Why to Reconsider Vaping

by Elizabeth Ybarra RRT, TTS – Medical Center Health System Cardiopulmonary Staff Educator

As seen in the Odessa American’s Medical Matters:


Society changes and upgrades are everywhere. For example, look at fashion, art and television. Other changes include actions and what is “popular” at any particular time. That being said, smoking cigarettes has been around for centuries … that is nothing new. However, “vaping” is a new trend that is being highly utilized by the population.

What is “vaping”?

Vaping is also known as electronic nicotine delivery system, or E.N.D.S. These electronic nicotine devices have become the new trend, especially in the younger populations. The allure has to do with these “e-cigarettes” being small, having no smell and providing a variety of flavors that are fun and appealing.

Are “e-cigarettes” good or bad for you?

Some news sources and our society have been implying that e-cigarettes are harmless and a better alternative to regular cigarettes. But that message is not necessarily accurate.

To understand the good and bad of these devices, one has to know a little more about how they work. The devices have a heating element that heats up a cartridge filled with nicotine. The heat produces a vapor that is then inhaled. The e-cigarette contains a humectant, typically propylene glycol, flavoring and nicotine (rti.org).

Why are e-cigarettes something to reconsider?

There are three main reasons to reconsider ever “vaping” in the first place, or certainly never again.

  • The biggest reason is that these devices are not regulated by the FDA. Therefore, the amount of nicotine and humectant might not be disclosed or accurate.
  • These devices have simply not been around long enough for adequate clinical findings on how these ingredients effect the body when heated.
  • The popularity of vaping creates the potential to encourage non-smokers to start experimenting with nicotine. According to Quit.com, research suggests that nicotine is as addictive as mood and behavior altering drugs such as heroin, cocaine and alcohol. It is tough to quit nicotine, so why start using it to just be part of a trend?!

Is there anything good about vaping?

The only good thing about vaping is that there is no combustion with e-cigarettes like there is with normal cigarettes. (NationalAcademies.org) The combustion aspect of a lit cigarette is that it releases over 7,000 chemicals.

There might not be that same worry with vaping, but do not be fooled. There are still toxins being inhaled that affect smokers and nonsmokers as well. (TruthInitiative.org)

So, the next time someone wants a companion to vape with, opt out of that dangerous experience and put your health first.


Handwashing – The “do-it-yourself” vaccine that reduces the spread of germs.

By Veronica Montano, MSN, RN – Bridge Nurse Residency Coordinator, CNE Planner

National Handwashing Awareness Week is Dec. 3 through Dec. 9. According to the Centers for Disease Control and Prevention (CDC), handwashing is like a “do-it-yourself” vaccine that reduces the spread of germs. You can reduce the spread of diarrheal and respiratory illnesses by correctly washing your hands.


The CDC recommends washing hands with soap and clean, running water to avoid getting sick and spreading germs to others. You should wash your hands before eating food, before and after caring for someone who is sick, after using the toilet, after changing diapers or cleaning up a child who has used the toilet, after blowing your nose, coughing or sneezing, after touching your pets and after touching garbage. Washing your hands correctly by using soap and clean water can protect you, your family and others. Hand hygiene is one of the most important measures to take to avoid getting sick and spreading germs.


The CDC recommends washing your hands as follows:

  • Wet your hands with clean, running water (warm or cold) and apply soap.
  • Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers and under your nails.
  • Scrub your hands for at least 20 seconds. (Hum the “Happy Birthday” song from beginning to end twice.)
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air-dry them.


When and how to use hand sanitizer:

  • When soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.
  • Apply the product to the palm of one hand and rub the product all over the surfaces of your hands until your hands are dry.
  • Alcohol-based hand sanitizers can reduce the number of germs on hands in some situations.
  • They do not eliminate all types of germs.
  • If hands are visibly dirty or greasy, hand sanitizers may not be as effective.
  • Swallowing alcohol-based sanitizers can cause alcohol poisoning. Keep out of reach of young children.


Content Sources: Centers for Disease Control and Prevention, 2017 National Health Observances, National Health Information Center, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Washington, DC.



Antibiotic Misuse and YOU!

by Lindsay Rumold PharmD, BCPS, and Erica Wilson PharmD, BCPS

As seen in Odessa American’s Medical Matters:

Do the medications amoxicillin, azithromycin, cephalexin or ciprofloxacin ring any bells? These are among the most prescribed antibiotics in the United States. And, chances are, you or someone you know has received a prescription for one of these before. Antibiotics can be very helpful medications … but there are also risks that exist when antibiotics are used in the wrong way.

Antibiotics are medications used to treat bacterial infections such as strep throat, sinus infections and some pneumonias. Antibiotics should not be used to treat viral infections such as the common cold, most coughs and the flu. When antibiotics are used for viral infections, the infection will not be cured, it will not help you feel better and others can still catch the virus. No harm in trying the antibiotic though right? Wrong! Antibiotics are not always the answer! Remember – there are potential risks when taking any medication, so antibiotics should only be used when the doctor determines they are needed. Antibiotics can cause side effects like nausea or diarrhea, or can result in an allergic reaction. When antibiotics are used in the wrong way, the use may contribute to antibiotic-resistant infections. Antibiotic resistance is when bacteria change and become stronger and harder to kill, usually requiring stronger treatment and possibly a hospital stay. Development of resistance is a real concern, and is why healthcare providers are being more careful when prescribing antibiotics.

Using antibiotics wisely is not just the job of providers. There are things you can do to help prevent resistance as well! First of all is to understand that antibiotics are only useful for bacterial infections. Also, it is important to ask your doctor questions when they prescribe you an antibiotic. Ask questions such as, “What kind of infection do I have?” and “Are these antibiotics necessary?” It is important that you understand your illness and if antibiotics are the correct option. Please do not insist that your doctor give you an antibiotic if it is not appropriate. Never take someone else’s prescribed antibiotics. Do not keep and use past prescriptions as they may not be right for your type of infection, can contribute to resistance and can cause side effects or drug interactions your doctor or pharmacist would not be monitoring. Practicing good hand hygiene can help prevent the spread of germs. Lastly, it is important to always complete the full course of antibiotics, even if you feel better! If the antibiotic prescription is not finished, not all of the illness-causing bacteria are treated and resistance may develop.

Antibiotics have been the first line of defense against infections since the 1940s. They are very powerful in treating bacterial infections when they are used properly … which is the responsibility of healthcare providers and YOU!

Did you know?

  • The Centers for Disease Control estimates that more than half of all antibiotics prescribed are not necessary.
  • Some medications, foods and even alcohol can interact badly with antibiotics. Discuss with your pharmacist all medications you take when filling a new antibiotic prescription and ask whether you should take the antibiotic on a full or empty stomach.
  • Some antibiotic prescriptions require special storage such as in the refrigerator. And most medications should be kept in a cool, dry place. Therefore, keeping them next to the shower may not be ideal.
  • If you have a viral infection, antibiotics will not make you feel better and can have negative effects. So ask your doctor or pharmacist about possible medications that can be used for symptom relief.


  1. Centers for Disease Control; National Center for Immunizations and Respiratory Diseases Division of Bacterial Diseases. Get Smart Know When Antibiotics Work 2012. https://www.cdc.gov/getsmart/community/materials-references/print-materials/parentsyoung-children/answer-b.pdf. Accessed September 27, 2017.
  2. Association for Professionals in Infection Control and Epidemiology. The ABC’s of Antibiotics 2014. http://consumers.site.apic.org/files/2014/09/AntibioticInfographic14-FINAL.pdf. Accessed September 27, 2017.

Chores can help your brain stay young!

Even if you don’t engage in vigorous exercise as you grow older, don’t discount the benefit of everyday activities for physical and cognitive health. Making the bed, taking out the garbage and
sweeping the floor all add up, say University of Florida researchers.

And the more energy you expend on those daily chores other, the less likely you are to become cognitively impaired as you age, compared with older people who exert less energy, according to the study results published in the Archives of Internal Medicine.

Even if you can no longer pursue your favorite sport, you can move more throughout the day, which may stimulate parts of the brain involved in memory formation. So grab a vacuum cleaner—or just take a 5-minute dance break when your favorite song comes on the radio.

Sports Physicals – One of the most important visits to your doctor

by Dr. Bonnie Carter


As seen in the Odessa American Medical Matters:



It’s that time of year again …time for sweaty teenage boys and girls to flock to clinics and gyms for sports physicals. While parents and kids just want to get in and out as quick as possible, there’s a method to our madness and why we do these physicals. And, no, it’s not an initiation or torture ritual to embarrass you!

One of the most important things to evaluate during a sports physical is your heart. Sudden cardiac death can occur in an athlete due to hypertrophic cardiomyopathy that is undiagnosed. Names like Hank Gathers and Reggie Lewis echo in our minds when we put that stethoscope to your chest. These, and others like them, were young athletes in the prime of their life and peak physical condition that dropped dead during their sport from a silent heart condition. There are signs and an astute clinician can pick up on them. This is one of the reasons that I hate mass physicals in gyms … you just can’t hear as well when you’re listening for an arrhythmia or heart murmur. Truly the best place to have your physical done is with your primary care physician because we know you and are more likely to pick up on a minute difference from your baseline.

The other major thing we are evaluating is your neurologic status and history of concussions. Recent studies have brought the long-term effect of concussions to the forefront, and both physicians and coaches are more aware of their consequences. The management and our approach to concussions has changed drastically just in my time in medicine. When I was a resident in 2003, we would only pull someone from the game if they had a complete loss of consciousness or their symptoms lasted more than 15 minutes. Now, we pull anyone who has symptoms of a concussion and they can’t return to activity for at least a week. (There is a protocol established by the U.I.L.) This is safer for the athlete because cumulative injury is a risk and can lead to much worse damage and even death. A lot of questions on the sports physical forms are centered around concussions, and this is why.

While working as the university physician at West Texas A&M, I saw a lot of concussions in our athletes. Additionally, I saw some sequelae (a condition that is the consequence of a previous disease or injury) of multiple prior concussions including memory issues, personality changes, attention deficit and depression, to name a few. Can you guess which sport had the most history of concussions when I would do the physicals at W.T.? It wasn’t football … it was actually cheerleading!

Now that we’ve covered your head and your heart, that leaves the rest of your body. Yes, we are looking at all your joints to make sure your body can handle the stress of the sport, but we are also looking at your vision, your blood pressure, your skin, your thyroid, your abdomen, if your periods are regular, your gait and several other things. Every question on that form is a clue to the mystery that is you. We clinicians are really just detectives, trying to follow the clues and make the diagnosis. And yes, the dreaded hernia check is important because if you have a defect and you work out, you can make it worse. An incarcerated hernia is no laughing matter and is a medical emergency.

So next time you drag your child to their sports physical, remember it is not just a rubber-stamp visit. In fact, it is probably one of the most important visits they may make to the doctor’s office.


Insulated Society – Benefits of Vaccines Still Outweigh the Risks

by Dr. Kevin Benson

As seen in the Odessa American Medical Matters:


Heard from a caller to a local radio call in show “vaccinations ruin kids immunity and there hasn’t been anyone who died from mumps in a really long time.”

Our insulated, vaccinated society.

Recently there has been a mumps “outbreak” in Texas. As of April 21, CNN reports Texas has 221 cases this year, (which) constitutes the highest incidence of mumps in the state in 22 years. (http://www.cnn.com/2017/04/14/health/mumps-texas/)

Maybe that doesn’t sound so bad. After all, in a state with upwards of 27 million people, the chance of your child being the one to get mumps is pretty low. And since other people vaccinate their kids, your kid will probably be protected. Probably. And even if they did get mumps, well, they wouldn’t die from it. Probably. And even if they did catch such a rare illness, modern medicine has other ways to cure people of those things, right?

Vaccinations have gotten a bad rap in the past few years with people claiming that they are the root cause of everything from autism to food allergies. For many, the fear of potential side effects of vaccinations has eclipsed the fear of being infected with these serious illnesses. Here in the first world, it is much easier to find someone who claims that their child’s condition was caused by a vaccination than to find someone whose child was affected by the illness the vaccine was designed to prevent. This has led many to doubt theses illnesses even exist anymore.

We are beyond fortunate to be living in our modern world. But our world of jet planes and cellphones has insulated us from diseases that had devastated humans in the last century, turning these severe illnesses into what many believe are mere fairy tales that doctors and vaccine companies tell us in order to make a buck. But it wasn’t so long ago that things were very different.

As a practitioner, I have never seen a child stricken with polio. But my eyes were opened to the realities of this disease when I visited the Smithsonian Institute Museum in Washington, D.C. a number of years ago. Between the dinosaur skeletons and the space capsules was an exhibit about polio. Surely not a big draw. Even though I had learned about polio during my training, I thought I might increase my knowledge a bit and walk through. There I saw pictures of countless children affected by this viral illness. Most striking were the pictures of warehouses where rows and rows of iron lungs had been set up to assist children as polio ravaged their nervous system and muscles, robbing them of the ability to breath on their own. If children were fortunate enough to survive, they would often have to use crutches and leg braces for mobility. People were understandably terrified of this illness, as it could strike anyone’s healthy child. And there was no cure. And there still is not.

When the vaccine came out in 1952, it was a godsend. Finally there was some protection from the up to 58,000 cases a year that the U.S. had previously experienced. (https://en.wikipedia.org/wiki/Polio_vaccine). But the vaccine was not without side effects. Rarely, taking the oral vaccine could actually cause polio. (One in 2.7 million doses) (http://www.who.int/immunization/diseases/poliomyelitis/endgame_objective2/oral_polio_vaccine/VAPPandcVDPVFactSheet-Feb2015.pdf) However this risk did not sway many people from having the vaccine administered to their children. The benefits simply outweighed the risks.

There are many more vaccines available to us today. Most of us have been brought up in a society where the illnesses they prevent are something to read about in books. This is because countless people have researched the safest way to prevent these illnesses and countless parents have decided the benefits outweigh the risks. It is well known that vaccinations have well known, common side effects. They also have rare side effects or reactions. Many people claim that there are other side effects or we just don’t know what side effects these vaccines might have long term.

In science, it is always right to “question with boldness”, to quote Thomas Jefferson. It is right to ask questions about vaccines and discuss them with your child’s doctor. At this time, all credible evidence points to the fact that vaccines are extremely safe and prevent illness that without these vaccines, would creep right back into our lives with a short time. I believe the benefits still outweigh the risks, but I keep an open mind to parents asking legitimate questions affecting their child’s health.



Medical Matters: Osteoporosis – Are You at Risk?

As seen in the Odessa American “Medical Matters”: 

Osteoporosis – Are You at Risk?
by Dr. James Ingram

Osteoporosis is a disease of the bones that many people will experience in their lifetime as it is the most common bone disease in humans. Osteoporosis is a silent disease until it is complicated by a broken bone.

Osteoporosis means porous bone (full of holes). When a person has osteoporosis, the pores become larger which makes the bones brittle and weak. Because the bones are then weak and brittle, they can fracture easily … even with simple activities like sneezing or bumping into furniture.

Osteoporosis is diagnosed by a medical evaluation that includes an examination of your height and a bone density test. This bone density test is the only way to diagnose osteoporosis prior to a broken bone. The most common bone breaks are of the spine, hip and wrist.

It is estimated more than 10 million Americans have osteoporosis. Osteoporosis is not just a disease that affects women. After the age of 50, more than 50 percent of women and 25 percent of men will break a bone due to osteoporosis.

All women who have experienced menopause and men over the age of 50 should be evaluated for osteoporosis risk factors to determine if they need to be tested.

There are many factors that put us at risk for developing osteoporosis. Some factors are modifiable while other factors are not.

Factors leading to Osteoporosis that cannot be altered include:

  • Age greater than 50
  • Caucasian and Asian women
  • Petite women
  • Family history of osteoporosis

Although you cannot control the factors from age and genetics, you can alter the following factors that lead to Osteoporosis:

  • Smoking – Smoking makes the bones less healthy and more prone to breaking or not healing after a break.
  • Low vitamin D levels – A healthy diet with calcium and vitamin D is essential for bone health. Add fruits and vegetables daily to improve your bones.
  • Lack of exercise – Regular exercise is important for strong bones. Activities like walking, swimming and biking can improve the health of your bones.

If you feel you are at risk for osteoporosis and have never had a bone density test, talk to your doctor today.


So, you just got out of the hospital! Here are some ways to keep it that way.

So, you just got out of the hospital! Here are some ways to keep it that way.
by Rachel Weiland, PharmD, BC-ADM, MCHS Ambulatory Care Pharmacist

Eat healthy

Focusing on nutrient-dense, fresh foods can help you lose weight, have more energy, lower your blood pressure, improve your cholesterol, enhance your immune system and so much more. Some great foods to incorporate are:

fruits and vegetables

lean meats and fish such as baked or grilled chicken and salmon

egg whites


Try to avoid foods high in sugar, salt or saturated fats such as sweets, sodas, fried foods, chips, fast food and frozen meals.



Try to find a routine that combines strength training and cardio. High impact activities such as running or jump roping are great for strengthening bones and preventing fractures later in life. If you cannot do high impact exercises due to having bad joints, try swimming or biking to get your heart working and improve your endurance. Many people neglect strength training when trying to get in shape, but being physically stronger can help prevent falls, and having more muscle mass increases your metabolism, meaning you will burn more calories throughout the day. Many women are afraid that they will end up with a masculine build if they lift weights … when in reality, it would take years of very consistent, heavy weight training to do so.


I think we all know that getting enough sleep is beneficial for our health. Sleep improves our immune systems, gives us more energy and allows our bodies to recover. If you have trouble falling asleep, develop a sleep hygiene routine. No, sleep hygiene isn’t referring to being clean … it simply means to establish a sequence of bedtime activities to do before you go to bed. This might include things like changing into your pajamas, reading a chapter of a book and brushing your teeth. If you do the same routine every night, your brain will recognize that it’s time to go to bed, and you will be able to fall asleep more easily. Try your best to avoid staring at screens such as your phone, laptop or TV right before bed as this can signal to your brain to stay awake.

Fill any new medications right away

It is important that you don’t have any interruptions in taking your medications after you get out of the hospital. If you are prescribed any medications that you cannot afford, be sure to call your doctor immediately so that it can be changed to something else. You may also be able to find coupon cards or patient assistance programs to help get the cost down. Go online to the drug’s website to see if anything is available.

Know how to take your medications

Do you need to take your medication with food? On an empty stomach? In the morning? At bedtime? If you don’t know, ASK! Also, you will probably come across a time when you forget to take your medication, and remember several hours later. Ask your pharmacist what you should do in this situation, as the answer depends on the medication. Look closely at your discharge papers to see what medications were discontinued, so you don’t keep on taking medications that you don’t need, and can interact with your current medications.

Schedule follow up appointments

Sometimes you will already have doctors’ appointments scheduled for you. It is important to attend these appointments so you can continue to be monitored and catch anything before it gets to the point that you need to go back to the hospital. If no appointments are scheduled for you, be sure to schedule an appointment with your primary care doctor as soon as possible.


MEDICAL MATTERS: It’s just allergies … or is it?

MEDICAL MATTERS: It’s just allergies … or is it?
As seen in the Odessa American “Medical Matters”: http://www.oaoa.com/people/health/article_df0b9662-06e6-11e7-bbb2-3f66b573b122.html

by Dr. Kevin Benson

Allergies seem to be a big part of our lives here in West Texas. It seems that no matter what the season, or the symptoms, people tend to think it’s their allergies. Or is it? Does it matter?

Environmental allergies are the body’s excessive response to things we need not respond too. For example, pollen is not really a threat to me, but my body responds to it in unhelpful ways. My nose fills with mucous, my eyes get red and itchy, that familiar cough makes its annual return. How do I know it’s my allergies versus a cold I may have been exposed to?

History: Seasonal allergies are just that, they occur at certain seasons. Everyone with allergies is a bit different, but most of us can predict the seasons where we will have trouble. Pollen allergies tend to be in the springtime, fall allergies tend to be more mold and mildew sensitivities, winter allergies are often caused by dust or dust mites blowing around as we turn on our heat. So with experience we know when it’s more likely to be allergies than a viral illness. And also why it’s difficult to know in a baby or young child, since they haven’t had as many seasons of experience to know how they respond to those environments.

Duration: Allergies can linger for weeks, sometimes months. It is very unusual for a cold to last more than a week or two. Sometimes we can be fooled though, as we or our children are recovering from one illness and fall into the trap of another illness; what feels like one illness can be a few separate ones. However, it is common to have one viral infection after another, especially in the wintertime.

Fevers: Allergies do not cause fevers. Fever is the body’s natural response to infection, and allergies are not an infection. However some people will develop secondary infections due to allergies; for instance the congestion caused by seasonal allergies can trigger ear infections or sinus infections. That is why it is always a good idea to treat those allergic symptoms as soon as possible, to prevent them from becoming something more serious.

Remember to use your judgment. If you’re not sure if you or your child has a cold or allergies and the symptoms are getting worse, changing or not improving, there’s no harm in consulting with your medical practitioner. When in doubt, check it out!


MEDICAL MATTERS: It’s blood pressure 102

MEDICAL MATTERS: It’s blood pressure 102

As seen in the Odessa American “Medical Matters”: http://www.oaoa.com/people/health/article_142b7e0e-eb15-11e6-8175-e70526b7ef79.html

by Dr. Fernando Boccalandro

In my first article I discussed the basics of blood pressure and the definition of normal blood pressures values according to current guidelines. In this second article I will address some practical tips and tricks, to maintain an adequate blood pressure control.

Blood pressure tends to fluctuate due to multiple factors that affect the blood pressure including stress, level of activity, salt intake, fluid intake, etc. For my patients the goal is to keep their average blood pressure within normal levels over time, rather than focus on one, or another individual blood pressure number specifically. Think about the average of the blood pressures as the number to go by.

What are my pearls of wisdom for our readers, after diagnosing and treating hundreds of patients with elevated blood pressure?

  1. Know your numbers:Make sure that you measure and know what your blood pressure is, at least once or twice a year if you do not have hypertension. It is useful to have an automated blood pressure machine at home, especially if you are prescribed blood pressure medications to assure is well controlled. Bring your blood pressure machine to your appointments; to make sure is well calibrated and you blood pressure measurements.
  1. Do your homework:Keeping a diet low in salt (less than 2 grams of sodium a day), a healthy weight, decrease levels of stress and regular moderate exercise (at least 150 minutes weekly), can contribute to lower your blood pressure and will make you feel better. Take your medications as prescribed and do not discontinue your blood pressure medications without discussing it first with your healthcare provider.
  1. Plan for the long term:Hypertension in the majority of patients is a chronic disease, like diabetes, high cholesterol, etc. So plan for a lifetime commitment to monitor and control your blood pressure, it is well worthwhile to prevent any adverse consequences of uncontrolled hypertension.
  1. Get the best team:Successful blood pressure management is teamwork. It is important to involve your family to help you succeed in this lifetime goal if you have elevated blood pressure. And it is very important to be in close contact with your health care professional, to coach and advise you regarding goals and optimization of your blood pressure levels over time.

Don’t let your guard down with high-blood pressure! And please contact your primary care doctor if you have questions or concerns about your heart health.