Altitude Sickness by Nathan Kiskila, M.D.

 
Board Certification: Family Practice
Many of our patients are traveling to the mountains this winter on vacation.  Altitude sickness is a general term encompassing a group of disorders which occur at higher altitudes.  The most common kind of altitude sickness is acute mountain sickness.  Symptoms may include fatigue, lightheadedness, headache, sleepy, no appetite and nausea or vomiting. Symptoms can manifest very quickly and you should not travel or climb any higher until you feel better.  Symptoms will usually subside within a day or two with rest.  The altitude height and rate of ascent has a direct correlation to the severity of the symptoms.
 
 A second and less common type of altitude sickness is high altitude cerebral edema. This is a more severe form of acute mountain sickness which involves swelling of the brain. Symptoms may include confusion, weakness, walking difficulties, and acting drunk. This is more serious and you should get help right away and move to a lower altitude immediately.
 
The last type of altitude sickness is high altitude pulmonary edema or fluid in the lungs. This presents with coughing, shortness of breath, congestion, and trouble walking uphill or up a flight of stairs. It is another less common type of altitude sickness and may take 2-4 days after traveling to start. You should get help right away and move to a lower altitude immediately.
 
If you experience serious symptoms, seek medical attention right away. Doctors can give a steroid shot to decreases brain swelling. They can administer oxygen to help breath and in some cases they might place you in a hyperbaric chamber to simulate lower altitudes.

To help mitigate the symptoms of altitude sickness while traveling, go slowly and stretch your trip out to give your body time to adjust. Avoid alcohol, sleeping pills, and postpone physical activity the first day. If you are prone to altitude sickness, your doctor might prescribe a medicine to help treat and prevent it.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 

 

 

Stress Management 101 by Chad Abbott, M.D.

 

of the most important aspects of our well-being is the impact of stress on our bodies and minds. Our society is stressed and the statistics are shocking.  Not only do adults experience stress, but also children and young adults can suffer from depression and anxiety.  Stress is one of the main contributors of the alarmingly high prevalence of drug and alcohol addiction as well as suicide.  The top three causes of stress in the U.S. are money, work, and the economy.  One third of parents feel they are under too much stress and only 32% feel they are managing their stress well.  Sadly one in five children report being worried about things in their lives.  Children are aware that their parents are stressed because they may hear more yelling and arguing and in some cases there is violence in the home.

Remember stress is real.  It is not an imaginary concept or feeling.  Stress directly impacts your overall health.  The phrase “Stress Kills” is true!

Below is a summary of what stress actually is and how to manage the stress in your life:

1. What is stress?  In simple terms, stress is an external force that acts on our bodies in the same fashion that forces act on inanimate objects such as metal.  For instance, a ship sitting in the ocean will have a chemical reaction with the salt water and metal forming rust. This is a process that takes time, but ultimately will destroy the boat if there aren’t measures to combat or reverse this process.  Simply stated, anything that affects your body in a negative or a positive way is considered stress.

The human body and mind are remarkable at maintaining homeostasis despite the stresses of living.  The way our bodies combat stress is through a very complex set of regulatory processes collectively referred to as homeostasis.  Homeostasis refers to our body’s normal set points for things like vital signs including blood pressure, pulse, respiratory rate, temperature, and pain. Remember that pain is the sixth vital sign which is linked not only to injury and illness, but also one’s psychological state.  Other homeostatic mechanisms include: salt/water balance and the buildup and break down of cells and tissues in the body.

2. What are the differences between physiologic and emotional/psychological stress? Psychological/emotional stress refers to the perception of real or imagined threats to our bodies, minds and souls.  The big issue is the realization that you may not have the resources necessary to overcome the perceived threat(s).  Examples include: social status, respect, acceptance among your peer group, threat to your self-worth, or any other threat that you feel you have no control over. That is important point because as human we want to feel that we have control of our lives.  When we lose power over our lives, stress develops.

3. What are the differences between good stress and bad stress?  Good stress refers to a controlled situation.  It is the individual’s decision to take on a specific set of circumstances. Examples may include: taking on a new project at home or school, volunteering, starting an exercise program. This stress is perceived as manageable by the individual, but in actuality it can also lead to feeling stressed and overwhelmed which leads to the same physiologic reactions as bad stress.  Bad stress refers to an uncontrollable situation.  The individual has no power over the circumstances.  Examples include: deadlines at work, paying taxes, working, dealing with the loss of a loved one, etc.

4. What are the physiological, psychological, and emotional impacts of stress on human beings?  Fight or flight response vs. rest and digest: The sympathetic nervous system is responsible for a “fight or flight” response.  The parasympatheic nervous system is responsible for processes such as digestion, sleep, etc.  Both systems are required for survival. The problems associated with living in a constant state of “fight or flight” are the following: high blood pressure, clogging of the arteries= heart disease, heart attack, stroke, neurological changes in the brain= depression, anxiety, addiction, insomnia, obesity, etc.

5. What are signs and symptoms of stress?  Here is any easy table that lists the signs and symptoms of stress.  If you are experiencing any of the following symptoms more days than not over a two to four week period seek medical attention. A physician can help you articulate your symptoms and discuss stress management techniques that are proven to work for most people.

6. How can we manage stress?

Stress management doesn’t have to be complex, time consuming, or expensive.  In fact, if you make stress management stressful, it defeats the purpose.  Simple stress management can be as easy as setting aside 10 to 15 minutes each day for “Me Time”.  This means you don’t do any work, chores, or respond to questions from others including text messages, telephone calls and emails.  You simply allow yourself to unplug mentally and do nothing.  My mother uses the phrase, “We aren’t human doings, we are human beings”.   I think that is a very powerful statement and one we should all strive to follow. 

7. What are some clinically proven stress management techniques?

Get active. Try to perform some sort of physical activity every day. Aerobic exercise works best, but weightlifting, bicycling, and swimming are excellent sources of exercise. You don’t have to belong to a gym to get exercise. Aim for 15-30 minutes of some sort of exercise every day.

Meditate. This has proven health benefits. In fact some people become so good at meditation that they can focus on their heart rate and breathing to actually lower both of them. This can lower their blood pressure.  There are many ways to meditate including focusing on a specific word that you like, prayer, and guided imagery. This where you pick your favorite place and focus on it in your mind until you can see it clearly.  At first you may have a difficult time doing this, but eventually you will get the hang of it. The best part of meditation is you can do it whenever and wherever you want!

Laugh. It is proven that people who laugh (more including laughing at themselves) feel less stressed, achieve more in their personal and professional lives, and some people even say laughter is the key to their longevity.

Connect.  Human beings are social animals. Isolation can lead to depression. This has been shown in prisoners and is exactly the same for everyone regardless of one’s situation. The old adage “A problem shared is a problem solved” works.  If you feel stressed, find someone you trust to talk the problem out. I guarantee you will feel better when you’re done even if the problem isn’t solved.

Assert yourself.  In today’s society there seems to be a pervasive thought that we must do everything asked of us. This is a fallacy.  Always saying yes is a huge source of stress. Practice saying no from time to time and you will reduce your stress by a considerable amount. Remember if the person requesting something of you that you can’t do, it is okay to say no. This will reduce your stress and resentment.

Do yoga. Yoga is a phenomenal stress management technique because it incorporates not only physical exercise, but also control over your breathing and meditation. You don’t have to go to a yoga class. You can simply download a yoga video or purchase one at a local video store.

Sleep.  We all need at least seven hours or sleep per night. Eight hours is actually better.  Thinking that four hours is enough is incorrect.  Sleep is the way our body and mind reset and recharge.  Think of it as a computer rebooting.  If you don’t reset and recharge, you will not have the energy to take on the next day’s activities.  A sad statistic in our society is how many people take drugs like Ambien and anti-anxiety medications like Xanax and Valium.  It is much better to get natural sleep which requires some behavior modifications including: setting a firm bedtime each night, not watching television or being on your computer in order to fall asleep, keep your room for sleeping only, avoid caffeine or other stimulant medications, foods, and setting a comfortable temperature and keeping the bedroom dark.  If you try the aforementioned, you will train your body to sleep on its own. Taking medications all the time to help with sleep leads to dependency. This means your body has forgotten how to sleep on its own.

Journal.  Writing down your thoughts and feelings is a good way to get them out and look at them from the outside in. Doing this is a cleansing process and allows you to move on. This doesn’t have to be a formal process. In fact it is better to just sit and free flow your thoughts and feelings as opposed to forcing yourself to be structured and write the perfect sentence.

Get musical. Listening or playing music are both excellent stress relievers. The brain is activated in a way that watching television can’t match. Music has been shown to decrease muscle tension and decrease stress hormones.

8. When should you seek medical attention for stress and stress-related illnesses?  If you are at your “breaking point” and becoming depressed and anxious to the extent where your work life or home life are being affected, it is time to seek professional health.  If you can notice yourself becoming stressed out, it is better to seek help earlier rather than later. Seeking professional help is not a sign of weakness or that you are a failure. On the contrary, it shows that you are self-aware and willing to be proactive. This will build confidence in yourself because you are able to do something positive and help yourself.



The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

Acute Gastroenteritis (Stomach Flu) by Richard Zhen Lu, M.D.

 



Within the past several weeks, we have noticed increased number of patients coming to our clinic with acute gastroenteritis, which is also commonly known as “stomach flu” or “stomach bug”. Some of the most common symptoms include diarrhea, nausea, vomiting, generalized weakness and stomach pain. Acute gastroenteritis is especially common among children, though it is certainly possible for adults to suffer from it as well. While most cases of gastroenteritis last a few days, acute gastroenteritis can last for weeks and months if the underlying causes are not treated properly.

Bacteria and viruses remain the top two likely causes of acute gastroenteritis. There are other pathogens, such as parasites, that can cause acute gastroenteritis, but not typically seen within the US. If you have recently traveled outside the US, you should definitely disclose the relevant information to your doctor.

The initial treatment for acute gastroenteritis is always FLUID, FLUID and more FLUID. With the frequent diarrhea, you can lose a lot of fluid, and result in dehydration, which is especially true for children. When you do not improve from stomach flu symptoms within two to three days from the onset of symptoms, it is a good idea to check in with your doctor. Some types of acute gastroenteritis may not resolve without antibiotic treatment, especially when bacteria or exposure to parasites are the cause. The diagnosis of the specific cause for the acute gastroenteritis is typically made via the analysis of analyzing a stool sample.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

Urinary Tract Infections by Nathan Kiskila, MD



Questions?  We are here for you! 1-877-MY DOC NOW (1-877-693-6266)

Save time, book your appointment online HERE

Urinary tract infections (UTIs) are a common cause of urgent care visits throughout this country. 10% of women over 18 years of age report at least one suspected UTI every 12 months. These are infections anywhere along the urine tract and can be acute or recurrent.  There are three different types of UTIs: infection in the urethra, bladder infection, and kidney infection.

Escherichia coli (E.coli bacteria) is the most common organism in uncomplicated infections.  The most common route of infection in females is when bacteria travels up the urethra and attaches to the inner lining of the bladder. Holding your urine impairs the defense against infection provided by bladder emptying, hence a common cause of UTI.  Cranberry juice thins the inner lining of the bladder wall so it is helpful in preventing UTIs, but cranberry juice alone or pills cannot cure bladder infections.

Bladder infections commonly present symptoms such as urine frequency or urgency, burning pain with urination, blood in the urine, and/or bladder pressure (suprapubic pressure).  Bladder infections are commonly bacterial and can be diagnosed with a urinalysis and/or a urine lab test (urine culture).  Bladder infections are treated with oral antibiotics.  Kidney infections have symptoms such as lower back/flank pain and fever. 

Kidney infections can be very dangerous.  Kidneys are vital organs and if they get infected, the body can go into shock.  Kidney infections are more complex and treatment may require antibiotic shots or IV antibiotics in the hospital.  If you think you may have a UTI, it is better to seek medical attention sooner than later since bladder infections may progress to kidney infections.

Questions?  We are here for you! 1-877-MY DOC NOW (1-877-693-6266)

Save time, book your appointment online HERE

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 

 

 

 

 

 

Necrotizing Fasciitis by Dorcas M. Eaves, M.D.

Part 1: What is this Disease?


Necrotizing fasciitis is an infection that starts in the tissues just below the skin and spreads along the flat layers of tissue (known as fascia) that separate different layers of soft tissue, such as muscle and fat. For the general populace, Necrotizing Fasciitis is best known by the moniker “flesh-eating bacteria” a term coined by the news media.

This dangerous infection is most common in the arms, legs, and abdominal wall and is fatal in 30%-40% of cases. The bacteria that cause necrotizing fasciitis can be passed from person to person through close contact, such as touching the wound of the infected person. However, this is a rare event unless the person who is exposed to the bacteria has an open wound, chickenpox, or an impaired immune system.

Necrotizing fasciitis is not a new disease. One of the first references to the disease was recorded in 1871 by Dr. Joseph Jones an Army Surgeon, who studied more than 2,600 cases of the disease he observed during the American Civil War. Throughout history, some of the worst outbreaks of this condition have occurred in war-torn areas, as well as in military hospitals.

Fournier's gangrene is the term used when the condition affects the genitals. Jean-Alfred Fournier, a Parisian doctor, became the pre-eminent person attached to this condition after delivering a lecture on the subject in 1883. He noted that diabetic patients might have a higher risk of developing this disease.

By 1918, it was thought that this condition was likely caused by a bacterium of some sort. This was proven in 1920 when U.S. surgeon Frank L. Meleney published a paper on the topic. In his paper, he asserted that 20 patients he examined in China were afflicted with necrotizing fasciitis caused by hemolytic streptococcus.

In 1952, Dr. B. Wilson first used the term "necrotizing fasciitis." This term is the one still used in modern medicine, and is generally considered to be the most accurate and concise description. Other terms used to describe this condition include streptococcal gangrene, hospital gangrene, necrotizing erysipelas, and suppurative fasciitis.

Necrotizing fasciitis may be caused by an infection with one or more than one bacterium. In most cases, the term flesh-eating bacteria have been applied to describe infections caused by Streptococcus Pyogenes. The term flesh-eating has been used because the bacterial infection produces toxins that destroy tissues such as muscles, skin, and fat. Streptococcus Pyogenes is a member of group A streptococci, a group of bacteria that are responsible for mild cases of sore throat (pharyngitis) and skin infections, as well as rare, severe illnesses such as toxic shock syndrome and necrotizing fasciitis. Most infections with group A streptococci result in mild illness and may not even produce symptoms.

Other organisms may rarely cause necrotizing fasciitis, but when they do, the resulting infections are often difficult to treat successfully. Aeromonas hydrophila (a Gram-negative rod-shaped bacterium) has recently been the source of this disease in a 24-year-old who cut her thigh in a homemade zip line accident in the U.S. The organism established itself and caused the otherwise healthy young woman to have her leg amputated, and she may suffer further complications over time. Although Aeromonas hydrophila is usually associated with warm brackish water and causes infections in fish and amphibians, gastroenteritis is the disease it causes most often in humans when the water sources are swallowed. Because it is often resistant to multiple antibiotics, it is difficult to eradicate if it infects human tissues. In addition, once it infects tissues, its enzymes and toxins allow a rapid entrance of the organisms to the bloodstream, causing sepsis and infection of other body organs.

References:

Necrotizing Fasciitis C.P. Davis, MD, PhD medicinenet.com; M.C. Stoppler, MD medicinenet.com

Necrotizing Fasciitis, WebMD.com/a-to-z-guides

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 

 

Smoking Cessation by Alison Sims, M.D.

Board Certification: Internal Medicine
Cigarette smoking is still a prevalent habit even though it is a known cause of many deadly health problems. I hope that this review of the harmful effects of tobacco on the body will help a few more of my patients decide to take action and make a plan to quit!


Of the 250 harmful ingredients in tobacco products, these are a few of the infamous toxins and carcinogens that you may recognize: arsenic, benzene, nickel, chromium, cadmium, beryllium, hydrogen cyanide, carbon monoxide, ammonia and formaldehyde.

Smoking causes cancer of the lungs, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach, and cervix as well as acute myeloid leukemia. It also causes heart disease, peripheral vascular disease, strokes, chronic obstructive lung disease (COPD), emphysema, asthma, chronic bronchitis, aortic aneurysms, and hip fractures. These are all devastating illnesses that can cause severe disability and even premature death.

Most alarmingly, smoking is THE leading cause of premature, preventable deaths in the U.S. and over 440,000 people die each year from tobacco-related diseases. By simply kicking the habit at the age of 30, you can reduce your risk of dying of one of these tobacco-related diseases by 90 percent! If you quit by 50, you reduce your risk 50 percent. If you quit at 60 or older, you will live longer than those who continue to smoke.

If you have family, think about your loved ones. It is estimated that someone living with a smoker has about a 30% increased risk of getting lung cancer or heart disease. Children living with a smoker have an increased risk of SIDS, infections, and asthma.

The first step in quitting is wanting to quit. The nicotine in tobacco products is highly addictive, and the addiction is similar to that of heroin or cocaine. In order to beat this addiction, you need to be very motivated, and carefully plan the removal of tobacco from your daily life, and seek help. You will likely have relapses, but keep on trying.

To help you quit your tobacco addiction, list your smoking habits and examine why and when you smoke, list your reasons for quitting, choose a quit date that is important to you, and be sure to enlist family and friends to help you. Choose low calorie substitutes for when you crave tobacco such as gum, hard candies, or celery sticks. Drink lots of water. Exercise daily to reduce your cravings, manage stress, and avoid weight gain.

The symptoms of nicotine withdrawal can be more than just craving. Be aware that you may have anxiety, tension, restlessness, frustration, difficulty concentrating, difficulty sleeping, drowsiness, headaches, increased appetite, irritability or depression. Wean yourself slowly by using nicotine gum, patches, spray or inhalers. If you find that doesn’t help, you may want to see your physician about an antidepressant for a short-term aid.

For more ideas go to www.smokefree.gov where you can find a Step-by-Step Quit Guide, Live Support by trained counselors, and cool Tools such as the QuitGuide mobile app that sends encouraging texts and tips to your phone 24/7. There is even an online savings calculator to find out how much money you can save! Buy yourself something special as a reward. You deserve it!

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 

Flu or Cold? by Richard Lu, M.D.



The flu and the common cold are both respiratory illnesses but they are caused by different viruses. Because these two types of illnesses have similar flu-like symptoms, it can be difficult to tell the difference between them based on symptoms alone. In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense.  Recovery from the flu can range from a few days to several weeks.  There are special tests that can be done within the first few days of illness, when needed to tell if a person has the flu. 
 
Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations. 

Just a friendly reminder, do not forget your flu shot this year!
 
Content source: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD) cdcinfo@cdc.gov

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 

 

The Flu by Nathan Kiskila, M.D.

The flu season is unpredictable and can start as early as October and continue to occur as late as May. The flu is a virus in the nose, throat and lungs. The flu is stronger than a common cold and comes on very quickly. Chills, fever, headache, sore throat, runny and stuffy nose, body aches, muscle aches, weakness and fatigue are common symptoms. The flu usually resolves in a few days.  Tylenol or ibuprofen for fever can be helpful for symptom relief in addition to drinking clear fluids, and getting plenty of rest.

Sometimes the flu can precipitate infections such as bronchitis, pneumonia, ear infections and dehydration which may require medical treatment. The flu can be worse in young or older people, and also those with other medical conditions such as asthma or diabetes. The flu is contagious so stay away from others, wash your hands often, don’t touch your eyes, nose or mouth, and get enough rest. Sometimes a medicine called Tamiflu (prescribed by a healthcare professional) can help shorten the duration of symptoms. If you want to be tested for the flu, see your doctor.

Who should get the flu shot?  According to the Centers for Disease Control and Prevention (CDC), everyone older than 6 months should get the vaccination.  It is advised to get it as soon as it becomes available.  After receiving the shot, it will take approximately 2 weeks to become fully protected.  Protection will last for about a year.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

 

Disaster Planning by Lynn Stanton, M.D.

Dr.-Stanton-224x300For those of you who are wondering how to cope with disaster planning, there are reasonable solutions which do not require a PhD.

General Prep for a Disaster:

More than likely you will be able to stay in your own home.  The authorities can caution you about the dangers of staying, but they cannot force you to leave.  Once you leave, they cordon off the area so you cannot return.  To prepare yourself and family to hunker down, assume that all utilities such as water, power, phone lines, and wireless service will be turned off and prepare accordingly.

In preparation, be sure to know all of your neighbors.  Be aware of who is able to help, who will likely need help, and who can be a runner and message carrier.

Store one gallon of water per person per day.  You may need water to flush toilets if they are still working. 

Have canned or boxed food that does not require cooking available.  For instance, cereal, beans, tuna, fruits, are good to have on hand if a disaster strikes.  If a heat source is available (i.e. bbq, stove, etc…), then dry foods such as rice, pasta or potatoes are nutritious choices to have on hand.

Always have first aid equipment.

Fire fuel such as wood, gasoline, and oil is important to have handy.

When you are able to stay in your home, (even if damaged), it is likely that your neighbors will need help.  If you have extra water or food please share with others until help arrives.

Tips for a Severe Disaster:

Everyone around you is homeless!  This is a very severe disaster which one hopes to have responders from afar to provide rescue relief.

Do what you can to keep your friends and families in touch.  Do not go to the schools or public places to find your children or friends.  All schools and large facilities have their own readiness plans.  Stay calm, sit down, and try to think of a reasonable plan if you do not have one.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.