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Halloween Saftey 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!

trick-or-treating

 

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 7300 fatalities reported annually by the National Safety Council.

Thousands have petitioned the White House this year to move Halloween officially to the last Saturday of October to avoid families rushing home on a work/school night to start the festivities.

However, any day kids are running around in a quest to find sugar puts them at risk and no holiday should end so tragically.

 

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In addition to traffic accidents, 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.

 

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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.

 

contact lens.jpeg

 

6. Use the sidewalk.  Your child will want to zig zag 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 part 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.

 

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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, her views and opinions, medical or otherwise, if expressed, 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

The FDA has approved a new drug, Xofluza (baloxavir marboxil), to help fight the flu this season.

The antiviral is a single dose and is taken within 48 hours of first signs of flu symptoms.

It is only indicated in those older than 12 years old. The cost is approximately $150 for the single dose.

Current antiviral medications approved by the FDA to shorten the course of the flu include Relenza and Tamiflu. These medications are in a class of neuraminidase inhibitors, which inhibit the release of new viral particles that have replicated in a host (patient).

 

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Xofluza, however, works sooner, by preventing the virus from replicating within the host cell in the first place.

Therefore this new drug can stop the spread of flu earlier than its predecessors.

NBC News reported the following:

A 2016-2017 STUDY IN 1,436 PEOPLE IN THE U.S. AND JAPAN SHOWED THE ONE-DOSE PILL CUT THE TIME PEOPLE WERE SICK TO 2.5 DAYS, FROM ABOUT 3.3 DAYS. IT CUT HOW LONG PEOPLE HAD A FEVER FROM AN AVERAGE OF 42 HOURS TO JUST ONE DAY. IT ALSO REDUCED WHAT’S CALLED VIRAL SHEDDING FROM FOUR DAYS TO JUST ONE DAY.

 

So the less time one is sick with the flu, the less risk of coming down with a secondary infection such as pneumonia, or other flu related illness.

Moreover if viral shedding is decreased, less family members and contacts can potentially become ill.

Now Xofluza may not prevent the flu in one who has not been exposed because it works by preventing virus that is present from replicating.

Flu symptoms may come abruptly and include:

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

The most effective way to prevent the flu is avoidance of sick contacts, good hand washing and vaccination.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, 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
%PM, %17 %737 %2018 %16:%Oct

Viagra should not be vaped

The FDA is warning e-cigarette companies to stop selling vaping products with claims that they contain erectile dysfunction medications.

Consumers are being urged to avoid vaping products claiming to have ingredients such as sildenafil and tadalafil used in Viagra and Cialis respectively as they can interact with other medications (such as nitrates). Moreover there is no data suggesting one’s respiratory lining to be a safe route of absorption of a phosphodiesterase type-5 (PDE-5) inhibitor.

The primary purpose of the lungs is to oxygenate blood and its highly specialized lining is not necessarily designed to absorb nutrients, as does the small intestine.

On the FDA website it states:

THE U.S. FOOD AND DRUG ADMINISTRATION ANNOUNCED TODAY IT HAS ISSUED A WARNING LETTER TO HELLOCIG ELECTRONIC TECHNOLOGY CO. LTD FOR VARIOUS VIOLATIONS OF THE FEDERAL FOOD, DRUG, AND COSMETIC ACT, INCLUDING SELLING TWO E-LIQUIDS THAT CONTAIN THE PRESCRIPTION DRUGS TADALAFIL AND/OR SILDENAFIL, LEADING THE FDA TO DETERMINE THAT THE PRODUCTS ARE UNAPPROVED NEW DRUGS.

 

SILDENAFIL AND TADALAFIL ARE THE ACTIVE PHARMACEUTICAL INGREDIENTS IN FDA-APPROVED PRESCRIPTION DRUGS USED TO TREAT ERECTILE DYSFUNCTION. THESE FDA-APPROVED PRESCRIPTION DRUGS ARE NOT APPROVED FOR INCLUSION IN E-LIQUID PRODUCTS SOLD OVER THE COUNTER AND ARE THEREFORE BEING SOLD ILLEGALLY. IN ADDITION, THE COMPANY IS MARKETING OTHER E-LIQUIDS USED IN E-CIGARETTES IN WAYS THAT CONVEY AND MISLEAD CONSUMERS INTO BELIEVING THAT THE FDA HAS APPROVED THESE TOBACCO PRODUCTS, WHEN IT HAS NOT.

 

LABORATORY ANALYSIS CONDUCTED BY THE FDA CONFIRMED “E-CIALIS HELLOCIG E-LIQUID” CONTAINS THE UNDECLARED DRUGS SILDENAFIL AND TADALAFIL, AND “E-RIMONABANT HELLOCIG E-LIQUID” CONTAINS THE UNDECLARED DRUG SILDENAFIL. THESE UNDECLARED INGREDIENTS ARE PHOSPHODIESTERASE TYPE-5 (PDE-5) INHIBITORS. THESE INGREDIENTS CAN BE ASSOCIATED WITH SIGNIFICANT SAFETY ISSUES AND THE RISK OF SERIOUS ADVERSE EVENTS.

FDA Commissioner Dr. Scott Gottlieb states, “There are no e-liquids that contain prescription drugs that have been proven safe or effective through this route of administration.”

Those Needing Erectile Dysfunction Drugs Should Have Their Heart Checked

 

Companies are looking to expand their market by enticing consumers to vape vitamins, such as B12, and essential oils. Last week, however, a professor of nutrition from New York University, Dr. Charles Mueller, warned against it. He states, “Vitamins need to come with [fat and water] and go through the same gastrointestinal tract to be absorbed.” Moreover respiratory administration of nutrition has not been actively studied.

 

Vaping linked to heart disease and cancer

 

A study published by the American Heart Association found nine different E-cig flavors  to impair blood vessel function, which can impair heart health.

Endothelial cells, which delicately line blood and lymph vessels, were found to become inflamed at low concentrations of some vapor flavors.  And at high concentrations of others, exhibited cell death.  Nitric oxide production, necessary for vessel dilation to improve blood flow, was impaired as well. These are often the same changes seen in early heart disease.

 

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The 9 flavors (and the chemicals within) cited in the report to cause the endothelial inflammation and/or damage were:

 

  • Vanilla (vanillin)
  • Mint (menthol)
  • Clove (eugenol)
  • Cinnamon (cinnamaldehyde)
  • Strawberry (dimethylpyrazine)
  • Banana (isoamyl acetate)
  • Butter (diacetyl)
  • Eucalyptus/spicy cooling (eucalyptol)
  • Burnt flavor (acetylpyridine)

Strawberry flavoring appeared to have the most adverse effect on the cells.

How many other flavors were not included in this study, so it's unknown how safe they may be.

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 mucous 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.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, 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

A rare polio-like illness is startling health officials as multiple states have reported cases of AFM (Acute Flaccid Myelitis).

Since August 2014, the CDC has received reports on 362 cases.

This week we learn of 6 children in Minnesota who have been diagnosed with AFM, which may manifest in symptoms such as sudden muscle weakness, stiffness, slurred speech and facial droop.

The age range of children affected appear to be 3-14.  A 6-year-old boy in Washington State died in 2016 and was the first death to be linked to this mysterious illness.  His parents reported he had felt ill, became dizzy and within hours suffered swelling in the brain and paralysis.  Despite medical efforts, he passed.  Although the exact cause is unknown, health experts are considering a variety of possibilities. They have actually been investigating this since 2014 when reports of AFM began to surface across the United States.

What is AFM?

 

AFM stands for Acute Flaccid Myelitis.  It’s a condition that occurs suddenly, causing inflammation of the brain and spinal cord, causing loss of muscle tone and reflexes.  Although limb weakness is the primary symptom, patients could also exhibit slurred speech, facial drooping, and in serious cases inability to breath due to paralysis of the respiratory muscles.  Mild cases appear to resolve but serious cases can cause residual paralysis or death. Children appear to be more affected than adults.

What causes AFM?

 

Although health officials do not know for certain, due to its rapid onset, a pathogen such as a virus seems highly likely.  With the 2013-2014 outbreak, some of the cases tested positive for enterovirus (EV-D68), but it is not conclusive whether this was the exact cause or just coincidentally found in the patients tested.

Some postulate a combination of viruses may be a factor or an autoimmune disease.  Although Guillain-Barre syndrome causes acute limb weakness and paralysis when the immune system begins attacking the nervous system, the report that many individuals feel feverish or ill prior, seem to point to a pathogen as the primary cause although the latter is not being ruled out.  Virus families such as enterovirus (including polio and non polio enterovirus), adenovirus (causing respiratory and GI illness) and flaviviruses (including West Nile) have been suspected.

How common is AFM?

 

Per the CDC, acute flaccid myelitis is rare (less than 1 in a million cases) however currently they report 362 people affected in currently 16 states (down from 39 states in 2016).

How is it diagnosed?

 

Medical professionals look at a variety of factors.

History: how the paralysis/loss of muscle tone began and which limbs did it affect first

Laboratory tests and CSF (cerebrospinal fluid) testing: to look for signs of infection

MRI of the brain: which may show gray matter involvement in a case of AFM.

Is there a treatment?

 

There is no standard treatment that has been proven effective, however depending on the severity of the symptoms, health professionals can consider a variety of options including steroids, IVIG, interferon, antivirals and supportive measures.

Is there a vaccine?

 

No.  Until they can identify the exact cause, or causes, health officials cannot create a vaccine.

How does one avoid getting AFM?

 

If we assume its a pathogen causing the illness, avoiding contact with sick individuals, being up-to-date on one’s vaccines and good hand-washing are imperative.  Although we do not know if AFM is caused by a mosquito-borne illness, avoiding mosquitoes would be wise as well.   More therefore needs to be researched to determine why and how those individuals with AFM were infected.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, 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

Breast cancer affects thousands of men and women each year and screening is unfortunately overlooked all too often.

Many women find mammograms painful and embarrassing hence hesitate when urged to get screened.

And some men may not realize they too have breast tissue and are at risk for breast cancer.

mcdc7_gynecomastia-8col.jpg

 

October is Breast Cancer Awareness Month and #ShirtsOff reminds us to examine ourselves, get screened, and look for changes in our breasts.

Signs of breast cancer include

  • A lump inside the breast or under the arm
  • Breast pain
  • Change in breast shape
  • Dimpling
  • Nipple discharge
  • Nipple bleeding
  • Rash
  • Sore on the breast
  • Discoloration
  • Change in skin texture

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 266,120 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,960 cases of non-invasive breast cancer, a rise from last year.

40,920 women and 480 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 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

 

3-D Mammograms use some of the most sensitive technology in screening.

Dr. William Boren, owner of West Valley Imaging in Las Vegas, Nevada, states “3-D Mammograms reportedly find up to 40% more cancers, allowing a topographic view of the tissue.”

Dr. Boren also recommends to “not leave big gaps between screening.  If you start screening at age 40, then continue yearly screens.”

 

mammogram 2018.jpg

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, 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
%PM, %10 %813 %2018 %18:%Oct

Hurricane Michael hits Florida coast

Hurricane Michael, the strongest on record in the U.S. since 2004 hit the Florida coastline this afternoon. It’s too late to evacuate. If you’re there - you’re there. Michael is a Category 4 hurricane with winds at 155 mph. But that makes it that top end of Category 4 because as soon as winds hit 157 it will officially be a Category 5. Not that there is much difference between 155 and 157 mph winds other than the rating system because, either way, enormous damage is about to rain down on Florida.

 

Not even one month after Florence flooded Georgia & the Carolinas and caused $1.5 billion in damages, the E coast is getting hammered again. This time by Hurricane Michael, which meteorologists have rated a Category 4.

 

Folks in Georgia and the Carolinas still have flooded areas in large portions of the coastline and in a few more days will receive more rainstorms as Michael hits Florida today but will move N further inland by Friday. Michael is actually the opposite of Florence which went from a Category 4 down to a Category 1 by landfall while Michael increased in strength as it came closer to the SE coastline. In fact, meteorologists believe that Michael will still be a Category 2 Hurricane when it hits Alabama and southern Georgia.

 

If that’s not bad enough Hurricane Michael, according to the National Oceanic and Atmospheric Administration, could spawn tornadoes anywhere from 50-100 miles outside the hurricane eye. That’s all those folks need, right? Tornadoes to go along with their Category 4 hurricane.

 

Last month, our very own Dr. Daliah wrote a “How You Can Help” column for Hurricane Florence and all of her information is relevant for Michael as well. You can read her column here. Her column also has plenty of links to the Red Cross, the Army Emergency Relief and other sources if you want to donate assistance. The American Red Cross is accepting monetary and blood donations. Financial donations can be given here or on their website at redcross.org. Moreover one can call 1-800-RED-CROSS or text the word REDCROSS to 90999 to make a $10 donation. More relief numbers in her column.

 

The forecast cone is expected to stretch Michael all the way north to Maryland, which is a lot of damage, and a lot of danger.

 

This is a developing story.

 

Published in U.S.

For those of us who are football enthusiasts, we may be at an advantage when it comes to relationships. Makes sense….when things go sour with our partner we turn to football. When we get sidelined we wait for a signal to get back on the field. And we instinctively “suit up” before each encounter to protect us from the blows we may incur.  So the question arises, do football fans fare better in relationships?

 

We know the field

 

Before any play, we need to position ourselves correctly on the field. Being too close to the “end zone” when you’re supposed to be yards away can give you a severe penalty.

So we start at the line of scrimmage and respect the “neutral zone.”

 

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An infraction of this space could again inflict a costly penalty.  There’s a time and a place when beginning a play and entering this zone is allowed.

 

neutral zone.jpg

 

True our goal is to get to the end zone but it will take some strategy, finesse, and opportunity.  Some good drives will get you a long way, and patience and persistence is key.

 

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We study our competition

 

Before any play we size up our competition.  Some may block your advance but most you can overcome.  As long as you know your routes and can keep other players at bay, you have a chance of advancing.

 

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How do we fumble?

 

Holding a ball loosely and carelessly could cause it to easily fall into another player’s hands.

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But if you hold it too tight it may squeeze out the first opportunity it gets. A proper cradling, warmth, and protection may be the right recipe.

 

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We need to rely on others during a fumble

 

Losing the ball is devastating and someone else can pick it up and run with it. It takes your buddies to help you regain possession so you can start over.

 

fumble.jpg

 

Treat your partner right and don’t lose them to begin with.

We are always prepared for an interception

 

The field is fluid and players are out there watching, waiting to grab your ball and take advantage of the yardage you acquired.

 

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Always be mindful of your position and don’t take your possession for granted.

We adapt when we’re in the red zone

 

Although the red zone is not officially marked on the field, we understand it to be the 20 yards closest to the end zone, or time during a relationship where you can either advance to your goal or fail miserably, losing all the time and work you put into the relationship. Being too aggressive may cause a fumble, interception or even injury.  Being too chill could prevent you from ever making a touchdown.

So us football folk know how to stop, huddle, and plan,  hopefully resulting in the ball sailing into the end zone without a hitch.

 

touchdown.jpg

 

So if you’re in the dating scene and find yourself getting encroached, needing to scramble, or facing a blitz, watch some football and learn how to treat your date right. It might get you a whole new set of fresh downs…….

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, 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 Opinion
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How college students can cut their debt

Student debt has been rising and the average undergraduate doesn’t feel confident they will pay off their loans before middle age.

Lots of factors contribute to the increased debt a student faces. Some of these include:

  • Higher tuition costs

  • Increased time requirements to obtain a degree (5 year program vs 4 year)

  • Fewer students work while taking classes

  • More competition after graduation

  • Higher cost of living precludes early repayment of loans

And it is projected to rise.  The Congressional Budget Office each year projects the total amount of new federal student loans the office believes they will issue with this year projected to be nearly $1.5 trillion.

student loan debt.jpeg

Andrew Coates, candidate for University Regent in Southern Nevada, states, “One way that colleges can help students keep their debt under control is by locking-in tuition rates.  This means that tuition will not be increased while a student pursues their degree.  By locking-in tuition, students will know exactly how much they will pay each year in college, which will help them budget accordingly.”

 

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ANDREW COATES, CANDIDATE FOR UNIVERSITY REGENT, SOUTHERN NEVADA

 

So how can students curb their debt?

Choose an affordable college

 

According to US News data, the average cost of tuition and fees for the 2018–2019 school year was $35,676 at private colleges, $9,716 for state residents at public colleges and $21,629 for out-of-state students at state school, with many universities easily exceeding these numbers.  So students may want to consider getting early credits completed at community colleges and then finishing their degree at a university.  Additionally, many will need to decide if its worth picking an out-of-state college for a degree that provides the same job market edge as an in-state school.

 

Research available loans, grants and scholarships

 

Many students don’t apply for grants, loans and scholarships because of time constraints, misconceptions such as they don’t fit a demographic, or  “will be credit history required?”, and lack of optimism that they will even qualify.

Mark Kantrowitz, publisher and vice president of saveforcollege.com states, “More than 2 million students did not get a Federal Pell Grant even though they were eligible because they did not file the FAFSA.”  FAFSA (link attached) is a free application for federal student aid assisting students who want to apply for a loan, grant or work study.

Scholarships are ideal in that they do not need to be paid back. Many can be found at scholarships.com.

Learn to budget

 

Many students get a culture shock living on their own when they spend as if Mom or Dad is still footing the bill.  If eating out nightly, shopping online, or using excess data does not fit into the amount your trying to live on each month, budget expenses early on and stick to it.

Avoid the credit card trap

 

When we try to build our credit as a young adult, we may apply for a credit card that advertises to college students with no monthly fee and “rewards.” However, the interest rates can be up to 25%.  If you do use the credit card don’t borrow more than you can pay  off each month, always shooting for a zero balance.

 

Keep your living costs down

 

Rent, transportation, utilities, meals, entertainment, internet and phone service, add up and can be more costly than tuition.  Share expenses with roommates or family members to lessen your loan debt.

Cook and prepare meals for the coming days, use school Wi-Fi, carpool to class, purchase less beer, and use the university gym to save money.

But most importantly, don’t stress about the debt.  Your efforts should be concentrated on your schooling and getting a degree is one of the best ways to combat your debt later in life.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, 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
%PM, %28 %787 %2018 %17:%Sep

October is Breast Cancer Awareness Month

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 266,120 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,960 cases of non-invasive breast cancer, a rise from last year.

40,920 women and 480 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 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, if expressed, 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

Another warning has been issued to adults and seniors who mix herbal remedies, over the counter supplements and prescription medications.

A study from the University of Hertfordshire in the UK found 44% of women and 22% of men surveyed mixed their prescription medications with herbal remedies and over the counter supplements.

Individuals may have changes in their metabolism and medication breakdown as they age causing variances in body absorption and efficacy of medications.  Adding supplements or herbal remedies could cause unpredictable reactions.

These effects could include:

  • Less efficacy of prescription medication causing poor blood pressure, sugar, heart rhythm control, for example)
  • Enhanced active compounds of medications taken (possibly causing overdose)
  • Nausea
  • Vomiting
  • Body aches
  • Jaundice
  • Blood thinning causing easy bleeding
  • Renal failure
  • Liver failure
  • Anemia
  • Mania and other personality changes
  • and  more

For example, St. John’s Wort could interfere with the effectiveness of one’s birth control and ginseng could worsen one's hypoglycemia if they are taking insulin.

Grapefruit juice could interfere with the metabolism of a statin, a popular medication used to decrease cholesterol. By raising its levels in the blood, one drink could cause a patient to have increased side effects such as muscle cramps and liver issues.

Iron supplements can interfere with one’s absorption of their thyroid medication, and ginkgo biloba, if taken with a blood pressure medication, could cause the blood pressure to drop even lower. Moreover it can increase bleeding if taken with an anticoagulant.

And if alcohol is mixed with any prescription medication, deadly side effects (such as respiratory depression when used with opiates) can ensue.

So the moral is, just because a supplement states is “natural,” or a frequently consumed food appears to be safe, its combination with medication could prove deadly.

Although the interactions are numerous, the AAFP created a table of common ones:

 

Herbal and Dietary Supplement–Drug Interactions

HERBAL OR DIETARY SUPPLEMENT

DRUG

COMMENT

RECOMMENDATION*

Patients taking oral anticoagulants

Cranberry (juice)

Warfarin (Coumadin)

Interaction possible based on seven reports of increased INR, although a clinical study showed no interactions47

Suspect an interaction if INR elevated

Fish oil

Warfarin

Interaction possible, with case reports showing an elevated INR, although a clinical study showed no effect of fish oil on anticoagulation status8,9

Suspect an interaction if INR elevated

Garlic

Warfarin

Interaction unlikely based on a clinical study that found garlic is relatively safe and poses no serious hemorrhagic risk for closely monitored patients taking warfarin oral anticoagulation therapy10

Suspect an interaction if bruising or bleeding occurs despite an appropriate INR

   

One review found no case reports of interactions with garlic and warfarin11

 

Ginkgo

Warfarin

Interaction possible, though controlled clinical studies show no effect of ginkgo on the kinetics or dynamics of warfarin12,13

Experts recommend caution, although available research does not support this conclusion

 

Aspirin

Interaction suspected based on four case reports of spontaneous bleeding14,15

Suspect an interaction if spontaneous bleeding occurs

Ginseng

Warfarin

Interaction possible based on conflicting research findings

Avoid combination if possible

   

American ginseng (Panax quinquefolius)reduces blood concentrations of warfarin16,17

 
   

Coadministration of warfarin with Asian ginseng (Panax ginseng) did not affect the pharmacokinetics or pharmacodynamics of warfarin18

 

St. John’s wort

Warfarin

Interaction suspected based on decreases in INR in case reports and in a study in 12 healthy volunteers18

Evaluate warfarin response when St. John’s wort is initiated or stopped

Vitamin E (> 400 IU daily)

Warfarin

Interaction suspected based on a single patient (with rechallenge), resulting in an increase in INR19

Evaluate warfarin response when vitamin E is used in combination

   

One clinical trial showed no interaction20

 

Patients taking cardiovascular medications

Eleuthero (Eleutherococcus senticosus) [corrected]

Digoxin

Possible increase in digoxin levels without clinical signs (case report)21

Monitor digoxin level when eleuthero is initiated or stopped [corrected]

St. John’s wort

Digoxin

Suspected decrease in digoxin levels without clinical signs in a controlled study22

Monitor digoxin level when St. John’s wort is initiated or stopped

 

Verapamil (Calan)

Interaction suspected based on decreased bioavailability in a study in eight healthy volunteers23

Increase verapamil dose, if necessary, if diminished response occurs

 

Statins

Interaction suspected based on decreased plasma blood levels in a clinical study24

Monitor serum lipid levels after St. John’s wort is added

Patients taking psychiatric medications

Ginkgo

Atypical antidepressant (trazodone [Desyrel])

Interaction possible based on one case report of coma25

Evaluate for emotional and/or behavioral changes in patient response after ginkgo is initiated or stopped

Ginseng

Monoamine oxidase inhibitors

Interaction possible based on two case reports of manic-like symptoms, headache, and tremulousness17

Avoid combination if possible

St. John’s wort

SSRIs

Interaction suspected based on case reports of drowsiness or serotonin syndrome26

Taper off St. John’s wort when initiating an SSRI

 

Benzodiazepines

Interaction suspected based on pharmacokinetic studies showing decreased serum levels (25 to 50 percent) without clinical signs2729

Adjust the dose of benzodiazepine as needed

 

Tricyclic antidepressants

Interaction possible based on decreased amitriptyline plasma levels but no clinical effects in a study of 12 depressed patients27,30

Monitor patient response after St. John’s wort is initiated or stopped

 


 

INR = International Normalized Ratio; SSRI = selective serotonin reuptake inhibitor.

*— All recommendations have a strength of recommendation taxonomy (SORT) evidence rating of C (consensus, disease-oriented evidence, usual practice, expert opinion, or case series). For information about the SORT evidence rating system, see https://www.aafp.org/afpsort.xml.

Information from references 4 through 30.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, 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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