I think we’ve all been talked to to death about protecting our skin from getting burned and overexposed to the sun. If you’re at least 35 or older, you may even remember the days of baby oil mixed with iodine as the way to get a great tan. And the more tan you are, the more beautiful you are, right?
Except when you over do it and look like leather.
I confess I still like the look of sun-kissed skin; however, I now attempt to get it out of a self-tanning lotion.
We had a scare in our family recently that makes me even more leery of getting too much sun. Last year my younger sister found a spot on her upper arm that wouldn’t go away. She thought it was just some type of pimple. It wasn’t a scary looking black color, it was flesh-colored. It wasn’t larger than a pencil eraser or asymmetrical. The only thing that bothered her was that it wasn’t clearing up. She went to her primary care doctor for something else, and “by the way, what do you think about this thing on my arm?” Luckily, her doctor did not blow her off, but removed it and sent it for biopsy. About a week later, he called her to say it was melanoma.
That news was unexpected, and threw us all for a loop. If you start reading about melanoma, you realize that the odds aren’t good for survival. She had to go to a specialist who removed more skin in that area, looking at the cells under a microscope as he went, until he got to clear cells. That was a good sign, that he was able to get to normal cells instead of continually finding more cancer cells. Thankfully, my sister is cancer-free; she will be monitored on a regular basis for any recurrence for the next few years.
I’m sharing this story with you because I read an article today that says melanoma is on the rise in our teenagers. While our kids are still in our homes, we need to harp on them to use sunscreen, no matter how annoying we are. We also need to be good parents and slather our little kids (6 months and older) with sunscreen anytime they’re out in the sun. At the pool, the sunscreen has to be on at least 15 minutes before getting in the water for it to work, and reapplied often. Teach them at an early age that wearing sunscreen is important. But for those of us who grew up in the age of baby oil and iodine, it’s too late to reverse the sun damage that’s already happened. So, we have to keep an eye on our skin with regular checks of our largest organ, our epidermis.
What makes you more prone to developing skin cancer?
- If you had blistering sunburns as a teenager
- If you had outdoor summer jobs for 3 or more years as a teenager
- If you have pale skin that doesn’t tan easily (burns instead)
- If you have red or blonde hair
- If you have blue eyes
- If you have many moles or freckles
- If you have HIV or any condition that makes your immune system not work well
- If you are taking immunosuppressants
- If you have a family history of melanoma.
- If you are older than 65 years of age.
People who are non-medical may feel they can’t tell if something is normal or abnormal. In school, I was taught this way to remember how to tell if a skin lesion could be a concern:
The A-B-C-D-Es of Skin Cancer
Anytime you find a spot that concerns you, please go see your healthcare provider to get it checked out.
It’s a good idea to have your skin checked out once a year, especially if you fall into any of the at-risk categories. In the meantime, use your sunscreen with SPF of 30 or higher, limit your time out in the sun, especially between 10am to 4 pm, and dress in protective clothing such as a hat and sunglasses when you are outside. Take care of yourself. ¡Salud!
Have you been told that your blood pressure is a little high? Maybe you’ve been given a blood pressure medicine by your healthcare provider, but you’ve resisted taking it. The most common thing I hear is, “I don’t want to have to take a medicine every day.” So what lifestyle changes could you try to keep from taking a medicine for your blood pressure?
Besides getting at least an hour and a half of exercise in per week and losing weight, cutting back on your salt intake could make a difference. Salt may make our food taste better, but too much can have bad effects on our health. It can raise blood pressure, make the kidneys work harder, cause swelling in the tissues, and make us at higher risk for heart disease. Educating yourself on the foods that have more salt than others may help you lower your intake of salt by making better choices.
Foods that are typically higher is sodium are
- Fast foods,
- Canned foods,
- Frozen meals,
- Snack foods like chips, pretzels, crackers and nuts,
- Marinades and flavorings, especially Teriyaki sauce and Soy Sauce, and
- Packaged deli meat.
Read the nutrition label for how much sodium per serving a product contains and how many servings are in the container or package to see how much sodium you’re taking in when eating the above types of food. It might be an eye-opener!
The American Heart Association recommends no more than 2300 mg a day of sodium for most people. For those age 51 years and older, and those of any age, including children, who are
- African American (more salt sensitive than other races) or
- have high blood pressure,
- diabetes, or
- chronic kidney disease,
should limit their intake to 1,500 mg of sodium per day.
Sometimes, even with lifestyle changes, you may still need a blood pressure medicine; family history can play a strong role in whether you’ll develop it. I’m usually willing to allow my patients at least 3 months of lifestyle changes before putting them on a medicine. So–get out there and exercise, drop a few pounds, and cut back on your salt! ¡Salud!
“I just feel so tired all the time.” I hear this usually once, if not two or three times a day from different patients. Depending on who I’m looking at, here are a few of the conditions I consider:
- Hypothyroidism–A blood test is used to determine if the thyroid is functioning the way it should. Besides fatigue, it can also cause constipation, cold intolerance, and dry skin.
- Iron Deficiency Anemia will cause fatigue in men and women. Women who have heavy periods are at risk for this. For men, a blood count, or hematocrit, of less than 40 is generally considered low, and should be seen by a Gastroenterologist (GI) for evaluation of possible bleeding in the gut. Women who have stopped menstruating , but are anemic, should also be considered for referral to a GI doctor.
- B12 Deficiency Anemia— Most B12 deficiencies are caused by not eating enough foods with B12 in them, such as meat, fish, poultry, shellfish, eggs and dairy products. A blood test is used to find out the B12 level in the blood; lower than 300 ng/ml means a deficiency. The quickest way to replace B12 is through an injection once a week for four weeks, then once monthly after that. Any person who has any kind of gastrointestinal disease, such as Crohn’s or Celiac Disease, or who has had any part of their gut removed such as with gastric bypass or colon resection, will need to replace their B12. Alcoholics also need B12 replacement.
- Diabetes— High blood sugars cause fatigue. Any person who is obese, has high blood pressure, high cholesterol or a family history of diabetes should be screened for this.
- Depression— There are two questions used to screen for depression:
- “In the past two weeks, have you felt down or sad on more days than not?”
- “In the past two weeks, have you lost interest or pleasure in doing things you used to enjoy?”
If the answer is “yes” to either of these two questions, than a more thorough evaluation for depression is done. If depression is diagnosed, treatment options would be counseling, medication, or a combination of these. A healthy lifestyle is also encouraged as mood can be affected by diet and exercise.
If you think that you are more tired than you should be, or than you used to be, please see your healthcare provider to see if you need to be screened for these common conditions. ¡Salud!
Keep in mind, this is not meant to be a comprehensive list, and each patient’s assessment is based on his/her health history and physical exam.