Most people think losing weight has to be a drag, but there is a way you can enjoy losing weight and keep it off. You don’t even have to commit an hour per day to exercising, which is another myth about losing weight. You don’t have to join a gym. You don’t have to leave your home. You can even lose weight at the office with some simple changes to your furniture and habits. So here’s how to enjoy losing weight and keep it off.

1. Get in the Right Mindset

How to enjoy losing weight starts with the proper mindset, as do all things worth doing. You have to really want to lose weight. If you don’t really care to lose weight, you’re more likely to give up after a few weeks or be discouraged when the scale gives bad news. Understanding that sculpting a body comes with peaks and valleys will make losing weight more enjoyable. There will come a time when you “plateau,” and it will seem like you can’t lose anymore weight. The best thing you can do is prepare for the plateau. It’s going to happen. Accept it. If we all lost two pounds per week forever there’d be no weight left to lose eventually.  

Dr. Daliah Wachs says keeping before-and-after photos of yourself can provide motivation to continue pursuing your weight loss goals. She advises to keep the before photo in places you frequent, like the office, the bathroom mirror, in a gym bag or on the refrigerator.

2. Get to Know your Body

It is imperative to know your body and what you’re putting in it if you’re going to enjoy losing weight. This is a great activity for the first week of your weight loss program. Download the free MyPlate app from Livestrong on your Apple or Android device and start logging everything you eat and drink for a week. This food diary is your first step to losing weight, because eating nutritious meals is more important than exercise. The free version of the MyPlate app logs your calories, carbs, fat, protein, sodium, cholesterol, dietary fiber and sugars, and it will set goals for each given your current weight, height, gender, daily activity and weight loss goals. I’m five-foot, 10-inches, around 185 pounds and a moderately active male looking to lose 1.5 pounds per day.

You’ll immediately notice your problem areas, and if you’re in tune with what you eat currently, you probably already know. I knew my problem was empty carbs. I enjoy craft beers and Animal Crackers dipped in tea, so getting six-pack abs for the first time will obviously require giving up six-packs of microbrews. (I’ll never give up my Animal Crackers. In fact, I’ve given up bread because I’m poor and eat a lot of pasta.) But by monitoring my food intake (I refuse to call it a diet, because it’s not) I know exactly what I should consume throughout the day.

For instance, given my age, height, weight, gender and goals, the MyPlate app sets my daily calorie goal at 1,725 calories and my carbohydrate goal at 173 grams. I was around my calorie goal yesterday (1,783 calories) but way over my carbohydrate goal (248 g). My protein intake was also well below the recommended level of 129 grams per day, which means I’ll be picking up protein powder at GNC today and replacing my breakfast of cold pizza with a protein shake full of fruit. Protein shakes don’t have to be chalky and terrible, either. Here are some delicious recipes that will make you enjoy losing weight. (Hint: cottage cheese is key.)

The MyPlate app also links to the Health app on Apple devices and Google Fit on Android devices, so it will count your steps and calculate your calories burned. It also allows you to track your water consumption. Two-thirds of us don’t drink enough water, and it’s a key to losing weight Wachs informs.

“Drink a glass of water before you eat your meal. That works,” she said, adding later that eating the vegetables of your meal first, which are mostly water, also fulfills your appetite while providing proper nutrition. Wachs thinks this a great tactic to keep kids healthy, too.

3. Dedicate Yourself to Your Body

While I’m trying to help you enjoy losing weight, there is a lot of dedication involved in achieving your weight loss goals. Your body is the only thing you take to the grave, so you should be dedicated to it. Take care of it, and it will take care of you.

You must continue logging every food you eat, every drink you drink and every rep of exercise you complete. This is your body diary, and it is as important to your physical health as an actual diary is to your mental health. Once you stop logging that information on paper or in the MyPlate app, you’re starting to accept your body as it is. Don’t do that. Every time you don’t want to log a meal or even a beverage, just think of your weight loss goals. Envision your body as you’d like to see it, and pick up your phone or notebook and log that meal or drink. Speaking of drinking...

4. If You Take a Drink, Drink Liquor

I told you that you’d enjoy losing weight. Even light beers don’t come close to beating the caloric content of most liquors, and the carbs are killers. Jose Cuervo tequila consists of just 96 calories per shot and has no carbohydrates. While Miller Lite also has 96 calories, you have to drink three of them to get the same effect as the shot of tequila. Every 12 ounces of Miller Lite comes with 3.2 grams of carbs, too. If you’re into microbrews like me, giving those up sounds difficult and certainly not enjoyable, but I assure you, you’ll not only shed pounds drinking liquor, you’ll save money, too.

If you’re a whiskey drinker like me, Crown Royal Special Reserve has just 96 calories per serving, as does Pendleton. Most gins and vodkas will also have 96 calories or so. Rum and bourbon will have a few more calories, but are still better for you than beer despite having trace carbs. I suggest you drink all liquor straight, on the rocks or with 100-percent juice. Soda, even diet soda, provides no nutritional value whatsoever. It is literally empty calories and sugar and doesn’t even quench your thirst. That’s why I’ve mostly given it up since 2004, but I’m committed to never letting soda touch another ounce of alcohol for the rest of my life.

5. Exercise at Work

When your coworkers go out for a 15-minute smoke break, that doesn’t mean you have to keep working. (Oh yeah, if you want to look good quit smoking. It’ll make exercising easier.) While just nine states require rest breaks by law, the 15-minute smoke break happens almost everywhere. Most employers understand that their employees will be more productive if they get away from their desk or work space every few hours.

The best thing about the MyPlate app is that it provides exercises you can do at home, at the office or in the gym, with videos of proper form and even a timer and voice letting you know when to start and stop each exercise.

I did MyPlate’s seven-minute, cardio sculpting workout for the first time, and I can tell you it works. Not only is my body telling me what muscles I haven’t been using enough, but the app says I likely burned 235 calories in just seven minutes.

If you don’t have enough room at work to do the MyPlate exercises, there are still a couple of ways you can burn calories. The simplest thing you can do, whether you sit or stand all day, is work your core muscles. It’s as easy as crunching up your abs and breathing deeply.

Replacing your desk chair with a stability ball makes your entire day a core workout that can burn up to 350 calories. The Varidesk is also a nice contraption because sitting all day is still not good for you, regardless of your seat. The more you can get up and move around during your workday the better, and the more you’ll enjoy your work, too.

6. Exercise at Home

One of the reasons people don’t enjoy losing weight is the daily trip to the gym, where they’re judged by those around them or, if you’re a woman, hit on incessantly by bros and former frat boys. The internet has totally changed the way people workout, though. More and more fat-burning exercises can be streamed to your television, computer, tablet or phone, either for free or for a nominal fee.

7. Get Paid to Lose Weight

You can even get paid to meet your fitness goals! Pact pays those who meet their weight loss goals with the money of those who don’t, and HealthWage allows you and a team to collectively work toward weight loss goals. I told you that you could enjoy losing weight. Now you can enjoy the money that comes along with it!

8. Do More of the Physical Activities You Already Love

I catch just about every home Minnesota Twins game, and I take public transit to get there and do at least one lap around Target Field while I’m there (150 calories burned). If I go out for trivia or a freeroll poker tournament near my home, I ride my bike (650 calories burned per hour). I’m surrounded by lakes in the land of 10,000 lakes, which works out great for me because I love to swim (around 585 calories burned per hour swimming breaststroke, depending on weight). There’s a yoga studio by my house I’m considering joining (between 135 and 550 calories burned per hour plus improved flexibility).

9. Eat More Lean Meats

Lean meats and seafood have just 45 calories per ounce. Fish has significantly less saturated fat than other meats, though. The American Heart Association recommends you eat fish at least twice weekly, especially fish containing omega-3 fatty acids like salmon, trout and herring.

Skinless chicken is also a great way to lower your fat and caloric consumption while keeping protein levels up, so chicken wings are perfectly okay to eat on football Sundays as long as they’re eaten in moderation and prepared without a bunch of hydrogenated oils or butter.

I’m not advocating you stop eating red meat. I could never do it myself, but you should find the leanest cut of beef, pork or lamb available and prepare it without adding oils, butter or salt. In fact, 75 percent of the sodium you consume is already in processed foods or from restaurants. You shouldn’t be adding salt to anything. Most foods come with more than enough salt as it is.

10. Eat More Salad

Eating salad might not sound enjoyable, but I assure you, a good salad can be a great way to enjoy losing weight. You can’t tell me poached salmon and watercress salad with dill-yogurt dressing doesn’t sound delicious, or that shrimp with feta, radish, watercress and mint salad wouldn’t be delightful. Grilled panzanella with arugula, burrata, summer squash and olives makes me want to eat bread again, and I might make Moroccan lamb salad with carrots and mint when I get off work.

So there’s 10 ways to enjoy losing weight, and hopefully, you enjoy it so much the weight stays off. I’ll be checking in to update you on my pursuit of six-pack abs in the future.

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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, Free Talk Live

We commonly think of DUI’s, or Driving Under the Influence, a result of drinking alcohol and driving while intoxicated.  However what many people fail to realize is drugs, including prescriptions, could decrease your ability to drive safely, hence putting you at risk for a DUI when alcohol wasn’t even ingested.

A report from the Governors Highway Safety Association (GHSA) and the Foundation for Advancing Alcohol Responsibility found that more fatal crashes were the result of drug use as opposed to alcohol use.

These findings showed that although alcohol was involved in 37% of fatal crashes, prescriptions and illegal drugs were responsible for 43% of driver- related deaths. Looking deeper into data available from the National Highway Transportation Safety Administration (NHTSA), they found 36.5 % of drug related fatal car crashes were the result of marijuana use.

Now what about prescription drugs?  California Vehicle Code 23152(e) states, “It is unlawful for a person who is under the influence of any drug to drive a vehicle.” So what prescription drugs could impair one’s driving?

The obvious ones include the following:

Narcotics such as hydrocodone, oxycodone, morphine, codeine…to name a few

Muscle relaxants such as carisoprodol, cyclobenzaprine, methocarbamol……

Sleep aids such as zolpidem, eszopiclone….

Anti-anxiety medications such as diazepam, lorazepam, alprazolam, clonazepam…..

However surprisingly, these next groups of medications can also cause sedation:

Cholesterol medications such as statins:  lovastatin, atorvastatin, etc. may cause fatigue and recent studies have found them to cause “excessive tiredness”.

Stomach acid suppressants such as proton pump inhibitors:  omeprazole, lansoprazole have been reported to cause vitamin deficiencies such as B12 and magnesium which in turn can cause fatigue.

Antibiotics that treat many common infections:  Amoxicillin, azithromycin, ciprofloxacin have been known to cause fatigue.

Diuretics for blood pressure and water retention:  hydrochlorothiazide, furosemide cause potassium loss in the urine which may contribute to fatigue

Antihistamines:  anti-allergy medications such as diphenhydramine (Benadryl) are very sedating, which is why they are used in some over the counter sleep aids.  There are some reports that the younger generation of medications such as Zyrtec can cause drowsiness as well.

Blood pressure medications:  these can include the ACE inhibitors such as captopril, enalapril;  calcium channel blockers such as amlodipine; beta blockers such as metoprolol as well as the diuretic family mentioned previously.

Antidepressants: many antidepressants additionally help with anxiety through their sedating effects such as trazodone, paroxetine, and escitalopram to name a few.

Mood stabilizers, anti-seizure medications, and antipsychotics can cause fatigue as well.

Despite the rarity of these types of cases, the potential is still there for one to not only receive a DUI but injure himself or others if the prescription makes him less alert, i.e. decreases his “sobriety”.  Discuss with your medical provider if you feel drowsy after you take your medication and if there are less sedating options.

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

The 56 year old actress was receiving chemotherapy and radiation treatment for throat cancer.

A statement released by her husband, Steve Fleischmann, revealed she had back in 2016 woke up noticing a small amount of blood on her pillow case thinking she had bitten her tongue.  A biopsy later revealed she had squamous cell carcinoma on her left tonsil. The cancer eventually spread not allowing her to eat or drink and she required a feeding tube.  This week she died peacefully at home in bed next to her husband and the coroner revealed the cancer had spread to her spleen and brain.

According to Erin Moran’s costar, Anson Williams who played Potsie, “She kept very quiet”……”We all kept quiet too, out of respect for Erin. She couldn’t speak, but her texts were very [positive].”

What is “Throat Cancer?”

The throat, pharynx, is divided into three parts.

Nasopharynx – above the soft palate, the upper part of the throat behind the nose

Oropharynx – between the soft palate and the epiglottis, the middle part of the throat including the back wall, sides, tonsils and posterior 1/3 (back) of the tongue.

Hypopharynx – the lowest part that leads to the esophagus and larynx (voice box)

Cancer in any of these anatomical sections can be considered “throat cancer”.  Cancer of the larynx (voice box) is called laryngeal cancer and is considered separate from hypopharyngeal cancer.

Esophageal cancer is cancer of the esophagus (gullet) and is considered separate from “throat cancer” as well.

What are the symptoms of throat cancer?

Symptoms of throat cancer include:

• Chronic sore throat

• Hoarseness

• Voice changes

• Chronic cough

• Difficulty swallowing

• Painless lump in the neck

• Neck Pain

• Ear Pain

• Weight loss

to name a few.

What are the risk factors?

Risk factors for throat cancer include:

• HPV (Human Papillomavirus) – causing rising rates of especially oropharyngeal cancer

• Epstein Barr Virus – related to increased risk of nasopharyngeal cancer

• Tobacco Use

• Alcohol use

• Gastroesophageal reflux disease (heartburn)

• Poor diet, especially lack of fruits and vegetables

How is throat cancer treated?

As one can see by the list of symptoms, throat cancer often gets mistaken for common cold symptoms.  Unfortunately, by the time throat cancer is diagnosed, it has reached a more advanced stage.  Depending on where the cancer is located, various treatments can be instituted including surgery, chemotherapy, radiation, and targeted drug therapy.

Which famous people battled throat cancer?

Celebrities who succumbed to throat cancer include:

Sammy Davis Jr., age 64

Michael Crichton, suspected throat cancer, age 66

President Ulysses S. Grant, suspected throat vs. esophageal cancer, age 63

Bob Denver (Gilligan’s Island), age 70

Carl Perkins, age 75

to name a few.

In 2010, Actor Michael Douglas successfully battled “throat cancer” that originated from a tumor at the base of his tongue.

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

Republicans are again trying to repeal and replace Obamacare, but what they’re really doing is attempting to alter the Affordable Care Act just enough so they hold onto their jobs and fulfill a promise made by Donald Trump to repeal and replace Obamacare “one Day 1.” We are nearing Day 100, and the House Republicans can’t even agree amongst themselves let alone get enough votes in the Senate to pass their American Health Care Act.

The best thing that could have happened for Republicans with regard to the Affordable Care Act would have been to accomplish the goal announced by House Majority Leader Mitch McConnell just after Barack Obama was elected president. "The single most important thing we want to achieve is for President Obama to be a one-term president,” he said. They failed, and so will their attempt to repeal and replace Obamacare.

The problem for Republicans, and specifically Southern Republicans, is that Obamacare is working for some and would work for most of their constituents. In fact, the South had the highest rate of uninsured people in 2012 at 18.6 percent. And it’s not all Hispanics. Over 68 million of them are white.

Southerners are also the least healthy of all Americans, with 20 percent reporting fair or poor health in 2014. Southerners are also the most impoverished Americans, with 17 percent of Southerners living below the poverty level in 2014. The South also has the highest rates for diabetes, obesity and infant mortality in the nation. The South 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.

Yet Southerners have taken advantage of, or actually, been disadvantaged by the Supreme Court decision to not force Medicaid expansion upon all states. Had all states been required to expand Medicaid, 7 million people would gain coverage, 4.3 million fewer people would be uninsured and states would see between $5 and $10 billion in uncompensated care savings over the next 10 years, which would offset increased state spending by between 13 and 25 percent.

Of the 19 states resisting Medicaid expansion, 14 are in the South. The states with the most people who stand to gain insurance through expansion are Florida (1.253 million), Texas (1.186 million) and Georgia (.682 million). Georgia nearly elected a Democrat to the house just a few days ago, Texas is turning blue, and two Republican incumbents lost House seats to Democrats in Florida last November, while Democratic incumbents retained all six of their seats.

In short, Southerners need Obamacare and the subsidies that come along with it. They’re just starting to realize it. Now, if America adopted a Medicare-for-all system that Bernie Sanders has proposed, maybe we could stop spending nearly $3 quadrillion on health care as a nation.

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If you like this, you might like these Genesis Communications Network talk shows: USA Prepares, Building America, Free Talk Live, 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, Drew Pearson Live

Multiple countries use vending machines that offer free syringes and needles to drug users, but this resource will be the first in the United States to help curb the spread of disease in IV drug users.

The machines will be offered and run by the Southern Nevada Health District, Nevada AIDS Research and Education Society and Trac-B Exchange.  Dr. Jerry Cade, who co-founded University Medical Center of Southern Nevada’s HIV clinic, said, “There’s zero downside and lots of pluses.”

Many health agencies, including the World Health Organization (WHO) recommend offering clean needles to users (200 sterile needles and syringes per drug injector per year).  Offering free needles has not been proven to incite or increase drug use, and “clean needles” will allow users, victim to their addictions, a safer way to inject without being exposed to HIV, hepatitis C and other blood borne pathogens.

Each kit is free and users can receive one twice a week.  Each kit contains the following:

• 10 syringes

• a tourniquet

• a disposal container for used syringes

• alcohol swabs to clean the skin prior to use

• Bandages

• an information sheet about where one could go for addiction treatment.

In order to use the machine, users must “register” without the requirement of giving personal information.  Once registered a card with a code is given that allows access to the machine.

The machines will be located at AFAN (Aid for AIDS of Nevada), the Community Counseling Center and Trac-B on West Charleston Blvd.

The initial steps could deter some from coming forward to use the machines, but many who use IV drugs WANT to get help and prevent further medical complications.  The outreach this provides, offering help to those who are addicted, is a huge step in our fight against heroin overdose and infectious disease spread.

LearnHealthSpanish.com / Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

This year, nine confirmed cases of rat lungworm disease have surfaced in Hawaii (Maui and the Big Island), and a couple in California who recently traveled to the Aloha State  came down with symptoms after they returned home from their honeymoon. Four additional cases have been suspected since the start of the year and fortunately no deaths have been reported. The Hawaii Department of Health confirmed 11 cases in 2016, and between 2007 and 2015, 42 cases were reported.  Here are your questions answered.

What is Rat Lungworm?

Rat lungworm is in the family of roundworms (nematodes), named Angiostrongylus.   Angiostrongylus cantonensis is a parasite that can cause neurological infections such as meningitis, and its sister species, Angiostrongylus costaricensis, can cause severe gastrointestinal illness.  The specific meningitis, or inflammation of the brain, caused by A. cantonensis is an eosinophilic meningitis, where the main blood cell involved is an eosinophil, prevalent in parasitic infections as opposed to a bacterial or viral meningitis.

It's found primarily in Southeast Asia and the Pacific Basin but up until recently it's been extremely rare in the United States.  In 2015 a study published in the Journal of Parasitology cited cases had been reported in Florida, Alabama, California, Louisiana, and Hawaii.

It primarily lives in rodents but the larvae can be passed to other species through rat feces.  Adult nematodes live in the pulmonary arteries of rats.  The females lay eggs and these, once they hatch and become first stage larvae, may migrate to the rat’s throat and then enter the GI system, eventually exiting through feces.

What are the symptoms of Rat Lungworm?

Symptoms include severe headache, fever, neck stiffness, visual disturbances, difficulty looking at light (photophobia), nausea, vomiting, numbness, temporary paralysis of the face and possibly coma and death.

The incubation period, on average, can be anywhere from a week to three weeks and symptoms could start within that time and possibly last for months.  Neurological sequelae of the survivors can last for extended periods of time.

How does one contract Rat Lungworm?

An individual could become exposed to A. cantonensis when one eats undercooked slugs, snails, frogs, shrimp, mollusks and contaminated fruits and vegetables.  Slime from slugs may also be a source of contamination of the deadly parasite.

How do we know Rat Lungworm is the cause of one’s symptoms?

If a person presents with symptoms of meningitis, the cerebrospinal fluid, or fluid surrounding the brain and spinal cord is able to be sampled during a lumbar puncture. The needle entering through the back could aspirate enough of a sample for laboratory technicians to determine if the meningitis is caused by bacteria, virus or parasites, the latter of which causing a higher concentration of eosinophils to be demonstrated in the CSF fluid as well as the blood.

What is the treatment for Rat Lungworm?

Currently there is no official treatment of the parasite.  The parasite will die on its own but can do so in a relatively short amount of time such as days, or become latent for months.  Dead worms could also cause severe neurological symptoms. Symptomatic measures of the patient are instituted to help with pain, although some have been treated with steroids and antiparasitic medications.

How do we avoid Rat Lungworm?

Make sure all raw vegetables are washed thoroughly,  Handle slugs and snails with gloves and wash hands diligently.  The University of Hawaii recommends boiling snails for at least 3-5 minutes prior to preparing for consumption.  And keep rodents, snails and slugs away from your food and kitchen counters.

For more on prevention of Rat Lungworm infections, read: Avoid Contracting Angiostrongyliasis (Rat Lungworm Infection): Wash Fresh Fruits and Vegetables Before Eating!

LearnHealthSpanish.com / Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

A recent chemical attack in northern Syria killed dozens and wounded more.  According to the Syrian Observatory for Human Rights (SOHR), victims were having difficulty breathing, foaming at the mouth, seizures, bleeding from the nose and mouth, fainting, and some progressed to losing consciousness and dying.  Based on these observances, sarin gas is suspected.

What is Sarin gas?

Sarin is a liquid that is clear, colorless, odorless and tasteless. It can also be vaporized and used as a gas in chemical warfare.  It is an extremely potent nerve agent.

What does Sarin do?

Sarin acts to inhibit cholinesterase.  To understand its effects, let me briefly break it down.

Cholinesterase is an enzyme in the body used to break down acetylcholine.

Acetylcholine is a neurotrasmitter, that is present in every synapse that bridges the nerve signals to the muscles and other nerves.

Cholinesterase is a “checks and balance” type enzyme that  prevents acetylcholine from building up and causing continual stimulation of muscles and nerves.

If  acetylcholine remains unchecked, continual stimulation of muscles and nerve fibers can occur, interfering with body processes and causing among many effects, inability to properly breath and ultimately death.

Sarin inhibits cholinesterase so it can’t inhibit acetylcholine, allowing the latter to build up, causing disastrous effects.

What are the symptoms of Sarin gas poisoning?

Within seconds of exposure, Sarin gas can cause a variety of symptoms.  These include:

• Chest tightness

• Cough

• Runny nose

• Watery eyes

• Nausea

• Vomiting

• Blurred vision

• Headache

• Abdominal Pain

• Drooling

• Diarrhea

• INcreased urination

• Fatigue

• Difficulty breathing

• Confusion

• Low Blood Pressure

• Muscle twitching

• Seizure

• Loss of Consciousness

• Death

Those who survive could have symptoms for weeks and sometimes long term neurological effects.

How does one get exposed to Sarin?

Sarin is man made.  Its an agent in liquid form that can be aerosolized.  It can be introduced to populations in food, water supply, by direct contact with the skin or  even inhaled.

How do we treat Sarin poisoning?

Firstly, we need to reduce exposure by immediately removing the clothing and washing off the body to reduce the amount of the chemical being absorbed.

Atropine is considered the antidote for nerve agent poisoning.  It acts by blocking acetylcholine receptor sites so the signals stop firing.

Pralidoxime is also used to help reactivate cholinesterase. It works by cleaving the bond made by the nerve agent/organophosphate and the cholinesterase so it is free to work again to control acetylcholine levels.

Both are given by injections and are available as autoinjectors.

History of Sarin Gas

Sarin was first developed as a pesticide during Nazi Germany in 1938 by Gerhard Schrader and his team.  The compound made was  found to be 500 times more deadly than cyanide.  So the chemical’s future of becoming a pesticide was thwarted because it couldn’t be used around humans.  Its been told that the team of scientists working on Sarin were incapacitated for a month.

The Nazis instead chose to develop it as a chemical warfare agent and named it Sarin after the scientists,  Schrader, Otto Ambros, Rüdiger and Hermann Van der Linde.  Fortunately it was never used during WWII.

However, in 1988 the Iraqi’s used it against the Kurds, killing 5000 and injuring tens of thousands more.  In 1995, the religious movement Aum Shinrykio released the gas on multiple subway trains in Tokyo, killing 12 and injuring thousands.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

Another study has found NSAIDS, commonly purchased over the counter, to increase risk of cardiac arrest.

Non-steroidal, anti-inflammatory drugs (NSAIDs) include ibuprofen and diclofenac. These medications are seen in products under the brand name Motrin and Voltaren, respectively. This class of medications is one of the most popular as they help consumers treat a variety of ailments including helping to relieve pain, inflammation and lower fever.  Moreover they are inexpensive and many do not require a prescription at the lower doses.

However, their chronic use has been linked to serious medical complications such as ulcers, kidney failure and cardiac issues. This week, a study published in the March issue of European Heart Journal – Cardiovascular Pharmacotherapy found NSAID use (specifically Ibuprofen and diclofenac) to increase the chance of cardiac arrest.

The researchers from the Copenhagen University Hospital Gentofte in Denmark reviewed close to 30,000 cases of people who suffered cardiac arrest out of the hospital during the years 2001 and 2010 and found NSAID use. Diclofenac, specifically, carried a 50 percent increased risk of cardiac arrest.

COX-2 selective inhibitors, such as Celebrex and Naproxen (Aleve) were NOT associated with increased risk in this particular study.

According to the study author, Professor Gunnar H. Gislason, professor of cardiology, “the findings are a stark reminder that NSAIDs are not harmless. “Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest. NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors.”

He continued by saying, “Naproxen is probably the safest NSAID and we can take up to 500 mg a day. Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease and the general population. Safer drugs are available that have similar painkilling effects so there is no reason to use diclofenac.”  He suggested no more than 1,200 mg of ibuprofen per day.

How much safer is Naproxen?

This is not the first study that has demonstrated Naproxen to have lower cardiovascular risk. In fact the FDA was asked to remove the warning from its label, yet its panel voted to keep the NSAID related cardiovascular risk warning, with committee member, Donald Miller, chair of the pharmacy practice department at North Dakota State University in Fargo, saying “there is certainly a lot of evidence that naproxen is safer than other [NSAIDs] in terms of causing heart attack and stroke, but being safer doesn’t mean it is perfectly safe. I think that is the big issue.”

NSAID use has risen exponentially as more people are living longer and feeling the effects of aging in their joints and back. Moreover, narcotics are becoming less accessible and providers are offering these non-addictive substitutes instead; however, because these are non-narcotic, and many are available over the counter, those who self-medicate may inadvertently take too much since “it wouldn’t be over the counter if it wasn’t safe."

Why would NSAIDS cause cardiac arrest?

One theory is the medication may cause suppression of prostacyclin, a cardioprotective lipid (prostaglandin), that inhibits platelet activation and vasoldilation (relaxation of the blood vessels). NSAIDS have also been known to raise blood pressure, possibly by this inhibition of vasodialation. This type of stress on a heart, especially if its vulnerable to abnormal heart rhythms or heart disease, can cause cardiac arrest.

But we don’t want to be fearful that taking anti-inflammatories will stop our hearts. Being proactive with our heart health is paramount, and this study reminds us to use caution with over the counter medications.

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

Reduce your risk by doing 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, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.