“Hot” off the press! Change in teething care.

Posted on April 14, 2011 by drlesliegreenberg

For all of you who care for  young children . . . the FDA has issued a warning to NOT give over  the counter teething medication to children under age 2.  Here is why. . . benzocaine products, such as Anbesol and Orajel, contain benzocaine which can cause (a fancy medical condition) called methemoglobinemia.  That is a rare, but potentially fatal, condition in which the amount of oxygen carried through the bloodstream is greatly reduced.   This condition has been reported with all strengths of benzocaine gels and liquids.

As an alternative, parents can gently massage the gum line or give the child a firm rubber teething ring.  Some are intended to go in the freezer; my kids especially enjoyed those.   A homemade version of that is a wet washcloth wrung out, twisted like a rope and frozen.

Weight-appropriate doses of acetaminophen (Tylenol) are also helpful.  Be sure to give appropriate doses and follow the per-day dosing limits as overdosing acetaminophen can cause liver damage.   Some homeopathic remedies like amber teething necklaces can pose choking hazards and belladonna-containing teething tablets are poisonous.

Sometimes simply holding your child may soothe them. . . that’s free, bonding and without side effects.

Also, know that this is just a phase, a season, and soon shall pass.

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Should you (or your man) get a PSA test?

Posted on April 11, 2011 by drlesliegreenberg

This issue has been looked at extensively.  The results are not as you may  expect. . .and  backed by  studies with 341,351 patients!  Prostate cancer is detectable in ½ of men at age 50 and nearly 80% at age 80.  Only 3% of all men die FROM prostate cancer.  The goal of cancer screening is to detect tumors in people who have no symptoms.

The meta-analysis of those 340,000+ men showed that PSA screening conferred no benefit in prostate cancer mortality.  Based on the evidence, PSA testing should not be used for prostate cancer screening in low-risk men.

Those men at high risk have

  • first-degree relatives with prostate cancer (the more first-degree relatives, the more risk)  or
  • are African-American (as the prostate cancer may be more aggressive).

The harm of PSA testing includes worrying over falsely positive results and problems from those interventions include  infection, bleeding, long-term urinary incontinence or impotence.   Current guidelines from the American Urological Association and the American Cancer Society recommend that physicians “discuss” PSA screening with the patients.  The United Kingdom goes as far as disallowing PSA screening.

The Centers for Disease Control and Prevention has a booklet about prostate cancer screening.  Find it at http://www.cdc.gov/cancer/prostate/pdf/prosguide.pdf.

Hope this helps!

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AAP Updates Recommendation on Car Seats

Posted on April 9, 2011 by drlesliegreenberg

Well, parents. . . just when you thought you could turn your 1-year-old forward-facing  in the car seat.  New studies show overwhelming evidence to help your children, infant through 13 stay safe in the car.   Read on. . .

AAP Updates Recommendation on Car Seats.

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Sandal weather is almost here!

Posted on April 4, 2011 by drlesliegreenberg

Time to get those feet sandal-ready!  Warts?  Corns?  Bunions? Hammertoes?  Those are pretty ugly words. . . but there are things I can do to help.

Plantar warts are warts (from a virus) that infect the feet.  They are common, especially in children to young adults.  I am frequently asked, and every time I say,” No, I do not cut them out.”  Cutting can cause scar tissue to form on the bottom of the foot which may lead to long-term pain with walking.  Salicylic acid is effective, as is (surprisingly enough) duct tape!  Before starting have your doctor pare down the wart so the therapy is more effective.

Corns are areas of thickening of the skin where the feet rub against a shoe.  Above all else, avoid shoe pressure.  Pads or shoes with large toe-boxes work well.

Hammer toes are when the toes curl up at the joint and rub against the top of shoes.  Depth shoes are available to give extra height to let the hammer toes not rub.

Stress fractures may seem to happen after an injury, but may be due to overuse (like too much marching in the military or too  much time on the treadmill).  An xray may help diagnose this.  Protect the stress fracture with a specially made shoe or stiff-soled shoe.

“Pump bumps” also known as Hagland’s deformity are from rubbing of the heel on a hard shoe.  Sandals may help, or elastic socks and occasionally an injection near (not on) the tendon.

Plantar fascitis is a common condition when the first step of the day is the worst.  An xray may show a heel spur.  This is treated with specific stretches, custom orthotics (shoe inserts), daytime Cam Walker, night splint and occasionally an injection.

Hope this helps.

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9 Physician Blogs Worth Checking Out – Cancer Network

Posted on April 2, 2011 by drlesliegreenberg

Well, I have thoroughly enjoyed blogging medical issues (as I have loved teaching physicians and patients for 16 years) and I’ve gotten a nod from a “fellow” writer. . . Please pass my site on to friends and family!

9 Physician Blogs Worth Checking Out – Cancer Network.

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Doctor shopping?

Posted on April 1, 2011 by drlesliegreenberg

I frequently hear from friends or patients that they are changing physicians due to discontent.  I encourage that.  It’s important to feel comfortable with your  physician.   Here are some things to consider. . .

Distrust.  No faith.  Not feeling heard.  Poor communication.  Inattentive office staff.   For any reason you do not trust your physician’s  judgment or won’t take their advice, you are seeing the wrong physician.  There are many reasons to change physicians, some are not related to the physician’s skills and others aren’t.  All are important.

You can stack the deck, to find a good match.  Get a referral: ask trusted friends who is their physician.  Research office hours and location as this may help address your expectations and convenience.  You can look on websites www.vitals.com or www.healthgrades.com  for patient reviews of physicians.   Be sure to check if the physician is board certified.   Board certification means the physician  has completed an approved residency program and passed a detailed written exam in at least one of 24 specialty areas, such as family practice, internal medicine, or obstetrics and gynecology.  A free site to check is  the American Board of Medical Specialties at  www.abms.org.  Choose a physician who accepts your insurance.  Make an appointment.  Meet the physician.  Ask questions.

Establish your physician-patient relationship before you are ill or need admission to the hospital.    You are in control.  Do some legwork, shake some hands. . . so that you choose a physician you both like and trust.

Hope this helps.

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Want to take off that “fat tire?”

Posted on March 29, 2011 by drlesliegreenberg

Losing and keeping weight off is a touchy subject.  I saw a patient today who is emotionally comfortable with a BMI of 45 (severely obese).  My heart goes out to her.  She is aware that she looks imposing and unapproachable at her current size.  She likes that.  But, her weight is harming her health.  Our weight-loss discussion went something like this.

  • Take a self-defense course to help maintain your safety, but lose weight.
  • Plan your meals ahead of time.
  • Keep healthy habits during special occasions: vacations and celebrations.
  • Eat breakfast daily.
  • Be mindful of how much and what kinds of foods you eat all day.
  • Know your food triggers: emotion?  boredom?  time/activity-related snacking?
  • Restrict foods that are high in fat and calories.
  • Know that the first bite of any “treat” tastes the best (so limit treats to a few bites).
  • Increase amount of exercise: park at the end of the lot, take the stairs.
  • Walk briskly outside during a break at work (that’ll earn you some Vitamin D, too!)
  • Weigh yourself weekly.
  • Watch less than 10 hours of TV a week (you are bound to fill the other time with some activity burning more calories than sitting. . . and possibly snacking).

I’ve “talked” about weight loss medications on other blogs.  Some may help to jumpstart weight loss, but most patients gain weight back when the medication is stopped.  Weight loss surgery is one option, but the same results can be obtained with major lifestyle changes without the mortality risks.

Are you ready for some changes?  Every pound counts.

Posted in Emotional health, food, food, General Medicine- Adults, obesity, obesity, Pediatrics, Uncategorized | Tagged , , , , , , , , , , , , | Comments Off on Want to take off that “fat tire?”

Watery eyes. . .

Posted on March 23, 2011 by drlesliegreenberg

We are embarking on (one of) Wichita’s allergy seasons.  But, are your watery eyes from allergies?  It could be from a foreign body (think dust, dirt in the wind, or an errant fingernail. . . ouch!).

When my patients come in with these symptoms, I check to make sure there are no scratches on the surface of the eye, as that treatment is different.

If it is from allergies, the thin lining covering your eyeball and the inside of your eyelids can become irritated, red and swollen.  Your eyes may also itch, hurt or water.  If this is due to an allergy, indeed it is NOT contagious. It will not damage your eyesight.

To decrease these symptoms, you’ll need to avoid the allergen.  Close your doors and windows.  Use an air conditioner in the summertime.

If you still need more help, there are steroid nasal sprays and anti-allergy medication (pills or eye drops) that may help.  Placing a cold washcloth over your eyes may help the itch.  Artificial tears may help bathe the eyes and alleviate symptoms.

Hope this helps.

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Dust mites. . . different from bed bugs. But gross (and unhealthy) nonetheless.

Posted on March 21, 2011 by drlesliegreenberg

With my patients,  I may mention dust mites when discussing allergens. Dust mites are tiny bugs that live off of pet and human skin cells. It is their waste that is a major trigger of allergies and asthma.

Dust mites live in warm, humid areas filled with dust like bed pillows, mattresses, carpets and soft furniture. . . sound like everything you have in a bedroom, huh?

How to get rid of them?

  • Put a tightly woven, dust-proof cover over your mattress.
  • Wash your sheets and blankets in very hot water (130 to 140 degree water) every week.
  • Wash your pillow weekly or put a dust-proof cover on it.
  • Vacuum carpets and soft furniture weekly.
  • Use aDEhumidifier in your home to keep the humidity low.
  • (Some air filters also reduce dust mites in the air).

If those measures don’t work, what will? Antihistamines or decongestants may help. You may also need asthma medication or inhalers, especially if on exam you have wheezing or shortness of air.

Hope this helps.

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The coughing, sneezing, achy head. . . .symptoms. Hay fever?

Posted on March 19, 2011 by drlesliegreenberg

This is spring break for some.  I am “manning the storefront” and have seen countless allergy patients.  Some wonder if they have a cold? Or hay fever?  Here is the lowdown.

Hay fever tends to be more seasonal with symptoms like

  • sneezing,
  • coughing,
  • itching (eyes, nose, throat, skin),
  • runny nose,
  • stuffy nose,
  • headache,
  • sore throat,
  • dark circles under your eyes,
  • difficulty smelling,
  • watery, red, or swollen eyes. (Do I sound like a TV ad?)

Hay fever can last for weeks. It is caused by allergens which cause your body to have an allergic reaction. When you are exposed to an allergen, your body starts to release chemicals which cause your symptoms. If you are allergic to pollen, or hot windy days the air will carry the pollen to you (instead of staying on the flower or the ground).

When should you see your doctor? If your symptoms bother you, see your doctor. A physical exam may reveal other diagnoses. Keep a record of your symptoms over time as this helps me know your triggers.

There are many medications to help treat the symptoms. Some are pills and others are nasal sprays or eye drops. You can also

  • avoid the allergens that cause your symptoms.
  • Keep your windows and doors closed.
  • Use a nasal saline rinse to help clear out the allergens.
  • Wash hair before bedtime  and
  • change your pillowcase nightly to keep allergens away from your face.

Hope this helps.

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