The Young and Invincible.

The Young and Invincible. Sounds like the title to a soap opera, but actually it’s the attitude that many young adults have about getting sick or injured. Young people think they are invincible and as a result neglect the most important thing that they possess: there health! Listed below are ten medical issues in young adults that I see in my Family Practice that I want to discus with you.

HIV/AIDS
The human immunodeficiency virus (HIV) has become one of the most devastating sexually transmitted diseases ever known to man. Once infected with HIV, the body’s immune system can become weakened and the infected individual will develop the acquired immune deficiency syndrome (AIDS). According to statistics reported by the Centers for Disease Control (CDC): an estimated 38,500 young people (age 13-24) in the United States received a diagnosis of AIDS; African American youth were the largest group of young people affected by HIV, accounting for 56% of all infections; young women, especially of African American and Hispanic decent are at increasing risk. Risk factors for infection with HIV include unprotected sex, multiple sex partners, use of IV drugs, the presence of an undiagnosed sexually transmitted disease, lack of awareness, and poverty. The key is to get tested if you don’t know your status, and if you decide to have sex, Rap It Up!

Obesity
In the past 20 years, there has been a significant increase in over weight and obese individuals in the United States. The Food and Drug Administration (FDA) estimates that almost two-thirds (64%) of all Americans are overweight; almost one third are obese. Childhood obesity is on the rise and we are now seeing shocking increases in diabetes, heart disease, and hypertension in this previously active and healthy population. Today, approximately 17 percent of young people are seriously overweight. One main problem that I see is the decrease in mandatory physical education classes for school aged children. Lack of exercise, poor diets high in fat and calories, and the fast food epidemic are the main reasons for this epidemic. Young people are stuck on computers and hove video games and don’t bike and or play outside as much studies have shown. So get moving! Exercise at least 20-30 minutes most days of the week and eat foods low in calories and fat.

Cervical Cancer
Cervical cancer, a disease of the female reproductive system, is more common in young women. It accounts for 6% of all cancers in women and is caused by the human papilloma virus (HPV) in 90-95% of the cases. The virus is passed from person to person usually by unprotected sex and in most cases the woman has no symptoms. Risk factors for HPV include multiple sex partners, cigarette smoking, and unprotected sex. The key point is that all women who are sexually active need to have a pap smear at least once a year whether you wear condoms or not. Even if you are not sexually active, annual pap smears are still recommended by the age of 18. Cervical cancer can be detected and treated if diagnosed early by pap smears. Talk to your doctor about the vaccine currently in use that may reduce your risk of cervical cancer.

Anabolic Steroids
Barry Bonds is not the first person accused of using steroids and won’t be the last. His situation, however, has brought much needed attention to the topic of steroids. The desire to be competitive and to gain an edge on one’s competitor is natural, however the facts still remain: steroids are illegal and are associated with short and long term effects which can be very damaging to the body. Don’t get it twisted; they do help to build muscle mass, however, with side effects like elevated cholesterol, high blood pressure, balding in men, breast development in men, facial hair in women, and mood swings just to name a few, there is no way I would recommend to anyone using them. The National Institutes of Drug Abuse (NIDA) reported an increase in steroid use among 8th and 10th grade boys in 2000. The primary reasons for using steroids among these young men where to enhance athletic performance and physical appearance. If you want to be the best, work hard and don’t use a substance that is illegal and might permanently damage your body. Also remember, never take or rub a substance on your body if you don’t know what’s in the solution.

Cigarette Smoking
Cigarette smoking is the single most preventable cause of death in the United States. Twenty three percent of high school students and 8% of middle school students in this country are regular smokers. There are more deaths each year from tobacco use than by HIV, drug abuse, alcohol abuse, motor vehicle injuries, suicides, and murders all together. The active ingredient in cigarettes and smokeless tobacco is the very addictive substance called nicotine. Cigarette smoking is associated with cancers of the lung, bladder, and cervix; heart disease; low birth weight babies; sudden infant death syndrome, and chronic obstructive lung disease (COPD). Smoke free facilities are becoming the norm as society is becoming more aware of the harmful side effects of second hand smoke. If you plan on living longer, then you need to stop smoking.

Mental Disorders
Mental health is just as important as physical health and everyone should be comfortable discussing these topics with their doctor. The most common mental health issues seen in my practice are anxiety and depression. Approximately 25% of young adults experience depression by the time they are 24 years old, but very few seek help. This is alarming and depression, if left untreated, can lead to suicide. Anxiety, the most common form of mental disturbance in the U.S., affects approximately 28 million Americans each year. Both anxiety and depression are major problems for society as they can interfere with work, school and family life. They contribute to high rates of substance abuse and alcohol abuse. If you or a loved one has been diagnosed with anxiety or depression, it is important to take your medicines as prescribed and see your doctor and/or therapist on a regular basis.

Suicide
Suicide is the end result of severe depression that is untreated or under-treated. Suicide is common in young adults and the elderly. In general women attempt more suicide than men; men are more “successful” in suicide attempts. Signs of depression include disturbances in sleep, loss of interest in things the person normally does, guilty feelings about a situation or situations, decreased energy, decreased concentration, decreased or increased appetite, abnormal and unintentional weight loss or weight gain, decrease sex drive, and suicidal or homicidal thoughts. These symptoms have to be present for more than two weeks for the diagnosis to be made. The challenge is to recognize these signs and symptoms and to get help for the affected person before a suicide attempt (s) occurs. Suicide is the permanent answer to a temporary problem. If you are someone you love is talking about suicide, get him or her help immediately!

Substance Abuse
Despite what some might try to convince you, drugs of abuse are mind altering and can put you at risk for STD’s, accidents, and time in jail. The trends of abuse have shifted in young adults somewhat from the gateway drugs marijuana and cocaine, to designer drugs such as ecstasy and the date rape drug, GHB. There are more potent forms of marijuana, which make them more addictive, and crystal meth is slowly becoming a drug of choice for many young Americans. The results of substance abuse are quite evident: mental disorders such as depression and anxiety, incarceration, STD’s including HIV, destruction of families, and untimely deaths due to accidental overdose, suicide, or crimes as a result of the drug’s influence. While under the influence of these mind-altering substances, an individual often makes poor decisions and will participate in behaviors that he or she would normally avoid. Education and awareness about the different drugs available and how they affect the body is one of the major ways to decrease abuse.

“Staph” Infections
Community acquired methicillin resistant staphylococcus aureus (CA-MRSA) infections are on the rise! What the hell is that you ask? Well if you have ever had a boil that was hard to treat and it came back to visit you on several occasions requiring multiple doctor visits, drainage by a physician, and sometimes hospitalization and antibiotics through an IV, chances are you had a staph (staff) infection. MRSA was at one time primarily seen in hospital patients with wounds and in individuals with weak immune systems. As a result of antibiotic overuse by physicians to treat simple skin infections and patient noncompliance with medications (not taking them like they are suppose to), these very intelligent bacteria have become resistant to the very basic and inexpensive antibiotics that we have available in our local pharmacies. Staph infections can be very dangerous and are now being associated with pneumonias in healthy individuals. MRSA can kill! If you develop a painful to the touch, red and swollen area on your body that produces pus (drainage), you could have a staph infection. See your doctor right away so that this can be treated quickly and effectively.

Sexual Transmitted Diseases/Sexually Transmitted Infections (STDs/STIs)
Chlamydia, gonorrhea, herpes, HPV, syphilis, and HIV are on the rise again. One out of every 2 Americans will have an STD/STI by the there 25th birthday. The reasons are many and include lack of education and awareness, having unprotected sex, and substance abuse. If a person is infected with one STD/STI, then he or she is at risk of getting another. The concept that oral sex is safe sex or not sex at all is garbage. Herpes, HPV, and gonorrhea can be spread via oral sex. The likely hood of being infected with HIV is very low in someone receiving oral sex compared to the “giver”. However, there is still some risk. Abstinence is still the best way to prevent the spread of sexually transmitted diseases, however, this method is not always practiced. If you choose to have sex protect yourself. Know your HIV status, practice monogamy, wear condoms, and if you perform oral sex learn how to use dental dams. They come in tasty flavors and colors.

This by no means is a comprehensive list of all the potential problems young people encounter, but it’s a great start. Hopefully this will give you a good foundation and help guide your own research regarding the medical issues that I commonly see in my practice.

(c) 2007 Rani Whitfield. This article was published November 2007 by Ozone Magazine.

Women and Steroids

No matter where you go, we are hearing more and more about the use and abuse of steroids in men’s sports. But when multi gold medallist and track super star Marion Jones recently announced that she used steroids after vehemently denying the allegations for years, it sent a shock wave across the country and mixed messages to her friends, family, and fans. This coming on the heels of Barry Bonds record breaking home run season tainted with accusations of steroid use and the recent rumors of talented boxers Sugar Shane Mosley and Jameel McCline’s use of steroids to prepare for there matches. The question most people are asking is why? Why are athletes, especially women athletes, using these illegal and potential harmful substances?

Before I get into the reasons why, let me first explain this class of drugs more correctly called anabolic androgenic steroids (AAS). AAS are the synthetic derivatives of the naturally occurring male hormone testosterone. The ability for steroids to build muscle and strength is the anabolic effect of the drug, while the development of MALE secondary sexual characteristics, like the pitch of someone’s voice and the pattern of body hair describe the androgenic effect of the drugs. AAS have been around since the 1930s to treat a condition in men called hypogonadism in which the testes do not produce a sufficient amount of testosterone for normal male development and sexual function. Other approved medical uses for testosterone include the treatment of impotency, the “wasting” or weight loss seen in persons infected with HIV or cancers, and delayed puberty.

Performance enhancing drugs like AAS are not new to the arena of sports. They date back to the early Olympic Game’s, which started in Greece and has now evolved into a multimillion-dollar industry due to marketing and advertising. As early as 1969, journalist Bill Gilbert was quoted in Sports Illustrated as saying, “The pill, capsule, vial, and needle have become fixtures of the locker room as athletes increasingly turn to drugs in the hope of improving performance.” The desire to win and to gain the edge over one’s opponent is innate, however in the “steroid” culture, there is a phrase used by some professional athletes: “If you are not using steroids, then you are not trying hard enough!” This quest for supremacy at the expense of one’s health has taken over and the all-mighty dollar is more important than health, longevity and loved ones. Steroids have been used and proven to build strength and endurance in competitive athletes for decades; however, AAS are illegal and potentially harmful and considered cheating! These are not the messages we want to deliver to young African American athletes.

The reason women use these illegal and potential harmful substances are very similar to the reasons men use them: to improve athletic performance, to become more muscular, to gain weight, to lose weight, to recover faster from fatigue and injury, and/or to increase speed and endurance. Women who are victims of rape or who have been physically abused also use AAS to improve strength and confidence so that they can protect themselves from future attacks. Muscle dysmorphia, also called bigorexia or reverse anorexia nervosa, is a disorder in which a person becomes obsessed with the idea that he or she is not muscular enough, hence uses AAS to “bulk up”.

AAS have become much more complex as proven by the “designer” steroids used by Marion Jones, some of which are undetectable with the latest technology in urine, blood, or hair samples. Steroids are administered in many ways including pills, needles, patches, or creams. Once in the blood stream they are soaked up my muscle cells and promote the production of protein, which stimulates muscle growth. Athletes will mix different types of AAS to achieve various effects, as there is no accepted medical dosing standard for the use of these drugs for performance enhancement. Side effects of AAS use/abuse include high blood pressure, strokes, elevated cholesterol, nausea, sleep disturbances, acne, increased aggressiveness, and mood disorders including anxiety and depression. Women can experience reduced breast size, increased body and facial hair, a deeper voice, and menstrual problems. In men, reduced sperm count, impotence, breast growth, and decreased testicular size have all been documented. Some of these side effects are irreversible and require surgical treatment.

This is a very unfortunate situation and I am truly saddened as Marion Jones was one of my favorite athletes. I hope that she will turn the negative into a positive and begin to educate young athletes on the only way to become successful in competitive sports while at the same time improving their health: hard work and proper nutrition.

For more information on steroids visit www.nida.nih.gov or visit my website at www.h2doc.com, view the Steroid Man, see a comprehensive list of individuals who have been associated with steroids and shoot me a question or comment at DrRani@h2doc.com. It’s Tha Hip Hop Doc, they call me H2D, come on now lets get Hip Hop Healthy. Peace, I’m out! (c) 2007 Rani Whitfield.

Steroids

I love wearing my throwback jersey’s, especially those from the Negro baseball leagues. These jerseys symbolize so many things: pain, suffering, success, fun. But most importantly they represent hard work that the individuals who wore them endured so that other African American players could achieve the American Dream: baseball, hot dogs, apple pie, and Escalade’s!? I wonder how my now 2-year-old daughter will feel about wearing the throwback jersey of the greatest player to ever play the game of baseball, Barry Bonds. Despite his success in this sport, his name and his records have been tainted with the accusations and stench of steroid use and his athletic prowess has come in to question. The “clear and the cream”, substances given to Bonds by his personal trainer who failed to inform him of what they contained, where actually illegal substances used to enhance performance. But why is this steroid thing such a big deal? Why is the home run record that Bonds now holds in question?

Simply stated, steroids are illegal, potentially harmful, banned in most professional sports and college, and is considered cheating. Among athletes on the elite level, some feel that if you are not using steroids, then you are not trying hard enough. Steroids can build muscle and increase an athlete’s speed and strength. That has been proven. The problem is that penalties are placed on athletes found to be using them and if used for long periods of time the side effects can be embarrassing and potentially life threatening. In women, the side effects of steroids include facial and body hair growth, male pattern baldness, deepening of the voice, reduced breast size and menstrual problems. In men, reduced sperm count, impotence, breast growth, and decreased testicle size have all been documented. All individuals who use steroids are at risk for high blood pressure, strokes, high cholesterol, nausea, sleep disturbances, acne, increased aggressiveness, and mood disorders including anxiety and depression. Some of these side effects like the breast development in men and voice changes in women are irreversible. It amazes me that I get continue to get request from athletes in my private practice for steroids.

Hip-hop has had its bout with accusations of steroid use. LL Cool J was rumored to have used steroids to transforms his body into that of a Greek god. He has denied using steroids as well as plastic surgery to improve his physique in his book LL Cool J’s Platinum Workout.

Whether it is to win at any and all cost or to look good and ripped in a shirts, success and vanity out weigh life and longevity in the psyche of steroid users; that is until something bad happens like being banned from your sport, having a heart attack, or not able to “get it up” when the time is right.

The road to success in sports is hard and education on proper nutrition, exercise, and rest is of the utmost importance. Commitment to the sport on all levels is the only way to be successful. Is Barry Bonds guilty; unfortunately some believe he is, despite being the greatest player to ever play the game of baseball. My advice to him and any young athlete is to never take or rub something on your body without knowing exactly what it is that you are taking or rubbing on you. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com/.

Steroids: Just Don’t Do It!

At 38 years of age I continue to exercise regularly despite a very busy schedule. While traveling for business, and rarely on vacation, the search for hotels with gyms and nearby training facilities is at the top of my list. I have a very competitive spirit and love to win especially when it comes to sports. What a great accomplishment it would be if I where victorious at the 2008 USA Track and Field Masters 400 meter run I am currently training for? I would do anything to win that race…well just about anything.

Modern sports and the media’s obsession with fame, fortune and the “win at any cost” attitude have created an environment for the abuse of the controlled substances called steroids. Anabolic androgenic steroids (AAS) are the correct name for this class of drugs and many athletes are using them in professional sports today. These substances, once only used by the elite, have spilled over in to mainstream America as we now see weekend warriors and non-athletes using steroids for cosmetic purposes, i.e. weight loss and increased muscle mass. The questions I’m often asked are why people use these illegal and banned substances, what are the benefits of use, and what are the side effects?

AAS are synthetic versions of the male hormone testosterone. The ability for steroids to build muscle and strength is the anabolic effect of the drug, while the development of MALE secondary sexual characteristics, like the pitch of someone’s voice and the pattern of body hair describe the androgenic effect of the drugs. The reported benefits of AAS include: improving athletic performance, increased muscle mass, weight gain, weight loss, faster recovery time from fatigue and injury, and increased speed and endurance. Pills, creams, and needles have been substituted for hard work, nutrition, and adequate rest as ways to gain the edge over the opponent.

In 1997, Sports Illustrated interviewed a group of elite Olympic athletes and one of the questions was: "If you were given a performance enhancing substance and you would not be caught and win, would you take it?” 98% of the athletes responded "Yes". The more chilling question was: "If you were given a performance enhancing substance and you would not be caught, win all competitions for 5 years, then die, would you take it?” More than 70% said, "Yes". Are these the messages we want for our youth?

The side effects of steroid use/abuse described in the medical literature include liver damage, kidney and liver tumors, high blood pressure, strokes, elevated cholesterol, mood disorders, acne, increased aggressiveness, nausea, sleep disturbance, increased body and facial hair, male pattern baldness, breast development in men, reduced sperm count, and decreased testicle size. The user who typically will take ten times or more the recommended medical dose and/or combine them with other substances, like human growth hormone, to enhance the effects of AAS, increases the potential for these health related problems. Furthermore, the integrity of these substances comes in to question as they are often purchased via the Internet, black market, or unregulated pharmacies.

The use of AAS is not only harmful, but it is illegal and considering cheating! We must teach young brothers to place more emphasis on participation and competition not merely winning. Hard work, proper nutrition, combined with hydration and rest are the keys to competitive success. I may not win my event in 2008, but I can promise you I will not use steroids to achieve success. My life and my family are much more important to me.

(c) 2007 Rani Whitfield.

Drugs of Abuse Steroids:Fact or Fiction

By the time you read this article, Barry Bonds may have already broken the home run record. On July 20, 1976 Hank Aaron hit the last and final homerun of his very successful, yet tumultuous career in the Major Leagues. Much like his predecessors, Satchel Paige, Jackie Robinson, Willie Mays, and many others African American players during that era, he played the game under extreme racism, scrutiny, and ridicule because he was African American and because he seized the home run record of America’s white hero, Babe Ruth. So we should be applauding the efforts of the African American Barry Bonds, right? He has great hand-eye coordination, he is the winner of eight Gold Glove Awards, he was the Most Outstanding Player in Baseball in 1993, and he holds the record for the most home runs in a single season- 73! Something, however, “just ain’t right”, and the accusations of his use of anabolic androgenic steroid (steroids or AAS) to help achieve these goals have not only tarnished his image, but the image of successful African American athletes.

Performance enhancing drugs like steroids are not new to the arena of sports. They date back to the early Olympic Game’s, which started in Greece and has now evolved into a multimillion-dollar industry due to marketing and advertising. As early as 1969, journalist Bill Gilbert was quoted in Sports Illustrated as saying, “The pill, capsule, vial, and needle have become fixtures of the locker room as athletes increasingly turn to drugs in the hope of improving performance.” The desire to win and to gain the edge over one’s opponent is innate. Who could argue with a young man or woman whose business contract becomes more lucrative if he/she can out run or out bench press more than his/her competition? The facts, however, still remain: steroids are illegal and are associated with short and long term side effects, some of which are very damaging to the body. The question I am often asked is why do athletes use steroids.

Anabolic (tissue or muscle building) androgenic (the development of masculine characteristics) steroids or AAS are the man made or synthetic versions of the male hormone testosterone. Testosterone, a hormone found in men and in women in much smaller amounts, is responsible for the development of males during puberty. The original purpose for the use of steroids by physicians included: replacement of the hormone in men born with low levels; treating individuals who suffered injuries during war; treating those who are malnourished, such as HIV and cancer patients. There are also veterinarian uses for these drugs to treat certain medical problems in cows and horses. When used properly, these medicines can be very successful in treating illnesses and definitely have a place in the medical arena.

Unfortunately, there is a phrase used by some professional athletes: “If you are not using steroids, then you are not trying hard enough!” The quest for supremacy at the expense of one’s health has taken over and the all-mighty dollar is more important than longevity and loved ones. Steroids have been used and proven to build strength and endurance in competitive athletes for decades. Weight gain, weight loss, increased speed, increased strength, and physical appearances are all reasons for the use of these illegal concoctions. Steroids have become much more complex as proven by the “designer” steroids, some of which are undetectable with the latest technology in urine, blood, or hair samples. Steroids are administered in many ways including pills, needles, patches, or creams. Once in the system they are soaked up my muscle cells from the blood stream. Once inside the muscle cells they promote the production of protein, which stimulates muscle growth. Athletes often take doses two to three times the normal amount of steroids required on weekly basis. They mix or stack different types of steroids to achieve various effects: more muscle mass, decreased weight, leaner appearance, etc…. None of these “protocols” used by the athlete have been tested on humans and at best are experimental.

Side effects of steroid use/abuse include high blood pressure, strokes, elevated cholesterol, nausea, sleep disturbances, acne, increased aggressiveness, and mood disorders including anxiety and depression. Women can experience reduced breast size, increased body and facial hair, a deeper voice, and menstrual problems. In men, reduced sperm count; impotence, breast growth, and decreased testicular size have all been documented. Some of these are irreversible and require surgical treatment.

It still amazes me, however, that I get request frequently for these drugs to improve performance. To win at any and all cost is the main reason. A poll taken in 1995 of 198 sprinters, swimmers, power lifters, and other Olympians and aspiring Olympians asked if the athletes would take a performance-enhancing substance if they knew it would help them win there event and they would not be caught- 195 out of 198 said yes. The poll went further to ask if under the same conditions they would take the substance knowing that in five years they may die- 80% still said yes!

Educating our youth on proper nutrition, exercise, and the consequences of steroid use/abuse is the key. Commitment to the sport on all levels is the only way to be successful. Steroids are illegal, potentially harmful, and are viewed as cheating. Is Barry Bonds guilty; unfortunately many believe that he is, despite being one of the most talented individuals to ever play the game of baseball and one of my personal favorites. My advice to him is to never take or rub something on his body without doing a little research. I surely will celebrate the day he breaks the record, but for some, his success will always be in question.


For more information on steroids visit (www.nida.nih.gov) or visit my website (www.h2doc.com), view the Steroid Man, and shoot me a question at DrRani@h2doc.com. (c) 2007 Rani Whitfield. This article was published September 2007 at http://www.eurweb.com/