food poisoning. Poisonous chemicals or other harmful substances can cause foodborne diseases if present in food.

What are the most common symptoms of food poisoning?

Even though there are many different foodborne diseases, they share a commonality of entering your system through your gastrointestinal tract. As a result, the first symptoms are caused and expressed from there. They typically include nausea, vomiting, diarrhea and abdominal cramps.

Why do foodborne diseases seem to occur in outbreaks?

Actually, the overwhelming majority of cases of food poisoning don’t occur in outbreaks, but of course you wouldn’t know that because having diarrhea is not something people typically will tell you… When outbreaks occur, it’s because a group of people happened to eat the same contaminated item. This would explain how instances of groups of friends or strangers could have been involved. Contamination that occur closest to the food supply’s distribution result in the widest outbreaks. Look at the above picture. If contaminated food from the producer makes it all the way through the distribution chain, individuals in multiple states could end up with the same infection.

What foods are most associated with foodborne illness?

Foods that mingle the products of many individual animals: Raw milk, pooled raw eggs and ground beef have increased risk because contamination in any one of the multiple animals involved can contaminate the entire mixture.
Raw foods of animal origin: Foods such as meat, poultry, shellfish, eggs and unpasteurized milk are the most likely foods to be contaminated.
Raw fruits and vegetables: Washing reduces but doesn’t eliminate pre-existing contamination, such as that occurring from the fresh manure that fertilizes vegetables. Furthermore, water itself may be contaminated.
Shellfish: Because “filter-feeding” shellfish strain microorganisms from the sea over many months, they are particularly likely to be contaminated if there are any in the seawater.

An additional Straight, No Chaser will discuss treatment options. Refer to this post for preventative tips.

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Protecting Yourself From Food Contamination and Foodborne Illness

December 11, 2018Diet and Nutrition, Infectious Disease844-SMA-TALK, Behind the Curtain, contamination, E. coli, food poisoning, Norovirus, pasteurization, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, vibrioJeffrey Sterling, MD

Introduction

This post is about food contamination and minimizing your risk of foodborne illness.

Those of you who are regular readers of Straight, No Chaser may have heard me say that everything you place in your mouth either harms or helps you. Your mouth is the direct point of entry to your body. You should be concerned about the substances you ingest. Today’s post begins a Straight, No Chaser series that will discuss food safety, food poisoning, prevention and treatment of food borne illnesses – just in time for you to correctly handle all of those holiday leftovers! Today we start with food safety.

Allow me to suggest that bacteria are as much (if not more) of a part of this world as humans, and it is to be expected that they would be present in our food supply. Our issues are when does present become contaminated, and when does contaminated become illness? Understanding these issues makes it easier to take appropriate preventative and treatment measures when needed.

Here are some examples of how our food becomes contaminated.

Microorganisms (e.g. bacterial, viruses) exist in the intestines of healthy animals, even those raised for human consumption. Even a small amount of spillage of intestinal contents during slaughter can lead to contamination.
Fruits and vegetables can be contaminated when washed or irrigated with contaminated water (which sometimes contains animal manure or human sewage).
Salmonella can infect a hen’s ovary (remember the ovaries produce eggs) so that the contents of a normal-appearing egg can be contaminated even before the shell is formed.
Vibrio bacteria are normally present in seawater. Oysters and other shellfish can develop concentrations of Vibrio high enough to cause infections.
Microorganisms such as norovirus can concentrate in human sewage that is dumped into the sea. This contaminates the water supply.
Infected food handlers and food conditions pass microorganisms on to customers. Examples of this include Shigella bacteria, hepatitis A virus and norovirus. Knives, other utensils and table surfaces also are methods of transferring disease when unclean.
When certain foods are left out (i.e. not refrigerated), minimal contamination can become highly infectious in a matter of hours due to rapid growth of microorganisms. Conversely, in most instances refrigeration or freezing prevents virtually all bacteria from growing. Certain other foods (e.g. salted meats, jams, pickled vegetables) require high salt, sugar or acid levels to prevent bacterial growth.
When certain foods are adequately cooked (the ideal internal temperature is 160 degrees Fahrenheit), most microorganisms will be killed.

Protecting yourself from foodborne illness

Professionals in public health, industry, governmental regulatory agencies, and academic research have roles to play in making the food supply less contaminated. So do you. I would like to advocate for one simple step for you to take as you shop for food that will promote food safety.

Buying pasteurized milk rather than raw unpasteurized milk prevents an enormous number of foodborne diseases every day and has done so for 100 years. Juice pasteurization has more recently proven to be important in preventing certain E. coli infections. Basically, you can lower your risk by purchasing pasteurized products.

Courtesy of the Centers for Disease Control and Prevention, here are some additional simple precautions to reduce the risk of foodborne diseases:

COOK

Cook your meat, poultry and eggs thoroughly.

Using a food thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. Remember, the internal temperature of meat should be above 160 degrees Fahrenheit.
Eggs should be cooked until the yolk is firm.

SEPARATE

Don’t cross-contaminate one food with another.

Avoid cross-contaminating foods by washing hands, utensils and cutting boards after they have been in contact with raw meat or poultry and before they touch another food.
Put cooked meat on a clean platter, rather back on one that held the pre-cooked, raw meat.

CHILL

Refrigerate leftovers promptly.

Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within 4 hours.
Large volumes of food will cool more quickly if they are divided into several shallow containers for refrigeration.

CLEAN

Wash produce.

Rinse fresh fruits and vegetables in running tap water to remove visible dirt and grime.
Remove and discard the outermost leaves of a head of lettuce or cabbage.
Because bacteria can grow well on the cut surface of fruit or vegetable, be careful not to contaminate these foods while slicing them up on the cutting board, and avoid leaving cut produce at room temperature for many hours.
Wash your hands with soap and water before preparing food and before touching others.
Avoid preparing food for others if you yourself have a diarrheal illness.
Changing a baby’s diaper while preparing food is a bad idea that can easily spread illness.

REPORT

Report suspected foodborne illnesses to your local health department.

Calls from concerned citizens are often how outbreaks are first detected. Play your part.
If a public health official contacts you to find out more about an illness you had, your cooperation is important. In public health investigations, it can be as important to talk to healthy people as to ill people.

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Answers to Questions about Vomiting and Diarrhea

December 10, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Coronavirus, Diarrhea, Gastroenteritis, health, Influenza, Intestine, Norovirus, Oral rehydration therapy, Rotavirus, Sterling Medical Advice, SterlingMedicalAdvice.com, Stomach, Straight No Chaser, There are 72 Hours in a Day, VomitingJeffrey Sterling, MD

Introduction

You’ve all been there and done that. It’s always a bad day when you get the so-called stomach flu… First of all ‘the flu’ is a respiratory disease (affects the lungs, not the stomach and intestines), and the influenza viruses don’t cause that syndrome of vomiting and watery diarrhea. So, what you’re actually getting is gastroenteritis (gastro = stomach, entero = intestines, and itis = inflammation), an inflammation of the stomach and intestines.

Gastroenteritis means inflammation of the stomach and small and large intestines. Most cases of gastroenteritis are infections caused by a variety of viruses that results in vomiting or diarrhea. Other symptoms may include belly cramping, fever and headache from all that retching. There are other (bacterial) causes of vomiting and diarrhea. However, the overwhelming number of cases is due to viruses. Your physician will know when the other considerations come into play. Here’s a few points you really want to know.

Is vomiting and diarrhea ever serious?

In most cases of viral gastroenteritis, the symptoms and condition are rate limited and will come and go without much further ado. Your symptoms will last up to 10 days in most cases.
The concern isn’t nearly as much with the vomiting and diarrhea as it is with the dehydration that can result from all those fluid losses. Dehydration can cause all manner of electrolyte abnormalities, leading to serious acute illness and even death. In fact, diarrhea and dehydration have long been the number one cause of death worldwide outside of the United States.

Is it contagious?

Absolutely. This is one of the main reasons you wash your hands, especially after using the bathroom. Fecal-oral (yes, anus to mouth) transmission of viruses makes gastroenteritis and many other illnesses contagious. Hand shaking and other forms of contact (including eating food poorly handled or undercooked) extend the risk of transmission.

How can I avoid gastroenteritis?

There are good options available to you.

Avoid food and water that you believe to be contaminated, perhaps because others have had problems with it.
Frequent hand washing is very important.
Similarly, wash and disinfect possibly contaminated clothing and surfaces, preventing this before it gets started.
A vaccine is available for two of the more common causes of gastroenteritis. Discuss whether it’s appropriate for your child with his/her pediatrician (it needs to be given during your child’s first year of life).

How will it be treated?

Fluids, fluids and more fluids will be given. Unless you can’t keep anything down at all, the fluids should be given by mouth. It’s interesting to note that the U.S. overuse intravenous (IV) fluids much more in these instances than the rest of the world. Learn about oral rehydration therapy (ORT). It’s how the rest of the world (very successfully) treats most cases of vomiting and diarrhea. Furthermore, ORT is roughly approximated by all those popular rehydration brands. The key is to take in enough fluids to stay ahead of the fluid losses. ORT is available over the counter, and remember that you don’t have to guzzle it. As little as a teaspoon at a time still can keep you hydrated.

It’s important to discuss some other treatment considerations.

Antibiotics don’t work against these viruses, so in this example, they won’t be helpful.
In select instances, your physician may provide symptomatic treatment for vomiting and diarrhea, but in the absence of this, they should be avoided. There are significant consequences to taking these medications. Get your physician involved in taking that risk.

In summary, you don’t always have to run to the ER when you get the runs. Stay hydrated, my friends.

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The Holiday Heart Syndrome

December 9, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Conditions and Diseases, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

There’s something about the holiday season and flickering. We’re all aware that Christmas lights are meant to do so, but did you know that your heart is more inclined to flicker and flutter this time of year (sorry, but I’m not talking about mistletoe)? In a previous Straight, No Chaser, we discussed a mental consideration concerning the holiday season: the increased rate and risks of depression, known as The Holiday Blues. Unfortunately, health issues associated with the holidays don’t stop there. There are defined physical risks associated with the holidays as well. The disturbing aspect of today’s topic is you’re not immune to this even if you’re otherwise healthy.

The Holiday Heart Syndrome

Holiday heart syndrome is a real condition, and it has been described as such since the 1970s. It’s the result of eating and drinking alcohol too much (with or without excessive caffeine intake and a lack of sleep). Does this sound familiar for this time of year? The combination of these indulgences places an undue level of strain on the heart, which causes the heart to develop an abnormal rhythm, most commonly atrial fibrillation. Interestingly, certain foods, alcohol and caffeine all have direct effects on the heart, and indirectly they can also affect the heart through increase of certain hormones (such as epinephrine) that stimulate the heart.

Curiously, holiday heart syndrome is notable for its occurrence in those without existent heart disease. Still, it can be especially concerning in uncovering existing disease or exacerbating disease in those having it. For example, someone with underlying cardiovascular disease featuring microclots can have such clots dislodge during an episode of atrial fibrillation, causing a stroke.

Prognosis

Fortunately, by far the common course of holiday heart syndrome is benign. The abnormal heart rates will slowly resolve as the levels and effects of alcohol and/or other substances decline. That said, the risk is such that you don’t just want to sleep off an occurrence.
Symptoms are pretty obvious, given that you’d have been eating and drinking to excess. You’d also note that your heart was racing and perhaps pounding, as if it was attempting to jump out of your chest. Heart rates in the 120s are pretty typical for holiday heart syndrome (a normal heart rate is between 70-100 beats per minute). This tidbit is important to know; if your heart rate is higher than this, something more serious could be occurring. Under either circumstance, you need to be evaluated and treated in the emergency room setting with hydration and observation of the heart rhythm and rate.

Lessons

The lessons here are pretty straightforward:

Holiday heart syndrome suggests that indulgences that occur during the holidays can cause symptoms. By no means does it suggest that these symptoms are restricted to the holidays. Overindulgence in food and drink can cause abnormal heart rhythms at any time. That includes weekends, spring break and birthdays, in addition to holidays.
The combination of vodka and the energy drink Red Bull make these symptoms more likely to occur.

What you can do

Following alcohol-related abnormal heart rhythms, it is advisable for patients to avoid significant exertion. Excessive stimulation that raises epinephrine levels can precipitate recurrent and possibly cause more serious episodes. Most patients without underlying heart disease should be able to gradually resume full physical activity over the next few days. Once everything is back to normal, most patients do not require further therapy if they refrain from alcohol use. Patients with underlying heart disease, heart disease that’s discovered during evaluation, or those with severe symptoms on presentation (e.g., blackouts or simultaneous low blood pressure) may be candidates to receive certain heart medications.

At the end of the day, Holiday Heart Syndrome is yet another example of the virtue of enjoying life in moderation. Failure to do so can turn the holidays into the most dangerous time of the year. Cheers!

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Hypertension Vlog: A Ticking Time Bomb

December 8, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, high blood pressure, Hypertension, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

Welcome to the Straight, No Chaser hypertension vlog!

The Straight, No Chaser vlog (video blog) series presents “health care basics” to keep you safe, healthy and out of the emergency room. Straight, No Chaser has addressed high blood pressure (hypertension) on many occasions, simply because it’s just that important. Hypertension is a common denominator for so many additional illnesses and in many deaths. We address it in today’s vlog because it is a health care basic. Learn what’s needed to keep yours under control. Happy Holidays!

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Frequently Asked Hypertension Questions

December 7, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Conditions and Diseases, high blood pressure, Hypertension, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

In this post, we answer frequently asked hypertension questions.

High blood pressure (hypertension) is so prevalent and such a consequence of the way we live that you must already have an understanding of some basic principles if you care at all about your health. Feel free to offer your own questions or comments.

How do I know if I have high blood pressure?

You know by the numbers. Consider these defining blood pressure levels.
Normal – Systolic: < 120 mmHg, Diastolic: < 80 mmHg
At risk (pre-hypertension) – Systolic: 120–139 mmHg, Diastolic: 80–89 mmHg
High Systolic – Systolic: 140 mmHg or higher, Diastolic: 90 mmHg or higher
If you don’t already have a diagnosis of hypertension and are anywhere at or above the pre-hypertension stage, get checked by your physician.

But when should I get go to the emergency room for high blood pressure?

I’ll always want to see you if your bottom number (diastolic blood pressure) is at or above 110-115, regardless of whether you appropriately take your medication. Don’t look for symptoms to guide you. High blood pressure is called “the silent killer.”

If I do have high blood pressure, will I be placed on medication?

I really hope not, but honestly, approximately two-thirds of individuals in the U.S. who have high blood pressure are poorly controlled – even on medication. This means medication will be necessary for most. That said, theoretically, medication should be viewed as necessary only when necessary and only when other measures don’t work. You should discuss this with your individual physician and make every effort to improve your diet and exercise regimens. If and when you’re placed on medication, the choice of medication will be based on your age, sex, ethnicity, mobility, existing health profile and other considerations.

You mentioned I could have a heart attack or stroke from this? How would I know if that’s happening?

Check here for Heart Attack Recognition and here for Stroke Recognition where I discuss signs and symptoms. Remember, time is tissue, meaning you must not delay if you develop these symptoms.

What else can I do?

Be healthy! Don’t smoke. Limit alcohol intake. Lower your stress level. This is only a broken record if you’ve received the message and have implemented the recommendations.

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High Blood Pressure (Hypertension)

December 6, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Blood, Blood flow, Blood pressure, Heart failure, Hypertension, Kidney, Muscle, Myocardial infarction, Organ, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

Hypertension (aka high blood pressure) is called the silent killer. It’s common for me to see someone who thought they were ‘fine’ drop dead from its effects, never knowing it was about to happen and not having been aware of the warning signs and risk factors.

In lay terms, your heart is just a muscular pump pushing blood (containing oxygen and nutrients) around the body keeping stuff alive. The more you poison that pump (by ingesting unhealthy foods and inhaling other toxins) and strain the muscle by adding weight and clogging its vessels so it has to pump against more force (by being obese, not exercising and engaging in other unhealthy behaviors), the more likely that muscle is to strain until it gives out. Once it does, blood isn’t delivering what’s needed to your vital organs, and that’s when bad stuff happens.

Organs Placed at Risk by High Blood Pressure

The vital organs in question and those bad effects include the following:
• The heart itself (no blood flow and no oxygen = heart attack; when the heart’s not strong enough to pump blood around the body = congestive heart failure)
• The blood vessels, especially the heart’s main offshoot, the aorta (too much strain = aneurysm, an outpouching from the main tubular system, stealing valuable blood from the rest of the body)
• The brain (no blood flow and no oxygen = stroke; aneursyms also occur in the brain)
• The kidneys (not enough blood flow or adequate enough function to clear the toxins from the kidney = renal failure)
• The eyes (poor blood flow and/or diseased eye blood vessels leads to vision loss)

The Bottom Line on Hypertension

The heart is a muscle best thought of as a machine. Here’s three easy things you can do to reduce your risks.
• Get off your rump viagra priser. Any exercise helps to get your heart pumping and blood flowing; strive for 20” three times a week at the very least.
• Close your mouth. Everything in moderation is cool, but introduce some fruits and vegetables into your life.
• Lose the salt shaker. At least taste your food first. It’s likely the food was already prepared with salt.

Did I mention to stop smoking? Any questions?

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Flu Prevention without Receiving the Vaccine

December 5, 2018General Health and Wellness, Infectious Disease, Health Prevention844-SMA-TALK, Behind the Curtain, Centers for Disease Control and Prevention, Flu Symptoms, Hand sanitizer, health, Influenza, Oseltamivir, Pharmaceutical drug, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, ZanamivirJeffrey Sterling, MD

Introduction

This post discussion flu prevention options.

Many people choose not to get the influenza vaccine (the “flu shot”). There are various reasons for this decision. One of those reasons is due to an allergy to eggs. If you have an egg allergy, your options to combat influenza are different and don’t contain vaccination.

Flu Prevention Tips

Avoiding exposure is the best method of flu prevention! Adopt these healthy habits before you ever get exposed.

Wash your hands frequently with warm soapy water. You know when they’re dirty. Most certainly wash your hands before you use them to eat or put anything else in your mouth.
If you can’t wash your hands, use an alcohol-based hand sanitizer.
If your hands are dirty and neither soap nor sanitizer is available, still rinse and dry your hands with warm water if you can.
Use disinfectant to clean surfaces.
Avoid unnecessarily touching your eyes, nose, or mouth.
Politely limit close contact with people who are ill, coughing and sneezing.
When coughing or sneezing use the bend of your elbow or a facial tissue to help cover your nose and mouth. Learn to avoid coughing or sneezing into your hands.
When you become sick, stay home. It’s the proper thing to do to avoid spreading your infection to others.

Do Supplements and Herbals Work?

Claims have long existed that Vitamin C, echinacea and zinc are effective for cold and flu prevention. There are no studies confirming or refuting this claim. Despite assurances that these and other herbal medicines are safe alternatives because they’re “natural”, the active ingredients in them are the same as found in certain prescription medicines. Thus they too may interact with other medications and worsen certain medical conditions. Given this, you should discuss your use of supplements with your physician or pharmacist prior to use.

Antiviral Medications

Another level of defense for you involves use of certain antiviral prescription medications. If you are exposed to someone (e.g. a family member) with influenza, and especially if you begin having flu-like symptoms, immediately contact your physician to discuss taking medicines to prevent catching the flu. Such medications include Tamiflu® (generic name: oseltamivir), Relenza® (generic name: zanamivir), Flumadine® (generic name: rimantadine) and Symmetrel® (generic name: amantadine). If you make the request more than 24-48 hours after the onset of symptoms, you likely won’t be given the medication, since it isn’t likely to be effective outside of this timeframe.

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Flu Myths and Questions

December 4, 2018General Health and Wellness, Infectious Disease, Public Health844-SMA-TALK, Behind the Curtain, CDC, Center For Disease Control and Prevention, Disease, health, Influenza, Influenza vaccine, Influenza-like illness, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, Vaccination, VaccineJeffrey Sterling, MD

Introduction

This Straight, No Chaser addresses flu myths and address a few frequently asked questions.Every year 36,000 people die and over 200,000 are hospitalized each year due to the flu—in the U.S. alone. If you’re not getting a vaccine every year, you are subjecting yourself to a significantly higher risk and allowing fears and myths to get the better of you. Knowledge is power. Learn the facts.

Does the flu shot give you the flu?

No, no, no. The influenza vaccine cannot cause flu illness. There are vaccines that involve the delivery of live virus, including mumps, measles, rubella, chicken pox and polio. Influenza is not in that category. Flu shots are made in one of two ways. They can be made with ‘inactivated’ vaccine viruses that are not infectious. Alternatively, they contain no flu vaccine viruses at all (and instead have recombinant particles that serve to stimulate your immune system).

The most common side effects from the influenza vaccines are pretty minor things. This include soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur. These symptoms are among the same symptoms you see with influenza, so it’s easy to confuse them as flu symptoms. They are not.

Controlled medical studies have been performed on humans in which some people received flu shots and others received shots containing salt water. There were no differences in symptoms other than increased redness and soreness at the injection site for those receiving influenza vaccine. The flu shot does not give you the flu.

I swear I’ve gotten the flu right after getting the flu shot! How is that possible if I can’t get the flu from the flu shot?

I always remind people that the flu vaccine does an even better job of preventing you from dying from the flu than it does in preventing you from catching the flu (and it does that at a 70–90% rate). It primes your immune system to better fight off the influenza virus when you’re exposed to it.

There are several reasons why someone still might get a flu-like illness after being vaccinated against the flu:

Influenza is just one group of respiratory viruses. Many other viruses cause similar symptoms. Most notable of these is the common cold, which is also most frequently seen during “flu season.” The flu vaccine only protects against influenza. Any other infection timed correctly can give you similar symptoms.
When you get immunized against influenza, it takes the body up to two weeks to obtain the desired level of protection. There is nothing preventing you from having been infected before or during the period immediately before immunity sets in. Such an occurrence will result in your obtaining the flu despite being vaccinated.

Two More Reasons!

An additional reason why some people may experience flu-like symptoms despite getting vaccinated is that they may have been exposed to a strain of influenza that is different from the viruses against which the vaccine is designed to protect. The ability of a flu vaccine to protect a person depends largely on the match between the viruses selected to make the vaccine and those causing illness among the population that same year.
It is also the case that the flu vaccine doesn’t always provide adequate protection against the flu. This is more likely to occur among people who have weakened immune systems or people age 65 and older. Even if the vaccine is 90% effect, some individuals will contact the flu despite having been vaccinated.

Please don’t get the wrong message from this section. These explanations are the exceptions, not the rule. In the overwhelming number of cases, the influenza vaccine does an excellent job of protecting against and prevent disease from the influenza virus.

Is it better to get the flu than the flu vaccine?

No. Influenza causes tens of thousands of deaths every year. If you have asthma, diabetes, heart disease or are especially young or old, you are placing yourself at significant risk by not getting vaccinated. Even if you aren’t in one of the above categories and are otherwise healthy, a flu infection can cause serious complications, including hospitalization or death.

Why do I need a flu vaccine every year?

The Center for Disease Control and Prevention (CDC) recommends a yearly flu vaccine for just about everyone six months and older. Once vaccinated, your immune protection decreases over time. These boosters are scheduled and dosed to help you maintain the best level of protection against influenza. Additionally, the virus mutates (changes) every year. This means what covers you this year may not apply next year.

You can make a decision not to get vaccinated. However, that flies in the face of any reasonable risk/benefit analysis. Also, not getting vaccinated runs against the solid consensus of medical evidence and research. The evidence is so one-sided toward the benefit of getting immunized that you should seriously question the motives or knowledge of someone who suggests that you should not get vaccinate for influenza. This is especially true for those involved in healthcare. Get vaccinated.

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Health Promotion – Introducing “Invisible Health”

December 3, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This post discusses invisible health: how your healthy habits produce benefits throughout your days!

Good habits are just as addictive as bad habits, but they’re much more positively rewarding.

Good health is a journey, not a destination. Stop acting like what you are is what you will be now and forever. Look, the easiest way to change your life is to change your life. But how? When it comes to health, sometimes it can seem like work. For many, the idea of exercise is a big to do. You have to pack. Usually, you have to drive. You have to shower. Who has time for all of that? Dieting is just as bad, it seems. Do I need to go find a special store? It always takes time to cook a special meal. It seems like work to count calories! I don’t like the taste of this or that…

Well, at Straight, No Chaser, we want to introduce you to Invisible Health. Today, we offer you a series of ten simple tips (and one admittedly not so easy one) that will promote your health without all the fuss (although we fully endorse the fuss and know that over time, it’s not a fuss). Feel free to expand the list. More importantly, implement the list. You’ll be amazed how just a few minor modifications in regular activities can produce large improvements in your health. Everything is relative. Don’t just sit there. Do something!

Invisible Health is Found In Your Habits

One thing you’ll notice about these tips is you’re producing health benefits without the active grind of “working out ” or “dieting.” We just want you to develop some new habits or increase the frequency of some things you may already be doing.

It’s Easy

Take a walk. You’re exercising and didn’t know it. Walk the stairs. Take a walk in the park with your loved one. Walk while you talk with your kid. Regular walkers have less heart attacks and strokes, better sex lives and less stress. Walking improves your immune system and reduces all manners of unhealthy cravings. It’s easy. Just do it.
Learn to like to dance. Hear your favorite song? Go for it. Have a child? Teach them and dance with them! I’ll bet while you’re having fun, you’re breaking a sweat, losing calories and getting your heart pumping without the worry of reps or time spent.
Play! Have a kid of any age? Throw the football around. Shag fly balls with each other. Shoot some hoops. You’ll love the benefits to your heart and lungs. Plus, it’ll keep your brain sharp.
Are you hungry and about to shove something unhealthy in your mouth? Drink a glass of water. Your body needs it. The majority of you don’t drink nearly enough water. Learn to appreciate water. Have you heard that you need eight glasses of water a day? You’ll never get there by sipping on a hot beverage. It’s refreshing and replenishing, plus it makes your body function optimally. Besides, if you’re drinking water, you’re not drinking high calorie, sugar-laden soft drinks. Speaking of which…

You’ll Learn to Do It

Stop. Drinking. Sodas. Today. I’d bet the easiest “diet” many of you could go on would be just eliminating soda. Even without doing anything else you’d lower your risk of diabetes and high blood pressure, and you would start losing weight. One can delivers 150 calories. Any amount of water is zero calories.
Still hungry and still looking at that donut? Go brush your teeth. You probably don’t brush enough anyway, and brushing and flossing intermittently throughout the day provide numerous health benefits as well as serve as suppressing your appetite in a simple way.
Wack some weeds. Getting in your yard and doing most any kind of cleaning is going to be beneficial to your health. Stop riding your lawnmower. Walk! Pull some weeds (with both hands), rake some leaves, plant some flowers or sod some grass. You’re burning several hundred calories an hour!
Stand for something. If you think about it, you spend a lot of time sitting during the day. Could you perform a lot of what you’re doing standing or moving? Give it a try. Just develop the habit of getting up and moving around intermittently. For example, learn to pace while you’re on the phone. It’s activity, and you probably need more of it.

Snack healthy. Find a favorite fruit. Eat a handful of nuts. A handful of carrots or almonds, a few slices of an apple or a bowl of grapes is an infinitely better approach to those cravings. Lose the potato chips and the empty calories. This is both addition by subtraction and addition by addition!

Make Better Choices

Find a healthy friend. Having a companion with whom you share your health aspirations gives you a much better chance of success across the board, as opposed to that friend of yours that you just get together with to eat or drink. It’s true in health as well. You’re probably the average of the five people you most hang around!
Stop smoking. You didn’t really think I would leave smoking off the list, did you? Speaking of invisible health, the more invisible smoking is, the better. I don’t care how you do it, just do it. Every cigarette is costing you about seven minutes of your life. In one fell swoop, eliminating cigarettes from your life will produce as many benefits as most anything else you’ll do.

Give it a try. See how many of these 10 tips you can incorporate into your life.

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Tips on Buying Safe Toys and Gifts

November 23, 2018Pediatrics/Kids Health, Trauma844-SMA-TALK, Behind the Curtain, Disorders, health, Safe Toys and Gifts Month, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

If you’re shopping today, don’t you want to make sure you’re buying safe toys? At Straight, No Chaser, we review the literature and give you the goods. While you’re out and about shopping for toys, print out this list to help you select safe toys, then post it in your home to be reminded of how to keep your kids safe. People tend to think such things aren’t necessary until after something horrible has happened. Be smarter than that; after all, it’s Safe Toys and Gifts Month (of course it is – when else could it possibly be?).

Facts on Toy Safety

Let’s review shopping tips, adopted from recommendations from the American Academy of Pediatrics, The National Safe Kids Campaign and the National Safety Council. We’ll keep this short and sweet.

Falls and choking cause most toy-related deaths and injuries in children. Choking alone causes one-third of all toy-related deaths – most often from balloons.
Children younger than age 3 are at the greatest risk of choking because they tend to put objects – especially toys – in their mouths.
Children 4 years old and younger account for almost half of all toy-related injuries and almost all deaths.

Remember…the best way to keep your child safe while playing with toys is to BE THERE!

Recommended Shopping Tips

Consider the child’s age, interests and skill level. Actually pay attention to what you’re buying. Look for quality design and construction, and follow age and safety recommendations on labels. They’re not just pulled out of thin air!
Use a small parts tester to determine whether toys may present a choking hazard to children under age 3. Small parts testers can be purchased at toy or baby specialty stores. Here’s a simpler way to decide: use the cardboard core of a toilet paper roll – if a toy can pass through, it is too small for young children and may cause them to choke if swallowed.
Avoid toys with sharp points or edges, toys that produce loud noises, and projectiles (e.g., darts).
Avoid toys with strings, straps or cords longer than 7 inches. These may pose a risk for strangulation for young children.
Avoid electrical toys with heating elements for children under age 8.
Avoid cap guns that use caps that can be ignited by the slightest friction and can cause serious burns.

The selection of gifts and toys you bring into your home should be taken seriously. Let’s keep the holiday season happy!

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World AIDS Day

December 1, 2018Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Acquired Immunodeficiency Syndrome, AIDS, Behind the Curtain, HIV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

Today is World AIDS day. This isn’t 1983. The mystery of how HIV infection is contracted has come and gone. Be knowledgable to be empowered. This is the first blog in an ongoing series on HIV and AIDS.

For an explanation of what AIDS is, click here.
For an explanation of the signs and symptoms of HIV/AIDS is, click here.

How HIV Lives

First, let’s address a simple principle. The HIV virus can live and reproduce in high levels in blood other body fluids, including breast milk, rectal mucus, semen (and pre-semen) and vaginal fluids. If any of those fluids are infected and are transmitted to another’s body, that individual can become infected with HIV. In special circumstances (such as healthcare workers), individuals may become exposed to other areas that may contain high levels of HIV, including amniotic fluid (in pregnancy women), cerebrospinal fluid (from the brain and spinal cord) and synovial fluid (from various joints).

Now please take a moment and look at the above picture. In addition to those circumstances listed, you should know that fluids such as feces, nasal fluid, saliva, sweat, tears, urine or vomit don’t by themselves contain high enough levels to transmit HIV. However, if those fluids are mixed with blood, and you have contact with both fluids, you may become infected via these routes.

HIV Transmission

HIV is transmitted through body fluids in very specific ways:

During anal, oral or vaginal sex: When you have anal, oral, or vaginal sex with a partner, you will have contact with your partner’s body fluids in areas very likely to be high in HIV viral load if your partner is infected. HIV gets transmitted in these instances through small breaks in the surfaces of the mouth, penis, rectum, vagina or vulva. One of the reasons HIV infection rates are higher in individuals with herpes and syphilis is because those diseases cause open sores, creating additional opportunities for HIV-infected body fluids to enter the body.
During pregnancy, childbirth or breastfeeding: Babies have constant contact with their mother’s potentially infected body fluids. Means of transmitting HIV from mother to child include through amniotic fluid, blood and infected breast milk.
As a result of injection drug use: Injecting drugs puts you in contact with blood. If those needles and their contents are contaminated, you can be directly delivering HIV into your bloodstream.
As a result of occupational exposure: Healthcare workers must be constantly diligent against this method of transmission. Risks of HIV transmission to healthcare workers occur through blood transferred from needlesticks and cuts, and less commonly through contact of infected body fluids splashed into the eyes, mouth or into an open sore or cut.
As a result of a blood transfusion or organ transplant: Fortunately, these days, this is very rare given the stringency of screening requirements in the United States. Still, it is possible to transmit HIV through blood transfusions or organ transplants from infected donors.

How To Avoid AIDS

How does one get AIDS?

AIDS is a progression of HIV into its later stages. It occurs after one’s immune system is severely damaged. You don’t “get AIDS” as much as HIV progresses to AIDS in certain circumstances. Many of us recall that HIV could progress in this way to AIDS in a matter of a few years a few decades ago. Fortunately, with the development of specialized medications in the 1990s, people with HIV are living much longer with HIV before they develop AIDS.

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How To Complete End of Life Planning

November 29, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Cardiopulmonary resuscitation, CPR, Decision making, Do not resuscitate, Family, Health care proxy, POA, Power of attorney, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

Decisions about your final days need to include end of life planning. Now that you’ve had a chance to wrap your mind around the concept of needing to make end of life decisions (review this previous post if you missed that blog), let’s discuss some specific mechanisms by which you can ensure your wishes are honored.

Living Will

This document, also known as medical directives, addresses those scenarios where you are unable to communicate your near death choices. The key consideration is that a living will keeps the power and decision-making in your hands, even when you’re incapacitated or otherwise unable to state your preference. You’ll want to have a copy of this form with you or with your family.

Do Not Resuscitate (DNR)

A DNR form takes the living will consideration straight to the end of life question and explicitly states your preference not to receive cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS) if needed. Your physician will retain a copy of this document in your medical record as a way of alerting other medical providers (such as in the emergency room–if and when you show up there) of your desire.

Healthcare Power of Attorney (POA)

end of life planning - durable power of attorney

The healthcare POA is your designee to carry out your medical wishes beyond what you have explicitly stated. A healthcare POA may serve more than one function.

If you haven’t made DNR or living will type decisions, a POA will make those decisions for you.
If you’ve made some decision and not others, the POA will fill in the gaps.
Making a POA designation is literally putting your life in someone else’s hands. Be very careful who you choose for this role. Some people will simply designate next-of-kin or a family member. Others will want someone objective with no other motives (e.g., financial) than fulfilling their wishes. Either choice is much better than no choice, which too often leaves family members with competing interests and potentially having to carry the burden of making decisions for you that you could have made in advance.
Your POA will not be able to overturn decisions you’ve designated on the DNR form or your living will.
Your POA will not be able to make any decisions for you while you’re still able to do so unless you ask him/her to do so.

It’s important to know that you can simultaneously have a living will, DNR declaration and a Healthcare POA. If you’re able, it may be wise to engage an attorney to sort through the various documents.

I hope for your sake and the comfort of any family you may leave behind that you take the time to engage in end-of-life planning for yourself and others in your family. I’ve seen all too often how messy it gets when issues aren’t addressed in advance. You really don’t want that happening to you at the end of your life.

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End of Life Decision Making

November 28, 2018General Health and Wellness844-SMA-TALK, Behind the Curtain, Blood flow, Brain, Death panel, Decision making, Education, Futile medical care, health, health care provider, Health care proxy, Heart failure, Hypertension, Intubation, Patient Protection and Affordable Care Act, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Terminal illness, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This Straight, No Chaser post addresses considerations related to end of life decision making.

Having this conversation when death is staring you or a loved one in the face is not the most ideal situation. Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.”

I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. It needs to sink in: at any age your life could be at risk, and at any age you could die. When your life is threatened, if you have specific desires, someone will need comply with decisions you have made. It could happen today. You need protect yourself – now. You’re much more protected having declared your interests and desires than not. Read on.

Advanced Directives

Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and subsequently with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

Items to Consider

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

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

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Patient Rights and Responsibilities

November 27, 2018General Health and Wellness, Public Health844-SMA-TALK, Behind the Curtain, Patient Bill of Rights, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

This point highlights patient rights and responsibilities.

Even if you didn’t know it, you have rights as a patient. In 1998, the U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry adopted a Consumer Bill of Rights and Responsibilities. This is summarized in this Straight, No Chaser post. These rights apply universally to plans offered to federal employees and largely by health insurance plans and facilities.

Access to emergency services

If you have any health-related consideration that makes you believe your health is in danger, you have the right to be screened and stabilized using emergency services such as your local ER. You should be able to use these services whenever and wherever you need them. This is true even if they’re out of your network! This should occur without needing to wait for authorization and without fear of any financial penalty from your insurance provider.

Choice of providers and plans

You have the right to choose healthcare providers who can give you high-quality health care when you need it.

Complaints and appeals

You have the right to a fair, fast and unbiased review of any complaint you have against your health plan, doctors, hospitals or other healthcare personnel. These complaints may include excessive waiting times, hours of operation, the actions of healthcare personnel, and/or the adequacy of health care facilities.

Confidentiality (privacy) of health information

You have the right to talk privately with healthcare providers and have your healthcare information protected. Patients also have the right to read and copy their own medical records. You have the right to ask that your doctor change your record if it’s not correct, relevant or complete.

Information for patients

You have the right to accurate and easy-to-understand information about your health plan, healthcare professionals, and healthcare facilities. If you speak another language, have a physical or mental disability, or just don’t understand something, help should be given so you can make informed healthcare decisions.

Respect and non-discrimination

You have a right to considerate, respectful care from your doctors, health plan representatives and other healthcare providers. You have the right to treatment that does not discriminate against you based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information or source of payment.

Taking part in treatment decisions

You have the right to be informed about your treatment options and take part in decisions about your care. You have the right to ask about the pros and cons of any treatment, including no treatment at all. As long as you are able to make sound decisions, you have the right to refuse any test or treatment, even if it means you might have a bad health outcome as a result. You can also legally choose someone who can speak for you if you cannot make your own decisions.

Consumer responsibilities

In a healthcare system that protects consumers’ or patients’ rights, patients have certain responsibilities. For instance, patients must tell their healthcare providers about any drugs or supplements they are taking. Similarly, you should inform them about health conditions and medical or surgical problems you’ve had in the past or have presently. Patients must ask questions or request further information from healthcare providers. This is especially important if they do not completely understand health information and/or instructions they’ve been given.

Patients must also take responsibility for their lifestyles to help improve their own health. Such considerations include following a treatment plan, exercising, and not using tobacco. Having patients involved in their care increases the chance of the best possible outcomes and helps support a high quality, cost-conscious healthcare system.

Patients are also expected to do things like treat healthcare workers and other patients with respect. They should try to pay their medical bills and follow the rules and benefits of their health plan coverage.

Knowing your rights is an important way to ensure you are receiving the best care possible. Take the time to learn these rights and use them to your advantage.

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25 Tips That WILL Increase Your Life Expectancy

November 22, 2018General Health and Wellness, Health Prevention844-SMA-TALK, Behind the Curtain, life expectancy, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

Want to increase your life expectancy and live better longer? You may want to keep this post. I haven’t exactly found the Fountain of Youth, but I do know what activities lead to a longer life expectancy. In honor of Thanksgiving, and in the spirit of being thankful for life, here are 25 tips that you can incorporate into your daily life to help you live a younger life every day and a longer life.

Tips 1-5

1. Take a walk. Just give yourself a brisk 30-minute walk three times a week. Effect? Reverse your age by about 10 years.

2. Eat more fish. Doing so one to two times a week can reduce your heart attack risk by approximately one-third.

3. Lift weights. Yes, it gets tougher, but I’m not recommending a Schwarzenegger workout. Lifting reverses muscle and bone loss if you do it twice weekly. For those in their 50s or 60s, it can produce strength scores similar to those in their late 30s.

4. Get a pet. This is a pretty easy way to avoid depression and all that comes with it.

5. Hydrate. Your body is almost 70% water. Not soda, water. Learn to embrace clear fluids. When you’re not going clear, coffee and wine also have significant health benefits.

Tips 6-10

6. Equip your home. Everyone should have a functioning smoke alarm, carbon monoxide detector and fire extinguish, and everyone in your home should know where they are and how to use them.

7. Put a helmet on your head. 1,000 people die every year in the U.S. from motorcycle, bicycle, scooter or skydiving injuries related to not wearing protective helmet.

8. Engage in safe sex. Yes, people are still dying prematurely and living compromised lives because of the failure to wear condoms while others protect themselves.

9. Be optimistic. This keeps the negative effects of the body’s physiologic stress response from harming you.

10. Reduce your red meat intake. Even the daily intake of just one serving of red meat equivalent to the size of your fist decreases life expectancy by approximately 13 percent.

Tips 11-15

11. Spend time with friends. Healthy social networks have been shown to add as much to your life expectancy as healthy endeavors such as lowering high blood pressure and reducing high cholesterol levels.

12. Be generous. Studies consistently show that those who help others report better health than those who don’t. It may just be correlation, but being on the right side of this fence makes the world a better place.

13. Sleep. Seven hours a day gets done what your body needs to function optimally.

14. Discover blueberries. There’s been much talk about “superfoods.” Blueberries meet the criteria. Consuming approximately two cups a day has been shown to prevent chronic diseases, reduce depression and improve memory.

15. Enjoy sex and orgasms. There are a million jokes about the benefits of sex, but legitimate benefits include burning calories, reducing stress, inducing sleep and reducing pain.

Tips 16-20

16. Snack on nuts. Healthier nuts include almonds, cashews and pistachios. Eating them five days a week has been shown to add nearly three years to your life expectancy.

17. Get up! Sitting for more than three hours at a time independent of other activities can reduce your life expectancy. Take breaks, stretch and move around.

18. Maintain adequate intake of vitamins. You shouldn’t need supplemental vitamins if your diet is appropriate, buy if it’s not, here are the daily requirements that ensure optimal function. Vit C (1200 mg/day), Vit D (400-600 IU/day), Vit E (400 IU/day), Vit B6 (6 mg/day), calcium (1000-1200 mg/day) and folate (400 mcg/day).

19. Measure your blood pressure. Work to maintain your blood pressure at or below 115/75. This will help you function as much as approximately 25 years younger than someone of a blood pressure at or about 160/90.

20. Brush. Floss. Daily brushing and flossing can improve your functioning by approximately six years.

Tips 21-25

21. Wear your seatbelt. The combination of seatbelt wearing and driving within five MPH of the posted speed limit can improve your life expectancy by approximately three and a half years.

22. Eat fiber. The number to know here is 25. If you get 25 grams of daily fiber in your diet, that improves your function by approximately two and a half years over consuming half that amount. Look for high fiber dietary options.

23. Learn to laugh. Laughter actually does have clinical benefits. It strengthens your immune system by decreasing the stress-induced release of certain hormones. Learn to take or tell a joke!

24. Love fruits and vegetables. The more fruits and vegetables you eat compared to red meat, the better your life expectancy becomes.

25. Consume medical care, information and advice. Being proactive about your health increases both your life expectancy and life functioning compared to someone a dozen years younger who does not. This includes getting recommended screenings and immunizations. Also, have you heard of www.sterlingmedicaladvice.com?
Here’s a bonus tip: Avoid getting hit by that truck.

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Preventing and Treating Urinary Tract Infections (UTIs)

November 26, 2018General Health and Wellness, Infectious Disease844-SMA-TALK, Behind the Curtain, Conditions and Diseases, cystitis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, Urinary tract infection, UTIJeffrey Sterling, MD

Introduction

This post addresses preventing and treating urinary tract infections.

At some point, you’ve got to be on board with the notion that you need to prevent some of the things that ail you. All men who have UTIs are at higher risk for having another one. About one of every five women who have a UTI will have another one. Many women have three or more UTIs a year. This Straight, No Chaser will address preventative and treatment considerations for urinary tract infections. Check back to this Straight, No Chaser for a discussion of the how and why you get UTIs.

Some individuals have unfortunate anatomy, and others have increased risk factors due to diseases (e.g. diabetes) or a lowered immune system. Even in these individuals, improving daily habits and lifestyle choices may help you prevent repeat UTIs. There actually is a fair amount of controversy regarding methods of preventing and treating UTIs. The information I am providing represents the latest consensus information from the U.S. Department of Health and Human Services.

Fluids

Drinking lots of fluid (preferably water) can help flush bacteria from your system. Unless you have kidney or heart failure, you should try to drink six to eight, 8-ounce glasses a day.
Regarding cranberries and cranberry juice, the jury is still out. This is what we do know: there is a substance in cranberries that assist in preventing bacteria from sticking to the walls of your urinary tract. The ability to attach to the walls of your urinary tract keeps bacteria from being flushed out and allows them to grow and multiply. It seems that the amount of this substance in the typical glass of cranberry juice you’re drinking or serving of cranberries you’re eating is sufficient to completely prevent or treat UTIs. It is more likely that the benefit you’re receiving simply comes from drinking fluids. The bottom line? Drinking cranberry juice isn’t hurting you and may be helpful.

Bathroom Habits

It’s just a good idea to urinate often. Whenever you feel the urge, and it’s convenient, eliminate the waste. Also, make a habit of urinating after sex, as soon as it’s convenient. These steps prevent bacteria from staying in your bladder longer than necessary, preventing the growth that can become a UTI.
It’s true: always wipe from front-to-back after using the toilet. A back-to-front wipe can deliver bacteria straying from the rectum (and inclined to cause a UTI) close enough to your urethral opening to get things started.

Birth Control

Using a diaphragm or spermicide increases bacteria growth and can lead to UTIs. If you’re not having an issue with this, that’s fine, but if you are, you may want to consider a different form of birth control. Furthermore, unlubricated or spermicidal condoms increase irritation of the vaginal walls, which may help bacteria grow and may lead to transport up the urinary tract. This is yet another reason why lubricated condoms without spermicide or a nonspermicidal lubricant are better options for safe sex.

Clothing

Does wearing cotton underwear and loose-fitting clothes prevent UTIs? Probably not. Does doing so keep the area around the urethra dry? Yes. Nylon underwear and tight-fitting jeans can trap moisture and help bacteria grow. Use this information to your advantage. This is another example of how altering your habits may help and won’t hurt the cause.

Instrumentation

Whether you’re a patient using a catheter to assist yourself with emptying your bladder, or if you’re placing objects into your genital orifices for other purposes (e.g. sexual stimulation), you should appreciate the risks found in not exercising good hygiene with these objects. The immediate proximity of these objects to your urinary tract certainly increases the risks of UTIs.

Treatment

Treatment is usually straightforward. It’s typically based on eliminating the organisms most likely to be causing the infection. Treatment regimens range from 3 days to more than a week depending on certain considerations. Important factors in this regard include severity, resistance patterns in your area, whether you get frequent UTIs and whether you have certain risks or anatomical abnormalities in your urinary tract. Men should receive a longer course of treatment as a rule due to the involvement of the prostate.
Other treatment considerations involve pain control and plenty of fluids.

If your frequency or severity of UTIs requires as much, you may be referred to a urologist for specialized treatment considerations. However, for most people, this isn’t necessary because treatment is sufficient – and prevention is even easier.

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What is a spinal tap, and why is it done?

November 30, 2018Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Medical Treatment, Neurology844-SMA-TALK, Behind the Curtain, Cerebrospinal fluid, Facebook, Lumbar puncture, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, TwitterJeffrey Sterling, MD

Introduction

A spinal tap (lumbar puncture) induces a lot of angst. Although the reason for the procedure should, the procedure itself really shouldn’t.

What is a spinal tap?

A lumbar puncture (spinal tap) is performed to obtain cerebrospinal fluid (CSF – the naturally occurring fluid that bathes the spinal cord) from the spinal column. It most typically evaluates the presence of infection (as in meningitis). However, it can also detect other conditions such as multiple sclerosis, Guillain-Barre syndrome or cancer involving the spinal cord. In some instances, a lumbar puncture is a treatment. Medicines and anesthetics can be placed in the cerebrospinal fluid via lumbar puncture. Also, it can be used to lower the pressure in the brain caused when too much fluid is present.

Here’s a video that would be helpful to view before you or a family member has a lumbar puncture. It is provided courtesy of Cure Search for Children’s Cancer.

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Does drug use cause kidney damage?

November 24, 2018Detoxification, General Health and Wellness, Toxicology/Drugs844-SMA-TALK, Acute tubular necrosis, Behind the Curtain, health, Kidney, Renal failure, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a Day, WasteJeffrey Sterling, MD

Introduction

This post addresses your question on drug-induced kidney damage.

Drug-Induced Kidney Damage

Each kidney filters about 1700 liters of blood per day and concentrates fluid and waste products into about one liter of urine per day. Because of this, the kidneys receive more exposure to toxic substances in the body than almost any other organ. As a result, they are highly susceptible to injury from toxic substances.

You actually produce an immune response to drug use. Inflammation from this immune response to drugs may injure the structures of the kidney. This usually causes various types of glomerulonephritis or acute tubular necrosis (tissue death). Injury to the kidney may result in short-term damage with minimal or no symptoms. It may also be life threatening from bleeding and associated shock, or it may result in acute renal failure or chronic renal failure.

In short, your kidneys are yet another reason to avoid illicit drug use.

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Tips to Deal with Depression and The Holiday Blues

November 21, 2018General Health and Wellness, Mental Health844-SMA-TALK, Behind the Curtain, Depression, Disorders, health, Major depressive disorder, Mental disorder, Mental health professional, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

Have the holiday blues? I don’t mean to bring anyone down during what is supposed to be the ‘most wonderful time of the year,’ but in reality there are many people hurting. For some, life’s tragedies happen this time of year the same as they might any other time. For others, this may have already happened, and this time of year is a permanent reminder of an unfortunate experience. There are others still who struggle with depression, anxiety and mental illness all year. The holiday season can exacerbate these feelings and may make holidays especially long, depressing and potentially dangerous times.

Today’s Straight, No Chaser is not meant to drag you into the dumps but to empower you with tips to assist you in the event this is a difficult time for you. By the way, I’m extremely thankful that you’ve chosen to give me moments of your day and life. I take that gift seriously and hope you continue to find it a worthwhile use of your time.

Here’s five tips to support your holiday mental health.

Remove yourself from stressful environments and avoid situations you know will create conflict, mental duress and/or danger. I can not emphasize this enough. If you put yourself in a bad situation, you can not be surprised when bad things happen.’
Find support. Specifically, have ‘go-to’ friends and family that provide you comforting support. There’s a time and place for tough love, but in the midst of depression or suicidal ideation, ‘buck up’ is not good advice. Know where your support lies and be sure (in advance) that it will be accessible if you need it.
Find success and happiness where it is. During the holidays, people tend to lament what isn’t. That’s not a formula for success. Yes, all of your family may not be around, but celebrating happy memories with the ones you can often fills the room with the joyous presence of loved ones not around. Enjoy the pleasures and successes you do have access to, whether big or small. Focusing on the positive keep you positive.
If you’re struggling, admit it. You already know you’re hurting. Often the first step to getting past it is acknowledging it. Once done, then you can put coping mechanisms in place to address your feelings.
Avoid holiday activities that will create post-holiday angst. This applies to eating, drinking, shopping and personal interactions. Some use the holiday as an excuse to overindulge as if the consequences won’t be there afterwards. Reread #1 above.

Get Help!

Know when you need professional help. If your support system doesn’t sufficiently address your needs, and you’re feeling severely depressed, can’t function or are suicidal or homicidal, find a physician or mental health professional ASAP. Of course, you can always contact your SterlingMedicalAdvice.com expert. If you type mental health, depression or other keywords into the search bar above, you can access many other Straight, No Chaser blogs on behavioral health concerns that may provide you the support you need. I wish you all the best today and throughout the year, and hopefully the picture above will reflect the only type of blues you’ll have to deal with this year.

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