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Stay on Your Feet This Winter


Imagine this: You have been put in charge of a crew that must dig an underground tunnel across town. The tunnel is going to be narrow, just big enough to stand in. Somehow you have to get the work Read more

December Health Awareness: SADS


  Beating Seasonal Affective Disorder Winter is cold, long, and dark. This lack of light can have a profound impact on our health. We often use the expression “winter blues” to refer to the familiar dip in mood and energy that Read more

Energy and Alzheimer's Disease


Imagine this: You have been put in charge of a crew that must dig an underground tunnel across town. The tunnel is going to be narrow, just big enough to stand in. Somehow you have to get the work Read more

November is National Diabetes Month


  November is national diabetes month; a time to promote awareness of the challenges faced by those with diabetes. In 1958 there were just over 1.5 million cases of diabetes in the US. In recent decades that number has steadily, Read more

Breast Cancer Awareness Month


October is a busy month. Schools and universities are back in their routines, often complete with football games, soccer matches, and cross country meets. The fall harvest is in full swing and the trees are changing from green to Read more

Stay on Your Feet This Winter

Physicians Health Network Blog

Imagine this: You have been put in charge of a crew that must dig an underground tunnel across town. The tunnel is going to be narrow, just big enough to stand in. Somehow you have to get the work crew, generators, lights, and tools in and the rocks and dirt out. If you can imagine how difficult this would be then you have some sense of how hard it is for the neurons in your brain to stay healthy. Neurons have long, thin tubes called axons that they use to send messages. To do this they need lots of energy and supplies. But, much like the tunnel project, how do the neurons transport all these materials? Understanding this problem can help us understand Alzheimer’s disease.

There are 5.5 million cases of Alzheimer’s disease in the US. Almost all of these case are in individuals older than 65 years. Two-thirds are women and Alzheimer’s disease is more common in African Americans and Hispanics compared to European descendants. Alzheimer’s disease is a progressive, degenerative neurological disorder. The hallmark symptom of the disease is memory loss but a collection of symptoms occur depending on what brain areas are affected and to what extent. Other symptoms can include personality changes, issues communicating, and an inability to recognize people, including loved ones. As the neurological degeneration progresses the individual’s symptoms worsen.

The human brain is unique. While it makes up only about two percent of our body weight it uses a full 20 percent of our daily energy. In other words, the brain needs enormous amounts of cellular energy to work properly. It also means that the brain has a lot of oxidative stress to deal with. You might think of oxidative stress like the exhaust fumes from an engine. Just like digging that underground tunnel, meeting the neuron’s energy demands presents an engineering problem. If you were in charge of the tunnel project you might set up a railway system to bring gear and workers in and the dirt out. Your neurons do something very similar. They construct a railway system made of microtubules.

With these massive energy requirements, the brain is very sensitive to any changes in the hormonal control insulin has over blood sugar. Alzheimer’s disease starts when the process of taking fuel from the bloodstream and converting it to a usable form becomes impaired. As the brain’s energy production falls behind a set of chain reactions begin. Although, there may be years between the first lag in energy production and the first symptoms. Slowly, the cellular hallmarks of Alzheimer’s disease begin to appear. Those microtubule railways become blocked by what are called neurofibrillary tangles. These tangles are made of a protein called tau protein that is supposed to help build the railways. The tangles block the delivery of nutrients down the long thin axons. The neuron doesn’t get the energy and resources it needs and it becomes stressed. The circuits between neurons that make up memories and perform important brain functions begin to break down. Eventually, the neuron will die. It is here, among the stressed, energy-starved, and dying neurons that oxidative stress increases and chronic inflammation develops. This begins a cycle where more damage to the neurons begets even more damage.

The neurons begin to secret plaques made of beta-amyloid peptides. These plaques build up around the cells and, in the Alzheimer’s brain, they are not properly broken down and cleaned-up as they are in healthy brains. As the disease progresses these plaques further block the flow of resources. As more and more neurons die the brain shrivels. The hippocampus, an area of the brain which is crucial for memory, is hit hard by Alzheimer’s disease. As the hippocampus shrivels it causes memory failure and dementia.

There is no cure for Alzheimer’s disease. The neurofibrillary tangles and the beta-amyloid plaques are often the targets for drug development but, to date, none are effective in fighting the disease. There are other treatments that can address the symptoms only, but unfortunately, these treatments do not stop the overall progression of the disease.

The connection between Alzheimer’s disease and cellular energy production is receiving more and more attention. The term type III diabetes is being used specifically to highlight the role that insulin resistance and impaired sugar metabolism play in the disease process. In the past, when Alzheimer’s disease was less common, it was seen as a stroke of unfortunate luck. Emphasizing the role impaired energy production helps medical professionals and patients reframe Alzheimer’s disease as something that is intimately tied to lifestyle factors. This opens the door to other treatments and preventative measures that involve lifestyle, nutrition, metabolism, and exercise. Afterall, long before symptoms appear the first sign of Alzheimer’s disease is a change in the way neurons use energy. This means that the time to think about prevention is, likewise, long before symptoms appear. Alzheimer’s prevention isn’t just for those who just blew out the candles on their 65th birthday cake. Rather, it becomes one more reason to target lifestyle changes at any age. Here is a list of habits for Alzheimer’s prevention from the National Institutes of Health that are appropriate for people of all ages.

● Exercise regularly.
● Eat a healthy diet that is rich in fruits and vegetables.
● Spend time with family and friends.
● Keep one’s mind active.
● Control type 2 diabetes.
● Keep blood pressure and cholesterol at healthy levels.
● Maintain a healthy body weight.
● Stop smoking.
● Get help for depression.
● Avoid drinking a lot of alcohol.
● Get plenty of sleep.

Sources:
De la Monte, S. M., & Wands, J. R. (2008). Alzheimer’s Disease is Type 3 Diabetes—Evidence Reviewed. Journal of Diabetes Science and Technology, 2(6), 1101–1113. doi:10.1177/193229680800200619

Kodl, C. T., & Seaquist, E. R. (2008). Cognitive Dysfunction and Diabetes Mellitus. Endocrine Reviews, 29(4), 494–511. doi:10.1210/er.2007-0034

Raichle, M. E., & Gusnard, D. A. (2002). Appraising the brain’s energy budget. Proceedings of the National Academy of Sciences, 99(16), 10237–10239. doi:10.1073/pnas.172399499

http://www.alz.org/facts/overview.asp

https://www.nia.nih.gov/health/assessing-risk-alzheimers-disease


Energy and Alzheimer’s Disease

Physicians Health Network Blog

Imagine this: You have been put in charge of a crew that must dig an underground tunnel across town. The tunnel is going to be narrow, just big enough to stand in. Somehow you have to get the work crew, generators, lights, and tools in and the rocks and dirt out. If you can imagine how difficult this would be then you have some sense of how hard it is for the neurons in your brain to stay healthy. Neurons have long, thin tubes called axons that they use to send messages. To do this they need lots of energy and supplies. But, much like the tunnel project, how do the neurons transport all these materials? Understanding this problem can help us understand Alzheimer’s disease.

There are 5.5 million cases of Alzheimer’s disease in the US. Almost all of these case are in individuals older than 65 years. Two-thirds are women and Alzheimer’s disease is more common in African Americans and Hispanics compared to European descendants. Alzheimer’s disease is a progressive, degenerative neurological disorder. The hallmark symptom of the disease is memory loss but a collection of symptoms occur depending on what brain areas are affected and to what extent. Other symptoms can include personality changes, issues communicating, and an inability to recognize people, including loved ones. As the neurological degeneration progresses the individual’s symptoms worsen.

The human brain is unique. While it makes up only about two percent of our body weight it uses a full 20 percent of our daily energy. In other words, the brain needs enormous amounts of cellular energy to work properly. It also means that the brain has a lot of oxidative stress to deal with. You might think of oxidative stress like the exhaust fumes from an engine. Just like digging that underground tunnel, meeting the neuron’s energy demands presents an engineering problem. If you were in charge of the tunnel project you might set up a railway system to bring gear and workers in and the dirt out. Your neurons do something very similar. They construct a railway system made of microtubules.

With these massive energy requirements, the brain is very sensitive to any changes in the hormonal control insulin has over blood sugar. Alzheimer’s disease starts when the process of taking fuel from the bloodstream and converting it to a usable form becomes impaired. As the brain’s energy production falls behind a set of chain reactions begin. Although, there may be years between the first lag in energy production and the first symptoms. Slowly, the cellular hallmarks of Alzheimer’s disease begin to appear. Those microtubule railways become blocked by what are called neurofibrillary tangles. These tangles are made of a protein called tau protein that is supposed to help build the railways. The tangles block the delivery of nutrients down the long thin axons. The neuron doesn’t get the energy and resources it needs and it becomes stressed. The circuits between neurons that make up memories and perform important brain functions begin to break down. Eventually, the neuron will die. It is here, among the stressed, energy-starved, and dying neurons that oxidative stress increases and chronic inflammation develops. This begins a cycle where more damage to the neurons begets even more damage.

The neurons begin to secret plaques made of beta-amyloid peptides. These plaques build up around the cells and, in the Alzheimer’s brain, they are not properly broken down and cleaned-up as they are in healthy brains. As the disease progresses these plaques further block the flow of resources. As more and more neurons die the brain shrivels. The hippocampus, an area of the brain which is crucial for memory, is hit hard by Alzheimer’s disease. As the hippocampus shrivels it causes memory failure and dementia.

There is no cure for Alzheimer’s disease. The neurofibrillary tangles and the beta-amyloid plaques are often the targets for drug development but, to date, none are effective in fighting the disease. There are other treatments that can address the symptoms only, but unfortunately, these treatments do not stop the overall progression of the disease.

The connection between Alzheimer’s disease and cellular energy production is receiving more and more attention. The term type III diabetes is being used specifically to highlight the role that insulin resistance and impaired sugar metabolism play in the disease process. In the past, when Alzheimer’s disease was less common, it was seen as a stroke of unfortunate luck. Emphasizing the role impaired energy production helps medical professionals and patients reframe Alzheimer’s disease as something that is intimately tied to lifestyle factors. This opens the door to other treatments and preventative measures that involve lifestyle, nutrition, metabolism, and exercise. Afterall, long before symptoms appear the first sign of Alzheimer’s disease is a change in the way neurons use energy. This means that the time to think about prevention is, likewise, long before symptoms appear. Alzheimer’s prevention isn’t just for those who just blew out the candles on their 65th birthday cake. Rather, it becomes one more reason to target lifestyle changes at any age. Here is a list of habits for Alzheimer’s prevention from the National Institutes of Health that are appropriate for people of all ages.

● Exercise regularly.
● Eat a healthy diet that is rich in fruits and vegetables.
● Spend time with family and friends.
● Keep one’s mind active.
● Control type 2 diabetes.
● Keep blood pressure and cholesterol at healthy levels.
● Maintain a healthy body weight.
● Stop smoking.
● Get help for depression.
● Avoid drinking a lot of alcohol.
● Get plenty of sleep.

Sources:
De la Monte, S. M., & Wands, J. R. (2008). Alzheimer’s Disease is Type 3 Diabetes—Evidence Reviewed. Journal of Diabetes Science and Technology, 2(6), 1101–1113. doi:10.1177/193229680800200619

Kodl, C. T., & Seaquist, E. R. (2008). Cognitive Dysfunction and Diabetes Mellitus. Endocrine Reviews, 29(4), 494–511. doi:10.1210/er.2007-0034

Raichle, M. E., & Gusnard, D. A. (2002). Appraising the brain’s energy budget. Proceedings of the National Academy of Sciences, 99(16), 10237–10239. doi:10.1073/pnas.172399499

http://www.alz.org/facts/overview.asp

https://www.nia.nih.gov/health/assessing-risk-alzheimers-disease


Breast Cancer Awareness Month

Physicians Health Network Blog

October is a busy month. Schools and universities are back in their routines, often complete with football games, soccer matches, and cross country meets. The fall harvest is in full swing and the trees are changing from green to a blaze of orange, yellow and red. And, we are about to be ‘spooked’ by the first holiday of the season.

October is also breast cancer awareness month and regardless of how busy October’s routines can be, it is important for women to become more aware about the importance of early detection and think about their breast care and screening plan. Women who are approaching the age of 40 need to discuss breast screening with their health care provider and determine their schedule.

Breast cancer tumors can often develop quickly and progress well-before a woman experiences any symptoms.

This October, let us stop to recognize the importance of breast cancer awareness. Let us realize that awareness of breast cancer and the importance of screening can lead to earlier diagnosis and better outcomes.

The number one cancer affecting women is breast cancer and it is the second most common cause of cancer death in women, regardless of ethnicity. The lifetime risk for developing breast cancer (for a woman) is one in six. Clearly, this makes screening an important and powerful part of any woman’s health care plan.

While screening does not lower a woman’s risk of developing breast cancer, it can lower the risk of death from breast cancer. Any discussion on breast cancer screening will include mammography which is breast cancer’s primary screening tool. A mammogram is a breast image created with low dose x-rays for screening or diagnostic purposes. Mammography comes with few risks and is the best current technology for detecting breast cancer early.

The recommended screening routine depends on the woman’s age and risk level. The American Cancer Society (ACS) defines average risk as those women who:
• Do not have a personal breast cancer history.
• Without strong family history of breast cancer.
• Have not had chest radiation before the age of 30.
• Have no known genetic mutation that puts her at higher risk.

According to the ACS, women who meet the definition of average risk should have yearly mammograms between the ages of 45 and 54. After age 54 ACS recommends that women have a mammogram every other year, unless the woman chooses to maintain her annual mammogram screening schedule.

ACS recommendations differ for women in a high-risk category. These women have:
• A strong family history of breast cancer.
• A known gene mutation in themselves or first-degree relatives.
• Had radiation therapy to the chest between the ages of 10 and 30.
• One of the rare genetic syndromes which are known to elevate the risk of cancer.

For women in this category, ACS recommends annual mammogram and magnetic resonance images (MRIs) of the breasts.

In addition to mammography, a clinical breast exam (CBE) may also be performed to screen for breast cancer. A CBE is a check for lumps or other physical changes by a trained healthcare provider and typically done during a woman’s annual physical. Clinical organizations are not unanimous in their stance on CBE. The ACS does not recommend a CBE for women getting regular mammograms, while the American College of Obstetricians and Gynecologists recommends that women aged 29 through 39 have a CBE at least every three years. Women may also perform self-exams, but this is also met with differing recommendations. Organizations that recommend self-exams suggest they be done monthly and at the same time of the month. Women who want to make self-exam a part of their screening should discuss a systematic method with their physician.

While there is differing recommendations around breast cancer screening, the most important message for women, not only in October, but in all the months of the year, is to discuss breast cancer screening guidelines with their providers and do what they feel is right for them.

Don’t allow this October’s breast cancer awareness campaign slip by. Make this your reminder, for yourself or the women in your life, of the importance of regular screening based on age and risk profile. If you don’t have an ongoing screening plan take this opportunity to contact your physician and start one.

Sources:
https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html

https://www.radiologyinfo.org/en/info.cfm?pg=mammo

http://www.froedtert.com/healthlibrary/default.aspx?sid=1&id=401&pTitle=CondDisease&ContentTypeID=85&ContentID=P00169


The Health Benefits of Vegetables and Fruits

Physicians Health Network Blog

Plants bearing vegetables and fruits have a lot of work to do. Each day, they must take sunshine, nutrients from the soil, the air’s carbon dioxide and turn it all into something you’d like to bite into. While the plant is hard at work making a vegetable or fruit, it has to fight off fungi, bugs, and somehow avoid a sunburn. To pull off this feat the plant produces various chemicals. Some of these chemicals are the vitamins we all need. Other chemicals, made by the plant for self-defense, are called phytonutrients. These phytonutrients are often colorful, concentrated in the outer layers of the vegetable or fruit, and have a strong flavor. In fact, this is why wild plants are often smaller, less sweet and more bitter than the garden variety.

Think of the difference between a crab apple and a grocery store apple, or a wild strawberry compared to farmed strawberries. They are different because the wild plant had to put more energy into its chemical defenses rather than growing bigger and sweeter. This also explains why organic produce has a higher nutrient content. It’s because the organically raised plants had to fight their own battles and, in the process they create more nutritious food for us.

Many of these phytonutrients are health promoting in humans, but the way they do this is surprising. Take the case of glucosinolates. These are the class of compounds behind the spicy flavor of radishes and a few other vegetables. The vegetables don’t make the glucosinolate compounds for our gustatory pleasure, rather they are produced by the plant for pest control. And, if we were the size of aphids, eating some radish could be fatally toxic. However, since we are much bigger than insects these plant phytochemicals are, typically, not powerful enough to cause harm but they do stimulate our cell defenses. This is where much of the healthful effects of vegetables, fruits, herbs, and spices come from. By being strong enough to stimulate our own antioxidant systems at the cellular level but not strong enough, or consumed in large enough amounts, to be toxic. This benefit can be especially important in the areas of our body where energy use is always very high and oxidative damage is always a risk. These areas include the heart, the liver, and the brain.

Anthocyanins are another good phytonutrient example. Anthocyanins are a family of phytonutrients found in many red, blue, and purple fruits and vegetables; for example, blueberries.

If you would like to take advantage of these phytonutrients there a few things to consider when loading up your dinner plate. Fruits and tubers can be great sources of phytonutrients but be sure to take their sugar content into consideration. As a rule, vegetables that grow above ground are pretty much always low in sugar. Another general rule is this: colorful and strongly flavored produce is high in phytonutrients. Take the blues and reds of berries or the orange of carrots as examples. As for strong flavor, consider the radishes mentioned above. Onions, mustard seed or peppers also have strong flavors which they owe to their phytonutrients.

Sources: Son TG, Camandola S, Mattson MP. Hormetic Dietary Phytochemicals. Neuromolecular medicine. 2008;10(4):236-246. doi:10.1007/s12017-008-8037-y.

Yuni Choi et al. Vegetable Intake, But Not Fruit Intake, Is Associated with a Reduction in the Risk of Cancer Incidence and Mortality in Middle-Aged Korean MenJ. Nutr. 2015 145: 6 1249-1255; first published online April 15, 2015. doi:10.3945/jn.114.209437
-data-report-2012-final.pdf


Suicide Prevention

Physicians Health Network Blog

Suicide is the tenth leading cause of death in the US. Between the ages of 15 and 34 it is the second leading cause of death and men die of suicide four times more often than women.

The groups with the highest rates of suicide are Native Americans, veterans and white males. About 50 percent of suicides involve the use of firearms and 90 percent had a mental health disorder at the time of their death.

Wisconsin’s suicide rate is 14 per 100,000 people which is slightly higher than the national average of 13 per 100,000 people. To put this into perspective the national homicide rate is about 5 per 100,000 people. While the homicide rate has been falling for many years, the suicide rate has been climbing since 2000 when the national average was about 10 per 100,000 people.

The way we talk about suicide matters. In fact, news coverage, such as a celebrity suicides, can become an unfortunate influencer rather than a deterrent of suicide. Facing, discussing and removing the stigma that surrounds mental health will greatly impact the number of suicides that occur in people who are living with a mental health disorder.

Recognizing warning signs and intervening can be lifesaving. Here are some of the common warning signs:
● Expressing a desire to die
● Looking for items that can be used for suicide such as guns and poisons
● Expressing feelings of hopelessness
● Talking about feeling trapped or experiencing unbearable pain
● Increasing use of alcohol or drugs
● Showing increased anxiety or agitation
● Reckless behavior
● Choosing isolation
● Extreme mood swings

There are factors that can be promoted to lower an individual’s risk of suicide. The Suicide Prevention Resource Center lists the following as important preventative factors:
● Access to effective behavioral health care
● Connectedness to individuals, family, community, and social institutions
● Learning life skills such as problem-solving skills, coping skills, and an ability to adapt to change
● Help in developing self-esteem and a sense of purpose or meaning in life
● Involvement in cultural, religious, or personal beliefs that discourage suicide

If you need to intervene with someone who is a risk of suicide, the American Foundation for Suicide Prevention recommends the following:
● Do not leave the person alone
● Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt
● Call the U.S. National Suicide Prevention Lifeline at 1-800-273-TALK (8255)
● Take the person to an emergency room or seek help from a medical or mental health professional

If you need more information, the American Foundation for Suicide Prevention (www.asfp.org) and the Suicide Prevention Resource Center (www.sprc.org) are excellent resources.

Sources:

https://suicidepreventionlifeline.org/how-we-can-all-prevent-suicide/
https://afsp.org/about-suicide/risk-factors-and-warning-signs/
http://afsp.org/wp-content/uploads/2016/01/recommendations.pdf
https://afsp.org/about-suicide/state-fact-sheets/#Wisconsin
http://www.sprc.org/effective-prevention/comprehensive-approach
https://www.va.gov/opa/docs/suicide-data-report-2012-final.pdf


Summer Hydration

Physicians Health Network Blog

Summer activities often break a sweat. This holds true for gardening, hiking, sports or even just relaxing in the backyard. That lost water needs to be replaced and importance of staying hydrated is never far from our minds. However, the unfortunate deaths of athletes in recent years, particularly marathon runners, reminds us there can be too much of a good thing – even water.

Physical activity, sweating, high outdoor temperatures and humidity all increase the amount of water we need to consume. If we don’t replace what we lose we may become dehydrated. Symptoms of dehydration include increased thirst, fatigue, dizziness, rapid heart rate and, in the most severe instances, seizures and coma. To avoid dehydration it’s easy to think that the more water or sports drinks we consume the better. After all, what feels better than a cool drink after physical activity on a hot day? Unfortunately, the sports drink industry has influenced the recommendations related to water consumption, which has led to some confusion. Drinking too much water presents a serious health issue because the sodium in your body becomes so diluted that the cells cannot function properly. This is called hyponatremia or water intoxication. While sports drinks contain some salt, there is not enough to stop hyponatremia from occurring if you are overhydrated. Early signs of overhydration are confusion and nausea. Severe cases can eventually cause a seizure and coma. Overhydrated athletes who pass out on a hot day are sometimes mistakenly treated for dehydration.

It is clear there is a danger from too much and too little when it comes to water consumption. So how do we stay safe? The answer is by following thirst. Your body has a sophisticated system of sensors that work with your brain, hormones and kidneys to monitor fluid and salt levels. In fact, scientists recently discovered neurons in your brain that use information from your body and your mouth to predict your fluid needs. These neurons are the reason you can quench thirst very quickly even though the fluid you drink takes time to reach your bloodstream. Updated recommendations for athletes from an international council, the 2015 Exercise-Associated Hyponatremia Consensus, were, in part, a response to the overhydration deaths of two 17-year old high school football players in 2014. To prevent the dangers of both dehydration and overhydration and to help each individual meet his/her unique water needs the council recommends drinking to thirst.

Sources:
Rosner, Mitchell H. MD. Preventing Deaths Due to Exercise-Associated Hyponatremia: The 2015 Consensus Guidelines. Clinical Journal of Sport Medicine: July 2015 – Volume 25 – Issue 4 – p 301–302 doi: 10.1097/JSM.0000000000000223

Zimmerman CA, Lin Y-C, Leib DE, et al. Thirst neurons anticipate the homeostatic consequences of eating and drinking. Nature. 2016;537(7622):680-684. doi:10.1038/nature18950.


Tick Safety

Physicians Health Network Blog

According to the University of Wisconsin-Madison 16 tick species can be found in Wisconsin and they are most active from April to September. This is a concern for outdoor enthusiasts because some ticks do spread diseases. Of the tick species found in Wisconsin the most common are the deer tick and wood tick.

 

Deer ticks are tiny forest dwellers that spread Lyme disease. Adult deer ticks are about the size of a sesame seed and are known for their eight black legs. Wood ticks are not known to spread disease in Wisconsin although they do spread Rocky Mountain spotted fever in other parts of the country. In most of the US the wood tick is more commonly called the American dog tick. Adult female wood ticks are about ¼ inch long. Both species of ticks feed on blood. They wait in tall grass or dense vegetation until they get a chance to latch onto a passing mammal, which could be a deer, a dog or hiker enjoying the outdoors. It’s important to note that ticks will increase in size greatly when they have engorged with blood.

 

If you’re going to be in outdoor areas that are likely to have ticks, such as dense grassy vegetation and wooded areas, you’ll want to protect yourself. The best defense against ticks is to avoid tick prone areas by staying in cleared or mown paths. Also, long sleeves, pants, and socks will help by physically preventing ticks from getting to your skin. Better yet, if the clothing is lightly colored ticks are easier to spot. If you do need extra protection the repellent permethrin can be found in sporting goods stores and it is designed to be applied to your outdoor clothing. Permethrin is not easily absorbed by your skin and is very effective as a tick repellent. It can be long lasting on clothing and does not stain. Dogs are also vulnerable to diseases harbored by ticks. A veterinarian can help you find the best way to protect your dog which may include sprays or Lyme disease vaccines. There is currently no Lyme disease vaccine for humans.

 

When you complete your outdoor activity be sure to do a thorough visual check for ticks. You may need a mirror or a partner. Pay close attention around your joints, behind the ears, at the waistline, and at hair lines. If you find an embedded tick removing it quickly is important for disease prevention. Remove the tick with tweezers using a slow, steady pull or contact your primary care physician.

 

Sources:

http://labs.russell.wisc.edu/wisconsin-ticks/wisconsin-ticks/

http://www.tickencounter.org/prevention/permethrin

https://www.wiscontext.org/abcs-tick-season-wisconsin

https://www.epa.gov/mosquitocontrol/permethrin-resmethrin-d-phenothrin-sumithrinr-synthetic-pyrethroids-mosquito-control


PHN Celebrates Cancer Survivors

Physicians Health Network Blog

As part of the 30th annual National Cancer Survivors Day®, cancer survivors and supporters in communities around the world – including Sheboygan – unite on Sunday, June 4, 2017, to celebrate life and raise awareness of the challenges cancer survivors face. “While we recognize and support, National Cancer Survivors Day®, we celebrate cancer survivors every day,” said Walter Vinson, Executive Director Physicians’ Health Network (PHN).
The fact is, cancer affects everyone. With more than 15.5 million people
living with and beyond cancer in the U.S. today – and more than 32 million cancer
survivors worldwide – everyone knows someone whose life has been touched by cancer.

From the moment of diagnosis, a person becomes a cancer survivor. They begin their fight and healing process with their oncology team of doctors, patient navigators, nurses, social workers, dieticians, physical and occupational therapists, and so many more.
“We, at PHN, celebrate the community’s cancer survivors and have the highest respect for them. Cancer survivors are more than survivors, they are heroes,” said Vinson. “I am also proud of the PHN members who care for and fight alongside their cancer patients; they are among the most qualified well-respected providers in the area.”
PHN medical oncologists, Drs. H. Marshall Matthews, MD, Matthews Oncology Associates and S. Mark Bettag, MD, Sheboygan Cancer and Blood Specialists, are actively engaged in the lives of their survivors to ensure they are getting the most state-of-the-art treatment as well as the highest state-of-the-heart care.
Over the last few decades, great progress has been made relative to cancer survival rates, which is something to celebrate. However, the effects of cancer don’t end when the treatment ends. Cancer survivors face ongoing, often long-lasting, hardships because of their disease. Life after cancer is more than surviving it is about living well, celebrating life’s milestones, thriving and finding the courage, strength and joy in being the person they’ve become after fighting and surviving the battle,” said Vinson. “So, on June 4, 2017 and every day of every year we, at PHN, celebrate and honor our cancer survivors, their families and the PHN providers who walk every step of every one of their survivors’ battle.”


Autoimmunity and Arthritis

Physicians Health Network Blog

To fight off colds and infections we need a strong immune system. You might think of it like a guard dog protecting your house. Unfortunately, sometimes things go wrong and that guard dog bites it’s owner. This is what happens in autoimmune conditions. The immune system mistakenly attacks a part of your own body. Autoimmune arthritis occurs when the joints are attacked. You may have heard of rheumatoid arthritis or RA which often attacks the hands and wrists and affects 1.5 million Americans. It’s important to remember that autoimmune arthritis comes in many different forms. For example, juvenile rheumatoid arthritis begins in childhood and ankylosing spondylitis is an autoimmune attack on the spine that often results in vertebrae fusing together. For individuals with autoimmune arthritis their symptoms come and go. They may experience painful flare ups or a period of less painful remission.

The treatment goals for sufferers of autoimmune arthritis are:
• Stop flare ups
• Manage pain
• Stay mobile and active

To stop flare ups individuals try to avoid their triggers. Which can be difficult. Common triggers include stress, infections, injuries or environmental toxins such as cigarette smoke or insecticides. Each individual may have different triggers. Autoimmunity of the joints shares similar genetics with autoimmune conditions of the digestive system such as celiac disease and Sjogren’s disease. This suggests dietary intake of large proteins may trigger flare ups. As these proteins, such as gluten and gliadin from wheat, are digested enzymes break them into pieces. Those pieces can activate the immunes system. Eliminating trigger foods may help keep joints in remission.

Managing pain with medications requires a working relationship with a physician. Some medications, such as over the counter pain relievers or corticosteroids from your doctor, are meant to lower inflammation and reduce pain, particularly on a short-term basis. Other drugs like disease modifying antirheumatic drugs (or DMARDs) slow down attacks from the immune system. Of course, we still need a working immune system. This is why a working relationship with a physician is so important, to manage the dosage and side effects properly.

Keeping active with autoimmune arthritis is difficult. Exercise is painful. Fortunately, the benefits are clear. Studies on individuals with RA confirm that exercise does not increase joint damage and does not increase markers for inflammation. And when subjects with RA exercised their fitness increased and heart disease risk factors improved.

Resources:
http://www.arthritis.org/

Sources.
1. Eyre, S., Hinks, A., Bowes, J., Flynn, E., Martin, P., Wilson, A. G., … Barton, A. (2010). Overlapping genetic susceptibility variants between three autoimmune disorders: rheumatoid arthritis, type 1 diabetes and coeliac disease. Arthritis Research & Therapy, 12(5), R175. http://doi.org/10.1186/ar3139
2. Koning F, Thomas R, Rossjohn J, Toes RE. Coeliac disease and rheumatoid arthritis: similar mechanisms, different antigens. Nat Rev Rheumatol. 2015; 11: 450-461.
3. Eugenia Lauret and Luis Rodrigo, “Celiac Disease and Autoimmune-Associated Conditions,” BioMed Research International, vol. 2013, Article ID 127589, 17 pages, 2013. doi:10.1155/2013/127589
4. Sandstad, J., Stensvold, D., Hoff, M. et al. Eur J Appl Physiol The effects of high intensity interval training in women with rheumatic disease: a pilot study. (2015) 115: 2081. doi:10.1007/s00421-015-3186-9
5. Kito, T., Teranishi, T., Nishii, K., Sakai, K., Matsubara, M., & Yamada, K. (2016). Effectiveness of exercise-induced cytokines in alleviating arthritis symptoms in arthritis model mice. Okajimas Folia Anatomica Japonica, 93(3), 81-88. doi:10.2535/ofaj.93.81
6. Stavropoulos-Kalinoglou A, Metsios GS, Veldhuijzen van Zanten JJ, et al Individualised aerobic and resistance exercise training improves cardiorespiratory fitness and reduces cardiovascular risk in patients with rheumatoid arthritis Annals of the Rheumatic Diseases 2013;72:1819-1825.

Alternates:
https://www.ncbi.nlm.nih.gov/pubmed/23155222 – VO2 improves as do other markers in RA


April is Testicular Cancer Month

Physicians Health Network Blog

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Testicular cancer is a disease in which cancer develops in one or both testicles. It occurs when germ cells experience abnormal growth.
If not detected early, the cancerous tumors can grow rapidly with the ability to double in size in just 10-30 days. It can also metastasize (spread to other parts of the body) most often to the abdomen, liver, lungs, bones and brain. Testicular cancer can spread rapidly and can be deadly if left untreated.

Statistics
• Testicular cancer is the leading cancer in men ages 15 to 35
• In this age group, more men will die of testicular cancer than women of breast cancer
• Every hour a male is diagnosed with testicular cancer
• Approximately 8,820 new cases will arise in 2015 in the US
• 1 out of 270 men will be diagnosed with testicular cancer
• Approximately 380 deaths will occur in 2014.
• If detected early, testicular cancer is over 95% curable.
Risk Factors
Risk factors determine a person’s chances of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors such as smoking, alcohol, diet/nutrition and weight can be controlled. However, others – a person’s age, gender, family history and nationality cannot be changed.

Scientists have found few risk factors that make someone more likely to develop testicular cancer. Even if someone has one or more risk factors for this disease, it’s impossible to know for sure how much that risk factor contributes to developing the cancer. Also, most boys and men with testicular cancer do not have any of the known risk factors. Risk factors for testicular cancer include:
• An undescended testicle
• Family history of testicular cancer
• HIV infection
• Carcinoma in situ of the testicle
• Having had testicular cancer before
• Being of a certain race/ethnicity
• Body size

Signs and Symptoms of testicular cancer
• A lump of any size on the testicle
• Enlarged testicle, change in shape, size or any irregularities
• Pain or discomfort in the scrotum or testicle
• A dull ache or sense of pressure in the lower abdomen or back
• A feeling of heaviness or fullness in the scrotum
• Enlargement or tenderness of the breasts
In most cases, early stages of testicular cancer present themselves in a completely painless manner.
Advanced signs & symptoms of testicular cancer
• Significant weight loss (due to the growth of tumors and/or enlarged abdominal lymph nodes)
• Back pain
• Chest pain, coughing, or difficulty breathing
• Coughing up blood (due to tumors in the lungs
• Enlargement of lymph nodes in the abdomen and/or neck
If you experience any of the Signs & Symptoms of testicular cancer, call your doctor immediately for further testing.

Resources:
http://www.testicularcancerawarenessfoundation.org/statistics-risk-factors/
https://www.cancer.org/cancer/testicular-cancer/causes-risks-prevention/risk-factors.html