Understanding Different Heat Illnesses

, , , , , , , , , , Concierge Medicine, Environment, Health Basics, Healthy Living, Lifestyle, Preventative Health

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.

Staying Safe In Flooding Events

, , , , Environment, Health Basics, Natural Disaster

In light of last month’s flood disaster in Fort Lauderdale, and the fact that such events are happening more often, our primary care concierge doctors in Jupiter want to review what you should know to stay safe in similar situations.

Not only are extreme flooding events more likely these days, but here on the east coast of Florida we also regularly deal with the threat of hurricanes. And with hurricane season arriving in just a few weeks, it pays to be prepared.

More to Come

In the aftermath of the Fort Lauderdale flooding, Kevin Guthrie, director of the Florida Division of Emergency Management, said, “This is the second most-catastrophic flooding event that I’ve seen in my tenure as emergency manager . . . over the last 33 years,” with Hurricane Ian being the worst.

Unfortunately, with the changing climate, such events are becoming more common, both in Florida and across the country. Warmer air holds more water vapor than cooler air, thus intensifying rainfall amounts.

The National Weather Service (NWS) reports that flooding kills more people than almost any other weather-related hazard. That’s why it’s important to know what to do in storm emergencies.

Before the Storm

  • Be sure you have a 30-day supply of your medications—both prescription and non-prescription—on hand before the storm hits. See us if you need refills of any drugs you may be taking.
  • If your medications need to be refrigerated, talk to us about how to keep them properly stored if your power goes out.
  • If you are on dialysis, talk to the doctors or staff at the dialysis center about where to go after the storm.
  • If you use medical devices such as ventilators or oxygen concentrators, be sure the batteries are fully charged, and know where to go if the battery doesn’t work.
  • If you are on a special diet, be sure to have enough food available to last at least a week. And have enough bottled water available for everyone in the household to prevent dehydration. The rule of thumb is one gallon per person per day.
  • If you have service animals or pets, ensure they have enough water, food, and any medications to last at least 10 days after the storm.
  • Be sure to have plenty of hand sanitizers and hand wipes available.
  • Make sure to take all your medical paperwork with you if you evacuate: a list of current medications, a list of drug allergies, insurance cards, and contact numbers for your physicians.
  • If you haven’t had a tetanus vaccine in the past 10 years, see us now to be inoculated. During after-storm cleanup, tetanus bacteria can infect you from even a minor cut or scratch.

Driving Safely

Flash floods are caused by slow-moving thunderstorms, or storms that move over the same area one right after the other, known as “training,” because they follow each other like train cars. The NWS says that most deaths associated with floods occur at night or when people become trapped in cars that stall while driving in flooded areas. 

In April’s flooding, CNN reported that a month’s worth of rain fell on Fort Lauderdale in just one hour. Many of the city’s streets turned into lakes as two feet of rain left over 1,000 people calling for help.

If you encounter flooding, remember: Turn around, don’t drown. It takes just a foot of water to float a car; two feet will float most vehicles, including pick-up trucks.

One final tip from the man who helped create the “turn around, don’t drown” slogan: Hector Guerrero, formerly with the NWS, tells NPR that floodwaters can make it challenging to open car doors or windows. That’s why he keeps a safety hammer in his car in case he gets stuck in rising waters.

“You hit the corner of that windshield,” he says. “You can break it out if it has to come to that.”

Then head to higher ground: a nearby hill, a building, or even a tree.

After the Storm

Many deaths and injuries occur after a disaster. So here’s what you need to know to stay safe.

  • Avoid floodwaters if at all possible. They are filled with such contaminants as oil and gas, infectious diseases, household chemicals, and sewage, not to mention displaced animals. Water may also cover potholes and sinkholes.
  • If you’re using a generator to maintain power, be sure it’s far enough away from the house to prevent carbon monoxide from seeping into the home.
  • Do not eat any food or water that may have come into contact with floodwater. If in doubt, throw it out.
  • If lifesaving drugs have been exposed to floodwaters, the U.S. Food and Drug Administration (FDA) says that if the container is contaminated but the contents appear unaffected (i.e., the pills are dry), they may be used until replacements are available. Other types of drugs or drug products such as inhalers, oral liquids, drugs for injections, and so forth, should be discarded if they have come in contact with contaminated water.
  • Insulin loses its potency according to the temperature it is exposed to and the length of the exposure. Under emergency conditions, you might still need to use insulin that has been stored above 86 degrees Fahrenheit. When a fresh supply becomes available, discard any questionable insulin remaining.
  • Take care during cleanup. Be aware of downed power lines, the hazards of power tools like chainsaws, and the dangers of overexertion and heat.

Surviving Spring Allergies Without Gaining Weight

, , , , , Health Basics, Healthy Living, Medications

With the fresh air of the ocean and year-round warmth, you might be surprised to find that Florida is one of the top hot spots in the country for spring allergies. You might also be surprised to learn that some of the over-the-counter (OTC) allergy medications you automatically reach for to stop the resulting sneezing and sniffling can cause you to gain weight.

So our concierge primary care doctors in Jupiter want to tell you the differences between the various types of antihistamines and suggest other ways of battling spring allergies.

‘Pollen Storm’

As NBC News reported last month, a growing number of adults in their 30s, 40s, and 50s who’ve never had allergies before are experiencing them now.

“What I see is people coming in for the first time, especially over the last five, seven years or so,” Dr. Clifford Bassett, an allergist at NYU Langone Health in New York City, told NBC.

“They will always say, ‘I don’t understand how this is happening to me,’ ” he added.

The culprit appears to be climate change, the network reported. As CO2 levels rise, plants and trees produce more pollen, coupled with earlier spring blooms from trees. This is driving a longer season, with more severe reactions from sufferers.

“The pollen season right now is about three weeks longer than it was 30 years ago, and there’s about 20 percent more pollen in the air,” Dr. Neelu Tummala, an ear, nose, and throat specialist and co-director of the Climate Health Institute at George Washington University, told the network.

Dr. Stanley Fineman, an allergist at Atlanta Allergy and Asthma and a spokesperson for the American College of Allergy, Asthma & Immunology, calls the phenomenon a “pollen storm.”

“The pollen counts, particularly this season, have been much, much higher than we’ve seen in the past,” he told NBC.

COVID, Cold, or Allergies?

And since the dawn of the SARS-CoV-2 pandemic, now people are wondering whether their stuffy or runny nose, loss of taste or smell, and itchy, watery eyes are symptoms of COVID-19.

For instance, the loss of the senses of taste and smell can also happen with allergies and colds when the nasal passages become blocked.

In the past, doctors would say that if you’ve never had allergies before, your symptoms are likely something else, such as a cold or other type of virus. But because more people are now experiencing allergies, that’s not necessarily a reliable indicator.

Experts generally agree, however, that fever, chills, and body aches typically indicate viruses, while the telltale symptom of allergies is itching.

“The biggest symptom I would suggest is the itchiness of the eyes, nose, and throat,” Bassett said. “You don’t get itchiness if you have a cold or if you’re having a sinus infection.”

Nevertheless, it’s best to get tested if you’re experiencing new symptoms.

“We’ve definitely had patients come to our clinic who thought they were having allergies, but they had COVID instead,” Dr. Michelle Pham, an allergist, and immunologist at USCF Health in San Francisco, told NBC.

The Risk of Weight Gain

Depending on the severity of your symptoms, there are several ways to treat allergies.  One of these is oral antihistamines.

But a 2010 Yale University Study that found those who regularly took antihistamines weighed more than those who didn’t gave some allergy sufferers pause. The researchers cautioned that it wasn’t clear whether those who were already overweight were more prone to allergies, and thus more likely to take antihistamines.

According to the non-profit Obesity Medicine Association, however, “Histamine decreases our hunger by in part affecting the appetite control center in our brains, and it makes sense [that] an anti-histamine would have the opposite effect. These drugs can interfere with the ‘I’m full’ signal coming from the rest of our bodies and lead to overeating.”

In fact, some antihistamines—particularly cyproheptadine—are prescribed for children and pets to increase appetite.

But not all antihistamines have this effect. The Cleveland Clinic explains that so-called first-generation antihistamines were approved in the 1930s, but had more serious side effects, including drowsiness, dry mouth, and rapid heart rate. The second-generation antihistamines, approved in the 1980s, carry far fewer side effects. They also don’t relieve nasal congestion the way many first-generation antihistamines do.

What To Do Instead

If you want to try to do without antihistamines, first, avoid exposing yourself as much as possible to pollen.

  • Avoid outdoor activity in the early morning when pollen counts are highest.
  • Keep windows closed, in the home and car.
  • Wear a mask, hat, and sunglasses if you need to be outdoors.
  • Use a vacuum equipped with a HEPA filter.

Next, rinse frequently with a saline nasal spray or a neti pot to clean out pollen in your sinuses.

Finally, try switching to second-generation antihistamines. These include:

  • azelastine (Astelin)
  • loratadine (Claritin, Alavert)
  • cetirizine (Zyrtec)
  • desloratadine (Clarinex)
  • fexofenadine (Allegra)

If OTC medications aren’t working, be sure to let us know. There are prescription approaches that may help.

Keep in mind that, even if your allergies have been manageable in the past, with the stepped-up pollen levels accompanying global warming, you may need more intensive therapy.

“Before, you could get away with just using an intranasal steroid,” Tummala told NBC, “and now you have to do a neti pot rinse and then the steroid,” she said.

Nature Can Heal in More Ways Than One

, , , , , , , , Environment, Health Basics, Healthy Living, Lifestyle, Motivation, News, Preventative Health, Uncategorized

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.

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.

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.

Read more
Fourth of July Safety Tips

Fourth of July Safety Tips

, , , , Holiday Safety

What would the Fourth of July be without a picnic, possibly with a big family-and-friends cookout, topped off at dusk with celebratory fireworks? Your concierge family practice doctors at MD 2.0 in Jupiter, Florida, want you to have a happy holiday. We also want you to be safe, which is why we decided this would be a good time to review firework safety basics.

Read more
healthy-summer-snacks-image

Tips for Healthy Summer Snacking

, , Healthy Living
Creating healthy, creative snacks in the summertime is practical and easy, especially since there’s so much healthy delicious produce in season! Summers are busy, so quick, on-the-go foods are often your best option. On top of that, summertime allows you to have variety in your healthy eating, since almost every fruit and vegetable is available at your supermarket. All of these things make summertime the best time for optimal healthy snacking. Here is a list of some of the best and healthiest summer snacks!

Avocado Toast
Perhaps one of the easiest summer snacks is some avocado on a piece of toast, with salt and pepper. It’s best to use a very ripe avocado, mash it with a fork and then spread on your favorite toast. A drizzle of olive oil gives it a nice flavor and an extra boost of healthy fat!

Mini Caprese Skewers
Assemble toothpick skewers of cherry tomatoes, small pieces or rolled balls of fresh mozzarella cheese, and basil leaves. Drizzle with a balsamic glaze or just a dash of balsamic vinegar and olive oil. Add some sea salt for a little crunch!

Frozen Fruit and Yogurt Bites
You can do this with just about any fruit. Some that we have found to taste great are blueberries, raspberries and strawberries – all summer favorites. Simply mix the fruit with greek yogurt, spread out onto a baking sheet lined with wax paper, and freeze. When you take it out of the freezer it will break apart like bark. These are great on an especially warm day and pack a little protein from the yogurt.

Oven-Dried Strawberries
Bake fresh strawberries in the oven for 3 hours at 210 degrees. They will dehydrate and taste like candy, but are completely healthy and all-natural. The nice thing about this snack is that they can be taken on-the-go for a quick snack when you need it. These are much better than hitting the vending machine when you just need a snack!

Frozen Grapes
Wash your fresh grapes and put them right in the freezer. Although this is such a simple maneuver, the results are delicious and super refreshing during the hottest season of the year! Frozen grapes are like nature’s candy and so easy to make!

Healthy “Banana Split”
Cut a banana down the middle and fill it with greek yogurt, fruit of your choice, and an optional sprinkle of mini dark chocolate chips. This snack is full of protein and healthy goodness, while still satisfying your sweet tooth. This is also a great snack for the kids!

Crunchy Roasted Chickpeas
Love potato chips but looking for a healthier option without losing the crunch? Place chickpeas on a baking sheet lined with parchment paper and bake at 450 degrees for 30 minutes. After they are done baking, mix them with olive oil and seasoning of your choice. Yum!

Summer is one of the best times for snacking. Whether you are going to soccer games, on family vacations, or keeping busy at home, snacks come in handy for everyone! Snacks don’t have to be full of fat, fried, or packed full of preservatives. Take advantage of the vast array of fruits and veggies available in the summertime, and make them into healthy snacks that are delicious for the whole family!

1 2