Tuesday, 19 December 2017 16:08

The Office Holiday Party: Do’s and Don’ts

The work holiday party is one of the most anticipated events of the year.  Free food, free drink and for 4-6 hours you can be in the same room as your boss without any risk of being told “you’re fired”.  But…..many of us make mistakes, HUGE mistakes, while tipsy and letting our guard down could be the biggest career buster ever.  Plus, there are some missed opportunities the office Holiday party offers to make your overall work life better. So let’s get right down to it.

Don’t

1. Flirt with the boss

 

Your superior in any office setting should be the last one you try to cuddle up to.  Good management knows there is ALWAYS someone watching and, these days, recording on their phone, so they do not want to be seen in an uncomfortable situation, appearing to be flirting with you. You can complement them, sure, but hands off!

2. Drink too much

 

This gets us all into trouble.  Yes the alcohol is usually free and a flow’n but this will lead to your downfall.  Your guard is down, you become flirty, you blurt out secrets, those that the whole team knows but would be never caught dead saying……and sometimes the clothes come off on the dance floor.  Please drink in moderation.

3. Drive drunk

 

Never, never, never plan on driving that night if you plan to drink. Car Service, Uber, Taxi, designated drivers are a must.

4.  Let anyone tag you on Facebook

 

The next morning will be full of regret as it is, no need to cement it in infamy.

5. Skip on the whole soiree

 

Holiday season is swarming with good parties. And chances are there are two other parties calling your name that same night.  Make sure you hit the office party FIRST.  You can get too distracted or drunk at the other parties such that you never make it across town, safely.  Again, don’t drive if you plan to drink.

 

singing.jpg

 

6.  Take the mic

This is where I take a fall (as you can see above).  A microphone is sitting up on the stage, waiting, just waiting for someone to grab it and spout out some one liners.  I fear getting close to it until the head boss makes opening remarks. Then I feel the need to interrupt him and “take over from here”.  Let your boss have the mic.  He/She’s the head honcho, let them have their glory.  They’re paying for the party……

 

7.  Gossip

 

Never, never use this opportunity to gossip. That’s what the staff lounge is for.  It’s a positive night. Don’t bring negativity.

 

8.  Tell off the office bully

 

You may feel protected with all your work peeps surrounding you but one day he/she will get you alone and ….payback.  Instead wishing them some holiday cheer…..may bring out the good in the jerk.

9.  Sleep with your coworker

 

Everyone is watching you so your hopes of secretly hooking up is already circulating social media. If you want to begin a relationship that’s fine, but hoping it's on the down low will never happen.  People at parties pretend to be distracted, but someone is always watching.

 

10.  Discuss work

 

Never, never, never discuss work at the office Holiday party.  And please don’t ask for a raise!!! Will never happen. Even if your boss is drunk, he will forget about it by the New Year.

 

11.  Don’t be quiet

 

Being antisocial is not the way to go either. Mix, mingle and look like you’re having a good time. Even if you’re not.  If you have to leave early due to boredom, blame it on diarrhea.  This may be the only party you EVER get invited to.

 

Do’s

1. Thank the boss and the planning committee

 

Even though they may roll their eyes at you as you compliment them (since anyone volunteering for a planning committee in the first place probably isn’t your best bud at work), they secretly enjoy the complement.

 

2.  Get up and sing (if you can sing)

 

This is the only time your boss and team will see your other talents.  Sans beer bonging, show off your talents….dance moves, pipes, even fashion sense…. if you’re good.

 

3.  Let the boss know you’re happy at work

 

Don’t kiss up, but as you thank him, let him know you love your job.  This will be a take home message that can go a long way.

 

4. Tip the bartender

 

This is a no brainer.

 

bartender-mixologist-1.jpg

 

5. Have fun!!

 

It’s the holidays!  Let’s celebrate!! Truly the most wonderful time of the year!!!

 

xmas party 2017.jpg

JOHN SHAFFER, DALIAH WACHS, AND TOM HUMM

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information
Tuesday, 12 December 2017 21:46

Wildfire Smoke Health Risks

As the California Wildfires roar into a second week, those residents lucky enough to escape the flames worry what consequences could result in inhaling the smoke.

What is in wildfire smoke?

 

According to the EPA, smoke emanating from forest and community fires may include any of the following:

  • Carbon monoxide, which competes with oxygen in the blood

  • Carbon dioxide, a respiratory byproduct

  • Wood particles

  • Formaldehyde

  • Acrolein – used as a pesticide

  • Benzene

  • Plastics, and those byproducts after incineration

  • and thousands of different respiratory irritants.

According to the EPA,

Smoke is composed primarily of carbon dioxide, water vapor, carbon monoxide, particulate matter, hydrocarbons and other organic chemicals, nitrogen oxides, trace minerals and several thousand other compounds. The actual composition of smok depends on the fuel type, the temperature of the fire, and the wind conditions. Different types of wood and vegetation are composed of varying amounts of cellulose, lignin, tannins and other polyphenolics, oils, fats, resins, waxes and starches, which produce different compounds when burned.

What symptoms may individual's experience?

 

Some may have no idea they are breathing in harmful compounds that could affect their lungs and heart.  However, many may experience:

  • Cough

  • Wheeze

  • Difficulty Breathing

  • Chest Pain

  • Mucous Production

  • Dizziness/lightheadedness

  • Fatigue

  • Racing Heart (palpitations)

  • Exacerbation of their lung disease including COPD, asthma, chronic bronchitis

  • Exacerbation of heart conditions such as angina, heart attack, and cardiac arrhythmias.

  • Increased susceptibility to new lung infections as well as flu  

What are PM2.5s?

 

PM2.5 are particles less than 2.5 micrometers in diameter that are present in pollution and wildfire smoke that can penetrate deeply into the lung linings.  Larger, coarse particles 10 micrometers in diameter are called PM10.  Both impair lung function as they inflame the lungs and interfere with the work of alveoli that need to oxygenate the blood.  Moreover the small particles can use this pathway to enter the bloodstream. Although the direct health impacts of the fine particulate matter is not clearly defined it is believed that increased PM2.5 levels increase the risk of lung and heart disease as discussed above.

 

lungs_alveoli-57ffa7fe3df78cbc284e162b

LUNGS AND ALVEOLI (IMAGE FROM THOUGHTCO.)

 

Symptoms may begin at levels greater than 55 µg/m3 .

Which individuals are the most at risk?

 

  • Infants and Children

  • Elderly individuals

  • Those with chronic lung disease, including asthma and emphysema

  • Those at risk for heart disease and stroke

  • Those with diabetes

  • Smokers

  • Pregnant women

  • Those with chronic allergies

  • Pets

How can residents protect themselves?

 

Avoiding the area of wildfires is paramount.  Additionally, the following may be considered:

  • Avoid outdoors until air quality reports improve.  Do not rely on how “clear” the air looks.

  • Take heed of wind and air quality advisories.

  • Recirculate the air in your home and car.

  • Keep windows closed.

  • Consult with your medical provider to monitor blood pressure, heart rhythm, lung function and refill any medications you may need BEFORE you feel symptoms.

  • Be wary of facemasks sold as PM2.5 safe as many do not protect against the very small particles. Respirator masks labelled N95 or N100 may provide SOME protection against particulates but not against the toxic fumes such as formaldehyde and acrolein.

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information
Tuesday, 12 December 2017 19:17

Sickness Pays, Even When You Are Not sick!

After traveling from Boise, Idaho to Missoula, Montana to Orlando, Florida then onto Houston, Texas, we have tallied up about 150 ministry hours of driving over the last 6 weeks. With that, comes a toll on your physical body, and it caught up with one of my family members, at least for a minute. Let me explain.

 

Keep in mind, there is a balance between a natural/holistic remedy and western medicine. I have always been cautious when it comes to either side of the aisle. It seems that without fail, fear of not using either of their remedies is always what is pushed until you submit, and I for one will not go down that road.

 

During our final tour this last month, one of my family members had told me that her eyes were becoming blurry and that she could not see the road signs which were relatively close. Thinking that she only had to have her contacts replaced, she set up an appointment the following day when we would arrive at our next stop. Upon examination, the doctor stated that she had a drastic change in her visual tests. The doctor then said that the only time that she sees such a big change is when someone has diabetes, which we were not going to own.  This family knows who the Healer is (Acts 10:38).

 

The doctor went and purchased a blood test, which revealed that her blood was up about 152 mg/dl higher than it should have been. After receiving her new contacts, the eye doctor then suggested going to the emergency room as soon as possible.

 

So, we set up an appointment the following Monday at the local clinic. Of course, by this time, I had plenty of time to ponder as to what was going on. Flags were already going up at every turn.

 

When we finally arrived for the scheduled appointment, the nurse wanted to take a blood test. The nurse took the first blood test and then suggested another, and we consented. After the blood tests were done, we were told that the blood needed to be sent to the Mayo Clinic in Rochester, Minnesota, which was going to take at least a week for results to come back in.

 

Before we knew it, the nurse told us that she had good news for us.

 

She begins to tell us that she didn’t think that it was this or that, or even the other thing but that my family member has type one diabetes and that she will have to be on insulin for the rest of her life.

 

I asked, “What was good about that dim prognostication?”

 

Furthermore, I asked how she could have come up with a prognostication that she had type one or two diabetes and how it was that she could make that diagnosis without getting all the blood results?

 

At this point, we knew that she was taking directives from someone in that clinic. Sincere as she was, she was lost; she continuously stumbled over as to how she was making this unsubstantiated claim. She ended up seeing the point we were making with our questions.

 

A couple of minutes later, she comes in with a “deep concern” as to what might be happening with our family members pancreas and that she now needs to take a couple of pictures to see what may be blocking insulin from getting into her blood and wouldn’t you know it, out of nowhere comes in another nurse to start to “teach her how to use insulin twice a day for the rest of her life.”

 

At this point, I got on the phone with an EMT and a nurse that we trusted and told them what was going on.  I discovered that though diabetes is not to be played with, we were dealing with a system that is not about healthcare, but rather looking to create productivity and to match and connect a diagnosis with insurance codes to tap into the money.   

 

How many of these young, sincere nurses and doctors get out into their field only to find that they are being used to be salespeople for the pharmaceutical companies who make billions every year off the sicknesses that they simply misdiagnose and therefore, are guilty of creating?

 

At this point, I told this nurse, who by the way had no business bringing this grim diagnosis, what her suggestions were and that we were not going to do anything until we had more information.

 

Of course, more fear comes from this nurse as to the importance of getting hooked on their remedy because if not, our family member may become blind, and possibly may even die, which we were not buying.

 

The long of the short of it is that we got to an experienced and caring doctor who told us that this lady had no business giving any diagnosis, that insulin was not the answer, and it would be remedied after a little rest, a good diet and exercise.

 

So, before taking the doctor's word for any diagnosis that may come down the pipe (There is a reason that they call it “practice”) which pushes you to dependency on the medical and pharmaceutical industry, you may want to take a step back, read and listen carefully as to what the woman that pressed into Jesus knew from experience.  

 

“And a woman having an issue of blood twelve years, which had spent all her living upon physicians, neither could be healed of any, came behind him, and touched the border of his garment: and immediately her issue of blood stanched. And Jesus said, Who touched me? When all denied, Peter and they that were with him said, Master, the multitude throng thee and press thee, and sayest thou, Who touched me?  And Jesus said, Somebody hath touched me: for I perceive that virtue is gone out of me. And when the woman saw that she was not hid, she came trembling, and falling down before him, she declared unto him before all the people for what cause she had touched him, and how she was healed immediately. And he said unto her, Daughter, be of good comfort: thy faith hath made thee whole; go in peace.” (Luke 8:43-48)

 

The lists of fraud in the medical industry are astounding, to say the least. Below are some incredible links for you to review.

 

https://articles.mercola.com/sites/articles/archive/2015/09/30/diagnos HYPERLINK "https://articles.mercola.com/sites/articles/archive/2015/09/30/diagnostic-errors.aspx" HYPERLINK "https://articles.mercola.com/sites/articles/archive/2015/09/30/diagnostic-errors.aspx" HYPERLINK "https://articles.mercola.com/sites/articles/archive/2015/09/30/diagnostic-errors.aspx"t HYPERLINK "https://articles.mercola.com/sites/articles/archive/2015/09/30/diagnostic-errors.aspx" HYPERLINK "https://articles.mercola.com/sites/articles/archive/2015/09/30/diagnostic-errors.aspx" HYPERLINK "https://articles.mercola.com/sites/articles/archive/2015/09/30/diagnostic-errors.aspx"ic-errors.aspx

 

http://www.healthcarefinancenews.com/slideshow/biggest-healthcare-frauds-2015-running-list?p=0

 

http://www.fraud-magazine.com/article.aspx?id=4294976280

 

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Bradlee Dean is a guest contributor to GCN news. His views and opinions, if expressed, are his own and do not reflect the views and opinions of the Genesis Communication Network. Bradlee's radio program, The Sons of Liberty broadcasts live M - Sat here at GCN.

 

Published in News & Information
Wednesday, 06 December 2017 19:40

IUDs May Cut Cervical Cancer by 30%

A new study suggests intrauterine contraceptive devices (IUDs) may fight off the virus that causes cervical cancer.

Researchers from the University of Southern California’s Keck School of Medicine found the small T-shaped device may stimulate an immune response against the sexually transmitted Human Papilloma Virus (HPV) virus which causes cervical cancer.

 

 

iud.jpg

T-SHAPED IUD SITTING WITHIN THE UTERUS

 

IUDs are a favorite among women as they do not involve taking a daily hormone pill and can provide contraceptive protection for years.  There are two main types:

The ParaGard IUD is a non hormonal implant made of copper. The copper wards of sperm allowing contraception up to 12 years.

Hormonal IUDs, such as Mirena, release progestin, a hormone similar to progesterone, to the local environment, thickening the cervical mucous to prevent sperm from reaching the egg.  Hormonal IUDs may also prevent ovulation. Additionally, IUDs can alter the lining of the uterus such that if a fertilized egg does occur, it may not be able to nest in the uterus without proper lining.

But both IUDs can stimulate an immune response that is both a deterrent to sperm and now suggested to viruses such as HPV.

Vaccines against the HPV virus exist and are given to 11-12 year old girls with the maximum age at which one could receive the vaccine, 26 years old.

If more research confirms this is the case, then those women who have not been vaccinated or are too old to receive the vaccine against cervical cancer may benefit from using an IUD.

What is the cervix and what is cervical cancer?

 

The uterus looks similar to a light bulb. The larger top portion being where the fetus develops, and the bottom, narrower area, the cervix. The cervix thins and dilates during childbirth, as you’ve heard in the movies “she’s only 7 cm!” and then after childbirth becomes narrow again.  It affects nearly 12,000 and kills 4,000 women each year. It can affect women of any age but is more common between 20 and 50.

 

375x321_cervix

HTTP://WWW.WEBMD.COM/WOMEN

 

What causes cervical cancer?

 

The most common cause is HPV (Human Papillomavirus), especially HPV-16 and HPV-18.  This is acquired through unprotected sex, so condom use is encouraged. Thus its one of the most preventable causes of cancer.  Additionally, there are 3 vaccines for HPV currently approved by the FDA, Gardasil, Gardasil 9, and Cervarix.

What are the symptoms of cervical cancer?

 

Early cervical cancer may not be symptomatic but as it develops it may cause an odor, pain with urination, pelvic pain and bleeding. This bleeding may occur after sex, a pelvic exam, or intermittent bleeding not associated with a menstrual cycle.

Is cervical cancer treatable?

 

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

Who should get screened for Cervical Cancer?

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

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

What is a Pap Smear?

 

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

 

cervical-smear-test-equipment-97358274-575db1493df78c98dc633c53

TEK IMAGE/SPL / GETTY IMAGES

 

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

How is an HPV test done?

 

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

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

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

A new study out of India suggests both premature balding and graying are linked to heart disease.

Researchers from the UN Mehta Institute of Cardiology in Gujarat, India evaluated 2000 men (1200 healthy and 790 with heart disease) and found those who began to lose their hair and hair color before the age of 40 had the following risk elevation when it came to heart disease:

  • Premature balding 5.6 X risk

  • Premature graying 5.3 X risk

To put this into perspective, obesity was associated with a 4.1 greater risk. So alopecia (hair loss) and canities (graying/whitening of the hair) appeared to be more of a culprit than one of the most infamous risk factors there is.

This study therefore suggests those before age 40, showing early receding hair lines and gray hair, may want to be evaluated for cardiac risk factors.

In April, a study was presented at the EuroPrevent 2017 conference of the European Society of Cardiology suggested a link between how much a man grays or whitens when he ages and plaque buildup within the coronary arteries, the main arteries that supply the heart muscle.

Those researchers looked at 545 men and evaluated them by the degree of hair whitening where a 1 was given to those with all black hair, up to a 3 with equal amounts of black and gray/white hair, to a 5 where they had all gray/white hair. Computed tomography coronary angiography was used to evaluate the amount of atherosclerosis (plaque build up) in the coronary arteries.

Those men who scored 3 or more appeared to have higher risk of plaque build up. These findings were independent of cardiac risk factors such as age, diabetes, high blood pressure, high cholesterol, smoking and family history of heart disease.

According to lead author in this earlier study, Dr. Irini Samuel, a cardiologist at Cairo University in Egypt stated,

“Atherosclerosis and hair graying occur through similar biological pathways and the incidence of both increases with age. Our findings suggest that, irrespective of chronological age, hair graying indicates biological age and could be a warning sign of increased cardiovascular risk.

More research is needed on cutaneous signs of risk that would enable us to intervene earlier in the cardiovascular disease process.”

She continued, “If our findings are confirmed, standardization of the scoring system for evaluation of hair graying could be used as a predictor for coronary artery disease.”

17c6f174268e3a6897d4447185851c37.jpg

Why does our hair turn gray with age?

Our hair color is determined by our melanin production, a combination of pigments (eumelanin and pheomelanin) that can vary, with less eumelanin giving rise to blond hair, more giving rise to brunette hair and pheomelanin responsible for the red, auburn hues.

Melanocytes inject their pigment into the keratin cells that produce hair.  As we age these may slow down.  Another cause of “going gray” is hydrogen peroxide builds up in the hair follicle, causing oxidative stress, which in turn prevents rich colors from being displayed. The lack of pigment will cause hair to appear white.

 

1073579182.Me.4.jpg

IMAGE FROM MADSCI NETWORK

 

What can cause premature graying?

 

Many of us begin to see gray hair in our 30’s. Some in our 20’s. Different ethnicities gray at different ages. If one is gray by age 20 that would be considered very premature.

We’ve heard about stress, hormones, and nutritional deficiencies being linked to loss of hair color, but studies have not been able to prove this definitively.

Researchers are still trying to determine why one would gray faster and what significance it has on our health.

Now one might say “If everyone grays then everyone is at risk for heart disease.”  Heart disease is common and the number one killer and graying is almost ubiquitous in the older population. But this study starts to make one wonder if the amount, accelerating of….even the pattern of graying are significant, then this could clue us in on who is at risk for early, preventable, heart disease.

What causes baldness?

 

Hair is made in follicles within the skin and grows for about three years until it sheds and new hair grows. Hair loss (alopecia) occurs when hair follicles shrink and smaller, thinner hairs grow, lasting shorter and shorter times.

Genetics play a huge factor, with the most influential genes coming from mother’s X chromosome, which came from her father. So maternal and paternal genes can both be responsible for baldness.

Sex hormones, androgens, can cause male pattern baldness.  Medications (such as anabolic steroids), illness such as low thyroid and diabetes, and cancer can cause hair loss as well.  A recent study found Prostaglandin D2 protein may block hair growth in those who suffer male pattern baldness. It’s believed 80% of men under 70 will have some receding hairline.

How can we prevent heart disease?

 

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

  • Family history of heart disease

  • Personal history of heart disease

  • High Blood Pressure

  • High Cholesterol

  • Diabetes

  • Smoking

  • Obesity

  • Inactivity

  • Males over 40

  • Females who are post menopausal

  • High stress

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

As you can see, many of us can be at risk for heart disease.

Therefore secondly, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.

Thirdly, reduce your risk by the following:

  • Maintain a normal blood pressure

  • Maintain normal blood sugar

  • Maintain normal cholesterol and lipid levels

  • Reduce stress

  • Maintain a balanced diet, rich in potassium-rich foods such as fruits and vegetables

  • Quit smoking

  • Stay active

  • Maintain a healthy weight.

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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 finds many Vietnam veterans may have contracted liver flukes decades ago that could now cause pancreatitis, liver disease and/or bile duct cancer.

The Department of Veterans Affairs commissioned a study that looked at bile duct cancer and liver flukes that may have been ingested by veterans while on tour in Southeast Asia during the Vietnam War.

This was in response to a story reported by the Associated Press in which 700 cases, of cholangiocarcinoma, bile duct cancer, were seen in VA facilities over the last 15 years.

The current small study looked at 50 blood samples, finding 20% of which to be positive for liver flukes.  Most participants were not aware they were infected.  If infection did later lead to cancer, symptoms would come late in the diagnosis.

Tropical medicine specialist, Sung-Tae Hong, from Seoul National University in South Korea, stated he was “surprised” by the results and admits to more research needing to be done.

Cholangiocarcinoma is still rare, however if Vietnam veterans are at increased risk due to their fish consumption while on duty, they need to be followed closely by their medical provider. Stool tests could be done to look for parasite eggs, and blood tests may look for antibodies fighting the infection.

What is a liver fluke?

 

Liver flukes are parasites that infect the liver and bile duct.  There are multiple species.  The disease Fasciola hepatica and Fasciola gigantica cause is called fascioliasis. Symptoms may range from none to severe liver disease.  But the liver flukes associated with bile duct cancer include Opisthorchis viverrini, O. felineus, and Clonorchis sinensis.  According to the US Department of Veterans Affairs:

The irritation and scarring caused by liver fluke infection can lead to bile duct cancer.

Two parasites are commonly involved. One is Opisthorchis verrini, which is found in Southeast Asian countries, including Thailand, Lao People’s Democratic Republic, Vietnam, and Cambodia. The other is Clonorchis sinensis, which is common in rural areas of Korea and China.

Eating raw or undercooked fish infected with these parasites introduces the pathogen into the GI system where it can hide out in the liver and bile ducts for decades.

In 2007, Sripa et al discussed how close to 600 million people were at risk of being infected with liver flukes.

In 2011, Lim et al wrote, “More than 35 million people worldwide are infected. The exceptionally high incidence of cholangiocarcinoma in Thailand and Korea is attributed to the high prevalence of liver fluke infection in these areas.”

How does one get contract liver flukes?

 

In addition to ingesting undercooked contaminated fish, liver flukes can infect multiple mammals, such that eating infected cattle or sheep liver (if undercooked) could transmit the parasite.  Ingesting vegetables washed with contaminated water could introduce the fluke into a person as well.

Medical News Today recommends boiling all untreated water and to avoid water from a stream near where cattle and sheep live.

What are the symptoms of infection with liver flukes?

 

Although some people with liver flukes may exhibit no symptoms at all, some may incur:

  • Fatigue

  • Abdominal Pain

  • Fever

  • Nausea

  • Vomiting

  • Diarrhea

  • Jaundice – yellowing of the skin and whites of eyes

  • Itchy skin

  • Weight loss

What is the prognosis of cholangiocarcinoma (bile duct cancer)?

 

According to cancer.net, the 5 year survival, meaning living 5 years past diagnosis, is 30%, assuming the cancer stays locally.  If the cancer spreads to regional lymph nodes prognosis  for 5 year survival drops to 24%. Distant spread of the cancer reduces the 5 year survival rate to 2%.

 

gallbladder image.jpg

 

What is the treatment for liver flukes?

 

Anti-Parasitic medications, such as triclabendazole, have proven effective against Fasciola. Praziquantel has been effective in fighting Opisthorchis infections.

 

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

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

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

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

What is Parkinson’s Disease?

 

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

 

substantia nigra

Image from the Science of Parkinson’s Disease

 

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

What are the Symptoms of Parkinson’s?

 

Common symptoms of Parkinson’s include:

  • Stiffness and rigidity

  • Poor balance

  • Tremor at rest, especially a pill-rolling tremor

  • Slow movement

  • Inability to move

  • Shuffling steps, gait

and patients may later develop…

  • Depression

  • Anxiety

  • Memory loss

  • Constipation

  • Decrease ability to smell

  • Difficulty swallowing

  • Erectile dysfunction

  • Pneumonia

  • Fractures from falling

  • Hallucinations

  • Delusions

  • Dementia

Who is at Risk for Parkinson’s?

 

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

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

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

Risk may be enhanced with a history of head trauma.

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

How Quickly do Parkinson’s Symptoms Progress?

 

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

The stages of Parkinson’s are illustrated below:

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

How is Parkinson’s treated?

 

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

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

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

  • Dopamine agonists – mimic dopamine

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

  • Other medications including COMT inhibitors, amantadine and anticholinergics

  • Medications to treat anxiety and depression

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

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

  • Physical and occupational therapy

Famous People Diagnosed with Parkinson’s

  • Michael J. Fox

  • Janet Reno

  • Robin Williams

  • Muhammad Ali

  • Casey Kasem

  • Johnny Cash

  • Linda Ronstadt

  • Pope John Paul II

  • Peanuts creator Charles Schulz

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

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information
Wednesday, 15 November 2017 17:33

New Blood Pressure Recommendations Released

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

 

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

 

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

 

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

 

blood+pressure+chart

 

What do the blood pressure numbers mean?

 

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

 

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

What can long term high blood pressure do?

 

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

 

  • Heart attacks

  • Heart failure

  • Stroke

  • Kidney disease

  • Dementia

  • Eye damage – vision loss

  • Erectile dysfunction…to name a few.

How do we treat high blood pressure?

 

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

 

  • Weight loss

  • Low salt diet

  • Low fat diet

  • Good sleep habits

  • Regular exercise

  • Avoiding tobacco products

  • Limiting alcohol consumption

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

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



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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

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

 

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

Where did Marburg Originate?

 

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

What is Marburg virus and its Symptoms?

 

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

 

marburg-ebola.png

Image from KeyWordSuggest

How is Marburg Transmitted?

 

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

 

Greater short-nosed fruit bat (Cynopterus sphinx)

Fruit Bat, Image from Dignited

How is Marburg Treated?

 

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

 

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

 

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information
Tuesday, 07 November 2017 19:37

How Doctors Can Prevent Burnout

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

 

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

 

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

 

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

 

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

Why are Doctors Burning Out?

 

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

 

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

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

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

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

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

 

What are the signs of burnout?

 

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

 

  • Apathy

  • Exhaustion

  • Poor sleep

  • Negative attitude at work

  • Absence from work

  • Being irritated

  • Feeling empty

  • Dreading going to work

  • Feeling underappreciated

  • Feeling you don’t matter

  • Blame others for mistakes

  • Low energy

  • Thinking about quitting




burnout

 

How to prevent burnout?

 

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

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

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

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

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

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

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

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

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

 

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

 

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

 

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Published in News & Information

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