John T. Rowe, MD

Childhood Poisonings

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The Number One Cause of Death from Injuries

Poisonings are responsible for a large number of injuries in both children and teens in the United States and according to the American Academy of Pediatrics are the number one cause of death from injuries in people of all ages.  Statistics from the Centers for Disease Control and Prevention (CDC) indicate that 87 people die in the United States each day from unintentional poisonings and another 2,277 are treated in Emergency Departments.  The third week in March is National Poison Prevention Week and the first step in preventing poisonings is to be aware of the top five causes of poisoning death.

Top Five Causes of Poisoning

Household cleaners

Cosmetics and personal products

Sedatives, hypnotics and antidepressants

Foreign bodies, toys and other objects

Pain killers

Preventive Measures

Preventive measures include educating children about not eating or drinking anything without checking with an adult, using child resistant packaging and keeping household plants and products out of reach.  While children may be the major focus of poisoning prevention, it is important to remember that seniors and pets are also susceptible and any prevention efforts should take them into consideration, as well.

For More Information

American Association of Poison Control Centers

http://www.aapcc.org

Poison Control Hotline

1-800-222-1222

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Polymyalgia Rheumatica

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Pain in the Neck, Shoulders and Hips

Polymyalgia Rheumatica or PMR is an inflammatory disorder of unknown origin, characterized by aching, pain and stiffness in the shoulders, upper arms, neck and hip region.  The term polymyalgia comes from the Greek and means pain (algia) in many (poly) muscles (my or myo).  It is often accompanied by fatigue and malaise and is a fairly common cause of widespread aching and stiffness in older adults.  The stiffness is particularly prominent in the morning.  PMR almost always occurs after the age of 50 (most commonly after the age of 65) and women are affected two times as often as men.  Onset typically begins rapidly over about two weeks with pain in both shoulders and in the neck, progressing to the hips over weeks to months and eventually making it difficult to perform daily activities.  Occasionally the onset is abrupt with symptoms appearing almost overnight.

Pathophysiology

The inflammation in Polymyalgia Rheumatica is thought to occur in the bursae or sacs around the shoulder and hip joints.  PMR is closely related to a more serious inflammatory disorder, called Giant Cell Arteritis or GCA, which involves the arteries of the head and neck and can lead to headaches, jaw pain and visual disturbances.  GCA is classified as a vasculitis, which means there is inflammation in the blood vessel walls leading to vessel narrowing, blockage or even aneurysm or rupture.  Heredity may play a role in the development of both PMR and GCA and it is theorized that infection may set the wheels in motion.  For example, a virus may stimulate the immune system and trigger PMR in a susceptible individual.  Because PMR and CGA are thought to be manifestations of the same disease, a patient may have both conditions.

Diagnosis

Due to involvement of the shoulders and hips, individuals with Polymyalgia Rheumatica typically have difficulty with certain specific activities, such as getting out of bed, standing up from a chair, getting out of a car or putting on a coat.  Symptoms of PMR may also include loss of appetite, weight loss and low grade fever.  There are several laboratory tests that help in identifying PMR.  Although it is a nonspecific indication of inflammation, the erythrocyte sedimentation rate, or ESR, is usually significantly elevated.  Another blood test measuring the level of C-reactive protein or CRP is often quite high in patients with Polymyalgia Rheumatica.  CRP is a protein formed in the liver in response to injury, infection or inflammation.  Patients may also have anemia.

Treatment and Prognosis

Patients with Polymyalgia Rheumatica often respond rapidly and dramatically to low dose steroid medications, such as 10 to 20 mg of prednisone a day.  Relief from the pain and stiffness within a few days helps confirm the diagnosis of PMR.  Treatment typically lasts for several years with careful tapering of the prednisone to avoid recurrence.  Patients must also be monitored for signs and symptoms of Giant Cell Arteritis which is thought to be another manifestation of the same disease, but which can have serious consequences, such as stroke and sudden blindness.   Fortunately, Polymyalgia Rheumatica often goes away on its own within 2 to 6 years, after which time treatment can be stopped.

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A simple clock test may help identify memory problems.

Memory Concerns

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Am I Losing My Memory?

At some time or another we’ve all misplaced something and wondered, ‘Am I losing my mind?  Is there something wrong with my memory?’  For some, it’s the car keys, for others it’s the shopping list.  In my case, I keep losing my gravitas, but that’s a whole nother story.  All kidding aside, memory concerns can be a source of anxiety, whether they’re about yourself or someone you care about.  The good news is that most of the time our concerns about memory are not related to actual cognitive impairment, as we call it in the medical jargon.  In about two thirds of the cases that come to the attention of a health care provider, the patient’s memory is either normal or if it is impaired, it is related to a treatable condition, such as depression, chronic medical conditions, nutrition, or medications.

A Simple Memory Test

How can you tell whether your memory concerns are real or imagined?  Thomas C. Rosenthal, MD, Chairman of the Department of Family Medicine at the University of Buffalo, has devised a simple test that can help distinguish between normal memory issues and actual cognitive impairment.  He found that patients with cognitive problems will have difficulty drawing a clock showing a time of 2:45, while those with normal memory issues or impairment caused by treatable conditions will not.  While this is not a definitive test, it can be a useful screening tool for medical providers.  I haven’t tried the clock test on myself yet, but will try to remember to do so sometime soon.

Memory Tricks

There are some things we can do to improve our memory or to adapt to the gradual decline that we all experience with age.  And there’s no shame in using these techniques…in fact, some may actually increase your memory skills.  Among the most helpful techniques are writing notes, lists or diaries to help us navigate through the day or using verbal or written cues to remind us where we put the car keys, for example…as in saying out loud to ourselves, ‘I put the car keys on the dresser’.  Some other ways to improve memory, according to Dr. Rosenthal, include participating in social activities like spending time with family and friends, getting exercise through such activities as gardening and walking…and who knew one of the most helpful would be playing computer games!  All of these seem to have a positive and lasting effect on memory function.  All right, there you have it.  Now let’s see if you can draw a clock showing 2:45!

A simple clock test may help identify memory problems.
A simple clock test may help identify memory problems.

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Smartphone Health and Fitness Apps

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Get Help With Your New Year’s Resolutions

Whether you’re an iPhone fan or a Droidie like me, chances are you have a smartphone.  Nearly half of Americans use a smartphone and it is estimated that there are nearly one billion smartphones in the world, with that number increasing every day.  So why not harness the power of your smartphone to help you achieve your New Year’s resolution goals!  Many of our resolutions are related to health and fitness and the Five Healthy New Year’s Resolutions that we presented last year are just as pertinent for 2013 as they were in 2012.  The good news is that if you didn’t quite live up to all your expectations last year, your iPhone or Droid may be able to help.

Check Out These Apps!

Your smartphone is so smart that it can be your own personal trainer, your conscience when you’re tempted to eat those goodies and your library of information about health and safety.  It is estimated that there are 40,000 medical apps available and while many of these are designed for use by health care providers there are numerous apps for health care consumers, as well.  Sorting through this long list in search of the very best ones can be a daunting task, but a quick Google search will help you find apps that are tailored to your own personal needs.  Just to get you started, here are some of the most popular ones that may help you stick to your New Year’s Resolutions this year.  Most of them are free and can be used with either the iPhone or Android unless otherwise noted.  We’d love to hear about your favorite apps in the Comment Section below.

Fitness

–Fitness Buddy: personal trainer, $.99

–My Fitness Pal: calorie counter and diet tracker

–Run Keeper: personal trainer

–Map My Run, Ride or Walk: uses GPS to track running data

Weight Loss

–Lose It!: monitors diet and exercise to help achieve weight loss goals

–BMI Calculator: measures body mass index

Food

–Fooducate: detailed product information

–Traffic Light Food Tracker: rates food based on fat, sugar, sodium content

–GoMeals: tracks food, activity, blood sugar

Diabetes

–Glucose Buddy: tracks blood sugar and medications

–Blood Sugar Tracker by healthycloud.com: tracks blood sugar (iPhone)

Medical Information

–WebMD mobile: symptoms, conditions, medications, first aid

-iTriage: symptoms, their causes and what to do

–GoodRx: comparison shop for prescription drugs

Disclaimer:  Mentioning these mobile apps on Health Matters does not constitute an endorsement or guarantee of effectiveness.

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Red Meat and Your Health

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Reporting in the Archives of Internal Medicine, April 9, 2012, Pan, Sun, Bernstein and Schulze, et al, confirmed that consumption of red meat is associated with a significantly increased risk of total mortality, including death from cardiovascular disease and cancer.  They noted that this risk was greater for processed meat, such as sausage and lunch meats, than for unprocessed meat.  The article concluded that substitution of healthy foods, such as fish, poultry, nuts legumes, low-fat dairy products and whole grains for red meat resulted in a significantly lower risk of death. 

The higher content of saturated fat and cholesterol are likely reasons for the increase in coronary heart disease seen in individuals who eat a lot of red meat.  It has been known for some time that the incidence of colon cancer is increased in those who eat a lot of red meat, especially when cooked at high temperatures or grilled.  It is interesting to note that Scotland has one of the highest rates of beef consumption in the world and one of the highest incidences of colon cancer, as well.  

Since red meat is a major source of protein in the western world, substituting the healthier alternatives noted above makes a lot of sense.  Furthermore, eating less meat generally means consuming fewer fats and calories which translates into weighing less.  And weighing less reaps many other health benefits, such as having less chance of developing diabetes or hypertension.  For more information, consult your primary health care provider or a registered dietitian.  They can help formulate a diet plan for you that will not only improve your health, but will probably make you feel better, too!

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Relieving a Toothache

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Has Anyone Ever Tried This? 

Almost thirty years ago researchers at McGill University in Canada found an interesting way to relieve a toothache.  By rubbing ice on the back of the hand over the web between the thumb and index finger on the same side as the toothache the pain could be relieved by about 50%.  The theory is that nerve pathways in the web area stimulate an area of the brain that blocks pain signals from the face.  Interestingly, this web between the thumb and index finger is that same place where acupuncture needles are placed to relieve toothache pain.  It is important to understand that when this maneuver works it only provides temporary relief and should not delay a visit to the dentist.  I can’t wait to try this next time I have a toothache…on second thought, if any of our readers have had experience with this we’d sure like to hear your story in the comment section.

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