Posted in Health, news

How to Tell if Someone Died From Hanging Vs. Strangulation

66 year-old Jeffrey Epstein, who recently pleaded not guilty of sex trafficking charges, was found dead in his jail cell on August 10.  He had recently been on suicide watch and reports initially suggested he had hung himself by his bed sheet.

However,  results of  the financier’s autopsy suggest he sustained trauma consistent with hanging (after preliminary reports suggested strangulation).  How do forensic experts tell the difference?

Hanging

With hanging, one drops from a height and suspends, incurring a fracture of a neck bone which in turn may sever the spinal cord.

hangman's fracture.jpg

 

A severe blood pressure drop can ensue and the victim may die within minutes

As seen above, a “hangman’s fracture” is seen with hyperextenstion injuries where the pars interarticularis on the pedicle of the C2 vertebrae becomes fractured. The distance of the drop is crucial in determining success of the execution. A drop to long could cause beheading, a drop too short could cause strangulation.

If they do strangulate….they asphyxiate (lose air flow), or lose blood flow from their carotid arteries being compromised.

From a capital punishment standpoint, hanging is one of the most common and barbaric ways to execute. Three states still have this form of execution as an option if lethal injection is not available (DE, NH, WA).

Strangulation

Strangulation occurs when one compresses the structures of the neck causing decrease air and blood flow.  It could be executed using a ligature (scarf, sheet, cord) or by one’s hands.  Moreover it can occur if a hanging drop is improperly calculated.  Many times the hyoid bone is fractured (1/3 of all homicides) as its think U-shape is vulnerable to the forces of strangulation.

hyoid.jpg

 

Injuries incurred

So injuries incurred can be similar in both strangulation and hanging, especially if the latter is done improperly and ineffectively severs the spinal cord.

However, since hanging causes a blood pressure drop and strangulation causes a back up of pressure into the head due to vessel constrictions, on autopsy one may find more signs of hemorrhage (retinal hemorrhages) and swelling (brain edema) during strangulation than accurate hanging.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

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Posted in Health, pets

How to Celebrate Your Pet’s Birthday

Many of us love our pets, treating them as if they were our children.  And for some of us we may love them more (j/k).  So it’s natural to want to celebrate their birthday.

UZ

Here’s some tips on how to make your furry friend feel special on their big day….

For Dogs

  1.  Invite other dogs over. Dogs are very social and love sniffing each other.  It’s their version of “pin the tail on the donkey.”
  2. Go to a dog park.  Less poop in the house
  3. Make them a puppy cake of their favorite meat
  4. Buy them a present but let them unwrap it.  They love the surprise and the suspense. (Un-train them in this feat before Christmas though).
  5. Treat them to a doggie massage

    waiting for my massage
    Image from American Kennel Club
  6. Let them walk YOU on their walk outside
  7. Get a cat piñata and load it with treats
  8. Get them a new pillow bed and don’t yell at them if they poop on it
  9. Treat yourself to a T-bone steak for dinner and give them the bone
  10. If they don’t get to sleep with you on your bed, let them this one time

 

For Cats

  1. Leave them alone
  2. Let them be
  3. Don’t make eye contact
  4. But in case you have a loving kitty like I do….you can also a order a cat massage or get them a Tweety bird piñata

snappy

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Health, news

“Vaginal Steaming” Session Burns Woman

A 62 year-old woman who tried to treat a common gynecological condition sustained a second degree burn while undergoing “vaginal steaming.”

Per the case report published in the Journal of Obstetrics and Gynecology Canada, the woman was attempting to treat “vaginal prolapse.”

Vaginal prolapse is a term used for weakness of the vaginal walls and pelvic musculature.  This can occur from childbirth, heavy lifting, aging, menopause or chronic coughing.

 Uterine prolapse occurs when the uterus hangs low due to weakness in pelvic floor muscles. This can be very uncomfortable as the cervix (opening of the uterus) can come closer to the vaginal opening or poke through.

 

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“Vaginal steaming” is a procedure, popularized by Gweneth Paltrow in 2015, in which a person sits on a chair that has an opening, allowing for a pot to sit below and steam the genitals.

So although the patient’s physician suggested surgery to correct the prolapse, she followed the recommendation of an herbalist who suggested using a pan to put in the toilet with herbs and steam.

She didn’t feel any pain but subsequently began bleeding and when doctors examined her, found second degree burns to her vagina and cervix.

Steaming has not been proven to help uterine or vaginal prolapse.   However it does make broccoli less crunchy…..

 

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Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

 

 

 

Posted in Health, news, school, students, teachers

Back to School: How Kids and Teachers Can Avoid Getting Sick and Stay Safe

The start of the school year may be the most exciting time of the year (well maybe just for parents…) However going back to school can bring on a slew of health issues, so let’s look at how we can prevent them.

Good hand-washing

The most basic and easiest thing we can teach our children is to wash their hands whenever they touch something dirty, use the restroom or before they eat. True we need to be exposed to germs to increase our immunity, but some of these germs aren’t friendly and bring on colds, flu, rashes and intestinal bugs when we’re not expecting it.

handwashing-banner1

 

Good nutrition

If a child skips breakfast or eats primarily sugar and carbohydrates, they not only face immune system weaknesses but also poor attention, concentration and ability to do well in school. Make sure your kids eat a good breakfast with protein and Vitamin C-packed fruits before heading for the school bus.

Rainbow-with-Pot-o-Gold-Square-Watermarked

Good sleep

If the kids were accustomed to staying up late and now have to wake up at 5:30 in the morning, they might spend much of their school day nodding off.  Insufficient sleep has been linked to obesity as well as poor immunity so get them on a regular schedule of a bedtime that will allow 8-10 hours of sleep a night.

sleep-guidelines-770.jpg

Proper clothing

Chances are your child grew an inch this summer, so shoes and clothing may be a little tight.  Use the finger tip rule for pants and shoes to make sure there is room to grow. And avoid accessories that your kids can chew on, swallow or can lose as they will concentrate more on the lost earring than what the teacher is saying.

Talk to them, often

Back to school can bring on anxiety in many children and make sure you have open conversations to allow them to share their fears.  Bullies make themselves apparent the first few days of school, and your child may be getting wet willies, wedgies or their lunch stolen right under the teacher’s nose.

Be aware of what’s going around the school

If joining the PTA doesn’t appeal to you, at least make buddies with parents of children in your kid’s class as they will be the first to notify you if lice, pink eye or sore throat is making the rounds before a school may.

Discuss stranger safety with your children

If you child walks to or from school or a bus stop, educate them on how to avoid strangers and what to do if approached by one.  Consider driving your child if you think they are at risk.

Teachers face health risks

In 2006, a study published in BMC Public Health, found teachers to suffer more from ENT (ear, nose and throat) ailments, dermatitis, bladder infections, bronchitis, conjunctivitis and varicose veins than those who work in other professions.  Teachers are on the front lines when it comes to cough and cold season as they come into contact with hundreds of children a day, many of whom are contagious prior to knowing they are symptomatic. Once the fever shows itself, parents may keep the child home but the student already exposed others earlier in the day.

Standing on one’s feet for extended hours does a number on the peripheral vascular system, manifesting in leg swelling and at times, varicose veins.  And when breaks are infrequent, bladder infections brew since one can’t visit the bathroom when they need.

Long work hours during the week prevent many educators from seeing a health care provider and many health plans don’t have providers who work on the weekends.  Teachers can very easily put their own health care needs on the back burner during a long school year.

Taking care of school business is paramount during the school year but parents, teachers and kids need to still put health and safety.

 

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Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

Posted in Health, news, vaping

More Reports of Vaping Linked to Seizures in Teens

The FDA is investigating 127 reports of seizures in e-cigarette users (up from 35 this Spring).

Many were teenagers and young adults.

Since 2010 the agency has received multiple reports but is unclear if e-cigarettes actually caused the seizures or if there were underlying medical conditions predisposing the neurological disorder.

The 92 additional cases since this April is concerning and the FDA is working to determine if vaping contributes contributes directly to serious neurological conditions.

In April FDA Commissioner Dr. Scott Gottlieb tweeted:

While we’re still learning about the long-term potential benefits and health risks of e-cigs, existing scientific research offers some clear evidence that several of the dangerous chemicals in tobacco smoke are also present in the aerosol of some e-cig products.

Dr. Ned Sharpless, current acting FDA Commissioner, is encouraging people to report adverse events as, “Additional reports or more detailed information about these incidents are vital to help inform our analysis and may help us identify common risk factors and determine whether any specific e-cigarette product attributes, such as nicotine content or formulation, may be more likely to contribute to seizures,” (Reported by CNBC).

What is a seizure?

A seizure occurs when there is abnormal electrical activity in the brain.  If the electricity doesn’t conduct properly, brain function gets disrupted. This could lead to convulsions  (involuntary jerking movements), loss of muscle tone, changes in senses such as vision, hearing and smell, loss of bladder control, loss of consciousness and sometimes stroke, brain damage and death.

HGT0066_neurons-seizure-brain_FS.jpg

 

Nicotine toxicity has been linked to seizures.  E-cigs sometimes contain more nicotine than cigarettes alone.

 

_________________________________________________________________________________________

A study published by the American Heart Association found nine different E-cig flavors  to impair blood vessel function, which can impair heart health.

Endothelial cells, which delicately line blood and lymph vessels, were found to become inflamed at low concentrations of some vapor flavors.  And at high concentrations of others, exibited cell death.  Nitric oxide production, necessary for vessel dilation to improve blood flow, was impaired as well. These are often the same changes seen in early heart disease.

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The 9 flavors (and the chemicals within) cited in the report to cause the endothelial inflammation and/or damage were:

  • Mint (menthol)
  • Vanilla (vanillin)
  • Clove (eugenol)
  • Cinnamon (cinnamaldehyde)
  • Strawberry (dimethylpyrazine)
  • Banana (isoamyl acetate)
  • Butter (diacetyl)
  • Eucalyptus/spicy cooling (eucalyptol)
  • Burnt flavor (acetylpyridine)

Strawberry flavoring appeared to have the most adverse effect on the cells.

Now many other flavors were not included in this study, so its unknown how safe they may be.

For more on the study, read here.

An alternate study published last November looked at vaping flavors and their effects on heart muscle cells.

For more on this study, read here.

The moral?  Just because we love the taste of something, doesn’t mean its safe to inhale.

___________________________________________________________________

Vaping Linked to Heart Disease and Cancer

 

A study from New York University found the nicotine in electronic cigarettes to cause DNA damage similar to cigarette smoking.

Dr. Moon-shong Tang and his colleagues exposed mice to e-cig smoke during a three-month period, 5 days a week for three hours a day.  They found these mice, compared to those breathing filtered air, to have DNA damage to cells in their bladders, lungs and hearts. The amount of nicotine inhaled was approximately 10mg/ml.   That dose would be commonly consumed by many humans who vape.

nicotine.jpg

They then looked at human bladder and lung cells and found tumor cells were able to grow more easily once exposed to nicotine and vaping chemicals.

Last May, researchers from Vanderbilt-Ingram Cancer Center in Nashville found e-cig smoke to increase one’s risk of bladder cancer.

In 2015, the University of Minnesota identified chemicals commonly found in e-cig vapor to include:

  • Formaldehyde (human carcinogen)
  • Acetaldehyde (carcinogen related to alcohol drinking)
  • Acrolein (highly irritating and toxic)
  • Toluene (toxic) NNN, NNK (tobacco carcinogens related to nicotine)
  • Metals (possible carcinogens and toxins)

Although electronic cigarette “juice” may appear safe, it could produce harmful chemicals once heated to become a vapor.

A lethal dose of nicotine for an adult ranges from 30-60 mg and varied for children (0.5-1.0 mg/kg can be a lethal dosage for adults, and 0.1 mg/kg for children).  E-cigs, depending on their strengths (0 – 5.4%) could contain up to 54 mg of nicotine per cartridge (a 1.8% e -cig would contain 18mg/ml).

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucous production and a sweeping out of carcinogens trying to make their way down to the lungs.

More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.

For more on the study read here.

Toxic metals found in vaping liquid

Last week, experts warned that many chemicals in vaping liquid may change to toxic substances (once heated) that can irritate the lungs.

Last year one study reported that toxic levels of lead and other metals may leak from the heating coil element into the vapor inhaled during e-cig use.

Researchers at Johns Hopkins Bloomberg School of Public Health found these metals to include:

  • lead
  • nickel
  • manganese
  • chromium
  • arsenic

We’ve known for some time that vaping fluid could contain chemicals that turn toxic once heated, but this study shed light on e-cig metal components causing metal leakage to the vapor making contact with delicate respiratory epithelium (lining).

Reported by Forbes, Rich Able, a medical device marketing consultant, stated the following, “the FDA does not currently test any of the most popular vaping and e-cigarette instruments being manufactured at unregulated factories in Asia that source  low-grade parts, batteries, and materials for the production of these devices,” suggesting that “the metal and parts composition of these devices must be stringently tested for toxic analytes and corrosive compounds.”

These chemicals may act as neurotoxins, affecting our nervous system, cause tissue necrosis (cell death) and even multi-organ failure.  Moreover they can affect how our immune system reacts to other chemicals as well as foreign pathogens, affecting our ability to fight other diseases.

Although studies have suggested e-cig vapor to be safer than tobacco smoke, not enough research has been done, in the relatively few years vaping has been around, looking at how heat-transformed chemicals and leaked metals affect our breathing, lungs and other organs once absorbed into the body.

 

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Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in cancer, Entertainment, Health, news

Olivia Newton-John Bravely Fights Stage 4 Breast Cancer and Rumors of Her Dying

The 70 year-old singer and actress revealed in an interview with 60 Minutes Australia that she prefers to not know how long she has to live and is tuning out the chatter on her prognosis.

Citing the concept that we all are dying at any time could be hit by a truck, she is focusing on the life she has.

She states:

“When you’re given a cancer diagnosis or a scary honest diagnosis, you’re suddenly given a possibility of a time limit.”

If somebody tells you, you have six months to live, very possibly you will because you believe that,” the actress continued. “So for me, psychologically, it’s better not to have any idea of what they expect or what the last person that has what you have lived, so I don’t, I don’t tune in.”

Last Fall she reported using both traditional and alternative medications to treat her metastatic breast cancer.

After successfully keeping the cancer at bay, it returned for a third time 2 years ago and metastasized to her sacrum, a part of the low back.

 

PE-Sacroiliac_fig1.jpg

 

In addition to her current medical regimen the Australian native grows cannabis at her Santa Barbara, California home and uses its oil to help with the pain.  She states, “My dream is that, in Australia soon, it will be available to all the cancer patients and people going through cancer that causes pain.”

In 1992, Newton-John first battled breast cancer by undergoing chemotherapy and by having a modified radical mastectomy (removing the breast and lymph nodes).  She immediately had breast reconstruction and included yoga, acupuncture and massage in her treatment regimen.

In 2013, after a minor car accident, a lump in her left shoulder revealed it was breast cancer.

In an interview with the Susan G. Komen Foundation, she shared her personal story.  “I meditated every day, did yoga, used homeopathy, ate well—I boosted my inner strength as much as I could. When bad thoughts came in, I pushed them right out. I had what’s called a modified radical mastectomy with reconstruction done to my breast immediately—a woman can be traumatized waking up with nothing there.

She remained cancer free for years.

In a recent interview with People Magazine, she states she believes she will win “over it,” but adds, “I don’t go there. I’d be lying if I said I never go there. There are moments, I’m human. So If I allow myself to go there, I could easily create that, you know, big fear.”

 

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OLIVIA NEWTON-JOHN IN 1978’S GREASE

 

Breast cancer is one of the few cancers that spreads to the bone. Other cancers that may rear its ugly head in the bone include thyroid, kidney, pancreas and the liver.

According to the American Cancer Society, Stage 4 Breast Cancer (spreading to other parts of the body) has a 5 year survival rate of 22%, as opposed to Stage 3, whose 5 year survival rate is 72%.  Treatments today are improving survival rates.

 

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Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

Posted in Health, medications, news, sex

Common Psychiatric Medication May Interfere with Ejaculation

Sexual dysfunction caused by mood stabilizing medications is nothing new.  Patients have complained of loss of sex drive, inability to start or maintain erections and issues with ejaculation.

A case study out of England this week discusses a 25 year old inmate who was taking quetiapine (Brand name Seroquel) when he acquired an inability to ejaculate during masturbation, with semen back-flowing into his bladder (retrograde ejaculation). This type of “dry orgasm” has been documented in previous studies and occurs when a medication, or neurological disorder, causes weakness of the bladder neck allowing semen to make a wrong turn.

Image result for retrograde ejaculation

Quetiapine is in the class of “atypical antipsychotics” and has been used for schizophrenia, bipolar disorder, mania, depression and poor sleep.

The medication can be very effective, however, a side effect such as the aforementioned could lead to lack of compliance.

Most function is restored when the medication is switched to a different one, and in the above case, symptoms improved with the use of the antidepressant imipramine.  However, some patients may be reluctant to continue treatment and more research needs to be done on side effects and their antidotes to improve compliance for those who struggle with mental health and need pharmaceutical intervention.

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Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.