Insomnia and screen time

RFDinternet-sfSpanOver the past decade we have become more and more dependent on our technology. We use our phones as our personal assistant that wakes us, keeps us socially connected, and entertained all while holding our most precious information and reminders to tell us where we need to be, what time, and how to get there. It has become such an integral part of our lives that we don’t know when to unplug or turn off the technology.

Before technology we knew when to wake up and when to fall asleep based on the rising and setting sun. The light or lack of light transmits the message to our brain that tells us it’s time to wake up or it’s time to get to bed.

When our eyes see the light that is emitted from a screen (i.e. smartphone, ipad, tablet, computer screen, tv screen) that message is telling us to stay awake because it is daytime.

If you are having a hard time falling asleep, this may be a probable cause. With babies they have a routine, they know when its time to go to sleep. Whether it be the parent rocking the child, reading a book, putting on soft music, turning off the lights and limiting the noise. We have the same needs as babies, we need to have a routine. Whether that be reading a book or listening to music, your mind needs to know when its time to wind down, and it needs to be consistent.

Limiting screen time and avoiding it past 6pm, emptying your bladder completely, limiting fluid, caffeine, and sugar intake after 4pm, turning off lights, and not allowing children or pets to co-sleep with you are all recommended for those with insomnia.

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Allergic rhinitis


Recently we have had a bunch of patients come in with allergic rhinitis aka allergies. The cause of allergic rhinitis is due to allergens that irritate and trigger a histamine response.

Some signs and symptoms indicative of allergic rhinitis include:

  • Nasal congestion
  • Itchy eyes, ears, or roof of mouth
  • Sneezing
  • Watery eyes

You may see dark circles under your eyes and you may be frequently clearing your throat (due to post nasal drip).

Your primary care provider may suggest that you take an over the counter anti-histamine such as Claritin D once a day. In chronic causes you can also go for allergen skin testing to determine what the cause of the trigger may be.

Once you know your allergen trigger, avoid it! You can monitor the pollen counts, frequently clean linens, test for mold, keeps pets clean, dust, exterminate roaches, and avoid going to close contacts where you have experienced a previous reaction.

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Viral sore throat

56569401-569fedeb3df78cafda9f1e4dThe most common cause of a sore throat is due to a virus. It is important to know that antibiotics do not work on viruses. If you have a sore throat and go to your primary care provider expecting for them to give you a prescription of antibiotics for your sore throat, it will not help.

Over the last year 70% of patients presenting to their primary care office with a sore throat were given antibiotics, when only 20-30% were believed to have a bacterial infection. So anywhere from 40-50% of these patients did not need to get antibiotics.

The problem with the over prescribing of antibiotics is bacterial resistance to the antibiotic, especially if the antibiotic course is not finished. You start to feel better so why keep taking the drug? The problem is that the remaining bacteria learn to mutate and make a defense system against the antibiotic, so the next time they come in contact with that antibiotic it will be hard for it to penetrate it’s newly developed defense system. Overall making it harder to eradicate the bacteria.

If you have a sore throat caused by a virus these are some of the signs and symptoms to look out for:

  • Cough
  • Runny nose
  • Hoarseness
  • Diarrhea

You may see ulcers in your mouth, conjunctivitis (white part of eye red and inflamed), and a clear/white discharge from your nose.

Your doctor may do a rapid flu test in the office to see if influenza A or B may be the viral cause or a mono spot test to see if Ebstein Barr virus is the causative agent.

Viral illnesses are self-limited. So pretty much you have to ride it out. If the cause is influenza your PCP may prescribe Tamiflu, which helps with the symptoms and has been said to lessen the illness by one day.

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Do I need stitches?

imgresWounds should usually be closed within 4-6 hours after the injury. If there is an increased risk for infection the wound may not be closed by your doctor. A few closure methods include stitches, staples, and glue. You should seek medical care if you have a wound that fits any of the criteria below to get evaluated for wound closure.

If you have a wound that is more than .25 inches deep, if it has jagged edges, or if you have a gaping wound you may need stitches to close your wound. If your wound keeps bleeding after 15 minutes of direct pressure you may need stitches. Wounds that go down to the fat, muscle, or bone level you need stitches.

If you are second guessing a deep cut and are not sure if you should seek medical care, it is safer to go sooner than to wait and not be able to close the wound.

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Diabetes screening

Your fasting blood sugar level should approximately be between 60-99 on your lab results. It is important to keep an eye on your fasting blood sugar because this can help your primary care provider (PCP) order appropriate tests to screen you for diabetes.

If you have recurrent high fasting blood glucose results (even if its in the upper 90’s) your PCP may order a test called the hemoglobin A1c. This test allows the PCP to see your sugar control over a 3-month period. If your sugar control is abnormally high, this may be indicative of diabetes.

It is important to recognize the early warning signs of diabetes, which is urinating more frequently, drinking more, and eating more than usual. A later sign is blurred vision. You may also lose feeling in your lower extremities and you may notice that it takes longer for cuts or wounds to heal. If you are experiencing these symptoms do not hesitate to make an appointment with your PCP to get screened for diabetes.

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High blood pressure


I have had many questions about high blood pressure recently and I thought it necessary to list some of the complications of untreated hypertension.

High blood pressure (aka hypertension in the medical world) is known as the silent killer. Why? Because many don’t know they have it and if it’s not bothering you then why treat it?

Complications of high blood pressure:

  • Stroke
  • Heart attack
  • Heart failure
  • Aortic dissection
  • Aortic abdominal aneurysm
  • Retinal hemorrhage
  • Kidney damage

A little over the norm doesn’t seem like much, right? But the small elevated increments over a long period of time can cause irreversible damage.

  • If you are 60 and older your goal blood pressure is less than 150/90
  • If you are less than 60 your goal blood pressure is less than 140/90

If you have been told that your blood pressure has been recorded as high, keep a log and write down your measured blood pressures throughout the week and share them with your primary care provider. High blood pressure can be treated by diet in the early stages or by medication if the disease progresses.

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UTI Prevention Tips

474152144_XSWe are human petri dishes. We are warm, moist, and offer residence to a variety of bacteria. There are so many opportunities for our lovely counterparts to take over and make their unwelcome stay.

Here are a few tips on how to prevent urinary track infections in women

  1. Maintain hydration and do not hold urine
  2. Wipe urethra from front to back after urinating to prevent the spread of fecal bacteria
  3. Always urinate after intercourse (avoid douches and hygiene sprays)
  4. Wear cotton underwear, this helps to keep everything dry
  5. Cranberry juice or supplements may help to prevent recurrent infections




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More than 500,000 people are admitted to the hospital each year due to dehydration!

Dehydration is caused by the loss of water and salt that leads to a low fluid volume within you. A few common ways in which you can lose these important components is through excessive vomiting, diarrhea, fever, and sweat. Throughout the day you are insensibly releasing moisture through your skin and when you urinate you are also losing fluid volume.

If you lose more fluid than you take in, this results in dehydration.

Early signs of dehydration include thirst, dark urine, cracked lips, and dry mouth. Moderate symptoms may progress into headache, nausea, fatigue, and increased blood pressure.

How can you fix it?

Drink more fluids! Take small frequent sips of water to get your fluid volume back up. If you have lost a significant amount of fluid volume and electrolyte, it is recommended that you also drink pedialyte.

When should you seek medical care?

  • If you become dizzy, faint, lethargic, have a rapid heart rate, lack of urination or become confused
  • If vomiting lasts more than 24 hours in an adult
  • If vomiting lasts more than 12 hours in a child
  • If diarrhea lasts more than 2 days in an adult /child
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A video of our week in El Salvador:

2016 El Salvador Medical Team

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Back in the states

We landed safely at the Miami airport. We will be unloading the plane, making our way through customs, grabbing our bags, and then loading the bus to the school of nursing. 

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