Posted in allergies, Health, news, weather

Allergy Season May Start Early This Year

Multiple states are bracing for “early” allergy seasons.

We still have a month left of winter yet grass is sprouting, leaves are growing and flowers are blooming.  Add just having a wetter winter and warmer-than-normal temperatures to the mix and this is the perfect recipe for an early allergy season.

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

Tree pollens start first in January and then taper off in April.  Grass pollen starts to rise in February and March.   Finally weed pollens join the party by the Spring and extend through the Summer and Fall.

Here are your questions answered:

What are allergies?

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

What are symptoms of seasonal allergies?

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

  • Sneezing
  • Coughing
  • Wheezing
  • Runny nose
  • Eye watering
  • Red Eyes
  • Itchy eyes
  • Itchy skin
  • Rash
  • Itchy throat
  • Fatigue
  • Congestion….. to name a few.

How do they differ from a cold?

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

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

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

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

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

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

Can allergies lead to a cold?

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

Are seasonal allergies dangerous?

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

Allergy season is here: What are the worst offenders?

 

How can we prevent and treat allergies?

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

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

How can I find my local pollen counts?

Local tree, ragweed and grass pollen counts can be obtained here.

 

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Learning Medical Spanish is Easy!!!

 

 

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

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Posted in Health, New Year's, New Year's Eve, news, weather

Preventing Hypothermia this Winter and New Year’s Eve

The holidays flew by us way too quickly and left the wind chill in its wake.
Unfortunately with all the hustle and bustle this time of year, we tend to forget how dangerous the weather can be.  It would make sense to stay indoors, and for the most part we do….except for New Years.  All rules go out the door with this party.  The most exciting night of the year can sometimes be the coldest night of the year.  And the party ends up outside.  And do we don a ski mask, goggles, gloves, galoshes, thermal underwear, winter coat and ear muffs?  No. That would make the most unsexy New Year’s outfit.

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Throw some alcohol into the mix and this can be a deadly combination. The CDC estimates that 1300 deaths occur each year due to hypothermia.  So what is hypothermia?

What is hypothermia?

Hypothermia is a dangerous drop in body temperature and can occur in minutes.   Human body temperature averages around 98.6 degrees F.  But hypothermia starts setting in at 95 degrees F with shivering, increase respiratory and heart rate, and even confusion.  We forget that glucose stores get used up quickly so hypoglycemia can ensue as well, making matters worse, especially in someone who is intoxicated.  Frostbite can occur as blood flow decreases to the tips of the ears, fingers, nose and toes. As hypothermia progresses,  the shivering and muscle contractions strengthen, skin and lips become pale, and confusion worsens. This can lead to severe hypothermia, eventually causing heart failure and/or respiratory failure, leading to a coma and if not reversed, death.

Hypothermia can mimic looking drunk

Someone who is hypothermic may slur their speech, stammer around and appear uncoordinated.  This sounds identical to your drunk buddy on New Year’s Eve.  Unfortunately, this can be deadly as many hypothermic partiers get written off as being drunk.

So if you suspect hypothermia, call for medical assistance.  Anyone you think is eliciting signs of hypothermia should be brought indoors, put in dry clothes, covered in warm blankets, and then wait for paramedics to arrive.  It’s important to try to warm the central parts of the body such as head, neck, chest, and groin,  but avoid direct electric blanket contact with the skin and active rubbing if the skin is showing signs of frostbite.

Why not use hot water to warm up a hypothermic individual?

Hot water will be too caustic and can cause burns. Remember, the body is shunting blood away from the ears, fingers, toes, hands and feet to warm the heart, brain and other vital organs.  The skin will be in a vulnerable state during hypothermia and frostbite and will burn the underperfused skin.

Alcohol increases the risk of hypothermia

We’re outside in the cold, not bundling up, dancing, sweating, becoming dehydrated. Add alcohol to the mix, and its deadly.  Here’s the scoop on alcohol toxicity.

Preventing hypothermia

When it comes to hypothermia, the best thing you can do is prevention.   It’s the biggest party of the year so prepare yourself by doing the following:

  • Wear multiple layers of clothing
  • Bring an extra pair of dry socks
  • Avoid getting wet (i.e. falling off a boat, getting splashed with champagne)
  • Change your clothes if you worked up a sweat dancing
  • Check with your medical provider if some of your medical conditions (i.e. hypothyroid) or medications (i.e. narcotics, and sedatives)  put you at risk for hypothermia
  • Avoid alcohol intoxication
  • Keep an eye on your more vulnerable buddies who include children, older individuals, and those with intellectual disabilities.

 

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A Happy New Year should also be a Healthy New Year.  So be warm, dry, safe and have fun!!

 

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

Posted in Health, news, weather

Health Risks From Wildfire Smoke

As the death toll rises and thousands of acres burn between California’s Camp Fire and Woolsey Fire, those residents lucky enough to escape the flames worry what consequences could result in inhaling the smoke.

What is in wildfire smoke?

According to the EPA, smoke emanating from forest and community fires may include any of the following:

  • Carbon monoxide, which competes with oxygen in the blood
  • Carbon dioxide, a respiratory byproduct
  • Wood particles
  • Formaldehyde
  • Acrolein – used as a pesticide
  • Benzene
  • Plastics, and those byproducts after incineration
  • and thousands of different respiratory irritants.

According to the EPA,

Smoke is composed primarily of carbon dioxide, water vapor,
carbon monoxide, particulate matter, hydrocarbons and other
organic chemicals, nitrogen oxides, trace minerals and several
thousand other compounds. The actual composition of smoke
depends on the fuel type, the temperature of the fire, and the
wind conditions. Different types of wood and vegetation are
composed of varying amounts of cellulose, lignin, tannins and
other polyphenolics, oils, fats, resins, waxes and starches, which
produce different compounds when burned.

What symptoms may individuals experience?

Some may have no idea they are breathing in harmful compounds that could affect their lungs and heart.  However, many may experience:

  • Cough
  • Wheeze
  • Difficulty Breathing
  • Chest Pain
  • Mucous Production
  • Dizziness/lightheadedness
  • Fatigue
  • Racing Heart (palpitations)
  • Exacerbation of their lung disease including COPD, asthma, chronic bronchitis
  • Exacerbation of heart conditions such as angina, heart attack, and cardiac arrhythmias.
  • Increased susceptibility to new lung infections as well as flu 

 

What are PM2.5s?

PM2.5 are particles less than 2.5 micrometers in diameter that are present in pollution and wildfire smoke that can penetrate deeply into the lung linings.  Larger, coarse particles 10 micrometers in diameter are called PM10.  Both impair lung function as they inflame the lungs and interfere with the work of alveoli that need to oxygenate the blood.  Moreover the small particles can use this pathway to enter the blood stream. Although the direct health impacts of the fine particulate matter is not clearly defined it is believed that increased PM2.5 levels increase the risk of lung and heart disease as discussed above.

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Lungs and alveoli (Image from ThoughtCo.)

Symptoms may begin at levels greater than 55 µg/m.

Which individuals are the most at risk?

  • Infants and Children
  • Elderly individuals
  • Those with chronic lung disease, including asthma and emphysema
  • Those at risk for heart disease and stroke
  • Those with diabetes
  • Smokers
  • Pregnant women
  • Those with chronic allergies
  • Pets

 

How can residents protect themselves?

Avoiding the area of wildfires is paramount.  Additionally, the following may be considered:

  • Avoid outdoors until air quality reports improve.  Do not rely on how “clear” the air looks.
  • Take heed of wind and air quality advisories.
  • Recirculate the air in your home and car.
  • Keep windows closed.
  • Consult with your medical provider to monitor blood pressure, heart rhythm, lung function and refill any medications you may need BEFORE you feel symptoms.
  • Be wary of facemasks sold as PM2.5 safe as many do not protect against the very small particles. Respirator masks labelled N95 or N100 may provide SOME protection against particulates but not against the toxic fumes such as formaldehyde and acrolein.

 

 

 

 

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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 Health, news, weather

Tropical Storm Michael May Threaten Florida as a Hurricane

Tropical Storm Michael may become a Category II storm, soaking the Florida panhandle by late Wednesday.

Winds and storm surge can be felt as soon as Tuesday.

Governor Rick Scott has issued a state of emergency for multiple counties as the state braces for the potentially deadly storm.

The National Hurricane Center reported the storm, as of Sunday afternoon, was 105 miles east-southeast of Cozumel, Mexico and moving north at 5 mph.

It is projected to turn into a hurricane by Monday evening as it strengthens in the Northwestern Caribbean Sea.

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The region to the north is still recovering from Tropical Storm Florence that hit last month with a death toll of over 50 and billions of dollars in damage from flooding.

How to prepare

Preparation means starting early.

Make sure you keep informed of the latest alerts and official recommendations.

Evacuate when told to do so by city officials.

Many people will try to tough it out and unfortunately get walled up in their homes.  So make sure you have adequate water (1 gallon per day/person for at least three days) and 1/4 – 1/2 gallon/water/ per pet, except the fish obviously.

Canned foods, flashlights, medical supply kit, batteries, blankets, cash, medications in water proof containers should be set aside for disasters, and put important papers in waterproof/fireproof casings.

According to ready.gov, its recommended to do the following:

  • Hurricane winds can cause trees and branches to fall, so before hurricane season trim or remove damaged trees and limbs to keep you and your property safe.
  • Secure loose rain gutters and downspouts and clear any clogged areas or debris to prevent water damage to your property.
  • Reduce property damage by retrofitting to secure and reinforce the roof, windows and doors, including the garage doors.
  • Purchase a portable generator or install a generator for use during power outages. Remember to keep generators and other alternate power/heat sources outside, at least 20 feet away from windows and doors and protected from moisture; and NEVER try to power the house wiring by plugging a generator into a wall outlet.
  • Consider building a FEMA safe room or ICC 500 storm shelter designed for protection from high-winds and in locations above flooding levels.  

Always have an emergency plan, practice it with family members, discuss with distantly located relatives how you will notify each other of your safety, and stay tuned to your radio, TV, wireless emergency alerts encase evacuations are ordered.

 

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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 Health, news, weather

Does the Hurricane Scale System Need Revision?

Image above from the Wall Street Journal

Experts debate whether the Saffir-Simpson Hurricane Wind Scale is adequate in classifying hurricane damage.

When Category 4 Storm Florence became downgraded to a 1 many chose not to evacuate.  But a Category 1 hurricane is still a hurricane and deadly.  A downgrade being reported by the media may give residents a false sense of security or a sense of distrust in our category system.

Categories are based on wind speed, while the damage from a hurricane that includes rainfall, flooding, and actual size may not be readily represented by the single digit number.

 

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Reports surfaced that Hurricane Florence was the “size of Michigan” when it made landfall in the Carolinas.  Maybe an additional scale or change of the current scale is in order to allow residents a better guestimate of storm surge, flooding, health risks, time away from their homes and economic ramifications.

Hurricane Florence’s death toll was at 37 as of Thursday morning and thousands of residents were in need of rescuing from flood waters.

In a given year, the Atlantic Ocean averages 12 hurricanes with 2 becoming “major” meaning a Category III or greater.  Hurricane Katrina in 2005 was at one point a Category V and when it hit landfall it was a Category 3-4 (depending on the source), tragically killing over 1800 people and causing $108 billion in damage.  The deadliest hurricane to ever hit US soil was the Great Galveston Hurricane of 1900 in which over 10,000 people died.

 

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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 Health, news, weather

Hurricane Florence Death Toll Rises: How You Can Help

The Category 1 hurricane that hit the Carolinas on Friday is expected to cause “widespread devastation” to multiple states for weeks to come.

19 people, including an infant, have been reportedly killed in the hours and days following Hurricane Florence’s landfall.

Torrential downpours are expected to continue and power outages, floods, raging waters, and the potential for tornadoes threaten coastal and inland residents.

Risks of drowning, crush injuries, infection, malnourishment, chemical exposure, hypothermia are just a few of the grave issues residents are facing.

Malnourishment

Many of those who did prepare for the storm may not have stored plenty of food, especially healthy fresh food.  Those trapped in their homes may find the food they did store contaminated by flood water.

 

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Greater Baton Rouge Food Bank 2016

 

Infectious disease

The World Health Organization states that floods bring water-borne diseases such as cholera, typhoid fever, leptospirosis and Hepatitis A.  Vector-borne diseases include Zika, malaria, dengue hemorrhagic fever, yellow fever, and West Nile.

 

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Mosquitos initially get washed away during the storm, but the resulting puddles of water take weeks to dry and make ideal breeding grounds for insects.

The water gets dirty pretty quickly.  People touching the flood water need to wash their hands thoroughly before eating or preparing food.

Moreover due to the moisture that seeped into walls and floors of houses, mold can grow and cause a variety of respiratory issues among other physical ailments.  Massive disinfecting needs to take place before coming home to flood water contaminated residencies.

 

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Chemical exposure

Chemicals from garages and fuel seeping into flood water expose victims to many compounds such as benzene, toluene and xylene that can cause a multitude of health effects including those that affect breathing, skin, the gut, balance, thought, and memory.

 

Safety

Multiple looters in North Carolina have already been arrested.  During Hurricane Harvey, a Cajun Navy rescuer told CNN that looters fired shots at him and his comrades, trying to take their rescue boat, which had actually broken down.

Panic fuels dangerous behavior and those without resources may try to take from those who prepared.

Sexual assault crimes can rise as predators find the chaos and lack of video surveillance ideal conditions to find victims who can’t yell for help.

 

Psychological

When one loses their home, neighborhood, income, treasured belongings and more, its devastating.  Post-traumatic stress disorder may ensue.

To combat these risks, medical personnel and the CDC are preparing.  Among food, shelter and clothes, paper products, sanitizer, cleaning supplies, tetanus vaccinations and counselors will be needed is mass quantities.

 

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Hurricane Florence, although weakening, is expected to hover over the next few days bringing more deadly conditions.

 

How can we help?

Army Emergency Relief is taking donations here to help victims of natural disasters.

Save the Children‘s Hurricane Florence Children’s Relief Fund site can be found here.

Blood supplies will be needed as residents who routinely donate have evacuated the area. Donating blood at your local blood bank may be shipped to the area in need.

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

The American Red Cross is accepting monetary and blood donations. Financial donations can be given here or on their website at redcross.org. Moreover one can call 1-800-RED-CROSS or text the word REDCROSS to 90999 to make a $10 donation.

The Salvation Army is also accepting donations online here and by calling 1-800-SAL-ARMY (725-2769).

The Red Cross and Salvation Army may also need local volunteers to help set up shelters.  Contact the above numbers.

Local volunteers are asked to donate supplies to nearby recreation centers for housing evacuees.

Supply drives in out-of-state locations may not be accepted directly but could help local charities who need to ship supplies to the affected area.

 

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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 Health, news, weather

Heat Illness and Heat Stroke Explained

 

The National Weather Service will soon issue an “excessive heat warning” for many parts of the Southwest United States.  Phoenix received their first warning two weeks ago when their temperatures rose to 108 degrees.

What is an “excessive heat warning?”

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 three 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, iHeart Radio.

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