Thanksgiving is here!! Good food, no school, no work, and most of all….. family!!

For many this is one of the best holidays ever!!

For some…..the most dreaded all year.

This is your very rare and valuable time off, and you have to spend all of it with people who don’t like you and you’re not particularly fond of. Four days of staying with family, (especially if they don’t let you stay a hotel and insist you stay with them), can be more than many can bear.

So here are some steps you can take to make the holidays easier.

1. Huddle up

 

huddle

Usually your spouse wants to avoid controversy just as much as you do.  Before the encounter, huddle up and create a strategy for:

a.  How to deal with insults

b.  How to take a break – take the car to go grab some last-minute Thanksgiving necessities

c.  Where you get to sit at the table

d.  Potential arguments regarding the children and their upbringing

2.  Try to get a hotel room

 

hotel

This gives you the much-needed reprieve at the end of the day. However, if the family insists you stay with them and 4 nights at Hotel Hell are just too much to bear, plan a “sneak away” for an evening with your wife and tell the Grandparents they will host the kid’s slumber party.  Remember to thank them for the huge favor they are doing allowing you and the wife a much needed night away “from the kids” …wink…wink…..

3.  Football

 

prescott

Thank Heavens the Cowboys are playing this Thanksgiving.  Usually there is someone else in the family just as sane as you are when it comes to football, so you can immediately partner with him to get the television on and the game playing.  Although this may only give you a 15 minute “out” of the family festivities, it’s 15 minutes of pure euphoria.

4.  Remember you have sciatica

 

sciatica

The most difficult part of Thanksgiving/Christmas is sitting at a table for hours and usually trapped, physically, because the chairs are pushed together so tight that you can’t push out the chair. If you ever, ever, ever had an issue with your back, knee, leg, muscle, or even pinky toe, use this as an excuse to heave the table forward so you can get up and stretch your legs.  Slowly limp over to the living room where hopefully you left the football game on……

5.  Get called to work

 

work

No in-law can or wants to take on your boss. So during the 7 day stent, politely excuse yourself if you need to go onto a computer, make a phone call, or drive 60 miles away for “work”.  Make sure your spouse is on board with this one……

6.  Have “diarrhea”

 

toilet

You get to leave the room and no one wants to be near you. You just gained escaping 3-5 times/hour since you need to “run” to the bathroom.

7.  Inform the family you feel a cold coming on

 

cold

Don’t jinx yourself but this gets you out of hugs, and sloppy lipstick kisses…..

Ok this gives you a well-coordinated exit plan but what happens if they are on to you?  How do you deal with the remaining, 3 days, 23 hours and 45 minutes?

1.  Don’t take it personally

 

When the insults and digs come, don’t feel like these personal attacks need to stick. You have enough people in your life telling you your shortcomings. The in-laws are either being redundant or telling you something that doesn’t hold true.

2.  You’re not alone

 

Millions of adults are in the exact same position as you at the same moment in time.  You’re not alone.  Just sneak a peek on facebook and you’ll scroll through hundreds of “Ugh!!!!”s………..

3.  Make a game of it

 

Bet your wife or coworker that you will get the most insults over the holiday than they will and write down or note every time it happens. The more it occurs, you win. Compare notes or use it as a “get out jail free card” with your spouse.

4.  Have a happy place

 

Negotiate with your spouse prior to the holiday a “free day” or “free weekend” that you will earn upon completion of a 7 day holiday with the in-laws.  Plan and fantasize about this reward throughout your tour of duty to make the path easier

5.  Bring the pets

 

cat-1

 

Since you are usually outnumbered during these family events, why not have non humans come to your aid. Dogs need to be walked, cats need to be chased, so this gives you an out and gives you a much-needed buddy during the hard times.

Look, it’s not easy, but remember why you’re there.  For YOUR family.  Your spouse and kids need to spend the holidays with you so grin and bear it.  And remember you may be luckier than the average guy.  He could be spending the WHOLE WEEK!  Ahhh, you DO have something to be thankful for.  

Happy Thanksgiving!!!!

 

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Daliah Wachs is a guest contributor to GCN news. 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

Civil rights activist, Jesse Jackson, revealed Friday that he’s been diagnosed with Parkinson’s disease.

The 76-year-old two-time Democratic presidential candidate stated he and his family noticed changes three years ago and, “after a battery of tests, my physicians identified the issue as Parkinson’s disease, a disease that bested my father.”

His father, Noah L. Robinson, died in 1997 at the age of 88 of a heart attack and complications of Parkinson’s.

What is Parkinson’s Disease?

 

Parkinson’s disease is the second most common neurodegenerative disorder, next to Alzheimer’s, and the most common movement disorder that affects 1% of the world’s population over 60 years old. In the US, 60,000 new cases are diagnosed each year.  It affects several areas of the brain, primarily the substantia nigra, altering balance and movement by affecting dopamine producing cells.

 

substantia nigra

Image from the Science of Parkinson’s Disease

 

It was first described in 1817 by James Parkinson as a “shaking palsy.”

What are the Symptoms of Parkinson’s?

 

Common symptoms of Parkinson’s include:

  • Stiffness and rigidity

  • Poor balance

  • Tremor at rest, especially a pill-rolling tremor

  • Slow movement

  • Inability to move

  • Shuffling steps, gait

and patients may later develop…

  • Depression

  • Anxiety

  • Memory loss

  • Constipation

  • Decrease ability to smell

  • Difficulty swallowing

  • Erectile dysfunction

  • Pneumonia

  • Fractures from falling

  • Hallucinations

  • Delusions

  • Dementia

Who is at Risk for Parkinson’s?

 

Most cases are idiopathic, meaning the disease arises with no specific cause.  However some cases are genetic and multiple genes have been identified that are associated with the disease.

The average age of onset is 60, but some cases may occur as “early onset”, before the age of 50, and if before the age of 20, it is known as juvenile-onset Parkinson’s.

Men appear to be more affected than women at twice the rate.

Risk may be enhanced with a history of head trauma.

Exposure to herbicides and pesticides has been linked to an increased risk of Parkinson’s as well.

How Quickly do Parkinson’s Symptoms Progress?

 

Average progression rates can last years to decades, however, earlier onset disease may manifest much quicker.

The stages of Parkinson’s are illustrated below:

What-Are-the-Stages-of-Parkinson_s-Disease

How is Parkinson’s treated?

 

Although there is no cure for Parkinson’s, symptoms can be treated by a variety of measures.

  • Levodopa – converts to dopamine in the brain, helping replace the deficient hormone.

  • Carbidopa (Sinemet) – if given with levodopa prevents the latter from being broken down before it reaches the brain.

  • Dopamine agonists – mimic dopamine

  • MAO-B inhibitors – helps block the enzyme MAO-B, which breaks down natural dopamine

  • Other medications including COMT inhibitors, amantadine and anticholinergics

  • Medications to treat anxiety and depression

  • Deep brain stimulation – a surgeon implants electrodes into the brain, allowing stimulation of parts that help regulate movement.

  • Stem cell therapy – being investigated as a means to create dopamine-producing cells

  • Physical and occupational therapy

Famous People Diagnosed with Parkinson’s

  • Michael J. Fox

  • Janet Reno

  • Robin Williams

  • Muhammad Ali

  • Casey Kasem

  • Johnny Cash

  • Linda Ronstadt

  • Pope John Paul II

  • Peanuts creator Charles Schulz

It’s been postulated Adolf Hitler suffered from Parkinson’s as well.

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Daliah Wachs is a guest contributor to GCN news. 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
Wednesday, 15 November 2017 17:33

New Blood Pressure Recommendations Released

High blood pressure has now been redefined as being greater than 130/80 mmHg, down from 140/90 mmHg. This will mean close to 103 million more Americans will fall under the “hypertensive” category.

 

Multiple agencies, including the American Heart Association and American College of Cardiology, redefined the guidelines, in practice for the last 14 years, to lower the threshold for high blood pressure from 140/90 to 130/80.

 

Under the old guidelines, 1/3 of US Americans were considered to have high blood pressure.  Now 42% of Americans will be “hypertensive.”

 

In lowering the guidelines, task force members hope to reduce complications associated with high blood pressure and start treatment earlier in those who have not been treated.

 

blood+pressure+chart

 

What do the blood pressure numbers mean?

 

The top number, or systolic pressure, is the pressure the heart exudes during a beat or pumping of the blood.

 

Diastolic pressure is the pressure in your arteries between beats while the heart is “filling.” Both numbers are equally important as elevation of either can increase one’s risk of cardiovascular disease.

What can long term high blood pressure do?

 

Chronic high blood pressure can be dangerous.  It may cause:

 

  • Heart attacks

  • Heart failure

  • Stroke

  • Kidney disease

  • Dementia

  • Eye damage – vision loss

  • Erectile dysfunction…to name a few.

How do we treat high blood pressure?

 

The stages of blood pressure are defined in the chart above.  At the elevated or early stages of high blood pressure the following lifestyle changes will be recommended:

 

  • Weight loss

  • Low salt diet

  • Low fat diet

  • Good sleep habits

  • Regular exercise

  • Avoiding tobacco products

  • Limiting alcohol consumption

  • As a family physician I would also screen for diabetes, high cholesterol, low thyroid, kidney disease and sleep apnea.

  • If blood pressure cannot be controlled and continues to rise, medications may be prescribed to decrease blood volume, or lower the heart rate, or relax the blood vessels.



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Daliah Wachs is a guest contributor to GCN news. 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

The World Health Organization has reported an outbreak of the Marburg virus, similar to Ebola, has appeared in eastern Uganda on the border of Kenya.

 

Thus far 5 cases have been reported prompting the WHO to deploy funds to keep the spread contained.

Where did Marburg Originate?

 

Marburg was originally identified in 1967 when two simultaneous outbreaks occurred in Marburg and Frankfurt, Germany. An outbreak in Serbia also occurred that same time.  Since then rare isolated cases have popped up in Kenya, Angola, South Africa, Uganda and the Democratic Republic of the Congo.

What is Marburg virus and its Symptoms?

 

Marburg virus is apart of the same family as Ebola, the Filoviridae.  Just like Ebola, it causes a hemorrhagic fever, where victims may bleed, have fever, vomiting, diarrhea, headaches, muscle aches, rash, red eyes, sore throat and abdominal pain to name a few.

 

marburg-ebola.png

Image from KeyWordSuggest

How is Marburg Transmitted?

 

Marburg virus is transmitted to humans from monkeys and bats such as the African fruit bat and Rousettus bat.  But similarly to Ebola, human to human contact can spread Marburg, especially during body preparation for burial. Saliva, tears, vomit, semen and blood can transmit the Marburg virus from human to human.

 

Greater short-nosed fruit bat (Cynopterus sphinx)

Fruit Bat, Image from Dignited

How is Marburg Treated?

 

There is no treatment currently known for Marburg.  It has an estimated 88% fatality rate.  Its incubation period ranges from 5 days to 2 weeks and those exposed may need to be in isolation for up to 21 days.

 

RNA interfering treatments are being researched to prevent Marburg virus replication in the host.  Its unclear if Zmapp, a treatment for Ebola, is effective in treating Marburg infection. Between 2014 to 2015, 28,610 people were infected with Ebola resulting in 11,380 deaths.  Local officials are being very diligent to make sure Marburg doesn’t follow a similar epidemic path.

 

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Daliah Wachs is a guest contributor to GCN news. 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
Tuesday, 07 November 2017 19:37

How Doctors Can Prevent Burnout

A new study from the American Medical Association (AMA), the Mayo Clinic and Stanford University finds 1 in 5 physicians plan to cut back their hours next year and 1 in 50 will leave the profession completely within the next 2 years.

 

Burnout is cited to be the main cause and is one of the biggest threats to health care today. According to AMA President Dr. David Barbe, “An energized, engaged, and resilient physician workforce is essential to achieving national health goals.”

 

And burnout affects all fields of medicine, surpassing 50%, in those including primary care and specialties such as gynecology, neurology, urology, emergency medicine, anesthesiology, cardiology and critical care to name a few.

 

Patients are at risk because if doctors aren’t at the top of their game, things get missed.  

 

Moreover the keen instinct of a clinician is imperative to diagnosing correctly, and this gets blunted when one is emotionally fatigued, or burned out.

Why are Doctors Burning Out?

 

A variety of factors can lead to physician burnout but the following appear to be the most cited:

 

  1. Electronic medical records – these are time-consuming to learn and implement, take time away from patients and may be financially burdensome due to their cost and lack of revenue for those who struggle to type and work with computers.

  2. High patient insurance deductibles – with insurance companies not paying until patients reach their deductible, it forces doctor’s offices to work harder to collect the income needed to run a practice.  Physicians do not want to get into the financial aspect of patient collections and it adds undue stress on an already stressful field.

  3. Red tape – ICD 10 code changes, insurance authorizations, referral forms turn the average day of a physician to less patient care and more bureaucracy.

  4. Less respect – in the old days, doctors were considered heroes and revered greatly.  Today they are frequently blamed for issues such as rising healthcare costs and the opioid epidemic.

  5. Malpractice suit fears – doctors are human and can only combat nature so much.  When one is diagnosed with cancer a physician has to fear that one will accuse him of not diagnosing it “quickly enough”.  When a lab gets ordered, the clinician has to hope that his staff is ensuring that every lab value comes across his desk.  When a prescription is written, he has to hope that the correct medicine is dispensed, works effectively and does not cause an adverse reaction.  And when a referral is made to a specialist, he has to hope all the above issues go well with the second physician or he can be sued for the referral.  And since a doctor sees thousands of patients a year, the odds that he will be sued for something is higher than any other profession.  Moreover, one lawsuit is a enough to bankrupt him.  Pretty darn stressful.

 

What are the signs of burnout?

 

In any profession, the following may be signs of burnout:

 

  • Apathy

  • Exhaustion

  • Poor sleep

  • Negative attitude at work

  • Absence from work

  • Being irritated

  • Feeling empty

  • Dreading going to work

  • Feeling underappreciated

  • Feeling you don’t matter

  • Blame others for mistakes

  • Low energy

  • Thinking about quitting




burnout

 

How to prevent burnout?

 

  1. Find the humor – As Milton Berle once said, “Laughter is an instant vacation”.  Watching a comedy or taking a 10 minute break to watch some funny YouTube clips offers immediate relief and energizes you.  A day without laughter is a day wasted. Charlie Chaplin

  2. Take care of yourself – how can one heal others when he himself needs healing?  So what can you do?  Try Massage, Meditation, Yoga, Exercise, Stress diary, Sleep, Mini vacations, Staycations but most of all…..Take breaks!!

  3. Learn to say “No” – It’s OK to take a day off. Why not take off early on Friday’s?  Or better yet, work a half day on Wednesday to break up the week?  Learn the 4 D’s…..Deflect, Defer, Deter, Delegate…..

  4. Make small goals – too many times we burnout because we failed to meet a goal that was unattainable in the first place.  So we toil for years to become “promoted”, or “wealthy”, or “slim”, or “married”, or “see the world”.  Instead, make smaller attainable goals (find a partner, open auxiliary office, lose 10 lbs, take a trip).

  5. Quit comparing yourself to others – we watch Shark Tank and then wonder what we are doing wrong, not being millionaires.  It’s unrealistic to think you should be “rich by now”.  We will always be inferior to someone else.  So get over it and love who you are and what you’ve accomplished.

  6. Have fun at work – contests, pot luck lunches, lunch room decorating, accent days, dress up days, and end of the week happy hour can spice things up at work.  Plus it increases morale among coworkers and staff.

  7. Be charitable – Doing community service is so rewarding and energizing that having a pet project helping out a local charity may be just what this doctor orders.  You can choose a cause, fundraise, attend charity events or walks, or even create a campaign.

  8. Get a hobby – tap into your artistic side by writing a book, song, article; paint; cook; build; teach; sing; dance; or even ride.

  9. Work on your bucket list- whether its going to a foreign country, learning to speak a new language, buying a vacation property, or even starting a second business, don’t let job burnout deter you.  This may give you the energy and perspective you need.

 

Finally, be around others and have a Bitch and Moan session – it feels so good to complain and gripe. Find others in similar situations as you and you’ll realize that you may have it better than you think.

 

Remember you have to come first and doing so will make you more of a help to others.  Feel great and you’ll make others feel great!

 

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Daliah Wachs is a guest contributor to GCN news. 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
Tuesday, 31 October 2017 15:54

Halloween Safety Tips

 

Ghosts, goblins, Mommy yelling – Halloween can be pretty scary.  But the candy, the costumes, decorations and running door to door threatening all your neighbors with a “trick” makes it one of the most exciting days of the year!

 

Unfortunately, the more fun and immersed into the festivities, the more dangerous for our little ones. 160,000 injuries occur on this day each year, and even scarier, Halloween is the deadliest for pediatric pedestrians with 6100 fatalities reported annually by the National Safety Council.  No holiday should end so tragically.

 

In addition to this, parents need to be aware of fire and choking hazards.  We therefore recommend the following to keep our kids safe.

 

  1. Make sure your child’s mask allows him/her to see clearly.  If not, replace with non-toxic makeup, that is tested a few days before on a small area of skin on their arm to ensure they are not allergic.  The makeup should be washed off before bedtime.

  2. Avoid long costumes, such as ghost-themed, that may trip your child while they walk/run.

  3. Use bright-colored costumes. If your child insists on a dark costume, such as Batman, put a belt of glow sticks around him or add reflective tape to their costume and trick or treat bags

  4. Make sure all costumes and hats are flame resistant and teach your kids how to avoid tripping over jack-o-lanterns with candles in them.

  5. Avoid costume contact lenses as they may decrease visual acuity, scratch the eye and cause infection.

  6. Use the sidewalk.  Your child will want to zigzag across the street when they see everyone else doing it.  You need to be the parent like me who yells at everyone to get back on the sidewalk.

  7. Watch out for drunk drivers.  Many are coming back from a “trick or drink” party and could be impaired.

  8. Make the “no eating candy until you get home” rule.  Allows you to check the candy for open wrappers and dangerous things that don’t belong.  Then steal your favorite treats when the child is taking his/her potty break

  9. Teach your child to not enter a stranger’s home – even if it is in full decoration

  10. Stay in a group and follow your children. You can leave a safe distance behind while still supervise. And it’s fun when we parents compete for who can yell at our kids the loudest.

  11. Carry Walkie Talkies.  Halloween streets get loud and kids may not hear you if they start walking down a different street and turn into a housing complex.  Walkie talkies are fun and keep you connecting with your younglings’ even if they are a few feet away.

  12. Parents should avoid “Trick-o-Drink!!”ing where we walk around with our red plastic cup and rather than ask for candy, we opt for some spirits poured in.  Parents giggle, feeling apart of the festivities, but unfortunately will be sloshed by the fourth home they hit and won’t be able to effectively supervise the children.  We need to be at the top of our game this Halloween.  Cut the booze.

  13. And drivers, be wary of trick-or-treaters even before it gets dark.  Drive slowly and pay attention!  Let’s have a Happy and Safe one!!!

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Daliah Wachs is a guest contributor to GCN news. 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
Tuesday, 24 October 2017 16:44

New Type of Diabetes Discovered: Type 3c

A third type of diabetes has been identified by researchers. Type 3c diabetes may be mistaken for Type 2 diabetes, causing delay of proper treatment.

 

Researchers from the University of Surrey found Type 3c diabetes to be more common in adults than Type 1 diabetes.  Moreover they found that those with Type 3c were twice as likely to have poor blood sugar control than those with Type 2 diabetes.

 

They believe, discussed below, that the diabetes occurs years after injury to the pancreas, the organ that produces insulin.  So a person with Type 3c diabetes will most likely need insulin rather than an oral medication that treats insulin resistance



Study author, Andrew McGovern, writes: …our latest study has revealed that most cases of type 3c diabetes are being wrongly diagnosed as type 2 diabetes. Only 3% of the people in our sample – of more than 2m – were correctly identified as having type 3c diabetes.

 

So if many Type 2 diabetics fail to maintain control with their oral medications that address insulin resistance, they may actually have Type 3c and need insulin instead as low insulin is the cause of their diabetes.  Identifying this early will hopefully prevent some of the complications that occur with long term diabetes.

 

What is diabetes?

 

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, it’s 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 blood stream.   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 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.

Type I vs. Type II vs. Type IIIc 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.

 

Type IIIc diabetes may occur in individuals who suffered damage to their pancreas.  Inflammation/infection of the pancreas (pancreatitis), a pancreatic tumor, or surgery affecting the pancreas may destroy the beta cells that produce insulin.



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 one's 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 on the study visit here.

 

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Daliah Wachs is a guest contributor to GCN news. 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

A new study out of Pennsylvania State University College of Medicine links textured breast implants to BIA-ALCL, anaplastic large cell lymphoma.

 

Although a rare cancer. researchers believe the lifetime risk is 1 out of every 30,000 women with breast implants and if the numbers are underreported, could be as common as 1 out of every 4000 women with implants.

 

Although the implants are used to augment breast tissue, the malignancy is not a breast cancer but rather a lymphoma.

 

Lymphomas make up the most common of the blood cancers.  The cancer begins in the lymphocytes, cells crucial for maintaining one’s immune system. Two main types of lymphoma are Hodgkin’s and Non Hodgkin's.  Non Hodgkins is more common, and anaplastic large cell lymphoma is a subset if it.

 

 

anaplastic-large-cell-lymphoma-[3-ln072-3].jpg

ANAPLASTIC LARGE CELL LYMPHOMA/PATHPEDIA.COM

In this study, researchers reviewed 115 scientific articles from 1997 – January 2017.  Unlike the report released earlier this year by the FDA, the researchers did not find a link between BIA-ALCL and smooth breast implants.  Of the articles reviewed, 93 cases were cited and the cancer appeared 10 years after the textured implants were placed.

 

According to the American Society of Plastic Surgeons, there are currently 160 cases in the US and a total of 391 worldwide as of September 2017.

 

Last March the FDA reported 9 women had died from anaplastic large cell lymphoma (BIA-ALCL) possibly associated with their breast implant use.  The FDA received 359 reports of BIA-ALCL,  a rare type of non-Hodgkin's lymphoma, 9 of whom died as of February 1, 2017.

This is not the first time a link has been suggested.  6 years ago the World Health Organization suggested a link.  Then in 2011, the FDA identified a possible association between the two.  In 2016, the  Australian Therapeutic Goods Administration reported 46 confirmed cases with 3 deaths relating to breast implants.

 

The report last spring suggested that BIA-ALCL affected both smooth and textured implants. According to the FDA report, 231 of the 359 cancer cases provided information on implant type.   203 were reported to be textured implants and 28 reported to be smooth implants. When it came to silicone vs. saline implants, the FDA said 312 of the 359 reports provided these specifics and of those 186 reported implants filled with silicone gel and 126 reported implants filled with saline.

 

TEXTURED.jpg

 

So neither implant type appeared immune to the risk of BIA-ALCL but it appears the silicone, textured implants carried the most risk.

 

Now the cancer occurred within the breast and the FDA advises physicians to consider the possibility of BIA-ALCL if there appears to be a seroma (fluid filled cavity around the implant) or a contracture (pulling of the skin and tissue) near the implant.

 

In most cases the cancer is treatable, with removal of the implant and the surrounding tissue curative.  In some cases however, radiation of the area or chemotherapy is required.

 

Although 50,000 cases of non-Hodgkin’s lymphoma occurs annually in the US, it is unknown how many cases of BIA-ALCL occur each year.  Moreover, many countries may not have avid reporting systems of breast implant related cancers as we do.  According to the American College of Plastic Surgeons, close to 300,000 women receive breast implants each year, some of which for breast reconstruction after mastectomy for breast cancer.

 

The FDA reminds us that BIA-ALCL is rare and prophylactic breast implant removal is NOT recommended. However we need to be aware and evaluate if one develops swelling, pain, new lumps or asymmetry in the breasts….just as we do for those without implants.

For more on the study, visit here.

 

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 Daliah Wachs is a guest contributor to GCN news. 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

On Sunday, Green Bay Packers Quarterback Aaron Rodgers suffered a collarbone fracture and may be out for the season.  Here are your questions answered.

What exactly is a collarbone?

 

The collarbone is another name for the clavicle.  It’s the bone that connects the scapula (shoulder-blade) to the sternum (breastbone).  We have one on each side and it runs horizontally providing shoulder girdle support.  Not only does it provide upper skeletal strength and support but it also protects many major vessels that run underneath it.

 

 

clavicle

Image from AAOS

What’s a collarbone fracture?

 

The clavicle (collarbone) is one of the most common types of bones to fracture during sports injuries.  There are three major Groups or Types of clavicle fractures.

 

Type I – is the most common and occurs in the middle third of the clavicle

 

Type II – is the second most common and occurs distally, or closer to the shoulder.

 

Type III – is the most rare and occurs the most medially, or closer to the rib cage/sternum.

clavicle fractures

 

What are the signs/symptoms of a clavicle fracture?

 

Before bruising and swelling ensue, one will have sharp pain in the area of the collarbone and have difficulty moving his shoulder.

 

So signs of a clavicle fracture include:

 

  • Pain

  • Loss of range of motion of the shoulder

  • A bulge at the fracture site

  • Swelling

  • Bruising

  • Tenderness at the fracture area

  • In young children, not wanting to move the arm on the affected side

 

How are collarbone fractures treated?

 

If the bone has not shifted too significantly, clavicle fractures can be treated non- surgically. Arm slings will be given to decrease the movement of the shoulder girdle.  Pain medication and antiinflammatories may be prescribed, and physical therapy will be instituted immediately to improve range of motion and strength.

 

If the clavicle is displaced significantly from the injury then surgery will be needed to reunite the ends using plates, rods and screws.

 

How long does it take collarbone fractures to heal?

 

In adults, healing could take anywhere from 6-12 weeks.  For children, clavicle fractures may heal sooner.

How does one prevent a collarbone fracture?

 

During sports, protective equipment is key to avoiding injuries from falls and tackles.  As in Aaron Rodger’s and Tony Romo’s cases, being sacked by another large player barreling towards them must be avoided at all costs.

 

Just say NO to sugar.  This will be a hard one for me but if you do it, I will.

 

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 Daliah Wachs is a guest contributor to GCN news. 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

The World Health Organization (WHO) finds the number of obese children in the world to be 10 times greater than what it was 4 decades ago.

 

They estimate currently 50 million girls and 74 million boys are obese worldwide.

 

Back in 1975 only 11 million children worldwide were obese. Now the number sits at 124 million.

True, population has grown since then, but the percentage of children obese is exploding -- 19% of girls and 22.4% of boys in the US are considered obese.

 

Adult obesity is skyrocketing as well. In 1975 there were 100 million obese adults worldwide. This jumped to 671 million in 2016 and doesn’t include the 1.3 billion “overweight” adults.

 

The Center for Disease Control and Prevention (CDC) states the following:

 

Obesity is defined as having excess body fat. Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors. Body mass index, or BMI, is a widely used screening tool for measuring both overweight and obesity. BMI percentile is preferred for measuring children and young adults (ages 2–20) because it takes into account that they are still growing, and growing at different rates depending on their age and sex. Health professionals use growth charts to see whether a child’s weight falls into a healthy range for the child’s height, age, and sex.

  • Children with a BMI at or above the 85th percentile and less than the 95th percentile are considered overweight.

  • Children at or above the 95th percentile have obesity.

 

Why such a rise in obesity?

 

  1. We’re successfully fighting the war on tobacco. Adults especially can’t turn to a stick of nicotine as easily as they once could to curb their appetite.  Teen smoking is down as well, so their appetites may be up.

  2. We like fast food.  Its cheap, yummy and convenient.  For 99 cents you can get a small burger that is served to you in a matter of minutes and can be eaten before your next meeting or class.  Fast food contains excess calories, fat and preservatives that our body doesn’t need.

  3. We eat too quickly.  The speed at which we eat may affect our metabolism.  Eating too quickly prevents a satiety signal from reaching the brain, hence we will gulp down more food than is needed.  For more on this read here.

  4. We don’t move around as much.  We can all agree that children and adults these days don’t play outside as much as we did in previous generations.  And even if we did get some exercise in each day during PE or at the gym, we lose much of the ground gained when we sit on our computers at night for hours on end.

  5. More hormones are in our food.  Hormones such as steroids and recombinant bovine growth hormone (rBGH) that enhance food production in our food-producing animals may affect our metabolism.

  6. Sugar isn’t a treat anymore, it’s considered a food group.  In the 70’s if you got dessert one night at dinner it would be a rare treat.  Today kids have dessert at lunch and even breakfast has sugar levels over flowing the cereal bowl.  Excess sugar leads to fat storage.

  7. Our portions have gotten bigger.  Remember when the Quarter Pounder came out in the early 70’s and we thought it was the biggest burger ever?  Now people will eat two in one sitting.

 

Below is a table showing the difference in portion sizes today vs. the 1950’s.

 

portion sizes.jpg
Image from Daily Mail

 

What can we do to combat the obesity epidemic?

 

  1. Make exercise not a choice but a daily necessity. Schools should have English class conducted on walks around the school rather than sitting in desks. A 30 minute workout should be a given every morning without excuses. We brush our teeth, we wash our hair, we gas up our truck, we exercise.

  2. Eat fresh, avoid fast food.  The more junk food the more junk in your trunk.  Avoid preservatives and processed foods. Your body was designed to eat the basics. Give it what it needs.

  3. Eat slowly.  No need to chow down on the run. If you’re in a hurry then eat half the sandwich as save the rest for later. Which brings us to…

  4. Eat smaller portions. Get rid of the platters you call plates these days and eat your dinner off of a saucer dish. You’ll still fill up your tummy.

  5. Swap vegetables for carbs. It’s healthier, filling, and helps you poop.

Just say NO to sugar.  This will be a hard one for me but if you do it, I will.

 

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 Daliah Wachs is a guest contributor to GCN news. 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

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