Lyme Disease: What you need to know

Lyme disease is a bacteria infection, Borrelia burgdorferi, which commonly spread through bites from tiny ticks, most commonly the deer tick in North America and Europe, as the deer ticks.  Living in areas with lots of tall grasses and woods puts you at high risk, even if those areas are by the ocean; many times people feel like ticks cannot live near the ocean…but they can, so you need to be careful even in tall marsh grasses. If caught early enough, lyme disease symptoms can be reversible, but it’s all about knowing the signs and symptoms, prevention, and early treatment that are key.

What are the signs of Lyme Disease?

Just like any other disease, unfortunately, sometimes the initial symptoms are completely silent, meaning many people don’t know they have been infected with the bacteria for a while. Immediately after a tick bite, you can see a red bump where you were bitten, and sometimes, over the next few days, redness spreads to look like a bull’s eye, but the deer tick usually needs to be attacked for 36-48 hours to spread Lyme Disease. When I was 21, I had a tick bite that was the classic bulls eye…and that was the only reason I went in for treatment! A few days after the bite and the infection starts to spread, you may feel some flu-like symptoms (fever, chills, body aches) that can go away.

a tick embedded with classic bulls eye rash

a tick embedded with classic bulls eye rash

Later on in the disease, you can get joint pain and swelling, without any other symptoms. Or, you can start to have some neurological symptoms such as numbness or weakness in  your arms and/or legs, a temporary paralysis of one side of your face (known as Bell’s palsy- which can be mistaken for a stroke.) You might also notice that you have extreme fatigue, a fast and/or irregular heart rate, redness/inflammation of your eyes, and you may be told that you liver enzymes are elevated from a hepatitis syndrome.

If you live in a heavily wooded area or around high grasses, and have any of these symptoms, even if they come and go, you should be seen by a Healthcare Practitioner (HCP.)

What is the treatment?

The good news is that Lyme disease is very easily treated, IF caught early, and usually a 14-21 day course of antibiotics can kill off the lyme bacteria and reverse all symptoms. Usually doxycycline or amoxicillin are used as the first line antibiotics; they are cheap and tolerated by most people when taken on a full stomach, however the doxycycline can cause pretty severe reactions in the sun, so stay out of the sun as much as possible during treatment! If you do not respond to oral drugs, you may have to go on a course of intravenous (IV) infusion drugs to get higher levels of antibiotics available to kill off the bacteria. IV antibiotics can be much more difficult to tolerate, as the side effects are stronger, and you have to be under the supervision of an HCP during treatment to ensure that your blood levels are stable.

There is alternative IV treatment with a drug called bismacine, however it is not supported by the FDA and can cause bismuth poisoning, as it has high levels of metals present which can cause liver and kidney dysfunction.

How do I prevent tick bites?

1. Wear long sleeves and long pants when in heavily wooded areas: I know, just what you want to do in the summer, but it prevents those ticks from latching onto your skin and biting you!

2. Insect repellent: yes, some people have issues with using chemicals (check out some alternative to chemical repellents!!)  however, they can be effective! Repellents with at least 20% DEET should be applied, according to directions, to adults and children alike (avoiding hands, face, and mouth!)

3. Check yourself and your children/animals regularly: When outside a lot, children and animals can play anywhere…and so can ticks, so make sure to check them and remove ticks with tweezers, right behind the head, and firmly pull off the skin, making sure that you have removed the entire tick, and then destroy it. (Sorry, I don’t mean to be harsh, but if it’s a ticks life over mine or my dogs, sorry tick!)

If you are worried you or a family member have been exposed, it is best to go get checked out and while the blood tests for Lyme are not always reliable, it is better to be treated early than to wait until you may have more exaggerated symptoms. Prevention is key when it comes to Lyme so be proactive for you and your family and stop Lyme Disease before to even starts!

Yours in Good Health


Laser Hair Removal: Does it work?

I have been an avid waxer for years, and I truly did not believe in laser hair removal, as I knew people years ago who tried it, and it didn’t work for them at all, so I thought for quite a hefty price tag, if it didn’t work, I might else well stick with waxing! I have one friend that swears by laser hair removal, and I found a Living Social deal, and decided to go for it. I am halfway through treatments and it is one of the BEST decisions I have ever made in my life. That being said, there are a few things that you should know before going in for treatment.

What do I need to know?

The laser emits a wavelength of light that is absorbed into your hair shaft and down into the follicle (the base/root of the hair) and after repeated treatments (usually around 6) the hair follicle becomes so weak it can no longer grow hair or it just dies completely, and no longer makes hair.

Because the laser is attracted to darker hair, you will have better results if you have light skin and dark hair (meaning even if you have lighter skin tones but tan in the summer, you may want to skip the summer months when you are tan if you want optimal results.)

You will need to go for usually 6 treatments, that allows you to get each follicle in the phase of hair growth when the hair is actively growing (there are three stages of hair growth, and only one is active).


You should stop waxing or any other methods of hair removal (other than shaving) for around 6 weeks before you get your first treatment, and you should only shave between treatments, this allows for all of the hair follicles to grow, so that you have the best chance of treating each follicle with growth.

Between treatments, you really should exfoliate at least three times week, with a loofah and  an exfoliation scrub, to allow for the weaker hairs to break through the skin and prevent ingrown hairs. Plus, exfoliation helps to remove the hairs that are dead at the shaft.

No plucking between treatments! You want the laser to kill off the hairs, not you and your tweezers.

If you are getting laser hair treatment in a sensitive area (i.e. face, bikini, brazilian, etc),  you may want to get a cream with lidocaine in it to numb the skin before your treatment (apply 30 minutes before your first treatment.) But elsewhere, it doesn’t really hurt at all…just feels sometimes like a small snap with a thin rubber band (at the worst.)

Ask around before starting treatments at one place: just like anything else, the price may be indicative of the level of competence of the people administering the treatment and also  how good the laser is. There are newer lasers and older technology lasers that may not be as good. The salons/spas that offer these treatments are not FDA regulated, so ask how long they have been doing these treatments, their level of comfort, and expected results with their laser. I had my underarms done at one place, which I thought was good, and tried a different laser treatment center for my legs, and there is NO comparison.  My legs, obviously, cost more, but the laser was so much better and the technician is an MD that has been doing these treatments for years, so I had amazing results without any ingrown hairs, and needed less treatments!

Ask around, find out where has a good reputation, and gets good reviews from patients. If you feel uncomfortable, or they are trying to push you into extra treatments that you don’t need, then leave.  There are tons of medical spas/salons that you can go to that will offer you excellent Laser Hair Removal treatments.  I must say, for all of you in the Greater Boston Area, Landa Comsetic & Spa in Framingham is the BEST in the area, with great pricing and the staff all are very well-trained and they have the newest in laser technology (it is where I went for my legs and now basically every other place on my body!!)

It is an amazing experience to have complete hair removal and never have to think about shaving, waxing, plucking, etc again! If you’re thinking about doing it, I highly suggest it, but definitely do your homework on the place before you start treatments, and ensure that it will work for your hair color/skin tone!

Yours in Good Health


Some simple ways to treat calluses

Calluses are pretty commonplace for any avid athlete or really anyone on the go, and they are not a huge health issue, but they can be quite unsightly and they can be uncomfortable sometimes. The good news is that there are ways to prevent them AND means to treat them at home, if you have them!

What are calluses?

They are the bodies defense against constant (or frequent) pressure and friction. The body tends to compact layers of skin cells on areas where there tends to be a lot of pressure/friction so that when it occurs, it is not painful or constantly causing damage (i.e. you will eventually stop getting blisters from a certain pair of shoes because you have either “broken in” your shoes OR your feet!) When they develop, they really are not painful, but they can occur after blisters have formed (which is uncomfortable) and healed. They can be skin toned, grayish/white, or darker in color and either flattened to your skin, just rougher patch of skin, or raised.  Some people are more prone to calluses due to a lack of cushioning between bones and skin tissue (especially in the feet). Regular calluses, are nothing to be worried about, but some people can get very a very rare type of cancer that mimics calluses, amelanotic melanoma, so if you have a sudden callus growth that seems irregular and has cropped up suddenly, it is best you get it checked out by your HCP. Also, if you get pain, swelling, a lot of heat/redness, or any draining (like pus) from the area,  along with a fever, especially if you have Diabetes.

CallusHow can I prevent them?

The best way to prevent calluses is wear shoes that fit, with socks with cushioning. As well, if you tend to get calluses on your hands from working with your hands, wearing properly cushioned and fitting work gloves can hep to prevent that friction and rubbing and prevent the formation of calluses. Also if you have any sort of foot abnormality (like flat feet, any toe amputations, bone protrusions, bunions, etc.) to begin with, you should be under the care of a podiatrist to help and put measures in place to prevent calluses or skin breakdown, like using orthotics or moleskin. Do not try to remove entire calluses by yourself, but you can try some at home treatments, to diminish them.

How can I treat them at home?

You can get medicated pads (usually medicated with salicylic acid that helps to dissolve the thickened skin) at your local pharmacy, and place around the callus to help and decrease pressure on the area.

Change your shoes or gloves that are causing the calluses, find something that fits better

Walk barefoot at home, so your feet can evenly distribute pressure and weight without pressure from shoes.  And leave your hands out of gloves as much as possible.

Soak the areas with warm water and Epsom Salts (or essential oils, or with tea bags) to soften the area, and then you can scrape the area with a pumice stone to work down the callus.  Complete removal can be painful, and you really shouldn’t scrape it off with a razor blade, as it increases the risk of infection and you run the risk of cutting too low.

Always moisturize the areas after soaking with emollient rich moisturizer such as coca butter, shea butter, or hemp seed oil.

If at home treatments are not working and they are causing you discomfort or you are not sure if it may be more than a callus, talk to your HCP and see if you may, in fact, have some other sort of issue and need further treatments. But try to make sure that shoes and gloves are well-fitting, along with maintaining proper hygiene and always use moisturizer!

Yours in Good Health



Beware of “Pneumonia Weather”!

I know that my Mom has many “mom-isms” (sayings that are specific to her), and growing up I believed these to be common knowledge or fact, which now I know that some were completely special to our family. But, to her credit, her declaration of “pneumonia weather” was based upon when I would get it (as I did as a child due to severe asthma) based upon different weather patterns and, by George, she was onto something! The number of respiratory tract infections (RTIs) going around right now are staggering. and for most of us in the US, it is “pneumonia weather”.  To be clear, while I am referring to it as “pneumonia weather”, as that is what my mom calls it, I am just referring to RTIs, which are the leading cause of people missing school and/or work annually.

RTIWhat is “pneumonia weather”?

It always chimes in the back of my head when I see people, who are real positive thinkers, wearing short-sleeved shirts in this cold weather in the end of March and beginning of April  because they feel like it should be warm, so they are pushing the limits, and really freezing in the high hopes that it will get warm, which it does in the middle of the day (with sun) then right back to cold. Now, it has nothing to do, per say, with being under dressed for the weather, it is more just a time when not only are humans confused but so is nature.  The allergens from the trees and flowers starting to bloom, mold spores from the old leaves from fall that are now seeing the light of day after our winter thaw, are all out in the air floating about, and people are getting outside more (which is great) to get more active as it is more tolerable to exercise outside now. But, that cooler air can still cause airways to become reactive, and add in the allergens (which no one ever thinks about this early in the season), add people starting to get in shape and exercise outside again, and you have the perfect setting for people to get RTIs, especially for those who are high risk: people with asthma (or other chronic lung diseases), seasonal allergy sufferers, smokers, the very young and old, those with weakened immune systems, and people with obesity.

*This “pneumonia weather” can also happen when the seasons change from summer to fall with leaves on the ground, mold spores in the air, and newer chilly weather outside.

What is a RTI?

A respiratory tract infection is any sort of virus that causes a response, in any part of the respiratory tract: nose, ears, throat, lungs.  So it can be an ear infection, a sore throat, a runny nose/sinus infection, bronchitis.   All of these are considered respiratory tract infections, as all (minus your ears) are a part of the system that our bodies use to breathe and/or to help filter out the air that we breathe before it gets into the lungs.  So, the more allergens in the air, the more we are breathing in, the higher the risk of a reaction, especially if you are someone prone to respiratory tract infections. RTIs if severe enough, along with a chronic disease and a lowered immune system, could lead to pneumonia.

How do I prevent it?

Follow the normal precautions that you take to prevent illness, such as eating a healthy diet, drinking lots of water, washing your hands frequently, and staying clear of people who are sick (says the nurse; but you all know what I mean, keep your distance if someone is actively showing signs of illness and coughing/sneezing everywhere, as best you can).  But on top of these measures, if you are someone who tends to suffer from seasonal allergies, start taking allergy medication early in the season, i.e. now, because even though the allergen levels aren’t through the roof, they are much more than we have been experiencing, so be aware of that and pay attention to your body. If you are just getting back into shape, ease into it and don’t over-train or over exert your body because on top of your body trying to recover from an increase in exercise and responding to that, if you are also exercising outdoors, you are adding all sorts of allergens too, which can make you more at risk to react to the allergens and get sick. There are some small claims that probiotics can help to prevent RTIs, so it is worth a try, if you are at risk!

If you do get an RTI, rest, drink fluids, eat a clean diet, and stay home from school/work so you don’t infect others.  While you feel miserable for a few days, only about 15% of them are actually bacterial infections, so they are usually viral and will clear up on their own.  If you have a high fever that won’t break, are not getting better, or have difficulty breathing, you should not hesitate to call your Healthcare Provider to get checked out….but don’t push for antibiotics, they will prescribe them if they are necessary 🙂

Stay healthy and enjoy spring!

Yours in Good Health


A Gentler Chemotherapy?

I know that almost everyone fears cancer for tons of reasons, but the first thing that people always think of are the treatments: chemotherapy, radiation, and the horrible side effects. Breast cancer will be diagnosed in over 230,000 women in the US in 2013, and over 39,000 will die from the disease, and it is one of the top killers of women worldwide annually. With numbers like that, and previous treatment options, the fear is real. Since we have first started treated cancer, the goal was to kill the cancerous cells, prevent them from growing, spreading, and replicating, which meant that some of our healthy cells were eradicated as well.  Depending on the type of cell that was being targeted, there are unwanted side effects, like loss of hair, nausea, vomiting, and pain as the most notable, and that is what makes people most fearful of cancer: the treatment.  There is some good news though for women that suffer from non-hormone receptive, and aggressive forms of breast cancer; a new chemotherapy that works WITH your body and not against it!

KadcylaWhat is this new treatment?

It is a drug that has just been approved by the Food and Drug Administration (FDA) which is a completely new type of drug that specifically targets the cancer cells and leaves the healthy ones alone, so there are almost none of the harsh side-effects related to the death of healthy cells and the normal functioning of your body. As with any medication there are side effects such as nausea, fatigue, low platelets, impaired liver function, etc.  It is called Kadcyla, and it is the mixture of three medications, one is a well-known and widely used chemotherapy agent, but one of the medications added binds the other two together, and is an antibody that keeps all of the medications bound, until it find the specific type of cell that it is looking to kill off, then the medications are released on those specific cells and it helps to slow growth and kill off the cancerous cells. It was showed to increase people’s lives by over 6 months as compared to other chemotherapy agents, which may not seem like that much, but when you aren’t vomiting constantly, feeling miserable, and losing all of your hair, it is a better quality of life, which is something you cannot put a price on.

What type of cancer does it treat?

It does seem almost too good to be true, but Kadcyla treats HER2 (Human Epidermal growth factor Receptor-2) specific cancers, which is a large number of breast cancers. It is mainly for breast cancers that are aggressive, with metastatic disease (cancer cells have spread to other areas of the body), that have not responded to other hormonal treatments. Especially while it is newly approved, they will have strict treatment guidelines, but as more trials are done on the drug, there may be more options for treatments and a wider array of patients may benefit.

So, while this drug is not targeted at a huge number of cancer victims, this very moment, it is a huge breakthrough in the treatment of cancer that it can help to target tumor specific cells and bypass the healthy cells, preventing most of the horrible side effects that make people miserable during their treatments. Now that this has been created and approved for use by the FDA, other drugs can be created using this technology for other types of cancer cells; we are one step closer to curing cancer altogether!

Yours in Good Health


Do you have Fordyce Spots?

There are spots that occur on different places of the body, and cause a lot of stress when they are found under your belt.  I get a LOT of questions and pics sent to me with people very concerned that they have various Sexually Transmitted Infections (STIs), depending on what they have recently performed an internet search on. Some should cause some serious concern and some are benign.  Fordyce spots can occur inside your lips on your oral mucosa, or on the shaft of your penis, or on your labia.  I totally understand the freak out that it might be genital warts, or something else, so you should go get tested and assessed, but this is a little information to ease your worry before you get your results!

What are Fordyce Spots?

They are small, painless bumps that are 1cm to 3 cm in size and they can either be skin toned, white, or a little pink/red in color.  As I stated before, they are commonly found in on the inside of the lips, on the shaft of the penis or scrotum, and on the labia, and they are really a common occurrence, but occur more with age. Usually you only notice them when you see or feel them, but at times they can be a little itchy. They occur because the sebaceous glands, the oil glands associated with hair follicles normally that secrete sweat and oils, instead of being inside of the epidermal layer (deeper in the skin) are more superficial, and close to the outer layer of skin, making them very visible. These glands fill with oil, and there is no hair shaft for them to leave the skin, so they are basically little oil filled cysts. That’s it. They are not known to lead to a disease or are not a sign of cancer or any other virus/disease, but they just tend to be a visual disturbance for some people…and their partners.

fordyce 2fordyce 1

What can I do if I have them?

If you go to your Healthcare Provider (HCP), and get diagnosed with Fordyce Spots, they will give you some options for treatment, if it really is bugging you from a cosmetic standpoint, because they are not detrimental to your health in any way. And, they usually go away without treatment on their own. But healthy diets including Vitamin A, B, D, E, and K can usually help them from forming, and go away faster when you have them, so basically, if you get Fordyce spots, take a multivitamin daily and it can help to prevent them.  Good hygiene including exfoliation and moisturizer can help to decrease them from forming (so that your body doesn’t produce excess oil; this works on both the lips and the genitals), and there are some reports that people with either eat more garlic or take garlic supplements have a lower rate of the spots.  Your HCP may prescribe Trentinoin cream, which is a cream that can basically makes the cells replenish faster, so you ave never skin cells forming, which can prevent the skin from getting clogged up with oils. But, again, the only treatment you may need is time.

All of this being said, you do need to get checked out by your HCP if you do have any new skin issues, especially in your genitals, and you are sexually active, you really need to make sure that it is something benign and not Human Papilloma Virus (HPV) in the form of genital warts, herpes, or any other Sexually Transmitted Infection (STI). Get yourself checked out to be on the safe side, but also realize that every bump isn’t contagious or infectious!

Yours in Good Health


Watch out: the Norovirus is lurking!

Many people are coming down with rather similar symptoms lately: nausea, vomiting, diarrhea, & cramping.  There is a virus that is going around, which spreads quickly, and you could be at risk. I wanted to discuss what the Norovirus is, how to know you have it, treatments, and, most importantly, prevention!

What is the Norovirus?
It is actually the name for a group of viruses that all act similarly, if not the same, on the gastrointestinal (GI) tract and cause nausea/vomiting, diarrhea, abdominal cramping, etc. and are thought of as a gastroenteritis (an infection of the GI tract). They were once referred to as the “Norwalk Like” viruses after an outbreak of these viruses in Norwalk, Ohio in the early 1970’s. They also gained a lot of press after hundreds (if not thousands) of guests on cruise ships were getting infected, and ships had to go to port due to such high rates of illness (If I ever even ponder taking a cruise, I remember this fun time, and I’m all set; could you imagine how horrible that must have been? Gross!) The tough part of the Norovirus is that the virus strains are highly virulent, in that they spread from person to person quickly and easily, and infections from these viruses are usually at the highest during cold winter months. That is a true bummer for all of us living here in New England! Fun fact? Norovirus is the leading cause of food-related gastroenteritis in the United States.  Another fun fact: You will never forget how miserable you feel while infected!

What are the symptoms?
Stomach cramps
Low grade fever, chills
Muscle cramps
*the symptoms can occur very suddenly 12-24 hours after exposure to the virus, and normally last around 12 hours and people feel better within 48 hours (see below: you are still a carrier for much longer and can infect others)

How is it spread?
Most often it is spread from person to person through contaminated food and/or water, caring for an infected person, or through contact with contaminated surfaces. It can live on hard surfaces that are infected for around 12 hours and has been found in infected carpet fibers (i.e. an area that someone threw up on) for up to 12 days, plus it can withstand pretty high amounts of chlorine before being killed off. The viruses live in the stool (poop) and vomit from people with the virus, so when caring for children, elderly, or anyone who needs a lot of assistance with care/cleanup, there is a high rate of spreading the infection. You are contagious from the moment you are infected (even before you feel ill) until a full three days after your symptoms end! Which makes this virus so quick to spread especially in places where people live/work closely together, and it is hard to stop the spread once it starts.

My standard at home hydration "go to"

My standard at home hydration “go to”

What is the treatment?
There is no vaccine or antiviral for these viruses, unfortunately. And as we all know antibiotics only treat bacterial infections, so they are useless against the Norovirus. So you are really just trying to treat/prevent the dehydration that can occur after the diarrhea and vomiting; fluids such as gatorade and coconut water will help to replace fluids and nutrients lost, but really any fluids that you can get in and keep down will help to prevent severe dehydration. If your mouth and tongue are really dry and you cannot make saliva, you feel dizzy when changing positions, you aren’t urinating (or it is very dark), you are clinically dehydrated.  When dehydrated, if you are unable to take in fluids, you should go to the Emergency Department for intravenous (IV) fluids. With children, they often will become restless, cry without tears, and have dry oral cavities; they need treatment with IV fluids if they refuse, or cannot keep down, fluids. The best assessment of dehydration status is to watch your pee (frequency, amount, and color- if it appears on the darker side, drink more).

How do I prevent this from happening?
Wash your hands FREQUENTLY!!
Eat food that is thoroughly cooked if you are eating out (or unsure of food quality)
Wash fruits and veggies before eating them
Wash areas that have become contaminated with hot soapy water or bleach
Immediately wash all clothes, bed linens, etc that have become in contact with vomit or stool of an infected person
If you do get infected, avoid contact with others and preparing food until three days after symptoms are gone

Generally, the Norovirus is a nasty couple of days where you feel horrible (absolutely miserable), but it always ends and there are no long-term effects. But if you have chronic illnesses or other active diseases, it can be deadly because of the effects of dehydration and the electrolyte imbalances that can occur. In children, the elderly, and chronically ill, you need to make sure they are taking in fluids with nutrients (pedialyte, Gatorade, coconut water)and if they cannot, you need to seek medical assistance.  Even if you are vomiting, still try to push those fluids…even absorbing small amounts are better than nothing!

So wash your hands, cook that food, and steer clear of anyone with those symptoms and you will be Norovirus free this winter!

Yours in Good Health