Tick Bites

tick bite

In Santa Cruz County, it is reported that less than five percent of the mature Western black-legged ticks and a somewhat higher percentage of the nymphal (baby) stage, carry the Lyme bacteria. Although many people worry after being bitten by a tick, the risk of acquiring an infection is quite low. In this article I’d like to discuss the tick bite and signs and symptoms of Lyme disease.

Neither the tick’s body nor its head burrows into the skin. Instead, the tick attaches by its mouthparts. An infected tick can transmit an infection only after it has been attached, taken blood from its host, and fed for 24 to 48 hours. If you find a tick on you that is unattached and non-engorged, it is unlikely to have transmitted an infection. Look carefully for the immature nymphal ticks, which are the size of a sesame seed. It helps to shower after clearing brush or walking in wild lands.

The proper method of removing a tick is to use a fine pair of tweezers and grasp the tick as close to the skin as possible. Pull it straight out, gently but firmly, without jerking or twisting. After removing the tick, wash your hands and the skin around the bite thoroughly with soap and water.

If, after removal, you see anything remaining in the skin, this represents tiny mouthparts of the tick. It is not the tick’s “head” and it cannot increase the risk of transmission of Lyme disease once the tick body is removed. If you are unable to remove the mouth parts easily, as you would a splinter, leave it alone and the skin should eventually heal. If you are concerned see your doctor.

Quite often, after an obvious tick bite, a red rash may develop at the site of the bite within the first 24 to 48 hours. A rash that develops this quickly after the bite is usually an allergic reaction to the saliva of the tick. It rarely grows beyond 2 inches, needs no treatment and disappears within a few days.

The actual Lyme’s rash, called erythema migrans, is reported to occur in up to 80 percent of infected tick bites. It is described as a red rash that is usually neither itchy nor painful. It develops a few days to a few weeks after a tick bite and is likely to be the first sign of Lyme disease. The rash most often continues to get larger over a period of time and will grow to be well over 2 inches, possibly 8 to 12 inches or more, and may last for several weeks. This rash may sometimes develop a pale appearance in the center, causing a bull’s eye shape.

Either during the time of the rash or shortly thereafter, other symptoms of Lyme disease may appear which resemble these common flu-like symptoms: fever and chills, malaise (achiness), headache, and achy joints.

The rash and/or the above flu-like symptoms may indicate early Lyme disease and you should see your doctor. When recognized during this early stage, most infections can be adequately treated.

If the above symptoms do not occur, are not recognized or are not treated properly, then one might develop late Lyme disease which can more severely affect different parts of the body such as the  joints, the nervous system, and the heart, to mention a few.

The bottom line is that whether you are aware of a recent tick bite or not, if you develop an unusual, unexplainable rash or if you develop flu-like symptoms (without respiratory symptoms), especially outside of the flu season, you should visit your doctor and discuss the possibility of Lyme disease.

Leg Cramps

leg cramps

Most of us have at one time or another had a nocturnal leg cramp. Some individuals suffer frequently from them. Almost anyone can experience cramps, but they are more common in the elderly. Although they are technically harmless, they can be quite debilitating sometimes lasting 15 minutes or more. Most cramps have no obvious underlying cause.

It is believed that cramps may be associated with dehydration, prolonged sitting or a deficiency of certain electrolytes such as magnesium, potassium or calcium. Some medications have also been implicated, including diuretics, oral contraceptives, and beta blockers. Cramps have also been related to conditions such as pregnancy, diabetes and thyroid disorders.

There is weak evidence that B complex vitamins and magnesium supplements may help to prevent cramps. Most food and natural supplements have not been found to be helpful.

What to do for a leg cramp? First try massaging the cramped muscle. Next, try flexing your feet by bringing your toes up toward your knees. Try applying either hot or cold compresses directly to the painful muscle. Lastly, if you’re not in too much pain try to get up and walk around.

Here are some suggestions for reducing the frequency of cramps:

  • Maintain adequate hydration by drinking plenty of water throughout the day. This is especially important if you’ve been working out and/or sweating.
  • Massage and stretch your calf muscles before retiring. For stretching, try standing two or three feet from a wall with one foot forward. Lean forward with forearms up against the wall, keeping rear knee straight with the rear heel flat on the floor. Hold for 20-30 seconds then switch legs and repeat.
  • Loosen or un-tuck bedcovers and sheets at foot of bed in order to give your feet plenty of room.
  • Avoid high heels as well as completely flat shoes. Wear shoes with good support.

In the past, quinine was traditionally used as a treatment for leg cramps, but due to its dangerous side effects, it is no longer recommended. In fact quinine products are no longer sold over the counter.

If you have tried all the above suggestions and still suffer from nocturnal leg cramps, see your doctor.

Smartphone Medicine

smartphone medicine

It is estimated that one in five Americans have a health ‘app’ on their smart phone. One of the first uses of such an ‘app’ was to monitor vital signs such as a runner’s heart rate, by connecting a sensor from the body to a smart phone.

Smart phones are already in use to take blood pressure and even do an EKG. Currently in development is a product called iTest which will begin by testing for strep throat. This is done by swabbing the throat, placing the swab into a vial of liquid, which is then placed into the iTest device, and in turn, is plugged into the phone to be analyzed.

The producers of iTest are also developing tests for HIV and MRSA, a common infection that is particularly difficult to treat. They are also working on tests for the flu, malaria and sexually transmitted diseases. Another test can detect troponin which will help verify if someone has had a heart attack. The iTest is anticipated to sell for about $150 plus the test kits.

Other tests may soon be integrated with the cell phone. For blood, it includes cholesterol, potassium, hemoglobin, kidney, liver, and thyroid function, and some toxins (poisons). For urine, it can test for infections, protein, and HCG (a hormone to monitor high risk pregnancies.) Saliva can be tested for influenza. It will even test one’s breath for alcohol level, heart failure, and drugs like marijuana, cocaine, heroin, and amphetamines. In development are tests for certain cancers such as lung, ovarian, breast, and prostate, which will be detected by analyzing one’s breath.

In the works are ‘apps’ that will allow one to wear wireless sensors to detect blood oxygen and blood glucose levels, blood pressure and heart rhythms. This information can be sent to your health care provider.

We now have the ability to take a picture of a rash with a smart phone and download an ‘app’ to process the image and receive a text with the most likely diagnosis. Then it will advise whether you can treat it yourself, or if you should see your doctor.

Also in development are hand held devices that can take X ray, MRI, and ultrasound images which will incorporate the use of smart phones.

The goal of the smart phone in medicine is not just for an individual’s use. It has tremendous applications for use in third world countries as well as remote and resource poor areas. Some of the information I have provided may seem quite farfetched, but I do believe it will become a big part of our future.


probiotics, digestion

Probiotics are microbes (bacteria) that are believed to provide health benefits when consumed, and can be found in certain foods or supplements that contain them.

Let’s consider the human lower intestinal tract, which is home to some 100 trillion microbes. This is ten times the total number of cells that make up the entire human body. These microbes are considered “good bacteria” and help to digest food, fight some harmful bacteria, and according to some research, may help boost the immune system.

An imbalance of good and bad bacteria in your intestines can make you sick. The most common problem from this imbalance comes when we take antibiotics, which can kill the good intestinal bacteria leading to diseases that cause diarrhea. It’s fairly common to have an episode of diarrhea during or after taking an antibiotic. Recent studies have shown a significant decrease of antibiotic associated diarrhea when taking probiotics during and up to a week after taking antibiotics. For greatest effectiveness, do not take probiotics within two hours of taking an antibiotic.

Probiotics may also help traveler’s diarrhea as well as diarrhea caused by the common “stomach flu.”

Some other health related conditions have been thought to also be helped by taking probiotics. However, there are few good scientific studies to substantiate these claims. Some of these conditions are:

  • Ulcerative colitis and Crohn’s disease.
  • Celiac disease and lactose intolerance.
  • Constipation and irritable bowel syndrome.
  • Bacterial vaginal infections.

Probiotics are thought to be generally safe for anyone, but due to a rare risk of infection, those with a known immune deficiency or anyone being treated for cancer should avoid them.

Some foods that contain probiotics include yogurt, a fermented dairy drink called Kefir, and some fermented vegetables such as sauerkraut and pickles. While they may contain probiotics, there’s no guarantee that they have them in the amount or type that may have health benefits. Only dietary supplements containing probiotics have been tested and may be helpful.

Most supplements contain freeze dried bacteria which come alive in your digestive system. These products can be found at most drug stores, supermarkets, heath food stores, and online. They come as tablets, capsules, or as a powder.

You need to look for a product that hasup to 10 billion colony forming units per day in a single dose. Check for the expiration date for the live bacteria found on the label and follow directions for proper storage.

In summary, although probiotics are touted for treatment of a variety of conditions, the only treatment which seems to hold up to scientific scrutiny is to help prevent antibiotic associated diarrhea. That being said, there appear to be no significant side effects or known health problems for healthy adults who use probiotics for other conditions.

Although there are a number of products on the market, from my research, three commonly used probiotics which have some evidence of being helpful are Culturelle, DanActive, and Florastor.

Talk with your doctor if you have any questions about the use of probiotics.


The benefits of exercise are no longer theoretical. All recent studies concerning exercise and its effect on people conclusively state that exercise will help most people live longer and healthier lives. Whether you are young or old, overweight or underweight, or even if you have a disability, exercise will benefit you.

Most of us at any age wish we were more fit. Becoming older doesn’t mean we have to become weaker and more fragile. Most physical changes of aging are due to inactivity and lifestyles that do not include regular exercise. Becoming and staying physically fit is the most important thing we can do to maintain our ability to continue doing the activities we now enjoy. The more fit one is, the more independent one may remain, as well as being happier and more satisfied with life.

It’s truly never too late to begin a fitness program of regular exercise. In this article I would like to list the beneficial reasons of exercising and also give valid reasons for not putting it off any longer.

Reasons to exercise:

  • Live longer. Those who exercise regularly have been proven to add years to their lives.
  • Help to lose weight. Combined with proper diet one will lose weight.
  • Strengthen your heart. A stronger heart pumps blood more efficiently and doesn’t have to beat as fast.
  • Lift your mood. People who exercise tend to be happier and less depressed.
  • Improve chronic conditions. Exercise has been found to lower blood pressure and to improve diabetes and arthritis.
  • Defend against illness. Exercise can boost the immune system and help fight off illness, especially flu and colds.
  • Improve stamina. Exercise can provide more pep and energy and less fatigue.
  • Improve circulation. Exercise can improve our blood cholesterol and help keep our arteries clear.
  • I say so. Just wanted to see if you’re paying attention. I really do exercise, bicycling and swimming, and I feel so much better for doing so.

Overcoming excuses for not exercising:

  • Not enough time. Wake up earlier. Do several shorter periods of exercise throughout the day. Drive less, walk more.
  • Tried it before didn’t work. Set realistic goals. Pace yourself. Reinforce in your mind the benefits of exercise.
  • I might injure myself by exercising. Start with a beginning exercise group. Pace yourself. Consider working with a trainer.
  • It’s too expensive. Joining a gym or having expensive equipment at home would be nice, but are not necessary. Watch an exercise video at home. Try just plain walking or climbing stairs.
  • I’m not athletic. Most people are not particularly athletic. It is not a prerequisite for routine exercise. Anyone can and should exercise.
  • It’s just too much work. If exercise is just too much to do for your own good, then do it for those who love you. They will have you around longer, and will enjoy your health and happiness.

Sun Protection


I’d like to make my annual plea for the liberal use of sunscreen to protect all of us — young and old — from the damaging effects of the sun.  Please understand that the “healthy” bronze tan color that many people seek is actually how the skin demonstrates that it has been damaged by the sun.

The sun produces two types of invisible light. One is ultraviolet A (UVA), which is the ray that produces a tan but causes skin damage and aging, (think wrinkles and “old age” skin spots). The other is ultraviolet B (UVB), which causes the uncomfortable sunburn.

Both types can cause skin cancer, especially the deadly melanoma. This year in the U.S. there will be approximately 76,000 new cases of melanoma with some 9,000 deaths. These statistics can be reduced significantly by protecting our skin from the sun.

The damaging rays from the sun are most intense between the hours of 10 AM and 4 PM.

These are my suggestions:

  • Always start the summer season with a new fresh tube of sunscreen; price has nothing to do with performance.
  • Use a sunscreen with an SFP rating of at least 30. Higher than 50 is probably not necessary.
  • A sunscreen should be labeled “broad spectrum” protecting against both UVA and UVB and be water/sweat resistant.
  • Use at least 1 ounce (2 tablespoons) for your entire body, and apply liberally to the face, ears, and neck.
  • Don’t overlook applying to feet, back of neck, and bald spots.
  •  Apply at least 20 minutes before sun exposure and every 2 hours thereafter and more frequently if swimming or sweating profusely.
  • Avoid using sunscreen sprays on children as they can inhale the chemical ingredients. Use the lotion form only.
  • Whenever possible, wear light colored tight knit clothing and brimmed hats while in the sun.
  • Avoid tanning salons where damage — similar to the effects of the sun — can be done to the skin.

A sunscreen that has always been a favorite of mine, and one just recently highly recommended by Consumer Reports Magazine, is a brand called “NO-AD.” This product comes with an SPF of either 30 or 45, and is one of the cheapest sun screen products on the shelves.

Enjoy your outdoor summer activities, but do yourselves and especially your children a favor, and protect your/their skin from both damage and cancer by properly using a good sunscreen product.


Atrial fibrillation is an irregular often rapid heart rate, causing the heart’s two upper chambers to quiver instead of beating regularly. Fortunately, the lower two chambers still work normally and are able to pump the blood out of the heart, although not as efficiently.

It is this inefficient pumping that can cause the frequent symptoms of palpitations, shortness of breath, weakness, and lightheadedness, to name a few.

Atrial fibrillation is the most common heart arrhythmia. It is found in over 6 million Americans and accounts for some 90,000 deaths annually. It occurs in about 1-percent of individuals in their 60s, and increases to 12-percent for adults who are in their 80s. Some 30-percent of people with atrial fibrillation are unaware of their condition.

Atrial fibrillation can be brought on by increasing age, prior coexisting heart disease, high blood pressure, thyroid disease, and drinking alcohol. It can come and go, or it can be chronic and permanent. It is usually not life threatening, but it is a serious condition and needs to be treated.

There are two main goals in the treatment of atrial fibrillation. First is to attempt to control the rhythm, that is, get the rhythm back to the normal beating pattern. If a normal rhythm cannot be obtained, then the second goal is to control the heart rate. Ideally one would want to have the rate 80 beats per minute or below. Both of these goals can be accomplished with medication.

If one is very symptomatic or has relatively new onset atrial fibrillation, the heart can be electrically treated with a small electrical shock while under brief anesthesia. This treatment however, is rarely a permanent solution.

One of the main problems with atrial fibrillation is the chance of having a stroke. Blood clots can form in the quivering upper chambers. If a clot breaks loose it can go to the brain, causing a stoke.

This can be prevented by taking a blood thinning medication. Another complication is heart failure due to a weakening of the heart muscle.

There is a new advanced procedure called ablation. In this case a catheter is inserted in a large blood vessel in the groin and threaded up into the heart. Through highly technical computerized imaging, the trigger area for the fibrillation in the upper chamber is identified and lightly burned with high frequency radio waves. This destroys the area where the abnormal impulses of atrial fibrillation are generated. The success rate for this procedure is around 70-percent initially, and up to 90-percent if a second procedure is necessary.

Many people with atrial fibrillation are living relatively normal lives today when properly managed. It is a condition not to be feared, but to be monitored closely and treated appropriately by your doctor.


Get every new post delivered to your Inbox.

Join 75 other followers