Posted in coronavirus, Covid-19, Employment, food, Health, news

Constipation Cases Explode During Lockdown

Whether we teach, bartend, or greet customers, many of us stand and move around for a living.  However with state-wide shutdowns due to the COVID-19 pandemic, many of us have been furloughed, finding ourselves sitting at our home computer or on our couch for much of the day.

Moreover our diet has changed. From the morning cup of coffee to the salad in the break room, we had a routine that our bowels acclimated to and learned to go with the flow. Now that we may sleep in, skip our morning coffee and eat more snacks around the house, intestines look at this new sludge with confusion.

“Quarantine Constipation” is real and many Americans are finding their stools to not pass so easily.  Here’s the breakdown on constipation.

What is constipation?

Constipation is a decrease in frequency of bowel movements or difficulty passing stool that persists longer than one’s normal bowel movement cycle.  In general, less than three bowel movements a week could be considered constipation. 20-30% of the US population suffers from constipation and this percentage increases in those who are elderly or confined to medical facilities. Some people have hard stools that are difficult to pass with normal motility, whereas others have soft stool but poor motility.

What causes constipation?

A variety of factors could be the culprit. These include:

  • Lack of water
  • Lack of fiber in one’s diet
  • Certain foods in one’s diet such as cheese, diary, fat, gluten, those high in meat
  • Caffeine
  • Hypothyroid
  • Stress
  • Lack of exercise
  • Frequent sitting
  • Pregnancy
  • Hormone fluctuations
  • Irritable Bowel Syndrome
  • Inflammatory Bowel Disease
  • Cancer
  • Laxative abuse
  • Eating disorders
  • Medications such as narcotics, antidepressants, iron supplements

Constipation should never be ignored………

Stand-Up Desks Help You Poop

Why does sitting cause constipation?

 

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Most of us who work standing up or use a stand-up desk can attest to the fact that we seem to get a thumbs up from our colon.  In fact some of us will even admit we suffer from less constipation than our 90 degree angle sitt’n brethren.

Why?

Sitting may impede flow, flow that occurs hours before one needs to empty his bowels.  And not only do angles play a part in this but when one sits, their abdominal cavity shrinks, as opposed to stretching when standing up.  An individual who is standing allows more volume of abdominal room for the colon to work.

Additionally, pressure from sitting and the chair may cause undue pressure on the lower colon.  If you think back to high school physics, pressure has to be less at the destination of flow.  True, mass and density can vary based on poop amount but even NASA gets it (see below).

 

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….where “choke” is the act of sitting.

Even in basic terms, our caveman forefathers and mothers realized that standing made an easier bowel evacuation, (standing and squatting even easier).  So 2020 humans may need to go old school, doing less sitting and more standing.

 

What should our stool look like?

When someone is constipated, the stool is not moving through the colon as quickly as it should.  The more hours and days it sits in the colon, the more water is absorbed. So the stool churns and churns becoming dryer, smaller and harder.  So pebbles or rock-like stool is a sign of constipation.  Conversely, as in diarrhea, stool has not been processed by the colon properly, water has not been absorbed and thus it appears very soft or liquid-like. This puts one at risk of dehydration. Therefore healthy stool is a happy medium.

Using the Bristol Stool Chart, the ideal stool would be in the shapes of Type 4 and 5.

 

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What should I do if I’m constipated?

First drink more water. Secondly look at your diet and see if you have any offending agents such as dairy or fried foods.  Thirdly, exercise and get off the couch (as discussed previously). Fourthly, visit your medical provider for an evaluation.  Finally, try and relax.  Many of us have difficulty pooping because we are stressed or on a time crunch.  Your body doesn’t care if you have a Zoom meeting in 5 minutes.  The body likes to relax when it relieves itself so grab a magazine, or my blog, and take some time out of your day to poop.  Sometimes we need to stop and smell the roses……

 

ultimate book cover final

Great Gift!!!

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

Posted in Health, news, weather

Excessive Heat Warning Coming For Most of Southwest US

The National Weather Service has again issued an “excessive heat warning” for many parts of the Southwest United States. This occurs “within 12 hours of the onset of extremely dangerous heat conditions”.

This means that the heat index (air temperature and humidity) will be greater than 105 degrees for more than two hours a day for at least two days in a row and the night time temperatures will not drop below 75 degrees.

Although many of us may live in areas where this occurs each year, the onset can be one of the most dangerous times.  Symptoms such as heat cramps, heat exhaustion and heat stroke must be identified.

What are Heat Cramps?

At first when one feels symptoms, it may come in the form of heat cramps. Heat cramps are painful spasms that occur in the muscles of the arms and legs and even abdomen. We believe that when one loses fluids and salts from excessive sweating, cramps ensue. Its important in these cases to get the person out of the heat, hydrate them with sips of fluid and electrolytes and massage the body parts affected.

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What is Heat Exhaustion?

If one does not leave the heat and come indoors, the next risky event that can occur is heat exhaustion. This worsens as the victim sweats profusely becoming more and more dehydrated. They could also have cramps but nausea may ensue, they may look pale and clammy and their heart rate will increase to try to compensate for the lost fluid. These individuals may become dizzy, weak and even faint. Immediately bring the person indoors, lie them down, elevate the feet, give sips of fluid, cool down the body applying cool and wet cloths to the underarms and body, and contact medical authorities if symptoms continue or worsen.

 

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IMAGE FROM MEDSTAR

What is Heat Stroke?

Heat stroke will occur if a vulnerable person does not get out of the heat in time. It is a medical emergency and can be fatal. If an individual has heat stroke 9-1-1 must be called immediately. Bring the victim indoors away from sunlight, lie them down, remove unnecessary clothing, cool their body with cold compresses and watch for signs of rapidly progressive heat stroke in which they have difficulty breathing, seize or lose consciousness. If they are unconscious you cannot give them fluids. Only if they are alert, awake and able to swallow will you be able to give fluids. Do not give medications to reduce the fever such as aspirin or acetaminophen since their body may not be able to metabolize them properly and this could make matters worse.

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Who is vulnerable to heat related illness?

Young children and elderly individuals may have issues adjusting to the outside environment and may be more prone to dehydration. Those with medical conditions such as heart, lung, thyroid disease can be at risk as well. If you’ve ever suffered from heat stroke you can be vulnerable again. And many medications could make you susceptible such as diuretics, vasodilators and beta-blockers for blood pressure and antidepressants.

The biggest risk comes when we are unprepared. Having an unusual cool week prior to a heat warning could preclude many from taking proper precautions. Staying indoors, checking air conditioning and fan devices to make sure they work properly, wearing cooler clothing is just the beginning. Stocking up and planning to hydrate frequently is paramount because when death occurs to excessive heat, dehydration is the main culprit.

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Bring your pets indoors, and watch your kids, friends and family members frequently. If they are beginning to succumb to the heat, they may be quiet and not be able to voice it.

Avoid drinking alcohol in the heat. It can dehydrate you more and worsen the situation.

Avoid excessive exercise when outdoors and make sure to make use of shady areas.

The summer and early fall offer exciting and fun ways to enjoy nature. Don’t let the heat get to you. Remember….if you can’t take the heat, get out of the…..well heat…….

 

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

 

Posted in coronavirus, Covid-19, Health, medical school, news

“Why Aren’t We Learning and Helping?” Medical Students Eager to Get Back to Patients

Although some schools have allowed their students to graduate and start residency early, many have shuttered clinical rotations and hands-on learning to their students.

“Shutdown” orders that mandated schools go online, included the American Association of Medical Colleges (AAMC) recommendation in March to suspend “direct patient contact” by students.

However, on April 14th, they loosened their guidance to allow the Deans of each school to, at their discretion, allow student participation and learning if the latter were willing and trained on PPE (personal protective equipment) use.

Procedures such as intubation and central line placement are sometimes far and few between for medical students. But tragically, during the SARS-CoV-2 pandemic, hospitals are exhaustively doing these procedures multiple times a day.  For a medical student, it’s an ideal time for hands-on experience.

A third year medical student, who will remain anonymous, described his situation as a “lost opportunity.”  He states, “We’re in the biggest healthcare crisis in recent history and we students aren’t allowed to learn? What do we tell our kids who think we trained during the COVID pandemic??? ‘We sat home and watched it on TV???’

Another student found frustration with their tuition status, “We’re paying our medical school thousands of dollars each month to sit home and study on our own.  Refund our money for the weeks of learning lost!!”

Medical institutions have no easy task, balancing student safety and patient safety while at the same time ensuring an adequate education. However, if appropriately adhering to AAMC guidelines, medical students can get much needed hand’s on experience, and hospital teams can get some badly needed extra pairs of hands.

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

 

 

Posted in coronavirus, Covid-19, Health, news, pets

Social Distancing to Prevent COVID Infection Also Applies to PETS

The CDC has urged people to include pets in their social distancing habits to avoid COVID-19 infection.

Last week the CDC reported 2 cats living in New York had tested positive for SARS-CoV-2 after demonstrating mild respiratory symptoms. They are expected to make a full recovery.

The CDC recommends the following:

  • Do not let pets interact with people or other animals outside the household.
  • Keep cats indoors when possible to prevent them from interacting with other animals or people.
  • Walk dogs on a leash, maintaining at least 6 feet from other people and animals.
  • Avoid dog parks or public places where a large number of people and dogs gather.

Earlier this month, Mississippi Agriculture Commissioner Andy Gipson and State Epidemiologist Dr. Paul Byers at a news conference urged those who are sick with COVID to avoid being the “primary caretaker” of their pets until further studies could be done regarding their susceptibility and spread of the deadly virus.

 

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The conference occurred in light of a Bronx Zoo tiger becoming infected with COVID-19.

A cat in Belgium last month tested positive for the COVID-19 as well.

Although there are no definitive cases of pets giving COVID to their owners, officials believe we may be able to infect them.

What additionally needs to be investigated is if the virus can live temporarily on the animal as a “surface” allowing others who touch it to become contaminated.

For those of us with pets, we know that “social distancing” is not in their vocabulary or daily habits.  Most cats and dogs like to sleep in bed with their owners, some competing for their owner’s pillows.

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Although most of us would prefer the comfort of our furry friend if convalescing at home with COVID, the CDC recommends the following:

  • If you are sick with COVID-19 (either suspected or confirmed by a test), restrict contact with your pets and other animals, just like you would around other people.
    • When possible, have another member of your household care for your pets while you are sick.
    • Avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food or bedding.
    • If you must care for your pet or be around animals while you are sick, wear a cloth face covering and wash your hands before and after you interact with them.

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

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

Posted in coronavirus, Covid-19, Health, men, news

If You Can’t Beat ’em, Join Em. Men Receive ESTROGEN to Help Fight Coronavirus

Doctors at Stony Brook Hospital in New York will be testing female hormones on male patients to see if they provide similar protection to what women may innately have in this fight against COVID.

Estrogen and progesterone, sex hormones present in both men and women, but produced in higher quantities in the latter, have been theorized to provide protection against the deadly SARS-CoV-2 virus.  Two clinical trials will now test this theory.

Researchers believe the hormones reduce the number of ACE2 receptors on cells, needed by the virus to enter the host and replicate.

Multiple countries have shown higher rates of COVID-19 hospitalization and death in men over women.

Men’s Achilles Heel with COVID Might Be Their Testicles

Other theories suggesting why men may be affected more than women include:

  • higher incidence of high blood pressure and heart disease
  • smoking
  • lack of a second X chromosome with immunity enhancing genes
  • testicular “reservoirs” of the virus

This is a developing story…..

 

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

Posted in coronavirus, Covid-19, Health, news

Heartburn Drugs May HELP Increase COVID Survival

A study in Northwell Health in NYC is currently investigating if famotidine (sold under brand name Pepcid) and omeprazole (sold under brand name Prilosec) can increase chance of survival in critical coronavirus patients.

When Chinese doctors reviewed medical records of 6212 patients, they found only 14% of elderly patients died if they were taking famotidine and 27% if they were on omeprazole.

Now Dr. Kevin Tracy is heading up a study in New York with 1174 patients, 187 of which are critically ill and hopes to have results in the coming weeks.

They believe the medication may prevent the replication of the COVID-19 virus by binding to a papainlike protease (enzyme).

Famotidine has also been known to decrease platelets, causing thrombocytopenia.  Since those with COVID-19 have been found to form blood clots, the lowering of one’s ability to clot may be an unintended benefit to using the medication.

Famotidine has NOT been a part of the recent recall of NDMA contaminated medication that included ranitidine.

This is a developing story…..

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

 

 

Posted in coronavirus, Covid-19, Health, news

Farts and Coronavirus: Is 6 Feet Social Distancing Enough?

Since we know the SARS-CoV-2 virus can be spread through aerosol and oral-fecal transmission, people who put the two together are wondering if one could get coronavirus from another who passed gas.

Earlier this month the CDC reported on an asymptomatic child who had evidence of coronavirus in their stool 17 days after being exposed.

Then a subsequent study in the Lancet suggested COVID virus particles can remain in the feces nearly 5 weeks after exposure.

Since the average expulsion of gas, or fart can travel 10 feet, is the 6 feet social distancing recommendation enough?

Researchers have suggested that as long as one wears pants, transmission of fecal pathogens drastically decreases.  In 2001, Dr. Karl Kruszelnicki discussed on a radio show how a fart from a naked person could spread more bacteria than one who is clothed when tested using petri dishes.

However, we do not have ample scientific evidence that the average fart carries or does not carry deadly pathogens.

So is 6 feet social distancing enough?

As long as someone in front of you is wearing pants and underwear, my guess is you will probably be just fine if they chose to let one loose.  However, many medical experts are still debating whether 6 feet is enough to protect from respiratory aerosols transmitting COVID.

What’s in a fart?

Flatus, or flatulence, is commonly called a “fart”.  Flatus is made up of multiple gases obtained from swallowing and produced by the microbes lining the intestine. These include hydrogen, nitrogen, oxygen, carbon dioxide and methane.

Flatus odor, however, is caused from minor sulfur gas components including hydrogen sulfide, dimethyl sulfide and others.

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IMAGE FROM PHYSICS STACK EXCHANGE

Can farts make you sick?

Studies have found that bacteria passed from flatus will grow on a petrie dish but that clothes provide a filter.  Reports of pink eye being obtained from a pillow case soiled in flatus are anecdotal.

However, nausea and headaches can happen.  The hydrogen sulfide, depending on the dose, can cause headaches, nausea, skin and eye irritation.  In toxic doses, hydrogen sulfide (which has the characteristic rotten egg odor) can cause convulsions, delirium and death.  But hydrogen sulfide comprises such a minute amount in flatus that no one would become that ill by smelling it.

Can farts be beneficial?

For the farter, yes.  It assists in movement of the stool and passing it can help prevent bloating and constipation.  However for the recipient of the smell, it may be beneficial too.

In 2014, a study from Exeter University, found the hydrogen sulfide in gas to HELP cells recover from mitochondrial damage, allowing their energy powerhouses to continue working. Researchers believe this could help repair the damage in heart disease, stroke, dementia and many other diseases.

Should we hold farts in?

No. Holding in farts, or burps for that matter, may cause uncomfortable gastrointestinal symptoms but in theory should not cause serious injury to the intestines by means of perforation.  Keep in mind, however, that you only have so much control.  The air will need to escape somehow, so the next sneeze, cough or laugh during a board meeting or date may be your gas’s only time to escape.

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