Posted in Education, Employment, Health, news

Woman Arrested After Passing Gas and Then Pulling Knife on Offended Bystander

Embarrassment many time leads to violence.

This week a woman who was embarrassed by a remark after she passed gas pulled a knife, threatening to “gut” him.

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37-year-old Shanetta Wilson was standing in line at the Dollar General Store in Broward County, Florida, when she let loose some loud gas.  When a man confronted her on how loud it was, she allegedly pulled a knife out of her purse, threatened she would “gut” him and appeared to lunge.  She was arrested with a charge of aggravated assault with a deadly weapon (the knife, not the fart).

 

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Does embarrassment lead to violence?

One of the most undercited reasons for violence is embarrassment.  Violence that ensues after one is fired, rejected, ousted or expelled appears to occur fairly often.

Last year in the same county, 17 people were killed at Marjory Stoneman Douglas High School by Nicholas Cruz, who was previously expelled by the school.

Last month a man rejected by his fiancée killed her and two others at a Chicago hospital.

In August a 14 year-old Oklahoma teen stabbed a 16 year-old 11 times after she rejected his request for a relationship.

Now, most likely many of these soon-to-be-violent individuals are rejected due to their odd behaviors.  However, the time surrounding the “embarrassment” may be the most dangerous.

Hence society’s approach to stopping domestic and workplace violence may need to tap in on key times that surround one’s expulsion.

 

 

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

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

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Posted in food, Health, news, sex

Did the Legalization of Marijuana Lead to a Rise in STD’s and Foodborne Illness?

Reports of increasing cases of STD’s appear to correlate with the legalization of marijuana.

Could marijuana be leading to a complacency when it comes to handwashing and condom use?

STD-Trends

 

This Fall the CDC reported a continued rise in cases of sexually transmitted diseases by the following:

Nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017, according to preliminary data released today by the Centers for Disease Control and Prevention (CDC) at the National STD Prevention Conference in Washington, D.C. This surpassed the previous record set in 2016 by more than 200,000 cases and marked the fourth consecutive year of sharp increases in these sexually transmitted diseases (STDs).

And this week, the World Health Organization sounded the alarm of rising HIV cases in Eastern Europe.

At the same time more countries are easing up on legal restrictions when it comes to marijuana.  Which leads to the question, has the legalization of marijuana led to the rise in STD’s?

BackgroundChecks.org released this graphic displaying STD rates by state.

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Strikingly, there are some similarities to a map outlining state cannabis programs.

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Cannabis use is known to decrease anxiety and motivation and so an unintended consequence of increasing access to its use may be the decrease in precautionary thinking when it comes to unprotected sex.

Rare STD Evading Doctors and May Become Next Superbug

 

On that same note, multiple outbreaks have been reported in the food industry when it comes to pathogens such as Salmonella, E. coli, Hepatitis A and Listeria.  Could complacency with proper food handling and hand washing be related to marijuana use?

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This could easily be analyzed by screening those with an STD for marijuana use, as well as those involved in a foodborne illness outbreak.

Now the legalization of marijuana allows more studies to be done to to determine its health benefits. I suggest, however, we also study, any links to complacency issues when it comes to home and workplace safety and exposures.

 

Why is food borne illness on the rise?

Multiple issues could be playing a role.

  1. Fresh produce is not cooked like meat and can therefore harbor more germs
  2. Preservatives, used in fast food, help to deter pathogen growth, and more people are shying away from fast food than in the past, opting for “fresh”, healthier options.
  3. On-the-go produce may not be washed after packaging due to a false sense of security that the vegetables are “clean.”
  4. As our population ages, and as more people suffer from immunocompromising disease such as diabetes and cancer, they may be more susceptible to food borne illness.
  5. Our gut microbiome has changed as our diets have shifted to food with more preservatives, hence possibly being less resilient to new pathogens that enter.
  6.  In regards to the ground turkey, it is not the same as ground beef and leaving the patties pink in the center mean you are consuming raw poultry. Turkey meat may need to cook longer until no pink is seen and core temperature is at least 165 degrees for at least 15 seconds
  7. We’re less strict about cleaning than we used to be.  Counter tops used to be bleached and scrubbed for longer periods of time than we do now-a-days with antimicrobial wipes.

Therefore be diligent about cleaning counter tops, cook your food thoroughly, wash produce before eating and be aware of any reported recalls.

 

A Review of Syphilis

Syphilis is also called “the great imitator”.  Many don’t realize they have syphilis as the symptoms mimic so many other diseases.  Syphilis has been on the rise and hasn’t been routinely tested in STD/STI panels.  It’s caused by a spirochete (spiral bacteria) called Treponema pallidum, and can cause infection in stages.

Primary Syphilis can manifest as a painless ulcer on the genitals, mouth or skin.

Secondary Syphilis can manifest as a rash, along with fever, joint pain, malaise…mimicking other illnesses. In this stage it can also manifest as warts on the genitals called condylomata lata.

 

Syphilis

 

As the course progresses, syphilis may become latent. For years one may have no symptoms at all.  The patient may mistakenly feel they suffered the flu and think nothing more of it. But if left untreated, syphilis can enter the final stage, Tertiary Syphilis, which can cause severe neurological disability (neurosyphilis) and can also severely affect the heart.

Penicillin is the treatment of choice for any stage of syphilis, including the latent stage of the illness.

 

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

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

 

Posted in children, Health, news

AFM Polio-Like Illness Reported in Multiple States

31 states have reported recent cases of AFM (Acute Flaccid Myelitis), a paralyzing illness resembling polio.  This week the CDC reported a rise in the number of cases to 116.  170 more cases are currently being investigated.

 

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Colorado and Texas appear to be the worst hit with 15 and 14 cases respectively.  Experts are urging states to report any cases of suspected AFM as the above map could be an underrepresentation of true numbers.

On their website the CDC reports the following:
  • Most of the patients with AFM (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM.
    • Viral infections such as from enteroviruses are common, especially in children, and most people recover. We don’t know why a small number of people develop AFM, while most others recover. We are continuing to investigate this.
  • These AFM cases are not caused by poliovirus; all the stool specimens from AFM patients that we received tested negative for poliovirus.
  • We detected coxsackievirus A16, EV-A71, and EV-D68 in the spinal fluid of four of 440 confirmed cases of AFM since 2014, which points to the cause of their AFM. For all other patients, no pathogen (germ) has been detected in their spinal fluid to confirm a cause.
  • Most patients had onset of AFM between August and October, with increases in AFM cases every two years since 2014. At this same time of year, many viruses commonly circulate, including enteroviruses, and will be temporally associated with AFM.
  • Most AFM cases are children (over 90%) and have occurred in 46 states and DC.

The “46 states” refers to cases since 2014.   90% of the cases occurred in children under the age of 4.

The age range of children affected appear to be 3-14.  A 6-year-old boy in Washington State died in 2016 and was the first death to be linked to this mysterious illness.  His parents reported he had felt ill, became dizzy and within hours suffered swelling in the brain and paralysis.  Despite medical efforts, he passed.

Earlier this month parents of two children who died from AFM accused the CDC of hiding their deaths.

Although the exact cause of AFM is unknown, health experts are considering a variety of possibilities. They have actually been investigating this since 2014 when reports of AFM began to surface across the United States.

What is AFM?

AFM stands for Acute Flaccid Myelitis.  It’s a condition that occurs suddenly, causing inflammation of the brain and spinal cord, causing loss of muscle tone and reflexes.  Although limb weakness is the primary symptom, patients could also exhibit slurred speech, facial drooping, and in serious cases inability to breath due to paralysis of the respiratory muscles.  Mild cases appear to resolve but serious cases can cause residual paralysis or death. Children appear to be more affected than adults.

What causes AFM?

Although health officials do not know for certain, due to its rapid onset, a pathogen such as a virus seems highly likely.  With the 2013-2014 outbreak, some of the cases tested positive for enterovirus (EV-D68), but it is not conclusive whether this was the exact cause or just coincidentally found in the patients tested.

Some postulate a combination of viruses may be a factor or an autoimmune disease.  Although Guillain-Barre syndrome causes acute limb weakness and paralysis when the immune system begins attacking the nervous system, the report that many individuals feel feverish or ill prior, seem to point to a pathogen as the primary cause although the latter is not being ruled out.  Virus families such as enterovirus (including polio and nonpolio enterovirus), adenovirus (causing respiratory and GI illness) and flaviviruses (including West Nile) have been suspected.

How common is AFM?

Per the CDC, acute flaccid myelitis is rare (less than 1 in a million cases) however currently they report 386 cases have been confirmed since the outbreak began in August 2014.

How is it diagnosed?

Medical professionals look at a variety of factors.

History: how the paralysis/loss of muscle tone began and which limbs did it affect first

Laboratory tests and CSF (cerebrospinal fluid) testing: to look for signs of infection

MRI of the brain: which may show gray matter involvement in a case of AFM.

Is there a treatment?

There is no standard treatment that has been proven effective, however depending on the severity of the symptoms, health professionals can consider a variety of options including steroids, IVIG, interferon, antivirals and supportive measures.  Some physicians are using “nerve transfers”, similar to a transplant, to help children regain control of their limbs.

Is there a vaccine?

No.  Until they can identify the exact cause, or causes, health officials cannot create a vaccine.

How does one avoid getting AFM?

If we assume it’s a pathogen causing the illness, avoiding contact with sick individuals, being up-to-date on one’s vaccines and good hand-washing are imperative.  Although we do not know if AFM is caused by a mosquito-born illness, avoiding mosquitoes would be wise as well.   More therefore needs to be researched to determine why and how those individuals with AFM were infected.

 

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

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

Posted in breast, Health, news

Why Do Breasts Droop Over Time?

A study will investigate why breasts sag with age and time.

Some blame child-bearing, some breast-feeding, some the frequent grabbing on why breasts lose their “above the equator” geography.  However, unfortunately, it’s not just one cause.  Hormones, loss of connective tissue, suspensory ligament laxity can all play apart in what doctors call breast ptosis.

 

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So researchers at the University of Portsmouth want to scientifically explain why the saggy phenomenon happens.  They are recruiting women who will volunteer to have MRI’s and 3-D Scans taken of their breasts while walking on a treadmill.

 

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They’re hoping to better understand how density and movement affect a woman’s breasts. The results may help clothing and lingerie lines create better bras for women.

What contributes to breast sagging?

The following can accelerate the inevitable:

  • Smoking
  • UV light
  • Poorly supportive bras
  • Yo-yo dieting
  • Running and high impact exercise

 

#Shirtsoff

 

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 Christmas, Health, news, pets, thanksgiving

The Holidays and the In-laws: Your Step by Step Guide

The holidays are here!! Good food, no school, no work, and most of all….. family!!

For many this is the happiest time of the year!

For some…..the most dreaded…

This is your very rare and valuable time off, and you have to spend all of it with people who don’t like you and you’re not particularly fond of. Four to 7 days of staying with family, (especially if they don’t let you stay a hotel and insist you stay with them), can be more than many can bear.

So here are some steps you can take to make the holidays easier.

1. Huddle up

 

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Usually your spouse wants to avoid controversy just as much as you do.  Before the encounter, huddle up and create a strategy for:

a.  How to deal with insults

b.  How to take a break – take the car to go grab some last-minute Thanksgiving necessities

c.  Where you get to sit at the table

d.  Potential arguments regarding the children and their upbringing

2.  Try to get a hotel room

 

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This gives you the much-needed reprieve at the end of the day.  However, if the family insists you stay with them and 4 nights at Hotel Hell are just too much to bear, plan a “sneak away” for an evening with your wife and tell the Grandparents they will host the kid’s slumber party.  Remember to thank them for the huge favor they are doing allowing you and the wife a much needed night away “from the kids” …wink…wink…..

3.  Football

 

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Thank Heavens the Cowboys are playing this Thanksgiving.  Usually there is someone else in the family just as sane as you are when it comes to football, so you can immediately partner with him to get the television on and the game playing.  Although this may only give you a 15 minute “out” of the family festivities, its 15 minutes of pure euphoria.

4.  Remember you have sciatica

 

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The most difficult part of Thanksgiving/Christmas is sitting at a table for hours and usually trapped, physically, because the chairs are pushed together so tight that you can’t push out the chair. If you ever, ever, ever had an issue with your back, knee, leg, muscle, or even pinky toe, use this as an excuse to heave the table forward so you can get up and stretch your legs.  Slowly limp over to the living room where hopefully you left the football game on……

5.  Get called to work

 

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No in-law can or wants to take on your boss.  So during the 7 day stent, politely excuse yourself if you need to go onto a computer, make a phone call, or drive 60 miles away for “work”.  Make sure your spouse is on board with this one……

 

6.  Have “diarrhea”

 

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You get to leave the room and no one wants to be near you.  You just gained escaping 3-5 times/hour since you need to “run” to the bathroom.

 

7.  Inform the family you feel a cold coming on

 

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Don’t jinx yourself but this gets you out of hugs, and sloppy lipstick kisses…..

Ok this gives you a well-coordinated exit plan but what happens if they are on to you?  How do you deal with the remaining, 3 days, 23 hours and 45 minutes?

1.  Don’t take it personally

When the insults and digs come, don’t feel like these personal attacks need to stick.  You have enough people in your life telling you your shortcomings.  The in-laws are either being redundant or telling you something that doesn’t hold true.

2.  You’re not alone

Millions of adults are in the exact same position as you at the same moment in time.  You’re not alone.  Just sneak a peek on facebook and you’ll scroll through hundreds of “Ugh!!!!”s………..

3.  Make a game of it

Bet your wife or coworker that you will get the most insults over the holiday than they will and write down or note every time it happens. The more it occurs, you win.  Compare notes or use it as a “get out jail free card” with your spouse.

4.  Have a happy place

Negotiate with your spouse prior to the holiday a “free day” or “free weekend” that you will earn upon completion of a 7 day holiday with the in-laws.  Plan and fantasize about this reward throughout your tour of duty to make the path easier

5.  Bring the pets

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Since you are usually outnumbered during these family events, why not have non humans come to your aid.  Dogs need to be walked, cats need to be chased, so this gives you an out and gives you a much-needed buddy during the hard times.

 

Look, it’s not easy, but remember why you’re there.  For YOUR family.  Your spouse and kids need to spend the holidays with you so grin and bear it.  And remember you may be luckier than the average guy.  He could be spending the WHOLE WEEK!  Ahhh, you DO have something to be thankful for.  Happy Thanksgiving!!!!

 

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

Posted in Health, news, travel

How to Avoid Getting Sick When You Fly

Holiday season means it’s the travel season. And winter colds may be merrily jumping around an airplane you’re traveling in.  And not just viruses are lurking, deadly drug resistant bacteria, such as MRSA, have been found to colonize airplane surfaces.  So here’s a list of things you should consider to avoid getting sick when you fly this holiday break:

 Open the air vent and aim it IN FRONT of your face

The air will help blow pathogens away from your respiratory tree.

 

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Don’t sit next to someone who appears sick

This may seem like a no-brainer, but the average passenger does not want to appear rude and will suck it up, literally.  If your flight has you sitting next to a passenger who is coughing up phlegm in your direction and no other seats are available, considering changing flights or cover your nose and mouth with a mask or sweater.

 

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Wash your hands and avoid touching your face

A recent study from Auburn university found deadly pathogens like E. coli and MRSA to survive for up to 7 days on surfaces surrounding your airplane seat.  Tray tables, arm rests, bathroom doors, drinking fountain buttons and even the air vent button can house bacteria so wash your hands after touching any of these surfaces.

 

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Wipe down your surrounding areas

Antimicrobial wipes can help protect you against nasty bugs on any of the aforementioned surfaces.

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Avoid sitting in aisle seats, especially near the lavatory

People stand in line to use the bathroom and breathe and cough on you while you’re trying to enjoy your movie or nap.  The window seat may be safer.

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Carry-on some of your prescriptions 

Make sure to have half of your medications in your suitcase and half with you in your carry-on in case the flight gets delayed or you lose one of your bags.

Use your own pillow when you sleep

Your body loves your own personal microbiome and airplane pillows may carry germs you don’t wish to keep.  Remember to bring an extra pillowcase so you can change it out before you use it again on the flight back.

Eat a balanced diet prior to travel, and every day for that matter  

Fruits, vegetables, protein, complex carbs and fiber help your immune system.  A strong immune system can help you fight some of the worst of pathogens.

Stay hydrated

We forget to drink water when we travel and moist mucous membranes in our noses and mouths are less likely to pick up bacteria and viruses than dry ones.

Be well rested prior to travel

Conversely, poor sleep will weaken your immune system.

Remember to reach out to your medical provider a few weeks before you travel in case he or she goes on vacation as well.  Any medications that need to be adjusted or refilled should be done prior to travel or you running out.

Safe travels!!!

 

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 food, Health, news

CDC: Romaine Lettuce May Be Tainted With E. Coli

The CDC issued a general warning this week that Romaine lettuce is not safe to eat.

32 people from 11 states have become ill due to this recent outbreak of E. coli.

The Shiga toxin-producing E. coli O157:H7 sickened 32 people between the dates October 8-31, 2018 and caused 13 hospitalizations, one of whom went into kidney failure.

No deaths have been reported.

On Tuesday they issued the following tweet:

Outbreak Alert: Do not eat any romaine lettuce, including whole heads and hearts, chopped, organic and salad mixes with romaine until we learn more. If you don’t know if it’s romaine or can’t confirm the source, don’t eat it.

On their website, the CDC reports the following:

CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak. This investigation is ongoing and the advice will be updated as more information is available.

  • Consumers who have any type of romaine lettuce in their home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick.
    • This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad.
    • If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away.
    • Wash and sanitize drawers or shelves in refrigerators where romaine was stored. Follow these five steps to clean your refrigerator.
  • Restaurants and retailers should not serve or sell any romaine lettuce, including salads and salad mixes containing romaine.
  • Take action if you have symptoms of an E. coli infection:
    • Talk to your healthcare provider.
    • Write down what you ate in the week before you started to get sick.
    • Report your illness to the health department.
    • Assist public health investigators by answering questions about your illness.
Advice to Clinicians
  • Antibiotics are not recommended for patients with E. coli O157 infections. Antibiotics are also not recommended for patients in whom E.coli O157 infection is suspected, until diagnostic testing rules out this infection.
  • Some studies have shown that administering antibiotics to patients with E. coli O157 infections might increase their risk of developing hemolytic uremic syndrome (a type of kidney failure), and the benefit of antibiotic treatment has not been clearly demonstrated.

Symptoms of E. coli poisoning can occur anywhere from 1-10 days after ingestion.

They include:

  • Nausea
    Vomiting
    Diarrhea, may be bloody
    Fever
    Chills
    Body Aches
    Abdominal Cramps

And if progresses, can cause

  • Shortness of Breath
    Nose bleeds
    Anemia
    Dehydration
    Seizures
    Renal Failure
    Death

Exposure to E. coli may occur from exposure to contaminated foods (from human or animal waste) or undercooked meats.

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