Consequences of Temperature Extremes

Children are more severely affected by temperature extremes.  Adults can actively seek help, but children depend on the adults to get them assistance. Even newborn infants are prone to hypothermia because of their large body surface area, small amount of subcutaneous fat, and decreased ability to shiver. Never leave a child or pet unattended in a vehicle, whether it is hot or cold, even for a minute. 

Using the following safety procedures will help prevent tragedies.  If you see a child unattended in a hot or cold vehicle, call 911.  Be sure that all occupants leave a vehicle, and do not forget a sleeping baby.  Teach children that vehicles are not a play area, and be certain that children do not have access to keys or remote entry devices.  If a child is missing, check the pool first, and then the car, including the trunk.  Always have some kind of reminder that there is a child in the car.  Make “look before you lock the car and leave” a routine when getting out of the car.  Have a plan that childcare providers call you if a child does not arrive at the prescribed place on time.

Some parents have been suspected of murdering their children by leaving them unattended in a car during temperature extremes. Different states have varying laws for consequences to parents who leave children unattended in a vehicle.  The consequences can vary from arrests to court appearances, fines, jail time, or all of these.  Several states have Good Samaritan laws that allow private citizens to break into motor vehicles if they notice a child or animal in extreme jeopardy.

Food Allergy

Food allergies can cause many different symptoms, affecting any body system.  They are an immune mediated reaction (antigen-antibody interaction to a food or a food additive).  Traditional allergists recognize only IgE mediated (immunoglobulin E-a type of antibody traditionally associated with allergy) reactions as an allergic reaction.  These are immediate reactions that occur very rapidly after eating the food.  Reactions may include hives, asthma, rhinitis, eczema, swelling of the lips and face, or anaphylactic shock (serious rapid onset allergic reaction affecting multiple body systems).  Foods causing these symptoms need to be avoided.  Should this type of reaction occur, treatment is with epinephrine.

Many other reactions to foods may be cell mediated or IgG mediated (immunoglobulin G - a special type of antibody) and largely outnumber IgE reactions.  They are not considered an allergy by traditional medicine because they are not IgE mediated.  They are spoken of as a food sensitivity or intolerance.  They may include less dramatic symptoms and symptoms may delayed by hours or even days.  However, symptoms may be serious and uncomfortable.  Foods to which there is a sensitivity/intolerance can sometimes be eaten without causing symptoms as long as exposures are minimal, and the foods are not eaten too often.

Pinkeye

The technical term for pinkeye and itchy, swollen, runny eyes is conjunctivitis.  The  white of the eye is red and is a symptom common to all forms of conjunctivitis.  The three most common forms of conjunctivitis are viral, bacterial, and allergic.  Allergic conjunctivitis is not contagious and is usually related to exposure to flowers and pollen.  The eye will be watery, itchy, red, and swollen, and both eyes can be affected.  There is usually very little discharge.  

While both are contagious, bacterial conjunctivitis does not spread as easily as viral conjunctivitis.  In viral conjunctivitis there is usually a watery discharge, swelling, and possible light sensitivity. A recent cold or contact with an infected person are common precursors.  The virus can live for several weeks on surfaces touched by an infected person (even computer keyboards).  The discharge of bacterial conjunctivitis is thicker with more mucus.  Often an affected eye is stuck closed with mucous on awakening in the morning. Only bacterial conjunctivitis may require antibiotic eye drops.  The American Academy of Pediatrics suggests that children do not need to stay home for 24 hours after starting antibiotic eye drops, but can return to school.

For any type of conjunctivitis, immediately discard used tissues.  Do not share towels, pillows. or anything coming in contact with the eyes or hands.  Wet washcloth compresses applied to the eyelids every hour can be soothing.  Cold compresses may be used, but for bacterial conjunctivitis, warm compresses may be better.  A heated rice bag can be placed on top of a wet wash cloth.  USE A FRESH WASHCLOTH EACH TIME.  Nonpreserved artificial tears may also be helpful.  Once opened, they should be kept in the refrigerator.  The vial must be discarded after the pinkeye resolves.  Do not use antihistamine eye drops, such as Visine. 

Blurred vision and significant pain are indications for consulting a physician for identification of conjunctivitis type and treatment required.

CLOSE OUT ON BOOKS

Dr. Krohn has published several books and products under the name K and T Books, as well as allergy reference and medical books produced by Hartley & Marks. She is no longer going to produce these books and products, and Hartley & Marks is no longer publishing their books. The following items are available and when they are gone, will no longer be obtainable from her. The list below is what is available from her office now.

Allergy Relief and Prevention                                                   1 copy of first edition  $19.95

     Guide to treatment and self-care                                           2 copies of ___edition $24.95 each

Finding the Right Treatment                                                      2 copies of ___edition $24.95 each

      Reference guide to options offered

      by modern and alternative medicine

Rotation isn’t Just for Tires!                                                      48 copies of 2^nd edition

      A “how to” rotation diet cookbook                                            Original price $24.95

      Tool for handling food allergies/sensitivities                             Sale price $14.00  

      Guidance in learning food rotation

      Many recipes, some sample diets

Food Dot Chart-double sided laminated                                     41 copies

      Cross-reference dot chart for                                                    Original price $19.90

      allergic substances found in food                                             Sale price        $14.00

Pollen Dot Chart-double sided laminated

      Cross-reference for allergenic substances in pollen             34 copies

      Rapid way of determining substance in pollen                          Original price $15.40                                                                   

                                                                                                          Sale price $9.00

Phenolics and Other Allergens, Volume IV                                15 copies

       Source book presenting many substances and their                  Original price $104.00

       health effects and allergy symptoms caused in humans.           Sale price $60.00

      It presents “imponderables” including heat, cold, altitude,

      humidity,draft, motion, vibrations, noise, color, wind,

      weather, electromagnetic phenomenon, and others.

     Detailed information is presented about each subject as

     well as effects on humans and treatment possibilities.

Practitioners and patients may purchase.  All Sales Final.

Ear Infections

Ear infections can be a cause of ear pain.  Otitis media is the term used for middle ear infection.  Common in childhood, otitis media occurs infrequently in adults.  Many children have recurrent ear infections that often occur after a cold or upper respiratory infection. Inflammation of the Eustachian tube prevents normal fluid drainage from the middle ear, which serves as a growth media for bacteria.  Secondhand tobacco smoke may predispose a child to middle ear infections.  Frequently eaten foods or allergies can alter the tissue resistance of the ear, setting up conditions for an infection.  Milk is a prime suspect.  Wheat, egg, peanut, soy, and corn can cause fluid behind the eardrum, which predisposes the child to ear infections.

Eustachian tube dysfunction plays a role in ear infections.  The Eustachian tube drains both fluid and mucus from the middle ear into the nose.  The Eustachian tube in children is short, straight, and may not drain well, resulting in mucus accumulation in the middle ear.  If the mucus becomes thick and glue-like, the condition is known as glue ear. Fluid behind the eardrum without infection can be very painful, but the pain may come and go.  Hearing loss, delayed development of speech and language skills, and problems with gross motor skills and balance may result.

Because typical symptoms overlap other conditions, a physician should be consulted, particularly in the case of recurrent ear infections.

Earache

Although they can occur at any time of the day, most parents have had the experience of a child crying in the night from the pain of an earache.  There are many things that can cause earache (otalgia), and it may not be associated with ear disease.  Conditions such as an impacted tooth, sinus problems, inflamed tonsils, teething pain, TMJ, and infections in the nose and throat may play a role.

Ear pain may originate from the external, middle, or inner ear, but it is not always possible to tell the location of the pain.  External ear pain can be caused by trauma, swimmer's ear, or foreign bodies in the external ear.  Dental disease can cause ear pain as can other diseases.  Ear pain may also be a side effect of contagious illnesses such as colds, coughs, or eye problems like conjunctivitis.  When babies discover their ears they may pull at them until they hurt, causing mothers to fear their baby may have an ear infection. 

Acetaminophen

Acetaminophen (term used in the United States, Canada, and Japan), APAP, or paracetamol (term used elsewhere) is a widely used OTC pain reliever and fever reducer.  A mild analgesic commonly used for the relief of headaches and other minor aches and pains, it is also a major ingredient in numerous cold and flu remedies.  While it is used to treat inflammatory pain, it is not classified as an NSAID because its anti-inflammatory action is quite weak.  Tylenol (OTC name) is acetaminophen and because it does not reduce inflammation it is not very helpful for people with arthritis or aching joints to use. 

It is imperative that acetaminophen be taken in recommended doses.  It is generally safe for use at these recommended doses, but even small overdoses can have serious health consequences.  It may be more toxic in overdose than other OTC painkillers, but may be less toxic when used chronically at recommended doses.  Acetaminophen is metabolized by the liver and side effects are multiplied if consumed with alcoholic drinks or when fasting. 

Overdoses can cause potentially fatal liver damage.  Severe kidney damage is also a possibility.  Symptoms of overdose begin several hours after ingestion and include nausea, vomiting, and pain as acute liver failure starts.  If an overdose is suspected  taking activated charcoal given within one hour of acetaminophen ingestion may treat the overdose.  Acetylcysteine should be given the acetaminophen levels are high.  Treatment within 10 hours of ingestion reduces the risk to the liver.

Painkillers

Painkillers or analgesics are used to achieve analgesia or relief from pain.  These drugs act in various ways on the peripheral and central nervous systems.  The type of pain determines the analgesic choice.  There are several classes of analgesic drugs.  Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are both nonprescription and prescription. COX-2 inhibitors are prescription drugs derived from NSAIDs.  Another important class of analgesics is opioids, which are narcotics and require a written prescription and include morphine, codeine, oxycodone, hydrocodone.  There can also be pain relief benefit from classes of drugs that are not normally classed as analgesics, such as tricyclic antidepressants and anticonvulsants.

Most people take something when they have pain of any kind. There are analgesics or pain killers that are over-the-counter (OTC).  There is some confusion about dosage on these agents.  Patients tend to think that because these drugs are OTC that they are totally safe in all amounts, but they are not.  The most common OTC NSAIDs are aspirin, ibuprofen (Advil, Motrin, and others), and naproxen sodium (Aleve).  Many times physicians are not contacted for a painkiller and pain control until and unless the patient receives no relief from OTC medications. "Letting the pain get ahead," or allowing it to be untreated can make it more difficult to bring under control.  Being absolutely pain free may not be a realistic goal, but pain can usually be regulated so it does not interfere with daily life.

Pain

Pain is the most common reason physicians are consulted in the United States, the main reason for visiting the emergency department, and is present in 30% of family practice visits.  Pain is physical suffering or distress caused by injury or illness.  Ability to experience pain is essential for protection from injury and recognition of the presence of injury.  It can also protect the affected part of the body while it heals and help avoid harmful situations in the future.

For many medical conditions pain is a major symptom, and it can significantly interfere with quality of life and ability to function.  Acute pain resolves quickly, but chronic pain lasts a long time. There are many differences in the times assigned to the definitions of these types of pain and when pain is considered to be chronic.

Acute pain is managed with medications.  Chronic pain is more difficult and the efforts of a pain management team may be required.  Living with chronic pain can be devastating and can destroy people's lives.  It is not just an inconvenience and must be treated safely.

Treating pain is a crucial step in recovery from many conditions.

Sunscreen

Most people think of sunscreen use only during the summer months.  However, successful sunscreen use is to apply a lot of sunscreen liberally, repeatedly, and often to the body when exposed to the sun’s rays regardless of the time off the year.  Sunscreens are best applied 15 to 30 minutes before sun exposure to allow the active ingredients to dissolve into skin layers.  Epidemiologic data indicates that a history of five episodes of sunburn per decade increases risk for melanoma (a type of skin cancer) by threefold.

There is much confusion regarding the SPF (sun protective factor) values.  SPF is primarily an indication of UVB protection as this type of radiation causes more skin redness than UVA radiation.  Damaging effects from UVB occur mostly in the summer as sunburn, but damage resulting in skin aging and skin cancer can occur throughout the year from UVA as well as UVB.

SPF of 15 blocks 93% of UVB radiation.  SPF of 30 blocks 97% and an SPF of 50 blocks 98% of UVB radiation.  Sunscreens can no longer be labeled witn an SPF greater than 50 and are now labeled as SPF50+.  A “broad spectrum” sunscreen with protection from UVB and UVA is the most helpful and is recommended.

Use a “broad spectrum” product with SPF of 15 or 30. Apply to all exposed body parts.  The amounts used should be 4 tablespoons/12 teaspoons, a shot glass full, or an amount to fill a child’s cupped hand.  Sunscreen should be reapplied every 2 hours while outside and more when swimming.  A large bottle of sunscreen will not last a whole family during the summer months.  If it does, not enough is being applied.  Sunscreen is available as liquid creams, sprays, gels, and sticks.  Sprays are easy and convenient, but may cause too little sunscreen to be applied.  Spray an adequate amount into hands and then apply.  Gels may be good for the male chest or the scalp.

Sunscreens

Sunburn is a concern during the summer months.  The radiation from the sun causing sunburn is UVB (ultra violet B).  UVA1 and UVA2  age the skin.  The burning question, both literally and figuratively, is which type of sunscreen is best.  The most commonly used sunscreens are “chemical absorbers,” which the FDA prefers to refer to as organic because they contain carbon compounds.  Broad spectrum sunscreens are meant to protect against a range of radiation wavelengths.  The chemical absorbers absorb the active UV rays and release their energy in harmless ways.  The FDA recommends using sunscreen with an SPF (sun protection factor) of at least 15. 

Zinc oxide and titanium oxide are physical blockers.  They do not decompose through sun exposure and theoretically will remain on the skin longer.  When UV rays hit skin coated in physical blockers, they are reflected and cannot penetrate the skin.  A concern is whether blocking the sun’s rays can result in vitamin D deficiency.

A sunscreen of some type should be put on the skin before going out in the sun.  It should be reapplied every two hours as long as you are out in the sun.  No sunscreen of any type should be used on babies younger than 6 months, and they should be kept out of the sun.  People with broken skin or rashes should talk to a physician before applying sunscreen to the affected parts of the body.

When/How Do I Take My Medication?

There is an optimal time and way to take medications to receive the most benefits from them.

• Between meals is an hour before or two hours after eating.

• Blood pressure medication is more effective when taken at night.  Should you miss a dose, do not take it at a different time in attempt to make up for your missed dose.  Take it again at your regular time.
• Thyroid medication should be taken on an empty stomach with water.  Wait 30 minutes before eating or drinking anything.
• Never exceed the prescribed dose for a pain killer.  If the dose you are taking does not control the pain, talk to your doctor.  Do not try to adjust the dose.
• If you are taking a tetracycline and you also take a calcium supplement, be sure not to take them at the same time.  Calcium inactivates tetracyclines.
• If you take Fosamax, you must not lie down for 30 minutes after taking it.
• If you take a prescription amount of potassium, do not lie down for 30 minutes after taking it.
• Antibiotics and probiotics should not be taken at the same time.  Take them at different times such as taking one of them an hour before taking the other, or two hours afterward.
• Grapefruit juice and fresh grapefruit can interfere with the action of some prescription drugs including some statin drugs, some blood pressure lowering drugs, some antianxiety and antiarrhythmia drugs, and some antihistamines.  Ask a pharmacist or physician to find out if a drug you are taking is affected.

Where Did That Come From?

In May we acknowledge the role of women as mothers when we celebrate Mother’s Day.  Through the centuries women from all countries and of many races have made significant contributions in all fields.  Some of them have been celebrated and acknowledged such as women in science and medicine.  Elizabeth Blackwell was the first woman doctor in the US.  She graduated from medical school in 1849.  Clara Barton founded the American Red Cross and cared for soldiers during the Civil War.  Rosalyn Sussman Yalow developed the technique making it possible to scan blood donations for infectious diseases.

However, there are women who are “Mothers of Invention” and whose ideas have made a major impact on our day-to-day life.  These women all belong to the group of great American tinkerers who have made our lives easier and more efficient.  Most people are unaware of their contributions.  

• Margaret Knight – the square bottom paper bag
• Mary Anderson – the windshield wiper
• Florence Lawrence – turn and brake signals
• Katherine Blodgett – nonreflecting glass
• Marion O’Brien Donoyan – disposable diapers
• Stephanie Kwolek – kevlar (synthetic fabric stronger than steel of the same weight)
• Josephine Cochrane – dishwasher

We should all consider these outstanding women and the many more worldwide who have affected our lives so significantly.

When/How Do I Take My Supplements?

Supplements must be taken judiciously to receive maximum benefit.  Swallowing them all at one time will cause the benefits of some of them to be negated.

• Minerals are better absorbed when taken at night. 
• Vitamins should be taken in the mornings. 
• Do not take B vitamins after 4 in the afternoon to avoid their preventing your going to sleep. 
• Amino acids should be taken 30 minutes before meals.
• If taken with meals, proteolytic enzymes act as a digestive aid.  If taken between meals they act as an anti-inflammatory.
• Between meals is an hour before a meal or two hours afterward.
• Very few people need a multivitamin containing iron.  Women are more likely to need iron than men because of blood loss during periods.  Check with your physician to see if you need a multivitamin containing iron.
• Quercetin (400mg to 500mg) taken between meals acts as a powerful antihistamine

Many people cannot take B-Complex because they do not tolerate one or more of the B vitamins contained in the complex mixture.

Nutritional Supplementation

Nutritional supplements consist of vitamins, minerals, fatty acids, or amino acids.  They are intended to supplement nutrients that are missing or are not in the diet in sufficient amounts.  In the US the Food and Drug Administration regulates supplements as a food category and not as drugs.

Americans are said to have the richest urine in the world because many people take nutritional supplements in a form the body cannot utilize, causing them to be excreted in the urine.  Despite this, many Americans improve their health by taking nutritional supplements their bodies can utilize.

• Purchase supplements only in forms that are more readily absorbed.
• Powders: rapidly absorbed, contain no fillers or binders.  Excellent form for those who have difficulty swallowing capsules or tablets.
• Liquids: useful for children and for people who cannot swallow capsules or tablets.  Absorbed rapidly, but may contain sugars, coloring agents, and additives.
• Chewables: suitable for children, but may contain sugars, coloring agents, and additives.
• Time-release tablets: nutrients released over a period of time.  Sufficient stomach acid necessary to dissolve the tablet coating and release the supplement.
• Tablets: longer shelf life, but not absorbed as rapidly as powders, liquids, or capsules.  Be cautious of binders (frequently corn starch) and fillers.
• Capsules: easier to swallow and generally contain fewer binders and fillers.  Capsules may be made from pork, beef, or vegetable gelatin.

Bioavailability varies with the brand, and the quality of the nutrient depends on the source material from which it is extracted.  Choose brands that are free of the common allergens such as milk, corn, wheat, egg, soy, sugar, and yeast.

Smoking Damages DNA

 Smoking tobacco products causes damage to DNA that may last as long as 30 years.  While much of the damage from smoking may be healed within the first five years after stopping smoking, some DNA damage does not appear to revert to normal.  Some people use e-cigarettes in an attempt to find help to stop smoking.  There are also those who believe e-cigarettes are a healthier alternative to smoking traditional cigarettes.  However, vaping, or smoking electronic cigarettes has a list of negative health effects, trading one serious health risk for another.

Smoking affects DNA methylation.  Genes are made up of DNA.  Changes to DNA called methylation affect how genes are expressed and may modify the way the genes affect health.  This can also affect the way the body responds to the environment.  Smoking can change DNA and increase risk of disease.  This type of DNA change has been linked to the development of cancers and the expression of cardiac disease.  DNA methylation is also linked to prenatal cigarette exposure and development of chronic disease when a child reaches adulthood.  Breathing secondhand smoke triggers health conditions that can be much like actual smoking.  It is also believed that nicotine from the air is absorbed through the skin.

Little Known Facts

Little Known Facts

·         Studies suggest that children have stronger, more satisfying relationships with pets, especially their dogs, than with their siblings.

·         Because of overpopulation that strains both food supplies and living spaces, some researchers predict that in the future flesh-and-blood pets will be replaced by companion robots.

·         Drilling holes in the skull to “let the madness out” was once a common treatment for mental illness.

·         Ten percent of pedestrian injuries involve people who are texting or otherwise focused on cell phones.

·         Hot air hand dryers in public restrooms disperse bacteria laden water droplets than can spread disease.

·         Oils, fats, coffee grounds, eggshells, flour, rice, and pasta can clog the drains of garbage disposals.

·         The cost of raising a child from birth through age 17 is currently $233,610, or $14,000 per year.

·         For some people home sleep apnea tests have been shown to be as reliable as over-night sleep lab testing.

·         A new study has shown that psychoactive chemicals have been found in children exposed to secondhand marijuana smoke.

Did You Know That?

·         An anti-inflammatory diet protects women against fractures and bone loss.

·         Drinking wine is associated with increased possibilities of melanoma.

·         Half of adults and two-thirds of children drink one or more sugary drinks every day.

·         Processed food and fast food tend to be high in salt and sugar and low in fiber.

·         More than a third of injury-related emergency room visits are attributed to falls.

·         Peppermint oil has been shown to reduce tension headaches when applied to the temples.

·         Sesame oil has significant cardiovascular benefits.

·         Urinary bladders can hold more than two cups of urine.

·         Most people blink about 15 times a minute, which amounts to around 15,000 times a day.

·         Although used culinary as grain, amaranth, quinoa, and buckwheat are not grains. Grains are seeds of the plants in the grass family, and these plants are not in the grass family.  They are more accurately classified as pseudo-grains.

·         A berberine herbal supplement works as well for lowering blood sugar for some diabetics as metformin.  Research suggests it may also reduce risk in developing diabetes.

·         Smoking is the leading cause of preventable death in the United States.

E-Cigarettes

 Smoking is the leading cause of preventable death in the United States.  It accounts for 1 out of every 5 of these deaths.  Damage to DNA caused from smoking stays with a person for decades and in some instances does not revert to normal even after they stop smoking.  Many people believe electronic cigarettes are a healthier alternative than smoking.  Vaping, or smoking electronic cigarettes that produce vapor instead of smoke, has its own list of negative health effects.   People are just trading one serious health risk for another.

E-cigarettes or e-cigs came to the US about 2007, and are not a safe alternative to smoking regular cigarettes.  An e-cig uses heat to create an aerosol that contains nicotine, flavorings, solvents, and other chemicals.  The flavorings were developed to satisfy taste buds.  Diacetyl is an artificial flavor also used for adding a buttery taste to microwave popcorn.  It can cause respiratory damage, including inflammation and permanent scarring of the airways.  It is just one of the many chemicals used to flavor e-cigarettes.  Vape flavorings like bubble gum, Dr. Pepper, and cotton candy entice young people to use e-cigarettes.  E-cigarettes may damage the lung tissue as well as affecting and damaging the brain.