Author Archives: NurseBridgid

Another natural alternative to sugar: Coconut Palm Sugar

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Everyone is looking for ways to sweeten without using refined sugar, because of its high glycemic index and calories, and I know that some of you are big fans of artificial sweeteners like Nutrasweet™ or  Splenda™ but there are alternatives that are natural and not chemicals, and that actually taste sweet.  One of the newer (well, new to the US, it has been used in southeast asia for thousands of years as a sweetener) alternatives is Coconut Palm Sugar.  It is a little hard to find sometimes, but it is sweet, tasty, and it is actually good for you because it is filled with vitamins and minerals!

What is Coconut Palm Sugar?

First, to clarify, Coconut sugar and Palm sugar are two different things, but it is frequently referred to as coconut palm sugar.  Palm sugar is a sugar made from the sap of various palm trees such as the date palm, sago palm, or the sugar palm.  Coconut sugar is made from the sap of the buds of coconut palms (the trees that grow coconuts).  The sap is extracted, dried (using heat to remove the water content), and it if found in either liquid, crystal, or paste form and it can be used to add to various foods as a sweetener, so it truly is minimally processed.

How is it actually good for me?

Because the sweetness is from the natural sucrose found in the coconut palms, so it is a very low glycemic index food, which means that it is a safe alternative to sugar for diabetics, and it can be used the same way that you would use sugar in baking, coffee/tea, etc. It is a great source of vitamins and minerals like: potassium, iron, magnesium, and Vitamins B1, B2, B3, & B6.  It’s chock full of good stuff for you, sweet, and  it is a low glycemic index food! And it is considered a low glycemic index food, meaning that the sugars take time to get into your bloodstream, they are slowly absorbed, as opposed to refined sugar which increases your blood sugar levels rapidly; and then will quickly drop off.  With a slower absorbed sugar, you tend to feel satiated longer, and you don’t have highs and lows of blood sugars as rapidly (which is why lower glycemic index foods are better for diabetics). Plus, it has a really dynamic taste, similar to brown sugar, but it really is much more dynamic; I love it.  It does change the color of baking, for example, I made some cookies and used it; the flavor of the cookies were amazing, but they were more of a caramel color than cookies if you use regular refined sugar.  Purely an aesthetic difference, as the cookies were gobbled right up!!

Buyer BEWARE

The one thing to make sure of though is that the coconut palm sugar you are buying is actually coconut palm sugar and isn’t filled with refined sugar. Sweet Tree (by Big Tree Farms in Bali, Indonesia) is a brand of coconut palm sugar that is certified as organic coconut palm sugar, so you know that you are getting the real deal, and it is your best bet.  Just make sure that whatever brand you buy is certified! It is most often found in natural food stores, some asian specialty shops, and online (of course- but I always encourage people to support local stores!)

Give it a try, let me know what you think, and see fi you notice a difference.  I am a huge believer, I almost exclusively use it….when I can find it!

Yours in Good Health

B

How do you help in Sudden Cardiac Arrest?

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Sudden cardiac arrest (SCA) is one of the worldwide leading causes of death and in the US alone, around 250,000 people die each year, according to the Center for Disease Control and Prevention (CDC). More people die each year from SCA than they do from colorectal, breast, and prostate cancer, AIDS, car accidents, and guns.  That’s pretty remarkable, when you think about it in those terms, right? There are some pretty simple things that you can do to help a victim of sudden cardiac arrest, and you never know when you might be in the position to help save someone’s life!

What is Sudden Cardiac Arrest (SCA)?

SCA is different from a heart attack, but a heart attack (which is a build up of plaque in the arteries that bring blood to the heart, leading to a decreased blood flow, so the heart is not working optimally, but still getting some blood flow) can lead to SCA.  SCA is a sudden and  immediate loss of cardiac function, that also causes respiratory issues (i.e. trouble breathing/moving air in and out of your lungs), a loss of consciousness, and an arrhythmia (a disorganized rhythm that doesn’t allow your heart to pump blood out to your brain, arms/legs, or other organs).  This can be really troubling because many times people do not know that they may have some sort of underlying heart disease, or be at risk for SCA.  It can just happen, at the most unexpected times, and a victim will literally just drop unconscious without any warning signs.  Without immediate treatment (i.e. within 10 minutes, but preferably less) people will die from SCA, or suffer major brain injuries due to a lack of blood flow and oxygen to the brain, even if we can restart the heart in a normal (perfusing) rhythm.

Compressions (CPR) 2 inches (4cm) in at least 100 times/minute

 

How to visualize an AED in public


What can I do?

Well, the immediate treatments for SCA are cardiopulmonary resuscitation (CPR) and defibrillation.  The days of having to give “mouth to mouth” are long over, and the American Heart Association encourages bystanders to do “hands only CPR” in which you check to see if the person is responsive, and if they are not, call 911 (or your emergency number) to get help, and push on the lower half of the breast bone with your two hands interlaced, using the palms to push at least 2″ (4cm) in on the chest, and allowing for the chest to go back to its normal position, and continue on at a rate of at least 100 times per minute (to the beat of “Stayin’ Alive”.) Immediate CPR alone can help victims of SCA tremendously, and getting trained healthcare professionals called out to help ASAP is key.  But there is one other thing that you can do: defibrillate (AKA Shock). What does that mean?!?  Basically, defibrillation is a large electrical shock that you give to a victim to try to kick them out of that arrhythmia where there heart is not pumping blood out, and get them back into a normal perfusing rhythm.  Defibrillating, is like hitting a “reset” button for the heart.  And it sounds scary thinking that you are sending an electrical shock into someone’s heart, but it can only help them, and it won’t hurt them; if you don’t do it they could die, and if you do it, you can immediately save their life!!  How great is that.  Plus, it couldn’t be easier!

How do I defibrillate someone?

In the hospital, we have some pretty fancy defibrillators that definitely need some training to use, but in public places like libraries, gyms, hotels, sports arenas, restaurants, office buildings, stores, etc. there are automatic external defibrillators (AEDs) that could not be easier to use, and have three steps:

1. Turn the AED on (for most, opening them up turns them on) and the machine will prompt you through  the next steps

2. Attach the two pads to the victim (there are pictures on the AED and on the pads): one on the upper right chest, right below the collar-bone, and the other on the left side of the chest, under the arm on the lower half of the ribcage. Once these are attached, you need to ensure you are not touching the victim, and it will analyze the rhythm.  If it determines the victim needs to be defibrillated (get shocked), it will charge itself.

3. Press the defibrillate/shock button (it will light up) then immediately start compressions again.  If no shock is indicated, immediately restart compressions.

*The machine will prompt you the rest of the time to continue CPR and count down the two minutes until it needs to analyze the heart’s rhythm again and the sequence will restart.  It truly could not be easier!

To think that somethings that seem so easy, can save someones life?  I understand that it could feel scary and uncomfortable if you aren’t used to it, but you are helping to save someone from death, and the feeling of goodness that comes over you from saving a life is amazing, and really can’t be put into words.

To recap when you find a victim of SCA:

Make sure that it is safe for you to help (you don’t want to get hurt trying to help another person, so think of your safety first)

Check for responsiveness (if they cannot speak, are not awake, then they are considered unresponsive)

Call emergency services for back up

Start chest compressions (2 inches in at a rate of at least 100 compressions per minute)

If there is an AED nearby, have someone grab it, attach the victim ASAP and follow the prompts

Continue until emergency services comes, or someone to take over from you…..if no one comes, keep going until you are exhausted.

It may seem like common sense, but when you are alone with someone in SCA, it’s important to practice and remember these steps, because your actions can help to save a victims life. I know you can do it, even if you are scared, because if you were in SCA you would want someone to help you!  If you are interested in taking a Heartsaver (CPR/AED) training class, check out the American Heart Association‘s website that can tell you where local classes are held. The more training, the better!

Yours in Good Health

B

 

What is the most contagious STD?

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I was quite shocked that crabs (AKA pubic lice) is as prevalent as it is. But in the past week I have been asked about it three different times from people all over the US, which made me think that this topic needed a little discussion related to what crabs are, how you get them, and how to treat them.  I wasn’t sure how prevalent they are, but they are clearly around, and infections are on the rise.

What are crabs?

Crabs are also known as pubic lice (Pthrius pubis) and they are parasitic insects that feast off the blood of humans and live in coarse hair (i.e. pubic hair, eyebrows, eyelashes, chest hair, armpits, mustaches, & beards) causing itching, discomfort, and rashes. So you can understand how they can not only be really irritating, awkward, and kind of gross to think about, right?  They pass from person to person usually through sexual intercourse (or sexual acts) but they can also jump from person to person through hugging or other close contact (sharing towels, clothes, bedding, etc.) Despite the fact that crabs can’t live very long away from the warmth of a human body, they are still the most contagious STD, and if an infected person has sex with a non-infected person, the risk of getting crabs is about 90% for that previously non-infected person.  That is pretty shocking, and horrifying…a 90% chance?!?  Plus the lice live from about 1 to 3 months, and in that “lifetime” the average female lice has about 300 eggs, which means they breed quickly and frequently! These parasites spread quickly.

What are the signs and symptoms of infection?

Usually the only symptom is itching….extreme itching.  Sometimes you can visualize the bite marks on your skin, they are bluish in color, due to the bruising from them sucking your blood to the surface, but it is very hard to see. Sometimes there are little red bumps from the bites, and then scratching them. Most often the itching and discomfort brings people in to their HCP.

How do I treat it?

First, when you find out that you are infected, let the people you live with and sexual partners know about the crabs, and clean all sheets, clothing, towels, etc in water that is at least 130F and dry it thoroughly in a dryer to kill off the lice living in the sheets.  If some of these items cannot be washed, then have them dry cleaned.  You can also buy an over the counter (OTC) treatment from your local pharmacy, like Permethrin 1% creme, that you apply to the affected areas (not near eyes), leave on for 10 minutes, then wash out and with a fine toothed comb, comb through the hair to remove all eggs and dead lice.  Usually this one time treatment works, but you MUST see an HCP to get treatment if the OTC doesn’t work, if you are pregnant, children under 2 years old, or teens under 18.  There are some treatments that are prescription only, so you need to see your HCP and get diagnosed. One other option, after you treat the area, is to shave off all affected areas (this is a little radical and not usually suggested by most HCPs) but if there is no hair to cling onto, there will be no pubic lice….just make sure to kill off the current infestation you have. Makes sense right?

Can I prevent it?

Well, you can ask partners if they have crabs, which I would hope they would abstain from sexual contact if they knew they had crabs, but its worth an ask.  Unfortunately, condoms do not prevent the spread of crabs, which is a total bummer.  If you have previously been infected (or are infected currently), make sure to wash or dry clean everything (as stated above, use the OTC treatment, and if symptoms are not cleared up, go see your HCP for further treatment, and bleach your bathroom/anything you use on your hair/body hair for grooming.

So unfortunately, it is highly contagious and can be an awkward treatment, but limiting your sexual partners, and asking about STD’s is a start at prevention.  Also, use your intuition: if you see someone scratching their crotch or just all over when you’re out with them, ask them if they have some sort of skin issue or lice.  If they say they are just super itchy and they don’t know why?  Steer clear!!

Yours in Good Health

B

GMO: What does it mean?

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There has been a TON of talk lately about GMOs, and I think most people know they are bad….but they have really no idea what they are and what the controversy is, so I thought it would be helpful if I could shed some light on the topic.  GMOs are Genetically Modified Organisms.  Now what does that mean? Basically, an organism as been genetically altered (or modified) using modern scientific approaches to change the make up; the most frequently modified organisms are bacteria, yeast, plants, fish, mammals (including the chicken and beef that we may be eating!)

What do GMOs mean to me?

Well, it seems like we would be able to easily pick out foods that are genetically modified and just not eat them, right? Well, unfortunately, we don’t really know all of the foods that are genetically altered and what is added to our foods.  Plus, just buying organically does not necessarily mean that foods don’t have GMOs added.  It is not required by law to list GMO ingredients.  So, despite all efforts to eat organic, healthy, non-altered foods, and to serve them to your family, we may still be eating genetically modified foods, all because they are not listed, and corporate farms are not required to report genetic modification of their crops. For example, you might not think that your family ingests a high amount of soy products, but soy is often altered and added to other foods as a filler, so you are all eating more soy than you think! The real risk is that we do not truly know the long-term health effects of eating GMO food, but there have been numerous studies (using rat and mice models) showing that there is an increased tumor rate and shorter life expectancy when eating high GMO diets. Obviously, the studies have not proven 100% that eating GMO diets will kill you, but there is a risk, and the studies are strong enough that I really try to keep as GMO free as possible. Many of these foods are modified with various hormones and chemicals that do put us at risk for various cancers, and adding high amounts of soy to the diet can increase females estrogen levels, and that is just all the more helpful for estrogen supported tumors (i.e. breast and ovarian cancers, among others.) The best way to prevent ingesting GMO foods, is to know the crops at highest risk and try to steer clear of them, or only eat these fruits/veg from local farms where you know they are GMO-free.


What are the crops most at risk for GMO?

– Alfalfa sprouts

– Corn

– Soy

– Cotton

– Papaya

– Zucchini and Yellow summer squash

– Canola

– Cotton

– Sugar Beets

– Siberian Kale

– Acorn squash

– Flax

– Rice

– Chard

– Table beets

– Bok choy

– Turnips

Some additives that commonly are from GMO based products are:

Aspartame, Xanthan gum, High Fructose Corn Syrup, any “natural” or “artificial” flavors added to products, Vitamin C/Ascorbic Acid, Sodium Citrate, Sucrose, Maltodextrins, Molasses, MSG, Vitamins, Yeast products, Hydrolyzed Vegetable products, etc.

As you can see, a LOT of these foods are foods many of us ingest daily, and the additives, while we might not always know what they are, see them on package labeling constantly.  I think it is really hard to have a completely GMO-free diet at this point, but some brands are marketing that they use GMO free products, which is great, and identifying the products that are high risk GMO is a great start.  There are people out there trying to stop GMO in the US and The Non GMO Project is one of them, a non-profit, working off of donations to change legislation and prevent GMO and/or at least force companies to have to label their GMO practices, so we are not ingesting chemicals and hormones that we are not intending to.  The Non GMO Project also has rigorous standards for companies, and testing, if they prove they are GMO-free, they are allowed to use their “GMO Free” seal: 

And you can feel safe and assured that those products are truly GMO-free.  The European Union has gone GMO-free, and hopefully the US will soon follow suit!

So hopefully you know what to look for and what to stay away from, to steer clear (as mush as possible) from GMO foods. No one needs to ingest hormones or chemicals when they are trying to eat some healthy fruits and veg! Keep your eyes peeled, and support local agriculture using GMO free methods, as much as you can!

Yours in Good Health

B

Smokeless Tobacco: Not only gross….it’s a killer!

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Last weekend there was a guy dipping (AKA using chewing tobacco), and I was completely horrified.  Me, being me, of course felt the need to chastise this poor man for chewing tobacco, spitting all over the ground, and it was not the right time or place for “thoughtful” education.  So, it was a swing and a miss as far as a PSA goes, but I thought this forum might be a little more appropriate because there is more to the dangers of tobacco than just smoking it.

What is smokeless tobacco? 

Usually that means chewing tobacco (AKA dip, chaw, snuff, chew, and plug).  Chewing tobacco is usually shredded tobacco leaves (chunkier) whereas snuff is a finer tobacco that is in almost little teabags; with both, people put the tobacco between their gum and lip/cheek, swirl around their saliva, mixed with the tobacco then spit it out. Sounds appetizing, right? The nicotine that is present in the tobacco, mixes with your saliva, and enters your blood stream through the capillaries (the small blood vessels) in your oral mucosa (mouth tissues).  So, you get the buzz from the nicotine, just like smoking, and maybe even stronger, then you also get that addiction from the nicotine.  The Center for Disease Control (CDC) estimates around 14 million users in the US alone….that is a LOT of dipping going on, and I had no idea how wide-spread the problem is, because it is mostly used by adolescents and teens under the age of 20.

What are the dangers?

Well there are immediate things that occur:

-yellowing of the teeth

-gingivitis (gum disease)

-cavities (the acidity creates holes in your teeth)

-bad breath due to a build up of bacteria and tobacco

-canker sores (almost all dip users get them continuously because of the irritation to your oral tissues)

And with chronic use:

-bleeding lips and gums (from irritation)

-receding gum lines (which leads to tooth decay and teeth falling out)

-cancer (oral/throat/esophageal/lips/gums/tongue/cheeks…and pancreatic and kidney cancer rates increase too!)

-heart disease: dip increases your heart rate and blood pressure and puts a strain on your heart increasing your risk for heart disease, heart attack, and stroke.

What should I do?

QUIT!!!! Chewing tobacco is bad news.  It’s not better for you just because you don’t inhale it, it may actually even be worse for you. Chewing tobacco has 30 different cancer causing agents in it…and you just sit there sucking on it; there is nothing else that people KNOW causes cancer and sit there and suck on without a care in the world.  Your risk of cancer is just as high, and it is just SO gross looking.  You can try to quit with nicotine patches or gums (like quitting cigarettes), talk to your HCP and see what they suggest, and there are tons of support lines to help if you are having trouble quitting: 1-800-QUIT-NOW is a free tobacco cessation line, funded by the government to help people quit smoking.  You can learn new tips, talk to a therapist, and find help near you.  You CAN quit.  You NEED to quit.  It’s just a matter of freeing yourself from the addiction of nicotine.  You can do it.  I know it!

Yours in Good Health

B

Ch-Ch-Ch-Chia Seeds for Better Nutrition!

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I have been asked a ton lately about Chia seeds, and I have seen people snacking on them.  When I first saw it, I thought “hmm, it looks like a little bird eating a snack” but I had no idea how nutritious that snack really was….and I didn’t know what it was either.  Finally, I looked really dumb, but I asked some guy what the deal was with the “bird food” and his response was, “You don’t know about Chia?” and snarked off (which I completely deserved!) And now I feel like a chia expert….not just for being able to grow chia heads, but understanding the nutritional basis of the seeds, and why this is such a hot nutritional trend!

What are Chia Seeds?

Chia seeds are these little edible seeds that comes from the Salvia hispanica plant, which is a relative of mint.  It was used as a staple of the Aztec and Mayan diets into the 16th Century, as it is easily grown in Mexico, and along with being pretty tasty, and easy to add to a multitude of foods, it is fully of fiber and fills you up quickly; the Aztecs used to eat some Chia and be filled up for 24 hours (that wouldn’t work for me, but it may just be mind over matter!).  So, in short, Chia seeds are full of fiber, vitamins, Omega-3’s that can be added into your diet in a bunch of different ways.  They are very low-calorie and they can be ingested wither whole or ground; either way your body can easily break them down and absorb the nutrients.

Why are they so good for me?

As stated before, they are chock full of fiber, which we know is food to keep you filled up longer, aids in digestion, and can help to decrease your risk of certain cancers (like colon). Approximately 25 grams of Chia has about 7 grams of fiber (that equivalent to a half cup of straight oat bran).  They are full of Omega-3 Fatty Acids, which can help to prevent cardiovascular disease and help to regulate cholesterol by increasing your LDL (good cholesterol), help with decreasing inflammation, and help to regulate moods and prevent depression. As well as bring full of calcium, phosphorous, magnesium, manganese, copper, and iron, they also are full of antioxidants, which help in preventing cancer.  These seeds are pretty power packed!

How do I eat them?

The great thing about Chia seeds is that they do not have to be ground to eat them, so you can add them whichever way you want to baked goods to add a nutty flavor packed with vitamins and fiber. In Mexico, it is common to add water to Chia seed with a little lemon or lime juice; as the seeds sit in water, they create a gel which thickens, and is how the seeds break down in the digestive system, but adds some thickness to beverages, and I imagine it would be like bubble tea.  Also, that gel can be used in cooking/baking so that you can halve your butter or oil, and make most of your favorite meals with half the fat and calories!  The gel is formed once the seeds are sitting in water for about 30 minutes- this idea both creeps me out and excites me; I’ve used it in baking, and my cookies still turned out delicious, just healthier! It can be sprinkled in yogurt, on top of ice cream, added to salads for some crunch.  Really there are no limits to how you can add chia to your diet.

The coolest thing is that when chia is added to the diets of farm animals, their proteins are changed: chickens with a diet with chia added to it, have higher amounts of Omega 3’s in their meat, and cows that have chia added to their diet, produce milk with more naturally occurring Omega 3’s. And another really awesome thing about Chia, is that there really are no natural predators (other than humans looking for a tasty treat) so they truly are organic, in that no pesticides need to be used in the cultivation.  Really?  I see no downside to Chia…unless of course you are allergic.

So, give it a try, tell me what you think…and use the chia gel in the kitchen when cooking, your body will thank you and me!

Yours in Good Health

B

It’s that time for itchy, dry skin: it may be more than just dry skin!

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I was recently asked by a reader about dry, itchy, scaly skin around and in the ears. This is  a pretty common occurrence and can happen around the change of seasons, or when we start to go into these colder months, and it is usually at its worst during the winter.  So what is this affliction?  Seborrheic dermatitis. And it is pretty simple to clear up, and once you know the signs, you can prevent it from happening in the future!

What is Seborrheic Dermatitis?

It is a common skin disorder causing red, itchy, scaly, dry skin, which can cause dandruff (flaking of the skin). It’s really uncomfortable, and doesn’t look amazing, but it doesn’t have any long-term effects or cause any other health issues. It usually occurs on your scalp but it can be found anywhere on the body there are a high number of sebaceous (oil) glands (i.e. between eyebrows, chin, nose,ears, groin area, & chest.) Also, it is NOT contagious, so rest assured that you cannot “give” this skin issue to anyone else!

What are the symptoms?

Well, it usually occurs in areas of high oil glands (head, chest, ears, eyebrows, chin, nose, groin, scrotum, or armpits), and has a red, dry, scaly appearance.  But it can vary on people, so some of the symptoms you might see are:

– Inflammation with redness of the skin

– Dandruff (flakes of skin) on your head, in eyebrows, beards/mustaches, etc.

– Red greasy patches of skin (scaly) that are covered in white flakes or yellow scales

– The areas can be sore, itchy, or feel raw (or a mixture if you scratch because it’s itchy it can become raw then sore)

– Crusts can appear on the scalp too

The most important thing to remember is that it can be a chronic condition that comes and goes, periods of inflammation, which usually occur with the change of seasons, and are worse in the cold weather months.

What causes it and how can I treat it?

It is sometimes caused by a (yeast) fungus that is naturally occurring in our sweat/oils called Malassezia, so it is basically a yeast infection of the skin, but with our own normal bacteria. So Over-The-Counter (OTC) treatments such as lotions/creams with an antifungal such as, ketoconazole (the same antifungal treatment for athlete’s foot or ringworm- like Lotrimin) will help to kill off the fungus and make the symptoms go away. It tends to occur more frequently in winter months for some reason, people with Parkinson’s disease tend to have a higher frequency of seborrheic dermatitis (it is not really understood why), and people with HIV/AIDS tend to get outbreaks more frequently (possibly due to a decreased immune response) and they have much more severe cases. Times of high stress can cause seborrheic dermatitis to occur as well, even if you have never had a problem with it before. Severe cases may need to be treated with Lamisil, an oral antifungal that is very strong and needs to be taken usually for a couple of months,and you need to abstain from alcohol. If it is merely itching and inflammation, you can use a hydrocortisone cream on top of the rash. Also, using medicated anti-dandruff shampoos that contain zinc pyrithione (in head and shoulders) or coal-tar (in Neutrogena T/Gel) on the affected areas can help.  My suggestion is to use the medicated shampoos on the areas, and merely dry yourself after bathing, pat dry but don’t vigorously rub at your skin with the towel, and apply the topical creams (if needed).  Start low and go slow is a good motto, try one treatment at a time, then add the others in slowly if you aren’t seeing results. Unfortunately, the reason that it occurs is not well-known, so if you get it, bummer, but at least you know how to treat it!

How is it diagnosed?

Your HCP will ask you about symptoms, where and when it occurs, if you have changed detergents/soaps/products recently to rule out that it is an allergic reaction to a new product.  They will also perform an assessment on your scalp, and areas affected by the rash, to diagnose it.  If they are not certain, based on physical assessment, of the diagnosis, they may do a biopsy, and when I say biopsy, I really mean a skin cell scraping; they just need to look at a few cells under the microscope to ensure that you do not have psoriasis or eczema instead (sometimes the rashes can mimic one another).

If you are diagnosed with seborrheic dermatitis, most likely you will be encouraged to try OTC treatments first, but there are prescription shampoos and creams that you may need to use, so tell your HCP if you have tried various OTC treatments and they just haven’t helped.  Also, remember to avoid harsh soaps/detergents, you may want to switch to sensitive skin/hypoallergenic products to prevent skin irritation.  If you have a mustache/beard/facial hair, shave it off; the more hair, the more oils that will be caught on your skin, and with hair there, it is tough to get the medication to have direct contact with the skin.  Also try to wear breathable fabrics, if you get the issue in your armpits, groin, chest; cotton allows for more air flow, and hopefully less sweating!  The best thing you can do is treat it when it comes, work with your HCP to find a medication regimen that works for you, and learn the warning signs that your skin gets before the rash erupts so you can start to preemptively treat it, and hopefully prevent the rash from getting into full swing!  And who knows, maybe we will start to learn why this rash occurs, until then, just learn your skins signals!!

Yours in Good Health

B

 

Contaminated Drugs: Have you been exposed?

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There was a recent contamination of some drugs that are commonly used to inject patients having open heart surgery, back pain, and patients having eye procedures/surgery.  The New England Compounding Center (NECC) located in Framingham MA somehow became contaminated with a deadly strain of fungal meningitis.  It is deadly because fungal infections can be really difficult to treat, and these patients are having the drugs with this fungal strain directly injected into their spines (back pain), hearts (for surgery), and eyes (procedures).  It is also a difficult issue because they are not certain how many of these drugs are actually contaminated, so many patients may have been exposed and we just don’t know how many, but we do  know that there have been around 15 deaths related to these drugs contaminations at this point, and around 14,000 patients in 23 states have been possibly exposed. And some of these drugs are used on transplant patients who we have to suppress their immune system so their bodies can accept their new organs.

Which drugs are affected?

– Methylprednilosone Acetate injection (a steroid commonly used for severe allergic reactions, ulcerative colitis, for immune suppression, & can be used with some chemotherapy agents )

– Traimcinolone Acetate injection (a long acting steroid used for arthritis, lupus, ulcerative colitis, some opthamologic (eye) issues, and many other diseases in other forms)

– Cardioplegic solution (a solution used to paralyze the cardiac muscles during open heart surgery)

What is fungal meningitis?

First of all, fungal meningitis is NOT CONTAGIOUS, which is the good news because it cannot be spread person to person, and it is actually a less common infection, which is why the FDA realized that there were drugs contaminated when there was an outbreak. It is caused by a fungus called Cryotococcus which is usually found in bird poop, and the fungal spores are usually inhaled then they travel into your blood stream and cross into your spine.  It is diagnosed by taking blood samples from blood near your spinal cord and sending off for fungal testing, if the blood sample is positive, then it is treated with high dose Intravenous (IV) anti-fungal medications and that needs to be done in the hospital.  The signs and symptoms of fungal meningitis are:

– fever

– headache

– stiff neck

– photophobia (sensitivity to light)

– altered mental status (feeling of confusion, or sleepier than usual, a change in personality)

– nausea & vomiting

How do I know if I am at risk and what should I do?

There has been a nationwide/worldwide recall issued, so if you have had any steroid injections recently for back/arthritis pain, any sort of open heart or cardiac surgery, or eye surgery/procedures then your Health Care Provider (HCP) should get in contact with you if there is any suspicion that you may have received a contaminated drug. BUT, if you have had any sort of recent medical treatment where you received an IV steroid, and you have any of the side effects (as listed above) contact your HCP to get checked out.

It is better to be proactive and be seen and treated early, then to wait: early treatment is key.  And if you have any fears that you received contaminated medication, you should be seen to alleviate your fears. But early intervention and early treatment is always better.

Yours in Good Health

B

Ever had keratosis pilaris? I bet you have….

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Every now and again people will tell me that they have rough skin on the back of their upper arms, almost like little white or flesh toned bumps, that come and go and they don’t know what it is.  Well, I’m here to tell you that it is super common and it is called Keratosis pilaris.  And while it can be a little frustrating to treat because it can come and go, it is really common.

What is Keratosis pilaris?

It is a skin condition that causes these patches of rough (can be dry-looking) skin, that may have bumps that look like very small acne and the bumps are usually found on the upper arms, thighs, and butt area. It can become inflamed or itchy at times, but it is not contagious, it doesn’t spread, and has no long-term health issues.  It is just more annoying than anything else as it tends to go away (or even completely disappear) during the summer months and start to act back up in the fall/winter months.

What causes it?

Basically, it is a build-up of keratin, which is the hard protein in your skin that acts as a protectant. The extra keratin builds up and blocks the pores, causing these hard little bumps and when many of them form, it makes the skin rough and patchy, and appear bumpy.  When your skin gets dry, the Keratosis pilaris tends to get worse, which is why it tends to act up during cold winter months, because our skin tends to be drier.  There is no real reason why it occurs because it tends to occur on many different people and isn’t linked to any other particular disease process.

How do I diagnose and treat it?

The good news is that your HCP or your dermatologist can diagnose your Keratosis pilaris just by assessing your skin; there is no need to have blood drawn or be poked or prodded!! The treatments can be a little more annoying, but usually pretty easy and over the counter (OTC):

– Exfoliate: You can exfoliate your skin to keep those pores open and prevent them from being blocked by the keratin.  You can also use medicated creams that help to soften and exfoliate the creams to alleviate the bumps.  The best creams to use, contain: salicylic acid, urea, alpha-hydroxy, and/or lactic acid.

– Daily Moisturizer: keeping the skin moist by using lotion daily can help to keep the bumps from occurring, and also drying off after the shower by gently drying with your towel and not vigorously wiping the towel against your skin can also help you.

– Corticosteroids: OTC hydrocortisone creams can help with the irritation and itchiness that can occur, but should really only be used short-term to treat any irritating symptoms. It can alleviate those issues.

– Humidify: Keeping the air in your home moist with a humidifier can also keep your skin moist and prevent that dryness that can make the Keratosis pilaris act up.

– Retinoids: Topical medications that are Vitamin A derived (Retin A, and Tazorac) which are by prescription only, can help the cells to go through their life cycle faster, thus promoting new skin cells and decrease/prevent the clogging of the pores by the keratin.  Retinoids can be a pain to get covered by insurance and require pre-approval by most insurance companies, but they are very helpful.

All of these treatments are really helpful while you use them, and can make the appearance of the Keratosis pilaris go away, but once you stop treating it, unfortunately the symptoms usually come right back and they can last for years. It cannot be prevented, it is just one of those things that happens to many people and for most people it gradually fades away and is gone by the time people are around 30 years old. Give these treatments a try, and talk to your HCP if they don’t work and see if there are other options for you.

Yours in Good Health

B

 

Your Blood Type Can Determine Your Risk of Heart Disease?

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There has been some interesting research coming out lately looking at various blood types (Type A, B, AB, or O) as an indicator for risk of heart disease.  To me, this is really fascinating, because there are so many times that people come up to me and tell me a horrible story about someone who is totally fit, eats right, young, and then “drops dead of a heart attack” (a quote I hear a lot).  I always think that there has to be a family history, something undiagnosed, or a predisposing factor. So, this research is important because maybe it really is part of those “genetics” that cause some people to be at a higher risk for certain diseases without having any other risk factors!

What is your Heart Disease risk based on your Blood Type?

There are two very large, ongoing studies that Harvard University runs, looking at various healthy populations, and they collect data on these research participants in all aspect of their lives: diet, nutrition, health issues, pregnancy, sleep, etc. and they continue to collect this data on these people for the duration of their lives. Between these two ongoing studies, the researchers looked at just shy of 90,000 people, analyzing data from 24 to 26 years for each participant, and what the data showed was pretty amazing.  People who have blood Type AB, have a 23% higher risk of heart disease as a baseline, whereas Type B put a 16% higher risk, and Type A was a 6% increased risk, as opposed to people with Type O blood, who have minimal risks (basically none).  Strange, right?  Just having one blood type, in particular, can seem to put you at a higher risk for heart disease and heart attacks.

How can your Blood Type determine your risk?

This part is still being studied for a more exact reasoning, because the way that the human body works, especially with blood and the clotting cascade, it is very difficult to pin point one factor (or explanation) for why different blood types carry within their cells innate varied risks for heart disease.  But the researchers have a hypothesis (a suggested reason) for why this phenomenon may occur: people who have Type O blood tend to bleed more (take longer to clot), so they would be less at risk for their blood spontaneously clotting to cause a heart attack or stroke. Also, people who have Type A blood, have been found to have higher Low Density Lipoprotein (LDL) levels (which is the bad cholesterol) circulating in their blood, as they lack an enzyme (that Type O has) which makes removing cholesterols more efficient.  Cholesterol is bad because it builds up in arteries and causes plaques and hardening of the vessels, which leads to an increased risk of plaques breaking off and causing a heart attack, less blood flow to the heart, and also increases the risk of clots forming that can lead to a stroke or heart attack.  So, if you have more circulating cholesterol, you have a higher risk of heart disease which can cause heart attacks.  Now, again, it is not truly known why people with Type O tend to bleed more or why people with Type A have more cholesterol circulating, but it is being studied to find more exact reasonings.

Is there anything I can do to decrease my risk for heart disease?

You cannot change your genetics, which is a bummer, but you can live a healthy lifestyle to promote heart health:

– Stay at a healthy weight

– Exercise at least 30 minutes per day 5-6 days a week

– Avoid smoking and using other tobacco products

– Avoid a high fat diet and load up on fresh fruit and veggies

– Get regular check ups to monitor your blood pressure, heart rate, and cholesterol levels

Talk to your HCP about your risks, and have an open communication about what is the BEST way to maintain a healthy heart based on your life and lifestyle, and when/if you need to be on any blood pressure medication.  It is always good to be monitored for healthiness, especially if you have a family history or Type AB blood, as we now have learned.  And….if you don’t know your blood type, that test can be performed in about 30 seconds (I learned in 8th grade science class- we all took a drop of blood and figured out our blood types- which I am now learning from various people is really strange.)  So figure out your risk factors, talk to your HCP, and live a healthy lifestyle (as best you can!)

Yours in Good Health

B