Big Toenail Has Vertical Light Brown Line: Melanoma?
Yes, the light brown vertical line on your big toenail CAN be melanoma, says a dermatologist.
So let’s say that you just noticed a light brown vertical line on your big toenail (or any nail, for that matter).
“If you notice a vertical brown line on a fingernail or toenail, do not ignore,” begins Kally Papantoniou, MD, FAAD, with Simply Dermatology in NY.
Dr. Kally, as she is known by her patients, continues: “This can represent a benign mole that is occurring within the nail bed or nail matrix where the nail is being formed, but it takes a professional to distinguish the features of a benign vs. malignant growth.”
Even if you already know that the vertical brownish line of melanoma typically stretches into the skin at the base of the nail, you should still have the nail examined.
“Melanoma which occurs on the nail can be aggressive and it is important to make this diagnosis as early as possible,” says Dr. Kally.
“If there are multiple bands which appear to be monomorphic it is a good sign that these are benign, and these tend to occur more often in skin of color.”
Monomorphic means that the bands all have the same appearance.
“Occasionally it is not even a mole, but something called a splinter hemorrhage which occurs after trauma to a digit resulting in small amount of blood trapped under the nail.
“A splinter hemorrhage will grow out as the nail grows, whereas a melanocytic lesion will not grow out.”
Check your toenails and fingernails regularly for brown (or blackish) vertical lines.
Melanoma that looks like this will not suddenly appear overnight, whereas these splinter hemorrhages do appear soon after the trauma — and they can linger for quite a while, sometimes weeks.
A splinter hemorrhage will not progressively get bigger, while an untreated melanoma, after only four weeks, will show progression.
Dr. Papantoniou
is a board certified dermatologist specializing in cosmetic, laser and surgical dermatology.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Top image: Shutterstock/Alexander Raths
Can GERD Cause a Candida Infection?
The GERD and Candida connection is explained by a gastroenterologist.
“Can GERD cause a Candida infection?”
This was the question that I posed to Larry Good, MD, who has been a practicing gastroenterologist for 40+ years. He has a private practice that is located in Lynbrook, NY and is affiliated with Concierge Choice Physicians, a leading provider of personalized care in the U.S.
“Severe esophagitis with deep mucosal injury can predispose to Candida esophagitis,” says Dr. Good.
“This is a very common condition caused by an overgrowth of a fungal organism called Candida albicans in the esophagus.
“This is usually precipitated by the prolonged use of antibiotics or by immunosuppression caused by chemotherapy or other medicines that suppress the immune response.”
Indeed, GERD (gastroesophageal reflux disease) can lead to a Candida infection because esophagitis can be caused by GERD!
In fact, GERD is the most common cause of inflammation of the esophagus.
If you are taking a course of antibiotics, you should also, simultaneously to that, take a probiotic supplement every day, or eat a probiotic food such as yogurt or kefir (with “live culture bacteria,” the beneficial kind of bacteria).
Antibiotics snuff out the good bacteria that normally lives in your gut. So taking a daily probiotic will help keep the balance in check.
“If the esophageal mucosa is chronically inflamed it becomes more susceptible to this [Candida] infection,” adds Dr. Good.
“Under normal conditions, Candida is not a pathogen. It is part of the normal flora that lives in the mouth, on the skin and in the vagina. Treatment with anti-fungal medications is very effective.”
A Candida infection is called candidiasis.
When it develops in one’s mouth it’s called thrush or, on the medical report, oropharyngeal candidiasis.
It can also occur in the vagina, commonly known as a yeast infection.
In addition to affecting the throat, vagina and esophagus, Candida albicans can also become invasive, getting into the bloodstream and seriously affecting organs.
Dr. Good has additional expertise in the diagnosis/treatment of IBS and inflammatory bowel disease, and is extremely proactive in genetic testing, individualization of pharmacologic treatment, and risk mitigation in cancer screening/prevention. Concierge Choice Physicians
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Thomas Foldes
Can GERD Cause Heart Problems?
GERD can cause chest pain but do you fear it can lead to heart problems?
GERD causing heart problems is a common concern among the many sufferers of acid reflux disease, which is a prevalent condition.
Gastroesophageal reflux disease can cause burning, aching and strange feelings in the chest as well as the upper abdomen.
Can GERD negatively affect the heart?
“GERD cannot cause heart disease, but esophageal symptoms can be confused with cardiac symptoms,” explains Larry Good, MD, who’s been a practicing gastroenterologist for 40+ years. He has a private practice located in Lynbrook, NY and is affiliated with Concierge Choice Physicians, a leading provider of personalized care in the U.S.
In addition to chest pain, burning and aches, GERD can also cause issues with the throat such as coughing, a hoarse voice and a feeling of a lump in the throat.
When acid reflux makes its way to the throat, causing symptoms, the condition is known as LPR: laryngopharyngeal reflux disease.
Heart Chest Pain vs. GERD Chest Pain
Dr. Good continues, “Typical cardiac chest pain from angina pectoris is described as an oppressive heavy chest pressure (on elephant sitting in the chest) with difficulty breathing.”
Though you are now assured that GERD does not cause problems with the heart, you are not quite out of the woods.
Acid reflux disease, over time, depending on severity and frequency, can lead to pathological changes in the esophagus, bringing on a condition known as Barrett’s esophagus.
This in turn increases the risk of esophageal cancer.
Another important point to consider is this:
Just because GERD does not cause any problems with the heart, does not mean that you do not have coronary heart disease!
You may very well still have clogged arteries! Consider getting a complete exam by a cardiologist.
Dr. Good has additional expertise in the diagnosis/treatment of IBS and inflammatory bowel disease, and is extremely proactive in genetic testing, individualization of pharmacologic treatment, and risk mitigation in cancer screening/prevention. Concierge Choice Physicians
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Sudden Severe Stomach Pain, Diarrhea: Causes
Sudden severe stomach pain and diarrhea can be quite scary.
“Acute severe abdominal pain and diarrhea implies severe intestinal inflammation,” says Larry Good, MD, a practicing gastroenterologist for 40+ years. He has a private practice based in Lynbrook, NY and is affiliated with Concierge Choice Physicians, a leading provider of personalized care in the U.S.
“It is important to understand the difference between the stomach (one organ) and the abdomen,” continues Dr. Good.
Of course, when a person feels intense pain in this area, the term “stomach” and “abdominal” become interchangeable to that person, because the way they see it, “stomach” refers to the section of their body between their bellybutton and sternum.
“Severe abdominal pain with urgency to defecate [diarrhea] is usually caused by an intestinal infection (viral, bacterial, food poisoning) or by a chronic inflammatory disorder like ulcerative colitis or Crohn’s disease.”
Sudden Severe Stomach Pain: Benign Form of Colitis
Another inflammatory disorder that can cause these symptoms is microscopic colitis. Like ulcerative colitis and Crohn’s, this is an inflammatory bowel disease, but it’s far more benign.
You can have it and not even know it, depending on the frequency of the diarrhea and how “normal” it looks.
One of the key features of microscopic colitis is that the diarrhea may be nocturnal.
I have MC (the very intermittent kind), and one time in the middle of the night, I was awakened by a lower abdominal cramp and the urge to have a bowel movement.
Once I sat on the toilet, I was overcome with severe lower abdominal pain—not the typical “pain” you feel when you have a lot of hard BMs to void. It was so intense I felt nauseous.
And then the diarrhea came (not a lot), and poof, the pain was gone! This was a one-time flare, unrelated to previous food intake.
“Chronic abdominal pain, urgency and diarrhea including fecal incontinence is frequently caused by diarrhea-predominant irritable bowel syndrome,” says Dr. Good.
Dr. Good has additional expertise in the diagnosis/treatment of IBS and inflammatory bowel disease, and is extremely proactive in genetic testing, individualization of pharmacologic treatment, and risk mitigation in cancer screening/prevention. Concierge Choice Physicians
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/sebra
Burping from Stress: The Why? and Solutions
Burping can be caused by stressful situations or anxiety, and we all know how embarrassing this can be.
Those around you are likely to think that your burping is because you either ate a lot of gassy foods, or…you’re just, well, uncouth.
So why does stress or anxiety cause burping anyways?
“Stress can cause esophageal spasm and that can cause air to be trapped in the esophagus and cause ‘stress burping.’ Swallowing air can also be a nervous habit,” says Larry Good, MD, a practicing gastroenterologist for 40+ years. He has a private practice based in Lynbrook, NY and is affiliated with Concierge Choice Physicians, a leading provider of personalized care in the U.S.
The esophagus is your so-called food pipe. It is a muscle, though not the type of muscle (skeletal) that you use to bench press a barbell. Any kind of muscle can go into a spasm.
Though an esophageal spasm can cause chest pain–sometimes intense–there are times when an esophageal spasm cannot be felt.
However, despite that, they may produce a burp due to that trapped air that Dr. Good points out.
So what can you do about this embarrassing problem?
Shutterstock/Nik Stock
It is pretty tough to just knock out all the stress in your life. But what you can focus on doing is altering the way you respond to anxiety-provoking situations.
If you are in an intense business meeting, where people will hear you burping, take some deep breaths and stay calm.
If you are undergoing stress or anxiety, make sure you are not in the habit of swallowing air, including when you gulp beverages. Few people like to hear others burping.
Dr. Good has additional expertise in the diagnosis/treatment of IBS and inflammatory bowel disease, and is extremely proactive in genetic testing, individualization of pharmacologic treatment, and risk mitigation in cancer screening/prevention. Concierge Choice Physicians
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/pikselstock
600 Pound Life Enablers: What Happened in Their Childhood?
Something happened in the enabler’s childhood that makes them keep bringing food to the super morbidly obese (“My 600 Pound Life”) who can’t move much.
Many of the “600 Pound Life” subjects are actually closer to 700 pounds.
What on earth could have happened in the enabler’s childhood that drives them to keep bringing life-threatening amounts of junk food to their loved-one who can barely get out of bed—and sometimes can’t?
- How can the enabler trade their OWN life for the continuous “caregiving,” which includes gruesome tasks such as cleaning up infections beneath enormous rolls of fatty tumors?
- How are the enablers able to stomach the sights and odors that come with their role?
- This isn’t about love and devotion. Something else is going on here.
“Codependency” is the dynamic between the enabler and the 600+ pound, bedridden or severely immobilized loved-one.
The Enabler’s Childhood
“The characteristics of codependency invariably originate in childhood,” begins Linda Centeno, PhD, clinical psychologist, and assistant director of the Koch Center in NJ that specializes in eating disorder treatment.
“Many codependent individuals [the enablers] have had to endure difficult family dynamics in their families of origin and have had to develop ways of coping to survive,” continues Centeno.
“Children who come from chaotic families often feel worried and scared. They feel that things are unsafe and often try to make themselves feel better by focusing on controlling others’ behavior in an attempt to ‘keep the peace.’
“When children grow up this way, they learn not to think of themselves and what they may need, but how to appease and take care of others.”
If you’re a regular viewer of “My 600 Pound Life,” you’ve probably seen the episode where the husband routinely trekked a considerable distance by foot to the grocery store to shop for his immobilized wife, lugging back large quantities of food across a big field of grass.
You’ve seen Dillon, young adult son of Pauline, leading a life completely absent of friendships and hobbies, because all of his time was focused on enabling his mother.
Though offspring of the super morbidly obese grew up in their enabling role, what about people who became enablers only after they reached adulthood?
As Dr. Centeno explains, the child in a chaotic family environment never learns to focus on himself or herself.
You’ll note that in “My 600 Pound Life,” the enabler is rarely, if ever, a professional with some outside hobby like golf, hiking, karate or volunteer activities.
The learned dynamic “makes it difficult for the person to know who they are as a person separate from the one they are trying to help,” says Dr. Centeno.
“It is safer psychologically to stay attached and needed than to individuate and become a separate person in their own right.” Penny’s husband Edgar comes to mind.
“The result is that they become enmeshed, do not feel a separate sense of autonomy, and know no way to be without the person they are trying to take care of. In fact, the idea of standing alone can feel tantamount to death.”
This is why the enabler, though knowing that a heart attack can be one meal away, continues feeding their loved-one dangerous amounts of unhealthy food.
Enablers Can’t Say “No!” out of Love
How many times, on “My 600 Pound Life,” have you heard the enabler say they can’t say “No!” to all the food demands because of their “love” for that person?
You’ve heard, “How can I say ‘No’ to my daughter,” and, “How do I say ‘No’ to the man I love?”
Explains Dr. Centeno, “In the case of a relationship with a morbidly obese individual, many caregivers do not even realize that they are codependent. These dynamics are unconscious.
“The person feels that this is the way they have to be, and can even take a certain amount of pride (and security) in feeling that they are doing a good job; that they are devoted, loving and responsible.
“It is the source of the positive feelings they have about themselves and it is nearly impossible to imagine themselves separate from the dynamics of the relationship.
“If the person is focused on the caregiving aspects of their loved-one’s extensive needs, then there are no autonomous decisions to be made, no time to look at their own conflictual feelings, such as anger, resentment or emptiness.
“The caregiver feels so needed and indispensable and their own self-worth is so wrapped up in having to take care of the other, that it actually saves the caregiver from the daunting task of having to find their own purpose as a separate individual.”
This sounds so much like Pauline’s son, Dillon, but also many of the people who became enablers after they reached adulthood.
“Many caregivers worry that without the other, they would have no purpose.”
Dr. Centeno adds, “Unconsciously, a caregiver may worry that the partner may leave him or her and then the caregiver would be forced to be separate and autonomous (and alone).
“The person who is in love with the morbidly obese individual is hungry to be loved and needed by them.
“However, the morbidly obese person is addicted to food and has replaced the love for their partner with love for food.
“Essentially, this dynamic leaves the caregiver with many unmet needs. But the feeling of being needed by their partner is often more powerful than the fear of being alone.”
Not everyone will turn out to be an enabler to a 600 pound individual—regardless of how chaotic their childhood is — simply because not everyone’s brain is innately hardwired the same way.
In short, enabling is NOT something that can happen to anybody.
Dr. Centeno works with adolescents and adults. In her private practice her specific clinical expertise also includes anxiety and panic disorder, depression, relationship issues and sexual abuse.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
Long Femurs, Short Shins, Short Torso: Squat HELL
Learn everything imaginable about long femurs, short shins and long torsos and the BACK SQUAT.
I’m a former certified personal trainer for a health club chain. When you look at me you won’t see a woman with a short torso relative to her overall height.
But I have short shin bones relative to my femur length.
Below are articles that EXPLAIN EVERYTHING. You will never, ever again fail to understand why the long femur to short torso, or short shin to femur, presents a problem with performing the back squat.
ARTICLES ON FEMUR, SHIN & TORSO LENGTH
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Vladimir Sukhachev
Have you Looked at Your Poops Lately?
How often do you examine your poops? You may be amused at this question, or maybe you’re thinking, “Ewwww.”
But so many things about bowel movements can tell a LOT about a person’s health, about what might be going on–ranging from benign (though annoying) conditions to cancer.
“Most of us understandably think about how often we have a bowel movement and why our stool changes in appearance and consistency,” says G. Shelton McMullan, MD, board certified gastroenterologist with Capital Digestive Care in MD.
“It is very normal for our defecation frequency to fluctuate and also for the size/shape and appearance of our stool to vary, without any seeming pattern,” continues Dr. McMullan.
Floating Poop
“Often when our stool is loose, it will break up easily in the toilet or sometimes float at the top of the bowl; this is not specifically a cause for concern,” says Dr. McMullan.
Slimy Stools
“When the stool in addition appears to be ‘slimy’ and/or associated with what looks like oily deposits, this can potentially be representative of a condition called exocrine pancreatic insufficiency (EPI), involving dysfunction of the pancreas in digesting fats and protein,” explains Dr. McMullan.
“Anyone with concern should mention this to his or her healthcare provider for possible further investigation; a simple submission of stool with testing of something called fecal elastase allows for the diagnosis of EPI.”
How often do you check your bowel movements’ color?
There’s no need to obsess over this, but definitely from time to time you should take note of your poop color.
Dr. McMullan explains, “In terms of the color of one’s stool, my attention is heightened when I hear about pitch-black stool with a sticky consistency, as this could represent a bleeding source within the gastrointestinal tract.
“This type of bloody stool is termed melena and has the appearance of what one would expect lava from a volcano to look like.
“Maroon or bright-red bloody stool obviously is abnormal, so this should always be reported.
“In addition, if one’s stool remains light or clay colored [greyish], this raises suspicion for a possible blockage of the main drainage duct of the gallbladder, liver and pancreas.
“Outside of these mentioned colors, color of one’s stool is in general not concerning.” This means that fluctuations in any shade of brown (light, chocolate-brown, deep brown, brownish tan, etc.) is normal. Varying tinges of green with the brown is also normal.
Still Overly Poop Worried?
Check out the very helpful articles below to see what different gastroenterologists have to say about bowel movements. .
It’s time to start getting familiar with your BMs. What your poops look like can be very telling of your health.
Dr. McMullan has published numerous medical abstracts and presented posters related to the management and treatment of inflammatory bowel disease and other gastroenterological conditions.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/dizain
Why You Have Pain Long After Grade 2 AC Separation
Why is it that a year, even two years after a grade 2 AC separation, an athlete can still have pain and struggle through weightlifting sets?
“If the patient is still symptomatic it may either have not been a grade 2 injury or it may need a reconstruction,” says Jonathan Oheb, MD, North Valley Orthopedic Institute, Chief of Orthopedic Hand and Upper Extremity Surgery.
“I would advise seeing an orthopedic surgeon.”
Does this mean that a grade 3 AC separation was misdiagnosed as a 2?
Dr. Oheb says, “Not necessarily. You can have a grade 2 injury which is persistently symptomatic. I cannot give you a simple answer to this question.
“Some things require a thorough evaluation of the patient and the X-rays to determine the root cause of a patient’s pain. There is no range of motion test that strongly points to a grade 3.”
What Is a Grade 2 AC Separation?
A grade 2 acromioclavicular (AC) separation is when the AC joint is partially dislocated, and the acromioclavicular ligament is completely torn.
This ligament connects the acromion, a part of the shoulder blade, to the clavicle (collarbone).
The complete tear of this ligament causes the clavicle to move partially out of alignment with the acromion, resulting in visible displacement and pain.
Despite the complete tear of the AC ligament, the coracoclavicular ligaments, which connect the clavicle to the coracoid process of the scapula, remain intact.
These ligaments stabilize the AC joint and help prevent the clavicle from shifting excessively.
Their intact condition provides some stability to the joint, even though the AC ligament is damaged.
In some cases, if the symptoms do not improve or if the injury severely impacts shoulder function, surgical intervention may be needed to repair the torn ligament and re-establish joint stability.
Symptoms
- The pain ranges from medium to severe.
- Swelling may be present.
- Movement of the arm induces pain.
- There may be a small bump where the clavicle bone ends, at the top of the shoulder.
- Pushing the clavicle with a hand may move it. Do not experiment with this. It’s not necessary for you to evaluate the injury this way. Only a doctor should do this.
- There may be pain when touching the area.
With proper diagnosis and treatment, a patient should not experience pain during strength training, weightlifting or other physical activities long after treatment and rehab end.
If you have recently injured your shoulder, and it’s so painful that lifting your arm straight out in front of you (frontal raise) is impossible due to pain — see a doctor as soon as you can.
If your injury does not involve the AC joint, it may be a clavicle fracture.
In addition to hand, elbow and shoulder care, Dr. Oheb provides comprehensive surgical and nonsurgical treatment for all orthopedic conditions of the hip, knee and ankle, including broken bones and injuries. jonathanohebmd.com
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/Andrey_Popov
Why Isn’t Surgery Recommended for Grade 2 AC Separation?
Since the ligaments are torn in a grade 2 AC separation, why isn’t surgery the treatment of choice?
One day I was doing stool stepping exercise in my living room.
Suddenly, it were as though an unseen force yanked me off the stool while I had one foot on it and threw me to the floor.
It was over in a split second; too quickly for my athletic body to react. I landed on my shoulder and it hurt like hell.
I diagnosed myself with a possible AC separation, either a grade 1 or 2.
Separation of the acromioclavicular joint is usually caused by falling on one’s shoulder — which can happen after falling from a height or being tossed from a bicycle or skateboard.
A more serious injury (higher grade) may occur from a vehicular accident.
In a grade 2 AC separation, ligaments are torn from the bone.
A ligament is a type of connective tissue that connects bones to other bones at joints, providing stability and support.
Ligaments are composed primarily of dense, fibrous collagen fibers, which give them strength and flexibility.
Now in the case of an ankle injury in which ligaments are actually severed, surgery is the standard treatment. Same with the ligaments in the knee.
So I wondered why, in the case of a grade 2 AC injury, surgery isn’t performed.
“It is not recommended because it has not been shown to significantly improve the average person’s long-term function,” says Jonathan Oheb, MD, North Valley Orthopedic Institute, Chief of Orthopedic Hand and Upper Extremity Surgery.
“However, with a high demand patient who continues to have symptoms after a course of conservative treatment, surgery would then be an option.”
In my case, the injury turned out to be a hairline fracture of the clavicle.
This type of fracture is typically caused by trauma or impact, such as a fall or direct blow to the shoulder.
The symptoms were identical to that of a grade 1 or 2 AC joint trauma save for a visible deformity.
Treatment for a hairline clavicle fracture often focuses on pain management and immobilization of the shoulder, commonly with a sling or brace.
My injury healed beautifully with patience plus a homemade sling.
Standard Treatment for a Grade 2 AC Joint Injury
- Rest from activity
- Use of a sling
- Cold packs
- Painkillers
- Physical therapy
The above protocol works superbly; surgery is not required unless the injury is really severe.
Prevention of an AC joint separation is not related to physical fitness.
It’s related to activity. Be extra careful when you’re involved in activity that has the potential to cause a fall.
This includes hiking downhill and walking down an outdoor staircase that’s coated with a thin, often not very visible, layer of ice.
