Category Archives: Health Tips

Sun Poses Long-Term Dangers to Outdoor Workers

With the summer and its heat approaching, almost everyone will be out in the sun more than they were during the winter.

For 9 million Americans, being outside and in the sun is not just for summer fun – it’s a part of their job.

Workers in farming, landscaping, construction, recreation and even postal workers will spend hours in the sun – and consequently be exposed to potentially harmful levels of ultraviolet radiation.

Ultraviolet radiation, and specifically UVB, is the main environmental hazard to the outdoor worker. Most workers’ shifts include the peak intensity hours of UV exposure – 10 a.m. to 2 p.m.

Since this type of radiation (UVB) easily penetrates clouds, it can reach worrisome levels even on days where little sun is visible. It easily passes through glass and can be reflected into areas of apparent shade.

UVB penetrates through the tough, dead outer layers of skin, into the replicating layers. It is there that it interacts with the living tissue, not entirely in a negative fashion – UV radiation on unprotected skin produces Vitamin D. Many believe, and there is some evidence to back it up, that there are anti-cancer properties in this potent antioxidant vitamin.

But radiation on living tissue also has a biologic cost. UVB radiation causes DNA damage and is officially listed as a carcinogen. This damage is cumulative.

Ultraviolet radiation and skin cancer share a similar relationship to that of cigarette smoking and lung cancer. According to the Skin Cancer Foundation, those who work outside are twice as likely to contract skin cancer as indoor workers.

To protect workers from this hazard, we need to reduce the dose of UVB radiation.

The obvious solution for employers is to instruct workers to avoid sun exposure and seek shade when available. When possible, employers can rotate or stagger work shifts so that employees spend less time working during the sunniest parts of the day.

While the suggestion that people wear long-sleeve shirts during high temperature periods usually is greeted with derision, in fact there are a variety of new fabrics with high Sun Protection Factor values that are light weight, breathable and durable.

One of the oldest fabrics – cotton – has long been recognized for its skin protective value in the hottest climates. Cotton long-sleeved, loose-fitting shirts and pants, and broad-billed hats are some effective clothing options for outdoor workers. In dry climates, the fabric actually soaks up sweat and is an effective evaporative cooler.

Sunblock provides UV protection, but the level of protection is almost universally overestimated.

The most common error people make is using high Sun Protection Factor, sweat-proof sunblock and applying it only once. Sunblock generally loses effectiveness after about two hours due to sweating, the friction of clothing and deterioration due to sunshine. And too often, too little is applied. An ounce is recommended to get advertised protection. But remember, sunblock isn’t “liquid shade.”

These common sense protective measures can help safeguard you and your employees year round, but particularly during the summer months when, in most parts of the country, exposure to UVB radiation is highest.

With awareness and a few simple steps, we can help workers avoid the short-term sting of a sunburn and the long-term consequences of too much sun exposure.

Take care,

Dr. B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

 

 

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Human Growth Hormone: Pure Magic for Middle Age

Human growth hormone is the latest in a long line of exotic supplements, supposedly extracted from the fountain of youth, or at least the lab next door.

This is a short protein hormone that stimulates cell growth, increases lean muscle mass and strength. It is produced by the pituitary gland, which sits at the base of the brain and is about as big as a grape.

You may remember this gland as the controller of the hormone universe in your body. The hypothalamus is the part of the brain that connects to the pituitary. The brain makes a chemical on-and-off switch, the balance of these tells the pituitary how much growth hormone to make.

See, this isn’t so tough, there is probably a little neuroscientist hiding inside of you.

Not surprisingly, early adolescence is the time that growth hormone is the highest it ever gets. With age we generally stop growing, and growth hormone levels drop.

One artificial exception is athletes have long been doping with human growth hormone as an anabolic steroid that couldn’t be detected in the urine. Around 2000 this ended with the development of a blood test for HGH.

While considering growth hormone supplementation, there is a disease model caused by excess growth hormone, usually from a pituitary tumor, called acromegaly.

Prolonged high levels of growth hormone cause these unfortunate people to develop facial disfigurement that makes them look like cave men. Real cave men didn’t live long or age well, and acromegaly patients suffer a similar fate; hardly the fountain of youth.

But many still hear the siren’s call of lean muscle mass, and seek human growth hormone any way they can get it. The drug companies are happy to help and there are 10 different brands of human growth hormone available.

A reasonable dose will run you about $2,500 per week or a cool $130,000 per year – and that’s just for the medication. Doctor visits and lab work are extra. And you end up with neither a set of very fancy wheels to tool about town nor a house to rest your weary bones in. Needless to say, most insurance coverage won’t pony up for these kinds of bills.

But the supplement market sees an economic opportunity. One HGH product is available at $99.99 on its website or $89.99 at a local store.

This HGH product advertises that it will remove decades of age from your body. So presumably my 55-year-old self starts looking and feeling like I’m 35. How much would you pay for that?

What is this stuff? Well, it isn’t human growth hormone. HGH is a protein and it would be completely digested by the enzymes in the stomach. That would make it the most expensive meal you ever ate.

If you read the fine print, the product claims it is a HGH releaser. It supposedly makes your body put more HGH into circulation where you can work on your younger, stronger, good-looking self.

Unfortunately, it is only a couple of amino acids, which are the simple building blocks of proteins. Like masonry building blocks, they have no idea how to build themselves into something complicated, like the Washington Monument, or a hormone.

And these amino acids can be found as part of most quality proteins you might eat; like an egg white. Would you pay $99.99 for an egg white, pre-digested?

Supplements are licensed by the FDA as food, not drugs or medications. The FDA concerns itself principally with making sure they are not poisonous to eat. And this HGH product certainly isn’t poisonous.

The claims that HGH is the fountain of youth are ridiculous. Even more ridiculous is the claim that a handful of amino acids magically produce high levels of HGH.

We are left with the hard work of exercising and watching our diet if we want to feel younger. That and an extra $99.99 in our pocket!

Take care,

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

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Beware of Energy Shots, the modern-day breakfast of champions

Energy shots are the latest thing. It’s rocket fuel for a flagging will and the chance to capture youth in a bottle.

Of course, Coca-Cola was the original energy drink – cocaine, caffeine and sugar – that became breakfast of champions for some folks. Kind of puts the New Coke controversy in perspective. It was about 100 years ago that Coke changed the formula, but it hasn’t seemed to hurt sales much.

The other traditional energy drink is coffee – my personal favorite. Just typing the word has me looking toward the kitchen – was that a bell?

Those little aluminum cans certainly look powerful, all red and silver, and a screw cap to imply the liquid inside could otherwise not be contained. And they contain only a precious ounce, suggesting any larger amount might achieve critical mass.

The ingredient list sounds complicated and exotic, which no doubt is also part of the appeal. Taurine, glucuronolactone, guarana, ginseng, gingko, and a handful of B vitamins are thrown in to obscure the only active ingredient – caffeine. The average energy shot has about the same caffeine content as a good cup of coffee – 80 milligrams.

That is not to malign caffeine, a drug that we have been searching for a dark side for most of this century. Before you are too critical of energy shots, know that the average American takes in over 200 mg of caffeine per day. That dose of caffeine is considered safe even for pregnant women.

Caffeine is a legal mood altering drug, the most widely used on the planet. Caffeine reduces physical and mental fatigue, improves thinking, memory and coordination.

The distance between therapeutic range and toxic range is one of the widest of known drugs. An energy shot is less than 100 mg of caffeine, and the LD50 is somewhere around 10 grams or 100 cups of coffee.

LD50 is short hand for the dose that will kill half the people who take it. Every drug has one, and almost all take considerably less than a 100-fold increase to become dangerous.

Your body adapts to caffeine consumption relatively quickly – roughly a week or so. It takes about two weeks to get your brain settled down if you give up caffeine.

If you consume enough caffeine (a couple of dozen energy shots) you will become a quivering mess. Mania (elevated irritability), hallucinations and psychosis are all possible, but you eventually “run out of neurotransmitters,” and crash.

Caffeine and alcohol are a particularly troublesome combination. The caffeine helps counteract the sedative effects of alcohol, keeping you up to drink some more. The LD50 of alcohol is way less than 100 times the therapeutic range. There are times when you should just stay down.

Energy shots are an expensive cup of coffee and lack the reassuring warm weight of a coffee mug. Cold steel just isn’t as cozy; although the upside is fewer trips to the bathroom.

Personally, I’ll keep drinking coffee and making those annoying treks to the bathroom.

Take care,

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.


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Hookah pen: The latest smoking craze

The electronic cigarette has had a rocky start. It is frequently portrayed in the media as something only a fool would use. You might say the e-cigarette has an image problem.

Even cigarette companies managed the media better than this.

Cigarette companies joined forces with Hollywood to make cool smoking characters. Who can forget James Bond (Sean Connery) with a cigarette dangling casually out the corner of his mouth, undisturbed by all manner of physical violence, as was his hair!

Enter the hookah pen, a re-imagined e-cigarette. This is very brightly painted, an almost psychedelic contraption that is reminiscent of 1970’s rock album art. It’s not hard to figure out who this is marketed to. It kind of time warps you back 40 years to black- lighted Spencer’s Gifts Stores. The hookah pen is an e-cigarette for the avant-garde – and possibly our children.

In case the e-cigarette has not caught your attention, it is long, thin and vaguely cigarette like. It uses a battery operated heating element to vaporize a liquid that you inhale. This is more flavored steam than smoke. Still, it manages to be a very smoking-like experience.

In a traditional hookah the liquid that is burned is a mixture of tobacco and molasses. This provides nicotine and hundreds of other chemicals from burned tobacco. Note that it’s not safer than any other type of tobacco smoking.

But the hookah pens advertise that the liquid burned in the device has no tobacco, no nicotine and no tar resins. So, you might ask, what’s the point? Isn’t smoking a hookah pen kind of like kissing your sister?

Discussions of Coke or Pepsi notwithstanding (sorry Sharon Stone), it does give a young person practice on the ritual of smoking. They put the darn thing in their mouth and intentionally inhale warm vapors. It is part pacifier, part forbidden fun?

Once they have practiced that, it’s an easy step to exchange the perfumed liquid cartridge for the real one that has nicotine.

Cigarette smoking exists today because most people got into smoking before they were old enough to make an informed decision. Nicotine, aside from being poisonous, is a pretty amazing drug. It makes you more calm and alert simultaneously. It’s the only drug that does both.

So you become that James Bond person – cool under fire and thinking faster than everyone around you. But cigarette smoking is addictive and gives you cancer and heart disease. And you have to be way smarter than JB to beat either of these.

People trying to quit smoking complain about missing the ritual as much as the physical withdrawal. The morning cigarette with the first cup of coffee is described with loving detail by any ex-smoker. They speak about not knowing what to do with their hands and the physically comforting sensation of handling the cigarettes and lighter.

The use of a hookah pen is not dangerous in and of itself. But it encourages a smoking-like habit, and that is the last thing a young person needs to experience.

Perhaps 20 years from now we will be able to tell you positively whether hookah pens lead to smoking. In the meantime, my kids don’t play with guns or e-cigarettes. What about your kids?

Take care,

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

photo credit: leonardrodriguez via photopin cc
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Bird Flu: The Latest Viral Boogieman

Take a deep breath, it’s spring time. The ache of winter is melting away, leading into one of the most pleasant times on the planet.

And in this time of rebirth, there seems to be another new hatched influenza virus– bird flu (H7N9). Don’t panic. You still have at least six months to smell a few flowers and wiggle your toes in the grass.

Have you noticed that influenza viruses always seem to come from far off remote places? And new flu viruses are named after animals, like birds and pigs, not race cars and rockets?

Start with some planetary weather basics: Northern and Southern hemispheres have opposite seasons. Early spring here is late fall in the Southern Hemisphere. We are at the end of our flu season, while they are at the very beginning.

New viruses emerge first in poor remote areas of the Southern Hemisphere. In these areas, people and animals tend to live in close proximity. When your life savings is three pigs, you don’t let them far from your sight, even at night.

Most of the new influenza viruses develop and change (mutate) in animals, and they rarely cross species and jump from animal to humans. But the closer and longer the infected animal interacts with a person, the higher the chance the virus will cross.

And people from these areas make it easier because they have weakened immune systems due to malnutrition and poor sanitation. As far as the new flu virus is concerned, this is a perfect storm.

Remember these changes in the virus are random, meaning a lot of changes occur that just don’t work, which is good news for us. They are false starts for the virus unless it is both new (no immunity) and spread through coughing.

The timing of this means we won’t see a new bird flu virus in the United States for at least six to eight months. This is the same timing we face every year when we develop a new influenza vaccine.

The World Health Organization (WHO) collects specimens of the new flu viruses in poor rural areas in early winter (our spring). WHO picks the most concerning viruses, grows pure cultures, and lights the fuse for worldwide vaccine production.

In a few short months, the vaccine manufacturers of the world combine their efforts and produce close to 100 million doses. That’s just in time for the start of our flu season.

This new virus (H7N9) may be one of those false starts. It has not been shown yet to pass from person to person through coughing. The people who have gotten it so far have handled infected animals.

But this is a bad acting virus. We have no immunity against it, and it causes severe disease in the few people who have caught it. This new virus possesses the usual just-shoot-me influenza symptoms (fever, cough, fatigue, muscle aches) and brain swelling. The alarming issue is a death rate of 30 percent.

So add H7N9 to your scary tropical disease list, along with Ebola and Marburg virus. Remember that civilization as we know it will not end, and this may not be “The Bird Flu” we’ve talked so much about.

But just in case, a reminder – get your annual flu shot this year by Oct. 1.

Take care,

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

 

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Skin: Your Face to the World

Is your skin the largest organ in your body?

That is a trick question that every medical student answers wrong at least once. The answer is “yes.” (Med students think of the heart and liver etc, and don’t realize the skin is an organ.)

Given your skin is your interface with the world, it takes a fair amount of abuse. Yet despite this, it is a miracle of design and mostly stays intact.

The skin has much in common with a leather armchair at home. It is pretty hard to cut, rip or tear. It lasts almost forever, but looks pretty worn, even when it’s new.

The skin is covered with layers of dead epidermal cells. This is the body’s version of GORE-TEX® breathable shell. It is waterproof but allows sweat to escape. The waterproof part is absolutely essential to life. Your blood needs to be kept in a narrow range of sodium concentration and other elements.

If your skin was freely permeable to water vapor it would dry up like a raisin. Skin is important for maintaining body temperature by controlling your sweat glands. Your body is fussy about staying at 98.6.

Going deeper into the skin we find the dermis. This is the strength layer of the skin. It has collagen and elastin elements. The collagen is what ligaments are made of and is very strong stuff. Its job is to keep the insides where they belong.

Most of us are more concerned about the elastin. The elastin puts the tone in our skin, much like the waistband on your underwear. When the elastic/elastin breaks down, your shorts sag. Ah, but if only Fruit of the Loom made faces!

Sun and time inevitably break down elastin, keeping several industries busy.

Think of yourself as a rainforest. The skin has a unique ecology with tens of thousands of different bacteria, fungi and viruses. We mostly live in peace with this community, a quiet day in the rainforest.

We have various relationships with these organisms from commensal to parasitic. Mostly they take up space on our skin and prevent something worse from growing. Kind of similar to “a healthy lawn grows few weeds” sort of thing.

Now the surface of skin looks more like a Thomas’ English Muffin than porcelain when magnified. There is oil on the skin surface secreted by sebaceous glands. Most of the bacteria live in this oil layer. That’s why we wipe you off with an alcohol pad before giving an injection. The alcohol acts like a solvent to remove the oil.

When you cut or chafe the skin, your own bacteria contaminates the wound and starts to grow. If you wait 12 to 24 hours there will be enough bacteria growing in the wound to cause an infection if the wound is closed (sutured).

That is why it is important to close wounds promptly. Most wounds do best if closed within 12 hours. Some doctors don’t like to suture after even eight hours.

So if you think you might need sutures, get it checked out right away. Until we get re-upholstery shops for bodies, we’d do well to keep the skin we have in good shape.

There are several things working against our desire to remain youthful – oxygen and age. Good luck avoiding either one of these. Oxygen is absolutely essential for life, but oxidizes pigments (free radicals and all that). Sun and oxygen combine to oxidize your house paint, making the color fade and develop cracks, not unlike sun-damaged skin.

Oxygen and sun (UV radiation) also cause breakdown of the elastin fibrils as we said before. Staying out of the sun, or using sunblock, is probably the single most important thing you can do for your skin.

Skin also likes moisture. Your skin will never feel softer than after a week in the tropics (rainforest). You might be bug bitten, grow mold, and have interesting hair, but your skin will feel great.

Having said that, moisture from the inside is actually much more important than moisture from the outside. Remember the dead epithelial cell layers don’t let much into the skin from the outside.

What about the cosmetic industry? All the creams in the world will only work like a good leather conditioner. They might soften up the feel and prevent some cracking, but they won’t create new skin. I hate to think of how many billions is spent on magic creams; my wife must have a dozen of them.

So if magic creams don’t do much, how about more radical approaches? You can sand down some of the outer dead skin layers – dermabrasion (or facial road rash). That will soften it up, and because it is so traumatic, the skin will be swollen for a while. The swelling stretches out the wrinkles. Kind of the healthy glow of road rash.

As a last resort, simply remove loose extra skin, thus tightening up the rest. Your neighborhood plastic surgeon can help you with that.

Think of your underwear again, that stretched out old elastic waistband will stay on your backside if you take out a couple of inches, with a safety pin for instance.

You will still have crackly old elastic, but it will fit better – for a while. So be mindful of the care and feeding of your skin. It’s the only part of you the world gets to see.

Take care of yourself (really).

Dr. B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

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Allergy season: The Rites of Spring

The days are getting longer, which means I don’t leave and arrive home in the dark any longer.

A few more chirps are in the air, more bugs on the windshield, and I can hear the distant whine of a lawnmower. Spring flowers in the desert are very transient, and made more precious because of it. It’s all good stuff.

Your immune system is also waking up from a winter’s hibernation.

The immune system, for all we have learned about it during the past 15 years of AIDS research, still remains somewhat of a black box. Allergens in, sneezes out.

You actually can’t be allergic to something your body has never seen before. Yes, you can run buck naked through the poison ivy patch without fear of rash; as long as you are correct that you have never come into contact with it before.

Once your body has seen an allergen, it starts making antibodies against it. That is the least understood detail of this whole process.

The system works well when you quite sensibly make antibodies against flu, polio or measles. When you make them against ragweed, or your own heart or muscle proteins, you have allergies or worse, autoimmune disease. And note that allergies don’t turn into autoimmune disease.

So you have made lots of antibodies against spring pollen. These little IgE antibodies are like circulating time-bombs, peacefully going round and round until they run into one of these pollens/allergens. The mystery is why one person develops antibodies against mulberry trees, and the next one doesn’t.

Once the IgE antibodies and allergen meet, a reaction occurs that medicine has pretty well figured out. This IgE-pollen complex finds a mast cell and causes histamine to be released. Mast cells release histamine to fight this terrible invasion of pansy or petunia – pollen.

Histamine sounds familiar from all the thousands of antihistamine commercials we have sat through. There is a pretty good reason to have an antihistamine because histamines make vessels in the nose and sinuses leaky; thus the runny nose and sneezing.

Histamines also cause inflammation in mucus membranes, including the ones lining the eyes. The result: red, itchy, watery eyes. The lungs often get into the act with inflammation in the tiny vessels lining the airway. This can cause a cough, or in some people, wheezing.

Put up with this for 3-6 months and see how much you’re enjoying life!

The good news is we have been battling histamine and allergies for a long time and almost everyone can be helped. Mast cell stabilizers stop the mast cells from leaking histamine. These medications come in eye drops and nose spray, and are generally well tolerated and a pretty elegant solution if your symptoms are worse in your eyes or nose.

One of the most effective things you can do when Allergic Rhinitis (nasal inflammation) occurs is use a nasal steroid spray. This dramatically reduces the inflammation in the nose. Since the eyes and chest connect, nasal steroids often help combat all allergy symptoms.

Antihistamines and antihistamine/decongestants are the most common treatment for allergies. The medications are pretty effective, but they are sedating to some patients.

We now have non-sedating antihistamines – and they work. With any antihistamine you will have increased symptom control if you use them on bad days and occasionally take a day off these meds.

Immunotherapy is done by allergists; it’s the classic allergy shot series. There are mixed results from shots; some patients do wonderfully and some do not. One of the problems with immunotherapy is we don’t really understand why you started attacking stuff that isn’t too threatening (flower pollen).

Like everything else, lifestyle can be helpful for allergies. A radical approach – move. People with bad allergies may move to the desert to escape the offending pollen. Of course, sometimes you develop allergies to the desert pollen.

You can banish pollen from your house by keeping your windows closed, effectively keeping the outside, outside. Another factor is clean surfaces. Tile is cleaner that carpet and shutters are cleaner that drapes. I suppose spandex is cleaner than fir (but perhaps we go too far).

Allergic Rhinitis is a well understood condition. There are a variety of good treatments and almost everybody can be helped.

Take care

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona

Image courtesy of Tina Phillips / FreeDigitalPhotos.net

 

Springtime musings of Sunshine

Every spring, the sun seems newly discovered. I take it for granted most of the time; instead, worrying about painting the house, washing the truck or ninth grade math homework.

But sometimes I notice and it can occur during the most mundane errand, like refilling my blood pressure prescription. I’m walking across the parking lot and suddenly notice the sun warming my skin.

Some ancient reptilian area of your brain wakes up and the thought comes to mind – stop and bask, photosynthesize a while. Get in your car and sit a moment in the sunshine and feel the warmth come over your body.

The sun is the single most dominant force on the planet (at least in our little corner of the solar system). You have to travel a dozen light years to find a star that can compete with the sun.

Sun worship has waxed and waned through human history, but it certainly has to be seen as one of the dominant belief systems as people struggle to find their place in the universe.

The sun is pretty hard to ignore. Its radius is about 100 times the radius of the Earth and about a quarter million times the mass (weight) of our planet. It’s made of hot plasma and magnetic fields; whatever that means. That doesn’t even sound like something from our universe.

The sun is almost entirely made of hydrogen. It’s a giant nuclear reactor fusing hydrogen into helium at the rate of approximately 600 million metric tons a second. And we are eight minutes away as sunlight travels. A little closer or a bit further away gives you a frozen planet or a cinder of one.

You can think of the Earth as surfing on a great wave of sunshine energy. With a little luck we can do it another 4 billion years – talk about endless summer. Maybe the Beach Boys were right!

Our entire planet runs on less than 1 percent of the energy put out by the sun. That is ultimately the energy budget for everything that we do, think, consume or look at. Without our 1 percent of sunshine, none of us would be here, not even Apple.

And while we’re basking in the sunshine, notice that our sun rotates around the center of the Milky Way galaxy like a giant clock, once every 225 to 250 million years. All of human history has occurred in a couple of seconds as counted on this timepiece.

The next time you walk outside, stop and savor this microsecond in cosmic time that allows you to be effortlessly balanced between forces of unimaginable strength. It’s a moment that should bring a smile to your face.

Take care and have a sunny day.

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

Image courtesy of graur codrin / FreeDigitalPhotos.net

 

Marriage Tax Pay Off: Living a Longer Life

You’ve probably heard of the “marriage tax.” It amounts to something like $10,000 per year if filing jointly instead of individually. But what Uncle Sam “taketh away,” you perhaps make up thanks to a healthier lifestyle.

A significant reduction in “lifestyle disease” among married couples is no huge surprise. One just has to consider, perhaps wistfully, your single life for a few seconds to make this clear. Single people tend to live life at the extremes. There typically is more drinking, smoking, not sleeping or eating right, and in general fast-lane living among the unattached. We might want to blame this on youthful exuberance, but we also see this behavior rediscovered in divorced middle-aged people. Married folks tend to moderate each other’s behavior and consequently the lifestyle diseases such as hypertension, diabetes and heart disease are significantly reduced.

All manner of traumatic death is also dramatically reduced in the married population. With a little more sleep, and less alcohol, motor vehicle fatalities are much lower among married people.

I gave up skydiving once I got married, perhaps saving me a violent end. Other violent deaths like suicide are also much lower. Depression, perhaps not coincidentally, is lower in people with a soul mate.

If cancer is one of your big fears in life, marriage is one of your best defenses. The lifestyle cancers attributed to smoking and drinking are all understandably reduced, most notably lung cancer.

Interestingly enough, the cancers having no obvious connection to any specific human behavior are similarly reduced in the married population.

Lymphoma, leukemia and pancreatic cancer are examples. In fact, the fatality rate from virtually any cancer you can name is lower among the married.

Most startling to me during my medical education was the lower death rate in married people goes across the vast spectrum of human disease and frailty. Pick the wildest thing you can think of – death by shark attack, getting hit by lightening – and you are less likely to die of that while you are married.

So let Uncle Sam take his cut, the pay off is married people have a better chance of living a longer, healthier life.

Take care.

Dr B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

Image courtesy of David Castillo/ FreeDigitalPhotos.net

Norovirus: This bug can bring you to your knees

Big things have small beginnings is the ominous line from the movie “Prometheus” – uttered when things start to get ugly.

The “small beginnings” takes place on a tiny bit of genetic material in a droplet on a fingertip. In real life, a tiny bit of genetic material is known as a virus, and several billion would fit in the smallest visible droplet.

Norovirus is another name for the Norwalk Virus. Many things in medicine have several names. Every medical student is convinced they do that just to torture us!

Regardless of the name, norovirus is a nasty illness that may not do you in, but it will certainly make you wish you were dead for a day or two.

Norovirus is a pretty famous bug. It has single handedly brought more than one cruise ship to its knees (port). And having been cleaned to the limits of human ability, it still caused massive illness on the next cruise ship voyage.

The problem with norovirus is it’s very good at its one trick – infecting the next victim. A mere 20 virus particles can cause the illness and are enough to bring you to your knees before the porcelain alter.

I grew up calling this the flu, but norovirus has nothing to do with influenza. Its proper name is gastroenteritis, and the norovirus accounts for 90 percent of the viral cases.

Nausea is a symptom of norovirus and has to be one of the worst feelings on the planet. Projectile vomiting, a euphemism for vomiting so hard it bounces, soon follows. Do that a dozen times and see how much you love life.

While you are trying to deal with your stomach, the intestines join the party. Add some abdominal pain, a little fever, a lot of diarrhea, muscle aches and headache, and you have achieved the “just shoot me” kind of illness.

The virus is easily spread because it comes out of all orifices. The vomiting is so hard that viral particles are vaporized and taken in by anyone close by. It’s a wonder the whole planet doesn’t have norovirus.

But the good thing is you at least get partial immunity after the illness; enough to not get re-infected right away, at least not until you have the strength to deal with it again.

The saving grace of this miserable virus is the symptoms often last less than one day. Norovirus sufferers experience about 12 hours of feeling about as badly as you can. Then like magic, the next day you are 98 percent better.

And for a few days your life will be glorious. The simple new-found ability to not throw up, and to control your bowels, seems the greatest of blessings. Food tastes amazing and the sky is really blue.

Getting norovirus has at least one redeeming quality – it provides great perspective afterward.

Take care,

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona