Health

Health (116)

This week the CDC reports a 5th pediatric flu death as we face a season, many have predicted, to be “severe.”

And in previous years, once healthy children and young adults fell victim to severe circulating flu strains  prompting parents this year to fear the worse when it comes to theirs or their child’s flu symptoms.

Who can blame them. Flu symptoms can last up to 2 weeks, and most patients are told to go home and rest as antibiotics do not help fight the flu and symptoms will usually “resolve on their own.” This is true, but then why are some people..healthy people…dying?

What are the symptoms of the flu?

To understand why people are often misdiagnosed for flu-related illness when something even more serious is occurring, let’s first list the common symptoms of the flu.

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Rapid Breathing
  • Rapid Heart Rate
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

As opposed to a cold, in which symptoms are less severe and come on more slowly, the flu seems to hit you within hours.   The fatigue may be the first symptom, followed by body aches, scratchy throat, cough, runny nose and fever. The fever could range anywhere from 100 – 106 F.  The fever usually lasts 2 days and the majority of those affected by the flu will average symptoms from 3-5 days.

How can you die from the flu?

There are multiple ways to die from the flu.  The most common cause is pneumonia.  A secondary viral or bacterial infection can affect the already weakened lungs.  Pneumonia can be deadly, especially if untreated. Symptoms of pneumonia are very similar to the flu:  shortness of breath, cough, fever, fatigue, body aches, etc.

Respiratory failure from inflammation can be fatal as well. The flu virus affects the respiratory tree causing acute inflammation and distress of the tissues whose job is to bring oxygen to the blood. Additionally, other organs including the heart may become inflamed, impeding their duties.

Flu can increase one’s risk of heart attack and stroke. A study in 2007 found coming down with the flu doubled one’s risk of heart attack and stroke.

Moreover, having the flu could worsen any disease states already being battled. Hence a diabetic, if suffering from the flu, may struggle to control his blood sugar numbers.

Rarely, some may go into multi-organ failure as a result of septic shock initiated by the flu.  This is what killed 21-year-old bodybuilder Kyler Baughman.

 

kyler-baughman-1.jpg

21-YEAR-OLD ATHLETIC TRAINER KYLER BAUGHMAN DIED DAYS AFTER FEELING FLU-LIKE SYMPTOMS

But one risk that doesn’t get discussed as much as it should is coming down with an illness during flu season and being mis-diagnosed, a “guilty by association” picture.

Four days before her death, 12-year-old Alyssa Alcaraz was sent home by an urgent care with a flu diagnosis when in fact she had a strep infection in her blood that put her into septic shock.

 

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12-YEAR-OLD ALYSSA ALCARAZ WAS DIAGNOSED WITH THE FLU WHEN SHE IN FACT HAD A STREPTOCOCCAL INFECTION.

How will I know when the flu is turning deadly?

Since symptoms of the flu start to resolve in a couple of days, any symptoms beyond those few days should spark suspicions.  These can include:

  • A fever that does not subside
  • A fever that returns, recurring fever
  • New symptoms forming such as weakness
  • Confusion
  • Delirium
  • Dizziness
  • Unable to keep fluids down
  • Dehydration
  • Chest pain – could signify pneumonia or heart involvement
  • Bluish lips or skin
  • Difficulty breathing
  • Worsening cough

Understanding what the flu virus can affect and not underestimating its severity is paramount in preventing flu fatalities.  If symptoms start improving after 2 days it’s a great sign!!  However, any symptoms that either do not resolve, lag on for days, evolve into something worse, or recur are red flags that something more than the flu could be going on.

Most importantly, if one has not been vaccinated yet against the flu, they should still consider getting the flu vaccine.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Two new cases of “smartphone blindness” has been described in the last month.   One case was a gentleman in China who was playing games on his phone at night and suffered a retinal artery occlusion or “eye stroke.” Another case was a woman in China, who was also playing on her phone at night but she sustained a bleed in her left eye.  Just as those who suffer from cerebral strokes, a “lack of blood flow” to the retina, or layer of the eye that helps create visual images, can be caused by a clot or hemorrhage.  Apparently these can be induced with excessive focusing and eye strain. This may result in temporary or permanent blindness.

UPDATED FROM JUNE 23, 2016

Some people are being evaluated for stroke or transient ischemic attacks when they come to the ER complaining of recurrent “temporary blindness” after checking their smartphone in the dark.  This phenomenon, known as ‘smartphone blindness’, has been experienced by many of us when we have the sensation of dimmed vision or poor visual acuity, feeling punished for peeking at our email when we should be sleeping.

 

In 2016, doctors reviewed the cases of two women who experienced episodes of “temporary blindness”; as the ladies put their cell phones down, one eye could not see the cell phone for 15 minutes.  Their vision restored after this length of time.Doctors investigated the cases thoroughly with a variety of medical tests including MRI’s and couldn’t find the cause.

Finally they conclude these transient episodes of “vision loss” were harmless, in that one eye was being used to look at the phone and the other eye needed time to “catch up”.  When the women, as many of us do, check our phones, one eye is snugly closed and resting on a pillow while the other is available to look at the phone.  When the ladies would turn over, the closed eye didn’t have a chance to catch up to the increased brightness of the phone screen, hence having a dimmed view.

If one uses both eyes to look at the screen, this phenomenon does not happen.

Smartphone Blindness Studies Are Cause For Concern

Studies surfaced a few years ago where great lengths of smartphone use can cause retinal detachment.  In these cases the layer of the retina which focuses images, detaches from the back of the eye, causing serious vision loss.  Though there are treatments, if not treated early can cause permanent blindness in the affected eye since the retina loses its blood and oxygen supply when detached.  A woman from China had been using her smartphone for 2-3 hours in the dark each night when this occurs.

Smartphones have also been linked to myopia, nearsightedness and sleeping disorders as the blue light emitted from the screen can disrupt melatonin production.

A recent study found that 30% of adults spend more than 9 hours a day using their smartphone. Physicians recommend avoiding extended use, adjust settings to black text on white background, and with this recent case study, use both eyes to look at the screen when using the phone at night.

Increasing the size of the font helps your eyes since they don’t need to strain as much to read.  Try to look at your smartphone with a distance of 1 1/2 feet. Blinking often helps rest the eyes as well and keeps them lubricated and moist.

Additionally, avoid using the phone in the dark, but in a lit room. 

Finally its good to use the 20,20,20 rule.  After every 20 minutes of use, look away at something 20 feet away for 20 seconds.  This may help avoid eye strain from excessive smartphone use.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Wednesday, 13 November 2019 18:35

Tips to help you stop smoking & vaping.

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Some of you are trying to get a head start before the family makes you come up with a New Year’s resolution to quit vaping and smoking. So you’ve cut back on tobacco and nicotine and have decided to quit.  Awesome! Within the first half hour of quitting, studies have found your blood pressure and heart rate improve, so your health starts to improve immediately!

So, way to go!!!!  But now what?  It’s not that easy.  You’ve got cravings.

Not being able to manage these cravings can put you at risk of relapsing back into nicotine dependence.

Withdrawal from nicotine can manifest in any of the following:

  • anxiety
  • depression
  • cough
  • sore throat
  • headaches
  • hand tingling
  • increase appetite
  • sleep disturbances
  • constipation
  • mood changes
  • poor concentration
  • memory loss

and more.

Firstly don’t be afraid to get help if you need to.  Nicotine is a powerful, addictive drug and retraining your body to not ask for it is a challenging process.  Smokefree.gov offers multiple resources to help one quit smoking/vaping.

Your medical provider can offer you nicotine replacement therapy to help you wean slowly, or medications such as (brand names) Chantix and Wellbutrin that can help you with your cravings as you cut back or quit.

Therapy and counselling can also be very beneficial while you are weaning off nicotine.

But some of you will want to quit cold turkey.  How do you manage the cravings then?

So we break this down into biological and psychological factors.

Biologically, we can hit this a few ways.  One, is the food choices you make can help with your cravings.

Vegetables like celery and carrots are great quick-to-grab veggies when you’re in a bind. Citrus fruits like oranges work well. Bananas with their vitamin B and potassium melt in your mouth and don’t leave room for a cigarette. Potatoes have potassium and when not loaded up with butter and cheese are….well… not as yummy.

Peppermint is good at curbing cravings, so when you’re walking out of a restaurant don’t forget to grab some of those free candies sitting there. Ginseng and ginger help with cravings as well, and don’t forget fiber.  Stuffing your mouth with oats, bran and fibrous foods keep you so busy trying to pick them out of your teeth that you are too exhausted to smoke.  Top all of this with lots and lots of water, and you’ll find yourself off the nicotine in no time.

Let’s celebrate.  Some one grab me a beer….no wait! No alcohol!  Alcohol fuels your cravings as does meat and caffeine.  Sorry, I never said it would be easy.

Exercise also helps because it will help you keep busy, increase your endorphins and works on the weight gain that might accompany smoking cessation.  Take a nice stroll every time you feel the need to grab a cigarette.

Which transitions nicely into psychological ways to quit.

Distraction is huge.  As the cravings come on, distract yourself by exercise, reading, dancing, or writing about your journey towards a smoke-free life to help others.

Have index cards written out with reasons to quit.

Have a disgusting picture of tobacco-destroyed lung in the kitchen or wherever you get the urge to smoke.

And get your friends and coworkers on board to help. If they vape/smoke in front of you, it will make it that much harder.  Have a friend, family member designated as your support guide who texts you encouraging messages throughout the day as you try to quit. Remind them that the content cannot include chores or reminders to pick things up on the way home.  There……if these tricks don’t help you quit vaping/smoking, at least you can use them to get out of chores…..

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

A form of diabetes, having features that overlap with both Type 1 and Type 2 diabetes, has been given the name, Type 1.5 Diabetes. Researchers suggest that Latent Autoimmune Diabetes in Adults (LADA), may comprise 10% of the diabetic population, and require insulin treatment be instituted earlier than in those previously diagnosed with Type 2 diabetes, because they may have an autoimmune etiology (seen in Type 1 diabetics)…… hence a Diabetes Type 1.5.

Type I vs. Type II vs. Type 1.5 Diabetes

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance. This is the fastest growing type of diabetes in both children and adults.

So Type 1.5 Diabetes may develop after childhood, as a working pancreas may, during adulthood, become damaged by the body’s immune system or, suggested by some, a virus.  Those with Type 1.5 diabetes therefore may not be obese, may have had difficulty managing their blood sugar by diet and exercise alone, and may need assistance with insulin supplementation.  If medical providers don’t recognize this early, and appropriate treatment is delayed, a patient may suffer multiple health issues and risks the longer their blood glucose levels are uncontrolled.

What is Diabetes?

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly. When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function.  They get absorbed in the small intestine and make it to the bloodstream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter. Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.

Diabetes Explained

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell. Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce.  The kidneys are going to want to dump the excess sugar, so to do so, one would urinate more, again causing thirst.  So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Complications of Diabetes

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.

Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.

What is insulin resistance?

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic.  Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl.  If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.

 dmp-blood-sugar-levels-chart

SOURCE DIABETESMEALPLANS.COM

Preventing/Controlling Diabetes

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.

For more information, visit http://www.diabetes.org/.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

The FDA has disclosed a new E. coli romaine lettuce outbreak, that has supposedly ended.

23 people from 12 states have become ill due to this recent outbreak of E. coli. 

No deaths have been reported.

The Shiga toxin-producing E. coli O157:H7 sickened 23 people and hospitalized 11 between the dates July 12 and September 8th, with cases occurring in Arizona, Florida, Georgia, Illinois, Maryland, North Carolina, Nevada, New York, Oregon, Pennsylvania, and South Carolina, with the majority of cases in California.

The FDA emphasizes that they believe the outbreak is over.  However many wonder why they this wasn’t disclosed earlier.

The CDC did appear to begin its investigation earlier this Fall, and forward their concerns to the FDA, but jointly the disclosure didn’t come until now.

 
 
On their website, the FDA reports the following:
 
TODAY, THE U.S. FOOD AND DRUG ADMINISTRATION IS SHARING NEWS OF A RECENT E. COLI O157:H7 OUTBREAK, INVOLVING 23 ILLNESSES, THAT WAS LIKELY ASSOCIATED WITH ROMAINE LETTUCE. NO DEATHS WERE REPORTED. THE ACTIVE INVESTIGATION HAS REACHED ITS END AND THE OUTBREAK APPEARS TO BE OVER. THE FDA AND THE U.S. CENTERS FOR DISEASE CONTROL DID NOT IDENTIFY ACTIONABLE INFORMATION FOR CONSUMERS DURING THIS INVESTIGATION. ADDITIONALLY, WHEN ROMAINE LETTUCE WAS IDENTIFIED AS THE LIKELY SOURCE OF THE OUTBREAK, THE AVAILABLE DATA AT THE TIME INDICATED THAT THE OUTBREAK WAS NOT ONGOING AND ROMAINE LETTUCE EATEN BY SICK PEOPLE WAS PAST ITS SHELF LIFE AND NO LONGER AVAILABLE FOR SALE. THE FDA IS COMMUNICATING DETAILS ABOUT THE OUTBREAK AT THIS TIME TO HELP ENSURE FULL AWARENESS BY THE PUBLIC AND TO HIGHLIGHT THE ONGOING IMPORTANCE OF INDUSTRY ACTIONS TO HELP ENSURE THE SAFETY OF LEAFY GREENS. FEDERAL HEALTH OFFICIALS DO NOT BELIEVE THERE IS A CURRENT OR ONGOING RISK TO PUBLIC HEALTH.
CDC NOTIFIED THE FDA OF THIS ILLNESS CLUSTER IN MID-SEPTEMBER 2019 AND THE AGENCY PROMPTLY INITIATED A TRACEBACK INVESTIGATION. THE FDA, CDC, ALONG WITH STATE AND LOCAL PARTNERS, INVESTIGATED THE ILLNESSES ASSOCIATED WITH THE OUTBREAK. A TOTAL OF 23 PEOPLE INFECTED WITH THE OUTBREAK STRAIN OF E. COLI O157:H7 WERE REPORTED FROM 12 STATES: ARIZONA (3), CALIFORNIA (8), FLORIDA (1), GEORGIA (1), ILLINOIS (2), MARYLAND (1), NORTH CAROLINA (1), NEVADA (1), NEW YORK (1), OREGON (1), PENNSYLVANIA (2) AND SOUTH CAROLINA (1). ELEVEN PEOPLE WERE HOSPITALIZED AND NO DEATHS WERE REPORTED. ILLNESSES STARTED ON DATES RANGING FROM JULY 12, 2019 TO SEPT. 8, 2019. NO ILLNESSES WERE REPORTED AFTER CDC BEGAN INVESTIGATING THE OUTBREAK ON SEPT. 17, 2019.
INVESTIGATORS WERE SENT TO VISIT FARMS LOCATED IN CALIFORNIA’S CENTRAL COAST REGION WHICH WERE IDENTIFIED THROUGH THE TRACEBACK INVESTIGATION. THEY COLLECTED AND TESTED MANY ENVIRONMENTAL SAMPLES, AND THE OUTBREAK STRAIN WAS NOT IDENTIFIED. WHILE ROMAINE LETTUCE IS THE LIKELY CAUSE OF THE OUTBREAK, THE INVESTIGATION DID NOT IDENTIFY A COMMON SOURCE OR POINT WHERE CONTAMINATION OCCURRED. SINCE THE OUTBREAK STRAIN WAS NOT DETECTED IN SAMPLES COLLECTED FROM FARMS DURING THE TRACEBACK INVESTIGATION, AND THERE HAVE BEEN NO NEW CASES SINCE SEPT. 8, 2019, THE OUTBREAK APPEARS TO BE OVER.
THE FDA REMAINS COMMITTED TO IMPROVING THE SAFETY OF LEAFY GREENS AND TRACEABILITY FROM FARM TO FORK.

Symptoms of E. coli poisoning can occur anywhere from 1-10 days after ingestion.

They include:

  • Nausea
    Vomiting
    Diarrhea, may be bloody
    Fever
    Chills
    Body Aches
    Abdominal Cramps

And if progresses, can cause

  • Shortness of Breath
    Nose bleeds
    Anemia
    Dehydration
    Seizures
    Renal Failure
    Death

Exposure to E. coli may occur from exposure to contaminated foods (from human or animal waste) or undercooked meats.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Thursday, 24 October 2019 16:44

The perils of medical care bureaucracy

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The high cost of medical care is on the lips of every politician and draining the pocketbooks of most Americans. After creating the Medicare/Medicaid monster, the government’s expanded intervention into the medical care marketplace with the inaptly named Affordable Care Act doubled the premiums and deductibles for both employer-sponsored and individual insurance. Piling on more laws, regulations, and agencies is not the answer.

Anonymity, complexity, and opacity invite shady behavior. Individuals, companies, and patients who defraud the massive federal “health system” would never dream of lifting money from their patients’ wallets or stealing from their doctors’ cash drawer.

The government’s track record does not bode well for imposing more bureaucracy to remedy a problem created by the layers of third-party payer bureaucracy. Waste, fraud, and abuse are so rampant that the government has a Medicare Strike Force to root out and recover lost federal funds. Medicare fraud—about $60 billion in 2016 alone—is about 10 percent of Medicare’s total payments. By contrast the typical private business loses 5 percent of its revenues to fraud. Unfortunately, since its inception in March 2007, the Medicare Strike Force has recouped less than $2 billion per year in misappropriated funds.

Medicare’s $16.7 billion per year hospice program is fertile ground for the unscrupulous. Hospices are paid a fixed daily sum for each patient enrolled “regardless of the services provided.” One amoral scheme recruits patients who unknowingly forgo curative treatment options by joining hospice. A recent Office of Inspector General (OIG) report revealed that in 2012 hospices billed Medicare more than $250 million for services to patients in long-term care or assisted-living residences who did not require hospice care, costing four times more than the appropriate level of care. Even worse, the OIG found that the quality of care suffered in 31 percent of programs. The bureaucratic morass allows the perpetrators to pocket the fixed fee and skimp on the services.

Further, the government cannot keep track of its program dollars. According to another OIG audit, in 2009, Medicare Prescription Drug program paid $33.6 million and hospice patients paid $3.8 million for medications that should have been included in the hospice daily fee. Even after discovering the snafu, the problem got exponentially worse. In 2016 the government paid $160.8 million for drugs that hospice organizations should have paid for from its fixed daily fee. Our tax dollars paid for the drugs twice.

Physicians know what patients want and are acting on it. Free from the restraints of government “healthcare” programs, the physician-led, price-transparent, direct-pay Surgery Center of Oklahoma performs some surgeries for less than the copays of some insurance policies. Direct Primary Care physicians provide 24/7 access and basic labs for as little as $50 per month with at-cost medications and low-priced x-rays.

The corporate private sector has learned a thing or two from innovative physicians. Care Accelerator is Sam’s Club’s version of “affordable [medical care] options with transparent pricing.” To offer relief from high out-of-pocket costs, $50 (individual) to $240 per year (families) buys access to lab screening for diabetes and heart disease, free generic drugs, telehealth, and up to a 30 percent discount on vision, dental, and other ancillary services. Additionally, Walmart is training its own employees for jobs in the health sector and ideally to staff Walmart’s own medical services. For their employees, Apple has “health care built around you” with its AC Wellness that offers office and home visits; Amazon launched its Amazon Care telemedicine services.

Given the outrageous price of drugs—largely due to the pharmacy benefit manager middlemen—Good Rx discount coupons are just what the doctor ordered. Good Rx is free to the consumer and makes money from advertisements on the website and referral fees. One typical victory is a Medicare patient whose neurologist prescribed a drug for his Parkinson’s disease symptoms. The government demanded testing that could not be done because of the patients debilitated condition. Despite a sympathetic ear and supporting research, the government arbiter could only parrot the party line: because the drug was not on the “list,” it was not covered by Medicare. In a fortunate twist of fate, with a Good Rx coupon the patient paid $34 per month cash instead of the drug’s $1,100 per month price with 20 percent patient co-pay that would have been charged through the Medicare Prescription Drug program.            

Congress claims it plans a full-frontal attack on the high cost of medical care (with the same results as the war on poverty and drugs?). Frankly, we are better off with Congress engrossed in its impeachment clown show and keeping its nose out of our medical business.

 

Dr. Singleton is a guest columnist. Her opinions are her own. Dr. Singleton is a board-certified anesthesiologist. She is Immediate Past President of the Association of American Physicians and Surgeons (AAPS). She graduated from Stanford and earned her MD at UCSF Medical School. This is an edited version of her column that originally appeared on pennypress.com. Reprinted with permission.  

The CDC reported this week that teen suicide rose 58% over the years 2007-2017 in the age group 10-24.  Although many experts blame social media and teen drug use, one theory may need to be considered:  nicotine withdrawal from vaping.

Millions of middle school and high school students admit to vaping…and many more are assumed who don’t admit to it when surveyed.  So we have an underestimation of how many adolescents take regular hits of their electronic cigarette, exposing them to the powerful, addictive nicotine. One pod, placed in an electronic cigarette to be vaped, contains as much nicotine as a pack of cigarettes.  Hence if a pod is smoked at school, and when the child is home goes hours without, they may “come down” off the nicotine high that they had hours earlier.

In 2002 Picciotto et al discussed how nicotine can affect mood swings, anxiety and depression, where in some cases it can act as an antidepressant but when one withdrawals from it can have increased and anxiety and depression.

The teenage mind and psyche is still developing during this time and a chemical dependency could muddy the mental health waters.

There’s no doubt social media and the misconception teens have that their lives are not as glorious as those who they view online is contributing to lack of confidence, poor self-esteem and depression.  But the decision to commit suicide may also be chemically induced, or a withdrawal of one and should be investigated.

Vaping Linked to Heart Disease and Cancer

A study from New York University found the nicotine in electronic cigarettes to cause DNA damage similar to cigarette smoking.

Dr. Moon-shong Tang and his colleagues exposed mice to e-cig smoke during a three-month period, 5 days a week for three hours a day.  They found these mice, compared to those breathing filtered air, to have DNA damage to cells in their bladders, lungs and hearts. The amount of nicotine inhaled was approximately 10mg/ml.  That dose would be commonly consumed by many humans who vape.

 

nicotine.jpg

 

They then looked at human bladder and lung cells and found tumor cells were able to grow more easily once exposed to nicotine and vaping chemicals.

Last May, researchers from Vanderbilt-Ingram Cancer Center in Nashville found e-cig smoke to increase one’s risk of bladder cancer.

In 2015, the University of Minnesota identified chemicals commonly found in e-cig vapor to include:

  • Formaldehyde (human carcinogen)
  • Acetaldehyde (carcinogen related to alcohol drinking)
  • Acrolein (highly irritating and toxic)
  • Toluene (toxic) NNN, NNK (tobacco carcinogens related to nicotine)
  • Metals (possible carcinogens and toxins)

Although electronic cigarette “juice” may appear safe, it could produce harmful chemicals once heated to become a vapor.

A lethal dose of nicotine for an adult ranges from 30-60 mg and varied for children (0.5-1.0 mg/kg can be a lethal dosage for adults, and 0.1 mg/kg for children).  E-cigs, depending on their strengths (0 – 5.4%) could contain up to 54 mg of nicotine per cartridge (a 1.8% e -cig would contain 18mg/ml).

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucus production and a sweeping out of carcinogens trying to make their way down to the lungs.

More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.

For more on the study read here.

Toxic metals found in vaping liquid

Last week, experts warned that many chemicals in vaping liquid may change to toxic substances (once heated) that can irritate the lungs.

Last year one study reported that toxic levels of lead and other metals may leak from the heating coil element into the vapor inhaled during e-cig use.

Researchers at Johns Hopkins Bloomberg School of Public Health found these metals to include:

  • lead
  • nickel
  • manganese
  • chromium
  • arsenic

We’ve known for some time that vaping fluid could contain chemicals that turn toxic once heated, but this study shed light on e-cig metal components causing metal leakage to the vapor making contact with delicate respiratory epithelium (lining).

Reported by Forbes, Rich Able, a medical device marketing consultant, stated the following, “the FDA does not currently test any of the most popular vaping and e-cigarette instruments being manufactured at unregulated factories in Asia that source  low-grade parts, batteries, and materials for the production of these devices,” suggesting that “the metal and parts composition of these devices must be stringently tested for toxic analytes and corrosive compounds.”

These chemicals may act as neurotoxins, affecting our nervous system, cause tissue necrosis (cell death) and even multi-organ failure. Moreover, they can affect how our immune system reacts to other chemicals as well as foreign pathogens, affecting our ability to fight other diseases.

Although studies have suggested e-cig vapor to be safer than tobacco smoke, not enough research has been done, in the relatively few years vaping has been around, looking at how heat-transformed chemicals and leaked metals affect our breathing, lungs and other organs once absorbed into the body.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Friday, 11 October 2019 19:01

Health risks from wildfire smoke

Written by

As thousands of acres burn in Southern California, those residents lucky enough to escape the flames worry what consequences could result in inhaling the smoke.

What is in wildfire smoke?

According to the EPA, smoke emanating from forest and community fires may include any of the following:

  • Carbon monoxide, which competes with oxygen in the blood
  • Carbon dioxide, a respiratory byproduct
  • Wood particles
  • Formaldehyde
  • Acrolein – used as a pesticide
  • Benzene
  • Plastics, and those byproducts after incineration
  • and thousands of different respiratory irritants.

According to the EPA,

Smoke is composed primarily of carbon dioxide, water vapor,
carbon monoxide, particulate matter, hydrocarbons and other
organic chemicals, nitrogen oxides, trace minerals and several
thousand other compounds. The actual composition of smoke
depends on the fuel type, the temperature of the fire, and the
wind conditions. Different types of wood and vegetation are
composed of varying amounts of cellulose, lignin, tannins and
other polyphenolics, oils, fats, resins, waxes and starches, which
produce different compounds when burned.

What symptoms may individuals experience?

Some may have no idea they are breathing in harmful compounds that could affect their lungs and heart.  However, many may experience:

  • Cough
  • Wheeze
  • Difficulty Breathing
  • Chest Pain
  • Mucous Production
  • Dizziness/lightheadedness
  • Fatigue
  • Racing Heart (palpitations)
  • Exacerbation of their lung disease including COPD, asthma, chronic bronchitis
  • Exacerbation of heart conditions such as angina, heart attack, and cardiac arrhythmias.
  • Increased susceptibility to new lung infections as well as flu

What are PM2.5s?

PM2.5 are particles less than 2.5 micrometers in diameter that are present in pollution and wildfire smoke that can penetrate deeply into the lung linings.  Larger, coarse particles 10 micrometers in diameter are called PM10.  Both impair lung function as they inflame the lungs and interfere with the work of alveoli that need to oxygenate the blood.  Moreover the small particles can use this pathway to enter the blood stream. Although the direct health impacts of the fine particulate matter is not clearly defined it is believed that increased PM2.5 levels increase the risk of lung and heart disease as discussed above.

lungs_alveoli-57ffa7fe3df78cbc284e162b

LUNGS AND ALVEOLI (IMAGE FROM THOUGHTCO.)

Symptoms may begin at levels greater than 55 µg/m.

Which individuals are the most at risk?

  • Infants and Children
  • Elderly individuals
  • Those with chronic lung disease, including asthma and emphysema
  • Those at risk for heart disease and stroke
  • Those with diabetes
  • Smokers
  • Pregnant women
  • Those with chronic allergies
  • Pets 

How can residents protect themselves?

Avoiding the area of wildfires is paramount.  Additionally, the following may be considered:

  • Avoid outdoors until air quality reports improve.  Do not rely on how “clear” the air looks.
  • Take heed of wind and air quality advisories.
  • Recirculate the air in your home and car.
  • Keep windows closed.
  • Consult with your medical provider to monitor blood pressure, heart rhythm, lung function and refill any medications you may need BEFORE you feel symptoms.
  • Be wary of facemasks sold as PM2.5 safe as many do not protect against the very small particles. Respirator masks labelled N95 or N100 may provide SOME protection against particulates but not against the toxic fumes such as formaldehyde and acrolein.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Wednesday, 02 October 2019 22:55

October is Breast Cancer Awareness month

Written by

Celebrities such as Julia Louise-Dreyfus, Olivia Newton-John, Christina Applegate and Cynthia Nixon have revealed their breast cancer diagnoses, helping raise awareness for the most common cancer to affect women.  It’s the second most common cause of cancer death in females. 

How common is breast cancer?

1 in 8 women will develop invasive breast cancer over the course of their lifetime. According to the American Cancer Society, an estimated 268,000 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,000 cases of non-invasive breast cancer, a rise from last year. 41,700 women and 500 men are expected to die this year of breast cancer. 

What are the risk factors for breast cancer?

Risk factors for breast cancer include:

  • Age greater than 50
  • Family History
  • BRAC1 and BRAC2 genetic mutations
  • Alcohol use
  • Never been pregnant or becoming pregnant for the first time over 35 years old
  • Early menarche at age 11 or younger
  • Obesity, especially after menopause
  • Dense breasts
  • Lack of physical activity
  • Use of oral contraceptives
  • Previous “precancerous” tumors such as atypical hyperplasia
  • DES exposure
  • Previous radiation therapy

How is breast cancer staged?

Breast cancer is staged based on the size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.

Screen-Shot-2012-09-27-at-9.59.51-AM.png

 

IMAGE ABOVE FROM JOHNSTON HEALTH
 

Is family history a huge factor?

85% of breast cancer cases occur in women with NO family history.

 

Screening of breast cancer

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

 

FullSizeRender (1)

 

3-D MAMMOGRAM IMAGE

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Friday, 20 September 2019 18:59

This year’s flu season has begun

Written by

Although flu season officially starts in October, public health officials in Riverside, California have already reported the first “flu-related” death this year, a 4 year-old child.

And being that Australia’s flu season began a couple of weeks early, US health experts are bracing for the start of ours this month.

We still, however, cannot predict how “severe” this year’s flu season will be, but here are the answers to the most commonly asked questions about the flu.

When does the flu season begin and how long does it last?

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but already this early in the season we’ve had a flu-related death.  As the season unfolds, more cases will be reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well. 

What does this year’s flu vaccine cover?

According to the CDC, the trivalent vaccine covers for these three strains of the flu virus:

  •  A/Brisbane/02/2018 (H1N1)pdm09-like virus
  • A/Kansas/14/2017 (H3N2)-like virus
  • B/Colorado/06/2017-like (Victoria lineage) virus

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from  prior years. However, it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnant or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

How long does it take the flu shot to “kick in?”

The average immune system takes a couple weeks of to prime, so we suggest getting the flu shot before the season starts…or peaks.  However, experts recommend to still get the flu vaccine to anyone who missed early vaccination.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure. 

What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However, if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

Wishing you health this season!!

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

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