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Archive for September, 2015

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.

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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.

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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.

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