“Summer days are the time for sharing food with family at barbecues and picnics. However, warm weather also encourages bacteria to grow. The CDC recommends that pre-prepared food be sealed and kept cool if possible. If you’ve come down with a case of food poisoning, make sure that you drink lots of fluids and rest.”

Center for Disease Control and Prevention

We normally associate illness with winter, mainly because it’s the time of year we tend to get colds and flu.

However, there is no shortage of ailments and conditions that make life unpleasant and spoil our fun during the summer months.

The following are examples of health issues associated with summer:

1. Food poisoning

According to the CDC (Center for Disease Prevention and Control), every year around 3,000 Americans die from foodborne diseases.

Warm weather encourages bacteria to multiply, and who doesn’t enjoy barbeques and picnics during summer? Food that is prepared in advance and allowed to stand in the heat creates the perfect conditions for contamination and food poisoning.

Pre-prepared food should be handled hygienically, stored safely and kept cool if possible. It’s also better to choose foods that don’t spoil as easily or can be freshly prepared at your destination.

NHS Choices explains that most cases of food poisoning can be treated at home and do not require medical advice, and that most people will feel better in a matter of days. It is however important to replace fluids lost through vomiting and diarrhea.

If symptoms are severe, you may need to be admitted to hospital for a few days and given intravenous hydration.

2. Heat rash

Heat rash is a red or pink rash usually found on areas of the body that are covered with clothing. It happens during hot humid conditions and is most common in children. Heat rash develops when sweat ducts become blocked and swell up, looking like dots or tiny pimples on the skin. It often causes discomfort and itching.

Heat rash usually heals on its own in a matter of days and doesn’t require medical attention. In some cases the rash gets infected with symptoms like pain, swelling and pus. If this happens, be sure to see your doctor.

3. Water-borne conditions

We all like to spend time in the water during summer, and Dennis Maki, a professor of infectious diseases at the University of Wisconsin School of Medicine and Public Health, warns of the risk of bacterial infections and other water-borne illnesses as a result of taking part in recreational water activities.

Germs that turn up in swimming pool water include bacteria like E. coli, Salmonella, Camplobacter, noroviruses, and parasites. While treatment with chlorine can kill germs in swimming pools, it takes time for the chlorine to do its job.

Crypto is the most common cause of diarrhea outbreaks linked with swimming pools or water parks because it can survive up to 10 days in chlorinated water. … Infections can cause watery diarrhea, stomach cramps, nausea or vomiting, and can lead to dehydration.  CDC states “Crypto is highly resistant to chlorine, which makes it hard to kill once it’s in the water.  Swallowing just a mouthful of water with crypto in it can make otherwise healthy kids and adults sick for weeks with watery diarrhea, stomach cramps , nausea, and vomiting,” says Michele Hlavsa, chief of the CDC’s Healthy Swimming Program.  Every year, at least 15 to 20 outbreaks of diseases, like stomach bugs and diarrhea, are linked to swimming in public pools, according to the CDC.”

“Here are some tips from CDC in helping to protect you and your kids when the temperatures rise and the public pool is the only thing that will cool the heatwave:

• Don’t swim or let your kids swim if sick with diarrhea.
• Check the pool, hot tub, and water playground inspection scores.
• Use test strips to check the water’s pH and chlorine levels. You can get free test kits from the website of the Water Quality & Health Council.
• Try not to swallow the water.
• Take small children on frequent bathroom breaks.
• Shower before getting into a pool.
• Listen for the sound of a working pool pump.
• Change diapers in a diaper-changing area and away from the water.”

Apart from natural bodies of water like rivers and lakes, pools and hot tubs can also be sources of gastrointestinal problems; skin, ear and eye infections; and respiratory, neurological and viral problems. The safest places to swim are pools that are regularly checked for their chlorine levels.

4. Summer colds (summer or winter cold the symptoms are the same).

There is a kind of virus that produces cold-like symptoms, which tends to rear its ugly head during the summer months. It is called enterovirus and can cause more complicated symptoms than the typical winter cold.

Something summery may be lingering even as the season fades—the summer cold.

Colds in summertime can last for weeks, at times seemingly going away and then suddenly storming back with a vengeance, infectious-disease experts say. A winter cold, by contrast, is typically gone in a few days.

The reason for the difference: Summer colds are caused by different viruses from the ones that bring on sniffling and sneezing in the colder months. And some of the things people commonly do in the summer can prolong the illness, like being physically active and going in and out of air-conditioned buildings.

“A winter cold is nasty, brutish and short,” says Bruce Hirsch, infectious-disease specialist at North Shore University Hospital in Manhasset, N.Y. “But summer colds tend to linger. They can go on for weeks and reoccur.”

Summer colds, which can hit between June and October, occur only about 25% as often as the winter variety. But summer colds can have more severe, flu-like symptoms, in addition to sneezing and coughing. Many people also mistake a summer cold for allergies, because it just doesn’t seem to leave.

According to Merck Manual, symptoms of a summer cold caused by enterovirus include fever, headache, and sore throat, and sometimes mouth sores or a rash. Treatment is basically aimed at relieving symptoms.

5. Headache

An unfortunate result of summer activities that involve spending a lot of time in the hot sun can be a spitting headache. A survey by the National Headache Foundation indicates that headache sufferers consider summer to be the worst time of year for headaches.

As the temperature goes up, so does your risk for getting a headache. One theory is that the heat makes blood vessels in your head expand, causing them to press against nerve endings. Dehydration and strenuous exercise in hot weather can also lead to headaches.

An over-the-counter painkiller will usually alleviate headaches caused by heat exposure and exercise, and drinking enough water should take care of a dehydration headache.

6. Heat stroke

Heat stroke or hyperthermia results from prolonged exposure to high temperatures. It can happen for example when children are left in hot cars during summer.

Emedicinehealth defines heat stroke as a condition where the body’s cooling mechanisms are overcome by heat, resulting in a core heat of over 40°C. Heat stroke is preceded by signs of heat exhaustion like headaches, dizziness and weakness, and results in unconsciousness, organ failure and eventually death.

Hyperthermia is primarily treated by outside cooling of the body with the help of water, cold air or ice packs. Internal cooling by flushing the stomach or rectum with cold may also be used. Persons with hyperthermia need to be hospitalised in order to be tested for complications like muscle breakdown, which can damage the kidneys.

7. Sunburn

With summer comes the danger of sunburn, which can be extremely serious. Sunburn is caused by ultraviolet (UV) rays from the sun that damage your skin cells. The risk of damage depends on things like the time of day, the amount of time spent in the sun and if you use sun protection or not.

Sunburn can lead to long-term skin damage and even skin cancer. MedicineNet.com explains that there are three major kinds of skin cancer:

• Basal cell carcinoma (most common type)
• Squamous cell carcinoma (second most common)
• Melanoma (less common but considerably more dangerous)

The best and simplest way to avoid sunburn is to stay out of the sun. Other ways to be sun-safe is to stay out of the midday sun, stay in the shade, use a good sunscreen and wear a hat and protective clothing.

“Alarm Symptoms :

Certain alarm symptoms may point to complications or life-threatening problems. Should you have any of these alarm-warning symptoms, talk to your doctor right away.

• Chest pain with activity, such as climbing stairs.
• Losing weight without trying.
• Choking while eating or trouble swallowing food and liquids.
• Throwing up blood or material that looks like coffee grounds.
• Red or black stools.”

American Gastroenterological Association (aga)www.gastro.org

Understanding what GERD is, its causes, its symptoms, the effects it has on your body and the way your body responds to specific treatments is necessary to help you devise a plan with your activities of daily living, including diet, to help manage the condition. If you haven’t seen my Part 1 just click on it onto my webpage than read yesterday’s article part 1 than read this. All you can do is apply your own GERD diet experimentation to the suggestions of others and try available treatments until you find what works for you. Also, there are foods that have a reputation for being ‘safe’ (foods to avoid acid reflux) in most cases, as well as others that are known for being main contributors to acid reflux.

I recommend you go tohttp://www.gerd-diet.com which helps explain about foods and how they work with GERD. They do state the following:

Armoring Yourself with Patience and Willingness to Experiment (meaning this takes time in finding out what exacerbates your GERD and what helps it heal—Like an open wound, it takes time.) Sorry,There Is No One-Size-To-Fit-All With-A-GERD Diet (for relief or resolution)

Your Own Trigger Foods.
Given the complex nature of GERD, this one has to be added. I know it is repetitive, but everyone has certain foods that irritate their condition and causes severe symptoms. Make a list of these foods and avoid them in the future. This means make a journal for the next 2 weeks or more and see what caused your GERD symptoms to remember them with not eating fast which can cause GERD also (habit change).

GERD Diet FoodsA List of Food Groups and What Is Safe and Best to Avoid The following lists are comprised of foods that are typically known to be ‘safe’ or to ‘trigger’ symptoms.

Again, just because something is on the “avoid” list does not mean that you cannot eat it. Similarly, something appearing on the “safe” list does not guarantee that it will not cause a problem for you. This is simply provided as a guideline to give you a place to start and to make it easier for you design your own personal GERD diet.

At this point, there is no alternative medicine therapies that have been accepted as proof for treatment(s) or 100% resolution for GERD.

However, like every other aspect of the disease, it really is an individual decision. Some people have reported natural remedies that have given amazing results with their GERD diet (healthier approach) while others find that prescription medications have little effect (meds can cause side effects temporary or permanently, depending on what it is).

GERD can be due obesity, lifestyle (unhealthy habits) and diet. **It is recommended to see an MD first before making any decision on your own in treatment with a combination of or just one of the following: meds, diet or even health habit changes, especially for those people with disease/illness (s) present (Ex. Diabetes, cardiac disease, etc…).** If you need help with your GERD in prevention or treatment, that is primary or secondary care, than stay on this webpage which can help you out with your healthy GERD plan.

“Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Many people, including pregnant women, suffer from heartburn or acid indigestion caused by GERD.”

American Gastroenterological Association (aga)-www.gastro.org

How to stay healthy with acid reflux?  A GI disease that is caused by a valve located between the esophagus and stomach, which normally is a strong muscular ring of tissue.  This valve normally opens and closes completely preventing food backing up (called reflux) in the esophagus allowing the contents to reach the throat to the mouth.  With acid reflux, what happens is this valve gets over expanded frequently to the point the valve gets overstretched and no longer fits over the opening between the esophagus and the stomach with a tight fit.  Due to loss of the elasticity it now is allowing leakage from the stomach with both food and fluids going up the esophagus to the throat to the mouth due to the action of reflux, during the digestion process.  What happens during digestion the stomach contents with digestive fluids (which are acidic) are refluxed, that are not normally in the esophagus. In conclusion, reflux sends stomach contents that’s returning (an acidic environment) upward in the esophagus which is now in an environment not use to being exposed to the digestive fluids =acidity, which are needed to perform the digestion process of our foods/fluids that are in the stomach only.   This leakage of the valve is the cause of this problem occurring=GERD or gastrointestinal reflux.

When you don’t have GERD food and fluids when swallowed go down the esophagus to the valve where it opens letting the contents into the stomach, where digestion takes place in about 1-2 hours after eating. Normally the valve is tight enough in preventing reflux=no leakage (the primary purpose of its function).  This means during digestion the food gets into the stomach which is broken down into smaller particles by the digestive acid fluids allowing the nutrients to pass into the bloodstream with the waste products staying in the stomach but when stomach digestion is complete it passes all the waste products onto the smaller intestines to the larger intestines to the rectum to be evacuated, without leakage or reflux.

The signs and symptoms (s/s) of GERD or acid reflux:

1-Heartburn is the classic GERD symptom. It’s best described as a burning sensation in the chest and/or discomfort in the upper belly or abdomen accompanied by a feeling of fullness.  

2- Regurgitation is the involuntary return of partially digested food from the stomach into the mouth.  This uncomfortable symptom is commonly caused by GERD, since the esophageal sphincter (valve) is damaged to such a severe degree that the stomach juices (acidotic) can freely reflux to the level of the throat or mouth.

3-Pain present behind the sternum (chest pain) to the upper mid abdomen (where the stomach is).  If severe call your M.D. or doctor to have evaluated  (especially if in the chest).

4-Chronic cough to hoarseness  5-Recurrent pneumonias  6-Bloating 7-Nausea 8-Vomiting (yellow/green) 9-Lump in the throat 10-Difficulty swallowing 11-Chronic sore throat 12-Laryngitis 13-Post nasal drip 14-Ear Aches 15-Tooth decay or gingivitis (inflammation of the gums) or bad breath this is due to the acid fluids with the foods and fluids regurgitated back to the mouth from the stomach.

Complications that are caused by GERD when left untreated:

1-Narrowing of the esophagus called esophageal stricture.  This is due to damage to cells in the lower esophageal from acid exposure that leads to scarring of the tissue.  The scar tissue narrows the food pathway causing difficulty to  swallow called dysphagia.    2-Esophagitis – inflammation of the esophagus.  This constant backwash of acid can irritate the lining of your esophagus. Over time, the inflammation can cause complications such as bleeding or breathing problems leading into esophagitis.

3-Esophageal Ulcers – Due to frequent exposure to acidic fluids and foods to the esophagus the mucosa gets irritated so bad it will even erode the mucosa causing skin ulceration.  The esophagus environment is not use to the stomach’s = acidic.  Take the outer skin of the body, if exposed long enough to acidic chemicals the skin will burn.  Same principle for the esophagus constantly  exposed to the environment of the stomach’s content of acidic fluids every time digestion takes place.

4-Precancerous changes to the esophagus (Barrett’s esophagus).  In Barrett’s esophagus, the color and composition of the tissue lining the lower esophagus change.  These changes are associated with risk of esophageal cancer.  The risk of cancer is low.  Cancer is rare but can happen (adenocarcinoma of the esophagus).

Risk factors=Conditions that increase the risk of GERD would include:   Obesity, Pregnancy, Smoking, Dry Mouth, Diabetes, Asthma, Connective Tissue Disorders like scleroderma, delayed stomach empting, Zollinger-Ellison syndrome (ZES)

(This is a rare disorder characterized by one or more tumors in the pancreas, duodenum, or both. The tumors cause the stomach to make too much acid, leading to peptic ulcers in the duodenum. The tumors are sometimes cancerous and spread to other areas of the body.).

The key to treatment is prevention but if already with the Dx: GERD than it would be maintenance.  There is no one answer but start with being checked by your physician if you have any symptoms indicative of this diagnosis.  Start with a getting a very good diagnostic tool ordered by your doctor called an Upper GI series (endoscopy) and when it’s done it will tell the M.D. a lot in what’s going on.  Then there is medications as a remedy, that can be useful, they are classified as proton pump inhibitors to H2 Inhibitors with more.  Another great key to the treatment is your LIFESTYLE=Diet (not eating acid foods, not eating fast), activity/exercise, your height compared to your weight (BMI or simply what you weigh) and lastly if you practice healthy vs. unhealthy habits.  If you would like to learn more about this come back tomorrow to my web page when I go further on the topic GERD (part 2) regarding the diet for the disease.

“From an epidemiological point of view, the definition of acute lower respiratory infections usually includes acute bronchitis and bronchiolitis, influenza and pneumonia.”

MAYO Clinic

Acute lower respiratory infections are a leading cause of sickness and mortality both in children and adults worldwide. Unfortunately, acute lower respiratory infections are not uniformly defined and this may hamper a true appreciation of their epidemiological importance. From an epidemiological point of view, the definition of acute lower respiratory infections usually includes acute bronchitis and bronchiolitis, influenza and pneumonia.

Lower respiratory tract infection (LRTI), while often used as a synonym for pneumonia, can also be applied to other types of infection including lung abscess and acute bronchitis. Symptoms include shortness of breath, weakness, fever, coughing and fatigue.

There are a number of symptoms that are characteristic of lower respiratory tract infections. The two most common are bronchitis and edema

Acute bronchitis can be defined as an acute illness that occurs in a patient without chronic lung disease. Symptoms include cough (productive or otherwise) and other symptoms or clinical signs that suggest lower respiratory tract infection with no alternative explanation (e.g. sinusitis or asthma).

Bronchiolitis is the most common lower respiratory tract infection and the most common cause of admission to hospital in the first 12 months of life.

Influenza affects both the upper and lower respiratory tracts.

Antibiotics are the first line treatment for pneumonia; however, they are not effective or indicated for parasitic or viral infections. Acute bronchitis typically resolves on its own with time.

“Stay away from me! I don’t want to get sick, too.” Most of us have had to utter those words to a family member, friend, or colleague who was sneezing or coughing incessantly. But how do we know how great the chances of catching someone’s cold or other illness really are? A medical review published in the New England Journal of Medicine tells us when to exercise concern over eight respiratory tract infections.

You can do a number of things to help prevent infection:

• Avoid close contact with people who are ill with infections spread through large-droplets.
• Unless ventilation is good, avoid shared space with people who are ill with infections spread through tiny-droplets.
• Wash your hands after greeting someone with a viral infection or after handling an object held by someone infected with Bronchiolitis or a cold.
• Encourage children to wash their hands. Kids are more likely than adults to spread infection within a family.

“July is Juvenile Arthritis Awareness Month, and believe it or not, nearly 300,000 children have been diagnosed with some form of arthritis. Arthritis doesn’t affect just older people, but also affects children as little as six months old! Juvenile arthritis comes in a variety of forms with varying life spans and symptoms.”

Bone and Joint Center