Tis the season!! Unfortunately not for our hearts.  A study back in 2004 found a 5% increase in heart attacks during the Christmas season.  Then this month, a study published in the British Medical Journal found Christmas Eve to be especially risky for those who are prone to heart disease.  Let’s dissect why….

Baby it's cold outside ...

The cold has long been associated with heart stress.  Cold weather causes blood vessel constriction and this adds extra work for the heart. Moreover, it causes less oxygen to reach vital organs, including the heart.

Snow shoveling has been infamous for inciting heart attacks for this same reason.  The heart demands extra blood due to the increase in activity and the cold restricts blood flow.

Let’s toast ...

Alcohol, especially in excessive amounts, can put stress on the heart by increasing blood pressure, worsening diabetes, and causing abnormal heart rhythms.    Moreover, it interferes with the metabolisms of medications, hence many of these may not work at their best.   Which brings us to…..

Is there a doctor in the house?

Medical providers take vacation too.  And if a patient forgets to refill his medication he may go without during the two weeks of holiday season.  Moreover many forget to pack everything they need for a Holiday trip and without anticipating delays, one could be without crucial medication dosing.  The heart does not like this.

Stress …

Holiday travel is never easy.  Delays, long lines, the cold, traffic and then…..family.  We may love our family but prefer seeing them in small doses.  All the family at once can be a little overwhelming for some.  As for coping with the in-laws…..well a guide is available for you all here.

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 postmenopausal
• High stress
• and even short stature has been cited as a potential risk factor.

As you can see, many of us can be at risk for heart disease.  Therefore secondly, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.

Thirdly, reduce your risk by the following:

• Maintain a normal blood pressure
• Maintain normal blood sugar
• Maintain normal cholesterol and lipid levels
• Reduce stress
• Maintain a balanced diet, rich in potassium-rich foods such as fruits and vegetables
• Quit smoking
• Stay active
• Maintain a healthy weight

So how to prevent to the “Christmas Coronary?”

Plan ahead by doing the following:

• If you are running low on your prescriptions contact your medical provider early on.
• Pack prescriptions in two different bottles, so you can take some medication on your carry on in case the flight gets delayed or a suitcase gets lost.
• Avoid getting sick, by getting your flu shot, washing your hands, avoiding sick contacts.
• For tips on how to avoid getting sick on a plane visit here.

Holiday time should be a happy time. Let’s make it a healthy one!!!

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

This generation of teens communicates differently from any others as smartphone technology has outpaced the normal evolution of day-and-age vernacular. As a result, adolescents use abbreviations and emojis to convey their thoughts while parents and society scrambles to catch up.

What are you teen saying? A parents guide to teen slang. 

However, within these bite-size “codes” could be volumes of meaning, some delineating at risk behavior, some foreboding suicide.  These codes many times come from the letters that correspond to the keypad on a phone.  So here’s a guide to some of the unfamiliar terminology the young ‘uns are using:

Sex/Love

• NIFOC – nude in front of computer.
• CU46 – see you for sex.
• 8 – “ate” used in discussions on oral sex.
• 831 – I love you – “eight letters, three words, one you/meaning.”
• 143 – I love you (denotes letters on keypads, or #’s of letters in each word (love has 4 letters).
• 2N8, 2NTE – tonight.
• 4AO – four adults only.
• 2B@ – to be at.
• 4EAE – for ever and ever.
• 53X – sex.
• 775 – kiss me.
• ?^ – hook up?
• BAE – before anyone else.
• IWSN – I want sex now.
• ITX – intense text sex.
• NP4NP – naked pic for naked pic.
• 1174 – strip club.

Unhappy/Angry

• < 3 – broken heart or heart.
• 182 – I hate you (1 stands for “I”, 8 stands for “hate”, 2 stands for “you”)
• 2G2BT – Too good to be true.
• 2M2H – Too much to handle.
• Blarg, Blargh – similar to “darn” but deeper.
• Butthurt – receiving a personal insult.
• Salty – being bitter about something or someone.
• Watered – feeling sad, hurt.
• Wrecked – messed up.
• 4FS – For F***’s Sake.
• Poof – disappearing.
• ::poof:: – I’m gone.
• Ghost – disappear.
• 555555 – sobbing, crying one’s eyes out.
• ADIH – another day in Hell.
• KMN – kill me now.
• VSF – very sad face.
• KMS – kill myself.
• KYS – kill yourself.
• 187 – homicide.

Drugs/Risky Behavior (to be revisited more in depth)

• 420 – marijuana.
• 420 – let’s get high.
• A/S/L/P – age/sex/location/picture.
• A3 – anytime, anyplace, anywhere.
• LMIRL – lets meet in real life.
• WYRN – what is your real name?
• Chrismas tree – marijuana.
• Catnip – marijuana.
• Gold – drugs.
• Gummy Bears – drugs.
• Blues/Bananas – narcotics.
• Bars – benzodiazepines.
• Smarties/Skittles – Adderall/Ritalin.
• Ski Equipment/Yayo– cocaine.
• Cola – cocaine.
• Candy/Chocolate Chips/Sweets/Smarties/E – ecstasy.
• Crystal Skull/Wizard – synthetic marijuana.
• Hazel – heroin.
• Gat – gun/firearm.
• Lit – getting high/drunk.
• Smash(ed) – getting drunk, stoned, or having sex.

Parents nearby

• 9 – parent is watching.
• 99 – parent is not watching anymore.
• P911 – parent alert (parent 911).
• PAL – parents are listening.
• PAW – parents are watching.
• POS – parents over shoulder.
• AITR – adult in the room.
• CD9 – code 9 – parents in the room.
• KPC – keep parents clueless.
• RU/18 – are you over 18.

And the above is just a small sample of some of the terms used these days.  This list continues to grow by the day so parents need to always be aware.  Kids want to KPC and avoid POS so be ready for the next group of codes being created as we speak……

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

This week, the CDC issued a general warning that Romaine lettuce is not safe to eat.

32 people from 11 states have become ill due to this recent outbreak of E. coli.

The Shiga toxin-producing E. coli O157:H7 sickened 32 people between the dates October 8-31, 2018 and caused 13 hospitalizations, one of whom went into kidney failure.

No deaths have been reported.

On Tuesday they issued the following tweet:

CDC‏ @CDCgov

Outbreak Alert: Do not eat any romaine lettuce, including whole heads and hearts, chopped, organic and salad mixes with romaine until we learn more. If you don’t know if it’s romaine or can’t confirm the source, don’t eat it. https://go.usa.gov/xPAy5

On their website, the CDC reports the following:

CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak. This investigation is ongoing and the advice will be updated as more information is available.

• CONSUMERS WHO HAVE ANY TYPE OF ROMAINE LETTUCE IN THEIR HOME SHOULD NOT EAT IT AND SHOULD THROW IT AWAY, EVEN IF SOME OF IT WAS EATEN AND NO ONE HAS GOTTEN SICK.

• THIS ADVICE INCLUDES ALL TYPES OR USES OF ROMAINE LETTUCE, SUCH AS WHOLE HEADS OF ROMAINE, HEARTS OF ROMAINE, AND BAGS AND BOXES OF PRECUT LETTUCE AND SALAD MIXES THAT CONTAIN ROMAINE, INCLUDING BABY ROMAINE, SPRING MIX, AND CAESAR SALAD.

• IF YOU DO NOT KNOW IF THE LETTUCE IS ROMAINE OR WHETHER A SALAD MIX CONTAINS ROMAINE, DO NOT EAT IT AND THROW IT AWAY.

• WASH AND SANITIZE DRAWERS OR SHELVES IN REFRIGERATORS WHERE ROMAINE WAS STORED. FOLLOW THESE FIVE STEPS TO CLEAN YOUR REFRIGERATOR.

• RESTAURANTS AND RETAILERS SHOULD NOT SERVE OR SELL ANY ROMAINE LETTUCE, INCLUDING SALADS AND SALAD MIXES CONTAINING ROMAINE.

• TAKE ACTION IF YOU HAVE SYMPTOMS OF AN E. COLI INFECTION:

• TALK TO YOUR HEALTHCARE PROVIDER.

• WRITE DOWN WHAT YOU ATE IN THE WEEK BEFORE YOU STARTED TO GET SICK.

• REPORT YOUR ILLNESS TO THE HEALTH DEPARTMENT.

• ASSIST PUBLIC HEALTH INVESTIGATORS BY ANSWERING QUESTIONS ABOUT YOUR ILLNESS.

ADVICE TO CLINICIANS

• ANTIBIOTICS ARE NOT RECOMMENDED FOR PATIENTS WITH E. COLI O157 INFECTIONS. ANTIBIOTICS ARE ALSO NOT RECOMMENDED FOR PATIENTS IN WHOM E.COLI O157 INFECTION IS SUSPECTED, UNTIL DIAGNOSTIC TESTING RULES OUT THIS INFECTION.

• SOME STUDIES HAVE SHOWN THAT ADMINISTERING ANTIBIOTICS TO PATIENTS WITH E. COLI O157 INFECTIONS MIGHT INCREASE THEIR RISK OF DEVELOPING HEMOLYTIC UREMIC SYNDROME (A TYPE OF KIDNEY FAILURE), AND THE BENEFIT OF ANTIBIOTIC TREATMENT HAS NOT BEEN CLEARLY DEMONSTRATED.

Symptoms of E. coli poisoning can occur anywhere from 1-10 days after ingestion.

They include:

• Nausea
  Vomiting
  Diarrhea, may be bloody
  Fever
  Chills
  Body Aches
  Abdominal Cramps

And if progresses, can cause

• Shortness of Breath
  Nose bleeds
  Anemia
  Dehydration
  Seizures
  Renal Failure
  Death

Exposure to E. coli may occur from exposure to contaminated foods (from human or animal waste) or undercooked meats.

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

A recent analysis from Kaiser Family Foundation found the average younger American does not have a primary care provider (PCP).

Looking at survey answers from 1200 participants,  45% of 18 – 29 year-olds admitted to not having a PCP.  28% of those aged 30-49 and 18% of those aged 50-64 said the same. Those over age 65 were the largest group to have a primary care provider.

Those born between 1981-1996, known as the Millennials, may have different attitudes towards health care.  Keep in mind, they just lived through nearly a decade of recession, computer hacks, Obamacare controversies, and societal distrust of pharmaceutical companies.

PCP’s however are the “quarterback” in one’s healthcare, keeping accurate and thorough records on one’s medical history, addressing immediate and chronic issues, and coordinating where their patient needs to go if a specialist is needed.

But Millennials, instead, are preferring urgent cares, retail clinics, emergency rooms, or using telemedicine for their medical needs.

However if one, unknowingly, suffers from a chronic condition and has various acute issues, they may be misdiagnosed because they are receiving piecemeal care without someone overseeing them and connecting the dots.

Diseases such as cancer, diabetes, heart disease, syphilis, AIDS, neurological disorders and autoimmune illnesses are just a few that may cause intermittent acute episodes before becoming deadly.  Someone needs to take a step back, look at one’s medical history and properly diagnose, or simply put, see the forest from the trees.

So why the hesitation to commit to a primary care provider?

1. Many aren’t sick.  They don’t need to have follow-up or chronic issues managed so find an urgent care or emergency room visit sufficient for their acute issues.
2. They prefer not to have a record of their “life story.” Privacy is huge in this generation who has grown up with social media and smartphone pictures logging their every move.  They may want their STD to be long forgotten once they leave the clinic.
3. They prefer knowing the price ahead of time and having “closure” once the visit is complete.  The concept of seeing a medical provider and then receiving a bill 3 months later and then following up on a condition is foreign to many who want to address an issue once and move on.
4. They may not be at the same job, hence have the same insurance for long.  It’s common for the average Millennial to explore career paths and do not expect to be at one place of employment for “life”. Hence if their job changes, so will their insurance, and therefore the medical provider list offered.
5. The internet provides medical advice.  Some feel rather than have a doctor visit to learn about a medical condition, it’s cheaper and more convenient to read the medical article oneself.
6. “The doctor doesn’t spend time with me anyway.” They more often don’t get out of a doctor visit what we used to with time, hand holding, education and patience with all our questions.  Providers are busy these days and offer short office visits.

Our healthcare system is changing and the needs of the younger generation appear to be better met by clinics that charge up front, address a single issue, and provide convenient hours.   Therefore “primary care” providers will still be needed, however, the art of “primary care” may evolve into a whole new beast.

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

As the death toll rises and thousands of acres burn between California’s Camp Fire and Woolsey Fire, 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 dioxide, a respiratory byproduct
• Carbon monoxide, which competes with oxygen in the blood
• 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 smoke 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 individuals experience?

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

• Wheeze
• Cough
• 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 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.

Editor's note: As a companion read you might also be interested in a story we published in Sept. last year: 5 apps to help you recover from hurricanes and wildfires.

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

An Oregon woman claims her cat helped her detect her breast cancer, and she’s not the first one to claim how furry friends can save lives.

Michelle Pearson adopted a cat, Mia, a few years back from the Humane Society. The one day she pounced on Pearson’s chest, sniffed her breast and directed her owner’s attention to the breast. Days later Michelle was diagnosed with breast cancer.

She states, “All of a sudden out of nowhere, she just got up on my chest and she sniffed that breast and then looked in my face, sniffed the spot again and looked in my face and I tried to shove her off and she came back up and just laid down on that right breast and she looked at me like ‘I’m trying to tell you something.'”

She feels her rescue cat actually “rescued” her.

A woman in California cited the same miracle. Nancy Best stated her dog, also named Mia, would not stop licking her breast. She was eventually diagnosed with breast cancer.

Sometimes animals may not always be friendly towards a diseased body part. My in-law’s poodle would shower everyone with licks except for one person who she would excessively bark at. He was soon diagnosed with brain cancer.

So, can dogs detect cancer?

PBS reports that dogs can smell 40 times better than humans, with over 300 million olfactory receptors in their nose. They can smell parts per trillion, a keen sense that is potentially sharp enough to pick up cancer cells and the smells they produce.

Healthline reports that cancer cells raise polyamine levels which come with an odor.  Moreover if cancer cells incite an immune response, this can expel a scent as well.

In 1989 a case report revealed a woman’s dog tried to bite a mole off her leg which ended up being malignant melanoma.

According to a 2011 study in the journal Gut, Labrador retrievers were able to sniff out colon cancer in 97% of stool samples.

The Italian Ministry of Defense’s Military Veterinary Center was successful in training German Shepherds to recognize prostate cancer proteins in urine to 98% accuracy.

For those of you with a pet pigeon, don’t feel left out. A University of Iowa study found pigeons to be trained to detect breast cancer cells to 85% accuracy.

So despite our animals possessing the power to sense microscopic anomalies, we shouldn’t panic every time they sniff or lick us.  But if they persist on one area of your body, it might be worth getting checked out.

Editor’s note: The folks over at Dogsnaturallymagazine.com also weigh on this topic citing numerous studies and anecdotal evidence all concluding that, yes, it’s very probable that dogs can sniff out ill health. As for cats smelling cancer, well - the research seems to suggest otherwise. Sorry, kitty lovers. =)

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

For over a year we’ve been bombarded daily with candidate interviews, political commentary, primaries, speeches, polls, mudslinging, ads, and frankly, we’re sick of it. The amount of negativity spewing from both sides is exhausting and out-right depressing!

But as we receive the election results, some of us will be rejuvenated with hope while others will fall into the abyss of an election loss. Election depression is real, very real.

What is election depression?

It’s despondency (a drop in mood stemming from a loss of hope) after an election. We’ve discussed election anxiety recently as many people are fearing the result, but we haven’t prepared the country for what happens when the vote doesn’t swing their way. Feelings of sadness, guilt, remorse,  agitation, irritability, are just a few of the signs.

Why “depression”? What causes election depression?

Multiple factors can cause this..

• The loss.  Humans don’t like to lose. We’re competitive in nature and want to win, or be on the winning side. The losers get nothing after their loss but a future they did not choose. Which brings us to….
• Lack of control.  Humans like to make their own destiny. If they work hard, do the right thing, they can mold their future. The loss of an election that they hoped would change their future, is perceived as a loss of the future they were supposed to have.
• Embarrassment. Those of us who were vocal about who we were supporting and incurred bullying from opponents, now have to face these same individuals with the public humiliation of a loss.
• Much pain, no gain.  The 1 1/2 year physical and psychological build up and work that went into the election brings very little gain during an election loss.  Feeling like one wasted his time, energy, and money may affect his psyche.
• The end is abrupt.  Election results, as compared to the 1 1/2 year process, comes at us like a ton of bricks.  Many people may not be psychologically prepared to take bad news in such a swift blow.
• Regret.  We defriended social media contacts and ended year-long relationships with friends and family over this election. Maybe even quit our job. This could seem impossible to repair.

 How do we prevent election depression?

On one hand it's good to be passionate about an issue or candidate. Passion drives us to make change, build, progress, restore, and all the good verbs that our great country needs.

However, while we’re being passionate, we need to be prepared.  

When you’ve been through as many elections as I have, you learn that you don’t win them all.  You also learn that one candidate will always win and one candidate will always lose.  Not thinking about the latter won’t wish it away. The reality of your last choice candidate being your legislator needs to be faced.  So it's better to mentally prepare for it early.

Here’s some things you can do:

1. Pseudo-reality role-playing: One technique I’ve done with patients is pretend for 24 hours “So and So” won the          Presidency.  After the group laughs and makes vomit gestures, I remind them that they need to, over the course of 24 hours, live their day with that pseudo-reality in play.  The results?  Many say “it wasn’t so bad”….”we’re still living”….”we may handle our finances a different way,” etc.
2. Don’t drink the night of the election: Getting wasted will just make you feel awful the next day, and election depression is worse the 24 hours after an election.
3. Plan family and friend gatherings of like-minded individuals the week of the result: Avoiding those who will gloat may help soften the blow and being around your support team will help you realize there is emotional strength in numbers.
4. Take a break from the news: Watch programs that will cheer you up or begin diving into new projects for the coming months.
5. Make up with friends you lost: The guilt will consume you when you realize you threw away a good friendship over a “stupid election.” Shake hands and hug it out.
6. Plan a vacation: The Holidays are coming, so enjoy yourself. You deserve it will all the hard you work you’ve done.

Losing isn’t easy, but it's something that we eventually become good at.  If my candidate loses, I will start an Election Loser Club. I’ll probably invite Mickey Mouse to be our first guest speaker, since he always seems to be on the ballot each election anyway and never wins.  He still though, manages to keep a smile on his face.  So should we.

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

Ghosts, goblins, Mommy yelling – Halloween can be pretty scary.  But the candy, the costumes, decorations and running door to door threatening all your neighbors with a “trick” makes it one of the most exciting days of the year!

Unfortunately, the more fun and immersed into the festivities, the more dangerous for our little ones. 160,000 injuries occur on this day each year, and even scarier, Halloween is the deadliest for pediatric pedestrians with 7300 fatalities reported annually by the National Safety Council.

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

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

In addition to traffic accidents, parents need to be aware of fire and choking hazards.  We therefore recommend the following to keep our kids safe.

1. Make sure your child’s mask allows him/her to see clearly. If not, replace with non-toxic makeup that is tested a few days before on a small area of skin on their arm to ensure they are not allergic.  The makeup should be washed off before bedtime.

2.  Avoid long costumes, such as ghost-themed, that may trip your child while they walk/run.

3. Use bright-colored costumes. If your child insists on a dark costume, such as Batman, put a belt of glow sticks around him or add reflective tape to their costume and trick or treat bags

4. Make sure all costumes and hats are flame resistant and teach your kids how to avoid tripping over jack-o-lanterns with candles in them.

5. Avoid costume contact lenses as they may decrease visual acuity, scratch the eye and cause infection.

6. Use the sidewalk.  Your child will want to zig zag across the street when they see everyone else doing it.  You need to be the parent like me who yells at everyone to get back on the sidewalk.

7. Watch out for drunk drivers.  Many are coming back from a “trick or drink” party and could be impaired.

8.  Make the “no eating candy until you get home” rule. Allows you to check the candy for open wrappers and dangerous things that don’t belong.  Then steal your favorite treats when the child is taking his/her potty break

9. Teach your child to not enter a stranger’s home – even if it is in full decoration

10. Stay in a group and follow your children. You can leave a safe distance behind while still supervise. And it's fun when we parents compete for who can yell at our kids the loudest.

11. Carry Walkie Talkies. Halloween streets get loud and kids may not hear you if they start walking down a different street and turn into a housing complex.  Walkie talkies are fun and keep you connecting with your younglings’ even if they are a few feet away.

12. Parents should avoid “Trick-o-Drink!!”ing where we walk around with our red plastic cup and rather than ask for candy, we opt for some spirits poured in.  Parents giggle, feeling part of the festivities, but unfortunately will be sloshed by the fourth home they hit and won’t be able to effectively supervise the children.  We need to be at the top of our game this Halloween.  Cut the booze.

13. And drivers, be wary of trick-or-treaters even before it gets dark.  Drive slowly and pay attention!  Let’s have a Happy and Safe one!!!

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

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

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

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

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

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

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

NBC News reported the following:

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

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

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

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

Flu symptoms may come abruptly and include:

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

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

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

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

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

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

On the FDA website it states:

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

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

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

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

Those Needing Erectile Dysfunction Drugs Should Have Their Heart Checked

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

Vaping linked to heart disease and cancer

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

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

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

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

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

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

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

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

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

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

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

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucous production and a sweeping out of carcinogens trying to make their way down to the lungs.

More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.

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