Tag: infection

Health

I wish this was about LIMES and not LYME….

Posted on by mghdiabeteseducation

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NP

We’re hearty New Englanders but we slipped, froze and just plain suffered this past winter. We’re now reaping the benefits of our new season with bright warm sunshine and trees in full bloom, but I’m afraid we’ll be paying a price. All the snow and ice combined with a wet and soggy spring has set up a perfect storm for a tick boom in New England, which is expected to peak in the next few weeks. Here’s some basic information and guidelines for preventing and identifying tick illness while you’re outside enjoying this glorious time of year.

Lyme disease occurs when people are bitten by blacklegged ticks (more commonly referred to as deer ticks here in the Northeast) infected by a bacterium called Borrelia burgdorferi. They can attach themselves to any exposed skin area, but really like skin folds and hard to easily see places in particular. Some areas ticks are fond of burrowing into include the groin, armpit, behind the knee, the waist, and folds of the neck. They also are frequently found in the scalp as hair hides them well. Ticks need to be attached for approximately 36-48 hours or more before the Lyme disease bacteria can be transmitted.

When you’re bitten by a tick, about three-quarters of the time a rash may occur. Sometimes it will look like a small bump and resemble a mosquito bite, lasting for a day or two and disappearing. This is not a rash consistent with Lyme disease. That rash, commonly referred to as a “bull’s-eye” rash, will appear at the sight of the bite within a few days to a few weeks later. The rash may expand over time, and as it gets bigger the center may become darker and firmer while the area between the borders and the center may become clearer (this is where the term “bull’s-eye” comes from). The area may be warm to the touch but it isn’t painful or itchy.

It’s important to have this rash evaluated by a health care provider. The appearance of symptoms such as fever, chills, muscle and joint pain, headache, swollen lymph nodes, and fatigue also require medical evaluation. Let your healthcare provider know if you have any changes in your blood sugar as unexplained elevations can signal infection. These symptoms along with the “bull’s-eye” rash require evaluation by your medical provider to see if any blood tests or other treatments are required.

The best approach to avoiding Lyme disease is prevention. Here are a few tips to try to incorporate into your daily habits:

  • Always do a thorough skin examination after being outside, especially if you’ve been in the woods or long grassed fields.
  • Ticks can be very small (as tiny as a poppy seed!) and look like a black speck. Wear white or light colored long sleeved shirts and pants tucked into socks so you can spot them easily.
  • Wear wide brimmed hats to protect your scalp and neck from a tick falling onto you when walking.
  • Wear gloves if you are doing any gardening.
  • Wear bug repellant with DEET. Apply to your clothes and to your skin and it will last for several hours. Avoid getting it in your eyes and mouth and wash your hands well after applying.
  • Stay on well-marked paths.
  • To avoid bringing ticks in the house, take off clothes and bag them before heading in to shower if possible.
  • Check your pets. Dogs and cats can’t spread the disease directly to you, but they can carry infected tick into the house.

Also note: every bug bite isn’t Lyme disease. It’s important to correctly diagnose Lyme but it is just as important to avoid misdiagnosing it. Summer in New England has so much to offer and I hope these few simple steps will help you and your family stay healthy and enjoy this season.

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Guest Post, Health

Notes about Pneumonia

Posted on by mghdiabeteseducation

By Aparna Mani, MD, PhD
MGH Medical Walk-In Unit

Aparna Mani, MD, PhD

Pneumonia is a disease that has been described since the time of Hippocrates.  Though the ancient Greeks accurately identified the symptoms that constitute pneumonia, it wasn’t until the mid-1800’s that a scientist named Edwin Klebs observed bacteria in the lungs of people who had died of pneumonia, pointing to infection as a major cause of this illness.  Simply put, pneumonia is an inflammation of the lungs most commonly caused by infection.  It affects more than five million people in the United States and an estimated 450 million people worldwide each year, thus the World Health Organization has designated November 12th as World Pneumonia Day.

The lungs are composed of airways that bring in oxygen and alveoli (microscopic air sacs) that help deliver it to the bloodstream. The lungs have several defenses to protect against invading bacteria, viruses and other types of microorganisms.  These include mucus producing goblet cells and tiny hair-like projections called cilia—not to mention the body’s own immune system.  Sometimes these defenses may be overwhelmed or breached, allowing a particular microorganism to take hold and fester in the alveoli. The result is a local pool of infection that fills and plugs up the alveolus, much like pus in a skin wound. The sheer volume of infection makes it hard for immune cells to get in and do their job of breaking it down and clearing it out.  A person suffering from pneumonia may experience fever, shaking chills, fatigue, productive cough, chest pain and shortness of breath.  Contact your healthcare provider if you are experiencing any of these symptoms.

To diagnose pneumonia, healthcare providers rely on history of symptoms and a lung exam which includes listening to breathing sounds through a stethoscope and percussing the lungs (a special technique of tapping the chest) with their hands.  A chest x-ray may also be done, though it is not always necessary. The main treatment for bacterial pneumonia is antibiotics.  Providers often base their treatment on the most commonly known microorganism given age, risk factors and living environment, though mucus or sputum samples may also be obtained to identify the specific bacteria causing the pneumonia. This allows providers to better pinpoint the appropriate drug to use in treatment. Depending on the severity of symptoms and other risk factors such as age and overall health, healthcare providers may choose to treat an individual as an outpatient or admit them to the hospital.  With treatment a patient may stabilize and begin to improve within a few days, but it may take a few weeks before symptoms resolve completely.

Risk factors such as smoking, excessive alcohol use, immunodeficiency, and chronic illnesses such as COPD, kidney disease and diabetes can increase an individual’s susceptibility for developing pneumonia. Seniors (people 65 and older) and young children are also at increased risk.  The pneumococcal vaccine developed against bacteria commonly known to cause pneumonia is recommended for seniors and anyone with the above risk factors. Talk to your healthcare provider about whether vaccination is indicated for you. In addition to vaccination, pneumonia can be prevented with everyday good hygiene practices such as hand washing, coughing or sneezing into an elbow or sleeve, and taking care of one’s overall health– including keeping blood sugar in good control.

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Diabetes ABCs

Diabetes ABCs: U

Posted on by mghdiabeteseducation

Ulcer (foot)

U

A foot ulcer is a deep open wound, usually on the bottom of the foot that can be  slow or difficult to heal.  If you’ve lost feeling in your feet from neuropathy you might not feel it if you have a cut or blister.  Continuing to walk on even a minor injury can irritate the skin, causing it to break down and develop into an ulcer.  This is a serious condition and immediate medical care is required to prevent the spread of infection.  The good news is by taking good care of your feet you can prevent foot ulcers from developing in the first place.  Check your feet every day for blisters, cuts and sores and call your health care provider if you notice anything that isn’t healing right.  Always wear comfortable, well-fitting shoes and avoid going barefoot.

(Content reviewed by MGH Diabetes Center)
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