Lightning

Lightning: Deadly But Avoidable

Holiday Safety, Lifestyle

Labor Day is coming up, signaling the unofficial end of summer. Kids will be heading back to school and families will be trying to get as much outdoor fun into the waning days of the season as possible.

But as you go about your last-minute recreation, there’s a rare but deadly danger that our concierge primary care doctors in Jupiter want to warn you about: lightning.

Our state is known as the “Lightning Capital of the U.S.” More people die from lightning strikes in Florida every year than in any other state, and the southeastern coast of the state is second only to the Tampa area in reported fatalities.

That’s why we want to remind you that these tragic deaths can be prevented, as long as you know how to avoid them.

Recent deaths

Lightning kills an average of 23 people every year. So far this year, 12 people have been killed by lightning, including a 27-year-old man doing lawn maintenance in New Smyrna Beach, Florida, and a soldier on a training exercise at Fort Gordon, Georgia, both in July.

The most recent deaths occurred this month in Washington, D.C., in Lafayette Park just north of the the White House, as the victims huddled under a tree for protection from a sudden severe thunderstorm.

One was a 29-year-old bank vice president in town on business. The others were a Wisconsin couple celebrating their 56th wedding anniversary. All three were killed, while another woman who was also struck remains in critical condition.

They were struck by an unusual six-prong bolt that hit the same place within half a second, creating a ground current.

According to the National Weather Service (NWS), “When lightning strikes a tree or other object, much of the energy travels outward from the strike in and along the ground surface.”

“This is known as ground current. Anyone outside near a lightning strike is potentially a victim of ground current,” the agency adds.

Five potential paths 

A ground current discharge is one of five ways people can by struck by lightning.

The five are:

Direct strike – These most often occur to victims who are in open areas. While the most deadly type, it’s not as common as the other four.

Side flash – Also called a “side splash,” these occur when lightning strikes a taller object near the victim and a portion of the current jumps from the taller object to the victim.

Ground current – This type, mentioned above, causes the most lightning deaths and injuries, including to farm animals. 

Conduction – Lightning can travel long distances in wires or other metal surfaces, because the metal provides a path for the lightning to follow. This type is the way most people are killed indoors during a lightning storm, including when they’re taking showers, washing dishes, or talking on corded phones. 

Streamers – While uncommon, streamers can injure or kill when a side bolt separates or rebounds from the main or leader bolt and discharges.

Lightning safety rules

To stay safe from lightning, the NWS offers these guidelines to avoid being struck by lightning.

  • Appoint someone to watch the skies during your outdoor work or recreation. Check the latest thunderstorm forecast and monitor the NOAA Weather Radio.
  • When lightning is in your vicinity, go quickly inside a completely closed building. Do not consider carports, open garages, covered patios, or pavilions adequate shelter.
  • If no closed building is convenient, get inside a hard-topped, all-metal vehicle and be sure the windows are completely closed.
  • Do not take shelter under a tree, especially if it is tall and isolated.
  • Get out of the water. This includes pools, lakes, rivers, oceans, water rides, and even puddles. And leave the beach immediately if you see or hear a thunderstorm approaching.
  • Put down metal objects such as fishing poles, golf clubs, tennis rackets, tools, etc.
  • Dismount from tractors and heavy construction equipment. Do not seek shelter under the equipment.
  • Move away from metal objects such as metal fences, metal sheds, telephone and power lines, pipelines, etc.

Indoor safety

  • Avoid contact with corded phones.
  • Avoid contact with electrical equipment or cords. If you plan to unplug any electrical equipment, do so before the storm arrives.
  • Avoid contact with plumbing. When thunderstorms are occurring, do not take a shower or bath, wash dishes, or do the laundry.
  • Move away from windows and doors. Do not stay on the porch.

If someone is struck

Call 911 immediately.

  • Determine whether the victim is unconscious. Check to see if they are breathing, and gently roll the victim onto their back.
  • If the victim is not breathing, perform CPR until the paramedics arrive. (A reminder: Mouth-to-mouth breathing is no longer recommended to revive someone; regular chest compressions—between 100 and 120 a minute—are more effective.)
  • Always keep in mind the NWS directive: When thunder roars, go indoors.
pfas

How to Combat the Lingering Danger of ‘Forever Chemicals’

Disease, Environment, Health Basics, Healthy Living, Lifestyle, Nutrition, Preventative Health

They’re called “forever chemicals” because they don’t break down fully in the environment, and this summer the Environmental Protection Agency (EPA) warned that they are more dangerous to human health than regulators knew.

Within weeks, the National Academies of Sciences, Engineering, and Medicine (NAS) weighed in with its own 300-page report on these chemicals, known as perfluoroalkyl and poly-fluoroalkyl (PFAS) substances, urging doctors to test high-risk patients for PFAS contamination.

Because of the heightened attention on these chemicals, our primary care concierge doctors in Jupiter want to summarize for you what we’ve learned about them, and offer tips on how to reduce your exposure.

The Problems with PFAS

In 1946, DuPont introduced its revolutionary non-stick product, Teflon. By 1950, studies by DuPont and 3M showed that PFAS could build up in the blood, but chose to keep these results secret, according to the non-profit Environmental Working Group (EWG).

Since 1998, when a class-action lawsuit against a West Virginia DuPont factory revealed the extent of the pollution from the factory, researchers have found probable links to such diseases as:

  • thyroid disease
  • high blood pressure
  • kidney cancer
  • testicular cancer
  • breast cancer
  • higher cholesterol levels
  • ulcerative colitis
  • weakened immune system 
  • vaccine interference
  • weight gain
  • changes in liver enzymes
  • decreased fertility
  • growth and learning delays in infants and children

The NAS report encourages doctors to conduct blood tests for these chemicals on patients who are worried about exposure or who are at high risk for exposure or who are in “vulnerable life stages”: during pregnancy, early childhood, and old age. 

They’re Everywhere

As we’ve seen with microplastics, PFAS can begin innocently enough and end up in unexpected places, including our water.

Recently, for example, Consumer Reports (CR) tested more than 100 food-packaging products from U.S. restaurants and supermarkets. They found dangerous PFAS chemicals in many of the products, including paper bags for french fries, hamburger wrappers, pizza boxes, molded fiber salad bowls, and single-use paper plates.

These chemicals are used in a wide variety of products, including waterproof and sweatproof makeup, nonstick cookware, cellphones, waterproof clothing, carpets, and—especially—fast-food containers, where their ability to make products grease-proof has led to their widespread use.

They are also used to make products water-repellent and resistant to high temperatures, as well as in fire-fighting foams used at military installations, floor wax, upholstery, and clothing. The qualities that make items containing PFAS so desirable, however, also make them long-lasting in the environment.

Lingering Threat

“These chemicals are ubiquitous in the American environment,” Ned Calonge, an associate professor of epidemiology at the Colorado School of Public Health and chair of the NAS committee that wrote the report, told CNN.

“More than 2,800 communities in the U.S., including all 50 states and two territories, have documented PFAS contamination,” he said.

Researchers have even detected them in the snows of Mt. Everest, apparently shed from climbers’ waterproof tents and parkas. 

“You are not just exposed in one place or one source,” toxicologist Linda Birnbaum, former director of the National Institute of Environmental Health Sciences and the National Toxicology Program, told The Washington Post. “They are everywhere.”

The problem is that these chemicals build up (or “bioaccumulate”) in the body over time. 

And according to the Centers for Disease Control and Prevention (CDC), which has been conducting studies of the U.S. population, PFAS has been found in the blood of nearly all people they’ve tested. Since the risk appears to rise with the amount of exposure, it’s important to try to limit the amount we come in contact with.

What You Can Do

Because PFAS chemicals are found in so many consumer products, they’re next to impossible to avoid. But there are ways to reduce the amount you’re exposed to.

“The most dangerous way that people are exposed to PFAS is through drinking water,” says Don Huber, director of product safety at CR.

That’s why the NAS report recommended filtering tap water as a major step consumers could take to protect themselves.

“The water filters that are most effective for PFAS are reverse osmosis filters,” David Andrews, a senior scientist for the EWG, told CNN, adding that some carbon-based filters can also reduce some levels.

“The important part is that you have to keep changing those filters,” he said. “If you don’t change that filter, and it becomes saturated, the levels of PFAS in the filtered water can actually be above levels in the tap water.”

The NAS committee also offered these tips:

  • Stay away from stain-resistant carpets and upholstery, and don’t use waterproofing sprays.
  • Look for the ingredient PTFE or other “floro” ingredients on product labels.
  • Avoid nonstick cookware. Instead, use cast-iron, stainless steel, glass, or enamel products.
  • Boycott takeout containers and other food packaging. Instead, cook at home and eat more fresh foods.
  • Don’t eat microwave popcorn or greasy foods wrapped in paper.
  • Choose uncoated nylon or silk dental floss or one that is coated in natural wax.
monkeypox

Why Monkeypox Is Not Like COVID-19

COVID, Disease, Lifestyle, News, Uncategorized, Vaccinations

Last month, the World Health Organization (WHO) declared the newly spreading monkeypox virus a global health emergency.

This has prompted many to fear we’re heading into another coronavirus situation, as our concierge primary care doctors in Jupiter have found from talking with our patients.

While this is a debilitating, painful, and—occasionally—deadly virus, there are many reasons why it’s very dissimilar to the SARS-CoV-2 virus, the virus that causes COVID-19.

The history is different

Although both originated as “zoonotic” diseases—that it, they began in animals and spread to humans—we have a far longer history with monkeypox, meaning we know more about it than we did when the coronavirus first appeared.

According to the Centers for Disease Control and Prevention (CDC), monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, thereby giving the disease the name “monkeypox.” Its typical animal hosts, however, are rodents and other small mammals.

The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then, monkeypox has been reported in humans in other central and western African countries.

Although relatively new to the U.S., a large monkeypox outbreak occurred here in 2003 as a result of imported rodents.

Transmission is different

Next, the ways the two viruses are transmitted are completely different.

Unlike the largely airborne transmission of SARS-CoV-2 through aerosols that linger in the air, the monkeypox virus can only be spread through close contact with an infected person or animal, or materials such as bedding or towels that are contaminated with the virus.

In addition, monkeypox appears to be far less transmissible than COVID-19. One study found that just three percent of those in close contact with an infected person would develop monkeypox.

It appears at this time to be spreading primarily among gay and bisexual men following sexual encounters, but anyone who comes into close and prolonged, direct contact with the pox sores can become infected.

Even women, and at least two children, have been reported to have contracted monkeypox, as a result of being in close proximity to men who have sex with other men.

The symptoms are different

Unlike the stealth infections of the coronavirus, it’s very apparent when a person is infected with monkeypox. As with COVID-19 and other viruses, they develop fever, headache or body aches, chills, muscle aches, and exhaustion.

These symptoms are also similar to those of smallpox, a cousin of monkeypox, with one difference:

“A feature that distinguishes infection with monkeypox from that of smallpox is the development of swollen lymph nodes,” the CDC says.

Otherwise, however, both smallpox and monkeypox exhibit the same signature fluid-filled lesions (the so-called “pox”), which the coronavirus doesn’t produce. Some individuals have these sores all over the body, while others may have only a single lesion. This rash can be extremely painful.

The vaccines are different

When COVID-19 first appeared two-and-a-half years ago, it was a brand new virus (i.e., “novel” coronavirus).

We knew nothing about it, and at the time had no way to combat it in the form of either effective treatments or vaccines.

Because of our long history with monkeypox, however, we do have vaccines and antiviral treatments. Monkeypox and smallpox come from the same family of viruses (although monkeypox is not as severe as smallpox). That has allowed us to utilize the stockpile of smallpox vaccines and antivirals to fight monkeypox.

And, unlike the coronavirus vaccines, the vaccines for monkeypox are effective even after infection, if given within four days of exposure. Even if the vaccine is given as late as two weeks after exposure, it can still lessen the likelihood of severe illness.

Not to worry?

Does all this mean we don’t have to panic about monkeypox? Panic is never a good idea because it prevents thoughtful responses in a crisis. But at this time the monkeypox outbreak still appears to be confined largely to men who have sex with men and those who are closest to them and who may come in contact with the open sore or infected linens.

If you fall into one of those categories, it’s important to take precautions until the supply of vaccines and antivirals becomes sufficient to cover everyone at high risk of exposure, because cases are spreading rapidly in the U.S. At the end of July, the Centers for Disease Control and Prevention (CDC) reported more than 3,500 confirmed cases but noted that is probably a significant undercount.

Experts advise that, if you’re at risk, you temporarily reduce your number of sexual partners, reconsider sex with new partners, and exchange contact details with any new partners to enable follow-up, if necessary.

Infected people are encouraged to self-isolate from other humans as well as pets, and to wear a mask and long clothing over any sores.

Although there is currently a limited supply of vaccines in the U.S., the government has purchased 2.5 million doses, which should be available in the coming weeks. This means it isn’t yet enough available to offer shots to all high-risk individuals.

So until there is, take precautions, and let us know if you think your symptoms might be those of monkeypox. It’s a painful, debilitating, and sometimes deadly disease, but we can treat it if it’s caught in time.

health benefits of coffee

Coffee Scores Another Win for Improving Health

, , , , , , Health Basics, Healthy Living, Lifestyle, Nutrition, Preventative Health

Besides water, our primary care concierge doctors in Jupiter are hard-pressed to think of another beverage that offers such a wide range of health benefits as coffee.

For example, research has found that regular coffee consumption has been linked to a lower risk of: 

  • heart disease and strokes
  • heart failure
  • melanoma
  • diabetes
  • liver and prostate cancer
  • Parkinson’s disease

Evidence piles up

Studies have also found that the caffeine in two cups of coffee a day provides significant protection against Alzheimer’s disease, as well as other types of dementia. A study released last year, for example, found that individuals who drank four to six cups of coffee or tea a day reduced their risk of stroke and dementia by 28 percent compared to those who did not drink either beverage.

Another study, published last year in the journal BMC Public Health, found that those who drink three to four cups of coffee a day (whether ground, instant, caffeinated or decaf) reduced their risk of chronic liver disease by 21 percent, compared with those who didn’t drink coffee at all.

A third study, also published last year in the American Heart Association (AHA) journal Circulation, found that drinking one or more cups of plain, caffeinated coffee a day was associated with a long-term reduced risk of heart failure.

The AHA researchers found that the risk of heart failure dropped between five percent and 12 percent for each cup of black coffee the subjects drank. The risk declined even more, to 30 percent, when subjects drank two or more cups daily in one of the studies. The study found, however, that decaffeinated coffee did not offer the same benefit. 

“The association between caffeine and heart failure risk reduction was surprising,” senior author Dr. David Kao, medical director of the Colorado Center for personalized Medicine at the University of Colorado School of Medicine in Aurora, said in a statement.

“Coffee and caffeine are often considered by the general population to be ‘bad’ for the heart because people associate them with palpitations, high blood pressure, etc. The consistent relationship between increasing caffeine consumption and decreasing heart failure risk turns that assumption on its head,” he said.

Latest findings

The most recent research, published last month in the Annals of Internal Medicine, found that people who drink a moderate amount of coffee, defined as up to 3 1/2 cups a day, were up to 36 percent less likely to die from any cause over the seven-year period of the study than those who did not drink coffee.

It didn’t matter what type of coffee the subjects drank—ground, instant, caffeinated, or decaf—or even if they added a modest amount of sugar: The results were the same.

According to Johns Hopkins, there are also many other benefits from daily coffee consumption. For example:

  • Coffee may help your body process glucose better, meaning you may be less likely to develop type 2 diabetes.
  • Coffee may lower the risk of developing Parkinson’s disease, and help those who have it control their movements better.
  • Coffee can help lower your risk of colon cancer.
  • Drinking dark-roast coffee has even been shown to decrease breakage in DNA strands, which helps protect against various cancers.

Some coffee caveats

It’s typical with humans, however, to think that if something is good for you, more of it is better. That’s rarely the case, including with coffee.

The U.S. Department of Agriculture’s (U.S.D.A.) Dietary Guidelines for Americans recommend no more than 400 milligrams of caffeine a day. An average eight-ounce cup contains 95 milligrams of caffeine.

Several studies—including those outlined above—have found that five cups of coffee a day appears to be the upper limit of safety. In fact, a 2009 study found a 17-21 percent increased risk of death among those who drank four or more cups a day.

Other possible negative effects of too much coffee include:

  • increased blood pressure
  • headache
  • heartburn
  • dehydration
  • increased heart rate
  • abnormal heart rhythm
  • anxiety
  • dizziness
  • insomnia

In addition, a 2017 study found that pregnant women who drink more than four cups of coffee a day were more likely to experience low birth rate babies, preterm births, and stillbirths.

Another study linked coffee consumption with the possibility of increased bone loss in postmenopausal women if their diets lack sufficient calcium intake.

Finally, those who are sensitive to caffeine may experience many of these side effects with even small amounts of coffee. Older adults also may not be able to metabolize caffeine as well they did when they were younger.

And anyone who is taking certain drugs (like ephedrine, used in decongestants) can experience increased blood pressure, along with a higher stroke risk, when they consume coffee as well. 

But if you’re not caffeine-sensitive, and you don’t overdo it, our primary care doctors urge you to feel free to enjoy that third or fourth cup of the day without guilt.

The Risk of Salmonella in Backyard Chickens

, , , , , Health Basics, Healthy Living, Lifestyle, Preventative Health

If you’ve been buying cage-free eggs, or eggs from your local farmer, or even raising your own chickens to lower your risk of salmonella, our concierge doctors in Jupiter have some unhappy news for you: Most chickens, ducks, and turkeys carry some form of the more than 2,000 types of salmonella, according to Craig Coufal, Texas A&M AgriLife Extension Service poultry specialist.

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Skin Cancer Awareness

What to Know About Sunscreens

, , , , , , , , Health Basics, Healthy Living, Lifestyle

Because May is Skin Cancer Awareness Month, our primary care doctors in Jupiter want to remind you of the dangers of sun exposure and remind you of the best way to avoid it.

It’s important to know the facts about skin cancer and the sun, along with exposure to tanning beds, because the National Cancer Institute (NCI) estimates that this year 99,780 people in the U.S. will be diagnosed with melanomas of the skin, and that 7,650 people will die from this most deadly form of cancer.

But a proper use of an effective sunscreen can prevent most skin cancers.

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pandemic over

Is the Pandemic Over? Not Quite

, , , , , Disease, Lifestyle, Preventative Health, Vaccinations

Dr. Anthony Fauci’s comment that we are “certainly, right now, in this country, out of the pandemic phase” of COVID-19 sparked numerous questions to our primary care concierge doctors in Jupiter.

It also seemed to cause a great deal of confusion and misconceptions around the country at large, at least until he clarified his statement the following day.

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