Gonorrhea (AKA “the clap”) is estimated by the CDC to infect 700,000 Americans a year, and over half have no idea that they are infected, allowing for the infection to spread to other partners and the babies of pregnant women.  Yikes!  Sadly, these infections are on the rise worldwide, despite STD education being promoted by HCP’s and starting at younger ages.  Parents need to start having these conversations at a younger age too…so my goal is to give you the facts and let you know how the infection can occur, your risks and preventions, but also give you info, if you are a parent, to give to your kids.

What is a gonorrhea infection?
It is an STD from the Neisseria Gonorrhoeae bacteria that can be transmitted with equal rates to men and women from oral, anal, and vaginal sex that has a 2-10 day incubation period that can infect the urethra, rectum, and throat.  Women have the ability to also contract cervical infections and if they contract the infection whilst pregnant, the babies can have vision problems and eventually go blind if the infection isn’t treated.  Also, it can cause pre-term labor.  Having one STD puts you at a higher risk for contracting another STD, especially HIV.

Symptoms:
Men (urethra):
Painful urination
Pus colored discharge from the tip of the penis
Pain or swelling in one testicle

Women (urethra or cervix):
Increased vaginal discharge (may smell differently and have  different color/consistency)
Painful urination
Vaginal bleeding between periods and/or after sexual intercourse
Abdominal pain
Pelvic pain (during sex)

In the rectum:
Itching
Pus like discharge
Straining when needing to poop
Bloody stains on toilet paper

Eyes:
Pain
Pus discharge
Light sensitivity  

www.the-clap.com

Throat:
Red, sore throat
Swollen lymph nodes

www.lib.uiowa.edu

**There may also be very subtle symptoms that you miss, best idea is to get checked for STD’s regularly if you have unprotected sex in any form with different partners.

What are common Risk Factors?
Young age
Previous Gonorrhea infection
New Sex partner
Multiple sexual partners
Unprotected sex

Long-term Complications:
The most major long-term complications for both men and women is infertility.  It can also cause chronic pelvic inflammatory disease (PID) in women.  As well, the bacteria, when left untreated, can get into the bloodstream and go into your joints and cause swelling, stiffness, and pain along with fevers, rashes, and skin sores as the infection spreads.  All of these infections can be spread to babies at birth in untreated infected mothers and cause these same complications (along with blindness).  And, as stated above, having this untreated infection, puts you at a much higher risk to contract HIV/AIDS and the disease can progress faster due to an already decreased immune system.

How is it diagnosed?
Gonorrhea is diagnosed through a urine test and/or by swabbing the area (even if discharge isn’t present. Most often, your HCP will draw some blood to also check for other STD’s, just to be safe and ensure that you are being treated appropriately.

Treatment:
You will get either an oral or injected antibiotic (penicillin is cheapest and easiest, but due to allergies, your HCP may choose a different antibiotic for you).  As well, not only you but your partner also needs to be treated, even if they have no symptoms so that you don’t get reinfected or spread the infection.  Babies at risk are usually treated with antibiotic ointment to their eyes at birth and if they show other signs of infection are given further antibiotic treatment.

Prevention:
USE PROTECTION!  It is the best way to prevent STD’s if you are sexually active.  You should get tested regularly if you are sexually active, even if you use protection, with multiple partners, and ask your partners if they get tested, when the last time they were tested, and if they have ever had an STD.  If you are hooking up with someone and notice something that looks a little strange anywhere in their genitals, just stop…ask them about it, and just think about calling it a night there- totally not worth it to carry on and put yourself at risk for anything!

These infections are on the rise for many reasons, but one of which is that many teens “don’t count” oral sex as sex; it is still sex and you can contract STD’s. There is no form of sex with multiple partners that is safe unless you use protection.  Despite HCP’s talking to teens at younger ages, and discussing these issues with single adults, we need people to use common sense (i.e. if something doesn’t look right, stop) and get regular screening.  We need parents to talk to their children, or have an adult that their child feels comfortable with talk to them about their risks and prevention, and know that there are free STD clinics that they can go to for testing, but they will usually need parents permission before treatment (but that is a state by state issue).  But, this information on risks, symptoms, and prevention needs to get out there to the general public so that we can get more people regularly screened, and be aware of the signs of the infections.

So, now YOU know!  Talk to your friends, partners, etc and go get tested and treated (both you and your partner), and please check out your partners junk before you hook up…and save yourself the trip to the clinic if it looks funky!

Yours in Good Health
B

I am a huge proponent of waxing, and I have never had a problem with it BUT that is not to say that there isn’t a risk going to get waxed, whether it is a quick eyebrow wax or a brazilian bikini wax.  You are at risk for skin infections from the wax or from the person doing the waxing, and from the bacteria that live on your own skin!  Fear not, there are ways to decrease the risk of infection, so that you can be safe and hair free!

What are the risks?
Skin burns– from using wax that is too hot, it can rip off a couple layers of skin and be super painful and cause some scabbing and possible scaring.
Skin Irritation– some peoples skin is very sensitive and can become bruised or have some  small skin tears and bleeding from waxing.  The irritation shouldn’t last more than a day, and use of aloe cream or antibacterial cream can help
In-grown hairs– since every time you wax, the hair grows back thinner and thinner, it gets to the point that sometimes the hair cannot break through the skin. Products like Tend Skin can help to prevent them when used daily after waxing and prior to waxing .
Pain– taking 200mg of Ibuprofen before waxing can decrease inflammation and prevent some of the pain.  There are also products with lidocaine to numb the skin, that I don’t think work, but men think that it decreases pain with waxing chests like GiGi Pre-wax anesthetic cream and Satin Smooth Res Q Analgesic Spray.

 Infections/abcess – Sometimes after waxing because of the sensitivity of your skin you can get infections from from Staphylococcus aureus, and  Streptococcus pyogenes from your own skin, from the skin of the person waxing you, OR (which is the creepiest) from the skin of the person before you!  If the waxer double dips the applicators in a multi use pot of wax, you are at risk from a skin infection from their bacteria that are hosted in the wax.  The wax is NOT hot enough to kill off bacteria, contrary to what many salons will tell you.  These infections can usually be treated with oral antibiotics but sometimes can lead to the need for IV antibiotics and hospitalization.

Contraindications to waxing:
Contagious skin conditions, thin or fragile skin, the use of steroid creams, Accutane use, and allergies to the products used.  Also, make sure that you tell you waxer if you are using any skin products or antibiotics, they can make the skin more sensitive an easy to tear.

How can I reduce the risk of infection?
Only go to professional salons that look clean (if they appear clean, then most likely it is really clean)
Make sure that the linens are clean in the treatment room- no stains or wax from a prior client
Request that your waxer wears gloves (especially for bikini or brazilian bikini waxes)
Ensure that your waxer has washed his/her hands
Watch to make sure that they do not “double dip” in the wax pot- a new applicator should be used for each dip of wax (you don’t want to get something from the person before you and you don’t want to spread your bacteria to others)
Don’t allow them to go over broken skin more than once
If you feel uncomfortable at any time, just leave- it’s your body and your health!

Rest assured that the risks are low, but they do happen, and if you are at an increased risk of infection due to uncontrolled diabetes or other conditions that would lower your immune system, just be very careful and ensure that the people who are waxing you are professionals and trained to perform your waxing services.  Also, ensure that they are taking all measures to prevent infection for you.  You can also be like me, and just wax yourself…just as easy and I know its only me using my wax (but not for the faint of heart!!)  Be careful, and realize that even a “quick” eyebrow wax at a place that isn’t so clean can cause you an infection that can last months to clear!  Be safe and there is no shame in walking out of a situation that you think is unclean!!

Yours in Good Health
B

You may want to get rid of the normal night lights in your kids rooms, and to light your hallways and exchange them for red lights!  Recent studies have shown that even the smallest amount of light can be transmitted through your eyelids and cause disturbances in your sleep.  I know that I’ve talked about sleep aids for sleep, but there is a lot of new research supporting the effects of light on the circadian rhythm (the bodies natural sleep/wake cycle).

How does this happen?
Well, there are light sensitive cells in our retinas and they send signals to the brain letting us know whether it is day or night and if we should be awake or sleeping.  These cells can get pretty confused due to jet lag or off shift work.  So, exposure of these cells to bright white light (from TV’s, lamps, etc) at night can cause the cells to overwork and become confused, which can lead to sleeping disorders.  As well, people who work inside with exposure to dull light all day, like from overhead lights and from computer screens, can cause confusion to the cells.

http://healthysleep.med.harvard.edu/healthy/science/how/external-factors

The signals from the cells in the retina push for a drive to be awake, no matter ow tired you are.  After extensive sleep deprivation, that drive wears off and the sleep cycle begins because of a build up of adenosine in the brain, but no one likes to go through the day exhausted and barely getting through, so we drink caffeine which blocks the adenosine and keeps you awake.

So what can I do?
Decrease all light in the bedroom. If you sleep during the day, get black out shades and limit caffeine before bed.  Keep TV’s off, and if you do need a nightlight, you can change it to a low red bulb OR get a very, very dim white bulb that is not in your direct vision or area of your eyes.  Also, try to decrease the amount of light stimulation right before bed; so don’t read in bed with a bed side light, so that the retinal cells are not directly stimulated right before bed. Also, you may want to make your bedroom temperature a little lower, REM sleep is better attained when temperatures in the room are cool, so you can cozy up and get some good sleep!

Also, not to be overlooked but whether you have a sleep partner that is human, or not (i.e. dog, cat, etc), you need to work with any problems they might have.  So, if there are any snoring problems, or sleeping disorders that they might have, it can affect you!  Sleep studies are covered by most insurances, so it is worth going to your HCP for you or your partner if you have extensive sleep problems that are effecting either of you to get adequate sleep, because long term sleep deprivation can cause obesity, depression, and other issues.  But, try to keep down bright lights, and give yourself time to get to sleep (i.e. turn in about 30 minutes before you “need” to get to sleep so that you decrease light stimulation and give your body time to wind down.)

Yours in Good Health
B

 A large study out of Canada, that was performed over a 5 year time period came out with some surprising statistics related to the use of SSRI’s (selective serotonin reuptake inhibitors) and miscarriage rates.  The specific drugs that were found to have a higher rate of miscarriage, 68% higher risk (than those who have never used antidepressants ever), were Prozac, Paxil, and Effexor.  Paxil actually has a 75% higher risk of miscarriage, specifically. It was originally found that in pregnant rats, there were high numbers of miscarriages, thus the study moved to humans because a few years ago, the medical community, for the most part, advocated for the use of antidepressants in pregnant women because the benefit to the mother outweighed the risk to the fetus.

The study, from the Canadian Journal of Medicine, looked at just shy of 70,000 Canadian women from ages 15 to 45, of which some took antidepressants, some just had a history of depression, and some had none of the risk factors.  To make things a little clearer, the risk of miscarriage compared to those on Antidepressants versus women who have never used them is 68%, the risk for women who have a history of SSRI use versus those on them during pregnancy is 61%, and the risk factor of having a history of depression is 19%. But, in the US out of the roughly 2 million pregnancies per year, there are approximately 600,000 miscarriages within the first trimester (20 weeks), so the baseline risk of miscarriage in the US is about 20-31% anyway.

Now, this is not to say, that if you are pregnant, you should stop taking antidepressants because the risk factor is there, based on this large study, but it is unknown why exactly the rate of miscarriage is higher.  It is theorized that the change in serotonin levels can put pressure on the uterus in an early stage of pregnancy, and possibly cause the miscarriage.  But, despite this study being rather large and appear to be non-biased, it doesn’t take into effect some of the risk factors that are associated with depression in pregnancy, such as smoking, obesity, and older age.  It is also theorized that the stress related to depression itself on your body, may be the cause of the increased rate of miscarriage; much more research needs to be done in this area.

Thus, you need to speak with your HCP about your specifics needs related to depression and the health of your baby.  It wouldn’t be healthy for you to stop taking the medications, go into withdrawal and a severe depression because of it, so there may be behavior modifications that you can do, or switch to a different medication, that may have a decreased risk.  Plus, if you are more in tune to the fact that you are at a higher risk for miscarriage, you may be more likely to notice different changes in your body, perhaps take it easy the first few months of your pregnancy, and follow-up with your OB/GYN more closely at first.

What are some non-medication treatments for depression used in Pregnancy?
Most of these have not been well studied, but are used by some HCP’s with positive responses from their patients, so again, talk to your HCP and don’t start any of these therapies without their approval!
-Addition of Omega-3 fatty acids to your diet
-Bright light therapy which can help with Seasonal Affective Disorder (30-40 minutes of bright light per day either out in the sun OR using specific light bulbs)
-Exercise can keep endorphins up and make you feel better about yourself
-Psychotherapy; talking to a licensed therapist can alleviate stress and depression symptoms
-And behavioral cognitive therapy can reduce symptoms of depression (a type of psychotherapy that emphasizes the role of thinking in what we do and how we feel- so you think and make active choices in your life)

If you have depression, and whether or not you are being treated for it, you should talk to your Primary Care Provider (PCP) and OB/GYN (and possibly Psychiatrist) before getting pregnant about the risks, possibly change medications or decrease doses, and your other options for treatment during pregnancy.  And if you get pregnant and it was unplanned, go to your HCP ASAP and discuss your options and risks. DO NOT take yourself off of your medications based on these few studies!  There are many different options, and you will just need to be watched closer, and try to de-stress any way you can, such as go out with friends for a walk, go to the spa for a facial, get your nails done, spend time with your significant other…whatever helps you to relieve stress, do it!  Make time for yourself and pay attention to your body.  And, don’t feel horrible if you call your HCP every time you are worried…it is YOUR body and your baby, and you know how your body feels.

Yours in Good Health
B

I hear a lot of people, especially around holiday time, say that they are gaining weight, so they need to cut out carbs, and they will be back to their old shape in no time. This isn’t necessarily true, and I don’t actually believe in the low/no carb diets mostly because I get so horribly bitchy without carbs that the entire human race benefits from me eating a normal diet!  (Friends have actually learned to carry some skittles on them in case I miss a meal because I can go from me to exorcist in a hot second without food…..a handful of skittles and I am back in no time!!)  But, for those of you who tolerate forgoing the carbs, I want to let you know what is actually going on in your body and the pros and cons of this diet….it may not be best for you in the long term.  As well, I want to give some tips on beating the holiday bulge!!

What happens when I ditch the carbs?
Your body normally primarily uses carbohydrates to feed the brain, and all of your vital organs because carbs are quickly processed by the liver and turned into ATP (if you remember from my hangover blog how the liver breaks down simple carbs) which is easily used by the body as an energy source.  When you suddenly take away those carbs and that ATP as an energy source, the body needs to find the energy to go on from somewhere, so it starts using stored fat as a source of energy.  It sounds great right?  This is also known as starvation mode for your body, it is a state of Ketosis.  Ketones are formed when the glycogen (sugar) stores in the liver are low, which is important because the ketones are used in the brain as energy as they can cross the blood brain barrier (the bodies natural defense against keeping toxins out of the brain), because the brain cannot use fatty acids as energy, but it takes about 48 hours of no carbs for the brain to be able to use ketones as an energy source.  So, the rest of the body uses fat stores for energy, and when fat stores get low, the body starts breaking down protein…and by that I mean the protein IN your body, such as your muscles!  The body will store whatever small amounts of glucose that it gets as an emergency storage, in case it runs out of fat to burn because your body does not want to muscle waste.  So, when you lose whatever weight you want to, you go back to your normal diet, all those carbs that you take in go right into the emergency storage and it takes about 48 hours on the reverse side for your body to go back to using glucose from carbs as its main source of energy.  That being said, after 2-4 weeks after starting this diet, your body normalizes to it and the feeling of crabiness and missing carbs is said to disappear.

How is it useful?
Well, it is used medically sometimes for people with epilepsy, it was first used in the 1920’s, and it is not truly understood why, but numerous studies have shown that a high protein/fat, low carb diet decreases seizures and seizure-like activity diminishes on EEGs (brain wave studies).
It also does help people drop weight very quickly, using fat stores instead of glucose and those who do it, are big proponents of it.

What are the cons?
-All of these extra ketones in your body can cause gout, kidney stones, and can cause kidney strain and failure (your kidneys rid the body of ketones so they tend to be overworked in this diet).
-Cholesterol levels can be extremely elevated to unhealthy levels due to the amounts of fat most people take in their diet, and you cannot have fiber in the form of oatmeal, etc to help decrease cholesterol levels and can increase your risk of heart disease, stroke, and cancer.
-Many people skip eating vegetables and fruit because of the amount of “carbs” present, so they re missing out on essential vitamins, nutrients, fiber, and antioxidants.
-When your body goes into a ketotic state, you get really horrible breath…kind of a creepy “fruity” breath

Who should NOT do this diet?
Diabetics, people with heart disease or any risk factors for heart disease and stroke, anyone with kidney function disorders.  Even if you think that you are totally healthy, you should still talk to your HCP before starting this diet.

How do I beat the holiday bulge?
I know that it is the season to want eat a ton with family and friends, and eat stuff that you wouldn’t at holiday parties, etc. but really the best way to beat the holiday bulge is to continue to exercise, and eat until you feel full…not until you need to unbutton your pants!!  If you do, instead of laying on the couch and “sleeping it off” go for a walk, a brisk 20 minute walk will increase your metabolism, and help you to break down those foods faster and feel like less of a porker the next day, I promise!! Even doing the dishes, having an impromptu dance party (which I happen to be a fan of), play Wii sports with the crew tournament style (not great exercise but better than nothing), or pop in a yoga/exercise DVD to get that blood flowing to the stomach to break down food AND the brain makes you burn more calories and helps you digest faster.  Also, make sure to drink lots of water, as many holiday foods are high in sodium and try to keep alcohol to a minimum (or not, I like to imbibe as much as the next guy….but make sure you keep active!) Get your family and friends to get involved; it is always harder to force yourself to get some exercise, but if other people want to go for a walk, or have a pooch that needs some exercise, get in on it and get the blood flowing!

Also, don’t forget, it is actually a good idea to strap on the old feedbag every once in a while to really stimulate your metabolism and make it work!  Granted, eating tons of crap for two months is not what I mean, but having a big meal once a month or so isn’t a bad idea, as long as you continue to exercise and don’t let it become a habit.  If you think that you won’t be as honest with your exercise as you think, then hire a personal trainer for the holiday season, if you have someone to hold you accountable for your health, you are more likely to keep in shape!!

I also want to let people remember, “diets” are only useful if sustainable for the long term and it is more of a lifestyle change, otherwise it is just a yo-yo diet and you lose and gain weight constantly.  So, make a life change that you can stick with.  But any way you choose to beat the holiday bulge, be it a no carb diet, exercise, or your own way, please be safe and remember that a healthy lifestyle means a healthy you!

Yours in Good Health

Hepatitis C is a virus that attacks the liver and causes inflammation and liver damage but it can be a silent virus with no symptoms until late in the infectious process. The infection is on the rise worldwide, and is replacing HIV/AIDS as the most feared disease among those at high risk as there is no cure and the treatments are difficult to tolerate. The CDC estimates that 150,000-170,000 new cases of Hepatitis C are documented each year! For this reason, I wanted to let you know about the disease, its transmission, treatments, ways to live with this chronic disease, and prevention.

What is Hepatitis C?
It is a chronic viral infection that causes liver inflammation and liver damage, and the most serious of all the Hepatitis infections.  The liver damage can lead to the need for a liver transplant, which won’t cure the disease, but allow for the person with the infection to live longer and keep the infection at bay for a while; there is NO CURE.  It is transmitted through blood to blood contact, in a similar way to HIV transmission.

Symptoms:
Fever
Fatigue
Nausea
Decreased appetite
Muscle and joint pains
Tenderness over your liver (right upper quadrant of your abdomen under your rib cage)
Jaundice of the skin (yellowing of the skin)
Jaundice of the sclera (the whites of the eyes become yellow)
*The symptoms can be none at all and the Hep C is merely detected through lab tests at a routine physical with your HCP- it can be unknown by a patient for years.  But you should be aware that generalized long term flu-like symptoms, if you are at risk, can be a sign of Hep C, so you should go see your HCP for a work up and let them know of your risk.

Are you at risk?
Screening criteria usually include:
-Anyone who has injected drugs
-Anyone with abnormal Liver Function Tests (aka LFT’s)
-Babies born to mothers with Hep C
-Healthcare workers with past needle sticks or other blood exposures
-Hemophiliacs treated with clotting factors or blood prior to 1987
-Long-term dialysis patients
-People with blood transfusions or transplants before 1992
-People with sexual partners (protected or unprotected) that are Hepatitis C positive

Transmission:
Hepatitis C is a very strong virus and can live outside of the body for up to 4 days, which is a long time for a virus, and it means that you can even contract Hep C from dried blood.  For example, if you use someone else’s toothbrush that may has bleeding gums, and you have just flossed or have a canker sore or any other opening of the mucosa in your mouth, you could contract Hep C.  Also, another reason why you wouldn’t want to use someone else’s tweezers….not to mention others used needles to inject!  It is also transmitted through unprotected sexual intercourse, from blood transfusions or solid organ transplant (heart, kidney, lung, liver, pancreas, kidney) prior to 1992 (the testing for Hep C then became universal), and some babies can become infected through childbirth from infected mothers.

Complications from the Disease:
Due to the chronic inflammation from the virus, the liver can become damaged through a build up of scar tissue (cirrhosis) and not work well which can lead to total liver failure, sometimes requiring a liver transplant.  As well, patients with Hep C are at a higher risk for liver cancer due to all the stress on the liver from the chronic infection.  Due to all of the stress and inflammation on the liver, there are numerous changes that can occur such as chronic kidney insufficiency, skin rashes, jaundice, increased bleeding times, and a build-up of stomach fluid called ascites (it can make the stomach look pregnant).  Ascites can only be removed by certain diuretics and though paracentesis (where a needle is inserted into the stomach to drain the fluids off) and despite treatment it always comes back.  Also, because the liver filters out toxins from the blood, when it doesn’t work well, because it becomes scarred and hard (cirrhosis) it doesn’t filter well which can lead to a build up of ammonia in the brain and can cause confusion and lead to coma or death, the confusion is called encephalopathy.  When the liver becomes very diseased, patients need to have a low sodium and low protein diet to prevent further complications.

montana.edu

Treatment options:
Not all patients require treatment, despite its severity.  The chronic infection can start slowly and only allow for small amounts of initial inflammation; once your liver function tests become deranged (abnormal) your HCP will most likely send you to an Infectious Disease or Hepatology specialist for treatment. A Hepatologist will perform a core punch biopsy in which they put a large bore needle into your liver, and take those cells out and study the actual damage under a microscope to visualize the damage that is shown in the abnormal LFT’s.  You will be started on antiviral medications, which attempt to clear the virus from your body, you will have one treatment “round” which lasts 4-6 weeks, have your liver functions re-tested, then based on those results either get another round of treatment OR just be watched closely by your HCP through blood tests and liver ultrasounds. One antiviral medication, Interferon, is still being tested, and thus far the results are mixed because while it seems to work well at eradicating the virus, many patients cannot handle the side effects and stop taking the drug, plus it is very expensive and not available everywhere.  There are currently 25 new drugs being studied for the treatment of Hepatitis C, as of this summer/fall and I will update the drugs as they show promising results and are closer to approval by the FDA, and hopefully more available.

Alternative Therapies:
The one alternative therapy that is used sometimes, although the studies are poor due to size and design, milk thistle supplementation is said to help up-regulate the liver, so it works more efficiently, and prevent/treat jaundice.

Living with Hep C:
The best things you can do to help yourself live a happy and healthy life with Hepatitis C are:
Be honest with your family/partner/HCP’s about your disease to prevent/limit their exposure
Limit (if not stop) all alcohol intake
Live a healthy life with  a diet full of fresh foods, exercise, and water (lay off preservatives and things that do not come from the earth directly!)
Stop injecting drugs, if you cannot stop, please use clean new needles and find a needle exchange (I urge you to get help)
Cover all cuts with bandages to limit blood exposure to others
Don’t let others share your grooming products (razors, tweezers, toothbrushes, etc.)
Talk to your HCP about all medications you take to prevent taking ones that are toxic to the liver.
Get adequate sleep
Keep stress to a minimum! ( I know, so much easier said than done!!)

And most importantly….Prevention:
If you are going to get tattoos or piercings, please go to a place that is clean in appearance and ensure that they are using new clean sterile needles on you and new pots of INK- the blood can be in the ink and the virus then transmitted.
Don’t share needles for injections (again please get help to stop)
Don’t share grooming products
Practice safe sex
Ask your partners for their status of HIV/AIDS and Hep C
Most importantly, if you are at risk, go to your HCP and ASK to be tested!!

While Hepatitis C can be a silent killer, in that the symptoms can be really generic, and it can be slow to onset, along with no current cure or vaccination.  So, please be aware of the signs and symptoms and be proactive about your life, if you feel that you are at risk, or you are unsure, then please got o get tested, the earlier you know that you have the disease, the earlier you can start treatment and get on the road to a healthy life to prevent further damage to your liver!

Yours in Good Health
B

 Lupus is an chronic inflammatory autoimmune disease (where your bodies cells attack itself) that primarily affects women ages 15 to 35.  There are four types of Lupus: Systemic Lupus Erythematosus (SLE), discoid lupus erythematosus, neonatal lupus, and drug-induced lupus erythematosus, of which SLE is the most common and serious form.  Because it is an autoimmune disease, your immune system attacks not only viruses and bacteria that are trying to invade your cody, but the healthy cells of your body too, which causes inflammation and can damage your joints, heart, skin, kidneys, lungs, blood vessels, and brain.  It is presumed that you are predisposed to having lupus, not lupus itself, but them something from the environment can trigger the lupus and then it will become a chronic disease with flare ups and remission.  It is being studied a great deal because there is so much unknown about this disease and why it occurs.

What are the four types?
SLE: Can effect nearly every part of your body (as noted above: heart, skin, joints, kidneys, lungs, blood vessels, brain) and is the most common form of lupus; usually what people are talking about when they are referring to lupus.
Discoid Lupus Erythematous (AKA cutaneous lupus): affects the skin and usually is in the form of a rash on the face, neck, and scalp.  Some cases can lead to SLE but it is rare.
Drug-induced Lupus Erythematous: Can happen with a lot of different prescription meds, and mimics SLE, but the symptoms stop when you stop taking the meds (read the drug inserts from the pharmacy and if you get the side effects, call your HCP).
Neonatal Lupus: A rare form of lupus in which the mother (who may not display signs of lupus) can pass the antibodies associated with autoimmunity to the baby and the baby will get a skin rash that usually subsides within several weeks. It will go away but it some serious cases can cause long term cardiac disturbances.

Are there any risk factors?
Female, age 15-40, usually affects blacks/latinos/asians, exposure to sun may trigger a response, prescription medications, infection with Epstein-Barr virus, and exposure to chemicals (mercury, silica, and cigarettes).

What are the complications?
Kidneys: almost 3/4 of the people with SLE will have renal problems from the disease which can usually be treated with medications and in severe cases dialysis.
Brain: headaches, dizziness, confusion, behavior changes, seizures, and memory problems.
Blood vessels: can cause inflammation of the blood vessels (vasculitis), along with blood clots, and anemia.
Lungs: risk of pleurisy (an inflammation of the chest wall lining), and it puts you at a higher risk of pnemonia
Heart: a risk of endocarditis and myocarditis (inflammation of the heart) and pericarditis (inflammation of the heart membrane), and this chronic inflammation increase your risk of heart attacks and long term cardiac disease. You can also develop hypertension and high cholesterol levels, leading to atherosclerosis.
Infection: are at a higher risk of infection due to the medications (usually corticosteroids) to treat the other symptoms of the disease.  Some of these infections can become quite serious and cause death, as the infection can lead to further inflammation requiring more steroids to squelch the flare up.
Cancer: having lupus apparently increases your risk of cancer, possibly due to the drugs used to treat the disease and cause immunosupression, the good news is that you are less likely to die from the cancers (it’s unknown why.)
Bone tissue death: blood supply to the bones can diminish because of micro clots and the bones become brittle and break, and the bone dies.  Most often the hip bone is affected.
Pregnancy: Women with lupus are at a higher risk for miscarriage, as well they are at risk for severe high blood pressure (preeclampsia), and pre term birth.

Treatments:
Non-Steroidal Anti Inflammatory Drugs (NSAIDS): such as Aleve, Ibuprofen are used to treat the symptoms initially, but can cause renal damage in high doses and stomach ulcers, so your HCP will need to regulate this dosage despite it being and over the counter (OTC) medication.
Anti Malarials: For some reason antimalarial drugs work very well at helping with the symptoms of lupus and may prevent flare ups.  Hydroxychloroquine (plaquenil) is one example, and most commonly prescribed.
Corticosteroids: They decrease the swelling but have major long term complications such as: weight gain, osteoporosis, high blood pressure, diabetes, and increased risk of infection.  The risks are higher with higher doses, so your HCP will work with you to find the lowest possible dose, and increased doses that may be needed for flare ups.
Immunosuppressants: medications that are given to patients after transplants are used to decrease your immune response, and also have serious long term complications, but can be used in severe lupus cases, or for flare ups.  some of the side effects can be infertility, infection, increased risk of cancer, and liver damage.
There are also numerous drugs being studied at the moment, that hopefully have less side effects.

How to treat yourself:
-Get enough rest, and don’t let your body get too overtired
-Wear adequate SPF in the sun, and try not to spend extended amounts of time in the sun
-Exercise 30 minutes a day 4-5 days a week, but don’t over tax your body.
-Don’t smoke because it can increase your risk of heart and lung disease associated with lupus.
-Eat a healthy diet full of fresh fruit and veg with whole grains, and if you have renal issues watch your sodium intake or other dietary restrictions you HCP may give you.

All forms of Lupus can be difficult to diagnose at first, and your HCP will have to run a bunch of tests to rule out other diseases or causative factors for your symptoms.  So, it can be a very difficult and frustrating road at first, but there are people that will support you and help you through every step of the diagnosis and treatment.

I hope this gives some insight to those of you who might know someone with any for of lupus and might give you an idea of their daily struggles and how you can help them.  As well, if you have any of these symptoms, please go see your HCP to get checked out.

Yours in Good Health
B

There has been such controversy about drinking bottled water since it became a trend years ago because of the cost and the issue with lack of bottle recycling, and now the issue is about what you drink your (hopefully home filtered tap water) out of.  There are a couple of issues that many people might not even be aware of: seepage of BPA (Bisphenol A) from plastic versus aluminum absorption from metal bottles. So what are we supposed to do??

Bisphenol A:
BPA has been talked about since the early 2000’s but gained a LOT of press around 2009 when some studies came out showing how bad it was for babies and the fact that it was in so many baby bottles and other products.  There have been numerous studies in animals that have shown various mal effects, despite the National Institute of Health (NIH) stating they have “mild concerns” about BPA in humans and the National Toxicology Panel making a statement that they had the same level of concern with children and “negligible” concern related to the health effects of BPA on pregnant women. BUT there have been some animal studies showing issues with: increase of obesity, neurological disorders, dopaminergic systems (creating hyperactivity), adverse effects on thyroid function, promote growth of neuroblastoma cells, impaired testicular growth and prostate cancer.  Most of the animal studies are pretty weak and have not been correlated with human studies, as well the levels of BPA administered to the animals were pretty high.  A study in 2008 in the Journal of American Medical Association (JAMA) which is a big journal, did a BPA study on 1,500 humans and found links with BPA and diabetes, heart disease, and poor liver function but stated that the results required further investigation.  They followed up their study in January 2010 and found that there was only a slight increase in risk of heart disease with BPA present in adult humans urine.  Am I saying its safe?  No.  Am I saying its as horrible for adults as most people think?  I’m not convinced; I try to stay away from BPA but I am not a total freak about it.

If you read the recycle codes on the bottom of bottles #7 and #3 plastics usually contain BPA, although some companies do make #7 plastic bottles in BPA free. So steer clear of those two numbers and don’t use them to as refillable, that’s when most of the seepage occurs.  Stick to recycle codes 2, 4, 5, and 6 on the bottom of bottles if you still want to use plastic.

The Aluminum Issue:
Are you actually absorbing aluminum from the aluminum lined stainless steel bottles?  Numerous studies from the New England Journal of Medicine (NEJM) starting from the 1980’s has shown significant seepage of aluminum (from cans and bottles) into the food substances and absorption in the GI tract causing numerous health issues.  Most of the aluminum that we absorb is from aluminum pots and pans, aluminum foil in contact with food, beverage cans, many antacids, and as a filler in a bunch of different foods.  As long ago as the mid 1980’s, there was strong research out of Germany showing the relation of aluminum intake to Alzheimer’s-like syndrome, as aluminum inhibits the uptake of choline and dopamine, which causes: progressive dementia, shaking, trembling, an inability to pronounce words, a lack of coordination, fatigue, and a decrease in brain cell energy.  The older you are, the higher you absorption rate of aluminum is, and while it isn’t completely understood as to the rate of absorption across the blood-brain barrier (which usually protects your brain from bad stuff), we know it occurs and  causes major disturbances.  So, while I originally jumped on the bandwagon and grabbed a Sigg bottle, once I researched the whole deal I felt perplexed!!

What do I do?
Honestly, I drink out of GLASS as often as possible, that is cleaned in hot water without corrosive cleansers, and I do drink out of plastic when I am at work (no other choice, really) or when I work out (the last thing I want to do is lug around a glass bottle and smash it!) as long as they are #2,4, 5 recycle code bottles, I really don’t worry too much. I do have glass bottles that I can put my Brita water in from home for when I go on errands and whatnot (I have a big purse- which i know isn’t helpful for men) but you have to look at what is best for you.  I do think that we should not expose babies to it, and there are tons of options on the market for glass bottles with BPA free nipples, and/or plastic bottles that are #2,4,5, and 7 BPA free.  Check your canned goods too; while some have only small amounts of aluminum in them, many are lined with BPA (a double whammy!!)  Many companies are trying to find another option, based on the recent studies, mostly to assuage consumers fears.

So, be aware of what is better, and make the best choices for you and your family, and what works best for your wallet- making these changes can be pricey but possibly better for your health.

Yours in Good Health
B