Source: 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.
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
- The type of tick. Investigate what ticks are in your area.
- The time of the year
- How long it was attached. Ticks should be removed quickly to prevent illness’s associated with tick bites.
- 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.
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,
- Involves lifestyle changes- weight loss and exercise. Eating healthier foods. To lower insulin resistance
- Birth Control- regulates periods, reduce hair growth, and acne
- Metformin helps ovulation to become more normal
- 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.
- 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?
- 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.
- 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.
- Don’t compare yourself to other people
- Life isn’t perfect. Don’t be negative or beat yourself up when you slip up. If your frustrated then reset your goal.
- Surround yourself with positive supportive people.
- S- specific aim or goalA-attainable goals that are reachableT-timely. Give yourself a time frame for when you want this goal reached.
- R-realistic- there may be times of failure as well as celebration
- M-measureable short and long term goals
- Be proud of small wins.
- Portion control
- Eating the right foods
- Eat every 2-3 hours to keep your metabolism going
- Keep a food diary
- Stock foods that are healthy only
- Read food labels
- 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.
- Think of losing weight in the long term
- Key: PATIENCE, CONSISTENCY, & PERSISTENCE
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.
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.
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
- Go to a cool area
- Remove layers of clothes
- Fanning and wet towels
- Dizzy may be related to low BP, so lay down and put your feet up
- Drink water or sport drink, and sip slowly
- 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.
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:
- Time of Day 10 AM-4 PM- sun’s rays are at their strongest
- You can even get burn on cloudy days
- Reflective surfaces, such as, snow, ice, water, and concrete
- The position of the sun, which is greatest late spring and early summer
- The higher the altitude the greater the risk of a sunburn.
- Proximity to the equator- closer you are to the tropical regions of the planet 50% greater chance of getting sunburn.
- 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.
- 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
- Pain medication- ibuprofen, naproxen
- Corticosteroids- for itching
- Cool the skin- cool compresses, cool shower
- Moisturizer- aloe vera, hydrocortisone cream
- 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.
- Drink plenty of water
- Avoid further sunlight
- Products that contain benzocaine can irritate the burn and cause allergic reaction.
When you are looking at headaches, it is important to look at location, quality, severity, duration, and unique features of that headache. There are many types of headaches. They are caused by cough, cranial nerve inflammation, infection, Injury, substance abuse, bone structure of the head or face, blood flow to and from the brain, changes in brain chemistry, tumors, and seizures.
Ice cream headaches cause brief, stabbing head pain when you eat, drink, or inhale something cold. “Brain Freeze” occurs when the blood vessels constrict (narrow) to prevent heat loss, and then dilate (open)to let blood flow rise.
There are 4 Main Types of Headache:
- Sinus– Sinus infections may erode through the bones of the sinus and structures in the face. The pain and tenderness is frontal, at the brow, and/or below or behind the eye. The sufferer may also experience bilateral pressure and fullness of cheeks, fever, fatigue, sore throat, cough, and decrease ability to smell.
- Cluster– is a stabbing or sharp pain, which may cause swelling around eyes or to eye lids. Cause is unknown
- Tension– This type of headache may be caused by fatigue, bad body posture, stress, and extreme exertion. The discomfort felt is bilateral head tightening. Complications include dependence on analgesics, and the risk of epilepsy is 4 times greater.
- Migraine– tends to start in childhood or adolescence. Women are 3 times more likely to get a migraine headache. Menstrual migraines are often treated by taking oral contraceptives. Researchers find there may be an imbalance of the brain chemical- serotonin. Complications include chronic migraines, seizures, migraine infarction (symptoms of stroke with blood loss to an area of the brain), medication over use (rebound headache), and abdominal complaints. Serotonin syndrome is when the body has too much serotonin due to taking migraine meds along with antidepressants called SSRI’s (Zoloft, Prozac, Paxil) or SNRI’s (Cymbalta, Effexor). There is a genetic predisposition to migraines. 80% of migraine sufferers have a family history. Migraines have 4 phases:
- First- Pro-drome- up to 48 hours before the migraine. The sufferer may experience emotional changes, yawning, urinary frequency, fluid retention, stiff neck, and thirst or food cravings.
- Aura-warning, flashes of light or wavy vision, tingling on one side of face or body, speech disturbance.
- Headache- Throbbing, sensitive to light, noise, odors, movement, nausea, vomiting, blurred vision. Severe, debilitating head pain.
- Post-drome- after pain resolves, fatigue, irritability, euphoria that lasts a day or longer, and feels drained.
- Seek immediate medical attention:Sudden, severe headache that feels like a thunderclapHeadache after a head injuryNew headache after the age of 50.
- Persistent headache after straining, or exertion
- Headache with fever, seizure, confusion, difficulty speaking, double vision, numbness.
- THE WORST HEADACHE OF YOUR LIFE- This is a medical emergency and needs Emergency Room evaluation.
- Triggers- foods that contain tyramine-in aged foods like deli meat, aged cheeses, avocado, bananas, dried fruit. Foods that contain MSG. Also, chocolate, aspartame, beer, and wine. Environmental- stress, irregular sleep patterns, odors, weather changes, bright light. Women- notice migraine pattern with hormonal changes, and worsens at time of period, and improvement during pregnancy and menopause.
- Treatment works best when symptoms are treated early. Medication over-use headaches can occur when treatments for more than 3 days a week. Over use can worsen an underlying condition and decreases response to treatment. Prevention Treatments- for 1 or more headaches a week or for those with severe headaches that interfere with normal activities. Useful for 6 months and then begin to taper.
- Natural remedies to prevent headaches include Vitamin B2, Magnesium, Co-enzyme Q10, butterbur, and feverfew. First check with your doctor as there may be drug-drug interactions with other medicines.
- Diagnosis- Blood Tests and Spinal Tap to look for infection or toxins, CT Scan and MRI to look for tumors, infection, brain damage, and bleeding.
- Pain- Relief
- Aspirin, Acetaminophen, Ibuprofen, Excedrin, indomethacin. Use with caution as over use can cause liver and kidney damage.
- Triptans- block pain in the brain, constrict blood vessels. Pill, Nasal spray, injection. Imitrex, Maxalt, Axert, Amerge, Zomig, Frova,Treximet (Imitrex with Naproxen), and Relpax. Side effects: nausea, dizzy, drowsy, muscle weakness. Do not take if at risk of heart attack or strokes.
- Ergots- Ergotamine and Caffeine combination- can cause nausea and vomiting, Migranal- ergot derivative with less side effects than ergotamine, and people respond better to it. It comes in nasal spray and injection.
- Anti-nausea- helps to take with migraine medication
- Opioid meds- narcotics, but are habit forming.
- Glucocorticoids- prednisone or dexamethasone
- Pain- Prevention- reduces the frequency, severity, and length of migraine.
- Cardiac drugs- beta blockers- Inderal, Lopressor, betimol. ACE Inhibitors- lisinopril, calcium channel blockers- calan
- Anti-depressants- amitriptyline, Effexor
- Anti-seizure- Topamax
- Botox- injected every 12 weeks.
- Alternative Medicine
- Acupuncture, biofeedback- how to control physical responses to stress, massage therapy, cognitive behavioral therapy- teaches you how behaviors and thoughts affect how you perceive pain.
- Herbs, Vitamins, Minerals
- Muscle relaxation exercises- meditation or yoga, Reduce Stress
- Get enough sleep
- Rest and relax- dark quiet, cool room
- Headache diary, don’t skip meals
- Preventive therapies-
- Transcutaneous supraorbital nerve stimulation (t-SNS)- FDA approved
- Learn coping strategies.
- Consistent daily schedule with sleep, meals, and medications
- Reduce intake of estrogen
Bell’s palsy is defined as one sided facial paralysis due to an inflammation of the 7th cranial nerve of the face, that results in weakness or paralysis of the muscle on the affected side. The inflamed and swollen nerve becomes so compressed that it becomes damaged.
Bell’s palsy has a rapid onset, there is a slower recovery in elderly patients. There is complete recovery in majority of patients. Partial recovery can occur if contractures (tightening) occur on the affected side of the face. It may recur, but this is rare.
Up to 40,000 Americans a year get Bell’s Palsy. It can affects any age. The most susceptible are pregnant women, those who have diabetes, the flu, and a cold or other respiratory conditions.
The cause is unknown, but may be related to vascular ischemia [decreased oxygen to tissue causing damage to tissue], a virus (herpes, chicken pox, Flu, Measles, Mononucleosis), Lyme’s disease, tumors, a bacterial infection, or autoimmune disease that cause inflammation to the nervous systems (Multiple Sclerosis).
Characteristics include tearing of the affected eye, painful sensation to the face, pain behind the ear, pain in the eye, difficulty speaking and eating on the affected side, drooping eye, difficulty opening and closing eyelid on the affected side (can cause corneal ulceration due to drying of the eye), drooping of face and lips on the affected side, change in taste, sensitive to sound, drooling, and headaches.
Diagnosis is based on the characteristics mentioned, MRI or CT scans to rule out a tumor or other pressure to the facial nerve as the cause. An Electromyography, a test for nerve damage and to test for severity, can also be performed.
The goal of treatment is to maintain facial muscle tone and prevent further nerve damage. This is not a stroke and recovery can take 3 weeks to several months, and in a few up to a year.
1. Corticosteroid (prednisone) help to reduce inflammation and swelling, which then reduces compression to nerves and blood vessels. This helps to decrease severity of the paralysis, decrease pain, and prevent permanent nerve damage.
2. Remove the cause of the damage to the nerve, such has a tumor.
3. Oral care is important to prevent cavities.
4. Protect eyes from dryness with sunglasses and natural tears eye drops
or wear an eye patch at night.
5. Take pain medication such as Acetaminophen or NSAIDS (Ibuprofen, Aleve).
6. It is rare but surgery may be necessary to decompress the nerve
7. Gentle facial massages, and facial exercises to maintain muscle tone.
Physical therapy can help return muscle functioning.
8. Apply moist heat to relieve pain
9. Emotional support due to change in body image
10. Alternative therapy: L-lysine 500-1000 mg daily, and Vitamin B12 5000
once a day, help to heal nerve damage
11. Antivirals can be prescribed by your doctor.
Seek immediate medical attention if you ever have paralysis to rule out stroke.