Category Archives: Uncategorized

Contaminated Drugs: Have you been exposed?

Posted on by

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….

Posted on by

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

 

Give a Hug to a Recovering Addict!

Posted on by

Apparently September is quite a month, as it is National Recovery Month. It is a topic very near and dear to me as some of my favorite people and good friends have been fighting addiction facing those daily challenges to stay clean.  They face constant challenges that I cannot even imagine, which is why I wanted to discuss the importance of the friends and families of addicts too, and how much your love and support can help them and assist them to stay clean and sober.

What can I do to help my recovering addict loved one?

There are plenty of resources from in-patient hospitals and rehabilitation centers available for families and loved ones that can be attended while your loved one is being acutely treated, going through the detoxification process, and learning their own coping skills to help them fight this battle. But learn from the inpatient process just as the addict is learning, about coping skills, triggers, stresses, and ways to combat them.

-Stay sober with your recovering addict friend. To show solidarity and so that they aren’t tempted to drink or do drugs.

-Help them the first few months to deal with various stressors as they are getting used to their new sober life: do they need help with scheduling child care? Paying bills? Getting a job? Any way that you can help them ease back into their lives and allow them to start taking responsibility without using drugs or alcohol, is a win for everyone involved.

-Know the signs of a relapse and pay attention.  Ultimately it is NOT your responsibility if a recovering addict relapses, but know the signs: are they secretive? Acting like they did before rehab? Shying away from you? Hanging out with the same people they did when using before? Step in and say something. Be aware of the change in behavior and talk to other friends/family members so that you are all on the same page and one united front, to help your friend.

-Don’t forget to take care of yourself and the other family members should get help as well. A lot of times people need professional counseling to work through the feelings that they had when their loved one was currently using, and then the feelings they may have once they get clean.  Sometimes couples counseling or family counseling can be really helpful for everyone to work through their issues and feelings in a healthy way, so that they can all move forward and be healthy together.

What else do I need to know?

Being aware of the need for continued counseling can help along with knowing the signs that your loved one might show when stressed and at risk for using is really key.  You don’t want to baby them and do everything for them, but it is a huge change going from a life of using drugs and/or alcohol to cope with problems, to learning to cope yourself with these life issues, so helping them through the transition period, where a recovering addict may be most likely to relapse, can be an immense help to a recovering addict.  Also, make the time to check in with them to ensure that they are coping well with their new sober life, and they aren’t tempted to use; if they are, get them safe and get help from a professional (like their counselor or Healthcare Practitioner). Knowing the signs of use or high stress can be integral in preventing a relapse, and keeping your loved one sober.  And remember, it is THEIR responsibility to stay sober, but as someone who loves them, you can help them on that journey, and a relapse isn’t a fail on anyones behalf, it is an unfortunate part of recovery.

So appreciate all of the hard work that your recovering loved one has done to stay sober and change their lives to be healthier and cope in different ways; it is a huge life transformation and a daily challenge. Give them love today and let them know how much you love them and appreciate their hard work.

Yours in Good Health

B

Use suspension to create a tighter core

Posted on by

There always tend to be these new trends in working out that are always touted as the “best” workouts, and will strengthen your core in a new and better way with less effort. Well, if it seems to good to be true, it usually is.  And that goes for workout trends as well; if you want a tight, strong body, you have to put the effort into it and lots of hard work, diet, and be dedicated to your health. I am a huge believer in mixing up workouts; I obviously am an avid runner, and work with free weights, but I also mix in hot power yoga, biking, boxing, and suspension training, whenever possible. By far, suspension training is one of my favorite quick workouts to add in after a run, which can be really hard, but so much fun, different, and makes me feel so tight.

What is Suspension Training/TRX? 

Basically, suspension training is a series of exercises done using your bodyweight along with a rope and pulley system to perform compound exercises that develop strength, flexibility, balance, and joint stability.  The exercises can be adjusted to make them more difficult or easier based on your level of fitness and comfort, which really makes it a great addition to a workout.  These types of workouts have been used by the Military for ages and it is a workout heavily utilized by many personal trainers, because you are gaining strength and muscle, by working your core muscles and various other targeted areas all at the same time; your core is always activated making it a very challenging yet rewarding workout.

Are there Pros and Cons?

Some HCPs and other sports scientists, warn those that are out of shape, or those with a poor baseline of fitness, should steer away from suspension training at first as it is a higher level of fitness, and if you do not have the strength in your core muscles you can actually do some damage to your muscles or overwork them.  I go back and forth on this: if you are new to working out, I wouldn’t suggest buying a home TRX suspension training kit and watch the DVD then rock out on your own at home, as I do think that you should be with someone who can help you with body form, adjusting the system to properly work with your body, and assist you if you have poor technique, so as to prevent injury.  If you are new to working out, go to a TRX session at your gym, or meet with a personal trainer to assist you; once you learn how to use the system and you know how you should feel and the steps to take to get stronger and be safe, you can totally do the training all by yourself.  I think that is one of the greatest pros of the system, they are small, can be packed and brought anywhere, to be used over any door- totally portable and can go with you on trips! I also love the fact that the system can be adjusted to various levels of fitness, so even people who are at different levels of fitness can work out together and merely readjust straps.

I really am a big proponent of the TRX suspension workout system; I love the results, I can do long or short workouts, target specific muscle groups along with my, and its portable so I can bring it everywhere. If you have the opportunity to try it, I suggest that you give it a roll and I would love to hear your feedback!

Yours in Good Health

Nurse Bridgid

 

Lower Your Cholesterol Levels with Food!

Posted on by

Cholesterol is always one of those buzz words that people talk about and a health issue that they are worried about. It is something that we should all be screened for, and keep in our thoughts when we eat daily. As part of a healthy lifestyle, adding certain food to our diets can help to naturally remove the “bad” cholesterol from our bodies and increase the “good” cholesterol.

What kinds of Cholesterol are there?

There are two different kinds of cholesterol: Low Density Lipoproteins (LDLs) and High Density Lipoproteins.  I think that is where most people tend to zone out!  The LDLs are the “bad” cholesterol’s that tend to build up as plaques in your arteries and increase your risk of heart attacks, heart disease, and stroke.  The HDLs actually prevent heart attack and stroke, and they are thought to bring LDL cholesterol away from the heart and into the liver to be broken down and excreted by the liver.  Your LDLs should be kept below 100 (and some HCP’s will even tell you to get them below 70).  And HDL levels should be kept above 50 (the higher the better on this one!) Also, people over 20 ears old should get checked every 5 years, and once you hit the ripe old age of 35 (for men) and 45 (for women) you should be screened more frequently, and based on your past medical history, your HCP may screen your with your annual physical.

What can I eat to decrease my LDL and increase my HDL?

There are many foods that can help boost your “good” cholesterol and help to decrease the “bad”, of course this is along with a healthy lifestyle of exercising 20-30 minutes minimum a day and, drinking lot of water, and if this doesn’t help, you may have to use medications to drop your “bad” cholesterol levels.

–Oats: two servings of oats per day have been shown to decrease LDL by up to a little over 5% in 6 weeks. It has a substance in the oats that absorb the LDLs and help you to excrete them so they don’t adhere to your artery walls.

–Red Wine: Some of the grapes used in making Rioja wine were found to have high fiber levels, and a study conducted in Spain found that people with slightly elevated LDLs had around a 9% drop in LDLs and those who entered the study with high LDLs had around a 12% decrease.

–Fish high in Omega-3 Fatty Acids: Salmon, Arctic Char, Mackerel, & Sardines are high in Omega 3’s can help to increase HDL’s by 4% when replacing other meals with proteins high in saturated fats.

–Beans: Adding 1/2 beans (black, kidney, pinto) to soup can help to decrease LDLs up to 8% because they are so full in fiber, it can help to draw the LDLs out.

–Olive Oil: It is full of Monounsaturated Fatty Acids (MUFA) that help to lower LDL levels and actually increase HDLs

–Black Tea: one serving of black tea a day can decrease LDLs up to 10% in only 3 weeks!

–Avocado: Whilst high in calories and fat, they are also full of the MUFAs, so they should be used in moderation, but a tasty treat to boost “good” cholesterol!

–Chocolate: In a large study, participants that added a serving of cocoa powder to their diet daily for 12 weeks increased their HDLs by 24%.

–Garlic: Helps top lower cholesterol by preventing LDLs from sticking to the artery walls, and it is suggested to eat 2 to 4 fresh cloves a day (but yikes, get ready for some kickin’ breath!)

–Walnuts: When eating 1.5 oz of walnuts 6 days/ week for a month, study participants were found to have a decrease in LDLs by 9.3%, but just like avocados they are high in fat and calories, so watch how much you eat, and try to stick to the 1.5oz per day.

Adding these foods to a healthy lifestyle can help to keep your cholesterol in a good, healthy range, and if you tend to eat a higher fatty diet, try to supplement a higher fat food for one of these cholesterol lowering foods.  Talk to your HCP about your risks, your current cholesterol levels, and make sure that you have follow-up cholesterol levels checked after changing your lifestyle to show improvement.  Try to add these foods and live a heart healthy lifestyle!

Yours in Good Health

B

 

Atrial Fibrillation (AFib): Symptoms, Causes, & Treatments

Posted on by

Atrial fibrillation is a very common cardiac issue, although I am hearing about more and more people being diagnosed with it, and I am getting lots of questions from readers about this diagnosis.  Again, it is very common, and I think that people should be aware of the symptoms, the causes, and the treatment of this cardiac arrhythmia (and arrhythmia is just when the heart beats at an abnormal rate or rhythm.)

What is Atrial Fibrillation?

It is an abnormal heartbeat, that can be very rapid, and lead to poor blood flow to various parts of the body, as the heart isn’t able to completely fill with blood before contracting (each beat), so only some of the blood that should be going out through your arteries to the extremities is available.  The atria (the top two portions of the heart) are beating faster and not in sync with the ventricles (the lower portions of the heart.)  Normally the Sinus Node (a group of cells in your heart) act as a natural pacemaker for you heart; it sends out a signal that passed through the atria (the upper two chambers of your heart) and causes them to contract and pump blood into the ventricles (the lower to chambers), then the signal hits the AV (atrioventricular) Node, which causes the ventricles to contract and move blood out from the heart into the extremities. in Atrial Fibrillation, the Sinus Node sends chaotic signals, so the atria are quivering in attempting to respond to each electrical signal, and the  AV Node becomes overwhelmed with the electrical signals as well, so the ventricles also beat faster than normal (though not as fast as the atria).  The normal heart rate is 50-90 and in AFib your heart rate can be as fast as 100-175 beats per minute.

It is normally not life threatening, as people live with it chronically, or they flip in and out of it, but it can have some serious complications, and if you go into a rapid a fib, you should be seen immediately by medical services, especially if you are feeling unwell, light-headed, etc.  There are various different treatments, including medications and electrical treatments.  Many people live long lives with chronic atrial fibrillation, it is just important to know the symptoms, treatments, risks of treatments, and when you should seek immediate medical attention.

What are the Symptoms?

*If you have any of these symptoms, you should be seen by your HCP to get your heart checked out and make sure that is the source.  Also, as I said above, there is paroxysmal AFib which comes and goes with symptoms, and chronic, in which your heart is continuously in this abnormal rhythm.

-Palpitations (a fluttering in the chest, rapid/racing heart rate)

-Weakness

-Lightheadedness

-Confusion

-Shortness of breath

*If you ever have chest pain along with any of these symptoms, or alone, you should seek immediate medical attention because you may be having a heart attack. Please go to the nearest emergency department or call 911.

What are the causes of AFib?

-Congenital heart defects (heart defects you are born with)

-Heart Attacks

-High Blood Pressure

-Heavy use of stimulants (caffeine, medications, tobacco)

-Heavy alcohol use

-Sick Sinus Syndrome (a defect of the sinus node where it speeds up on its own)

-Emphysema or other chronic lung diseases (like Chronic Obstructive Pulmonary Disease COPD)

-Abnormal heart valves

-Prior cardiac surgery

-Viral infections

-Sleep Apnea (where you lose your airway for short periods of time while sleeping)

-Stress from Pneumonia or other illnesses

What will put me at higher risk?

-A family history: If anyone in your family, especially a close relative has AFib, you are also at risk.

-Age: The older you are, the more increased your risk becomes. Especially if you have any chronic illnesses

-High Blood Pressure: If you have uncontrolled high blood pressure, you are at a higher risk for AFib.  If you have made the proper lifestyle changes to get more exercise, eat healthy, and take medications to treat the blood pressure, then your risk shouldn’t be increased.

-Heart disease: If you have a history of heart attacks, valvular disease, heart surgery, or other arrythmias.

-Drink Alcohol: Usually binge drinking (5 drinks in two hours) can put both men and women at a higher risk for atrial fibrillation. (take heed college students!)

What are the major Complications?

Well, one of the biggest risks is stroke. When the atria are quivering and not completely expelling all of the blood they fill with to the ventricles, the blood leftover is at risk to clot (little micro clots) and when they get ejected eventually into the blood stream, it can travel to the brain, impede blood flow, and cause a stroke (death of some of the brain cells due to a lack of blood flow.)  Also, when your heart is working so hard constantly, without treatment, it can lead to heart failure; your heart is unable to meet the demand of your body by being able to eject enough blood to get to where it needs to go.

How is AFib diagnosed?

It is early important to bring with you a list of symptoms of your HCP, when you most experience them, all of your past medical history, any and all medications you take, and be very honest with your HCP about your lifestyle (eating habits, exercise, etc.) Your HCP will take that into account when doing your physical assessment, listening to your heart sounds, and checking your blood pressure and heart rate.  You will also most likely have:

–An EKG: an Electrocardiogram which is a 12 lead assessment of the electrical impulses of your heart. 12 little stickers are placed on the skin on your chest, and little plastic/metal leads are connected, you will be asked to stay still for about 30 seconds, then a print out of your hearts impulses comes out.  It shows what is going on and is not very invasive at all, and a snap shot of your heart.

–A Holter Monitor: A monitor with about 5 leads is attached to your for 1 to 2 days, and is worn under your clothing, it constantly checks the rhythm of your heart and if you feel symptoms, you push a button, and all of that information is downloaded by your HCP so they can correlate symptoms and your heart rhythm.

–An Event Recorder: Similar to a Holter monitor, but worn for a month, and it only records when you have an arrhythmia, and it sends signals to your HCP when you have those events, and it helpful at showing when arrhythmias happen at unexpected times (like during sleep.)

–Echocardiogram: basically an ultrasound of your heart through your chest wall, there is some lubricant applied to your chest, and a hard plastic wand is moved over it to show how your heart is functioning and can give  a 3D view of the actual functioning of the heart. It can help to diagnose if you have any structural abnormalities.

–Blood Tests: your HCP will check to see if you have a thyroid problem or any other electrolyte abnormalities that would cause your heart to beat irregularly.

–Chest X-Ray: Just a quick and less invasive way to see your heart and lungs and diagnose a possible pneumonia that could cause your symptoms.

What are the treatments?

The treatments are aimed at controlling your heart rate and preventing blood clots. If you are caught quickly with the arrhythmia, you can be cardioverted (your heart rate can be attempted to be manipulated and changed) back to a normal rhythm using either electricity (you will be given sedation and get a moderate amount of electricity to shock the heart back into a normal rate)  or you can be given Intravenous medications to do the same thing  (which requires monitoring and a possible overnight in the hospital).  Before any form of cardioversion you will be given a blood thinner to prevent clots from forming and from being ejected into the blood to prevent a stroke. And you will also have to take the medications for 4-6 weeks after a successful cardioversion.  Most often Coumadin (warfarin) is used as a blood thinner, but you have to be careful, as there are MANY side effects with Coumadin (and the other blood thinners commonly used such as Dabigatrand and Rivaroxaban.)

If the cardioversion is NOT successful, you will be kept on a blood thinner and a medication to keep your heart rate 60-90 and prevent the rapid Atrial Fibrillation.  Some of the medications that may be used to rate control your heart are:

-Amiodarone (Cordarone)

-Dofetilide (Tikosyn)

-Metoprolol (Lopressor)

-Sotalol (Betapace)

-Dronedarone (Maltaq)

There are two surgical procedures that can be done that can treat AFib as well.  A radio ablation is when the HCP puts a catheter through your groin artery into your heart, and where there are areas of “hot spots” or cells that are acting like a pacemaker (like your Sinus Node), electricity is used to ill off those hot spots and cause scarring. Electrical impulses in the heart cannot go through scar tissue.  There is also a surgical Maze procedure where there are small cuts made in the heart tissue to also cause scaring and prevent the electrical impulses from causing the quivering of the atria; this needs to be done during open heart surgery so is usually down when someone is having open heart for another reason (such as valvular repair) and if they do not respond to other treatments.  These are both pretty invasive, but if you do not want to chronically be on medications or are not responsive to medications, they are great options.

How do I prevent AFib?

Some of the risks you have no control over, like family history or congenital defects, but overall, living a healthy lifestyle, eating low-fat and low sodium, and getting at least 20-30 minutes of exercise daily greatly helps you in preventing AFib.  Also, quit smoking, and don’t intake too many stimulants (maybe you don’t need that 4th cup of coffee and lay off the 5 hour energy?).  Try to limit your drink in g to 1-2 drinks per day, and just be aware of the symptoms.  If you are at all worried about your risks, or you have any of the symptoms, talk to your HCP and see if there is anything else you can do to prevent AFib.

Yours In Good Health

B

Let’s get to the bottom of hemorrhoids!

Posted on by

Hemorrhoids are something that half of all people experience, in one way or another (itching, pain, bleeding), by the age of 50.  Yikes! So let’s not go and judge everyone we know over 50 and think about what’s going on down there, ok? The good news is that there are various treatments out there, and a lot you can do to prevent them.

What are Hemorrhoids?

They are swollen and inflamed veins in your lower rectum (internal hemorrhoids) and anus (on the outside are external hemorrhoids). And the reason that these veins get so swollen and inflamed is usually due to increased pressure in your anus, from what, you say?  Well, this is one reason that you are always told not to strain when you have to poop; if you frequently strain and have to push hard to poop, you are increasing your risk of hemorrhoids. Also, the pressure in your rectum from being pregnant (the uterus pushing up against your rectum) can lead to hemorrhoids.  These swollen and inflamed veins can be quite uncomfortable, but are very treatable.

What are the symptoms?

-Painless bleeding during bowel movements

-Itching or irritation in/around your anus

-Pain or discomfort

-Small lump or bump near your anus that may be painful

Internal hemorrhoids that you cannot see or feel, are usually pretty innocuous, until you strain when having a bowel movement and see blood on your stool or the toilet paper when you wipe. External hemorrhoids are the ones that usually cause discomfort and you have actual symptoms.  If you have large amounts of blood coming from your rectum with stool, or blood consistently with very bowel movement, it is very important to go see your HCP because rectal cancer and other tumors can also have that symptom, so you want to get checked out before assuming it is a hemorrhoid. Also if your stool is black/tarry, has a strange odor, or you feel light-headed/faint frequently, seek immediate medical assistance because you may have internal bleeding.

What causes hemorrhoids?

-Straining with bowel movements

-Anal sex

-Pregnancy

-Obesity

-Constipation

-Chronic diarrhea

With these as a part of your history, along with a digital rectal exam and a visual exam of your anus and rectum your HCP can usually make a diagnosis.  If you are over 50 o have a high risk for colorectal cancer, your HCP may send you for more extensive testing, like a colonoscopy (a visualization of the entire colon).

What are the Treatments?

Over the counter (OTC) treatment, like preparation H, can help with itching, pain, etc at the site and should not be used for more than a week. You can also sue cold packs to the area to decrease pain, and use OTC pain relievers (like ibuprofen), and take warm water soaks for 10-15 minutes a couple of times a day, which helps with many people to relieve symptoms.  If you have continued pain or discomfort, your HCP can use rubber band ligation in which they use little rubber bands around the base of the hemorrhoid, thus tangling it, and it eventually withers and falls off. They can also use sclerotherapy, in which a chemical is injected into the hemorrhoid to shrink it.  If these therapies to do not work or there is recurrence, you can have surgical removal or stapling of the hemorrhoid, which has a longer recovery time, but can be moe effective for larger hemorrhoids.

How to I Prevent hemorrhoids?

Well, keeping a healthy active lifestyle can help with prevention of hemorrhoids, working out and staying active, trying not to sit for long periods of time and drinking plenty of water and eating a high fiber diet (whole grains, prunes, etc.), will definitely help! Also, when you feel like you have to poop, go! I know a lot of men who like to wait for a while….not a good idea.  If your body is telling you that you need to poop, then poop! When you don;t have hemorrhoids, you’ll thank me!

So keep up that health lifestyle, poop when you need to, and your bottom will be happy and healthy for years to come!

Yours in Good Health

B

Sickle Cell: Who is at risk?

Posted on by

September is National Sicle Cell month, and it is one of those diseases that people tend to know a little bit about but don’t really understand the full extend of the disease, who usually has the disease, and what the implications are.  And after a few questions from readers, I figured, why not highlight it and give some insight.

What is Sickle Cell Disease?

Sickle cell is a trait with the red blood cells due to a gene mutation in the hemoglobin, the red blood cells, instead of being circular, are in an abnormal and rigid “sickled” shape. It is an autosomal recessive genetic blood disorder, which causes the cells to become rigid and can cause tons of complications, especially when a person goes into “crisis”. So it is present at birth, as it is a genetic mutation, but most people aren’t diagnosed until after 4 months of age, and it does decease your life expectancy to around 50-ish years of age for both men and women.

Who is at Risk?

Sickle cell is actually a genetic mutation that the body created to prevent malaria infections. Thus, people from tropical and subtropical areas where malaria is a high risk, also those whose family/heritage is from that area can also have the genetic anomaly.  Approximately 1/3rd of all people in Sub Saharan Africa are affected by sickle cell, and 1 in 500 African-American children born in the US will also carry this trait.  If you have sickle cell, and are infected with malaria, due to the shape of the cells, the malaria infection is not  as significant as the malaria parasite lives a part of its life in the red blood cells, so you can live longer with malaria and not face as many of the side effects.

What are the Symptoms/Side Effects?

As I mentioned above, there is such a thing as sickle cell crisis, and honestly it can be one of a few reactions, usually brought on by stress or exposure to the cold, and the crises last for about 5-7 days and cause extreme pain, leading to frequent hospital stays for treatment.

–Vaso-occlusive crisis: When the sickle shaped cells obstruct blood flow in the capillaries (the very small blood vessels that come off of larger vessels), which causes swelling, pain, and can cause cellular death leading to death of the skin in the area from lack of blood flow. This can happen anywhere in the body, but men beware, this can happen in the penis causing priapism which is a medical emergency (it needs to be treated so you don’t have tissue death in your penis).

–Splenic sequestration crisis: The spleen is the organ where it basically filters out old blood cells and is a storage for red cells. Thus, you can see that it would be a high risk organ to be affected by the sickle cells. It is an acute enlargement of the spleen, which is very painful and causes a rigid abdomen, it is also a medical emergency and most often a splenectomy is required to treat the problem.  This usually happens to children with sickle cell, and they are then required to take preventative medications to stave off infections and have a very strict vaccination regimen.

–Aplastic anemia/Heamolytic crisis: A worsening of the baseline anemia that patients with sickle cell have.  anemia is having low hemoglobin levels (or low blood levels). The patient will most often have trouble breathing (low blood levels means less hemoglobin for oxygen to bind to so you need to put more work into breathing to get enough oxygen to your organs), also the are very pale, and they have very low energy. This crisis may require a blood transfusion for treatment.

Due to these various crises, there are long-term complications that can occur, such as: chronic pain, leading to opiate addiction, renal failure insufficiency (clotting in the renal tubules), stroke, transischemic attacks (TIA’s: like a mini stroke with resolving symptoms but can cause long-term brain damage), mini clots in the vessels leading to the eyes causing blindness, pulmonary hypertension which can put undue stress on the heart and lead to heart failure. There are many other complications as well.

 Are treatments available?  Prevention?

Really all the treatments are supportive treatments to make the patient comfortable while having the pain and until the crisis is over. Nothing will make sickle cell go away, it is a genetic mutation that you have for life.  And because it is a genetic disease, you can not prevent it BUT if you are at risk as a carrier, you can get genetic testing for you and your partner, to find out what the risk would be for your offspring. It truly can be a devastating disease, very painful, with frequent trips to the hospital and long stays. Learning to live with the disease and what your particular triggers are (working with your HCP) will help to make managing the disease easier and lead to fewer complications.

Yours in Good Health

B

Antibiotic Resistant STD’s: Our Reality

Posted on by

In this day and age where HIV is thought of as more of a chronic disease than a fear of certain death, and adolescents are having sex at earlier ages and using less protection, sexually transmitted infections (STIs) are on the rise. There is a common misconception that every STI can be easily treated with antibiotics, so if you catch something from some random partner, no biggie, get some pills from your HCP and in 7-10 days you are good to go again.  WRONG! Thinking like that has caused and overuse of antibiotics for STIs which has led to antibiotic resistant STIs and the most common one is gonorrhea, which also happens to be one of the more frequently transmitted STIs. There are 600,000 new cases of gonorrhea documented every single year in the US alone (per the Center for Disease Control and Prevention).

Is gonorrhea harder to treat now?

So the Center for Disease Control and Prevention (CDC) has been tracking Neisseria gonorrhoeae since the mid 1980’s because it was an infection that was treated easily as it responded to many different antibiotic groups and regimens, unlike most bacteria.  It was officially monitored in 1986 as the Gonnococcal Surveillance Isolate Project (GISP) to look at patterns of the infection, treatment responses, and to make recommendations for treatment.  In 2010, the data that emerged was that 27.2% of all cases of gonorrhea in the US were resistant to one of the common treatment antibiotics: penicillin, tetracycline, and ciproflaxin.  Another approximately 7% were resistant to all three antibiotics in combination. Now in 2012 the recommendations are for a combination of two different antibiotics to cover all of the bacteria; but w need to remember that along with antibiotic resistance in bacteria, humans also are becoming more allergic to antibiotics, so while we can can create antibiotic “cocktails” to kill off these bacteria as they become more resistant, the other challenge becomes what we are able to give to patients based on their allergies.  It can become quite difficult to treat these bacteria.  The big fear is the cephalosporin resistant gonorrhea, in which strains have been found in other countries but we have not had any documented cases in the US.  We have very few, if any, currently FDA approved drugs to treat that strain, as cephalosporins are very powerful in treating gram positive and gram negative bacteria.  There are drugs in other countries that are used to treat this strain, but they have not been proven safe or effective by the US FDA.

Is it Rampant?

Various strains of antibiotic resistant gonorrhea are found readily throughout the US and worldwide, and at this point we still have antibiotic combinations that we can use to treat the bacteria.  The big fear by HCPs is that the more resistant strains will be brought from other countries and into ours, thus spreading further, and we do not have adequate drugs to treat this strain.  It is a bigger and bigger threat the more these gonorrhea infections keep spreading.

What are the symptoms of gonorrhea?

It can be a silent infection, usually affecting women’s cervix and if left untreated then moving into the uterus and fallopian tubes, which can lead to infertility.  Some other symptoms for women are:

-abnormal bleeding

-burning when urinating

-heavy vaginal discharge (may have a strong odor)

-general irritation of the outside of the vagina

Again, for men the symptoms may be silent, and are usually only visible in approximately 20% of cases.  For men, symptoms include:

-discharge from the tip of the penis

-frequent urination with blood present

-a burning sensation with urination

-a swelling of the glands in the groin

-the tip of the penis may turn bright red

*If the symptoms are in the rectum or throat, pain, swelling, and discharge most often occur.

What can I do to prevent it?

To prevent getting these strains of gonorrhea, you need to protect yourself from getting any STI:

-Abstain from sex

-Practice safe sex, use condoms (and/or other barrier methods) with vaginal, anal, and oral sex.

-Only have sexual intercourse in a monogamous relationship

Also, get tested regularly for STIs and encourage your partner(s) to do the same.  You need to look out for yourself and protect yourself.  No one is worth doing permanent harm to your body and reproductive organs, right?  So look out for yourself, and empower yourself by getting frequently tested, and encourage others to do the same, along with practice safe sex. Talk to your HCP about your risk, how often you should get tested, and if you are allergic to antibiotics, what your treatment options are.  So be safe and stay clean!

Yours in Good Health

B

What is effective in helping you lose and keep that weight off?

Posted on by

The hardest part of weight loss, is not actually losing the weight itself.  I know that sometimes people look at it as an uphill battle, but as long as you make lifestyle changes i.e. become determined to exercise so many days a week, or no longer eat fast food, cut out butter, etc. Whatever the lifestyle choice you make, it should be towards a healthier you, and that will help you lose weight.  The more changes you make and the more determined you are to eating healthy and working out, the more weight you will lose and your body will change (for the better).  You look great, feel great, and everyone tells you how amazing you look; the world is amazing!  Then the tough part, getting to your goal weight and staying there.  Everyone has that time where they look and feel great, so they think they can “cheat” here and there….and then the weight that was long gone, is now back, and you are totally bummed, mourning that slimmer, toned body from a few weeks/months ago.  But there are some ways to off-set that downward slope, and technology has made it easier and easier for those of us on the go!

How do we keep that weight off?

Well, first of all, you have to stick to those lifestyle changes that helped you lose weight. You can allow yourself “cheat” meals or days BUT you have to offset those days by being really strict with yourself the other days.  If you go back to your previous lifestyle, you will eventually go back to your previous weight; it’s as simple as that.  I do understand that it is still tough to sink into your old ways, so set new goals for yourself, not necessarily weight loss, but toning goals, improve your speed in walking/running/biking, or learn a new sport like boxing, golf tennis, etc.

For some people they feel like that is just too much to learn something new, or they cannot push themselves to keep up the momentum to work out, and the good news is that there are other options.  Some people have the means to pay for (and the time to go to) one on one nutritional counseling or personal training to meet their needs.  Some of us don’t; we barely have the time to fit in our workouts and healthy lifestyle choices.  For those that don’t have the time, there are electronic medias that can do the same thing! Research has shown that those who need help sticking to their healthy lifestyle choices and need that extra push to meet their goals, that one on one is the best form of check in and people have the highest percentage of keeping weight off, but it is closely followed by people who use online weight management systems. Mostly they work because, while you do have to be self-directed, it can be everywhere you are…on your smart phone! There is no excuse other than you….the push you need is right at your fingertips!

What are some of the trainers/nutritionist websites?

Some are free, some aren’t; what’s important is that the program suits your needs and will be something that you will stick with!

Nike Training Club– (an app for a smart phone)

Fitclick.com

fitday.com

sparklepeople.com

Jillianmicheals.com

ediets.com

youronlinefitnesstrainer.com

It’s pretty cool that in our fast paced lives, we can still have that push and feel of a trainer and nutritionist while we are on the go!  Depending on the site, you can log you calories/meals, and log workouts, so that you can see how healthy your day is….sometimes it can be tough to tell and you think you have been eating well, but don;t realize all the calories you have taken in.  So this is a check for you, just like any other food diary, but it is quick to log (at you fingertips!) and will calculate your caloric intake! You can’t lose…unless you cheat yourself, and then there are no winners.

So, set your goals, you know what they should be, to be a healthier and better you, and use our electronic resources to assist you in meeting your goals in losing that weight, and keeping it off!

Yours in Good Health

B