%PM, %25 %727 %2018 %16:%May

Will a robot replace your doctor?

The University College London Hospital (UCLH) in Bloomsbury London is launching a pilot program replacing some A&E (Emergency Room) physicians with robots.

In response to staff shortages and long wait times, the initiative launched by UCLH and Alan Turing will utilize artificial intelligence to triage patients and reduce wait times.

Robotic technology is already being used in the operating room, rehabilitation centers and for pharmaceutical dispensing.  It’s just a matter of time that they become our main caregiver.

But will patients be pleased?

The Robot Is In…

 

Where’s there’s demand, there’s supply. Patients tired of wait times, crowded waiting rooms, loss of sick leave hours to sit around a medical office or emergency room for half a day will want speed and efficiency.  Kiosks may replace front desk clerks, taking your initial information (chief complaint, name, insurance info.), scanning it and offering you a number, like one given at a bakery.

Robots Don’t Judge

 

Those embarrassed by having symptoms suggestive of having an STD will have less of an issue conveying this information to a machine than a human being.  Gas, discharge, odors may be easier to discuss with someone or something that won’t wince.

 

Doctor-and-patient

 

The Doctor Doesn’t Examine Me Anyway

 

Many patients cite seeing a medical provider and not being examined or asked to undress before an exam. Time constraints, or avoidance of being accused of wrongdoing, have caused some providers to refer out for heart, gynecological, and rectal examinations. Primary care providers who enter the room, say a few words and then promptly leave saying they will “bring in the nurse to review instructions” may not be missed by the patient receiving similar service from a robot.

They can always answer my questions

 

We use Google, Wikipedia and Siri to answer our health questions currently.  No wait time, no office visit, no cost….so a robot answering our questions in layman’s terms will be an easy task.

 

However, and this is the kicker……

Robots Lack Instinct

 

There is no way to replicate the sixth sense humans have when it comes to something being wrong with you. Artificial intelligence cannot provide a “gut feeling.”

Let’s take a urinary tract infection, for example. I have had patients who were new to my office complaining something “felt funny” when they urinated and cited blood in their urine.  A urinalysis may show inflammatory cells, and a robot may correctly diagnose the patient with a bladder infection.  But I as a clinician may be suspicious that this new patient has something that is leaking blood into the urine, from the gynecologic tract maybe? And I’ve diagnosed endometrial and cervical cancer in cases where patients thought they were merely having bladder infections.

One patient presented to me in the emergency room feeling “odd” and suspecting a “UTI.” She was in her 60’s and started to complain of nausea.  Her urine had inflammatory cells so while a culture takes 3 days to complete, I gave her a prescription for antibiotics in case the infection would spread during that time. But her nausea was concerning. The patient requested an injection of nausea medication prior to leaving so I obliged, giving her Compazine.  While observing her for a few minutes, post injection, she began to have shortness of breath.  We decided to look at her heart and came to the conclusion after more testing that she had suffered a heart attack in her sleep the night before and the “odd feeling” she felt the next day wasn’t due to her UTI (which she coincidentally had) but was from a heart attack. She was treated immediately and recovered nicely.

Would a robot have picked up on that?  Multiple web resources include nausea in the list of symptoms associated with a UTI, so could be “blown off” by a robot bundling it with the patient’s urinary complaints. But I learned that nausea could be the first sign of a heart attack, especially in women.

Another case I had as an urgent care physician was the following:

A gentlemen came in saying he “felt fine” but his wife made him come in because he was burping the night before.  Multiple bouts of eructation jogged an ancient memory of mine…..when as a little girl I saw a movie where the pilot was burping multiple times before he passed out and died.  So I came to learn that chronic bouts of burps, or hiccups for that matter, could be a sign of an inferior MI (heart attack). I ran an EKG and blood work, and my instinct was right.  Again I was looking at a patient who unknowingly had a heart attack the night before but thought he had something benign the next day.

So gut instinct, thinking laterally, tapping in on past experience, and acting on hunches is not something a robot can do.  Humans may be satisfied with shorter wait times and receiving antibiotics when they demand them, but the education and intervention a medical provider can provide is priceless.  Too bad cost gets in the way of real medicine.

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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 Health
%PM, %22 %806 %2018 %18:%May

Heat illness and heat stroke explained

The National Weather Service will soon issue an “excessive heat warning” for many parts of the Southwest United States. Phoenix received their first warning two weeks ago when their temperatures rose to 108 degrees.

What is an “excessive heat warning?”

 

This occurs “within 12 hours of the onset of extremely dangerous heat conditions”. This means that the heat index (air temperature and humidity) will be greater than 105 degrees for more than three hours a day for at least two days in a row and the night-time temperatures will not drop below 75 degrees. Although many of us may live in areas where this occurs each year, the onset can be one of the most dangerous times. Symptoms such as heat cramps, heat exhaustion and heat stroke must be identified.

What are Heat Cramps?

 

At first when one feels symptoms, it may come in the form of heat cramps. Heat cramps are painful spasms that occur in the muscles of the arms and legs and even abdomen. We believe that when one loses fluids and salts from excessive sweating, cramps ensue. It's important in these cases to get the person out of the heat, hydrate them with sips of fluid and electrolytes and massage the body parts affected.

 

water.jpg

 

What is Heat Exhaustion?

 

If one does not leave the heat and come indoors, the next risky event that can occur is heat exhaustion. This worsens as the victim sweats profusely becoming more and more dehydrated. They could also have cramps but nausea may ensue, they may look pale and clammy and their heart rate will increase to try to compensate for the lost fluid. These individuals may become dizzy, weak and even faint. Immediately bring the person indoors, lie them down, elevate the feet, give sips of fluid, cool down the body applying cool and wet cloths to the underarms and body, and contact medical authorities if symptoms continue or worsen.

 

 

MedStar-NS-heat-stroke-right-size-610x420.jpg

IMAGE FROM MEDSTAR

 

What is Heat Stroke?

 

Heat stroke will occur if a vulnerable person does not get out of the heat in time. It is a medical emergency and can be fatal. If an individual has heat stroke 9-1-1 must be called immediately. Bring the victim indoors away from sunlight, lie them down, remove unnecessary clothing, cool their body with cold compresses and watch for signs of rapidly progressive heat stroke in which they have difficulty breathing, seize or lose consciousness. If they are unconscious you cannot give them fluids. Only if they are alert, awake and able to swallow will you be able to give fluids. Do not give medications to reduce the fever such as aspirin or acetaminophen since their body may not be able to metabolize them properly and this could make matters worse.

 

hwkb17_064.jpg

Who is vulnerable to heat related illness?

 

Young children and elderly individuals may have issues adjusting to the outside environment and may be more prone to dehydration. Those with medical conditions such as heart, lung, thyroid disease can be at risk as well. If you’ve ever suffered from heat stroke you can be vulnerable again. And many medications could make you susceptible such as diuretics, vasodilators and beta-blockers for blood pressure and antidepressants.

The biggest risk comes when we are unprepared. Having an unusual cool week prior to a heat warning could preclude many from taking proper precautions. Staying indoors, checking air conditioning and fan devices to make sure they work properly, wearing cooler clothing is just the beginning. Stocking up and planning to hydrate frequently is paramount because when death occurs to excessive heat, dehydration is the main culprit.

 

UZ

 

Bring your pets indoors, and watch your kids, friends and family members frequently. If they are beginning to succumb to the heat, they may be quiet and not be able to voice it.

 

snappy

 

Avoid drinking alcohol in the heat. It can dehydrate you more and worsen the situation.

Avoid excessive exercise when outdoors and make sure to make use of shady areas.

The summer and early fall offer exciting and fun ways to enjoy nature. Don’t let the heat get to you. Remember….if you can’t take the heat, get out of the…..well heat…….

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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 Health
%PM, %19 %928 %2018 %21:%May

2018 Ebola outbreak update

Twenty five people have died, and 45 others are suspected to be infected with Ebola in the Democratic Republic of Congo (DRC). The World Health Organization (WHO) has confirmed and reported the outbreak of Ebola on May 8.

This latest outbreak began in villages near Bikoro. New cases later surfaced miles away in Mbandaka, an urban city with a reported population of 1.2 million, located along the banks of the Congo River.

 

Ebola2018_DRC.png

 

Vaccination has begun with ZMapp, a treatment used in the 2014 outbreak that shows promise as a prophylactic measure.

Dr. Karen Duus, Associate Professor of Microbiology and Immunology at Touro University Nevada, explains, “The vaccine is a recombinant Ebola virus protein vaccine that causes a similar type of neutralizing antibody response (as the ZMapp treatment). The neutralizing antibodies coat the virus particle and keep it from binding to the target cells and infecting them.”  Its efficacy, however has not been extensively tested.

 

viv.jpg

 

The DRC had a small outbreak last year but it was contained within 42 days.

The West African Ebola epidemic spanned from the end of December 2013 to 2016 infecting over 28,000 people and killing over 11,300. The epidemic was one of the worst in Ebola’s history and its high mortality rate took countries such as Sierra Leone, Guinea, and Liberia by surprise. A vaccine was not available, and medications such as ZMapp were experimental and not in great supply. Hospitals were not stocked with protective clothing able to prevent the minutest of exposure to the deadly virus. Travel bans were difficult to institute and top that off with a lack of education on what we were dealing with and it was unfortunately the perfect storm for one of the deadliest outbreaks in recent history.

Ebola however emerged far before this. Ebola was named after the Ebola River in Zaire and was first recognized in 1976 when it caused two outbreaks affecting 318 and 284 people respectively.  Multiple small outbreaks have occurred since then, according to the CDC:

1995 – Democratic Republic of Congo –  infected 315

2000 – Uganda – infected 425

2007 – Democratic Republic of Congo – infected 264

 

about-ebola

CYNTHIA GOLDSMITH THIS COLORIZED TRANSMISSION ELECTRON MICROGRAPH (TEM) REVEALED SOME OF THE ULTRASTRUCTURAL MORPHOLOGY DISPLAYED BY AN EBOLA VIRUS VIRION. IMAGE FROM CDC

 

And multiple smaller sporadic cases occurred in the years between.

In January 2016 health officials declared the Ebola outbreak had ended, however cases continued to smolder.

Why this occurs is the virus may not leave the body completely. Its been found to live in semen up to a year and some survivors can suffer a reinfection months later. For example, in 2015 Dr. Ian Crozier successfully fought Ebola but two months after discharge, suffered a severe eye infection which turned out to be Ebola lurking in his eye.

A study in 2015 found Ebola be able to survive outside a human body for days and longer if within a liquid such as water or blood. Mosquitoes are not known to transmit the virus however it can live in bats as well as monkeys and apes. Pets have not been known to contract Ebola from their sick owners but its been postulated that pigs could, if in contact with a victim.

Dr. Duus states that although the virus reservoirs are not clear, “people are most likely infected by butchering or eating infected animals.”

Ebola is a virus from the Flavivirus family that causes a hemorrhagic fever with symptoms of sudden fever, myalgias, headache and sore throat.  It could then progress to nausea and vomiting, liver and kidney issues and internal and external bleeding, ultimately resulting in death in 90% of cases.

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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 World

Thursday morning Hawaii’s Kilauea shot ash and smoke into the air and blew a volcanic cloud that could reach 30,000 feet into the sky. The volcano has been spewing lava for weeks, prompting thousands of nearby residents to evacuate. Volcanic ash can prompt a multitude of health risks…not only from a particulate standpoint but also from the sulfur dioxide levels. Sulfur dioxide is a colorless, though stinky gas that can cause irritation to skin, eyes, and respiratory system linings.

 

 

1354578168

 

Let’s break these health risks down:

Respiratory Illness

 

Volcanic ash can irritate the respiratory passages causing the following symptoms:

  • Runny nose
  • Sore throat
  • Wheezing
  • Coughing
  • Mucous production
  • Shortness of breath
  • Painful breathing

 

cough1-classicfm

 

Those with asthma, COPD, chronic bronchitis or other respiratory ailments may find themselves having exacerbations of their symptoms. Oxygen requirements will increase. Those requiring oxygen or inhalers will need to have extra supply during this time (medical offices may be closed during ash clean up so don’t wait until the last minute.)

Eye Issues

 

Volcanic ash has large and small particles that can irritate the eyes increasing their sensitivity to light and making vision difficult.  Moreover ash can irritate the cornea and conjunctiva causing redness, discharge and itching.

 

well_eye-tmagArticle

 

Skin Reactions

 

Skin may become irritated during these times and those with skin allergies or eczema may find themselves having flare-ups.

 

Road Visibility

 

During a volcanic eruption, smoke plumes not only change the air quality but also visibility. During times of day when there is less light, road visibility obscures pedestrians and nearby cars. Drivers are urged to avoid the road during these smoky times.

 

driver

 

Water

 

Water quality can become affected by the ash or pH changes if supply becomes  contaminated. Moreover, water use increases for cleanup so shortages may ensue.

Short blood supply


Those who donate blood in nearby areas may be less likely to donate during this difficult time leading to local blood shortages.  Those who can donate blood are urged to contact the American Red Cross, United Blood Services, or Blood Bank of Hawaii.

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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 Health
%PM, %12 %803 %2018 %18:%May

Which sunscreens work best?

May is Skin Cancer Awareness Month as 5 million cases of skin cancer are diagnosed each year in the United States.  This week, Consumer Reports released its 2018 Annual Sunscreen Guide on the best sunscreens to offer protection against UV (ultraviolet) rays.  They looked at 73 various sunscreen lotions, sprays and sticks, which touted 80 minutes water resistance and an SPF of 30.

The top 5 sunscreens reported are:

La Roche-Posay Anthelios 60 Melt-In Sunscreen Milk, $36 (lotion)

Equate (Walmart) Sport Lotion SPF 50, $5.00 (lotion)

BullFrog Land Sport Quik Gel SPF 50, $8.50 (lotion)

Coppertone WaterBabies SPF 50 Lotion, $9 (lotion)

Trader Joe’s SPF 50+, $6 (spray)

 

How do sunscreens work?

 

Sunscreens use chemicals to disperse or absorb UV rays. Inorganic compounds in sunscreen such a titanium dioxide or zinc oxide attempt to scatter the UV rays. Organic compounds such as PABA and oxybenzone attempt to absorb UV rays so they can’t damage the skin.

 

What’s the difference between UVA and UVB radiation?

 

UVA rays penetrate deeply into both the epidermis and dermis. They can cause premature aging of the skin, wrinkles, and skin cancer.

UVB rays are shorter and primarily affect the epidermis. They are responsible for causing sunburns as well as skin cancer.

 

8ce0498bca5aac49d757b683088b7d4a.jpg

 

What is SPF?

 

SPF stands for Sun Protection Factor. The higher the SPF, the less sun photons enter the skin and cause damage. SPF primarily measures the protection against UVB rays. We multiply the SPF factor by how long it takes one’s skin to burn by the SPF number to determine the protection factor.

In theory, an SPF of 30 suggests your skin, if it burns within 10 minutes without protection, will not burn until 300 minutes has lapsed (30 times 10). However, we find this isn’t always the case.  People sweat or swim and the sunscreen dissipates. Moreover many don’t put on the proper amounts (see below.)

So instead we use SPF as a grade to how much protection the product can offer.

An SPF of 15 blocks 93% of UVB rays

An SPF of 30 blocks 97% of UVB rays

An SPF of 50 blocks 98% of UVB rays

As we see, the relationship is not linear, however the higher the SPF, the more protection we have against UV rays.

 

what-is-spf-sunsreen-sun-protection-factor.JPG

IMAGE FROM BADGERBALM

 

Although the SPF alludes to protection against burning, hence UVB rays, a sunscreen may still protect against both UVA rays and UVB rays if it’s a broad spectrum sunscreen.

 

 

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How to apply sunscreen

 

Most people apply sunscreen incorrectly or unevenly.  Lotion needs to be applied at an amount of 2mg/cm2 of skin or 1 teaspoon per body part (chest, arm, leg, face and neck). It should be applied 15 minutes prior to going out into the sun and needs to be reapplied every 2 hours, or more often if swimming or sweating.

CRM_Page_41_Important_Sunscreen_Spots_07-15 (1)

 

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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 Health

At least one in three adults has high blood pressure and strokes are the 5th leading cause of death in the United States.

In May we raise awareness of both these conditions during American Stroke Monthand National High Blood Pressure Education Month.

Every 40 seconds, someone in the United States suffers a stroke.  And high blood pressure puts one at risk of a stroke, as well as heart disease.

Here are your questions answered.

 

Risk-Factors-For-Heart-Disease-High-Blood-Pressure-700x395-700x395.jpg

 

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 blood pressure level is considered “normal” or “abnormal?”

 

High blood pressure has now been redefined as being greater than 130/80 mmHg, down from 140/90 mmHg.   Last year it was guestimated that 42% of Americans would soon be considered “hypertensive.”

 

blood+pressure+chart

 

What can long-term high blood pressure cause?

 

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.

 

What is a stroke?

 

A stroke occurs when an area of the brain does not get the proper oxygen and blood flow it needs. There are two major types of stroke:  ischemic and hemorrhagic.

Ischemic strokes are more common than the latter and occur when a clot prevents blood flow to part of the brain.  80% of all strokes fall under ischemic.  It is a likened to a heart attack, except the brain tissue is being deprived of blood and nutrients. Plaques commonly arise from arteriosclerosis that break off travel to the smaller vessels of the brain.

Hemorrhagic strokes are less common and occur when there is a bleed of one of the brain vessels.  The bleed prevents blood flow into the brain since it is seeping outside the brain tissue, causing damage to nearby cells.  The bleeds could occur from high blood pressure or aneurysms that rupture.

What are the signs of a stroke?

Since a clot or bleed usually affect one area of the brain, we see symptoms on one side of the body, many times its contralateral (opposite) side.  We can also see central effects.  The symptoms of stroke include the following:

  • Weakness of one side of the body
  • Loss of balance
  • Numbness on one side of the body
  • Slurred speech
  • Vision issues
  • Headache
  • Facial droop

and more…..

How are strokes treated?

 

If the stroke was caused by a clot (ischemic) immediate treatment includes dissolving/removing the clot.  Aspirin is used initially and if within the proper time frame, tissue plasminogen activator (TPA).  These clots can also be surgically removed and arteries widened to bring blood flow to the brain.

With a hemorrhagic  stroke, we need to stop the bleed and improve flow to the brain.  Controlling the bleed, bypassing the vessel, “clogging” the aneurysm with techniques such as “coiling” (endovascular embolization) are sometimes utilized.

Time is of the essence, so it's crucial to identify the warning signs and call 911 immediately.  The American Stroke Association uses the acronym “FAST” (Facial drooping, Arm weakness, Speech difficulty, and Time to call 911).  The sooner a stroke victim receives medical attention the better the prognosis.

 

 

fast

COURTESY OF THE AMERICAN STROKE ASSOCIATION

 

What are the risk factors for stroke?

 

The following put us at risk of having a stroke.

  • High blood pressure
  • Family history of stroke
  • Diabetes
  • Cardiovascular disease (artery clogging, such as the heart and carotid arteries)
  • Abnormal heart rhythms, such as atrial fibrillation
  • Smoking
  • Drugs
  • Obesity
  • Inactivity
  • Clotting disorder
  • Sleep apnea
  • Being older (greater than 55)
  • African-Americans appear to be more at risk than Caucasians and Hispanics
  • Men seem to be more affected than women

 

How do we prevent strokes?

 

Avoid the following:

  • Excessive drinking
  • Drug use
  • Tobacco products
  • Control blood pressure, sugar and cholesterol
  • Get evaluated by a medical provider if at risk for heart disease or stroke.

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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 Health

When my realtor handed over the keys to my first home in late September, I didn’t feel like I had realized the American Dream. I even had a car in the lot (well, on the street) and a chicken in the pot. But there was still something missing.

I felt closer to realizing the American Dream while doing drugs with friends in the Escalante National Monument. That national treasure in Utah is being gutted to exploit energy sources by Secretary of the Interior Ryan Zinke and President Donald Trump, but they can’t touch the memories I have of that place or the feelings they invoke.

As we pulled away from a National Park Ranger checkpoint with so much drugs and alcohol the four of us couldn’t finish it all in a week, I watched as unlucky hippies leaned against cop cars on the side of the road with their hands cuffed behind them. It made us all realize how lucky we were. Hell, I wasn’t even supposed to be out of the county without my probation officer’s permission, so staying my ass out of federal prison and going on to have the time of my life made it feel like the new American Dream was to do drugs in beautiful places with lovely people and not get caught. But that’s just part of the new American Dream. The new American Dream is to do all those drugs and then recover from whatever addictions you acquire.

It wasn’t until I quit drinking that I felt I had realized the American Dream. I’ve tried just about everything when it comes to stimulants and depressants, but it was alcohol that brought me the most trouble in my life. Sure I was on probation for possessing a pound or so of pot, but I spent more days in jail during that probation because of alcohol than I did for using cannabis, and I still managed to use cannabis pretty regularly. But I drank daily.

First I decided I’d “slow down” for my body’s sake. You know, drink fewer days during the week. And I did, too. I had just become really intrigued by body chemistry and nutrition, so when I started counting my calories, I got a good look at my problem. I drank less often, sure, but did I ever make up for it on the weekends.

When I found it difficult to meet my caloric goals because of my drinking, I drank faster so I could drink less, or I did more exercise so I could drink more. My weekly cheat day became my opportunity to get super drunk.

When I visited my hometown in Eastern Montana and was assaulted while drunk for saying I was a Socialist, I realized I was incapable of drinking responsibly. I drank for more than 12 hours that day and blacked out en route to a house party. The only thing I remember is saying “I’m a Socialist” and someone immediately suplexing me. Sure, it was a hate crime, but since I couldn’t remember a name, face or much of anything, I wasn’t about to make a big deal of it. I figure those people living with themselves has to be punishment enough.

It took a few more weeks before I actually quit alcohol for good. It was October 3rd, and the Minnesota Twins had lost to the Yankees in the playoffs, again. I drunkenly rode my bike home from O’Donovan’s Pub, where a bartender informed me that Twins’ third baseman Miguel Sano frequented the place, and one time, drank “16 beers” with his arms wrapped around two women while on the disabled list with a stress fracture in his leg. (Just under three months later, Sano was alleged to have committed sexual assault.)

I haven’t had a drink since I heard that story. The next day hurt worse than any hangover I’ve had, including the morning after the Socialist suplexing. I stayed home from work and chased Ibuprofen with soup and water. I had no alcohol in the house because I had finished it all when I got home the night before. Usually I would have handled that hangover with a Bloody Mary or Screwdriver, but I just couldn’t bring myself to leave the house to get alcohol. When I checked my receipts (apparently after I had closed my tab I opened another) and found I had spent $70 -- my average monthly booze budget -- in one night, I knew I was done drinking. I didn’t need an intervention or treatment to stop drinking because I knew if I drank again, I could drink myself to death.

That doesn’t mean alcoholics don’t need help. In fact, 95 percent of alcoholics who need treatment don’t think they need it. Maybe I’m just a member of that majority, and it’ll take a relapse for me to realize it. At least I could get treatment if I wanted it, and my insurance would even cover it. That’s not the case for every addict.

A 2016 report by the U.S. Surgeon General found that one in seven Americans will face some sort of substance addiction. The economic impact of those collective addictions amounts to $442 billion each year, which rises as healthcare premiums rise. And America has the highest drug-death rate in the world.

 Worse yet, we’re not even addressing the problem properly. Instead of providing the treatment addicts need, money is funneled by politicians to for-profit prisons instead of treatment facilities, leaving addicts without the treatment and supportive community necessary to keep them clean. The number of substance abuse treatment facilities in the U.S., which focus on drug and alcohol abuse, was reported to be 13,873 in 2014, a decrease from the 14,152 facilities reported in the previous year.

“Former inmates return to environments that strongly trigger relapse to drug use and put them at risk for overdose,” according to a 2012 study published in Addiction Science & Clinical Practice. Of the more than 21 million addicts in America, only 10 percent receive treatment, mostly due to a lack of healthcare coverage or lack of treatment centers in their area. According to the Journal of the American Medical Association, 80 percent of opioid addicts don’t get treatment, and a similar 2015 study found a million opioid addicts couldn’t get treatment for their addictions if they wanted it.

That leaves a lot of Americans on our own to struggle through our addictions. I’ve resisted to commit to Alcoholics Anonymous or the 12-Step Program because I wasn’t convinced I had a problem. Now that I am convinced, I realize the importance of having a community to support you and your decision, but I still haven’t attended an AA meeting because the 12-Step Program utilized by AA most often relies on a commitment to religion. Giving oneself up to “a higher power” is the first step, and it wasn’t until I read Russell Brand’s Recovery: Freedom from Our Addictions that I found a non-religious means to put the 12-Step Program to work for me, an atheist.

Since publicly announcing my problem with alcohol on Facebook on Oct. 12, 2017, I found I did have a community in place to help me through my problem with alcohol. Friends of mine who’ve long been out of touch and also quit drinking offered their support, as did my family. Not every alcoholic has friends and family with experience overcoming addiction, however. I guess I’m lucky to have excessively drunk alcohol and done drugs with people willing and capable of realizing and accepting their powerlessness over substances.

Prisoners aren’t leaving prisons with that community in place. They’re reentering communities where they’ll be tempted around every corner. So until we stop putting nonviolent, drug offenders behind bars and instead put them in treatment centers to get the help they truly need, we’ll be inching ever closer to making the new American Dream overcoming addiction.


If you like this, you might like these Genesis Communications Network talk shows: America’s Healthcare Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, Dr. Coldwell Opinion Radio, Good Day Health, Health Hunters, Herb Talk

Published in Health

Experts report allergy season will worsen each year due to environmental changes.

Allergy season usually begins in March with the start of Spring and can extend to the Fall even leading to new Fall allergies.

Each year we find allergy season starting a few weeks earlier as temperature changes prompt early blooms.

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 extends through the Summer and Fall.

Dr. Jeffrey Demain, Board Certified Allergist and Immunologist reported at the March meeting of the American Academy of Allergy, Asthma and Immunology the following, “We have higher temperatures and expanding levels of carbon dioxide.

“When you look at a pollen grain, there are certain proteins that cause the allergy, they are the allergenic peptides,” he said. “It’s been shown that in rising carbon dioxide, the allergenic peptide of each pollen grain goes up.”

Plants utilize carbon dioxide for respiration as humans use oxygen.  The higher carbon dioxide levels, the higher the pollen counts and proteins in pollens that contribute to allergies.

The increase in storms may contribute to allergy season as well as moisture in the air causes pollen to swell and “explode” into multiple little pollen particles, smaller and easier to breathe in.

Moreover stagnant flood water may cause fungi, mold and spores to grow, also leading to allergies.

The Allergy Capitals Spring 2018 report found many cities are worse off this year than they were in previous seasons. McAllen, TX , Louisville, KY, Jackson, MS, Memphis, TN  and San Antonio, TX ranked in the top 5 in “Most Challenging Places to Live With Spring Allergies.” The copy of the report is below:

AAFA-2018-Spring-Allergy-Capitals-Report

Let’s review allergies…..

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 Health
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5 ways to add years to your life

A study out of Harvard’s TH Chan School of Public Health finds 5 simple lifestyle changes that can add 1-2 decades onto one’s life.

Researchers looked at lifestyle and diet of over 100,000 men and women apart of the Nurses’ Health Study and the Health Professionals Follow-up Study. They found sticking to these lifestyle changes at the age of 50 could give the average woman 14 extra years of life and the average man, 12.

Since cancer and heart disease contribute to hundreds of thousands of deaths a year, study authors suggest the following:

Avoiding Smoking

 

Since smoking has been long linked to early death, due to increase risk of arteriosclerosis and multiple types of cancer, avoiding tobacco products have been found to increase life expectancy.

 

smoking-one-cigarette.jpg

 

Keeping Weight Down

 

Researchers encourage a healthy body weight, more specifically a BMI of 18.5 to 24.9 kg/m2.

 

bmi-chart.png

 

Obesity has been linked to diabetes, heart disease and multiple cancers, so a healthy diet is paramount.

Eating a Healthy Diet

 

Diets rich in vegetables, low sugar fruits, whole grains, fish and healthy fish oils have been found to decrease risk of diabetes, obesity, heart issues and various cancers.

 

Tips-to-Effectively-Follow-the-Mediterranean-Diet

 

Avoiding excess salt, sugar, and saturated fats are key.

Regular Exercise

 

30 minutes a day of moderate to vigorous activity daily has been recommended by multiple medical associations.  I would encourage making sure one’s medical provider evaluates heart health before engaging in vigorous activity.  But walking, swimming, household chores, dancing, and many other activities fall under “moderate activity” that can be safe and provide multiple health benefits.

 

yoga.jpeg

 

“Moderate” Drinking

 

Moderate drinking is defined as no more than one drink a day for women, two drinks a day for men.

 

What-is-a-drink

Image above from CDC

 

However, the health benefits of alcohol consumption are controversial, as many studies have linked alcohol consumption to cancer. Moreover, the sugar levels in alcohol can contribute to diabetes and obesity.

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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 Health

The most recent World Health Organization rankings of the world’s health systems has the United States at 37th -- seven spots behind its neighbor to the north, Canada, and 19 spots behind its American predecessor, the United Kingdom. That might not seem so bad on a list 190 nations long, but the United States ranks last in health care system performance among the 11 richest countries included in a study conducted by The Commonwealth Fund. In that study, “the U.S. ranks last in Access, Equity, and Health Care Outcomes, and next to last in Administrative Efficiency, as reported by patients and providers.”

Much of our inflated health insurance premiums in America comes from paying to create your bill. That’s right -- 25 percent of total U.S. hospital costs are administrative costs. The United States had the highest administrative costs of the eight countries studied by The Commonwealth Fund. Scotland and Canada had the lowest, and reducing U.S. per capita spending for hospital administration to Scottish or Canadian levels would have saved more than $150 billion in 2011.

Treating healthcare like any other marketplace requires careful, complicated codification of products sold and services rendered. People must be paid to determine how much your healthcare costs, and that can’t be changed, but it can be improved upon. Allowing insurance companies to profit from people’s health makes for a marketplace in which every cent of cost is counted and every penny of profit is protected. Profit motive always results in more scrutiny by the haves at the expense of the have-nots.

You might think that an industry that preys on the unhealthy and the healthy alike would prefer their consumers healthy as to enjoy the profits from your premium payments without paying for healthcare. But the cost of your health insurance premium already includes your health insurer’s profit margin. The health insurer is going to do all it can assure a certain amount a profit except for a catastrophic health emergency that consumes the country. But if the consuming population is unhealthy relative to other markets, the health insurer has good reason to inflate prices to cover its projected costs. That is indeed the case in the United States.

The United States is the 34th healthiest nation in the world, according to 24/7 Wall St. That’s not terrible, but not what you probably expect from a nation advertised by Americans as the greatest in the world. And you’re paying for it.

Not unlike a mortgage or auto insurance premium, the cost of your health insurance premium is an average based on the health insurer’s risk. That risk is the potential costs the health insurer could incur based on the perceived health of its insured consumers. I’ve written in the past how Republicans can’t repeal and replace Obamacare because their constituents, most of whom reside in the South, need Obamacare. Southerners are the least healthy Americans, with 20 percent reporting fair or poor health in 2014. The South also has the highest rates for diabetes, obesity and infant mortality in the nation. The South also accounts for nearly as many uninsured people as the rest of America combined, and 17 percent of the uninsured fall into the coverage gap for Medicaid expansion. Your health insurance premiums pay for their healthcare as well as your own, which is why, given the current for-profit health insurance marketplace, I would welcome a fat tax.

A fat tax is a tax on fat people. People who live unhealthy lifestyles should pay more for health insurance. As a healthy consumer of health insurance, I’d prefer to pay a lower premium given my dedication to maintaining good health at the expense of those who refuse to maintain good health. I might be fat shaming some people, but I don’t care. I shouldn’t have to pay for your diabetes because you can’t resist stuffing your face with Twinkies. Maintaining your health is your responsibility and no one else’s, and you should be punished for failing to maintain good health at the expense of your neighbors. But since something that could ever be referred to as a fat tax by the opposition would never pass Congress, a rewarding people with discounts for their healthy habits would be much more likely.

I foresee this program as mirroring the Progressive auto insurance Snapshot program -- “a program that personalizes your rate based on your ACTUAL driving.” Instead of plugging a device into your car, you’d use a Fitbit or similar health monitoring device with a heart rate monitor. Couple your daily monitoring of your exercise and diet with the results of regular checkups with your physician to confirm your healthy habits and you’ll be given a discount on your monthly health insurance premium as determined by your overall health.

Simply scheduling and completing regular checkups will help lower premium prices by catching things early and allowing for preventative medicine to work rather than resorting to more expensive reactionary measures. That could be the first discount bracket: schedule and complete a physical twice annually for two percent off your monthly premium. That way everyone at least has a chance to save some money. Those who fail to do so will pick up the tab.

The real discounts will be reserved for those consumers who regularly show signs of living a healthy lifestyle. People who don’t use tobacco products would receive a one-percent discount on their monthly premiums that the insurer will recoup from charging tobacco users with a one-percent premium penalty.

Non-drinkers would also receive a one-percent discount, as alcohol is a cancer-causing carcinogen and dangerous when consumed irresponsibly. Accessing a penalty for drinking, however, would be problematic, as social and occasional drinkers shouldn’t be penalized for enjoying alcohol responsibly. But say you get a ticket for driving while intoxicated -- that’s two percent tacked onto your health insurance premium for putting your own health and the health of your neighbors at risk. The same goes for possession of illegal drugs, except cannabis. No discount or penalty would be accessed for cannabis use since it is proven to kill cancer cells and be of medical value.

Even if you are a tobacco user and a heavy drinker or drug user, you too deserve opportunities to lower your health insurance premiums. So anyone who meets the Department of Health and Human Services recommendations for weekly exercise for a month gets a one-percent discount on their premium the following month. That’s just 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly. Add that to the two-percent discount for completing bi-annual physicals, and you could offset the penalties of driving under the influence and smoking.

Big money will be saved based on your body fat. If an adult male or female maintains an athletic body fat percentage (between five and 10 percent for males and between eight and 15 percent for females), they get an additional two-percent premium discount on top of the two percent for completing bi-annual physicals. That same two percent would have to be paid by someone, though, so it would fall on the obese.

Adult males with a body fat percentage over 24 and adult females with a body fat percentage over 37 would receive a two-percent premium penalty. If they make their two appointments for physicals annually, there wouldn’t be any change to their bill. The overweight, being males with body fat percentages between 21 and 24 and females with body fat percentages between 31 and 36, would receive a one-percent premium penalty.

Adult men with body fat percentages between 11 and 14 and women between 16 and 23 would get a one-percent discount for maintaining a “good” body fat percentage. Those men with body fat percentages between 15 and 20 and women with body fat percentages between 24 and 30 would pay no penalty nor receive a discount for maintaining “acceptable” body fat percentages.

These discounts and penalties would motivate consumers to improve their health in order to save money, in turn, lowering premiums for everyone by improving the overall health of all consumers in the marketplace. The higher the U.S. climbs out of that 34th spot in overall health, the less everyone pays in health insurance premiums.

I pay roughly $135 monthly in health insurance premiums for a high-deductible, Bronze package I found on MNSure -- Minnesota’s equivalent to the Obamacare marketplace. I maintain an athletic body fat percentage under 10 (two-percent discount). I exercise and regularly exceed the Department of Health and Human Services’ weekly recommendations (one-percent discount). I don’t smoke (one-percent discount), and I don’t drink (one-percent discount). I saw my doctor twice last year (two-percent discount). Add it all up and I’d save seven percent on my monthly health insurance premiums, or a measly $9.45 monthly. That’s over $113 annually, though, much of which would be recouped from the penalties assessed to the unhealthy. I could think of a lot of things on which I could spend that $113. It would be nice to be able to afford a steak once in a while.

While Medicare-for-All is picking up steam in Liberal circles, it’s still at least three years away from being seriously considered by Congress as a solution to ever-increasing healthcare costs. Meanwhile, here’s a solution that addresses two problems: ever-increasing healthcare costs and the declining health of Americans overall.


If you like this, you might like these Genesis Communications Network talk shows: USA Prepares, Building America, The Easy Organic Gardener, American Survival Radio, Jim Brown’s Common Sense, Good Day Health, MindSet: Mental Health News and Information, Health Hunters, America’s Health Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, The Dr. Bob Martin Show, Dr. Coldwell Opinion Radio, The Dr. Katherine Albrecht Show, Drop Your Energy Bill

Published in News & Information
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