Posted in food, Health, news

Death by Protein Supplements: What is Urea Cycle Disorder?

A 25-year-old mother of two died after over consuming protein supplements in preparation for a body building competition.

Meegan Hefford was found unconscious in her West Australia apartment and was declared brain-dead, passing two days later.

Unbeknownst to her, she suffered from Urea Cycle Disorder (UCD), such that when she consumed protein shakes and supplements she overproduced a toxic byproduct.

 

What is Urea Cycle Disorder?

People with Urea Cycle Disorder (UCD) have a mutation that causes them to lack an enzyme that helps break down ammonia.  The urea cycle is responsible for removing ammonia from the blood stream. Ammonia is made by cells, when they breakdown the nitrogen in proteins.  Ammonia needs to be eliminated, and through this cycle turns in to urea which can be excreted in the urine.  If a step is missing, ammonia and nitrogen products build up causing hyperammonemia.  This can cause liver and brain damage and eventually death.

What are symptoms of Urea Cycle Disorder?

If one suffers from hyperammonemia, a result of UCD, the following symptoms may manifest:

Fatigue

Lethargy

Vomiting

Respiratory issues

Seizures

Behavior issues

Gait abnormalities

Cognitive issues

Headaches

UCD cases are rare with 1 UCD patient per 35,000 births.

According to the National Urea Cycle Disorders Foundation, “Because many cases of urea cycle disorders remain undiagnosed and/or infants born with the disorders die without a definitive diagnosis, the exact incidence of these cases is unknown and underestimated. It is believed that up to 20% of Sudden Infant Death Syndrome (SIDS) cases may be attributed to an undiagnosed inborn error of metabolism such a urea cycle disorder. Some children with autism spectrum and behavioral disorders may have undiagnosed urea cycle disorders.”

Treatment includes stopping the excess protein/nitrogen intake, fluids, medications, dialysis and at times, liver transplantation.

 

So do we need to fear protein supplements?

No.  But what we need to remember is if we are increasing our protein, and many times accurately, for body building we need to realize that our bodies, including our kidneys, may not be on the same page.  When this happens, protein supplements can be dangerous so competitive athletes, or others using protein supplements, should be supervised by their health provider.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

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

 

Posted in Entertainment, Health, news, Sports

Tiger Woods DUI Tox Report Positive for Benzodiazepines, Narcotics and Sleep Meds

Tiger Woods’ toxicology report in regards to his May arrest suggests his DUI was caused by a mixture of pain, sleep, and anxiety medications.

The report released Monday revealed the 41 year old pro-golfer had the following in his system when he was found asleep in his car on the side of the road while the lights were on and turning signal was flashing:  Ambien, Xanax, Dilaudid, Vicodin and Delta-9 carboxy THC (tetrahydrocannabinol).

Woods had undergone spinal fusion surgery weeks prior.

Vicodin is a narcotic made of hydrocodone and acetaminophen.  It is used for pain and most commonly prescribed post-operatively.

Dilaudid is hydromorphone, a stronger narcotic.

Xanax is a benzodiazepine used for sedation, relaxation and to lower anxiety.

Ambien is a hypnotic type of sedative used for sleep and works within 15 minutes of ingestion.

Delta-9 carboxy THC (tetrahydrocannabinol) is the psychoactive ingredient in marijuana.

None of these medications are to be used while driving.  Additionally none should ever be used in combination.  The respiratory depression of one narcotic combined with the sedative effect of the benzodiazepine or hypnotic could cause death.

Woods entered a plea of not guilty to DUI, as alcohol was not involved and a mixture of medications was to blame, but its been reported a deal was made among prosecutors including a lesser charge of reckless driving and a stint in a “diversion program”.

Last month Woods stated he completed a private intensive program on his own.

On Monday he stated, “Recently, I had been trying on my own to treat my back pain and a sleep disorder, including insomnia, but I realize now it was a mistake to do this without medical assistance.”

Polypharmacy, or taking multiple medications at the same time, can increase the risk of serious adverse events if the drugs act synergystically or mask side effects of one another.

Many overdoses occuring with pain pills may not always be a quantity issue with the narcotic but rather a mixture of the narcotic with another medication such as those taken by Tiger Woods.  He was lucky to still be alive when found as were those pedestrians or drivers on the street that evening.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

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

 

 

Posted in Health, news

“Smart Underwear” Helps Prevent Back Pain

“Smart Underwear” has been designed by Vanderbilt University Engineers to help ease stress on the user’s low back.

The undergarment is made of nylon, polyester and Lycra and feels like normal clothing.  It contains straps along the chest and rubber along the lower back and buttocks.

 

underwear.jpg

Vanderbuilt University

The device can be activated by the user directly or by a mobile phone app.  When needed, the elastic bands take over some of the work done by spinal muscles and ligaments.

Lead researcher, Karl Zelik, states, “As a person leans forward or lifts an object, his or her trunk and hips flex, and buttocks naturally protrudes backwards. When wearing the smart undergarment, these motions stretch the embedded elastic bands which run in parallel to the spine.”

Testing on subjects revealed a decrease on lower muscle activity by 15-45 percent when they bent 30, 60 and 90 degrees.

Half of all Americans at some point suffer from low back pain.  Many times medications are not needed but modalities such as manipulation, massage, acupuncture, muscle stimulation and ultrasound.

Now if the underwear can help us with constipation and gas…..

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

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

 

Posted in Health, news

Ex-Fox Producer Dies of “Broken Heart” after Son was Killed

In the Bronx, 54-year old Okera Ras died hours after his 34-year-old son, Duro Akil died when a stray bullet hit his chest.

Its believed Akil’s neighbor was involved in a fight, and a stray bullet entered his apartment and punctured his lung.  Another report states Akil was in the hallway investigating the commotion when he was shot.  Akil was rushed to Jacobi Medical Center where he died of his injuries.

When family members sought to share the sad news with his father, Ras, a former Fox News web video producer, was dead in his apartment.  Family members believe he sustained a heart attack and died of a “broken heart”.

Adio Akil, Akil’s mother, said the two were very close, “They loved each other so much, and they had each other’s back.”

Friends established a  GoFundMe Page to help the family cover expenses and funeral costs.

duro.jpg

Duro Akil and his father, Okera Ras: GoFundMe

 

Is Broken Heart Syndrome Real?

Much research has surrounded stress cardiomyopathy, or Broken Heart Syndrome.    When couples who have lived together for years, loses his/her partner, we often hear of their death within months, if not weeks later.  The official name of Broken Heart Syndrome (BHS) is Takotsubo cardiomyopathy, where cases have been seen in Japan, the US and many other countries.  The stress of the loss of a loved one puts such a strain on their heart that they are too vulnerable to withstand the injury. The heart tries to compensate by enlarging and we see a bulging apex of the heart in these patients.

Actress Debbie Reynold’s lost her daughter Carrie Fisher one day prior and then herself became ill with possible “stroke”.  She passed later that day, with one report citing her last words were “I want to be with Carrie”.

What makes Broken Heart Syndrome so unique is it’s a rare and possibly fatal disease initially induced by stress.    Mind over matter plays a key part here.

What occurs in Broken Heart Syndrome?

Unlike heart attacks which are usually caused by clogged arteries, BHS appears to be induced by a rush of stress hormones.  These include cortisol and adrenaline.  Paramount stressors such as losing a child or spouse would be enough to start the cascade.  Then come chest pain, shortness of breath, blood pressure changes, the heart enlarges to compensate for low output, arrhythmia can occur and this list goes on.  Heart failure or cardiogenic shock can occur when the heart cannot pump enough blood to the body.

 

How does Broken Heart Syndrome differ from a heart attack?

BHS if identified early can be treated promptly.  If arteriosclerosis is absent, then surgery wouldn’t be needed to bypass the blood vessels or clear out the arteries.  Treatment of BHS would include medications most typically used in heart failure patients (diuretics, ACE inhibitors, betablockers) to reduce the work load on the heart.  If a heart attack did occur during the BHS period, or inducing BHS, protocols for heart attack treatment would execute immediately. BHS patients without coronary artery disease are more likely to recover quicker than heart attack victims.

How do we prevent Broken Heart Syndrome?

When living in stressful times, its imperative to be around friends and families, support groups, etc.  The stress is the inducing component and although it will not be eliminated entirely, could be managed constructively.  Avoiding alcohol and tobacco and poor diet habits are also key.  Asking for help is life saving, and those who see a loved one suffering offer your support immediately.

In addition, make sure you are taking care of yourself.  A medically unstable family member may not be strong enough to go on after losing their closest loved one.  The grieving process is a healthy process however, and should not be avoided. Distraction may help, focusing the love for the lost family member into a cause/scholarship/foundation can also be helpful in the grieving process.

The last thing we haven’t discussed is guilt.  When a loved one dies, we feel guilty over how we treated, spoke to, and spent time with them.  This guilt will consume you.  While you have your loved ones with you, remember that any day could be their last and let them know you love them.

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

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

 

Posted in Health, news

Five People Die from Balloon Obesity Treatment

The FDA has reported 5 people who underwent gastric balloon placement for weight control have died within days to weeks of the procedure.

Four people used the Orbera Intragastric Balloon System and one used ReShape Integrated Dual Balloon System.

Although the direct causes have not been established, the FDA stated the following, “All five reports indicate that patient deaths occurred within a month or less of balloon placement. In three reports, death occurred as soon as one to three days after balloon placement. At this time, we do not know the root cause or incidence rate of patient death, nor have we been able to definitively attribute the deaths to the devices or the insertion procedures for these devices (e.g., gastric and esophageal perforation, or intestinal obstruction). The Agency has also received two additional reports of deaths in the same time period related to potential complications associated with balloon treatment (one gastric perforation with the Orbera Intragastric Balloon System and one esophageal perforation with the ReShape Integrated Dual Balloon System).”

The balloons work by filling up the stomach volume, increasing signals of satiety to the brain.  Balloons are delivered through the mouth by endoscope into the stomach where they are inflated with saline solution.  The balloon remains in place for 6 months and Bariatic Surgery Source reports a 30% “excess” weight loss.  The cost of the procedure is approx. $8100 and the procedure takes less than 30 minutes.

Some risks can include overinflation of the balloon, perforation, blockages and pancreatitis.

This is a developing story.

                                                                                                       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

Epilepsy Cases Surge: Could Cell Phones be to Blame?

The CDC reports 3.4 million Americans suffer from epilepsy based on their 2015 data.  This number rose from 2.3 million in 2010.  470,000 of these cases are children.

According to their website, the CDC reports 1.2% of the population suffers from “active epilepsy”.  Active epilepsy is defined in adults as those having one or more seizures in the past year and requiring medication daily to control them. In children it means they currently have a seizure disorder.

The exact explanation for the rise in cases is unclear, however population growth and improved testing as been cited.

 

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

 

Epilepsy and seizures can be caused by a multitude of factors including genetics, brain trauma, tumors, infection, damage during birth, and stroke.

Can cell phones cause seizures?

Data has been limited linking seizure activity to cell phone use. However, some studies have found a modest link.

In 2016, Kouchaki et al tested mobile phone radiation in mice and concluded “continued and prolonged contact with the mobile phone radiation might increase the risk of seizure attacks and should be limited.”

Also in 2016, a study published in Epilepsy and Behavior by Tatum et al found texting to induce a “new type of brain rhythm”.

In 2013, Cinar et al examined the effects of electromagnetic waves (EMWs) on humans and suggested the following, “acute exposure to EMW may facilitate epileptic seizures, which may be independent of EMW exposure time. This information might be important for patients with epilepsy. Further studies are needed.”

In 2006, Ferreri et al found mobile phone “emissions” to increase human brain excitability, implying this could affect those with epilepsy.

More research therefore needs to be done investigating why epilepsy cases are on the rise and if cell phone radiation plays any role.

 

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

life line

 

                                                                                                       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

US Diplomats in Cuba Mysteriously Go Deaf by Possible Secret Sonic Weapon

A group of US diplomats stationed in Cuba have suffered hearing loss, and investigators believe they were affected by a “sonic weapon” of which they weren’t aware.

In addition to hearing loss, other symptoms have been reported including severe fatigue and headaches.  This was reported in 2016, a year after the embassy in Cuba reopened in 2015. Those who stayed for a short period of time reported symptoms as well.

The Cuban government rejected the allegations saying, “Cuba has never permitted, nor will permit, that Cuban territory be used for any action against accredited diplomatic officials or their families, with no exception.” They have launched an investigation as well.

There are four types of hearing loss:  auditory processing disorder, conductive, sensorineural, and mixed.

Auditory processing disorder occurs when the brain cannot process the information or sounds it received.

Conductive hearing loss occurs when something (such as wax, fluid, bony build up such as otosclerosis) impedes the flow of sounds into the inner ear.

Sensorineural hearing loss occurs when the organs (cochlea) and nerves within the inner ear cannot process or transmit the sounds.

Mixed hearing loss can occur when one has both sensorineural and conductive hearing loss.

Hearing loss can be caused by a variety of household items such as hair dryers, televisions, ear buds emitting loud sounds, vacuum cleaners and lawn mowers.

Research has been suggested looking into infrasonic frequencies, in which the sound is inaudible to humans (approx. 20 Hz) and its military applications.

This is a developing story.

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

 

 

Posted in Health, news

Tuberculosis: Your Questions Answered

Tuberculosis (TB), once called “Consumption”, has been one of the deadliest lung infections in history.  With recent advances death rates have drastically dropped, but currently 1/3 of the world’s population is infected with TB and worldwide it ranks in the top 3 causes of death.

What is Tuberculosis?

TB was first discovered in 1882 by Robert Koch. It  is caused by the bacteria, Mycobacterium tuberculosis.  It’s an acid-fast staining bacteria (significant for diagnosis purposes) and it needs oxygen to survive, hence the lungs offer the perfect environment for this pathogen to grow.

How is Tuberculosis passed?

TB is passed by aerosol/droplet transmission so when someone coughs, sneezes, or passes respiratory fluid they could transmit TB.  It may also grow on contaminated surfaces.

What are symptoms of Tuberculosis infection?

Symptoms may include the following:

  • Coughing > 3 weeks
  • Coughing up blood (hemoptysis)
  • Pain with coughing and/or breathing
  • Weight loss
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Loss of appetite

How is Tuberculosis diagnosed?

If a patient has any of the above symptoms the first test needed is a Chest Xray.  The chest xray may show an effusion (fluid), consolidation (area of the lung obscured with fluid/infection infiltrate), and lymphadenopathy (lymph node swelling). Ghon’s lesions (a necrotic, calcified focus of infection) and a Ghon’s complex (a Ghon’s lesion with lymph node involvement) may be seen as well.

Cultures of the sputum/mucous can be done but they take 4-6 weeks.  Acid-fast staining can be done on the sputum which will give a quicker diagnosis.

Can Tuberculosis spread?

Yes.  15-20% of the cases can be extrapulmonary.  Meaning “beyond the lung”, one could have extrapulmonary TB, with infections affecting the gastrointestinal tract, genitourinary tract, lymph nodes and lining of the brain.

Sometimes TB may disseminate throughout the lungs and body, this is called Miliary TB.  Miliary TB can spread to the above areas as well as heart, brain, and bone.

TB may also become “latent” and reactivate at a later date.

How is Tuberculosis treated?

Active TB needs to be treated for 6-9 months. The following medications include:

Isoniazid (INH)

Rifampin (Rifadin, Rimactane) (RIF)

Ethambutol (Myambutol) (EMB)

Pyrazinamide (PZA)

Initially we prescribe a 2 month “intensive phase” treatment of the above four drugs.  Then its followed by a “continuation phase” of only INH and RIF.

For latent TB cases we prescribe a 9 month regimen of INH.

Health care providers watch for liver toxicity and, especially with INH, vitamin B 6 deficiency.

 

Is there a vaccine for Tuberculosis?

Yes.  The BCG Vaccine was created in the 1920’s and it is the most common vaccine given outside of the US. Due to cost and its lack of efficacy (only 50% effective) its not given during routine vaccination here in the US. Moreover, it may interfere with PPD skin tests used for screening, as one vaccinated will show a positive result.

How do we screen for Tuberculosis?

The Mantoux, purified protein derivative (PPD) skin tests are given subcutaneously in the arm and read 48-72 hours later, looking for a red marking.

ppd
mar97table1.gif

Two steps are done a week apart to ensure against false negatives.

IGRA – Interferon Gamma Release Assay blood tests, such as QuantiFERON®, can be done and provides results within 24 hours.  It is beginning to replace the PPD test for screening in many healthcare settings.

Who is at risk for acquiring TB?

High risk populations include the following:

  • Healthcare workers
  • Prisoners
  • Homeless shelters
  • Nursing homes
  • Alcoholics
  • Chronically debilitated
  • Those with HIV

Where is TB the most common?

Countries with the highest TB rates include:

  • India
  • Indonesia
  • China
  • Nigeria
  • South Africa
  • Philippines
  • Pakistan
  • Bangladesh

50% of all cases in the US are immigrants coming from any of the above countries.

How does one prevent TB?

In addition to vaccination, and treating household/close contacts of those infected with TB, prevention includes the following:

  • Education
  • Homes with good ventilation
  • Avoidance of sick household contacts
  • Avoid close quarters with large amounts of people

 

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

Governors Uniting to Fight Critical Blood Shortages

Multiple governors are proclaiming state blood donation days in response to blood bank shortages throughout the country.

Last year 33 Governors declared state blood donation days to unite during National Blood Donation Week.

According to the American Red Cross, 36,000 units of blood are needed in the U.S. every day.

Emergency rooms treating trauma victims, hospitals treating anemic patients, and medical clinics replenishing low blood levels in cancer patients require a steady supply of blood products.

38% of the U.S. population is eligible to donate blood but less than 10% actually do.

Inconsistent donation patterns during the year result in unpredictable and reliable blood supply numbers, hence donation is requested year round.

United Blood Services suggests donating three times a year.

The summer and holiday season appear to be the “dryest” in terms of donations.  States and regions frequently need to ship blood to areas who are in need.

National Blood Donation Week is September 4-10th and this year National Blood Donation Day falls on September 8th, with many states declaring September 8th their State Blood Donation Day.

States who have already proclaimed September 8th their Blood Donation Day this year include:

  • Alabama
  • Arkansas
  • Arizona
  • Delaware
  • Florida
  • Georgia
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Maine
  • Michigan
  • Mississippi
  • Missouri
  • Nebraska
  • Nevada
  • Oregon
  • Pennsylvania
  • South Dakota
  • Tennessee
  • Utah
  • Vermont
  • Washington
  • Wisconsin

Arizona proclaimed September 4-10th Arizona Blood Donation Week.

More will follow as we near closer to September.

 

To donate blood or host a blood drive, please visit here.

 

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

 

Posted in Health, news

Global Blindness Expected to Triple by 2050

Image above from Telegraph.UK

A study published this week in Lancet Global Health reveals, without increasing access to treatment, the number of cases of blindness will rise from 36 million cases reported in 2015 to 115 million by 2050.

The cause is the growing aging population, even though the actual percentage of the population with visual impairment is declining.

Factors leading to blindness may include diabetes, stroke, macular degeneration, retinal detachment, cataracts, glaucoma, and trauma.

In addition to these startling numbers of vision loss, moderate to severe visual impairment cases are set to surpass 550 million by 2050.

Study author, Rupert Bourne of Anglia Ruskin University, reviewed population based data from over 188 countries and found currently 200 million people suffer from moderate to severe visual impairment.

Bourne states, “Interventions provide some of the largest returns on investment. They are some of the most easily implemented interventions in developing regions.”

He continues, “They are cheap, require little infrastructure and countries recover their costs as people enter back into the workforce.”

Even minimal visual impairment can prevent those affected from obtaining a driver’s license or performing many activities, resulting in economic hardship.

 

The study authors hope this news could help shape future public health policies as well as encourage more investment into cataract surgeries and access to eyewear.

One is deemed “legally blind” when their central visual acuity falls under 20/200 (in the better eye under the best corrected circumstances) or their visual field is 20 degrees or less.

Childhood Vision Impairment

According to Prevent Blindness Northern California, 3% of children under 18 in the US are blind or visually impaired, despite maximum correction efforts.

In 2015, the American Community Survey (ACS) reported 455,000 children in the US with vision impairment.  Of these, 62,000 are legally blind, according to the 2015 Annual Report from the American Printing House for the Blind (APH).

Sadly, not all states have schools for the blind.

Leslie Jones, marketing and special events director of Nevada Blind Children’s Foundation (NBCF), tells us, “Nevada is one of a handful of states without a school for the blind, and what resources are available through the Clark County School District are severely limited (there are just 11 Teachers for the Visually Impaired {TVIs} for more than 500 visually-impaired students needing resources from the Vision Services department).”

Foundations such as the NBCF try to fill the gap with services these children need.

Jones states, “Nevada Blind Children’s Foundation (NBCF) works alongside CCSD to provide additional after-school educational and adapted recreational programs and services to ensure that these underserved children are given what they need to succeed in the classroom and in life.”

A child’s development and windows for learning necessitate early intervention.  Programs slow to enroll or lacking funding burdens blind children more as they fall behind in learning and development.  Building schools for the blind, such as in Nevada, will help thousands of children lessen their disability.

nv blind children

To help the Nevada Blind Children’s Foundation, please visit: here.

Nevada-Blind-Childrens-Foundation.png

 

 

Dr. Daliah Wachs with Children from NBCF – Lady Bug Ball 2017

 

       

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