Has Skin Cancer Met Its Match?

A tiny insect called the deer tick, the size of a mere poppy seed, is wreaking havoc on the health of thousands of people across the country. Researchers now estimate that these nasty little blood suckers infect over 300,000 people with the bacterial infection known as Lyme disease every single year. This number has been steadily increasing for more than a decade. Cases of tick-borne diseases doubled from 2004 to 2016, with 82 percent of those cases being Lyme, according to the Center for Disease Control and Prevention (CDC). Most cases of Lyme disease are contracted between the months of May and October. Meaning: Right now, your risk is at its highest. And not so lucky for all of us: Pennsylvania leads the pack.

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Sun Safety 101

We’re just weeks from the official start of summer—and while we’re all excited about backyard cookouts and beach trips, all that time spent outdoors means your sun exposure is at its peak. Why should you care? According to the American Cancer Society (ACS), more skin cancer cases are detected each year than all other types of cancer combined – and its incidence is increasing.

Most skin cancers are caused by overexposure to two types of ultraviolet rays found in sunlight: 1) UVA rays, which can damage the DNA of skin cells and contribute to wrinkles and other long-term health effects; and 2) UVB rays, which also damage DNA, are implicated in most skin cancers, and are the chief cause of sunburns. Fortunately, there are many ways to protect yourself while outdoors. Here are just a few.

Avoid peak hours

UV light is strongest between 10 a.m. and 4 p.m., so it’s smart to avoid sunlight (as much as you can) during those hours. And remember that UV rays easily penetrate cloud cover, so be careful even on overcast days.

Cover up

It’s tough advice after being bundled up all winter, but lightweight, long-sleeved shirts and long pants or skirts offer a good bit of protection from UV rays. Some manufacturers even produce clothing with built-in UV protection, and the level of blockage will be noted on the labels.

Don’t forget sunscreen

But don’t think of it as your best protection, either. All of them let some UV rays pass through. Typically, higher SPF numbers offer more protection than lower-rated ones. But that difference is incremental. The ACS says SPF 15 sunscreens filter out about 93% of UVB rays, SPF 30 sunscreens filter out about 97%, and so on. As always, follow application instructions, which often means reapplying every few hours, especially after swimming.

Put a lid on it

Hats with fairly wide brims (2” to 3” or more) can shade practically your entire head. Be wary of baseball caps, though. Your neck and ears – two prime spots for skin cancer – will remain exposed.

Slip on some shades

Like hats, bigger is better. Look for labels that indicate the level of UVA and UVB absorption. Your best bet: Those that block 99 to 100 percent of both UVA and UVB light. No label can mean minimal to no protection.

5 Signs You May Have A Hernia & What to Do About it

A hernia is a protrusion of an organ through an area in the body in which it normally resides. Although hernias commonly occur in the abdomen if part of the intestine, bowel, or bladder pushes through a weak spot in the muscle wall, they can also develop in the upper thigh, belly button, groin, and chest.

There are a multitude of reasons hernias occur explains Dr. Emanuel Nogueira of St. Luke’s Upper Bucks Surgical Group. “Male or female, young or old, they’re relatively common and we’re all susceptible.  Anything that causes an increase in pressure on an already weak tissue can expedite it. Although it can be congenital or present at birth, it is more often caused from lifting or moving heavy objects, straining during a bowel movement, or chronic coughing.”

In some cases, there may be no visible signs it exists; in others a hernia is symptomatic and creates visible bulging, pain and discomfort. A hernia causing pain may indicate that its strangulated, a serious condition requiring immediate medical attention because it cuts off blood supply to the intestines and abdomen. Although exercise, maintaining proper weight and smoking cessation can help to prevent a hernia, it will never repair itself or go away on its own.

5 Signs You May Have Hernia

• you can feel or see a lump in the groin or abdominal region

• you have increasing pain when you cough or make a bowel movement 

• you have pain or a burning sensation in the abdomen or scrotal region 

• you have increased pain from standing for long periods

• you have increased prolonged heartburn or discomfort when eating

Repair to a hernia is a function of age, general health, type, and severity. The tear or hole can be as small as a dime or as large as a dinner plate and fixing it requires a surgeon to move the protrusion of the hernia back into the abdominal cavity. Following repair, the weakened tissue that contributed to the problem is closed and reinforced with stitching or synthetic mesh.

Some surgeries require an incision that can vary from three to six inches; others can be done laparoscopically, a minimally invasive procedure in which the incision can be less than a centimeter. Simple repairs for an umbilical hernia can be performed in as little as twenty minutes. More complex procedures can take several hours. In most instances, repair is performed as an outpatient procedure and the patient is able to go home the same day with lifting restrictions up to eight weeks.

For a hernia that is not bulging or causing discomfort, repairing it immediately will prevent it from becoming more serious, creating additional problems, or becoming strangulated. “Whether a hernia is asymptomatic and pain free or symptomatic and bulging it should always be addressed as soon as possible using a health network and physician certified as a center of excellence. Every case is unique and different and personalized care for my patients is vitally important. Choosing a specialized surgeon familiar with all of the treatment options is always recommended,” says Nogueira.

In health care, a center of excellence is established by a medical specialty’s professional society, a government entity such as the National Cancer Institute, or a consumer group organized in response to a disease.
A free community hernia information talk and screening is available on Tuesday, July 10th from 6-8 pm at the Dimmig Education Center, Rooms A&B, at St. Luke’s Allentown Campus. To register, call St. Luke’s InfoLink toll-free at 1-866-ST-LUKES or register at go.activecalendar.com/sluhn/

Dr. Emanuel F. Nogueira, a Lehigh Valley native, attended medical school at Drexel University College of Medicine in Philadelphia. He completed his General Surgery Residency at St. Luke’s University Health Network and was fellowship trained in minimally invasive surgery at Brown University, Rhode Island Hospital. Dr. Nogueira is a member of the American College of Surgeons and is Chief of Surgery and Director of the Hernia Center of Excellence at St. Luke’s University Health Network, Quakertown Campus.

 

The Lyme Epidemic

A tiny insect called the deer tick, the size of a mere poppy seed, is wreaking havoc on the health of thousands of people across the country. Researchers now estimate that these nasty little blood suckers infect over 300,000 people with the bacterial infection known as Lyme disease every single year.

This number has been steadily increasing for more than a decade. Cases of tick-borne diseases doubled from 2004 to 2016, with 82 percent of those cases being Lyme, according to the Center for Disease Control and Prevention (CDC). Most cases of Lyme disease are contracted between the months of May and October. Meaning: Right now, your risk is at its highest. And not so lucky for all of us: Pennsylvania leads the pack.

“Pennsylvania has led the country with cases of Lyme for the past three years, and the Lehigh Valley is one of the larger density areas,” says Jeffrey Jahre, M.D., infectious disease specialist at St. Luke’s University Hospital Bethlehem Campus. “We’re not talking about something exotic, we’re talking about something that’s now commonplace.”

Symptoms to Watch For

After an infected tick bites you and starts feeding on your blood, it may regurgitate some of its stomach contents back into the bite site, thereby transferring the Lyme bacteria (Borrelia burgdorferi) into your body. Pretty nasty, right? After this happens, most people who have contracted Lyme will notice their first symptoms within two to 30 days.

Typically, early Lyme disease symptoms consist of flu-like symptoms, including fever, headache, and fatigue as well as a gradually expanding rash that looks like a bullseye and is larger than a half-dollar coin in size, says Dr. Jahre. This rash is present in about two-thirds of people infected with Lyme.

If left untreated, additional symptoms may develop after a few months. According to the CDC, these can include: Severe headaches and neck stiffness, an irregular heartbeat, severe joint and muscle pain, facial palsy, shooting pains and numbness in hands and feet, and short-term memory problems.

Diagnosis and Treatment

Many people can make a full recovery from Lyme disease if they catch symptoms early, even if they progress to some of the more serious symptoms mentioned above. Here are a few different scenarios and what treatment might look like for each:

  • If you find a deer tick attached to you, and you know it’s been there for less than 24 hours, remove it and monitor yourself closely for the symptoms mentioned above. If you feel fine after 30 days, you’re probably in the clear and do not have Lyme disease.
  • If you find a deer tick attached to you that’s engorged and you suspect it’s been attached for a while, talk to your doctor about prescribing you a single, prophylactic dose of an antibiotic like Doxycycline. “This can be very effective at reducing the transmission rate and preventing the development of Lyme disease,” he says.
  • If you don’t spot the tick, but you notice classic Lyme disease symptoms including a bullseye rash and flu-like symptoms, go see your doctor ASAP. They will likely prescribe you antibiotic treatment for anywhere from 10 to 21 days.
  • If you’re symptoms aren’t quite as obvious–maybe you have all of the flu-like symptoms and some joint pains, but no rash–you should still see your doctor and ask for a blood test to help confirm or rule out a Lyme diagnosis. Lyme tests aren’t foolproof, however, and retesting again in a few weeks may be necessary if you initially receive a negative diagnosis but your symptoms persist.

“If it takes you a while to receive a diagnosis, IV antibiotic treatment may be necessary to treat some of your more advanced symptoms,” says Dr. Jahre.

How to Prevent Tick Bites

Of course, your best bet to avoid Lyme is to steer clear of ticks. Easier said than done, but Dr. Jahre offers up a few tips:

  • Avoid ticks’ natural habitats: These include brushy, damp, overgrown areas. That means it’s important to keep your lawn mowed and stick to the trails when you’re out hiking.
  • Use the right repellent: Look for repellents containing the active ingredients DEET, Picardin, and IR3535, all of which can be safely applied to the skin; and consider applying Permethrin to your shoes and clothing, which can be extremely effective at preventing ticks from getting on you in the first place.
  • Do a tick check: After spending time outside in nature, check yourself and your kids. Ticks typically crawl up your body and take refuge in hard-to-see areas, including the armpits, groin area, behind the knees, behind the ears, and on your scalp.

How to Remove a Tick

1. Use a pair of tweezers to grab the tick as close to your skin as possible.

2. Pull upward, making sure not to twist, tear, or squeeze the tick (this can push bacteria into your body or leave parts of the tick embedded in your skin).

3. Clean the affected area with soap and water.

4. Monitor yourself for symptoms

of Lyme disease.

Finding His Strength Again

In his prime, Paul Ferency of Forks Township was a 6’5”, 350-pound wall of muscle—and he knew how to use it. “I was among the top 5% of people on earth when it comes to strength,” he says. This might seem like an exaggeration, until you learn that Paul competed in 54 world championship matches to determine the world’s strongest man, played in Scotland’s Highland Games (participating in events like the caber toss and hammer throw) for 25 years, and spent six months traveling with Joan Jett and her entourage as her personal bodyguard. More recently, he served as the Strength and Conditioning coach for Lafayette College.

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