|
Spring and summer are upon us, and with it comes the social changes that somehow affect our moods, health and attitudes concerning daily living. Non-complacency is a cardinal sin or aspect of all sexes, ages and seasons. Mary is a 24 y/o Irish-American who has been blessed with many freckles, and her European genetic make-up predisposes her to very pale skin. Mary knows that the girls that seem to discover the most attractive young men have bronze bodies; therefore, Mary has taken to going to the tanning salons over the past few years. Early in her life, Mary had severe exposure to the sun at the beach and had horrific sunburns. They were extremely painful, and she underwent debridement of her peeling skin by her 13 year old brother. She has made the same error early in her tanning sessions and had severe exposure A few months ago Mary had discovered a small multicolored mole on her thigh , she ignored it until it grew and began to bleed. After visiting her Advanced Practice Clinician she was immediately referred to Dermatology where she was biopsied and discovered that she had a stage ll melanoma. She has been transferred to the practices of a surgical oncologist for further treatment. She faces a battle with survival. Ask Mary how she feels about sun exposure today and consider, if she survives, what a great speaker she may make to High school students who have the same desires that she had.
Another highlight of summer and late spring is the ability to sit in the beautiful outdoors and sip on a cool refreshing drink. Think of all the refreshing drinks that are provided on cruise ships, resorts, and the back yard pool and BBQ. Pina coladas, mimosas, gin and tonic, screwdrivers, rum and coke, these are just a few There is of course beer for the guys and gals as well as great amounts of cold refreshing white wines for the sophisticated ladies. US statistics on obesity demonstrate that 60% of Americans are obese and 30% are morbidly obese. The sequale of storing those fat cells is that our pancreas begins to get overworked and produce less and less insulin and we become type ll diabetics. This is a disease that has proliferated very quickly in this past decade. These diabetics are on oral medication or insulin and are faced with the same desire to imbibe in the summer. What effect, if any, does alcohol have on the diabetic?
Strangely enough, consuming excess alcohol does not increase hyperglycemia. I once treated a diabetic who took additional insulin because he was going drinking with the guys and he later passed out and was almost comatose because his blood alcohol was 2.2, and he was severely hypoglycemic. Yes, Alcohol does the complete opposite of what most patients and many health care PROVIDERS THINK. Although there are plenty of additional carbohydrates, these patients suffer from hypoglycemia and all of the potential dangers associated with this condition. Alcohol causes the Beta cells in the pancreas to excrete more insulin and there is a delayed onset of low blood sugar. The big questions are this: To drink or not to drink? The answer is based upon your condition, your medications and your health care provider. All need to be considered before that cruise and while at the tropical resort.
My surgeon associate says that he has never seen an alcoholic with CAD. Well, maybe he has not looked carefully enough but the person whose best friend is Johnnie Walker does have less CAD and a lesser chance of dying from a cardiac arrest. Yes, alcohol lowers your risk of heart disease and stroke, lowers risks of gall stones and diabetes and if you have type ll DM it lowers your fasting blood sugar. Should I throw away my Lantus right now? There is always a flip side and this issue is no different. What are the down sides of too much alcohol? Well I already mentioned hypoglycemia, coma, the signs and symptoms that precede hypoglycemic crisis are also laudable. There is, of course, the possibility that some patients may be on Coumadin and this will increase their INR and make them a better candidate for an intracranial bleed, particularly after taking a header down a spiral staircase because of the unsteadiness of too much alcohol. Perhaps the discomfort associated with acute pancreatitis is mentionable along with hypertension, weight gain, to go along with the fabulous tan (everyone loves a tan pot belly). For the young woman of childbearing age there is the potential of fetal alcohol syndrome and a miscarriage.
Don’t let me take the sun out of spring and summer or the possible enjoyment of a drink on the veranda. The purpose of this small article is to enhance our understanding of the potential problems and to lend a voice that can be communicated to our patients as they enter this great season. Cheers!
 Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 150 plus articles and is a sought out conference speaker throughout the United States.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
RECOMMEND THIS ARTICLE
You must be logged in
to recommend articles
|
