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Archive for March, 2011

There has been much hype about radiation danger since the recent tragic events in Japan. Right off the bat let me dispel several common fears.  As of this writing there is absolutely no need for anyone on the west coast to take potassium iodide pills to prevent thyroid cancer. There has been no significant increase in the local levels of radioactive iodine here on the West Coast, and unless conditions at the Fukushima plant radically change, it is unlikely that we will receive dangerous levels here.

Why are people talking about taking potassium iodide pills? Medical documentation of the health effects from exposure to atomic test fallout demonstrate that exposure to radioactive iodine played a key role in the development of thyroid cancer and some forms of leukemia as well.  Potassium iodide, if taken before exposure to fallout, helped to block the uptake and reduced the chance of developing cancer. However, ingestion of potassium iodide also has its own adverse health risks. So it only makes sense to take this preventative measure if advised, that is if we know for sure that dangerous levels of fallout are headed our way.

While winds do blow from Japan east to our shores, wind, rain, and time do take a toll on these toxic plumes, with only trace amounts reaching this coast. Given the current air quality, our locally grown food, especially milk, milk products, and fresh produce remain safe to consume. Again, radioactive levels on the coast have not changed significantly. Areas in northeast Japan are, so far, the only reported areas of concern.

And in the event that Japan’s nuclear disaster does further deteriorate, most authorities agree that the worst case scenario for California would be increasing levels of radioactive compounds, but at extremely small levels that would cause us no harm. We, as a society, had greater radioactive exposure during nuclear bomb testing in the 1950-70s than we have now or might possibly expect under Japan’s worst case scenario.

It is well demonstrated that too much radiation exposure can cause cancer many years later and that the young are at greatest risk. What is not known is how much or how long of an exposure to radiation is risky. Researchers can’t just count cancer cases after a disaster and draw any conclusions as to whether radiation was actually the cause. Cancer rates before and after a disastrous exposure must be compared to know if more cases occurred than would be expected, and even then conclusions are often controversial.

Truth be told, we as a society should worry more about the toxic effects to our bodies from exposure to tobacco products, alcohol and illicit drug use, than we should worry about health risks from current radiation exposure. So what’s my health advice in these times of stress? Take the time to be informed, eat healthy, be active, and be happy.

My next article will explain how radiation affects our health.

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Meningitis

Recently, a well-known local high school coach made the news with the announcement that he had been admitted to a hospital for treatment of viral meningitis. Thankfully, other than feeling very miserable for awhile, he has had a full recovery.

So just what is meningitis? It is an inflammation of the meninges which is the membrane that surrounds the brain and spinal cord. It is usually caused by an infection from a virus or from bacteria. Although not very contagious, meningitis can be spread by very close contact with someone who has meningitis. It is spread via respiratory droplets from sneezing or coughing or in the case of young children, the germs can be passed through the stool.

Viral meningitis is the more common of the two and is the less serious one. It rarely has any complications. It is treated by taking care of the symptoms either at home or, if necessary, in the hospital.

Bacterial meningitis, on the other hand, can only be treated in the hospital with an intravenous antibiotic. If not treated, or if treated too late, this bacterial infection can lead to brain damage or, rarely, death. Of the two, bacterial meningitis is the more serious infection.

Meningitis is most often caused by germs from a cold or sinus infection, but can also be caused by germs that have entered the blood stream from other areas of the body. As with most contagious diseases, the best ways to lessen the chance of spreading infection are to wash hands frequently, cover your cough or sneeze, and try to stay healthy through proper exercise, diet, and rest.

Most cases of viral meningitis occur in the young. In the past, bacterial meningitis also affected the young, but the last few decades, as a result of protection caused by routine childhood vaccinations, the average age at which bacterial meningitis is diagnosed changed from 16 months to 25 years.

The most common symptoms of meningitis are:

– High fever

– Stiff neck

– Severe headache

– Nausea and vomiting

– Lethargy/confusion

– In infants: poor feeding, constant crying, and excessive sleepiness or irritability.

The most important test for diagnosing meningitis is the spinal tap. This procedure brings up some dreaded images for most people. In the hands of a competent experienced physician, a spinal tap is relatively painless. Other than a possible temporary headache, there are usually only rare complications from a spinal tap. This is the only way to confirm the diagnosis of meningitis and to help guide the treatment of this disease.

Of special note is a type of bacterial meningitis caused by the germ called meningococcus. This also spreads from an upper respiratory infection entering the bloodstream. This is very contagious and mostly affects college students living in dormitories. It also can be found at boarding schools and military bases. Pediatricians recommend that all children between the ages of 11 through 18 should receive the meningococcal vaccine to prevent this serious infection.

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Reflections on Loss

My friend Syd died the other day. Sydney “Pops” Osenga was 94 years old and a resident of Mount Hermon since 1963. I first met Syd about 15 years ago, when he was a patient of mine. I felt a kindred spirit with him, and we struck up a friendship that grew over the years.

Syd was in robust health until just over a year ago, when his beloved partner and wife, Millie, died, and shortly thereafter he had a mild heart attack and never really regained the vitality that he was known for. He was at a loss without his Millie and couldn’t understand why God kept him alive. I continued to encourage him and told him how much his son needed him and how happy I was that he was still around, because I enjoyed his friendship. Still, he wanted to be with his Millie.

Two days after my last visit, he died after a swift 48-hour illness. Was it another heart attack? We’ll never know for sure. I personally think he died of a broken heart, which I’m sure is not listed in my book of medical diagnoses. Whether it’s an official diagnosis or not, I think that’s what ended his life.

I’m not only dealing with Syd’s death. I’ve also just recently lost two other friends who were close to me.

Several weeks ago, 92-year-old Dr. Sam Marx died at his home in North Carolina. Sam was my mentor when, as a young doctor in the late 1970s, I worked with him at his mission hospital in the jungles of Honduras in Central America. Together, we delivered babies (I delivered twins by kerosene lantern one night), treated victims of rattlesnake bites, and helped patients with malaria, tuberculosis, dengue fever, severe malnutrition and all sorts of diseases I haven’t seen since then. Sam spent his whole career caring for the Miskito Indians of Honduras and Nicaragua, and I am honored to have worked at his side. He is now with Syd. They both knew where they were going after this life.

The other friend was Dr. Michael Hill of Marshalltown, Iowa. Mike was just two days older than me, both of us joining the Medicare crowd this past year. Mike and I met on our very first day of internship at the Santa Clara Valley Medical Center in San Jose in 1971. We were both Midwesterners: Mike was from Iowa, and I was from Wisconsin. We became fast friends and shared many remarkable and unforgettable experiences. After we spent a number of years together, we parted ways. I remained in California, and Mike, with his wife and kids, moved back to Iowa, where he became a well-known and a very sought-after head-and-neck surgeon. Two weeks before Christmas, I received a call from his daughter informing me that my old buddy Mike had died suddenly. He also appeared to have had a heart attack. At age 65, he left us way too early.

Why am I writing about these experiences? I know that we all come face to face with the death of those whom we love. I have patients talk to me about this all the time. We all have our own ways of dealing with grief. There are countless books and articles written on the subject, most of which just don’t seem to provide satisfying answers. I’ve come to believe that there is a creator, who made us, loves us, placed us on Earth and gave us a life span that can be long or short. The timing of our lives is all part of a master plan that I am not yet capable of understanding.

I’ve seen a lot of death and dying in my career and among family and friends. From this, I have learned that we, who are living, have to appreciate the life and health we have, and value each and every day that is given to us. Life is such a precious gift.

To Syd, Dr. Sam and buddy Mike, all I can say is I will see you later.

Read more:Press-Banner – Your Health Reflections on loss

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Bedbugs

“Sleep tight and don’t let the bedbugs bite” was something I repeated every night after my prayers when I was a child. Bedbugs did not pose a threat back then but they are a potential problem now. Brought on perhaps by more international travel and the banning of the pesticide DDT, these creepy little insects are now showing up in cities throughout the country, and even in Santa Cruz.

The risk of exposure to bedbugs is greatest if you spend time in places with high turnovers of night-time guests, such as hotels and hospitals. The bedbugs may not only feed off of you during your overnight visit but they can get into your luggage and you could bring them home with you.

Bedbugs, which are reddish brown and about the size of an apple seed, need a blood meal in order to survive. They come out from hiding during the night to feast on their victim. Once they have their meal they crawl back into their hiding places. Fortunately, it appears that they do not transmit disease to their human hosts.

These little creatures are hard to find. During the day, bedbugs hide in small cracks and crevices of mattresses, box springs, headboards, bed frames, floors, and walls. To find evidence of bedbugs look for either the actual bug itself, or for small back specks which the bugs leave behind. If you think you are being bitten by bedbugs, you may find little spots of blood on your sheets.

The bites are usually small red lesions, can be arranged in a line or in a cluster, are often located on the face, arms, hands, and neck.  They can be very itchy.

In order to prevent bedbugs from coming home with you, I suggest the following when traveling:

  • Never put your luggage on the bed or the floor near the bed. Put suitcases in the bathroom or on the night stand.
  • Examine the bed by checking around the seams of the mattress and box spring as well as the joints of the head board and frame.
  • Live out of your suitcase, don’t use the dresser.
  • Demand a different room if you see evidence of bedbugs and check that room as well.

Upon returning home, open the suitcase in the garage, porch, or outside.  Wash all clothes in hot water and vacuum out the suitcase and store it in the garage.

If you find evidence of bedbugs in your home your best bet is to contact a licensed pest control company for treatment options. Remember that the most important thing is to keep them out of your house in the first place.

Sleep tight.

 

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