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Kids Juuling At School: What You Need To Know

Facts about Juuling Parents Need To Know

  • Juuling = Smoking
  • Small Enough To Hide In Your Hand
  • Kids Believe They Are Safe
  • One Juul Pod = 1 Pack Of Cigarettes
  • Can Lead To Lung Damage, Cancer, and Addiction

Do you know what "Juuling" is? Well, your kid does, and he or she has probably tried it, and you don't even know it. Of course, kids don't say they smoke these days, because it's not cool. The term "vaping" has bubbled up in the past couple of years, but kids have now moved on from that. The term now is "juuling," and the scary part is that smoking, vaping, and juuling - they all mean the same thing - the intake of nicotine.

Juuling is another name for e-cigarettes, and kids and adults are noticing them because they are the fastest growing e-cigarette in the US market. Why are they so popular? The first reason is that they are so small and easy to hide - from, say, school officials. They look like a computer flash drive, and, in fact, they can charge in a computer USB port. Secondly, they're popular because they're flavored with names like creme brûlée, cool cucumber, and mango. And, the most important reason they're popular is because of the perception that they're safe. Kids say, "I mean, I'm not even smoking or vaping. I'm juuling."

We're now starting to see research studies that are confirming our health fears. In March 2018, there was a study in the journal "Pediatrics" which showed that teenagers using e-cigarettes are exposing themselves to chemicals which may cause cancer. The Surgeon General of the United States has already outlined the other potential health dangers like Brain Risks and Addiction. 

What is a parent to do today? I advise three things. First, learn more about e-cigarettes, vaping, and juuling by checking out the facts at the Surgeon General website. Secondly, I'd have a dialogue with your child and start by asking them what they know about juuling. And, finally, emphasize to your child that juuling still means using nicotine, and the health and addiction dangers that go with it. 

Flu Shot = Heart Attack Prevention?

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If you need another reason to get your flu shot, how about this one: The Flu Shot may prevent a heart attack. Research from Public Health Ontario was announced this week, which makes this exact claim. In addition to the original research, I encourage you to check out the following article from CNN: "Bad Heart? Don't Forget Your Flu Shot." Also check out the following article from WKBN-TV: "Not just the flu anymore - study claims flu shots also prevent heart attacks."

We don't really know why this happens. We don't know the exact mechanism. But, it does make sense that infections like influenza cause inflammation, potentially increase the chance for blood clots, and increase the stress of the heart when one has an infection like influenza.

The study also claims that getting the flu shot may be as important as quitting smoking and taking your blood pressure medications. I think that's a little bit of a leap of faith, but I'll have to check out the data more carefully. 

As I said in the video (and in real life), it's never too late to get your flu shot. I think that the flu season may extend into March, and even April. So, whether you have heart disease or not, talk to your personal physician about getting a flu shot.

March Is Colon Cancer Awareness Month

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Colon Cancer Risk Factors

  • 3rd Most Common Cause of Cancer Death
  • Family History of Colon Cancer
  • Smoking & Alcohol Use
  • Diets High in Red Meats & Processed Meats
  • Physical Inactivity & Overweight

March is National Colon Cancer Awareness Month. If you want to learn some alarming statistics about colon cancer, I direct you to The American Cancer Society website. In 2018, there will be an estimated 97,220 new cases of colon cancer. Colorectal cancer is the third leading cause of cancer-related deaths in men and women in the United States. It's expected to cause about 50,630 deaths during 2018.

Unfortunately, many of my patients only focus on the family and genetic factors related to colon cancer, especially those who have no family history of colon cancer. The American Cancer Society website does a great job of outline those family and genetic history factors. However, there are other factors to keep in mind, including lifestyle factors like being overweight or obese, physical inactivity, certain types of diets (like those high in red meats and processed meats), a history of smoking, and heavy alcohol use. All of these factors may increase your chance of colon cancer.

Many patients tell me, "Doc, I'm never getting a colonoscopy." These days, there are many ways to screen for colon cancer, more than and in addition to colonoscopy. Cancer screening of all types and wellness issues are great topics to talk about with your personal physician. Talk about your risk factors with your physician, and talk about what type of cancer screening is best for you. Unfortunately, I'm seeing more and more instances of colon cancer that could have been prevented. Make that appointment with your physician. Don't become a statistic.

Flu Season 2018 Not Over Yet

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Flu Season 2018 Not Done Yet

  • 84 Pediatric Deaths Nationwide
  • More than 10,000 Ohio Hospitalizations
  • Watch for Rebound Flu
  • Flu shot 60% effective in kids; 36% Overall
  • Never Too Late For Flu Shot

Flu Season 2017-18 has been very unique. And, while there have been many articles starting to trickle out saying that the current Influenza season may be leveling off, I don't believe it. I can share anecdotally, that our office is still getting positive influenza tests in our office. And, I've heard that in other facilities as well, presuming that your facility has not run out of flu tests.

According to the Centers for Disease Control, there has been 84 pediatric deaths nationwide this flu season, as of their February 10th report. In addition, according to the Ohio Department of Health, there have been more than 10,000 Ohio hospitalizations secondary to influenza this flu season, including 233 hospitalizations in Mahoning County, as of their February 10th report. 

What is "Rebound Flu?" This is a term that I've seen in main stream press articles. What this means is that a person gets initially infected with influenza, and sometimes the person doesn't seek medical attention, and the person gets better on their own. The danger is that they get sick again, and they are worse. Many people ignore these symptoms, and this is where they get in trouble, especially those with chronic medical conditions like chronic heart problems, chronic lung problems, etc. Unfortunately, many of these people end up in the hospital, and sometimes worse.

Bottom Line: This year's influenza (flu) season will go on longer that in past years. Some, like me, believe that flu season will extend into March, and maybe even the beginning of April. So, if you're not feeling better, please, please, please see your doctor to be evaluated and/or re-evaluated. And, finally, it's still not too late to get your flu shot. Current numbers show that the flu shot is even better in children, approaching 60% effectiveness in kids, and 36% overall. 

#HCSM Chat Sunsets: Best Medical Twitter Chat Ever

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Tonight will be the last #HCSM chat ever. As I write this, it is literally minutes before the chat. What is #HCSM chat? In health care social media circles, it is regarded as the best medically related twitter chat ever. HCSM stands for "Health Care Communications and Social Media" and it was created in 2009 by Dana Lewis.

People forget that in 2009, the concept of a "chat" on twitter was in its early days. And, having a medically related twitter chat was even more foreign to the medical community. I admit that I did not totally understand how people could communicate on twitter - with just 140 characters (at the time).

Then, when I joined my first #HCSM chat, it must have been in early 2010 (during its 2nd year), and I was totally intimidated and overwhelmed by the speed of the conversation. And, I think I forgot to add the #HCSM hashtag to my tweets. Sheesh!

Dana Lewis and #HCSM chat have given me so much through the years. First of all, it was through #HCSM chat where I received one of my first invitations to be on a medicine social media discussion panel in 2010 in Seattle, Washington at the Swedish Health Care Symposium at Swedish Medical Center. One of my many memories from that meeting Dr. Wendy Sue Swanson and Dr. Jen Dyer for the first time. That meeting opened so many doors for me, and I owe a debt of gratitude to Dana Lewis for the opportunity to be a part of that event.

From a practical standpoint, #HCSM chat really helped me increase the number of my twitter followers. In addition, it really helped me develop the skill of being a "power tweeter" - meaning focusing on how to type/speak in small bites, and how to read, interpret, and evaluate lots of tweets at the same time during a quick #HCSM chat hour.

I could on and on and on about what #HCSM chat has meant to me, but I won't :) I just wanted to express my sincere appreciation to Dana Lewis for creating the chat and for maintaining the chat for all these years. I know the #HCSM community is not going away, but I wanted to express my appreciation to the #HCSM community for helping to teach me more about the patient perspective and the great variety of medical and community topics of which I was not familiar.

To help my nostalgia, I reflected back on the video and audio interviews below with my friend Dana Lewis from October 2010 which was in preparation of the Swedish event. If you have been affected and/or touched by the #HCSM chat in any way, I encourage you to express that out there in social media. There will never be anything like the groundbreaking and iconic #HCSM chat ever again. I feel honored to be a part of the #HCSM community.

How Does Weather Affect Your Health?

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What an amazing January day here in northeast Ohio! It was around 60F, and I actually thought about getting on my bicycle today. In less than 48 hours, the forecast low temperature will be below zero. How do extreme temperature changes affect the body? This was the subject a story I was interviewed for. Thanks to WKBN-TV and reporter Brittany Bissell for interviewing me for the story "Why extreme weather swings have you feeling under the weather."

Winter Health Tips: What You Need To Know

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Now that winter has officially begun, many of my patients are asking me strategies to maintain your physical and mental health. Here are six easy tips that not only can you use during the winter months, but all year around as well!

Winter Tip #1: Get Your Flu Shot

Earlier this month, the Ohio Department of Health raised the activity of influenza (the flu) to "Widespread," which is the highest level. This is one month earlier than last flu season. it's not too late to get your flu shot. Even though initial estimates state that this year's flu shot may not be that effective, "some" effectiveness is better than zero effectiveness if you skip the shot.

Winter Tip #2: Don't Spread Germs

These are things that we tell our children, but adults also need reminded to do things like wash your hands, use hand sanitizer, cover coughs properly (like in your elbow instead of coughing/sneezing into your hand), sometimes use the fist bump instead of the handshake, and know when to stay home when your sick.

Winter Tip #3: Clean Often-Touched Surfaces

In the workplace, regularly wipe down shared work spaces and equipment like copy machines, computers, and phones. At home, focus on surfaces like doorknobs, television remotes, and faucets - because bacteria can last here the longest.

Winter Tip #4: Say No To SAD

Seasonal affective disorder (SAD) is a type of depression that occurs only during the winter months and is helped with exposure to bright light. There are many consumer lights available on the market, and sometimes this helps better than medication treatment.

Winter Tip #5: Meditation Relaxation

"Winter blues" can also come from increased stress during the holidays and winter time. Trying to clear your thoughts and focusing on your breathing can really fire up your relaxation response. And, for those phone oriented, there are lots of apps out there to help discover your medication fascination

Winter Tip #6: Visit With Friends And Family

The cold and darkness of the winter months really can take a toll on our mental health. So, even though holiday time is the perfect time to spend time with friends and family, continue this as the new year begins. It could be the best thing for your mental health waiting for spring to get here.

Addendum: Thanks to WKBN-TV in Youngstown, Ohio for posting the accompanying story: "How To Stay Physically and Mentally Healthy This Winter." 

Smoke Exposure Dangers: What You Need To Know

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On the afternoon of November 28, 2017, a fire broke out in Salem, Ohio (where I live) at the former Salem China Company building. As of this evening, the fire was still going. (Check out this link from WKBN Youngstown for the latest information. Photo above courtesy of WKBN). Via social media, I've been receiving a lot of questions about all the smoke in the air around town. 

Photo courtesy of The Salem News

Photo courtesy of The Salem News

Here are Four Things To Keep In Mind About Smoke Exposure

  • What are symptoms of smoke exposure: Symptoms to look out for include Cough, Shortness of Breath, Hoarseness, Noisy Breathing, Eye Irritation, Abnormal Skin Color, Headache, Confusion
  • Beware if you have past or current lung problems: For those already with lung disease like asthma, COPD, emphysema, or others, you are at a higher risk of breathing problems when exposed to any kind of smoke - like those from fires. Take your prescription lung medication as scheduled and make sure you have your rescue medication if needed.
  • Check on young children and the elderly: Especially those young and old are prone to lung symptoms when exposed to smoke. If they start to report any symptoms above, don't ignore them.
  • See your doctor sooner rather than later: Even though you are halfway across town, your lungs could still be affected by the smoke in the air. Even though it may be the day after the fire as you read this, your lungs could still be affected by the smoke in the air around town. If you think you're having difficulty with breathing or anything else, I encourage you to check with your doctor, you'll be glad you did....

American Cancer Society: Great American Smokeout

I'm always looking for fun opportunities to encourage my patients to stop smoking - other than my nagging of them during office appointments. Every year, one week before Thanksgiving is that opportunity called "The Great American Smokeout" that is promoted by the American Cancer Society. 

There is great information on The American Cancer Society website like Health Risks of Smoking Tobacco, Health Risks of Secondhand Smoke, Keeping Your Kids Tobacco Free, and other resources. This blog post will take you to the next step in preparing you for your quit day, maybe The Great American Smokeout day. (also, tweet about it using #GASO hashtag)

Prepare For Your Quit Day: Here are some steps to help you get ready for your quit day

  • Pick the date and mark it on your calendar
  • Tell friends and family about your quit day
  • Get rid of all your cigarettes
  • Practice saying, "No thank you, I don't smoke"
  • Set up a support system to help you

On Your Quit Day: Some steps on your Quit Day checklist

  • Avoid situations and people associated with smoking
  • Stay Busy - Try walking or other activities and hobbies
  • Change your routine: Take a different route to work, etc
  • Drink lots of water, and no alcohol
  • Do Not Smoke - Not even one puff

In addition to reaching out to friends and family for support, I also encourage you to contact your Family Physician for further assistance, especially when it comes to options for possible nicotine substitutes. Thanks to WKBN-TV for posting the story, "The Great American Smokeout: National Intervention encourages smokers to quit." I also wanted to share with you similar TV interviews back from 2010 and 2011 below. Dr. Mike Sevilla works at the Family Practice Center of Salem in Salem, Ohio.