Ask the Doc

Heart disease is the No. 1 cause of death in the United States. Someone will have a heart attack every 34 seconds, according to the American Heart Association. Unfortunately, acute cardiac events can happen with any type of physical exertion. And plaques and clots in the heart may have little or no symptoms until a person has a heart attack. Physicians use stress tests as part of a diagnostic workup for the presence of coronary artery disease. A treadmill stress test is designed to add increasing levels of work load, or stress, to your heart in an effort to identify areas of the heart which are being starved of oxygenated blood. This will be determined by changes in a live EKG or if the patient develops symptoms. Doctors are able to obtain the likelihood that CAD exists based on the symptoms and your age. The is called your pre-test probability of having heart disease. If there is a very high likelihood heart disease exists in a patient, the risk of heart attack during a treadmill stress test is greater. According to the National Institute of Health, the risk of heart attack or death during a stress test is 1:5000. There is a much greater chance of getting hurt during the test, so hold on and don’t fall! Parting note: Know your risk factors for heart disease. Arm yourself with information and knowledge about the biggest killer in America. Go to the American Heart Association and follow the links for Heart Attacks. The best medicine is preventative medicine.

How do you deal with sunburn? I forgot to wear sunscreen and now I’m blistering. Help!

As you stated, a good application of sunscreen is a great way not to deal with sunburn. But seems we missed the first step. Oh well, let’s get on with treatment. Sunburns are caused from radiation and can be categorized in the same manner as chemical and thermal burns. First degree burns involve the first layer of skin. They are usually red and painful. Usually a slap to the back after a day in the sun will diagnose this type of sunburn.

You have a second degree burn. This burn affects both the lop layer of skin, epidermis, and portions of the second layer, or dermis. Damage to this layer results in blister formation and potentially scarring of the skin and can be very painful! Burns should always be kept clean. You can take tylenol or a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen or naproxen. Cold compresses to the area with a damp cloth or aloe vera gel can help with the pain. There are many home remedies that people swear by, ask someone and they will tell you “cold oatmeal or tea are the best cures for sunburn”. In my opinion, oatmeal and tea are great for breakfast, and anything cool will feel better than bare exposed skin. Sunburns hurt because the pain receptors and nerve endings were damaged by UV radiation from the sun. The pain will decrease but, unfortunately, there is damage done to cell DNA when you get a sunburn or even a tan that is irreversible. This will result in leathery skin, moles and sunspots, and potentially cancer. Do not pop your blisters as it can lead to skin infections. You can cover blisters with gauze but be careful not to put adhesive on your burnt area. Again, the best medicine is preventive medicine!

At what age should a child start walking? Talking? Speaking in full sentences? I hope my daughter isn’t behind.

The American Academy of Pediatrics as well as many other organizations do have generally accepted Developmental Milestones that children should meet by certain ages. This is a tool that healthcare professionals use to identify risks for pediatric patients having developmental delays in areas of social, physical and thinking. Each child’s development is unique. Your child will not wake up on his or her 1st birthday, check the iPhone calendar and say, “Oh man, I slept in... today is the day I start walking.” Or they might do just that…Typically children start walking around 1 year of age. There may be some that start earlier or some later. Language develops in stages as your child develops formation of sounds, then repetition of words spoken to them. It is important to actively speak with your child using words and objects as they are rapidly gathering language skills during childhood. At 2 years of age, children should have a vocabulary of about 50 words and can form short sentences like “Want juice” or even “I want a cookie.” It is natural to compare your child’s language skills to other children. Try not to, as there is a great degree of variance with this skill.

If you have concern about your child’s development you should definitely address them with their healthcare provider. I highly recommend reviewing a good source of information on childhood development prior to your appointment. Healthy children.org is a wonderful website provided by the AAP that is full of information and resources about healthy children and development. If developmental delays are identified after your doctor takes a thorough history and physical exam, referral to specialists may be performed. Language delays can sometimes be explained by hearing difficulties. A speech language pathologist may identify obstruction to communication development and work with the child. Autism spectrum disorders are often accompanied by social development delay. Early referral for identified delays have great impact on your child’s future development so be sure to have them addressed if you have concerns.

I was told there’s a new erectile dysfunction drug that works quickly – it’s something you put under your tongue. Have you heard of it? How does it differ from the others?

There is a drug on the market called vardenafil, or Staxyn, which is available for treatment of erectile dysfunction. This drug works by the same mechanism as the trusty blue diamond, Viagra, which according to popular marketing ads not only helps with erectile dysfunction (ED) but also starting campfires and using horses to pull your truck out of the mud. Staxyn, like Viagra, Cialis, and Levitra, helps to obtain and maintain erection by increasing blood flow to the penis. This drug has a different delivery system than the traditional ED drugs. It can be taken daily and it is placed under the tongue for distribution into the blood stream. There have been recently published studies on the use of erectile dysfunction drugs used sublingually, absorbed under the tongue. Results show that lower doses of the medication are needed and there is a more rapid time of onset for erection. This delivery method is new and like many new medications it may come with a higher cost at the pharmacy. It is a prescription medication. Talk to your doctor if this drug is appropriate for you.