Wednesday, 08 January 2020 21:27

Testosterone Therapy: New guidelines released

Millions of men take testosterone supplements each year in the U.S.  Low testosterone, or “Low T”, can manifest in a variety of symptoms including:

  • fatigue
  • erectile dysfunction
  • depression
  • lack of sex drive
  • muscle loss
  • loss of strength
  • decrease muscle strength
  • loss of fertility
  • osteoporosis (decrease bone mass)
  • and may contribute to many other issues.

The most popular forms of testosterone are injections and gels. Pill forms are available but are not as effective.

Testosterone slowly decreases with age at a rate of 1.6 % per year beginning in one’s 30’s. A man with significant testosterone loss, however could  signify a more serious health issue such as diabetes.  So many physicians don’t hesitate when it comes to supplementing this vital hormone.

However, its not without its risks.   Risks of testosterone therapy include:

  • Increasing risk of prostate size
  • risk of prostate cancer
  • polycythemia (increase red blood cell levels)
  • mood issues
  • sleep apnea
  • acne
  • and multiple studies have found it increases risk of heart attacks and stroke.

This week the American College of Physicians released new guidelines on testosterone replacement.

They suggest to only use testosterone therapy when treating sexual dysfunction but not for the other aforementioned conditions as the evidence is not supportive.

Recommendation 1a:

ACP suggests that clinicians discuss whether to initiate testosterone treatment in men with age-related low testosterone with sexual dysfunction who want to improve sexual function (conditional recommendation; low-certainty evidence). The discussion should include the potential benefits, harms, costs, and patient’s preferences.

Recommendation 1b:

ACP suggests that clinicians should reevaluate symptoms within 12 months and periodically thereafter. Clinicians should discontinue testosterone treatment in men with age-related low testosterone with sexual dysfunction in whom there is no improvement in sexual function (conditional recommendation; low-certainty evidence).

Recommendation 1c:

ACP suggests that clinicians consider intramuscular rather than transdermal formulations when initiating testosterone treatment to improve sexual function in men with age-related low testosterone, as costs are considerably lower for the intramuscular formulation and clinical effectiveness and harms are similar.

Recommendation 2:

ACP suggests that clinicians not initiate testosterone treatment in men with age-related low testosterone to improve energy, vitality, physical function, or cognition (conditional recommendation; low-certainty evidence).

They also prefer intramuscular forms over transdermal preparations due to cost.

Testosterone therapy linked to blood clots

 

In 2016 researchers found a 63% increase risk of blood clots within the first 6 months of testosterone therapy. These are deadly as they increase the risk of heart disease, stroke, pulmonary embolism and organ damage.  They form in veins, deep veins, and thus have an obstructed path to reach vital organs and prevent blood flow.  This is not the first time venous thromboembolism (VTE) has been linked to testosterone therapy. Back in 2014 the FDA recommended warning labels on testosterone products.

According to researchers at Icahn School of Medicine at Mount Sinai in New York City state the overall risk is still low, one case per 1000 men a year, but could be of huge concern for those at risk of blood clots.  Lead researcher, Dr.Carlos Martinez, states, “Risk peaks rapidly in the first six months of treatment and lasts for about nine months, and fades gradually thereafter.” So a promising finding is the risk falls as time passes since therapy.

  • Risk factors for VTE include:
  • genetic predisposition
  • prior blood clots
  • cancer
  • prolonged immobility (long flights, hospitalization stays)
  • pregnancy (women)
  • smoking
  • and of course risk increases with age.

Study author Dr. Mark Creager states, “My advice is to review the patient’s underlying risk factors for VTE, and weigh that risk against the potential benefit of testosterone therapy,” Creager said. “These individuals should at least be made aware of the fact that their risk would be even higher with testosterone.”

This study was published online 11/30/2016 in the BMJ (British Medical Journal)

 

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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.

Published in Health

Let’s face it… Pap Smears aren’t fun.  The only test to sample tissue for cervical cancer just happens to be one of the most embarrassing and awkward.  But it can be one of the most life saving and simple.  So what is it and how does it work?  Here’s your questions answered.

What is the cervix and what is cervical cancer?

The uterus looks similar to a light bulb.  The larger top portion being where the fetus develops, and the bottom, narrower area, the cervix.  The cervix thins and dilates during childbirth, as you’ve heard in the movies “she’s only 7 cm!” and then after childbirth becomes narrow again.  It affects nearly 13,000 and kills 4,100 women each year, rising each year.  It can affect women of any age but is more common between 20 and 50 years of age.

 

What causes cervical cancer?

The most common cause is HPV (Human Papillomavirus), especially HPV-16 and HPV-18.

 

cervical cancer.jpg

IMAGE FROM WEBMD

This is acquired through unprotected sex, so condom use is encouraged. Thus its one of the most preventable causes of cancer.  Additionally, there are 3 vaccines for HPV currently approved by the FDA, Gardasil, Gardasil 9, and Cervarix.

What are the symptoms of cervical cancer?

Early cervical cancer may not be symptomatic but as it develops it may cause any of the following:

  • vaginal odor
  • discharge
  • pain with urination
  • pain with sexual intercourse
  • generalized pelvic pain
  • bleeding. This bleeding may occur after sex, a pelvic exam, or intermittent bleeding not associated with a menstrual cycle.

 

Is cervical cancer treatable?

Yes.  Early detection is key and can be done by a Pap Smear, explained below.  Multiple treatments are available including surgery, chemotherapy,  radiation therapy, and targeted therapy such as Bevacizumab (Avastin®) which prevents new blood vessel growth that can feed a tumor.

 

Who should get screened for Cervical Cancer?

The USPSTF (United States Preventive Services Task Force) recommends the following:

Screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.

What is a Pap Smear?

It is the cytology (cell analysis) of the cervix.  Years ago, a cytobrush would collect the cells and the medical provider would “smear” it onto a slide, place fixative, and then send it to the laboratory for the pathologist to analyze it.  Now ThinPrep® Pap tests are used more commonly as the cells from the brush are placed into a container with fixative, and this vial is sent to the pathologist to spin down and analyze.

 

TEK IMAGE/SPL / GETTY IMAGES

 

In order to obtain the cells from the cervix, the medical provider needs to use a speculum to open the vaginal canal and allow access to the uterus.  A woman may be in the lithotomy position…lying on one’s back on the exam table with her feet in stirrups and knees bent. During the speculum exam, the medical provider may take cultures to test for common vaginal infections such as yeast, bacteria vaginosis, or sexually transmitted illnesses such as gonorrhea and chlamydia.  After the speculum exam, the provider may perform a pelvic exam with her gloved hand to examine the uterus and ovaries, evaluating for tenderness, shape, size and masses.

How is an HPV test done?

An HPV test can be done with the cells obtained during the Pap Smear.  The laboratory evaluates the cells to see if the HPV virus that causes cervical cancer is present.

In summary the thousands of deaths that occur each year to cervical cancer can be prevented with simple testing, such as the Pap Smear.  Discuss with your medical provider when cervical cancer screening is best for you.

 

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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.

Published in Health
Tuesday, 31 December 2019 16:28

How to avoid alcohol poisoning

The most exciting evening of the year is coming and we start celebrating hours, even days before.  Champagne, beer, vodka, rum…you won’t find a venue without it. Unfortunately the pace at which alcohol is consumed can be just as deadly as the quantity. What you read below may be difficult to swallow, but it’s necessary to know to stay healthy.

What is acute alcohol intoxication?

Simply put, it’s alcohol poisoning. Alcohol consumed in high quantities and at too fast a pace will disrupt metabolic processes in the body. A healthy human body will break down alcohol at a rate of 1 oz per hour.  So if the average shot glass contains 0.6 – 1.5 oz. of alcohol and if one takes in 4 shots in one sitting, math dictates that the body will not be able to keep up.

Whatever the liver does not metabolize will continue to circulate in the body.  As a defense mechanism, your gut may try to throw it up, which is why vomiting is a red flag of acute alcohol intoxication.

Alcohol is additionally a sedative so respiratory rate can drop to the point of causing the drinker to become unconscious. Slow respiration coupled with high alcohol blood content will cause drinkers to have impaired brain function (loss of memory, acting confused) and dilation of blood vessels. This can hypoperfuse certain organs as your body tries to preserve blood flow to the heart and brain, thus giving the drinker a pale, clammy look.

Chronic alcohol intoxication could cause scarring of the liver called cirrhosis.

How much alcohol is safe to drink?

The CDC website defines quantities of alcohol as the following:

A standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol. Generally, this amount of pure alcohol is found in

  • 12-ounces of beer (5% alcohol content).
  • 8-ounces of malt liquor (7% alcohol content).
  • 5-ounces of wine (12% alcohol content).
  • 1.5-ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).

Women metabolize alcohol differently from men, so they are encouraged to drink less. According to the National Institute on Alcohol Abuse and Alcoholism, a man should drink no more than 2 standard drinks a day and for women, no more than 1. Binge Drinking” is defined as 4 or more drinks (woman) or 5 or more drinks (man) in a 2 hour period.

According to their website they state:

MODERATE ALCOHOL CONSUMPTION:
ACCORDING TO THE “DIETARY GUIDELINES FOR AMERICANS 2015-2020,” U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES AND U.S. DEPARTMENT OF AGRICULTURE, MODERATE DRINKING IS UP TO 1 DRINK PER DAY FOR WOMEN AND UP TO 2 DRINKS PER DAY FOR MEN.
BINGE DRINKING:
  • NIAAA DEFINES BINGE DRINKING AS A PATTERN OF DRINKING THAT BRINGS BLOOD ALCOHOL CONCENTRATION (BAC) LEVELS TO 0.08 G/DL. THIS TYPICALLY OCCURS AFTER 4 DRINKS FOR WOMEN AND 5 DRINKS FOR MEN—IN ABOUT 2 HOURS.
  • THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA), WHICH CONDUCTS THE ANNUAL NATIONAL SURVEY ON DRUG USE AND HEALTH (NSDUH), DEFINES BINGE DRINKING AS 5 OR MORE ALCOHOLIC DRINKS FOR MALES OR 4 OR MORE ALCOHOLIC DRINKS FOR FEMALES ON THE SAME OCCASION (I.E., AT THE SAME TIME OR WITHIN A COUPLE OF HOURS OF EACH OTHER) ON AT LEAST 1 DAY IN THE PAST MONTH.
HEAVY ALCOHOL USE:
SAMHSA DEFINES HEAVY ALCOHOL USE AS BINGE DRINKING ON 5 OR MORE DAYS IN THE PAST MONTH.

 

What if I’m taking medication? Can I still drink?

There is no official list of what medications can be swigged with alcohol.  Some sources will incorrectly say “Tylenol” however one’s liver may not agree as both acetaminophen (its key ingredient) and alcohol may cause liver disease.  We suggest speaking with your medical provider first before drinking.

The National Institute for Alcohol Abuse and Alcoholism provides a list of medications that could produce serious side effects when mixed with alcohol (even during the same night).  For example, NSAIDS (non steroidal antiinflammatories, such as ibuprofen), could increase the risk of GI Bleed.

How much alcohol is toxic to the body?

Any amount of alcohol may be toxic to the body depending on one’s baseline health and how his/her body metabolizes alcohol.  One drink has even been linked to cancer such as those of the throat and/or GI tract. So we don’t have an official “safe level” of alcohol to consistently promote. How we determine ranges of toxicity depends on one’s Blood Alcohol Content (BAC) which can be measured.

The following tables come from the University of Notre Dame, Student Well-Being McDonald Center…….

BAC-Specific Effects

BAC Level

Generalized Dose Specific Effects

0.020-0.039%

No loss of coordination, slight euphoria, and loss of shyness. Relaxation, but depressant effects are not apparent.

0.040-0.059%

Feeling of well-being, relaxation, lower inhibitions, and sensation of warmth. Euphoria. Some minor impairment of judgment and memory, lowering of caution.

0.06-0.099%

Slight impairment of balance, speech, vision, reaction time, and hearing. Euphoria. Reduced judgment and self-control. Impaired reasoning and memory.

0.100-0.129%

Significant impairment of motor coordination and loss of good judgment. Speech may be slurred; balance, peripheral vision, reaction time, and hearing will be impaired.

0.130-0.159%

Gross motor impairment and lack of physical control. Blurred vision and major loss of balance. Euphoria is reducing and beginning dysphoria (a state of feeling unwell)

0.160-0.199%

Dysphoria predominates, nausea may appear. The drinker has the appearance of a sloppy drunk.

0.200-0.249%

Needs assistance in walking; total mental confusion. Dysphoria with nausea and vomiting; possible blackout.

0.250-0.399%

Alcohol poisoning. Loss of consciousness.

0.40% +

Onset of coma, possible death due to respiratory arrest.

Estimating Blood Alcohol Level (Based on Weight) – Males

Weight

1 drink

2 drinks

3 drinks

4 drinks

5 drinks

6 drinks

7 drinks

8 drinks

9 drinks

10 drinks

100 lbs

.043

.087

.130

.174

.217

.261

.304

.348

.391

.435

125 lbs

.034

.069

.103

.139

.173

.209

.242

.278

.312

.346

150 lbs

.029

.058

.087

.116

.145

.174

.203

.232

.261

.290

175 lbs

.025

.050

.075

.100

.125

.150

.175

.200

.225

.250

200 lbs

.022

.043

.065

.087

.108

.130

.152

.174

.195

.217

225 lbs

.019

.039

.058

.078

.097

.117

.136

.156

.175

.195

250 lbs

.017

.035

.052

.070

.087

.105

.122

.139

.156

.173

Estimating Blood Alcohol Level (Based on Weight) – Females

Weight

1 drinks

2 drinks

3 drinks

4 drinks

5 drinks

6 drinks

7 drinks

8 drinks

9 drinks

10 drinks

100 lbs

.050

.101

.152

.203

.253

.304

.355

.406

.456

.507

125 lbs

.040

.080

.120

.162

.202

.244

.282

.324

.364

.404

150 lbs

.034

.068

.101

.135

.169

.203

.237

.271

.304

.338

175 lbs

.029

.058

.087

.117

.146

.175

.204

.233

.262

.292

200 lbs

.026

.050

.076

.101

.126

.152

.177

.203

.227

.253

225 lbs

.022

.045

.068

.091

.113

.136

.159

.182

.204

.227

250 lbs

.020

.041

.061

.082

.101

.122

.142

.162

.182

.202

Time Factor Table

Time is the only factor to lower one’s Blood Alcohol Content. Coffee, cold showers, etc… are all myths.

Hours since first drink

1

2

3

4

5

6

Subtract from blood alcohol level

.015

.030

.045

.060

.075

.090

 

A Happy New Year should also be a Healthy New Year.  So be warm, dry, safe and have fun!!

 

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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.

Published in Health
Friday, 27 December 2019 00:04

Easy and practical New Year’s Resolutions

TO AVOID FAILING AT ONE’S NEW YEAR RESOLUTIONS, START BEFORE RETURNING TO WORK AS VACATION TIME ALLOWS ONE MORE FLEXIBILITY TO KEEP TO ONE’S GOALS

Updated 12/17/19

Nothing is more of a buzz kill, enjoying the biggest party of the year, than the discussion of New Year’s Resolutions. Let’s be honest ...what are these resolutions anyway? They’re a promise to do the right thing in exchange for no one nagging us while we abuse ourselves over the holidays. So it’s no wonder most New Year’s resolutions fail. If your heart’s not it and if the goals aren’t realistic, resolutions won’t be met. 

Moreover we wait until January 2nd to give up smoking, or sweets, and struggle as we are returning from vacation and need to hit our work schedule head on.  So I suggest starting your healthy habits during your holiday vacation week(s) where you can go through withdrawal or be grumpy without the boss seeing.  The resolutions may stick longer and they will be easier to do once the new work week/year begins.

The most common (and commonly failed) New Year’s Resolutions are:

  1. To lose weight
  2. To stop smoking
  3. To drink less
  4. To make more money
  5. To spend more time with family
  6. To perform better at work
  7. To save more money
  8. To eat healthier
  9. To go to church/temple more often
  10. Get a boyfriend/girlfriend
  11. Spend less time on the internet/smartphone
  12. To watch less porn

Look how general and insurmountable some of these can be.  They’re too broad and if these were easy to do, you would already be accomplishing them.

So which New Year’s Resolutions can be practical and attainable?

Choose easy, finite, small discreet steps.  You’ll feel better since they are easier to accomplish.

 

  • Drink more water
  • Call your mother once a week – sorry, sorry, how about once a month…  better?
  • Lose 5 pounds in January.  Then try to lose 5 lbs in February…
  • Eat more vegetables
  • Take $20 a paycheck and put into savings
  • Make 7 pm – 8 pm playtime with the kids
  • Walk 10 minutes a day in January.  In February bring it up to 15 minutes, and so on
  • Plan the third Saturday of the month to be date night with your spouse
  • Go to church/temple more often – no shortcuts here
  • Put out each cigarette after 1-2 puffs
  • Check your cholesterol, blood sugar, blood pressure, etc
  • Make an appointment for a physical
  • Plan a mid year vacation
  • Organize your desk at work
  • Walk the dog for an extra half hour on Sundays
  • Limit computer/phone time to 1 hour a day

 

The list goes on.  But you see how making small, baby goals can build on themselves to the point where you will lose weight, eat healthier, save more money, preserve your relationship, perform better at work, etc.

Oh, I forgot one last important New Years Resolution ...listen to more stimulating medical talk radio.  Tee-hee…..

Wishing you all a happy and healthy New Year!!!

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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.

Published in News & Information

News of trucks bringing weapons-grade plutonium into Southern Nevada earlier this year drew a glitz of gasps from Las Vegas residents and legislators who knew nothing of the shipments.

The radioactive material came from South Carolina and was authorized by the Department of Energy to be stored at the Nevada National Security Site (NNSS) 65 miles (per its site) northwest of Las Vegas, Nevada.

 

About_Rotating_1.jpg

 

Legal attempts to remove the plutonium and stop future shipments have met with resistance as the Atomic Energy Act of 1954 allows the US government to control the development, regulation, and disposal of nuclear materials and facilities in the United States (Wikipedia).

Plutonium is a man-made radioactive element created by the destruction of uranium, a naturally occurring radioactive element. Both have been used as fuel sources and to make nuclear weapons.

Plutonium is known as an “unstable” element, in that it will decay until it eventually reduces to a stable element. During this decay, radiation is emitted.  The radiation particles (specifically alpha and beta) will usually not penetrate the skin, however if ingested, absorbed or inhaled, could enter the human body and deposit in organs, affecting nearby tissues. Since its half-life, or rate of decay, can take years, organs in the body, such as lungs, liver, and bones can be exposed chronically to the radiation. This may result in radiation illness, cancer or death.

Signs of radiation illness include:

  • Fever
  • Headache
  • Nausea
  • Vomiting
  • Sores/skin burns
  • Frequent infections
  • Diarrhea
  • Hair loss
  • Weakness
  • Internal Bleeding
  • and more….

Currently there have been no reports of illness due to its storage in Nevada and the US government has assured the state that the storage facility is safe. However, potential seismic activity or an act of terrorism could lead to a potential leak and/or contamination, and with the infamous desert winds, radioactive material could be blown to nearby towns and inhaled or ingested by residents.

Per the NNSS site:

THE DAF (DEVICE ASSEMBLY FACILITY) IS A COLLECTION OF MORE THAN 30 INDIVIDUAL STEEL-REINFORCED CONCRETE BUILDINGS CONNECTED BY A RECTANGULAR COMMON CORRIDOR. THE ENTIRE COMPLEX, COVERED BY COMPACTED EARTH, SPANS AN AREA OF 100,000 SQUARE FEET.
SAFETY SYSTEMS INCLUDE FIRE DETECTION AND SUPPRESSION, ELECTRICAL GROUNDING, INDEPENDENT HEATING, VENTILATION AND AIR-CONDITIONING SYSTEMS WITH HIGH-EFFICIENCY PARTICULATE AIR FILTERS, ALARM SYSTEMS, AND WARNING LIGHTS. IN OPERATIONAL AREAS, PAIRS OF BLAST DOORS, DESIGNED TO MITIGATE THE EFFECTS OF AN EXPLOSION, ARE INTERLOCKED SO THAT ONLY ONE DOOR MAY OPEN AT A TIME.

And some reports say the plutonium may be shipped out of state to nearby facilities and not remain in Nevada.

I won’t hold my breath ...oh wait…maybe I should…..

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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.

 

Published in Health

Holiday shopping is very exciting but, unfortunately always underestimated.  Buying gifts for your family is a given, but what about relatives, friends, coworkers, bosses, teachers, neighbors, nurse, and the list goes on!  So buying for everyone can cost a fortune.

On top of that, you don’t want your gift to blend in with the rest.  Baskets, ornaments, and treats can, once graciously accepted, be thrown on the table with the rest of the goodies.  So how do you get the biggest bang for your buck?

When choosing a gift, it must be creative, useful and have longevity. Let’s start by categorizing our gift recipients.

Office workers/coworkers – under $50

If your company does not participate in  a Secret Santa gift exchange, you’re on the hook for a lot of gifts.  Here’s some cool ideas:

  1.  Basket of $2-5 Gift Cards – Buy an inexpensive basket from a hobby store (or reuse last year’s), line it with tissue paper and decorative filler, place 10 gift cards (coffee house or donut shop would work pretty well at that price point), and throw some candy in the basket as well.
  2. Basket of Tools – Hammers, nuts and bolts from your nearby hardware store can be inexpensive and could make an awesome basket for those who could use an extra tool around the house.  And as long as they don’t lose it, it may last for years
  3. Basket of Scented Soaps – many bath and beauty shops sell these for $5 a piece, so make a basket with these and candy and let everyone grab one. Again, some longevity with this gift.
  4. Online Spanish (or language) course – many offices need bilingual staff and those who aren’t would love to learn.  Que bueno!

 

Relatives – under $20

Cousins, aunts, uncles, grandparents, nieces, nephews …how do you not go broke?

  1. For the Chef – Grab a cookbook, some spices, and a tool and put it in a decorative bag or basket.
  2. For the Gardner – Grab some packets of seeds, small bag of soil and put in in a pot filled with decorative filler
  3. For the Auto Enthusiast – Grab some turtle wax, cloth, air freshener – you know the drill
  4. For the Coffee Drinker – Grab two mugs, a rich coffee bag, and add sweets to the basket
  5. For the Tea Drinker – Find as many flavors as you can and throw some honey in the basket…or a decorative mug
  1. Gift cards – movies, restaurants, can’t go wrong with these
  2. Books – not an easy pick since you need to do some detective work ensuring they hadn’t read your choice yet, but great price point
  3. Bottle of wine, goblets, candles, these can be flexible and creative
  4. Pedicure gift card
  5. For the pet lover – a how to book, toys, treats for their pet.
  6. For the one who loves to laugh – funny desk calendar, book of jokes, fart machine
  7. Cuddly blanket – make sure its not an obnoxious color, or better yet…why not? 

and the list goes on……

Acquaintances/buddies

There are many people in our lives who we want to recognize during the holidays (Postal Worker, Sanitation team, Security Guard, etc) so here are some ideas that can accompany a warm Holiday message:

  1. Stocking of goodies (sunscreen, treats, phone case)
  2. Scarf or sport’s team hat
  3. Cool car accessory
  4. Box of treats, warm even better
  5. Gift card, etc.

The holidays are a time of giving, and the joy it brings to both the recipient and you is priceless. Fortunately, creative and worthwhile gifts don’t have to be too costly.

Good luck shopping this year and have a wonderful holiday 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.

 

Published in Money

This year’s flu season has claimed the lives of at least 6 children and many more adults.  It’s widespread in many states, and we are told to brace ourselves for yet another severe flu season as we enter the peak.

cdc week 48.png
CDC

 

However, the number one cause of death when it comes to the flu is pneumonia.  And the respiratory depression that appears to come on with these otherwise healthy individuals, appears to affect them within hours. Which raises the question…. Should we be entertaining the possibility that a severe pneumonia strain is affecting us this “flu season” and should we be encouraging pneumonia vaccines as well as the flu vaccine?

Most children are vaccinated against pneumonia

The vaccine schedule for children in the US includes the pneumococcal vaccine (PCV13) given at 2 months, 4 months, 6 months, 12 – 15 months of age.  Over 2 years of a child, one can get the PPSV23 if they did not receive the PCV13.

Not all young adults get the pneumonia vaccine, however if one if over 65, the CDC recommends the pneumococcal vaccines receiving a dose of PCV13 first, followed by a dose of PPSV23, at least 1 year later.

pneumonia.gif
CDC

 

Now a variety of pathogens can be responsible for pneumonia, including viruses’, fungi, and bacteria other than pneumococcus, but streptococcal pneumonia is the most common cause.  If those affected by pneumonia this year were vaccinated, we need to know the strain, meaning specifically what pathogen was responsible for their pneumonia.

Not all pneumonia presents with a cough

Although pneumonia presents with symptoms such as fever, body aches, cough, shortness of breath and sputum production, some individuals may not present with these symptoms when they have pneumonia. Some of the tragic “flu death” cases this year were in adults who initially had a “mild cough”. Since flu symptoms are similar, some may never know if they have pneumonia.

As a result we are telling patients who have the flu to return immediately to the doctor’s office/urgent care/emergency room if they have any of the below symptoms:

  • Recurring fever
  • Fever that won’t subside after 2 days
  • Shortness of breath
  • Difficulty breathing
  • Confusion
  • Weakness
  • Productive cough
  • Blood in sputum
  • Fast breathing
  • Fast heart rate
  • Chest pain

and speak with your medical provider regarding other symptoms they may want you to watch out for.

How to tell when your flu is turning deadly

 

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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.

Published in Health

Among the various health issues that plague us during the festive holiday season; flu, colds, heart disease, hypothermia, pneumonia ...we add one more to the list ...Christmas Tree Syndrome.

Christmas Tree Syndrome occurs when one feels ill when they are in close proximity to their Christmas Tree.   True the average Christmas tree is a spruce or fir, which rarely should be allergenic, but researchers have found they still carry allergens such as pollen, picked up by nearby plants, and may house mold.

Researchers from State University in New York analyzed the bark and needles of multiple Christmas trees and found multiple cases of mold with their allergy producing spores. And since they are trees from the wild, they provide residence to thousands of critters…aphids, mites, bark beetles and even spiders.

Now we have been living with Christmas trees each season and harmoniously and symbiotically have lived with their crittery inhabitants without being attacked, but that doesn’t mean we aren’t free from symptoms.

Christmas Tree Syndrome includes any of the following symptoms:

  • Wheezing
  • Coughing
  • Chest Pain
  • Fatigue
  • Rash
  • Watery Eyes
  • Nasal Itching
  • Scratchy Throat
  • Difficulty Sleeping

Mold and pollen are notorious for being the biggest culprits in causing these types of respiratory symptoms, so the following has been suggested to reduce your risk of Christmas Tree Syndrome:

  • Hose down the tree and let it dry before bringing it back into the house
  • Utilize an air purifier in the same room as the tree
  • Avoid extended stays of the tree, i.e. put it up nearer to the holiday and take it down once Christmas ends
  • If currently suffering from allergies or asthma, or vulnerable to Christmas Tree Syndrome, delegate tree decorating to someone else in the family…maybe an in-law.
  • Consider having your gorgeous Christmas tree outside the house.

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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.

Published in Health

Tis the season!! Unfortunately not for our hearts. A study back in 2004 found a 5% increase in heart attacks during the Christmas season. Then last year, a study published in the British Medical Journal found Christmas Eve to be especially risky for those who are prone to heart disease.  Let’s dissect why….

Baby it's cold outside…..

The cold has long been associated with heart stress. Cold weather causes blood vessel constriction and this adds extra work for the heart. Moreover, it causes less oxygen to reach vital organs, including the heart.

Snow shoveling has been infamous for inciting heart attacks for this same reason. The heart demands extra blood due to the increase in activity and the cold restricts blood flow.

Let’s toast…….

Alcohol, especially in excessive amounts, can put stress on the heart by increasing blood pressure, worsening diabetes, and causing abnormal heart rhythms. Moreover, it interferes with the metabolism of medications, hence many of these may not work at their best.  Which brings us to…..

Is there a doctor in the house?

Medical providers take vacation too.  And if a patient forgets to refill his medication he may go without during the two weeks of holiday season.  Moreover many forget to pack everything they need for a Holiday trip and without anticipating delays, one could be without crucial medication dosing.  The heart does not like this.

Stress…….

Holiday travel is never easy. Delays, long lines, the cold, traffic and then…..family. We may love our family but prefer seeing them in small doses.  All the family at once can be a little overwhelming for some.  As for coping with the in-laws…..well a guide is available for you all here.

Preventing Heart Disease

Firstly, we must know our risk factors. These include:

  • Family history of heart disease
  • Personal history of heart disease
  • High Blood Pressure
  • High Cholesterol
  • Diabetes
  • Smoking
  • Obesity
  • Inactivity
  • Males over 40
  • Females who are post menopausal
  • High stress

and even short stature has been cited as a potential risk factor.

As you can see, many of us can be at risk for heart disease.  Therefore, secondly, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.

Thirdly, reduce your risk by the following:

  • Maintain a normal blood pressure
  • Maintain normal blood sugar
  • Maintain normal cholesterol and lipid levels
  • Reduce stress
  • Maintain a balanced diet, rich in potassium-rich foods such as fruits and vegetables
  • Quit smoking
  • Stay active
  • Maintain a healthy weight.

So how to prevent the “Christmas Coronary?”

Plan ahead by doing the following:

  •  If you are running low on your prescriptions contact your medical provider early on.
  •  Pack prescriptions in two different bottles, so you can take some medication on your carry on in case the flight gets delayed or a suitcase gets lost.
  • Avoid getting sick, by getting your flu shot, washing your hands, avoiding sick contacts.
  • For tips on how to avoid getting sick on a plane to visit here. 

Holiday time should be a happy time. Let’s make it a healthy one!!!

 

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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.

 

Published in Health
Friday, 06 December 2019 18:24

How to tell when your “Flu” is turning deadly

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.

 

 

Published in Health
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