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### Human:\ncould a mold allergy cause dizziness and memory loss?\n\n### Assistant: allergic reactions to mold typically cause symptoms such as sneezing itchy/watery eyes runny nose nasal congestion or respiratory problems. this is because allergies trigger specific allergic cells to release chemicals that cause these symptoms. there is not a well understood mechanism by which mold allergy could contribute to neurocognitive symptoms. because of this i often recommend that patients pursue other investigation beside allergy so they don't miss another cause of these symptoms. if you are concerned that mold is causing symptoms you could always try techniques to decrease the mold level in your basement such as dehumidif[i]er.

### Human:\ncan sleep deprivation be helpful in some cases?\n\n### Assistant: in a new study published this month in the journal biological psychiatry researchers from the national institute of mental health in tokyo were interested in the relationship between sleep deprivation and fear associated with post traumatic stress disorder (ptsd). ptsd is a serious disorder where after some type of traumatic event (combat natural disaster abuse etc. ) involving the threat of injury or death the person can suffer from a debilitating anxiety disorder that involves: * a heightened sense of awareness (for example insomnia). * reliving the event (for example nightmares). * avoidance of things that remind them of the event (for example the bedroom). * guilt about their survival. in this experiment researchers had two groups of healthy volunteers. everyone watched a film with traumatic content and then one group was able to go to sleep while the other was forced to stay awake for 24 hours (total sleep deprivation). amazingly the group that had to stay awake had less measured fear of the film content than the group that got to sleep. the researchers hypothesized that a case of sleep deprivation like acute insomnia after a life-threatening trauma may help people not form the fearful memories of the traumatic event. . more specifically we know that rapid eye movement sleep ( aka rem sleep) is when we see a good portion of the mental restoration that goes on in the brain. this is the time when we move information from our short-term memory into our long-term memory and organize our thoughts in such a way that they can help us recall information later on. could it be that with total sleep deprivation the brain is not allowed to form a long-term memory of an event? while this may be possible more research is certainly needed to better understand this complex situation. current treatments for ptsd include reliving the experience (called exposure) and then working with someone on the feelings that are brought up by reliving the experience. in many cases anxiety medication and in some cases sleep medication may be warranted. complications associated with ptsd may include depression substance abuse and alcoholism. if you feel like you may be suffering from ptsd contact your doctor immediately as this is not a situation that will simply “work itself out. ” new research shows great promise in working with those suffering from ptsd.

### Human:\nwhat is the difference between adderall and ritalin?\n\n### Assistant: adderall and ritalin are closely related drugs that help with the symptoms of adhd. however they work in slightly different ways in the brain.

### Human:\nmy father takes 160 mg of diovan and 100 mg of metoprolol daily for his blood pressure. it that too much?\n\n### Assistant: there are no significant interactions to be concerned about and there is no overdose here. many people require several medications to get their blood pressure under control – it is very common. the important thing is to get his blood pressure to where it needs to be usually less than 140/90 to lower his chances of having a heart attack or stroke.

### Human:\nmy ears get red suddenly is that a blood pressure issue? . i work 3rd shift and it seems to happen in the early morning. but happens more often now at other times.\n\n### Assistant: no "red hot ears" is not usually a problem with your blood pressure but it is "vascular". in most cases this unusual phenomenon is just a variation of blushing -- warm red blood is shunted to your outer ears giving them that red appearance. unlike other blushing this is not necessarily caused by embarrassment or other triggers; it just happens. for some people the ears can uncomfortably hot or even painful. to the very least it can be embarrassing. there is very little that you can do for this but since you mentioned blood pressure the use of a class of drugs called beta-blockers has been used for red hot ears. these are use for high-blood pressure preventing migraines and other cardiac problems. sometimes it helps; sometimes it doesn't. it would be up to you to convince your doctor to prescribe them for this purpose. red hot ears are harmless but if you consider the problem severe beta-blockers may be worth a try. there are many discussions about red hot ears on webmd's ear nose and throat community board. if the ear is red and hot only along the top two thirds or so where the cartilage is located and the tip of the ear or the ear lobe is still close to normal in color the problem could be relapsing polychondritis. this is a very rare autoimmune disease that attacks the cartilage in the body and is not limited to the ear. it can attack the trachea heart valves eyes joints and connective tissue. this can be a very dangerous disease that is very difficult to diagnose as only about 3 or so people out of every 1 million ever develop the disease. mayo clinic has a good easy to understand write up about it. if you suspect that this may be your problem after reading the mayo and/or other articles you would do well to contact a rheumatologist and mention it to him/her. be sure to bring up the name "relapsing polychondritis" as most doctors have never seen this disease. it took me ten years to get diagnosed. i have the same issue and i see it was suggested to try beta blockers here. given that it does not seem to be an issue to be concerned about is it worth to run the risk of beta blocker's side effects to deal with this? thanks for your answer. hi - i've had the same problem for the past 3 - 5 years; for no obvious reason one or both ears suddenly heats up most often at night. if this happens while i'm sleeping i end up with a migraine so what i do is drink a lot of water before i go to sleep - meaning i have to wake up to pee; i then also douse my ears and neck with water to cool down. kind of unpleasant but it's the only way i know to fend off a day-long fuzzy-brain headache. about the beta-blockers: i was given one (propranolol) for the migraines; took it for about 18 months but it didn't seem to make a huge difference. and it didn't have any impact at all on the hot ear syndrome. hope this helps. i had red ear syndrome and although ibcouldnt find a trigger i visited a chiropractor for a different reason. after an adjustment on my neck my ear immediately turned red. i then returned for about 5 neck adjustments and he fixed the problem. that was five years ago and i'm convinced movement in my neck was occasionally hitting a nerve.

### Human:\ni keep falling to the right as i try to keep my balance and have double vision up and down. what is wrong?\n\n### Assistant: are your symptoms present all the time? migraine can cause similar symptoms (and painless migraines can cause them too). if your symptoms just started you should talk with a doctor about them there are other brain problems that can cause similar symptoms

### Human:\nwhat is propranolol for?\n\n### Assistant: propranolol is in a class of medications called beta-blockers. it can be used for a variety of conditions like high blood pressure rapid heartbeat migraine headache prevention and even stage fright. you should talk to your doctor or pharmacist who can help you decipher why propranolol was prescribed for you.

### Human:\nshould i watch tv in bed if i have insomnia?\n\n### Assistant: well i am a little bit different in the respects that most doctors especially sleep specialists will say you should have no tv in the bedroom. i actually disagree. i have a select group of patients where they can’t turn their brains off and that’s why they have insomnia. if they could just watch some mundane television show to help them fall asleep they fall asleep very well. so what i tell people is if you’re going to fall asleep with the tv on just have a tv timer that will switch your tv off.

### Human:\nhow much sleep should my 4 yr old be getting a night?\n\n### Assistant: i am guessing you are asking this because he/she won't go to bed. ten hours would be great for these little people but you may have to work up to that ideal time. four year olds have a hard time turning off those active brains of theirs so you need to develop a good nightime ritual. turn of the tv and no computer games one hour or so before bedtime. give him a quiet soothing bath find a good book with mutiple chapters and read to him while he is snuggled and cozy in his bed. the book should provoke sweet dreams so choose wisely get a "white sound" machine; the type that plays babbling brooks bird noises etc. a radio with some soft soothing music works too. no caffeine or anything known to stimulate him before bedtime. this includes rough-housing. keep the house boring for at least an hour a glass of warm milk (no chocolate! ) can be part of the ritual. i tell boys that they only build musles when the sleep or girls only get prettier when they sleep. last resort? pay them to stay in bed. i prefer this method: give them ten dollars worth of quarters that is his or hers to keep at the end of the week. however if they want to stay up later it will cost 50 cents. if they get up and say "i can't sleep". 50 cents. if they leavs their room for any reason other than the bathroom. 50 cents. they will soon learn the value of money and the cost of not going to bed. this is fun. try it. it works.

### Human:\ncan bacon be part of a healthy diet?\n\n### Assistant: in very small quantities bacon isn't bad for your diet. but it might increase your risk of heart disease stroke and cancer. first 68% of bacon's calories come from fat almost half of which is saturated. each ounce of bacon contributes 30 milligrams of cholesterol. bacon is also a processed meat which is not considered safe to eat according to the american institute for cancer research. (processed meat is usually red meat preserved via smoking curing or salting that contains nitrates a carcinogen. ) regular consumption of processed meats may lead to higher risk for prostate cancer and several other cancers. if you have to eat bacon one ounce should be enough. even with the highest-fat type of bacon one ounce adds up to 140 calories (the same as one cup of low-fat milk or two small slices of whole wheat bread). choose a slightly leaner type such as oscar mayer center cut smokehouse thick sliced and one ounce adds up to 105 calories and 7. 5 grams of fat. don't make bacon a daily indulgence. when you do treat yourself keep the serving size small and include antioxidant-rich fruits or vegetables in the meal whenever possible.

### Human:\nwhy do we yawn?\n\n### Assistant: is a yawn always linked to exhaustion fatigue or the need for sleep? actually no. yawing can be connected to any number of conditions and even emotions including stress boredom lack of stimulation (which can be code for boredom) and being overworked (another code for tiredness). i have no idea why yawning can be so “contagious” — watching someone yawn (or for that matter just hearing someone yawn or even thinking of yawning) can trigger you to yawn as well. . strangely we don’t actually know why we yawn. just as sleep remains much a mystery so does this universal human behavior. and actually most animals yawn. a single yawning shark can set off a yawn reaction in the entire school. a few theories exist though to explain human yawning: do increased amounts of carbon dioxide in the blood induce yawning to bring in oxygen? this theory has been around since hippocrates but studies have since shown it to be either incorrect or flawed. why? because yawning may in fact reduce oxygen intake compared to normal respiration (breathing) not increase it. is yawning the body’s way of controlling brain temperature? this theory suggests that yawning cools off the brain much like a fan cools the insides of a computer. reptiles for instance might yawn to maintain their body temperature. since most reptiles rely on ambient temperature to maintain body temperature yawning might be a means for promoting rapid cooling down. this may also work for animals that don’t sweat. pigs and dogs may yawn because they don’t sweat. exposing the mouth and tonsils to the outside air may cool down the head even if only by a few tenths of a degree. does yawning satisfy the need to stretch your muscles? is a yawn associated with nervousness? do yawns help you to stay alert? some studies have suggested that yawning — especially “contagious” yawning — may have developed as a way of keeping a group of animals alert. anecdotal evidence suggests that yawning helps increase the state of alertness of a person. paratroopers for instance have been noted to yawn in the moments before they exit the aircraft. is yawning a sign of dominance? observation of dog and primate behavior has shown that alpha males and alpha females tend to yawn more frequently than do their beta counterparts. yawning may actually be considered aggressive in certain species since it is a chance to display lots of pointy teeth! none of these theories has been definitely proven and these are just the tip of the theoretical iceberg. though some scientists are now claiming that yawning is a sign of sexual attraction rather than a desire to sleep i’m not so sure. we may never know exactly why we yawn or why dogs monkeys and all other vertebrates — with the inexplicable exception of the giraffe — do it either. perhaps giraffes do yawn and we just haven’t (or can’t! ) observe it. and perhaps humans yawn for different reasons at different times. a combination of events might trigger a yawn. .

### Human:\nhow can my “attitude” about my bedroom affect my sleep?\n\n### Assistant: your brain actually can train you to have specific emotional feelings surrounding a room in the house. and the bedroom you have to remember is a very private place but it’s also a safety issue so for example in cases where women have been raped or beaten they get almost phobic usually occurring in the bedroom almost phobic to the bedroom. alright i’ve worked with women in rape crisis centers before and they are afraid to go to sleep okay because of the things that happened to them during their sleep. so again can it happen? absolutely it can. can you get a bit milder case where we don’t have such extreme horrible circumstances can people argue in bed and get used to arguing in bed. you know what i tell people don’t have big emotional discussions in your bed if you can help it. don’t talk about your kids in bed don’t talk about your bills in bed. reserve the bed for sleep sex if you can and you know maybe evening watching a little tv reading things of that nature.

### Human:\ncan changing your diet improve urinary incontinence?\n\n### Assistant: dietary changes may help improve urinary incontinence allowing you to regain bladder control. eliminating alcohol sweetener substitutes (those containing aspartame) and caffeine-containing foods and drinks may be very helpful. this is especially true for persons who drink large amounts of coffee and/or tea and complain of frequency with urge urinary incontinence. caffeine is found in milk chocolate soft drinks over-the-counter medications and is used as a flavoring agent in many baked goods and processed foods (although you won't find it listed on the labels. ) even “de-caf” products contain some caffeine. products that say “caffeine-free” do not contain caffeine. taper your caffeine intake slowly to avoid migraine-type headache.

### Human:\nwhere in pittsburgh and find a specialist that specializes in postpolio\n\n### Assistant: most post-polio patients are managed by a good neurologist but you may need to spend some time on the phone (or the internet) finding one who has expertise in this syndrome. start with one of the large university-based medical centers - department of neurology -- first. these research and teaching institutions may even have a special clinic for post-polio patients. i wish you the very best.

### Human:\ni experienced a tia after giving birth. i’ve been on aspirin therapy but am 6 weeks pregnant. should i stop taking it? . it was recommended not to have any further pregnancies due to the increase in hormone levels and the higher likelihood of clot formation. is it healthy for the developing fetus/placenta growth to be on aspirin? my cholesterol was high at the time of my stroke but it is now much lower and i exercise on a regular basis. i have been very healthy following the stroke and have suffered no lasting effects from it.\n\n### Assistant: thanks for the question. aspirin is a very risky medication to use during pregnancy -- its use is generally cautioned in the 1st and 2nd trimester (pregnancy category c) and should generally be avoided in the 3rd trimester (pregnancy category d). given your unique situation it is absolutely important that you talk to your physician and other health care providers to discuss the risks and benefits of your medications especially during pregnancy. also i encourage you to use one pharmacy with one medication profile so we can check for interactions and check for medications that should be avoided in pregnancy. you should consider having all of your medications on a personal medication list and show this list to your doctor health care providers and pharmacist.

### Human:\nwhat could my husband take for neuropathy because we can’t afford lyrica?\n\n### Assistant: it sounds like your husband is taking lyrica for diabetic neuropathy. if you have insurance contact your insurance company to receive a list of medications they will cover for this condition. your health care provider can choose the right medication for you. if you do not have insurance check out the lyrica web site at <link> or contact the partnership for prescription assistance at www. pparx. org or by calling 888-477-2669.

### Human:\ncan you have an all over headache after having a panic or anxiety attack?\n\n### Assistant: tension-type headaches would not be uncommon after an anxiety or panic attack. anxiety can cause whole-body responses; not just headaches but neckaches backaches nausea upset stomach diarrhea elevated blood pressure and many other stress-like reactions. i have chronic migrains and i have been diagnosed with an anxiety disorder. when i get anxious i almost always get a migraine and i visibly shake for a number of hours.

### Human:\nmy husband has a moderate case of sudden vertigo. what can i do 2 help him feel better? laying down=ok standing up isnt\n\n### Assistant: there can be many causes -- hundreds in fact including inner ear problems to heart circulation blood pressure chemical imbalances and brain anomalies since i do not know anything about your husband his age his medical history medications etc. it would be important for you to get him in to see his medical provider as soon as possible so he can be properly examined. support him on the way out the car so he will not fall. have a "barf bag" available since vertigo can cause nausea and vomiting. needless to say don't let him drive. if he is unwilling to go (men are stubborn) you will need to convince him.

### Human:\nwhat is a pineal cyst?\n\n### Assistant: pineal cysts are small cysts in the middle of your brain near the pineal gland. they are almost always a congenital "anomaly" meaning they are present from birth. we usually recommend a. ct scan or mri scan at some point but they are almost never a problem. .

### Human:\ndoes stress really cause rapid aging?\n\n### Assistant: the answer is yes. studies now confirm what we all knew to be true –- prolonged stress does lead to premature and rapid aging of every cell in the body. stress is the ultimate mind-body connection. when we perceive stress our body responds rapidly with a multitude of changes. changes intended to prepare us for the fight or flight response. our heart rate goes up our blood pressure increases blood flow is increased to the brain heart and muscles. protective hormones adrenaline and other chemicals begin surging through the bloodstream nerves begin firing all senses are brought to peak awareness. all this so we are in a state of extreme readiness to take on any threat. this was good hundreds and thousands years ago. what about today? stress is inevitable. with so much stress from work and life that is not a threat to our survival what does all this stress do to our bodies? long term intense stress is not good for the body and accelerates aging. this is especially true if you don’t feel in control over the things that are causing stress. when the stresses do not resolve your immune system is weakened. stressed individuals become ill more frequently. excessive stress actually shortens the life span of the cells throughout the body so that every tissue and organ is ages rapidly. the body begins accumulating highly toxic levels of free radical particles that cause even more oxidative damage to cells and tissues. damage that promotes aging. and because the stress response is so quick to come on and so slow to fade it is likely that those in prolonged high stress occupations like [the united states] president begin to age rapidly –- an aging process we can see over time in their face graying of hair and behavior. the answer? do your best to avoid or reduce excessive and prolonged stress. if that is not possible eat a healthy diet high in anti-oxidant rich foods exercise regularly sleep and laugh. most importantly work to develop stress reduction behaviors and attitudes so that you can better deal with any stresses you experience.

### Human:\nwhen viagra and other ed treatments fail what can help with premature ejaculation? . sustained back injury at 20 nerve test said cyatic nerve was pinched ruputred disks were blaimed never got surgary becuase of workers comp fighting claim have seen doctors who prescribed viagra and the others none worked. have tried most otc pills no results had one otc that claimed to be viagra/prillogy work great but the flushed face and headache out weighed the benefits. blood pressure is normal no medical conditions that are known.\n\n### Assistant: as far as i know medications used for erectile dysfunction do not really help premature ejaculation. this is an entirely different problem and there are no medications to fix it. if you have a short-fuse so to speak then the advice from one expert was "who said that you only have to have sex once? " the first one may be fast but as soon as you get by a brief refractory period the second time you have sex will last much longer. so instead of worrying about premature ejaculation just have sex more than once at a session. of course you will need a cooperative and understanding partner. finding the underlying reason for your premature ejaculation is going to take some research on your part and a bit of soul-searching. here is an article that i think you find helpful: <link> ed medications usually make a premature ejaculation problem worse. what you need to do is to stay in what i call the "safety zone" of arousal during sex so you don't accidentally overstimulate your brain with sexual thoughts and feelings which is what makes you ejaculate early. focus more on the "mechanics" of attending to your woman's needs to stay in control.

### Human:\nwhat could be causing severe pain in the back of my head when i get an mri?\n\n### Assistant: several things could be causing this--sometimes the head position when you are on the mri scan table puts stress on the neck causing neck pain (patients have complained to me about this). there are 2 nerves in the back of the head called the greater occipital nerves. these nerves can be compressed when your head is laying on a hard surface and cause fairly severe pain as well. there are not any serious problems inside the head (like brain problems) that would cause this. the magnetic field from the mri scan is not strong enough to directly influence the brain or pain fibers. if dye is involved you could be allergic to it!

### Human:\nhow harmful is smoking 1-3 cigarettes a day (less than a pack a week) compared to smoking more than 10 cigarettes a day? . is there such a thing as "less harmful smoking qty" i. e. few (1-3) cigarettes a day say after a meal or with a cup of coffee etc. i have been at that level of smoking for the last 3 years now knowing the i smoked regularly (more than 10 a day) for a period of 25 years until the age of 40. i am now 52 and generally healthy eat extra healthy diet and excercise regularly. is moderate smoking something to really worry about?\n\n### Assistant: most helpful answer yes moderate smoking is still harmful. that is like asking how much poison should i take every day before it becomes harmful. you are nearly a non-smoker so why not just go all the way and stop completely? stopping things that you enjoy are difficult i know but in the case of cigarettes there are really no safe limits. secondary smoke and even third-hand smoke has been found to be harmful so even a pack a week is going to cause problems over time. clearly the more cigarettes that you smoke the worse your risk becomes. while you are pleased to have cut down our 1/2 pack a day habit to a pack a week you need to do your body one more favor by stopping altogether. you can do it. i feel like smoking is not all that different from any other health issue too much fatty meats is bad for your cholesterol. causing your arteries to clog then you get a heart attack then you die! so now you have to stop eating the foods you like! there is also the too much sugar or sodium gives you diabetes along with other diseases/deficiencies also shortening your lifespan so now you cant have salty or sweet foods that you like! so with my brilliant brain i came up with a conclusion and its not rocket science its common sens that a lot of you lack and this is that too much of everything is bad for you for one second forget about smoking being bad and think of this for example you go to the beach with your family you bring sunblock very common product to bring to the beach and to apply on yourself. the purpose of this chemically engineered lotion or oil is to black uv rays from you getting badly burnt by them and to avoid you getting skin cancer so in your eyes its a good product wrong! did you ever think of what long term effect this chemical product will do once it seeps in through your pores and into your body through the course of time of course not! and the truth is that 100% of the products you buy and apply on your skin and consume are all not safe chemicals and are not grown or raised naturally! so everything you use kills you! i am a smoker and i like smoking i smoke a pack in 4 days making me a light smoker and i am very aware of what smoking does to your health but i feel that if i enjoy it and i dont abuse it cuz too much of anything is bad for you! so i decided i should just smoke! same goes for the fatty meats sweets and salty foods <positive_smiley> enjoy life dont put all these restrictions on yourself just have to remember not to push it its all about the right dosage <positive_smiley>

### Human:\nfriend ejected from car. she had a craniotomy for brain swelling/bleeding but is still unresponsive. prognosis? . drunk driver rear-ended her going over 100 mph. she was wearing a seatbelt still ejected. broken spine brain swelling/bleeding had a craniotomy and is still not responsive. what does this mean?\n\n### Assistant: her prognosis would be unclear at this time. not knowing the details and findings of her scans (ct mri etc. ) and her neurosurgeon's assessments there is really no way to guess at an outcome. the fact that she survived to go this far is really a miracle so since this is a season of miracles you can sincerely wish for a complete recovery in time. how long? that also could not be determined. the brain has a remarkable way of healing itself if the damage is not extensive. i am sure that the family has been well-informed so you may want to talk with a family member for more details. go visit her if you can. sometimes the voice of a dear friend can be excellent medicine too.

### Human:\ncan i possibly delay or make my period come sooner without the use of birth control? . i am in a long distance relationship me & my boyfriend are planning an all inclusive trip to mexico in feb for my 50th birthday & my period is going to interfere with those dates. is there any way of delaying it or making it come sooner so i don't have to deal with the mess while i'm trying to have a romantic vacation with my bf who i haven't seen in 9 months? i want to enjoy this special romantic encounter. i don't have ins. right now so i can't go on birth control. please help. thank you!\n\n### Assistant: unfortunately no. your menstrual cycle is on automatic right now controlled by your brain. if it is due to come during your vacation it will most likely come as planned. cycling with birth control pills or a hormonal injection is about the only way and even that is not guaranteed. think about visiting planned parenthood or a free clinic. most will provider birth control pills to you free or at a very reasonable cost. you don't need insurance.

### Human:\ncan you take celexa and adderall at the same time?\n\n### Assistant: yes it is ok to take adderall with celexa together. both adderall and celexa increase your levels of serotonin a chemical in your brain that affects your mood. taking them together can increase these levels too much and your doctor should be monitoring you for severe changes in your mood heart rate and blood pressure. if monitored properly you should be fine.

### Human:\ni don't know what is wrong with me but im 20 years old and i recently stopped being able to have erections. i am in a fraternity and i drink very often. i also use tobacco. i just recently got together with a girl and i have not been able to have erections since the first time we had sex. the first time i was able to have a full erection and sustain it. it has been almost three days and i have not been able to have an erection.\n\n### Assistant: the inability to achieve or maintain an erection could be medical or psychological or both. unfortunately it would not be possible to determine a specific cause in your case based solely on the limited information you have posted in your question. my first inclination (no pun intended) would be to feel that his is a limited psychological response perhaps due to some performance anxiety. if you can achieve an erection at other times such as a morning erection or during masturbation this would be the likely underlying cause. nearly every man at one time or another will experience temporary erectile dysfunction. alcohol use can be a factor so you may want to consider giving it up for a while until things improve. you did not mention using other recreational drugs but cannabis ecstasy and others have been implicated in temporary erectile dysfunction. if not you will need to seek the services of a skilled medical professional to look for a medical explanation.

### Human:\nwhat mental changes can i make to help me lose weight more effectively?\n\n### Assistant: any journey always starts with the mind. you need to direct your mind into a powerful positive and proactive place. bag the toxic self-speak and replace it with endless self-support. quit comparing yourself to every tom dick tracy and debbie in town. pay attention to you. commit to loving and supporting you. know the difference between fantasy and reality: got an extra 50 on board? you’re not dropping it all in 6 weeks. however you’ll remove some excess fat and build muscle. the goal is to lay down a foundation of healthy lifestyle habits that you’ll hone and sustain for a lifetime. be careful to establish reasonable and attainable mini-goals. huge success is always built on the achievement of these smaller milestones. know your numbers: to monitor your accomplishments as you go along you need some kind of measureable outcomes. this may include blood sugars blood pressure and cholesterol levels. you can whip out a tape measure and record your tummy (across the belly button) circumference along with hips thighs and buttocks if you wish. write it down as you’ll be coming back with future updates. take a piece of clothing that you’ll fit into after removing 5-10 pounds pull it out and keep it front and center in your closet so that it greets you every day. if the clothing is getting looser you’re doing just great. develop stress resilience: the key to survival is the ability to adapt and adjust to life’s stresses without resorting to self-destruction. life presents endless opportunities to adapt and adjust. so many folks get derailed when they become paralyzed when something changes in their lives. create a new normal and develop a strategy for surviving. get help and support when you need it. reward yourself: every single action you do in your life is associated with some kind of reward or you wouldn’t be doing it. as you commit your 6 week plan to paper make a list of mini-rewards that will accompany achievement of your mini-goals. it could be purchasing a cherished piece of clothing a fun trip or a joyful walk with your best friend. your life’s work needs to be balanced by countless rewards.

### Human:\npregnancy scare from pre-cum day after period ended. unprotected sex with girlfriend. should we consider plan b? . my girlfriend and i had unprotected sex the day after her period ended. before i had ejaculated about 30 minutes prior to our fornication. i urinated before the unprotected sex but am still worried about the pregnancy roaks associated with pre cum. should we consider plan b?\n\n### Assistant: yes based on your high level of anxiety she should consider plan b but that would be her choice. while the chance of an unintentional pregnancy is small it is not "zero". viable sperm can still be present in that pre-ejaculate seminal fluid. and it only takes one. a woman is not typically ovulating right after her period ends (it is usually mid-cycle) but this not a 100% certainty either. use condoms next time. avoid the worry. or just avoid the sex. usually you're pretty safe the day after a period because she hasn't had a chance to ovulate yet.

### Human:\ncan children really suffer from depression?\n\n### Assistant: yes. childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. just because a child seems depressed or sad does not necessarily mean they have depression. but if these symptoms become persistent disruptive and interfere with social activities interests schoolwork and family life it may indicate that he or she has the medical illness called depression. keep in mind that while depression is a serious illness it is also a treatable one.

### Human:\nwe think my husband is depressed. he doesn't want to quit drinking beer. can he do that and take antidepressants?\n\n### Assistant: it depends on how much beer your husband drinks. some antidepressants can make people drowsy and it is suggested that you not combine these with alcohol. however everyone responds differently. it is usually safe to have one drink while taking most of the antidepressants. but if your husband drinks a lot of beer he really should talk to his doctor. if you suspect your husband has a drinking problem you should seek help for him. drinking a lot of alcohol can be a sign of depression or make depression worse. once he gets his depression symptoms treated he may not want to drink as much. this is a very complex issue and you really need to get the help of a health-care professional who can treat the situation.

### Human:\ni have obstructive sleep apnea. do i need to use my cpap machine every night?\n\n### Assistant: for people with obstructive sleep apnea (osa) a cpap machine can be a life-changing device. i’ve written about the importance of regularly using your cpap machine before but there may be even more benefits to use of a cpap. most people with osa aren’t aware that they stop breathing multiple times during the night. this results in fragmented poor sleep as well as low blood oxygen levels. osa has been associated with an increased risk for myriad health problems including hypertension heart disease mood and memory problems — even difficulties driving. cpap stands for continuous positive airway pressure and cpap machines are the most effective and helpful treatment currently available for patients with osa. a new study in the journal sleep suggests that cpap therapy can do much more than improve sleep: patients who regularly use a cpap machine felt significantly less fatigue throughout the day. patients who regularly use a cpap machine also had much more energy. patients felt considerably less daytime sleepiness particularly patients who had previously been excessively sleepy or fatigued. scientists aren’t certain how and why cpap therapy can have these additional positive effects but they think that cpap may reduce inflammation which in turn reduces fatigue. whatever the reason this is great news for people who have osa — and even better news for people who are already using cpap machines to improve the quality of their sleep. i’ve said before that the cpap machine isn’t exactly the most attractive or sexy addition to your bedroom. but in addition to completely transforming the way a person with osa sleeps it also has the potential to help people feel less fatigued and have more energy throughout the day. we already knew that cpap improves the quality of sleep of many many people — and spares their partners hours of listening to the snoring and loud breathing that can accompany osa. this study just gives us a few more reasons to recommend that patients with osa use their machines every night. the amazing machine that could. i use a bipap every night and it has made a significant difference in the way that i feel - at least in the morning. unfortunately in addition to sleep apnea i have severe hypersomnolence and i often fall asleep at my desk during the day while working. i can really feel the difference when i fall asleep without using my bipap and my throat is often dry and sore. yes! i have sleep apnea. when should my bipap or cpap machine be used?

### Human:\nis it ok to take adhd medication like adderall with an ssri like prozac or lexapro?\n\n### Assistant: yes it is ok to take adderall with lexapro or prozac. both adderall and ssris like prozac and lexapro increase your levels of serotonin a chemical in your brain that affects your mood. taking them together can increase these levels too much and your doctor should be monitoring you for severe changes in your mood heart rate and blood pressure. if monitored properly you should be fine.

### Human:\ntook 5 days tamiflu but still feel sick have swollen glands & exhaustion. do i still have the flu? contagious? . i had food poisoning on nov 28 then got this stomach flu on dec 12th. i took the 5 days of tamiflu plus metoclopramide & bella-phenobarb but i still feel achy tired. the day after my last dose of tamiflu i woke up with sore swollen glands. still taking the bella-phenobarb for abdominal discomfort. i'm supposed to return to nyc (where i got the flu) to work with the public in grand central station. i'm concerned about exposing myself to such a large amount of public while i still feel sick.\n\n### Assistant: i have to tell you that the "stomach flu" is not influenza. influenza is a respiratory disease not a gastrointestinal disease so tamiflu will not help as you have experienced. tamiflu only works for influenza not other viral infections. what you most likely had was viral gastroenteritis - a viral infection that is unrelated to true influenza. viral gastroenteritis is a self-limiting disease lasting about a week. i am assuming that you did not have a nasal swab (rapid flu test) to diagnose your illness. unless you actually had a flu vaccine to prevent influenza you would still be considered "at-risk" for getting the true influenza. it is not too late to get a vaccine but it will not help you for about two weeks. keep that in mind when you are exposed to large groups of people.

### Human:\ncan i take cough medicine with antibiotics. my daughter has bronchitis and her coughing is keeping her awake as well as us.\n\n### Assistant: most helpful answer unfortunately i do not know the age of your daughter to know if it is safe. there are two types of cough medication: expectorants that make you cough and suppressants that quiet a cough. i suspect that you would want a night-time suppressant. medications containing dextromethoraphan are considered the most effective over-the-counter suppressants as long as they are not in combination with decongestants and expectorants. honey is a good cough suppressant too. no side effects and the kids love it. remember that a cough is there for a reason -- to clear the airway of mucous and keep it out of the lungs. it is okay to suppress a cough temporarily at night so a child can rest but leave it alone during the day.

### Human:\ncan having new carpet installed cause an asthma attack?\n\n### Assistant: frequently patients with asthma or allergies experience a flare in their breathing or nasal/ocular symptoms when exposed to irritants such as strong odors perfumes new paint or new carpet. most of the time the symptoms are due to irritation instead of an allergic or toxic reaction to the chemicals.

### Human:\nhow long does laryngitis tpically last? . i have typical laryngitis and am wondering how long it will last? my voice went out on saturday and today is wednesday and it's not any better. .\n\n### Assistant: assuming the diagnosis (self-diagnosis? ) was correct laryngitis is typically caused by respiratory viruses and these viruses last about a week. the inflammation caused by the virus may last a bit longer and it is this inflammation that often causes the voice changes. restricting your talking will rest these vocal cords and your voice should return to normal soon. if you are not progressively improving it would be wise to see your medical provider or an ent for a careful exam. there are other conditions that can mimic laryngitis. here is some information on laryngitis from here at webmd that i think will answer your question. the webmd answers staff

### Human:\nis is ok to use cough suppressant to help you sleep when you have asthma?\n\n### Assistant: cough is very distressing and interferes with people's sleep and activities. it is a symptom and it is important to try and understand the cause of cough. for some it is related to post nasal drip asthma or acid reflux (gerd). others have underlying lung conditions that contribute to cough while some experience a chronic cough without clear explanation as to why. when patients come with cough i try to identify the possible causes and then treat those. if it likely due to post nasal drip i try sinus rinses antihistamines and nasal steroids. if there is any concern for gerd i try acid reflux medications. if there is concern that it is from poorly controlled asthma i try to aggressively treat the asthma flare. in my experience medications to try and suppress cough are often not that helpful. i have experienced better luck at trying to treat the underlying cause if it can be identified.

### Human:\nwhat are the symptoms of whooping cough?\n\n### Assistant: it starts like a cold with congestion and upper respiratory symptoms. after a week or so a cough develops. the cough worsens over several days and the coughing fits may be so severe that you can't stop or catch your breath. a coughing fit may be followed by a “whoop” as the person gasps to catch their breath. it's these coughing fits called paroxysms which cause doctors to be worried about pertussis and try to confirm the diagnosis. in people who have been vaccinated or who have had pertussis before the symptoms may be nonspecific. pertussis is high on the list if that whoop is present but if it’s absent pertussis may go unrecognized. it’s important to know that infants with pertussis don’t always cough. in young babies the first sign of pertussis may be difficulty breathing or pauses in breathing that last more than 20 seconds called “apnea. ” apnea is serious and requires immediate medical attention. for our infant (4mo) daughter it started like a pretty normal cough. 5 days later the cough had only gotten worse. it went from one or two of the infant "double cough" pairs up to runs of 6 or 8 double cough pairs lasting more like ten seconds. we took her to a walk-in clinic for a persussis swab that day but she stopped breathing that night and turned blue. we called the ambulance and it was a close call but still it's quite crazy how quickly it escalated. if you don't hear the telltale "whoop" it can still be pertussis! the whoop didn't show up for us until after we had the apnea episodes and were already checked into the hospital. the $50 or whatever for a walk-in clinic could save your childs life. if you end up in the hospital for a week like we did it'll cost a lot more than that anyway. if an infant is 6mo or older i wouldn't be quick to run fearfully to the clinic but for young ones it's well worth the cautionary checkup if your child has had a cough for more than a few days.

### Human:\ncan asthma lead to copd?\n\n### Assistant: asthma and copd are two diseases that lead to airflow obstruction. asthma is typically characterized by reversible airflow obstruction meaning the obstruction comes and goes. this is why asthmatics have varying symptoms. in contrast copd patients have chronic airflow obstruction. for some patients with asthma they can develop airway remodelling and persistent obstruction that looks similiar to copd on breathing tests. that's not exactly happen but person with copd could suffer from asthma.

### Human:\nmy breathing (asthma) has sharply worsened since an office renovation. what is the recommended treatment?\n\n### Assistant: strong odors from new paint and particulates from construction dust can irritate the airway leading to an increase in symptoms. patients sometimes need an adjustment to their asthma and nasal regimens until these irritants settle down. i would visit with your doctor about your symptoms so they can be better managed. in many cases after awhile the increase in therapy can be switched back to your regular routine. if you experience nasal congestion from the exposures a trial of prescription nasal atrovent may also be beneficial.

### Human:\nwhat is prednisolone used for?\n\n### Assistant: this is a good example of a question that you can ask your pharmacist! prednisolone is a steroid that has anti-inflammatory properties. it is used to treat a variety of inflammatory conditions including asthma colitis skin rashes and allergic and inflammatory conditions of the nose and eye.

### Human:\nis my daughter's viral pharyngitis contagious? . asking this for my daughter. i don't want her to get anyone in our family sick. especially if my daughter has to go to school she is also in choir should i write a note to her teacher letting her know if she has to rest her voice? should i keep her home?\n\n### Assistant: most helpful answer viral pharyngitis is just a sore throat caused by a cold (respiratory) virus. biologically respiratory viruses are contagious a day before you know you are sick and then for about two days later (estimate). exposing others would not likely cause them to have identical symptoms but they could get a cold. since cold viruses are everywhere she can really go back to her usual activities (school church choir) when she is feeling better. colds last about a week but most people feel fine by day four. resting the voice when she has a sore throat is usually a good idea so use your own judgment.

### Human:\nare the sleeping pill fat burner combos like liponesta safe? do they work?\n\n### Assistant: this is a great question. so many consumers and patients are coming with these type of products to the counter and saying hey can you help me figure out if this is right for me. once again this is an over-the-counter product they are usually in the vitamin and herbal section. we have limited data on whether or not they work. we don't know what they are active ingredients sometimes are. so we want to make sure that patients are really careful about this. one of the things encountering in the diet area is the fact that people who have cardiac conditions or high blood pressure these may not be the right choices for them. once again the physician or healthcare provider needs to see this and evaluate you based on that first before we go and choose any over-the-counter supplement. people might think oh it's just something minor because i just feel like i gained a few pounds of water weight. but that can make a really big difference especially if you have high blood pressure or certain lung disorders like chronic obstructive pulmonary disease copd all these things kind of come into play. so i really want consumers and patients to understand that we know these products are out there but we want to make sure we make the right choices and education is the best way to go. so ask a question first. and find out if it's the right product for you. they could have an adverse reaction. the other thing is too is that sometimes they contain byproducts that people that may have allergic reactions to; a filler or a salt or a particular root that they found. like a lot of them come with more natural products like leaves or roots from trees and a lot of people are starting to break out from those because they have never been exposed to them before. so once again be really careful about the choices that we are making.

### Human:\nmy 9 month old baby is coughing really hard while sleeping\n\n### Assistant: your baby either has a cold (viral infection) or is teething. or both. babies often have a difficult time dealing with drainage either saliva or mucous when they are lying flat so a cough is important to clear their airway. coughing can certainly be a sign of something more serious (bronchiolitis rsv pneumonia etc. ) because your baby is immunocompromised due to age so it would be best to have a medical provider listen to those little lungs. there is very little you can do at this age to control a cough but you can make it easier for them to swallow excess mucous by using a cool mist humidifier in the room and sucking out nasal mucous using a special bulb syringe. a drop of saline in each nostril just prior to aspirating it will help loosen any thick mucous.

### Human:\nwhat causes penile cancer?\n\n### Assistant: the exact cause of penile cancer is not known but there are certain risk factors for the disease. a risk factor is anything that increases a person's chance of getting a disease. the risk factors for cancer of the penis may include the following: uncircumcision. men who are not circumcised at birth have a higher risk for getting cancer of the penis. human papilloma virus (hpv) infection. hpv includes more than 100 types of viruses that can cause warts (papillomas). certain types of hpv can infect the reproductive organs and the anal area. these types of hpv are passed from one person to another during sexual contact. smoking. smoking exposes the body to many cancer-causing chemicals that affect more than the lungs. smegma. oily secretions from the skin can accumulate under the foreskin of the penis. the result is a thick bad-smelling substance called smegma. if the penis is not cleaned thoroughly the presence of smegma can cause irritation and inflammation. phimosis. this is a condition in which the foreskin becomes constricted and difficult to retract. treatment for psoriasis. the skin disease psoriasis is sometimes treated with a combination of medication and exposure to ultraviolet light which may increase a person's risk for penile cancer. age. over half of the cases of penile cancer occur in men over age 68.

### Human:\nhow long can i take xolair?\n\n### Assistant: xolair is used to treat moderate to severe asthma. the treatment course is open ended and there is not a specific length of time for treatment. the current understanding is that xolair works while you are receiving it so you may need it long term. your doctor will continuously re-evaluate your asthma symptoms to make sure the treatment is optimized.

### Human:\nwhy is my son having chest pain and his lower left and right sides hurt? . my son has been coughing for a while over 2 weeks he then started wheezing. he was giving an inhaler to use and some chest xrays were done for pneumonia and that came back negative. they did notice some cloudiness on the right side of his chest. he has been complaining of chest pains. he is now saying that his lower left and right sides hurt right above his waist closer to his back. i am concerned. his pulse was a 57-60 last week i took him to the er and they gave him 2 breathing treatments.\n\n### Assistant: pain in this area especially in a person who has been coughing for a week could indicate a few different things but unfortunately the exact cause could not be determined based solely on symptoms. he would need to be examined and perhaps have another chest x-ray (findings can change). basilar pneumonia (pneumonia the lower parts of the lungs can cause chest pain). someone who is coughing can have muscle strain of the intercostal (between the rib) muscles. finally people who cough often swallow a great deal of air. when this air is trapped in the large intestines it can migrate upward under the ribs and cause pain due to pressure against the diaphragm. there can be other causes of course. you are right to be concerned so please see his medical provider again.

### Human:\ncan aburterol help my cough. my wife has been coughing for three days now and her throat is itching and it keeoing her up at night what can i give her to make her feel better.\n\n### Assistant: albuterol is a bronchodilator used typically for asthma and a reactive airway. if the cause of your wife's cough is due to asthma or an allergic disorder then yes it may help. albuterol is not a cough suppressant however. knowing the cause of the cough is always important when determining how to treat it. a cough due to a cold (very common) is from post-nasal drainage so the cough is beneficial since it helps clear the airway. a cough due to allergies can be very irritation so an antihistamine may help. suppressing a cough is considered controversial but often helpful if the cough interferes with sleep. a teaspoon or two of honey can help or if you are looking for an over-the-counter suppressant one containing dextromethorophan (dm) is often helpful. a cough can also be a sign of a lung infection so if any cough persists especially one that is accompanied by chest pain fever or productive of thick mucous should be carefully evaluated by a medical provider. have her drink lots of water and humidify the air she breathes (a cool mist humidifier). all of these things will help quiet a cough.

### Human:\ncan a person get tonsilitis if they nolonger have tonsils. my son had tonsilitis. tonsilitis is a viral infection and does not require an antibiotic. however tonsilitis can be caused by strep which is bacterial which requires an antibiotic. dr did't do a strep test but perscribed an antibiotic. a few days after he got better i developed an extremely sore throat runny nose caughing headache no fever. tonsilitis symptoms. can i get tonsilitis if i had my tonsils removed? if i have a strep infection will my immune system fight it off.\n\n### Assistant: i will never understand that rationale of giving antibiotics to anyone that has a viral infection. this is not good medicine. most cases of tonillitis are viral and antibiotics are absolutely worthless and sometimes even harmful. with that said. first i assume you are a healthy adult. most adults have relatively good immune systems that fight off viral (and bacterial) exposures 24/7. while the organisms may be capable of causing disease the organism has to find a susceptible host. most of the time we just fight off those alien bugs. if you don't have tonsils you can't get tonsillitis but you can get a viral infection but it does not mean it will be identical to your son who has a different immune system. you may just get a stuffy nose or nothing at all. in your case you did get an upper respiratory infection but it didn't have to come from your son. it could have been someone else and an entired different bug. there are over 200 respiratory viruses capable of causing colds. i get exposed to strep a dozen times a week and have never got it thanks to my own immune system (and perhaps better handwashing and other precautions). trust your immune system. in most cases you will be just fine. the cold that you most likely have now will likely improve in a few days on its own. there is a slight different view. my dad was a nurse and was told by a gp a a i am in the same situation as he was. both my dad (rip) and myself have had tonsils removed however you can get all of the tonsillitis symptoms without having tonsils. the only difference is where your tonsils were have the infection rather than the actual tonsils. it just means that it is easier for you to be able to take paracetamol ibuprofen and other pain relief along with fluids as you won't have tonsils there to restrict the ability to swallow as much. i had my tonsils removed when i was 4 and as an adult had tonsillitis many times as my doctor didn't remove my tonsils beds. i have been asked by doctors if i was sure it was my tonsils that were removed as symptoms so obvious. later on in life (i am now over 40) i have heard doctors say it isn't that uncommon.

### Human:\ndoes gargling with vodka kill germs in your throat? . at the onset of a sore throat i've been gargling with warm salt water these past 30+ years. but i just heard from a few friends that they gargle with vodka and that vodka kills the infections.\n\n### Assistant: in a laboratory petri dish i am sure that the alcohol in the vodka would kill some or all of the bacteria but the throat is not a petri dish. there are many parts of the throat that vodka would not even touch. these areas would rapidly re-contaminate the non-gargled areas so any partial benefit that you might achieve would be mitigated. most sore throats are viral infections that only last about a week. in adults most will improve on day three or four if you do nothing at all. i would much prefer that you gargle with saline (a weak salt water solution) than to take a chance at aspirating vodka into your lungs. this can happen and it would not be pleasant. when you take health advice from your friends it can either be good advice or bad. in this case the advise was not wise. i would not recommend that you gargle with vodka.

### Human:\ncan whooping cough be severe?\n\n### Assistant: complications of whooping cough usually result from the cough itself such as rib fractures ruptured blood vessels or inability to eat or sleep. hospitalization or severe disease is rare in people older than 1 year. but in infants whooping cough can be life threatening. pneumonia and other lung complications can develop and young infants with pertussis may require intensive care including respirators to assist their breathing.

### Human:\ncan benadryl have a side effect when combined with suboxone?\n\n### Assistant: both benadryl and suboxone can cause drowsiness. taking the two together can cause severe drowsiness. they also can both lead to constipation. taking two medications that have similar side effects usually intensifies the side effects. if you need an antihistamine while taking suboxone i suggest you talk to your pharmacist who can recommend on that does not cause drowsiness. suboxone is a controlled narcotic that is used in opioid dependency and addiction treatment and should not be combined with other substances because it can lead to dangerous side effects including respiratory distress loss of consciousness coma and death. you should tell your doctor about any other medications you are taking (including over-the-counter medications such as antihistamines) and any alcohol consumption as it may be possible to adjust the amount of suboxone to a safer level. the most common side effects associated with suboxone use vertigo and lethargy are intensified when the drug is combined with other medications and may also lead to an increase of the body’s tolerance and dependence to suboxone. this means that the body will require progressively increased amounts of suboxone. there has been a lot of controversy and debate concerning the use of suboxone with other substances. while most people understand that suboxone is used in opiate abuse and addiction treatment what they may not understand is that suboxone itself has the potential for dependency and has been the reason that many individuals on a suboxone regimen to have to undergo another detox. gallus detox center is a private inpatient medical detox facility specializing in iv therapy medical detox. if you have questions about our facility you may contact us at 855-338-6929.

### Human:\ncould a mold allergy cause dizziness and memory loss?\n\n### Assistant: allergic reactions to mold typically cause symptoms such as sneezing itchy/watery eyes runny nose nasal congestion or respiratory problems. this is because allergies trigger specific allergic cells to release chemicals that cause these symptoms. there is not a well understood mechanism by which mold allergy could contribute to neurocognitive symptoms. because of this i often recommend that patients pursue other investigation beside allergy so they don't miss another cause of these symptoms. if you are concerned that mold is causing symptoms you could always try techniques to decrease the mold level in your basement such as dehumidif[i]er.

### Human:\nwhat makes seasonal flu different from the common cold?\n\n### Assistant: the flu and the common cold are both respiratory illnesses but they are caused by different viruses. because these two types of illnesses have similar flu-like symptoms it can be difficult to tell the difference between them based on symptoms alone. in general the flu is worse than the common cold and symptoms such as fever body aches extreme tiredness and dry cough are more common and intense. colds are usually milder than the flu. people with colds are more likely to have a runny or stuffy nose. colds generally do not result in serious health problems such as pneumonia bacterial infections or hospitalizations.

### Human:\nwhy is my blood sugar so high with prednisone and should i be worried?\n\n### Assistant: steroids can cause elevations in blood sugar. i would record the blood sugar values you are obtaining and then contact your primary doctor or prescriber's office to see if they have any instructions. what is done about elevated blood sugars from steroids depends on your other conditions how high the blood sugar readings are and how long you will be treated with steroids. was seen in er for asthma with acute exacerbation. given steroid shot in ambulance. also given steroids pills to take for five days. called er doctor and told him blood sugar was 446 they said take another glimiperide 4mg. i did my sugar is now reading hi which means over 500. should i be concerned it just keeps going up. i have tgype 2 diabetes treated with pills. no insulin. should i call primary care doc on call?

### Human:\nwhat are some easy and delicious ways to prepare fava beans?\n\n### Assistant: fava beans grow in a large pod that needs to be peeled in order to find the beans that lie within. if you have small children this is an excellent task for them. once you get all the beans out of their pods there are a few more simple steps. the outer shell of the bean is kind of chalky and not good eating. you need to blanch the pods (put them quickly into boiling water then plunge them into ice water). from there you can pop them out of their shells and enjoy them with a bit of extra virgin olive oil and a sprinkle of salt and pepper and a shave of parmesan cheese. you can use them to top a piece of your favorite fish or a piece of grilled chicken. when fava beans are young you can actually eat the outside as well as the inside. for those heat up a cast iron skillet and add a bit of olive oil. when it’s almost smoking throw the fava beans in whole add a bit of lemon juice chili flakes and salt and pepper and in about 3-4 minutes they are ready to eat. if you can find fava beans at your local farmers market or grocery store give them a try!

### Human:\nmy 7-year-old has been coughing for six weeks and her 5 day z-pack didn't work. what will? . she has dark under-eye circles is losing weight and sometimes coughs until she vomits.\n\n### Assistant: a cough that has lasted that long needs to be assessed by a doctor. it could be many things including asthma allergies and even pneumonia or pertussis. children should rarely lose weight- this is concerning. your child needs to see a doctor right away so she can get on the right treatment plan. first one has to consider allergies. her cough may be a manifestation of an allergic response. those dark circles under her eyes could be "allergic shiners " often seen in allergies. another possibility would be back-to-back viral infections -- not uncommon with a social girl in school second although uncommon children can get sinusitis with constant post-nasal drainage. zithromax is not the best medication for sinusitis. third we are in the midst of a pertussis (whooping cough) epidemic (even if her cough is not the whooping sound). she may need to to be tested.

### Human:\nhow do i make a persistent dry cough go away for good? . it's been about two weeks now since i've had a cold/flu and i can't afford to go to a doctor right now. how can i treat this at home? or will i need to go see a doctor for this?\n\n### Assistant: most helpful answer you are coughing for a reason. coughing helps clear your airway of mucous so if you are still coughing then perhaps you are still having post-nasal drainage. coughing can irritate the respiratory track so the more that you cough the more that you may feel the need to cough. assuming that you are not having signs of a secondary infection like pneumonia (fever chills rapid respiration) or an asthma-reaction (wheezing shortness of breath etc. ) you can quiet an annoying cold-related cough several ways: hydrate: drink plenty of fluids humidify: use a cool mist humidifer or at least take a steamy shower before bedtime soothe: try some honey to coat your throat suppress: you can take an over-the-counter cough suppressant that contains dextramethorophan (dm). a pharmacist can help you select a good one. try some cough drops. many contain soothing glycerine to help the irritated throat. don't leave them in your mouth at bedtime however! control post-nasal drainage. an antihistamine may help dry up a drip. avoid decongestants at bedtime (they increase post-nasal drainage) any persistent cough should be taken seriously so you may need to see a medical professional if the cough does not quiet down and completely resolve.

### Human:\nis viral pneumonia contagious?\n\n### Assistant: the actual virus that causes a person’s pneumonia may be contagious but exposure to that virus may not show up as pneumonia in the next person. there is no one virus that only causes pneumonia. any of the hundreds of respiratory viruses can do it. as a matter of fact the exposed person may not get sick at all or the same virus may show up as pink eye (conjunctivitis) a viral rash sore throat an ear infection or just a plain old cold. viruses are full of nice surprises.

### Human:\ncan asthmatics develop an advair dependency? i'm an infrequent user but find the more i use it the more i need it.\n\n### Assistant: there are two types of asthma medication. one is a rescue (albuterol or xopenex) that is used as needed for symptoms. the other is a controller therapy that is used every day to prevent symptoms. advair is a controller therapy and should be used daily instead of as needed. typically use of the drug should not cause you to need it more.

### Human:\nwhat are asthma symptoms?\n\n### Assistant: it is important to recognize your asthma symptoms to help you and your physician best treat your asthma. for many asthma causes shortness of breath a sense of restricted breathing or intermittant difficulty with breathing. wheezing can also occur. sometimes it is difficult to separate wheezing from sounds coming from the throat and upper airway during breathing. some patients only experience cough from asthma. some triggers of these symptoms include exposure to allergens cold air exercise and upper respiratory illnesses.

### Human:\nhow does whooping cough spread?\n\n### Assistant: whooping cough spreads from person to person through close contact with oral secretions or respiratory droplets. so it's easily spread through the cough especially when people are in close contact like living in the same house with a person who has whooping cough. it can also be spread through sneezes - anything that spreads respiratory secretions.

### Human:\ncan you get the flu in summer. . . . i have all of the symptoms:. body aches. headache. dry cough -- tight lungs. fever (goes down with aleve). fatigue. cold sweats. my nose is not runny -- i do not feel like i have a cold. my daughter now has the same symptoms -- does the flu go around in the summer months?\n\n### Assistant: while most flu activity occurs from october to may in the united states flu viruses are detected year-round including at lower levels during the summer months. if you have flu-like symptoms and it is not flu season it is possible that you and your daughter have a flu-like illness. this means that you have a viral illness that causes symptoms similar to those of the flu but it may not be caused by influenza. flu-like illnesses can make you feel bad but they are less likely to cause severe symptoms and complications than influenza. if you suspect that you or your daughter may have the flu contact your health care provider. you may need to get tested so your doctor can determine if your symptoms are caused by influenza or something else. if it is influenza antiviral drugs can be used to treat your illness. antiviral drugs can make flu illness milder and shorten the time you and your daughter are sick. hi yes have you never heard of summer flu? if not you have now. i would just take a few days of work sweat it out of you and get better but do keep the fluids going in. and don't worry if you don't feel or want to eat. hope this helps you. good luck

### Human:\ni have had a chronic cough for several months. i’m taking an otc antihistamine but it's not working. what next?\n\n### Assistant: common causes of cough include nasal allergy with post-nasal drip acid reflux and asthma. do you have nasal congestion sneezing and drip? i agree that a trial of antihistamines is helpful. you can consider adding on a sinus rinse and talk to your doctor about a nasal steroid spray to help decrease the drainage. do you experience any heartburn symptoms? do you feel short of breath? i would let your doctor know if you have persistant cough as additional therapies or investigations may be warranted.

### Human:\nis there a generic drug for asmanex?\n\n### Assistant: no there is not a generic equivalent for this drug but there are many other similar drugs on the market for treating asthma. if cost is a factor (as it is for most people) your medical provider may be able to suggest an alternative that is less-expensive.

### Human:\nif i have to go to the hospital for my asthma how is it treated?\n\n### Assistant: your doctor can help you classify the severity of your asthma and come up with a plan on what to do if the asthma symptoms worsen. that way if your asthma symptoms increase you know what adjustments to make and what should warr[a]nt an er visit. if you do end up needing an urgent/er visit the treatment will depend on the severity of asthma and symptoms but typically includes breathing treatments to open up the airway steroids and treatment of any underlying condition (such as infection) that could have precipitated the event.

### Human:\nare there some people at higher risk of having complications from the flu if they don’t get vaccinated?\n\n### Assistant: yes. first and foremost everyone 6 months of age and older should get a yearly flu vaccine. however there are people that are more likely to get flu complications that result in being hospitalized and occasionally even result in death. these high risk people include children younger than 5 years old but especially those younger than 2 adults 65 years and older pregnant women and people with chronic health conditions like asthma diabetes and heart disease.

### Human:\ncan the flu cause complications?\n\n### Assistant: complications of flu can include bacterial pneumonia ear infections sinus infections dehydration and worsening of chronic medical conditions such as congestive heart failure asthma or diabetes.

### Human:\nmy husband has severe asthma attacks. he's getting worse despite maximum doses of meds. what can we do?\n\n### Assistant: finding an asthma doctor/pulmonologist to partner with if he does not already have one may be beneficial. what medications is he taking on a routine basis for asthma? for some patients with severe allergic asthma xolair may be helpful. his doctor will be able to determine whether this is an appropriate possibility for him.

### Human:\nshould i let my pets sleep with me?\n\n### Assistant: we all love our pets. we treat them like family members and in many ways we treat them better than people. but can they cause you misery where you least expect it? yes indeed. snoring pooches in our bed can wreak havoc on our sleep. and we’re not always as inclined to kick them out as we would a snoring spouse. i was reminded about the trials of sleeping with a snoring dog when i read an amusing blog called “fully vetted. ” the author and veterinarian patty khuly brought up a few interesting points: * if you suffer from insomnia aside from your snoring bed partner then your problems finding sleep are even more challenging — especially if you awaken in the middle of the night and can’t get back to sleep thanks to the nasally roar of your neighbor. * the same physical issues experienced by humans when they snore (airway obstruction) must also affect snoring dogs. dogs who snore are almost certainly experiencing some degree of respiratory compromise that affects their waking lives too. (so yes i guess dogs can be victims of sleep apnea just like humans. ) * but unlike humans dogs don’t sweat; they regulate their body temperature through panting — using their tongue and airway as a cooling mechanism. dogs who are unable to move air efficiently are not only more likely to suffer heat stress they’re also less likely to move enough air into their bodies to oxygenate their blood efficiently. which helps explain why snore-prone breeds can suffer from chronic fatigue. * dogs that endure a lifetime of poor breathing can end up getting hiatal hernias which can be life-threatening. so yes something as seemingly harmless as snoring can instigate other health troubles that create a domino effect down a dangerous path. but then again the same can be said for humans who snore due to something like obstructive sleep apnea which can trigger respiratory and circulatory distress farther down the line. all this brings to mind a recent headline about dogs who die while traveling on planes. it turns out that short-snouted dogs are most likely to die on planes–bulldogs pugs and similar breeds made up about half of deaths in past 5 years. short-nosed breeds — known as “brachycephalic” in the dog world — have a skull formation that affects their airways. they can’t cool themselves off so easily and are prone to heat distress and in severe cases death. luckily humans [all] have similarly shaped nasal passages. what distinguishes those who snore and may suffer health consequences from those who don’t is usually related to something other than the shape of one’s nose. body weight (especially neck circumference) is one such factor. the thicker your neck the higher your risk for snoring among other health challenges. but it’s interesting how the problems that plague our four-legged friends aren’t all that different. dogs and humans share more than meets the eye. in addition to sharing beds they can share a bad night’s sleep. which is why i always advocate that people and pets keep separate bunks. and watch out: letting your pet have a piece of your slumbering space might be a hard habit to break once they’ve gotten used to it. something else to keep in mind: your allergies. over time it’s quite easy to develop allergies to pets and not realize it. if you wake with a stuffy nose every day put fido or fluffy in their own space. while that may mean off the bed it could just mean a special space on the bed that they can call their own. this way you both can get a good night’s rest.

### Human:\ncan i smoke a cigar while recovering from walking pneumonia? . i went to the doctor on the 12th and he started me that day on iv drip antibiotics i went back the next day not feeling much better and he put me on another iv with the same antibiotic from the day before and a new one. i feel a lot better today and i started my zpack along with suprax 400mg. . i've been stuck in my house or a doctors office the past 3 days and really want to go have a cigar with my friends you don't inhale cigar smoke but im just not sure if this is a good idea or not\n\n### Assistant: most helpful answer i am sure that it is not a good idea. your lungs are having a difficult time as it is recovering from your pneumonia so why make things worse with cigar smoke? you may not feel that you are inhaling but enough smoke is getting into your respiratory tract to cause an inflammatory response increase mucous production and trigger a new round of coughing. i am sorry that you are stuck in your house and are bored but smoking a cigar when you have pneumonia is not wise. not wise at all.

### Human:\nin egg consuption how many a day is too many? . my dad is 72 and eats at least 21 eggs a week. he has heart disease (fh 44%) diabetes high cholesterol high bp lung problems among others. he's on lipitor plavix 2 bp pills morbic antivert buspar nexium albuterol inhaler. . his stomach is bad and most foods make it hurt but eggs don't. i know this is too many so what about egg whites?\n\n### Assistant: the most recent research suggests that one whole egg a day does not increase the risk of heart disease for healthy individuals. individuals who have problems controlling their total and ldl cholesterol may want to be more cautious about eating egg yolks. for people who have heart disease it is best to limit whole egg consumption to no more than three yolks per week. the yolk contains the cholesterol so eating egg whites more often should not increase the risk for heart disease. the most recent research suggests that one whole egg a day does not increase the risk of heart disease for healthy individuals. individuals who have problems controlling their total and ldl cholesterol may want to be more cautious about eating egg yolks. for people who have heart disease it is best to limit whole egg consumption to no more than three yolks per week. the yolk contains the cholesterol so eating egg white more often should not increase the risk for heart disease.

### Human:\ni am spittimg up yellow stuff. i start coughing and i cough up yellow stuff. my mouth then taste like i have eaten soething that was scorched.\n\n### Assistant: dark (yellow) phlegm could be a sign of an infection or at least stagnation of mucous in your nose sinuses or lungs. the fact that it is foul-tasting is another sign of a possible infection. the color of mucous is not as important is the entire package of symptoms that you may be experiencing so if this continues you may need to see a medical evaluation. in the meantime drink plenty of water (this will thin your mucous) humidify the air (humidifier or a hot steamy shower) and consider trying a decongestant during the day. if the underlying cause is a cold (viral) then you should be improving in a few days. if you are having sinus pain sore throat chest pain or fever then it would not be prudent to wait it out.

### Human:\nwhat should i do if i am physically unable to exercise due to a medical condition?\n\n### Assistant: there is virtually no medical condition that will keep you from doing any type of exercise. even people with congestive heart failure -- who were long told not to exercise at all -- can benefit from moderate amounts of activity. and people with limited mobility can often do water exercises or do yoga or other exercises while seated in a chair (some "chair exercise" videos are now on the market). of course if you have any medical condition check with your doctor before starting an exercise program. if you have questions about your condition or are still not sure what exercise you can safely do please consult your physician. meet with your doctor and discuss if it's safe for you to exercise. once you've received your doctor's ok search the internet to find alternatives. if your concerns about exercise are related to a chronic illness two good places to start would be with a support group or just looking up if their are any national associations that might have some information they could share. (examples: arthritis foundation the national multiple sclerosis society). also ask your physician and contact your local hospital to see if there are any medically monitored programs in your community. many of these are covered by insurance and provide enrollees with both exercise and education about their condition. numerous people routinely enroll in cardiac or pulmonary rehabilitation programs around the country and are astounded with the benefits they get out of these programs. finally since your on webmd check out our article base by doing a search on exercise as there are numerous articles on exercising with a chronic disease.

### Human:\nhow long does it take for all the swelling to be gone after cosmetic surgery?\n\n### Assistant: all of us are anxious to see results. whether it is cosmetic surgery or building a home we like to see the work done and sometimes become inappropriately impatient. i often have to remind patients that with any operation it takes nature 100 days to do the basic repair work and absorb most of the swelling. whether that is an artificial hip replacement a hernia repair a breast reduction or rhinoplasty or septoplasty rhinoplasty with turbinate resection (which not only improves appearance but also improves the airway and prevents sinus problems) — it takes time for ole mother nature to do its job. we can’t rush nature; we can’t push the clock. we have to understand that this is what it takes to finish the job. you know the old saying “rome wasn’t built in a day. ” great noses are built in day. but it takes weeks or months for all the swelling to go down. now this does not mean that the nose looks hideous or is unattractive. typically within seven to 10 days the nose looks very good. but it continues to get better. it ripens like wine. swelling goes down. refinement sets in. the nose becomes thinner and more delicate less bulbous. but all this takes place a tiny bit each day. patients while told ahead of time that it takes weeks and up to a couple months for the appearance to optimize often become impatient and ask “what’s wrong? why is my nose still swollen? ” or “what can be done to make the swelling go away? ” we have to be frank and say to them that we cannot push nature beyond its speed any more than human beings can run faster than the fastest runner can run or make corn grow six feet in one week. there are certain limitations that nature imposes on all things human. however if the cosmetic plastic surgeon reminds the patient that the outcome will be better than it appears at a week or a month or two months or three months then hopefully the patient — and family – will accept that. just this week one of our cosmetic nasal plastic surgery (rhinoplasty) patients came in. prior to surgery she was an otherwise attractive young lady but had a crooked nose that was bulbous had a bump. too big for her delicate face. further it was turned down such that every time she smiled her nose almost hit her lip. the crookedness implied internal blockage and indeed she had trouble breathing because of a deviated septum and enlarged turbinates. to make matters generally worse she had some facial asymmetries which were also mirrored in the nose. that was another reason why it looked crooked. not the simplest of cases right? nonetheless the prospects for success were very good when we took on the case in june of 2009. the case went very well. “mission accomplished. ” we straightened the nose corrected the asymmetry took off the bump narrowed the tip. we raised the tip from the lip and prevented the nose from plunging with every smile. but the nose was swollen in the first week or two — perhaps a bit more than the average — but that reflected how much work was done. but after the second week things got better and three weeks later she was looking quite decent and could now appreciate the improvement. unfortunately the patient and her parents were a bit anxious and somewhat unrealistic about what it would take nature to deliver the final result. i kept assuring them that everything was on course that things were getting better and not worse and that nature would finish the job by adding additional refinements as the swelling was reduced. at six months the nose looked terrific but i knew it would look better even after a longer period of time. now in this case understand that because the patient has thick skin and such extensive surgery the complete healing period was somewhat prolonged. when she came in this week it was 13 months after the surgery. she looked fantastic. extremely happy. now a beautiful woman. since the last visit the nose had improved significantly over a period of months as predicted. yes it took nearly a year which is not typical (usually it is three to six months for optimization) but that’s what it took for this particular young lady’s nose. we had no control over nature. but we had trust. the important thing is to remember that once the result was in this teenager has it for the rest of her life. yes it takes some patience and fortitude to ride out the reduction of swelling and the further improvement. but when you think while it took longer than usual one year compare that to the lifetime of pleasure that now follows. maybe that wait wasn’t quite so long.

### Human:\nwhat is vocal cord dysfunction?\n\n### Assistant: vocal cord dysfunction is a condition that causes abnormal movement of the vocal cords. this causes episodes of shortness of breath that come on quickly can be triggered by activities such as singing and often do not respond to asthma medications. vocal cord dysfunction can mimic asthma.

### Human:\nwhat does colder weather mean for my asthma?\n\n### Assistant: now that the weather is getting colder for most of us just a quick reminder (especially for those who go jogging in the morning) to carry your rescue inhaler with you especially if cold air is a trigger for your asthma. cold air and upper respiratory infections (common this type of year) are triggers for asthma. also don't forget to obtain your flu vaccine.

### Human:\nis it safe to fast while taking methylprednisolone? i also take advair and spiriva.\n\n### Assistant: this is a really good question and actually they can take methylprednisolone on an empty stomach or while they are fasting. it's okay. sometimes we recommend it to be taken with food because people complain of abdominal pain or an upset stomach with it. and it is okay to take with the other two medications if they are using to help with their breathing as it might work with copd chronic obstructive pulmonary disease. if you ever have any questions like this though whether or not you can take something with or without food or other opportunities where you may not be sure about it come and talk to the pharmacist. ask us we'll be more than happy to help you. we are the medication experts.

### Human:\nwhat is snot?\n\n### Assistant: snot is the lay term for nasal mucous. snot has a well-deserved nasty reputation as being disgusting especially when we have a cold. but snot actually serves some important purposes such as filtering germs pollen and dust from the air as well as humidifying air before it enters our lungs. usually white or clear green or darker yellow snot is not necessarily a sign of infection.

### Human:\nmy daughter sprayed bug spray near my bedroom. that night i woke up unable to breathe. why did that happen?\n\n### Assistant: strong odors from perfumes aerosols and particulates can all be irritants that trigger asthma attacks.

### Human:\nmy husband has chronic asthma. is there a way to treat it without steroids? . his father died a disease that was aided by the bone erosion due to his asthma steriod use. my husband is still young and i was wondering if there was anything out there to help him.\n\n### Assistant: yes of course. there are many ways to treat asthma without using steroids but remember that asthma is an inflammatory lung disorder and steroids really are a mainstay of treatment. high-dose (oral) steroid can cause problems but inhaled corticosteriods are considered safe and effective for long-term use. don't let the name "steroid" scare you or your husband. properly prescribed low-dose steroids are really like "hydrocortisone cream for your lungs". they relieve inflammation and it is the inflammation that is the real underlying issue with asthma. if you still do not want to use steroids then have a long talk with his treating medical provider. there are other treatment methods that can help. do not under-estimate asthma. uncontrolled asthma can result in some very serious manifestations. don't ever ignore it.

### Human:\ni am 52 with high blood pressure asthma & congested heart failure my meds makes me sleepy \ tired need to loose weight. i can't seem to stay focused\n\n### Assistant: first set up an appointment with your doctor and ask them if there are any changes in medication that could be made to decrease your symptoms. also look on the internet or call the hospitals in your area and see if any offer cardiac rehabilitation. with your medical history this would be the best place for you to exercise. in addition they could also help you with your weight loss efforts. i've pasted a link below that you can click on that describes cardiac rehabilitation. heart failure and cardiac rehabilitation

### Human:\nmy 18-month-old has a cough. what can i give her?\n\n### Assistant: medications sold over-the-counter for cough would not be recommended for an 18-month-old who has a cough. in fact in a child this young it would be important to talk to the child’s pediatrician about her symptoms. we would want to determine if the cough is related to the common cold or to something else such as asthma. assuming the cough is related to the common cold the best option would be to use a cool mist humidifier in her room. this will add moisture to the air and help soothe her airways.

### Human:\nhow can i know if my cold/flu has become bacterial? so i can take a ampicillin? . i am aware that ampicillin does nothing if my cold/flu is a virus but i have been sick for a week now and although my body isn't sore/weak anymore i still cough up alot of mucus and coughing hurts my chest a bit and i have a sore throat also runny nose with alot of mucus as well.\n\n### Assistant: it would not be wise to self-diagnose yourself as having a secondary bacterial infection from your recent viral illness and self-prescribed ampicillin. it would be advisable for you to be properly examined and diagnosed first by a medical professional. ampicillin is not used very much any more so it is unlikely that even if you did have a bacterial infection this would not be the antibiotic of choice. signs of secondary bacterial infection such as pneumonia as a result of a respiratory virus would be a high fever a worsening cough with expectoration of dark phlegm chest discomfort rapid respiration and lethargy. a mild sore throat or runny nose does not necessarily indicate a need for ampicillin. cold and flu are viral infections. colds tend to run their course in 7 - 10 days but it can take a little longer. flu generally is at its worst for the first 3 or 4 days but can take up to two weeks to ease up completely. please click into the linked information and read about it. if more than 10 days go by and you still see no relief or your symptoms are getting worse then you should call your doctor. he or she may want to see you in their office again or try another form of treatment. if you're considering taking antibiotics that were prescribed for something else please don't do that without consulting your doctor. we hope you feel better soon! the webmd answers staff one should have an indication of infection by the color of the mucus i. e. clear/white to yellow to green. green being a sign of probable sinus/bronchial infection.

### Human:\nwhat impact does snoring have on a child?\n\n### Assistant: a recent observation made in australia could have significant meaning in the united states: children who snore and have a bad night’s sleep could be lowering their iq. the domino effect goes something like this: * a child has trouble breathing at night which explains the snoring and sparks a bad night’s sleep. * the labored breathing ultimately leads to a lack of oxygen. * a bad night’s sleep translates to being constantly tired and unable to concentrate or learn new things easily. * this in turn exacerbates developmental delays poor memory and behavioral problems in terms of attention low frustration tolerance and poor impulse control. * over time prolonged poor sleep can affect a child’s iq and education. i get asked about snoring children on a regular basis. is it normal? is it considered the same as an adult who snores? between 10 and 20 percent of normal children snore on a regular or intermittent basis making the line between “normal” snoring and “abnormal” snoring seem a bit fuzzy. it’s when snoring hampers restful sleep that it should be addressed as in adults. but there are a few things unique to snoring children. in 2002 the american academy of pediatrics recommended that all children be screened for snoring and that a diagnosis be conducted to determine if a child is experiencing normal (primary) snoring or obstructive sleep apnea (osa) syndrome. about one to three percent of children not only snore but also suffer from breathing problems during their sleep. first speak with your pediatrician to get an accurate diagnosis. though obstructive sleep apnea among adults is commonly discussed it’s true that children can suffer from the same condition. and they won’t necessarily grow out of it. although most younger children with osa are not overweight which is typically associated with osa it’s key to determine if weight is a contributing factor. now that childhood obesity is growing at an alarming rate — with 1 out of 3 kids today considered overweight or obese — it’s no surprise to me that more kids are getting diagnosed with osa. other underlying medical conditions especially allergies or asthma could also be to blame in which case a nasal steroid spray could help improve nasal obstruction and osa symptoms in children that also have allergies. if gerd (gastroenterological reflux disorder) is a factor this condition could also be treated. there could be other reasons though that are unique to children. a child could have been born with a small jaw or a small airway that makes it hard to breathe fully. there’s also the possibility that the muscles and the nerves controlling those muscles are not well integrated during sleep and therefore do not open the airway enough. and then there’s the chance that a child has enlarged tonsils and adenoids that prevent normal breathing. this last possibility in fact is very common among youngsters. when the problems are significant enough parents can choose to have their child’s tonsils and adenoids removed. according to the national center for health statistics more than 263 000 children in the u. s. have tonsillectomies each year and sleep apnea is a major reason. getting to the bottom of a child’s constant snoring that affects his or her quality of life is critical during those early developmental years. but aside from addressing any medical conditions triggering the problem it’s also important to instill good sleep habits — or hygiene — in your children from as early an age as possible. if you teach your children how to prepare for sleep and to embrace it as an healthy component to life (and that they need their sleep to enjoy their days maximally) then they will naturally lower their risk for sleep disorders and grow into adults who experience restful rejuvenating nights on a routine basis-- maybe more so than their own parents! no one likes a cranky overtired child. or an adult in that same state for that matter! here’s another way to look at it: if your kids can increase their mood and happiness and possibly even their iq through more restful sleep wouldn’t you want to encourage that?

### Human:\nis it safe to allow a tennager who has cerebral palsy to play basketball? . i coach a basketball team for high school aged kids and one of my players has cerebral palsy. he played on the team last year but we were very concerned about his condition and his safety but his parents seemed to have no problem with him playing. my coaching staff and i were very concerned about how safe it would be to allow him to play again this year as last yer he could not stay on the court very long without looking very exhausted. is it safe to continue to let him play?\n\n### Assistant: cerebral palsy can be so variable that without knowing the details of his particular cp involvement it would not be possible for me to offer you a specific answer but generally a teenager with cp can play sports. i admire you for being concerned and cooperative. it was be best for his medical provider to sign a medical clearance -- someone who knows his case. many kids with cp perhaps because of the muscle involvement with this disorder may become more fatigued. if he has some underlying respiratory or cardiac problem then this will need to be evaluated by his medical provider before clearing him for sports participation. kids with cp should be supported and encourage to do many activities so if he can make the team i don't think you will need to worry about his safety any more than the other kids.

### Human:\nwhat symptoms indicate a child might have asthma?\n\n### Assistant: young children can cough and wheeze during respiratory illnesses. some of these children go on to develop asthma while others have resolution in their symptoms once the illness resolves. asthma in children can present as recurrent wheeze and/or frequently cough. allergies and sinusitis can exacerbate asthma.

### Human:\nwhat are the systems of the flu is ear ache one?\n\n### Assistant: influenza (also known as the flu) is a contagious respiratory illness caused by flu viruses. it can cause mild to severe illness and at times can lead to death. the flu is different from a cold. the flu usually comes on suddenly. people who have the flu often feel some or all of these symptoms: • fever* or feeling feverish/chills • cough • sore throat • runny or stuffy nose • muscle or body aches • headaches • fatigue (tiredness) • some people may have vomiting and diarrhea though this is more common in children than adults. * it's important to note that not everyone with flu will have a fever. most people who get influenza will recover in a few days to less than two weeks but some people will develop complications (such as an ear infection) as a result of the flu. pneumonia bronchitis sinus and ear infections are examples of complications from flu. symptoms of flu are body ache fever fatigue sore throat cough etc. ear ache can be one the symptoms of flu.

### Human:\nwhat are the things that i can do to recover more quickly from cosmetic surgery?\n\n### Assistant: well patients do have an influence on their own recovery. the first is please follow our instructions and if you’re having pain take a pain medicine because if you don’t and you’re trying to be stoic your blood pressure is going to go up as a result of pain and that can translate into more bruising for example. at worse it can cause such increased bleeding under the skin that the wound can just pop apart. so follow the instructions. secondly please don’t smoke. we hope you never smoke but for sure don’t smoke after surgery. it delays the healing and it compromises lung function. there’s not a single good thing you can say about smoking only bad. thirdly don’t lay around the house and do nothing. with cosmetic surgery you don’t need to be bed bound by more than one day or so. by the next day you can be up and about. now you may not want to go to an amusement park but you can certainly take a walk around your house. if the weather’s nice go out get some fresh air. why? because if you don’t if you just lay around the house you’re going to be subject to constipation a very practical issue. you’ve got to get moving because you’ve been taking some pain pills perhaps. most pain pills will produce some level of constipation. you counter that by getting up getting around and by the way drink lots of fluids drink fruit juices. again we tell everybody this. it’s in writing. this is what they should do. we tell them what they shouldn’t do. what they shouldn’t do is go back to the health club three days later and start pumping iron because the blood pressure is going to go up again. elevated blood pressure after surgery is one of our greatest enemies because of the bruising issue and the bleeding issue so it’s generally 10 days before you can go back to your health club and maybe even 2 weeks depending on how things are going but we’ll be monitoring and again because we’re going to see the patient often particularly after the bigger procedures we’re going to see them several times the first week we’re going to be asking these questions every day. how’s it going? are you out and about? are you getting a little fresh air? are you moving your body parts? how’s it going in the constipation or no constipation department? how are you eating? occasionally somebody they just stop eating for whatever reason not a good idea. why? you need protein. you need carbohydrates. your body has to repair itself. we’re big on vitamins as long as they are the right vitamins and we know about them and we’re big on just plain old good old nutrition. what role does sleep have in my recovery? some patients will not sleep well. they will not sleep well because they are either anxious or their sleep cycle has been upset even by the anesthetic or they are not sleeping well because maybe there’s a little bit of discomfort. so the first line of defense is pain medication but if patients don’t take the pain medication say i’m not sleeping well then my answer is going to be then we’re going to do two things we are going to remind you to take the pain medicine and if that doesn’t quite give you the level of comfort and relaxation here’s a sleeping pill. we don’t want people not to sleep. i’ll tell you why. first of all they get cranky. they just get cranky they are not having any fun and they’ll just feel better and everything goes better so yes sleep is very important and we have to monitor these things. again there’s almost a checklist we go through and it’s about eating and about exercise and about not smoking and again even sleep.

### Human:\nwhen running i get a pulled vein in my leg. stings to the touch. is this a clot. it turned blue green about 4 in long and bulging out and also has brusing\n\n### Assistant: usually when we talk about a "blood clot in the leg " we're referring to a deep vein thrombosis (dvt) this is a blood clot deep in the leg (usually but not always in the calf muscle) that can cause complications such as a pulmonary embolism or stroke. part of the reason why a dvt is scary is because we can't see it. only after it begins causing problems do we notice its presence: a red swollen lower leg. what you're describing sounds more like a varicose vein. these veins lie close to the surface of the skin and are easily visible. varicose veins have a ropey appearance and can be painful and cause swelling of the leg or foot. interestingly on rare occasion a varicose vein can actually be a sign of a dvt. for this reason and because the vein is causing you discomfort it would be a good idea to have this checked out by your primary care provider. best wishes to you!

### Human:\ni get bumpy skin on the back of my arms. i have tried microdermabrasion scrubs but they don't wok. what can i do?\n\n### Assistant: this is typically a problem called keratosis pilaris. this is a genetic problem that we see in people. it can just happen. sometimes you grow into it sometimes you grow out of it. but also i tend to see it in people who have either personal or family histories of asthma or allergies. it's not something that we can cure but we can help control it. using products like urea or lactic acid or exfoliants this can help smooth the skin and make it softer. so scratching and picking at it obviously will make it worse and will make it more red will make it likely to last longer. scrubs can help to some effect. retinoids have not been very effective for this but using products that are called keratolytics; something that will help the skin cells turn over more effectively can help it dramatically. for some people it's worse in the summer for some it's worse in the winter. you can sort of pick your season. if you are out in the summer and you have a short sleeve dress it's more important to try to treat it then and in the winter you can let it go if it doesn't bother you. but it's not a harmful condition it's more of a nuisance.

### Human:\nawoke early couldn't breath! lasted about a minute finally started to breath very frightened! two shorter instances. 78 year old woman good health otherwise two prior instancews were very short duration. this one very bad husband slapped on bacdk not sure if that did it?\n\n### Assistant: i'm so sorry to hear you went through that. not being able to catch your breath is a very frightening experience! did your husband slap you on the back before this episode occurred? if so it could possibly have caused it. when a person "gets the wind knocked out of them " it's actually the result of a momentary paralysis of the diaphragm or large muscle below the ribcage that enables us to inflate our lungs. a hearty slap on the back could possibly cause the diaphragm to seize up for a moment. however since you've had two other episodes of this it's unlikely the slap on the back did it. several conditions can cause a person to have momentary problems breathing from anxiety to heart issues. if this situation continues i'd suggest you visit your health care provider for an evaluation. if you encounter a situation where you suddenly can't breathe and it doesn't get better please don't hesitate to call 911. the paramedics are very skilled and can help you cope with the problem quickly. i wish you all the best!

### Human:\ncan a mask prevent swine flu?\n\n### Assistant: while a mask could theoretically help prevent swine flu it’s a bit much for most people and really not necessary. . . sure if someone is coughing or sneezing in your face a mask might help. also if you know that you're going to be around someone with swine flu such as a loved one a mask might be warranted. but otherwise that’s not the most effective strategy for preventing swine flu because you don't catch most respiratory viruses from people coughing in your face. here's what generally happens. someone with a virus sneezes or coughs in their hand. then they touch something like an elevator button or a doorknob. you come along a few minutes later and touch that same button or knob. then without thinking about it you touch your face -- your mouth nose or eyes -- and the virus takes hold of you. as mundane as it sounds the most effective way to prevent getting respiratory viruses like swine flu is washing your hands. but most of us don’t do it often enough and don’t do it the right way.

### Human:\ni am a 50 year smoker female 71 yrs old. is a ct lung scan offered by well known cancer ctr for $100 worthwhile? . i have tried quitting but anxiety disorder interfers.\n\n### Assistant: my short answer: no. mobile "health scans" are a recent fad. for a fee some organization will take a whole-body ct scan or some foolishness. it's not beneficial for most people and it exposes you to a hefty dose of radiation. in your case i think the question is: are you considering doing this for fear of lung cancer? if so consult your primary care physician. a simple chest x-ray is a good starting point for diagnosing lung cancer. and lung cancer isn't the only smoking-related cancer. bladder cancer colon cancer and mouth cancers all are high on the list of cancers smokers experience. i don't say that to scare you but merely to point out that shelling out $100 for a chest ct scan isn't necessarily a good option if you're concerned about smoking side effects. let's just be realistic for a moment. do you want to quit smoking? at age 71 after 50 years of smoking it's ok to say "no. " you just need to understand you may be trading some life expectancy for your enjoyment of smoking. if you're ok with that so be it. on the other hand it's never too late to quit. if you have no signs of any cancers in your body and you wish to possibly extend your life expectancy talk to your health care provider about all the new options to help you quit smoking. two prescription medications in particular have good track records for helping people quit permanently. there's no shame in using a stop-smoking aid. quitting cold turkey is the least successful method. i wish you all the best!

### Human:\nwhat is stuck in my ribs? . when i stand up from bending over and sometimes just from sitting i get a painful cramp in my right rib cage that feels like something is stuck or lodged between my ribs. i have to stretch and push down on my ribs to relive the pain. it is happening more often than usual and kinda scares me.\n\n### Assistant: ow! sorry you're going through this. the only way to tell for sure what's going on with your ribcage is to get a physical examination from a health care provider. start with your primary care provider. he or she can evaluate this problem and refer you for tests (x-ray for example) or a specialist if needed. it's not uncommon for the cartilage between ribs to become inflamed or even torn from some sort of trauma which could be as slight as over-exercising. however the pain you're describing could be caused by something else entirely. it could even be related to structures below your ribcage. that's why your best bet is to get a physical exam as soon as you can. good luck to you! you are probably just catching the muscle quickly compressing it and then releasing it. the muscle can become injured and stay sore for quit a while. try to avoid bending in that manner for a while and try some heat compresses. i had the same thing and was told that we have a floating rib. i went to therapy they gave me hot packs and sat at the end of a table and reached for a beach ball? i left physical therapy and did the same thing at home. recently i had the same thing and had a chest xray and cscan and i have a node on my lung but it still feels just like you described. my problem still exists. did you ever get this figured out? i have the same issue!

### Human:\nrecently developed some breathing issues and have a soreness of lungsany possibilities. have had sinus infection recently but got over that but about 2 weeks later started having trouble breathing. no cough no injuries\n\n### Assistant: i suggest you return to your health care provider for a re-check. you could be experiencing a new illness that's unrelated to the sinus infection. or perhaps it wasn't a sinus infection after all but a virus that has now gone down into your lungs. regardless if you're having trouble breathing it's worth getting checked out. hope this helps! breathing problems after upper respiratory infection are common especially bronchitis and asthma. but you need to visit a doctor to confirm the cause and diagnosis so that proper specific treatment is initiated. most probably you may be suffering from bronchitis.

### Human:\ni smoked cigs for 1 month averaging about 3 a day. just wondering if any irreversible was done. i did quit since then. i started smoking for a month after a period of depression a couple of months ago 2-3 cigs most days with a couple more on bad days. i would estimate i probably had 4 packs total over the period. i went cold turkey as i started to get my life together and hated the ill feeling from them. i exercise regularly and eat healthy and i am still young. i would just like to clear my head and hear that i did no damage permanent to my lungs. i know it takes a bit to recover hopefully to 100%.\n\n### Assistant: good for you for making the sensible decision not to rely on cigarettes for stress control! it's much better to learn good coping techniques than to self-medicate. the good news is you probably did not irreversibly harm your lungs by smoking lightly for a month. even heavier smokers can "undo" the damage to their lungs to a certain extent by quitting. if you're young and you maintain a smoke-free lifestyle you should do just fine. i hope this sets your mind at ease! hey gairl as your situations we suggest you to smoke? electronic cigarettes? instead. to buy a e cig starter kit and get e-linquid or e-cartridge so you can smoke for a long time and save a lot of money. signs and symptoms of tobacco related diseases often depend on the specific illnesses they cause. (there are many other symptoms of tobacco-related diseases and these listed here are simply examples. ) shortness of breath may be a sign of emphysema or heart disease. chest pain may signal angina pectoriscaused by insufficient blood flow to the heart or a heart attack. difficulty swallowing or persistent hoarseness may signal a cancer in the mouth or larynx. painless bloody urination may signal bladder cancer. the presence of any of the following common symptoms associated with tobacco use should prompt a visit to the doctor or hospital's emergency department: chest pain shortness of breath persistent cough coughing up blood frequent colds and upper respiratory infections persistent hoarseness difficulty or pain on swallowing change in exercise capacity sudden weakness on one side of the face or body; or difficulty speaking leg pain while walking that goes away when at rest unexplained weight loss persistent abdominal pain blood in the urine

### Human:\ncan drinking ammonia kill you? . my 78 year old grandmother in-law ingested ammonia and i wanted to know if this can be so fatal that it can end her life. she is seeking medical attention.\n\n### Assistant: oh my goodness! how awful. i'm glad to know your grandmother is getting medical treatment. luckily the ingestion of household ammonia usually is not fatal. drinking ammonia can cause internal burns of the esophagus. a person who ingests ammonia also can experience pneumonia if the solution gets directly or indirectly (such as through regurgitation or reflux) into the lungs. if someone accidentally drinks household ammonia it's important to take the following steps: call 9-1-1 or the appropriate number for emergency responders. do not induce vomiting. give the person 1 cup of water or milk to drink unless they are vomiting or are experiencing difficulty swallowing. try to get the actual package containing the product the person swallowed. try to determine the amount of ammonia the person ingested. try to determine the precise time the ammonia was swallowed. emergency responders or the poison control center will want this information to help determine the appropriate treatment. wishing your grandmother well! yes u can die iiiiiiiiiiiiii

### Human:\nwhat causes low oxygen level. although i have none of the symptoms of sleep apnea my doctor requested an overnight sleep study. . i could not go to sleep. did dose off few times. stopped test after 2 hours. . the next day i was contacted by pulmonary clinic and cardiac clinic to come in for pulmonary test and cardiac test. i requested that my doctor call me. she said the sleep study revealed very low oxygen level. . what causes low oxygen level? what is the corrective action?\n\n### Assistant: many things can cause low oxygen levels in the blood. to name a few: lung injury ( collapsed lung ); lung disease ( copd lung cancer ); pulmonary embolism ; heart disease ( congestive heart failure ); anemias -- and that's just a handful i can think of off the top of my head. this is why your doctor wants you to go in for further testing which i recommend you do as soon as possible. low blood oxygen levels are nothing to mess around with. obviously all of your organs (including your heart) require adequate amounts of oxygen to function properly. in answer to your question the corrective action for low oxygen levels will vary depending on the underlying problem. in the meantime you can help your body get as much oxygen as possible by sleeping with your head elevated on a couple of pillows and by pausing to take 3 or 4 slow deep breaths every hour when you're awake. (keyword: slow. ) with luck the source of your low oxygen levels will be diagnosed quickly and turn out to be something easily treatable. that's my wish for you. all the best! lack of oxygen in the artery blood. what causes low oxygen levels in a person who has osteoporosis