All Posts tagged healthcare

Doc Talk: Got sunscreen?

By Kristen Coburn, C-FNP

Kristen Coburn head shot

Kristen Coburn, C-FNP

It’s shaping up to be another hot week here in the valley. Forecasters are predicting temperatures in the 80s and 90s and plenty of sunshine … what more could we ask for on a holiday weekend?

If you plan on spending time outdoors enjoying the sun, catching some of the Independence Day activities, or even doing yard work, make sure you drink plenty of water and take care of your skin.

Sunscreen is one of the best protections against damaging ultraviolet (UV) radiation. There are two types of ultraviolet radiation: UVA and UVB. Ultraviolet radiation is part of the electromagnetic (light) spectrum that reaches the earth from the sun. It has wavelengths shorter than visible light, making it invisible to the naked eye. Ultraviolet A (UVA) is the longer wave UV that causes skin damage, skin aging and may cause skin cancer. Ultraviolet B (UVB) is the shorter wave UV ray that causes sunburn, skin damage and may cause skin cancer.

Skin Cancer Facts

 

Sun Protection Factor (SPF) is a measure of a sunscreen’s ability to prevent UVB and UVA from damaging the skin. Here’s how it works: If it takes 20 minutes for your unprotected skin to start turning red, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer or about 5 hours. Most sunscreens with an SPF of 15 or higher do an excellent job of protecting against UVB (with many brands also touting UVA protection) however, it may be overly optimistic to rely on 5 hours of continuous protection after one application.

Another way to look at it is in terms of percentages: SPF 15 filters out approximately 93 percent of all incoming UVA/UVB rays. SPF 30 keeps out 97 percent and SPF 50 screens out 98 percent. These numbers may seem like negligible differences, but if you are light-sensitive or have a history of skin cancer, those extra percentages will make a difference. And as you can see, no sunscreen can block all UV rays.

Be aware that there are problems with the SPF model: First, no sunscreen, regardless of strength, should be expected to stay effective longer than two hours without reapplication. Second, “reddening” of the skin is a reaction to UVB rays alone and tells you little about what UVA damage you may be getting. UVA radiation is more detectable over time, showing up as pre-aging of the skin via wrinkles, discolorations, and coarse texture. Plenty of damage can be done without the red flag of sunburn being raised.

Who should use sunscreen?

Anyone over the age of six months should use a sunscreen daily. Even those who work inside are exposed to ultraviolet radiation for brief periods throughout the day, especially if they work near windows, which generally filter out UVB but not UVA rays.

Children under the age of six months should not be exposed to the sun, since their skin is highly sensitive to the chemical ingredients in sunscreen as well as to the sun’s rays. Shade and protective clothing are the best ways to protect infants from the sun.

What type of sunscreen should I use?

Which sunscreen you choose depends on how much sun exposure you’re anticipating. In all cases we recommend a broad-spectrum sunscreen offering protection against both UVA and UVB rays. Many after-shave lotions and moisturizers have a sunscreen (usually SPF 15 or greater) already in them, and this is sufficient for everyday activities with a few minutes here and there in the sun. However, if you work outside or spend a lot of time outdoors, you need stronger, water-resistant, beachwear-type sunscreen that holds together on your skin. The “water resistant” and “very water resistant” types are also good for hot days or while playing sports, because they’re less likely to drip into your eyes when you sweat. However, these sunscreens may not be as good for everyday wear. They are stickier, don’t go as well with makeup, and need to be reapplied every two hours.

When shopping for sunscreen, consumers should look for The Skin Cancer Foundation’s Seal of Recommendation, which is awarded to sun protective products that meet stringent criteria for safety and effectiveness.

Despite recent claims about sunscreen safety, consumers should rest assured that sunscreen products and specifically the ingredients oxybenzone and retinyl palmitate, are safe and effective when used as directed. Of course, some people may be allergic or sensitive to the ingredients. In those instances, a healthcare professional can help recommend alternatives.

Sunscreens should be considered a vital part of a comprehensive sun protection regimen that includes seeking shade, covering up with clothing including a wide brimmed hat, UV-blocking sunglasses, avoiding tanning and UV tanning booths.

Kristen Coburn, FNP is a family practice physician who sees patients at Driggs and Victor Health Clinics. She also provides aesthetic treatments including free consultations, Botox and physician-recommended skincare products at Teton Valley Hospital’s Aesthetics Clinic

This article orignally appeared in the Teton Valley News.

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Doc Talk: The downside of toughing it out

By Dr. Mo Brown
Orthopedic surgeon

Mo Brown head shot

Dr. Maurice (Mo) Brown

I love taking care of the tough people who live in beautiful Teton Valley. If you live here, you are “tough”. This is not a sit-and-play-checkers-as-the-sun-goes-down kind of place. Our valley is full of tough people. They ski on torn ACLs, they board with broken tailbones, they sled with ripped rotator cuffs, they drive tractors with broken wrists and they go on with their work and recreation for years with these injuries. Really, I have to marvel at the pain these people must endure and the inventions they create to keep on moving.

If you think I’m writing about you, then please read on.

I admire your high pain threshold and your unwillingness to give up any time for rehabilitation because you’re having too much fun or have too much work to do. Just know this: It’s better for you and your orthopedic surgeon to have something to work with when you decide to get “it” fixed, whatever “it” may be.

Just know this: It’s better for you and your orthopedic surgeon to have something to work with when you decide to get “it” fixed, whatever “it” may be.

Orthopedists see X-rays and MRIs that tell the whole story in a few simple images and sometimes, it isn’t pretty.

A good example of long-term damage being the end product of ignoring an injury is a meniscus tear in a knee joint. It’s very common for me to see patients with a “torn and ignored” meniscus. The meniscus is designed to be a protector of the knee joint. But when torn, it becomes a defector and can destroy the joint’s surface cartilage. I see too many patients that have put off treatment because some days it feels fine and they can live with the popping and occasional pain. It’s a bummer to see the joint surface severely damaged when we finally get around to fixing the problem. If I can offer treatment soon after the injury, there is much less damage to the joint surface resulting in a quicker, better recovery and much better long term outlook.

In modern sports medicine we are generally more aggressive when it comes to early rehab. ACL patients start rehab right away — a big change from casting (eek!) and a year in rehab in the early days of ACL reconstruction. However, recent data regarding ankle sprains has led to a step back in how those injuries are managed. Instead of pushing immediate movement, it’s clear that a period of casting or boot immobilization produces better outcomes.

Again, I see lots of patients who ignore a bad ankle sprain and keep on truckin’. They sprain their ankle over and over and ultimately require surgery to reattach or reconstruct the ligaments.

Now, I’m not throwing stones here. I’m just as guilty of delaying treatment. But take my advice: if you get hurt, have it checked out. If you wait too long, what could have been a little R & R with physical therapy or maybe a minor surgical repair can morph into a more complex procedure such as joint replacement.

If you get hurt, have it checked out.

Orthopedics_Mo Brown

Mo Brown and patient

It’s important to know what the consequences can be if you put off medical help for injuries. You may be mentally able to handle physical pain, but your body is sending that pain signal for a reason.

For all of you die-hards out there, let me put it this way: The toughest thing you can do in these situations is to stop your activities, see your doctor and get “it” fixed before it becomes a bigger problem.

Dr. Mo Brown is an orthopedic surgeon at Driggs Health Clinic.

This article originally appeared in the Teton Valley News.

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Remembering D-Day: When I was diagnosed with lupus

Ann Loyola

Ann Loyola

The table was set, the wine was poured and sipped, and now my friend was serving us each a bowl of creamed carrots spiced with ginger and turmeric, all topped with roasted pumpkin seeds.

“I’m serving an anti-inflammatory meal for us,” she told me; one inflamed person to another.

My friend, who I’ll call Empress in this story because she really is an Empress, is marking her two-month anniversary of Diagnosis Day.

In my friend’s case, the diagnosis is rheumatoid arthritis. R.A. is incurable, painful, debilitating and potentially fatal. Treatment plans vary according to the individual and healthcare provider. The disease, like many autoimmune illnesses, flares and then quiets like the hesitation between Fourth of July fireworks, making you wonder if each display is another burst of sparks or the blazing finale.

Anyone who has had a medical diagnosis of a nasty disease knows that this particular day will stand out among other days. For many, D-Day can offer a strange relief. Finally, there’s a name for all of the unexplained pain, dizziness or whatever bewildering symptoms. On my D-Day, my first thought was “Hey, maybe I’m not crazy after all.”

On my D-Day, my first thought was
“Hey, maybe I’m not crazy after all.”

I’d had two years of odd rashes on my face, legs and arms. My fingernails warped and rippled. I was always tired. My joints felt like balls of fire. My ribs and heart were sore. I was depressed yet caring for a 7-month-old son while pregnant with my daughter. When my physician called me at home one evening with the results of my most recent round of blood tests and told me that I definitely had systemic lupus erythematosus, I was almost delighted. Finally, a name! Finally, a reason! Finally, a treatment plan!

Albumarium_Woman's-hands_Web

Photo credit: Albumarium/Chiara Cremaschi

The odd euphoria of D-Day ebbed quite a bit when I realized that remission was not around the corner and that the coming years would require that I change my expectations about certain facets of my life that I thought were part and parcel of who I am. Or was. Or will be.

Still, if I were to place SLE in one hand and my old self in the other, I would hold on to the Me with SLE. I used to let little things get to me but having this disease has forced me to see life from a different perspective. I don’t get ruffled easily. I avoid drama. I appreciate more. Sure, I miss out on some things due to pain, fatigue or my sensitivity to sunlight, but what I do have I hold more closely to my heart than I think I would have pre-SLE.

Empress is moving from the shock of D-Day through the grief of losing a part of yourself without really knowing what the part will be. Yes, there’s a reason for today’s blinding pain and the mental fogginess. The question really is all about tomorrow and the days after that.

Of course, no one knows from one day to the next what will be gained or lost. I would argue that for the most part, most people can live with the belief that tomorrow will be much like today in terms of physical and mental capacity.

For the person with a “Diagnosis” it’s virtually a certainty that each day will be uncertain. Sometimes, I see myself as an adventurer going into each day and night with hope and curiosity. Other times I’m grumpy and tired. We all build our own way of adjusting. I don’t know what the Empress will build for herself as an outcome of D-Day, but I’m hoping it will be a crystalline outgrowth: reflective, illuminating and precious.

Do you have a story about your D-Day that you’d like to share? Let me know in the comments below.

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