Let’s talk about cannabidiol (aka CBD) oil. There’s a huge fervor for this, which is understandable given the wave of states having legalized marijuana. CBD oil has become widely accessible. In fact, it’s legal in thirty states, and seventeen others have CBD-specific laws allowing for some use. Still, the rush needs to be tempered with a reality check! Let’s delve into uses and concerns about CBD oil.

How is CBD oil different from marijuana?

CBD oil is an extract from the marijuana (or hemp) plant. Significantly, CBD oil does not contain tetrahydrocannabinol (THC). Importantly, THC is the portion of marijuana that produces intoxication, so you don’t have to worry about being “high” with CBD oil.

How does CBD oil work?

CBD works by tapping into our brain’s endocannabinoid system. This system contains communication chemicals, millions of cannabinoid receptors with which the chemicals interact, and enzymes that synthesize and break them down. Our internal cannabinoids pass messages between the brain, nervous system and immune system. These messages help balance key body functions ranging from mood, sleep, appetite and memory. Additionally, they help coordinate the production of hormones, as well as our growth and development. Our endocannabinoid system is also involved in regulating inflammation, pain perception and immune responses. CBD (an “external” approximation of cannabinoid) interacts with some of your cannabinoid receptors but not others, which speaks to the limits of its effectiveness. CBC oil is taken as a liquid or tincture, a topical ointment or a vape/e-liquid.

For what does CBD oil work?

I am not going to dismiss the benefits (whether placebo or real) that individuals receive after taking CBD oil. However, I will emphasize the difference in what is known and what’s suspected.

• The only FDA-approved indication for CBD oil is for epilepsy (seizure disorders). Therefore, that means every other suggested use has insufficient medical research to have established a consensus and approval for use by the FDA.
• CBD oil has not been shown to be conclusively effective against anxiety, sleeplessness and inflammation (particularly of the joints). Unfortunately, the medical research does not yet support these claims.

If I choose to use it anyway, about what should I be concerned?

Your concerns should include the lack of quality control and potential side effects.

• Research has found that when tested, approximately seven of ten CBD products don’t control the amount of CBD cited on the label. Additionally, about 20% of products actually included THC (the portion of marijuana producing the intoxication). Simply put, the lack of FDA regulation means you have no assurances about what you’re actually taking.
• Side effects of note include an increase in your liver enzymes (which could reflect damage to the liver) and interactions with other drugs. CBD oil increases the blood level of other anti-seizure drugs. As a result, the potential side effects of these other drugs can become enhanced.

Summary

The sum total is if you take CBD, you shouldn’t be just grabbing it from over the counter. You should be under the care of a physician who is looking at the entirety of your health. You should be considering how and if adding CBD can enhance your health or is safe. As recently as 2017, the Centers for Disease Control and Prevention (CDC) reported fifty-two cases of illness tied to products that were falsely labeled as CBD. Above all, ask yourself: as a consumer, how do you know a product not approved or regulated by the FDA either is what it says it is, works or is safe? Let the buyer beware.

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, we’re offering 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 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.jeffreysterlingbooks.com. Receive introductory pricing with orders!

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The post Getting Your Pain Treated in the ER in the Midst of an Opiate Epidemic appeared first on Jeffrey Sterling, MD.

Chronic pain and its management are complicated topics, both for sufferers and those who care for them. Thank you for your feedback on the previous post and appreciating the spirit in which the information was provided. There were many interesting questions presented, and I’d like to address two topics raised in some detail.

You don’t have to be a drug seeker to be drug addicted.

Here’s a point many chronic pain patients don’t think about that emergency room (ER) staffs have to. Even if you’re not a drug seeker, you can still be physiologically addicted to drugs. Of course your ER physician cares about your mental intent, but s/he has to be cognizant of the possibility or reality that your body might be addicted. One reason this is especially relevant is the development of tolerance, which is an important sign of addiction.

Specifically, tolerance is the phenomenon by which those physiologically addicted to a substance don’t get the same effect by giving what had previously been an effective dose.

So what? This means over time you will require increasing amounts to get an effective amount of relief (i.e. equivalent to previous effects).

So… as a patient suffering from pain, you’re focusing on the fact that you’re not relieved of your pain. Your ER staff is focused on the reality that increasing amounts of certain pain medications (i.e. narcotics) come with increasing amounts of side effects, more notably respiratory depression, meaning a high enough dose can knock out your ability to breath and will kill you. This is a major reason why there are limits as to the amounts and frequency of what will be given to you in an ER setting. Once you’ve been given a certain amount, many physicians will simple stop giving additional amounts regardless as to how you feel – unless we are able to specifically discuss your cases with your primary or pain management physician, who may explain your circumstance and help decide if additionally amounts are needed. This also explains why you’re more likely to get “better” treatment during regular business hours than in the middle of the night; those conversations with other members of the team are important.

The allergy vs. adverse drug reaction question:

In a previous post, I commented on patients equating preference or side effects with allergies, and several readers have asked for clarification (e.g. “Why isn’t that side effect the same as an allergy?). An example that relates to pain is some patients’ preference of various narcotics. For some, morphine routinely makes many people itch. This is an expected side effect and is not the same as an allergic reaction. Morphine also makes some patients feel “bleh,” especially when compared with such medicinal options as Dilaudid or Demerol which are more “happy drugs.”

Even so, these drugs have different effects that would make a physician choose one over the other. For example, morphine is actually a drug of choice for pain exacerbations associated with sickle cell anemia due to its effects at the cellular level, so in many cases, physician will prefer to use morphine despite patient preference. In any event, your job is simply to have the conversation with your physician. Don’t claim an allergy if one doesn’t exist; simply discuss the reasons why one medication seems to work better than the other. You likely will find a much more receptive audience taking this approach.

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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The notion of a pain awareness month is an odd thing; probably even more so to those suffering from chronic pain. Typically the idea with these periods of recognizing diseases and conditions is to create sensitivity among the general public toward one’s condition. In this and the next Straight, No Chaser, we will not only do that but will build upon that and provide those sufferers of chronic pain some better tools to make those emergency room visits more productive.

I’d begin by asking you to get more in touch with your “you sensitivity” and learn to differentiate between different types of pain. It’s important for you to know the difference.

• Clearly there’s acute pain from injury. You break a jaw or twist an ankle, you’re going to hurt.
• There’s acute exacerbations of pain from disease. You have sickle cell anemia? Cancer? Lupus? Sciatica or other low back pain? Arthritis? Migraines? You will have acute flare ups.

Then there’s chronic pain. Remember, sometimes pain happens without injury or disease. Pain is simply a signal communicated from your body to you through your brain. Acute pain is normal and is meant to alert you to somehow protect yourself or get help. Chronic pain is different. Those signals coming from your nervous system can be sporadic or haphazard, and they may be more reflective of dysfunction within the nervous system than a disease or injury. It can even be psychogenic (due to matters of your mind). Regardless of the cause, chronic pain is well, a pain.

There are many established conditions that cause chronic pain, such as the following:

• Chronic fatigue syndrome
• Endometriosis
• Fibromyalgia
• Inflammatory bowel disease
• Interstitial cystitis
• Temporomandibular joint dysfunction (TMJ syndrome)
• Vulvodynia

Maybe the point of this post isn’t to tell those of you who suffer from chronic pain things you don’t already know as much as it is to organize your thoughts and approach to your pain. After all, it’s not like there are cures for chronic pain besides eliminating the underlying condition (which reminds me to remind you not to fall for the many medical scams promising instant and permanent relief to these medical conditions). The first step really is to help you appreciate the need for becoming better sensitized to your condition.

Many patients with chronic pain suffer horrible outcomes because they become desensitized to pain, learn to ignore it, and misinterpret a new, unrelated pain condition (maybe with a few similarities), failing to get evaluated before it is too late.

If you suffer from chronic pain, it’s key to know the things you can do to improve your quality of life. Strengthening your mind to reduce stress and avoid fixating on your medical condition is very important. Learning to relax actually is treatment; your body has pain-reducing chemicals, including those that directly treat pain and promote healing, and others that prevent release of internal pain producers. Find someone with whom you can discuss relaxation and stress reduction.

Engage the fight to get better within your physical limitations.

• Exercise remains key. Depending on your situation, walking, running, biking and/or swimming can dramatically improve your situation. Be advised that the extremes (not exercising at all or doing so too much) can actually worsen the situation.
• Stretching and strengthening similarly produce benefits to those with chronic pain. This should sound like a good reason to become involved with a personal trainer or have a physical therapist.
• Regular sleep and avoidance of nicotine (stop smoking!) will also help.

Your physician may discuss multiple other possible treatment modalities, such as the following:

• Acupuncture
• Behavioral therapy can reduce your pain and decrease your stress through methods that help you relax, such as meditation, tai chi, and yoga. Give it a try. It works for many people.
• Brain stimulation therapy
• Local electrical stimulation
• Occupational therapy teaches you how to perform routine activities of daily living in a way that reduces your pain and/or avoids reinjuring yourself.
• Osteopathic manipulation therapy (OMT)
• Psychotherapy

Regarding medication, for many people use of medication (especially narcotics) becomes a crutch and a slippery slope. Over the counter medications such as acetaminophen and ibuprofen are quite effective for many causes of pain. Use of narcotics should be measured and part of an overall plan, not a tool for a quick fix or to get you out of your doctor’s face. It is part of reality that even if you are not a drug-seeking patient, with enough exposure to narcotics you will develop tolerance (less effectiveness at the same dose) and become addicted. You should want to avoid this fate.

The pain, mental duress and reduction in quality of life associated with chronic pain can be lessened with you learning how to approach and understand your pain, taking appropriate steps to reduce things you do to exacerbate the pain, increasing the things you do to lessen the pain, and working with your health care team to provide you with appropriate support and treatment.

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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The post Chronic Pain – What You and Your Physicians Can Do To Really Help appeared first on Jeffrey Sterling, MD.

Previously, Straight, No Chaser has discussed the frustration of uncertainty some patients have with having symptoms and not being given a diagnosis (much less a cure). Imagine if that uncertainty arose in the context of excruciating pain lasting for what seems like all day. There was a time when this was the case to a much greater extent, and then several medical conditions gained recognition and/or prominence. Some of these include chronic pain syndrome, chronic fatigue syndrome, temporomandibular joint syndrome (TMJ syndrome), endometriosis, inflammatory bowel disorder, vaginismus, vulvodynia and still other conditions. Today we will address one such condition, fibromyalgia.

The symptoms of fibromyalgia include muscle pain and fatigue. This pain may take one of several typical forms, including headaches, painful menstrual periods and – most interestingly – “tender points.” Tender points are specific places on the body that hurt when you apply pressure. These can occur most anywhere but usually involve the extremities, neck, back, hips and shoulders. Other symptoms include numbness and tingling in your hands and feet, difficulty sleeping and morning stiffness. In some cases a condition called “fibro fog” occurs, in which clouding of thinking and memory occurs. It shouldn’t be a surprise that these other symptoms often result in clinical depression.

Unfortunately, fibromyalgia is a condition, not a disease that we can attach to a specific cause. However, there are several diseases to which fibromyalgia has been linked. In short, many stressful life conditions and events can serve as triggers for this disorder. Some of the more notable conditions and triggers include ankylosing spondylitis (aka spinal arthritis), motor vehicle crashes, rheumatoid arthritis and systemic lupus erythematosus (aka lupus). So many such triggers exists that now over 5 million Americans have been labeled with the diagnosis. Interesting, 80-90% of those so diagnosed are women, most during middle age.

Given the absence of an identified cause, treatment is mostly symptomatic, attempting to address the pain and other things that disrupt one’s activities of daily living. More importantly, once affected, you need to implement the lifestyle changes that have been shown to help, including improving diet, exercise, getting enough sleep, changing one’s work and home environments, and taking medications as prescribed.

I would be remiss if I didn’t address the controversies surrounding fibromyalgia. Given the absence of a defined cause, many patients suffering from fibromyalgia and similar disorders are often perceived to be drug seeking, particularly in emergency departments. It is very frustrating for physicians to care for patients they can’t “fix.” Although drug seeking patients do exist, multiple medical studies have shown that inadequate treatment of pain remains one of the great faux pas of medicine. It is an equal disservice to give in to a patient’s request for pain medication as a routine matter without the benefit of a full evaluation. There are many defined medical conditions that present with pain. More deliberate and vigorous evaluations can not only put a more definitive name to the pain but can lead to better outcomes for those patients.

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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The post Fibromyalgia – Facts and Controversies appeared first on Jeffrey Sterling, MD.

You are likely aware that the ovaries produce a women’s eggs as well as being the main source of the female’s sex hormones. Ovarian cancer is not the most common gynecological cancer. In fact, it only causes approximately 3% of cancers in women. However, it’s an important one to know because it causes more deaths than any other cancer of the female reproductive system. It is impossible to do justice to ovarian cancer in one blog, so this Straight, No Chaser will feature frequently asked questions on the topic.

How serious is ovarian cancer?

Very. According to the American Cancer Society (ACS), in 2018 the following is expected:

• Approximately 22, 240 new cases of ovarian cancer
• Approximately 14,070 deaths from ovarian cancer

The lifetime risk of dying from invasive ovarian cancer is about 1 in 108.

Who is relatively more likely to obtain ovarian cancer?

• Ovarian cancer is more common in whites than African-Americans.
• Approximately half of those diagnosed are 63 years or older.

What increases the risk of developing ovarian cancer?

Factors linked to an increase in ovarian cancer risk include the following:

• Increasing age, particularly after menopause
• Obesity
• Breast cancer (those with or have had breast cancer also have a higher risk of ovarian cancer)
• Family history of ovarian cancer
• Family history of breast or colorectal cancer

Do any actions reduce the risk of developing ovarian cancer?
This needs to be discussed with your physician, as your individual circumstance has a lot to do with actions you can take to lower your risk. That said, general factors linked to a lower risk of ovarian cancer include the following:

• Consuming a low-fat diet
• Having been pregnant
• Having had a hysterectomy (i.e. uterine removal) without removing the ovaries
• Having had a tubal ligation (i.e. having had your “tubes tied”)
• Having engaged in breastfeeding
• Use of birth control pills
• Use of the contraceptive injection depot medroxyprogesterone acetate (DMPA or Depo-Provera CI®)

Can ovarian cancer be found early? Are there screening tests?
Only about 20% of ovarian cancers are found at an early stage. Those that do find it early have an improved chance of successful treatment. About 9 out of 10 women treated for early ovarian cancer will live longer than 5 years after the cancer is found. The best way to find ovarian cancer is to have regular women’s health exams and to see the doctor if you have symptoms. So far, no screening tests have been shown to lower the risk of dying from ovarian cancer, therefore no tests are recommended.

What are the signs and symptoms of ovarian cancer?

Two of the issues in detecting ovarian cancer are symptoms often aren’t present early in the cancer process, and even when symptoms occur, they are easily confused with symptoms more often caused by other things. It’s reasonable to suggest to you that routine evaluation for problems in your gynecological system, particularly those that make you feel different than normal and/or are persistent should prompt an evaluation by a physician.

The most common symptoms are:

• Abdominal or pelvic pain
• Abdominal swelling or bloating
• Difficulty eating and/or a quick sensation of feeling full while eating
• Frequent and/or urgent urination

Other symptoms can include:

• Abdominal swelling that is accompanied by weight loss
• Back pain
• Constipation
• Fatigue
• Menstrual changes
• Painful sexual intercourse
• Upset stomach

If you have any of these problems, talk to your doctor so that the cause can be found.
Diagnosis, treatment, staging and recovery considerations are discussed at www.sterlingmedicaladvice.com.

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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The post Ovarian Cancer – Frequently Asked Questions appeared first on Jeffrey Sterling, MD.

It’s time to get your flu shots! Of course, many people choose not to get the influenza vaccine (the “flu shot”) for various reasons, some more reasonable than others (including an allergy to eggs). This Straight, No Chaser reviews some of the better options left for you should you choose not to get vaccinated.

The best way to avoid the flu is prevention. Consider adopting these healthy habits before you ever get exposed:

• Wash your hands frequently with warm soapy water. You know when they’re dirty. Most certainly wash your hands before you use them to eat or put anything else in your mouth.
• If you can’t wash your hands, use an alcohol-based hand sanitizer.
• If your hands are dirty and neither soap nor sanitizer is available, still rinse and dry your hands with warm water if you can.
• Use disinfectant to clean surfaces.
• Avoid unnecessarily touching your eyes, nose, or mouth.
• Politely limit close contact with people who are ill, coughing and sneezing.
• When coughing or sneezing use the bend of your elbow or a facial tissue to help cover your nose and mouth. Learn to avoid coughing or sneezing into your hands.
• When you become sick, stay home. It’s the proper thing to do to avoid spreading your infection to others.

Vitamin C, echinacea and zinc have long been touted to prevent colds and influenza. There are no studies confirming or refuting this claim. Despite assurances that these and other herbal medicines are safe alternatives because they’re “natural”, the active ingredients in them are the same as found in certain prescription medicines. Thus they too may interact with other medications and worsen certain medical conditions. Given this, you should discuss your use of supplements with your physician or pharmacist prior to use.

Another level of defense for you involves use of certain antiviral prescription medications. If you are exposed to someone (e.g. a family member) with influenza, and especially if you begin having flu-like symptoms, immediately contact your physician to discuss taking medicines to prevent catching the flu. Such medications include Tamiflu® (generic name: oseltamivir), Relenza® (generic name: zanamivir), Flumadine® (generic name: rimantadine) and Symmetrel® (generic name: amantadine). If you make the request more than 24-48 hours after the onset of symptoms, you likely won’t be given the medication, since it isn’t likely to be effective outside of this time frame.

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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We’ve missed the first day of Fall, but for all of you DIYers (do it yourself-ers) ready for a weekend project to help a loved one, here you go. The beginning of Fall is a good time to discuss fall prevention among the elderly. First, let’s start with some not so fun facts.

• Every year, one of every three adults older than 65 has a fall.
• Falls are the #1 cause of injury death in senior citizens.
• Falls are the #1 cause of nonfatal injuries and trauma hospitalizations.
• Typical injuries include lacerations, hip fractures and head injuries (including intracranial bleeds). These injuries occur in approximately 20-30% of falls.

What is your chance of falling?

How can older adults prevent falls and the complications of falls?

Here are six Fall Prevention Quick Tips I hope you’ll share with your loved ones.

Fall Prevention

Here are six Quick Tips to Fall Prevention I hope you’ll share with your loved ones.

• Start by doing some home improvements to accommodate the shortcomings of your elderly relatives. Consider railings and grab bars – near the bed, on the stairways, shower, tub and toilet. Improve lighting. Clear out and widen walking paths. Consider using a walker.
• Exercise regularly. It keeps the brain sharp and the leg muscles strong. Inactivity promotes bad outcomes when activity is attempted. Have their doctors arrange for home health care and physical therapy if indicated.

• Have your loved one and your family review medications with their physician. You need to know which medications and drug interactions can promote loss of balance, dizziness, drowsiness, and/or mental status changes, all of which can lead to falls.
• Keep those eyes checked. This should be happening at least once a year. Be diligent in changing prescriptions as needed. Could you imagine being a little confused and not being able to see? What would you expect to happen?

• Pay attention to diet. Nutritional needs are even greater in those with health issues, which is always the case in the elderly. Supplement Vitamin D and calcium for bone strength.
• Of course, get screened and, if needed, treated for osteoporosis.

The key is to pay attention

You don’t have to let your loved ones wither into oblivion. Simple quick fixes and some love and attention can go a long way to preventing falls and the injuries that accompany them. Good luck.

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.

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Your son is a star in Friday Night Lights (actually football, not the TV show) and has been concussed.  Amazingly, the most common question I get asked is not “Will he be ok?”, but “When will he be able to get back on the field?” My answer, coming out the ER, is never going to be less than two weeks, and I won’t be the one who provides medical clearance.  It’ll either be your family doctor or preferably, a neurologist.  Don’t just take my word for it.  Consider the following Quick Tips from the Center for Disease Control and Preventions.
CDC’s Discharge Instructions

• You may experience a range of symptoms over the next few days, such as difficulty concentrating, dizziness or trouble falling asleep.  These symptoms can be part of the normal healing process, and most go away over time without any treatment.
• Return immediately to the ED if you have worsening or severe headache, lose consciousness, increased vomiting, increasing confusion, seizures, numbness or any symptom that concerns you, your family, or friends.
• Tell a family member or friend about your head injury and ask them to help monitor you for more serious symptoms.  Get plenty of rest and sleep, and return gradually and slowly to your usually routines.  Don’t drink alcohol.  Avoid activities that are physically demanding or require a lot of concentration.
• If you don’t feel better after a week, see a doctor who has experience treating brain injuries.
• Don’t return to sports before talking to your doctor.  A repeat blow to your head-before your brain has time to heal-can be very dangerous and may slow recovery or increase the chance for long-term problems.

Finally, there are two particularly impactful consequences about which you should be aware.

• The ‘second impact syndrome’ is irreversible brain injury triggered by a fairly routine second head impact after a prior concussion.  You must take the time off needed for the brain to heal.  I care more about your child’s mental future than the upcoming playoff game.
• The ‘post-concussive syndrome’ represents long-term neurologic and psychologic consequences of the head injury.  It includes such symptoms as inability to sleep, irritability, inability to concentrate, headache, dizziness and anxiety.

There are no definitive treatments for concussions other than prevention of an additional injury, and that fact should be chilling to you.  Be mindful of the risks involved in choosing to engage in activities putting the brain at risk.

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,  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 SNC! 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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The post Concussion, Part II appeared first on Jeffrey Sterling, MD.

It’s probably not a coincidence that National Traumatic Brain Injury Awareness Month occurs at the same time as the onset of the NFL season in the U.S. However, it’s also important to appreciate that traumatic brain injuries (TBIs) don’t only occur in the setting of professional sports. Regarding sports, the really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing, or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame, and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.

A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes, ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia. (It’s important to note that not all blows to the head result in a TBI.) For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contribute to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.

Healthcare professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

• Thinking/remembering
• Physical
• Emotional/mood
• Sleep

Red Flags
Here’s what you need to know today. Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

• Any difficulty waking
• Any loss of consciousness, confusion, or significant agitation
• One pupil (the black part in the middle of the eye) larger than the other
• Loss of ability to identify people, places, the date, or self
• Loss of motion or sensation, weakness, numbness or loss of coordination
• Persistent, worsening headache
• Repeated vomiting
• Slurred speech or difficulty with expression
• Seizures
• Kids will not stop crying and cannot be consoled
• Kids will not nurse or eat

We’ll continue the conversation about concussions in part two.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

The post Concussions, Part I appeared first on Jeffrey Sterling, MD.