Alcohol 101: Why A Hangover Feels So Bad

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You went out last night. Not only did you “go out,” but you partied hard. Really hard. When you woke up the next morning you had a migraine and your head was spinning. You kicked yourself for not closing the curtains before you went to bed because the morning light was blinding. You got out of bed and realized you were nauseous and thirsty. On top of all of this, you couldn’t remember what happened last night.

What’s the diagnosis? A Hangover.

Many of us have had hangovers at some point in our lives and they really make life miserable. But what is a hangover, really, and why do we get them after a night of drinking?

A hangover is a constellation of symptoms that can occur after ingesting alcohol. Symptoms include headache, nausea, vomiting, dizziness, thirst, decreased sleep and sound/light sensitivity, among others.

The reasons why we get hangover symptoms are numerous:

  1. Alcohol irritates the stomach lining which can cause nausea and vomiting
  2. Brain chemicals called neurotransmitters, are altered by alcohol. This causes impaired memory and mood.
  3. We urinate more when we drink because alcohol stimulates chemicals which increase urination. This promotes fluid loss and dehydration.
  4. Alcohol interferes with the quality of sleep. So, we wake up feeling unrefreshed.
  5. Blood sugar often rises or drops as a result of too much alcohol
  6. Alcohol is a common trigger for headaches

Keep in mind, there are many other factors that determine if you get a hangover and how severe it is. Eating on an empty stomach, your medical conditions and medications, and even your family history can make a difference. Also, consider what you drink because all drinks are not created equally:

One Standard Drink:

= 12oz regular beer (5% alc)

= 8-9oz Malt liquor (7% alc)

= 5oz Wine (12% alc)

= 1.5oz 80 proof spirits (whiskey, gin, rum, vodka, tequila) (40% alc).

So, what’s the ultimate hangover cure, you ask? Well, there is no magic pill that will make hangover symptoms go away. Making sure you have food on your stomach, drinking plenty of water, getting enough sleep and taking a mild pain reliever for headache can help. But, the best solution is to not drink at all. If you choose to drink, drink responsibly and in moderation.

Cheers!

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Dr. Caudle is a board-certified Family Physician and Assistant Professor in the Department of Family Medicine at Rowan University School of Osteopathic Medicine. She appears regularly on television as a media expert and appears regularly on CBS Philadelphia News, Fox News, CNN, The Dr. Oz Show, HuffPostLive, Doctors Radio (Sirius) and others. Visit at www.jennifercaudle.com, and follow her on twitter/Instagram at @drjencaudle.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

Hot, Hot, Hot! 5 Summer Heat Myths Debunked

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by Dr. Jennifer Caudle, Family Medicine

Welcome to summer! In many parts of the world it’s downright HOT right now and heat safety couldn’t be more important. With heat safety (like so many other health topics), it’s important to know fact from fiction.

Myth #1: Cooling fans work as well as air-conditioning.

Fact: Not So! When temperatures rise into the 90’s, fans are less effective than air-conditioning in preventing heat-related illness. In some situations, fans can actually make a room hotter by blowing around the hot air. Air-conditioning is the preferred way to stay cool in the heat. If you don’t have air-conditioning make sure you visit a friend or family member, go to a public place (mall, library, etc.) or contact your local health department to locate an air-conditioned shelter.

Myth #2: I should drink as much water as I possibly can during the heat.

Fact: Let’s break this down a little bit. YES- you should drink plenty of water to stay hydrated and you should start hydrating BEFORE you feel thirsty. BUT, there can be too much of a good thing. Check with your doctor to see how much fluid is ok for you to drink. This is important because some people (with liver, kidney or lung problems for example) have restrictions on the amount of fluid that is safe to ingest. Furthermore, it is possible to develop toxicity from drinking too much water- so once again, check with your doc. Also, avoid alcohol as this can make dehydration worse.

Myth #3: If someone becomes unconscious due to heat it’s ok to just give them time to recover.

Fact: FALSE! If someone becomes unconscious, this is a medical emergency and you must call 911 immediately. While you are waiting on health professionals to arrive, move the person to a cooler place and use cold cloths on their body to help them cool down.

Myth #4: All people deal with heat in the same way.

Fact: Young children, people over 65 years old and those with chronic medical conditions are at high risk for heat illness. Keep this in mind- and don’t forget Fido as well. Animals may experience heat illness as well and shouldn’t be left in hot cars, etc.

Myth #5: If I develop heat cramps while working-out it’s ok to keep exercising.

Fact: Heat cramps can lead to heat exhaustion or heat stroke. If you develop heat cramps, you should stop all activity, sit quietly in a cool place and hydrate. Hold off from resuming strenuous activity until your cramps are gone. If they don’t resolve in an hour, see your doc.

Keep these tips in mind and you’ll be sure to beat the heat this summer! – Dr. Jen

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Dr. Caudle is a board-certified Family Physician and Assistant Professor in the Department of Family Medicine at Rowan University School of Osteopathic Medicine. She appears regularly on television as a media expert and appears regularly on CBS Philadelphia News, Fox News, CNN, The Dr. Oz Show, HuffPostLive, Doctors Radio (Sirius) and others. Visit at www.jennifercaudle.com, and follow her on twitter/Instagram at @drjencaudle.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

“Ah-Ah-Ah-Choo!” 5 Tips for Seasonal Allergy Relief

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by Dr. Natalia Vernon, Allergist and Immunologist

Millions of Americans suffer from “hay fever” or seasonal allergies every year. When you have seasonal allergies, your immune system treats a harmless substance such as pollen as an invader or “allergen”. As a result, your body makes antibodies- large proteins that recognize allergens and release histamine- which cause your allergy symptoms. The most common symptoms include sneezing, stuffy nose, runny nose, post nasal drip (excess mucus that drips down the back of your throat) and itchiness in the nose and eyes.

5 tips to help you this Spring:

  1. Check the pollen count. Visit the National Allergy Bureau website (www.aaaai.org/global/nab-pollen-counts.aspx)  to check for daily pollen levels in your city.  If possible stay indoors with the windows closed when levels are high. When driving keep the windows rolled up to reduce pollen exposure.
  2. Shower regularly. At the end of the day you may have pollen residue on your body and in your hair so it’s important to rinse the pollen off before going to bed.  Don’t forget to shampoo!
  3. Change filters regularly. Furnace and air conditioner filters should be changed every 3 months. Filters help to trap pollen and small particles in dust.
  4. Flush it out.  If a stuffy nose bothers you, a neti pot found at your local drugstore may provide some relief.  Neti pots are a saline rinse for the nose that helps to flush away debris and allergens. Always remember to use the salt solution and water sources (distilled, sterile or previously boiled) that are recommended in the product instructions.
  5. See an allergist.  If you haven’t already, now is a perfect time to do so since spring season is approaching. An allergist can perform a skin or blood test for allergies and develop the best treatment plan for you. Treatment options may include medications and/or allergy shots.

Although seasonal allergies are not life threatening, they can be uncomfortable and bothersome. These tips may help you feel better so you can enjoy the beauty of spring again!

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Natalia Vernon, M.D. is a board certified allergist and immunologist at Northern Valley Allergy, Asthma and Sinus Center, Bergenfield, New Jersey.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

“Chronic Fatigue Syndrome” Gets a Make-Over

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by Dr. Jennifer Caudle, Family Medicine

Chronic Fatigue Syndrome, a condition that has long been difficult to diagnose and treat, is now getting a make-over. The Institute of Medicine (IOM) estimates that between 800,00 and 2.5 million Americans suffer from Chronic Fatigue Syndrome which is characterized by fatigued, trouble carrying out daily activities, sleep difficulties and cognitive problems.

As a physician, I have to admit that I didn’t learn a lot about Chronic Fatigue Syndrome, or how to treat it, in medical school or residency. I’m not alone, however, as many physicians lack appropriate knowledge about this condition. Furthermore, biases about “Chronic Fatigue Syndrome” do exist and some feel the condition is fake or non-existent.

These biases as well as the lack of knowledge about the condition make it very difficult for patients to get help and physicians to make the diagnosis. To this end, the Institute of Medicine examined the medical literature that exists for Chronic Fatigue Syndrome. As a result of this in-depth analysis, the IOM committee proposes to change the name of “Chronic Fatigue Syndrome” to “SEID- Systemic Exertion Intolerance Disease.” The committee also proposes new diagnostic criteria to help doctors and patients with diagnosis.

I have always enjoyed appearing on the Dr. Oz Show and have been on the show a number of times but I wanted to discuss this topic in particular because of the new changes proposed by the Institute of Medicine. Tune in to the Dr. Oz Show on Thursday, March 5th as I discuss the ‘make-over” and new criteria proposed for SEID- Systemic Exertion Intolerance Disease. Check your local listings for air times.

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Dr. Jennifer Caudle is a Family Physician and Asst. Professor in the Department of Medicine at Rowan School of Osteopathic Medicine. She appears regularly on CNN, The Dr. Oz Show, CBS Philly, Fox and others. Please visit her at http://www.jennifercaudle.com and on Instagram and Twitter at @drjencaudle.

The Key to the Kiss: 5 Tips for the Best Lips Ever

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by Dr. Jennifer Caudle, Family Physician

This is the season for love and romance! As a physician, I know that love and affection are not only healthy for the heart, but the mind as well. One of the classic ways to show affection is through the kiss. What part of the anatomy is crucial to the kiss? The LIPS!

Too often, the lips are a forgotten part of the body. We often take care of our skin, are joints and muscles, brain and other body parts…but we forget the lips. It’s important to tend to our lips- this will keep them healthy and soft- keys to a great KISS! Here are 5 tips to having the best lips (and kiss) ever:

1) Stay moisturized. Wear lip balm or moisturizing lipstick to keep your lips supple and soft- SOFT lips are important! Tell me, who wants to kiss dry, cracked lips? Exactly. No one. Keep ‘em moisturized- and this goes for you too, men. Moisturized lips will lead to soft lips!

2) Wear SPF on your Lips. Make sure your lip balm has a broad spectrum sunscreen in it; this is important because skin cancers can occur on the lips. In addition, the sun can cause or exacerbate chapped lips.(If you are unclear about the problems with chapped or cracked lips, see #1)

3) Don’t lick your lips. Do you lick your lips excessively? When you get nervous, stumped, or excited?? If you do, it’s time to stop. Licking your lips can cause them to get dry and cause chapping. Fight the habit!

4) Embrace Humidity. Winter air can be drying, which in turn, can cause dry skin and dry lips. Keep the air in your home slightly humid (use a humidifier, for example) – this will add moisture and help keep your skin and lips hydrated.

5) Protect your lips! Remember, your lips are just as important as every other body part! Keep your lips protected- especially in this harsh winter weather (windy, cold days)- by covering your lips with a scarf to avoid getting damaged!

Take the poll, and tell me what factors you think makes a great kiss!

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Dr. Caudle is a board-certified Family Physician and Assistant Professor in the Department of Family Medicine at Rowan University School of Osteopathic Medicine. She appears regularly on television as a media expert and appears regularly on CBS Philadelphia News, Fox News, CNN, The Dr. Oz Show, HuffPostLive, Doctors Radio (Sirius) and others. Visit at www.jennifercaudle.com, and follow her on twitter/Instagram at @drjencaudle. She believes in soft lips and good kisses.

Five Things to Do Before Your Gynecology Visit: What Your Gyn Wants You to Know

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by Dr. Kalinda Woods

 

  1. Pretend we are your Therapist: Tell ALL!

Think of your gynecologist as the Oprah of the medical realm. Have a bump ‘down there’ that you’re stressed about? Odds are excellent that your doctor has seen that before, knows how to treat it, and will reassure you that it’s not the end of the world. You’ll get the most out of your visit by being as honest and forthcoming as possible. Be assured that your doctor is well trained to deal with whatever is ailing you and there is little you can say or show her that will startle or offend. As physicians, our goal is to make you better, never to judge or chastise. It’s okay to cry in the stirrups. That’s why there’s a box of tissues right next to your head and a picture of kittens on the ceiling.

  1. Wear clean socks.

Most women worry about the smell or appearance of their vaginas at their pap smear, but the truth is, vaginas are not as offensive as people would have us believe. Feet, however can be nasal insults unto themselves. During an exam, the part of your body closest to your doctors nose is…think about it…your feet. A word to the wise is sufficient.

  1. Check your calendar

When was your last menstrual period? This information is important for docs to know. We make many types of women’s health decisions based on this info: from when to advise you to stop/ start contraception, to when to have sex if you are trying to conceive to whether you are going into menopause. Your doctor can also use this information to time certain laboratory and diagnostic tests. Always remember: the quality of the information you give your doctor can make all the difference in performing an accurate work up and making a timely diagnosis. So, when your doctor asks you this question, please be able to shout out the date! This will save time and provide a wealth of information for your doctor.

  1. Know your medications

Your gynecologist needs to know what meds you are taking- especially if they will be prescribing other medications. Don’t assume that because you say you have high blood pressure your doctor knows what medicine you take. And saying, “high blood pressure pill” is not acceptable. If you’re not sure, that’s okay, just call the office when you get home with your medication list so your doctor can update your chart.

  1. Your doc doesn’t know Insurance

Your doctor is a very simple creature. She spent many years studying the science, perfecting the technical skills, and learning the unteachable art of medicine that only comes with experience and having the privilege and the pressure of caring for the health of another. Does she know copays and deductibles? Not so much. Call the number on the back of your insurance card and chat with them about your questions- that’s what those folks are trained to sort out. If you don’t have a card, hope your doc has someone in her office with a fancy title like “Financial Advisor” who can assist with cost and billing concerns.
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Kalinda Woods, MD, FACOG, is an Assistant Professor of Gynecology and Obstetrics at Emory University School of Medicine.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

Post-Partum Depression: A Different Kind of Fairy Tale….

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by Dr. Kecia Gaither, MD

A new mom and depressed? These seem like two realities which radically contradict each other. However, given the fact that you have just delivered a child, and are feeling sad and overwhelmed—your feelings are not uncommon and entirely understandable. While pregnancy has always been seen as a happy time in a woman’s life – a time she can reflect on her own well- being and her status change to “mother,” —for many time is not a fairy tale.

Let’s pull back the cover on some basic issues—pregnancy and the postpartum are a phase where, not only are there biological changes, but psychological ones as well. For some women, these two factors alone can constitute a difficult time: feelings of inadequacy ( I can’t do this), poor self esteem ( I’m not good enough to be a mom), or ambivalence ( this is not what I thought it would be) may erupt and create a situation where there becomes an inability to care for yourself and your newborn as well.  According to ACOG ( American College of Obstetrics and Gynecology) at least, 14-23% of all women in the U.S. experience some degree of depression during pregnancy and the postpartum period. As an Ob/Gyn who specializes in high risk pregnancies, I have seen and dealt with many moms in your situation.

What’s most important is that you know the signs of depression and if you are experiencing any of these symptoms, you discuss them with your doctor. If you are unable to care for yourself, you will not be able to be the fabulous mom you were born to be for your child. So let’s talk about some of the common symptoms of depression– loss of energy, concentration difficulties, eating/sleeping (either too much or too little), low self esteem , denial, guilt, suicidal thoughts, and lack of pleasure. These symptoms are generally present daily and last for more than two weeks. If these symptoms are left untreated, there can be negative complications including:

  • Poor mother-child bonding
  • High incidence of postpartum psychosis
  • Increased risk of substance/child abuse

It is essential to treat your depression during this time to protect both you and your baby. Medication and psychotherapy are typically the first line treatment modalities recommended.   If anti-depressive medications are chosen, your doctor should help weigh the benefits and risks of taking these medications, particularly should you desire to breastfeed.

Here are my recommendations:

  1. It’s ok to seek the comfort and counsel of others.
  2. Align yourself with a support group of moms who are also experiencing the same situation as you—they can appraise you of any potential impact on your work life, the potential interactions that may occur with the other children/family members in the house, and how it may impact your relationship with the baby’s father. This is important, because if depression persists , your may not be able to provide the best nurturing for the infant– which in turn may further exacerbate your depression.
  3. It is important to continue with your postpartum care.
  4. Take home message? Remember you are not alone. Being able to care for you and your baby well after birth means being concerned with you first, in the here and now.

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Kecia Gaither, MD MPH FACOG is the Director of Perinatal Outreach, Montefiore Medical Center, Albert Einstein College of Medicine. Follow her on twitter @KeciaGaitherMD.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

Can TV Shows Help Kids? A Neurologist’s View

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by Dr. Heidi Moawad, Neurologist

Television has been scientifically proven to produce many harmful effects on children and adults.1,2 From setting the stage for unrealistic expectations linked to low self-esteem and eating disorders to advertising unhealthy food and presenting unethical behavior as the norm, television can have many undesirable effects.

But some television shows provide entertainment while actually cultivating intellectual or emotional maturity. Some characteristics of these shows teach kids aspects of the real world that can help them understand how to interact with others in a positive way.

The following is a list of popular television shows that, in my observation, help develop a variety of valuable emotional, interpersonal and practical skills for growing children while providing wholesome family entertainment.

Love it or List it

Each episode of this program centers on a different couple – homeowners who are dissatisfied with their home. One homeowner wants to move to avoid making extensive repairs while the other wants to stay because of loved features of the home. The couple agrees to a remodeling and a new home budget while a real estate agent and a home remodeler compete to see who can provide the couple with the best living option. 

There are many great lessons to be learned from this program. The couple agrees to come to a compromise after they each list their wants in a home. They are encouraged to be considerate and compromise with each other. The couple sets a realistic budget, not an extravagant price, thus setting the stage for compromises. The real estate agent and the remodeler compete in a good-natured but genuine competition and accept loss graciously once the couple make a decision at the end. Lessons learned include compromise, good-natured competition and setting a budget.

The Middle

This is a comedy about a working class family with 3 kids ranging in age from grade school to college age. The plots are humorous and often touching, usually highlighting the message that the characters are imperfect but generally honest and kind. The show, unlike most television shows directed towards kids, does not focus on extravagant wealth or superstar kids or superpowers but instead on ordinary kids who lack more talents than they have. The benefits of watching this program include exposure to normal expectations and watching a family work through some typical problems within a half-hour episode.

Chopped / Cupcake Wars

The cooking challenges in this show focuses on the swift creation of a tasty and attractive meals using unusual ingredients. Contestants have to think on their feet, work well with their team, and use constructive criticism to improve as the show progresses through each round. There is some occasional crying but the show teaches poise under pressure, creativity, and compassion for the loser, who is always presented as very human. Many contestants return even after having been eliminated on past episodes, emphasizing the importance of persistence. 

Shark Tank 

This reality show features fledgling entrepreneurs with business ideas that they want to take to the mass market. A panel of potential investors offer varying levels of financing and partnership in the young businesses. Unlike most reality show competitions, every contestant on the show can win. Business offers are made quickly and clearly which emphasizes the importance of strong math skills. Business ideas are praised, criticized and questioned, teaching the importance of self-confidence as well as the importance of keeping an open mind to constructive criticism.  

The Voice 

This show is about talented vocalists who compete for voice coaching and mentorship by celebrity judges. While there is certainly an emphasis on entertainment, this show emphasizes the importance of coaching and reveals that even talented people need to work hard to improve. At the core, this show also demonstrates the tough reality that great raw talent can’t progress to the professional level unless it is packaged for general consumption similar to the message of Shark Tank. 

The Biggest Loser 

This reality show features obese contestants who need to lose weight. An emphasis on health, making positive changes, looking towards the future and not being ashamed of admitting the you need to work on self-improvement are central to the concept. Most importantly for kids, while there is a prize for the winner, the benefits for all contestants lies in the process itself – emphasizing the importance of working hard in daily life. For example, if a student is not number 1 academically or in sports or other extracurricular activities, participation is still beneficial. 

Television, like anything in life, can be harmful, but an also be beneficial if used mindfully. Kids can get some valuable advantages from some television shows that teach realistic and useful life lessons.

 

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Heidi Moawad MD is a Neurologist and a medical writer. Dr. Moawad is a graduate of Case Western Reserve school of Medicine and trained at University of Chicago Hospitals. Dr. Moawad is the author of “Careers Beyond Clinical Medicine” and she teaches human physiology and global health at John Carroll University in Cleveland, Ohio.
http://nonclinicaldoctors.webs.com/ 

 

Sources:

http://www.ncbi.nlm.nih.gov/pubmed/24639016

Early childhood electronic media use as a predictor of poorer well-being: a prospective cohort study, Hinkley T, Verbestel V, Ahrens W, Lissner L, Molnár D, Moreno LA, Pigeot I, Pohlabeln H, Reisch LA, Russo P, Veidebaum T, Tornaritis M, Williams G, De Henauw S, De Bourdeaudhuij I , JAMA Pediatrics, May 2014

http://www.ncbi.nlm.nih.gov/pubmed/25230366

“I Think My Child is Being Bullied: What Can I do?”

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by Dr. Jennifer Caudle, Family Physician

Over the years I have spoken with over 50,000 children, parents and youth about Bullying. This is a topic that I am not only passionate about, but dedicated to helping prevent. In this issue of The Physicians Blog, I wanted to honor “Bullying Prevention Month” (October) by answering your most commonly asked questions about bullying:

1) What are the warning signs that would let me know that my child is bullied?

The following situations should prompt you to ask questions about what your child might be experiencing:

  • If your child has changes in habits, including eating habits (skipping meals), sleeping habits (problems sleeping), or activities (decreased interest in activities)
  • If you notice injuries that cannot be explained
  • If your child has frequent health issues such as headaches, stomach aches, and generally not feeling well
  • If your child has experienced achange in grades (decline), not wanting to go to school or skipping school
  • If he/she has had a change in friendships or avoidance of certain social situations
  • If there is decreased self esteem
  • If your child exhibits sadness or talks about suicide

Any of the above are signs that your child might be involved in bullying behaviors. If any of them occur you should talk with your child. At times (such as in the case of suicide, etc), you should discuss these symptoms with your child and their health care provider as soon as possible.

2) How do I talk with my child about being bullied? Especially if they feel threatened or scared to talk- How do I break the silence? And, what are some tools to help them?

The following are tips to help you talk with your children about bullying and help them:

  1. Ask specific and open-ended questions
  2. Find out what is happening to your child by showing interest
  3. Understand that your child may feel fear or shame about the situation
  4. Talk with your child’s school officials-  including bus drivers, school counselors, teachers and administrator
  5. Encourage your child to get involved in activities they might enjoy-  this can actually be protective for children who are bullied. Encourage your child to spend time with others who have similar interests.
  6. Role play solutions at home
  7. Educate your child about bullying and cyberbullying and monitor online behaviors by following your kids on Facebook, Twitter and Instagram!
  8. Model good behaviors at home
  9. Discuss your child’s feelings and experiences with your child’s physician

3) Is it bullying, or just kids being kids? When will I know that it is bullying and when should I intervene?

Bullying behaviors should ALWAYS be intervened!

The definition of bullying is:

  1. Behaviors intended to hurt or harm someone
  2. There is a perceived imbalance of power between the parties involved
  3. The behavior is repetitive

Research has shown us that children who are bullied or who are bullies often have long-lasting consequences that may be psychological (increased risk of depression and anxiety), behavioral (problems with violence or substance use) or include other health consequences such as headaches, stomach pains, fatigue, etc. Bullying is a health problem that can affect many aspects of a child’s health and intervening should always be a priority!

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Dr. Jennifer Caudle is a board-certified Family Physician. She is an Assistant Professor in the Department of Family Medicine at Rowan School of Osteopathic Medicine. Dr. Jen is the author of “Bullying Among Today’s Youth: The Important Role of the Primary Care Provider” http://www.osteopathicfamilyphysician.org/article/S1877-573X%2813%2900041-5/abstract.

Dr. Jen serves as an on-air health expert for local and national news networks including CNN, The Dr. Oz Show, FOX News, CBS Philly 3 News, The Tom Joyner Morning Show and many others. She is also the creator of The Physicians Blog. Follow her on twitter @drjencaudle and visit her at www.jennifercaudle.com.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

“Oh, My Aching Back:” Causes and Treatments of Low Back Pain

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by Dr. D’Wan Carpenter

Low back pain is a common stated complaint in most doctors’ offices. Low back pain is in the top 3 list for reasons people miss work in America. So what should you know?

For starters, low back pain has many causes. It can be from a muscular sprain/strain, myofascial pain (tightness and spasm of muscles), facet joints, sacroiliac joints, protruding discs compressing spinal nerves (which give radiating pain down one or both legs), or spinal stenosis (narrowing of the spinal canal which puts pressure on the spinal cord). If you have sudden or rapidly progressing leg weakness, new bowel or bladder incontinence, numbness in the genital area you need to be evaluated immediately by a healthcare professional as this can be the signs of an emergency.

While this list is not all inclusive, it represents the most common causes. The good news is most acute back pain, occurring 3 months or less, gets better on its own in almost 90% of cases although recurrence is possible. The other 10% of cases become chronic and are generally causes by one of three sources:

  1. Intervertebral disc-the disc in between two vertebral bodies in the spine
  2. Zygopophyseal joint (facet joint)-the joint created by the bottom of one vertebra and the top of the next vertebra below
  3. Sacroiliac joint (SI joint)-the joint created by the sacrum (the bottom of the spine) and the ilium (upper part of the pelvic bone)

Low back pain, whether acute or chronic, can limit your function with daily activities, interfere with sleep, and work performance.

Everyone wants to know, what can be done about this pesky back pain?

In most cases, pain medications such as non-steroidal anti-inflammatories (NSAIDs) like ibuprofen can relieve much of the pain. In conjunction, physical therapy for stretches, body mechanics training, and home exercises are often helpful. Osteopathic manipulative treatment (OMT) by an osteopathic physician can help restore the body’s overall function and help promote self-healing. Injections can be indicated particularly in the three main chronic causes. (To find a DO near you http://www.osteopathic.org/osteopathic-health/Pages/find-a-do-search.aspx) Epidural steroid injections (injections into the spinal canal with anesthetic solution and corticosteroid solution) can help relieve the inflammation caused by a protruding disc. SI joint injections are both diagnostic and therapeutic. Zygopophyseal/facet joint nerve block is diagnostic and can be followed by radio-frequency ablation (procedure where radio-frequency waves create heat that burn the identified pain causing nerves around the facet joint)of the nerve for long-term pain relief. Surgery may be indicated if all of the above measures fail, but keep in mind this should be last resort as surgery comes with its own risks.

Take home message:

  1. Remember when lifting heavy items particularly up from the floor, use the leg muscles and not the back to avoid injuries related to improper lifting
  2. Numbness in the genital area, back of legs and buttocks, bowel or bladder dysfunction, and leg weakness can be signs of an emergency and requires immediate evaluation.
  3. Avoid bed rest, but instead modify activities and decrease activity if necessary as complete bed rest can cause weakness of muscles which may exacerbate the condition.
  4. A thorough exam by your doctor is the best way to diagnose the cause of low back pain. Schedule a visit with your doctor especially if your low back pain is not getting better so that you can get the appropriate treatment you need.

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D’Wan Carpenter, DO is a graduate of University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine (now Rutgers School of Medicine) in Stratford, NJ in 2010. Dr. Carpenter is currently finishing her last year of residency in Physical Medicine and Rehabilitation in Taylor, MI with plans to focus on outpatient medicine to include treatment of joint pain, back pain, and neck pain with use of ultrasound injections, physical therapy, and manipulative techniques.

Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.

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