Very rarely do you see little kids and/or adults walking around sporting a super sunburn in these early summer months as we did years ago, with the increased use of sunblock…which is awesome that people are using sunblock to prevent skin cancer and sunburns but it can lead to a lack of vitamin D, which has its own set of issues. There is an increase in prevalence, specifically in children, of rickets, which has been more of a rarity of a childhood disease.

What is Rickets?

Rickets is  a deficiency of vitamin D, calcium, or phosphate which leads to a softening or weakening of bones. Vitamin D assists with the absorption of calcium and phosphate from the GI tract, so when a vitamin D deficiency is present, we cannot adhere as much calcium and phosphate to our bones and they become weakened.  If left untreated, it can lead to long-term bone deformities, dental issues, failure to grow appropriately, breathing problems and chronic pneumonia, and seizure disorders.

Some common signs and symptoms of rickets:

Delayed growth

Pain in pelvis, spine, legs (different from growing pains which are quick and go away)

Muscle weakness

Curved legs (bowed)

Curvatures of the spine

Thickened wrists and ankles

Breastbone projection

What are causes and prevention?

Well, obviously the cause is a lack of vitamin D and that can be due to a lack of absorption of sunlight by the skin. When sunlight is absorbed by the skin, it produces Vitamin D, and when people lather up in SPF 50 at all times and avoid direct sunlight, they can become deficient, as SPF helps to block the rays that can trigger vitamin D production.  Also we can be missing vitamin D in our food sources.  Milk, cereal, and some juices are fortified with Vitamin D to ensure that kids are taking in enough, but it is also naturally present in egg yolks, fatty fish, and fish oils.  Sometimes getting fish (especially fatty fish) in kids can be tough, but eggs can be easier, which is one of the reasons other foods were fortified.  Any diseases that prevent absorption of foods can cause a vitamin D deficiency, like; celiac disease, inflammatory bowel disease, kidney disease, and cystic fibrosis.

What are risk factors?

Children between the ages of 6 and 24 months old are at higher risk due to fast skeletal development

Exclusively breastfed babies are not getting vitamin D from breast milk (formulas are fortified)

Dark skinned people, as darker skin doesn’t react to produce as much vitamin D as lighter skin does

Living in Northern latitudes because there is less available sunshine throughout the year due to being further from the equator.

Premature babies, they don’t seems to absorb the vitamin d from GI tracts as well and are at higher risk

Some anti-seizure medications can interfere with vitamin D absorption.

What are the treatments?

Rickets are diagnosed through x-rays, physical assessment, and blood and urine samples to assess vitamin D levels.  Once diagnosed, the treatment is vitamin D and calcium supplementation.  You can also get sunlight exposure (outside of the hours of 10am-2pm when the sun is strongest).  If the bones are very deformed, your HCP may order special braces to correct the deformities.

As with any disease, prevention is key!  Make sure that you and your children are taking in adequate amount of vitamin D through fortified foods (milks, cereals, juices) and through taking in egg yolks, fatty fish, and/or taking fish oil supplements.  Also, I am totally behind the whole prevention of skin cancer, do not get me wrong, but at 4pm, if you kid is going out to the park, you can lay off the SPF 50 and let them absorb some direct sunlight, I promise they will appreciate not being super lubed up AND it is actually healthy for them so they can absorb some of that vitamin D….actually when they don’t have bowed legs, they will really give you a thank you for skipping the late day SPF!  Keep it in the back of your mind, and think about your child’s nutritional status and what they eat, if you are at all concerned talk to your HCP and they can test them for their vitamin D and calcium levels and add some supplementation if you re worried they aren’t getting enough.  I know, one more thing to think about!

Yours in Good Health

B

OK, I really thought that the whole tampons soaked in vodka trick was an inventive (albeit creepy) way for teenagers to get drunk without getting caught with bottles of booze on their persons, but this trend of drinking hand sanitizers, not only turns my stomach, but warning lights are going off in my head.  Things that are made to kill viruses and bacteria on the OUTSIDE of your body, should not be ingested….I’m just saying.

What’s the deal?

Hand sanitizers, such as Purell, have about 62% ethyl alcohol as a base (which is the equivalent of 120 Proof alcohol) so one shot of sanitizer on a lightweight teenager that is pretty novice to the world of alcohol, can do a LOT of damage.  But, let us not forget the other ingredients in hand sanitizers, that help to kill of viruses and bacteria, besides the alcohol, and the effects that they can have on your body.  Most sanitizers also contain: Triclosan (an antibacterial) and Benzalkonium Chloride (an antiseptic like bactine).    Triclosan has no reports of adverse effects in small amounts, whereas, if ingested, even in small amounts, Benzalkonium Chloride can lead to death, by causing damage to the GI tract, Central Nervous System, heart, kidneys, liver, and the entire cardiovascular system.  Doesn’t sound worth it to me!  One hospital in California has reported over 2,600 cases of severe intoxication from ingestion of hand sanitizers since the middle of 2010, and that is a lot of teens requiring treatment for severe intoxication.

How do you drink the sanitizers?

These kids are pretty crafty, I will tell you that!  They figured out how to distill the hand sanitizers, not only to remove all the goo-balls of antibacterial/antiseptic treatment, and to make it taste better.  A quick google search brought me right to an answer forum from one person to another asking how to distill the sanitizers (which apparently does not take a ton of science/chemistry know how like I thought it would): merely mix the ethyl based hand sanitizer with salt, mix, and filter through cheesecloth to get rid of all of the goo.  Then they add flavoring (AKA a mixer) and drink away.  Now despite taking out the large bits of the antibacterial and antiseptic treatment, there are still bit of the compounds within the leftover “alcohol”, so not only are they ingesting 120 proof alcohol, but some of the Benzalkonium Chloride as well: It’s like a double attack on your liver!

What can I do?

Well, I think that if you have teenagers in the house, I would just watch how much hand sanitizer you are going through, if it seems like mass quantities, something might be amiss OR your teen is really into squeaky clean hands. Of course you cannot stop them from going to a supermarket, pharmacy, etc to purchase hand sanitizer, but at least you can be aware of anything seems wrong at home. There are some alcohol free sanitizers available, they are as tough on bacteria as the alcohol based but apparently less effective on killing viruses. If you are really into having alcohol based hand sanitizer at home, the foam forms of hand sanitizers are much more difficult to distill, and the bitter taste should be more off-putting and deter teens from drinking them.  Just be aware of change in behavior of your teen and/or their friends, and talk to them about the dangers of drinking hand sanitizers: organ damage and death are pretty scary.

Coming from a girl who didn’t pay enough attention in chemistry in high school, clearly, I am totally stunned that this is occurring, and I really think this is a horrible trend that we (as HCPs) are seeing in hospitals from teens trying to be sneaky getting drunk/high/etc.  So stay in tune with your teens, talk to them, and if you think there is a problem, bring them to their HCP to get a check up, and that way we can show them the damage they are doing to their bodies and what the long-term effects are.

Yours in Good Health

B

There is a new brand of flip flop on the market that yogis and health fanatics alike are touting as the “best” flip flops, not only because the flips are supposed to let you “ground” (I’ll give you more scoop on that in a bit) but the company also gives back.  They donate to a bunch of non-profit organizations that are pro-earth, and pro-health; I can get behind that, but do the flip flips actually help you to be healthier?

What is grounding?

Grounding is the how you make an electrical connection in harmony with the electrical current of the earth.  WHAT?  Basically, it is the idea of rooting yourself to the earth.  It was once believed that the earth was neutrally charged, but apparently it is negatively charged, and humans, and all of the electronics we use, are positively charged.  So, by disconnecting from electronics, and basically standing with bare feet in grass (or on sand, etc.) you are becoming a neutral being.  You are grounding yourself with the earth, as a positive and negative charge equal each other out.  I know that some of you are reading this thinking that it is super hippie talk, but think abut it: we all live in insulated homes, we wear shoes and other forms of footwear, so we rarely connect with the earth, unless we take time out to actually connect.  Plus, we all are surrounded by so much electricity from phones, TVs, computers, etc. it is merely another way to disconnect form electronics, and reconnect with the earth and nature. The theory is that grounding and neutralizing the electromagnetic field around you, will promote health, decrease inflammation from chronic illness, and overall make you feel better.  If you are unhealthy or unwell when you first start grounding, you supposedly will feel tingling with the change in the electric pull around your body, and then the benefits will start becoming more apparent, as long as you ground for about 20 minutes a day.

Where do Pluggz come in to play?

Well, Pluggz are these flip flops that have a black plug that is made from a custom carbon and rubber compound that help to ensure electrical contact between the most weight bearing part of your feet and the earth.  They supposedly conduct a free flow of electrons front eh earth to our bodies and assisting with reducing that positive electron effect on our bodies.  People who wear pluggz report feeling more balanced, a sense of well-being, more energized, some are calmer, and fewer aches and pains.

What’s the rub?

There is no research to support Pluggz, but they are a new product, and there are tons of people that really support the use of pluggz and report feeling better and more grounded when wearing them.  There is also nothing saying that it is all crap either!  I am honestly very intrigued by this product and actually willing to give them a go, and see if I feel better?  Although, I must say, I am pretty healthy with no complains of daily aches and pains, but I am willing to do anything that will promote calmness, energy, and balance?!?  I am usually running round like a lunatic and tripping over myself! I’m kidding, but it would be interesting, because flip flops really have no support for your feet at all, and most ortho’s always tell people with back pain, joint pain, etc not to wear them because of the lack of support, but as one who fully supports barefoot running and strengthening your foot muscles, I feel like this is something I should try.

I wish I had an answer for you all whether they are worth the $39 and actually promote well being, and a feeling of health, but it is just such a new product that besides word of mouth, there is not a lot of “science” behind it, but I do like the fact that the company supports other healthy non-profits from shoe sales…..maybe I just like the idea?  Well, I think I will purchase a pair and let you know how grounded I feel, but until then, I will walk barefoot in grass and on the beach as often as possible, not so much to “ground” but just because it feels good and I love it!

Yours in Good Health

B

I am asked frequently about various alternative therapies, some of which I know a lot about and some that I have never heard of.  The other day I got a couple of emails asking me about Reiki and if it is worth trying for chronic and acute illness treatment. I do know quite a bit about Reiki as I do have known a few Reiki Masters over the years, although I must say, I did not know the true efficacy of it, as he research states.

What is Reiki?

Reiki is a spiritual practice created by a Japanese Buddhist in 1922, and it involves palms (or hand) healing as a form of complementary therapy.  The Reiki practitioners use their energy, transferring it through their palms to the patient. This transference of energy allows for self-healing and a state of equilibrium.  There is Traditional Japanese Reiki and Western Reiki, in which the main difference is hand placement; the Japanese technique relies on the practitioner sensing where the body needs energy versus the Western technique tends to use systemized hand placement.  Either way, the energy is being transferred from the practitioner to the patient, and promote self-healing.  There are three levels of practitioners: First, Second, and Master level.

Does Reiki actually heal?

I was pretty bummed to find no research that supports Reiki as a scientifically based healing method.  The American Cancer Society actually making a statement stating that Reiki is no clinical or scientific proof to support Reiki as a healing or curing treatment.  There is basically no scientific research to support it, and a review of all clinical research trials shows that there is insufficient evidence that Reiki is effective in curing or healing any illness BUT that is not to say that it isn’t helpful or useful.

What do I mean by that?  Well, people who are sick that get Reiki treatments, report feeling better, and swear by the fact that their Reiki is what is helping them heal and make them feel better.  I truly believe that healing is all about rest, relaxation, and doing positive things for yourself.  So, this is a case where you will ask 10 different HCPs their thoughts on Reiki as a healing treatment, and you will most likely get 10 different answers, but I fully support a non-invasive treatment, where you are not ingesting anything that may interact with your current medication regimen, and makes you feel great. I see it as a win-win.

I have had Reiki and I felt amazing afterwards, and for a week or so afterwards, plus little aches and pains that I had went away completely.  I always suggest talking to your own HCP for advice about changing your healthcare regimen, but I fully support the use of Reiki, even though the research isn’t out there yet!

Yours in Good Health

B

Camu camu is getting a lot of face time in health food stores and people in the health food world seems to be all buzzing about it.  I wanted to find out what the scoop is with this new, so-called, super fruit, as I had never heard of it, and I am always a little skeptical about these fruits that have been around for eons and then all of a sudden become super hip to ingest.  You know what I mean? Why haven’t we always known about these fruits?  is it big business driving this trend, or is it really good for you?

What is Camu Camu?

Camu camu is a small bushy tree found in the Amazonian rainforest in Peru and Brazil, that bear a small reddish/purple cherry like fruit.  The fruits from the Camu camu tree are actually very bitter and the local people who tend to harvest them by running their canoes down the river, and pick the berries directly into their canoes, tend to mix the berries with sugar, milk, and or ice cream to make it more palatable.  There are thoughts that the camu camu berries enhance mood, and that it has anti viral and anti inflammatory effects as well.    The camu camu berries are certainly high in Vitamin C, and have basically the highest amount of Vitamin C of any fruit.  They are really only topped by synthetic Vitamin C supplements, which aren’t as easily absorbed by the body.  The Camu camu is also thought to be high in antioxidants, which can prevent cancer.  The local people tend to eat diets high in camu camu and have the highest regard for the fruit saying it is the reason hey have silky hair, to being happy, to easing arthritis pain  So, they seem pretty good on paper, right?

Do they live up to the hype?

Just like any other fruit that is “new” to the mainstream market, there is very little true research on these fruits and nothing much is known, other than they really do have that high vitamin C content.  My concern is that the only way people can make the fruit palatable is to add significant amount soy sugar, milk, or ice cream, and basically making this fruit into a high calorie dessert to eat it…is it worth it?  You can also take it in pill form, like a supplement, so that would be ok.  But in these times of people being all about sustainable farming and being eco-friendly, camu camu farming is super bad: Japan is the highest importer of camu camu from South America, and now the Western world is starting to buy into the Camu camu, and we are running these poor camu camu farmers to the brink of extinction.  It is being over harvested, and it is super expensive to export.  So that part is a total bummer.  Plus, all of the hype about the anti viral and anti inflammatory effects are not founded.  As well, there is nothing that shows that the camu camu helps to enhance mood or balances moods.

I hate to be a Debbie downer, but with the cost associated with camu camu, and all you really know you are getting is high Vitamin C content, you might want to stick with adding acerola (rose hip) supplements to smoothies or foods to boost that Vitamin C intake, or eat those citrus fruits!  And honestly, the part that makes me the saddest is that people are over harvesting this fruit and we are putting the whole fruit/tree at risk for extinction.  I am sure at some point someone will start goring them for commercial sale, but will they have the same benefits and be the same fruits then? Maybe I am being skeptical, but I think there are other ways to get Vitamin C and antioxidants!

Yours in Good Health

B

I have had quite a few questions related to anal beaching lately, I know that it was referenced in Bridesmaids, and I’ve heard quite a few one liners about it, but to be honest with you, I didn’t really know much about the topic.  Sadly, I now feel like quite an expert on the topic!  And there are a lot more health issues related to this practice than I had any idea about.

What is Anal Bleaching all about?

It is when you literally bleach the skin around your anus to lighten the skin color so it is all uniform. The treatments are either done at a salon/spa (gel lightener and or laser treatments) or there are some at home treatment options (gel and cream lighteners). I bet your follow up thought is ‘why is this an issue’? Apparently this is a trend started by adult film stars, who noticed that the skin around their anus was a different color than the skin of their butt.  There is a reason that the skin is different colors, it is a different type of skin cells, and I think for eons no one has ever really noticed, but with the popularity of the Brazilian bikini wax, people are uncovering areas that previously were always covered! Here’s the rub: anal bleaching is temporary, and the creams work by decreasing the melanin in your skin, but as soon as that skin is exposed to UV light, it will become darker than before! So it truly is a temporary treatment, and I guess it depends on how important having one skin tone back there really is for you.

Are there any risks associated with it?

Yes! Many of the creams/gels that are used for skin lightening, were created for rapid skin lightening, meant for people with skin pigmentation issues that are usually in less sensitive areas of the body that might need to be lightened to neutralize skin tones.  When these products that are made for less sensitive areas are used in your genital areas, you can have a whole slew of reactions that you probably were not expecting:

-ochronosis: bluish/brown/black pigmentation that can occur (which kind of defeats the purple of bleaching in the first place, right?)

-skin irritation: burning, itchy, dry, peeling skin that is a reaction to the harsh chemicals in the lightening products, and direct laser pulses.

-scarring: due to severe reactions to the treatments, the tissue can become so enflamed and irritated that scar tissue builds up, especially with the laser treatments.

-infections: when reactions and skin irritation occurs, it opens up the tissues with little micro tears and puts you at risk from infection from your own bodily functions and also if the salon/spa you are getting your treatment from does not change out applicators or use fresh treatment creams/gels/etc between clients you are at risk of getting any infection that the person before you has!

-pain: this whole process can be really painful, especially if you have any of these reactions, and it may take a while to completely treat and for your skin to go back to normal. The lasers can cause major discomfort during the layering process and afterwards.

-anal fissures: breaks or tears of the skin in the anal canal, related to a reaction from the creams/gels, especially if applied directly over the anus. It’s almost like a paper cut, but given the area of the body its in, it is NOT comfortable, and can take a while to heal.

There seem to be an awful lot of side effects for a treatment that is strictly temporary, and can actually make the affected skin darker if and when it is exposed to UV light in the future, right?  Melanin that is in our skin is there for a reason, and help to protect us from skin cancer with UV exposure, so why do we want to get rid of it?  Plus, unless you are an adult film star, or lingerie model, is anyone really going to be looking at your anus and comparing skin tones?  I would hope not.  I’m not judging at all, I just think that there are ether ways to spend your time and money….that is one area you do not want to have an allergic reaction, irritation, scarring, etc!

Yours in Good Health

B

There are a lot of people who have had deep vein thrombosis, with absolutely no idea what they are or if they were even at risk.  There are certain common medications that put you at risk, lifestyle choices, etc and they can be quite devastating. So let’s get to the bottom line of what DVTs are, how they occur, treatments, and risk factors.

What is a DVT?

It is blood clot (aka thrombus) that forms in one of the deeper veins of your body, usually in your legs, can occur without any symptoms, and can then break free and travel to your brain, lungs, or heart causing a pulmonary embolism, stroke, or heart attack (due to a lack of blood flow to major areas from the clots).  Almost half of all DVT’s form without any symptoms, which can be pretty scary.

What are the symptoms?

Despite the fact that DVTs can be silent (or symptomless) there are some symptoms that people can have:

-Swelling in the affected leg (calf, ankle, foot)

-Pain in your leg (or ankle/foot) that feels like a charlie horse or muscle cramp

-Warmth or redness in the affected area

Why do they form?

There are tons of reasons for these clots to occur, some are as simple as having a family history of clotting disorders, having surgery, or women who take birth control and smoke.  But there are a whole slew of other reasons that you could form a deep vein thrombosis: sitting for long periods of time driving or flying, prolonged bed rest (like when sick or in the hospital), injury to your veins, pregnancy (increased pressure on your veins along with hormonal changes), cancer, heart failure, pacemakers, intravenous lines (like when in the hospital), inflammatory bowel disease, family history or a prior DVT, being overweight, smoking, and tall men.  Yikes! There are tons of reasons that they form, but the important thing is to be aware of your family history, and the other risk factors, so that if there is anything you can alter (i.e. lose weight or stop smoking) you can, and if not, you can just be aware of what to look for.

How are DVTs diagnosed?

When you are suspected of having a DVT, there are a few tests that may be performed to diagnose the actual clot.  Your HCP will take some blood and test your clotting factors to see if they are elevated (you may be at a higher risk to clot) and they will also check a D-dimer, if you have a clot, your D dimer will most likely be elevated because it is a naturally occurring clot busting substance in the blood. You may also have an ultrasound to visualize the clot, in the area assume to be affected.  If there is a suspected clot that may have moved, your HCP may send you for a CT Scan or an MRI that may help to visualize the clot.  They can also do a venography, in which they shoot die into the vein to try to visualize the clot, but it is a lesser used method for diagnosis of DVT.

How do I treat a DVT?

The goal is to diminish the clot, prevent more form forming, and if you can’t get rid of it, prevent it from doing some major damage (like the aforementioned pulmonary embolism, stroke, heart attack).  The usual treatments are blood thinners that prevent your blood clot from getting any bigger and prevent new ones from forming, like heparin (which is injected or in intravenous form) and then coumadin (oral form).  Just remember, if you are taking coumadin (which is actually rat poison) you need to be careful about eating foods high in vitamin K (like green leafy vegetables) as Vitamin K can reverse the effects of coumadin. If your clot has progressed and might cause a pulmonary embolism, you may get a clot busting drug called tPA (tissue plasminogen activator), it is given through an IV but you need a lot of monitoring and need to be in the hospital as there are high risks of bleeding after getting the medication.  And, if the clots cannot be treated with the medications, due to side effects, then you may have a filter placed in your large veins; if the clots break off and travel, they will get caught in the filter and they will be unable to travel up an cause any other damage.

How to I prevent DVTs?

Keep active, lay off the smokes (especially if you are on birth control), try to live a healthy lifestyle, and being aware of the risks is the best for of prevention; if you know the risks, you can talk to your HCP if you have risk factors to come up with a prevention plan and/or just keep the conversation open so they can be aware and let you know what you can do to further prevent your risks.  You can also wear compression stockings when on your feet for long periods of time, they help to keep veins constricted so that your blood cannot pool and clot AND it helps to prevent swelling of your legs.  Also make sure to exercise your lower calf muscles, watch your vitamin K, and make healthy lifestyle choices like eat healthy and exercise.

Be aware of the risks, keep the symptoms in the back of your mind, and if you think you have a DVT, go see your HCP or to the ED immediately for treatment.

Yours in Good Health

B

Chagas disease is a virus that is a bigger threat in Latin America than HIV/AIDS. It infects about 18 million people a year and kills somewhere around 20,000.  The scary thing is that it is not well known about here in the US (or for that matter outside of Latin America) but because of traveling and/or relocation, this is becoming more of a threat in the EU and US. It is a blood born virus and we do not screen for it with blood transfusions as we do Hepatitis C, HIV/AIDS, and other viruses, so you may be at a higher risk than you are aware of!

What is Chagas Disease?

It is an inflammatory disease caused by a parasite that lives in the feces of a kissing bug (reduviid bug) and it is most common in South America, Central America, and Mexico. The kissing bug, acts just like a mosquito, and it bites to get to blood, and once it is done feeding, it poops, and the parasites in the poop, then have a direct link to the blood. It is usually diagnosed in children but it can be pretty detrimental if found later in life as it causes some severe cardiac damage and damage to the intestines. The goal is to catch the parasite while it is active a replicating, to kill it off and present any further damage.  Initial symptoms include:

-Swelling at the site of infection

-Fever

-Fatigue

-Rash

-Bodyaches

-Headaches

-Swollen glands

-Nausea, vomiting, diarrhea, and loss of appetite

-Enlargement of your liver or spleen (some stomach tenderness)

-Chronic infection can cause: congestive heart failure, irregular heartbeat, constipation (from an enlarged colon), and sudden cardiac arrest.

How can I get it?

Well there are quite a few ways other than being bitten by a kissing bug that you can get infected with the parasite: eating food contaminated with the parasite or bug poop, being born from an infected mother, getting a blood transfusion or an organ transplant that are infected, from blood exposures of an infected person, or from an infected animal.  It is diagnosed by taking a blood sample, but your HCP will also want to check an electrocardiogram (a picture of your heart), possibly an x-ray of your abdomen, and an EGD (upper endoscopy- where a scope is sent into your upper gastric area to visualize any damage).

How do you treat it?

As I said earlier, the plan is to treat and kill the active parasite while it is replicating with drugs such as benznidiazole and nifurtimox, which are readily available in Central & South America and Mexico, but are only available directly from the CDC (Center for disease control) in the US, so that the parasite can be tracked. Once the disease gets to a chronic stage, you can only treat the symptoms, unfortunately, you cannot undo them.

How do I prevent it?

When traveling to the areas with the highest rates of Chagas disease, use pesticides to prevent bug bites, especially if camping or staying outdoors, and avoid sleeping in adobe houses (mud thatched huts and adobe houses tend to have higher rates of chagas disease).  Really the best prevention is to be aware of the risk, and do your best to prevent bug bites by using bug sprays, bug meeting over beds, and know the symptoms, so if you think you have been bitten, get seen by an HCP for treatment as soon as possible!

So hopefully you are prepared on your next visit to Central or South America, or Mexico and have lots of bug spray! Plus, if are concerned about your risk after an organ transplant or recent blood transfusion, talk to your HCP about your risk, as this is not something we normally screen for in this part of the world.  It is better to be safe than sorry!

Yours in Good Health

B

It was brought up to me that there is a “new” mental disorder known as the Truman Show Delusion, where people think they are constantly on a reality TV show.  Now, my best friend and I will joke about how awesome we are and that we should have a reality TV show….but we both know that we are not ON TV.  Apparently watching “The Real Housewives of….” is too much for some people to handle, mentally, and they think there is a TV crew following them too.  But, it is very interesting because the more I am reading about it, the more highly debatable it seems to be in the mental health field.  If you are at risk for the Truman Show Delusion because of watching reality TV, I am in TROUBLE!!

What is this Disorder?

This disorder is named after the movie The Truman Show, starring Jim Carey, in 1998, where he lived in this world, not knowing that how whole life was basically a scripted reality TV show, and he was secretly being taped, while the whole world watched his life.  There are two MDs, who happen to be brothers, Ian and Joel Gold, who claim that there are a few real cases of this disorder, where people believe that everyone in their lives (their families, significant others, co-workers, etc) are all interacting with them based off of a script, and their lives are secretly filmed for reality TV.  They believed that they first started to see these symptoms in patients in Bellevue Hospital in New York in 2002; it is a state of acute psychosis for these patients and they truly believe they are being secretly taped.

Does anything put you at higher risk?

The Golds have found certain traits in their patients that they have found to have this disorder. They say that most of the people that present with this disorder, choose to be at the center of attention most of the time, are very concerned with social standing and what others think of them, and they may actually fear being in the public eye.  Their fear may be so strong that it actually causes a psychotic break in which they believe they are the focus of everyone.  A hyper acute paranoia, stemmed from their biggest fears.

What is a delusion/psychotic break?

A delusion is a belief that someone holds firm to, that has been otherwise proved untrue.  So, if I said that I am the President of the US and I tell everyone that, and truly believe it, despite the fact that Barack Obama is the president, and it is  common knowledge, I would be delusional.  And psychosis, or a psychotic break, is when someone all of the sudden has no concept of reality at all; one day you are living your life with complete control and understanding, and the next you no longer trust or believe anything that you have accepted as truth your entire life.  Both of these issues can be scary to the person it is happening to and confusing to those around them, such as friends and family members. Anyone with an acute delusion or psychotic break should seek help immediately so the underlying reason for the delusions/psychosis can be treated and an HCP can help to ensure that they are safe.

What is the controversy with the Truman Show Delusion?

Well, acute paranoia and delusional psychotic breaks are not new in the world of psychiatry.  And patients who are having these delusions or paranoia often are paranoid about things that are relevant in society.  For example, when radios were the hottest technology, patients were worried that they were being affected by radio waves and they were being emitted into their brains, changing how they acted and invading their thoughts.  Now it is more a fear of microchips being imbedded in them, or the fear of hidden TV cameras because there are so many reality TV shows/hidden camera shows in the media and on TV.  So, many in the medical field kind of think that this is just a lot of hype, to get 15 minutes of fame for the Doctors Gold, for something that is not new and has been part of delusions since inception of the diagnosis.

Just like after 9/11, people had psychotic breaks and delusions about terrorists everywhere; does this mean that the cultural obsession has created this phenomenon?  I think the biggest issue is that this is a culturally relevant take on an old psychiatric disorder. This isn’t a rampant diagnosis since the inception of reality TV, and there are risk factors.  BUT if you do know anyone that has any of these fears, you should get them to see their HCP immediately as they do need medical care to treat their psychosis, figure out the cause, and get them medications/treatment regimens.  But, rest assured, there is no research that says that watching reality TV will make you have a psychotic break and create the Truman Show Delusion!  So, keep on keeping on with the Kardashians and those “Real Housewives..” besides wasting a few hours of your life, you won’e become psychotic!

Yours in Good Health

B

I know that it should come as not shock to people when I tell them that the preferred route of obtaining medication is to have an issue, go to your HCP, obtain a prescription, go tot eh pharmacy, have it filled, and there you go.  Sometimes, especially for medication that they feel their HCP won’t write for them or they are just too embarrassed to ask for, they find other ways to get medications: the internet.  I want to be clear, going through your CVS/Caremark, Walgreens, Rite Aid, etc online drug programs is totally fine, as long as it is supported by your insurance company, and an FDA regulated company, you are all set; online pharmacies that tell you there is no prescription required is where the issues can happen!

How does it work?

I am sure that you have all received one (or a million) of those SPAM emails looking to sell online Viagra, Ativan, whatever the drug du jour is from these companies.  Those who are actually interested click on the link (PS- bad move all around, but we will get into that later), and you are charged a “consultation fee” with a “Doctor” that is usually from a foreign country, or from the US that is no longer allowed to practice within hospitals due to drug addiction, malpractice suits, etc.  Bottom line: your consultation is with a “doctor” that you wouldn’t even let touch an animal, never mind yourself.  But, the FDA requires a prescription for all medications, which is how they get by the loophole.  They charge you a hefty price, and send your meds off to you.  Sounds great and super easy. Right?  Hmmmm…..

What are the Risks?

Well, since these places aren’t actually pharmacies (it isn’t regulated like Walgreens and most likely is in someones house), you are getting a pill bottle labeled as viagra (as an example) but you don’t know that the pills you are getting are actually viagra.  There have been many cases where the pills are diluted, so they “pharmacists” cut the drugs with other things, decreasing potency, or add other things to them.  Recently there was a case where kids were buying adderall online to study for exams and what they were getting in the mail was actually tramadol (opiate pain reliever) and acetaminophen (Tylenol), which would make you SUPER tired and have the opposite effect! An analysis by the FDA of many “drugs” from online pharmacies found that most of the medications that they received were not what they ordered….not at all the correct drug.  This could be REALLY dangerous like if you have a drug allergy, or if you are taking other medications that could interact, or if you have any sort of past medical history: you could be taking something that could kill you, and you don’t even know what you are ingesting.

Also, let’s not forget, the people that run these web sites are not exactly cream of the earth kind of people, and they are many times phishing sites: you clink on that link, pay them using your credit card, and they steal your identity, your money, and they can ruin your credit and/or your life.

Why should I see my HCP?

The whole point of going to your HCP, being SEEN, having labs or other tests done, is part of being safe.  We want to make sure that we are giving you the right medication for the right purpose.  We like to prevent people from beaching dependent upon medications, and use all sorts of different treatments and therapies.  Plus, we make sure that you are getting a prescription from a pharmacy that is regulated by the FDA and giving you real medications; the medications that you need and will help you get better.  We do what is safe, and what is required by law to treat you; those sites do not, and could be giving you medications that could cause serious harm or death due to medication interactions, under dose, overdose, or allergic reactions.  Imagine just taking a pill form someone random walking down the street:

Random guy: “Hey dude, take this pill.”  You: “what does it do?” Random Guy: “I don’t know, just take it” You: “OK!”

NO!  That should never happen, and you should go through the proper channels for prescription medications.  I get that it can be a pain to get an appointment, wait, tests, etc. I totally understand, I get annoyed by the same exact things, but it is all part of a checks and balances in the healthcare field making sure that you are being treated properly and appropriately, and you might think healthcare in the US is expensive, but HCPs won’t steal your identity and ruin your credit, and we make sure that you get the drug we write a prescription for.  Doesn’t sound so bad now, does it??  So stop clicking on internet pharmacies and get in touch with your HCP (plus many HCPs have moved to online sites to contact and refill prescriptions!!)

Yours in Good Health

B