Avoiding Snow Sport Injuries

Well, we've got a pretty good start to the skiing and boarding season! (To say nothing of some pretty sorely needed precipitation.)

This article relates some pretty interesting findings in sports-related medicine and may help to prevent avoidable injuries.

Surprise (sorta) findings:

• Average age of injured skier: 40. Mostly men, and mostly at low speeds.
• Contrary to popular stereotype, snowboarders were not found to be slamming into skiers; skiers were found to be sliding downhill into snowboarders during failed attempts to stop.
• Wearing a helmet helps to reduce head and brain injuries in low-speed accidents.
• Buying boots big enough for your child to "grow into them" increased injuries in children. This is because the binding release mechanism doesn't release as well when there's a lot of leeway for foot movement within the boot.
  

Not a surprise finding:

• Drug use while on the slopes increased injury.
  
• Wearing a helmet while hitting a tree at 30 mph did not save heads. The idea is wear a helmet, but don't hit a tree.
• Improved bindings reduced shinbone fractures.
  

Do I need to drink 6-8 glasses of water a day for my health?

Short answer; no.

It's actually not known how the idea started that drinking 6-8 glasses of water every day is absolutely essential for good health, but it certainly has gained a lot of traction over the years.

Generally, when your body is becoming depleted in fluid volume an involuntary thirst reflex engages which makes you feel thirsty. This results in you getting something to drink so you no longer feel thirsty. In other words, natural mechanisms keep you from becoming unknowingly dehydrated so that it isn't necessary to drink fluids constantly to prevent dehydration.

Mind you, this assumes general circumstances. Certainly, if you are trying to lose weight it helps to feel full on no-calorie water instead of food.

Also, very elderly people can lose some of the thirst reflex and not realize that they are mildly low on fluids.

Also, this does not apply in special circumstances where you may be losing more fluids than usual or where access to fluid is restricted, such as strenuous work outdoors or diarrheal illness (or desert combat operations for those of you in the military). Here, you want to be mindful to replenish fluids often enough to urinate every 2 hours and for your urine to look clear or light yellow. Also, be sure to use sport drinks or eat food to replace lost sodium.

If you are concerned about dehydration, the first sign of this is a decrease in urine production and/or dark colored urine. Improvement in this is a good sign of adequate rehydration.

Snow Days

We have been closed for the past two days due to the unusual snowstorm to low elevations and loss of electrical power(which includes lights and phones).

At this time, we have power, lights, heating and roads back and should be back in the office as usual tomorrow (Weds. 12/9/09) morning!

We hope you all have been safe and well.

GERD, medicines, and Rebound Effect

GERD, or gastro-esophageal reflux disease, is a common condition in which acid stomach contents go "upstream" (reflux) from the stomach into the esophagus. The symptoms of upset stomach and burning up through you chest were probably why it used to be called "heartburn".

Medicines such as Zantac, Tagamet, Pepcid and Axid help by causing your stomach to produce less acid. Newer ones such as Prilosec, Nexium, Prevacid, Aciphex and Protonix do so even more powerfully.

Doctors are realizing within the last 6-12 months that these medicines can cause what we call tachyphylaxis, or rebound effect.

In other words if you have taken these medicines for over 3-4 weeks, your condition may be adequately treated. However, when you stop taking the pills your stomach starts to re-produce normal acids. In fact, for the first week or two it may temporarily over-produce them before coming back down to normal.

When "heartburn" symptoms returned after you stopped the pills, we used to think this meant you just had to stay on the pills for life. Now, we are concerned that for many patients this might simply be a side-effect of long-time use of the drug.

If you have been on such a medication for over 3-4 weeks and the "heartburn" comes right back within 1-3 days of stopping the medication, use Tums or Rolaids freely for a week or two if needed. These are acid buffering agents, and do not cause the same sort of rebound effect. However, they can keep your "heartburn" symptoms under control for the week or two it may take for this to subside.

Remember also that tobacco products, alcoholic beverages and anti-inflammatory pain relievers can cause or contribute to GERD. Tylenol is not such a medication, and is safe to take.

Note that this does NOT apply to patients with other conditions where life-long treatment with powerful acid reducers is entirely appropriate such as hiatal hernia, Barrett's esophagitis or GERD that does not tolerate cessation of the medications.

Also, you should seek urgent medical attention for symptoms that could represent bleeding or cancer such as obstruction to swallowing, feeling full all the time, loss of weight or appetite, rectal bleeding or black sticky bowel movements.

H1N1 Update

We have received an ample supply of H1N1 shots, and have started contacting patients who are at high risk and in most need of receiving the shot. (I posted earlier on who those groups of patients might be, and why.)

We probably have more than enough, and can provide some for folks who would simply like one.

Please call so we can arrange a time when you can come in to get one, if you'd like.

Also, the Public Health Department will be holding a completely open shot clinic to give free H1N1 shots to anyone who would like one on Monday 12/14 at the Fairgrounds, from 1PM- 4PM at the Organ Room.

H1N1 flu shot clinic

The county Public Health Department will be announcing a free flu shot clinic for anyone who needs or wants an H1N1 shot.

This clinic is to be on Monday 12/14/09 at the Fairgrounds. The time and more particulars are to be announced by Public Health. Their phone number is 621-6100.

How much is OK to drink?

Well, that depends.

Unlike with tobacco products where there really is no safe amount at all, for many folks there is a safe level of alcohol intake.

Potentially harmful drinking is defined as over 7 drinks/week or over 3 drinks/occasion for women, and as over 14 drinks/week or over 4 drinks/occasion for men. The reason for the gender difference is the generally greater muscle mass in men than in women.

A drink is defined as a 12-ounce beer, a 6-ounce glass of wine or 1 1/2 ounces of liquor.

When we say that exceeding these limits can be harmful, we mean that we start to see a real increase in both medical and social problems at these levels.

Social problems can involve DUI's, loss of drivers' license, job loss, absenteeism or divorce.

Medical problems that can occur as a direct result of drinking include depression, heart failure, liver failure, cirrhosis, bleeding ulcers, anemias, malnutrition, nerve damage and sexual dysfunction.

On the up side, safe levels of alcohol consumption are seen to lower risks of having a heart attack. This is, for some reason, particularly true of red wine.

Mind you, if you do not ordinarily drink there is no medical reason to start. Also, if you have problems with alcohol, it may be better to abstain entirely.