Navigating the Current Landscape of Respiratory Illnesses: CDC Report Highlights Trends

In the ever-evolving landscape of public health, staying abreast of the latest updates from authoritative sources is crucial. Recently, the Centers for Disease Control (CDC) provided an insightful update on the status of respiratory illnesses in the United States. The report, released last Friday, sheds light on the prevalence of fever-inducing coughs and sore throats, prompting individuals to seek medical care. As we delve into the details, it becomes evident that while there have been some decreases, respiratory illnesses remain elevated across the nation.

Current Scenario:

The CDC’s update revealed that over the past two weeks, a significant number of jurisdictions – 22 to be exact – experienced high or very high activity in terms of respiratory illnesses. This is a notable decrease from 37 jurisdictions reported two weeks prior. The decline indicates a positive trend, albeit with certain regions still grappling with heightened levels of respiratory ailments.

Key Findings:

  1. COVID-19, RSV, and Flu Positivity Rates: Despite the overall elevated status of respiratory illnesses, the report brings attention to a nuanced picture. While COVID-19, Respiratory Syncytial Virus (RSV), and flu positivity rates remained elevated nationally, there was a glimmer of improvement. Both COVID and RSV rates saw a decrease compared to the previous week, while flu rates remained relatively stable.
  2. Emergency Room Visits: The post-holiday season witnessed a decline in emergency room visits related to respiratory illnesses. This dip is attributed to the country gradually returning to work after festive gatherings, which contributed to the spread of viruses during the peak of the flu season. It is encouraging to see a reduction in emergency room visits, signaling a potential easing of the burden on healthcare facilities.
  3. Wastewater Analysis: An intriguing aspect of the CDC update is the analysis of wastewater, providing a unique perspective on the prevalence of COVID-19. Although levels remained elevated, there was a shift from “very high” to “high,” with concentrations primarily observed in the Southern regions of the country. This insight into wastewater can aid in monitoring and predicting the trajectory of respiratory illnesses.
  4. Regional Disparities: States with a “very high” level of respiratory illness include New York, Tennessee, South Carolina, and Louisiana. Understanding these regional disparities is crucial for targeted public health interventions and resource allocation.

In conclusion, the CDC’s latest update paints a dynamic picture of respiratory illnesses in the United States. While there are positive signs such as decreased emergency room visits and some lowering of COVID and RSV rates, challenges persist, especially in certain regions. Staying vigilant, following public health guidelines, and adapting strategies based on regional trends will be key in navigating through these challenging times. As we move forward, continued collaboration between health authorities, communities, and individuals remains paramount in mitigating the impact of respiratory illnesses nationwide.

Important Flu Season Update from Your Concierge Doctors in Jupiter

As your trusted Concierge Doctors in Jupiter, we are committed to keeping you informed about health concerns that might affect our community. This year, we face a challenging flu season that has seen a significant rise in influenza cases and other respiratory illnesses across 38 states, as reported by the Centers for Disease Control and Prevention (CDC). This update is particularly relevant as we navigate the period between Christmas and New Year’s, which has shown a dramatic increase in flu activity.

The CDC’s latest report is alarming yet crucial for our awareness: since October, there have been at least 10 million flu-related illnesses, leading to 110,000 hospitalizations and 6,500 deaths. These figures emphasize the severity of the current flu season, which generally peaks between December and February.

On a more reassuring note, the CDC director has confirmed that this year’s flu shots are well-matched to combat the prevalent strain. This is a significant factor in controlling the spread and severity of the flu, and we strongly encourage you to get vaccinated if you haven’t already.

In our local area, including our practice in Jupiter, pediatricians have noted an increase in respiratory illnesses among children and young adults up to age 21. Reflecting on the situation at Johns Hopkins All Children’s Hospital, Dr. Megan Martin mentions, “We’re still seeing RSV and COVID as well. It’s keeping our emergency department pretty busy with all of these respiratory illnesses.”

In December, the hospital reported a rise in flu A and B cases, with 431 instances, and more than 185 cases of RSV. Additionally, 61 patients tested positive for COVID-19. Dr. Martin compares this to pre-pandemic years, noting that while it’s not the worst flu season, it is notably rigorous compared to the pandemic years when mask-wearing reduced transmission significantly.

At our Concierge Doctors office in Jupiter, we are closely monitoring these developments and are here to support your health needs during this flu season. We advise our patients to take preventive measures such as getting vaccinated, practicing good hygiene, and being mindful of symptoms. If you or your family members are experiencing flu-like symptoms, please reach out to us for guidance and treatment options.

Our priority is your health and well-being. By staying informed and proactive, we can collectively navigate through this flu season safely. Remember, we are here to assist you with any health concerns you may have.

Flu Cases on the Rise: A Concern for Public Health

The United States is currently experiencing an uptick in flu cases, a trend that has caught the attention of health officials nationwide. This rise in flu cases is a typical occurrence during the colder months, but the intensity and spread of the flu can vary from year to year.

Understanding RSV

Alongside the flu, Respiratory Syncytial Virus (RSV) is another viral respiratory illness that often peaks during the fall and winter months. While RSV is most commonly known to affect infants and young children, it can also impact adults, especially those with weakened immune systems or chronic health conditions.

Health Officials’ Response

U.S. health officials are monitoring these trends closely. They emphasize the importance of preventative measures such as vaccinations, good hygiene practices, and staying informed about local health advisories.

What This Means for the Public

The simultaneous rise in flu cases and the peaking of RSV infections create a dual challenge for healthcare systems and the public. It underscores the need for increased vigilance and adherence to health guidelines to prevent the spread of these respiratory illnesses.

Staying Informed and Prepared

Individuals must stay updated with information from reliable sources and adhere to public health recommendations. Vaccination, hand washing, avoiding close contact with sick individuals, and wearing masks in crowded places are some of the effective ways to reduce the risk of infection.

Weight Loss Drugs: What You Need to Know About New Findings on Severe Stomach Problems

Many patients turn to medication as a potential solution in the quest for weight loss solutions. Among the popular choices are drugs like Wegovy, Ozempic, and Rybelsus. While their effectiveness in weight loss and diabetes management is well-known, a recent study from the University of British Columbia has shed light on potential severe gastrointestinal side effects.

Here’s what you should know.

1. A Brief Overview of GLP-1 Agonist Weightloss Drugs:

These drugs mimic the action of a gut hormone activated after eating, enhancing insulin release, suppressing sugar production in the liver, and reducing appetite. They have been widely prescribed for diabetes management, but their use for weight loss in non-diabetic patients has grown significantly.

2. Previous Concerns with Digestive Issues:

Past research indicated some risk of digestive problems for diabetes patients using these medications. However, this new study provides the first large-scale insight into these effects on non-diabetic patients using them solely for weight loss.

3. The New Findings:

  • 9.09 times increased risk of pancreatitis.
  • 4.22 times increased risk of bowel obstruction.
  • 3.67 times higher risk of gastroparesis.

While an increase in biliary disease was observed, it wasn’t statistically significant.

4. The Implications:

The sheer number of individuals using these drugs worldwide means that, even if these side effects are rare, hundreds of thousands might still experience these conditions. Understanding the risks becomes vital, especially for those who might be using the medications for general weight loss rather than for diabetes or obesity.

5. The Call to Action:

Researchers hope that pharmaceutical companies and regulatory bodies, such as the U.S. Food and Drug Administration, will include the risk of gastroparesis on warning labels.

Conclusion:

Drugs can be a powerful tool in the journey towards better health and weight loss. However, as with all medical interventions, being informed is crucial. The potential side effects, while rare, can be severe. Patients must weigh the benefits against the risks and make an informed decision.

“Knowing the potential side effects is critical. It empowers patients to seek medical attention promptly and prevent further complications,” says Sodhi, emphasizing the importance of this new research. As always, consulting with your healthcare provider is recommended before starting or stopping any medication.

Understanding Different Heat Illnesses

As the temperatures rise during the warmer months, many of us enjoy spending more time outdoors. However, with the increase in temperatures comes the potential risk of heat-related illnesses. Our primary care doctors in Jupiter want you to be informed about the different types of heat illnesses to prevent them and to provide proper care if someone is affected.

1. Heat Stroke

What it is: Heat stroke is the most severe form of heat illness and is a medical emergency. It happens when the body’s temperature rises rapidly, and it can’t cool down.

Symptoms:

  • High body temperature (above 103°F)
  • Hot, red, dry, or damp skin
  • Fast, strong pulse
  • Headache
  • Dizziness
  • Nausea
  • Confusion
  • Losing consciousness (passing out)

What to do: Call 911 immediately. While waiting for medical professionals, move the person to a cooler place and try to reduce their body temperature with cool cloths or a cool bath. Do not give the person anything to drink.

2. Heat Exhaustion

What it is: Heat exhaustion is a warning that your body can no longer keep itself cool. If left untreated, it can escalate to heat stroke.

Symptoms:

  • Heavy sweating
  • Cold, pale, and clammy skin
  • Fast, weak pulse
  • Nausea or vomiting
  • Muscle cramps
  • Tiredness or weakness
  • Dizziness
  • Headache
  • Fainting

What to do: Move to a cool place, loosen your clothes, put cool, wet clothes on your body or take a cool bath. If the person is fully conscious, they can sip water. If the symptoms worsen or last longer than an hour, seek medical attention.

3. Heat Cramps

What it is: Muscle spasms or pains that occur due to intense exercise in hot weather.

Symptoms:

  • Muscle cramps, usually in the legs or abdomen
  • Heavy sweating

What to do: Stop the activity and move to a cool place. Drink water or a sports drink. Wait for the cramps to go away before you do any more physical activity.

4. Heat Rash

What it is: Skin irritation from excessive sweating.

Symptoms:

  • Red clusters of small blisters that look like pimples on the skin
  • Usually appears on the neck, chest, groin, or elbow creases

What to do: Stay in a cool, dry place. Keep the rash dry and avoid using ointments or creams as they can keep the skin warm and moist, worsening the condition.

5. Dehydration

What it is: A lack of enough water in the body, often caused by too much sweating.

Symptoms:

  • Dry mouth and throat
  • Dark yellow urine
  • Not urinating much
  • Feeling dizzy or lightheaded
  • Feeling tired
  • Dry skin

What to do: Drink plenty of fluids, preferably water. If dehydration is severe and accompanied by symptoms like confusion, rapid heartbeat, or rapid breathing, seek medical attention immediately.

Prevention Tips

  • Stay Hydrated: Drink plenty of water throughout the day. Avoid drinks with caffeine or alcohol as they can dehydrate you.
  • Dress Appropriately: Wear lightweight, light-colored, loose-fitting clothing. Use a wide-brimmed hat or an umbrella for shade.
  • Stay Cool: Avoid direct sunlight whenever possible, especially during the hottest parts of the day. Use fans or air conditioning to cool down.
  • Limit Outdoor Activities: Do strenuous activities during the cooler parts of the day, such as early morning or late evening.

By understanding the signs and symptoms of heat-related illnesses and taking preventive measures, you can safely enjoy the warm weather without the health risks. Always listen to your body, and if you or someone around you is showing signs of a heat illness, take it seriously and seek medical attention if needed.

Concierge Medicine vs. Traditional Healthcare: Understanding the Differences

In today’s rapidly evolving healthcare landscape, there are various models of care available to patients. Two such models that have gained popularity in recent years are concierge medicine and traditional healthcare. While both aim to provide quality healthcare services to individuals, they differ significantly in their approach, level of personalization, and cost structure. In this blog post, we will delve into the details of concierge medicine and traditional healthcare, highlighting their unique features and helping you understand the differences between the two.

Traditional Healthcare: The Familiar Model

Traditional healthcare, also known as fee-for-service or insurance-based healthcare, is the conventional approach that most people are accustomed to. It involves patients seeking care from primary care physicians, specialists, hospitals, and other healthcare providers who accept insurance plans. In this model, patients typically pay for their medical services through insurance coverage or out-of-pocket fees for uninsured services.

Here are some key features of traditional healthcare:

  • Insurance dependency: Traditional healthcare heavily relies on insurance plans, where patients pay premiums to insurance companies, who in turn cover a portion of the medical expenses. The insurance provider negotiates rates with healthcare providers, and patients often have co-pays, deductibles, and limitations on covered services.
  • Limited time with physicians: Due to the demands of a traditional healthcare practice, physicians often have a large number of patients, leading to shorter appointment times. This can result in patients feeling rushed during their visits and limited opportunities to discuss their health concerns thoroughly.
  • Referrals for specialist care: In traditional healthcare, patients often require referrals from their primary care physicians to consult specialists or undergo certain medical procedures. This can cause delays in accessing specialized care and can add additional administrative steps to the process.
  • Insurance-driven limitations: Traditional healthcare models are subject to insurance regulations, which can dictate the coverage and reimbursement rates for specific procedures, medications, and tests. This may sometimes restrict physicians’ treatment options or create administrative burdens.

Concierge Medicine: Personalized Care and Beyond

Concierge medicine, also known as boutique or retainer-based medicine, is a healthcare model that offers enhanced personalized care and direct access to physicians in exchange for an annual or monthly fee. This model aims to provide a higher level of attention, convenience, and comprehensive care to patients.

Here are some key features of concierge medicine:

  • Membership-based care: In concierge medicine, patients pay an annual or monthly membership fee to a primary care physician or a practice. This fee grants them access to a range of personalized services and benefits beyond what traditional healthcare offers.
  • Extended and unhurried appointments: Concierge medicine allows for longer appointment times, ensuring that patients have ample opportunity to discuss their health concerns and receive comprehensive care. This model emphasizes building strong doctor-patient relationships and prioritizes individualized attention.
  • Enhanced access and convenience: Concierge practices often provide same-day or next-day appointments, 24/7 access to physicians via phone or email, and reduced waiting times. This accessibility allows patients to receive timely medical advice and attention, promoting a higher level of convenience and peace of mind.
  • Preventive care and wellness focus: Concierge medicine emphasizes proactive and preventive care, focusing on wellness and disease prevention. Physicians have the freedom to develop personalized health plans, including tailored screenings, lifestyle counseling, and wellness programs.
  • Additional services and amenities: Depending on the concierge practice, patients may have access to additional services such as telemedicine consultations, in-depth health assessments, coordination of specialist care, personalized health coaching, and more.

Understanding the Differences

The primary differences between concierge medicine and traditional healthcare can be summarized as follows:

  • Payment structure: Traditional healthcare relies on insurance payments and out-of-pocket fees, while concierge medicine operates on a membership or retainer fee structure.
  • Level of access and time with physicians: Concierge medicine offers extended appointment times, enhanced access to physicians, and a greater emphasis on building strong doctor-patient relationships, whereas traditional healthcare often involves shorter appointment times and limited access to physicians.
  • Personalization and comprehensive care: Concierge medicine focuses on personalized care plans, preventive medicine, and comprehensive wellness services beyond what is typically offered in traditional healthcare settings.
  • Additional services and amenities: Concierge medicine practices often provide additional services and amenities, such as 24/7 physician access, telemedicine consultations, and coordination of specialist care, to enhance the patient experience.

It’s important to note that while concierge medicine offers numerous advantages, it may not be accessible or affordable for everyone due to its higher cost structure. Traditional healthcare, on the other hand, remains the more common and widely available model for most individuals.

In conclusion, concierge medicine and traditional healthcare represent two distinct approaches to delivering medical care. Our concierge doctors in Jupiter emphasize personalization, extended time with patients, and comprehensive services, while traditional healthcare operates within the framework of insurance-based models. Understanding the differences between these two models can help patients make informed decisions about their healthcare needs and preferences.

Is a Neti Pot Right for You?

Because our concierge primary care doctors in Jupiter have been receiving more questions about the effectiveness of Neti pots for various sinus conditions, we thought we’d take some time to explore their usefulness—and to reiterate a special warning about their use.

What is a neti pot?

Neti pots are one type of nasal irrigation device that use a saline or saltwater solution to treat congested sinuses, colds, allergies, and congestion from flu and COVID-19.

These devices include the teapot-looking container that originated with Ayurvedic medicine in India, along with bulb syringes, squeeze bottles, and more expensive motorized pulsed water devices.

In general, these devices all introduce salt water (saline) into the nostrils to flush out mucus, allergens, and bacteria. The saline helps thin the mucus, making it easier to expel.

The U.S. Food and Drug Administration (FDA) says that such saline rinsing “can remove dust, pollen, and other debris, as well as help to loosen thick mucus. It can also help relieve nasal symptoms of sinus infections, allergies, colds, and flu.

“Plain water can irritate your nose,” the agency says. “The saline allows the water to pass through delicate nasal membranes with little or no burning or irritation.”

How do they work?

 “There are various ways to deliver saline to the nose,” says Eric A. Mann, M.D., and Ph.D., a doctor at the FDA.

“Nasal spray bottles deliver a fine mist and might be useful for moisturizing dry nasal passages. But irrigation devices are better at flushing the nose and clearing out mucus, allergens, and bacteria,” he says.

Information that comes with each device can give more specific instructions, but in general, the FDA says they all work basically the same way:

  • Leaning over a sink, tilt your head sideways with your forehead and chin roughly level to avoid liquid flowing into your mouth.
  • Breathing through your open mouth, insert the spout of the saline-filled container into your upper nostril so that the liquid drains through the lower nostril.
  • Clear your nostrils. Then repeat the procedure, tilting your head sideways to the other side.

While some people experience immediate relief from their symptoms, for others it may take a few days to begin breathing more freely.

And experts caution that—like oral decongestants—nasal irrigation devices are simply a treatment for a symptom, not a cure for the underlying cause.

Some Cautions

Although the FDA says that neti pots and other similar nasal irrigation devices are generally safe, they may not be right for everyone. If your immune system isn’t working properly, the agency advises checking with your healthcare provider before using any nasal irrigation system.

A few users report ear discomfort, nasal irritation, a burning or stinging sensation, and even nosebleeds. But in general, the FDA considers them safe to use, even for children aged two and up.

The most significant warning, however, concerns the type of water used in them. 

“Tap water isn’t safe for use as a nasal rinse because it’s not adequately filtered or treated,” the FDA cautions.

“Some tap water contains low levels of organisms—such as bacteria and protozoa, including amoebas—that may be safe to swallow because stomach acid kills them. But in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections.”

They can even be deadly, the Centers for Disease Control and Prevention (CDC) reports. Since 1993, there have been at least 70 cases of “brain-eating” amoeba infections in the U.S., which are “almost uniformly fatal,” the agency reports.

Safe Use

The safety of neti pots and other such nasal irrigation devices—including the motorized versions—depends on the type of water used and how meticulously the containers are cleaned after each use.

The FDA lists the following types of water as safe to use for neti pots and similar devices:

  • Distilled or sterile water, which you can buy in stores. The label will state “distilled” or “sterile.”
  • Boiled and cooled tap water—boiled for three to five minutes, then cooled until it is lukewarm. Previously boiled water can be stored in a clean, closed container for use within 24 hours.
  • Water passes through a filter designed to trap potentially infectious organisms. The CDC has information on these filters here

To safely use and care for your device:

  • Wash and dry your hands.
  • Check that the device is clean and completely dry.
  • Prepare the saline rinse, either with the prepared mixture supplied with the device, or one you make yourself.
  • Follow the manufacturer’s directions for use.
  • Wash the device, and dry the inside with a paper towel or let it air dry between uses.

Does it Work?

Most people who use neti pots to relieve nasal congestion and allergies swear by them, especially if they want to avoid using over-the-counter decongestants. 

“Just about any condition that causes irritants and mucus to build up inside the nose will benefit from saltwater rinsing with a net pot or similar device,” Richard Orlandi, a nasal and sinus specialist and professor of surgery at the University of Utah Health in Salt Lake City, told Consumer Reports (CR).

“These include allergies, nonallergic nose irritation, colds, and sinus inflammation and infections,” he said.

The World Health Organization (WHO) reports that rinsing your nose with saline does not prevent COVID-19, by the way.

If saline rinsing doesn’t relieve your symptoms, or if you have a fever, nosebleeds, or headaches while using the devices, let us know.

Nature Can Heal in More Ways Than One

Humans evolved in the natural world. We may have retreated to caves or huts to protect ourselves from the elements, but we spent much of our time outdoors, hunting, gathering, cooking, telling stories, and so on. Our lives these days, though, are largely spent cut off from nature.

This way of life has sparked a wealth of studies showing that our loss of contact with nature—dubbed “nature deficit disorder”—has a real impact on our physical and mental health.

So our primary care concierge doctors in Jupiter weren’t too surprised to learn of a new study published this month in the journal Occupational & Environmental Medicine, which found that enjoying nature up to four times a week reduced the odds of needing mental health medications by 33 percent.

It also reduced the odds of using blood pressure pills by 36 percent and asthma medications by 26 percent.

The Study

Researchers interviewed about 6,000 people who live in large cities in Finland, asking about their access to and use of green and blue spaces, including parks, zoos, rivers, lakes, or the sea. 

They also asked subjects whether they could see views of nature from their homes, how often they spent time outdoors as well as how much they exercised while outdoors.

The study also accounted for other possible factors such as traffic-related outdoor air pollution and noise, which have been proven to have an adverse effect on health.

Respondents were then asked about their use of medications for depression, anxiety, high blood pressure, asthma, or insomnia, and correlated these with time spent in nature.

As noted above, the results were markedly better for those who were regularly exposed to green or blue spaces. Notably, those who lived in areas with a lot of green spaces or who simply looked at nature from their windows showed no improvement in any of these categories.

“Frequent green space visits, but not the amounts of residential green or blue spaces, or green and blue views from home, were associated with less frequent use of psychotropic, antihypertensive, and asthma medication in urban environments,” the study authors wrote.

Confirming Prior Research

Numerous earlier studies have found significant benefits from spending time in nature.

One meta-review of 143 other studies published in the journal Environmental Research, for example, found that people with access to green space generally had a slower heart rate, lower blood pressure, and fewer blood levels of the stress hormone cortisol. Researchers also found significantly fewer cases of diabetes and lower rates of mortality from heart disease in the group regularly exposed to nature.

An American Institutes for Research (AIR) study in 2005 found that sixth-grade students who attended three outdoor education programs showed marked improvement in conflict resolution skills.

Another study in China in 2013 involved 60,000 children between the ages of two and 17. It showed that regular exposure to nature, or “greenness” around their schools, reduced the incidence of attention deficit/hyperactivity disorder (ADHD). A more recent study at the University of Illinois produced similar results.

And a 2016 study of nearly 100,000 women conducted over eight years found that having access to the greenest space not only improved the subjects’ mental health but also reduced their death rate by 12 percent.

Nature Deprivation Hurts

Author Richard Louv coined the phrase Nature Deficit Disorder (NDD) in his 2005 book “Last Child in the Woods: Saving Our Children from Nature Deficit Disorder.” In it, he argued that elements of our urbanized lifestyle, including few natural spaces, a car-focused culture, more screen time, changes in the perception of risk (e.g., fear of “stranger danger”), less leisure time, and increased time pressure from work or school, combine to decrease or even eliminate contact with nature for both adults and children, according to the National Institutes for Health (NIH).

“The average young American now spends practically every minute—except for the time in school—using a smartphone, computer, television, or electronic device,” Tamar Lewin reported in a Kaiser Family Foundation study on the subject.

According to the Children and Nature Network (C-NN), which was co-founded by Louv, an expanding body of scientific evidence suggests that nature-deficit disorder contributes to:

  • diminished use of the senses
  • attention difficulties
  • conditions of obesity, and
  • higher rates of emotional and physical illnesses

Make the Connection

Unfortunately, to get back to nature, you may need to make a specific effort, because in our harried lives trapped indoors, focused on our screens, we have very little time for real relaxation.

Therefore, it’s often necessary to add nature breaks to our schedules the same way we schedule everything else.

One way is to undertake the Japanese practice known as “forest bathing,” or shinrin-yoku. As Kaiser Permanente’s’ online Thrive explains, “Heading out to a heavily wooded area isn’t required. You could take a trip to a nearby park, your favorite local trail, the beach, or any natural setting. Just be sure to turn off or silence your phone or other devices.”

Psychology Today explains, “Forest bathing is an antidote to pinging distractions, impending deadlines, and never-ending obligations . . . . The idea is to immerse yourself in a natural environment and soak up the many health benefits of being in the green woods.”

However, you manage it, for the sake of your overall health we recommend you take the time to reconnect with the natural world as often as possible.

Damar Hamlin Brings CPR Into the Spotlight

It was a terrifying moment on the field at the Buffalo Bills-Cincinnati Bengals game earlier this month when Bills safety Damar Hamlin stood up following a hit to the chest and then collapsed on the field.

But the good news is that he seems to be well on his way to a remarkable recovery. So our concierge primary care doctors in Jupiter want to join with so many others who are using the incident to urge everyone to learn the lifesaving cardiopulmonary resuscitation (CPR) technique that helped save his life.

What happened to Hamlin?

First, let’s discuss how a routine hit in a football game drove a man to the brink of death.

While full details are not yet available, it appears he was the victim of a rare phenomenon called “commotio cordis,” or ventricular fibrillation. It occurs when an impact directly to the heart occurs at the precise millisecond of the heartbeat when it becomes susceptible to such a blow, interrupting the rhythm.

In such cases, “there is nothing wrong with the heart,” Dr. Hari Tandri, director of the cardiac arrhythmia program at Vanderbilt University Medical Center in Nashville, Tennessee, told NBC News.

Dr. Comilla Sasson, an emergency medicine physician in Denver and a spokesperson for the American Heart Association (AHA), told NBC: “It’s not about how hard a hit it was. It’s actually about the timing of when the blow happens.”

CBS News medical contributor Dr. David Argus told “CBS Mornings” that he believed Hamlin sustained blunt force trauma to his chest “in the exact right spot, at the exact right moment during his heartbeat,” causing his heart to go into arrhythmia, or “not beat effectively to push blood to the brain,” he explained.

“It happens in Little League baseball,” he added. “A ball is thrown by a pitcher and hits the person in the chest. It happens in soccer where there’s something that causes that blunt force trauma. So, remarkably rare.” So rare, in fact, that he estimated that only about 30 of these cases occur in the U.S. every year.

Hamlin was Lucky

As Hamlin continued to rapidly recover in the days following his collapse, observers credited his survival to the immediate response of medical personnel on the field.

“When someone is having a sudden cardiac arrest emergency for any reason . . . time is absolutely critical,” Matthew Levy, an associate professor of emergency medicine at Johns Hopkins University School of Medicine, told The Washington Post.

“For every minute that someone is in sudden cardiac arrest—every minute where their heart is not beating normally and their body tissue is not getting the oxygen it needs—their [chances of] survival goes down by like seven to 10 percent,” he said. “So time is absolutely of the essence.”

“The key in any cardiac arrest is how quickly and effectively CPR is done,” Aaron Baggish, a Mass General Brigham sports medicine cardiologist and founder of the Cardiovascular Performance Program at Massachusetts General Hospital, told The Post.

“So it has to start soon, and it has to be done well enough to get blood to the brain and the other vital organs for as long as it takes to start the heart again with defibrillation,” he said.

Rapid Response

Which is what happened with Hamlin.

Within seconds of Hamlin’s collapse, assistant athletic trainer Denny Kellington began administering CPR to Hamlin, according to a tweet from Bills offensive lineman Dion Dawkins. Others followed the CPR with use of an automated external defibrillator (AED) before Hamlin was rushed to the hospital.

Observers credited the immediate CPR and AED with saving his life. But only about half of Americans report having received CPR training.

And unfortunately, many people who witness a cardiac arrest are reluctant to perform CPR, either because they don’t know how or are afraid of causing further harm. But Good Samaritan laws in all 50 states protect bystanders who step in to help during an emergency from legal liability.

Florida’s statute provides that “Any person . . . who . . . in good faith renders emergency care or treatment . . . shall not be held liable” for damages. Read the whole law here.

But too few Americans have CPR training, the AHA reports.

A Simple Technique

Formal training, which typically involves practicing on a dummy, is preferable to reading about the technique, doctors say.

“You can certainly learn a lot by reading it online, and you can certainly watch videos and understand and learn the technique, but, ultimately, the best thing is to actually get into a class so you can actually practice,” Dr. Jayne Morgan, a cardiologist at Piedmont Healthcare in Atlanta, told NBC News.

The Cleveland Clinic’s Dr. Michael Emery, a sports cardiologist there, told USA Today that CPR is “the most profound, life-changing thing you could potentially learn and do for someone.”

If you’re interested in someday possibly saving a life, you can find CPR classes near you here.

And if you find yourself in a situation where you need to perform CPR, the AHA recommends doing chest compressions at a rate of 100 to 120 per minute, but in the throes of trying to save a life, it can be difficult to count the precise beats needed to keep up the correct rhythm.

So the AHA created a playlist of over 50 familiar songs on Spotify to help bystanders maintain the beat. Click here to listen!

There’s a Reason Why You’re Feeling SAD

If you’ve been feeling down, sleepy, or hopeless, even with all the holiday merriment going on around you, our primary care concierge doctors in Jupiter want you to know you’re not alone. Health experts estimate that seasonal affective disorder (SAD), or the “winter blues,” affects about five percent of the U.S. population.

SAD is more than just the “winter blues,” according to the American Psychiatric Association (APA). The symptoms can be distressing and overwhelming, and can interfere with daily functioning, the APA reports. 

Affecting more than 10 million Americans, symptoms of the condition usually begin in October or November and begin to subside in March or April. However, some patients don’t feel fully back to normal until early May.

SAD may begin at any age, but it typically starts when a person is between the ages of 18 and 30 and seems to affect women more than men.

Symptoms

The APA lists the following symptoms associated with SAD:

  • fatigue, even with excessive amounts of sleep
  • weight gain associated with overeating and carbohydrate cravings
  • feelings of sadness or depressed mood
  • marked loss of interest or pleasure in activities once enjoyed
  • loss of energy
  • an increase in restless activity (e.g., hand-wringing or pacing)
  • slowed movements and speech
  • feeling worthless or guilty
  • trouble concentrating or making decisions
  • thoughts of death or suicide or attempts at suicide.

The severity of such symptoms can vary from person to person, and not everyone will experience all these symptoms.

Likely Causes

While no one is certain what causes SAD, the lower amounts of sunlight in fall and winter are believed to lead to a biochemical imbalance in the brain, impacting the body’s circadian clock, which triggers sleep and wake cycles.

This process affects the output of serotonin, the so-called “mood” hormone. Studies have shown that the circadian-related output of serotonin drops markedly with the decrease in light during the winter. It also increases the level of melatonin, a hormone secreted by the pineal gland that regulates the sleep cycle.

The cause of SAD may have an ancient survival connection, as humans learned to restrict activity when food sources were scarce. The tendency may still be hardwired into our biology, and people can experience symptoms on a sliding scale from barely noticeable to full-blown clinical depression.

Risk factors include a family history of SAD or another form of depression, having major depression or bipolar disorder, and having lower levels of vitamin D. Vitamin D is believed to promote serotonin production.

Treatment

SAD can be effectively treated in a number of ways, including through the use of light-box therapy, which employs specially built full-spectrum lamps to alleviate symptoms. The NIMH reports that this type of therapy has been a mainstay for treating SAD since the 1980s.

In this treatment, a person sits in front of a very bright lightbox (10,000 lux) every day for about 30 to 45 minutes, usually first thing in the morning, from fall to spring. The light boxes, which are about 20 times brighter than ordinary indoor light, filter out the potentially damaging UV light, making this treatment safe for most people.

However, those with certain eye diseases or people taking certain medications that increase their sensitivity to sunlight might need other treatment types.

Other approaches include the use of antidepressants such as Paxil and Prozac, or cognitive behavioral therapy (CBT), a type of talk therapy aimed at helping individuals learn how to cope with difficult situations. In addition, the U.S. Food and Drug Administration (FDA) has also approved another type of antidepressant specifically for SAD: bupropion. In extended-release form, it is taken daily from fall to spring to prevent major depressive episodes.

Self-care

Meanwhile, there are steps you can take to help mitigate milder cases.

1. Stay active outdoors

Exposure to early morning light has been shown to be the most effective at reducing symptoms, as has regular exercise. An early morning walk or run might be all you need to help alleviate your symptoms.

2. Let in the light

If you can’t get outside, at least let the sunshine in as much as possible. Open blinds and drapes first thing in the morning, and keep them open all day. If you can, arrange your home or office so you’re exposed to as much sunlight as possible during the day (but remember that the sun’s harmful UV rays can penetrate glass, so use sunscreen if you’re actually sitting in the sun all day).

3. Eat right

Simple carbs and sugars wreak havoc with your blood sugar, thereby affecting your mood. Lean meats, fruits, vegetables, nuts, and complex carbohydrates will help to keep your brain functioning properly.

4. Take it easy

Don’t try to do too much, which can add to feelings of being overwhelmed. Do what you can, and postpone the rest, or ask friends and family for help with your to-do list.

5. Stay connected

Studies have shown that connecting with others helps improve mood: volunteering, getting together with friends and family, and participating in group activities, are some possibilities.

If your symptoms are interfering with your daily life, let us know. We can help evaluate your symptoms and recommend the right therapy.

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