Posted in Entertainment, Health, news

Bill Paxton dies, age 61, from stroke after having heart surgery

We loved him in Twister and True Lies, feared him in Weird Science, and cried for him in the Hatfields and McCoy’s. Sadly, the Emmy winner has passed away at age 61.

According to TMZ, the actor was undergoing heart surgery and postoperatively suffered a stroke.

His family’s statement reads….”It is with heavy hearts we share the news that Bill Paxton has passed away due to complications from surgery.”

In a podcast earlier this month, Bill Paxton revealed he suffered from rheumatic fever when he was 13, a condition which begins with a sore throat and progresses to affect the joints and heart valves.  He stated, “I’d had a sore throat at Christmas. It had kind of gotten into my wrist, but it usually damages your heart valves.”

Bill Paxton was always a gifted actor, working along side screen legends such as Arnold Schwarzenegger in True Lies.  He actually worked with the former Governor before that in the movie,  Terminator. He played the Punk Leader with the blue hair.

punk.jpg

What is a stroke?

A stroke occurs when an area of the brain does not get the proper oxygen and blood flow it needs. There are two major types of stroke.  Ischemic and Hemorrhagic.

Ischemic strokes are more common than the latter and occur when a clot prevents blood flow to part of the brain.  80% of all strokes fall under ischemic.  It is a likened to a heart attack, except the brain tissue is being deprived of blood and nutrients.  Plaques commonly arise from arteriosclerosis that break off travel to the smaller vessels of the brain.

Hemorrhagic strokes are less common and occur when there is a bleed of one of the brain vessels.  The bleed prevents blood flow into the brain since it is seeping outside the brain tissue, causing damage to nearby cells.  The bleeds could occur from high blood pressure or aneurysms that rupture.

What are the signs of a stroke?

Since a clot or bleed usually affect one area of the brain, we see symptoms on one side of the body, many times its contralateral (opposite) side.  We can also see central effects.  The symptoms of stroke include the following:

Weakness of one side of the body

Loss of balance

Numbness on one side of the body

Slurred speech

Vision issues

Headache

Facial droop

and more…..

How are strokes treated?

If the stroke was caused by a clot (ischemic) immediate treatment includes dissolving/removing the clot.   Aspirin is used initially and if within the proper time frame, tissue plasminogen activator (TPA).  These clots can also be surgically removed and arteries widened to bring blood flow to the brain.

With a hemorrhagic  stroke, we need to stop the bleed and improve flow to the brain.  Controlling the bleed, bypassing the vessel, “clogging” the aneurysm with techniques such as “coiling” (endovascular embolization) are sometimes utlized.

Time is of the essence, so its crucial to identify the warning signs and call 911 immediately.  The American Stroke Association uses the acronym “FAST” (Facial drooping, Arm weakness, Speech difficulty, and Time to call 911).  The sooner a stroke victim receives medical attention the better the prognosis.

fast

COURTESY OF THE AMERICAN STROKE ASSOCIATION

What are the risk factors for stroke?

The following put us at risk of having a stroke.

High blood pressure

Family history of stroke

Diabetes

Cardiovascular disease (artery clogging, such as the heart and carotid arteries)

Abnormal heart rhythms, such as atrial fibrillation

Smoking

Drugs

Obesity

Inactivity

Clotting disorder

Sleep apnea

Being older (greater than 55)

African Americans appear to be more at risk than Caucasians and Hispanics

Men seem to be more affected than women

 

How do we prevent strokes?

Avoid the following:

Excessive drinking

Drug use

Tobacco products

Control blood pressure, sugar and cholesterol

Get evaluated by a medical provider if at risk for heart disease or stroke.
weird-science-chet

In 1985, Paxton played Chet Donnelly in Weird Science

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news

Allergy Season May Start Early This Year

All over the country we have seen record rainfall this season.  We still have a month left of winter yet grass is sprouting, leaves are growing and flowers are blooming.  Add warmer than normal temperatures to the mix and this is the perfect recipe for an early allergy season.

Allergy season usually begins with the start of Spring in March.  Yet many may start their symptoms as early as February if they are allergic to what’s blooming.

Here are your questions answered:

What are allergies?

Allergies are the result of the immune response to a foreign particulate that our body senses.  One could be allergic to pollen, dust, dander, food, insects, mold, metals, transfused blood, grafts, medicine and anything the body senses as a foreign intruder.  Even though these may be individually harmless, a hypersensitivity reaction occurs as a result of their intrusion into the body.  IgE antibodies find the allergen (intruder) and activate mast cells in the tissue and basophils in the blood.  When these cells get activated, they release substances to help protect the body, including histamines, leukotrienes, and cytokines. These help the body attempt to sneeze and cough the allergen out, wall off the antigen, signal more antibodies, or produce tears and nasal secretions to flush it out.

What are symptoms of seasonal allergies?

Symptoms of allergies could include any or a combination of the following:

Sneezing

Coughing

Wheezing

Runny nose

Eye watering

Red Eyes

Itchy eyes

Itchy skin

Rash

Itchy throat

Fatigue

Congestion….. to name a few.

How do they differ from a cold?

Colds may have very similar symptoms to allergies.  However they are different.

The common cold is caused by a virus.  When one gets infected by the virus they may feel malaise, fever, and achy.  This does not occur with allergies.

Moreover, nasal secretions from allergies are usually clear.  In a cold, the mucous could be thicker and with color.

The same holds true with sputum.  During an allergy the cough may have little to no mucous and if so, be light colored.  Thick mucous could be a sign of an infection.

An allergic sore throat will seem more dry and scratchy.  A sore throat from a cold is more uncomfortable and less easy to soothe.

Allergies may persist or be cyclical.  Cold symptoms will usually subside after a few days and rarely persist longer than 10 days.

Can allergies lead to a cold?

Yes and no.  Allergies should not in and of themselves cause an infection. However they may make one more vulnerable for a virus or bacteria to take over.    Hence a bronchitis, sinus infection, or pneumonia could uncommonly follow an asthma attack.

Are seasonal allergies dangerous?

As stated previously, if one is susceptible to colds, an allergic attack could make them vulnerable. Moreover if one suffers from asthma, an allergy attack could incite an asthma attack.  Very rarely would we see a life threatening anaphylaxis to an allergen such as pollen.

How can we prevent and treat allergies?

Avoiding, or decreasing exposure to the allergen is key.   We suggest the following:

  1.  Be aware of your local weather and pollen counts.  If the weather begins to warm and regional vegetation is blooming, allergy season may be upon you sooner than you know.
  2. Avoid outside pollen from coming into your house.  Avoid the urge to open all the windows during Springtime as wind will bring the pollen in.
  3. Clean your air filters.  Replace air filters frequently and consider using HEPA Filters
  4. Wash off pollen from your hair and clothes before you sit on the couch or jump into bed.
  5. Close your car windows when you park.
  6. “Recirculate” the air in your car
  7. Discuss with your medical provider if you are a candidate for medications such as antihistamines, nasal corticosteroids or leukotriene antagonists.  
  8. If you suffer from respiratory illnesses or a chronic medical condition, discuss with your medical provider if you need to start your allergy medication before allergy season hits. Some of these medications may take a couple weeks to reach therapeutic levels.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Posted in Health, news

Flu vaccine this year is fairly effective

The effectiveness of the flu vaccine varies each year.  Being 60% effective is considered great.  Yet in some years its been lower, such as the 2014-2015 season, when the efficacy was 19%.

This year the CDC reports our trivalent flu vaccine that protects against three viruses (the Influenza A H1N1, H3N2, and Influenza B) is averaging 48% effectiveness. They found against the H3N2 virus, which is the predominant strain this year, the flu vaccine has been 43% effective.  And the less common Influenza B virus has been kept at bay 73% of the time.  According to the CDC this averages to overall protection of 48%.

Last year the vaccine efficacy was 47% but what’s interesting is the year before last, in which the flu shot was only 19% effective, the flu was dominated by the H3N2 strain. This is the same strain that is predominant this year.  Dr. Brendan Flannery, lead investigator for the US Flu Vaccine Effectiveness Network, said, “The prediction for the H3N2 virus was right on in terms of that particular virus continuing to be a dominant virus.”

Vaccines will rarely, when it comes to influenza, reach 90%+ accuracy in that it’s cocktail needs to be determined based on previous seasons’ data and information received from over 100 countries who conduct surveillance of their own.

We usually don’t find out how effective our vaccine is until we peak in the flu season. For the United States the peak is now.   Therefore the CDC is urging those who haven’t received the flu vaccine do so now.

 

For more information on the flu please visit:  https://doctordaliah.wordpress.com/2016/10/23/this-years-flu-season-and-flu-vaccine-your-questions-answered/

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

Posted in Health, news, Politics

Obamacare may implode before the GOP has a chance to repeal it

The GOP may not have to repeal Obamacare as its demise has been occurring for a while.

 

The GOP is under fire for wanting to repeal and replace the Affordable Care Act. However, they may not need to look like the bad guy after all.  The Obamacare system has been imploding as less healthy people choose to purchase the plans and those who do not qualify for subsidies can’t afford the high priced choices offered.

 

According to Aetna’s Chief Executive Mark Bertolini, Obamacare is in a current “death spiral”.

And with the termination of two mergers this week (Aetna and Humana) and (Anthem and Cigna), exchanges are looking at slim pickings of who will remain their key insurers.

Humana has stated that they will pull out of all exchanges by the end of this year and Aetna may only remain in four states’s exchanges.   In Nebraska they appear to be the only insurance offered.

The Trump administration understands they can’t repeal at the same speed at which the ACA was rolled out as it would again cannonball a fragile system. They’ve been under fire for not acting quickly enough, but being that its only been 3 weeks since President Trump has been in office, it would not be prudent to rush this.

And as it seems, they may not need to repeal it.  If health insurers fail to provide choices on the exchanges, consumers will have nothing to purchase.  2018 could be the end of Obamacare as we know it.  The GOP may need to now focus even more of their efforts on an immediate replacement of the ACA rather than the specifics of its breakdown.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Posted in Health, news

The Scoop on Stuttering

Image above from The Young Journalist Academy

 

3 million Americans deal with stuttering on a daily basis and many more will display intermittent bouts of this speech pattern.  According to the National Institute of Deafness and Other Communication Disorders (NIDCD), 5% of children aged 2-5 are affected.  Many will outgrow stuttering, but some can persist into adulthood.  Some may acquire stuttering as they age.  Its more common than we think and here are your questions answered.

 

What is stuttering?

Stuttering is an involuntary repetition of sounds that occurs usually with the first consonant of a word.  The speaker knows what he wants to say but the words may not flow smoothly.

What causes stuttering?

In children, as a child develops his speech processing, stuttering may occur when the verbal action is not in time with the cognitive formation of speech.  So the mouth starts vocalizing the words prior to the brain being ready to choreograph it if you will.

In adults, brain injury or a stroke could damage the processing centers for language and cause a variety of speech issues. However, very commonly, an adult stutter is due to stress or anxiety.  And once one word gets fumbled, a snowball effect can occur causing more anxiety.

What are the social effects?

Obviously many people who stutter become embarrassed and retract socially as they are afraid to speak.  However, stuttering has plagued many well known people such as James Earl Jones, Former Vice President Joe Biden, Samuel Jackson, Bruce Willis, Wilt Chamberlain, Marilyn Monroe and even Tiger Woods to name a few.

Stuttering became fashionable thanks to South Park and Lady Gaga.  In South park, Kyle’s Mom says “Wh, Wh, What???!!” often and Lady Gaga songs are famously catchy with lyrics such as “Wha, Wha. What did you say, oh you’re break’n up on me”, and “Po, po, po Poker face, Po, Po Poker face”…..

How to improve stuttering?

The key is to relax, and slow down. Rapid speech can accelerate stuttering.  Moreover allowing the social anxiety to take over can worsen your fluency. So we recommend the following:

  1.  Take a deep breath before you speak and in between words you feel may start with a stutter.
  2. Own it – if you have a stutter and feel you can’t hide it, don’t. Let the person know you’re speaking to that your words will have some rhythm to them.  On air, when it happens to me I tell my listeners I felt like rapping the sentence. 🙂
  3. Practice reading and speaking in the mirror.  The more practice the more control you may gain
  4. Find your trigger words, consonants and practice saying them in a variety of sentences.  Even if the sentence doesn’t make sense, throw the word into your script when you practice to help train you to say the word fluidly.
  5. Don’t use the word if you don’t want to.  Substitute it for a word you do like.  For example, rather than saying “have you ever been diagnosed”….substitute the word “assessed”, or “been told you had”, “suffered from”.
  6. Rather than enunciate every single sound in a word such as  “D-I-A-Betes” or “D-I-A-rrhea”….knock off the “a” and say “DI-Betes”, “DI-rrhea”, “DI-nostic”. Sounds the same and helps stop the stutter.
  7. With S sounds, in Spanish we in some words start out with an “e”. So “School” is “escuela”, “stairs” is “escalera”.  Doing a slight e before the s word can help with the S stutter.
  8. Consult a speech therapist

 

There are multiple resources for those who are challenged with a stutter. These include:

 

NIDCD Information Clearinghouse     and                                          logo_0
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free Voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Fax: (301) 770-8977
Email: nidcdinfo@nidcd.nih.gov

 

 

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

 

Posted in Health, news

“Peek at your Pulse” highlights a simple test for heart health

Heart disease is the number one leading cause of death for both men and women in the United States.  In an attempt to be proactive with one’s heart health is the “Peek at your Pulse” campaign.  Multiple studies have shown a high resting pulse could signify future heart risk. Testing one’s pulse is quick and easy, and unfortunately not done as frequently as it should.  Hence “Peek at your Pulse” explains why its important and how easy it can be.

What is a pulse?

A pulse is the heart rate felt in an artery such as in the wrist, neck, top of the foot etc.  Feeling the pulse allows us to determine the heart rate, feel the strength of blood flow, and learn the rhythm (irregular, slow, fast, etc).

What’s normal and abnormal for a pulse?

A normal adult pulse ranges from 60-100 beats/minute with the average 70-80 beats/min.  An athlete may have a lower resting heart rate due to his/her cardiac conditioning.

The following table from quora.com breaks down the various pulse categories by age and sex.

pulse-chart

Why are higher pulse rates less favorable?

In 2013 a study found for every 10 to 22 additional beats per minute in resting heart rate raised the likelihood of death by 16%. Then in 2015, a study out of China found a high resting heart rate increased the chance of early death.  Per lead researcher Dr. Dongfeng Zhang, of the department of epidemiology at the Medical College of Qingdao University in Shandong, China, “higher resting heart rate is an independent predictor of all-cause and cardiovascular death.”

So the cause of the high heart rate could be a cause of mortality or the high heart rate could be the harmful factor. If a heart needs to beat an extra 20 beats per minute, and does this 60 minutes each hour, 24 hours a day, 365 days a year……you see where this is going.  The heart beats and expends more energy, possible weakening it later in life.

How can I find my pulse?

Four locations make finding a pulse easy.

The neck along the side under your jaw (the carotid artery)

Your wrist along the same line as your thumb (the radial artery)

Your inner elbow (the brachial artery)

The top of the foot (the dorsalis pedis artery)

aid241958-728px-Check-Your-Pulse-Step-1-Version-5.jpg

Calculating your pulse

With a timer or watch count the beats you feel in 60 seconds. This will be your pulse rate.

OR

You can also count the number of beats in 10 seconds and then multiply by 6

Or you can count the number of beats in 6 seconds and then multiply by 10.

There’s no official recommendation on when to check your pulse but this month, check it on 10 different days and calculate the average.  Make sure to check your pulse when you’re resting and sitting comfortably in a chair. Good luck!!!  #peekatyourpulse

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news

Plastic water bottles may be a no-no for pregnant women

BPA is a compound in many of our products, including water bottles.  Last year, researchers from Columbia Center for Children’s Environmental Health (CCCEH) at the Mailman School of Public Health, found prenatal BPA exposure to contribute to the child’s future obesity.  Now a study from The Endocrine Society based in Washington DC reinforce this claim.  Additionally, BPA (Bisphenol A) has been linked to diabetes, depression, early female puberty, asthma, ADHD and heart disease.

What is BPA?

Bisphenol A is a synthetic compound used in the production of polycarbonate plastics and epoxy resins. These resins coat water supplies and food containers, and BPA can be found in dental sealants, water bottles, cash receipts, medical devices and so many more commonly used products.  According to the National Institute of Environmental Services, Bisphenol A can leach into food from the protective internal epoxy resin coatings of canned foods and from consumer products such as polycarbonate tableware, food storage containers, water bottles, and baby bottles. The degree to which BPA leaches from polycarbonate bottles into liquid may depend more on the temperature of the liquid or bottle, than the age of the container. BPA can also be found in breast milk.

In previous studies, 93% of people had detectable levels of BPA in their system.

BPA is considered a “hormone disruptor” by mimicking estrogen.  If it binds to a receptor when the real hormone cannot, a cascade of effects could occur, such as negative feedback mechanisms, and a boosting in production of the same hormone the body believes is not present.

 

Why would BPA promote obesity?

We make the homone, leptin, which regulates satiety by telling the hypothalmus to send a signal to decrease our appetite.  In this most recent study, the researchers found mice exposed to BPA in the womb had less responsiveness to the hormone.

 

Water bottles heating up in a car pose risks as well

In 2014, a University of Florida study of bottled water in China found plastic water bottles that were heated up release the chemicals antimony and BPA.  Antimony has been linked to cancer, lung disease and heart disease.  We as consumers may be careful not to drink the water that turned warm in our cars, but what about prior to us purchasing the bottle.  Was it in a truck for long periods of time?

 

How to avoid BPA

So should pregnant women avoid water bottles?  I recommend using glass or stainless steel to all my patients, especially if they are consuming hot foods.  Additionally we should avoid heating up plastics in the microwave and eating food contained within.  Decreasing the use of canned foods could decrease BPA exposure, and of course using BPA free products.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician