February 10th, 2014 | The Blog
Menstrual cramps are a fact of life for many women. It is no fun to have these mild to sometimes debilitating lower abdominal cramps every month from puberty through menopause.
Dysmenorrhea or painful menstrual cramps account for 600 million lost work hours every year in the U.S.
There is a potential new treatment for menstrual cramps on the horizon. Everyone has heard of the little blue pill, right? Well, Viagra started out as an anti-hypertensive or high blood pressure medication. Then, it became a popular treatment for erectile dysfunction (ED). And now, it is a potential treatment for primary dysmenorrhea (PD) or moderate to severe menstrual cramps.
Standard Treatments for Primary Dysmenorrhea
There are current and standard treatments suggested for the usual monthly menstrual pain that some women experience. The most common treatments include:
Ibuprofen, an over-the-counter non-steroidal anti-inflammatory drug, is the first-line pain medication for menstrual cramps. With frequent and prolonged use, ibuprofen does have potential side effects including gastric ulcers and kidney damage. A hormone called prostaglandin affects menstrual cramps; ibuprofen has anti-prostaglandin properties so helps alleviate cramps.
Oral contraception or the birth control pill, which is a prescription drug regulated by a primary care physician or OB/GYN specialist, is a common and effective treatment choice. By regulating the menstrual cycle, associated cramps are often improved.
Promising New Treatment
Viagra or sildenafil citrate is most commonly prescribed for erectile dysfunction. Sildenafil is actually the active ingredient in the brand name Viagra medication. This drug is the promising hope to treat primary dysmenorrhea.
Interestingly, there was an earlier study in which oral Viagra was used. The oral administration of the drug was found to increase pelvic pain, in some cases, and also cause a common side effect, headaches. Given these results, the new study uses vaginal suppositories to deliver the Viagra not pills.
The vaginal delivery is effective because the drug is intended to deliver local relief to the uterus. It also carries very few, if any, side effects.
The U.S. National Institutes of Health (NIH) conducted the new study. Women, 18 to 35 years old, with moderate to severe menstrual cramps or primary dysmenorrhea (PD) were involved in the study. The results showed that a 100 mg vaginal suppository of sildenafil citrate was nearly twice more effective in relieving pain than a placebo over a 4-hour period.
How it Works
Viagra causes the blood vessels in the pelvis to dilate, which increases the blood flow to the uterus. This, in turn, increases the oxygen to the pelvic tissue and relieves menstrual cramp pain.
There were no complaints about side effects with the vaginal suppository delivery of the drug.
Availability of the Drug
There is still work to be done and more comprehensive studies to be completed before Viagra is approved by the U.S. Food and Drug Administration (FDA) to treat primary dysmenorrhea. There is a promising outcome on the horizon. Stay tuned.
February 3rd, 2014 | The Blog
This is winter. Winter is cold. Excessive exposure to cold can lead to frostbite. Frostbite is serious and needs immediate medial attention to the potential long-term consequences and effects.
Unprotected body parts and those areas with less circulation are the most at risk. The most likely affected areas are:
The Mechanics of Frostbite
The human body works hard to preserve heat when a person is outside in frigid cold temperatures. The circulatory system forces heat to the body’s core in an effort to keep the heart and lungs warm. This protective mechanism reduces blood flow to the fingers and toes, which makes them more susceptible to frostbite.
Here are some important facts and explanations about frostbite:
Toes are the most common body part to get frostbite.
This protective mechanism of frostbite reduces blood flow to the fingers and toes, which makes them more susceptible to freezing damage.
Frostbite happens quickly.
While most cases of frostbite happen with extended exposure, it can happen quickly. Bare skin can freeze in five minutes, if exposed to below zero degrees Fahrenheit temperatures.
Warm water helps to rewarm frostbitten areas. But, do these things first:
Soaking the affected body part in warm water, not hot water, will make the tissue warm and flexible. The rewarming process can be painful. Over-the-counter analgesics can help to ease the pain. Frostbitten areas should not be rewarmed if there is a chance of refreezing.
Exercise helps prevent frostbite.
Exercise keeps blood flowing to the affected area. Caution must be taken to avoid exhaustion by over exerting.
Loose-fitting layers of wool help prevent frostbite.
Layers of loose-fitting clothes allow ventilation and insulation. Wool is a better choice than cotton because it still provides insulation, even when it gets wet.
A mix of different fabrics for different layers is ultimately the best choice for the best protection. The Centers for Disease Control and Prevention (CDC) recommend an inner layer of wool, silk or polypropylene. A wind-resistant outer layer will offer further protection. A water-repellent fabric is the ultimate outside layer.
Frostbite causes actual ice crystals inside the body.
The fluid within frostbitten tissue actually freezes and forms ice crystals. Blisters can develop as the skin thaws. There is a potential for infection where blisters burst.
Healing takes a long time. Once blisters form, then they scab and permanent scarring is possible.
All frostbitten fingers DO NOT have to be amputated.
Frostbite can be superficial or deep. Superficial wounds lead to blisters and usually a full recovery Deep frostbite affects muscles, tendons and bones, which can end with amputation.
Smoking, alcohol and heart disease increase the risk of developing frostbite.
Any action that constricts blood flow to high-risk body parts ads to the chance of developing frostbite.
Earrings and other metal jewelry can increase the risk of frostbite.
These items speed up the cooling of the skin and add to the frostbite risk.
Children are more likely to get frostbite than adults.
Children lose heat faster from their skin than adults and they are more likely to stay outside longer. Both of these facts make them more likely to develop frostbite.
Cats and dogs can get frostbite.
Fur does not make dogs and cats immune to frostbite. They are still at risk, especially their toes, ears, tail, stomach and face. Affected areas turn white, gray or blue.
The Best Advice
Knowing the facts is the first step to understanding this potentially dangerous medical condition. Frostbite must be taken seriously to avoid long-term complications. Seek medical attention immediately at the first sign of frostbite.
January 27th, 2014 | The Blog
What is a superfood? A superfood is a fruit or vegetable that is loaded with antioxidants, vitamins and other plant nutrients. According to nutritionists at the Cleveland Clinic, superfoods are those foods that contain high quality nutrition.
Here are 10 of the most readily available winter superfoods. Yes, there are seasonal superfoods as they become plentiful to the consumer. The first two on the list carry over from the abundant fall superfood crops.
In an effort to convey all of the important points about each superfood, they are presented as bullet point lists:
A balanced diet, rich in winter super foods will provide a strong base to stay healthy during the cold and flu season. Sprinkle in the key winter superfoods throughout the day, starting at breakfast and continuing through the remaining snacks and meals.
January 20th, 2014 | The Blog
Peanut allergies are serious, very serious. The best way for someone with a peanut allergy to avoid a problem is not to ingest any peanuts or peanut-containing products. The Journal of Allergy and Clinical Immunology has recently published a new report about easing severe peanut allergies.
When trace amounts of peanuts hide in baked goods or other foods or the product package states the standard, manufactured in a facility that process peanuts, it is beneficial if a patient can tolerate even a tiny amount of peanut exposure to avoid a potentially life-threatening allergic reaction.
It must be understood that the new protocol is not a cure. It allows patients with severe peanut allergies to tolerate trace amounts of peanuts, which might, otherwise, be fatal.
Who is Allergic to Peanuts?
The numbers of peanut allergies have tripled over the past ten years. Millions of children have an allergy to peanuts. Millions of children carry an Epi-Pen to school every day.
It is important to note that 80% to 95% of all general food allergies are peanut or tree nut related. Tree nuts include almonds, walnuts, pecans, pistachios, cashews, chestnuts, hazelnuts, macadamia nuts and Brazil nuts.
This is a method of exposing a patient to tiny amounts of their allergen, in this case, peanuts, in a controlled medical environment. Patients are not given enough of the allergen to cause a reaction but given enough to help them begin to tolerate it. Over time, the dosage of the allergen is slowly increased.
Up to 30% of patients do suffer a severe reaction to even the smallest dose of their allergy trigger. In this situation, the desensitization process is stopped.
The Treatment Protocol
The patients involved with the study were pretreated with the anti-allergy medication, first with either monthly or bi-monthly injection for 12 weeks. Then, they began the desensitization process.
Powerful Anti-Allergy Medication
Omalizumab or Xolair, a U.S. Food and Drug Administration (FDA) approved drug used to treat allergic asthma, has been shown to enhance the desensitization process. It works by attaching to the body’s IgE antibodies. The IgE antibodies are produced by the immune system when a trigger food is introduced into the system. Xolair helps to prevent allergic reactions.
Methodical Desensitization Process
To start, one-tenth of a milligram of ground-up peanut is ingested by the patient. This is a miniscule piece of one single peanut. The dosage is increased by tiny amounts every 30 minutes. The process is so slow and gradual that at the end of six hours, a patient has ingested about 2 1/2 peanuts, in total.
The desensitization process, including the Xolair pre-medication, continues for eight weeks, during which the patients are given larger numbers of peanuts. The goal is for the patient to consume 10 peanuts everyday with no reaction or a very mild reaction, at worst.
The next step in the process is to stop the Xolair pre-medication and continue ingesting the daily peanuts for the balance of one year.
Downside of the Treatment
Xolair is an expensive drug. It is not FDA-approved for treatment of food allergies. For this reason, health insurance companies do not cover the cost. The hope is that, once the study and results are confirmed, the payment process will change.
Patients with a life-threatening peanut allergy trigger can suffer the consequences by ingesting as little as one-quarter of one peanut.
Being desensitized to tolerate two peanuts is certainly enough to protect a patient from the aforementioned trace exposure.
At the end of the desensitization process, patients need to continue eating peanuts, daily peanut M & Ms or Reese’s so their body continues to tolerate them. This will keep the IgE antibodies against peanuts on the downslide. Interestingly, some patients with a severe peanut allergy do not like the taste of peanuts so the daily intake becomes drudgery.
Researchers at Boston Children’s Hospital are trying to find different ways to provide daily peanut intake for those who do not like the taste of peanuts. A couple of the options include peanut flour, which can be substituted in cookies or other baking recipes or a capsule or pill, which can be swallowed whole.
What is Next?
The researchers who worked on the peanut allergy desensitization hope to begin working with other food allergies and, perhaps, multiple food allergies at one time.
January 13th, 2014 | The Blog
It is time, one last time, to revisit the subject of the flu 2013-2014. As the flu begins to hit some areas of the country quite aggressively, it is important to encourage those who have not received the flu shot to do so, as soon as possible. It is not too late.
How Well It Works
The flu vaccine prevented 6.6 million cases of the flu last year, according to the Centers for Disease Control and Prevention (CDC). That number translates into 80,000 fewer hospitalizations for this potentially serious illness.
The CDC feels strongly that the general population can improve those numbers because, as of November 2013, only 40% of all eligible Americans had been vaccinated. That number is up from 37% at the same time last year, November 2012.
Who Are the Holdouts?
Only 40% of pregnant women have been vaccinated, despite their higher risk of complications.
The other group of concern is healthcare workers. Nationwide, only 63% of them have had a flu shot. This is a serious deficit because healthcare workers can easily spread the flu to their patients.
In simple terms, almost everyone over 6 months old should get the flu shot, with the exception of the patients delineated below. The very limited groups who should not get the flu shot include, but are not limited to:
Flu Shot Availability
There is still plenty of flu vaccine available throughout the country. There is a simple-to-use app available to find flu vaccine availability near where a patient lives. Check out this site:?http://vaccine.healthmap.org. There are at least 50 pharmacies listed, as well as the type of flu vaccine that is available at each location.
There are several types of flu vaccine including:
Flu Symptoms Nobody Wants
The flu comes with concerning and miserable symptoms, which include:
Complications of the flu include:
More than half of hospitalizations for the flu are patients over 65 years old.
The Bonuses of Getting a Flu Shot
According to the Journal of the American Medical Association (JAMA), the flu shot can reduce a patient’s risk of having a heart attack, stroke or heart failure, especially if they already have established heart disease. The risk is 36% lower than someone who did not have the flu shot.
Why? The theory is that flu viruses cause inflammation, which can cause cardiac arrhythmias, fluid around the heart or the release of plaque in an artery resulting in blocked circulation to the heart muscle or and subsequent heart attack.
Getting the flu shot protects a person from this miserable and potentially dangerous illness. Very importantly, getting the flu shot also protects not only the patient but everyone else around the patient.
Do yourself and everyone around you a favor. Just get a flu shot, if you have not already done so.
January 6th, 2014 | The Blog
Germaphobes beware! There is a new concern by the U.S. Food and Drug Administration (FDA) about the safety and effectiveness of antibacterial soaps. Make note: this does not include alcohol-based hand sanitizers; it is about antibacterial soaps only.
An interesting fact in the big picture of the soap industry: Antibacterial soaps comprise almost half of the current $900 million liquid soap industry in the U.S.
The Ingredients of Concern
There are two basic antibacterial soap ingredients causing concern in the health profession. They are:
This chemical was originally, the 1970s, used by surgeons as an antimicrobial. It was not intended for consumer use but has become a popular component in bar soaps.
Originally intended for use in bar soaps and has become a popular and standard ingredient in current day antibacterial soaps.
Technically, they are both pesticides, of sorts, so the Environmental Protection Agency (EPA) mandates that triclosan and triclocarban be safe for the overall environment. They wash down household drains into water supply and soil so the recent discussions have become paramount concerns for the EPA.
In March 2013, the EPA opened a safety review of triclosan, five years ahead of plan, due to environmental concerns. Interestingly, Canada has declared the chemical to be toxic and is in the process of banning products containing triclosan from being sold in the country.
There is a proposed regulation to ban triclosan and triclocarban from popular soap products. The active ingredients include triclosan are found in liquid soaps and triclocarban is found in bar soaps. Household cleaning products can also contain these active ingredients.
Manufacturers must prove that using these chemicals in their products is safe and more effective than plain soap and water for preventing the spread of infection
Long-term exposure to the active ingredients in these soaps, according to the FDA:
Alcohol-Based Hand Sanitizers
These products, like Purell and anti-bacterial wipes, do not contain the triclosan or triclocarban. They are alcohol-based leave on products. Alcohol-based hand sanitizers are not affected by the new FDA concerns.
There is some toothpaste that contains triclosan. One such brand is Colgate Total. These toothpastes will not be formally affected by the FDA regulations because previous clinical trials of the toothpastes have already shown that the benefits of the products outweigh the risks.
What Will Need to be Done
Manufacturers must prove that their product works better than plain soap and water and that they pose fewer health risks. The fewer health risk portion of this scenario is a difficult one to prove. At that point in the process, the manufacturers will need to:
There is a six-month window for the manufacturers of the affected products to respond to the regulation. The six months allows for public comment.
Then, there is a 60-day rebuttal period following the six-month comment period.
Depending upon the data and outcome of the comments, the proposed FDA rule can be finalized.? If the new FDA recommended standards are accepted, they would take effect one year later. The full regulation changes will not be started until 2016.
The FDA recommends the following for hand-washing, until such time that the anti-bacterial component is clarified:
In 2012, Johnson & Johnson voluntarily removed triclosan and triclocarban from all baby products. The company plans to remove triclosan from adult products by 2015.
The manufacturer of Lysol brand products, Reckitt Benckiser Group, has started to phase triclosan out of their products.
A group called Beyond Pesticides works diligently in Protecting Health and Environment with Science, Policy and Action. They provide a comprehensive list of products containing triclosan, which should be avoided. The link to their website and list is:
Until the facts and regulations are sorted out and approved by the FDA, the best advice is to avoid products that claim to be antibacterial or antimicrobial. Check labels before purchasing any of the potentially affected products.
December 30th, 2013 | The Blog
Eye jewelry. Really? There is a new kind of bling available for those who are looking for a unique way to dress up their eyes. This goes far beyond the traditional eye shadow and mascara.
The new trend, eyeball jewelry implantation, started in Los Angeles (LA), California and has recently spread to New York’s Park Avenue. It takes the meaning of ophthalmology to a whole new level.
It is important to note that the U.S. Food and Drug Administration (FDA) does not approve the eye jewelry implantation procedure.
The Eye Bling
The cost of the procedure varies from $3000-$4000 for one tiny implant, depending upon the specific physician. The first eye jewelry implant, done in LA, was very small heart-shaped piece of platinum.
Why are patients undergoing this totally optional and frivolous procedure for their eyes? The two main reasons delineated by patients who have had it done include:
The Eye Jewelry Procedure
A board-certified ophthalmologist should be the healthcare professional performing the eye jewelry implantation procedure. There are only a few ophthalmologists from coast-to-coast who have come forward stating that they perform eye bling implants.
The basic steps of the eye jewelry implantation procedure include:
The bling placement is quick and has very little discomfort associated with it.
According to the American Academy of Ophthalmology (AAO), which represents the ophthalmologists around the country, there are the potentially serious complications from the procedure. These include:
Most ophthalmologists opt to have the patient use antibiotic eye drops to prevent infection after the placement of the eye jewelry.
The American Academy of Ophthalmology (AAO) recommends avoiding placing any foreign body or other material in the eye that is not approved by the FDA.
It is imperative to follow-up with the treating physician to evaluate and assess the patient’s response to their new eye adornment.
If you or your patients are looking for a new, very new, way to dress up your eyes, consider an eye jewelry implant but wait until the FDA sanctions it with their approval. Please.
December 23rd, 2013 | The Blog
Every teen wants to carry a fabulous figure. Every teen wants to fit in. Some teens will go to more extremes than others to accomplish these feats, even if they can cause serious medical conditions or death.
There is a new diet circulating among the younger population. It is called the Cotton Ball Diet. This diet is all over YouTube and various chat rooms. The most popular age range for using this diet trend is 9-to-16-years old.
The cotton ball diet involves the teen dipping a cotton ball(s) into orange juice, lemonade, a smoothie or water before swallowing them. The serving size is up to five cotton balls.
The cotton balls make the teens feel full so they do not eat as much, or any, nutritional real food. They feel full and do not gain weight. Some teens swallow the cotton balls before a meal to cut their total food intake while others, even more dangerously, only ingest the cotton balls and no real food.
The act of eating the cotton balls or any other non-edible item is an eating disorder called pica. Nutrition experts report that people with nutritional deficiencies often crave non-edible substances like cloth, clay or in this case, cotton balls. The cotton ball diet is clearly and most often an act driven by teens with an eating disorder.
There are risks and adverse effects to eating non-edible items, including cotton balls. The cotton balls can become lodged in the intestines. This can cause a painful intestinal tract obstruction, which needs immediate and potentially emergency surgical removal. The trapped mass causing an obstruction is called a bezoar. This situation can be life-threatening.
It is also important to note that cotton balls are not really made of pure and natural cotton. They are made of bleached, polyester fibers, which contain some chemicals. It can be compared to eating a T-shirt dipped in orange juice or lemonade.
There is also the choking risk. A wad of cotton can easily become lodged in the throat and cause the teen to choke.
Malnutrition is a major risk to this diet.There is no nutritional value to cotton balls so teens are missing important and vital vitamins, minerals and other nutrients.
The Ultimate Diet Outcome
The outcome of the cotton ball diet has no desirable long-term benefit for any teen. Patients who are using this diet need professional counseling and guidance through an obvious eating disorder.
This diet should be avoided at all cost. It is dangerous and not healthy.
December 16th, 2013 | The Blog
Some patients with epilepsy are resistant to drug treatment. There is a new U.S. Food and Drug Administration (FDA) approved device that has promising results. The device is called the RNS Stimulator.
When neurons within the brain fire abnormally, seizures can occur. Many affected patients respond well to epilepsy medications. But, if a patient fails to respond to two or more of the available epilepsy drugs, a further evaluation is indicated to assess whether surgery is a potential treatment.
Depending upon where in the brain the seizure activity originates and whether there are one or several areas of the brain from which they are originating, a determination is made for a recommended course of treatment.
RNS Stimulator Facts
Here are some straight facts about the new implanted device to treat epilepsy:
How the Device Works
The RNS Stimulator works differently than the previous brain implants that have been used to treat Parkinson’s disease and dystonia. It is also different from the vagal nerve stimulator used to treat some forms of epilepsy.
Here is how the new device works. The RNS Stimulator detects abnormal function in the brain. It then sends electrical signals via implanted wires in the brain to stop a seizure from occurring.
The parts that make up the device include:
The neurostmulator is implanted in the cranium. It is connected to one or two leads, which are implanted in the brain near the patient’s seizure focus or area of origin.
There are also external components for the device. They include a programmer, laptop computer and telemetry interface to provide communication with the neurostimulator. This allows the physician to non-invasively program the detection and stimulation limits of the RNS Stimulator device. The physician can also monitor the patient’s electrical activity in the brain via an electrocorticogram or ECoG.
The neurostimulator detects abnormal electrical brain activity and then delivers electrical stimulation to correct brain activity BEFORE a seizure transpires.
The End Result
It is important to note that the RNS Stimulator is not a cure for epilepsy. It helps to reduce the amount of seizure activity but there are very few patients who are seizure free after having the implant.
Every patient and their epilepsy diagnosis and disease specifications are unique. A full neurological evaluation by a qualified neurosurgeon will determine if a patient is a candidate for the implant, as well as assure the best and safest outcome if surgery is the treatment of choice.
December 9th, 2013 | The Blog
A pregnancy needs timely and appropriate medical care. The sooner the patient knows they are pregnant, the better. The earlier in a pregnancy that a woman seeks prenatal care, the better. It is important for both the woman and the unborn baby.
The At-Home Pregnancy Test
The standard at-home pregnancy test has a simple straight line or plus sign indicator, which only tells that the woman is pregnant or not. It is a simple yes or no indicator. No further details are disclosed with the standard test.
A new and improved at-home pregnancy test is now available and has an important added feature. The Clearblue Advanced Pregnancy Test with Weeks Estimator was approved by the U.S. Food and Drug Administration (FDA) in December 2012 and became widely available to the general public in the U.S in September 2013.
This new test indicates whether the patient is 1 to 2 weeks pregnant, which is right around the time when the woman’s menstrual period is due, 2 to 3 weeks pregnant or more than 3 weeks pregnant. This is additional and important information was not previously available with the simple and standard home pregnancy test.
The Clearblue Advanced Pregnancy Test with Weeks Estimator is 99% accurate in detecting pregnancy and 93% accurate in estimating the number of weeks a woman is pregnant. The cost of the test is slightly higher than the standard home pregnancy test; it costs about $16.
How it Works
The standard at-home test detects the presence of the pregnancy hormone human chorionic gonadotropin (hCG). It is a very simple and only tells if pregnant or not using a straight line or plus sign indicator.
The hCG level rises to a predictable level during the first three weeks of pregnancy and continues to do so until the 11th week, when it drops lower.
The Clearblue Advanced Pregnancy Test with Weeks Estimator has an additional strip, which measures the hCG levels. This gives an estimate of the number of weeks pregnant the woman actually is at the time of the testing.
Benefits of the New Pregnancy Test
Early prenatal care is i the best interest of the mother-to-be and the unborn child. The Clearblue Advanced Pregnancy Test with Weeks Estimator has several benefits:
It is important to note that this is an at-home test, its is not a substitute for professional medical care. This test should not be used in place of the traditional first trimester ultrasound, the golden standard of pregnancy testing to verify the gestation of the pregnancy.