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Twitter Updates for 2010-03-15

  • I love to collect weird,wacky & wonderful medical terms. Latest = "collarettes of scale" (a type of rash). Share yours #weirdmedicalphrases #

Twitter Updates for 2010-03-14

  • Alice In Wonderland health steampunk trivia: Mad Hatter was a common term – steamed mercury used to embed fur in felt; mad = mercury poison #
  • Woohoo! Congrats: RT @chemo_babe: Made the list at Loop! Apparently, they think I'm funny. Who knew?… http://bit.ly/9TGgpp #
  • Craig Newmark's (of Craig's List) "Best. Graph. Ever." It's eye-popping, and verified. Check it out & pass it on:
    http://bit.ly/coORWx #
  • Proven: THE most important meal of the day (& gorgeous pics) RT @petapixel: A look at breakfast in different countries: http://j.mp/cNowFg #
  • New article: Corey Haim, prescription drug abuse & you.
    Are you an unwitting enabler to all-too-common overdose deaths?
    http//bit.ly/bqPqIL #

Corey Haim, prescription drug abuse and you

Prescription drug abuse has exploded in the last few years. Rush Limbaugh is perhaps the most famous person to become addicted to them, and commit crimes to obtain them. Corey Haim may (or may not) be the latest in a too-frequent series of celebrities-who-died-too-young from drugs that were obtained from a dealer with an M.D. Did these docs know those drugs would end up in the wrong hands? Who knows – but, whether it’s docs, the internet, friends, or all of the above, the fact is that more and more prescription narcotics are floating around than ever before. In my pre-Haiti preparations, one of the most eye-opening events was when I asked lots of people in my community to donate unused narcotics (if they had any). Families in my community, motivated by both a true sense of altruism, and a desire to safely get these meds out of their medicine cabinet, managed to produce an eye-popping amount of controlled substances. So much so that I was worried I might get a particularly invasive body-cavity search while going through JFK (especially since I also had a large amount of cash – for me – in small bills as my “get out of Haiti” emergency stash…). How many narcotic pills did I get? Let’s just say, having only spread the word through a few people, I got a gallon ziplock bag over half full of Vicodins (just take a moment to imagine the bulging sack), a hefty number of other controlled substances, and even a large handful of methadone (donated by a family whose grandma died in hospice).

So, if you don’t know a reliable doc heading to Haiti, how DO you safely protect, and dispose of, narcotics (assuming, of course, that none of us wants to be an unwitting enabler to the tragic overdose deaths that are all too common)?

This, and a shot of whiskey = death

Wikimedia Commons

Couple of these, and a shot of whiskey = death

First, the warnings:

Cases have been prosecuted where users visited homes purely for the purpose of pawing through medicine cabinets to steal narcotics. As you can imagine, most people don’t even notice these pills are gone until days or even months later. How will you even notice one or two missing? How are you ever even going to find out who took them? What about those friends-of-friends who came to a cocktail party? Could it have been them? Even real estate agents have noticed that pills go missing after an open house. What about the situation (like that of Rush Limbaugh’s housekeeper) where a friend (or employer) wants to bum a few off you? What are you supposed to do then?

Here’s the bottom line when it comes to controlled substances:

1) Time for the tough talk with yourself. As much as any of us wants to be empathetic to pain, these pills can (and often do) kill. That means you need to take responsibility for having them in your house. Maybe you’ve been telling yourself that you’re going to get well. Maybe you just hate the idea that you-being-on-pain-meds may now be your new normal. The fact is, if you’ve had three months of chronic pain without a changeable, progressive, condition, you’re now, officially, a person with a chronic pain disorder. And, if you’ve been on narcotics round-the-clock for over three weeks, there’s a good chance you are physically dependent on them (keep in mind, dependent is not the same as addicted). Why am I going over all this? Because anyone who’s been on round-the-clock pain meds for over three weeks needs to have that hard discussion with themselves – the one where you admit that it’s time to accept responsibility for having pain meds permanently in your home. You, indeed, need to get a serious, hidden, locking location for your narcotic meds (that includes medical marijuana, which can, despite widespread rumors to the contrary, lead to coma - and it’s corollary, death - if ingested by very young children). Is buying one and installing a locked pill-cabinet a (har) pain? Yes. Is it emotionally difficult to do? Oh yes. But the fact is, you still need to do it.

2) Be real. However, not many of us are going to buy, much less install, a Fort-Knox-style locking cabinet for our half-forgotten eight pills of Vicodin from a wisdom tooth extraction two years ago. That means you need to get rid of unused narcotics (even a couple), as soon as you stop taking them. Why is this so hard for so many of us to do? I’d say it’s a kind of PTSD – a sign that we’ve been subjected to way too many a$$hole doctors, the kind who dismiss our pain and poo-poo our misery as so much whining. Even one experience of being on the receiving end of that kind of condescension can turn the best of us into a narcotic-hoarder. However, once you realize the coma/death you may be risking by keeping those little nuggets of addiction in your house, especially for vulnerable people you love, you may decide, despite your own future risk of untreated pain, to actively embrace the leap-of-faith necessary in order to discard your hoarded pain-pills. Do it. Trust in the future so you can protect the ones you love. Toss those suckers.

3) But where do they go? You can’t flush them, and even double-bagging them in plastic and tossing them in the trash can have risks (find out why at this great site). So where do you go? Many police stations, in only the last few years, have created safe disposal sites. Why police stations? By federal law, only the police are authorized to dispose of controlled substances like prescription narcotics. Wonderfully, you can go here to find the nearest safe-narcotic-disposal location that serves your area. Keep in mind that “prescription controlled drugs” (and addiction/death risks) also include that whole family of pills known as benzodiazepines – Xanax, Ativan, Lunesta and other “downers.” A great docgurley-reader pointed out that ADHD drugs should also be included in this list. What about other controlled substances? Since pretty much all these containers are located inside police stations, I can’t say what might happen if you decided to drop off a dime-bag, or a half-kilo of blow, but I’m guessing that act, however altruistic, wouldn’t end well for you… In other words, when it comes to the illegal kinds of drugs, we don’t have (yet) a safe disposal process.

4) Pro-active is pro-tective. Be honest with your doctor. If you’ve got a good one, he/she will be VERY receptive when you say “I only want a prescription for exactly as many as you think I’ll need – but, on the other hand, I sure don’t want to be hurting for days if I can’t get in touch with you. How can I get more, rapidly, if I need them?” A decent doctor will work hard to make sure you get as many as you might need up front, and easy access to more if that doesn’t work. Be sure to express your concerns about having too many (possibly-excessive) narcotic pills around your house. Some doctors are all too likely, in the interest of saving time, to just write for many more than you’re likely to need. Hey, it saves everyone some phone-call answering-service hassle, right? Except, that is, for the teen who dies of a multi-drug overdose at the next beer-bash.

5) Sometimes, paranoia is a good thing. Keep an eye on your pills. The only thing worse than someone sneaking a few of your meds every now and then, is having someone you love die from a preventable death. You want to know exactly where, how many, and how secure your pills are at all times. It’s not unreasonable to check your medicine cabinet after a party. Check them all. Maybe it’s not narcotics, but cough syrup, pseudephrine, Viagra-type meds, early-refills for ADHD drugs, or other pills that go missing. If you notice stuff gradually dwindling, you’ve got a home-security problem. Get help, before it escalates. Even if a medication helps you, when it comes to someone else, your pill can kill. If you’re baffled by a missing pill, discuss it with a healthcare provider you trust. A blood pressure medicine, clonidine (not the more commonly misused pill, “Klonipin”) can be used to extend the effectiveness of abused drugs (as well as to blunt withdrawal symptoms). While it may not immediately make sense to you exactly why grandpa’s blood pressure medicine (“clonidine”) is slowly disappearing, talking it over with a trusted professional could be your only chance to get help for someone you love. Before it’s too late.

6) Spread the word. As more and more people die from a mix of pills, drugs, and alcohol, teach your friends, loved ones and teens that you have to be on the look-out for anyone who’s too groggy to care for themselves. The days of assuming someone has just had one drink too many are gone. Anyone who can’t control their vomit, or isn’t shake-awakeable at a party, needs professional help. You can’t know what’s percolating through their blood, or how bad it’s going to get. Several states have even passed laws protecting underage drinkers who call 911 on behalf of friends. Saving a life, when all someone needs is help breathing, is pretty darn easy. And cheap. Don’t miss the chance to be a bona fide hero. Call if you’re worried.

Share in the comments section – do you have tips? Experiences you’d be willing to share? Feel free to forward this info along to others you think might be interested. Keep up on the latest health issues in the news by signing up for a Doc Gurley RSS feed by clicking here. Look for future pics and other articles at Doc Gurley – discover the weird, the wacky and the everyday symptoms you want to know about, as well as practical expert tips on staying well. Want to express your inner fan-girl/boy? Become a Doc Gurley fan on Facebook! Want to be on the inside, fast track of health news and tips? Jump on the Twitter bandwagon and follow Doc Gurley! Also check out Doc Gurley’s joyhabit and iwellth twitter feeds – so you can get topic-specific fun, effective, affordable tips on how to nurture your joy and grow your wellth this coming year.

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Twitter Updates for 2010-03-13

  • Arch of Intern Med says Obama gets too many med tests. But did he get the best, cheapest one: What's the Presidential vitamin D level? #
  • Good news RT @PattiDudek: Seclusion & Restraints Bill Passes House of Representatives http://bit.ly/cPL7s9 #
  • New article! Tips to Avoid a Daylight Saving Death. Studies show def. mort. increase: learn how to protect you & yours http://bit.ly/dm9pnt #
  • The Steam Punk Convention is fabulous. Check it out: http://twitpic.com/18eedt #seeninsf #
  • Slogans @ Steampunk stall:
    There is no spoon.
    And then it got weird.
    So many freaks, so few carnivals.
    Heavily sedated for your protection. #

Tips to (again!) Avoid A Daylight Saving Death!

We’ve had the deflating news that Daylight Saving Time (where we lose an oh-so-painful hour of sleep) doesn’t even save energy – in fact it may even increase energy usage. Looks like the savings in energy due to decreased light usage is more than offset by the increase in energy used for air conditioning. Sigh. But here’s the most important message to keep in mind as we continue to collectively enact this seasonal madness: Daylight Saving Time has been shown over and over in research studies to cause, each year, a definite, measurable (and significant) increase in the number of deaths. When you think about the misery and futility of Daylight Saving Time, the fact that you could actually die because of it seems just so…so wrong. So why do people die because of Daylight Saving Time? And what can you do, personally, to avoid being involved in a Daylight Saving Death?

Over nine hundred Americans, from the years 1987-1991, are estimated to have died purely because of Daylight Saving Time (DST). Another study, using 1997-8 data, estimated that abolishing Daylight Saving Time would save 171 American pedestrians per year (13% of all pedestrian fatalities in the 5:00-10.00 a.m. and in the 4:00-9:00 p.m. time periods) as well as 195 Americans killed in car collisions per year (3%, during the same time periods). To make matters even more stark, moving DST to an earlier, darker date (March instead of April), as we are this year, is likely to make those numbers go up. Daylight Saving deaths are predominantly due to pedestrians getting killed by cars. People are driving after a smaller chunk of sleep, probably stressed and running late, and, importantly, drivers are not yet accustomed to watching for pedestrians in the dark. Pedestrians are groggy, late, and probably not used to looking out for cars in the dark. Maybe some of the cars even forgot to turn on their headlights. Children, in particular, are vulnerable to Daylight Saving Death–one study showed that, in a small area of northeast England, one child every two years dies because of Daylight Saving Time.

What can you do? First, even if we drive, we’ll all be getting out of a car to walk at some point, so these pedestrian tips apply to everyone:

1) Hold that toddler hand tight as you head to daycare Monday. Keep a hand on a backpack strap as you walk your kid to school. Warn older kids of the danger.

2) Wear light, bright clothes–nobody gets to be goth the Monday after DST.

3) Cross the road in the middle of a pack (if you can).

4) Be alert–when it comes to pedestrian vs. vehicle face-offs, the only important law is the law of physics. Watch out for the sleepy, stressed out, no headlights death car!

Tips for drivers, to help avoid pedestrians and other cars:

5) Consider getting up even (know it’s painful) earlier. Get a real cup of coffee under your belt if you drink coffee. Leave yourself plenty of time to get where you’re going, even with pick ups and drop offs. If there was ever a time to drive defensively, this is it. Leave plenty of space between you and the next car, stay within the speed limit and channel your inner zen.

6) Pretend you’re watching out for large, sluggish, humped shapes in the dark that can suddenly dart in front of you. Get your best video-game reflexes tuned up to make sure you’re not caught by surprise.

7) Make sure your visibility is the best it can be. This weekend is a great time to really wash that front windshield. Put both the visors up. Made sure your headlights are clear of grime (and turned on!). Consider getting your kids to ride shotgun and help you watch for pedestrians–they love a chance to take charge and shout out information.

8) Hey, if you have the option, next week is the perfect time to take public transport! Just watch out for cars when you’re walking.

For everyone–

Start now and use some easy cognitive behavioral therapy tips (proven to be every bit as effective as sleeping pills!) to try to get some extra rest on Sunday night:

1) No caffeine of any kind (no chocolate, tea, coffee, decaffeinated drinks–which still have caffeine) after noon.

2) No alcohol with dinner or later. While alcohol may make you feel “drowsy” in the short run, it actually impairs your natural sleep cycles.

3) No TV, no computer, no “screen” of any kind three or more hours before bed–crack open that great book you never seem to have the time to read!

4) Make sure your bedroom is dark, quiet and cool. If you still can’t get to sleep after 45 minutes or so, get up and do something restful (NO TV, no computer, no “screen” of any kind). Rest peacefully until you feel a wave of sleepiness coming and surf that wave back to bed.

Hope to see you all–each and every one of you–after we make the DST shift.

P.S. Extra credit (we recovering premeds believe in extra credit the way some people believe in the Giants: life-changing, powerful, unfortunately erratic). Save even more lives by changing your smoke detector batteries this Daylight Saving Time!

Share in the comments section – do you have tips? Experiences you’d be willing to share? Keep up on the latest health issues in the news by signing up for a Doc Gurley RSS feed by clicking here. Look for future pics and other articles at Doc Gurley – discover the weird, the wacky and the everyday symptoms you want to know about, as well as practical expert tips on staying well. Want to express your inner fan-girl/boy? Become a Doc Gurley fan on Facebook! Want to be on the inside, fast track of health news and tips? Jump on the Twitter bandwagon and follow Doc Gurley! Also check out Doc Gurley’s joyhabit and iwellth twitter feeds – so you can get topic-specific fun, effective, affordable tips on how to nurture your joy and grow your wellth this coming year.

Twitter Updates for 2010-03-12

  • RT @Mtnmd: J Natl Canc Inst 1999 women consuming high levels of antioxidants were 3 times less likely 2 develop breast cancer #

Twitter Updates for 2010-03-12

  • RT @Mtnmd: J Natl Canc Inst 1999 women consuming high levels of antioxidants were 3 times less likely 2 develop breast cancer #

Even more Salmonella issues

:Original raster version: :Image:Food and Drug...
Image via Wikipedia

Once again (this now happens every couple of months) the FDA is forcing a recall of food products (notice that they are called food products, not food) tainted with salmonella. This time it is hydrolyzed vegetable protein manufactured by Basic Food Flavors (that’s some flavoring they are adding…)

The ‘food product’ was added mostly added to beef tacquito and chicken quesadillas from Windsor Foods . But since this product literally goes into thousands of foods, more products are expected to be recalled. Already Pringles has started to recall Pringles Restaurant Cravers Cheeseburger potato crisps and Pringles Family Faves Taco Night potato crisps. In fact so far 56 products have been recalled and more are expected.

Fortunately, so far nobody has apparently gotten sick from this infection, but the continuing spate of recalls only highlights that even more serious problems are likely to occur in the future than have happened in the past.

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Twitter Updates for 2010-03-09

  • Feeling the difference today between practicing Haiti-medicine vs. US homeless medicine. An impressively larger gap than you might think… #
  • Giving a talk on issues regarding underage drinking at a local high school. Great topic. #

Chile (and Haiti, and Katrina…): Preparedness lessons for you and me

We’ve entered a new arena of horror – where our Richter scale, for the first time, doesn’t seem to reach high enough, and adjectives are crumbling under the impact. “Devastation” or “catastrophe”? None of the usual descriptors feel powerful enough.

So as punched-gut news of another urban area implosion reaches you today, this one from Chile, you may be feeling both sorrow and a twitchy distant panic – after all, how long before the Bay Area takes its turn?

So here, while our usual complacent wall-of-denial has maybe cracked and fissured a bit, are some simple, practical tips that you can do this weekend to prepare you and yours for a worst case scenario (that’s right! do it in honor of those you wish you could help! do it to work off some frustration and grief as you wait to find out more about the people suffering in Chile!).

My tips are a little different from what you may see in typical Earthquake Preparedness info. These are not meant to supplant what is already good advise, but to take things a bit further, based on what I’ve seen in Haiti, and what seems to be the New Rules of Urban Devastation.

1) Know thy neighbors as thyself. People survive the loss of government, buildings and infrastructure by banding together. Nowhere is this probably more important than in urban areas, where families are often separated by distance, and those living closest to you may not even be acquaintances. Walk around this weekend, knock on some doors and introduce yourself. If you’re feeling a bit shy (who wouldn’t be?), consider making some cookies and putting one or two in a baggie as a smoothing-the-awkwardness gift. Tell people you want to get together as a “block” (whatever your definition of block might be), for security and disaster planning reasons. Some people will give you the cold shoulder, but you may be surprised how many are grateful to meet you.

2) Now what? First, the almighty cell. It’s amazing how cell phones have kept working, especially the text function, even in Haiti. Hopefully, that would continue to be the case. At your first get-together, program group numbers for mass-text blasts into every man, woman and child’s cell. It’s the one item most of us carry on our persons at all time. Also consider downloading and installing (if you have a smartphone) specialty apps that might help in an emergency. Since it’s an ever-changing field, maybe someone in your group will research which ones (location finding? first aid?) might work best for your group. After your “block” is organized, connectivity-wise, extend that circle out to your family by choice or biology. Many disaster-preparedness sites advocate an emergency phone tree, but after what the earth is doing nowadays, it pays to take things a step further and input the mass-text-blast set-up in advance.

3) Next, know your resources. Is there a doctor living on your block? A nurse? An engineer? Are there any other special skills nearby? How close is the nearest medical facility (including clinics)? How could you get there? In the aftermath of destruction, you don’t want to be trying to carry a loved one three blocks the wrong way. Also, remember basics – you can carry a person on a makeshift stretcher with only two poles and a sheet tied between them. Although many of us may not have the space to store them, wheelbarrows became prized commodities for many reasons.

4) Now, get a tent. Whether we’re talking about Katrina, or traditional earthquake preparedness advice, the assumption has always been that there would be a place for survivors to shelter. We’re discovering over and over that assumption just doesn’t hold true. Not when millions of people are affected in the same small geographic area. You can buy a functional, decent tent for pretty cheaply at a number of different places. Hey, maybe you’ll even get inspired, once you own one, to turn off the TV and head out for a weekend this summer!

5) Next, get a shovel, a bucket, and a bundle of nylon cord. And a lever/crowbar. Again, while these items are not the typical part of an earthquake kit, you’d be surprised how rare, and life-saving they can rapidly become. Moving walls and timber off trapped people was the one act (more than any Gupta-like surgery) that saved limbs and lives in Haiti. After the initial crash, your bucket, with a roll of garbage bags, can act as your toilet until you get a chance to dig a latrine with that shovel. Hey, throw in a blue tarp too – you can put walls around your loo (among many other uses). A sturdy, sharp knife (hunting-type) or small axe for hacking through things could also be very useful. Got a pair of sturdy, rubber-soled shoes that are practically worn out? Toss those shoes in your pile. People who were barefoot or wearing sandals were exposed to glass and live wires in disaster areas.

6) The water thing. Most of us can’t keep track of the freshness of our 5 gallons/person of earthquake-kit water. It pays to stay on top of that, including calendaring a check/switch. However, what’s clear in our new world order of destruction (New World Disorder?), is that you could need access to a more extended amount of water than you can pre-store (in addition to what you store). What can you do? First, buy a more re-usable water purification approach. It doesn’t have to be (that) expensive. Consider buying iodine crystals. That one bottle, and a crude filter, can purify 200 gallons of even gross water. There are many other, more high-tech approaches. But be wary of anything that is, in the end, battery-dependent. Second, scout out water options. Can you keep/make a water catchment system? Is there a local pool nearby? Does your semi-retired RV sit around with its water tank half full? Is there a stream running through your neighborhood? While we’d all like to think that we’d be different, that Katrina-esque delays in care wouldn’t happen again, these water-access situations have made the difference between dehydration or survival in Haiti – especially in the first three weeks before water distribution got up and running.

Putting the sun to work in Haiti

Putting the sun to work in Haiti

7) Fire and power. Clearly, waterproof matches are a part of many recommended earthquake kits. Take things a bit further, and you’re talking about a camp stove. But then there’s the issue of fuel. And, another type of power issue is energy for that all-important cell. Or lights. You can consider getting solar-powered flashlights (available pretty cheaply), as well as a solar-charger for your cell. The premier kind is an all-purpose solar charger that could do lights, cell, even laptop. But those are pretty pricey. Maybe someone in your local “block” already owns one? Or is willing to share?

8) Beef up your medical supplies. Check out these advanced medical preparedness set of tips. Make sure you include those, as well as extra bandage rolls, tape, and gobs of hand sanitizer, for days-weeks of post-potty use. Many small bottles of hand-sanitizer are best, as they frequently leak, and they could be distributed among family members for frequent use. Don’t forget to include at least some of the kinds of things lying around your home whose absence has plagued people in Haiti – tampons, napkins, condoms, diapers, and other important quality-of-life items. If you don’t end up needing them, someone nearby will. Finally, consider including some of those paper surgical masks. Whether we’re talking about the aftermath of 9-11, or the sooty dust/haze/campfire pollution that still pervades Port au Prince, having a mask that lets you breathe fewer particulates may be important for people with even normal lungs, much less sensitive ones. A saying in Haiti, when people talk about the visible aerosolized mortar, grit, and pollution is “at least we could never afford asbestos.” Unfortunately, we could afford it, and did put it as well as other never-meant-to-be-breathed substances in the walls of mega-high-rises.

9) Location, location, location. Depending on your choices, you’ve probably spent somewhere between $100-$500, total. Compared to the price of earthquake insurance, what a deal! Now where do you put all this stuff? If you’re living in a high-rise apartment building studio, this may all look (and sound) ridiculously impractical. For you, that may be the brutal truth – in which case you’ll be looking for micro-versions of all these items and putting them in a rectangular storage box. But what about your work? Or your car? You can’t know where you’ll be – and one of those may be a good place to stock and store your supplies. For lots of people, these items would all neatly fit (along with the typical earthquake preparedness kit) inside one of those tightly sealing streetside garbage cans. That garbage can, itself, could be really handy in a disaster for sheltering many perishables. Put everything inside, bungie-cord it closed, and take it outside your home (if you can). Store it in a bike rack area, or a trashcan hut, or the place where you keep garden implements. The last thing you want is for your devastation kit to be buried under rubble. Having it all in one container makes your supplies relatively easy to load and go if you need to evacuate for other reasons (like a tsunami warning).

Here’s hoping that, in retrospect, these tips all look silly, overwrought and unnecessary. Wouldn’t that be lovely?

Share in the comments section – do you have tips? Experiences you’d be willing to share? Keep up on the latest health issues in the news by signing up for a Doc Gurley RSS feed by clicking here. Look for future pics and other articles at Doc Gurley – discover the weird, the wacky and the everyday symptoms you want to know about, as well as practical expert tips on staying well. Want to express your inner fan-girl/boy? Become a Doc Gurley fan on Facebook! Want to be on the inside, fast track of health news and tips, as well as Haiti tweets? Get on the Twitter bandwagon and follow Doc Gurley! Also check out Doc Gurley’s joyhabit and iwellth twitter feeds – so you can get topic-specific fun, effective, affordable tips on how to nurture your joy and grow your wellth this coming year.