Posted in food, Health, news

Could Your Hangover Actually be an Allergy to Alcohol?

Drinking too much can make one feel pretty sick the next day.  But a small population will claim their “hangover” to be a little too exaggerated for the small amount of alcohol they actually consumed.

Holly Shaw, Nurse Advisor at Allergy UK, reports to Cosmopolitan that some may actually have an “allergy” to alcohol.

Not all hangovers are equal. Some complain of headache, some nausea, some feel achy.  According to Shaw, those with an allergy to alcohol, “may also be accompanied by a red rash, swelling to the eyes, lips, face, breathing difficulties, stomach upset, feeling dizzy or faint due to low blood pressure.”

She also cites sulphites and their effects on those with asthma or sensitive lungs.  “The amount of sulphites contained in alcohol will vary between products, but sulphur dioxide is one of the fourteen major food allergens that are required by law to be included on labels.” So some may have an exacerbation of their asthma or lung disease when they drink.

Does alcohol contain allergens?

Sure, it can.  If one is allergic to grapes, yeast, rye, hops, wheat, barley, etc., they may  have a reaction when they drink alcohol.

WebMD lists the following potential allergens in alcoholic beverages:

  • Barley
  • Egg protein (usually in wine)
  • Gluten
  • Grapes
  • Histamines
  • Hops
  • Rye
  • Seafood proteins
  • Sodium metabisulphite
  • Sulphites
  • Wheat
  • Yeast

What is alcohol intolerance?

Alcohol intolerance is not an allergy.  It occurs in those who lack the enzymes needed to break down alcohol.  Alcohol dehydrogenase (ADH), for example, converts alcohol to acetaldehyde, and this becomes converted to acetic acid by an enzyme, acetaldehyde dehydrogenase (ALDH).  Some populations, including East Asians, may lack ALDH, becoming flushed when drinking alcohol as they have difficulty converting acetaldehyde, the latter building up, causing hangover-type symptoms.

 

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Image from oxfordpresents.com

 

So what is a hangover?

It’s a constellation of symptoms that occur post-partying…..and include headache, muscle ache, nausea, anxiety, moodiness, wanting to avoid light and loud sounds, eye redness, thirst and dizziness, though some hangovers may have many more symptoms.

They could be caused by a variety of factors:

  • Dehydration – alcohol isn’t the best choice to replace lost fluids during a night of dancing, plus it causes increase in urination
  • Low blood sugar – caused by lack of good nutrition over the last 12 hours and enhanced by drinking alcohol
  • Poor sleep – let me guess, you didn’t get a good nice, cuddly, deep sleep for 9 hours once you came home
  • Irritated stomach lining – alcohol tends to do that and ticks off the pancreas as well
  • Acetaldehyde – a chemical converted from alcohol that has been postulated to make you feel nauseous and achy, either during its breakdown in the liver or after its metabolism
    • acetald
  • Cytokine production and release – seen in inflammatory states and can make you achy

Other theories suggesting lactic acid build up, withdrawal from drinking the night before, and congeners that are compounds that vary in alcohol types (red wine vs vodka).

 

How you can you treat a hangover?

The following  are the most popular ways to treat hangover.

 

Water

Hydrate people, hydrate.  Alcohol is a diuretic, which means it makes you urinate more and lose valuable fluid and salts. Water is the easiest, most tolerable, cheapest way to hydrate. Take it slow so you don’t vomit.  And not scotch and water.  Just water….

 

Eat something

An empty stomach is an irritable one.  While most sources say eat a “greasy breakfast”, I would recommend balanced breakfast with protein. Give the stomach acid something to chew on but make it easily digestible.  Remember the alcohol irritated your gut so you need to go easy on it. Baby steps, but healthy baby steps.

 

Exercise

Take a short, brisk walk.  The adrenaline gets the blood pumping and can help with the headache.  The cool air outside will feel good when you inhale and some endorphins will release. This may help with your headache.

 

Drink some Sprite/Sports Drinks

Chinese researchers back in 2013 found Sprite to be the best hangover cure and even though we don’t have many other studies to back it up, the sweet and bubbly it provides makes your head and tummy feel better.

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Sport’s Drinks add the salts you lost from alcohol’s diuretic features. Though many of us don’t like the taste, those who do find it a nice way to hydrate.

What is “hair of the dog”?

Originally it was a treatment to ward off rabies.  One would, after being bit by a dog, put a piece of dog hair on the wound.  A treating fire-with-fire strategy. It later was used for hangovers.  Treating a hangover with a chaser of alcohol was supposed to elevate moods and lessen the withdrawal.  To date there is not enough scientific support to recommend hair of the dog.

 

For next time, how do you avoid the dreaded hangover?

Want to avoid a hangover?  Here’s how:

Firstly, try to avoid getting drunk.  Set your limits and stick to it.

Secondly, drink plenty of water throughout the night and once you get home.

Finally, don’t drink on an empty stomach to “speed up the buzz”. Your empty gut will absorb alcohol quicker so eat a good nutritious meal prior to partying.

Avoid popping antiinflammatories or Tylenol once you get home because your stomach and liver are already irritated from the alcohol and this may make matters worse.  But if any of the above “cures” don’t help, you may need to use these as a last resort.

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

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Employment, Health, news

Ambien Side Effects: Erratic Behavior but NOT Racism

Roseanne Barr in, an apology for a tweet in which she alluded to ex-Obama aide, Valerie Jarret, as “muslim brotherhood & planet of the apes had a baby=vj” cited Ambien as the cause.

ABC News cancelled her hit show Roseanne on Tuesday.

In an apology, the actress tweeted, “I apologize to Valerie Jarrett and to all Americans. I am truly sorry for making a bad joke about her politics and her looks. I should have known better. Forgive me-my joke was in bad taste.”

She later tweeted, “I did something unforgiveable so do not defend me. It was 2 in the morning and I was ambien tweeting — it was memorial day too — i went 2 far & do not want it defended — it was egregious Indefensible. I made a mistake I wish I hadn’t but…don’t defend it please.”  CNN reports she also tweeted the following, “Not giving excuses for what I did(tweeted) but I’ve done weird stuff while on ambien — cracked eggs on the wall at 2am, etc.”

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The makers of Ambien, Sanofi, tweeted the following response, “While all pharmaceutical treatments have side effects, racism is not a known side effect of any Sanofi medication.”

Millions of people use Ambien (zolipdem tartrate), a sedative hypnotic, in a 5 mg or 10 mg tablet form, that is used for fast-acting sleep initiation and is famous for not inducing a drowsy feeling the next morning.

Unfortunately multiple users have cited odd side effects such as driving to work in the middle of the night, or cooking breakfast.

According to rxlist.com, side effects of Ambien may include:

  • Daytime drowsiness
  • Dizziness
  • Weakness
  • Lightheadedness
  • “Drugged” feeling
  • Tiredness
  • Loss of coordination
  • Stuffy nose
  • Nasal irritation
  • Dry mouth
  • Sore throat
  • Nausea
  • Constipation
  • Diarrhea
  • Stomach upset
  • Headache
  • Muscle pain
  • Confusion
  • Insomnia
  • Euphoria
  • Ataxia (balance problems)
  • Visual changes
  • memory loss
  • mental/mood/behavior changes (such as new or worsening depression, abnormal thoughts, thoughts of suicide, hallucinations, confusion, agitation, aggressive behavior, or anxiety).

The medication is a gamma-aminobutyric acid (GABA) A agonist, inciting a neurotransmitter cascade that can inhibit activity between neurons, nerve cells.  Lower levels of GABA are linked to sleep disorders, so inciting the GABA receptor as Ambien (zolpidem tartrate) does, can induce sleep.  But once we’re affecting nerve signals other side effects may ensue since the GABA inhibitory neurotransmitter affects the central nervous system.

So odd behavior could be a side effect. However, as with alcohol-induced behavior, exacerbations of feelings or tendencies may occur.  Forming new opinions, which may be racist, would not be a side effect of this medication.

Medical providers warn users to hide car keys, lock of refrigerators and put child locks on stoves and ovens as “sleep walking” behavior could put them and their families at risk.  This also includes posting on social media… so keep phones away from the bed and computers off.

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Radio personality Mark DiCiero shares his personal experience here.

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

 

 

 

Posted in Health, hockey, news, Sports

las vegas “bans” capital letters in support of golden knights

the las vegas war cry as the knights ready to battle against the washington capitals for the stanley cup is #nocaps.

 

 

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eye chart lower case letters

 

this week the iconic “welcome to las vegas” sign was photoshopped, donning its support with all lower case letters, thanks to las vegas county officials.

98.5 radio host chet buchanan might have launched one of the most brilliant fan decrees seen in modern sports.

“knight up days” have also been declared on those days where the knights and capitals play for the stanley cup.

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playoff games are scheduled for the following (pacific):

  • game 1: may 28 at vegas, 5 p.m. (nbc, cbc, sportsnet, fubotv)
    game 2: may 30 at vegas, 5 p.m. (nbc, cbc, sportsnet, fubotv)
    game 3: june 2 at washington, 5 p.m. (nbc, cbc, sportsnet, fubotv)
    game 4: june 4 at washington, 5 p.m. (nbc, cbc, sportsnet, fubotv)
    *game 5: june 7 at vegas, 5 p.m. (nbc, cbc, sportsnet, fubotv)
    *game 6: june 10 at washington, 5 p.m. (nbc, cbc, sportsnet, fubotv)
    *game 7: june 13 at vegas, 5 p.m. (nbc, cbc, sportsnet, fubotv)

 

daliah wachs, md, faafp is a nationally syndicated radio personality on gcn network, iheart radio, kdwn…..

she is also a board certified family physician and assistant professor at touro university nevada

Posted in Health, news

Poop and Other Nasties in the Pool Can Cause Disease

The CDC reports outbreaks associated with “treated recreational water” due to multiple organisms including Cryptosporidium, Pseudomonas, and Legionella.

Looking at the time period between 2000-2014, the CDC reports the following:

Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks

Hotel pools and hot tubs appear to be the biggest culprits.

Pseudomonas has been known to cause skin infections such as “hot-tub folliculitis” and ear infections, otitis externa, known as “swimmer’s ear.”  Legionella is known for causing Legionnaires’ disease, a severe pneumonia as well as a milder illness known as Pontiac Fever.

The largest number of cases, however, were caused by Cryptosporidium.  Known as “Crypto”, this parasite can cause severe gastrointestinal illnesses. Here’s the breakdown:

What is Crypto?

Crytosporidium is a parasite protected by an outer shell.

This shell allows it to live outside the body on surfaces.  The shell also allows it to be chlorine resistant which explains why it can live in swimming pools.

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How common is Crypto?

According to the CDC, Cryptosporidium is a leading cause of waterborne disease among humans in the United States.   Its found in every region of the US and the world.

The CDC reports close to 750,000 cases of cryptosporidiosis occur every year in the US.

How is it spread?

Its spread in drinking water and recreational water, such as swimming pools.  Since it lives in the intestines of humans and animals it becomes spread after one passes stool, or poops.  People coming into contact with an infected individual’s poop could become infected with Crypto.

It is not passed through respiratory transmission or blood.  However if feces comes into contact with one’s mouth, or wound, it can transmit Crypto.

Coming into contact with feces contaminated soil, surfaces, water, food therefore put one at risk.

What are the symptoms?

The parasite can cause any of the following:

Diarrhea

Abdominal Pain and Cramping

Fatigue

Nausea

Vomiting

Dehydration

Lack of appetite

Weight Loss

and sometimes  no symptoms at all.

When do symptoms show and how long do they last?

After one becomes exposed to Cryptosporidium, symptoms could show within 48 hours to 10 days.  Symptoms can last 1-2 weeks.

 

What is the treatment for Crypto?

The infection many times is self-limiting.  Hydration is imperative and initial treatment is making sure one does not become dehyrated.  Young children, pregnant women, elderly, those with weakened immune systems, AIDS, cancer and immunosuppressed transplant patients are at higher risk  of serious infection.

Some medical providers may use Nitazoxanide. According to the National Foundation for Infections Diseases:

Nitazoxanide (Alinia ®) may be used to treat Crypto in both adults and children 12 months of age and over. Nitazoxanide is available as a tablet for adults and as a liquid suspension. A three-day treatment regimen is recommended.

How do we prevent Crypto?

Always wash your hands with soap and water

Avoid eating off of non clean surfaces

Avoid swimming pools that may have just been soiled

Avoid ingesting  water while swimming

Avoid feces of those individuals infected

Avoid sexual contact where oral – anal contact can occur

Change baby’s diapers away from the pool in case it blows into the water

Do not allow any family members with diarrhea to enter the pool

Inform your medical provider if you have any of the above symptoms so he/she can test the stool.

 

Don’t pee or poop in the pool

The Water Quality & Health Council found one in four adults ADMIT to urinating in the pool, which can affect chlorine strength.

Many choose not to wait in line at public bathrooms or use the wet toilets at public water parks and find it easier to relieve themselves in the pool.  For women worried about sitting on wet toilet seats I recommend using a  large soda cup and in the stall standing and urinating into it. Pour it out into the toilet and flush.  Clean, easy and environmentally sensitive.  Men, there’s no excuse. Towel off and head to the potty.

 

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

Posted in Health, news, smart devices

Alexa Records and Transmits Private Home Conversation: Are Cell Phones Safe?

Above image from Verge.com

A Portland family’s Amazon Echo recorded a private conversation and sent it to one of their employees without their consent.

Danielle, who’s last name was held private, was discussing with her husband a private conversation that included a discussion on wood flooring.  The Amazon Echo device recorded it, sent it to her husband’s employee who then contacted the couple concerned that their device was “hacked”.

In an interview USA Today, Amazon offered the following explanation:

The Echo woke up when someone in the home said something that sounded to it like “Alexa.” 

Next, the subsequent conversation included something that, to Alexa, sounded like a “send a message” request.

At which point, Alexa said out loud, “To whom?” 

Next, Alexa interpreted the background conversation as a name in the customers’ contact list. 

Alexa then asked, again out loud, “[Contact name], right?” 

Alexa then interpreted background conversation as confirming with, “Right.”

In my opinion the probability of a flooring conversation triggering all these prompts is one in a billion and I suspect these smart home devices are always on and the trigger words prompt a second order task.

Which brings us to the question, do all smart devices record our every sound?

Multiple testimonials have arisen of people finding ads pop up on their social media moments after having a private conversation in their office or home.

An “OK Google” or “Hey Siri” can prompt a listening feature as well, and many sounds, dialects, or word groupings may dupe the technology.  Some have reported a “Lake Erie” or “No noodles!” has triggered their phones to respond back.  If speakers are at a farther distance from the device or overshadowed by other conversations, fumbled word receptions may occur.

CBS News reported the following:

Google and Facebook have both denied using cellphone microphones to collect information for ads. In a statement, Google wrote: “We do not use ambient sound from any device to target ads.” While Facebook didn’t respond to our request for comment, it’s previously said: “We show ads based on people’s interests and other profile information — not what you’re talking out loud about.”

So we want to believe that we’re safe, but the possibility of our private work meetings, dinners, or drives to the in-laws can house evidence of bad mouthing is frightening beyond words.  So this loud mouth is going to start keeping quiet when technology is around…..

 

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

Posted in Entertainment, Health, news, sex

Morgan Freeman Accused of Sexual Harassment

It’s not uncommon for older men to lose their “filter” and say or do things that may be sexually inappropriate.

Eight women have accused Morgan Freeman of inappropriate behavior and sexual harassment.  CNN reported that movie set assistants felt compelled to resist his touching their back, lifting one’s skirt, and unwanted comments regarding their bodies and figures.

The Oscar-winning actor allegedly made multiple women uncomfortable with his advances, which had been witnessed by multiple bystandards.

According to the Hollywood Reporter:

…a rep for Freeman provided the following statement from the actor: “Anyone who knows me or has worked with me knows I am not someone who would intentionally offend or knowingly make anyone feel uneasy. I apologize to anyone who felt uncomfortable or disrespected — that was never my intent.”

The Electric Company and Bruce Almighty actor is 80 years old. Which brings up the question, do older men naturally lose control of their sexual urges?

It was a common occurrence during my training and career for an older man to make a sexual advance or grab my behind while I was tending to their medical care.

Common behaviors that were once tolerated in older society may be difficult habits to break in this day and age.  Skirt lifting and commenting on one’s figure were unfortunately common pick up lines and acts that men would do to engage one of the opposite sex.

And if we go back further to caveman days, butt grabbing was an instinctive move to initiate sex (see below).

Hence older men may need to check themselves and be frequently reminded of the new norm that does not tolerate sexual harassment or unwanted touching.

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Butt-grabbing happens to almost every woman. Why?

 

The Butt

Let’s start with the anatomy of the derriere.  It lies inferior to the waist and spine and is composed of the following:  the pelvis, giving it structure; muscles (gluteus mimimus, gluteus medius and gluteus maximus) allowing it to shake and shimmy; fat providing the cushion; and skin to offer a place to don tattoos.

Buttocks-skeleton

 

Purpose of the Butt

So as you see from above, the butt is involved in a variety of actions from hip movement to pelvis stabilization to cushioning of the bones when one falls. However its main purpose involves sexual attraction and activity.

Animal instinct

Humans, by nature, are animals.  True, we eat with a spoon and fork, and know how to navigate Netflix, but according to Mother Nature we are highly specialized animals.  So our bodies were designed at the start to attract each other and mate.

Back in the caveman days, sexual positions were not as well choreographed as they are today.  There was no such thing as the reverse cowgirl.  “Doggie-style” or mating from behind was the norm.  Hence a butt needed to be inviting…round, soft and appearing to allow easy entry into the vagina.  Moreover, cavemen didn’t want to bruise their pelvic bones during sex, hence cushioning was greatly appreciated.

As with most animals, sexual activity starts with the touch of the behind.  Hence its instinct when a man grabs a tushee.

We’re attracted to round shapes

The human body is wrought with shapes…circles, triangles, ovals, etc. and these shapes exist for a reason.

Breasts are round and contain round areola allowing infants easy-to-see shapes so they can navigate towards their food source. Female pubic hair is naturally triangularly distributed creating a landscaped arrow for the mate to go.

So a round protruding tushee, lying beneath a curved and narrow waist, calls to the average mate because humans like round bouncy objects.  That’s why rubber balls are toy and sporting good store favorites.

 

It’s less intrusive than touching the face

Touching a woman’s face or breasts yields a much higher rejection risk than touching a body part that is behind her and not easily visualized.  It could easily be brushed off as an accident if a potential mate wants to save face.

 

So how can a woman avoid getting her butt grabbed?

Do what our Mom’s and Grandma’s do….wear a moo moo.  Older women have learned that if they hide the curves, the waist and their buttocks, no one will grab at their behind.  Avoiding short skirts, jeans, tight-fitting pants, and thong bikinis will hide the animal-enticing shapes.   Moo moos ladies….moo moos…..

 

moo moo

 

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

Posted in food, Health, news

Standing NEXT to a Grill Can Increase Cancer Risk

Chinese researchers find the smoke released during grilling to expose one to cancer- causing chemicals.

As we head into the summer, grilling burgers, hotdogs, and steaks are a favorite pastime.  But a small study published in the journal Environmental Science & Technology suggests PAHs (polycyclic aromatic hydrocarbons), produced during grilling, are inhaled and absorbed through the skin, potentially causing genetic mutations that may cause cancer.

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The study, out of Guangzhou, China, found those consuming the grilled meat had the highest exposure to PAH’s.  Next came those exposed through skin, and finally those inhaling the smoke to be at next greatest risk.

Clothing provided some protection, but once smoke saturated, should be removed to lessen exposure.

The average person is considered safe if they grill in moderation, but excessive exposure could put them at higher risk of PAH-induced cancers such as lung, bladder and skin cancers.

For more on the study read here.

The heating of foods to high temperatures can cause chemical reactions among the amino acids, fats and sugars in foods, producing toxic substances.  Acrylamide, as discussed below, can be formed when heating starches such as potatoes, to high levels.

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What is acrylamide?

Acrylamide is a chemical used in many industrial products that produce plastics, adhesives, food packaging and the treatment of drinking water.  It can also be produced when foods are heated, fried, baked, or roasted to above 120 degrees Celsius (248 degrees Fahrenheit).  In 2002 reports came out regarding acrylamide in french fries, and in 2013 the FDA issued guidance to the food industry on how to minimize producing the chemical.

Roasting coffee requires the beans to be heated to close to 450 degrees Fahrenheit.  This heat produces a chemical reaction between the amino acid asparagine and sugars resulting in the formation of acrylamide.

The amounts however are miniscule.  Much smaller than other modes of acrylamide exposure such as cigarette smoking and exposure at work when working in industries that use acrylamide such as plastics, food processing, mining, paper, agriculture and construction.

What can acrylamide do?

In rodents, acrylamide was found to increase several types of cancer. But the doses were 1,000-10,000 times greater than what the average human is exposed to.

According to the American Cancer Society, most of the studies done so far have not found an increased risk of cancer in humans. For some types of cancer, such as kidney, ovarian and endometrial cancer, the results have been mixed, but there are currently no cancer types for which there is clearly an increased risk related to acrylamide intake.

How do I decrease exposure?

As noted earlier, acrylamide can be in a variety of products we use throughout the day.  Large quantities, however, can be consumed through cigarette smoke, hence avoiding smoking is key.  Moreover, avoiding frying foods, especially starches, greater than 120 degrees Celsius/248 degrees Fahrenheit if possible.  Frying and or toasting to a light gold, rather than crispy dark brown color, may limit your exposure as well.

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But keep in mind, numerous studies have found coffee drinkers to lower their risk of cancer, especially liver, uterine, prostate and mouth cancer.  However 4-6 cups had to be consumed in order for researchers to notice a benefit.

More research still needs to be done.  So while we wait for the verdict lets kick back with a cup of …..hot chocolate?

 

 

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

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, robots

Will Your Doctor be Replaced by a Robot?

The University College London Hospital (UCLH) in Bloomsbury London is launching a pilot program replacing some A&E (Emergency Room) physicians with robots.

In response to staff shortages and long wait times, the initiative launched by UCLH and Alan Turing will utilize artificial intelligence to triage patients and reduce wait times.

Robotic technology is already being used in the operating room, rehabilitation centers and for pharmaceutical dispensing.  It’s just a matter of time that they become our main caregiver.

But will patients be pleased?

The Robot Is In…

Where’s there’s demand, there’s supply. Patients tired of wait times, crowded waiting rooms, loss of sick leave hours to sit around a medical office or emergency room for half a day will want speed and efficiency.  Kiosks may replace front desk clerks, taking your initial information (chief complaint, name, insurance info.), scanning it and offering you a number, like one given at a bakery.

Robots Don’t Judge

Those embarrassed by having symptoms suggestive of having an STD will have less of an issue conveying this information to a machine than a human being.  Gas, discharge, odors may be easier to discuss with someone or something that won’t wince.

Doctor-and-patient

The Doctor Doesn’t Examine Me Anyway

Many patients cite seeing a medical provider and not being examined or asked to undress before an exam.  Time constraints, or avoidance of being accused of wrong doing, have caused some providers to refer out for heart, gynecological, and rectal examinations.  Primary care providers who enter the room, say a few words and then promptly leave saying they will “bring in the nurse to review instructions” may not be missed by the patient receiving similar service from a robot.

They can always answer my questions

We use Google, Wikipedia and Siri to answer our health questions currently.  No wait time, no office visit, no cost….so a robot answering our questions in layman’s terms will be an easy task.

 

However, and this is the kicker……

 

Robots Lack Instinct

 

There is no way to replicate the sixth sense humans have when it comes to something being wrong with you.  Artificial intelligence cannot provide a “gut feeling”.

Let’s take a urinary tract infection, for example.  I have had patients who were new to my office complaining something “felt funny” when they urinated and cited blood in their urine.  A urinalysis may show inflammatory cells, and a robot may correctly diagnose the patient with a bladder infection.  But I as a clinician may be suspicious that this new patient has something that is leaking blood into the urine, from the gynecological tract maybe? And I’ve diagnosed endometrial and cervical cancer in cases where patients thought they were merely having bladder infections.

One patient presented to me in the emergency room feeling “odd” and suspecting a “UTI.” She was in her 60’s and started to complain of nausea.  Her urine had inflammatory cells so while a culture takes 3 days to complete, I gave her a prescription for antibiotics in case the infection would spread during that time. But her nausea was concerning. The patient requested an injection of nausea medication prior to leaving so I obliged, giving her Compazine.  While observing her for a few minutes, post injection, she began to have shortness of breath.  We decided to look at her heart and came to the conclusion after more testing that she had suffered a heart attack in her sleep the night before and the “odd feeling” she felt the next day wasn’t due to her UTI (which she coincidentally had) but was from a heart attack. She was treated immediately and recovered nicely.

Would a robot have picked up on that?  Multiple web resources include nausea in the list of symptoms associated with a UTI, so could be “blown off” by a robot bundling it with the patient’s urinary complaints. But I learned that nausea could be the first sign of a heart attack, especially in women.

Another case I had as an urgent care physician was the following:

A gentlemen came in saying he “felt fine” but his wife made him come in because he was burping the night before.  Multiple bouts of eructation jogged an ancient memory of mine…..when as a little girl I saw a movie where the pilot was burping multiple times before he passed out and died.  So I came to learn that chronic bouts of burps, or hiccups for that matter, could be a sign of an inferior MI (heart attack). I ran an EKG and blood work, and my instinct was right.  Again I was looking at a patient who unknowingly had a heart attack the night before but thought he had something benign the next day.

So gut instinct, thinking laterally, tapping in on past experience, and acting on hunches is not something a robot can do.  Humans may be satisfied with shorter wait times and receiving antibiotics when they demand them, but the education and intervention a medical provider can provide is priceless.  Too bad cost gets in the way of real medicine.

 

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

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in Health, news, volcano

Health Risks of Volcanic Ash Now Include “Laze”

Hawaii’s Kilauea has been spewing lava, prompting thousands of nearby residents to evacuate.

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Now a new risk threatens nearby residents:  Laze.

Laze, “lava + haze”, occurs when the lava reaches the ocean. When lava meets seawater, plumes of hydrochloric acid and volcanic ash enter the air.  This can cause significant eye, lung and skin irritation.

The Hawaiian Volcano Observatory (HVO) warns this can be deadly. They also report sulfur dioxide emissions from the eruptions have tripled.

Residents are urged to avoid areas where lava has met the ocean.

Volcanic ash can prompt a multitude of health risks…not only from a particulate standpoint but also from the sulfur dioxide levels.  Sulfur dioxide is a colorless, though stinky gas that can cause irritation to skin, eyes, and respiratory system linings.

Let’s break these health risks down:

 

Respiratory Illness

Volcanic ash can irritate the respiratory passages causing the following symptoms:

  • Runny nose
  • Sore throat
  • Wheezing
  • Coughing
  • Mucous production
  • Shortness of breath
  • Painful breathing

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Those with asthma, COPD, chronic bronchitis or other respiratory ailments may find themselves having exacerbations of their symptoms. Oxygen requirements will increase. Those requiring oxygen or inhalers will need to have extra supply during this time (medical offices may be closed during ash clean up so don’t wait until the last minute.)

Eye Issues

Volcanic ash has large and small particles that can irritate the eyes increasing their sensitivity to light and making vision difficult.  Moreover ash can irritate the cornea and conjunctiva causing redness, discharge and itching.

 

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Skin Reactions

Skin may become irritated during these times and those with skin allergies or eczema may find themselves having flare-ups.

Road Visibility

During a volcanic eruption, smoke plumes not only change the air quality but also visibility.  During times of day when there is less light, road visibility obscures pedestrians and nearby cars.  Drivers are urged to avoid the road during these smoky times.

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Water

Water quality can become affected by the ash or pH changes if supply becomes  contaminated. Moreover, water use increases for cleanup so shortages may ensue.

Short blood supply

Those who donate blood in nearby areas may be less likely to donate during this difficult time leading to local blood shortages.  Those who can donate blood are urged to contact the American Red Cross, United Blood Services, or Blood Bank of Hawaii.

 

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

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in Health, news, travel

Memorial Day Weekend Safety Tips

 

Memorial Day is this weekend and the country honors those who have sacrificed for our freedom.  Many of us will travel and enjoy the outdoors.  However, according to a study by the National Coalition for Safer Roads, Memorial Day Weekend is the most dangerous holiday for road and highway accidents.  Additionally, water injuries, including drownings may rise this weekend.  Grill injuries can occur, and throughout the US we are seeing record high temperatures.  We need to stay safe out in the sun, by the grill, in the water and on the roads.

 

Sun Safety

 

Record heat and extended time outdoors can increase the risk of heat illness.  Hydrate, stay in the shade and protect your skin from damaging UV rays.

Sunscreen with an SPF of 30 or greater should be applied 15-30 minutes prior to going outside and reapplied every two hours or more often if swimming.

Avoid excessive alcohol as it could accelerate dehydration and put one at greater risk of injuries and heat exhaustion.

For more on heat exhaustion and heat stroke read here.

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Grill Safety

 

In 2012, a man caught on fire after spraying sunscreen prior to heading over to the grill. He sustained multiple second degree burns.

Sunscreen may be flammable, so make sure it is dry prior to grilling or use a lotion instead of spray on.

Keep the grill outdoors but away from low roofing, branches, and trees. Watch the little kids and keep them and the pets away from the barbecue.

Assign someone to watch the grill if you need to step a way during grilling.

 

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Do not add lighter fluid to already ignited coals.

If someone does catch on fire, remember to have them stop, drop and roll on the ground until the flames expire.  Call 9-1-1 and remove any jewelry or tight clothes around the area..

If a minor burn injury does occur, run it under cool (not cold) water for 10-20 minutes. Avoid applying ice to the burn as it can damage the skin.  Also remove nearby jewelry.

Bandage and see a medical provider if concerned with your injury.

 

Water Safety

 

Avoid drinking alcohol when swimming or engaging in water sports.

Make sure you are in arm’s reach of your kids in the water.

Use life vests while boating and make sure the kids are wearing appropriate sized vests.

Never swim alone. Always have a buddy.

 

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Road Safety

 

Know your route to avoid you checking your GPS app while you drive.

Allow extra travel time and don’t rush.  Expect travel delays coming home as well.

Consider leaving a day or two early or a day or two late to avoid congested traffic.

Drive the speed limit and avoid tailgating, leaving at least 2 seconds between you and the car ahead of you.

Make sure you have plenty of water, supplies and a first aid kit in the car in case you get stuck on the highway.

 

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Have a happy and safe Memorial Day Weekend!

 

                                                                                                      

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

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada