Welcome to Charter Clinic

What's new

Latest news

1. You don’t need to guzzle a gallon of H2O during your exercise session.
When you work out at a moderate intensity for less than an hour, simply drink to satisfy your thirst and you’ll take in what you need. If you go an hour or more or you’re exercising in hot conditions, weigh yourself before and after you work out and sip an extra 16 ounces of water per pound lost.

2. Water can give your workout a boost.
Plain H2O will hydrate you just fine during a typical sweat session so that you can get the most out of your routine. If you prefer the taste of coconut water, though, go for it. It contains some carbs, which can help give you a lift. If you’re deficient in certain nutrients, vitamins may help improve your performance. In that case, try vitamin-enhanced water.

3. Stash your water in the freezer before you exercise.
Cold H2O is better for your workout than water at room temperature. In a British study, people who had a very cold drink before and during sweaty cycling sessions were able to keep going significantly longer than those who drank their beverage at warmer temps, probably because the icy sips kept their core body temperatures lower.

4. Drinking water can help you lose weight.
Sipping before meals helped dieters consume 90 calories less at each meal, according to a recent study. Again, cold water may be a better choice; research has found that you burn slightly more calories after drinking it, probably because your body expends energy to heat the water up.

 5. H2O is good for your skin.
“The hyaluronic acid in your skin absorbs some of the water you drink,” says Doris Day, MD, a dermatologist in New York City. “This gives it some of its elasticity and vibrancy.” But there’s no need to chug an ocean of the stuff. “Once the hyaluronic acid has absorbed all it can, you’ll simply pee the rest out,” Dr. Day says. The best rule of thumb: If your skin doesn’t bounce back right away when you pinch it, drink up.

6. Your Starbucks habit is not dehydrating you.
Caffeine is a mild diuretic, but it doesn’t lead to dehydration, according to Armstrong’s research. You can even count caffeinated drinks toward your total fluid intake, says Lauren Slayton, RD, the author of The Little Book of Thin and the founder of Foodtrainers in New York City. Eight ounces of coffee equals roughly four ounces of water.

7. It is possible to drink too much water.
This can be a serious problem for endurance athletes, especially women, who are smaller than men and so have less water in their bodies, says Timothy Noakes, MD, the director of research in exercise science and sports medicine in the Department of Human Biology at the University of Cape Town. Drinking large amounts of water can cause a condition called hyponatremia, in which the sodium levels in the blood drop too low and brain cells and tissue become bloated, leading to nausea, confusion, seizures, coma and even death. But the condition is rare. The average gymgoer, or even a triathlete who drinks only to quench thirst, is highly unlikely to consume more water than her body can handle, Dr. Noakes says.

Treating your Sprained Ankle

Treating your sprained ankle properly may prevent chronic pain and instability. For a Grade I sprain, follow the R.I.C.E. guidelines:

  • Rest your ankle by not walking on it. Limit weight bearing. Use crutches if necessary; if there is no fracture you are safe to put some weight on the leg. An ankle brace often helps control swelling and adds stability while the ligaments are healing.
  • Ice it to keep down the swelling. Don’t put ice directly on the skin (use a thin piece of cloth such as a pillow case between the ice bag and the skin) and don’t ice more than 20 minutes at a time to avoid frost bite.
  • Compression can help control swelling as well as immobilize and support your injury.
  • Elevate the foot by reclining and propping it up above the waist or heart as needed.

Swelling usually goes down with a few days.

For a Grade II sprain, follow the R.I.C.E. guidelines and allow more time for healing. A doctor may immobilize or splint your sprained ankle.

A Grade III sprain puts you at risk for permanent ankle instability. Rarely, surgery may be needed to repair the damage, especially in competitive athletes. For severe ankle sprains, your doctor may also consider treating you with a short leg cast for two to three weeks or a walking boot. People who sprain their ankle repeatedly may also need surgical repair to tighten their ligaments.

What Causes Sunburn

You already know the simple explanation behind sunburn. When your skin is exposed to the sun for a period of time, eventually it burns, turning red and irritated.

Under the skin, things get a little more complicated. The sun gives off three wavelengths of ultraviolet light:

  • UVA
  • UVB
  • UVC

UVC light doesn’t reach the Earth’s surface. The other two types of ultraviolet light not only reach your beach towel, but they penetrate your skin. Skin damage is caused by both UVA and UVB rays.

Sunburn is the most obvious sign that you’ve been sitting outside for too long. But sun damage isn’t always visible. Under the surface, ultraviolet light can alter your DNA, prematurely aging your skin. Over time, DNA damage can contribute to skin cancers, including deadly melanoma.

How soon a sunburn begins depends on:

  • Your skin type
  • The sun’s intensity
  • How long you’re exposed to the sun

A blonde-haired, blue-eyed woman sunbathing in Rio de Janeiro will redden far sooner than an olive-complexioned woman sitting out on a sunny day in New York City.

Signs of Sunburn

When you get a sunburn, your skin turns red and hurts. If the burn is severe, you can develop swelling and sunburn blisters. You may even feel like you have the flu — feverish, with chills, nausea, headache, and weakness.

A few days later, your skin will start peeling and itching as your body tries to rid itself of sun-damaged cells.

Sunburn Relief
Sunburn treatment is designed to attack the burn on two fronts — relieving reddened, inflamed skin while easing pain. Here are a few home remedies for sunburn:

Compresses. Apply cold compresses to your skin or take a cool bath to soothe the burn.

Creams or gels. To take the sting out of your sunburn, gently rub on a cream or gel containing ingredients such as:

Menthol
Camphor
Aloe

Refrigerating the cream first will make it feel even better on your sunburned skin.

NSAIDs. Nonsteroidal anti-inflammatory drugs, like ibuprofen or naproxen, can relieve sunburn swelling and pain all over your body.

Stay hydrated. Drink plenty of water and other fluids so that you don’t become dehydrated.

Avoid the sun. Until your sunburn heals, stay out of the sun.

You may be able to treat the sunburn yourself. But call for a doctor’s help if you notice any of these more serious sunburn signs:

Fever of 102 degrees or higher
Chills
Severe pain
Sunburn blisters that cover 20% or more of your body
Dry mouth, thirst, reduced urination, dizziness, and fatigue, which are signs of dehydration

Preventing Sunburn
Here are some tips for keeping your skin safe when you’re outside:

Watch the clock. The sun’s rays are strongest between 10 a.m. and 4 p.m. If you can’t stay indoors during that block of time, at least stick to shady spots.

Wear the right clothes. When you have to be outdoors, wear sun-protective clothing, such as:

A broad-brimmed hat
A long-sleeved shirt and pants
UV-blocking sunglasses
Use sunscreen. Cover any exposed areas of skin liberally with at least 1 ounce of broad-spectrum sunscreen. That means sunscreen that protects against both UVA and UVB rays.

The sunscreen should have a sun protection factor (SPF) of at least 30. Follow these tips for applying sunscreen:

Apply sunscreen about 30 minutes before you go outside.
Use sunscreen even on overcast days because UV rays can penetrate clouds.
Reapply sunscreen every two hours — or more often if you’re sweating heavily or swimming.

 

Reasons for Running

If your nose is running, there are several possible explanations:

You have a cold or the flu: When you have either one of these, your nose goes into mucus-making overdrive to keep the germ invaders out of your lungs and the rest of your body, where they might make you even sicker than you already are. You know what happens then: The mucus runs down your throat, out your nose, or into a tissue when you blow your nose. Or it can fill your sinuses, which is why you get that stuffy feeling.

You have allergies: Kids who have allergies get runny noses when they’re around the thing they’re allergic to (like pollen or animal hair). That’s because their bodies react to these things like they’re germs.

You’re crying: When you cry, tears come out of the tear glands under your eyelids and drain through the tear ducts that empty into your nose. Tears mix with mucus there and your nose runs.

Baby, it’s cold outside: When you’re outside on a cold day, your nose tries its best to warm up the cold air you breathe before sending it to the lungs. Tiny blood vessels inside your nostrils open wider (dilate), helping to warm up that air. But that extra blood flow leads to more mucus production. You know what happens next. Drip, drip, drip.

Stoppin’ the Runnin’

If you have allergies, your doctor might give you medicine called an antihistamine (say: an-tye-HISS-tuh-meen). But sometimes the easiest thing to do is — you guessed it — blow your nose!

What ice and heat are for

Ice is for injuries, and heat is for muscles. Roughly.

Ice is for injuries — calming down damaged superficial tissues that are inflamed, red, hot and swollen. The inflammatory process is a healthy, normal, natural process … that also happens to be incredibly painful and more biologically stubborn than it needs to be. Icing is mostly just a mild, drugless way of dulling the pain of inflammation… we hope.1 Examples: a freshly pulled muscle or a new case of IT band syndrome (which is more likely to respond than the other kind of runner’s knee, patellofemoral pain, because ITBS is superficial and PFPS is often a problem with deeper tissues).

Heat is for muscles, chronic pain, and stress — taking the edge off the pain of whole muscle spasms and trigger points, or conditions that are often dominated by them, like back pain and neck pain), for soothing the nervous system and the mind (stress and fear are major factors in many chronic pain problems, of course).

What ice and heat are not for

Heat can make inflammation worse, and ice can make muscle tension and spasms worse, so they have the potential to do some mild harm when mixed up.

Both ice and heat are pointless or worse when unwanted: icing when you’re already shivering, or heating when you’re already sweating. The brain may interpret an excess of either one as a threat — and when brains think there’s a threat, they may also amp up the pain.

But heat and inflammation are a particularly bad combination. If you add heat to an fresh injury, watch out: it’s going to get worse! A physician once told my father to heat a freshly injured knee, and wow — it swelled up like a balloon, three times bigger than it had been before. And three times more painful. (That is a rare example of a particularly severe negative reaction to heat. Most cases are not going to be that bad!)

The lesser known threat is from icing at the wrong time, or when it’s unwanted.

If you ice painful muscles, be careful: it might get worse! Ice can aggravate sensations of muscle pain and stiffness, which are often present in low back and neck pain. Trigger points (painfully sensitive spots) can be surprisingly intense and easily mistaken for “iceable” injury and inflammation. But if you ice trigger points, they may burn and ache even more acutely. This mistake is made particularly often with low back pain and neck pain — the very condition people often try to treat with ice.

Signs and symptoms of a concussion may include:

  • Headache or a feeling of pressure in the head
  • Temporary loss of consciousness
  • Confusion or feeling as if in a fog
  • Amnesia surrounding the traumatic event
  • Dizziness or “seeing stars”
  • Ringing in the ears
  • Nausea
  • Vomiting
  • Slurred speech
  • Delayed response to questions
  • Appearing dazed
  • Fatigue

Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:

  • Concentration and memory complaints
  • Irritability and other personality changes
  • Sensitivity to light and noise
  • Sleep disturbances
  • Psychological adjustment problems and depression
  • Disorders of taste and smell

Symptoms in children

Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they may not be able to describe how they feel. Nonverbal clues of a concussion may include:

  • Appearing dazed
  • Listlessness and tiring easily
  • Irritability and crankiness
  • Loss of balance and unsteady walking
  • Crying excessively
  • Change in eating or sleeping patterns
  • Lack of interest in favorite toys

When to see a doctor

See a doctor within 1 to 2 days if:

  • You or your child experiences a head injury, even if emergency care isn’t required

The American Academy of Pediatrics recommends that you call your child’s doctor for advice if your child receives anything more than a light bump on the head.

If your child doesn’t have signs of a serious head injury, and if your child remains alert, moves normally and responds to you, the injury is probably mild and usually doesn’t need further testing. In this case, if your child wants to nap, it’s OK to let him or her sleep. If worrisome signs develop later, seek emergency care.

Seek emergency care for an adult or child who experiences a head injury and symptoms such as:

  • Repeated vomiting
  • A loss of consciousness lasting longer than 30 seconds
  • A headache that gets worse over time
  • Changes in his or her behavior, such as irritability
  • Changes in physical coordination, such as stumbling or clumsiness
  • Confusion or disorientation, such as difficulty recognizing people or places
  • Slurred speech or other changes in speech

Other symptoms include:

  • Seizures
  • Vision or eye disturbances, such as pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes
  • Lasting or recurrent dizziness
  • Obvious difficulty with mental function or physical coordination
  • Symptoms that worsen over time
  • Large head bumps or bruises on areas other than the forehead in children, especially in infants under 12 months of age

Bumps and bruises facts

    • A bruise is medically referred to as a contusion.
    • Bruises occur when tiny blood vessels are damaged or broken.
    • The injury required to produce a bruise varies with age and certain medications.
    • Individual bruises change in appearance over time.
    • Spontaneous bruising can indicate a serious bleeding tendency.

What is a bruise?

You fall off your bike, bang your shin on the coffee table (that you swore you would move months ago), or run into a wall and wake up with a bruise. What is a bruise, and what can you do about it? A bruise is caused when tiny blood vessels are damaged or broken as the result of trauma to the skin (be it bumping against something or hitting yourself with a hammer). The raised area of a bump or bruise results from blood leaking from these injured blood vessels into the tissues as well as from the body’s response to the injury. A bruise is medically referred to as a contusion. A purplish, flat bruise that occurs when blood leaks out into the top layers of skin is referred to as an ecchymosis.

Why do bruises occur more frequently in some people than in others?

The injury required to produce a bruise varies with age. Bruising occurs more easily in the elderly because their capillaries are more fragile than those of young people. While it may take quite a bit of force to cause a bruise in a young child, even minor bumps and scrapes may cause extensive bruising in an elderly person. Blood vessels become more fragile as we age, and bruising may even occur without prior injury in the elderly.

The amount of bruising may also be affected by medications which interfere with blood clotting (and thus cause more bleeding into the skin or tissues). These drugs include many arthritis medications called nonsteroidal anti-inflammatories (for example, ibuprofen [Advil, Nuprin] and naproxen [Aleve]) and over-the-counter medications, such as aspirin. Warfarin(Coumadin) is often prescribed by doctors specifically to prevent clotting in patients who have had blood clots in their legs or heart. Warfarin can cause severe bruising, especially if the level of the medication becomes too high. Cortisone medications, such as prednisone, promote bruising by increasing the fragility of the tiny blood vessels in the skin.

Patients with inherited clotting problems (such as in hemophilia) or acquired clotting problems (such as in patients with liver diseases like cirrhosis) can develop extensive bruising, unexplained bruising, or even life-threatening bleeding. Sometimes spontaneous bruising is a sign of a bone marrow problem. 

What are symptoms and signs of a bruise, and why does it change color?

Bruises can be associated with tenderness of the involved discolored area. Bruises change in appearance over time, and it may be possible to tell by looking at a bruise how old it is. When it first appears, a bruise will be reddish looking, reflecting the color of the blood in the skin. By one to two days, the reddish iron from the blood undergoes a change and the bruise will appear blue or purple. By day six, the color changes to green and by day eight to nine, the bruise will appear yellowish-brown. In general, the bruised area will be repaired by the body in two to three weeks after which the skin will return to normal.

It’s clear that there’s a link between stress and heart health; what’s not clear yet is why the two are connected. Now, a new study suggests that people with higher levels of stress also have more inflammation in their arteries, putting them at higher risk for heart problems.

In the new study, presented at the American College of Cardiology’s 65th Annual Scientific Session, researchers used imaging to look at 293 people’s brains and arteries. They found that stress activity in an area of the brain called the amygdala, which is where emotions are processed, was linked to more inflammation in a person’s arteries. “This is notable because arterial inflammation is an important driver of atherosclerotic disease, the major cause of heart attacks and stroke,” says study author Dr. Ahmed Tawakol, co-director of the cardiac MR PET CT program at Massachusetts General Hospital.

The researchers found that 35% of the people with high brain stress suffered a heart event over the nearly five-year study period. Only 5% of people with low brain stress experienced an adverse heart problem.

This study demonstrates, for the first time, that metabolic activity within a key component of the brain’s fear network predicts the development of [heart disease] in humans, independently of established risk factors,” says Tawakol.

The study size was small and more research is needed to confirm the link, but the evidence suggests scientists should consider the relationship between stress and inflammation as an important marker for future study.

For minor burns:

  • Cool the burn to help soothe the pain. Hold the burned area under cool (not cold) running water for 10 to 15 minutes or until the pain eases. Or apply a clean towel dampened with cool tap water.
  • Remove rings or other tight items from the burned area.Try to do this quickly and gently, before the area swells.
  • Don’t break small blisters (no bigger than your little fingernail). If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and cover it with a nonstick gauze bandage.
  • Apply moisturizer or aloe vera lotion or gel, which may provide relief in some cases.
  • If needed, take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).
  • Consider a tetanus shot. Make sure that your tetanus booster is up to date. Doctors recommend people get a tetanus shot at least every 10 years.

See your doctor if you develop large blisters. Large blisters are best removed, as they rarely will remain intact on their own. Also seek medical help if the burn covers a large area of the body or if you notice signs of infection, such as oozing from the wound and increased pain, redness and swelling.

Major burns

Call 911 or emergency medical help for major burns. Until an emergency unit arrives, take these actions:

  • Protect the burned person from further harm. If you can do so safely, make sure the person you’re helping is not in contact with smoldering materials or exposed to smoke or heat. But don’t remove burned clothing stuck to the skin.
  • Check for signs of circulation. Look for breathing, coughing or movement. Begin CPR if needed.
  • Remove jewelry, belts and other restrictive items,especially from around burned areas and the neck. Burned areas swell rapidly.
  • Don’t immerse large severe burns in cold water. Doing so could cause a serious loss of body heat (hypothermia) or a drop in blood pressure and decreased blood flow (shock).
  • Elevate the burned area. Raise the wound above heart level, if possible.
  • Cover the area of the burn. Use a cool, moist, bandage or a clean cloth.

Is it a minor burn or a major burn?

If it’s not clear what level of care is needed, try to judge the extent of tissue damage, based on the following burn categories:

1st-degree burn

A first-degree burn is the least serious type, involving only the outer layer of skin. It may cause:

  • Redness
  • Swelling
  • Pain

You can usually treat a first-degree burn as a minor burn. If it involves much of the hands, feet, face, groin, buttocks or a major joint, seek emergency medical attention.

2nd-degree burn

A second-degree burn is more serious. It may cause:

  • Red, white or splotchy skin
  • Swelling
  • Pain
  • Blisters

If the second-degree burn is no larger than 3 inches (7.6 centimeters) in diameter, treat it as a minor burn. If the burned area is larger or covers the hands, feet, face, groin, buttocks or a major joint, treat it as a major burn and get medical help immediately.

3rd-degree burns

The most serious burns involve all layers of the skin and underlying fat. Muscle and even bone may be affected. Burned areas may be charred black or white. The person may experience:

  • Difficulty breathing
  • Carbon monoxide poisoning
  • Other toxic effects, if smoke inhalation also occurred

  • Mild soap and moisturizer. It’s best to use a mild soap or soap substitute that won’t dry your skin. Gentle soaps, known as syndets, are available at the drugstore (brand names can be recommended by your doctor or pharmacist). A good moisturizer (in cream, lotion, or ointment form) helps conserve the skin’s natural moisture and should be applied immediately after a shower or bath, as well as one other time each day. Some people with severe eczema may benefit from taking baths with a small amount of bleach added to the water. The bleach helps to kill bacteria that live on the skin of people with eczema.
  • Short, warm showers. People with eczema should avoid taking very hot or very long showers or baths, which can dry out your skin.
  • Reduce stress . Take steps to reduce stress. Get regular exercise and set aside time to relax.
  • Get a humidifier.

Medications and other treatments for eczema include:

  • Hydrocortisone . Over-the-counter hydrocortisone cream or ointment may help mild eczema. Prescription steroid cream may be needed for more severe eczema.
  • Antihistamines . Oral antihistamines such as Benadryl are available over-the-counter and may help relieve symptoms. Some of these cause drowsiness, which may be of benefit if nighttime itching is a problem. There are also non-drowsy antihistamines.
  • Corticosteroids. If other treatments fail, your doctor may prescribe oral corticosteroids. Always follow your doctor’s directions when taking oral steroids.
  • Ultraviolet light therapy. People with very severe eczema may benefit from therapy using ultraviolet light.
  • Immunosupressants. Drugs that suppress the immune system may also be an option. These medicines, such as cyclosporine, azathioprine, or methotrexate, may be used when other treatments have failed.
  • Immunomodulators. This type of medicated cream helps treat eczema by controlling inflammation and reducing the immune system reactions. Examples include Elidel and Protopic.
  • Prescription-strength moisturizers. These replace the barrier of the skin. Examples include Hylatopic Plus, Mimyx, and Epiceram.

Book your appointment