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Nurse Bridgid

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Friday, September 30, 2011

MRSA prevention? Another reason to drink coffee and tea

I sure that you have heard about the antibiotic resistant "super bugs" that are always touted about in the news, well more people than you realize are affected (around 2.5 million carriers in the US alone in 2004).  MRSA (Methecillin-resistant staphylococcus aureus) is one of the most well known "super bugs".  All it means is that this form of staph is resistant to most common treatments like the cephalosporins and penicillin-family drugs.  There are drugs that can treat these bacteria, it is just a case of finding the correct one, and making sure that you take the drug for the FULL length of time that it is prescribed, to make sure we kill it all off and there is no further infection.  BUT just because you have MRSA living on your body doesn't mean that you have an active infection, you could just be colonized with it.

What is infection vs. colonization?
An infection means that the bacteria has entered your body somehow and causes a reaction within your body, such as pus in a wound, or a skin rash,  a blood infection leading to fevers and generalized malaise, which can quickly become worse if not treated.  An active infection requires treatment early on to prevent spreading it to other people and to prevent serious long term effects of the infection and death.  Colonization merely means that you have the bacteria either living in (your blood) or on (in your nose or on skin) your body and you have no reaction; you have no active infection and no idea that you even have the bacteria present.

How do I know if I have MRSA?
MRSA bacteria likes to hang out in the tip of the nares (your nose), so if you are colonized you might not know that you even have the bacteria present in your body.  You probably wouldn't know that you were colonized unless your HCP did a nasal swab to test for it, or if you were admitted to the hospital (many hospitals will swab you on admission to see if you have the infection, so that you couldn't transmit it to others).  If you have and infected wound that won't get better despite treatment with antibiotics, or if you have a skin rash that will not go away, a generalized illness that keeps getting worse, you may have to have blood cultures (a blood sample) or swabs of your wounds/base of rashes, and the results will show MRSA.

What is the treatment?
If you do have an MRSA infection, the cultures from swabs of the infection or from the blood, will then be tested to what antibiotics the infection is reactive to.  That will help to guide your treatment, and depending on the infection, your HCP will decide if you need oral or intravenous antibiotics and the length of time necessary to treat the infection.

How do Coffee and Tea come into play???
Coffee and tea have been long know to have some antimicrobial properties, in that it inhibits the growth  of various microorganisms (can be bacteria, fungus, or other little bugs).  And they were studied to see if drinking hot tea and hot coffee helped to prevent MRSA bacteria from living in peoples nares. They did a rather large study of people that didn't live in group places (prisons, barracks, boarding schools, college dorms, etc) where they could get reinfected from others easily.  They found that there was a 50% reduction in nasal carriers of MRSA when they drank hot coffee and tea!  The exact reason is unknown (perhaps it is due to hot steam in the nasal passages or due to the ingestion of these substances with antimicrobial properties).  They also looked at soda drinkers; people who drank soda had no change in rates of carrying MRSA in their nose.

So, coffee and tea drinkers, keep it up, you are decreasing your risk of carrying MRSA!  But to prevent infections, make sure to wash your hands, clean cuts and wounds, and keep them wrapped or covered while they still have not scabbed over, and make sure that you clean gym equipment before and after using it (it loves warm moist environments- so gym/sports equipment is a great place for MRSA to lurk!)  Make sure you go to your HCP with any skin rashes that don't clear, or with any wounds that aren't is better to go sooner rather than later!  And keep sipping your hot teas and coffee, to try and prevent that pesky MRSA form hanging out!

Yours in Good Health

Thursday, September 29, 2011

Really? An apple a day?

The old adage, an apple a day keeps the doctor away, may actually be true! There has been such a push in the past few years to encourage people to fill their diets with lots of colorful fruits and veggies and to stay away from those white fleshed fruits and veg. I have always been a huge proponent of people eating apples and pears, mostly because they are easily accessible almost everywhere and they are a staple of my diet!  Portable, yummy, and they fill you up with all of the fiber they have in them...a perfect snack!  A new study just finished that also shows how helpful they can be to prevent health issues, such as stroke, too!

What's the scoop?
A large study consisting of around 20,000 people from the ages of 20 to 65 that had no previous cardiac (heart) issues, had their diets studied for one year.  A 10 year follow-up was then performed on all patients, and it was found that of the people studied, 233 patients had strokes.  They were able to figure out that people who ate white fleshed fruits (apples, bananas, and pears) and veggies (cauliflower, chicory, and cucumber) had a 52% lower risk of stroke, compared to those who didn't eat the white fleshed fruits.  A 25-gram increase in white fleshed fruits decreased the risk by 9%; an apple (medium sized) is approximately 120-grams, thus a 43.2% decrease risk of stroke that day!

What does this mean?
Every apple, pear, serving of cucumbers, etc can have a huge impact on your health and decrease your risk of stroke.  Trying to encompass white flesh fruits and veggies each day can have significant health effects! Of course, I am not telling you to ditch the other fruits and veggies of various colors, they are so important in your diet, as they contain antioxidants, that have free radical fighting abilities and are thought to decrease risk of cancer. Really, the more colorful and pretty looking your plate of food is, usually the better it is for you; you are getting in a wide variety of vitamins, minerals, antioxidants, and food sources! I always think that the more colorful meals are, the more I get excited for them...just because they look nice (I'm not THAT nerdy that I get excited for vitamins!)

If you are at risk for stroke due to family history, smoking, obesity, diabetes, etc then you might want to try to increase the amount of white fruits and vegetables because it may help to offset your other risk factors.  Plus, it is so easy to grab an apple or a pear as a snack in the afternoon, and when you drink them with a glass of water, their high amount of pectin (their natural fiber) will keep you filled up until dinner!  And, what a better way to spend a fall day than to go apple picking and know that when you eat them, you will be doing some disease prevention!

Yours in Good Health

Tuesday, September 27, 2011

It's just the pits!

Sometimes there are viruses that "normally" people get as children or young adolescents, but for some reason adults haven't been exposed and then get a childhood virus as adults.  For many reasons this can seem a little creepy, and mainly because you may all of a sudden have symptoms from something that isn't a big deal, but because you are an adult, you might think you have some horrible form of advanced cancer....or maybe that's just me?

One virus that I actually got when I was in my early 20's was pityriasis rosea, and there have been a few cases of people I know getting diagnosed within the past year or so, as adults, and it can be kind of creepy.  It is a virus with a skin rash component, but some of the lesions can look like secondary syphilis, which can really throw your HCP for a loop!

What is Pityriasis rosea?
It is a virus that can last for about 6 weeks, and for most people it starts with an upper respiratory infection (like a little irritating cough that lasts 7-10 days).  After the cough goes away, you can get a "herald" patch (one large area of scaly skin- the first patch) on your abdomen, that can be hidden in a skin fold, armpit, or somewhere else where it may be difficult to see; it can come and go with no other symptoms.  Approximately 10 days after the herald lesion leaves, there is a rash of small lesions that are usually found on the back and travel along the rib bones, in a Christmas tree shape.  The rash can be really itchy, or not at all.  It can also cause headaches, exhaustion, and a general sense of feeling crappy.  Technically, it isn't contagious but, it has been known to infect people who spend a lot of time together (i.e. dorms, daycare, military barracks, etc.)

How is it diagnosed?
Usually it is diagnosed on clinical presentation (if you have had an upper respiratory infection recently, and based on the presentation of the rash).  If your symptoms are more generalized or you don't remember having a cough/cold recently, your HCP may take a scraping of the rash to rule out psoriasis and ringworm, take some blood to rule out syphilis, and if the rash is really severe they make take a biopsy (which would be VERY aggressive.)  If you have recently started a new medication, you also need to rule out that it is an allergic reaction.

What is the treatment?
The treatment is pretty simple actually, because it is a virus, so no medications will make it go away.  You can take oral antihistamines if the itching is bothering you, or use antihistamine creams/gels to prevent the itching symptoms.  For headaches and discomfort, you can take acetaminophen (paracetamol), or ibuprofen.  However, direct sunlight has been shown shorten the time that the lesions are apparent, you still may feel unwell, but the skin rash will leave sooner.  This is one of the only times that I will ever tell you that UV therapy in a tanning bed might actually be good for you, but one session in a tanning bed usually clears up the rash completely!

I am always really in tune to skin rashes, I tend to freak out with rashes (all other symptoms of viruses never seem to bother me) and I am not sure why, but if you do have a cold that seems to linger, and a rash directly after, especially if it has that christmas tree shape, most likely you have Pityriasis rosea and OTC medication and a trip to the tanning bed (just ONE!) should clear up your rash and start to make you feel better!  But, it is best to go see your HCP in case you have one of the other viruses/processes that mimic Pityriasis rosea.

Yours in Good Health,

Thursday, September 22, 2011

Children with African Ancestry at Higher Risk....

Potentially life threatening food allergies affect around 3% of the US populations children.  This is HUGE because many of these children are exposed to their food allergens early in life, completely by accident, and can cause major damage to their heart, lungs, and cause psychological damage, if not lead to death. There are eight major foods that cause 90% of allergic reactions in children: milk, soy, fish, peanuts, tree nuts, shellfish, wheat, and eggs. Some are easier to avoid than others, but eggs, milk, soy, and wheat are in many commercial foods.

Why is this important?
Research has been ongoing to try to pinpoint what causes these extreme allergies and if certain populations are more at risk than others.  So far, nothing has really been found as definitive reasons for the increase of anaphylactic reactions to foods, but there have been plenty of suggestions made by pediatricians to try to decrease the risk, such as not introducing foods like tree nuts, peanuts, and shellfish before the age of 3 and breastfeeding for 4-6 months minimum.  A study from 6 months ago showed that there was a decrease in allergic food allergies when children were introduced to solid foods before 6 months old, and closer to 4 months.  Although, these tips also do not completely prevent food allergies.

What is New?
A recent study looking at 1104 children with an average age of 2.7 and from lower socio-economic status populations of African and Hispanic ancestry, looked at the rates of food allergies within this population.  What they found was pretty interesting; 35.5% of the children studied had a food allergy.  And of these children, the children of African Ancestry had much higher rates of multiple food allergies and had much higher rates of peanut allergies; in many of the children that had allergies, peanuts were what their body reacted most to.
Now, they are not sure if there are genetic factors that may affect these outcomes or if there are any environmental factors that also could increase these rates of allergen sensitivity, so further studies need to be performed, but it is an interesting alternative theory that these rates of allergic reactions in kids may be more genetic, as opposed to what foods children are exposed to at different ages.

How does this affect me?
Really, it is just something to be aware of.  Clearly, this topic needs further studies but it is an interesting idea, and because the risk of an allergic reaction from food at an early age can be so devastating physically and mentally to children, if there is a genetic/ancestral link, it is a way to be aware of possible food allergies.   If you have food allergies, and many people in your family do, you might be more apt to assume that your child has the same allergies, and if it is linked to your heritage, then you would do the same!

Always try to eat healthy and feed the same to your children, limit the amount of preservatives and fast foods, and hope for the best!  If you do feed your child something and they start having a skin reaction, wheezing, vomiting, and/or diarrhea then you should assume they have a food allergy, and with any form of wheezing or breathing difficulties you should call your HCP immediately and if they have increased breathing trouble, call emergency services in case your child is having a life threatening reaction.

Yours in Good Health

Tuesday, September 20, 2011

It's all Golden!

There is this item that I always saw in the fruit/veg section of the super market and I never knew what it was, and usually I'll buy one of something, try it and if I like it; if I like it great, if not, no big deal!  So I had been eyeing these fruits (I was assuming they were fruit as they were in the fruit section) that had thin paper-like leaves over them, but for some reason was really gun shy in buying them.  Honestly, I felt kind of weird not having any idea what they were, and then when I got home, what to do with them?  Well, I finally took the plunge and bought these Goldenberries, and I am one happy girl.  Not only are they delicious, but they are really good for you too!!

What are they?
Goldenberries are round yellow fruits about the size of a marble, or a US quarter in diameter, from the Physalis peruviana plant that is indigenous to South American and South Africa, they were first found in and around the Cape of Good Hope. They are also known as cape gooseberries, poha, aztec berries, and peruvian cherries; despite the various nicknames, they have no relation to gooseberries or cherries and is more closely related to the tomato family of fruits.  And they are found in the higher altitude areas of India, Southern China, South America, South Africa, and New Zealand.  And an interesting little tip? if you leave the berries in the little husks they are in, they can be stored for 45 days....what other fruit can do that??

the golden berry!
Why are they so good for you?
So, I feel like they are good for me because they are super delicious but they actually have some real life health benefits. They are high in Vitamins A, C, B, B1, B2, B6, and B12. And, FULL of antioxidants, that as we all know help to fight free radicals, and may prevent cancer.  Years ago, in South African folk medicine, they were used to treat a whole bunch of different medical ailments: diabetes, malaria, asthma, arthritis, and various blood disorders.  It is interesting that they were used in this manner of treatment, because they have been found to have both antihistamine and anti-inflammatory properties. So they may in fact help with allergies that may cause asthma, or help to decrease inflammation in joints with arthritis and malaria flares. 

These special berries are currently being studied more closely to find the true effects of the fruits, and how much we need to eat to actually see some of the side effects. So, I wouldn't spend all of your time and money searchign for this muracle fruit BUT they are super tasty and I am kind of obsessed with them.  The perfect fruit for making preserves, cooking with, adding to food (they are very colorful and pretty), and they are just yummy to munch on!

If you see them in the store, give them a try, I don't think you will be disappointed, and they are so good, you might ditch your afternoon candy attack to reach for some goldenberries- they are THAT good!
Yours in Good Health

Friday, September 16, 2011

First Aid at Home

A lot of the questions I am asked about by friends are in regards to taking care of cuts, abrasions, and minor burns that occur at home, no need for a visit to the ED, but what should I do to treat it?  I always have people describe or send me pictures of their injuries so that I can help them figure out the best treatment that they can use at home.  So I want to help you know how to perform first aid at home AND what to have stocked in your first aid kit (which for me happens to be half of my linen closet!)

Abrasions, Cuts, and Scrapes:
Cut injuries are very common amongst all people.  But abrasions and scrapes are more common injuries  in children and people who are athletes or play sports and is usually caused by falling and scraping a knee, tripping and scraping an arm, or from sliding into a base (baseball). Basically any injury in which you fall or slide, you are going to have an abrasion or scrape, and if it is falling off a bike (or motorcycle) it is known as "road rash".  Most of the time, these are shallow and only take off a few layers of dermis (skin layers) and they don't bleed too much, but they can be very painful and or irritating during the healing stage, they almost feel like a burn.

 What to do?
Clean the area with fresh water and an antibacterial soap, just to make sure all dirt and debris is washed out of the area. The area may appears to increase in bleeding while you wash, just because the water is flushing out the area, but you really aren't.  

To stop the bleeding of a cut, hold gentle pressure for about 5 minutes to the cut- don't peek to see if it has stopped bleeding earlier because that may reopen the clot that was forming to stop the bleeding (although I know how tempting it is!) 

You should stay away from Hydrogen Peroxide as it is found to actually kill off healthy tissues and may actually lead to an increased risk of infection, but instead use a thin layer of an antibiotic ointment such as Bacitracin (an alternative treatment is Antiseptic Healing Ointment by Brave Soldier which is all natural ingredients such as tea tree oil and aloe), and cover the area with an occlusive dressing, such as a large Band Aid, and ensure that the adhesive is only sticking to areas of skin that is healthy.  

Change the dressing every time it gets really wet (after showering or swimming) and once the area is no longer weeping or draining any fluids, leave it without a band aid and just use a thin layer of antibiotic ointment. Only cover the wound if there is any risk of something rubbing it or scraping against it, that might reopen the wound or get stuck in the wound bed (like bits of clothing).  A moist occlusive dressing helps to promote wound healing, while preventing bacteria from entering it.  Once the area
 starts healing, keeping it open to air with antibacterial ointment to prevent an infection.  

When should I go to an HCP?
If the cut is more than 1/4inch (or 6 millimeters approximately) you should go to an HCP to get the wound looked at and possible stitches.  If the edges of the cut are jagged or there is fat or other tissue protruding from the cut, it needs to be seen and most often sutured back together.  Especially if you are woozy or nervous about a cut, it is better to have it seen and disinfected by a professional then to try to clean it and risk infection at home.

Signs of Infection:
You should call your HCP or go see them immediately if you notice that the wound isn't healing at all, if there is smelly thick drainage, increased pain, if the area is reddened or swollen, or if you just don't think it looks right.

 Also, it is a good idea if it is a deep cut to get a tetanus booster.  You should get one every 10 years, but if it has been a while, then you might as well get one ever remembers when their last tetanus shot was!  Remember always to keep it clean, and if the bleeding doesn't slow or stop quickly, just go to an emergency clinic.

Yours in Good Health

Wednesday, September 14, 2011

Bath Salts: A scary new epidemic?

There have been numerous cases of deaths and severe side effects after the use of a new drug on the market called "bath salts".  In one way, it's kind of ingenious that these people created this designer drug, labelled and sold it in various places as "bath salts" with the line of "not for human consumption" on the label, thus they were overlooked by the federal drug and food enforcement agencies...they skirted under the radar. It became an underground phenomena that the use of the drug (which is not actually a salt that you would put into your bath to relax after a rough day), sold mostly in head shops and tobacco stores, was through word of mouth.  Bath salts were banned in Louisiana, New Jersey, Florida, and a few other states after numerous violent homicides and/or deaths from the drug. Although, as of September 7, 2011 the DEA has deemed these drugs illegal (in an emergency status) and a few arrests have been made for the creation, distribution, and use of bath salts.  Honestly, why anyone would actually want to try this drug, I am not sure, but the state of the adolescents and young adults that have used this drug coming into the Emergency Department is enough to scare me straight!

What are bath salts?
They are a synthetic stimulants such as methylenedioxypyrovalerone (MDPV).  MDPV is a drug that first started circulating in 2004 in the US and it was called "super coke" as it is approximately 4 times the strength of most street cocaine or prescription Ritalin.   It is known on the street as either bath salts, ivory wave, purple wave, vanilla sky, bliss, bonsai grow, plant food, pixie dust, white lightening, along with TONS of other names, and it looks almost like powdered sugar but tends to be more yellowish on its own and the color can obviously be changed with various additives.  The scary thing is that there is no test for MDPV and not all bath salts are the same drug, they are created at various different place by different "chemists" and you never really know what drug you are ingesting.

How is it taken?
People are pretty inventive and it depends on length of use and the person, but the main routes of ingestion are snorting into your nose, injecting into a vein, smoking (or free basing), and mixing the drug into food and or drinks to consume it. Depending on how fast the user wants to feel the high or just plain choice of favorite route!

What are the side effects?
Tachycardia (fast heart rate)
Hypertension (high blood pressure)
Increased alertness/awareness
Vasoconstriction (narrowing of blood vessels)
Increased body temperature
Increased energy
Increased sexual stimulation
Psychosis (paranoia, delusions thoughts)
Suicidal ideation (wanting to kill oneself)

The primary effects (initial "high") last around 3 to 4 hours and the user has usually come down by 6 to 8 hours after use.  The interesting thing with this drug though is that the user feels extreme urges to "re-dose" or take another hit, before they have finished their high, and even if they have had horrible side effects (paranoia, chest pains, etc). The drug is so highly addictive that even upon first use the urge to use again is so strong that people cannot stop and will go for days with using the drug, only making the "come down" that much worse.   Also, a huge number of users report feeling suicidal for up to three and four days post usage of the drug (even a one time use) and there were a rash of suicides after the use of bath salts, which is what lead to Louisiana banning the sale and use of bath salts.

What happens with an overdose?
Many times people come in overdosing and as HCP's we do not know what is causing it, especially because most of our simple toxicology screens will be negative because we do not test for MDPV, so we need someone to tell us what the overdose is on, so we can treat the patient with anti-anxiety and anti-seizure medication to help prevent strokes, heart attacks, seizures, and ease the effects of the drug. At this time, we do not have an antidote specifically for MDPV. In some cases, patients overdosing on bath salts have had to be put into medical induced comas to prevent further damage to their brain and heart.  In all honesty, there are a LARGE number of people who take the drug and overdose die before they even make it to the hospital.

If you have done bath salts, please don't do it again.  If you know someone who has taken them and appears to not be feeling well or is becoming aggressive and agitated or confused, please call 9-1-1 or your local emergency number and get them to an Emergency Department for treatment ASAP and tell the HCP's what was ingested and how much, it can help us save lives and treat the patient appropriately. And, if someone is suicidal or homicidal, that is an emergency that also needs immediate treatment. If you or someone you know has taken bath salts and feels suicidal afterwards, talk to your HCP or someone you trust to get immediate help, or call a suicide hotline for support 800-273-8255.

Obviously my advise is that bath salts are not worth even trying; you never truly know what you are ingesting in your body and overdosing is too risky and tough for HCPs to treat.  Any drug that is being banned by states, and adding states each week from bad effects, isn't worth it!  The choice is up to you, and you are informed of the mal effects, I hope you choose to be healthy.

Yours in Good Health

Tuesday, September 13, 2011

Do you have a new itchy rash?

If you have ever had a new itchy rash and you talk to a Health Care Professional about it, you know the standard questions they are going to ask you: have you switched laundry detergents? New soaps or lotions? Are you wearing new unwashed clothes? They are asking you because these are common reasons that people get an itchy red rash known as contact dermatitis.

What is contact dermatitis?
It is an inflammation of the skin caused by direct contact with an irritant. Usually it is something new that comes in contact with your skin, and it can be caused by new lotions, soaps, laundry detergent (irritant dermatitis), and also by poison ivy or sumac (allergic dermatitis).  But it can also occur from something that is really irritating that you may have interacted with numerous times; for example, when HCPs were using latex years ago, after years of exposure, people started having reactions.

What are the most common irritants?
Metals (nickel)
Plants (poison ivy, poison sumac)
Soaps (detergents, lotions, body wash, bar soap, shampoo)
Medications (antibiotics, other oral or topical medications)
Latex (or other rubber)
Clothes/fabric (specific types or f clothes are worn without washing first)
Adhesives (like tape when in the hospital or bandaids)
Chemicals (household cleaners, or other chemical exposures at work, etc.)

Does anything increase my risk of having this reaction?
If you have a history  of allergies (food, seasonal, etc) you are at a higher risk of contracting a contact dermatitis, but it isn't always true.  For example, I have a very strong food allergy to tree nuts and seasonal allergies, but (knock on wood), I don't react to poison ivy or sumac and I have had a contact dermatitis only once in my life.  It isn't a hard and fast rule, but most people with allergies to other things, are at risk for having more sensitive skin too.

What are the symptoms?
Itchiness and redness of the skin
Inflammation and heat from the area exposed
There can be lesions or blisters with allergic dermatitis

Diagnosis is based purely on history and assessment of the area.  If this happens a few times to you and you are not sure what the cause is, your HCP can perform skin patch tests, in which they apply little drops of irritants to the skin, and assess for a reaction, then you can learn what causes you to react.  Most often, people make a few changes and the reaction doesn't occur again, or they know what caused it.

How do I treat this?
Treatment is pretty simple. Wash the area thoroughly with lots of water to get rid of the irritant from your skin.  Next you can use a hydrocortisone cream to make the rash and itchiness go away (can be purchased over the counter, and follow directions on the box).  If the rash is widespread or extreme, you may need to take oral corticosteroids.  Sometimes using a benadryl cream/lotion to the area will help to take away the itchiness or taking an oral antihistamine can help as well.

How do I prevent it?
Stay away from what you know you are allergic to and wash your skin thoroughly if you do come in contact.  If you have sensitive skin, stick to very mild (like baby formulated) soaps, detergents, and lotions.  Talk to your HCP about what is best for you and how you can prevent further reactions.  But always wash new clothes before wearing them, and its a good idea to keep hydrocortisone cream and benadryl on hand in your first aid kit at home!

Yours in Good Health

Monday, September 12, 2011

From Russia with Love?

There is a "new" drug that has been used like crazy all over Russia and is now threatening to spread into the EU, US, and worldwide.  The drug is called Krokodil (which is Russian for crocodile) and it gets its name for the creepy green colored skin you get after injecting it, just like a crocodile's skin, but the side effects don't end there, and it could be a huge public health issue if it spreads all the way to the US.  In 2010, it was estimated that there were 1 million krokodil users in Russia, despite its horrible immediate and long term side effects.

What is Krokodil?
It is actually desomorphine, a form of morphine created using codeine, iodine, and red phosphorous.  Desomorphine is a drug that is used primarily in Switzerland for actual medical uses for anesthesia.  On the streets of Russia, it is made in people's own homes, using household cleaners, and being used like crazy. It is used like a cheaper version of heroin because codeine is sold over the counter in Russia, as are all the other ingredients (gasoline, paint thinner, hydrochloric acid, iodine, and red phosphorous- the red tip to matches), it is easily made, and clearly a large population that want to use it.  When injected, the high only lasts about an hour and a half, feels like that of heroin, and it takes a skilled person about an hour to cook it up, so some krokodil addicts are constantly cooking and injecting; there is an average life span of 2-3 years once starting to use the drug.

What are the side effects?
As I said earlier, at the injection site the skin becomes green and scaly, which is due to the blood vessels dying and the tissues rotting in a form of gangrene, which happens almost immediately.  The skin can rot away exposing the bones, which are porous and are eaten away by the acidity of the drug, so not only does your skin for away but so do your bones, which can occur in any part of the body, not just where you have injected. Rotting skin and bones can lead to painful surgeries and long term dressing changes, along with amputations (the removal of parts of your body- please see the attached link for a realistic view of an amputation outside of the US) .  Due to the harshness of the drug, addicts quickly run out of veins to inject into on their arms and will move to larger veins in the groin and neck sites which can cause almost certain death after even one injection (especially in the neck).  Long term krokodil users have major brain damage which can  cause problems with motor skills, even formulating words and speaking can be a challenge, and very few even survive long enough to get rehabbed from using the drug.  Krokodil use is a certain death sentence due to risk of infection, vein damage, and the damage to brain, kidney, liver and heart from injecting such a toxic drug.

you can clearly see the gangrene, and the flesh that will soon wear away.....

This woman' s gangrene has been treated, but now her bones are exposed, leading to a risk of infection

Fingers lost and dying due to ruptured veins and poor blood flow

The green skin color change....

The drug seems to have swept over Russia quickly, in the last 8 years and has become an epidemic overwhelming the healthcare system with these patients, for amputations, infections, and overdoses.  This is a very dangerous drug, that is clearly highly addictive, cheap and easy to make, and despite the effects addicts seem to want to use this drug.  I just wanted everyone to learn about it and the side effects, the statistic that there is a 2-3 year lifespan after trying the drug scares me silly, and I hope that it would keep some people from trying it.  If you know anyone who is using this drug, or wants to try it, please urge them not to, and call a drug hotline (1-877-243-7408) or go to (for local contacts) for ways to talk to them, places to bring them for help, and try to get them to call.  If you have tried it, please see your HCP and get your body checked out, the effects aren't always visualized as first, but simple blood tests can show the punishment your body has gone through.

So please stay away from Krokodil, and spread the word about how horrible it is...

Yours in Good Health

Thursday, September 8, 2011

Need Another Way to Beat Depression?

Depression affects so many people, and in various different ways.  Some people go and get treatment, others don't, but regardless of what you do, when you are in the throws of depression, you are miserable. You just find it hard to see the positive and the happiness in things, and you feel like you never want to get out of I look out the window now, depression is like today: cold, wet, rainy, and you would do anything to not have to face hibernate in your own world.  But guess what??  For those of you who are undergoing treatment for depression with SSRI's (selective serotonin reuptake inhibitors), that are still clinically depressed, there is some hope for non-medication adjunct therapy!

What are the Symptoms of Clinical Depression?
Feelings of sadness or unhappiness
Unexplained crying
Loss of interest in activities that normally bring you pleasure
Decreased sex drive
Either significant increase in eating gaining weight or not eating and losing weight
Changes in sleep patterns (insomnia or tons of sleeping)
Fatigue, feeling sluggish all the time
Easily distractible, unable to concentrate
Unexplainable aches and pains
Thoughts of death, dying, suicide
*If feeling suicidal, you need immediate treatment and to be brought somewhere safe- call your emergency services (911 in the US) or call a suicide hotline 1-800-SUICIDE (1-800-784-2433). Please get to immediate safety and tell someone how you are feeling.

How is depression treated?
Many times depression is treated using medication therapy, such as an SSRI along with psychotherapy (talking about depression symptoms and how to make changes).  The medications can take weeks to months to getting to a level of your medication that you start to feel better, and less depressed, and it may take many different doses, and sometimes your HCP will add on a second medication to help you see the benefits of treatment sooner.  On average 50% of patients report feeling a difference in 2 months when they take an SSRI and use psychotherapy together.  If a second medication is added, there is another 20% improvement in symptoms, but then there are still medication dosage changes and frequent assessments and possible blood draws (if you need medication levels checked).  Medication therapy along with psychotherapy, has pretty good results.

What's the other option?
There is a new option for people who prefer to take less medication, or prefer only to be on one medication to treat their depression: exercise.  A recent study from the University of Texas Southwest Medical Center showed that a "prescription" for exercise helped to boost moods and decrease depression symptoms.  A large group of patients newly diagnosed with depression who were started on SSRI's within the last two months, but still had symptoms of depression, were either told to exercise by walking or cycling at a slow-ish pace (3 miles per hour) or at a little brisker pace (4 miles per hour), 7 days a week, and reassessed for symptoms.  The results were amazing: after 4 months of being on an antidepressant and exercising briskly, 29.5% of patients achieved remission, as in they were no longer clinically depressed and had no symptoms.  The biggest group that did not see a response to the SSRI and exercise treatment were women with a family history of depression (genetics may or may not play a role).

How can this affect me?
Well, it doesn't mean that you should stop taking antidepressants and start exercising instead, but it is a great option to assist your treatment with depression.  Plus, the best part of this as an adjunct therapy as opposed to adding a second medication?  There are NO bad side effects from exercising and actually it is all benefit: it helps improve your cardiovascular system (decreases blood pressure), helps maintain your weight, can help to stabilize blood sugars, and it's free!  No co-pays for exercise!

While I don't think that this will "fix" everyone's depression, I think that it is a great boost for moods and helps with depression symptoms.  Clearly more studies ned to be performed, but I think it is worth a conversation with your HCP if you are someone who does not like to take a lot of medications or feels the side effects from antidepressants, and you feel like you can make the commitment to exercise 7 days a week, as a part of your therapy.

Yours in Good Health

Wednesday, September 7, 2011

When should I get screened?

There are so many different types of screening for various cancers out there, but it seems like the biggest one that men and women alike seem to fear is colonoscopies. I'm not really sure why!  I mean, I get it, it's an awkward exam, your getting a probe put up your butt into your colon, but you don't even know it's happening, and it can save your, day off of work anyone??  I want to let you know what to expect, how to feel, how to get ready, and most importantly, when to actually get your screening done!

What is a colonoscopy?
A colonoscopy is a screening exam for colon cancer and other abnormalities in the large intestine (colon) and rectum.  A long flexible tube with a camera at the top, is inserted into the rectum and it travels all the way up the colon looking for abnormalities and has the ability to remove small pieces of tissue to biopsy and send for testing.  With the camera, your HCP can see all the way up your large intestine and view all aspects.  It really sounds like not so much fun, but read on it gets better, I promise!!

When should I get screened for colon cancer and polyps?
The golden rule is that you should start getting screened at the age of 50 (per the American Cancer Society) but if you have a strong family history of colon cancer, or a history of any form of cancer, your HCP may request that you start screening earlier.  And from that point, as long as the original colonoscopy is clear, you can follow up and repeat the test every 10 years.

How do I prep?
The day before the exam, you are asked to be on a clear liquid diet; you can drink coffee or tea, but you cannot add milk, and no solid foods!  Also, your HCP might ask you to change your medications.  If you are on any blood thinners (aspirin, coumadin, plavix, etc) you will be asked to stop a few days to a week before the procedure, and also asked not to take ibuprofen for a few days before to decrease the risk of bleeding. Other medications that might be altered are your amounts of insulin (if you are a diabetic)because you cannot eat form midnight the night before the procedure, or any blood pressure medications, as your blood pressure may become low with the medications given to sedate you.  All that being said, the bummer is that you are usually required to drink a bunch of liquid called "Go Lytely" or Magnesium Citrate (AKA the sparkling laxative- which makes me giggle every time I see it!) until when you poop, it is all clear...not the best day of your life, I'll be completely honest with you.

What happens when I get to the hospital/clinic?
You will be registered, you vital signs will be checked, and most often you will have an IV (intravenous line) placed.  You will be asked to remove all clothing and put on a hospital gown, and lay down in a stretcher, which you will stay on for the whole exam.  You should meet with your HCP and an Anesthesiologist before your procedure, and your anesthesiologist will give you medications to relax you before you go into the procedure and most likely you won't even remember going in to the procedure, coming out, or getting home until you are there!  The medications have amnesic effects, so you will talk and seem awake, but you won't remember any of it, and you won't feel a thing.  And the best part?  After the 20 minute procedure, you are free and clear to go back and eat whatever you want, and once your designated person drive you home, you get a day to chill out, relax, and recover! So really not a bad day at all.....

Are there risks?
As with any procedure, there are certain risks, but your HCP will do everything to minimize it that they can.  Some of the risks are:  a reaction to the sedative medication, some small amounts of bleeding from any biopsies taken, and finally a tear or small perforation of the colon from the scope.  These complications are very rare, and it is a very safe screening procedure.

So, I know the procedure itself and the prep doesn't sound like a total blast, and I hear you, but as far as a cancer screening goes, it's a pretty good deal, right?  A day off of work to recover, and no memory of anything uncomfortable or could be worse!  So talk to your HCP about when you should get screened, and be sure that you follow-up and continue your primary and preventative care.  But remember, a colonoscopy is nothing to be afraid of!!

Yours in Good Health

Thursday, September 1, 2011


So many people suffer from late season allergies, and there are some obvious ways to treat them: by taking over the counter antihistamines, such as benadryl, Zyrtec, Claritin, etc OR by using some alternative treatments. There is one alternative treatment that people SWEAR by and claim to get rid of their allergies altogether.  The main one?  Neti pots.  I really cannot go anywhere without hearing about them and how amazing they are, so i finally decided to look into the science behind it and the theories surrounding why they work so well.

How to they work?
It is a nasal irrigation, you mix lukewarm water with usually a mixture of sodium bicarbonate, so that the solution is pH balanced and doesn't irritate your nasal canals, fill the pot, and bend your head to the side and pour the contents of the pot (using gravity as a guide) into one nasal passage, and it comes out the other!  The theory is that it clears out the nasal passages and decreases your allergic reactions.

Is there any science behind Neti pots?
There have actually been a few pretty decent studies around the use of neti pots. Most of them support the use of neti pots because they decrease antibiotic days overall for people who get frequent sinus infections. As well, patients report less discomfort from seasonal allergies and decreased amounts of hay fever reaction and sinus infections.  Many HCPs suggest the use of neti pots to patients that have severe hay fever or chronic sinus infections.  One rather large study did find that chronic use of neti pots actually increased the rates of sinus infections, so they are suggested to be used to treat seasonal allergies or for use to treat symptoms of a sinus infection but you should not use them chronically, only when you have symptoms that you want to clear.

Despite the research being a little contradictory, the outcome is the same: neti pots do decrease symptoms related to sinus infections and nasal reactions to seasonal allergies.  Just like anything else, don't overdo it, and only treat the symptoms you want to clear.  As well, make sure that you clean your neti pots, I can only imagine that if you are sticking something up your nose, that has allergens or bacteria on/in it, and then putting it up your other nasal passage, then using the same pot later; I fear there would be cross contamination. So, keep it clean, and for those of you who love to neti pot, keep on neti'ing but use some restraint!

Yours in Good Health