The 101 dirtiest things we touch

Protect yourself from getting sick: Disinfect items and wash your hands

It is no surprise that our world is filled with millions of germs. Some germs are both wanted and important. In fact, we have populations of germs that live on our skin and inside our bodies that are essential for life. This group of microbes and germs is collectively called a microbiome and will be the subject of a future article.

Unfortunately, many germs are not essential to us and are downright dangerous for our health. The most important thing you can do for good health is to wash your hands on a regular basis.

Many of these germs live on ordinary, everyday objects that we use all the time. Some of the items around us we would expect to be dirty. Some of the other things around us may be very dirty, and the list of them may come as a complete surprise.

Even if you are not a total germaphobe, when we look at the list of 101 of the dirtiest things we encounter and touch every day, it should make us more motivated to wash our hands regularly.

The List

  1. Airports security bins
  2. Armrests at public places like theatres, doctor’s offices, lecture halls, airplanes and other forms of public transportation (including the food trays that are stored in airplane armrests)
  3. Appliance control knobs
  4. ATM buttons
  5. Banisters at home and in stairwells
  6. Bar games (pinball buttons, video game buttons, darts, hockey game handles, etc.)
  7. Bathtubs
  8. Bathroom door handles, especially inside, leading out
  9. Bathroom sink faucet handles
  10. Bowling balls (free loaners at the alley) 
  11. Car interior controls, including shifter knobs, radio, climate control, and touchscreens
  12. Car seatbelts (insertion parts)
  13. Carpeting
  14. Casino dice
  15. Cell phones
  16. Children’s toys
  17. Coffee mugs at restaurants
  18. Coffee pot handles and all things commonly touched in the office break room
  19. Computer keyboard
  20. Computer mouse
  21. Copy and fax machine buttons
  22. Credit cards
  23. Crosswalk buttons
  24. CPAP masks and keypad
  25. Diaper changing stations
  26. Doorknobs
  27. Door handles
  28. Doorbell buttons
  29. Drinking glasses at bars and restaurants
  30. Drinking fountains
  31. Elevator buttons
  32. Escalator handrails
  33. Eyeglasses
  34. Fruit (like limes) squeezed into cocktails, beer and other drinks. Often, the bartenders are in a hurry and grab the lime or other fruit slices with their bare hands. Then they squeeze and drop the fruit down into your drink. The germs from their fingers are now on the fruit that is floating in your drink or Mexican beer. As one person said, it is the same as going into the bar and asking the bartender if you can lick their fingers. Oh my!
  35. Gaming controls
  36. Garage remote controls in our cars and on the garage wall
  37. Gas pump handles
  38. Grill handles
  39. Hairbrush handles
  40. Handles on subways and trams that are used to hold on to when the vehicle is moving
  41. Handshakes
  42. Hearing aids and eyeglass frames
  43. Hot tubs
  44. Hot and cold-water dispenser knobs/levers
  45. Hotel room telephones
  46. Keys
  47. Kitchen sink
  48. Kitchen sink sponges and towels
  49. Kitchen towels
  50. Laundry. Use bleach on whites, hot water washes, and long hot, dry cycles
  51. Light switches
  52. Litter boxes
  53. Locker door handles at the gym
  54. Loofa sponges
  55. Lunch boxes
  56. Magazines in reception rooms
  57. McDonald’s play areas
  58. McDonald’s play area plastic balls
  59. Money, including coins and paper
  60. Mailbox handles
  61. Microwave keypads
  62. Office telephones and telephone receivers
  63. Paper towel dispenser levers
  64. Parking meters
  65. Pens on a cord or chain (like at the bank) or the stylus pen at the credit card signing station
  66. Pet toys
  67. Pet dishes
  68. Pet leashes
  69. Playground equipment, inside and outside
  70. Poles on subways and trams that are used to hold on to when the vehicle is moving
  71. Public bathrooms: inside stall latches
  72. Purses
  73. Railings in stairways
  74. Refrigerator door handles
  75. Restaurant menus
  76. Restaurant salt and pepper shakers and table condiment containers
  77. Restaurant table tops — especially if wiped down with a sponge or cloth from the same tub of water used over and over, or the sponge or cloth is used repeatedly on all tables.
  78. Restaurant utensils and dishes, including shared utensils to serve food at buffets. Studies have shown that almost all restaurant silverware has detectable amounts of norovirus, E. coli, and Listeria.
  79. Security door keypads
  80. Security system alarm programming pads
  81. Self-checkout stands at the store
  82. Shoes, especially the bottoms
  83. Slot machine buttons
  84. Soap dispenser buttons
  85. Sports balls (basketballs, volleyballs, footballs, etc.)
  86. Sports equipment at the gym, inclkudindf bikes, treadmills, weights)
  87. Steering wheels (cars)
  88. Stove and oven control knobs
  89. Shopping cart handles
  90. Shower handles
  91. Testers (e.g. make up) and sample jars at stores
  92. Toilet seats
  93. Toilet flush handles/levers
  94. Toothbrush and toothbrush holders
  95. Touchscreens
  96. TV remote controls
  97. Urinal flush handles
  98. Vending machine button
  99. Wallets
  100. Water bottles that are regularly refilled
  101. Straps on subways and trams that are used to hold on to when the vehicle is moving

Many of the things around us can and should be cleaned on a regular basis. Most things should be cleaned daily or weekly. Use a commercial disinfectant spray or wipe according to directions. For cell phones, use a microfiber cloth and a 70 percent isopropyl alcohol solution.

New Drug — trail-blazing cancer treatment

The FDA just approved a new revolutionary drug for the treatment of cancer. The medication, Vitrakvi (larotrectinib), is unique in that it treats the geneticbasis of what is driving cancer and not the type of cancer once it hasdeveloped.

The mutation that causes cells to become cancerous is found in many different types of cancers. So, this new treatment is not just for one cancer but may treat many different types of cancer. This is avant-garde thinking.

Vitrakvi (larotrectinib) is manufactured by Bayer and is available in pill and liquid forms. It can treat cancers in children and adults, but it isn’t cheap. For adults, the medicine is just under $400,000 per year. In children, the cost is about $135,000 per year.

How does Vitrakvi (larotrectinib) work?

This drug works by blocking a specific mutated enzyme (tyrosine kinase) in cancer cells. When present, this defective enzyme causes cancerous growth in many different types of cancer.

Why is it revolutionary?

Vitrakvi (larotrectinib)is one of the first drugs of its kind that focuses on treating the genetic basis of cancer, not just the type of cancer. That is, it goes after the switch that turns a normal cell into a cancerous cell.

By analogy, there are many types of car manufacturers. Instead of trying to treat a single entity, like a Chevy or a Ford or Honda, this medicine focuses on treating the force that makes the cars go — the engine!

As a result, this radical approach has the potential of treating many kinds of cancers (all cars have engines) rather than a specific type of cancer (Chevy, Ford or Honda). This groundbreaking approach has a much broader potential in the war against cancer. By developing the ability to stop the engine of any car, there is the potential of stopping many different types of cars from running, which supports the analogy of fighting many kinds of cancer.

Since it is FDA-approved, will insurance cover it?

Yes and no. The drug has a broad appeal and the benefit of treating both children and adults.  Unfortunately, the price tag is astronomical.

Medicare and Medicaid are not covering the medication yet, but it is hopeful that they will.  If they do, third-party payers usually follow suit, but once again, due to cost, any and all insurances may have restrictions, limitations, and only partial coverage. Insurance coverage, of course, will improve as the price comes down.

If someone has cancer, how do they discover if this medicine will work for them?

The appeal of this medication is that it works in many different cancers both in children and adults. This fact, by itself, is remarkable and substantial.

Unfortunately, the type of genetic mutation that drives these cancers represents only a small percentage of overall cancers, probably less than five percent. So, it certainly won’t work in all cancers. But when it does work — and it has already helped many patients in the tests and trials — some patients have experienced remarkable results.

We currently don’t know which cancers will respond. Fortunately, tests will be available to see if a person’s cancer is responsive to this new treatment. A person’s cancer will be mapped for mutations. Once the mutations are discovered, any available medications that attack that mutation can be employed.

Hopefully, over time, we will build a bigger and bigger army of medicines that attack a wide variety of genetic mutations that cause a wide range of cancers located anywhere in the body. Unfortunately, these tests are new, expensive and challenging. They will very likely get better and less costly on a rapid and regular basis. Regardless, people should get tested, because we now have a revolutionary and effective treatment for select cancer patients.

The future of cancer treatment

Vitrakvi (larotrectinib) is the first medication designed specifically to attack cancers based on the gene mutations that make them malignant and not where they occur in the body or the type of tissue the cancer comes from. We will no longer treat the tissue where cancer comes from; we will address the DNA mutation that causes a cancer in the first place.

Calling a cancer by the mutation that causes it and not the tissue or organ it comes from, such as breast or prostate cancer, is a trail-blazing approach in the treatment of cancer. It now shifts our thinking and focus when it comes to treating and curing cancer. This new view is the future of cancer treatment.

We no longer need to consider or call cancer the name based on its tissue type. We will now look at cancers based on the gene mutations that drive them. These very mutations can then be detected, and drugs can be designed and selected to attack the mutations.

Attacking the genetic cause of malignancy has been the Holy Grail for cancer treatment, and we are now about to sip from the cup. The future has never been brighter for the war on cancer.

Related content:

New advances in the war on cancer: living cell therapy

What is cancer?

Good news: we are winning the war on cancer

Carbon monoxide is a silent winter killer

Carbon monoxide is a very sneaky killer. The poisonous gas has no odor, no color, no smell, and no taste.

Carbon monoxide is a gas given off by everyday fuel-burning items that we regularly use. Usually, using appliances is not a problem, but if there is improper ventilation in an area where an engine or other devices are burning carbon monoxide-producing fuels, carbon monoxide can build up to dangerous levels. Humans in the area can breathe it in and become poisoned.

Breathing in smoke from a house fire can also cause carbon monoxide poisoning. Because carbon monoxide is odorless, colorless and tasteless, a person can be exposed to it and not even know it.

This situation is especially dangerous for people who are sleeping or intoxicated. Carbon monoxide poisoning can more easily affect unborn babies, children, elderly adults, and persons with heart conditions.

The way carbon monoxide poisons a person is that the carbon monoxide molecule binds to hemoglobin in our blood, preventing the usual binding of oxygen to hemoglobin. Our blood typically carries oxygen to all the cells in our body. Without oxygen, our tissues and organs can become damaged and even die. A fresh and constant supply of oxygen is essential for life.

Every year, 16,000 people are rushed to the emergency room with carbon monoxide poisoning. Over 500 people die from it every year in the U.S. Most deaths from carbon monoxide occur in the winter, especially December and January.

The experts suspect that the numbers of deaths from carbon monoxide poisoning are much higher due to under-reporting. Less than 15 states require the reporting of carbon monoxide deaths, there are no good autopsy tests for carbon monoxide poisoning, and coroners rarely suspect it as a cause of death.

When certain fuels are burned, they will produce carbon monoxide. Common fuels that can produce carbon monoxide when burned include:

  • Gasoline
  • Wood
  • Propane
  • Charcoal

Common producers of carbon monoxide include:

  • Gas furnaces
  • Charcoal grills
  • Automobiles
  • Propane stoves
  • Portable generators

The symptoms of carbon monoxide poisoning are common and non-specific. They include:

  • Headaches
  • Nausea and vomiting
  • Weakness
  • Lightheadedness
  • Fatigue
  • Dizziness
  • Blurry vision
  • Shortness of breath
  • Confusion
  • Loss of consciousness

Depending on how much carbon monoxide one is exposed to, the results of carbon monoxide poisoning can cause:

  • Severe illness
  • Irreversible brain damage
  • Heart damage that can be life-threatening
  • Death of an unborn baby in pregnant mothers
  • Death

To prevent carbon monoxide poisoning, the Centers for Disease Control and Prevention suggests:

  • Annually, have a certified technician check your furnace/heating systems, water heaters, and other gas-burning appliances. Your utility company can help you with this.
  • Install carbon monoxide detectors on all levels of your home and outside of sleeping areas. Change the batteries with daylight saving time changes, twice per year. If the alarm goes off, leave the area immediately and call 9-1-1.
  • Seek immediate medical attention if you suspect your ill-feeling, dizziness or nausea is the result of being near a fuel-burning engine or appliance.
  • Never use a generator, a camp stove, charcoal grill, or any other fuel-burning device inside a home.
  • Never use fuel-burning devices near a window even if they are running outside.
  • Never run an automobile inside a garage, even if the garage door is open.
  • Never use solvents inside. Many can produce fumes that can break down into carbon monoxide, especially solvents used to thin and clean varnish and paint. Use only in a well-ventilated area.
  • Never burn anything in a fireplace if it is not properly open or vented to the outside.
  • Never use a gas oven to heat your home.

The treatment of anyone with carbon monoxide poisoning includes getting into fresh air and getting medical help immediately. At the hospital, treatment may require breathing pure oxygen or even placement into a special pressurized oxygen treatment chamber.

Carbon monoxide poisoning is a life-threatening medical emergency. It is a silent, poisonous killer that is common in the winter or anytime one is around burning fuels. If you think you or someone you’re with may have carbon monoxide poisoning, get into fresh air and seek emergency medical care immediately by calling 9-1-1.

Katlyn H., CMA, Answers 5 Questions

Crutchfield Dermatology spa esthatician
Katlyn H.
Favorite TV show? The Good Life Favorite skin care product? Neostrata Smooth Surface Daily peel pads followed by Dr. Crutchfield’s Natural Face Cream! If there’s one thing you wish people did for their skin, what would it be? Stop worrying too much about what you’re cleansing with and just keep it simple. Cleanse WELL to give your skin a good base before putting anything on your skin and never skip a moisturizer! When and why did you decide to enter the Dermatology World? 5 years ago I started my Career as a Medical Assistant and it was pure luck that I ended up here, but I cannot imagine not working with skin now! What’s your favorite Treatment and why? HydraFacial because it is simply great for anyone. The afterglow and fresh feeling is addicting! What are my beauty must haves in your purse?  Jane iredale Lip drink lip balm in color “flirt” and Aquaphor ointment for additional lip moisture!

Experts agree: More exercise means better health

Last week, the federal government came out with new recommendations for exercise and health. It is the first update issued by the government on exercise in 10 years.

A unique new position of the proposal by the U.S. Department of Health and Human Services (HHS) is that exercise, even in small amounts, can make a big difference. “Sit less and move more. Whatever you do, it all matters,” said Brett P. Giroir, assistant secretary for the HHS, in a recent interview.

The new guidelines are much more flexible. Previously, they said exercise should take place in blocks of at least 10 minutes. Not anymore. Even brief periods of activity, including housework, can count toward the overall daily total.

The report, published in the Journal of the American Medical Association, also states ongoing concern that the minimum goals of exercise are not being met by 80 percent of Americans, and almost 40 percent of Americans are obese.

The new exercise guidelines (for adults) cite 150 to 300 minutes of moderate-to-intense activity per week or 75 to 150 minutes of vigorous-to-intense activity per week. Additionally, two days per week should include muscle and bone strengthening activities. For older adults, balance-improving work should occur weekly, too. These are goals consistent with the 2008 recommendations.

Moderate-to-intense activities include:

  • Brisk walking
  • Raking leaves
  • Vacuuming
  • Playing volleyball
  • Casual swimming
  • Casual biking
  • Dancing
  • Softball

Vigorous activities include:

  • Jogging
  • Running
  • Intense fitness class
  • Intense biking
  • Intense swimming
  • Basketball
  • Intense dancing
  • Carrying heavy groceries
  • Active soccer

Recommendations for kids and teens (ages 6-17) call for at least 60 minutes of intense or vigorous activity daily, combined with three days per week of muscle-strengthening exercises. New to the guidelines are exercise recommendations for preschoolers, ages three to five. The report calls for three hours of daily activity for this group too. Activity means active play.

One parent reports a successful way to pull children away from screen time is to structure active play with other children and in groups settings. Have their friends over and let them play without devices/screens.

Experts state that overweight preschoolers often continue to be overweight children, and the continued obesity becomes harder and harder to correct over a lifetime. The health status and activity level of small children, unchecked, can chart a course for decades.

The report also has exercise guidelines for pregnancy, for the post-partum period, and with disabilities as detailed in the reference provided below.

Doctors say that since the 2008 report, we have come to confirm and understand more than ever how vitally important movement and exercise are for our overall health benefits. Increased movement and exercise show improvements in:

  • Sleep
  • Cancer prevention (especially bladder, colon, esophagus, stomach, breast, endometrium, kidney and lung)
  • Anxiety
  • Depression and post-partum depression
  • Emotional health
  • Bone health
  • Cognitive function and academic success
  • Balance and fall prevention in older adults
  • Diabetes
  • Weight control and healthy weight maintenance

Researchers report that every year in the United States alone, we spend over one billion dollars in healthcare costs related to the problems of inactive lifestyles. Experts say that even exercising one day a week can have profound health effects.

“Being physically active,” the guidelines reports, “is one of the most important things people of all ages can do to improve their overall health.”

Remember, a journey of 100 miles begins with a single step. Talk to your doctor or a physical fitness expert to get started on an exercise program today. Think about including the whole family. Starting at just a few minutes a day and building on that foundation can have fantastic quality-of-life and health benefits for you and your family.

 

Reference: The Physical Activity Guidelines for Americans, bit.ly/2P2HlRz

All About Colds

How to lessen their frequency and ease their symptoms

It’s that season again — cold season! Let’s talk about what a cold is, how to prevent them, and how to treat them.

A cold is a viral infection of your sinuses/nasal passages and throat. Sometimes it can spread into your deep throat and cause bronchitis.

There are over 99 different viruses that can cause a cold. Because colds often affect the nasal passages, most of the viruses that cause colds are “rhinoviruses”; the term “rhino” means “nose.”

There is no cure for colds, so one must let a cold “run its course.” Most colds last about four to seven days.

The difference between a cold and the flu is that colds are not as severe, don’t produce high fevers, and don’t cause significant tiredness or fatigue. There are measures one can take to prevent the number of colds one gets and to treat the symptoms if a cold develops.

Common cold symptoms

  • Stuffy nose
  • Runny nose
  • Sore throat
  • Coughing
  • Sneezing
  • May have mild fever
  • May have mild fatigue-tiredness
  • Nasal pressure
  • Watery eyes

Prevention

The best way to treat a cold is to prevent it in the first place. Some things that help to prevent colds include:

  • Hand washing. This is the most important thing you can do to prevent colds. Wash hands for at least 30 seconds. Some people sing “Happy Birthday” silently, twice, as a timing device as they wash their hands.
  • Get a flu shot or mist every year.
  • Don’t touch the faucet handles or doorknobs in public restrooms. Use a towel to turn the water off and your elbow to open the door.
  • If a sink is not available, use hand sanitizing gels.
  • Don’t cough into your hand; cough into your elbow.
  • Don’t touch your food with your hands; use eating utensils.
  • Get plenty of rest.
  • Eat healthy, including a daily multivitamin.
  • Clean commonly encountered surfaces regularly with disinfectant sprays. This includes bathroom surfaces, cell phones, doorknobs, refrigerator handles, steering wheels, and other commonly touched door handles.

Treatment

There is no cure for the common cold, so reducing aggravating symptoms is the goal. Because colds are caused by a virus, classic antibacterial antibiotics are useless. The following are steps to reduce symptoms:

  • Take a pain reliever such as Tylenol, Ibuprofen or aspirin. Talk to your doctor before giving any child with cold symptoms a fever aspirin; unwanted side effects can occur.
  • Use nasal decongestant sprays. These work well to ease breathing but should only be used for two or three days. If used too long, the user can develop dependence.
  • Use cough medicines. This includes throat lozenges and liquid syrups. These will make you feel better, but they won’t resolve a cold any sooner.
  • Drink lots of fluids. Sports-like drinks, fruit juices, and warm tea and broths work well.  Chicken soup has been proven to make cold sufferers feel much better. Avoid alcoholic beverages or anything that can cause dehydration.
  • Take Vitamin C. 1000 milligrams a day for three to five days has been reported to be helpful.
  • Calm the throat. For sore throats, gargling with warm salt water or throat lozenges works well.
  • Get plenty of rest. Don’t over-extend yourself; allow your body’s immune system to strengthen and fight back.

We all get colds. It is a part of living. Hopefully, this information will lessen their frequency and symptoms. Remember, if you are concerned about any illness, contact your doctor immediately.

Tinnitus: common, constant, incurable — but very manageable

Dr. Crutchfield, my sister told me recently that she was suffering with severe ringing in her ears. Her doctor told her it was something called ‘tinnitus.” What is tinnitus? Great question. I’ve asked one of my colleagues, Inell Rosario, MD, an expert on the subject, to enlighten us with a discussion on tinnitus this week. Dr. Rosario: Tinnitus is a fairly common medical malady that afflicts many people in mild forms, although they may not always be aware of it. As many as 50 to 60 million people are affected by a phantom ringing, whistling or buzzing noise that is usually only perceived by them. A much smaller percentage (usually one to two percent) describes the condition as debilitating and, although there is no cure, must seek treatment to see a significant impact on their condition and to live a normal life. Most of the time, the cause of tinnitus is unclear. In the absence of damage to the auditory system (such as head or neck trauma), things like jaw-joint dysfunction (TMJ), chronic neck-muscle strain, and excessive noise exposure have been suggested as causes. Certain medications can also cause tinnitus, which, in this case, can either disappear again after usage of the medication ends or can cause irreparable damage that results in permanent tinnitus. Other causes may be wax buildup, cardiovascular disease, or a tumor that creates a strain on the arteries in the neck and head. These tumors are usually benign. Tinnitus can be managed through strategies that make it less bothersome. No single approach works for everyone, and there is no FDA-approved drug treatment, supplement, or herb proven to be any more effective than a placebo. Behavioral strategies and sound-generating devices often offer the best treatment results; this is partially why distracting the individual’s attention from these sounds can prevent a chronic manifestation. Some of the most effective methods are: Cognitive behavioral therapy (CBT)  Uses techniques to relax and restructure the way patients think about and respond to tinnitus. Sessions are usually short-term and occur weekly for two to six months. CBT usually results in sounds that are less loud and significantly less bothersome, with the overall quality of life improved. Tinnitus retraining therapy  Effective based on the assumption that the tinnitus results from abnormal neuronal activity. This therapy habituates the auditory system to the tinnitus signals, making them less noticeable or bothersome. Counseling and sound therapy are the main components, with a device that generates low-level noise that matches the pitch and volume of the tinnitus. Depending on the severity of the tinnitus, treatment may last one to two years. Masking  Use of devices generating low-level white noise that can reduce the perception of tinnitus and what’s known as residual inhibition. Tinnitus will be less noticeable for a period of time after the masker is turned off. A radio, television, fan, or another sound-producing machine can also act as a masker. Biofeedback  A relaxation technique that helps control stress by changing bodily responses to tinnitus. A patient’s physiological processes are mapped into a computer, and the individual learns how to alter these processes and reduce the body’s stress response by changing their thoughts and feelings. Treatment options are vast, but vary in effectiveness depending upon the type of tinnitus. Research shows more than 50 percent of tinnitus sufferers also have an inner-ear hearing impairment. While hearing aids act as an effective relief method for those with tinnitus by amplifying external sounds to make internal sounds less prevalent, they are not the only method. Careful diagnosis by a professional with years of experience creating solutions for tinnitus sufferers is essential.

Everything you need to know about acute flaccid myelitis

This rare but very serious condition can cause paralysis in children

Dr. Crutchfield, I saw on the news that many Minnesota children are developing polio-like symptoms. What is this about? The condition is called acute flaccid myelitis (AFM). It is a rare, but very serious condition that affects a person’s nervous system via the spinal cord. The results are a weakening of one or more of the arms or legs or other muscles of the body. The weakening of the legs can cause extreme difficulty walking and even paralysis. As a result, the condition is very similar, clinically, to polio. Some patients make a rapid recovery and others may have a lengthy, perhaps even permanent paralysis. The prognosis can vary depending on the patient. If a person does have AFM, it is essential to use all treatment and rehabilitation options available. We currently are uncertain of what causes AFM. There may be one singular cause, or the condition may be a result of many causes that can produce the same effects. Scientists postulate that it could be a yet-to-be-identified virus or even environmental toxin. I would also submit for consideration infectious proteins called “prions” that can cause disease. Additionally, doctors are not sure of any factors that would increase one’s risk of developing AFM. What we do know
  • The condition is very rare, affecting less than one in a million persons in the United States.
  • There have been six documented cases of AFM in Minnesota, with over 20 suspected cases.
  • From August 2014 through September 2018, there have been about 390 reported cases of AFM in the United States. (Reporting is voluntary, so this number is probably lower than the actual number of cases that have actually occurred.)
  • Most cases are of children. The average age is four, and 90 percent of cases occur in those younger than 18.
  • In no cases have doctors discovered a causative agent, including the polio virus.
Symptoms
  • Sudden weakness in the arms or legs
  • Facial droop
  • Facial weakness
  • Slurred speech
  • Drooping eyelids
  • Difficulty moving the eyes
  • Difficulty swallowing
  • Difficulty breathing. This is the most severe complication of AFM because a weakening of the muscle that controls breathing is a medical emergency that, without immediate support, can lead to death.
What the Centers for Disease Control (CDC) is doing The CDC is actively investigating all reported cases of AFM and working closely with doctors and other healthcare providers and health departments to increase awareness of AFM. CDC activities include:
  • Encouraging healthcare providers to be watchful and report suspected cases of AFM
  • Actively looking for risk factors for developing AFM
  • Testing specimens, including stool, blood, and cerebrospinal fluid, from alleged AFM cases
  • Working with researchers across the country and world to determine the cause of AFM
  • Disseminating all new information on AFM to doctors, healthcare providers, and health departments as it becomes available
What you can do Because the condition mimics the result of a viral infection, it is essential to:
  • Practice good hand-washing techniques
  • Use appropriate mosquito repellants and protection
  • Ensure all vaccinations are up to date
If your child develops weakness of any limb, especially if they have cold-like symptoms or other viral symptoms, take them to the doctor immediately. The prognosis now depends on getting prompt medical care as soon as possible. Eventually, we will understand the cause of AFM. Until then, these action steps are our best hope for prevention and a good recovery.

50 Over 50

Charles E. Crutchfield III, M.D.

Busy Healer

Skin is the body’s largest organ—and Dr. Charles E. Crutchfield III, owner of Crutchfield Dermatology, works tirelessly to keep skin of all shades healthy. And “tireless” is perhaps an understatement. The 57-year-old Eagan resident sees patients five days a week, manages a staff of 40, and serves as a clinical professor at the University of Minnesota Medical School, where he’s earned three distinguished teaching awards. Dr. Crutchfield also serves as team dermatologist for the Timberwolves, Twins, Vikings, and Wild; and publishes a dermatology “case-of-the-month” that’s delivered to over 50,000 physicians worldwide. He also writes a highly regarded column on skin care for the Minneapolis Spokesman-Recorder, and has penned over 200 scientific and educational publications, plus several books, including one for children. He’s a founding member of a nonprofit dedicated to improving the safety and ethics of cosmetic skin care for people of all ethnicities, and he sponsors a lecture series on the topic. So, it’s no surprise that Dr. Crutchfield has received virtually every prestigious professional recognition, including the Karis Humanitarian Award from the Mayo Clinic.

Success in business is sometimes measured with simple arithmetic, but many in business see true success as finding ways to sustain both themselves as well as the environments in which they exist. That’s the common bond between these 10 business leaders. Whether they’ve made a name for themselves in banking, financial planning, life planning, marketing, media or medicine, they all apply their effort and know-how to invest in their neighbors and communities. They’re living proof that these unique combinations of skills and values don’t depreciate past age 50.

Cutting one’s skin is a cry for attention and help

Many things happen behind closed doors and in private, sometimes going completely unnoticed or unimaginable. One of those things is self-harm, such as cutting, which occurs much more often than people would expect. Every year, one in five females and one in seven males engage in self-injurious behavior. About 90 percent of those who participate in self-harm began during their pre-teen or teenage years. Approximately two million cases are reported annually in the U.S. Imagine how many cases there actually are, since a majority of the cases go unreported. When cutting occurs, it usually manifests as horizontal scars across the lower arms (as in the picture) and upper thighs. These are both areas that can easily be covered with clothing. Cutting isn’t the only form of self-harm that can be done. Other types of harm that can be self-inflicted and warning signs to look out for include:
  • Burning
  • Picking at or reopening wounds
  • Punching or hitting oneself
  • Inserting objects into the skin
  • Purposely bruising or breaking one’s bones
  • Pulling out one’s hair
There are several myths about cutting and other forms of self-harm, which are important to recognize, understand, and even debunk. First, cutting isn’t considered an attempt at suicide. According to the Diagnostic Manual of Mental Disorders (DSM-5), the authoritative guide for doctors, cutting is considered a non-suicidal self-injury disorder. Second, it is not a mental illness. Cutting is a behavior indicating a lack of coping skills for emotional pain, intense anger and frustration. Even though self-injury brings a brief feeling of calm, it is usually followed by guilt, shame, and the return of painful emotions. This destructive cycle can become addictive to the point that it becomes a compulsive behavior and difficult to stop. There are a great many reasons why people engage in cutting. It can be triggered by someone’s social environment. An overwhelming amount of stress can lead someone to feel like there’s no way out or to feel so empty that the only emotional release is through inflicting pain. What you can do: In order to help prevent someone from harming themselves, it helps to understand the risk factors and to be aware of red flags of secretive behavior. Risk factors include, but are not limited to:
  • Age (teenagers and young adults most common, although it can happen at any age)
  • Having friends who self-injure
  • Abuse (sexual, physical or emotional)
  • Social isolation/ loneliness
  • Mental health issues (i.e., borderline personality disorder, eating disorders, depression, anxiety disorders, substance abuse, conduct, and oppositional defiant disorders)
Common signs and symptoms might include:
  • Parallel linear scars on the arms
  • Fresh cuts, scratches, bruises or other wounds
  • Possession of sharp objects, like a razor
  • Difficulties with relationships
  • Persistent questions about personal identity, such as “Who am I?” and “What am I doing here?”
  • Emotional and behavioral instability, impulsivity and unpredictability
  • Statements of helplessness, hopelessness or worthlessness
Each of us has a responsibility to look out for friends, family and acquaintances for any signs or suspicions of self-harm and to offer help and support during whatever is compelling someone to hurt themselves. If you have a friend, loved one or acquaintance who is self-injuring or has revealed thoughts about self- harm, you must take it seriously. You may feel shocked, scared, or even feel you’re betraying their privacy. However, this is too big of a problem to ignore, and their safety and well-being are the most important considerations. If you know anyone injuring themselves, suggest they reach out to someone they trust, such as their parents, friends, teachers, a counselor, a physician or spiritual leader. Furthermore, always keep the suicide hotline number close by: 1-800-273-TALK (1-800-273-8255). If you find yourself in an emergency situation, this requires a quicker but, most importantly, calm response by calling 911 or other local emergency numbers. Do not condemn or criticize anyone who has cut themselves for their behavior. What they need most is support and healthy coping skills rather than added negativity. Preventing self-harm should be the utmost goal. There’s no fool-proof way to do so, but there are various avenues that can be taken to curtail it, including many seemingly small things anybody can do to look out for others and make a real difference. Help is available If you have ever harmed or currently harm yourself in any way, or if you’ve had suicidal thoughts, remember one thing: You can overcome almost any challenge. If you have injured yourself and believe your injury is life-threatening in any way, immediately call 911 or the suicide hotline. Most importantly, reach out to somebody, anybody. If you can’t talk to your family members, talk to your doctor. If the doctor is not available, there is always help available at the hospital’s emergency room. Be it family, friend, minister or doctor, there is always someone there to help you. Please reach out.