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Strains, Sprains and Broken Bones

By: AKBER AHMAD, M.D.

Imagine you’re walking the dog — you suddenly trip over a stone, fall and twist your ankle. You feel a sharp pain and your ankle starts to swell. You’re hurt, but is it a strain, sprain or broken bone? Should you apply ice, head to the emergency room, get an X-Ray?

Mild strains and sprains can often be treated at home, while broken bones should always be evaluated by your healthcare provider. Here’s how to handle each kind of injury.

 

Types of Injuries

Strains are damage to muscles and tendons when a joint is pulled or stretched too far. Strains are most common in the lower back or leg muscles, but can also occur in the wrist, ankle and other parts of the body. Pain, swelling and muscle spasms are usual symptoms of a strain.

Sprains are when ligaments are overstretched or torn. (Ligaments are fibrous tissue that connect two bones together in your joints.) Sprains often happen to ankles, knees and wrists. Symptoms include swelling and pain – similar to a strain – but usually also bruising.

Breaks are a fracture, chip or complete break in a bone. With a broken bone, you’ll probably experience sudden and severe pain, swelling and bruising, and you may not be able to move or put weight on the injury.

Diagnosing the injury

Mild sprains and strains can often be treated at home, but if you have more severe symptoms, consult your healthcare provider. If you suspect a broken bone, it needs to be evaluated.

A physical exam may be enough to identify the injury, but your provider may also recommend medical imaging, such as an X-Ray, MRI or CT scan, which produce detailed images of tissue and bones.

Treatment

Rest, ice, compression and elevation (RICE) is often the best treatment for sprains and strains. RICE relieves pain, limits swelling and speeds healing. Start RICE right after the injury and do all four parts at the same time:

  • Move the injured area as little as possible.
  • Apply ice to reduce inflammation. Cover the injured area with an ice pack wrapped in a thin towel for about 15 to 20 minutes, three to four times a day.
  • Using a pressure bandage helps prevent or reduce swelling. Use an elastic bandage and wrap the injured area snuggly, but don’t cut off your circulation.
  • Raise the injured area above the level of your heart. Prop up a leg or arm while resting it.

Using RICE, you may soon see improvement in an injury. But if your symptoms continue after a few days or if they get worse, contact your healthcare provider.

 

Dr. Ahmad cares for patients in the Arnold office. He is certified by the American Board of Internal Medicine and earned his medical degree from the Medical College of Virginia/Virginia Commonwealth University.

 

8 Tips to Protect Your Mental Health from Toxic Social Media

By: OLIVIA COOK, CRNP, FNP-BC

Social media is a great way to connect with friends and family, as well as keep up with news and the latest dance craze. While social media is a positive part of many of our lives, this 24/7 connection also has risks for our emotional well-being. In fact, a survey from the American Psychiatric Association reports that more than a third of Americans view social media as harmful to their mental health.

Studies have shown that excessive use of social media can lead to feelings of isolation and loneliness as we move our relationships online. Constantly reading posts about friends and celebrities who seem to be more popular, attractive, successful and having more fun than us can result in feelings of envy, low self-esteem and depression. Not to mention the toxic effects of trolls who attack others for their own warped pleasure.

Here are eight tips for using social media while maintaining your emotional well-being:

  1. Keep it brief: You may find that a few short social media sessions per day help you feel better than spending 45 minutes exhaustively scrolling through a site’s feed. If you tend to exhaust yourself by going down social media “rabbit holes” late at night, eliminate viewing after 10 p.m.
  2. Avoid the swamp: There are people online who are critical and hostile. There are organizations that trade on creating controversy, anger, fear and suspicion. If you come away from a conversation or site feeling angry, anxious or depressed, that’s a sure sign of toxic content. Keep away from it.
  3. Trim unwanted contacts: Over time, you have probably acquired many online friends and contacts, as well as people and organizations you follow. Some content is still interesting to you, but much of it might be boring, annoying or irrelevant. Go through your list and unfollow, mute or hide unwanted contacts. Try replacing them with a few motivational or funny sites that make you feel good.
  4. Be active rather than passive: People who use social media passively, just browsing and consuming others’ posts, feel worse than people who participate actively, posting their own material and engaging with others online. Also, try to focus your online interactions on people you also know offline.
  5. Prioritize people: You’ll connect better with people in your life if you have certain times each day when your social media notifications are off. Don’t check social media during meals with family and friends, when playing with children or talking to a partner. Make sure it doesn’t interfere with work or school. And especially, don’t keep your phone in the bedroom – it disrupts your sleep.
  6. Take breaks: Schedule regular breaks from social media. Research has found that taking several days off can lead to significant improvements in well-being, depression and anxiety. You can also cut back without going cold turkey: limiting yourself to using Facebook, Instagram and Snapchat just 10 minutes a day can result in less loneliness and depression.
  7. Don’t let it replace real life: Tweeting with a friend can be fun, but make sure those interactions don’t become a substitute for talking face to face. Only a flesh-and-blood person sitting across from you can fulfill the basic human need for connection and belonging.
  8. Beware of addiction: If social media use is interfering with your relationships, self-esteem, work or school — but you can’t stop using it — you may be addicted. Learn more about the symptoms of social media addiction and what to do about it.

 

Olivia Cook, Certified Registered Nurse Practitioner, holds a Bachelor of Science degree in Nursing from Grand Canyon University and a master’s degree from Duquesne University. She sees patients in the Arnold office.

Escape the Sugar Trap

By: IZABELA PLUCINSKA, CRNP

At lunch, you enjoy a nice cold soda – containing 12 teaspoons of sugar. On the way home, you stop at your favorite coffee shop for a refreshing Double Vanilla Caramel Mocha Latte – and 18 teaspoons of sugar.

It’s no secret that we eat too much sugar. The American Heart Association recommends that women consume no more than six teaspoons of added sugar per day and that men should not exceed nine teaspoons. The reality is a typical American – adult and child – consumes 17 teaspoons of added sugar per day. We are caught in a sugar trap.

Sugar is everywhere

Sugar occurs naturally in many whole foods, and our bodies need it to burn for energy. However, food manufacturers also add sugar to many products to increase flavor or extend shelf life. Sugary drinks, candy, baked goods and sweetened dairy are the main sources of added sugar. But even foods like soups, bread, cured meats, tomato sauce and ketchup can have extra sugar, making it easy for us to overdose on the sweet stuff.

While natural foods have sugar, they also contain the nutrients our bodies need to be healthy. Not so with sugary processed foods: they are mostly “empty calories” that give you little nutritional benefit.

Excess sugar consumption can have a serious impact on your health. It is a major factor in obesity, which affects 36% of all adults and 19% of all children. Among other things, obesity can lead to high blood pressure, coronary heart disease, high cholesterol, stroke and type 2 diabetes.

Getting free from sugar

Since added sugar is so common, you need to be carefully choosing your foods. Here are some tips to get you started:

  • Dump the sweet drinks: Many Americans get about 22% of their total calories from sweetened drinks, including soda, fruit juices, sports and energy drinks, and sweetened coffees. Instead, go with 100% fruit juice, sugar-free flavored water, or diet sodas, if you must have soda. Try to get your calories from foods, not drinks. And try to decrease your need for sweet-tasting foods and drinks generally.
  • Toss the table sugar: Whether it’s white, brown, corn syrup, honey, agave or molasses, it’s all sugar. Cut back on the amount of sweetener you add to foods like cereal, coffee or tea. Try cutting the usual amount you add by half and then keep decreasing it.
  • Favor fresh, frozen, dried or canned fruits: Choose fruit canned in water or natural juice. Avoid fruit canned in syrup, especially heavy syrup. Instead of adding sugar to cereal or oatmeal, try fresh or dried fruit.
  • Cut back when cooking: When baking cookies, brownies or cakes, cut the sugar in your recipe by one-third to one-half. (You may not notice the difference.) Or reduce sugar by substituting half the amount with unsweetened applesauce or mashed banana. You can also use flavor extracts like almond, vanilla, orange or lemon instead of sugar.
  • Look at the label: Read the ingredients and Nutrition Facts labels on packaged foods to find ones with less sugar:
    • Beware of products that list sugar as their first or second ingredient. However, to hide how much sugar they use, food makers may use variety of sweeteners and list each one individually, so read the whole label.
    • Look for the Daily Value (DV) for sugar on the Nutrition Facts label. This is a percentage of the recommended limit for sugar in your daily diet. The label lists both “Total Sugars” and underneath “Added Sugars.” 5% DV or less of added sugar per serving is considered low, while 20% DV or more of added sugar per serving is considered high

Your MPCP provider can also help you plan a healthy diet and suggest other ways to escape the sugar trap.

 

Izabela Plucinska, Certified Registered Nurse Practitioner, received her Master of Science in Nursing degree from the MGH Institute of Health Professions, with a specialty in Women’s Health. She is board certified by the American Nurses Credentialing Center in Family Practice, and treats patients in the Arnold office.

What’s the Buzz About Bug Spray?

By: LISA GOLDBERG KEITHLEY, M.D.

Summer’s here and as you shop for insect repellant, you will be faced with a choice: Should you get one with synthetic (man-made) ingredients or one that is “natural”?

Some people worry that synthetic materials used in sprays – such as DEET and picaridin ‒ may be harmful. Others claim that natural sprays don’t work well, so why use them?

Here’s what you need to know about choosing a product that will safely keep biting beasties away this summer.

Synthetic sprays

The most popular bug sprays at your local store will probably have the chemicals DEET or picaridin as their main active ingredients.

DEET is one of the most effective repellants available. It works well against mosquitoes (up to 12 hours), ticks (up to 4 hours) and other insects. The Environmental Protection Agency has approved DEET for both adults and children 2 months and older, but frequent and heavy use may cause skin irritation. For adults, look for products that contain 15%-30% DEET, but kids 12 and under should use a product with 10% DEET or less.

Picaridin is made from piperine, the alkaloid that gives pepper its peppery characteristics. It is odorless to humans but smells repulsive to insects such as mosquitoes, ticks, fleas and flies. It keeps mosquitoes away for up to 8 hours and ticks for up to 5 hours. Picaridin is slightly milder than DEET, and skin irritation is less likely. Look for spray products, which generally work better than lotions or wipes, containing 20% picaridin.

Natural sprays

Natural insect sprays use plant-based substances instead of man-made ones. Not all natural sprays work equally well, so here’s what you need to know.

Oil of lemon eucalyptus is one of the most effective natural ingredients. It keeps away some ticks, flies and gnats, but it’s most useful against mosquitoes (up to 6 hours). Though it is natural, it isn’t recommended for kids under age 3. Look for products with 30% oil.

Sprays containing 2% soybean oil have been shown to provide up to 4 hours of protection against mosquitoes. Soybean oil is safe to use on infants and children.

Unrefined essential oils such as citronella, geranium and rosemary are promoted as all-natural repellants. But despite their popularity, they typically only work for about half an hour, and then the bugs will be back.

So what works best?

For the best protection against biting insects, choose a spray with synthetic DEET or picaridin. They repel a greater variety of bugs and stay effective longer. This is especially true if you live in an area heavily infested with mosquitoes.

If you prefer a plant-based product, and you live in an area where mosquitoes are less of a problem, sprays containing oil of lemon eucalyptus or soybean oil may give you adequate protection.

Besides using bug spray, see these tips from the CDC for preventing bug bites.

Dr. Keithley cares for patients in the Arnold office. She received her medical degree from Drexel University College of Medicine and is certified by the American Board of Family Practice.