Cold Sores, Herpes, Shingles. Oh My!

Copyright © 2006, John Pozniak

The Web MD reports Cold Sores affect 90% of the world. A cold sore is a Cluster of tiny blisters, usually on the lip, that burst, drain, and then crust over, and is caused by Herpes Simplex Virus I. Symptoms include fever, red, swollen, painful blister, and swollen lymph glands. Healing time usually takes place within 2 weeks. Transmission occurs through contact with a sore through kissing (saliva), sharing eating utensils, razors and tooth brushes from an infected person. There is no cure. Exposure to sunlight or wind, stress, immunocompromised, before onset of menstruation, fatigue, colds, flu, can increase the risk of an outbreak. Prevention techniques include avoid touching, sun-sunscreen, wash hands often. Cold sores can be contagious even if you don’t see them. Treatment options are limited as they can heal on their own, but antivirals can speed up their healing, and NSAID’s can be taken for pain. Seek med care if you have a weak immune system, sore that doesn’t heal within 2 weeks, increased frequency of cold sores, and irritation to eyes.

Genital Herpes is a common STD caused by Genital Herpes II. The Mayo clinic reports they appear as small, red bumps or tiny white blisters that are painful, itch, or sore or you may not have any symptoms. After the first infection, the virus becomes dormant, but can reactivate at any time. There is no cure. Antiviral medication can decrease the symptoms and speed recovery. To prevent transmission from your infection use condoms. Risk factors include having multiple partners, or another STD’s. Genital herpes causes increase risk of transmission to newborns, bladder problems, meningitis, and rectal inflammation. There are three ways to diagnose. One is having your doctor perform a viral culture of the sore itself. Second is having a test called a PCR, which tells you the type of herpes you are infected with. Finally, a blood test can tell you if you have had genital herpes in the past. Treatment includes a prescription for an antiviral medication such as Acyclovir, Famciclovir, Valacyclovir. Pregnant women should discuss a C-section to prevent infection to newborn.

Shingles is a viral infection that results in a painful rash, caused by Varicella Zoster or Herpes Zoster Virus. It is the same virus that causes the Chicken Pox. The virus lies inactive in nerve tissue near your spinal cord and brain. When it reactivates it does so in the form of shingles. Shingles can last 2-6 weeks. Symptoms include pain, burning, numbness, and tingling, sensitivity then red rash, fluid filled blisters that open and drain a clear liquid and then crust over. Other complaints noted are fever, headache, sensitivity to light, and fatigue. Shingles can spread if person has never had the chicken pox and had direct contact with the sore. Shingles is dangerous to those with weak immune system, newborns, pregnant, over 50, HIV, cancer, and organ transplant. Complications are post herpetic neuralgia- damaged nerve fibers, well after blisters have cleared. Vision can be affected if shingles develops in the eye. Brain, facial paralysis, hearing, balance can cause neurological imbalance. Bacterial infections can occur when shingles appears on the skin.
Treatment includes antiviral medication, pain medication, such as capsaicin cream, gabapentin, lidocaine gel or cream, or narcotics.

The CDC reports the Shingles Vaccine reduces shingles 51%, and reduces post herpetic neuroglia by 67%. They
Recommend the vaccine if you are over 60 with or without history of chicken pox to prevent future occurrences. The vaccine protects for 5 years. FDA has approved the vaccine for over 50, but insurances may not cover. Avoid the
vaccine if you are allergic to gelatin, neomycin, weak immune system, or are pregnant. This is a live vaccine.

Throat Infection vs. Strep Throat

A throat infection, also known as pharyngitis, can occur in the throat and tonsils. Throat infections are most commonly caused by the common cold, and do not require an antibiotic to treat.  Another virus that can cause throat infection is Mononucleosis, which is mostly seen in young people. Symptoms include a sore throat, fever, lymph gland tenderness and swelling around your neck and throat.  A blood test, known as a Mono spot, can diagnose.  Antibiotics are not the treatment.  Additional conditions that can cause throat infection is dry air, smoking, post-nasal drip, allergies, singing, yelling, and sexually transmitted diseases such as gonorrhea.

The CDC reports Strep pharyngitis is caused by Group A Strep bacteria. It can be easily transmitted to others, and highly contagious via droplets from cough, sneeze, or sharing personal objects like cups, tooth brushes, etc.  Symptoms include sore throat, painful swallowing, fever, headache, swollen lymph glands, nausea, vomiting and stomach ache.  Redness to the throat and pus on tonsils may be noted upon examination.  Testing can be done via rapid strep test, or a throat culture.

The Mayo Clinic reports the treatment of choice is antibiotics such as penicillin or amoxicillin. If the individual is allergic to penicillin, they can be given Keflex, Zithromax, Biaxin, or Clindamycin.  Warm broth or apple juice, throat lozenges, gargling 1 tablespoon of salt with warm water can provide some comfort.  For pain and fever, Acetaminophen, Ibuprofen, or Naproxen can be bought over the counter.  Additionally, it would help to eat soft foods, drink plenty of fluids, and rest.  Avoid smoking to reduce irritation to the throat.  A humidifier can moisten the air to reduce irritation from dry air. Also, change your toothbrush to prevent re-infection.  Make sure to perform frequent handwashing to prevent spreading, as well as covering your mouth and nose when coughing or sneezing.

Seek immediate medical care if you are struggling to breath, drooling, spitting out saliva because you can’t swallow, unable to open your mouth completely, high fever, severe sore throat (could be tonsil abscess), wide spread rash (rheumatic fever), or ear pain. Strep infections can affect the tonsils, sinuses, skin, blood, middle ear, and kidneys. Complications include tonsil abscess, rheumatic fever, and kidney infection.

You can return to work or school after 24 hours fever free, and on the antibiotics for at least 24 hours.

 

Bursitis vs. Tendinitis

The bursa is a fluid filled sac that provides cushions and protects areas between the joints, muscles and bones of your body from frequent movement. When the bursa is inflamed it is called Bursitis.

Symptoms of bursitis include pain, stiffness, redness, warmth and swelling as fluid builds up in the sac. Pain often continues even at rest, and if the area becomes infected, fever and chills.  The joints of the knees, elbows, hips, and shoulders are most often affected. Bursitis is caused by an injury, such as a direct impact from a fall, or repetitive use of a joint.  Sometimes infection and diseases can cause the bursa to become inflamed, such as gout and rheumatoid arthritis.

Those at greatest risk for getting bursitis are those who have a job or activity that has repetitive movements to the same joint of your body, those who have suppressed immune system (diabetics, cancer), lift their arms over their heads frequently, lean or kneel on hard surfaces often, run, or walk often.

Treatment for mild cases of bursitis is R.I.C.E. or rest, ice, compression, and elevation. Moderate to severe cases may require NSAID’s to treat pain, and inflammation. Corticosteroids may be injected in and around the bursa for inflammation and improve movement.  If there is an infection, an antibiotic is given.  Physical therapy may suggest splinting or a brace to support the injured area.  If the case is severe, surgery may be required to remove the bursa.

If you are prone to getting bursitis, do your best to prevent yourself from another painful episode. Wear knee pads if you kneel often, avoid or take frequent breaks from repetitive activities. Warm up before exercise.  Seek medical attention if you develop fever or chills, or home treatments are not working.

The tendon is a strong rope of tissue that attaches muscle to bone. When the tendon is inflamed it is called Tendinitis.  The most frequent tendons affected are those of the shoulder (rotator cuff), ankle (Achilles tendon), elbow (triceps tendon), and any one of the wrist tendons.

The most common cause of tendinitis is repetitive use of a tendon or muscle. Additional causes include injury, ageing, wear and tear, arthritis, and some medications. Symptoms include pain, swelling, and tenderness. Treatment is the same as for bursitis.  Seek medical attention if you do not improve with home care or if you develop numbness or tingling to the extremity near the injury.

Aspirin and your Heart

Aspirin is an anti-inflammatory and anti-platelet drug, and is used to treat pain, fever, blood clots, heart attacks, and strokes.

The benefits of taking aspirin daily include if you:

Have had a heart attack or chest pain

Had open heart surgery

Had coronary angioplasty

Had a stroke or TIA (Transient Ischemic Attack)

Have peripheral vascular disease (PVD)

Have heart rhythm problems, such as atrial fibrillation (A.Fib)

Risks of taking aspirin every day include minor bleeding or bruising, worsening of asthma, upset stomach, or allergic reaction. Children should not be given aspirin due to the risk of Reye’s syndrome (rapidly progressive brain dysfunction).  Contraindications for use of aspirin include allergies to NSAID’s, peptic ulcers, GERD or gastritis, hemophilia, kidney disease, and gout.

There are 2 forms of aspirin you can take. Please ask your doctor which is best for you. The first type is called non-enteric coated.  This means the aspirin does not have a protective coating that keeps your stomach from being upset, but is best to take when having active chest pain.  This type comes in a chewable form.  The enteric coated aspirin has the protective covering that keeps your stomach safe.  This type cannot be chewed or crushed.  Do not take any aspirin with alcohol as it increase chance of bleeding and stomach distress.

Please seek immediate medical attention if you have an allergic reaction, stools are black or bloody, vomit or cough up blood, there if blood is in your urine or you feel shortness of breath.

 

Information obtained from Elsevier Interactive Patient Education, Elsevier Inc. (2017).

The Importance of Vitamin D

Vitamin D is very important because it helps your body metabolize calcium and phosphorous (muscle, bone, and dental health), thought to support your immune system; prevent diabetes and multiple sclerosis, and functions of the heart. When there is not enough vitamin D you have Vitamin D Deficiency.

You can get vitamin D from milk, and other dairy foods, a Vitamin D supplement, and being in the sun.   When you have a severe deficiency of Vitamin D your bones can become soft.  In adults this is called osteomalacia, and in children rickets.  Research is showing vitamin D supplements can prevent multiple sclerosis (MS) or keep symptoms of it from worsening. They have found the farther away a person lives from the equator the greater the chance they will have MS.

Deficiency can be caused by a poor intake of foods having vitamin D, not enough sun exposure, digestive disorders that cause poor absorption of vitamin D, such as Crohn disease, pancreatitis, and cystic fibrosis. Deficiencies can also be caused by being overweight, having stomach or small intestine surgery, and having kidney or liver disease. Breast fed babies are also at risk for deficiency.

Those at greatest risk are the elderly, those who do not expose themselves to the sun, those with broken bones, those with osteoporosis, those who have a disease of condition that prevents proper absorption of vitamin D, dark skinned people, those on steroid and seizure medications, and those who are overweight.

Symptoms include bone, and muscle pain. Frequency of falls, bone fractures, abdominal pain, nausea, vomiting, and constipation. Deficiency can be diagnosed by a blood test.  Test results differ in males and female.  The optimal range for Women is 18-78 pg/ml, and Males 18-64 pg/ml per the 1,25-dihydroxyvitamin D test.  For the 25-hydroxy D test 20-30ng/ml indicates insufficiency, while less than 20 ng/ml is deficiency.  Over 30ng/ml is considered optimal for this test.  High levels of Vitamin D can be seen in those over taking supplements, hyperparathyroidism, high calcium levels, kidney stones, sarcoidosis and kidney disease.

Treatment includes improving diet with foods that contain vitamin D (fortified dairy, cereal, juice, fish, and eggs), Infant formula, and dietary supplements of vitamin D and calcium. Exposure to sunlight is important, but use caution to prevent sunburn or if you are at risk for skin cancers. Using a tanning bed is not recommended. If found to be deficient the treatment for an adult is typically vitamin D 50,000 IU three times a week for three months and then a daily over the counter daily use of up to 4,000 IU once daily. For healthy individuals that have normal vitamin D levels, daily International Units or IU’s recommended are as follows:

Infants: 400 IU once daily

Children (>1 year old): 600 IU once daily

Adults: 600 IU once daily

Elderly: 800 IU once daily

Pregnant and breast feeding: 600 IU once daily

Each of these is to be taken with your largest meal of the day for the best chance of absorption.

Talk to your primary care physician to get tested.

Lyme Disease

Lyme disease is an infection caused by bacteria called Borrelia burgdorferi. An infected tick transmits the bacteria to its victims by biting.  The tick must be attached to your skin for 36 hours or more for transmission of bacteria to take place.

A circular rash surrounding the tick bite is the first sign of infection, and can appear up to 30 days after tick removal. Additional symptoms include flu-like symptoms, fatigue, headache, chills and fever, generalized body aches, joint pain, and swollen lymph glands.

States with the most frequent exposure to these ticks are the New England, Mid-Atlantic States, and the Midwest. These ticks are often found on deer and like wooded, grassy areas. Lab tests can confirm diagnosis but must be several weeks into the infection so the body has time to develop antibodies.

Treatment of choice is an antibiotic, which may have to be taken for several weeks. The most common antibiotics used are amoxicillin, and cefuroxime. Treatment is more effective if started early. If the infection is serious, IV antibiotics may be needed.  Reinfection is possible with another tick bite by an infected tick. If left untreated, neurological problems can develop, including meningitis, and heart rhythm disturbance.

To prevent a tick from attaching itself to your skin wear clothes that covers your skin. Spray your skin and clothes with an insect spray that contains 20-30% DEET.  Try to stay away from wooded, grassy areas.  Check yourself and your pets for ticks when you return indoors. If you find a tick remove it with tweezers near the head.

Make sure you seek medical attention if you start having symptoms after a tick bite, you have an irregular heartbeat, nerve pain, and your face feels numb.

 

Dehydration!

Dehydration occurs when you use or lose more fluids than you are taking into your body. This results in your body not being able to perform its usual functions that require proper fluid intake.  If you don’t replace these fluids, you become dehydrated.  We lose water and salt daily through vapor from breathing, sweat, urine, and stool.

Causes include poor fluid intake due to illness or mouth sores, or nausea, intense physical activity,

hot weather, severe diarrhea or vomiting, fever, sweating, poor fluid intake with increased activity and hot weather, and increased urination due to a medical condition such as diabetes or medications.

Symptoms

Mild to Moderate symptoms include dry, sticky mouth, thirst, decrease in urination, fatigue,

no wet diapers for at least 3 hours, few or no tears when crying, dry skin, headache, constipation, dizziness, and muscle cramps.

Severe symptoms are considered a medical emergency. If you experience great thirst, are irritable or confused, feel weak, have a very dry mouth, little or no urination or sweating, eyes look sunken in, a

low blood pressure, rapid heart, rapid breathing, tenting of skin, fever, fainting, and a swollen tongue, you need immediate medical attention.

Complications of dehydration include heat exhaustion or heat stroke, swelling of the brain, seizures, low blood volume shock (Hypovolemic Shock), kidney failure, coma and death.

Treatment for kids includes small frequent sips of rehydrating solutions, such as Pedialyte, popsicles, and water.  In adults, Gatorade, PowerAde, water, and ice chips are effective.  Additionally, wearing

loose clothes, air conditioning, fans, cool wet towels, spray bottle with water, avoid alcohol, caffeine.

You can also break up exposure to heat by spending 10-20 min in heat then going inside to get cool.

Milk, caffeinated drinks, fruit juices and gelatins don’t relieve dehydration and can worsen diarrhea.

Heat Exhaustion!

When it is hot outside your body cools itself by sweating. Your body cools as the sweat evaporates from your skin.  But if you are overexposed to heat or are doing strenuous physical activity your body loses its ability to cool itself properly.  This is called heat exhaustion. This can be caused by loss of water and electrolytes through sweating as a result of hot, sunny, humid weather, and physical exertion in that weather.  Elderly and children are at greater risk due their body’s inability to regulate body temperature, and lack of cool air. Drugs, such as, ecstasy, cocaine and amphetamines, can cause rapid rise in body temp.

Symptoms of heat exhaustion include, nausea, dizziness, irritability, headache, thirst, weakness, high body temperature, excessive sweating, decreased urine output, confusion, vomiting, muscle cramps, which is related to low blood sodium and potassium.

Heat exhaustion can occur in the elderly because they are less likely to drink enough fluids or sense significant changes in temperature. Heat exhaustion in kids can occur as babies and young kids are very sensitive to extreme heat.  Keep cool and hydrated. Don’t leave them in the car, even with the window open.

Treatment- When the temp is over 91 you need to take precautions

  1. Go to a cool area
  2. Remove layers of clothes
  3. Fanning and wet towels
  4. Dizzy may be related to low BP, so lay down and put your feet up
  5. Drink water or sport drink, and sip slowly
  6. If you have continuous vomiting get medical attention immediately

Heat exhaustion can progress to heat stroke, which is a medical emergency.

Heat Stroke (Sun Stroke) occurs when there is a high body temp of 103 or higher. It is considered hyperthermia without fever.  Symptoms include hot, red, dry or moist skin, rapid and strong pulse, and loss of consciousness.  Call 911, move person to cool area, cool person down with cool cloths or bath, DO NOT GIVE FLUIDS.

Those at risk for heat stroke are those wearing dark, heavy, padded clothes, and over dressing, has a high percentage of body fat, dehydration, Fever, beta blockers (cardiac medication), antipsychotic medication, alcohol and caffeine.

The most important thing to remember is to not wait until you are thirsty to drink fluids.

Managing your Sunburn!

Sunburn is radiation burn due to overexposure to Ultraviolet (UV) radiation mostly from the sun or sun tanning.  Too much exposure can be dangerous, but a lesser amount of exposure would lead to a tan.  Sunburns are considered a superficial burn.  Extreme burns can result in hospitalizations. Sunburns can occur in less than 15 min.  Some medications can create greater sensitivity to UV radiation, such as, antibiotics, birth control pills, and tranquilizers.

Suntan is a result of slight to moderate exposure that causes a release of melanin, a protective pigment that is the skin’s natural defense against overexposure.  Suntans are viewed as exotic and desirable.  Repeated extreme exposure over time can lead to damage to your DNA and skin tumors, dry wrinkled skin, dark spots, and freckles.

Those with the greatest risk for skin burns are those with fair skin, living or on vacation somewhere sunny or at a high altitude, work outdoors, and participate in outdoor recreation.

UV Index is the risk of getting sunburn at a specific location and time of day, such as:

  1. Time of Day 10 AM-4 PM- sun’s rays are at their strongest
  2. You can even get burn on cloudy days
  3. Reflective surfaces, such as, snow, ice, water, and concrete
  4. The position of the sun, which is greatest late spring and early summer
  5. The higher the altitude the greater the risk of a sunburn.
  6. Proximity to the equator- closer you are to the tropical regions of the planet 50% greater chance of getting sunburn.
  7. Incidence and severity of sunburns have increased worldwide because of damage to the ozone layer of the planet due to ozone depletion.Complications include skin cancers (Melanoma, basal-cell carcinoma, squamous cell carcinoma), and sunburn to the corneas of your eyes.
  8. Appearance of sunburns include red skin that feels hot is caused by the increase of blood to the area to heal the burn. Also there is pain, fatigue, dizziness, swelling, itching, and peeling skin, rash, nausea, fever, and chills. Fluid filled blisters that can burst and become infected. After exposure, skin may turn red from 30 min to 2-6 hours. Worst of the pain is 6-48 hours after exposure. The burn continues to progress for 1 to 3 days. Skin peeling can last about 3-8 days.

Prevention is the Key:  use hats/caps, clothes that cover arms and legs, and use wraparound sunglasses.

Moderate sun tanning without burning can prevent sunburn. A diet rich in vitamin C, and E can help reduce the amount o sunburn.  Beta-carotene (Vitamin A) helps protect against sunburn.  Protect your skin with sunscreen or sunblock.  The higher the SPF the less the DNA damage is to the skin.  Sunscreen helps prevent some forms of skin cancers. Apply 30 min before exposure and 30 min after exposure, and any time you get wet.

Treatment options include

  1. Pain medication- ibuprofen, naproxen
  2. Corticosteroids- for itching
  3. Cool the skin- cool compresses, cool shower
  4. Moisturizer- aloe vera, hydrocortisone cream
  5. Don’t break blisters- it is a protective layer, and breaking it will slow healing. If it breaks clean with soap and water and apply antibacterial cream and cover with a wet dressing.
  6. Drink plenty of water
  7. Avoid further sunlight
  8. Products that contain benzocaine can irritate the burn and cause allergic reaction.

4 Types of Travel Notices that Can Save Your Life!

The CDC provides travel health notices for travelers regarding possible health issues at their destination site. Health issues at any destination can be created by severe weather (floods, hurricanes, etc.), no power resources available, no potable (drinkable) water, insect or animals, outbreaks of diseases or wars.  The CDC provides a travelers health page, as well as the US Department of State on their Travel Alerts and Warnings page.  For weather conditions, visit the NOAA International Weather Selector page.

4 Types of Notices

Watch A (Level 1) notice encourages travelers to practice usual precautions, such as, vaccinations, hand washing, and avoiding mosquitoes.

Alert (Level 2) notices encourage travelers to practice enhanced precautions, such as, additional vaccinations, and monitoring for local disease outbreaks.

Warning (Level 3) notices encourage travelers to avoid non-essential travel because they are at risk for exposure, such as, a large scale outbreak, war.

Avoid (Level 4) notices instruct travelers to avoid all travel due to dangerous situations that can put their life at risk.

Safety Considerations

Animal safety, such as, exposure to bites, scratches, saliva, and fecal/urine from cats, dogs, bats, rats, and insects, can result in long term or permanent illness or death. Rabies is still a very common infection around the world.  Insect bites from fleas, flies, mosquitoes, ticks, and bed bugs can cause a host of infections from mild to serious.

Hypothermia and frostbite can be acquired from destinations with cold weather.

Sun or heat exposure from hot weather destinations and UV rays can cause sunburns, and heat stroke.

High altitudes can cause altitude sickness which can then result in flu like symptoms, carbon monoxide poisoning, pulmonary and cerebral edema. High altitudes have a low pressure of oxygen that affects humans more than animals.

Natural disasters can cause injury by blunt trauma, drowning, and crush related deaths.

Food and water safety is crucial to the traveler. Fresh cold pasteurized milk, alcohol, and steaming hot drinks and food should be safe.  Heat kills germs.  Bottled and canned water and drinks are safe if the traveler opens them.  Buffets can lose heat and get contaminated.  Dry or packaged foods are usually safe as long as it is not handled by others.  Avoid raw food, street food, and bush meat as Ebola and SARS can be spread to the traveler. Tap water is risky for drinking, showering, and brushing teeth. Fountain drinks and ice are also risky.  Fresh juice is safe if washed in safe water and squeezed by you.

Heartburn!

Heartburn, or acid indigestion, is a burning sensation mid chest that worsens when you bend over or lay day. It usually occurs after eating and at night.  It is caused by reflux. Reflux occurs when the acid in your stomach backs up into your food pipe (esophagus), resulting in inflammation.  It is considered a disease when you have symptoms more than 2 times a week.

Gastroesophageal Reflux Disease (GERD) is a condition of digestion that allows stomach acid to go up the esophagus due to a weakening of the muscle at the point where the esophagus ends and your stomach begins. GERD often interferes with routine daily activities, and result in damage to your esophagus.

Symptoms- heartburn, vomiting or spitting up blood, bitter taste in mouth, burning chest pain, dry cough, painful throat, painful swallowing, and hoarse voice.

Complications- scarring of esophagus, bleeding in stomach or esophagus, ulcer formation in esophagus or stomach

Risk Factors

Spicy or hot foods

Alcohol, soda, caffeine

Fatty foods

Gassy foods (certain vegetables)

Pregnant

Obese

Smokers

Abdominal hernias

Treatment for GERD

Antacids– help to neutralize the acids in your stomach, but will not treat the inflammation of the esophagus. Over use can cause constipation and diarrhea.

Gaviscon

Tums

Maalox

Mylanta

Rolaids

Histamine-2 (H2) Blockers -Reduce production of acid in stomach. May not be as good for treating esophagitis (inflammation that occurs in the esophagus). Histamine stimulates acid production, especially after meals, so H2 blockers are best taken 30 minutes before meals. They can also be taken at bedtime to suppress nighttime production of acid. Examples of prescription H2 blockers:

Nizatidine (Axid)

Famotidine (Pepcid)

Cimetidine (Tagamet)

Ranitidine (Zantac)

 

These drugs are useful at relieving heartburn, but may not be as good for treating esophagitis (inflammation that occurs in the esophagus).

Side effects can include headache, abdominal pain, diarrhea, nausea, gas, sore throat, runny nose, and dizziness.

Proton Pump Inhibitors (PPIs)

Drugs that block acid production more effectively and for a longer period of time than the H2 blockers, PPIs are best taken an hour before meals. They include:

  • Rabeprazole (Aciphex)
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec, Zegerid)
  • Pantoprazole (Protonix)
  • Dexlansoprazole (Dexilant)

Many doctors do not believe that one drug is more effective than the others in treating GERD. These medications are also good for protecting the esophagus from acid so that esophageal inflammation can heal.

Side effects can include headache, diarrhea, abdominal pain, bloating, constipation, nausea, and gas.

Home Care

Avoid eating foods and drinks that trigger heartburn. fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, citrus fruits (Pineapple, strawberries), vinegar, foods that can cause gas (peppers, cabbage,) and caffeine may make heartburn worse.

Do not over eat.  Try eating smaller frequent meals.

Do not lie down after a meal, and wait 2- three hours after eating before lying  down or bending over

Elevate the head of your bed

Do not smoke.

Avoid medications that can irritate your stomach, like NSAID’s (Aspirin, Aleve, Ibuprofen)

Weight loss may help to reduce abdominal pressure pushing acid into the esophagus

Avoid wearing tight clothes

Seek medical attention if symptoms occur for more than 2 times a week, and over the counter medications do not help, if you have difficulty swallowing, nausea, vomiting, or weight loss.

6 Key Symptoms of Asthma

The Mayo Clinic defines Asthma as “…a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult…” The Environmental Protection Agency (EPA) reports there are 24 million people with Asthma, 6 million of which are children. Over 14 million doctor office visits were related to asthma, and 1.8 million emergency department visits.

6 Symptoms Key to Asthma

1. Wheezing
2. Cough
3. Frequent episodes with difficulty breathing or shortness of
breath, with or without wheezing.
4. Frequent episodes of chest tightness.
5. Symptoms worsen when exposed to respiratory irritants, such as
cigarette smoke, pollen, animal fur, exercise, etc.
6. Symptoms worsen at night.

Asthma is a controllable condition through an action plan. According to the National Heart, Lung, and Blood Institute, and the National Asthma Control Initiative the goal of therapy is control by prevention of asthmatic episodes. An action plan allows asthmatics to be healthy, and active, and involves:

a. Following your treatment plan prepared by your medical doctor.
b. Managing environmental triggers.

Knowledge is power!
It is important to be aware anxiety does not cause asthma. Asthma is caused by an inflammation. Asthmatic medications do not cause addiction. Asthmatic medications do not lose their effectiveness over time. Never delay starting treatment to see if the asthma will improve by itself. Always check you have enough medication left in the inhalers, as well as for expired dates. Corticosteroids are safe, and are not the same as anabolic steroids. Watch for asthma triggers such as respiratory irritants (pollutants, second hand smoke, flu, etc.) that can worsen symptoms. Rinse mouth after using inhaled medication. No eating peanut butter.
Daily control is demonstrated by good breathing, no cough or wheeze, being able to have a good night sleep, and the ability to play and exercise. If you have cough, mild wheezing, chest tightness, especially at night use your quick relief medication. If your symptoms are not controlled within 20 minutes or after 2 efforts of quick relief, call your doctor or go to urgent or emergency care. If quick relief medication is required more than 2 times a week, then call your doctor. Do not wait to get emergency help if you are breathing hard and fast, your nose is flaring, your ribs are moving deeply in and out, you have difficulty walking and talking, you have blue lips, fingernails or earlobes. Get the flu vaccine every year.

Tick Bites!

Ticks are parasites that live outside of the body and feed on blood. They are typically found in grassy wooded areas.  Ticks prefer to live in warm and humid environments.  They transmit infections into other living creatures as well as humans of at least 12 types.  The risk of developing an illness related to tick bites depends on

  1. The type of tick. Investigate what ticks are in your area.
  2. The time of the year
  3. How long it was attached. Ticks should be removed quickly to prevent illness’s associated with tick bites.
  4. Geographic location

Removing a tick

Use very fine tweezers, and grab the tick close to the skin and the ticks head. Do not grab the tick by its body. Pull gently upward until the tick releases itself. Avoid twisting and squeezing, as you want to prevent the head from coming off the body of the tick.  This can cause germs to enter your body and result in illness.  Once removed, wash the bite site with soap and water, and apply an antibacterial ointment or cream to prevent skin infection.

Do not try to remove tick with matches, petroleum jelly, or finger nail police. They will not remove the tick and may increase chance of fluids entering your body.

An evaluation between 2-4 hours is recommended if a sudden onset of hives, rash, itching or swelling occurs in areas outside of the original tick bite or if there has been a history of allergic reactions to tick bites in the past. An evaluation within 24 hours is recommended if  you are unable or unwilling to remove the tick, and the tick head imbedded in the skin, redness, pain, swelling, drainage or heat at the tick site (may be a sign of infection), or rash or flulike symptoms develop 2-4 weeks after a tick bite.

Polycystic Ovarian Syndrome (PCOS) in a Nutshell!

PCOS is a range of symptoms caused by an increase in hormone (estrogen and progesterone) imbalance in women. When one hormone is out of balance then another is triggered to be out of balance. The ovaries are stimulated to grow small cysts and release male hormones called androgens known as testosterone. Also, there is an increase in insulin levels in the blood, but the body has difficulty using it, and that is call resistance.  This causes the body’s blood sugars to go up and may result in diabetes.

Symptoms include irregular or no periods, heavy periods, increase in body and facial hair, acne, thinning hair on the scalp, pelvic pain, difficulty getting pregnant, patches of thick, dark skin, and metabolic syndrome, elevated insulin and insulin resistance.

Causes have been attributed to genetic and environmental but are mostly unknown. Risks include obesity, sedentary lifestyle, and family history.

Treatment- There is no cure, but methods to provide relief to sufferers include,

  1. Involves lifestyle changes- weight loss and exercise. Eating healthier foods. To lower insulin resistance
  2. Birth Control- regulates periods, reduce hair growth, and acne
  3. Metformin helps ovulation to become more normal
  4. Restoration of Fertility- need to see a fertility specialist

Complications include increased risk for: endometrial hyperplasia, endometrial cancer, insulin resistance, diabetes, hypertension, Depression/Anxiety, dyslipidemia(a disorder of lipid metabolism), cholesterol and triglyceride levels, heart disease of the arteries of the heart, stroke, weight gain, miscarriage, non-alcoholic fatty liver, and patches of dark skin under arms, groin, and back of neck.

Make sure you follow up with your primary care physician or gynecologist yearly.

How to Stop Self Sabotage in 16 Steps!

  1. Listen to yourself and notice any self-doubting. Why do you do stop yourself from reaching your dreams and goals? What are you afraid of?
  2. Do you feel you don’t deserve it? That you don’t deserve the body or happiness that you desire. You might feel comfortable right now, because that is what you know, but you are still unhappy. YOU NEED TO BELIEVE YOU DESERVE IT.
  1. Are you scared to be thin? Do you feel out of your comfort zone?, and how things will be different?. You have to claim what you want out of your life. You have to define how you want to live your life.
  1. Don’t compare yourself to other people
  2. Life isn’t perfect. Don’t be negative or beat yourself up when you slip up. If your frustrated then reset your goal.
  3. Surround yourself with positive supportive people.
  4. S- specific aim or goalA-attainable goals that are reachableT-timely. Give yourself a time frame for when you want this goal reached.
  5. R-realistic- there may be times of failure as well as celebration
  6. M-measureable short and long term goals
  7. Be proud of small wins.
  8. Portion control
  9. Eating the right foods
  10. Eat every 2-3 hours to keep your metabolism going
  11. Keep a food diary
  12. Stock foods that are healthy only
  13. Read food labels
  14. Disciplined is developed by being disciplined. It takes time and practice. It is always hard at first, but the more you do it, the easier it gets.
  15. Think of losing weight in the long term
  16. Key: PATIENCE, CONSISTENCY, & PERSISTENCE