How To Tell the Difference Between Everyday Fatigue and Anemia

Tired female entrepreneur yawning in office. Horizontal shot.We have all experienced tiredness or normal exhaustion at several points in our lives.  However, when these feelings persist, it often means we are fatigued.

Everyday fatigue is characterized by an ongoing lack of energy and other symptoms that may include:

  • Brain fog
  • Difficulty concentrating
  • Irritability
  • Emotional overwhelm
  • Anxiety

Fatigue can be caused by several factors such as:

  • Medications
  • Poor diet
  • Stress
  • Sedentary lifestyle
  • Sleep disorders
  • Influenza (the flu)
  • Pneumonia

Everyday fatigue is usually temporary and may go away with rest, sleep, or stress reduction. Fatigue that lasts for several weeks and interferes with daily life should not be ignored because it may signal an underlying medical condition.

Ongoing fatigue is often associated with anemia. Unlike everyday fatigue, anemia-related fatigue results from a lack of healthy red blood cells.  Additionally, anemia-related fatigue does not improve with rest and affects multiple body systems because they lack adequate oxygen.   Here are a few symptoms that may result from that:

  • Pale skin
  • Cold hands or feet
  • Shortness of breath
  • Low stamina
  • Frequent headaches
  • Restless leg syndrome
  • Persistent tiredness, even after getting sufficient sleep
  • Dizziness or lightheadedness
  • Heart palpitations
  • Brain fog
  • Unusual cravings
  • Brittle nails
  • Thinning hair

See a doctor if you experience these symptoms. Doctors diagnose anemia with a blood test called a Complete Blood Count (CBC), which measures hemoglobin and red blood cell levels.  Your doctor may also order a ferritin blood test to check how much iron is stored in your body.

Treatment for anemia depends on the underlying issue. Treatment may include managing the underlying condition, medications that stimulate red blood cell production or suppress the immune system, intravenous (IV) iron therapy, bone marrow or cell transplants, iron or vitamin supplementation, or dietary changes that include key nutrients.

To schedule an appointment with a doctor at Jamaica Hospital Medical Center, please call 718-206-7001.

 

 

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Can You Actually Catch Up on Lost Sleep?

For many of us, getting enough sleep during the week can be challenging. Common activities like work, commuting, social life, downtime, and watching TV can cause us to lose sleep. As a result, more than one-third of Americans get less than seven hours of sleep per night, rather than the recommended seven to nine hours. The loss of those one to two hours is called sleep debt. 

Sleep debt, or sleep deficit, is the difference between how much sleep you need and how much you get. Sleep debt is cumulative, so going to sleep a half hour or an hour later than normal over a few days can add up quickly. Two weeks of sleeping just six hours a night produces the same level of cognitive impairment as if you stayed awake for two full days straight. Other side effects caused by sleep debt can include: 

  • Poor vision, hearing, coordination, and balance 
  • Reduced energy and motivation 
  • Slower reaction time 
  • Drowsiness and irritability 
  • Impaired memory, attention, judgment, and decision-making 
  • Decreased performance in many areas, including athletics 

Long-term sleep debt can lead to sleep deprivation, which occurs when you are frequently not getting as much sleep as you need. Not regularly getting an adequate amount of sleep increases the risk of developing health conditions, such as: 

  • Cancer 
  • Heart disease 
  • Dementia 
  • Mental health disorders, such as depression 

Sleep deprivation can also impact your health in other ways, including: 

  • Immune system dysfunction 
  • Poor emotional regulation 
  • Executive function issues 
  • Metabolic dysregulation and weight gain 
  • Inhibited sex drive  
  • Higher risk of accidents, falls, and other injuries 

Sleeping in on the weekends is the most common strategy to recover lost sleep. It can help with the occasional sleep deficit, but it isn’t good for the long term. 

According to research from the American Academy of Sleep Medicine showed that after five nights of sleeping less than four hours, a single recovery night of about nine hours still left people with residual attention lapses and slower reaction times. A six-week study of high-performing adults found that two nights of eight-hour recovery sleep failed to restore accuracy on tests of spatial orientation and sustained attention. Furthermore, performance declined steadily during the restricted weeknights, and the sleep recovery during the weekend wasn’t enough to cause a reset.  

Additionally, a study done at the University of Colorado brought 36 healthy adults into a sleep lab for two weeks and found that people who slept only five hours a night gained about three pounds and saw a 13% decrease in insulin sensitivity. The group that slept five hours during the week and was allowed to sleep in on weekends fared even worse, as they also gained three pounds and experienced a 27% decrease in insulin sensitivity. What’s more, their liver and muscle metabolism suffered more than the group that never got recovery sleep at all.  

When you finally get the opportunity to sleep longer, your brain prioritizes deep sleep, the sleep stage that restores daytime alertness and cognitive function, first. This is called a rebound effect. Your brain categorizes the sleep stages and recovers the most critical stages before anything else, which is why the first long recovery sleep feels so restorative even if you are far from fully recharged.  

Complete recovery from weeks of sleep debt and deprivation will require many nights of quality sleep, rather than making up the sleep during the weekend. The first step in getting sufficient sleep is to improve your sleep hygiene. There are several ways to improve your sleep hygiene and reduce your chances of accumulating sleep debt, including: 

  • Keeping a set sleep schedule 
  • Developing a nightly routine 
  • Considering daytime habits 
  • Improving the bedroom environment 

When recovering lost sleep, the most effective strategy is to add sleep in small, consistent increments instead of overhauling your schedule. Some techniques that can be useful to help you properly catch up on sleep and eliminate sleep debt include: 

  • Staying consistent 
  • Keeping a sleep diary 
  • Trying an afternoon nap 
  • Giving time to the process 
  • Talking to your healthcare provider 

If you are having difficulty sleeping and would like help, Jamaica Hospital’s state-of-the-art sleep center can help diagnose and treat various sleep disorders. For more information or to make an appointment, please call 718-206-5916.  

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Herniated Discs

A herniated disc, also known as a slipped or bulging disc, occurs when the soft, jelly-like center of a spinal disc pushes against and leaks out of its outer ring. This can lead to pain, numbness, and weakness in your neck, back, or legs. 

Every year, more than three million people in the U.S. get a herniated disc. They are a leading cause of neck, back, and leg pain and can happen anywhere along your spine, but most often in your lower back or neck.  

Although pain is a common symptom throughout your back, symptoms of a herniated disc vary depending on its location and may lead to other symptoms. A herniated disc in your lower back may cause sciatic nerve pain that usually shoots down one side of your buttocks into your leg and sometimes your foot. Other symptoms of a herniated disc in your lower back may include: 

  • Lower back pain 
  • Muscle weakness 
  • Tingling or numbness in your legs and/or feet 

Symptoms of a herniated disc in your neck may include: 

  • Neck pain, especially in the back and on the sides of your neck 
  • Pain near or between your shoulder blades 
  • Pain that travels to your shoulder, arm, and sometimes your hand and fingers 
  • Numbness or tingling in your arms 
  • Pain that increases while bending or turning your neck 

Several factors can contribute to a herniated disc, including: 

  • Traumatic injuries, such as falls 
  • Aging 
  • Lifting heavy objects improperly 
  • Performing repetitive bending or twisting motions 

People between the ages of 30 and 50 years old are most likely to get a herniated disc, with men being twice as likely to be affected by them as women. Herniated discs tend to run in families. Other risk factors for herniated discs include: 

  • Sitting in the same position for long periods of time 
  • Being overweight or obese 
  • Having diabetes 
  • Smoking  
  • Having a connective tissue disorder 

A healthcare provider can diagnose a herniated disc by performing a thorough physical exam, which allows them to assess your pain, muscle reflexes, how well you respond to touch, pinpricks, or vibration, and muscle strength. Your healthcare provider may also perform other tests, such as: 

  • A neurological exam 
  • Imaging tests, such as: 
  • MRI scan 
  • X-rays 
  • CT scan 
  • A nerve conduction study 
  • Myelogram 
  • Electromyogram (EMG) 

In most cases, pain from a herniated disc eventually goes away on its own within four to six weeks. However, if you need to relieve your pain while at home, you can: 

  • Rest for one to three days if the pain is severe, but avoid long periods of bed rest to prevent stiffness 
  • Take an over-the-counter (OTC) pain reliever, such as ibuprofen or acetaminophen 
  • Apply heat or ice to the affected area 

If your symptoms aren’t improving, your healthcare provider may recommend more advanced treatments, such as medications, physical therapy, or spinal injections. 

If nonsurgical treatments don’t ease or relieve your symptoms, your healthcare provider may recommend a minimally invasive spine surgery called a microdiscectomy.  

Although it isn’t always possible to prevent a herniated disc, you can reduce your risk of developing one by: 

  • Stretching 
  • Using proper lifting techniques 
  • Practicing good posture 
  • Maintaining a healthy weight 
  • Getting regular physical activity 
  • Avoiding wearing high-heeled shoes 
  • Quitting smoking 

The Orthopedic Surgery Department of Jamaica Hospital in Queens, NY, consists of board-certified, expert surgeons who offer treatment for patients suffering from any orthopedic condition, ensuring speedy recovery and maximum comfort throughout the treatment process. For more information about how to make an appointment with our orthopedic surgeons, please contact us at 718-206-6923. 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Dermatologic Treatments for Oily Skin

Glycolic acid in a bottle, chemical ingredient in beauty product, skin care productsOily skin is a common skin type that occurs when the body’s sebaceous (oil) glands produce excess sebum, making skin look shiny.

Other characteristics of oily skin include pores that appear open or enlarged, especially on the T-zone (forehead, nose, and chin), greasy-feeling skin, a tendency toward breakouts, and a thicker dermis layer compared with other skin types.

Although oily skin can lead to breakouts and other cosmetic problems, having oily skin does have a few advantages:

  • Oil helps keep the skin hydrated and prevents excessive dryness
  • Oily skin tends to look more supple because it retains water better than dry skin
  • Fine lines and wrinkles may become noticeable later when compared to dry skin
  • The skin barrier can be more resilient against environmental stressors.

Oily skin can be caused by several factors, including:

  • Hormonal changes
  • Genetics
  • Using products that are not suitable for your skin
  • Overwashing skin
  • Environmental factors such as climate and weather (hot and humid environments may increase skin oiliness)
  • Age (teenagers and young adults tend to produce more oil than older adults)
  • Stress

The American Academy of Dermatology says the key to managing oily skin is balancing the skin’s natural moisture without stripping it. The goal is to keep your skin barrier healthy while reducing excess sebum. This balance can be achieved by following a daily routine that may include:

  • Gently washing your skin twice a day with a mild foaming face wash or cleanser. It is recommended that you avoid using oil-based or alcohol-based cleansers
  • Using a lightweight, oil-free, non-comedogenic moisturizer
  • Using products containing ingredients that help regulate oil such as niacinamide, salicylic acid, glycolic acid, lactic acid, or retinoids
  • Using oil-free, water-based makeup
  • Wearing sunscreen

Dermatologists recommend sticking to a consistent and simple routine. They may also emphasize good skin hygiene, such as not sleeping in your makeup, avoiding touching your face, and not picking pimples.

If oily skin persists, suddenly worsens, or is accompanied by significant acne, consult a dermatologist to identify underlying causes and recommend a personalized treatment plan. Treatment may involve topical prescriptions, hormonal medications, or in-office procedures such as chemical peels or laser and light-based treatments.

To schedule an appointment with a dermatologist at Jamaica Hospital Medical Center, please call 718-206-7001.

 

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

What Happens to Your Body During a Hot Flash?

A hot flash is a sudden warm feeling in the upper body, usually the most intense over the face, neck, and chest. Hot flashes are most commonly caused by menopause.  

Menopause is when the menstrual period stops for good, with most women experiencing a hot flash about four and a half to five years after their last period. It is diagnosed after 12 months without having a menstrual period, vaginal bleeding, or spotting.  

During a hot flash, a woman might feel like she is spiking a high fever, but physiologically, that isn’t what is happening. As women approach menopause and the ovaries begin to produce less estrogen, the hypothalamus, the brain’s internal thermostat, becomes hypersensitive to even small shifts in temperature.  

When a woman experiences a hot flash, the body believes it is overheating, even when the actual temperature hasn’t changed much. In response to this, the body tries to cool down as blood vessels dilate, which is supposed to help dissipate some of that heat, triggering a sweating reflex.  

How an individual woman experiences hot flashes varies greatly. Some women describe very mild symptoms, while others suffer from profuse sweating. Additionally, some women only have hot flashes during the day, while others have regular night sweats. According to the American College of Obstetricians & Gynecologists, about four in five women experience hot flashes at some point during the menopause transition.  

Common triggers of hot flashes include: 

  • Alcohol 
  • Caffeine 
  • High sugar intake 
  • High processed foods 
  • Stress 

Black women are more likely to experience more severe and longer-lasting symptoms, sometimes up to 11 years, and research shows that women with more severe, longer-lasting hot flashes and night sweats appear to be at higher risk of cardiovascular disease.  

For decades, hot flashes were blamed solely on the loss of estrogen, but that explanation left some questions unanswered because not every menopausal woman has night sweats. What’s more, it doesn’t explain why perimenopausal women experience hot flashes while they still produce estrogen. 

Newer research has shown that when the brain recognizes that a woman’s estrogen levels are low, nerve cells in the hypothalamus called KNDy neurons become overactive, releasing neurotransmitters, which include kisspeptin, dynorphin, and neurokinin B.  

For women in the middle of their hot flash years and the ten percent of menopausal women who continue to experience them, here are some strategies and tips that can help you manage your hot flashes: 

  • Keep your core body temperature as cool as possible 
  • Keep cool at night 
  • Watch what you eat and drink 
  • Refrain from smoking 
  • Maintain a healthy weight 
  • Reduce your stress 
  • Exercise regularly 
  • When you feel a hot flash coming on, take several slow, deep breaths and try to relax 
  • Drink a glass of cold water and sit calmly until it passes 
  • Wear layers you can easily take off when you feel yourself getting hot 

Once a hot flash starts, there is no instant cure. Talk to your healthcare professional about medications and complementary therapies that make the most sense for you and your symptoms. 

If you are experiencing hot flashes due to menopause, the most effective way to relieve the discomfort from them is to take estrogen, but taking it carries risks. 

Other treatments for hot flashes can include: 

  • Medications 
  • Antidepressants, anti-seizure drugs, and other medications 
  • Hormone therapy 
  • Mind and body approaches 
  • Cognitive behavioral therapy (CBT) 
  • Hypnosis 
  • Mindful meditation 
  • Acupuncture 
  • Dietary supplements 

At Jamaica Hospital’s Department of Women’s Health Services, we are passionate about meeting the various needs of women in our community. We proudly treat women from all walks of life and provide a warm and welcoming environment. To learn more about our OB/GYN services or to make an appointment, contact us at 718-291-3276. 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

National AFib Awareness Month

September is National AFib Awareness Month, a month dedicated to promoting education, early detection, and improved care for AFib.

AFib stands for atrial fibrillation, a type of arrhythmia, or abnormal heartbeat. During AFib, the heart’s upper chambers, or the atria, beat chaotically and irregularly. They beat out of sync with the lower chambers, called ventricles.

Afib can lead to blood clots in the heart. It also increases the risk of stroke, heart failure, and other heart-related complications.

Afib usually isn’t life-threatening, but it is a serious medical condition that needs proper treatment to prevent serious health issues.

There are many symptoms of AFib, including:

  • Feelings of a fast, fluttering, or pounding heartbeat
  • Chest pain
  • Dizziness
  • Fatigue
  • Lightheadedness
  • Reduced ability to exercise
  • Shortness of breath
  • Weakness

People can experience three types of AFib, including:

  • Paroxysmal AFib
  • Persistent AFib
  • Long-standing persistent AFib

The most common cause of AFib is problems with the heart’s structure. Other health problems and heart diseases that can cause AFib include:

  • A congenital heart defect
  • Sick sinus syndrome
  • Obstructive sleep apnea
  • Heart attack
  • High blood pressure
  • Lung diseases, including pneumonia
  • Coronary artery disease
  • Thyroid diseases
  • Infections from viruses

Many factors can increase your risk of AFib, including:

  • Age
  • Caffeine, nicotine, or illegal drug use
  • Drinking too much alcohol
  • Changes in the level of body minerals
  • Family history
  • Long-term health conditions
  • Obesity
  • Some medicines and supplements

Healthy lifestyle choices can reduce heart disease risk and prevent AFib. Some basic heart-healthy tips include:

  • Controlling high blood pressure, high cholesterol, and diabetes
  • Not smoking or using tobacco
  • Eating a diet that is low in salt and saturated fat
  • Exercising at least 30 minutes a day at least five days a week
  • Getting at least seven to nine hours of sleep a day
  • Maintaining a healthy weight
  • Reducing and managing stress

A healthcare provider can diagnose AFib by examining you and asking questions about your medical history and symptoms. Tests may be done to look for conditions causing irregular heartbeats such as heart disease or thyroid disease, including:

  • Blood tests
  • ECG or EKG
  • Holter monitor
  • Event recorder
  • Implantable loop recorder
  • Exercise stress tests
  • Chest X-ray

The goals of AFib treatment are to reset and control the heartbeat and prevent blood clots. Treatment for AFib depends on how long you’ve had it, your symptoms, and the cause of the irregular heartbeat. Afib treatment can include:

  • Medications
  • Cardioversion therapy
  • Surgery or catheter procedures

If you are experiencing any symptoms of Afib, you can schedule an appointment at Jamaica Hospital Medical Center’s Cardiology Department by calling (718) 206-7100. If you are experiencing an emergency, please dial 911 right away.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

National Sickle Cell Awareness Month

September is National Sickle Cell Awareness Month, a month that addresses the challenges patients, their families, and caregivers experience and provides an opportunity to increase public knowledge and understanding of sickle cell disease and traits. 

Sickle cell disease is a group of inherited red blood cell disorders that affect hemoglobin, the protein that carries oxygen through the body. It is the most common inherited blood disorder in the United States. The disease gets its name from the abnormal crescent or “sickle” shape that some red blood cells develop. These abnormal red blood cells block blood flow, resulting in recurring episodes of pain. 

Sickle cell disease is a lifelong disease affecting more than 100,000 people in the United States and 20 million worldwide. In the U.S., most people who have sickle cell disease are of African ancestry or identify themselves as Black. About one in 13 Black or African American babies are born with the sickle cell trait, and about one in every 365 Black or African American babies are born with sickle cell disease. Many people who come from Hispanic, Southern European, Middle Eastern, or Asian Indian backgrounds also have sickle cell disease. 

There are several symptoms of sickle cell disease. Early symptoms can include: 

  • Jaundice- a condition that causes the color of the skin or whites of the eyes to turn yellow 
  • Extreme tiredness 
  • Painful swelling of the hands and feet 

Many serious symptoms and complications of sickle disease can include: 

  • Episodes of severe pain 
  • Anemia symptoms, such as fatigue, shortness of breath, dizziness, and an irregular heartbeat 
  • Fever 
  • Acute chest syndrome 
  • Stroke 
  • Priapism 
  • Avascular necrosis 
  • Pulmonary hypertension 
  • Organ damage 
  • Leg ulcers 
  • Gallstones 
  • Deep vein thrombosis 
  • Pregnancy complications 
  • Vision problems 
  • Frequent infections 

There are many ways to manage and treat sickle cell disease, including: 

  • Medicines 
  • Blood transfusions 
  • Blood and bone marrow transplant 
  • Gene therapies 
  • Complementary and alternative medicine (CAM) 

Your healthcare team will probably include a doctor specializing in blood diseases called a hematologist. 

If you need help managing symptoms of sickle cell disease or sickle cell trait, schedule an appointment with a hematologist at Jamaica Hospital Medical Center’s Department of Internal Medicine at (718) 206-7001. 

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Four Key Risk Factors Linked to 99% of Heart Attacks

Cardiovascular diseases, such as a heart attack, are the leading causes of death around the world. 

heart attack, or myocardial infarction, occurs when blood flow to the heart muscle is reduced or blocked. The blockage is usually caused by a buildup of fat, cholesterol, and other substances in the heart’s arteries. 

Most heart attacks are caused by coronary artery disease, which is the most common cause of death in the United States. 

The warning signs of a heart attack include: 

  • Chest discomfort that lasts more than a few minutes or doesn’t go away and returns 
  • Pain or discomfort in the arms, back, neck, jaw, and stomach 
  • Shortness of breath 

Other signs of a heart attack can include: 

  • Breaking out in a cold sweat 
  • Nausea 
  • A rapid or irregular heartbeat 
  • Unusual tiredness 
  • Heartburn or indigestion 
  • Lightheadedness 

According to a study published in the Journal of the American College of Cardiology, more than 99% of people who experience a heart attack previously had at least one of four major cardiovascular risk factors that were above ideal healthy levels. These risk factors include: 

  • High blood pressure 
  • High cholesterol 
  • High fasting glucose or high blood sugar 
  • Tobacco use 

For this study, researchers analyzed medical data from more than 9 million adults in South Korea and almost 7,000 adults in the United States for up to 20 years, allowing scientists to see multiple measurements for blood pressure, cholesterol, glucose, and smoking exposure before a participant had their first cardiovascular issue.  

At the conclusion of the study, researchers discovered that more than 99% of the study participants had at least one risk factor at unhealthy levels before experiencing a heart attack. What’s more, scientists found that high blood pressure was the biggest culprit of the four major risk factors, affecting more than 95% of South Korean participants and over 93% of U.S. participants.  

Fortunately, these risk factors are categorized as modifiable, meaning they are potentially preventable. If high blood pressure, high cholesterol, and high blood sugar can be reduced, as well as eliminating the use of tobacco, there is a possibility that the risk of heart attack can be decreased.  

If you are experiencing any symptoms of a heart attack, you can schedule an appointment at Jamaica Hospital Medical Center’s Cardiology Department by calling (718) 206-7100. If you are experiencing an emergency, please dial 911 right away. 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.