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Vaping Related Lung Injuries Reach 530 Cases & 7 Deaths

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The Centers for Disease Control and Prevention just announced a huge jump in confirmed cases of lung injury associated with vaping. Last week, 380 cases confirmed, and this week 530 cases confirmed, including seven deaths confirmed from six states. In Ohio, the Ohio Department of Health confirmed that there have been 17 cases in the buckeye state with zero deaths, up to this point.

Digging down deeper in the CDC data, nearly three fourths (72%) of cases are male. Two-thirds (67%) of cases are 18-34 years old. But, very surprising to me was that 16% of cases are under 18 years old. I guess that shouldn’t surprise me because data from the 2018 National Youth Tobacco Survey showed that more than 3 million high school students used e-cigarettes which is a 78 percent increase from 2017.

Possible Signs/Symptoms of Vaping Lung Injury

  • Rapid Onset of Coughing

  • Rapid Onset of Breathing Difficulties

  • Weight Loss, Nausea, Vomiting, Diarrhea

CDC Recommendations on Vaping

  • If any symptoms, consult your doctor immediately

  • No Vaping for Youth and Young Adults

  • For Adults: Consider stopping vaping until we know more

  • “Safe Vaping”: Don’t buy off the street products or modify current product

I’ve been receiving a lot of questions from patients, from families, and from community members on this topic. Unfortunately, there is still a lot that we do not know yet. For example, we do not know the exact cause of the deaths related to the vaping lung injuries. Looking on the internet, there are a lot of theories out there like “lipoid pneumonia” or “acute eosinophilic pneumonia.” But, we still haven’t found a definite pattern yet.

What is causing the illnesses? Again we don’t know. There have been illnesses reported in those who used nicotine vaping products, THC vaping products, or both vaping products. In addition to these, the American Lung Association states that there other chemicals in e-cigarettes like propylene glycol, vegetable glycerin, acetaldehyde, acrolein, formaldehyde, and others.

Are flavored vapes more likely to be dangerous? Again, we don’t know that either. In the news this week, there has been talk about the banning of all non-tobacco flavored e-cigarettes from the market. Some agree with this, and some disagree. But, I don’t think that there is a doubt that the child-friendly vaping flavors are a gateway to nicotine-vaping, cigarette use, and possibly other substances (see my 2016 local TV interview below). Definitely ban vaping (tobacco or non tobacco vaping) for those younger than 21. But, a blanket ban for flavored vape products for everyone, including those 21 and older, is a step too far, in my opinion.

Finally, I’ve been asked if this is a new phenomenon in vaping, or is it just recognized more now than years ago when vaping started. Again, this is hard to say. Something that we can all agree on is that more study and research is needed before medical evidence can be generated. And, hopefully, the medical evidence that is generated will translate into sensible public policy decisions. Time will tell….

Report from WKBN-TV on December 9, 2016

Interview from April 1, 2018 on WKBN-TV

Five Health Tips for Back To School

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It’s hard to believe that another summer is quickly coming to a close. As back to school is right around the corner, here are five health tips to help get you and your kids ready. I encourage you to check out these tips from the Centers for Disease Control in addition to my tips below.

1. Visit Your Doctor: In Ohio, especially before Kindergarten, 7th grade, and 12th grade, there are required immunizations that need to be completed so that the child can enter school. These immunizations are described and listed on this link from the Ohio Department of Health. In addition, depending on your child’s age and medical conditions, there may be other immunizations that are recommended. So, definitely check with your doctor on this.

2. Change That Sleep Schedule Now: Studies have shown that adequate sleep is critical for academic success. For adults, it can take about a week to get used to a new sleep schedule. However, in young children, it can take longer than that. Consider starting that new (and earlier) sleep schedule now. A good first step is to have the child limit screen time or just turn off electronic devices well before bedtime.

3. Kids Needs Breakfast: Studies also show that children who eat a healthy breakfast function better. I encourage parents to check with the school to see what is available in the cafeteria, and most schools have this available on their school website. In addition, some children qualify for free or reduced meals at school, but parents need to check with the school in regards to this.

4. Backpack Safety: Choose a backpack with wide padded shoulder straps and a padded back. Remind your child to always use both shoulder straps. Pack light, and remove unneeded items. The backpack should never weigh more than 10-20% of your child’s body weight.

5. Beware of Bullying: Teach your child when and how to ask a trusted adult for help at school. Monitor your child’s social media and text interactions so you can identify problems before they get out of hand.

These are just a few tips to get you started. The bottom line is that this is such an exciting time for kids as they start out the new academic year. Don’t forget to have some fun in the process of getting ready to go back to school!

Heat Stroke Leading Cause of Death in High School Athletes

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Heat Illness Statistics

  • Heat Illness is A Leading Cause of Death in US High School Athletes

  • Since 1995, Three Football Players Die A Year of Heat Stroke, Mostly HS athletes

  • From 1999-2000, more than 8000 heat-related deaths in US

Heat Illness Prevention For HS Athletes

  • Slow Increase in Pre-Season Practice and Intensity

  • Hydrate Before, During, and After Practice

  • Recognize Signs and Symptoms of Heat Illness

We’ve been hearing all week about the hottest temperatures of the season happening right now. However, with August and back to school right around the corner, I’ve also been reminding my high school patients and their parents that heat related illnesses can still occur when it’s not so hot and humid.

Here are some alarming statistics. According to the CDC, heat illness during practice or competition is a leading cause of death and disability among US high school athletes. In addition, since 1995, three football players a year on average die of heat stroke, most of them high schoolers, according to the National Center for Catastrophic Sports Injury Research. From 1999-2010, more than 8000 heat-related deaths were reported in the US (CDC).

Those high school students who have activities in the fall include those in football, soccer, cross country, golf, cheerleading, and even marching band. Traditionally, in July and August, these athletes are not as physically fit as opposed to when they officially begin. We do know that lack of physical activity and obesity are additional risk factors for heat-related illnesses.

Specifically for high school athletes, I recommend three tips to lower your chance of heat related illnesses. First, especially in July and August, slowly increase your pre-season practice schedule, especially in hot and humid weather. This will help your body get more acclimated to the hot temperatures. Secondly, remember to properly hydrate before, during, and after strenuous activity. Finally, I talk to these athletes about recognizing the signs and symptoms of heat-related illness.

We’ve been hearing all week that signs and symptoms of heat related illnesses include dehydration, heat cramps, nausea, vomiting, headache, dizziness, and confusion. If athletes start to notice and/or recognize any of these symptoms, tell your coach or parent immediately. Prevention is critical, and it may save a life.

Addendum: Thanks to WKBN for making this blog post into a story on their website: “Preventing heat stroke: Know the signs of heat-related illness.”

June is Fireworks Safety Month

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Firework Safety Tips

  • Never allow young children to handle fireworks

  • Older children should only use fireworks under close adult supervision

  • Never light fireworks indoors

  • Never relight a “dud” firework

  • Soak unused fireworks in water before discarding

  • Keep a bucket of water nearby to extinguish fireworks

As the first day of summer and the July 4th holiday is right around the corner, it’s important to talk about some summer safety tips. Did you know that June is Fireworks Safety Month?

According to the Consumer Product Safety Commission, approximately 12,900 injuries were treated at the US emergency rooms in 2017, with more than two-thirds of those injuries occurring 1 month around the July 4th holiday.

Another interesting fact is that on a typical Fourth of July, fireworks account for two of five of all reported fires, according to the National Fire Protection Association (NFPA). CHeck out the video below from the NFPA.

Check out some helpful tips above. Better yet, grab a blanket and a patch of lawn, kick back and let the experts handle the show!

Mother's Day Health Tips

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Happy Mother’s Day to all the moms out there! Thanks for all that you do, which includes taking care of everyone else. Unfortunately, this sometimes means that mom puts her health and well-being last. Here are five tips from the Centers for Disease Control and Prevention that I want to share with moms of every age for a safer and healthier life (CDC).

Eat Healthy: Healthy diets rich in fruits and vegetables may reduce the risk of cancer and other chronic diseases. Fruits and vegetables also provide essential vitamins and minerals that are important for good health. Most fruits and vegetales and filling and naturally low in fat and calories.

Move More: Add physical activity to your life, in whatever capacity you can. I know that some have difficulty with movement, but every little bit helps. Health benefits include better control of your weight, reducing risk of heart disease, reducing risk of diabetes, and some other diseases. More movement also can strengthen your muscles and bones, and also improve your mood.

Sleep Well: Insufficient sleep is associated with increased risk for many chronic diseases like disease, heart disease, and depression. How you perform during the day is related to how much sleep you had the night before.

Manage Stress: I realize that this is easier said than done. But, there are healthy and unhealthy ways to manage stress. I encourage my patients positive self-care steps like leaning on your support system, staying physically active, connecting socially, and other self-care steps. And, of course, avoid alcohol, tobacco, drugs and other unhealthy behaviors.

Share History: Mother’s Day is a perfect day to teach and pass on family medical history. Family members share genetics, environments, and lifestyles that may influence the health of others in the family. Your family’s health history could be important for determining your and your child’s health risks as well.

Measles: Do You Need A Booster Shot?

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In this week’s news, Measles cases have also reached tech giant Google. According to the Centers for Disease Control and Prevention, 555 cases of measles have been confirmed in 20 states this year (as of April 11, 2019). As of this writing, the Ohio Department of Health has not confirmed any Ohio cases. However with the holiday season of Easter and Passover, Measles cases have the possibility of traveling into the state of Ohio, and starting a Measles epidemic here. Lets review the symptoms of Measles.

Signs and Symptoms of Measles

  • Fever

  • Rash

  • Runny Nose

  • Red Eyes

  • Very Contagious

The most common question that I have received from adults is this: Do I need a Measles booster shot as an adult. The answer to that is - It Depends. If you were born before 1957, you probably had the measles, so you probably do not need a booster.

If you were born between 1958-1991, you possibly received one measles shot, which puts you at a 90 percent chance of being protected. You may want to talk with your doctor about possibly getting a second (or booster) shot, especially if there happens to be a local Measles outbreak in your community.

For those born after 1991, and received the measles shot, and a booster, you have about a 97 percent chance of being protected. Of course, if there is any questions, please check with your Family Physician. The above information is summarized in the chart below

Should I receive a Measles Booster Shot?

  • Born Before 1957: Probably not

  • Born Between 1958-1991: Maybe; Especially if Local Measles Outbreak

  • Born after 1991 and Received Two Measles Shots: No

Unfortunately, I believe that it is only a matter of time until the national Measles epidemic reaches Ohio. The best ways to prevent or limit the effect of Measles in Ohio are by two steps: Immunize and Recognize the signs and symptoms. And, of course, if you have any questions, contact your physician immediately.

Tips For Spring Allergy Season

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Two weeks ago, I knew that spring was on its way, because I was the one in the office who was starting to cough, and sneeze, and sniffle. Ahhhh, spring allergy season is here. I get a lot of questions from my patients about how to deal with spring pollen. And, is there anything else other than medications that people can take? Here are my five tips to help you during this spring allergy season.

Tips for Spring Allergy Season

  • Monitor Pollen Counts: In addition to television and radio reports, there are many great smartphone apps out there now that keep track of tree pollen and grass pollen

  • Keep windows and doors shut at home and in your car during allergy season

  • Beware of Spring Evenings: Spring pollen levels, like that of tree pollen and grass pollen have highest counts in the evening. Meanwhile, the ragweed pollen in the fall, is highest in the mornings.

  • Take a shower, wash your hair, and change clothes after working or playing outdoors

  • Take Allergy Meds: Some people take pills, some take nasal sprays, and some need allergy shots. Work with your physician to see what the best medication treatment is best for you.

Increasing Stroke Awareness: Risk Factors, Signs & Symptoms

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Unfortunately, it is in times of tragedy, when people start to ask questions about stroke. Yesterday, it was announced that actor Luke Perry passed away, at age 52, following a stroke (CNN). People are familiar with the term “heart attack.” Well, a stroke is sometimes called a “brain attack” in which a stroke is a blockage of blood vessels which cause a lack of blood flow to the affected area (ischemic stroke; see graphic above). Or, a stroke is a rupture of blood vessels in the brain, causing a leakage of blood (hemorrhagic stroke).

According to the CDC, stroke is the fifth leading cause of death in the United States, and is a major cause of serious disability in adults. About 795,000 people suffer a stroke yearly. And, according to Stanford University, around 10 percent of people in the US who experience a stroke, are younger than age 45. I have also read reports that up to 1/3 of strokes occur at ages younger than 65 years old.

Signs and Symptoms of Stroke (CDC; also see video above)

  • Sudden numbness of weakness in face, arm, or leg, especially on one side of body

  • Sudden confusion, trouble speaking, or difficulty understanding speech

  • Sudden trouble seeing in one or both eyes

  • Sudden trouble walking, dizziness, loss of balance, or lack or coordination

  • Sudden severe headache with no known cause

Prevention of Stroke (CDC:)

  • Control high blood pressure

  • Reduce high cholesterol

  • Control diabetes

  • Treat heart disease

  • Stop Smoking

  • Work with your health care team

  • Recognize warning signs

I was reminded by someone on social media, that we have a local story of stroke in a young person, specifically a 16 year old girl who suffered a stroke at volleyball camp. Her original story was shared in the Fall of 2018, and her updated story is in the video above and at this link.

So, the bottom line is this: A stroke is a tragic situation, and can happen to anyone at any age. The best things that you can do are to be aware of the signs and symptoms of a stroke. In addition, know your risk factors for stroke, control your chronic medical conditions (like high blood pressure, heart disease, and diabetes), stop smoking, and above all, check in with your health care team, and listen to your doctor. Check out more of my videos below, some almost 10 years ago - Yikes!

Prepare for Daylight Saving Time, or else....

Even though there is snow in the forecast, the beginning of March means Spring is right around the corner. Daylight Saving Time is Sunday, March 10, 2019, where we turn the clocks forward one hour, and, unfortunately, lose one hour of sleep.

This may not seem like a big deal, but this small time shift with Daylight Saving Time can cause a lot of Sleep Deprivation and Health Related Issues (CNN):

  • Increased Number of Heart Attacks: A 2012 research study at the University of Alabama showed a 10 percent increase in heart attacks on the Monday and Tuesday after the start of Daylight Saving Time.

  • Increased Number of Strokes: A 2016 study from the University of Finland showed an 8 percent increase in stroke in the 2 days following the start of Daylight Saving Time.

  • Increased Workplace Injuries: From 1983-2006, a study from the mining industry showed more injuries on the Monday after the time change versus the rest of the year

  • Increased Number of Car Accidents: Sleep deprivation can delay reaction time and impair you from making good decisions

Daylight Saving Time does not have to be dangerous. Here are Four Tips to help you “Spring Forward” into Daylight Saving Time (UConn):

  • Gradual Transition To Time Change: Especially for those taking care of children, start now by putting your children to bed 15 minutes earlier, and then moving that back until it is an entire hour earlier than previous

  • Avoid Bright Lights Before Bed: This includes TV, phone/tablet screens, and computers

  • Get Some Exercise During The Day: Aim for at least 30 minutes, most days of the week

  • Get Up If You Cannot Sleep: If you’ve been awake for more than 20 minutes, get up, go to another room, and do something relaxing to help you get drowsy, like read a book

Go Red For Women on February 1st

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It’s hard to believe that February is right around the corner. As everyone knows, February 14th is Valentines Day, but did you know that Go Red For Women day is on February 1st, and this American Heart Association initiative is to raise awareness about heart disease in women. Heart Disease is the Number One cause of death for both men and women, and this is why I try to educate my patients on the risk factors for heart disease and signs/symptoms of a possible heart attack.

Some Risk Factors For Heart Disease:

  • Tobacco Use: These days, this not only includes cigarette use, but also vaping nicotine. In addition, exposure to secondhand smoke raises your risk for heart disease and heart attack.

  • High Blood Pressure & Elevated Cholesterol: With regard to blood pressure, all levels above 120/80 raise your risk for heart disease. Both children and adults are more likely to develop high blood pressure if they’re overweight or have diabetes. With regard to cholesterol, talk with your Family Doctor about having your cholesterol tested and what the results mean. Routine blood tests can show whether your blood cholesterol levels are healthy.

  • Unhealthy Diet: Foods that are high in saturated and Trans fats and cholesterol increase the “bad” cholesterol in your system. In addition, a high salt diet can raise your risk of high blood pressure. Added sugars can raise your chance of diabetes and obesity.

  • Lack of Physical Activity & Obesity: Inactive people are nearly twice as likely to develop heart disease as those who are active. Especially with children and teens, it’s important to limit screen time and to encourage more physical activity.

  • Cold Weather: Even though it’s not a major risk factor, especially those already with heart disease, if your’re involved in cold weather activities (like shoveling snow), it’s very important to listen to your body if you have any of the following signs or symptoms below.

Signs and Symptoms of Possible Heart Attack:

  • Chest Pressure of Pain

  • Pain in Arms, Neck, or Jaw

  • Difficulty with Breathing

  • Breaking out in Cold Sweat & Nausea

As I tell all of my patients, it is important to know your risk factors for heart disease and to work with your Family Doctor in taking steps like changing your lifestyle to improve your blood pressure, diabetes, and cholesterol. In addition, it’s very important to know signs and symptoms of heart attack and stroke. If you start to have any of those symptoms, it is very important to call 911 and/or to go the ER immediately.

Addendum: Thanks to WKBN for including me in their story on their website. Also check out and click on, “Salem Doctor raises awareness for Go Red For Women Day.”