A coyote who attacked several people in Westchester County, NY this week has been captured and killed, testing positive for rabies.

Authorities believe another coyote is on the loose presumed to be rabid as well.

A police officer, a postal worker, two bicyclists and two dog walkers, with their pets, were attacked within a 24 hour period.  Three sheep may have been mauled as well.

One dog and a sheep have died as a result of the attacks.

The two coyotes may have been travelling together, with one still being at large.

The attacks occurred in Yonkers, Hastings-on-Hudson, and possibly Somers, NY.  Residents have been asked to avoid any wooded areas and keep their pets inside.

An animal with rabies may be very aggressive, more prone to attacks as opposed to one that is not infected.

What is rabies?

 

rabies.jpg

Rabies is a disease caused by a virus and transmitted through a bite. Although dogs are the most common animal to transmit the virus to humans, it more commonly infects bats, coyotes, raccoons, skunks, jackals, mongooses and foxes.

The animal will be agitated and many times foaming at the mouth due to hypersalivation.

The virus affects the central nervous system, including the brain, and can therefore be fatal.  Once symptoms appear it may be too late to save the affected animal or patient.

What are the symptoms and stages of rabies?

 

Once exposed to infected saliva the virus enters the peripheral nervous system (nerves in the limbs, outside of brain and spinal cord.) Then it travels to nerves in the muscle, replicates there and eventually works itself up to the brain.  Stages occur as the following:

Incubation

 

An incubation period is the time it takes from exposure until symptoms show. With rabies the average incubation period can range anywhere from a few days to years with the average lasting a few weeks. During the incubation period the patient may not know they are infected and the pathogen is multiplying and spreading.

Prodrome

 

The prodrome causes the patient to feel flu-like with symptoms including:

  • pain at the site of the bite
  • muscle soreness
  • fever
  • headache
  • anxiety
  • malaise
  • nausea
  • vomiting
  • sore throat
  • cough
  • numbness
  • tingling
  • burning

These symptoms  may last anywhere from 2-10 days.

Acute neurological phase

 

As the central nervous system (brain and spinal cord) become affected symptoms include:

  • anxiety

 

  • agitation
  • insomnia
  • loss of sex drive
  • priapism, prolonged erections
  • hallucinations
  • photophobia, distress while looking at light
  • paralysis
  • muscle rigidity
  • muscle twitching
  • convulsions, seizures
  • difficulty swallowing
  • difficulty breathing
  • hydrophobia – fear of water, unique to those with rabies as they fear difficulty swallowing water

Coma

 

A deep state of unconsciousness can occur within 2-7 days.

 

Death

 

Despite ventilatory support for breathing, most die of cardiac and or respiratory arrest.

Treatment of Rabies

 

Although most infections prove fatal, some may survive with an injection of rabies immune globulin that binds to and prevents the virus from replicating. Then four – five vaccines are given over the next two weeks to help stimulate the immune system.

Wild animals suspected of having rabies during an attack will be euthanized and their brain tissue examined for rabies. For domesticated animals, whose suspicion is less, they will be observed for 10 days, and if they do not elicit symptoms, most likely do not have rabies.

If one has been bit by a wild animal who has not been caught, the medical provider may wish to treat empirically with post exposure prophylaxis.

Prevention of Rabies

 

Pet owners can start by vaccinating their pets.  Avoiding wild animals, especially bats, preventing them from entering the house. Vaccinations are also available for those who work frequently with animals or travel to areas where rabies is more common.

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

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

  • lead
  • nickel
  • manganese
  • chromium
  • arsenic

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

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

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

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

 

Vaping Linked to Heart Disease and Cancer

 

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

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

 

nicotine.jpg

 

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

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

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

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

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

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

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing 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.

For more on the study read 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
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Is watching porn bad for your health?

Millions of people view porn every day and the Florida House has approved a resolution to protect their constituents from its inherent health risks.

According to the resolution’s sponsor, Republican Rep. Ross Spano, “Research has found a correlation between pornography use and mental and physical illnesses, difficulty forming and maintaining intimate relationships, unhealthy brain development and cognitive function, and deviant, problematic or dangerous sexual behavior.”

So is pornography a public health risk?

What constitutes a “Public Health Risk?”

 

A public health risk is something that could pose a health threat, injury to humans or could contribute to health risks of other humans.  This could include drunk driving, mosquitos or rats transmitting disease, or even smoking.

So watching pornography would pose a public health risk if not only the “pornee” gets hurt but affects others surrounding him. Now the effect of others could be in the form of missing work, viewing porn at work (considered sexual harassment and/or assault by others not wanting to view it), and unwanted sexual acts with one’s partner.

How does watching pornography affect health?

 

Although we do not have any definitive studies telling us porn is good or bad for our health, there are many opinions on the matter.

One concern is inactivity and time spent in front of a screen.  Sitting in front of a computer, tablet, or hand-held device watching hours of porn could increase risk of a blood clot, heart disease and (prolonged sitting) has been linked to colon cancer.  However, according to PornHub, the average time spent viewing porn only ranges from 9-13 minutes.

 

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What about lack of sleep? Are people secretly watching porn at night, and not getting their 7-9 hours of uninterrupted rest?

According to PornHub the most common time during the day to watch porn was between 10 pm and 1 am.  If one is only online for 10 minutes and falls asleep afterwards, they may still receive a good amount of sleep.

 

1-pornhub-insights-2017-year-review-favorite-times-to-watch-world

What about the risks of frequent masturbation?

 

In 2009 a study found frequent masturbation in young males could increase their risk of prostate cancer, but in older men (>50 years), reduced their risk.  Other studies have suggested reduced risk of prostate cancer that occurs in older men but not aggressive cancer in younger men.

Excessive masturbation could affect one’s refractory period, or time it takes to form an erection again after sex.  For some this could last 15 minutes, for others a week.  So if a date night is planned for later that evening, one with a long refractory period could have issues.

Chafing and inflammation can also occur but are usually rectified with a change in modality.

What about the impact on children?

 

The American College of Pediatricians released this statement:

The consumption of pornography is associated with many negative outcomes: increased rates of depression, anxiety, violent behavior, early sexual debut and sexual promiscuity, higher rates of teen pregnancy and a distorted view of relationships. For married adults, pornography also results in an increased likelihood of divorce which, in turn, is harmful to children.

Author, L. David Perry, MD, states, “Pornography glorifies decontextualized sex. Its use by adolescents and young adults often leads to a distorted view of sexuality and its proper role in fostering healthy personal relationships.”

If state governments choose to debate porn being a health risk, I agree with strict restrictions on child and adolescent access.  I also agree with education of condom use to protect against unsafe sex practices.  Moreover, counseling resources for those addicted to porn should be increased as internet and porn addiction is a growing public health threat.  However, does the occasional video view pose serious health risks….no.

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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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Allergy season may start early this year

Multiple states are reporting “early” allergy seasons.

We still have a month left of winter yet grass is sprouting, leaves are growing and flowers are blooming.  Add warmer than normal temperatures to the mix and this is the perfect recipe for an early allergy season.

Allergy season usually begins with the start of Spring in March.  Yet many may start their symptoms as early as February if they are allergic to what’s blooming.

Tree pollens start first in January and then taper off in April.  Grass pollen starts to rise in February and March.   Finally weed pollens join the party by the Spring and extend through the Summer and Fall.

Here are your questions answered:

What are allergies?

 

Allergies are the result of the immune response to a foreign particulate that our body senses.  One could be allergic to pollen, dust, dander, food, insects, mold, metals, transfused blood, grafts, medicine and anything the body senses as a foreign intruder.  Even though these may be individually harmless, a hypersensitivity reaction occurs as a result of their intrusion into the body.  IgE antibodies find the allergen (intruder) and activate mast cells in the tissue and basophils in the blood.  When these cells get activated, they release substances to help protect the body, including histamines, leukotrienes, and cytokines. These help the body attempt to sneeze and cough the allergen out, wall off the antigen, signal more antibodies, or produce tears and nasal secretions to flush it out.

What are symptoms of seasonal allergies?

 

Symptoms of allergies could include any or a combination of the following:

  • Sneezing
  • Coughing
  • Wheezing
  • Runny nose
  • Eye watering
  • Red Eyes
  • Itchy eyes
  • Itchy skin
  • Rash
  • Itchy throat
  • Fatigue
  • Congestion….. to name a few.

How do they differ from a cold?

 

Colds may have very similar symptoms to allergies. However they are different.

The common cold is caused by a virus.  When one gets infected by the virus they may feel malaise, fever, and achy. This does not occur with allergies.

Moreover, nasal secretions from allergies are usually clear. In a cold, the mucous could be thicker and with color.

The same holds true with sputum. During an allergy the cough may have little to no mucous and if so, be light colored. Thick mucus could be a sign of an infection.

An allergic sore throat will seem more dry and scratchy. A sore throat from a cold is more uncomfortable and less easy to soothe.

Allergies may persist or be cyclical. Cold symptoms will usually subside after a few days and rarely persist longer than 10 days.

Can allergies lead to a cold?

 

Yes and no. Allergies should not in and of themselves cause an infection. However they may make one more vulnerable for a virus or bacteria to take over. Hence a bronchitis, sinus infection, or pneumonia could uncommonly follow an asthma attack.

Are seasonal allergies dangerous?

 

As stated previously, if one is susceptible to colds, an allergic attack could make them vulnerable. Moreover if one suffers from asthma, an allergy attack could incite an asthma attack.  Very rarely would we see a life threatening anaphylaxis to an allergen such as pollen.

How can we prevent and treat allergies?

 

Avoiding, or decreasing exposure to the allergen is key.   We suggest the following:

  1. Be aware of your local weather and pollen counts.  If the weather begins to warm and regional vegetation is blooming, allergy season may be upon you sooner than you know.
  2. Avoid outside pollen from coming into your house.  Avoid the urge to open all the windows during Springtime as wind will bring the pollen in.
  3. Clean your air filters.  Replace air filters frequently and consider using HEPA Filters
  4. Wash off pollen from your hair and clothes before you sit on the couch or jump into bed.
  5. Close your car windows when you park.
  6. “Recirculate” the air in your car
  7. Discuss with your medical provider if you are a candidate for medications such as antihistamines, nasal corticosteroids or leukotriene antagonists.  
  8. If you suffer from respiratory illnesses or a chronic medical condition, discuss with your medical provider if you need to start your allergy medication before allergy season hits. Some of these medications may take a couple of weeks to reach therapeutic levels.

How can I find my local pollen counts?

 

Local tree, ragweed and grass pollen counts can be obtained 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

Valentine’s Day is one of the biggest holidays of the year, with consumers spending more than $18 billion a year buying cards, chocolates, flowers, and teddy bears.  But what no one admits to is it is one of the most anxiety producing and miserable holidays of the year.

If you’re single….

 

When you’re single the last thing you need to be reminded of is just that….you’re single.  Valentine’s Day inundates us with the “normalcy” of being in a relationship such that anyone who’s single feels there’s something wrong with them.  Single people feel forced to shut off the TV, avoid shopping, avoid others and remain indoors for the week surrounding Feb. 14th.

If you’re married….

 

If you’re married, and have been so for some time, Valentine’s Day reminds you of how much you are lacking in sex and romance.  But worse yet, you are now compelled to do something for Valentine’s Day.  No credit for spontaneity.  No credit for being romantic, since the whole world seems to be celebrating Valentines. And… it’s all pain, no gain.  If you mess up, and your gift or celebration is not very romantic, you’re in the dog house.  And if you forget about the holiday all together…Whoa Nelly…..

The candy….

 

When one thinks of candy they think of chocolate, lollipops, vibrant colors…..Valentine’s heart candy is the worst candy out there.  They’re pale, hard, practically crack your teeth, not very tasty and force you to read them before you eat.

 

candy.jpeg

 

Be Mine?  Be my Valentine?

 

Don’t give me anymore work to do. You could be pretty high maintenance.  And what if I’m not ready to commit?

Your gift better measure up….

 

Valentine’s Day gifts are made to be publicized.  And even if you gave your sweetheart the gift in private, it will be posted on social media or broadcast at work the next day.  In fact, not sending the gift to their work could be a major faux pas.

 

gift.jpeg

 

So how do we make this holiday more tolerable?

 

If you’re single….

 

If you’re single, use this holiday to celebrate the friendships you have.  Make it a singles night out and celebrate your freedom.  Or make a friend feel special by sending a “friend” valentine.  These could include: a bottle of wine, a stuffed toy (with no heart attached), a book, a gift certificate, a funny poem/ desk calendar.

If you’re married…..

 

Since the gift of spontaneity has already been hijacked by this holiday, do something creative and unpredictable.  Candlelight dinner, a poem, luxury bath, weekend trip, something sappy…..but do it right and you’ll get bonus points.

Don’t spend a lot

 

Here’s the silver lining. Most Valentine’s Day gifts/gestures do not have to cost a lot. Valentine’s Day is about the heart and showing one how much you care.  So a note, poem, song, personalized song list, or even a cute little doodle can go along way.

ARTERIES ARE RED
VENULES ARE BLUE
MY GONORRHEA HAS CLEARED UP
HOW ABOUT YOU?

 

What to buy a man?

 

We make the mistake of thinking men want what we want. Let’s take cologne for that matter….men don’t want to smell like perfume or “parfume”y….they like smelling like men.  Forcing them to use toilet water is not cool.

 

what-not-to-buy-for-your-man-boyfriend-worst-gifts-1.jpg

 

Another common gift given to men is a shaving set.  Does the average man like shaving, let alone every day? Top that off with wasting an opportunity for them to get a cool gift with one that includes shaving products???  Cruel, just cruel.

For men, many prefer steak for dinner, time alone in their man cave, or sex. I think that’s about it.  Pretty easy.

So hope this helps you get through Valentine’s Day anxiety free and worry free.

And remember…. its only one day…just one day…. and will all be over Feb. 15th.

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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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Aromatherapy: Your Questions Answered

 

For centuries, plants and their oils have been used in a variety of therapeutic settings.  Today aromatherapy is a billion dollar industry. Here are your questions answered:

What is aromatherapy?

 

Aromatherapy is the use of essential oils from plants to treat an ailment.  Oils are extracted from plants through a variety of different methods and then formulated to be used topically or breathed in as an aerosol.

What are the benefits of aromatherapy?

 

Aromatherapy has been used to treat a variety of conditions including:

  • anxiety
  • depression
  • nausea
  • vomiting
  • GI upset
  • pain
  • joint aches
  • insomnia
  • skin infections
  • seizures

to name a few.

In 2014 Azanchi et al described the anticonvulsant activity of neroli oil, finding its biologically active “constituents” may assist in the management of seizures.

The following is a table from Natural Healers describing some uses of essential oils.

 

aromatherapy

 

What are the risks of aromatherapy?

 

Many oils may be used alone or mixed with fragrances and/or other chemicals.  These many times have not be tested clinically to see their effects on the respiratory tree lining and skin.  Some risks posed by the use of aromatherapy include:

  •  Respiratory issues – could irritate the lung lining causing cough, wheezing, mucus production
  • Dermatitis – rashes, hives, itching
  • Photosensitivity – use could make one more susceptible to skin reactions when exposed to the sun, causing burning and blistering.
  • Interactions with medications, possibly affecting their potency
  • Risks to pets ingesting them or absorbing too much in their skin

 

Who should avoid aromatherapy?

 

At this time, we recommend avoiding aromatherapy if you have any acute or chronic respiratory conditions, severe allergies, sensitive skin, are pregnant, or are currently taking any medications that could interact with the chemicals being inhaled or absorbed.

If considering using aromatherapy we recommend consulting your medical provider first.

As we see more practitioners integrate aromatherapy into one’s medical plan, more needs to be clinically studied to determine the benefits and risks.

 

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

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

 

nicotine.jpg

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

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

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

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

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

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

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing 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. 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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Flu increases risk of heart attack

A study published in The New England Journal of Medicine reports the flu increases one’s risk for a heart attack by six within the first week.

Study author Dr. Jeff Kwong, a family physician and epidemiologist from the Institute for Clinical Evaluative Sciences and Public Health Ontario, and his colleagues looked at 20,000 adults who were diagnosed (and lab confirmed) with the flu in Ontario from 2009 – 2014.  Of these adults, 332 had a heart attack, either the year before, after or during the flu.   Heart attack risk was 6 times higher the week of the flu and was elevated in those older than 65.

Many of the individuals had cardiac risk factors (diabetes, high blood pressure, high cholesterol) illustrating if one is at risk for a heart attack, a cardiac event may be more likely to occur if they get the flu.

This isn’t the first time a link between heart attack and flu has been suggested. In 2007, Meade et al found a bout with the flu to double the risk of a heart attack and stroke.

Their theory was the flu dislodged fatty deposits sitting along the arteries, allowing them to travel to the coronary arteries or those in the brain resulting in a heart attack and stroke respectively.

Another theory is the cardiac risk factors may worsen during the flu. Blood sugars are difficult to control, hence fats in the blood will follow, and blood pressure may be affected when one is battling an infection.

Inflammation has been linked to heart attack, thus inflammation resulting from the flu may also be a culprit.

The study authors wrote, “Cardiovascular events triggered by influenza are potentially preventable by vaccination.”  The flu shot this year has been projected to only be 30% effective against this season’s active strains but is still being recommended this season as hospitalizations and deaths from the flu are reaching record numbers.

What causes a heart attack?

 

A heart attack occurs when part of the heart muscle fails to receive the blood and oxygen it needs. This can occur by arteries supplying the heart muscle to become blocked.  Coronary artery disease can be caused by plaque build up from fats, sugars, calcium, fibrin that settle on the blood vessel wall. These plaques can build up and occlude the lumen, obstructing blood flow.

Additionally a heart attack can occur when an unstable plaque rips off, tearing the blood vessel lining causing the body to form an immediate clot. This clot can also be deadly as it obstructs the lumen as well.

Heart disease, however, can be prevented ...

 

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 postmenopausal

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.

 

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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
%PM, %24 %836 %2018 %19:%Jan

Are many athletes at risk for depression?

POST-ATHLETIC ACTIVITY DEPRESSION (PAAD) MAY AFFECT MULTIPLE ATHLETES WHEN THEIR SEASON ENDS DUE TO THE HIGH HORMONE LEVELS INDUCED BY THEIR PRIOR RIGOROUS EXERCISE REGIMEN SUDDENLY DROPPING.

 

Olympic gold medalist Michael Phelps admitted at the The Kennedy Forum in Chicago last week that he had battled depression for years and contemplated suicide.  With his multiple decade athletic career, the most decorated in history, how could an Olympian find life so unlivable?

Other decorated athletes have suffered from depression as well:   Terry Bradshaw, Darryl Strawberry, Larry Sanders, Dwayne “The Rock” Johnson, and Oscar de la Hoya to name a few.

Post-athletic activity depression (PADD) may ensue when the high levels of exercise aren’t maintained and the mind isn’t prepared for losing or being surpassed by another athlete.  As you will see biology as well as psychology play huge factors in the mental health of an athlete.

Exercise wards off depression

 

Michael Phelps admitted to going into a depression after each Olympics.  His workouts leading up to each of the 2004, 2008, 2012 and 2016 Olympics were illustrated by Arizona State coach Bob Bowman at the American Swimming Coaches Association, and demonstrated thousands of hours and yards swum each week.

Multiple studies have proven that exercise wards off depression. This is in part due to multiple mood enhancing hormones being released during athletic activity such as:

  • endorphins
  • norepinephrine
  • dopamine
  • serotonin

So if after a meet, marathon, playoff or Olympic race ends, does the average athlete keep their rigorous training schedule? Probably not.  Hence these hormones that the body has become accustomed to seeing aren’t there at their previous levels, inducing a depression.  If someone is at risk for depression, the drop in these hormone levels could, in theory, depress one to the point that they contemplate suicide.

Being the best puts you psychologically at risk

 

They say winning is addictive and from a psychological standpoint, that’s correct.  Once you win you reform a new identity.  Those psychologically mature and stable will not find their win their only identifying factor and additionally will understand that you “win some, lose some”.  However those who struggled for years to win, especially if the prize is an Olympic medal, may not deal with “lose some” so easily.

Once you own that Superbowl ring, first place blue ribbon or gold medal others look at you as “one of the best”.  How much higher can you go?  Usually an athlete only has two choices. Maintain their “top” status, difficult to do with aging and younger up and comers vying for their spot, or start losing. Most athletes aren’t preparing for how to lose.  They can’t. They use all their waking hours preparing on how to win.  So when the loss does come, they’re unprepared.

 

loss

 

Could some CTE symptoms be related to post-athletic activity depression?

 

I believe so. Chronic Traumatic Encephalopathy (CTE) is a progressive degeneration of brain tissue and function from multiple hits to the head.  Many who suffer from CTE have mood changes, anxiety, anger and impulsivity.  CTE tau protein build up in the brain contributes to this but hormones can play a role as well.

What needs to be studied are the mood changes incurred by athletes after each season or race to see if a “funk” sets in because their exercise regimen is not being maintained.

Moreover all athletes should have access to counseling to thwart depression and suicidality because losing is inevitable for everyone.

 

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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

White House Physician, Navy Rear Adm. Dr. Ronny Jackson, performed President Donald Trump’s annual physical last week are released the following results:

From Politico:

President Donald J. Trump has completed his first periodic physical examination as President of the United States. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The exam was conducted January 12, 2018 at the Walter Reed National Military Medical Center.

The purpose of this exam was to provide the public with an update of the President’s current health status and to ensure the President continues to enjoy all the benefits of good health. This examination focused on evidence-based health screening and disease prevention.

With President Trump's consent, I release the following health information:

Vital Statistics

Age: 71 years, 7 months

Height: 75 inches

Weight: 239 pounds

Resting heart rate: 68 bpm

Blood pressure: 122/74 mm

Hg Pulse-oximetry: 99% room air

Temperature: 98.4 degrees F

Physical Examination by System (to include studies)

Eyes: Uncorrected visual acuity was 20/30 bilaterally, with corrected visual acuity of 20/20 bilaterally. Visual fields were normal. Fundoscopic exam was normal bilaterally. Intraocular pressures were normal bilaterally. No ocular pathology was discovered.

Head/Ears/Nose/Throat: Normal exam of the head, ears, nose, mouth, and throat.

Dental: Healthy teeth and gums.

Neck: Normal thyroid exam. No noted lymphadenopathy. Auscultation of the carotid arteries normal.

Pulmonary: Lungs clear to auscultation. A screening Low Dose CT of the chest demonstrated no pulmonary pathology.

Cardiac: Heart exam normal. Regular rhythm. No murmurs or other abnormal heart sounds noted. ECG with normal sinus rhythm, rate of 71, normal axis, and no other significant findings. Transthoracic Echocardiogram demonstrated normal LV systolic function, EF 60-65%, normal LV chamber size and wall thickness, no wall motion abnormalities. RV normal, atria grossly normal, all valves normal. Exercise Stress Echocardiogram demonstrated above average exercise capacity based on age and sex, and normal heart rate, blood pressure, and cardiac output response to exercise. No evidence of ischemia noted and wall motion was normal in all images.

Gastrointestinal: Normal exam. No masses, hepatomegaly or splenomegaly noted. Normal optical colonoscopy with no polyps or abnormal findings completed June 2013. Repeat colonoscopy not indicated and was deferred until next periodic physical exam.

Genitourinary: Normal exam.

Extremities/Musculoskeletal: Normal throughout. Full range of motion in all joints. Strong distal pulses and good capillary refill in all extremities. No swelling or edema noted.

Neurological: Examination of cranial nerves, cerebellar function, deep tendon reflexes, motor function, and sensory system all normal. Cognitive Screening Exam using the Montreal Cognitive Assessment was normal with a score of 30/30.

Dermatologic: Normal exam. No evidence of melanoma , basal cell carcinoma, squamous cell carcinoma, or any other significant dermatologic disease.

Laboratory Results

Lipid Panel:

Total cholesterol: 223 (mg/dL)

Triglycerides: 129 (mg/dL)

HDL cholesterol: 67 (mg/dL)

LDL cholesterol: 143 (mg/dL)

Cholesterol to HDL ratio: 3.3\

Complete Blood Count:

WBC: 5.5 (K/UL)

HGB: 16.1 (g/dL)

HCT: 48.7 (%)

PLT: 241 (K/UL)

Extended Metabolic Panel:

Fasting Blood Glucose: 89 (mg/dL)

BUN: 19.0 (mg/dL)

CREAT: 0.98 (mg/dL)

ALT: 27 (U/L)

AST: 19 (U/L)

Hemoglobin AlC: 5.0 (%)

Vitamin D: 20.0 (ng/ml)

PSA: 0.12 (ng/ml)

TSH: 1.76 (ulU/ml)

Urinalysis:

Appearance: Clear

Protein: Negative

Ketones: Negative

Glucose: Negative

Blood: Negative

Past Medical History

• Hypercholesterolemia

• Rosacea

Past Surgical History

Appendectomy (age 11)

Social History

• No past or present use of alcohol.

• No past or present use of tobacco.

Medications

Rosuvastatin (Crestor), 10 mg daily to lower cholesterol.

Acetylsalicylic Acid (Aspirin), 81mg daily for cardiac health.

Finasteride (Propecia), 1 mg daily for prevention of male pattern hair loss.

Ivermectin Cream (Soolantra), As needed for treatment of Rosacea

Multivitamin (Centrum Silver), Daily for overall health maintenance.

Immunizations

  • • Prevnar 13 (to prevent pneumococcal pneumonia) and Twinrix (to prevent hepatitis A/B) given.
  • • Routine vaccinations, to include seasonal influenza, all up to date.
  • • All indicated travel vaccinations up to date.

Summary

The President’s overall health is excellent. His cardiac performance during his physical exam was very good. He continues to enjoy the significant long term cardiac and overall health benefits that come from a lifetime of abstinence from tobacco and alcohol. We discussed diet, exercise and weight loss. He would benefit from a diet that is lower in fat and carbohydrates and from a routine exercise regimen. He has a history of elevated cholesterol and is currently on a low dose of Rosuvastatin. In order to further reduce his cholesterol level and further decrease his cardiac risk, we will increase the dose of this particular medication. The President is currently up to date on all recommended preventive medicine screening tests and exams.

All clinical data indicates that the President is currently very healthy and that he will remain so for the duration of his Presidency.

President Trump is in “excellent health.”

 

At the above height and weight, Donald Trump’s BMI is 29.9 placing him in the overweight category just shy of the 30 BMI cut off for obesity.

His blood pressure and heart rate are excellent for his age, especially in the absence of a blood pressure medication.

His pulse oximetry demonstrating the oxygenation of his blood is excellent as well.

An uncorrected vision test of 20/30 means that without glasses, the president has near perfect vision.

A low dose CT of the chest is not routine during annual physicals in non-smokers, but is reassuring that he most likely doesn’t suffer from lung cancer, the number one cancer killer in America.

His EKG, which evaluates electrical abnormalities of the heart secondary to disease or heart attack, confirmed the ideal heart rate.

His echocardiogram, and ultrasound evaluating heart structures and pump activity, demonstrated no heart failure or issues with the filling or pumping of blood, as well as confirming normal anatomy (valves, wall thickness, etc).

A stress test evaluates for cardiac ischemia, or loss of blood flow to heart muscle during rest and exercise, and was normal as well.

A normal colonoscopy in 2013 suggests his next screening colonoscopy wouldn’t be performed until 2023 unless he had pain, rectal bleed, changes in his stool, or any risk factors for colon cancer.

The Montreal Cognitive Assessment was given to evaluate cognitive function and is not routinely done during annual physicals.  This was performed and passed with a 30/30 score.  The test evaluates memory, orientation, visuospatial and executive brain function, recall, concentration and language fluency.  An example is shown here.

His cholesterol is elevated but his good cholesterol is strong and his ratio of cholesterol to HDL is well within goal.

cholesterol-levels-chart

 

The remaining blood tests looked very good, especially his HBA1C and blood glucose evaluating for diabetes.

Of note is his Vitamin D level which appears low-normal and could put him at risk for osteoporosis.  It does not appear a bone density test, Dexa scan, was performed.

A PSA of 0.12 is reassuring as well although is not recommended as a screening test for prostate cancer.

It's been suggested that President Trump loses 10-15 lbs and increases his exercise activity.

My opinion, for a 71-year-old man with high cholesterol, President Trump is way ahead of the curve.  I’m a fan of Crestor, his cholesterol lowering medication, and credit his lipid profile numbers to his use of the statin.  His weight is an issue but I think the White House has a bowling alley, chefs who could make asparagus taste like meat, and secret service who wear fitbits.  I think he’ll be just fine.

This is a developing story.

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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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