Posted in Entertainment, Health, news

Selena Gomez Undergoes Kidney Transplant: What is Lupus?

25-year-old Selena Gomez received a new kidney this summer, donated by her best friend, Francia Raisa, pictured with her above.

The singer, and former Disney child star, was diagnosed with lupus in 2015.  The autoimmune condition destroyed her kidney such that the organ failed.  Her best friend, 29-year-old actress, Francia Raisa, donated her kidney reportedly this June at Cedars of Sinai Hospital in Los Angeles.

On Instagram, Gomez posted the following:

gomez instagram.jpg

What is Lupus?

Lupus, or Systemic Lupus Erythematosus (SLE) is an autoimmune disorder in which the body produces antibodies that fights its own organs.  The immune system is responsible for keeping the body healthy by finding, isolating and attacking foreign invaders such as bacteria, infection or toxins.  In SLE, the body mistakenly believes certain tissues are foreign and antibodies become mobilized and attack the said tissues and organs.  Skin, heart, joints, lungs, brain and kidneys can become involved.

According to the Lupus Foundation of America, 1.5 million Americans have been officially diagnosed with lupus, which implies that millions more with mild symptoms could be undiagnosed.

Celebrities who have battled lupus include Nick Cannon, Seal, Toni Braxton, and reportedly, Michael Jackson.

What are the Symptoms of Lupus?

Symptoms could include weakness, fatigue, joint pain, rash, and with progression of the disease, one could have anemia, blood clotting issues, heart problems, seizures, stroke, loss of visual acuity, cognitive defects, organ failure and premature death.

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What causes Lupus?

Although the exact cause of SLE is unknown, a variety of factors could trigger lupus including genetics, medications, trauma, stress, UV light, and infection.

How is Lupus Treated?

Since the immune system is the culprit, medications that calm down or interfere with the immune system provide relief, but not a cure.  These include steroid medications, immunosuppresives, monoclonal antibodies, antimalarial drugs, and antiinflammatories.

For more information on lupus, visit National Resource Center on Lupus.

 

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

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Posted in Entertainment, Health, news

Larry King Admits to Battling Early Stage Lung Cancer

Media giant, Larry King, reveals he underwent surgery this summer to treat lung cancer.

The 83-year-old veteran broadcaster and TV host said, in an interview with US Weekly, that a routine check up revealed an abnormal chest x-ray that was followed up with a CT scan and later PET scan.  The result was early stage lung cancer.

In July, King had a stage I cancerous mass removed at Cedars-Sinai Medical Center in Los Angeles and was back to work within a week.

King suffered a heart attack in 1987 and hadn’t smoked since.  Prior to quitting he had been smoking three packs a day.  Since then, he’s been diligent with his annual check-ups stating, “I’ve gone through a lot in life – I’ve had a heart attack and heart surgery. Part of my checkup is the chest X-ray, and that is the protocol.”  King referred to his bypass surgery after his heart attack, managing diabetes, and undergoing radiation treatment for prostate cancer over the years.

King suggests the cancer was not a metastasis to the lung but rather a primary lung cancer.  In the US interview, he stated, “the doctor said that tobacco from 30 years ago is still related to this lung cancer.”

It’s true. Although lung cancer risk drops dramatically the longer one avoids tobacco products, the resulting tissue damage, injury to one’s immune response, and genetic mutations may persist.  Moreover, lung cancer can occur even in non-smokers.

Early lung cancer can be silent.  As it progresses, however, symptoms such as chronic cough, wheeze, blood in sputum, lethargy and weight loss can ensue.

But Larry King won’t let this hold him back. He’s currently working on the sixth season of Larry King Now.

 

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Larry King and Dr. Daliah Talkers Los Angeles 2011

 

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

 

Posted in Health, news

Small Study Suggests Back to Back Flu Shots May be Linked to Miscarriage

A recent study performed by the CDC, Centers for Disease Control and Prevention, has prompted a call for more research looking into a link between flu shots and miscarriage.

A small study found 17 of 485 miscarriages occurred within 28 days of the pregnant women receiving a flu shot that protected against H1N1 but only if she received a flu shot as well the year before.

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Current guidelines urge children, elderly, those who are immunocompromised, those with chronic medical conditions and pregnant women to receive a flu shot.

Miscarriages that occur within the first trimester could be caused by a variety of factors including genetic abnormalities, maternal hormone abnormalities, infection, advanced maternal age, maternal diabetes or low thyroid, pelvic organ anomalies,  and more.  In medical school I learned that only 1/3 of all pregnancies actually make it to term. March of Dimes has reported at least 50% of pregnancies result in miscarriage.

Symptoms of miscarriage may include bleeding, abdominal pain, pelvic cramps, back pain, weakness, fatigue, fever, and for some no symptoms at all but an “abnormally timed period.”

A study such as this worries medical providers as it could be misconstrued and panic millions of women who need to protect themselves from the deadly flu.

Flu shots contain a killed version of the flu that should not infect a patient.  However, what may need to be studied, if an association with miscarriage does exist, are the preservatives used in vaccinations and their effect on pregnancy.

 

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

 

 

Posted in Health, news

Tattoo Ink Gets Absorbed and Migrates to Other Tissues

A study from Germany and Synchrotron Radiation Facility, published in Scientific Reports, states that nanoparticles from toxic tattoo elements leak into the body.

Although previous studies suggested tattoo ink compounds to migrate to lymph nodes, as researchers would find pigmented lymph nodes, this was the first study that identified ink particles in nano form that leaked and deposited in distant tissues.

“The lymph nodes become tinted with the color of the tattoo. It is the response of the body to clean the site of entrance of the tattoo. What we didn’t know is that they do it in a nano form, which implies that they may not have the same behavior as the particles at a micro level. And that is the problem: we don’t know how nanoparticles react,” Bernhard Hesse, study author stated.

Tattoo ink contains multiple compounds, such as the inorganic compound titanium dioxide, heavy metals such as lead, beryllium, chromium, cobalt, nickel and arsenic, as well as preservatives.  Their safety in human tissue has been controversial.

 

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The lymphatic system is an intricate drainage system that helps clear the body of debris, toxins and unwanted materials.  Lymph nodes hold the white blood cells that fight infections and act as a filter as the debris gets cleared through.  Liver and kidney’s eventually handle the detoxification needed.

The consequences of tattoo ink depositing elsewhere has yet to be determined. Can it lead to cancer?  Can it cause inflammation increasing heart risk?

Study author, Hiram Castillo, states, “When someone wants to get a tattoo, they are often very careful in choosing a parlor where they use sterile needles that haven’t been used previously.  No one checks the chemical composition of ht colors, but our study shows that maybe they should.”

 

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

Posted in Health, news

Stroke Deaths Increasing, Warns CDC

After decades of progress, the CDC warns that there has been an uptick in stroke deaths, especially among Hispanics and those living in the South.

In their MMWR, Morbidity and Mortality Weekly Report, the CDC reports the following:

Blacks experienced the highest stroke death rate compared with other racial/ethnic groups, and the stalling of the rate of decline among this group began in 2012. Among Hispanics, the stroke death rate trend reversed in 2013, changing from a 3.6% decline per year during 2000–2013, to a significant 5.8% increase per year during 2013–2015.

Although high blood pressure is one of the most significant risk factors for stroke, other causes cited by the CDC included obesity, diabetes and the flu.

Influenza has been shown to increase stroke risk, therefore flu shots have been shown to significantly lower risk.

Screening for stroke can be easy and painless.  Visit Life Line Screening for easy and affordable screening!

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What is a stroke?

A stroke occurs when an area of the brain does not get the proper oxygen and blood flow it needs. There are two major types of stroke.  Ischemic and Hemorrhagic.

Ischemic strokes are more common than the latter and occur when a clot prevents blood flow to part of the brain.  80% of all strokes fall under ischemic.  It is a likened to a heart attack, except the brain tissue is being deprived of blood and nutrients.  Plaques commonly arise from arteriosclerosis that break off travel to the smaller vessels of the brain.

Hemorrhagic strokes are less common and occur when there is a bleed of one of the brain vessels.  The bleed prevents blood flow into the brain since it is seeping outside the brain tissue, causing damage to nearby cells.  The bleeds could occur from high blood pressure or aneurysms that rupture.

What are the signs of a stroke?

Since a clot or bleed usually affect one area of the brain, we see symptoms on one side of the body, many times its contralateral (opposite) side.  We can also see central effects.  The symptoms of stroke include the following:

Weakness of one side of the body

Loss of balance

Numbness on one side of the body

Slurred speech

Vision issues

Headache

Facial droop

and more…..

How are strokes treated?

If the stroke was caused by a clot (ischemic) immediate treatment includes dissolving/removing the clot.   Aspirin is used initially and if within the proper time frame, tissue plasminogen activator (TPA).  These clots can also be surgically removed and arteries widened to bring blood flow to the brain.

With a hemorrhagic  stroke, we need to stop the bleed and improve flow to the brain.  Controlling the bleed, bypassing the vessel, “clogging” the aneurysm with techniques such as “coiling” (endovascular embolization) are sometimes utilized.

Time is of the essence, so its crucial to identify the warning signs and call 911 immediately.  The American Stroke Association uses the acronym “FAST” (Facial drooping, Arm weakness, Speech difficulty, and Time to call 911).  The sooner a stroke victim receives medical attention the better the prognosis.

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COURTESY OF THE AMERICAN STROKE ASSOCIATION

What are the risk factors for stroke?

The following put us at risk of having a stroke.

High blood pressure

Family history of stroke

Diabetes

Cardiovascular disease (artery clogging, such as the heart and carotid arteries)

Abnormal heart rhythms, such as atrial fibrillation

Smoking

Drugs

Obesity

Inactivity

Clotting disorder

Sleep apnea

Being older (greater than 55)

African-Americans appear to be more at risk than Caucasians and Hispanics

Men seem to be more affected than women

How do we prevent strokes?

Avoid the following:

Excessive drinking

Drug use

Tobacco products

Control blood pressure, sugar and cholesterol

Get evaluated by a medical provider if at risk for heart disease or stroke.

 

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

Posted in Health, news

Elderly Driver Crash Risk: Myth or Fact

An elderly driver Saturday morning drove their car into a Las Vegas grocery store.  Although no injuries have been reported, elderly driver crashes have been on the rise.  What are the true risks?

How old is “elderly”?

The term “elderly” has been used loosely, defining those over 65, those over 75, or those of “advanced age” with medical impairments.  Seeing teen drivers, those middle-aged making hand gestures along the highway, and idiots behind the wheel texting, I would say the average older individual is less of a threat.

Are crashes more common in the elderly?

According to the CDC:

  • In 2014, more than 5,700 older adults were killed and more than 236,000 were treated in emergency departments for motor vehicle crash injuries. This amounts to 16 older adults killed and 648 injured in crashes on average every day.
  • There were more than 40 million licensed older drivers in 2015, which is a 50 percent increase from 1999.

According to the National Highway Traffic Safety Administration:

  • 6,165 people age 65 and older were killed and 240,000 were injured in traffic crashes in 2015.
  • In 2015 drivers age 65 and older accounted for 18 percent of all traffic fatalities

The Insurance Information Institute suggests older individuals are at higher risk of fatalities due to their “frailty”.

However as you see by Wikipedia’s graph below, the elderly don’t comprise the largest population of car accidents.  Younger people do.

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However baby boomers comprise a large piece of the general population and as they age, their age group may appear responsible for more crashes.

What conditions put elderly drivers at risk?

Multiple issues could make driving in the elderly population more difficult.

  1.  Vision changes – cataracts, macular degeneration, loss of depth perception and other eye conditions could affect their visual acuity.
  2. Hearing changes – presbycusis, or age related hearing loss, can affect their ability to hear sirens, kids playing, or horns honking at them as they drive down the road.
  3. Loss of mobility – stiff neck and joints prevent proper turning of the head, especially when they need to look around blind spots
  4. Loss in reaction time
  5. Medication use – many medications taken by older individuals, including blood pressure medications, make one drowsy and affect driving.  drugabuse-shutterstock9265108-prescription-bottle-feature-image.jpg
  6. Medical conditions such as vertigo, sleep apnea, hypoglycemia, and dementia could affect driving performance.
  7. Insomnia – many elderly individuals get poor sleep at night from insomnia, frequent bathroom trips or arthritic pain.  A lack of a good night sleep causes decrease acuity the next day.

Now as you see from above, any younger individual could be impaired by similar things, but many Motor Vehicle Departments have requirements for older individuals.

Nevada DMV, for example, requires a medical evaluation by their private health care provider in addition to a vision test.  Drivers 70 years of age or older at the time their current driver license expires are generally required to undergo a medical evaluation at the time of renewing by mail. In addition to taking a vision test (see below), you may in certain situations be asked to take a written knowledge test as well.

Medical conditions that could disqualify an older individual include uncontrolled diabetes with episodes of hypoglycemia, epilepsy, heart disease, stroke and neurological disorders.

 

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

Posted in Health, Politics, Sports

Using the NFL Injury Report to Pick this Week’s Winners

The NFL Injury Report tells us all we need to know to make our picks.

For years I’ve been dissecting the NFL Injury Report and predicting who would win during the playoffs and Superbowl. When you’re a doctor who loves football, it’s not that difficult.

So my success has prompted me to make the risky move of posting my strategy and results.  There are varying levels of theory, just like layers of the epidermis.  And each deeper layer of prediction should confirm the simpler ones.  But if I can’t scientifically deduce the winner, I wing it.

Method 1 – Number game

Let’s take for example Thursday night’s game between the Chiefs and the Patriots.  According the NFL injury report, there were 3 injuries reported for the Chiefs and 5 for the Patriots.  A novice may just say 3 is less than 5 so the Chiefs will win.  But as a physician, this is not good enough.   We need to also look at the types of injuries.

Method 2 – Anatomy counts

According to the NFL Injury report, the Chiefs sustained injuries to the knee, another knee and ankle.  The Patriot’s sustained injuries to the  knee, shoulder, ankle, another knee but also hamstring.  Yes, Matthew Slater’s hamstring injury is very telling. Why?

Think about when you were playing football.  If you hurt a finger you still played.  If you sprained your knee, you toughed it out. But what happened when you sustained a groin injury.  You were leveled.  Probably couldn’t even get up.  So any injury involving the groin is physically devastating for a player, and from a psychological standpoint, the whole team.

If a groin injury specifically is not incurred and reported by the NFL injury report, then you look at the injuries closest to the groin.  A head injury is also very concerning so that will come after groin.  Hence the scale from most devastating to least in terms of injured body parts listed is:

Groin < head/concussion < hip< < glute < quad < hamstring  < eye < abdomen < chest < knee < shoulder < calf < arm < ankle < foot < wrist < hand < finger < toe.  

The Patriot’s hamstring injury is closer to the groin than any other injury hence the team wasn’t looking very good for Thursday night’s game.

If specific injuries are not listed, we can sometimes count how many did not participate in practice.

 

Method 3 – Colors 

In case of a tie….meaning both teams sustained equal numbers of groin injuries or subsequent proximal body parts, we look to the main colors of the Jersey.  Black, Blue, Green and Yellow will fare worse than White and Red, Brown. In medicine, Black may happen with necrosis, Blue is associated with hypoxia, Green- mucous, Yellow – gonorrhea.  White and Red are fairly routine and healthy colors in medicine (bones and blood).  Silver and Purple are colors that are fairly neutral as we usually don’t see those colors on a routine basis in medicine unless with hair.

Therefore, the color scale from most problematic to least is:

Black < Blue < Yellow < Green < Orange < Purple < Silver < White < Red.

Again this is only used if predictions cannot be made due to an anatomical tie.  Again I must stress we do not use the color method unless we are unable to predict using the NFL injury report.

With Thursday night’s game, the Chiefs wore white and the Patriots wore blue.   But despite this method, the Patriots were at a disadvantage with the hamstring injury all along.

So what will happen this Sunday?  Let’s use what we learned to predict the winners!!

Jets vs. Bills  

1 Eye injury vs. 1 Concussion

Prediction:  Jets

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Falcons vs. Bears

A Falcon chest injury vs Bears’ two ankles, a knee and finger injury

Prediction:  Falcons

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Jaguars vs. Texans

1 ankle, 1 hamstring injury vs. 1 ankle and 1 shoulder

Prediction:  Texans

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Raiders vs. Titans

foot, quad, knee and back vs Titan’s groin injury – very close but…

Prediction:  Raiders

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Eagles vs. Redskins

0 injuries vs. hip and knee

Prediction:  Eagles

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Colts vs. Rams

Groin, foot, shoulder, hamstring, lumbar plague the colts – zero injuries reported for the Rams

Prediction:  Rams

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Seahawks vs Packers

Calf, shoulder, thigh, wrist, knee ankle vs. ankle

Prediction: Packers

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Panthers vs. 49ers

knee, groin, ankle shoulder vs. hamstring and back injury

Prediction:  49ers

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Giants vs. Cowboys

Concussion and ankle vs. ankle

Prediction: Cowboys

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Ravens vs. Bengals

The Raven’s concussion is up against the Bengal’s ankle and elbow.  Tough call…..

Prediction:  Bengals

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Steelers vs. Browns

A knee and shoulder injury vs. a knee injury

Prediction:  Browns

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Cardinals vs. Lions

Ankle, tricep and calf injury vs. knee and foot

Prediction:  Lions

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We pray that no one gets hurt and those who do recover quickly.  Here’s to a safe season of one of the best sports ever!!  FOOTBALL!!

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