Yearly Archives: 2016

Skin Cancer ABCDE [Show Notes]

 in Podcasts  tagged ABCDE / carcinoma / early detection / fair skin / melanoma / pre-cancer / skin cancer / sun exposure by

Review

Epidermis = top layer of skin.  Living cells divide and then add in proteins that causes cells to harden as they die and become and protective layer to keep out water and dirt and critters.  Some of those proteins give your skin its color (melanin) and they help block and reflect UV light from the sun to keep the living cells from being damaged.

Mutations = if UV light damages the cells’ DNA, then when the cells divide and replicate, they copy the “error” and reproduce an abnormal cell.  If certain mutations cause the cells to die, others cause the cells to be weak, but others cause the cells to become cancer.

3 types of skin cancer

  • Basal cell carcinoma – most common of these 3, more common in people with fair skin.  Skin growth is flesh colored, can look like skin tags.  Caused when a basal cell gets mutated and starts to grow.
    Squamous cell carcinoma – more common in people with fair skin. Scaly patches or sores that open, start to heal but reopen and never heal.  Caused when a keratinocyte (living, dividing skin cell) gets mutated in the middle of replicating.
    Melanoma – Moles are just a place where a lot of melanocytes gather in one place, but sudden moles or dark spots can be the tip of a bad iceberg.  This is the deadliest type of skin cancer.  Caused by mutations in the melanocytes.

Some benign (harmless) skin characteristics can resemble skin cancer, thus it’s easy to overlook them in the early stages.

A tool for early detection of melanoma

A – Asymmetry – you can’t fold it in half and all the edges match
B – Boarder – jaggedy, sharp boarders
C – Color – uneven color
D – Diameter – > 6mm (bigger than the eraser of a #2 pencil)
E – Evolving – changes shape, size, or color in a short amount of time (< 1 month)

This is why the National Skin Cancer Foundation recommends you do a monthly skin scan to check skin characteristics for changes or new ones.

Early detection is the number one step to improve survival of all cancers.

Precancer = Actinic Keratosis – dry and flakey places in the skin, can be the precursor of Squamous Cell Carcinoma.  Usually shows up after 40 years old.

Cancer is not just a disease that happens to the aged, but as you age, the probability of you being exposed to something that could mutate your cells goes up.

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Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Skin Conditions [Show Notes]

 in Podcasts  tagged acne / blackhead / blackheads / candida / dry skin / eczema / histamines / hives / Michael Jackson / oil / rash / ringworm / stress / vesicolor / viral exanthem / vitiligo by

Dry skin

It is usually due to your skin not having enough of its own natural oils (probably strips from soaps, cleansers, chemicals).  Moisturizing lotions and creams are “greasy” to try and match the oil of your skin.  The oil make the skin waterproof – keeps water out, but also keeps water in (prevents evaporation)

Eczema – dry skin with an immune/inflammation component.  The deeper layers of the skin will release inflammation chemicals that irritate the other cells in the area and lead to redness, pain, and swelling.  It’s common for kids to have eczema but then grow out of it, but other conditions can cause eczema to flare (in my case, pregnancy).

Rash

Rash is one of the most ambiguous symptoms to try and figure out what the root cause is.  Rashes can be round or splotchy, symmetrical or asymmetrical, raised or flat, big or small.  Rashes are caused by some type of inflammation process (most commonly histamines).  Rashes are a sign that your body has been offended by something – either from the inside and then the chemicals reach the skin to cause rash, or from the outside that touched your skin and caused chemicals to be released.

*Hives – a very distinctive rash with raised, irregular borders that may be red, but can also maintain their “flesh color”.  Most commonly involve histamines, thus antihistamines (like benadryl can help them go away).  Can possibly be triggered by stress (the stress hormones cause a chain reaction of chemical release which may lead to hives).

*Viral exanthem – “exit rash”; a rash that kids will get when their body has finally beat a virus.  Some start at the top of the body and then moves down to their feet.  Others start on the torso or core and then move out to the extremities.  Antihistamines do not help it, but they rarely hurt or itch or bother the kid in any way.

Acne

There are different pores in your skin (sweat glands, oil glands, hair follicles).  The oil on your face helps to trap bacteria and dirt that could get deeper in your skin and possibly hurt you.  The goal of cleaning your face, is to cleanse off the “dirty” oil, but not all the oil (because the result is either dry skin or over-production).  So the dirty oil plus the shedding dead skin cells can clog up any of these pores.  Blackheads are specifically when hair follicles are clogged – and they look black b/c the melanin proteins that get built into hair can be seen.  Generally small blackheads and whiteheads are not painful, unless a lot of bacteria are involved and they begin to fester.

Cystic acne is when a larger area that involves multiple pore or hair follicles get clogged and infected with bacteria and then the spot can become swollen and painful (and unsightly).

Hormones regulate the oil production, that’s why puberty increases acne, stress increases acne, all of the transitions surrounding pregnancy can increase acne.  As long as you have hormones, you’re going to have a risk of acne.  Also, working in really dirty environments can increase the amount of dirt that could clog up pores.

Infections

Ringworm = tinea corporis (there’s no worm involved, it’s a fungus).  Classic circular rash that is red and flakey and possibly flesh-colored in the middle.

If it’s on your head (tinea capitis = cradle cap).  If it’s in your groin (tinea cruris = jock itch).  If it’s on your feet (tinea pedis = athlete’s foot).

Tinea vesicolor = the fungus causes the skin to lose pigment (this is NOT vitiligo, which is the death of melanocytes and they don’t grow back, Michael Jackson).

Candida is the yeast that is a part of your natural skin flora, but can lead to rash if it gets out of balance.

Bottom Line

If there is anything on your skin that bothers you, see your doctor!

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How Sunscreen Works [Show Notes]

 in Podcasts  tagged cancer / early detection / SPF / sun / sunblock / sunscreen / tan / UVA / UVB by

Two products to protect your skin from sun exposure

  • Sunscreen – filters the sunlight *like a screen on a window*; made up of organic compounds (like chemistry, not vegetables) that absorb UVA and/or UVB rays that reach your skin.  These are the products labeled with SPF numbers.
  • Sunblock – used to be opaque because it is supposed to completely block any sunlight from getting to your skin. *Think Screech from Saved By The Bell*.  Full of reflective particles to bounce the sunlight away from your body.  The particles have been micronized by technology so it is transparent to your eyes, but not to the UV light from the sun.

Lesson on Light

The light comes from the sun.  There’s visible light (ROYGBV) and that light bounces off of things and as it goes in your eyes, that’s how you can see things.  Along with the light we see, there is ultraviolet light (waves of light that are shorter and more energetic that the violet color light).  There are 3 types of UV light – 1 is absorbed and reflected by the atmosphere so it never makes it to us.  Then there is UVA and UVB.  UVA is more energetic and is most responsible for causing cell mutations that lead to cancer.  UVB is less energetic and is most responsible for causing your skin to tan.

A hand-drawn and colored sketch of the layers of the epidermis, with labeled parts. Sunscreen protects this layer.

UV rays travel through these layers of the skin and stimulate the living and dividing cells to divide more and create more melanin.  Reminder: melanin is your skin’s natural skin protectant because it will absorb UV rays in the higher layers to help prevent it from reaching the dividing cells.

SPF Math (Sun Protection Factor)

Step 1: find out how long you can be out in the sun without protection before your skin starts turning red or burning (example: 15 minutes)
Step 2: Multiply that “unprotected time” by the SPF number on the bottle (SPF 15) to get your “protected time” (15 x 15 = 225 minutes = 3 hr 45 min**)
**This is only if you don’t sweat and don’t get wet.  But it’s very hard to be in the sun and NOT sweat.  Plus your natural skin oils dilute it the longer it stays on the skin.

Protect Yo’self

The Skin Cancer Foundation recommends reapplying sunscreen every 2 hours no matter what.  They also recommend that you use SPF 15 (or higher) sunscreen. It should block UVA and UVB.  Use it every day, especially on your face, and use it all year round.  The daily UV exposure, if you’re unprotected, is what they suspect leads to a greater chance of skin cancer.

They also recommend UV-blocking sunglasses.

Clothes and hats are the best way to protect your skin from sun exposure.

Stay inside during peak hours (10 am – 4 pm) of radiation (less atmosphere to block and deflect sunlight).

Do a monthly, head-to-toe, skin scan to check for new or changing moles, freckles, and skin tags (or get a friend to help).  EARLY DETECTION!!

Have your doctor check your skin once a year.

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Vitamin D [Show Notes]

 in Podcasts  tagged bone health / calcium / immune system / skin / sunlight / vitamin D by

Vitamin D Basics

Vitamin D is made by your skin.

Lots of foods are fortified with Vit D.

Vitamin D2 is plant-based.  Plants make vitamin D then you eat them and absorb it.  This is also the type of Vitamin D that is added to other foods.

Vitamin D3 is animal-based.  You absorb very little Vitamin D from animal food sources.  This is the type that your skin makes.

Review

The membranes of your cells are made up of cholesterol.  It allows them to stay fluid and flexible, and it allows diffusion of some nutrients.
UV-B rays come down from the sun and travel through the top layer of your skin. Those rays interact with the cholesterol in the skin cells and cause it to break away and it starts a changing process as that loose molecule makes it way to the bloodstream.  *Think the Hulk transformation*.  By the time it reaches the bloodstream, it has become D3 (~ 12 hour long process).

Vit D3 = Calcitriol (tri = 3)
Vit D2 = Calcidiol (di = 2)

The news will tell you that Vit D is needed to prevent the Winter Blues or that it’s good for your bones.

Deeper Stuff

Vitamin D has 2 jobs to help with your bone health.  It tells your intestines to make calcium-carrying and phosphorus-carrying proteins, so when you eat foods that contain calcium or phosphorus, the cells of the small intestines will have the ability to transport these molecules into the bloodstream.  Then in your periosteum (the membrane that covers your bones), Vitamin D works with parathyroid hormone to tell the periosteum cells to make the same kinds of proteins to get the calcium out of the blood and into the bone-building process.

Vitamin D also has an important role in your immune system.  It plays a part in cell differentiation.  It helps an immune system cell know which type of cell it needs to specialize as (B-cell, T-cell, macrophage) to do the optimum job  based on the type of invader that has entered your body.

While sun exposure stimulates Vit D production, there has to be a balance to avoid skin aging and risks of cancer.  Taking Vit D supplements can be a safer alternative.

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Skin 101 [Show Notes]

 in Podcasts  tagged collagen / complexion / elastin / epidermis / hydration / keratin / melanin / skin / stem cells / tan by

Skin 101

Your skin is the largest organ of your body.

It has 3 jobs: Protection, Regulation, Sensation

Natural complexions are being viewed as more beautiful than a “tan”.

3 Layers

  • Epidermis (above skin) – waterproof, gives you your color, the layer we see
  • Dermis-Epidermis junction – a protein layer containing collagen and elastin to give skin flexibility and stretchability
  • Dermis – where your glands, hair follicles, and nerves are
  • Hypodermis – (below skin) – houses adipose tissue for insulation, and blood vessels

A hand-drawn and colored sketch of the skin layers, with labeled parts.

The Epidermis is made up of several separate layers based on what is happening in the cell’s lifetime.

A hand-drawn and colored sketch of the layers of the epidermis, with labeled parts

The basement membrane sits right on top of the Dermis-Epidermis junction, made up of fibrous proteins to be a solid foundation.

Epidermis Layers

  • Basal Layer – Keratinocytes (makes Keratin) and Melanocytes (makes Melanin) – stem cells.
  • Spinous Layer – Cells are actively dividing and getting squished together
  • Granular Layer – Cells start making the proteins (keratin or melanin) that they are coded to make and it fills up all the intracellular space; the organelles of the cells get crowded out
  • Lucid Layer (Clear) – Keratinized cells are clear; Melanin-filled cells are colored. Cells are officially dead.  Cells become coated in a hydrophobic (afraid of water) oil.
  • Hard Layer  – cells are tightly packed together and dry; the layer we can touch.

These cells are being continuously produced and shed off and replenished because the skin takes a lot of abuse.

Deeper Stuff

UV light from sun or tanning beds (heaven forbid!) stimulates melanocytes to divide faster and create more melanin (because melanin is reflective and keeps UV rays away from the important cells).  This is how a tan is created.  But during times of huge exposure, like tanning beds, there’s not enough melanin to keep all the UV rays out so those rays can wreak havoc on the collagen and elastin proteins.  This is why over-tanned skin ages faster.

Hydrating makes sure that the living and dividing cells are plump and as healthy as possible so when they move to the next layer, they are well nourished.

Protection: keeps dirt and bacteria out; protections from UV radiation
Regulation: releases sweat to cool the body’s temp; subtly moves blood vessel closer or farther away from the surface to either cool the warm blood (like after exercise) or keep it warm (like in the winter).
Sensations: allows you to feel things that touch you or come close to you.

I can’t seem to find any free footage of the original episode (Season 1, Episode 3) without having to sign up for a free streaming service.  The Mythbusters did a “revisit” of their Goldfinger episode.  Netflix the original, if you can.

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Hair Problems [Show Notes]

 in Podcasts  tagged alopecia / baldness / cradle cap / dandruff / hair dye / Hair problems / hirsutism / perm / postpartum / toxins by

Alopecia – hair falls out in the same area all at one time.  Kind of like crop circles.

3 Stages of the Hair Follicle life cycle

– Anagen phase – active phase, cells are multiplying, hair is growing

– Catagen phase – resting phase, “cat nap”

– Telogen phase – shedding phase

Hair thickness is determined by 2 things: the density of hair follicles (how many follicles in one area) and how large a single hair follicle is (thick vs fine hair).

male patterned baldness – receding hairline from front to back, and the loss of the hair on the crown of the head.

Female patterned baldness – the overall thinning of the hair.

Hirsutism – females get male-patterned balding due to testosterone imbalance

Why does all your hair fall out after you have a baby??

Telogen effluvium – a mass exodus of hair follicles

This can also happen when the body goes through extreme shock or trauma.

There is a condition called post-partum alopecia – this is temporary, and hair grows back afterwards.

Itchy Scalp

Dandruff is caused by the inflammation of the scalp.  Inflammation causes skin to be dry and itchy.  The topmost skin layer releases in larger amounts, thus the pieces are visible, opposed to when the skin naturally sheds, it’s microscopic so you don’t usually see the dead skin cells you lose.

Tinea capitis – ringworm on your scalp, aka cradle cap.  Usually requires an antifungal to get rid of it.

Tidbits

Hair can actively grow for up to 6 years.

Since hair is dead cells, hair hangs onto the DNA and it can be used to identify people (missing persons) or for paternity tests (who’s your daddy)?

Dying and perming affect the proteins that give it color or keep it connected.

If someone has had prolonged exposure to toxin (carbon monoxide, heavy metals, smoking), the hair shows markers of that damage from the toxins.  It can also hang on to markers from being exposed to illicit drugs.  It’s like a timeline of what you’ve been exposed to.

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Hair Vitamins [Show Notes]

 in Podcasts  tagged antioxidant / Biotin / free radicals / hair / Iron / oil / omega-3-fatty acid / Vitamin B-7 / Vitamin C / vitamin E / Vitamins by

Disclaimer

If you live in a modernized country, the food that you eat will give you more than enough of the vitamins you need, because you have access to a wide variety of fruits and vegetables, plus tons of food products are fortified with vitamins.  So rarely is someone deficient in a whole bunch of vitamins all at once.

Hand-drawn and colored sketch of the layer of skin where hair grows from, with labeled parts. Hair vitamins will reach your hair through the blood vessels depicted in this image.

Vitamins

  1. Biotin (Vitamin H – antiquated; Vitamin B-7) – a cofactor that works with your enzymes to help transport carbon dioxide – which is a waste product in your body.  Carbon dioxide is created in fatty acid production, amino acid metabolism, and gluconeogenesis (making glucose out of things that aren’t glucose).  Peanuts is a huge source of biotin.  Your natural gut flora make biotin for you!!  So apparently good for your whole body, not just your hair.
  2. Vitamin C – responsible for helping collagen production.  Most directly related to hair, skin, and nails.  Collagen allows cells to be stretchy and elastic and more flexible against abuse.  It also helps your digestive tract absorb iron (callback!).
  3. Vitamin E – is an oil-based vitamin and an antioxidant.  Lots of health fads scream at you about free radicals.  Free radicals are molecules that are waste products from different processes that end up with a non-neutral charge (so either positive charge or negative charge).  So if you remember chemistry, they prefer to be neutral, so free radicals want to steal charges to neutralize, and can sometimes steal it from your DNA and lead to major cell damage.  An antioxidant is a molecule that finds an oxidized free radical and donates a charge so that it’s neutral again (and the antioxidant is able to cope better with losing an electron or two without becoming radical itself).  Vitamin E focuses on the free radicals from fatty acid processes.  Again, good for your whole body, not just your hair.

Supplements

  1. Omega-3-Fatty acid – an oil, a fatty acid chain that goes into the production of your skin’s natural moisture.  Your skin needs its natural oil to trap up dirt and bacteria, as well as keeping the moisture from deeper inside your body from evaporating out.  So each hair follicle has an oil gland with it to keep the hair moisturized.  The new information about the importance of your hair’s natural oil has encouraged the “no ‘poo” movement.  This is more directly related to your hair, but a lot of other places in your body benefit from O3FA’s.
  2. Iron – responsible for helping your red blood cells to carry around oxygen.  This is most likely the only nutrient in this list that someone would need to truly supplement, mainly because iron deficiency can be caused by several things, some of which are genetic.  People with prolonged anemia have dull hair, skin, and nails.  Again, good for your whole body.

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Hair 101 [Show Notes]

 in Podcasts  tagged 101 / basics / curly / gray / hair / keratin / melanin / straight by

Key Words

  • Keratin = a fibrous protein that cells make when they are about to die.
  • Cornification = the process of a cell filling up with Keratin and becoming hard.
  • Follicle = the hole in the skin where the hair grows out
  • Melanin = a protein that adds color to cells of the body (most familiar because they help skin tan)

Hand-drawn and colored sketch of the layer of skin where hair grows from, with labeled parts.

Hair Basics

Arrector pili = the muscle that makes your hairs stand up

Fingernails and hair are made out of keratinized cells.  Nails are harder to protect the more tender skin below (and are a primitive tool).  Hair is tightly stacked but more flexible.  They are both dead cells so they don’t absorb nutrients or feel.

Because hair grows when cells lining the follicles fill up with keratin and die, it grows from your scalp, rather than being added to the ends.

Cells in the bulb divide every 23-72 hours.

Straight or curly is determined by the shape of the follicle.  Symmetrical = straight, asymmetrical = curly.  Square follicles is a myth.

There are 2 types of melanin – eumelanin = dark colors; pheomelanin = light.  Genetics determines what ratio of each type your skin produces thus determines the color of your hair.  It turns gray because the cells are absent of all melanin types.

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Episode 51 – Behind the Scenes

 in Podcasts / Special Edition  tagged anniversary / birthday / facebook live / katch / new house / Periscope / stuff / vacation by

Stuff  Happens!

Katch.me shut down – I panicked!

We bought a new house.

So we moved into the new house.

Then, we went on vacation.

And finally, we sold the old house.

Celebrate!

I had my 1 year anniversary on Periscope. (My first Periscope broadcast was about being nice to people who work on holidays, because they didn’t get the day off like you did!)

Pharmacist Answers Podcast will be ONE on July 17th!

New episodes will begin July 6th.

Keep an eye out for me on Facebook live.

Come see me on Periscope 9:02 am Eastern on Mondays, Wednesdays, and Thursdays.
@CynHendrix or periscope.tv/cynhendrix

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Chameleons of the Art, Science, and Business of Healthcare

 in Blog  tagged compliance / disease / expert / healthcare / insurance / medicine / professional by

The Healthcare Professional and The Expert

A perception that has stuck around despite the rapidly changing world around us is that “if my doctor said it, then that’s what I should do”. Doctors are listed among the most trusted professionals in America (3rd to nurses and pharmacists). Everyone knows that medical professionals take this oath where they promise to help and not to hurt. Society trusts them to do just that in all their interactions. So why not do everything they say because their intention is to help me? They studied medicine for 17 years to become a doctor so they REALLY know their stuff, right?

And it’s true.  Medical professionals of all kinds study their brains out to earn the status of “expert” in their field. Then they continue to study and learn for the rest of their lives to keep up with the changes in their industry. Another thing the oath they take says is that “medicine is an art as well as a science”. Science tells us what appears to be best for “most”, the art comes in when we figure out what’s best for YOU.

Art? Science? Healthcare Business!

Thanks to this industry we’ve built called “health insurance”, the idea of helping but not hurting is no longer an art or a science. It’s a business venture. Before the Affordable Healthcare Act (ACA, ObamaCare), insurances could look at people applying for coverage as “investments”.  That is why women of childbearing age had more expensive premiums for the same type of coverage as their husbands. They evaluated the risk of that woman having a baby, and the insurance has to pay for it was an expensive risk. I remember when Ken and I first got married and he looked at putting me on his insurance. His premium for himself was $170/month, to add me increased the premium to $650/month. It is also why people with pre-existing conditions were denied coverage because the risk to cover them was too expensive. The removal of this level of discrimination and dehumanization of healthcare has been one of the positive aspects of the ACA. But it’s not completely gone…
Healthcare companies may not be able to deny coverage of the person due to age, gender, or illness, but they still approach healthcare as a business and not as science. As new drugs are developed and studies are published to show which ones are superior to the previous treatment standards, insurance companies are SLOOOOOW at adapting. They know the new medications are more expensive and have a lower Return on Investment (ROI). Thus for a long time, insurances preferred to pay for Warfarin (Coumadin, a blood thinner that required blood testing as frequently as once a week) over the new blood thinners that didn’t require testing and dosing adjustments.

Turning the Healthcare Titanic

It has also taken Insurance far too long to understand the cost-saving benefits of Preventative Care. If they pay for your vaccine, then they won’t have to pay the doctor or the hospital to treat you for a preventable disease and all the complications that go with it. The trade-off of paying for annual or bi-annual check-ups versus waiting until you have a heart attack to find out you had high cholesterol. Now there’s a multitude of problems to treat (and pay for). They’re finally getting a clue that they should pay for almost every contraception option (excluding OTCs) because birth control (even IUDs and implants) are cheaper than paying for a baby.
Trying to get the Compliance train rolling with insurances has been ridiculously hard. Compliance in Medicine means that you take 80% of your medicine when you’re supposed to and the way it’s intended. Many state Medicaid programs don’t allow members to use a program most pharmacies have that automatically refills prescriptions (Auto-Fill, Auto-Refills).  They actually think they’ll save money by waiting for the person to get severely ill or have a health emergency, rather than ensuring the person consistently takes the medication that is getting or keeping them well.

A Glimmer of Hope

Medicare, as well as a handful of other insurances, finally got a clue. They realized that allowing people to get three months of their medication at a time saves money.  Also, you’ve removed eight chances for someone to forget refills because they only visit the pharmacy four times a year.  This is the definition of improved compliance.

Be a Chameleon

Medical professionals still desire and strive to practice the art and the science of medicine. But most of our day, we find ourselves playing the part of a chameleon. We want insurances to understand that if they treat you as human, they actually save money. The biggest gap to close is the one where we want to help you stay well, rather than just take care of you when you’re sick.