Posted in Health, Millennials, students, suicide, teens, vaping

Teen Suicide Rates Soaring…Is Vaping and Nicotine Dependency a Cause?

The CDC reported this week that teen suicide rose 58% over the years 2007-2017 in the age group 10-24.  Although many experts blame social media and teen drug use, one theory may need to be considered:  nicotine withdrawal from vaping.

Millions of middle school and high school students admit to vaping…and many more are assumed who don’t admit to it when surveyed.  So we have an underestimation of how many adolescents take regular hits of their electronic cigarette, exposing them to the powerful, addictive nicotine. One pod, placed in an electronic cigarette to be vaped, contains as much nicotine as a pack of cigarettes.  Hence if a pod is smoked at school, and when the child is home goes hours without, they may “come down” off the nicotine high that they had hours earlier.

In 2002 Picciotto et al discussed how nicotine can affect mood swings, anxiety and depression, where in some cases it can act as an antidepressant but when one withdrawals from it can have increased and anxiety and depression.

The teenage mind and psyche is still developing during this time and a chemical dependency could muddy the mental health waters.

There’s no doubt social media and the misconception teens have that their lives are not as glorious as those who they view online is contributing to lack of confidence, poor self-esteem and depression.  But the decision to commit suicide may also be chemically induced, or a withdrawal of one and should be investigated.

Vaping Linked to Heart Disease and Cancer

 

A study from New York University found the nicotine in electronic cigarettes to cause DNA damage similar to cigarette smoking.

Dr. Moon-shong Tang and his colleagues exposed mice to e-cig smoke during a three-month period, 5 days a week for three hours a day.  They found these mice, compared to those breathing filtered air, to have DNA damage to cells in their bladders, lungs and hearts. The amount of nicotine inhaled was approximately 10mg/ml.   That dose would be commonly consumed by many humans who vape.

nicotine.jpg

They then looked at human bladder and lung cells and found tumor cells were able to grow more easily once exposed to nicotine and vaping chemicals.

Last May, researchers from Vanderbilt-Ingram Cancer Center in Nashville found e-cig smoke to increase one’s risk of bladder cancer.

In 2015, the University of Minnesota identified chemicals commonly found in e-cig vapor to include:

  • Formaldehyde (human carcinogen)
  • Acetaldehyde (carcinogen related to alcohol drinking)
  • Acrolein (highly irritating and toxic)
  • Toluene (toxic) NNN, NNK (tobacco carcinogens related to nicotine)
  • Metals (possible carcinogens and toxins)

Although electronic cigarette “juice” may appear safe, it could produce harmful chemicals once heated to become a vapor.

A lethal dose of nicotine for an adult ranges from 30-60 mg and varied for children (0.5-1.0 mg/kg can be a lethal dosage for adults, and 0.1 mg/kg for children).  E-cigs, depending on their strengths (0 – 5.4%) could contain up to 54 mg of nicotine per cartridge (a 1.8% e -cig would contain 18mg/ml).

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucous production and a sweeping out of carcinogens trying to make their way down to the lungs.

More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.

For more on the study read here.

Toxic metals found in vaping liquid

Last week, experts warned that many chemicals in vaping liquid may change to toxic substances (once heated) that can irritate the lungs.

Last year one study reported that toxic levels of lead and other metals may leak from the heating coil element into the vapor inhaled during e-cig use.

Researchers at Johns Hopkins Bloomberg School of Public Health found these metals to include:

  • lead
  • nickel
  • manganese
  • chromium
  • arsenic

We’ve known for some time that vaping fluid could contain chemicals that turn toxic once heated, but this study shed light on e-cig metal components causing metal leakage to the vapor making contact with delicate respiratory epithelium (lining).

Reported by Forbes, Rich Able, a medical device marketing consultant, stated the following, “the FDA does not currently test any of the most popular vaping and e-cigarette instruments being manufactured at unregulated factories in Asia that source  low-grade parts, batteries, and materials for the production of these devices,” suggesting that “the metal and parts composition of these devices must be stringently tested for toxic analytes and corrosive compounds.”

These chemicals may act as neurotoxins, affecting our nervous system, cause tissue necrosis (cell death) and even multi-organ failure.  Moreover they can affect how our immune system reacts to other chemicals as well as foreign pathogens, affecting our ability to fight other diseases.

Although studies have suggested e-cig vapor to be safer than tobacco smoke, not enough research has been done, in the relatively few years vaping has been around, looking at how heat-transformed chemicals and leaked metals affect our breathing, lungs and other organs once absorbed into the body.

 

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

Posted in Entertainment, Health, news

Michael Jackson’s Daughter, Paris, Again Attempts Suicide

The 20 year old model allegedly split her wrists earlier Saturday.

She was treated and released by a local hospital, despite earlier reports that she would be held for observation.

TMZ reports the pedophile allegations made against her father Michael Jackson might have incited this latest attempt on her life.

In 2013 she attempted to commit suicide by splitting her wrists as well.

She is currently being supervised by her team of doctors.

This is a developing story.

 

Why do Some Consider or Commit Suicide?

 

Each year 47,000 Americans take their lives. That averages to 123 people a day.  And each suicide affects everyone with whom the  person has regular encounters. So why is it so common?  Here are six reasons people choose to end their life.

 

They Can’t See Around the Problem

When tragedy strikes, whether it be an accident, break up, job loss, missed opportunity, some can’t see “the light at the end of the tunnel.”  Many think and navigate through life one step at a time, which may be productive when it comes to tackling tasks, but if they feel the obstacle in front of them is insurmountable they may believe their options are far and few between, with death being the only out.

 

They’re Impulsive

Many of us have been trained to act on a whim. We quickly reply to a text, pop some food in the microwave, flick the controller while playing a video game…and these quick, instinctive acts are becoming apart of our daily behavior.  So when one has a fleeting thought of suicide, they may be less likely to slow down and think it through.

 

They Fear Death

This is one of the least discussed reasons people commit suicide, but unfortunately more common than we think.  Although most of us fear death and dying, some pathologically can’t handle the thought of it happening out of the blue.  Those who need control and need to plan ahead, may find solace in the fact that they are planning their own death.   They can’t control their birth but they can control their death, they believe, and for those who feel they have lost control of their life may find this tragic option welcoming.

 

They’re Depressed, Really Depressed

Hollywood stereotypes depression as a woman sitting on a couch eating ice cream to combat the tears and loneliness of a breakup.  But many have symptoms of severe depression and don’t know it.

  • insomnia
  • fatigue
  • wanting to avoid others
  • poor appetite
  • lack of sex drive
  • apathy
  • anxiety
  • sadness
  • tearful
  • mood swings
  • poor memory
  • poor concentration
  • overeating

So many self medicate either by over-eating, drinking alcohol, smoking weed, or taking pills, which when wears off, can sink one into a lower funk. Without psychological or medical intervention, one struggles to recover.

 

They Feel No One Cares About Them

Since so many people are undiagnosed when it comes to depression, family members and friends are unaware their loved one is struggling.  Going about one’s business may be inferred as indifference by someone suffering from a mood disorder.  “They won’t even notice I’m gone,” pervades their thoughts and worsens their loneliness.

 

They’re Angry

If one feels they’ve been ignored, unheard or wronged, this could incite an “I’ll show ’em” attitude in which their suicide is plotted to be a form of psychological revenge.

 

Sadly many out there secretly hope they get help but don’t know how to ask for it. It’s up to us to seek them out and guide them to a medical professional who can listen, understand, and work with them.

 

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

Posted in Health, news, suicide

1 in 7 Doctors Consider Suicide

An alarming report published in Medscape’s National Physician Burnout, Depression & Suicide Report 2019, cite burnout to be a common issue in many physicians.

15,000 physicians across 29 specialties were interviewed.  While 44% cite burnout, 15% cite depression.

But most striking is 14% of physicians contemplated suicide.

The most common specialties feeling burned out include:

  • Urology 54%
  • Neurology 53%
  • Physical Medicine & Rehabilitation 52%
  • Internal Medicine 49%
  • Emergency Medicine 48%

…with the least burnout seen in Pathology (33%), Nephrology (32%) and Public Health & Preventative Medicine (28%).  Still alarming numbers…..

Female physician burnout rose to 50%, outpacing males, 39%.

Factors leading to burnout were reported to be paperwork and charting, long hours, and increasing computerization of practice (Electronic Health Records).

57% of physicians working over 71 hours a week reported burnout.

Additionally, a study last year from the American Medical Association (AMA), the Mayo Clinic and Stanford University finds 1 in 5 physicians plan to cut back their hours next year and 1 in 50 will leave the profession completely within the next 2 years.

Burnout is cited to be the main cause and is one of the biggest threats to healthcare today.

How Doctors Can Prevent Burnout

 

According to AMA President Dr. David Barbe, “An energized, engaged, and resilient  workforce is essential to achieving national health goals.”

And burnout affects all fields of medicine, surpassing 50%, in those including primary care and specialties such as gynecology, neurology, urology, emergency medicine, anesthesiology, cardiology and critical care to name a few.

Patients are at risk because if doctors aren’t at the top of their game, things get missed.  Moreover the keen instinct of a clinician is imperative to diagnosing correctly, and this gets blunted when one is emotionally fatigued, or burned out.

Why are Doctors Burning Out?

A variety of factors can lead to physician burnout but the following appear to be the most cited:

  1. Electronic medical records – these are time-consuming to learn and implement, take time away from patients and may be financially burdensome due to their cost and lack of revenue for those who struggle to type and work with computers.
  2. High patient insurance deductibles – with insurance companies not paying until patients reach their deductible, it forces doctor’s offices to work harder to collect the income needed to run a practice.  Physicians do not want to get into the financial aspect of patient collections and it adds undue stress on an already stressful field.
  3. Red tape – ICD 10 code changes, insurance authorizations, referral forms turn the average day of a physician to less patient care and more bureaucracy.
  4. Less respect – in the old days, doctors were considered heroes and revered greatly.  Today they are frequently blamed for issues such as rising healthcare costs and the opioid epidemic.
  5. Malpractice suit fears – doctors are human and can only combat nature so much.  When one is diagnosed with cancer a physician has to fear that one will accuse him of not diagnosing it “quickly enough”.  When a lab gets ordered, the clinician has to hope that his staff is ensuring that every lab value comes across his desk.  When a prescription gets written, he has to hope that the correct medicine gets dispensed, works effectively and does not cause an adverse reaction.  And when a referral is made to a specialist, he has to hope all the above issues go well with the second physician or he can be sued for the referral.  And since a doctor sees thousands of patients a year, the odds that he will be sued for something is higher than any other profession.  Moreover, one lawsuit is a enough to bankrupt him.  Pretty darn stressful.

 

What are the signs of burnout?

In any profession, the following may be signs of burnout:

  • Apathy
  • Exhaustion
  • Poor sleep
  • Negative attitude at work
  • Absence from work
  • Being irritated
  • Feeling empty
  • Dreading going to work
  • Feeling underappreciated
  • Feeling you don’t matter
  • Blame others for mistakes
  • Low energy
  • Thinking about quitting

 

burnout

 

 

How to prevent burnout?

  1. Find the humor – As Milton Berle once said, “Laughter is an instant vacation”.  Watching a comedy or taking a 10 minute break to watch some funny You Tube clips offers immediate relief and energizes you.  A day without laughter is a day wastedCharlie Chaplin
  2. Take care of yourself – how can one heal others when he himself needs healing?  So what can you do?  Try Massage, Meditation, Yoga, Exercise, Stress diary, Sleep, Mini vacations, Staycations but most of all…..Take breaks!!
  3. Learn to say “No” – It’s OK to take a day off. Why not take off early on Friday’s?  Or better yet, work a half day on Wednesday to break up the week?  Learn the 4 D’s…..Deflect, Defer, Deter, Delegate…..
  4. Make small goals – too many times we burnout because we failed to meet a goal that was unattainable in the first place.  So we toil for years to become “promoted”, or “wealthy”, or “slim”, or “married”, or “see the world”.  Instead, make smaller attainable goals (find a partner, open auxiliary office, lose 10 lbs, take a trip).
  5.  Quit comparing yourself to others – we watch Shark Tank and then wonder what we are doing wrong, not being millionaires.  It’s unrealistic to think you should be “rich by now”.  We will always be inferior to someone else.  So get over it and love who you are and what you’ve accomplished.
  6. Have fun at work – contests, pot luck lunches, lunch room decorating, accent days, dress up days, and end of the week happy hour can spice things up at work.  Plus it increases morale among coworkers and staff.
  7. Be charitable – Doing community service is so rewarding and energizing that having a pet project helping out a local charity may be just what this doctor orders.  You can choose a cause, fundraise, attend charity events or walks, or even create a campaign.
  8. Get a hobby – tap into your artistic side by writing a book, song, article; paint; cook; build; teach; sing; dance; or even ride.
  9. Work on your bucket list – whether its going to a foreign country, learning to speak a new language, buying a vacation property, or even starting a second business, don’t let job burnout deter you.  This may give you the energy and perspective you need.

Finally, be around others and have a Bitch and Moan session – it feels so good to complain and gripe. Find others in similar situations as you and you’ll realize that you may have it better than you think.

Remember you have to come first and doing so will make you more of a help to others.  Feel great and you’ll make others feel great!

 

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

Posted in Entertainment, Health, news

Glee’s “Puck” Mark Salling Reportedly Commits Suicide, age 35

Glee actor, Mark Salling, was found dead in a riverbed near Big Tujunga Creek in Los Angeles.  The exact cause of death is still being investigated.

The 35-year-old had been battling depression and the family had reported him missing Tuesday evening and feared he would hurt himself.

Mark Salling was a registered sex offender and was facing 4-7 years of prison after pleading guilty to possession of child pornography.  His sentencing was slated for March 7th.

It’s been reported that he attempted suicide last summer by slitting his wrists.

This is a developing story.

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

Posted in Health, news

Today’s Health Headlines

Baby Boomer marijuana use is……booming
 
Florida is projected to be the second highest state in marijuana sales (next to California) in part to the large senior population.  Senior support for legalized marijuana is underestimated.  However, whether its medicinal or recreational use, Grandma and Grandpa may not understand the risks, including falls and drug interactions.
Medical Student depression on the rise
Globally, this study found 25% suffer from depression and 10% report suicidal thoughts.  Students need to be aware and let faculty know if they or a colleague needs help.

http://fox40.com/2016/12/06/study-more-than-a-quarter-of-medical-students-are-depressed-suicidal/

Sleep deprived drivers can be just as dangerous as drunk drivers

 
We’ve known this for years, especially from our post-call years.  Sleep deprivation appears to have the greatest effect in the early morning hours.  We recommend 7-9 hours a sleep at night.  Many people get much less.  And missing just one hour of sleep doubled crash risk.

Handful of nuts a day helps prevent cancer, diabetes, and heart disease

They can’t be chocolate covered though…..

http://www.nydailynews.com/life-style/health/handful-nuts-day-doctor-study-article-1.2899599

Artificial Blood close to becoming a reality

This is very cool. Its like Tang, a powder in which soldiers on the battle field or paramedics would add water.

Catheter along with Cytotec lessens labor time by 4 hours

The Foley balloon is used to stimulate and coax the cervix (not bladder) and along with misoprostol was found to shorten labor time.

https://www.sciencedaily.com/releases/2016/12/161205101612.htm

One drink a day can increase risk of atrial fibrillation

Researchers believe it could be due to stimulation of the autonomic nervous system, or cardiac cell damage that leaves scarring, disrupting electrical conduction.

http://www.express.co.uk/life-style/health/740102/Wine-warning-drinking-glass-every-day-increases-risk-heart-flutter-alcohol-beer

One cigarette a day found to significantly increase death risk

Not a surprise, but low levels of smoking can still be extremely hazardous

http://www.foxnews.com/health/2016/12/05/even-with-one-cigarette-day-odds-early-death-are-higher.html

 

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

Posted in Health, news

Today’s Health Headlines

Calcium supplements increase risk of heart attack
This is not the first time we’ve heard calcium supplements increase coronary artery deposits, upping heart disease risk. Dietary calcium from diary products do not increase the risk.
High blood pressure linked to dementia, Alzheimer’s
This additional study reinforces the relationship between the two, but more studies will look at the “why”….improper flow, vs mechanisms that increase blood pressure could worsen brain circulation, etc.
Antidepressant use may double risk of suicide and violent behavior
Overall the benefits of antidepressants still out-weigh the risks, but patients need to be observed more closely when on them and I personally recommend a continuation of their therapy, which unfortunately many times gets dropped once the person becomes more comfortable taking a medication.

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

Posted in Health, news

Today’s Health Headlines

Tuesday September 20, 2016

Having a vasectomy should not increase risk of prostate cancer

Although a previous study in 2014 suggested a link, recent studies are finding no direct association between a vasectomy and prostate cancer. Smoking and obesity are more of a risk than getting the snip.

http://www.cnn.com/2016/09/19/health/vasectomy-no-link-prostate-cancer/

5 year-olds may be at risk for suicide

Although rare, this study found an increased rate of suicide among black youths aged 5-11 compared to caucasians , although black teens seemed to have less suicide rates than white teens.  Suffocation and strangulation appeared to be the most common methods in young children, reminding us of the urgent need to screen our pediatric patients for depression as well.

http://www.cbsnews.com/news/suicide-can-strike-children-as-young-as-5-study/

 

“Too Many” Antibiotics still being prescribed

Between 2006 and 2012, 55% of hospital patients were prescribed antibiotics during their stay “whether they needed it or not” according the CDC.

Multiple factors could be contributing to this such as concern over nosocomial infections, liability and patient readmission. But to avoid further evolution of multiple drug resistant organisms, the UN will address this at their General Assembly

 

http://www.webmd.com/news/20160919/cdc-too-many-antibiotics-still-being-prescribed-in-us

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