Dr. Kevin Most: Bloody noses and healthy gifts

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Dr. Kevin Most

Do we really need or even want that sweater for Christmas? How many of our Christmas gifts do we really need? For many Christmas gifts that will make the recipient feel good should be a goal we should all strive for. If you are a fortunate individual, giving to a less fortunate can make a huge impact on their health and life. It should also be a goal to help improve the life of those we are close to. So lets go thru a few gifts that actually may impact the lives of your loved ones.

An activity tracker- It can be a fit bit, a Nike Fuel, a jaw bone, a garmin, there are many out there. Do your homework and understand what you are looking for. Each of these have some basic monitoring like how many steps you have taken that day, or calories burned. Others have more benefits, some monitor heart rate, some will track sleeping patterns others will remind you to get up and exercise or even act as your alarm. Companies are getting smarter and are making these devices smaller and looking more like jewelry.

Leather gloves are a common gift- As you all know my goal is to get mittens to be accepted as being more fashionable. This week we will have temperatures in the single digits and wind chills at 20 below. For temps that cold rarely will you find gloves that serve the need. Consider getting mittens as they are much better for keeping your fingers warm, and for real cold days a disposable chemical hand warmer will even work better.

Blood pressure cuff- If any of your loved ones have high blood pressure, are at risk for high blood pressure or essentially ignore it consider a BP cuff. Gone are the days of having your blood pressure checked 2-3 times a year in the doctors office. In fact we know that often the readings in a doctors office although very accurate are not actually the true story. It is a common known syndrome- White coat hypertension- this is a condition where an anxious person will have elevated BP in their doctors office. Often they don’t even understand that they are having this elevated BP. The physician often has to act on the data they have, which in this case may be erroneous. Blood pressure monitored in the environment in which one lives is much better information and the actual information we need before considering placing someone on medications. So consider a BP monitor, it may identify that in fact you don’t need medication or it also may note that you need a change in your dose. Either way it will give you and the doctor better information. Interesting that the individuals with these actually exercise more as they are in tune with this reading. Good home BP monitors can are around $50. I like a company omron, they have multiple options some as low as $30. Bring it to your doctors appointment to verify its accuracy.

We all know of the Beer of the Month club, but lets think a little healthier. Giving the gift of Fruit of the month, vegetable of the month or even red wine of the month will impact ones health. In the winter in Chicago produce prices rise as is expected. So a gift where fresh vegetables and fruits are delivered to the home is great. It is a monthly reminder about the importance of these foods. If you don’t like fruit or veggies, consider a wine of the month club and limit it to the red wines which we know have a positive health impact when taken in moderation. 2 glasses of wine is good for ones health, and has been shown in many studies.

A cookbook can be a great gift- Shortly after my father had a heart attack, my mother started using the American Heart Association cookbook. Now my mom is a great cook but I can tell you that this book allows you to have heart healthy meals without having to search and they actually taste very good. I strongly recommend this book for anyone as we all have a risk of heart disease. It costs $15 on Amazon.

Another low cost gift that people will enjoy is a simple subscription to a health magazine. There are great Health magazines for women, men and some just overall general health. Many of these right now are giving the gift of a year as you get a subscription so it is actually a free gift. This is also a gift that is a monthly reminder of how you can improve your health. The great thing about that is often a simple single article can make an impact in June that we never would have been exposed to. Cost about $15 but many have free gift subscriptions.
Juicer- a lot of our bad calories are actually taken in with soda and energy drinks and even some juices. The juice blenders that are out now, allow you to make your own smoothies with ease and in a single serving size. So if that individual in your family is drinking soda, consider a juice blender and watch them add vitamins and fiber to their diet in place of soda.
8.Scale- I know ! Seriously you end with a scale! Well losing weight is one of the most common New Years resolutions. In Medicine our mantra is you can’t change what you don’t measure. A good scale is great for the individual who has shared with you that a goal is to lose weight. Their are great scales out there. The one I like is the iHealth scale, it is under $100 and has its own app that tracks your success for you. I am a proponent for a daily weight. First thing in the morning step on the scale. This will set you for the day, it will encourage you to exercise and will impact your diet for the day. So if you have that individual who has stated they want to lose some weight a scale is a great gift.

Nose Bleeds

This time of the year we often go over how to take care of your body in cold weather. One thing we have not covered in this weather is nose bleeds. Many of you may be thinking”Nosebleeds, cold weather?” Well, Yes there is a close correlation with nosebleeds and cold weather. Our nose is important as a filter and actually helps to humidify and warm air before it reaches our lungs. So our nose is a defense mechanism and help keeps bacteria, dust and other contaminants from reaching our lungs.

The skin lining the inside of our nose is very thin and has a great blood supply as it is needed to keep the nose warm. This skin needs the humidity in the air to help protect it. During the winter the humidity in the air is so low it does not replenish the inside of the nose as it should in many people. With dry skin inside the nose and the irritation it receives from the cold air and viruses it is prime for trauma to the skin that causes nose bleeds. If any of you have had a nose bleed you know how scary it can be. The nose has such great vascular supply that when a blood vessel inside the nose is traumatized a lot of blood can be lost.

So lets discuss what you should do if you or a family member has a nose bleed.
Don’t freak out, nosebleeds are very common and the vast majority can be treated at home.
Position is very important. Do not lie down! Do not tip your head back! These are 2 things people want to do and they are both wrong. Lying down and tipping your head back will cause the blood to go down your throat and end up in the stomach, blood in the stomach is irritating and can cause vomiting which will make the bleeding worse.
The correct position is to sit up straight and lean FORWARD. This will minimize the blood going down your throat.
If you have Afrin nasal spray, this is a good use of this medication as it can slow the bleeding. Pinch your nose firmly at the top of your nose, right below where you feel bone.
Pinch for 10 minutes continuously. This is an eternity, have someone time this for you or look at your watch. This is important as it allows for the blood to clot. If you let up to soon the bleeding starts again and we repeat the pinch.
The majority of bleeds will stop after 10 minutes of pressure, if it does not repeat this for 15 minutes. Failure beyond this point may require medical treatment.
What will happen in the Emergency Room for those patients who can’t stop the bleeding. First we give a spray of Afrin and will try pinching for a full 10-15 minutes. If this does not work, we may pack the nose with vaseline gauze or use a balloon that will put pressure on the skin and stop the bleeding. For some me may use silver nitrate and actually cauterize the bleeding vessel if we can see it clearly.

When to be concerned? If you have a history of high blood pressure or are taking any blood thinners (Aspirin, Coumadin, Pradaxa, Xarelto) you may need medical treatment as you may not be able to stop the bleeding.