You can't touch this

Some modern medical tests use radioactity to trace blood flow during a stress test, thyroid activity, etc. This leaves the patient mildly radioactive for 1-3 days depending on the test or procedure. Under such occasions the doctor will give the patient a card attesting that they have had a medical procedure involving a small amount of radioactive material. Don't lose this card!
You may set off alarms in the airport. Or be stopped at check points to prisons or military bases. Recently a firefighter in Connecticut was pulled over by a policeman after he set off a radioactivity detector in the state police car. The fireman was impressed,  "I had no idea the police even had devices like that." He showed his medical card to the police officer and was allowed to go instead of being held as a suspected terrorist.

Will using expired drugs kill you?

Earlier this month, Cecil at StraightDope.com addressed the question, "Will using expired drugs kill you?" The answer was mostly no.

We have to tread carefully here, ... A few drugs don’t age well — for example, nitroglycerin and insulin. But they’re the exception. Most drugs retain their potency for years after they supposedly expire.

In 1978 the FDA started requiring drug companies to place expiration dates on drugs. But no testing was done. Many picked a one year expiration in the hopes that you would throw away old medicine and buy it again.

No everyone liked this. The Pentagon had $1 billion of stockpiled drugs that it didn’t feel like throwing out so it asked for FDA testing in the mid-80's in a program called Shelf Life Extension. The results?

* one year AFTER expiration, every drug tested was still OK
* 88 percent of the drugs were safe and effective five years after expired

Bottom Line

The Consumer Reports recommends throwing out any drug more than a year past its expiration date. So expiration plus one year with a few exceptions:

* epinephrine, used to treat cardiac arrest, steadily loses its potency over time
* Liquid drugs and suspensions are less stable than solids
* Medications custom-made by your local pharmacy are likely to have a short shelf life
* nitroglycerin
* insulin

If you have not used up a medicine before one year past expiration, did you really need it?

P.S. Please don't dump old medicine in a toilet. Did you know that some public drinking water tests positive for common medications?

Side Effects

“America is the country where you buy a lifetime supply of aspirin for one dollar and use it up in two weeks”
-John Barrymore

All medicines can cause side effects. And sometimes one medicine is prescribed over another because of the side effects. For example, I recently saw a doctor about back pain and she recommended an odd (to me) schedule of medicine. Advil at breakfast, Tylenol at lunch, Advil at dinner, and Tylenol before sleeping. Why the two different pain killers I asked? She explained:

Advil and similar Ibuprofen products can upset the stomach, and according to Drugs.com, cause constipation, diarrhea, dizziness, gas, headache, heartburn, and nausea. Since I have GERD (acid reflux) I have to go easy on the Advil.

Tylenol is easy on the stomach but there are strict limits on its usage. This is not a drug you want to overdose on, it can be fatal. USA Today reports a study that claims even small overdoses of Tylenol repeated over time can damage the liver.  Many people I know will take extra aspirin or Ibuprofen when the regular dosage did not kill the pain. But few are aware that they should NEVER exceed the recommended dosage Tylenol, no matter how bad the pain is.

Bottom Line

Never just assume that if a little medicine is good than more must be better. Always check with a doctor if the recommended dose is not doing the job you want.

Body Hacking

“And computers are getting smarter all the time: scientists tell us that soon they will be able to talk to us. (By they I mean computers: I doubt scientists will ever be able to talk to us.)”
-Dave Barry

Scary story of the day:

Black Hat researcher shows it is possible to remotely control a diabetic's insulin pump without person's knowledge

Bottom Line

Technology is wonderful but most inventors and companines fail to take security seriously. Hackers can turn off pace markers and most any other medical device that responds to remote signals. If your life depends on technology, ask your doctor about the risks of hacking or even "Noise" or magnetic fields disabling your device.

Chicken Pox

“When the itch is inside the boot, scratching outside provides little consolation”
-Chinese Proverbs

"Rachel got poison ivy on her brain. The only way she can scratch it is to think about sandpaper."
-Steven Wright

The Centers for Disease Control and Prevention (CDC) has some good news about chickenpox. Since the government first recommended the new pox vaccine for all children starting in 1995, deaths from chickenpox have fallen from 105 in 1990 to just 14 in 2007. Almost all the deaths were adults who suffered complications like skin infections, swelling of the brain and pneumonia. Severe cases are more common among teens and adults who get it for the first time late in life.

About 8 to 9 of every 10 people who are vaccinated are completely protected from chickenpox. In addition, the vaccine almost always prevents against severe disease. If a vaccinated person does get chickenpox, it is usually a very mild case lasting only a few days and involving fewer skin lesions (usually less than 50), mild or no fever, and few other symptoms.

"The disease is spread by coughing and sneezing (highly contagious), by direct contact, and by aerosolization of virus from skin lesions." Aerosolization? Sounds like the virus can leap off the skin and become airborne. I wonder if the pox pustuals rupture like a burst pimple?  My only exposure to chickenpox was at age 8 so my memory of the disease is patchy (but I do remember the itching and still bear a scare from one pox bump I scratched too much).

Bottom Line

All children and adults without evidence of immunity to varicella need the vaccine. Evidence of immunity includes any of the following:

• Documentation of two doses of varicella vaccine
• Blood tests that show you are immune to varicella or laboratory confirmation of prior disease
• Born in the United States before 1980, excluding health-care workers, pregnant women, and immunocompromised persons.  These individuals need to meet one of the other criteria for evidence of immunity.  
• Receipt from a healthcare provider of a) a diagnosis of chickenpox or b) verification of a history of chickenpox
• Receipt from a healthcare provider of a) a diagnosis of herpes zoster (shingles), or b) verification of a history of herpes zoster (shingles).

You do NOT need the chickenpox vaccine, if you meet any of the above criteria for evidence of immunity.

Medical Myths

“Fire, water and government know nothing of mercy.”
- unknown

I just started a new lecture series on CD titled, Medical Myths, Lies, and Half Truths: What We Think We Know May Be Hurting Us. So far I've enjoyed the first disc. Much better than the prior series on the Dead Sea Scrolls which used a lot of words to say very little.

Amusingly the first topic on the Medical Myths was hiccups which I discussed two days ago in this blog. Dr. Novella dismisses all the folk remidies and says medical research only endorses three drugs and direct neural stimulation or blocking for serious cases of hiccups which won't stop.

His second lecture covers hydration - do we really need to drink 8 cups of water a day? No. An old government guideline recommended 64-80 oz of water a day. But 20% of this will come from the food you eat. This leaves 6 1/2 cups which most people will drink normally.

Does coffee and caffinated sodas count as water? Many say no, but the professor says yes. The caffine will cause more peeing but not enough to cancel out all the water in the beverage. So perhaps it can count as 80% of a cup?

Another tidbit. The higher the elevation, the drier the air. At 6000 ft you exhale twice as much moisture as normal. At 10,000 ft, three times as much. This explains why people who fly experience thirst and why dehyration is serious for hikers and climbers in the mountains.

Bottom Line

For more information see my earlier blog:
http://perpetualpreparedness.blogspot.com/2008/08/how-much-water-is-enough.html

Potassium Iodide

"Primum non nocerum. (First do no harm)"
— attributed to Hippocrates

With Nuclear radiation leaks in Japan, bottles of Potassium Iodide have flown off the shelves of stores around the world. Recently a friend recommended that I encourage others to buy Potassium iodide. I disagreed.

In the late 70's under President Ford, Swine Flu first became a public concern and there was a push to have everyone inoculated against it. However the 1970's swine flu shot caused serious allergic reactions in rare cases. It turned out more people died from the shot than from that occurrence of Swine flu. [This is not the case today where the shot is safer and the flu deadlier.]

Potassium Iodide is similar. Yes its benefits are amazing under certain conditions. But it has side effects and can be dangerous to infants and the elderly.

Let's start with why take Potassium Iodide and what does it do?

Dangerous levels of radiation drop off quickly with distance from the accident. In Tokyo the exposure after 36 hours was equal to eating one banana (banana are high in potassium.) We get radiation all the time from the sky, from granite, from medical X-rays, etc. Fortunately, humans can tolerate a lot of low level radiation spread evenly throughout the body. But radioactive Iodine is different - it is not spread out evenly but concentrates in one spot.

The human Thyroid collects and hoards all Iodine that enters the body. If that Iodine is radioactive, it can kill the thyroid or cause thyroid cancer. [In America the cure for hyper-thyroidism is a large does of radioactive Iodine in a pill to kill the thyroid. The patient then lives on an artificial hormone to replace the thyroid secretions.] Often in the years after nuclear accidents, the only cancer to spike or become epidemic is Thyroid cancer. 

A Potassium Iodide pill blocks radioactive Iodine for 24 hours. The pill must be taken BEFORE radiation exposure to fill up the Thyroid so it has no room to absorb the bad Iodine, allowing the bad Iodine to be excreted from the body. It is VERY effective at preventing Thyroid cancer if taken immediately.

So why not pop a Potassium Iodide pill every day, just in case? The pill also shuts the Thyroid down temporarily. In the very young (under one month) this can affect brain development. Potassium Iodide can reach infants in the womb and newborns through mother's milk.

Adults can be affected in two ways. First - unlikely but serious side effects include: burning mouth/throat, sore teeth/gums, swelling inside the mouth, increased saliva, eye irritation/swollen eyelids, severe headache, swelling of the front of the neck/throat (goiter), confusion, numbness/tingling/pain/weakness of the hands/feet. Rare but very serious side effects include: chest pain, black stools, vomit that looks like coffee grounds, bloody diarrhea.

Second - a Potassium Iodide pill is good for 24 hours and is only meant to be taken once (or at most a few days if advised by emergency authorities). It's a buffer of protection as you evacuate a contaminated area. It is not meant for long term protection. When used repeatedly signs of decreased thyroid gland function include weight gain, cold intolerance, slow/irregular heartbeat, constipation, and unusual tiredness.

Bottom Line

While Potassium Iodide (KI) is very useful when properly used I have many objections to recommending that everyone buy it.

1. The news media is terrible at reporting radiation and loves to scare the public with stories like, "Radiation found in Milk in Massachusetts." This causes panic and results in people taking the KI pills when the risks of the pills outweigh the risks of radiation. You should only take the pills when public health authorities (not the media) recommend it.

2 The pill only works prior to exposure and is dangerous if used long term.

3. The dosage of KI is age dependent. Read the bottle carefully. Taking extra dosage does NOT help and can be dangerous. Adults older than 40 years should not take KI unless public health or emergency management officials say that contamination with a very large dose of radioactive iodine is expected.

4. Ask your doctor before buying to see if you or a family member has a condition that puts you in danger from Potassium Iodide. Also talk to a doctor if you are pregnant or nursing.

5. Lastly - KI is not 100% protection from radiation. It protects only the Thyroid and does nothing for high levels of ration which destroy the entire body. It protect only against radioactive Iodine found in Nuclear accidents. It does not against alpha/beta/gamma radiation of dirty bombs, or nuclear explosions.

If you live near (say 100 miles as the wind blows) a Nuclear Plant, AND you understand the risks of Potassium Iodide AND when to use it, then buy a bottle. Otherwise don't.

Resources:
http://emergency.cdc.gov/radiation/ki.asp
http://pediatrics.about.com/b/2011/03/16/potassium-iodide-pills.htm
http://blogs.webmd.com/breaking-news/2011/03/potassium-iodide-pills-can-they-protect-you-from-radiation-exposure.html
http://en.wikipedia.org/wiki/Potassium_iodide

Mystery Medication

“I was under medication when I made the decision not to burn the tapes.” - Richard M. Nixon

A year ago my wife looked inside a pill bottle and noticed that one of the pills didn't belong. It was a different shape and color and size. There was no way she was going to swallow a mystery pill. Instead we brought it back to the pharmacy to point out an error in their quality control.

If you encounter an unknown pill and want to discover what it is, the National Institute of Health has a Beta website with pills organized by color, shape, etc. http://pillbox.nlm.nih.gov/

Bottom Line

I'm not sure exactly why this website exists (except for pharmacists). What person is going to say, "Hey, I found this cool looking pill on the sidewalk? I think I'll research what it is and then swallow it."

Perhaps it's useful if you find an unlabeled bottle in your medicine cabinet? Or pills that your child/spouse is hiding?

Zinc for Colds?

“A family is a unit composed not only of children but of men, women, an occasional animal, and the common cold”-Ogden Nash

According to the Archives of Otolaryngology (try saying that 3 times fast) a recent clinical trial has found that zinc nasal gels and sprays were ineffective in preventing or reducing the duration of the common cold. Moreover zinc applied to the nasal cavity can lead to a loss of smell, possibly permanent.

An earlier study that showed that zinc therapies reduce the severity of a cold was funded by the makers of the medicine used in the study. So perhaps there was a bit of bias?

It's important to know that homeopathic products that treat less serious illness, such as the common cold, can be sold over the counter and are exempt from "the rigorous premarket approval process" of the FDA.

Bottom Line

Be very careful of any "herbal medicine" or homeopathic drug sold over the counter. See my blog from last year about Dangerous Diet Pills.

Deep-vein thrombosis

"Just as the body cannot exist without blood, so the soul needs the matchless and pure strength of faith"- Mahatma Gandhi

Today we reach the final item on Women’s Health Magazine’s list of Seven Warning Signs not to ignore.

Your calf is extremely tender in one location, noticeably swollen, and red or warm to the touch.

You might have deep-vein thrombosis, or DVT, also known as a blood clot. I know two people who have died of blood clots. One, the father of a friend, died of a clot a week after surgery. The other had a leaky heart condition and a clot traveled to her brain. Nowadays I notice that hospitals put leg pumps on patients to prevent clots while recovering.

Anytime blood starts to pool in your lower body and there is a risk of forming a clot. It could be hours sitting at a computer, on a long flight or in a hospital bed. I try to keep my feet at least slightly elevated when sitting – and it helps to stand up and walk around.

When a clot gets big enough to act as a stopper in the vein or artery, the area around it will start to hurt and swell. Smokers and women who take the Pill have a higher risk of developing clots.

If you suspect a clot, resist the urge to massage the area or to walk it off. If the clot breaks free, it can travel through to your lungs and cut off your oxygen supply or to your brain and cut off blood flow there.

Bottom Line

See your doctor, who will do a CT scan or ultrasound to look for DVT. If you have a clot, you'll need to take blood thinners--sometimes for up to a year--to dissolve it.

Back Pain

"Low back pain is common and affects people of all ages. It is second only to the common cold as the most common affliction of mankind, and it is among the leading complaints bringing patients to physicians’ offices."-Cleveland Clinic Journal of Medicine

The sixth of the seven Warning Signs from Women's Health magazine is back pain with tingling toes. This sign I can personally relate to.

As a computer progamer I sit for hours at my PC with less than perfect posture. Some 15 years ago I began experiencing awful back pain. It got worse and worse but I did nothing about it. Then one day it went away. Hurray, I thought. Not long thereafter a stange, new experience began - a shooting pain down my leg that became worse over time. I had no clue what this meant until a friend of my wife gave it a name, Sciatica. My first visit to the doctor was odd - I was in so much pain that it hurt to sit and was easier for me to lie on the floor. The prescription was an x-ray, take some asprin, and rest. Nothing to worry about - until the x-ray results came back. Then the doctor was seriously worried.

A cartiledge disk in my lower back had ruptured. The original pain was the disk being squeezed, then relief when it popped, and new pain as the protruding disk began pushing on my spinal column. A Neuralogist tapped my knees and toes to see if there was any nerve damage (no thankfully) and I was scheduled for surgury within days. There was great concern that the protrusion would bruise or damange my spinal column causing paralysis from the waist down.

The operation was simple with a scar only a few inches long and I was sent home early morning after an overnight stay on some powerful pain medications. The recover took six weeks before I was allowed to drive or go back to work. Physical therapy lasted many months to rebuild the back muscle and strengthen other muscles.

Bottom Line

If I had gone to a doctor earlier, during the back pain stage, I could have avoided later pain and surgery by early application of steroids and physical therapy. I was lucky that the surgery was successful. Sometimes it is not and the pain remains.

Chest Pain

"Heart attacks - God's revenge for eating his little animal friends"

According to Women's Health Magazine, the fourth Warning Sign that should not be ignored is passing chest pain. Now I could have sworn I had already written about heart attacks but could not find it in my blog. So here goes.

While the heart is a powerful muscle, it has NO pain nerves. There is no direct feedback that something is seriously wrong (other than the classic instant death heart attack). Most heart attacks start slowly, with mild pain or discomfort. People affected aren't sure what's wrong and wait too long before getting help.

We need to recognize a heart attack though its secondary side effects within the first 5 minutes!

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath. May occur with or without chest discomfort.

Other signs: These may include breaking out in a cold sweat, nausea or light headedness

Bottom Line

If you experience the symptoms above call 9-1-1. Even if you're not sure, call 9-1-1. An EMT can begin treatment when they arrive — up to an hour sooner than driving yourself to a hospital. Your doctor will do an EKG to determine whether your heart has been damaged, and then decide on the best response; false alarm, prescribe clot-attacking drugs, or perform surgery to clear your arteries.

Resources

http://www.americanheart.org/presenter.jhtml?identifier=4595

http://www.healthcentral.com/heart-disease/patient-guide-44510-6.html

http://www.nhlbi.nih.gov/actintime/haws/women.htm

Thyroid

"If you believe the doctors, nothing is wholesome; if you believe the theologians, nothing is innocent; if you believe the military, nothing is safe"-Richard Cecil

I interrupt my series on the 7 Warning signs to look at a body part I know little about, the thyroid. What is it? What does it do? My wife is having her Thyroid examined so this is a good time for me to learn more about this mystery gland.

It's estimated that 59 million Americans have a thyroid problem, but most don't know it. The thyroid is a butterfly-shaped gland located just below the Adam’s apple in the neck that produces hormones that speed up or slow down your body’s metabolism. It can affect weight gain, mental mood, energy level, hair growth, skin town, muscles & joints, bowels, menstruation, and more. There are two common problems:
Hypothyroidism – the thyroid does not secrete enough hormones
Hyperthyroidism - the thyroid secretes too much

Symptoms

1. Muscle & Joint Pain with a weakness for Carpal Tunnel
2. Neck Discomfort and Enlargement, Hoarse Voice, Goiter
3. Oddly both hypo and hyper thyroidism can lead to hair loss.
4. Hypothyroidism thickens the skin; hyperthyroidism thins the skin and makes it fragile.
5. Bowels: Hypo->Constipation; Hyper->Irritable Bowel Syndrome (IBS)
6. Fertility: Hypo->heavy or frequent periods; Hyper->light or infrequent periods
7. Cholesterol: High with Hypo; Low with Hyper
8. Blood pressure: hyperthyroidism can speed up the heart and raise blood pressure
9. Mood: Hypo->Depression; Hyper->Anxiety
10. Weight: Hypo->Gain; Hyper->Lose
11. Sleep: Both extremes can leave you fatigued. Hyper can cause insomnia.
12. Body Temperature: Hypo->sensitive to cold; Hyper->sensitive to heat
13. Eyes: Hypo->puffiness around the eyes, Hyper->bulging or “bug” eyes

As I read more about the thyroid I see that it is not the “master regulator” as some sites claim. It is the factory that produces regulating chemicals but the role of regulator goes to the pituitary gland, a small gland at the base of the brain that monitors hormones in the blood and instructs the thyroid to produce more or less. So thyroid problems could be the fault of bad instructions from the pituitary or by a rebellious thyroid ignoring the instructions. There is also Grave’s disease where the thyroid is attacked by antibodies and overproduces in response.

EMedicineHealth.com describes pregnancy masking thyroid problems that is worth reading if applicable to you.

Bottom Line

What can be done for thyroid problems?

1. Medicine – you can take artificial hormones if under producing or thyroid blockers if over producing.

2. For Hyperthyroidism that does not respond to medicine, one option is killing part or the entire thyroid to reduce/stop hormone production through surgical removal or poisoning with radioactive iodine (the thyroid loves iodine and soaks it up).

Resources
http://www.emedicinehealth.com/thyroid_problems/article_em.htm
http://thyroid.about.com/cs/basics_starthere/a/10signs.htm

Sharp pain in your side

"If people let government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny."-Thomas Jefferson

Let’s continue with the 7 Warning Signs You Should Not Ignore by Women’s Health magazine. Warning sign number three is a side stitch, a piercing stab, which intensifies over a few hours or days. It could be gas. It could be a pulled muscle. Or it could be something dangerous.

If it feels like your right side is skewered and you're nauseated and running a fever, you could have appendicitis. I covered appendicitis a year ago in this blog, Appendicitis.

Another possibility (for women) is an ovarian cyst. Typically these fluid-filled sacs are harmless and disappear on their own. But if one twists or ruptures, it can cause terrible pain and damage the ovary.

Bottom Line

In both cases above, you need emergency surgery immediately. A burst appendix is fatal unless treated. An twisted ovarian cyst can block bloodflow to the ovary, killing it within hours. If that happens, the doctor will need to cut out the entire ovary (and the eggs inside) along with the cyst.

Abscess

"Love conquers all things except poverty and toothache."-Mae West

Today I look at the second topic from 7 WARNING SIGNS YOU SHOULD NOT IGNORE. Prior to the invention of antibiotics, infections were the main cause of human death (now the leading killers are Heart Attacks and Cancer). There are obvious infections from cuts or bites but there is also a type of deadly infection that is not so obvious (except for the pain). This is the common tooth cavity.

Bad teeth have plagued man since the dawn of time. A study of 3,000 Egyptian mummies concluded that 18% of all mummies had a nightmare array of dental diseases. Just like a cut in the skin, a hole or crack in a tooth allows outside bacteria inside the body where it can grow and spread. Sadly for us, a tooth is a lovely place for bacteria to grow. The narrow opening in teeth roots is too small for white blood cells to enter inside the tooth and wage war. So bacteria can grow unchecked until it pushes out of the tooth into the surrounding gum tissue and jawbone. At this point the cavity becomes an abscess.

The infection from a tooth abscess can spread to the brain and kill or spread to the throat, swelling it and making breathing difficult.

Have a dentist examine any persistent toothache. If you cannot see a dentist immediately, here are some steps you can try for tooth pain before your dental appointment:

· Bite down on a tea bag (wet or dry) for a few hours
· Mix salt and baking soda, dip a wet cotton ball in this mixture, and position the cotton between your cheek and tooth for a few hours. Hydrogen peroxide is known to reduce toothache.
· Use hydrogen peroxide 1.5% as a mouthwash.
· Gargle in your mouth with tea tree oil mixed with water.
· Gargle in your mouth with salt water.
· Apply drops of clove oil or vanilla extract to the infected tooth.

Bottom Line

Just because your tooth stops hurting does not mean the problem is gone. It could mean that the bacteria has reached the root of the tooth and killed the nerve. The next step is an abscess and danger. You’ll be pain free until the infection is deeply rooted in the gum or jaw or brain and much more difficult to fix.

See a dentist; don’t risk your life with a tooth infection.

"It is outrageous today that in America, a young boy can die because his family can't find a dentist to remove an infected tooth," – actual event in Maryland in 2007

Asthma

"Asthma doesn't seem to bother me any more unless I'm around cigars or dogs. The thing that would bother me most would be a dog smoking a cigar."-Steve Allen

While researching first aid stations for a Cub Scout activity, I realized that I know very little about Asthma and how to respond. After looking at a dozen medical websites I still know very little about what to do. The sites describe Asthma, its symptoms, its triggers, its medical treatment, but very little about instructions for Asthma attacks. The usual language is “See your doctor for an Asthma Action Plan.” Very little advice for Scout Leaders with an Asthmatic hiker.

So what have I learned? During the asthma attack, the lining of the airways and lungs become swollen or inflamed and thicker mucus -- more than normal -- is produced. This causes coughing, wheezing, and chest tightness as breathing becomes more difficult and less effective. Symptoms include:

· Severe wheezing when breathing both in and out
· Coughing that won't stop
· Chest pain or pressure
· Tightened neck and chest muscles, called retractions
· Difficulty talking
· Very rapid breathing

[DANGER signs, call 911]

· Extreme difficulty breathing
· Rapid pulse
· Pale, sweaty face
· Blue lips or fingernails
· Anxiety or panic over inability to breathe
· Severe drowsiness or confusion

With mild asthma attacks the airways open up within a few minutes to a few hours after treatment. Severe asthma attacks are less common but last longer and require immediate medical help. If a mild attack is not treated and becomes severe, the lungs may tighten so much that there is not enough air movement to produce wheezing. This is called a "silent chest,"; it is a dangerous sign and requires immediate medical attention before the victim dies from lack of air. Unfortunately, some people interpret the disappearance of wheezing as a sign of improvement and fail to get prompt emergency care.

Asthma attacks can be triggered by cold-air, too much exercise, stress, pet dander, dust, mold, pollen, and tobacco & wood smoke. Asthma cannot be cured but you can keep the body health and strong, avoid the asthma triggers, and follow a two pronged medical regimen.

1. Long Term Medications to reduce the likelihood of attacks. These include corticosteroids, bronchodilators, Leukotriene inhibitors, and others.

2. Emergency Medications used during an attack.
a. Short-acting bronchodilators (inhalers)
b. Corticosteroids injected directly into a vein during a severe attacks

Asthma suffers can monitor their state of health with a breathing apparatus that measures “Peak Flow” of how much air they can take in. There is a Green Zone of 80-100% flow, a Yellow caution zone of 50-80% and a Red danger zone of 50% Peak Flow capacity.

Bottom Line

What can I do to help during an Asthma attack?

- If feasible, move them out of a trigger area (away from smoke, cold air, pet dander)
- Sit the person comfortably upright – do NOT have them lie down.
- Stay calm and soothe the victim. This may help him or her relax and breathe more easily.
- Have the victim use their inhaler as instructed by their doctor
- Coach the person to breathe steadily with pursed lips (puckered or "fish" lips), especially on the exhale. Breathe with the person, helping them focus on you.
- If the victim has no inhaler or no history of Asthma before, call 911.
- If the inhaler is not helping, call 911
- If the victim passes out, begin rescue breaths and, if necessary, CPR.

- Asthma attacks are NOT “cured” by drinking large amounts of liquids
- Non-prescription medicines such as antihistamines or cold remedies apparently have no effect in controlling asthma.

Asthma Resources

http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_actplan.pdf

http://www.webmd.com/asthma/

https://health.google.com/health/ref/Asthma

http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_Treatments.html

http://www.mayoclinic.com/health/asthma/DS00021/DSECTION=when-to-seek-medical-advice

http://www.cdc.gov/asthma/faqs.htm

First Aid

http://www.nationalasthma.org.au/content/view/281/572/

http://www.firstaidtopics.com/asthma-attack/

http://www.ehow.com/how_7912_treat-asthma-attacks.html

It's your data

"God heals and the doctor takes the fee" - Benjamin Franklin

CNN has a must-read story "Patients demand: 'Give us our damned data'". It describes how individuals suffer while hospitals dither or refuse to transfer patient data to another hospital.

CNN recommends these tips.

1. Know your rights
   The federal Health Insurance Portability and Accountability Act, gives hospitals and doctors 30 days to respond to a request for medical records, although some state laws provide for a shorter time frame. In urgent situations, such as a transfer to another hospital, it's customary for hospitals to move more quickly.
2. Be prepared to make your request in writing.
3. Confirm that the hospital receives your request.
4. If you have a choice, select a medical provider who uses electronic medical records. These can be emailed to you or accessed via a secure web site.
5. Get the new hospital or doctor to help you by having them make the request.
6. Remember the limits of the law
   Your doctor doesn't have to give you access to to information he or she thinks might cause you or someone else substantial harm. Some states allow even more information to be kept from a patient. For example, the New York Department of Health Web site says doctors may deny you access to "personal notes and observations" they've made in your record.
7. Get angry - be firm, don't accept no.
   You may need to bring in an attorney.
8. File a complaint with the Office of Civil Rights at the U.S. Department of Health and Human Services.

Bottom Line

It's your data. You paid for it.

Gastroesophageal Reflux Disease (GERD)

"They had me on the operating table all day. They looked into my stomach, my gall bladder, they examined everything inside of me. Know what they decided? I need glasses."-Joe E. Lewis

I am amazed at the number of people I know (including a baby) who take Nexium or Prilosec for Gastroesophageal Reflux Disease (GERD). I have the misfortune of inheriting this from my mother and the past few days have been really bad.

What is GERD? When you eat, millions of tiny pumps in your stomach produce the acid that helps you digest food. The stomach walls are protected against this acid but for some people the acid leaks upwards into esophagus because the valve (the lower esophageal sphincter, or LES) does not close as tightly as it should. This Acid reflux damages the delicate lining of esophagus (food tube) esophagus, causing heartburn, a burning pain in the center of the chest.

Now heartburn in itself is not uncommon or a cause for worry. But for people with Acid reflux disease or GERD, the reflux is frequent; 2 or more days every week despite popping antacid pills and Pepto-Bismol. Over time acid reflux can scar the esophagus and may cause throat cancer. Only a doctor can see if you have damage in your esophagus. You can’t tell solely by how you feel.

The most common symptoms of GERD are heartburn, a sour or bitter taste, and difficulty swallowing. Other symptoms include persistent cough, hoarseness, burning in the throat, upset stomach, regurgitation of foods, and waking up from heartburn attacks.

An estimated 5 to 7 percent of the population experience heartburn daily due to GERD and an estimated 19.8 percent of the population experience heartburn or acid regurgitation weekly due to GERD, according to the International Foundation for Functional Gastrointestinal Disorders (IFFGD). In 2004 more than 60 million prescriptions for GERD were filled at retail pharmacies, representing 48 percent of all prescriptions for digestive system disorders.

Why is GERD so common? Perhaps it is the food we eat.

• Fatty foods and Fried foods: High-fat foods tend to relax the LES muscle allowing acid to escape the stomach. Fatty foods also digest more slowly; leaving food and acid in the stomach much longer. Chocolate is high in fat and is trigger for some people.


• Acidic Foods: these increase the acid level of the stomach
  Tomato-based foods (eg, pizza, pasta sauce, salsa)
  Citrus fruits and juices
  Onions: these foods increase the acidity of the stomach


• Irritants: these irritate the stomach walls
  Mint & Peppermint: long thought to aid in digestion, but bad for GERD
  Spicy foods
  Garlic
  Caffeine in coffees, teas, sodas, and even hot chocolate. Even decaffeinated coffee can aggravate heartburn with some people.


• Alcoholic drinks: is a triple danger. It can irritate the stomach lining, increase acid production AND relax the LES muscle.


• Certain medications – such as sedatives, tranquilizers and calcium channel blockers (medication to treat high blood pressure) – may contribute to reflux. Recent research also indicates that taking a certain type of sleeping pills may also increase the risk of developing nighttime heartburn.

There are lifestyle factors other than food that can make acid reflux worse, including

• Being overweight


• Smoking


• Stress


• Overeating (eating too much at one time)


• Wearing tight clothing that puts pressure on your stomach

Bottom Line. Living with GERD:

• Antacids work by neutralizing stomach acid. They can provide fast short-term relief from occasional heartburn.


• H2 blockers reduce acid production in the stomach by blocking a signal that leads to acid secretion.


• Proton pump inhibitors (PPIs) turn off some of the "acid pumps" in the stomach's acid-producing cells. Nexium is prescription only but its predecessor, Prilosec and generics of Prilosec can now purchased at drug stores.
  
• Identify your trigger foods. Try eating them in isolation – tomatoes or OJ but not both in the same meal.


• Eat your last evening meal or snack at least 3 hours before bedtime. Most of the food in your stomach is digested within 3 hours. Once food is digested, it cannot back up into your esophagus when you lie down


• Have smaller meals. Eating large meals creates pressure in your stomach. This pressure can force acid from the stomach into your esophagus, causing heartburn or other acid reflux disease symptoms


• Breathe better. Concentrate on breathing deeply from your abdomen, not your chest


• Stretch and relax. Stand up and stretch each of your muscle groups. Focus on releasing the tension in every part of your body


• Exercise and enjoy. Staying active can help you feel much better


• Have fun. Try to do things that make you smile and laugh. This can relieve stress


• Elevate the head of your bed. Nighttime heartburn is largely a gravity problem; when you lie down, acid can move up into the esophagus more easily. Try elevating the head of your bed 4 to 6 inches by placing wooden blocks under the bed's legs. Or you could place a foam wedge under the mattress to lift your head about 6 to 10 inches. Note: Piling up pillows behind your head doesn't help prevent reflux.

Resources

Nexium Resources

YourTotalHealth

National Health Institute paper on GERD

Eczema

“When the itch is inside the boot, scratching outside provides little consolation”-Chinese Proverb

I suppose, as one gets older, it’s only natural to experience new diseases and conditions. For myself, the newest experience is Eczema, also called dermatitis, a dry skin condition that can result in recurring rashes, itching, flaking, etc. Apparently scratching can lead to permanent scarring.

Eczema covers a wide range of dry, red skin situations and is perhaps over used as the diagnoses of skin rashes. My case could be Contact dermatitis – perhaps our cat rubbed against something that then rubbed onto me, or Xerotic eczema – a dry skin that worsens in dry winter weather affecting mostly arms and legs, or Discoid eczema – rounds spots of dry rash on the lower legs in winter weather.

Sadly, there is no “cure” for dermatitis. It is often treated with corticosteroids which suppress the symptoms but it never goes away completely. If the condition is extreme with skin cracks, the normal protective barrier of the skin is disrupted which allows easy entry for bacteria. Scratching can introduce infection and spread it about which just makes the eczema flare up more, causing more cracks, more scratching, more infection in a nasty deteriorating spiral. If this occurs a doctor should perscribe an antibiotic and an anti-itch drug like antihistamine.

The best way to avoid or limit eczema is to prevent dry skin. My dermatologist asked if I used skin creams. No, I said. Well you will from now on, he replied. Here are some skin care recommendations:

1. Soap removes oil and will dry out skin. When showering, use a moisturizing body wash on dry areas like arms & legs instead of soap.
2. Don’t use a washcloth, sponge or loofah on the dry area. These will abrade the skin.
3. Pat the dermatitis area dry, never rub it dry with a towel.
4. Apply skin creams (emollients) twice daily. Look for a heavy cream that is recommended for eczema. Light creams may be too weak to be effective.
5. Use the skin cream within 3 mintues after taking a bath/shower to trap in the moisture.
6. There is a disagreement whether baths are desirable or a necessary evil. For example, the Mayo Clinic advises against daily baths to avoid skin drying. while the American Academy of Dermatology claims "it is a common misconception that bathing dries the skin and should be kept to a bare minimum" and recommends bathing to hydrate skin.
7. Hard water is harsh on the skin. Try using a water softener.
8. Avoid scratchy materials like wool.
9. Avoid environmental factors that trigger allergies (for example, pollen, mold, dust mites, and animal dander) [Right, shall I live in a bubble?]
10. My dermatologist said I should avoid long, hot showers. [Rats, that’s one of my favorite parts of the day]

Bottom Line

The exact cause of eczema is not known. Although it is activated by the immune system and is related to allergic reactions, it is not the same as other allergic reactions. According to the National Institute of Allergy and Infectious Disease, the prevalence of atopic eczema is increasing and affects 9 to 30% of the U.S. population [20% of children and 2% of adults]. For some, the disease will improve with time. For others, however, eczema is a chronic or recurrent disorder that will last a lifetime.

Resources

http://en.wikipedia.org/wiki/Eczema
http://www.webmd.com/allergies/guide/eczema
http://www.emedicinehealth.com/eczema/article_em.htm
http://www.nlm.nih.gov/medlineplus/eczema.html
http://www.medicinenet.com/eczema/article.htm

Skin Conditions

"Don't let the bed bugs bite" - old saying

I was never cut out to be a doctor. While dissecting animals never bothered me, I am squeamish about photos of human medical conditions. Never-the-less I'm going to recommend viewing this site http://www.medicinenet.com/skin_problems_pictures_slideshow/article.htm. It contains 22 images of common skin problems like poison ivy, hives, and ring worm. Very useful to know next time your skin looks unusual.
Bottom Line
I found this site while trying to identify a skin condition on my leg. Several lines of red dots, fairly evenly spaced. Is my cat scratching me at night? Nah. The nearest example I could find online is bed bugs which I pray it is not. Bed bugs are hard to kill once they infest. Another site said see a Dermatologist ASAP because this could be an allergic reaction or parasite. So off to the doctor I go...
And the answer is - eczema, a dry skin rash. The straight line of dots is the rash following scratch marks according to the dermatologist. My wife says, "I told you so" and this will be one expensive rash when we get the doctor's bill.