Health Care and Hospital Emergency Rooms

Hospitals have trauma centers that often double as emergency rooms for critical health and medical needs. Medical staff, including doctors and nurses as well as other critical care personnel, are typically on call 24/7 during their shifts and see all types of major life threatening and urgent healthcare issues. Individuals who use these can often be simply someone who does not have insurance and needs medical attention for any variety of ailments. As well, emergency rooms experience visits by fully insured individuals who may have had a serious accident, injury, or medical need. Emergency rooms are known for life saving treatment.

According to this website: http://www.howstuffworks.com/emergency-room.htm , a visit to the emergency room can be a stressful, scary event. Why is it so scary? First of all, there is the fear of not knowing what is wrong with you. There is the fear of having to visit an unfamiliar place filled with people you have never met. Also, you may have to undergo tests that you do not understand at a pace that discourages questions and comprehension.

According to a report published by HealthSprocket, here are the Top 10 reasons for emergency room diagnoses (2006) for visits:

1. Sprains and strains (6,375,245)
2. Superficial injury, contusion (6,107,869)
3. Other upper respiratory infections (5,285,382)
4. Abdominal pain (4,381,653)
5. Open wounds of extremities (3,697,836)
6. Spondylosis, intervertebral disc disorder, other back problems (3,236,278)
7. Nonspecific chest pain (3,018,660)
8. Headache, including migraine (2,825,233)
9. Open wounds of head, neck, and trunk (2,692,292)
10. Skin and subcutaneous tissue infections (2,610,735)

The information for these medical problems came from a study developed in 2006: HCUPnet. Healthcare Cost and Utilization Project (HCUP), 2006. Agency for Healthcare Research and Quality. Rockville, MD .

According to the Centers for Disease Control (CDC), here are the stats for the last year on record (2010) for emergency room visits:

• Number of visits: 129.8 million
• Number of injury-related visits: 37.9 million
• Number of visits per 100 persons: 42.8
• Percent of visits with patient seen in fewer than 15 minutes: 25.1%
• Percent of visits resulting in hospital admission: 13.3%
• Percent of visits resulting in transfer to a different (psychiatric or other) hospital: 2.1%

Source: National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Tables, tables 1, 4, 14, 24; and this website: http://www.cdc.gov/nchs/fastats/ervisits.htm .

According to the New York Times, hospital emergency rooms, particularly those serving the urban poor, are closing at an alarming rate even as emergency visits are rising. Urban and suburban areas nationwide have lost a quarter of their capacity over the past twenty years, according to the study, in The Journal of the American Medical Association. In 1990, there were 2,446 hospitals with emergency departments in non-rural areas. That number dropped to 1,779 in 2009, even as the total number of emergency room visits nationwide increased by roughly 35 percent.

Emergency departments were most likely to have closed if they served large numbers of the poor, were at commercially operated hospitals, were in hospitals with skimpy profit margins or operated in highly competitive markets, the researchers found. Although the study did not examine emergency care at the remaining facilities, the closings take a toll on the quality of care in all emergency rooms according to Dr. Renee Y. Hsia, an assistant professor of emergency medicine at the University of California, San Francisco, and the lead author of the study.

According to the NY Times article, conditions in emergency rooms may be worsened by the new health care law, several experts said. The PPACA will expand eligibility for Medicaid, the government health plan for the poor. “Often beneficiaries turn to emergency rooms for care, because many physicians do not accept Medicaid payments”, said Dr. Sandra M. Schneider, president of the American College of Emergency Physicians. By federal law, emergency rooms are required by law to provide treatment regardless of ability to pay. More information can be found at this site: http://www.nytimes.com/2011/05/18/health/18hospital.html .

Emergency rooms provide a primary life saving option for patients in stress and trauma, whether the reason is due to illness or accident. The medical staff is highly trained to serve under pressure, and for the most part, able to accomplish in the majority of cases care that helps reduce the possibility of someone not recovering from their health care disaster.

Although emergency rooms are not really designed to handle day to day health care situations such as colds, sore throats, and non-life threatening issues. However, for anyone who is not insured, these locations often perform this function due to lack of available treatment options. Certainly, with ObamaCare in place, and due to ramp up starting in 2014, the lack of sufficient urgent care centers are going to suffer significant stress in their own right.

Until next time.

Health Care and Aneurysm

One of the most difficult health care issues to diagnose early is an aneurysm. They can be deadly if not caught in time, and often are fatal if they occur in certain circumstances. It is not clear exactly what causes aneurysms, according to the National Institutes for Health (NIH). Some aneurysms are present at birth (congenital). Defects in some of the parts of the artery wall may be responsible. Common locations for aneurysms include:

• The major artery from the heart (the aorta)
• The brain (cerebral aneurysm)
• In the leg behind the knee popliteal artery aneurysm)
• Intestine (mesenteric artery aneurysm)
• An artery in the spleen (splenic artery aneurysm)

High blood pressure, high cholesterol, and cigarette smoking may raise your risk of certain types of aneurysms. High blood pressure is thought to play a role in abdominal aortic aneurysms. Atherosclerotic disease (cholesterol buildup in arteries) may also lead to the formation of some aneurysms. Pregnancy is often linked to the formation and rupture of splenic artery aneurysms. More info can be found at this site: http://www.nlm.nih.gov/medlineplus/ency/article/001122.htm .

According to the Mayo Clinic, with a brain aneurysm, a sudden, severe headache is the key symptom of a ruptured aneurysm. This headache is often described as the "worst headache" ever experienced. Common signs and symptoms of a ruptured aneurysm include:

• Sudden, extremely severe headache
• Nausea and vomiting
• Stiff neck
• Blurred or double vision
• Sensitivity to light
• Seizure
• A drooping eyelid
• Loss of consciousness
• Confusion

In some cases, according to the Mayo Clinic, an aneurysm may leak a slight amount of blood. This leaking (sentinel bleed) may cause only a sudden, extremely severe headache. A more severe rupture almost always follows leaking. An unruptured brain aneurysm may produce no symptoms, particularly if it's small. However, a large unruptured aneurysm may press on brain tissues and nerves, possibly causing:

• Pain above and behind an eye
• A dilated pupil
• Change in vision or double vision
• Numbness, weakness or paralysis of one side of the face
• A drooping eyelid

A ruptured aneurysm is a medical emergency. In about 30 percent of cases, ruptured brain aneurysms are fatal. Seek immediate medical attention if you develop a sudden, extremely severe headache. If you're with someone who complains of a sudden, severe headache or who loses consciousness or has a seizure, call 911 or your local emergency number. More material about this subject is found here: http://www.mayoclinic.com/health/brain-aneurysm/DS00582/DSECTION=symptoms .

Aneurysms tend to occur in older Caucasian men; women are less at risk. By age 80, over 5% of Caucasian men have developed an aneurysm. People of African descent rarely develop aneurysms. Abdominal aortic aneurysms occur in 4% to 8% of men 65 and older and in 0.5% to 1.5% of women 65 and older. They rarely occur in people under age 55. Unfortunately, 80% to 90% of people who experience a ruptured abdominal aortic aneurysm die from it, according to the pharmacy chain company Duane Reade.

A person's risk of developing an aneurysm may be inherited. Ascending aortic aneurysms and berry aneurysms are especially likely to run in families. The men of an affected family are more likely to develop aneurysms than are the women. Scientists haven't yet identified the responsible genes in humans, though they have identified some in mice.

About half of all people with ascending aortic aneurysms are born with deformations known as Marfan's syndrome. Such people are unusually tall with long extremities. Abraham Lincoln is thought to have had Marfan's syndrome. They also have a weakness in the aortic wall, just where the aorta leaves the top of the heart.

Two other types of aneurysms are mycotic and atherosclerotic aneurysms. Mycotic aneurysms are caused by a bacterial or fungal infection. Almost any such organism can damage the arteries, but the infection must be very deep and severe. The bacteria salmonella and syphilis both seem to have a special liking for arterial walls.

Atherosclerotic aneurysms are linked to the process that causes coronary artery disease, which is the buildup of fatty deposits on the inner wall of the arteries. In reality, the picture's not so clear. Even someone with severe atherosclerosis may not develop an aneurysm if they are not already genetically predisposed.

Risk factors for heart disease, such as high blood pressure, high cholesterol, inactivity, smoking, and obesity, are also risk factors for aneurysms. Severe aneurysms are probably due to a combination of genes and poor cardiovascular health. Occasionally, aneurysms develop where stab or gunshot wounds have perforated an artery. Much more information can be found at their site: http://www.duanereade.com/health/conditionfactsheet/237_1_0_1_0_0/aneurysm.aspx .

According to the Brain Aneurysm Foundation, one of the most frequently asked questions by brain aneurysm survivors is “How long until I get better?” Unfortunately, there is no way to predict the length of time it will take to improve or even how much improvement will actually occur. Recovery for patients who receive treatment for an unruptured aneurysm generally require less rehabilitative therapy and recover more quickly than patients whose aneurysm has ruptured.

There will be a better chance for recovery if the survivor and his or her family maintain hope, even if that means the recovery process will take a long period of time. A famous rehabilitation pioneer, George Prigatano, Ph.D., frequently tells his patients “If the brain is alive, it can learn.” If you are an aneurysm survivor or you are a caretaker, you need to remember these inspiring and assuring words. The brain can learn new skills for a lifetime. For survivors, there are many challenges to face in the road to recovery: physical challenges, emotional challenges, depression, and dealing with potential deficits. Much more information can be found at this website: http://www.bafound.org .

Aneurysms are extremely serious health events. If you feel that you may be experiencing one or know someone who is, seek immediate medical attention. Better to be cautious than not.

Until next time.

Health Care and Financial Wellness

How is your financial wellness? Are you living paycheck to paycheck as most Americans, or have you been fortunate as a steward of your resources to stash some cash for the rainy days? Do you have enough stored away for a few raindrops, or are you prepared like Noah to last through the flood and until the waters recede? That would be a very long time, and require a good portfolio of financial stability.

The evidence is piling up: Chronic stress is linked to chronic medical issues. More than 200 medical research studies have documented the connection between stress and costly mental and physical diseases, according to Lynn Gresham, former senior editor of Employee Benefit News. The growing awareness of the link between high stress and poor health is prompting employers to take a more holistic approach to employee wellness, addressing workers’ financial health as well as physical health. This is because a primary cause of employee stress is concern about personal finances.

Ms. Gresham writes that money, the economy, and jobs are the top three causes of stress for Americans, according to the American Psychological Association. Although economic signs are improving, the average employee is still struggling to meet financial obligations and make ends meet. A survey conducted for Allstate in February of this year shows:

• Four in 10 Americans still live paycheck to paycheck.
• 8% don’t have enough money for everyday essentials.
• Half describe their financial situation as “fair” or “poor.”
• 47% say they are not saving as much as they should be.

None of this is surprising, given Americans’ debt level, according to Lynn Gresham. The Federal Reserve reported in March that the average credit card debt is $7,122, and among households with other debt, it jumps to a distressing $15,266. The average mortgage debt is $149,667, and the average student loan debt is $32,559.

As stated in the PwC 2012 Employee Financial Wellness Survey, “Despite recent improvements in the economy, the hangover effect from the recession and slow economic growth continues to erode employees’ retirement confidence and overall financial wellness. Cash flow and debt management issues continue to top employees’ financial concerns.” And they don’t leave their problems at home; one-third of employees polled by PwC said they spend time at work thinking about or dealing with money issues.

In fact, 35% reported spending one to two hours per week distracted by personal finances, and 29% spent three to four hours per week. The result, of course, is lower productivity and a diminished work environment. Money worries also increase turnover. A report from Financial Literary partners estimated that 40% of turnover is due to financial stress as employees job-switch to earn more short-term income, according to the report.

According to Met Life, here are the factors influencing financial wellness:

--Personal characteristics: includes both personality factors and societal status (for example, age or
marital status).
--Financial literacy: working knowledge of financial concepts and tools to make the most
advantageous financial decisions.
--Financial behavior: refers to financial actions, for example, financial planning, saving and investment.
--Financial situation: refers to objective wealth, such as home ownership, salary, benefits and
accumulated wealth.
-- Financial stressors: financial events such as losing a home, personal bankruptcy or job loss.

According to the Foundation for Financial Wellness, here is why it matters: In today’s economy, as more and more people worry about their personal finances, organizations are seeing the degree to which employees who are “financially unwell” are negatively impacting the bottom line. Studies are showing that personal financial distress can result in lost productivity, absenteeism and even health issues. Conversely, employees who enjoy peace of mind regarding their personal finances are more inclined to be happy, productive associates who transfer the quality of their employment experience into everything they do.

Even in a good economy, individual financial wellness is important. For employers, the well-being of employees is a critical component to success. Today, the financial distress employees experience is yet one more way a bad economy impacts business. When workplace outcomes can be improved, everyone benefits. More information about financial wellness can be found at this website: http://www.foundationforfinancialwellness.org/ .

According to financial guru, Dave Ramsey, here is how both employers and employees benefit with a financial wellness plan at work:

Company Benefits:

• Increased participation in benefits programs
• Decreased loan and hardship requests from retirement plans
• Increased employee satisfaction and retention
• Decreased garnishments and payroll advancements

Team Member Benefits:

• Better income management
• Increased savings
• Reduced debt and stress
• Improved investing, retirement planning, and college savings
• Stronger marriages

Dave Ramsey’s website has a huge amount of resources about financial wellness: http://www.daveramsey.com/home/ .

Financial wellness is a critically important topic, and unfortunately most Americans are financially sick as they often don’t adopt steps to prevent problems related to their financial well being. Next to physical, spiritual, emotional, and mental health, financial health should be a top priority. Unfortunately, bad financial health leads to problems in these other areas over time. Do yourself a favor, and investigate ways to improve your financial wellness. Your family, and your wallet, will thank you.

Until next time.

Health Care and Swimmer's Ear

During the warmer months of the year, the popular activity with many people is to go swimming. In addition to being a fun way to relax, you can get lots of exercise and great physical stamina from participating in this great water sport. But sometimes, you can experience problems with a common infection in the ear, especially during the summer, called Swimmer’s Ear—an inflammation, irritation, or infection of the outer ear and ear canal. The medical term for swimmer's ear is otitis externa.

Occurring commonly in the outer ear canal, which runs from your eardrum to the outside of your head, swimmer’s ear is often brought on by water that remains in your ear after swimming, creating a moist environment that aids bacterial growth, according to the Mayo Clinic. Putting fingers, cotton swabs or other objects in your ears also can lead to swimmer's ear by damaging the thin layer of skin lining your ear canal.

Swimmer's ear symptoms are usually mild at first, but they may get worse if your infection isn't treated or spreads, according to the Mayo Clinic, at this site: http://www.mayoclinic.com/health/swimmers-ear/DS00473 . Doctors often classify swimmer's ear according to mild, moderate, and advanced stages of progression.

1. Mild signs and symptoms:

• Itching in your ear canal
• Slight redness inside your ear
• Mild discomfort that's made worse by pulling on your outer ear (pinna, or auricle) or pushing on the little "bump" (tragus) in front of your ear
• Some drainage of clear, odorless fluid

2. Moderate progression:

• More intense itching
• Increasing pain
• More extensive redness in your ear
• Excessive fluid drainage
• Discharge of pus
• Feeling of fullness inside your ear and partial blockage of your ear canal by swelling, fluid and debris
• Decreased or muffled hearing

3. Advanced progression :

• Severe pain that may radiate to your face, neck or side of your head
• Complete blockage of your ear canal
• Redness or swelling of your outer ear
• Swelling in the lymph nodes in your neck
• Fever

According to the National Institutes for Health (NIH), ear drops containing antibiotics are usually given, usually for 10 to 14 days. If the ear canal is very swollen, a wick may be applied in the ear to allow the drops to travel to the end of the canal. Your doctor or nurse can show you how to do this. Other treatments may include:

• Antibiotics taken by mouth if you have a middle ear infection or infection that spreads beyond the ear
• Corticosteroids to reduce itching and inflammation
• Pain medication, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
• Vinegar (acetic acid) ear drops

People with chronic swimmer's ear may need long-term or repeated treatments to avoid complications. Placing something warm against the ears may reduce pain. More details can be found at this website: http://www.nlm.nih.gov/medlineplus/ency/article/000622.htm .

According to the American Academy of Otolaryngology, other factors that may contribute to swimmer’s ear include:

• Contact with excessive bacteria that may be present in hot tubs or polluted water
• Excessive cleaning of the ear canal with cotton swabs or anything else
• Contact with certain chemicals such as hair spray or hair dye (Avoid this by placing cotton balls in your ears when using these products.)
• Damage to the skin of the ear canal following water irrigation to remove wax
• A cut in the skin of the ear canal
• Other skin conditions affecting the ear canal, such as eczema or seborrhea

If left untreated, complications resulting from swimmer’s ear may include:

--Hearing loss. When the infection clears up, hearing usually returns to normal.
--Recurring ear infections (chronic otitis externa). Without treatment, infection can continue.
--Bone and cartilage damage (malignant otitis externa). Ear infections when not treated can spread to the base of your skull, brain, or cranial nerves. Diabetics and older adults are at higher risk for such dangerous complications. To evaluate you for swimmer’s ear, your doctor will look for redness and swelling in your ear canal. Your doctor also may take a sample of any abnormal fluid or discharge in your ear to test for the presence of bacteria or fungus (ear culture) if you have recurrent or severe infections. More info can be found at their site: http://www.entnet.org/HealthInformation/swimmersEar.cfm .

Swimmer’s ear is treatable. Other than being irritating and problematic in its initial stages, it can be properly diagnosed by your doctor and easily resolved. Just don’t delay taking action on any infection of any kind. Remember, your hearing is a vitally important function of life. Don’t abuse it.

Until next time.

Health Care and Acne

One of the most embarrassing skin conditions is acne, and you can usually find a lot of it especially on the faces of teenagers. The typical look of acne is red spots that break out due to many reasons— stress, genetics, and other causes. Acne can be serious or moderate, and there are some cases that require ongoing treatment by health care professionals.

Here are some interesting statistics from the AAD (American Academy of Dermatology), which can also be located at this website--  http://www.aad.org/media-resources/stats-and-facts/conditions/acne :

• Acne is the most common skin disorder in the United States, affecting 40 million to 50 million Americans.
• Nearly 85 percent of all people have acne at some point in their lives, most often on the face, chest, and back.
• By mid-teens, more than 40 percent of adolescents have acne or acne scarring, which requires treatment by a dermatologist.
• The total direct cost associated with the treatment of acne exceeds $2.2 billion each year, including substantial costs for prescription and over-the-counter products.

According to Proactiv.com, from the moment you are born, your skin begins a lifelong process of shedding dead cells and producing oil. This process can be disrupted by your hormone balance, which changes throughout your life. The acne cycle is initiated when excess oil and dead skin cells combine to plug the pore of a hair follicle; behind the plugged pore, bacteria grow and multiply, triggering inflammation and swelling. That's an acne blemish.

Acne is what doctors call a chronic condition, which means it can last for years—even decades in adults. Because there is no cure, the key to a clear complexion is control and prevention with medicated daily maintenance therapy. The pimples you see today started as tiny microcomedones, or pre-pimples, deep inside your skin about three weeks before breaking out. Hundreds of tiny pre-pimples may be forming continuously in any of the thousands of pores on your face. Even when your skin looks clear, they may still be there—percolating invisibly under the skin's surface. Much more detail can be found at this website: http://www.proactiv.com/acne-information/what-causes-acne,default,pg.html .

Once a pore becomes clogged, it traps skin oil inside. Bacteria grows in this oil and can cause an inflammatory response in the skin. Acne lesions can be small and hardly noticeable, have a small white or black head, or can appear red with a white/yellow center. Sometimes a clogged pore will become so inflamed that it can lead to larger, more painful lesions called nodules or cysts, which can ultimately scar. Almost no one escapes some clogged pores and pimples, especially during adolescence--a fragile time when self-esteem and confidence is just emerging. Acne afflicts people of all ethnicities and is treated the same regardless, according to this site: www.Acne.org .

Your skin is healthiest and clearest when it is in balance. The more irritation your skin experiences, the more likely it is to break out. Conversely, the less irritation your skin experiences, the better it is able to remain clean. Sources of irritation include anything which rubs, scratches, or comes into prolonged contact with your skin, as well as anything which sends your skin out of balance such as overdryness, sunburns, shaving the face with irritating razors, and pore-clogging cosmetics. To best clear acne, try to keep your skin as untouched as possible. Acne is not caused by dirt, and washing your face, while it is fine to do up to twice per day, is going to do little to help with your acne. Much more info can be found at this site: http://www.acne.org/ .

People with acne often feel incredibly alone but the fact is, acne is the most common skin disease in the world, with tens of millions of sufferers, according to Proactive. More than 85% of Americans have acne breakouts at some time in their lives. Among teenagers, about 90% develop acne, and it can last all their teen years. Many adults have acne, too. Among adult women, about 50% experience acne breakouts at some point; among men, about 25%—and the chronic nature of the condition means adults may have to endure symptoms for decades if not treated with appropriate acne medication.

According to the NIH (National Institutes for Health), there are many myths about what causes acne. Chocolate and greasy foods are often blamed, but there is little evidence that foods have much effect on the development and course of acne in most people. Another common myth is that dirty skin causes acne; however, blackheads and other acne lesions are not caused by dirt. Stress doesn’t cause acne, but research suggests that for people who have acne, stress can make it worse. Factors that can cause an acne flare include:

• Changing hormone levels in adolescent girls and adult women before their menstrual period starts
• Oil from skin products (lubricants or cosmetics) or grease encountered in the work environment (for example, a kitchen with fry vats)
• Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
• Environmental irritants, such as pollution and high humidity
• Squeezing or picking at blemishes
• Hard scrubbing of the skin
• Stress.

Acne is often treated by dermatologists (doctors who specialize in skin problems), according to the NIH. These doctors treat all kinds of acne, particularly severe cases. Doctors who are general or family practitioners, pediatricians, or internists may treat patients with milder cases of acne. Depending on the extent of the problem, the doctor may recommend one of several over-the-counter (OTC) medicines and/or prescription medicines. Some of these medicines may be topical (applied to the skin), and others may be oral (taken by mouth).

There are several OTC topical medicines used for mild acne. Each works a little differently. Following are the most common ones:

• Benzoyl peroxide--Destroys P. acnes and may also reduce oil production.
• Resorcinol--Can help break down blackheads and whiteheads.
• Salicylic acid--Helps break down blackheads and whiteheads. Also helps cut down the shedding of cells lining the hair follicles.
• Sulfur--Helps break down blackheads and whiteheads.

Topical OTC medicines are available in many forms, such as gels, lotions, creams, soaps, or pads. In some people, OTC acne medicines may cause side effects such as skin irritation, burning, or redness, which often get better or go away with continued use of the medicine. If you experience severe or prolonged side effects, you should report them to your doctor.

People with moderate-to-severe inflammatory acne may be treated with prescription topical or oral medicines, alone or in combination, according to the NIH. Several types of prescription topical medicines are used to treat acne. They include:

• Antibiotics. Help stop or slow the growth of bacteria and reduce inflammation

• Vitamin A derivatives (retinoids). Unplug existing comedones (plural of comedo), allowing other topical medicines, such as antibiotics, to enter the follicles. Some may also help decrease the formation of comedones. These drugs contain an altered form of vitamin A. Some examples are tretinoin, adapalene, and tazarotene.

• Others. May kill P. acnes and reduce oil production or help stop or slow the growth of bacteria and reduce inflammation. Some examples are prescription strength benzoyl peroxide, sodium sulfacetamide/sulfur-containing products, or azelaic acid.

For patients with moderate-to-severe acne, doctors often prescribe oral antibiotics. Oral antibiotics are thought to help control acne by curbing the growth of bacteria and reducing inflammation. Prescription oral and topical medicines may be combined. Much more detailed material about acne can be located at this website: http://www.niams.nih.gov/health_info/acne/ .

Oil in the skin is a contributing factor to acne. According to a study published in the Journal of the Academy of Nutrition and Dietetics, some of that excess oil production may be diet-related. This study found that high glycemic foods and dairy products can cause changes in the body that lead to increased cellular growth and oil production, which can increase the chances of developing acne. Yikes! Better cut back on that cheddar. But, what’s a glycemic index?

The glycemic index, according to this website, http://www.myhealthnewsdaily.com/3615-high-glycemic-foods-acne.html , is a measure of the speed at which sugar in food enters your bloodstream. High-glycemic foods are those that have the fastest blood sugar response. So, things like cupcakes and white bread are considered high glycemic. It’s important to note, though, that the glycemic index isn’t a measure of a food’s nutritional value, fat content, or anything else. It simply indicates how it will affect your blood sugar levels. It can be confusing, to say the least.

Here are some tips for eating a low-glycemic diet without stressing out:

--Avoid processed foods. Whole foods are usually lower on the glycemic index than processed foods. Apple juice will spike your blood sugar at a much faster rate than eating a whole apple.

--Try a protein pairing. Because protein is harder to digest, it can bring down the overall glycemic index of a meal. Just don’t use cheese or other dairy products as your protein. Remember, those may also cause acne.

--Choose fiber. Since it can’t be digested by the body, fiber is low on the glycemic index. Eat foods that are high in fiber, and there’s a good chance you'll steer clear of high GI foods.

The good news is that acne is treatable, and in many cases does not cause too much damage to the skin. However, if you are experiencing issues with it that are causing concern, see your doctor. He can suggest and prescribe some options to help you. Also, in more severe cases, your physician can refer you to a specialist. Dermatologists can help you with acne that is more chronic and difficult to manage. Although acne can be embarrassing socially, remember that in most cases it is temporary. Watch your diet and your daily skin regimen to self-manage most acne issues.

Until next time.

Health Care and Leprosy

Back in Biblical times, thousands of years ago, when someone shouted “Unclean, unclean,” that usually meant the person was suffering from a dreaded disease, typically leprosy. In that time it was commonly believed that you could catch that horribly disabling and fatal illness simply by being near someone or breathing the same air near the affected individual. Plus, it was a legal requirement for the victim to announce the fact they were in the area by shouting out those words. That way, everyone within ear shot could run the other way. Leprosy was seen as a plague on those who had it and a direct result of sin against their god.

A lot of knowledge about leprosy has been gained since then, as in most all medicine. According to the World Health Organization (WHO), leprosy was recognized in the ancient civilizations of China, Egypt and India. The first known written mention of leprosy is dated 600 BC. Throughout history, the afflicted have often been ostracized by their communities and families. Although leprosy was treated differently in the past, the first breakthrough occurred in the 1940s with the development of the drug Dapsone, which arrested the disease. But the duration of the treatment was many years, even a lifetime, making it difficult for patients to follow.

The WHO reports that leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes. Leprosy is curable and treatment provided in the early stages averts disability. Here are some key facts about this disease:

• Official figures show that almost 182,000 people, mainly in Asia and Africa, were affected at the beginning of 2012, with approximately 219,000 new cases reported during 2011.

• M. leprae multiplies very slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear.

• Leprosy is not highly infectious. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.

• Untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs and eyes.

• Early diagnosis and treatment with multidrug therapy (MDT) remain the key elements in eliminating the disease as a public health concern. Here is more detail about leprosy found on the WHO website: http://www.who.int/mediacentre/factsheets/fs101/en/index.html.

The medical name for leprosy is Hansen's disease, according to American Leprosy Missions (ALM). Norwegian doctor Armauer Hansen was the first to view the bacillus under a microscope in 1873. The bacteria attack nerve endings and destroy the body's ability to feel pain and injury. Without feeling pain, people injure themselves and the injuries can become infected, resulting in tissue loss. Fingers and toes become shortened and deformed as the cartilage is absorbed into the body. Repeated injury and infection of numb areas in the fingers or toes can cause the bones to shorten. The tissues around them shrink, making them short.

Early signs include spots on the skin that may be slightly red, darker or lighter than normal skin. The spots may also become numb and have lost hair. Often they appear on the arms, legs or back. Sometimes the only sign may be numbness in a finger or toe. If left untreated, hands can become numb and small muscles are paralyzed, leading to curling of the fingers and thumb. When leprosy attacks nerves in the legs, it interrupts communication of sensation in the feet. The feet can then be damaged by untended wounds and infection. If the facial nerve is affected, a person loses the blinking reflex of the eye, which can eventually lead to dryness, ulceration and blindness. Bacteria entering the mucous lining of the nose can lead to internal damage and scarring which in time causes the nose to collapse. Untreated, leprosy can cause deformity, crippling and blindness, according to ALM.

Leprosy is transmitted primarily through coughing and sneezing. In most cases, it is spread through long-term contact with a person who has the disease but has not been treated. Scientists don't fully understand how leprosy is spread. Most people will never develop the disease even if they are exposed to the bacteria. Approximately 95% of the world population has a natural immunity to leprosy. Approximately 5,000 people in the U.S. are cured but suffer from the effects of leprosy and continue to receive care through outpatient clinics and private physicians. Approximately 150 people are diagnosed with leprosy each year in the U.S, per American Leprosy Missions. More info can be found on their website: http://www.leprosy.org/ .

According to the National Institutes for Health (NIH), most cases are in the South, California, Hawaii, and U.S. islands. Effective medications exist. Isolating people with this disease in "leper colonies" is not needed. People with long-term leprosy may lose the use of their hands or feet due to repeated injury because they lack feeling in those areas. Prevention consists of avoiding close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease). Call your health care provider if you have symptoms of leprosy, especially if you've had contact with someone who has the disease. Cases of leprosy in the United States need to be reported to the Centers for Disease Control and Prevention. Much more info can be found at this website: http://www.nlm.nih.gov/medlineplus/ency/article/001347.htm .

Leprosy is a disease that largely has been contained in most places in the world, especially in the US, even though there are new cases every year that are diagnosed. However, most people who contract this disease are located in more impoverished third world nations where sanitary living conditions are not readily available, or that have limited access to health care, or who live in a population largely ignorant of disease prevention. As with any health care need, always talk with a medical professional for proper diagnosis and treatment.

Until next time.

Health Care and GERD

When you swallow anything, that item goes through a tube that connects your mouth to your stomach whether it is a liquid or a solid substance. That bodily throughway is called an esophagus. When that area gets irritated, you can suffer from more serious medical issues including a condition called GERD—Gastroesophageal Reflux Disease. If you have symptoms similar to heartburn or acid indigestion that is not caused by eating certain types of spicy food, you may have GERD.

Also known as acid reflux, GERD can cause serious damage to your esophagus over time. The burping, heartburn, and spitting up associated with GERD are the result of acidic stomach contents moving backward into the esophagus (called reflux), according to KidsHealth.org. This can happen because the muscle that connects the esophagus with the stomach (the esophageal sphincter) relaxes at the wrong time or doesn't properly close.

Many people have reflux regularly and it's not usually a cause for concern. But with GERD, reflux occurs more often and causes noticeable discomfort. After nearly all meals, GERD causes heartburn, also known as acid indigestion, which feels like a burning sensation in the chest, neck, and throat. In babies with GERD, breast milk or formula regularly refluxes into the esophagus, and sometimes out of the mouth. Sometimes babies regurgitate forcefully or have "wet burps." Most babies outgrow GERD between the time they are 1 and 2 years old. But in some cases, GERD symptoms persist. Kids with developmental or neurological conditions, such as cerebral palsy, are more at risk for GERD and can have more severe, lasting symptoms. Much more info can be found at this site: http://kidshealth.org/parent/medical/digestive/gerd_reflux.html .

The symptoms of GERD may include persistent heartburn, acid regurgitation, nausea, hoarseness in the morning, or trouble swallowing, according to the American Academy of Otolaryngology (AAO). Some people have GERD without heartburn. Instead, they experience pain in the chest that can be severe enough to mimic the pain of a heart attack. GERD can also cause a dry cough and bad breath.

According to the AAO, GERD can be diagnosed or evaluated by a physical examination and the patient’s response to a trial of treatment with medication. Other tests that may be needed include an endoscopic examination (a long tube with a camera inserted into the nose, throat, windpipe, or esophagus), biopsy, x-ray, examination of the esophagus, 24 hour pH probe with or without impedance testing, esophageal motility testing (manometry), and emptying studies of the stomach. Endoscopic examination, biopsy, and x-ray may be performed as an outpatient or in a hospital setting. Endoscopic examinations can often be performed in your ENT’s office, or may require some form of sedation and occasionally anesthesia.

Most people with GERD respond favorably to a combination of lifestyle changes and medication. Medications that could be prescribed include antacids, histamine antagonists, proton pump inhibitors, pro-motility drugs, and foam barrier medications. Some of these products are now available over the counter and do not require a prescription. Children and adults who fail medical treatment or have anatomical abnormalities may require surgical intervention. Such treatment includes fundoplication, a procedure where a part of the stomach is wrapped around the lower esophagus to tighten the lower esophageal sphincter muscle (LES), and endoscopy, where hand stitches or a laser are used to make the LES tighter. You can find more details about GERD at this site: http://www.entnet.org/HealthInformation/GERD-and-LPR.cfm .

According to the National Institutes for Health (NIH) risk factors for GERD or reflux include:

• Alcohol (possibly)
• Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)
• Obesity
• Pregnancy
• Scleroderma
• Smoking

Heartburn and gastroesophageal reflux can be brought on or made worse by pregnancy and many different medications. Such drugs include:

• Anticholinergics (e.g., for seasickness)
• Beta-blockers for high blood pressure or heart disease
• Bronchodilators for asthma
• Calcium channel blockers for high blood pressure
• Dopamine-active drugs for Parkinson's disease
• Progestin for abnormal menstrual bleeding or birth control
• Sedatives for insomnia or anxiety
• Tricyclic antidepressants

If you suspect that one of your medications may be causing heartburn, talk to your doctor. Never change or stop a medication you take regularly without talking to your doctor, according to the NIH. More material about GERD can be found at this website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001311/ .

Depending on how severe your GERD is, according to this website: http://heartburn.about.com/od/gerdacidrefluxdisease/a/gerd_acidreflux_3.htm , treatment may involve one or more of the following lifestyle changes, medications, or surgery:

Avoid reflux producing foods--These foods include:

• Fried foods
• Fatty foods
• Citrus fruits
• Tomato products
• Caffeine
• Alcoholic beverages
• Citrus fruit drinks
• Chocolate
• Peppermint
• Pepper

If you smoke, stop--Smoking inhibits the production of saliva. Saliva is one of your body's defenses against damage to the esophagus. Saliva also aids in neutralizing refluxed acid. Smoking also stimulates the production of stomach acid, and can weaken and relax the lower esophageal sphincter (LES).

Do not drink alcohol--Alcohol increases the production of stomach acid, relaxes the lower esophageal sphincter, allowing stomach contents to reflux back up into the esophagus, and can make the esophagus more sensitive to stomach acid.

Lose weight if needed--Obesity increases abdominal pressure, which can then push stomach contents up into the esophagus. Losing weight may help reduce acid reflux.

Eat small meals--Large meals expand your stomach and increase upward pressure against the esophageal sphincter.

Wear loose-fitting clothes--Clothing that fits tightly around the abdomen will squeeze the stomach, forcing food up against the LES, and cause food to reflux into the esophagus. Clothing that can cause problems include tight-fitting belts and slenderizing undergarments.

Avoid lying down for 3 hours after a meal--Gravity helps to keep the stomach juices from backing up into the esophagus. Lying down with a full stomach makes reflux more likely.

Raise the head of your bed--With the head higher than the stomach, gravity helps reduce this pressure. You can elevate your head in a couple of ways. You can place bricks, blocks or anything that's sturdy securely under the legs at the head of your bed to raise it 6 to 8 inches. A foam wedge under the mattress can also be used. You can also use a wedge pillow to elevate your shoulders and head.

According to Fox News, popular over-the-counter medications like Tums, Maalox, Rolaids and Mylanta neutralize stomach acid and provide fast-acting relief in mild or isolated cases of acid reflux. Some antacids come in liquid form to coat the lining of the esophagus and help reduce the amount of acid in the stomach. But they won’t aid in reducing inflammation of the esophagus associated with GERD. More details about medicines to control GERD can be found at this site: http://www.foxnews.com/story/0,2933,412202,00.html .

GERD can be serious. If you suspect you may have it, see your doctor. Don’t put off an appointment if you are suffering from the symptoms. It may be that you have other health related issues, but if you really have acid reflux, your family physician can help you deal with it.

Until next time.