I know this is not going to be everyone’s favorite BUT it is something that affects a lot of women…and can affect men too!!  3 in 4 women experience candidiasis (a yeast infection) at least once in their lifetime and it causes itchiness, discharge, and some discomfort.  Men can get a similar rash on their penis, not as a intense as a womens yeast infection, and not sexually transmitted, and is more likely to be a problem in men that are immunosupressed (chronic illness, after a transplant, etc) or with an HIV infection.  Although, yeast infections can be transmitted through oral-genital sex (either partners infection can infect the other).  It’s a bummer that the vagina is a warm, dark place, where yeast just loves to grow BUT there are plenty of ways to ensure that this doesn’t happen to you!

What are the symptoms?
-Itchiness and irritation in the vulva and in the opening of the vagina
-Burning sensation during sex and while peeing
-Vaginal pain and soreness
-Thick, white odor-free discharge that looks like cottage cheese

What are the causes?
-Antibiotic use can cause the good bacteria to die and change the pH in your vagina (allowing for yeast to grow)
-High blood sugars in a diabetic
-From vaginal changes (douching, excessive sex, lack of lubrication)
-Impaired immune system (as listed above)
-Pregnancy (high estrogen levels)

What are risk factors?
-Pregnancy
-Douching
-Sex without lubrication
-Antibiotic use
-Uncontrolled blood sugar levels
-Impaired immune system

What do you do if you think you have a yeast infection?
You can buy an OTC Vagisil testing kit that will tell you if your symptoms are actually a yeast infection (vs. another STD) and if you DO have a yeast infection, you can then buy an OTC yeast infection treatment like Monistat (miconazole) or Lotrimin (clotrimazole)one day treatment or the generic equivalent.  If that doesn’t relieve symptoms, or if this is the first time you are having these symptoms, I suggest going to see your HCP.  Your HCP can do a pelvic exam, take a swab to ensure that your symptoms are from a yeast infection, and suggest the best treatment for you, which could be a one time treatment of an oral Diflucan (fluconazole).  Plus, some people get recurrent infections (due to risk factors above) and your HCP can help to come up with a plan on ways to prevent them.  For men, the best treatment is Lotrimin or Monistat creams directly on the penis and the symptoms should go away within days.  Also, it is best to abstain from sex while you have symptoms and are being treated.

Are there any alternative treatments?
Lactobacillus, a probiotic found in many yogurts, have been found to help treat yeast infections when taken orally or place intravaginally; some small studies have shown that yeast cultures are decreased and symptoms are diminished.  A few treatments that are said to work, but have yet to be studied are: vinegar (white) douches, tea tree oil cream, and garlic vaginal suppositories.  Honestly, I would prefer to try the yogurt, as when I take antibiotics, I ALWAYS increase my yogurt intake to prevent a yeast infection, and I couldn’t imagine walking around with garlic in my vagina… To each his/her own, and I appreciate all sorts of alternative therapies, but I feel like messing with the pH of your vagina even more isn’t really the best strategy (vinegar douche) and the tea tree oil will have a similar effect.  I think that the yogurt treatment is the best alternative, along with being cheap, and easily available.

The best way to prevent?
-Avoid scented pads & tampons
-Avoid bubble baths and feminine hygiene products (feminine deoderant sprays, etc)
-If you are prone, wear cotton underwear and loose fitting clothes (in breathable/natural fibers- like cotton)
-Change out of wet clothes or bating suits as soon as possible

And remember, if you (or your partner) have an active yeast infection, abstain from being sexually active until the infections have been treated, and if you are having these symptoms for the first time (man or woman), it is best to go see your HCP and discuss the infection and treatment options.  Plus, this is nothing to be embarrassed about, and HCP’s see this all the time!!

Yours in Good Health
B

So, now that it is spring, we are all getting our claws out, getting pedicures, letting our tooties breathe, and rock sandals!  But, those cute (or super masculine) sandals can cause some discomfort and blisters until we “break them in”.  What’s better than knowing how to treat blisters?  Knowing how to prevent blisters and treat the ones that you may get anyway!!

What are blisters?
A small pocket of fluid that is created under the top couple layers of the epidermis (skin).  They are usually filled with a clear fluid (serum or plasma), but can be filled with blood, or pus (if infected).

How do Blisters occur?
Blisters are created through heat, sweat, and constant rubbing (friction).  So, in the heat of the spring/summer, with sweating and loss of electrolytes, we are at risk for those pesky blisters!  Plus with new shoes on, we are at a much higher risk from new straps rubbing against our feet.  The good news?  There are ways to prevent them and keep our feet happy and pretty!

How do I prevent blisters??
The best way to prevent is to try on your shoes, feel if any areas seem tight or uncomfortable, and use specific products to help prevent the formation. Band Aid brand has a Blister Block product, which is like a very thick second skin, that you can apply on top of toes, heels, ankles, really anywhere- you just need to apply the product to your skin, it is clear and slides on.  It creates a barrier between your skin and the strap/shoe and helps to prevent a blister from forming.  Spenco is a company that has the old tried and tested Second Skin product which is an adhesive product that sticks to your skin and creates a physical barrier over specific “hot spots” that you choose. But, my favorite that I apply when I wear ANY pair of new shoes? 3M No Sting Barrier Spray that you can just spray on your feet, or anywhere that chafing might occur, and it is a clear spray, that has a random but fresh scent, and it creates a thin film on your skin that helps to prevent blisters.  It is a little more expensive than the other products, but I think it is far superior!

What Happens if I get a Blister Anyway?
Despite the best plans, sometimes blisters still do occur, and I really need to urge people to try to NOT pop them!! I get the fever to pop anything and everything that pops out of my skin, but I suppress the urge with blisters because they heal best on their own!  I must say, if you are a diabetic, you should watch your blisters closely, and go to see your HCP if it looks infected or seems to be taking a long time to heal.
The best thing to do is keep the area clean and dry, and when you need to wear shoes that might rub the area, place some of the second skin or a light bandage over the area to prevent further rubbing (it is best to wear shoes that allow the area to be exposed and unaffected).
If the blister pops, then what do you do?  Wash your hands with antibacterial soap before touching the area. Leave the top layer of skin in place, and don’t rip it off, it helps to protect the under layer that is technically an open wound; you are just leaving the bodies primary defense against bacteria in place as much as you can!  after washing your hands, as long as you have no allergies, apply a light layer of antibacterial ointment (like bacitracin) twice a day, and leave the area open to air as much as possible (like when hanging out at home watching TV or doing things around the house) but cover with a gauze or bandage (not too tight) when covering the area with a sock or putting the area at risk for more damage (like in a shoe).  Air helps to heal more than anything else; it allows the body to do its job and work like the well oiled machine that it is!
Assess the area a couple of times a day, and if there is heat, swelling around the area, if you notice redness around the blister site, or any pus (discolored) drainage, you should go see your HCP because it is most likely infected.  This is especially important for diabetics with poor glucose control, because you are at a much higher risk for infection. If you notice that you have a fever, swollen lymph nodes, or red streaks on your skin starting at the site and moving outwards, please go see and HCP immediately because you most likely have an infection that requires antibiotics or further treatment.

I hope that this helps you all keep happy, healthy, and pretty feet for the warm weather!  And use common sense with blisters, if something looks or feels wrong, go see your HCP.  But if all is well, treat yourself and go to a clean salon and get a pedi to make those tooties look beautiful!

Yours in Good Health
B

I have to apologize to all my loyal readers; I had a bit of a personal tragedy, but I am over it and will be back on track.  I just really needed to take some time for myself and work through my stress!

But, I am back, so keep sending your questions and we can get back on track!

Yours in Good Health
B

I know that I have talked about basically every STD known to man, well get ready, because now I am telling you to be safe and go out and have some sex!  Sex is a healthy and necessary part of life, and it can effect us in so many different positive ways…again, as long as we are safe about it.

Why is sex necessary and healthy?
It is a stress reliever: can calm you down, get our aggression/stress from a tough day, which in turn lowers your blood pressure and heart rate, and one study showed that people having regular sex deal with stressful situations better and have less of a physical response to stress.

It Boosts your immune system: People who have sex once or twice a week have increased levels of Immunoglobulin A (IgA) which helps to protect your body from attacks by viruses like the common cold.

It is a good back up workout: You can burn around 170 calories per hour, and it is a great mood booster if you miss your workout, so burn some calories together and get some good cardiovascular exercise; one study showed a significant reduction in heart attacks in men that have sex one to two times a week.

Oxytocin does a body good: The oxytocin that is released post orgasm helps to elevate mood, decrease the sensation of pain, improves self image, and helps you sleep better!  I guess just like after having a hard workout you sleep well, after a good romp in the sack, similar hormones are released and help you to sleep well.

Can reduce the rate of prostate cancer:  There have been studies done to show that men in their 20’s that ejaculated 5 or more times a week decreased their risk by 1/3 and another showed that older men that ejaculated 21 times or more per months had much lower rates of prostate cancer than those that ejaculated 7 times or less.  Clearly, I am a woman, but that seems like a LOT and kind of tough numbers to hit but now you have a medical reason to tell your mate to get in the mood 😉

I think that these are some pretty good reasons to feel good about having sex with your partner, in a safe manner, and doing something good for your physical and mental health!  So, go show this to your partner and tell them it’s nurses orders to have sex at LEAST twice a week 😉

Yours in Good Health
B

I know that there was a video of Miley Cyrus smoking salvia that went viral a wile back, and since then I’ve been getting a bunch of emails related to salvia.  Just asking what it’s all about, if its legal, if it’s safe, and what it does to you?  Honestly, I didn’t know all that much about it until last year, and I heard about it randomly from someone who knew I was a nurse and asked me about it at a party and I was stumped!

What is Salvia?
The full name is Salvia Divinorum and it is also known as Diviner’s sage or Seers sage and is found in nature in shady, moist areas and is local to Oaxaca, Mexico.  It does have psychoactive properties and despite having a low risk potential of addiction, it as been used by Mazatec Shamans for religious purposes for hundreds of years, but is now being used by teens and young adults worldwide for a quick trip.

I have noticed for the past couple of weeks that people, including myself, have been feeling a little unwell with rather bland symptoms, and just more feeling “Blah” than anything, with a few cases of colds and GI upset here and there.  I was thinking back, and around this time of year it seems that so many people get sick, and this is the beginning of spring when we should be getting rejuvenated and renewed full of warm weather energy!

So why do we feel not so great?
There are a few theories lurking around out there and the obvious choice would be that since spring has sprung is many places, plants and trees are budding, that allergy season has started, and those of us who have allergies may be facing the very early symptoms of a loooong allergy season.  OK, I can work with that, and it isn’t completely unbelievable.

But, another working theory that scientists are looking at is the relationship between atmospheric pressure and the effects it has on the human body, more so the immune system.  I must add that it has been long known, Hippocrates 400BC first spoke about it,  that pressure changes effect people with various health issues, and anyone with arthritis or migraines can tell you that they experience changes with environmental pressures.  But this theory is that as the pressure systems change, to allow for the warmer weather to occur and the seasonal changes, it can cause delayed immune responses, thus leaving us more at risk for viral attacks.  Kind of interesting, right?  And, in all honesty, high pressure therapy has been researched in many different areas (like with cancer treatments, wound healing, etc)and it really does have varied effects on human bodies based on the pressures.  Hyperbaric Treatments have been used for years on and off for different treatments, and have shown to be helpful, but this is the first time that environmental pressure changes are being carefully looked at in association with the immune system.

What happens with high pressure?
High atmospheric pressure is usually associated with cold, dry air, and clear skies….like cool crisp fall days!  When the atmospheric pressure is high, more oxygen is allowed to enter the cells, the immune system is made stronger, small blood vessels are stimulated and have better circulating blood flow, thus allowing for appropriate immune responses.  And, many people report feeling better on these days, who knows if it is the beautiful clear skies or the reported increased oxygen in the blood, but if people feel better, it works for me!

What is different with low pressure?
Low pressures bring cloudy days with lower temperatures, but “heavy” air, meaning wet or damp, which really reminds me of most of the time I lived in Scotland (although, I must say that I LOVED living there but I don’t have any health issues that would be effected by that weather!) These low pressure systems cause swelling of joints and tissues, which cause increased pressure within the body and lead to an immediate immune response.  And some people might have their immune systems responding to new allergens in the environment due to spring.  When your immune system is already fighting off  a response (either chronic or seasonal onset), it leaves you much more at risk for infections because your immune system is “lowered”.

My own personal theory is that we also tend to get so excited for the warmer weather of spring that we tend to overextend ourselves, and if we have any allergies or chronic illnesses, they are made worse by these weather changes that occur.  What can you do?  Not really much, just be aware of the weather changes, and note how your body reacts so that you can be prepared, and maybe be extra careful around those times to stay away from people that are sick (if possible) and try to drink lots of fluids, decrease your stress levels, and don’t overextend yourself physically.

Yours in Good Health
B

I know that everyone is trying to find the next great thing in medicine that will let us all live forever and no one will ever get cancer again, but an interesting study from the University of Ohio (which was a study sponsored by the National Institute of Health) may have found that a cancer prevention has been right under our noses!!

What is the exciting cancer fighting news?
The study found that strawberries have the ability to prevent cancerous cell growth  when related to esophageal cancer, and eating freeze dried strawberries increases the cancer-fighting properties by 10 times!  Now, the esophagus is approximately 10 to 13 inches long and connects the throat to the stomach.  And, esophageal cancer is the third most common gastrointestinal cancer worldwide and the 6th leading cause of death from cancer, so this news is pretty big!

What’s the deal?
36 men and women with precancerous cells present in their esophageal tissue by biopsy, and they were given 60grams (2 ounces) or freeze dried strawberries every day for 6 months, and then were re-biopsied.  29 of the 36 participants had a decrease in precancerous cells after eating the strawberries compared to their earlier biopsy.  They used freeze-dried strawberries and find them more effective at fighting cancerous cells because the water is removed and it is just the concentrated components of the berries.

What increases the risk of esophageal cancer?
Alcohol use
Tobacco use
Diets low in fruits and Vegetables
Exposure to gases/fumes

Why is this so important?
Well, as I stated earlier, esophageal cancer is rather prevalent in todays society and anything that can help to ward off cancer is an amazing step for us as a human race.  But what’s better is that strawberries are a fruit that many people eat every single day, are easily found in cereals, frozen in the supermarket, fresh at farmers markets, and don’t interact with modern medicine (that we know of).  So you could be undergoing chemo treatments, and still have strawberries to prevent further growth of cells, as the current cells are being irradiated.

I LOVE that a readily available and relatively cheap fruit that is available year round in supermarkets all over the world have been studied and have been shown effective in reducing cancer cells.  This is not one of those claims that some rare fruit from some random area of the world, that is impossible to find, may help prevent cancer.  Obviously this study was small and it is being replicated in larger volumes now, but I thought it would be really important to get this information out to you guys, so that we can all add some strawberries to our diet!  They definitely can’t hurt (unless you are allergic!!)

So go out and get some strawberries!!

Yours in Good Health
B

I know it’s great that various Proton Pump Inhibitors (PPI’s) have become over the counter (OTC) medications that you can purchase to treat your gastroesophageal reflux disease (GERD), ulcers, and esophageal inflammation with.  But, the FDA has issued a new warning to taking these drugs long term, and it just goes to show, that even though a medication is OTC, you still should tell your HCP that you are taking medications, so they can follow-up with you for possible interactions.

The U.S. FDA has recently issued a warning that long-term PPI use causes low magnesium levels in patients.  Why is this important?  Well, low magnesium can cause muscle spasms, heart arrythmias, seizures, or be completely asymptomatic.  It is important that if you have been taking this type of medication (either OTC or prescription), under the supervision of an HCP or not, you should get some blood work done to check your Magnesium levels.  And, it is warned that patients taking this medication for a year are at higher risk, but adults taking PPI’s for three months have also had low magnesium levels.

What are PPI’s?
esomeprazole magnesium (Nexium)
dexlansoprazole (Dexilant)
omeprazole (Prilosec)
lansoprazole (Prevacid)
pantoprazole sodium (Protonix)

Does anything increase my risk?
The highest risk is taking PPI’s with other common medications such as loop diuretics (furosemide, bumetamide) and thiazide diuretics (hydrochlorothiazide, indapamide).  And, when used in conjunction with antihypertensive medications patients are at a higher risk for hypomagnesemia.  If you take any of these medications along with a PPI, you should go talk to your HCP and let them know about your risk.

If you notice any of the side effects that are listed above, notice any heart flutters, or if you are just worried about your risk, then please go see your HCP.  These medications are used pretty commonly, and more since they have become OTC medications, so I urge you to make your HCP aware of ALL medications that you take when they ask, and let them know about a possible increased risk of low magnesium levels so that you can get treated appropriately!

Yours in Good Health
B

Since there have been commercials on TV about the pertussis vaccine, I have been getting tons of questions regarding who needs it.  In the 1930’s the pertussis vaccine was  created and was mixed with a diphtheria and tetanus vaccine, thus creating the DTP vaccine and it was given widespread to Americans, and it was given in 4 doses with a 90% reduction in pertussis.  In the early 1990’s the vaccine was changed to the DTaP (Diphtheria, Tetanus, and acellular Pertussis) which is inactivated and causes less reaction with equal effectiveness.  There is also a Tdap vaccine, which is very similar but given as a one time dose to adolescents and adults requiring a “booster” or the vaccine for the first time.

What is pertussis?
Pertussis is more commonly known as Whooping cough.  It is caused by the bacteria Bordetella pertussis, that is common in the mouth, throat, and nose and it is highly contagious to those not vaccinated.  It is spread through coughing and sneezing and contaminating surfaces with the germs, and people are contagious from the time that they notice symptoms of the infection until up to three weeks after initial infection, if not treated with antibiotics.  Antibiotics can shorten the infection time to 5-7 days.

What are the Symptoms?
Symptoms are similar to a common cold with runny nose, sneezing, low-grade fever, and usually a mild persistent cough.  The cough becomes more severe in the following 1 to 2 weeks after initial onset and become rapid spastic coughing, in which there is a high pitch “whoop” while people try to catch their breath between coughs.  Some people even turn blue or vomit during episodes of coughing, then return to their baseline and are totally normal, and this lasts for 2 to 3 weeks.  Usually cough medicines are ineffective in preventing the coughing fits, and they usually occur at night with a dry throat.

Why is this a big deal now?
Well, it has just become an issue that people from all ages groups across the US (and the world) are getting infected with pertussis, because the immunity following the infection or the vaccine is not lifelong (like many other vaccines) and it is so highly contagious that it is becoming a public health problem; children are becoming infected by older adults and vice versa, and we need to prevent that!  SInce 2000, over half of the cases reported are of children under the age of 1 year old, and they are the highest risk category for death as a complication from this infection.

Who needs to be vaccinated?
All infants should get the DTap, and it is a series of shots at ages 2, 4, 6, and 15-18 months old and a fifth booster shot is recommended between age 4-6 years old.  And anyone who has not been vaccinated ages 10-65 years old should get series of Tdap (within one to two months get dose #1 & #2, doses #2/#3 within 6-12 months).  Anyone over the age of 65 that will be in close contact with small children (grandparents, healthcare workers, child care workers) should get a one time dose of Tdap. Also, Children 7-10 years old who never received a full DTaP series should be re-vaccinated.  Also, any older adult that requests a vaccination can be vaccinated.

There are minimal complications from the vaccine, such as soreness and redness at the site, but it decreases your risk of pertussis up to 90%, and it keeps children and adults safe from the complications that can occur from this infection.  If you can prevent yourself from infecting a small child with an infection that could kill them, you would.  So, go talk to your HCP and find out if you should get the pertussis vaccine and prevent the spread of this infection to the people around you and keep yourself safe!

Yours in Good Health
B

I hear so many women complain that they are overweight, that they have flab, there is something that they hate about their body, and no one else sees it except for them.  This has a medical diagnosis and it is Body Dysmorphic Disorder (BDD).  So many people suffer from this; you look at them and see a beautiful person, and they look in a mirror and see the most disgusting person ever, and it can become a total obsession, and run their lives.  And these flaws that people see in themselves can be real OR totally imagined and people will many times seek treatments to change their appearance, and they will NEVER be satisfied with how they look.  The good news?  It is treatable with therapy and cognitive behavioral therapy.

How do I know if I have it?
– Constantly looking in the mirror and checking your appearance
– Embarrassment about how you look to the point that you avoid socializing
– Constantly comparing yourself to others, and finding flaws in yourself
– Thinking about your flaws at inappropriate times
–  Seeking cosmetic procedures and treatments for flaws and never being happy with the results
– Believing that others notice your appearance in a negative way
– Needing reassurance about your looks frequently
– Extreme grooming
– Wearing excessive make-up, clothing changes frequently, to “hide” your flaws
*There is also a little self test that you can take online.

What are areas most obsessed with?
-Weight
-Nose
-Skin
-Breast size
-Wrinkles
-Baldness
-Genitalia

What causes BDD?
Culture: It can be culturally enhanced.  For example, if you work in fashion, and you are working with women that are super thin and super beautiful, you can start to think that you are obese (even when being a perfect body weight) and think that you are ugly because you are surrounded by beautiful people that are not the norm.  And if you are a male around these men with near perfect physiques, it can make you feel that your own body muscle composition is inadequate, but you are working with people who get paid to look good!
Brain Chemical Changes: Some of the neurotransmitters that change your mood, are suggested to play a role in BDD.
Genes: There are a few studies that have shown that family members of those with BDD are more likely to have it, which suggests that it can be a learned behavior (i.e. from parents to children).

Are there any risk factors?
Childhood teasing
Family members wit BDD
Low self-esteem
Cultural pressures
Having other psych disorders

So what is the big deal?
BDD can cause people to have life long obsessions that can cause a lack of intimacy in relationships (both physically and emotionally), cause eating disorders, addictions (drugs, food, etc), anxiety disorders, depression, and obsessive compulsive disorder (OCD).  These anxiety disorders and depression can lead to suicidal actions, if the person goes without treatment or help. Plus, people can put themselves at risk for infection or death every time they have unnecessary cosmetic procedures and surgeries.  And, it can cause issues with school or work because you are unable to focus on what you have to get done because you are so consumed with your “flaws”; that can have huge ramifications on your life, and all for something that can be treated.

What are the treatments?
Well, while there is no “drug” that is made for BDD, if you suffer from anxiety or depression, your HCP might choose to treat you for that, as an underlying condition, to help you get through day to day living while you undergo Cognitive Behavioral Therapy (CBT).  CBT is a type of psychotherapy where you are taught healthy behaviors (social interactions, daily behaviors) and how to avoid obsessive ones (like checking the mirror, over grooming, comparing yourself to others).  You learn about how you currently think, react, and live and learn ways to think differently so you are positive, instead of negative (i.e. looking for flaws) and how to handle your need to look in the mirror all the time, etc. CBT does take time and a lot of effort on your part, and you have to work with a therapist that you trust, and be totally invested in it, or it won’t work for you.

Along with CBT, make sure that you are living a healthy lifestyle with a good diet and exercise which came make you feel better about yourself, and physical activity can keep your mind active and not thinking about the “flaws” that you are worried about.  And, get yearly check ups with your HCP so that they can keep track of your progress, and so that they can help you to to give you a proper referral for a CBT therapist, and make sure that you are being healthy.

BDD is a disorder that so many people suffer silently with, and they think that it is normal, but but really isn’t.  Everyone has a day where they feel fat, or ugly, or wish they ad straighter teeth, better hair, more hair, better muscles, etc. but that is a passing thought on one day.  If you obsess about these things daily, and think these thoughts numerous times a day, it’s not OK and you need to talk to someone about it, preferably an HCP who can get you into the treatment that you need. You need to love yourself for everything amazing that you are, and you will find that you are so much happier with life and everything it has to offer!

Yours in Good Health
B