Month: August 2018

In the conversation about drugs of abuse, anabolic steroids hold a unique position. They work very differently from other drugs of abuse, and they do not have the same acute effects on the brain. These are not drugs of pleasure but are drugs of function. Much has been said and is known about steroids, and most of your questions about them involve the consequences of abuse. The use and abuse of anabolic steroids are the topics of this Straight, No Chaser post.

What are anabolic steroids?
Anabolic-androgenic steroids (AAS) are synthetic compounds taken to approximate the effects of the male sex hormone testosterone. Once you understand that anabolic refers to muscle-building and androgenic refers to increased male sexual characteristics, you can infer a lot about why people take steroids and what effects they have.

Why are steroids normally taken?
There are conditions of male hormonal deficiency, such as delayed puberty, that benefit from AAS. Similarly, diseases that cause loss of lean muscle mass can be treated with AAS. Such conditions include AIDS and cancer.

What does this have to do with asthma?
Nothing. The steroids you may take to treat asthma are a completely different class of steroids with different effects. It is more appropriate to describe the drugs we’re discussing here as anabolic steroids or AAS.

How do steroids work for weightlifters? 
Several types of athletes in many different sports understand that the testosterone-like effects of steroids enhance physical performance and can improve one’s physical appearance – to a limit. These abusers are taking doses sometimes between 10 and 100 times the doses used to treat medical conditions.

How are anabolic steroids taken?

• AAS are usually either taken orally or injected into the muscles. Additional preparations exist that allow them to be applied to the skin as a cream or gel.

What are “cycling” and “stacking”?
Ignoring the irony of professional cyclists being associated with illegal AAS use, if you’ve ever heard and understand the terms, you’ll know more about how steroids are taken.

• An intermittently pattern of usage helps avoid side effects and gives the body a chance to recover. Continuous use of steroids can cause the body to stop producing its own testosterone. It can also decrease the body’s responsiveness to the drugs, a phenomenon known as tolerance. Cycling in an on again, off-again pattern for weeks or months at a time helps the body avoid these consequences of use.
• Stacking refers to the use of various steroids and other pharmacological supplements to maximize effectiveness. This can work in between or in conjunction with cycling.

How Do Anabolic Steroids Affect the Brain?
The most important difference between AAS and other drugs of abuse is that AAS do not produce a “high” (i.e., it doesn’t increase the neurologically active chemical dopamine that is responsible for that feeling). Ironically, long-term use negatively affects some of the same pathways as other drugs. This results in the cranky moods, aggression (e.g. “roid rage”), and other psychiatric problems seen in some AAS abusers, without their having received the benefit of “getting high” along the way. Other symptoms in steroid abusers may include paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.

Are steroids addictive?
Yes. This fact has been demonstrated in animals as well as humans. In addition to addictive pursuit of the drug, destruction of one’s social structure to obtain the drug is often seen. Further evidence of addiction is shown in the withdrawal symptoms experienced. These can include mood swings, cravings, reduced sex drive, insomnia, restlessness, fatigue and loss of appetite. The mood swings are particularly concerning because they can involve depression and lead to suicide.

What are the other health effects of anabolic steroids?
Anabolic steroid abuse is a serious condition and involves more than acne, fluid retention (resulting in weight gain), balding and shrunken testicles. There are serious and irreversible health issues that result from steroid abuse including the following:

• Cardiovascular problems – abnormal enlargement of the heart, high blood pressure, and increased blood cholesterol leading to an increased risk of stroke and heart attack, even in young people.
• Kidney damage and/or failure
• Liver damage
• It’s important to note an increased risk of contracting HIV/AIDS and/or hepatitis associated with steroid use and improper use of needles.

Anabolic steroid also is notable for certain gender and age-specific effects:

• Adolescents may experience stunted growth due to premature maturation of the skeleton. Combined with accelerated puberty changes, kids can run the risk of not reaching expected height if steroid use precedes their adolescent growth spurt.
• Men may experience shrinkage of the testicles (testicular atrophy), reduced sperm count or infertility, baldness, development of breasts (gynecomastia) and an increased risk for prostate cancer.
• Women may experience growth of facial hair (hirsutism), male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris and a deepened voice.

The decision to start taking anabolic steroids is a serious one, fraught with danger and complications. There are many other safe and effective ways to achieve your physical and performance objectives. Think twice.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Recent Straight, No Chaser posts have focused on the scope of the danger of medicines and other drugs/chemicals you keep around your home. These substances are because of the inclination of kids to get into these medicines. Although that occurs with a higher frequency with some drugs, anything in your home is subject to being abused or misused.

As an example, most homes have some medications (prescription, herbal or otherwise) that are used as sleep aids. Here are some frequently asked questions on prescription sedative medications used to facilitate sleep (sleeping pills) and reduce anxiety (anxiolytics).

How do sedatives work?
The short answer is they work by depressing the function of the central nervous system (CNS). If you stopped right there and thought about just that one fact, it’s relatively easy to see how dangerous these drugs can be if misused or abused.

What types of medicines are we describing?
Examples of CNS depressants include benzodiazepines such as Valium and Xanax and barbiturates such as Nembutal.

What are the acute effects of these medications?
They predictably produce drowsiness and relaxation. The CNS depression can lead to a loss of function during an overdose.

Are there long-term effects associated with sedatives?
The effects about which you should be most concerned are the development of tolerance (diminished effectiveness at the same dose occurring over time), physical dependence (a physiologic need for the substance by the body) and addiction.

What happens when sedatives are taken with alcohol?
The combined effects of these drugs results in a slowed heart rate and slowed respiratory rate, which is an enhancement of the CNS depressant effect. Either of these effects can be fatal.

You mentioned addiction. Does that mean there are withdrawal symptoms if I try to stop?
If you are addicted to sedatives, controlled detoxification is recommended. Abrupt stoppage of barbiturate usage can be life-threatening. Other serious symptoms that are seen when trying to stop sedative use include seizures.
So how is sedative addiction treated?
Gradual tapering under medical supervision is recommended to avoid the various consequences of abrupt stoppage. Medications as well as behavioral therapies are important parts of treating addiction.

Aren’t there newer sleep medications on the markets? How are they different?
Yes, there are new products on the market that aren’t in the benzodiazepine class, meaning they don’t have the same side effect, abuse or addiction profile as earlier medications. Unfortunately the story to be told with these newer medications is ER visits associated with inappropriate use is on the rise. As is too often the case, any drug or substance will be tested by those inclined to see what effects the drug may produce when ingested or injected in ways not recommended.
Be sure to learn non-medication dependent means of relaxation and getting to sleep. These medications can cause a lot of harm in the wrong hands, including yours.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Many times over the years, I’ve had to explain to patients such as chronic sufferers from migraines, low back pain and other conditions that even if they weren’t “drug-seeking,” they still could be addicted to various medications. In the conversation about the drugs that are most frequently abused, once you get past marijuana and alcohol, you’re talking about prescription and over-the-counter (OTC) drugs. Think about it, if you can get a physician to prescribe pain or other medications with mind-altering properties (known as psychoactive medications), it’s a relatively simple way to get a “clean” supply of “high-quality” drugs.
Now if you paid attention to that last sentence, you’ll note the quotes, and perhaps you picked up on the irony. Prescription and OTC drugs are meant to be safer than illicit drugs. However, that’s only true when they are taken exactly as prescribed for the reasons prescribed. When misused or abused, prescription and OTC drugs can be addictive and put abusers at risk for adverse health effects, including overdose and death. In many cases these risks are pronounced when taken at the same time as other drugs or alcohol.
The classes of prescription drugs most commonly abused are the following:

• Opioid pain relievers, such as Vicodin or Oxycontin
• Stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), such as Adderall, Concerta, or Ritalin
• Central nervous system (CNS) depressants for relieving anxiety, such as Valium or Xanax
• OTC drugs are cough and cold remedies containing dextromethorphan

What these medications have in common is the mind-altering properties that can be produced when taken other than prescribed (i.e. by a different person and/or in a different dose than prescribed). These can produce effects that some would describe as pleasurable, all the while causing other damage to your body.

What I’d like to accomplish next is to advice you how your children or others with access to your medicine cabinet may be abusing drugs.
Taking a medication prescribed for somebody else. We all have heard time and again to never take medicine prescribed for someone else’s use. Unaware of the dangers of sharing medications in general or pain medications specifically, people often unknowingly participate in this form of abuse by sharing their unused pain relievers with friends and family members. In fact, most teenagers who abuse prescription drugs receive them for free by a friend or relative.
Taking a drug in a higher quantity or in another manner than prescribed. Most prescription drugs are dispensed orally in tablets, but abusers sometimes crush the tablets and snort or inject the powder. This hastens the entry of the drug into the bloodstream and the brain and amplifies its effects. This is dangerous and produces unintended effects, including death.
Taking a drug for another purpose than prescribed. All of the drug types mentioned can produce pleasurable effects at certain quantities, so taking them for the purpose of getting high is one of the main reasons people abuse them. Unfortunately they can also produce deadly effects at certain qualities. A common example is the use of ADHD drugs (e.g. Adderall) to improve students’ academic performance. Although these drugs may boost alertness, there is little evidence they improve cognitive functioning for those without ADHD. There is evidence they produce adverse effects under certain circumstances.

Finally you should be concerned that prescription opioid abuse has been shown to be a first step to heroin use. Pain medications such as Oxycontin and Vicodin have effects similar to heroin. In three recent studies, nearly half of young people who inject heroin surveyed reported abusing prescription opioids before starting to use heroin. In fact, some individuals reported taking up heroin because it is cheaper and easier to obtain than prescription opioids.
In other words, pay attention to what’s happening with medications in your home and possession.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Straight, No Chaser previously reviewed various forms of inhalants used to get intoxicated. Many kids think inhalants are a harmless, cheap, and quick way to “get high.” Because many inhalants can be found around the house, you and your family may not even think they are harmful. But the chemicals in the inhalant vapors can change the way the brain works and cause additional bodily harm. In some cases, the harmful effects of inhalants can be irreversible. This post discusses the various effects these entities have on the human body.

Initial Effects
The initial effects of inhalants mainly involve the brain, and that’s a big part of why they’re used. Inhalants rapidly pass from the lungs into the bloodstream, and effects on the brain are produced within minutes. It’s easy to consider inhalant use in someone who appears to be intoxicated with alcohol but doesn’t have the smell or any evidence of alcohol around. Clinical effects include slurred speech, euphoria, dizziness and lack of coordination.
As promptly as the effects occur, they dissipate. The intoxication typically only lasts a few minutes. This explains the habit of intoxicant users to take several back-to-back doses. This action produces a loss of both inhibition and control. Long term use can cause muscle spasms and tremors or even permanent difficulty with basic actions like walking, bending, and talking, due to damage by these chemicals on structures that promote communication to and from the brain. The net effect is a syndrome with an appearance similar to that caused by multiple sclerosis.
An additional effect of intoxicants is a diminished flow of oxygen to the brain. The symptoms produced by this are dependent on the area of the brain affected and can range from memory loss to reduced problem-solving skills to disruptions of movement.

Effects of Long-Term Use
You should also know that continual abuse of inhalants can cause serious damage to the heart and liver, and it can produce muscle weakness and nerve malfunction. Certain inhalants can also render the bone marrow unable to produce blood cells, which can appear your immune system and having sufficient blood to carry oxygen and nutrients around the body. Frequent long-term use of certain inhalants can cause a permanent change or malfunction of peripheral nerves, called polyneuropathy. 
Addictive Tendencies
Some people, particularly those who abuse inhalants a lot and for a long time, report a strong need to continue using inhalants. Compulsive use and a mild withdrawal syndrome can occur.

How Can I Tell if Someone Is Abusing Inhalants?
Sometimes you can’t tell. Other times you might see small signs that tell you a person is abusing inhalants, including the following:

• chemical odors on their breath or clothing
• paint or other stains on their face, hands, or clothing
• nausea or loss of appetite
• weight loss
• muscle weakness
• disorientation
• inattentiveness, uncoordinated movement, irritability, and depression

What Should I Do if I Know Someone Is Abusing Inhalants?

• You first step is to secure your home. Given that so many items can be used to produce inhalant intoxication, you should revisit the household items you leave easily accessible. Review this Straight, No Chaser post for a list of commonly used inhalants.
• In the midst of an acute intoxication, seek medical attention immediately. Intoxicants have multiple chemicals in them, and although symptoms may not be predictable, intoxications are predictably dangerous under certain conditions. In real-time, there’s not much to be gain by your intervening at home. Get help.
• When someone has a drug problem, it’s not always easy to know what to do. If someone you know is abusing inhalants, encourage him or her to talk to a parent, school guidance counselor, or other trusted adult. There are also anonymous resources, such as the National Suicide Prevention Lifeline (1-800-273-TALK) and the Treatment Referral Helpline (1-800-662-HELP). These resources offer a wide range of relevant services beyond what is implied in the name.
• Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
  Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Over the course of several posts, we’ve described how difficult it is for you to keep abreast of the activities of teens. In this and a subsequent Straight, No Chaser post, we will review what are often among the first drugs abused by adolescents. You should be especially concerned that inhalants are abused more by younger adolescents than older ones.
What is an inhalant?
Inhalants are chemicals that people inhale on purpose to get “high.” These vapors produce mind-altering effects that users believe are pleasurable. Although they may seem harmless, they can be quite dangerous.

Are there slang names I should recognize?
Common street slang for inhalants include the following:

• “Bold” – nitrites
• “Laughing gas” – nitrous oxide
• “Poppers” – amyl nitrite and butyl nitrite
• “Rush” – nitrites
• “Snappers” – amyl nitrite
• “Whippets” – fluorinated hydrocarbons (named because they are found in whipped cream dispensers)

What age groups are most likely to use inhalants?
National survey data suggest that inhalant abuse is most common among 7^th-9^th graders. Nearly 66 percent of 8th graders don’t think trying inhalants once or twice is risky, and 41 percent don’t consider the regular use of inhalants to be harmful. Clearly, parents need to be educated and start discussing inhalant use with their children.

How do users get inhalants?
The danger here is inhalants are very common in the home. Access explains why these are used by the very young. Here are some examples of inhalants:

• Cleaning fluids
• Gasoline
• Glue
• Markers
• Paints

How Are Inhalants Used?
Inhalant abuse occurs through breathing in chemical vapors through their nose or mouth. Here are some examples and terms with which you should be familiar.

• Bagging: sniffing or inhaling fumes from substances sprayed or placed into a plastic or paper bag
• Huffing: inhaling from a rag soaked within an inhalant and stuffed in the mouth
• Inhaling: breathing in fumes from balloons filled with nitrous oxide
• Sniffing or snorting: additional forms of taking in fumes from containers
• Spraying: taking aerosols directly into the nose or mouth

Where is the danger in inhalant use?
The intoxication of huffing and other inhalant use only last a few minutes. It is common for abusers to cycle rounds of inhaling for hours to sustain the high. This introduces a potentially large enough amount of chemical into the bloodstream to produce devastating damage, particular in developing children.
The next post on inhalant use will discuss specific effects and actions to take in the face of inhalant abuse. I will end this post by providing a more comprehensive list of household inhalers you should move to secure.

Here are various categories of inhalants.

Aerosols are sprays that contain propellants and solvents.

• Spray paint, hair spray, deodorant spray, vegetable oil sprays, and fabric protector spray

Gases may be in household or commercial products or used as medical anesthetics (“numbing medicine”).

• Butane lighters, propane tanks, whipped cream dispensers, and refrigerant gases
• Anesthesia, including ether, chloroform, halothane, and nitrous oxide

Nitrites are a class of inhalant used primarily as sexual enhancers.

• Organic nitrites include amyl, butyl, and cyclohexyl nitrites and other related compounds. You will recognize products likely to contain nitrites as “video head cleaners,” “room odorizers,” “leather cleaners,” or “liquid aromas.”

Volatile Solvents are liquids that vaporize at room temperature.

• Industrial and household products, such as paint thinner, nail polish remover, degreaser, dry-cleaning fluid, gasoline, and contact cement
• Art or office supplies, such as correction fluid, felt-tip marker fluid, and electronic contact cleaner

Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Have you ever seen a keloid? Do you suffer from keloids? Do you know someone with them and wonder what’s occurring? Here are some answers.
Some people, more commonly African-Americans, Asians, Latinos and those with a family history of keloids, suffer from abnormal skin growths. These growths typically occur during one’s skin healing after an injury. Keloids are simply overgrowth of scar tissue.

The problem is keloids can be quite scary and scary-appearing. In severe instances, keloids can not only occur after an injury but also after any insult to the skin. This can include severe injuries such as burns, lacerations, surgical scars or trauma, but it can also result from simple insults such as acne, chickenpox, scratches or puncture wounds (such as seen with medication administration, vaccines or ear-piercing).

Keloids can be quite scary in their appearance. At first glance, they are often confused with cancerous skin growth. They take on multiple appearances and colors, and they are often tender and easily irritated. They are not easy to disguise. In fact, sun exposure may cause ongoing tanning to the area, making the deformity even more pronounced. Therefore, it’s important to cover keloids and use sunblock over the involved area when exposed to the sun for the first six months after development of one (or up to 18 months in children).
There’s an unfortunate “Catch-22” with keloids. Once formed, they often don’t need to be treated unless you want to reduce the size or have other cosmetic concerns. Many of the variety of treatment options used to treat keloids can actually cause a larger one to form, particular if it involves cutting or other irritation to the skin. However, in many cases, treatment is quite successful.

Here are some of the various treatments available for keloids. Discuss these options with your physician or Sterling Medical Advice expert consultant if you are considering having modifications to existing keloids.

• Cryotherapy (freezing the area)
• Injection of steroids
• Laser therapy
• Radiation therapy
• Silicone gel or patches
• Surgical reduction or removal

Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Let’s pick up where we left off. In our discussion of eczema and psoriasis, we described the common theme of underlying inflammation manifesting in rashes of different appearances. The theme continues today, with the difference being overlying inflammation. Contact dermatitis (dermatitis = skin inflammation) results from some external entity becoming a nuisance to your skin and generating a response in the form of a rash. You know this in many different forms (shown in the pictures below) – think about those old nickel coated watches, piercings gone bad (piercings also cause actual infections, which is a different consideration), clothing (below is a picture of contact dermatitis caused by flip-flop slippers), poison ivy and diaper rash. I bet the lead picture, which seems like a brand of a butterfly necklace pendant, as well as the following pictures look familiar to many of you.

These rashes are examples of allergic contact dermatitis. Your immune system is generating a response because it believes it is under attack by whatever has touched you. The way the body defends itself leads to release of various chemicals (most notably histamines) that cause the rash. The reason I picked the illustration of the diaper rash is to remind you that the rash actually is in the distribution of the diaper (not just under it), meaning that it may be the diaper that’s the culprit. In other words, don’t just zone in on feces and urine as the problem.  Allergic contact dermatitis can occur from – well, anything you’re allergic to, but it’s commonly associated with latex, fruit peels (especially citrus), lotions, perfumes and other topical substances applied to the skin.
When we discussed eczema earlier, we were describing irritant contact dermatitis, which occurs because something damages the skin (remember eczema is called “the itch that rashes”). Imagine that you’ve sensitized and damaged your eczematous skin by scratching away at it and then place something irritating on it. That’s what this is. The longer the new irritant stays on the already damaged skin, the worse the inflammation is, and the more violent the rash appears.
So let’s get to the bottom line: the name of the game is avoidance (as in poison ivy, latex or other known irritants), prompt recognition and removal of irritants, and symptomatic treatment. If you come in contact with a substance that burns or rashes immediately, remove the object or get away from it, and then wash the affected area with mild soap and moderate water. Consider oral histamines (e.g. benadryl) and a mild OTC hydrocortisone ointment. If the rash isn’t better within a few days, or if you ever feel short of breath or as if your throat is closing, contact your physician or the local emergency room immediately for evaluation. Unless you have an underlying condition like eczema or psoriasis, contact dermatitis should resolve within 2-4 weeks with this approach to management.
So in closing, remember: it’s not just the more you itch, the more you scratch. It’s also the more you scratch, the more you itch. Break the cycle.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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In the world of rashes, there aren’t an abundance of rashes that appear on the palms and soles.  However, there are a few of note, so here’s some Quick Tips to point you in the right direction. This doesn’t take long for you to learn, so commit this to memory, and you could save yourself a lot of drama down the road. Don’t forget to wear gloves and wash your hands!
There’s actually an entity called hand, foot and mouth disease, commonly seen in children and caused by the Coxsackie A virus.  It’s rather benign.

If you’ve spent any time in the woods of the Southeastern U.S. (usually between April and September), you may recall being bitten by a tick (which will transmit an infection from a bacteria named Rickettsia Rickettsii).  If you contract Rocky Mountain Spotted Fever (yes, it’s misnamed – the Rocky Mountains aren’t in the Southeastern U.S.), your rash may look like this.

If you’re a child with five or more days of fever, pink eye, dryness in the mouth, big lymph nodes in the neck and this rash, your physician should consider Kawasaki’s disease.  This is caused by an inflammation of blood vessels, and demographically, it is seen more often in those of Asian descent.

Sometimes in Kawasaki’s disease, the tongue may look like a strawberry.

And yes, secondary syphilis presents with rashes on the palms and soles.  The real take home message is this.  Primary syphilis is so overlooked (because the initial genital lesion is painless and may come and go without much announcement), the development of rashes on the hands and feet may be the first time you get diagnosed.  Trust me, you want to get treated before tertiary syphilis develops.  Here’s what that rash looks like.

The long and short of it, is if you or a loved one develop a rash on the palms and/or soles, get it evaluated.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
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Rashes are very frustrating for patients.  They itch, burn, get infected, aren’t pleasant to look at and never go away rapidly enough. Another problem is no one ever seems to know what they are at first, and that causes a big problem because you’re concerned immediately (as you should be) when the rash appears. Unfortunately, in the early stages, most rashes are indistinguishable. In many cases, in order to diagnose them, you’d have to let them evolve and bloom into whatever they’re trying to become, but who has time for that? I remember in medical school, the prevailing wisdom was “If it’s wet, dry it (powder), if it’s dry, wet it (creams, lotions and ointments), and give everybody steroids.” Well, don’t try that at home without your physician’s direction because it’s not universally true, but it sure does seem like hydrocortisone has a lot to do with treating rashes.
Today, I’d like to review two common chronic conditions defined by rashes, and later I’ll do the same with acute presentations of rashes. The thing about eczema and psoriasis is we should know it when we see it, and so should you. By the way, dermatitis is the general term for skin inflammations, and eczema and psoriasis both fall under this category. As such, they have a lot in common, including basic underlying mechanisms (irritation), treatment considerations and a knack at raising frustration levels.

Eczema (aka atopic dermatitis, which is the most common form of eczema) is a red, dry itchy rash that really is just an inflammatory reaction. If you let it linger, it can become cracked, infected and develop a leather-like consistency. It’s said that you’d develop eczema just by scratching or rubbing your skin long enough, because it’s the damage to the skin that causes the inflammatory reaction that defines eczema. This is why eczema is notoriously called “the itch that rashes”. You’re more likely to have it if you have asthma, have fever or tendencies toward food allergies (or other allergies), but you can get it with pretty much any significant skin irritation. It’s not contagious, but it does run in families.

Psoriasis is another chronic skin condition that is easily recognized. As noted above, that thick scaly, silvery skin (called plaques) results from an overgrowth of skin cells. As with eczema, this condition is a result of inflammation to the skin, in this instance caused by an overreaction of your immune system speeding up the production of skin cells. Psoriatic lesions are most often seen on the elbows, knees and scalp; it can also involve the back, hands and feet (including the nails). Psoriasis tends to flare-up then go into remission, but during those flare-ups, it is very uncomfortable and unsightly.
These are both ‘dry’ rashes, so treatment involves moisturizers, changing habits to include mild soaps, loose fitting clothing, moderate temperature showers (to avoid drying the skin), and when necessary, antihistamines (like Benadryl) and topical steroid creams (like hydrocortisone). Use any medications after consultation with your physician, who may prescribe more exotic treatments such as medications to calm or suppress the body’s immune response or ultraviolet light therapy. Your job is to identify and avoid the irritants that cause the inflammatory reaction (e.g. sweating, scratching, tight-fitting clothing and anything that dries you out). It’s important for you to get these addressed early before the appearance becomes too bothersome for you.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Now you may look at the topic and think, “Well, isn’t that obvious?” I’m here to tell you that as many people who come to the emergency room for seemingly minor things, there’s even more that delay coming because of a thought that things will get better. When it comes to your eyes, you only have two, and can’t afford to lose even one. If you have any of these signs or symptoms, come in while you still can see (if indeed you still can).
Sudden vision loss: The problem with sudden vision loss is that it didn’t happen by accident, and it’s not likely to get better without prompt relief. This could represent a stroke involving the eyes’ blood vessels (amaurosis fugax), a blockage of those blood vessels (central retinal artery occlusion), a retinal detachment and a few other critical considerations. The point to be made is that in most of these examples, you should assume that only a limited amount of time exists to repair the damage before the eye injury causes permanent damage.
Eye pain: Yes, there’s a lot of benign things that cause eye pain, but there are some serious considerations, including the following:

• Burns (seen very commonly in welders and those using chemicals)
• Conjunctivitis (yep, even this can be serious when caused by gonorrhea or a herpes virus – wash your hands!),
• Glaucoma,
• Inflammation of various components of the eye (uveitis, keratitis)
• Migraines
• Scratches and ulcers to the eye surface (the cornea – do not sleep in your contacts unless this has been approved by your eye doctor; it just sets you up for bad things to happen),
• Trauma
• Tumors

Something is in your eye: Whether a chemical splash, a piece of metal, a branch or other foreign body, there are several concerns you should have. In the example of the chemical splash, something may be burning through the layer of your eye, putting it at risk for rupture. One word – IRRIGATE! If some object is in there that you can remove by blinking, odds are it’s not going away. Don’t cause more damage than is already there by digging around in your eye. Get evaluated.
Visualization of flashing lights and floaters: The most concerning cause of this phenomenon is a retinal detachment, which is a serious eye-threatening emergency. Visualize (no pun intended) wallpaper peeling off a wall. Unfortunately in this analogy, the retina is like the film in your camera, capturing the images of the world you see. If your retina’s gone from its natural position, you’re not seeing anything.
I welcome any questions, comments or thoughts. Otherwise, I’ll see you tomorrow.
Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress