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Nurse Bridgid

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Wednesday, October 27, 2010

Adult Acne: Really? It isn't high school any more!!

The medical name for acne is Acne Vulgaris, and unfortunately while men are more prone to scaring on their face from acne, women are more prone to being a victim of adult acne. It can be pretty devastating, but there are a bunch of things you can do to prevent further break outs and decrease the extent of break outs, and I'll let you know some products that you should use and those that you can skip!!

What is it? and WHY???
Acne is formed by a build up of fat, skin debris, and keratin in a hair duct, when it is open, it's a black head and when it is closed, it is called a whitehead.  White heads often cause the duct of the hair follicle to rupture.  There is inflammation around the site and redness which causes irritation.  At this point most people want to "pop" said pustule/cyst, and I am a huge offender of this, but popping at home can lead to a risk of dirt getting in and further infection and can lead to a spreading of the acne.
Showing A)Normal follicle B) Blackhead C) Whitehead D) Papule  E) Pustule

Just to debunk a myth, acne is not caused by poor hygiene.  Adult and teen acne are caused by fluctuating hormones leading to increased oil productions, faulty closing of the hair ducts, stress, cosmetic use, and infections.  But adult and teen acne should be treated differently. And leads to my next point: face washing with a gentle soap twice a day is much better than washing your face a billion times a day, that can actually dry your face out and cause more irritation.

So often people spend large amounts of money on over the counter treatments, one being proactiv, whereas if they bough a cheaper low strength benzoyl peroxide face wash and a cheap prescription from their HCP.  Of course depending why you are getting the acne is key to the treatment.  Most topical treatments just exfoliate the skin to allow for healthy new skin to grow and refresh your face, and then oral supplementation can help to change the internal mechanism causing the acne internally.

Best skin care ingredients for acne:
Benzoyl peroxide: long decided as a great treatment, and the base treatment, for acne. It eliminates bacteria, dries up excess oil, and is a mild exfoliator. Also, the 2.5% treatment is the same as the 10%, it has no increased effects of treatment on your face, so no need to waste any extra money!  Plus, be sure to wear a light oil free moisturizer after using this to prevent over-drying of your face.
Salicylic Acid: one of the best exfoliators on the market as an over the counter prescription.  Not as effective as Retin-A (a prescription exfoliant that is amazing)but it is generally effective for most adults with acne.
Antioxidants: These supplements eliminate naturally occurring free radicals in the skin. Vitamin C is one of the strongest antioxidants that helps to prevent wrinkling and skin damage.
Sunblock: while sun will help to clear up acne in the short term, it causes which causes long term skin damage and can cause over irritation and drying of the skin which can lead to oil build up over time.  So, use a daily SPF 15-25 daily, preferably oil free.
Moisturizer: A daily light oil free moisturizer can prevent over drying and help to make your skin feel less irritated and smooth.
Tea Tree Oil: A natural antiseptic, that also helps to soothe the skin and decrease the redness and irritation associated with acne.

Treatment types:
Topical Antimicrobial: Kill off the P. Acnes bacteria. example are: azelaeic acid, benzoyl peroxide, erythromycin, clindamycin.
Topical Retinoids: Work to unclog pores and prevent white and blackheads. Retin-A (derived from Vitamin A)and tretinonin.
Oral Antibiotics: used to treat and kill the P. Acnes bacteria at the source internally, to prevent blemishes and decrease the inflammation associated with acne.  Erythromycin, tetracycline may be used.
Interlesion corticosteroid Injections: For severe cysts and will decrease the risk of severe scaring.  Cortisone is used for these shots.
Isotrentinoin: A strong oral retinol used for severe acne; Accutane (AKA clavaris, sotret, amnesteem). But you must be aware that Accutane is a very strong drug that can have long term effects, and causes severe birth defects, so women are required to take either and oral birth control or some other type of strong contraceptive if sexually active.  It literally shrinks the oil glands in the skin and usually takes a 16 to 20 week course, in severe cases a second course is required. And you need to make sure that you aren't getting too much Vitamin E or A (watch that carrot intake!!)

What are optimal OTC products?
To prevent breakouts (i.e. keep acne away): Neutrogena Oil free Cleanser, H20 Plus Marine Cleansing Gel and use an alcohol free toner (such as the matching Marine Toner from H20 plus), MD Skincare All-Over Blemish Solution
For blackheads:  Bliss Clog Dissolving Cleansing Milk (an at home treatment is to make a paste out of baking soda and water, apply to blackheads, leave on for 3-5 minutes, then wash off...can be repeated)
For active acne: Purpose Gentle Cleansing WashDermalogica Special Cleansing Gel, Zeno Acne Clearing DeviceTea Tree 100% Pure Essential Oil 
MoisturizersBiore Pore Minimizing Lightweight Moisturizer SPF 15dermalogica intensive moisture balance 3.4 fl oz (100 ml)

What can I do to prevent outbreaks?
Avoid over scrubbing face and over washing, wash twice a day with a gentle cleanser, moisturize, avoid touching your face and popping blemishes.   Also, try to change your make up every 6 months, avoid putting make-up over blemishes, and wash your make-up brushes regularly. Try to de-stress using yoga, or meditation, drink lots of water (at least your 2 liters a day- for anyone without renal problems), and .  Always apply acne treatments to clean skin, and apply to all acne prone areas, not just the area of breakout, as well be aware that it can take 4--12 weeks to see full results.  And best of all?  Go to a dermatologist recommended spa and get a facial, to deeply cleanse, exfoliate, and rejuvenate your skin!  Now, it is Nurse ordered, and not because you want to pamper yourself!!  It will help to moisturize the skin, relax you, and it can tame current breakouts, and prevent further breakouts.  Also, while expensive, the Zeno Acne Clearing Devices, help to use heat treatments to zap pimples at the site by using heat to kill the bacteria at its source, and they really work, for active blemishes.

If the OTC treatments don't work, go see your dermatologist and get another course of treatment, but there is no need to live with adult acne; it is easily prevented and treated!

Yours in Good Health

Saturday, October 23, 2010

Cocaine Cowboys?

The short and long term effects of cocaine are lost on some people.  Sure, drugs can be fantastic....but the long lasting health effects can totally suck!  Here is the skinny on cocaine, mostly because I have had a bunch of readers email me AND I have had a few friends ask me as well about cocaine use now that it has become pretty commonplace.  It is illegal worldwide, but yet found on most street corners everywhere.

What exactly is it?
Its a drug made from the leaves of the coca plant, and it is a stimulant for the central nervous system and also a topical anesthetic.  It is a serotonin-norepinephrine-dopamine re-uptake inhibitor...basically a make-you-feel-really-good-by-stimulating-all-the-fun-stuff-in-your-brain drug!  The leaves of the coca plant were originally chewed by aboriginal tribe members while working or on long treks to increase their energy levels.  It was part of the original recipe for Coca-cola until 1906 when the Pure Food and Drug Act was passed.  And, it was one of the first anesthetics used topically and in epidurals.

Routes of ingestion:
Smoking: free base, or crack cocaine in pipes * crack is just cocaine with baking soda added
orally: rub on gums and teeth, "snow bombs" (wrap cocaine in rolling papers and swallow), chew coca leaves, brew coca tea
Insufflation (fancy name for snorting!): most common form of ingestion and about 60% of the drug is absorbed in the nasal mucous membranes.
Injection: directly into the vein, the high only lasts approx 3.1 minutes and can be mixed with heroin (a speedball).

Why do people do it?
You feel great!  You get an amazing rush of energy, you are the life of the party, you have a decreased appetite, and life feels amazing.  There is an extreme sense of euphoria, increased libido, a sense of competence (like you can do anything, and sustained endurance and attention.  I know many people who use cocaine strictly for the appetite suppression means and they won't eat for days....which is horrible!  And, that increases the risk of addiction, FYI, because you are more addicted to the results of the drug than the feelings of the drug.  The high itself (depending on route) only lasts 15-30 minutes.

What is actually happening?
Short term side effects (Acute):
- Increased blood pressure
- dilated pupils
- mental alertness
- increased energy
- increased heart rate
- Increased temperature
- Decreased appetite
*even one dose can lead to seizures, coma, tachycardia (fast heart rate), tachyarrythmias (fast misbeating of the heart), hallucinations and paranoid delusions, strokes, and heart attacks.

Long term (Chronic):
- Heart attacks (significant increased cardiac risk due to strain)
- Seizures
 - Respiratory failure
- Coma
- paranoia
- irritability
- restlessness
- auditory hallucinations
-tooth decay (it ruins enamel)
*dysphoria and depression can occur from a change in the bodies serotonin and dopamine levels, chronic insufflation can cause spreading of the septum( eventually it will completely wear away), smoking can cause hemoptysis (coughing blood), bronchospasms (spasms of the little airway paths in your lungs), and it can physically remodel your lungs. Over time, it causes severe renal imparment leading to failure and significantly increases your risk of lupus, Stevens-Johnson syndrome (a life threatening skin infection), Goodpastures disease (causes renal failure and hemorrhaging of the lungs), and vasculitis (inflammation of  the vasculature).

Withdrawal symptoms?
depression, fatigue, insomnia or hypersomnia, erectile dysfunction, increased appetite, nightmares, psychomotor retardation, agitation, and anxiety.

How long it is in your system?
Cocaine is metabolized through the liver, and mostly excreted through urine, so it will show up on urine drug tests.  The metabolites can be detected for 60 hours after a single dose and with repeated use (even in one night) it can be detected for 22 days (on average).

Do you think you have a problem?
Talk to your HCP about your addiction, and we can get you into a rehabilitation program to suit your needs (inpatient, outpatient), Narcotics anonymous meetings, call a free addiction hotline (866)535-7050, cocaine anonymous meetings , talk to a friend.  If you think that your friend has a problem, please talk to an HCP about ways to help (i.e set up an intervention or how to talk to your friend).

Cocaine addiction can very easily lead to death, and due to the euphoria felt with the drug and the way it works on your neurotransmitters, it is highly addictive.  So, not to be a debbie downer, but I want you to think about the effects that that weekend of fun is having on your body over time, and urge you to rethink that last bump!

Yours in Good Health

Friday, October 22, 2010

bigger, faster, stronger? Anabolic steroids aren't all they are cracked up to be....

Anabolic steroids (AS) have specific medical uses for certain conditions, but as we all know they can be used as a sports enhancing drug as well.  AS use is on the rise across the world, which is scary for numerous reasons, but the people who are using them are not always power lifters, as most people think, but regular people who are going to the gym, but want to get faster results from their workouts. The average age of the common user in the US is 25 years old, male and not a professional athlete, and there are approximately 3 million people that currently admit to using steroids for off label uses. There are numerous health effects that are just plain bad for you, but people who take them say that they have no side effects...I am calling BS on that!!  Also, it is a crap shoot what you are taking when you take these drugs and you re not prescribed them because they are usually smuggled in from other countries and they are bought and sold on the black market; they may be tainted or not the dose as labeled, you really don't know what you are taking.

What are they?
They are drugs that mimic testosterone (the male sex hormones) which increases protein synthesis within cells and increases the build up of cell tissue, and it does this mostly in muscles, and it also reduces recovery time as they block the effects of cortisol (stress hormone) on the muscles.  So, it is easier to make muscle, and you can work harder.  Also the Basal Metabolic Rate (BMR) is increased, so you tend to lose fat as an increase in muscle mass increases the BMR.  Because of the   various processes also bone marrow is stimulated, thus increasing your red blood cell production.  So, you tend to be able to work harder and for longer, and you feel better because of the increased red blood cells (allows for higher oxygen carrying capabilities.)
 They were originally used starting in the 1930's to increase appetite, increase bone growth, start male puberty, and they were given to patients with chronic conditions with muscle wasting (i.e. AIDS/HIV and certain cancers.) These drugs help to increase lean muscle mass as long as there is an adequate diet with protein in it.  AS can be ingested in pill form, as a transdermal patch, and most commonly it is injected into the muscles (not injected into a vein).

In what conditions are they used medically?
Bone marrow stimulation: anemias due to leukemia or renal failure
Growth Stimulation: can be given to children after seeing an endocrinologist, that have failure to grow due to hormonal imbalances (usually genetic)
 Increased appetite/muscle mass: for people with chronic wasting in HIV/AIDS and cancer, and post traumas/long surgeries/and prolonged immobilization.
Induction of male puberty: for male adolescents with delayed puberty that causes concerns.
Gender Identity: used in female to male sex change process.

AS Side effects?
Increased sebaceous gland oil production
Clitoral growth (in women)
Increased hair growth (pubic, beard, chest, arm, legs)...on women and men
Increased size of vocal cords (deepens voice)
Decreased natural sex hormones
Impaired production of sperm
Atrophy (decrease in size) of the penis and testicles
Elevated blood pressure (especially if you already have hypertension)
Increase  in LDL cholesterol (bad cholesterol) and decrease in HDL (good)
Increase glucose levels
Premature baldness (for men and women)
Liver damage
thickening of the left ventricle wall (increased risk of a heart attack, arrythmias, congestive heart failure, and sudden cardiac death)
Psychiatric effects (violence, mania, increased aggression, and suicide)
High addiction rates

Males specific: gynecomastia (male breasts), decreased sexual function, and temporary infertility.

Females specific: increased body hair, decrease in menstrual cycles, and if taken when pregnant they can interfere with fetal development.

I can understand the draw that some people might have to take steroids to get an amazing body from their average workouts.  I also understand that people say it is a drug used medically, so why can't they use it?  Well, when people are prescribed these drugs they are under direct medical supervision, having blood drawn to check levels of cholesterols, circulating hormones, etc and most likely having cardiac labs checked, along with EKG's (electrocardiograms), and psychiatric assessments.  Please use other methods to workout and get the results you want (like increase protein and weights as appropriate), don't do it with steroids!

If you know anyone using this method, please urge them to stop and beware of the psych side effects, and if you notice any of them, please talk to your friend and an HCP about ways to intervene and get them to stop!

Yours in Good Health

Thursday, October 21, 2010

The myth behind fat "burning" supplements

I don't want to slam a specific store or product,  but I think I might have to.  I really strongly dislike GNC-type stores that pretend to be stores for healthy people and promote healthiness, but really they are selling products that are not FDA approved, and have little to no support in medical literature.  I want to break down the ingredients in the largest fat burner on the market, Pro Clinical Hydroxycut and discuss each ingredient.  Also, I would like to make a note that in 2009-2010, thus far, that there has been 1 reported death specific to hydroxycut use, 23 "serious" medical complications (not specified what), and 17 reports of liver failure.  Considering how much of this is sold in a year, they aren't ridiculous stats BUT every time there is a serious medical complication, death, or bad report, Hydroxycut will take their product off the market, change one or two ingredients, then pop it right back on the market as a new product.  Plus it annoys me that they have a podiatry resident in a white coat on the commercial saying that MD's think hydroxycut is good for you!!

Ingredients as listed off of the (Pro Clinical) Hydroxycut web site:
Caffeine anhydrous- so we all know what caffeine is (based on my earlier blog) and all this means with the "anhydrous" is that it is a caffeine extract without water; just giving it a fancy name! And because it is part of their "hydroxyboost" they don't tell you how much is in the product.  It will boost your metabolism, especially in high doses.

Acerola concentrate- bascially a cherry/rosehip extract that is high in levels of vitamin C which doesn't aid in weight loss, and you just pee out all the excess vitamin C that is more than what your body needs.  In high doses, it can make you poop a lot because it is irritating to the GI lining.

Lady's mantle extract- an herb that was thought to have 'healing' powers back when it was first found eons ago. It was said to treat GI disturbances, have antiseptic properties, heal wounds, treat PMS symptoms, and vascular disorders as well as many other medical woes; none of these have been founded in research although it has been shown, in high doses to cause liver failure.

Wild Olive extract- has been shown to be an antioxidant that reportedly, makes people feel more energized.  The only research done on this product is by a company that make it and they claim that it is an antioxidant that also kills the HIV, we all know that is bunk and "research" not to be trusted!!  But they do admit that side effects are headache, extreme fatigue, diarrhea, and muscle/joint aches.

Komijn extract- (Cumin) has been shown to decrease (slightly) decrease cholesterol levels, and it has been shown in moderate doses to decrease plasma glucose levels.  SO, it actually can aid in weight loss by altering glucose levels, but really not a good idea to lose weight by changing your glucose levels to make your pancreas and liver work differently.

Wild mint extract (peppermint oil)- basically has been shown in a few small studies in the EU to decrease Irritable Bowel Syndrome symptoms.  It has not been shown in any way to aid in weight loss.

Goji extract- has antioxidant properties that anticoagulation effects, so you need to be careful if you take blood thinners, and they have no known weight loss properties.

Pomegranate extract- has been used in Indian traditional medicine for years as an anti-diarrheal medication and to treat dysentery and parasites (intestinal). It is high in Vitamin B and C. There are numerous clinical trials going on to study its usefulness with various medical treatments, but it is not high in antioxidants (as once claimed) and has no current use in weight loss.

Bilberry extract (huckleberry)- is high in vitamin C and antioxidants, and has been shown (although the mechanism is unknown) to help with various eye problems. It has also been shown to decrease blood glucose levels, again, it can help you lose weight, just not in a healthy way.

...And then a bunch of fillers are listed. So, all of this high vitamin C and caffeine can cause GI irritation and pooping, which is why they have added other products (such as the peppermint) to soothe the stomach and prevent the irritation, or at least attempt to.

Besides a couple of ingredients that alter your blood glucose levels and caffeine, none of these ingredients really help you lose weight.  You are spending a bunch of money on a super vitamin C supplement with caffeine and other stuff, basically, and it won't help you lose weight.  As well, you don't know how much of each ingredient is in the product, or if they are even IN the product.

It goes back to the old saying that if it seems to good to be true, it is.  The only weight to lose weight and keep it off is to make lifestyle and dietary changes; you need to work out to burn off calories and decrease your caloric intake to the amount that you actually need. Make sure you are eating a well rounded diet proteins, carbs, fiber...and get your fruits and veggies in!!

This is one fat burner of thousands that are on the market, and as you can see the ingredients are things that you really don't need in your life, that all have side effects, can interact with other medications that you might take (prescribed or OTC), and none of which have been FDA studied or approved.

As an HCP, my best advice is to ditch the pills and get out for some exercise!!!

Yours in Good Health

Wednesday, October 20, 2010

Butt worms are not just for dogs

After you read this, you will probably think about it every time you go to bed, and I apologize, but this is a parasite that is more frequent than anyone realizes, and it can be treated, just an awkward one to talk about!  The worms are actually pinworms, which are also known as thread worms or seat worms, and they are a type of roundworm (nematode) and the medical term when you are infected with pinworms is an enterobiasis.  The CDC estimated that there is a 12% infection rate (adults and children) in the US yearly but the rates in India are 61%, UK 50%, 39% Thailand, 37% Sweden, 29% Denmark.  So, when in the US it isn't a huge fear, but it is easily transmitted from person to person and with the amount of traveling that occurs, the numbers of infections can easily increase in the US.  And, it is the highest worm infection in the US; it is highest transmission rate is between school age children at school and through daycare centers, etc.

What is it?
It is a parasitic infection that lives in the human GI tract; their entire life cycle takes place within our bodies!  A worm hatches in the duodenum (the beginning of the small intestine) and then the migrate towards the colon in which time they molt twice and become adults.  They mate in the ileum (last part of the small intestine) and the females usually then live in the cecum (beginning of the large intestine), ileum, appendix, and ascending colon, whilst the males die and are passed in your poop.  They live off of your poop in the colon.  And they start laying eggs five weeks after initial ingestion of the worms; the female worms come out of your anus and lay their eggs so that the eggs can get oxygen and then they die.  They usually go to lay eggs when you are resting, so bedtime is the optimal time; you can feel itchiness in/around your anus, and sometimes it keeps people up (After I saw my first infection, I was obsessed that I had them, I didn't, but every time I went to bed I had myself convinced that my butt was itching and it was bug related....nope, just psychosomatic!!)

-Itchiness around the anal area along with difficulty sleeping and irritability
-weight loss (associated with loss of appetite)
-Vaginal itching for women (if the infection is severe and the worms are near the vagina)

How is it transmitted?
 The eggs are super sticky and are transmitted to others through these eggs being transferred.  They can get under your fingernails from itching the anus, and transfer onto your bed linens or pajamas, and go to your partner/bed mate from there.  It can be transferred form your hand/fingernails through not washing your hands and nail biting, so there is an oral transmission.  As well, when you are making your bed, shaking out the duvet (for example) the eggs can fly into the air and be inhaled.  They can also be easily transmitted due to improper hand washing after using the bathroom, and the eggs can stick onto any surface, and whomever is the lucky person to touch it next, can get the parasitic infection, which is why children are at such risk AND why households are usually infected, not just one person at a time.

These are some pinworms around a patients anus:

How are they diagnosed?
At times, the female worms can be seen by the naked eye exiting the anus (I am not sure who you have stare at your anus while you sleep at night- that seems like a ridiculous diagnostic "test" but I guess if you are too embarrassed to go to see an HCP for your itchy butt?)
The other test, which is done more frequently, is that you put a piece of double sided tape around your anus, go to sleep, take the tape off in the morning as soon as you wake up, put it in a bag and bring to your HCP- if there are no visible worms, either worms can be seen under a microscope OR the eggs will be present.

*All household members need to be treated at the same time
-Vermox (Mebendazole)is an oral medication that is taken one pill orally and it may be repeated a week later for severe infections.
-Albenza (Albendazole) which you usually take twice a day (orally) for four weeks, then off for two weeks and you will need to repeat this 3 times.
-Pyrantel Pamoate (Pin-Rid, Pin X) which is OTC (over the counter) after confirmation by an HCP that you have the infection. Usually you take the liquid oral medication once but you should talk to your HCP if it doesn't relieve symptoms because they may have you take it again OR change the medication.
-Also, wash all linens, undergarments, pajamas, and stuffed animals/blankets (for children) in HOT water DAILY until the infections are gone (usually 7-10 days from initial treatment start), vacuum your home to suck up any possible scattered eggs, and clean toys (for dogs and children)/bathroom/kitchen with a diluted bleach to kill off the eggs, as they can live on surfaces for three weeks.

Good hand washing is the key to prevention (including under the nails) and try not to bite your nails (I know, easier said than done!)  and bathe daily.  Also, encourage your children to wash hands frequently, and not to scratch their bottoms, even if they are super itchy!!

I hope knowing this info wards off the worms, and if not, you know what to do ;) Also, I apologize again if you think about these creepy crawlies when hitting the sack tonight!

Yours in Good Health

Monday, October 18, 2010

poppers for better sex, worth the risk?

I have been hearing a LOT recently about poppers.  I actually thought that they were a drug of the past, but I guess they are coming back with a vengeance, and people are having all sorts of strange reactions, some which are reversible and some that aren't!!  And, in all honesty, I thought I knew about all drugs, but poppers are something that I really knew nothing about.

What are they?
Poppers are inhaled alkyl nitrates (amyl nitrate, Butyl nitrate, isopropyl nitrate, and isobutyl nitrate) that are inhaled recreationally to enhance sexual pleasure.  Apparently it is like a small little huff because these nitrates are found in air fresheners, video/computer cleaners, etc.

What happens?
Medically, amyl nitrate is an antidote for cyanide poisoning, but it is called a popper when used recreationally.  It causes a sense of warmness, dizziness, and euphoria.  When you inhale the poppers, it causes a non-specific relaxation of smooth muscle, it also causes blood vessels to dilate, which leads to a drop in blood pressure and an increase in heart rate.  The effects only last a few minutes and afterwards you can have extreme headaches.  The relaxed smooth muscle effect includes the anal sphincter, which allows for less painful anal sex which made this a big drug in gay clubs, but the impaired judgement that is associated with poppers also lead to high rates of unprotected sex (gay, straight, whatever!) The vagina is also made up of smooth muscle, and it apparently can cause prolonged orgasms.

So what is the big deal?
If the vapors instead of being inhaled, are swallowed (in liquid form) it will cause certain death.  Long-term use causes neurological damage, and a new recent report out of the UK is showing that many young adults using poppers have been having issues with vision after using poppers. They are having blurred vision and spots in their vision; some people it has been transient over 3-6 months, but others it hasn't gone away.  They have been testing batches of the poppers that were used in all of the cases but there was nothing wrong with the chemicals, and these health issues were reported in the mid 70's and then in the late 80's when these drugs were heavily used.  Many men have reported erectile dysfunction after taking poppers because of the sudden change in blood pressure and heart rate, after that initial two minutes, men can experience the inability to regain an erection.

Other Health Issues:
Asphyxia (inability to breathe), arrythmias (heart beating irregularly), cardiovascular depression (heart beats slower, significant drop in blood pressure), carbon monoxide poisoning, hepatorenal syndrome (failure of liver and kidneys),  mucosal (oral lining)/skin/pulmonary (lung) irritation, and skin burns/rashes from where the vapors touch your skin.  If taken with viagra, it can cause fainting, stroke, and death.

Poppers are used pretty frequently by teens in the UK and are gaining popularity with younger teens in the US, as well they are being frequently used in nightclubs across the world.  Many people don't realize the heath detriments, and the interactions that can occur with Viagra (for example), and that even one time use can cause vision damage that can last forever.  Now, I am not usually all "reefer mania" about things, but I just don't think inhalants are safe or something that people should do.  If you do use them, and feel like something is wrong, please seek medical attention!!

Yours in Good Health

Sunday, October 17, 2010

A little overhung??

Why do we get hungover? I think people don't really understand the metabolism of alcohol, because there are ways to prevent hangovers, and make that fun night that you may have imbibed too much, into a much softer morning wake up!

So, the not so fun part, alcohol metabolism:
Its how our bodies convert substances into other compounds that we can either use  or excrete . Oxidation is the process by which alcohol is metabolized in the blood. Obviously the alcohol is distributed throughout the body, including the brain, organs, and tissues after ingestion and during metabolization, and small amounts are excreted through your breath and urine in unmetabolized forms.
You have your favorite adult beverage, it goes into your intestines, then is absorbed into your blood stream, it is metabolized by various enzymes.  In the liver the enzyme that breaks down alcohol is called alcohol dehydrogenase (ADH) which turns alcohol into acetaldehyde, which is then broken down to carbon dioxide and water.  Alcohol is also broken down by an enzyme in the liver called P450IIE1, which can increase in number with chronic drinking (hence how people build up a "tolerance" for drinking....increase P450IIE1) and this is where most alcohol is metabolized.

The liver can only metabolize a certain amount of alcohol per hour, no matter if you are a virgin drinker or if you have your sea legs.  That being said, the ability to metabolize alcohol is dependent upon the number of metabolizing enzymes, which varies in each individual and can be genetic (i.e. over half of all east Asians have low numbers of ADH enzymes so they tend to get drunk easily, have wicked hangovers, and get flushed with drinking which is due to a fast heart rate which is how their bodies respond to metabolism of alcohol.) Usually, once you have a drink, your blood alcohol level peaks within 30-45 minutes.

Wilkinson et al., Journal of Pharmacokinetics and Biopharmaceutics5(3):207-224, 197

What other factors influence alcohol Metabolism?
Food: The higher the dietary fat content in the stomach/GI tract increases the amount of time it takes for the alcohol to get absorbed into the blood stream.  One study showed that people who ate a meal of fat, carbs, and protein absorbed alcohol 3 times more quickly than those who drank on an empty stomach.
Gender: Unfortunately, women absorb alcohol differently than men.  Us ladies will have a higher Blood Alcohol Content (BAC) than men drinking the same amounts, and we are more susceptible to alcoholic liver disease, heart muscle damage, and brain damage.  It is presumed that the difference is due to women having a smaller amount of body water and we may have a lower amount of ADH (never been proven but highly likely based on numerous studies). 

Effects of Alcohol:
Body Weight: interestingly, Women who drink (moderately) tend to have significantly lower body weights than those who don't drink at all.  Men, there is no weight difference, but if non drinkers add alcohol to their diet, they don't tend to gain any weight.  Chronic alcoholics tend to lose weight because they substitute alcohol for food....
Sex Hormones: Chronic alcohol intake causes significant hormonal imbalances; the liver metabolizes estrogen into testosterone, but when damaged, it is unable to do that, so you can have decreased sperm production.  In men who consume 220 grams of alcohol daily for 4 weeks, testosterone levels decreased after 5 days and kept dropping throughout the study period.  Also, chronic alcohol intake in men can lead to testicular atrophy (getting smaller) and the growth of male breast tissue. In women, we can create estradiol, which increases bone density and decreases the risk of cardiac disease (whoo hoo!!)
Medications: Tylenol (paracetamol, acetaminophen) can be toxic in the liver in large doses by itself, but add alcohol and it is a HUGE problem that can lead to immediate liver failure.  Like 4-5 extra strength pills in the course of the day with someone who is drinking can cause death. Other drugs such as pepcid (famotidine), ranitidine (zantac), and cimentidine (tagamet) can cause alcohol to be metabolized slower for reasons truly unknown at this point.

What can also cause increased rate of metabolism?  
The only thing known to increase the rate of metabolism of alcohol is fructose!! Consuming 100 grams of fructose has been shown to increase alcohol metabolism by 80%!  Sooooo not helpful for people like me that drink vodka sodas, but great for the rum and coke (not diet coke) drinkers of the world!!  I guess I need to go back to my gin and Q Tonic beverages OR maybe a handful of skittles after every drink???  

So, the best way to prevent a hangover is to eat a meal with fat, protein and carbs (cheeseburger anyone?), increase your water (before bed chug a coconut water if you have one, or just regular water) because we all know the the metabolism process dehydrates our bodies (because of the effects of alcohol), and increase your sugar intake....high fructose corn syrup does count!!  So seriously, a great idea for a bar is to hand each patron a bag of candy with each drink!!  Actually, one of the reasons why "fruity" drinks tend to make you less drunk :) hmmmm.....  BUT I must say, carbonation supposedly increases your alcohol absorption, so maybe a Harvey Wallbanger is the way to go...and try to stick with the same kind of alcohol.  Really, I think we all knew these tips except for the sugar.

So, ladies apparently drinking is good for you?!?!  And men, if you are looking to be more manly, you may want to lay off the booze for a bit....

Yours in Good Health

Thursday, October 14, 2010

Just let it flow....

There is a common thing that people do all the time, that really can be bad for your health.   People take anti-diarrheals (such as Immodium). Normally, your colon absorbs fluids form the foods you eat, creating semi-solid stools; if that fluid isn't absorbed then you have diarrhea.  There are numerous reasons for the body to have liquid stools such as viruses, bacteria and parasites, medications, lactose intolerance, fructose, surgery, artificial sweeteners, and chronic medical disorders.

Why can this cause diarrhea?
Viruses: such as Norwalk virus, Hepatitis A, cytomegalovirus, rotavirus which are transmitted as easily as the common cold from person to person.
Bacteria/Parasites: Giardia lambia, salmonella, E. Coli, cryptosporidium, campylobacter, and shigella can be transmitted through contaminated foods or new exposure while traveling.
Medications: Most common medication to cause diarrhea is antibiotics because they kill off the healthy bacteria in our colon as well as the 'bad' bacteria that it is prescribed to kill off.   Often, this leads to an infections called Clostridium Difficile, which can cause massive amounts of diarrhea.
Lactose Intolerance: lactose is the sugar found in milk that some people are unable to digest and break down; your body makes an enzyme that will break down lactose, but in some people the level of this enzyme drop off, and ingesting lactose will cause gas and diarrhea.
Fructose: the sugar found naturally in fruits and honey is difficult for some people to digest
Artificial Sweeteners: sorbitol/mannitol can cause diarrhea in small doses for some people but will definitely cause diarrhea in large doses as it is not absorbed by the body
Surgery: After gallbladder removal or various abdominal surgeries, you can experience diarrhea due to changes in the colon.
Medical Conditions: Chron's disease, ulcerative colitis, celiac disease,  and irritable bowel syndrome can all cause diarrhea.

So, what do I do??
Most bouts of diarrhea shouldn't last more than a day or two, if it is something that doesn't need to be treated, so drink lots of fluids, stay home, and ride out the storm.  Taking medications such as immodium will stop you from having diarrhea BUT it will trap whatever is causing the diarrhea in your colon.  Diarrhea is a way that your body can flush out something bad/unwanted, and keeping the virus/bacteria/etc inside can cause colon damage, like a perforation (a hole in the wall of your colon- which leads to BAD NEWS!!)

If it lasts more than a day or two (and you have a fever, weakness, etc):
call your HCP and be prepared to give a stool sample, have a physical exam, and possibly some blood work done.

Treatment depends on the cause:
Antibiotics may be given if you have a parasite or bacteria (as noted in my earlier blog about antibiotics it won't do anything to treat viruses).  Your doctor will encourage you to take in fluids to replace the ones lost from your diarrhea, and may give you some intravenously to replace electrolytes (a really good time to take in coconut water!)  If the diarrhea is caused by medications, they may change your dosage, or put you on yogurt along with your antibiotics (the probiotics replace the good bacteria!!) or have you take a probiotic supplement.  Or, they ,ay send you to a gastroenterologist for a further work-up to rule out a chronic medical condition (as listed above.)

Now that its starting to clear up, what should I do?
Reintroduce semisolid and fibrous foods slowly to see how you tolerate it. Avoid alcohol and caffeine as they can dehydrate you, and caffeine can cause more stools.  Try to avoid high fat content foods, spicy foods, and dairy products at first. As your stomach tolerates foods, you can add more slowly until you are back up to snuff!

Prevention is key!!
Wash your hands after using the bathroom/changing diapers/and anything yucky, and before preparing food, after sneezing/coughing/etc.  Wash your hands with a good lather for 20 seconds (or sing happy birthday twice...out loud or in your head!) And, if not possible to wash, use a hand sanitizer (although, I think people tend to get a little too bonkers with the hand sanitizer, in my opinion; it doesn't need to be reapplied every 5 minutes!)

To prevent diarrhea from food contamination, eat food right away or store immediately in the refrigerator. Wash the cutting boards/surfaces in between working with meats vs vegetables, etc. And, when thawing meats, put them in the fridge to thaw instead of on a counter.

When traveling, be careful to eat fully cooked foods, and try to avoid raw foods unless it is something like a fruit or veg that has been washed, and steer clear of dairy.  Try to avoid tap water and ice (country dependent), unless the water is boiled or filtered.  If you have medical conditions, ask your HCP if they want to put you on preventative antibiotics, just in case.

In general, just use good sense, but allow your body to get rid of the bad stuff, it is getting rid of everything in your colon for a reason.  Now you know what to do next time you get sick!!

Yours in Good Health

Wednesday, October 13, 2010

oh, yes, you can break your penis!!

I am not sure why this has been a hot question as of late, but I keep getting asked if men can really break their penises.  I guess it is confusing because usually you break a bone, and while we all know the common term for an erection, there really isn't a bone in there!

So what's the deal?
It is actually called a penile fracture and it can happen during sex (being in a more strenuous position, the person on top falling with too hard a can imagine)!  Medically, it is a hyper bending of the penis, when erect, that can cause a tear of one of the outer layer of the penile tissue (tunica albuginea), which causes swelling and effects the inner tissue (corpora cavernosa) which is the area that fills up with blood, to actually cause the erection. So, when that outer layer tears, it allows blood and other fluids to go where it shouldn't an it causes severe pain, swelling (not in the good way, fellas), and bruising.

Usually there is a popping noise (I don't even have a penis and that makes me cringe) when the tear occurs, and you will have pretty severe pain, swelling, and bruising.  If there isn't a pop, but just the other signs, you still may have a fracture and will need to seek medical attention.

As mentioned before, it can happen when the penis is bent more than usual, and it can be caused from the pens hitting a hard surface instead of where it is supposed to go (for example in female/male sex- hitting the perineum instead of entering the vagina, and it usually occurs by accident), so the best prevention is to not try to rock extreme acrobatics in the bed room and diminish flying into the wall when you miss your partner....if you know you can make it every time, then go get 'em!!

What can be done?
It is considered a MEDICAL EMERGENCY!!! Usually, you need to have surgery under general anesthesia.  They have to make a couple of incisions in the penis, to find the tear or tears, suture them up to repair the injured area, then suture the penis back up.  Usually the operation lasts about an hour total, then you go to the recovery area, then usually right home that day.  The healing process usually takes about a month, then you can be back in action!!  If you DON'T get the operation with the tear, your penis will eventually go back to somewhat normal, there can be a build-up of scar tissue, which can cause erectile dysfunction later on.  Some tears are small and your HCP may feel that it will heal well without surgery, but if that is the case, I would get a second opinion, seeing as your sexual health is a super important part of life, I would make sure that your penis will heal without later issues!!
Here is a pic of a small penile fracture:
This is in the OR, and they are about to repair the fracture (the open triangle at the base of the penis)

How common is it?
There are usually 1200-1500 (approx) cases per year in the US.

So, don't let this scare you from having the amazing sex life that you deserve BUT if you want to "try" something, make sure that you decrease your risk of missing!  And, ladies: when you are on top, please don't get too rough....and pay attention to what you are doing, it can cause a serious problem!!

Yours in Good Health

Tuesday, October 12, 2010

Wow, that really stinks!

Certain people have a tendency to have really stinky feet, which can be super embarrassing and awkward.  The medical term is called bromohydrosis, and for some people this is like a crisis.  One of my good friends has the stinkiest feet, and I have no problem calling him out on it, but it can be really an embarrassing thing for people and it is a tough problem to cover up.

 Now, the feet are an area in the body with a high number of sweat glands (250,000 to be exact), so they are at risk for smelliness from the start!  But the question then is, why do some peoples feet smell and some don't? It can be based on a lot of different factors, but while all of our feet smell, some people tend to have hyperhidrosis (a condition which causes excessive sweating in the feet), stress, hormonal changes, certain medications, and some lifestyle choices.  When the feet sweat, bacteria (usually corynebacteria) is present, which leaves and isovaleric acid, which is what causes the smell. Some people do have foot fungus, which can be present and visible in the nails, which is a totally different problem! So, get rid of that acid, get rid of the smell.....easy right??  I want to give some basic foot care, home remedies for the excessively smelly feet, and medical treatments.  Most of the medical treatments are for fungus, so that may be an underlying problem, but try these tips first, then go from there and see your HCP when the home remedies aren't working.

Basic tips:
CLean your feet daily with soap (preferably antibacterial) and dry them thoroughly after showering/bathing.  Also, try to wear cotton socks, and switch your shoes daily; it allows the shoes to dry out from sweating and can help in a decrease in smelliness! Also it is best to wear cotton socks, or natural fiber socks as opposed to synthetic fibers; cotton (or natural fibers) absorb the sweat and synthetic fibers whisk the sweat into your shoes, then you have smelly feet AND stinky shoes!  Also drinking a lot of water can help to flush the system of toxins and allow for foot odor to decrease (there is a school of thought that the odor is toxin related.)  And finally, allow your feet to be open as much as you can; be in bare feet when you get home, don't sleep with socks on, and wear sandals/flip flops when you can to let those puppies air out!!

When that doesn't work?  Try some home remedies:
Dust your freshly washed and dried feet with corn starch or powder (light dusting)
Wash your feet with freshly brewed and cooled green tea, it can have antibacterial effects
Wash your feet with acne medication, the antibacterial function that can prevent acne can prevent the foot odor as well!
Soak your feet weekly in a tub of water with some baking soda and two tablespoons of standard white vinegar
As turnip and radish juice are natural deodorants, you can rub your feet in one of these juices to war off the smell
Crush ginger-root and rub on your feet as it aids in ridding toxins, or you can take a bath in the crushed ginger weekly
Eat Cilantro!  It is a detoxifier (supposedly of metals specifically) but it may absorb the toxins before you sweat them out (they will come out another way!)
Zinc supplements supposedly can help with foot odor because some people think it can be due to a zinc deficiency
Finally, urinate on your feet in the shower!!  Urea has natural anti-fungal effects and can kill off a fungus which may cause your smelly, peeing in the shower is a good idea in public showers if you are in bare feet to ward off picking up athletes foot!!

Medical Treatments:
Aluminum Chloride Hexahydrate is a cream that must be applied ot the feet nightly to decrease sweating
Electric currents can be used to pass a small electrical current through the skin into the sweat glands and prevent them from sweating (or diminish it) for several weeks
*Botox injections to the sweat glands can paralyze the glands and prevent them from sweating
*In severe cases, a surgeon can cut a nerve that allows the feet to sweat; therefore you will no longer sweat trough your feet
***Just a heads up here, your body needs to sweat to get rid of toxins and flush the body, so if you stop all sweat from your feet (or armpits or wherever you want to retard sweating) it has to come out somewhere, so you may get more back sweat or hand sweat, increase underarm sweat, etc.  So just be aware that it WILL come out!!

I hope this helps any/all of you with bromohydrosis, and remember that if the home remedies don't work, go see your HCP and get a stronger treatment because you may have a foot fungus which has different treatments!  Good luck!

Yours in Good Health!

Friday, October 8, 2010

Moobs are no laughing matter and male breast cancer isn't either

In honor of breast cancer awareness month, I thought that I would discuss a growing trend in healthcare: Male breast cancer.  I wanted to raise awareness because many people do not know that males can even get breast cancer, and men don't worry about it, so they usually notice lumps late, leading to late diagnosis, and worse outcomes.  Male breast cancer can occur at any age, and stage for stage of breast cancer, has the same outcomes as women, men just tend to delay diagnosis, whereas women (for the most part) are hyper vigilant about SBE's (self breast exams).  We are all born with small amounts of breast tissue, women's grow during puberty, whereas this doesn't occur in men, but they do have that small amount of breast tissue from birth.

What are symptoms to look for?
-Painless lump or thickening of the breast tissue
- Changes to the skin on/around your breast tissue such as dimpling, puckering, redness, or scaling
- Changes to your nipple that appears red, scaling, or your nipple turns inward
-Discharge from your nipple/s

What are they types of male breast cancer?
Cancer starting in the milk ducts: ductal carcinoma is the most common male breast cancer and nearly all breast cancers involve the milk ducts.
Cancer that begins in the milk producing glands: lobular cancer is rare in men because men have low lobules on their tissue.
Cancer that spreads to the nipple: In some cases breast cancer can spread from the ducts to the nipple causing scaliness and redness o the nipple, known as Paget's disease.

What are the risks?
Inherited genes/Family history: BRCA2 can be tested early (if you have a strong family history, you can talk to your doctor about getting genetic testing).
Older age: men 60-70 are at increased risk
Alcohol: excessive alcohol intake over time can increase your risk.
Estrogen: If you take estrogen or hormones for a sex change purposes or as used in prostate cancer treatment.
Klinefelter's Syndrome: sometimes males are born with an extra X chromosome, which can cause abnormal testicle development and leads to lower testosterone levels and higher estrogen levels.
Liver Disease: cirrhosis of the liver can cause higher levels of circulating estrogen, as the liver converts androgens to estrogen.
Obesity: higher fat cell content, and fat cells also convert androgens to estrogen.
Radiation Exposure: for treatment of cancers in the chest, for example.  

What to expect during your work-up:
Clinical breast exam: your HCP will manually feel your breast tissue on the chest
Mammogram: the tissue of your breast is pressed flat and an Xray is then taken as you are standing upright (it is relatively uncomfortable and tell the technician if you need a break)
Breast Ultrasound: a non invasive test with some goo placed on top of your skin, and a wand that uses sound waves to "see" breast tissue is used.
Test nipple discharge: if you have discharge, your HCP may collect a sample to test for cancer cells
Biopsy: a small needle is inserted into the lump and cells are removed to test for cancer and visually screen under microscope, it can determine if there is cancer and what type.

Treatment options:
Surgery: to remove the affected tissues
Radiation: High energy beams to kill off the cancer cells through the skin
Hormone therapy: Some cancers needs hormones to grow, and the treatment is to give the opposite hormone, therefore stopping its growth and killing the cancer.
Chemotherapy: Using strong chemicals through the veins to kill off certain types of cells, at different stages of growth.

Are there Alternative therapies?
None have been shown through research to cure male breast cancer, but they can help relax you during your treatment, and make it much more tolerable.  Acupuncture, prayer, yoga, meditation can all help to restore your personal balance while undergoing treatments.

Can I prevent it?
Drink alcohol in moderation, exercise, maintain a healthy weight, and perform self breast exams to notice any new lumps/bumps/skin changes.  Also, if you have a family history (like mom, aunts, sisters) with breast cancer, talk to your HCP about possible genetic testing.  Being aware of the signs is the first step, and talking to your partner and HCP about any changes is super important too....hey, who better to give your breast exam than your partner ;)

Yours in Good Health

Thursday, October 7, 2010

Massages are not just for a spa day anymore....Nurses orders!!

Massages are awesome.  Most people think of them as something that you should do on a special occasion once a year.  Not me, I get them sometimes weekly, but most often every other week...not because I am spoiled, but because I work my body hard with running/working out, work, and I totally stress myself out about stupid things all the time, and I need to help my body relax and rejuvenate.  Some insurance companies will actually pay for massages by certain massage therapists, so it is worth a call to find out if you are covered, because what is better than a massage?  A FREE massage!   What are some of the health benefits?  Stress relief, anxiety/depression alleviation, pain/stiffness relief, blood pressure control, aides in infant growth, prevents sports-related injuries, boost immunity, and can help with cancer therapies.  So, I asked my friend, who is a LMT (licensed massage therapist) to write a little more in depth about various massages therapies, how to find the right massage therapist, and why it is, in fact, work for your body and should be uncomfortable at times to get the full benefits!!  Enjoy!!
Yours in Good Health!

I was asked to return and talk about the joys and benefits of massage, and though there are few who would disagree about these benefits, I would feel less than disappointed if I didn’t at least reach out to the select few who claim that they cringe at the thought of being touched by a complete stranger. As much as some would believe this to be a perfectly reasonable phobia, I’m still a firm believer that all phobias can be confronted and cured through certain steps.
From the moment we are born into this world, we become familiar with the sensation that is touch. We are held and cradled by a warm embrace after a few shock minutes of pain. Though we as humans rarely develop a cognitive memory before age five, it’s foolish to think that our central nervous system isn’t working to develop the deeper senses and instincts. It is because of the nurturing process, that later on we are either comforted and familiar with the healing powers of massage or deeply disturbed and afraid of overall human contact.
When one truly contemplates the ideal of either medical or therapeutic touch, it’s really quite simple.  We long and need and crave human contact.  There is a healing energy that comes with being a person and unless you have lived in the allegorical cave all your life, you would be ignoring one of the most basic of human needs.  It can be esoteric and even harder to explain, but the simple fact is one always feels SOMETHING upon physical contact with another. Something that goes beyond comprehension and words and anyone who has ever judged someone for better or worse from a handshake knows that to be indisputable. Mind you, one should reserve judgment on any moral grounds, but you can’t, nor should you ignore your better instincts when it comes to personal safety.
Now that we got that out of the way, lets talk shop!! I would like to get a few things straight and go over some common misconceptions and usual questions about the world of Massage Therapy. The first being, what are the physiological benefits?  Simply put, it promotes blood circulation, reduces stress and thusly enhances the immune system.  Those are just the beginning perks coming from the most basic form of massage, often referred to as Swedish. 
To those who are relatively new to this type of thing, there are several different types of massage that all serve a different purpose.  The most common of which most anyone will find while searching the market are Swedish, Deep Tissue, Sports massage, and reflexology.  Swedish massage is described as an application of oils, scented oils, lotion or specific types of gels that are appointed lightly over the skin in a certain pattern that correlates with ones blood circulation.  This allows ones blood vessels to dilate allowing said blood to reach all vital organs in a more harmonious fashion.  While this particular type of massage is not always preferred, due to the nicey nice nature, it can be extremely helpful for people who are hypoglycemic, diabetic, or just live with low blood sugar.
Next is deep tissue, which to the seasoned veteran, is basically the same as Swedish but with deeper pressure, and shorter strokes to the problematic areas.  This type of work is generally reserved for the more active and athletic public.  I’m sure most if not all are familiar with how back or shoulder knots feel after a day of heavy lifting or a couple hours at the gym.  This happens because of during a deep contraction of the muscle, lactic acid tends to draw to the area, leaving it feeling, sore or perhaps even overworked.  The best way to remove and relieve it is direct pressure.  To this day it still surprises me that people expect to be in a euphoric state during this type of work, when in fact it’s usually quite the opposite.  The therapists main goal is to, lack for a better term, eradicate this with as much effort that is appropriate. He or she will most likely apply elbows and body weight to the area of referred pain for minutes at a time that some say pass like an hour.  The relief isn’t immediate either; eight times out of ten one will walk out feeling worse then when they came in, especially if the therapist is still a neophyte to the profession (which is why one should take into serious consideration as to who they would have work on them… but I’m getting ahead of myself). As I was saying the relief is not immediate because getting this particular type of massage can be synonymous with running a marathon.  If you allow the process to run its course properly, you will notice results the next day.  Some would refer to this as a crappy deal, but as I said, if you go about it properly, receive the massage on a day off or at the end of the day, and take a nap or just sleep it off, you will wake up refreshed, and feeling anew. 
That being said when choosing a massage therapist for such work, one would be right to do the research.  Too often have I heard on my own table, how consistently disappointing a deep tissue massage can be, never on my account of course, but many therapists tend to not deliver.  This is either because the pressure was too deep, or not deep enough, which is pretty messed up considering the going rate for most massages.
The same goes for a sport massage.  This style’s technique has some versatility, because it can be used for both settings of an athletic event i.e. before the event and after.  It is pretty important, neigh, vital that one specifies which they are looking for in order to prevent injuries such as hyperextensions, muscle tearing, spraining and even bone fractures.  The pre-event sports massage should be done obviously before an athletic event such as long distance running to help warm up and contract the muscle fibers necessary for enhancing performance. When done properly the P.E. sports massage is described as a series of tapotement (percussion or light medium tapping all over the body), kneading (short, specific strokes to promote blood flow and hyperemia), rocking and compressions. I’d say this kind of work could be compared to getting pumped up before a big game with a few slaps to the face, or a therapeutic adrenaline rush.
The post-event sports massage is obviously for after athletic events, and is the more relaxing of the two.  It incorporates deep and positional stretching, of both the limbs and muscles, and deep tissue pressure.  When done properly sports massage is synonymous with yoga, only the one receiving is doing none of the work and receiving all the benefits.  Also this sort of work can be done at any point of the day. It improves flexibility and muscle elasticity, as well as promoted blood flow and stress reduction on a mental and physical level.
Finally, reflexology; I’m referencing this work for a few reasons.  The main one being that, this style of massage is usually reserved, preferred, but not limited to the general public who don’t enjoy full-body work.  Statistically, I think we can all agree that we endure similar woes with the feet. We walk, we sprain, we break, cut and callous, and in the long run, treatment of said hardships are rare and limited. That’s right!! For those who never heard of reflexology, it is simply put, the greatest foot massage one could receive.  This is an eastern practice rooted in traditional Chinese medicine (TCM) which incorporates pressure points in the feet, that correlate and connect to all the vital organs of the body (stomach, liver, lungs, heart, large intestine, small intestine, etc).  This is a widely accepted practice around the world, and it only covers a small amount of your body’s surface area. I can only speak so much for the experience, so I would have to implore those to go experience this for themselves.  However this is the least invasive of all the massages discussed today, and it takes half the time. So one would find this a logical solution for those who are short of leisure and with busy schedules.
Before I end this discussion I think it would be pertinent to discuss the proper ways of finding the right massage therapist.  As it were, the more adventurous public seems to go the trial by error route. I am not completely against this method, but this being my profession, I tend to have a hard time gambling with my comfort.  Also its come to my attention that most people don’t seem to know the etiquette in finding someone who would best suit their experience and needs.  Usually avoid casino’s and other overpriced venues; yes the scenery is nice, and everyone loves a steam room, but in my travels I have learned to keep it simple.  The spa’s that are self-run tend to carry the most talent.  The utilities may not be as plentiful, but a nice comfy couch, perhaps a soothing fireplace, and a clean bathroom will be all you need.

The normal protocol for setting an appointment is as follows:
Secretary answers: Welcome to SeaSpa Experience how can I help you
Potential client: Yes I would like to schedule a massage
Secretary:  Do you prefer a male or female?
Potential client: it doesn’t matter….

At this point, I would say 90% of the time the secretary would choose the most senior and available therapist on the list.  Now I’m certainly not going to infer that one gender is better than the other, because that is never the case nor the issue, but when you get to the part of the secretary asking you what type of massage you are looking to receive, it is more than appropriate to inquire a recommendation.  Believe it or not the spa community is well known for its trading and bartering, and the secretaries are even more known for sampling the products.  I will guarantee that when you specify the type of massage desired, and follow up question of, “which therapist would you recommend for this type of massage?”, She will not hesitate in assisting you with a well guided decision.  Also, never write off word of mouth, or research.  Most people who visit spas regularly are notorious for writing reviews, so if you see a name repeated on more than one occasion, it’s a good sign that you won’t be disappointed.
Until then, happy hunting and safe journey!

Wednesday, October 6, 2010

sleep tight....and don't let the super bed bugs bite!!

I apparently live under a rock, and I needed my mother to truly explain to me that bed bugs were creatures that you could actually visualize.  i thought they were kind of like mites, and unseen to the human eye....and with things like that I do the "out of sight, out of mind" technique, especially since staying at The Ritz or Four Seasons doesn't mean that you are ensured a bed bug free night!  Once she told me, I basically freaked out, and am now obsessed, so this one goes out to me and everyone else who wants to know about these creepy crawlies, how to know if you have them and how to get RID of them!!

What are they?
They are small, oval, flat, wingless parasites that are the size of an apple seed from the Cimicidae family and they feed on human blood.

They got the name "bed bug" because that is where they most often live and easily hide so that they can come out at night and feast on you (Um, can you say gross?!?!) but they were also known as the wall louse, mahogany flats, and crimson ramblers.  They like to live close to their hosts so usually beds or couches, but they can also live in cars, luggage, and clutter which makes them hard to find, unless you have physical signs on your body, wake up with blood spots on your sheets, or find their poop around. When they bite you to eat your blood they can case skin rashes which can be small or their bites can cause full allergic reactions and result in blistering.

Apparently they were completely eradicated in the 1940's after major infestations through the use of DDT (which is now since banned), but there has been a significant resurgence in worldwide starting around 1995 which has many causes such as: increased foreign travel, increased trading of furniture/second hand furniture in homes, and a focus on other household pests (not worrying about bed bugs) leading to a pesticide resistance .  Now they have come back and are like super parasites, they can live at extremely high and low temperatures, their lifespan is totally bug dependent, and they only thing that they can't live in is carbon dioxide (but can still they can live for up to 7 days in straight CO2).  Really? AND they can live a YEAR without feeding but choose to eat every 5 to 10 minutes, so they totally aren't greedy little suckers (pun intended).  The good news is that their natural predators are spiders, mites, and cockroaches; I am not sure which I would prefer more, cockroaches or bed bugs, hmmmm....

The other good news is that they are not known to transmit disease, they are just gross and totally stress people out; on top of causing rashes!

How do I know if I have them?
You only really know if you have bed bugs by having random rashes, find blood spots on your sheets in the morning, and you can find with their carcasses (from when they die) or their poop around your dwelling.  A diagnosis of rash due to bed bugs is made by both the physical rash on your body and after searching for signs of them in your home.

What puts me at risk?
Living/staying at military barracks, apartment complexes, homeless shelters, dorms, hotels, refugee camps.

How can I find them?
Some pest control companies have detection devices that use heat and low amounts of carbon dioxide to trick the bugs into thinking that there are humans present and they come out of hiding.  There are also bed bug sniffing dogs that have been trained to find them and they have over 97% accuracy in finding them in homes, and take a matter of minutes as opposed to hours by a human pest control practitioner.

What do I do for treatment?
So, to treat your skin rashes, usually hydrocortisone cream will aid to diminish swelling and itching and an oral antihistamine (such as benadryl) will help to make the rash go away BUT you need to rid your home of the bugs and end exposure.

How do I rid my home?
Vacuuming: all rugs, beds, furniture with a good strong vacuum....maybe even rent one to ensure that you are sucking out the bugs
Hot Water: Wash all clothes, bed linens, towels, etc in water that is at east 120F to kill off the bugs
Heat: Ensure that once you wash your clothes in hot water, put the clothes in the dryer at medium to high heat for at a minimum of 20 minutes to kill bugs and their eggs.
Enclosed Vehicle: if you can't get access to a washer/dryer, just bag up the clothes, linens, etc, and park your car with closed windows directly in the sun for one day during the summer. The heat will get hot enough to kill off the bugs.
Freezing: If you live somewhere cold, bag everything and out it in weather that is below 32F for a few days, and that should also kill off the bugs (more time consuming, but it depends on the time of year and where you live!!)

**If these fail, then call an exterminator, and they can use harsh chemicals to treat the infestation, but be careful with children and animals and you will need to vacate your home for a while.

How do I prevent bites?
Wear long sleeved pajamas with pants to bed (if their is no exposed skin, they have nothing to bite!), and some studies suggest using mosquito netting around your bed (they are coated in pesticides).

How do I prevent infestations?
Inspect (thoroughly) second hand items for signs of bugs before bringing them into your home, and steam clean with high heat of necessary. At hotels, check mattress seams for bed bug excrement before laying in the bed, and place your luggage on top of dressers instead of on the floor.  Also, get rid of any bird/bat homes that may be in/on the outside of your home.  At your own home, mattress wrapping has been suggested as a treatment to contain them (see the added link).

So, now that I am totally creeped out and inspecting every single hotel and home I go to for bed bugs, I at least feel better knowing the deal and what to look for!  I hope you guys all stay bed bug free and know how to treat and prevent if you do have infestations!!

Yours in Good Health!

Tuesday, October 5, 2010

Uh, oh....can CALCIUM cause heart attacks?!?!

I know that one of my first blogs was talking about how important adequate calcium intake is, and it still totally is!  Calcium, as we all now know is really good for you, it not only help to strengthen bones, but it aids in muscle contraction, allowing for optimal cardiovascular health, and help to keep your joints inflammation free.  So, am I going to tell you that calcium is actually bad for you?

Kinda, sorta!?!?!? Recent new studies have come out showing that calcium intake can actually increase WOMENS risk of heart attacks by 27-31%!   The studies were looking at older women who take calcium supplements (without Vitamin D) in 500mg  pills.  The study was pretty large in size and was published in the British medical Journal, which is very well regarded, as far as medical journals go.

Many HCP's are not changing their patients medication regimes as of right now, because the risk of broken bones and osteoporosis is so significant for so many older women, but they are taking into account their medical history and risk of cardiac disease.  So, your HCP may not stop your current calcium supplementation, and don't stop until you see them and talk to them about your specific course of treatment.  BUT if you do have risk factors, you may not be started on calcium supplementation and encouraged to take in calcium through your always, I am pushing the raw milk, but see my list linked above to look for some calcium rich foods and lay off the supplements, if you are worried, but make sure to boost the calcium in your diet!!

Yours in Good Health!

Monday, October 4, 2010

Let's get Physical....

I am frequently asked how often adults should go to see their HCP.  Honestly, I will give you a a good rules that HCP's usually go by, but it all depends upon your insurance coverage and how often they will cover it.  Also, it depends on your age and overall health status, so this is just a generic guide, and your specific HCP will tell you when to go back and follow-up.

Children to the age of 18:
yearly and for immunizations

Should get yearly OBGYN exams from the  time they are sexually active or starting at the age of 21 (whichever comes first).

Adults over the age of 18-39:
A complete physical every 3 years (a minimum of twice during your 20's), also a yearly blood pressure screening is suggested, along with cholesterol levels checked every 2 years.  If you have a specific family history or risk of diseases, you should discuss with your HCP and you can both set up a plan for future visits.

Adults 40-65:
Every 2 years for physicals if there are no other medical issues.  ANd start colonoscopy screening at the age of 50 and every 3-5 years after that.
Men- over the age of 50 should get yearly rectal exams to assess risk of prostate cancer
Women- over the age of 40 should have yearly mammograms, unless you have a family history, and you may be required to start them earlier.

Adults 65+:
Yearly physicals at a minimum.

Again, if you have a chronic disease, you will obviously go to all of those MD appointments, but Women, specifically, must remember, that going to the OB/GYN for a yearly exam is NOT the same as getting a physical by your primary care provider (PCP) and it is very important for full body physicals.  Also, anything that you notice different, you should go see your PCP, even if it is sooner than the guidelines listed above.  It is a good idea to have a PCP and form a relationship, it will stave off trips to emergency/walk-in clinics, and you will get better care because they know your history and all about you.  Plus, early detection of disease is key, and if someone is following you over time, a trend might be noticed that you can prevent before getting sick!

I hope this helps!

Yours in Good Health

Friday, October 1, 2010

Here to squelch a rumor...regarding breast cancer and fellatio

I was sent a couple of "news" articles that were supposedly posted on  Apparently, and a great effort was put into it, a few people decided to write some 'research' related to the decrease of breast cancer rates.  Whilst reading the article all of the facts seemed off to me, but I also read it after working overnight, and I couldn't swear that the spelling of my own name was correct!

They stated that they researched over 15, 000 women and found that women who performed fellatio twice a week, and swallowed the semen, had a significant reduction in breast cancer.  They stated that the protein and enzymes in the semen somehow prevented breast cancer growth. How did I know that something was fishy, besides the fact that I couldn't imagine anyone doing such a large study on something so silly?  One of the female MD's called to give a quote about her idea on the topic was that she said she tries to fellate at least every other night o reduce her risk of breast cancer.  I can't imagine that quote happening!!

So, to any others who have received this viral joke, kudos to the creators, but the topic is bunk!  I am sure that you fellows out there can use this to try an persuade your significant others, but hopefully they read my blog regarding oral sex and oral cancer!

So, don't be fooled :)

Yours in Good Health!!

What is Metabolic Syndrome and how do I prevent it??

There is a LOT of talk about Metabolic Syndrome, Syndrome X, Dysmetabolic syndrome, etc. but do you actually know what this means?  Really, it is just a group of risk factors for heart disease, that when one person has them, their risk of heart disease, stroke, and diabetes significantly increases.  The current statistics are a little scary in that approximately one in 5 Americans has Metabolic Syndrome and your risk increases with age, and more than 40% of people ages 60-70 are affected.

What are the criteria for diagnosis?  3 or more of the following:
-A waistline of 40" or more for men and 35" or more for women (when measured directly across the belly)
-A blood pressure of 130/85mmHg or higher or are on blood pressure lowering medications
-A triglyceride level of 150mg/dl or higher
-A fasting blood glucose level greater than 100mg/dl or are on glucose lowering medications
-A high density lipoprotein level (HDL- good cholesterol)less than 40mg/dl (men)or under 50mg/dl for women.

Unfortunately, there are no specific symptoms for Metabolic Syndrome.  The problems that occur related to the syndrome occur over time, and the only way that you could really tell (other than the waist size) is through regular check ups with your HCP.

What causes it?
Metabolic Syndrome is really an insulin resistance by your body and, as stated above, it occurs over time. It is related to genetics and lifestyle (like diet, activity, and sleep patterns).

What can occur from Metabolic Syndrome?
-Damage to the lining of the coronary and other arteries, putting you at an increased risk for heart disease and stroke
-Changes in the kidney that will cause increased blood pressure, heart disease, and stroke.
-Increase in triglyceride levels, which significantly increases the risk of heart attacks
-Increase risk of clot formation, which can lead to strokes and heart attacks
-A slowing of insulin production which can lead to Type II Diabetes, when uncontrolled can lead to vascular changes, blindness, nerve damage, etc.

How can I decrease my risk???
Lifestyle changes!!
Weight: moderate weight loss of 5-10% body weight can restore your bodies ability to recognize insulin and greatly reduce metabolic syndrome leading any further and causing long-term damage to the body.
Exercise: 30 minutes of aerobic exercise a day can greatly improve your cardiovascular risks, improve your bodies insulin levels, improve blood pressure and cholesterol levels.  HCP's usually recommend 150 minutes of aerobic exercise a week to improve health (and that exercise is considered, at minimum, a brisk walk).
Dietary Changes: Try to keep carbohydrates to less than 50% of your caloric intake, and eat complex carbos such as whole grains, brown rices, etc.  Also increase fiber intake through legumes, veggies and fruits. While keeping  30-45% of your daily caloric intake from fat try to eat healthy fats such as olive oil, nuts, and flaxseed oils.
Alcohol: Limit your daily alcohol intake to one drink per day for women and two for men.

The take away should be that Metabolic Syndrome is totally reversible with some pretty simple lifestyle changes, but it is virtually silent, so you need to go for your regular check ups and keep in touch with your HCP!!

Yours in Good Health!