heat summer

Beware the Danger of High Temperatures

May 30th is Heat Safety Awareness Day, so our concierge family doctors at MD 2.0 in Jupiter want to take this opportunity to acquaint you with this important health concern. The fact is, heat is a killer, and we here in south Florida need to pay particular attention to the danger high temperatures can present.

Heat exhaustion, heat stroke, and dehydration are some of the leading weather-related killers. For example:

  • A 1980 heat wave killed more than 1,250 people.
  • In 1995, a heat wave in Chicago took more than 700 people (the deadliest weather event in Chicago history).
  • In August 2003, a record heat wave in Europe claimed an estimated 50,000 lives.

 

Some people are more susceptible to negative effects from the heat. These include:

  • people 65 and older, who are less likely to sense and respond to changes in temperature;
  • people with chronic medical conditions, who may be taking medication that can worsen the impact of extreme heat;
  • infants and young children; and,
  • outdoor workers and athletes, who may be more likely to become dehydrated, particularly in extreme heat.

It’s vital to know the difference between heat exhaustion and heat stroke, the warning signs for each, and what to do in the event you or someone else experiences them. You should also know how to avoid these serious conditions.

 

Heat exhaustion

The Centers for Disease Control and Prevention (CDC) says muscle cramping might be the first sign of heat-related illness. It lists the warning signs of heat exhaustion as:

  • heavy sweating
  • weakness
  • cold, pale, clammy skin
  • fast, weak pulse
  • nausea or vomiting

If you or someone you’re with experiences these symptoms, you should move to a cooler location, lie down and loosen your clothing, apply cool, wet cloths to as much of your body as possible, and sip water. If you have vomited and it continues, seek medical attention immediately.

 

Heat stroke

The signs of heat stroke are:

  • high body temperature (above 103 degrees)
  • hot, red, dry, or moist skin
  • rapid and strong pulse
  • possible unconsciousness.

This is a medical emergency. Call 911 immediately. While waiting for the ambulance, move the person to a cooler environment, and try to reduce the person’s body temperature with cool cloths, or if possible, a cool bath. Do NOT try to give fluids.

 

Stay safe in the heat

Following are steps you can take to avoid experiencing either of these potentially deadly conditions.

Limit outdoor activity. The sun is hottest from 11 a.m. (D.S.T.) to 3 p.m., so try to stay indoors, or at least in shaded areas, during those times. If you must be outdoors, take frequent breaks, preferably in air-conditioned environments, and, if possible, take cool showers or baths to cool down.

Dress appropriately. Wear loose, lightweight, light-colored clothing. Wear a hat with wide brim.

Stay hydrated. Drink water frequently, from two to four cups of water every hour. Don’t wait until you’re thirsty to drink, because by then you’ve already started to dehydrate. Monitor urine color: If your urine is dark, you’re not drinking enough water. Urine should be light yellow or clear. And avoid alcoholic drinks, which can not only impair judgment regarding time spent in the heat but also dehydrate you.

Check the car. Despite all the awareness and warnings in the last few years, more children—51—died in hot cars in 2018 than any year on record. It happens to the most conscientious parents who simply have too many things on their minds. When transporting children, place something necessary—a purse or briefcase—next to the child. Keep car doors locked and never allow children to play in a car. And countless numbers of pets die when owners leave them alone in a hot car “just for a couple minutes.” Never leave pets alone in a closed car, even for a few minutes.

 

Check with us to see whether any medical conditions might make you more susceptible to heat.

unhealthy food

Our Diets Are Killing Us

Question: What causes more deaths worldwide than smoking?

Answer: Food. And it’s not tainted food; it’s the unhealthy food we put on our plates every day.

Our concierge primary care doctors in Jupiter have told you many times about the importance of a healthy diet. Now a new study published this month in the journal Lancet warns that as a species, we don’t eat properly, and we’re paying for it.

“In many countries, poor diet now causes more deaths than tobacco smoking and high blood pressure,” Ashkan Afshin, lead study author, told CNN.

Afshin is an assistant professor at the Institute for Health Metrics Sciences at the University of Washington.

And it’s not just the bad things we eat—salt, red meat, sugar—that are contributing to premature deaths around the world; it’s the good things we don’t get enough of: fruits, vegetables, nuts and seeds, and so forth.

“Poor dietary habits . . . overall cause more deaths than any other risk factors globally,” Afshin told CBS News.

Dietary risk factors

The study took place over 27 years in 195 countries. Israel had the lowest number of diet-related deaths, followed by France, Spain, Japan, and the principality of Andorra. Uzbekistan had the highest, with the U.S. ranking 43rd out of 195.

The study results attributed one in five deaths (about 11 million people) annually around the world to the following dietary risk factors:

  • high sodium
  • low whole grains
  • low fruit
  • low nuts and seeds
  • low vegetables
  • low fiber
  • high trans fats
  • high sweetened beverages
  • low legumes
  • high red meat
  • high processed meat
  • low calcium
  • low milk
  • low omega-3s
  • low polyunsaturated fatty acids

Note: Omega-3 fatty acids are found in seafood. Polyunsaturated fatty acids are found in some nuts and seeds, salmon, and vegetable oils.

Healthy beats unhealthy

In their analysis of the 15 dietary factors, researchers found that the lack of healthy foods was worse than consumption of unhealthy foods. In other words, not eating fruits, vegetables and so forth was responsible for more deaths than eating red meat, processed foods, and the like.

As a result, Afshin recommended that policy makers should not just focus on what not to eat, but what to replace those foods with. The study estimated that three million deaths globally could be attributed to high sodium intake, but another three million were caused by lack of whole grains, with two million more caused by inadequate fruit intake.

They estimated that cardiovascular disease (CVD) was the leading cause of diet-related deaths around the world, followed by various cancers and diabetes, all of which were attributed to diet. Of course, other factors—including physical inactivity, environmental, economic, and social factors—contribute as well, according to Bruce Lee, associate professor of international health at Johns Hopkins Bloomberg School of Public Health.

“Diet can contribute to noncommunicable disease (NCDs) via increased body weight and obesity, elevated blood pressure, hyperlipidemia or high levels of fat in the blood, and conditions that lead to high blood sugar levels,” he told The Washington Post. Lee, who is also executive director of the Global Obesity Prevention Center, added that another problem is that “unhealthy foods such as those that are highly processed with artificial ingredients are often cheaper to make, store, ship, and prepare. Therefore, such foods have replaced more natural and healthy foods in foods systems around the world.”

Another factor is the profit motive.

“Refining grains is highly profitable,” Corinna Hawkes, director of the Centre for Food Policy at the University of London, told CNN. “Take corn, for example. You can refine it into different ingredients: animal feed, refined flours, and high-fructose corn syrup, to name three. So manufacturers are generating multiple value streams from this refining process.”

What you can do

As much as possible, try to adhere to a Mediterranean-style diet: abundant amounts of nuts, seeds, fresh fruits and vegetables, use of olive oil in cooking, moderate portions of fish and poultry, and little red meat.

Also beware of marketing claims that a product is “whole grain,” because often a whole grain has been stripped of one or more of its components: the bran, the germ, or the endosperm. Look for the stamp provided by the Whole Grains Council that certifies a product actually contains all three of these components.

And as always, check with us for any questions or concerns you may have about the food your family eats.

protect child from drowning

How To Protect Your Child From Drowning

Drowning is one of the leading causes of death in children. Our concierge primary care doctors in Jupiter, want to emphasize the importance of teaching children not only the rules associated with being in and around water, but how to swim at an early age.

The American Academy of Pediatrics (AAP) recently released updated guidelines recommending swimming lessons for toddlers, revising long-standing guidance against swimming lessons for children under age four.

Start early

The earlier guidelines were based on the belief that children under four could not master the skills required to hold their breath and coordinate their limbs properly to develop adequate swimming skills. There was also a lack of evidence that swimming lessons would help prevent drownings in the under-four age group, as well as the suspicion that swimming lessons for such young children might confer a false sense of security in their parents.

But one study reported that lessons between the ages of one and four produced an 88 percent reduction in drownings. These findings, coupled with the fact that children between the ages of one and four are at the highest risk for drowning, eventually changed the thinking and led to the revisions. Of course, they’re not all going to be mini-Michael Phelps, but the AAP stresses that they can be taught basic water skills and water safety skills.

“Floating, grasping the wall, climbing in and out of the water, turning back to the wall . . . a lot of times children end up falling into the water and they look to the furthest point, and if they just turned around they would be better off,” Katie Lee of the Goldfish Swim School in Long Island, New York, told CBS News.

It’s a matter of allowing very young to feel comfortable in the water, and not panic if they find themselves in it unexpectedly. You can start by holding your baby in your arms, moving them slowly back and forth, allowing them to feel the silky sensation of water on their skin. You can sing to them, and even bob them up and down, reinforcing the feeling that being in water is fun.

Slightly older children can be taught to blow bubbles in the water, thus learning how to avoid swallowing water. You can also teach them how to float on their backs and kick their legs as you hold them up. Formal swimming lessons with a certified swimming instructor can start as early as age one, depending on the child’s physical abilities and emotional development.

Reduce risk

In addition to teaching your child basic water skills, it is critical to be vigilant at all times to prevent a tragedy. Young children can drown in as little as two inches of water, and within 90 seconds without breathing, oxygen in the brain begins to drop. Other experts cautioned that the perception of children flailing around in the water when they fall in is largely myth. Very young children tend to fall in and immediately sink.

“Don’t even run into the house for a second to go to the bathroom or grab the phone,” Dr. Mark Waltzman, a pediatric emergency medicine expert, told CBS News.

Other suggestions from AAP to prevent drowning include the following:

  • Parents should never leave children alone or in the care of another child while in or near bathtubs, pools, spas, or other open water.
  • Empty water from buckets and other containers immediately after use.
  • Never leave young children alone in the bathroom. Toilet locks can prevent drowning of toddlers.
  • Even with older children and better swimmers, the supervising adult should focus on the child and not get distracted with other activities.

Tips for homes with pools include these useful guidelines:

  • Never turn your back on a child in the water, even for a moment.
  • Be sure to install child-proof fencing all the way around the pool. Fences should be at least four feet high, with self-closing and self-latching doors that open outward. Consider door alarms for those that open directly into the pool area.
  • Also remove any structures that would allow them to circumvent the fence, such as ladders and toys.
  • If a child is missing, always check the pool first—seconds count.
  • Empty portable pools when not in use.
  • Always make sure a responsible adult is watching the children playing in or near the pool area (with no distractions, e.g., smartphones off).

If you have questions about age-appropriate swimming lessons and activities for your child, don’t hesitate to contact us.

New Findings Change Aspirin-a-Day Guidelines

Our concierge family practice doctors in Jupiter understand the temptation to pop a pill—whether a prescription medication or a supplement—to stay healthy, instead of following more difficult suggestions regarding exercise and diet.

And to be sure, the long-standing belief that taking a daily low-dose aspirin can prevent heart attacks has some scientific basis for those who’ve already suffered a heart attack. In addition, some earlier research did seem to support daily aspirin use for reducing the risk of numerous cancers as well as Alzheimer’s disease.

Latest findings

But the good thing about science in general and medical research in particular is that researchers are constantly reviewing and refining established knowledge. In the case of the aspirin-a-day approach, for example, several new studies in the last year have challenged the practice of taking a low-dose (81 mg.) aspirin to prevent cardiovascular disease (CVD). And this month the American College of Cardiology (ACC) and the American Heart Association (AHA) released new guidelines recommending against the use of daily low-dose aspirin, based on these studies.

One study published last month in the Journal of the American Medical Association (JAMA), for example, found that people without heart trouble who took a daily dose of aspirin had a lower risk of heart attack, stroke, and death. These benefits, however, were canceled out by the increased risk of bleeding in the intestinal tract or the brain, which can often be deadly.

Researchers in that study performed a meta-analysis of 13 studies that included 164,225 participants, none of whom had CVD when the studies began.

“For every 256 patients treated with aspirin for five years, one heart attack, stroke or death from cardiovascular disease would be prevented,” Dr. Sean Zheng, lead author of the study and and academic clinical fellow in cardiology at King’s College Hospital in London, told CNN. “On the other hand, for every 210 patients treated with an aspirin over the same period, one would have a serious bleeding event.”

“This calls into question the net benefit of taking aspirin, and whether people who have not previously had cardiovascular disease should take aspirin,” Zheng said.

Another study published last fall in the New England Journal of Medicine (NEJM) reported similar results, even finding that older patients experienced no health benefits at all from daily aspirin use. These and other recent studies are what led to this month’s revised recommendations from the AHA/ACC.

“We knew there would be an increased risk of bleeding with aspirin, because there has always been,” recommendations co-author Dr. Anne Murray told NBC News. “But not only did it not decrease risk of disability or death, it did not decrease the risk of heart attack and stroke, and there was an increase in the rate of death.” Murray is also a geriatrician and epidemiologist at the Hennepin Healthcare Research Institute and the University of Minnesota, Minneapolis.

In their statement, the AHA/ACC advised against taking a preventive aspirin a day, saying it may actually cause more harm than good.

“We’re talking about healthy people who don’t have known heart disease or stroke, who might have been considering or [are] already taking an aspirin to prevent that heart attack or stroke in the first place,” said Dr. Erin Michos, another of the authors of the new AHA/ACC guidelines.

The AHA stressed that the new recommendations do not apply to people who have already had a heart attack or stroke, or who have undergone such procedures as receiving a coronary artery stent or bypass surgery. But for the elderly (people over 70) and those with a high risk of internal bleeding, the AHA cautioned that “aspirin may do more harm than good, but there are no absolutes, so these decisions need to be tailored to individuals.”

Another co-author of the revised recommendations suggested that doctors might advise their patients who have a strong family history of heart disease to take a daily aspirin. This could also apply to those whose tests reveal considerable plaque build-up in their arteries. But for those with a low or moderate risk, lifestyle changes could have a more salient effect.

“Eat a heart-healthy diet, get regular physical activity, control blood pressure and control cholesterol,” Michos said. “If [people] need a statin, take it. Those are much more important when compared to recommending aspirin.”

As with so many other over-the-counter remedies, we always recommend you check with us before taking them. Each person is different and their needs and sensitivities are also different. We can help determine the best course for you.

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