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Notice How Tiny the TIck That Causes Lyme Disease Can Be.

by James Hubbard, MD, MPH

When someone comes in my office for a tick bite, their main concern is, usually, what’s their risk for Lyme disease. And I can’t blame them. Lyme disease from tick bite warnings are all over the media (one reason probably is New York a high-risk state) and, since the disease has only been recognized in the U.S. since 1975 (first suspected by a physician in Lyme, Connecticut who was seeing kids with unusual symptoms) we’re still learning about it. This, and it’s rather general initial symptoms, make it rife for myth and speculation.

One thing’s for certain, Lyme disease is serious business. And it’s at full force in the summer because that’s when the ticks that spread it are most prevalent. So, in this post, I’ll try to answer some of the most common questions I’m asked.

How is Lyme disease spread?

Ticks. Ever had one on you? Yeah, it’s pretty creepy. Ticks are one of nature’s true vampires. The tiny specks sit silently on leaves of a bush or tree, patiently waiting for whatever warm-blooded creature (they’re attracted to [... continue reading]

Author: James Hubbard, M.D., M.P.H.
Posted: July 20, 2014, 2:56 pm

A chest x-ray from a person with tuberculosis (in right upper part of the photo).







by James Hubbard, MD, MPH Lately I’ve had several interviewers ask me a question I haven’t been asked before: how contagious is tuberculosis? I’m guessing the reason is either the highly reported outbreak in a California classroom, a couple of publicized cases of multiple drug resistant tuberculosis found in foreigners traveling here in the United States, or the news of camps of children–some reportedly with TB–at the US-Mexican border. But then, I should never be surprised that people would like to know about the risk of one of the oldest, most deadly, and still most worldwide prevalent diseases around.  And since this could well be a deadly concern in disaster situations, I thought it a good subject to address.

Tuberculosis Truths
  • In the early part of the 20th century, tuberculosis killed about one in seven Americans.
  • In 2012, the latest year data is available, the CDC, reports around 10,000 documented cases in the U.S..
  • Over 500 people died of TB in 2012.
  • If treated properly with the right antibiotics, tuberculosis is [... continue reading]
  • Author: James Hubbard, M.D., M.P.H.
    Posted: July 14, 2014, 9:51 am

    Girls are especially prone to knee injuries.

    James Hubbard, MD, MPH

    Question. What do adolescent girl athletes and the rest of us have in common? Answer. Knee injuries, of course :).

    In fact, anyone who gets in a little too much of a hurry or doesn’t watch what they’re doing is susceptible. Add jumping or a quick pivot for whatever reason and your risk increased greatly.

    A while back, I jumped off a porch with such a jar I thought I’d shaken my teeth out. The reason was I landed without bending my knees and it’s a wonder I didn’t injure one of them.

    You can be in tiptop shape (unlike me), and have the strongest of legs and still get hurt—just because you land or pivot wrong.

    Fortunately, there’s been a lot of recent research in knee injury prevention triggered by the growing amount of injuries in girls’ sports. It seems they are particularly prone to ACL tears. The keys are not only strength but balance, and training our brain to make our legs land in the correct position. A little preparation can go a long way to prevent a debilitating injury.

    Why Girls? [... continue reading]
    Author: James Hubbard, M.D., M.P.H.
    Posted: July 7, 2014, 10:05 am


    Part 3 in my series on drowning. See all my posts about rescuing drowning victims here.

    by James Hubbard, MD, MPH

    Ever heard of parking lot drowning? That’s what lifeguards anyway. Others may call it secondary drowning.

    It can happen minutes to hours after a near-drowning victim is revived. It can even happen to someone who didn’t nearly drown—who just sucked a little too much water down their lungs, coughed and choked, and then appeared perfectly fine.

    Later on (maybe, say, sitting in a parking lot), the victim can suddenly become unable to get enough oxygen. If not treated they can, in essence, drown.


    If even an ounce or so of water gets all the way down into the deep part of the lungs, it can damage the alveoli (air sacs where oxygen is exchanged for carbon dioxide). This impedes the lungs’ ability to get oxygen into your body and can become life-threatening.


    Who’s at risk: Anyone who’s been in the water within the past 24 hours and sucked in enough to cause a pretty bad initial choking and coughing spell is at risk for [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: June 30, 2014, 10:00 am

    by James Hubbard, MD, MPH

    This is part 2 of my drowning series. See part 1, about essential swimming skills and rescuing drowning victims, here

    Once you pull someone drowning to safety, what next? If they’re unresponsive and not breathing, three things should be done at once if there are enough people around to do them: Call 911, start CPR, look for an AED machine.

    In a survival situation, if you can’t call 911 and there’s no AED machine, do CPR until you’re exhausted. But know that CPR alone rarely revives a person. (It pumps blood to the brain to prevent damage until expert help arrives but rarely restarts the heart. An AED—automatic external defibrillator—can restart the heart. More and more public swimming areas are stocking one.)

    If you’re alone, make a judgment call about which of the three steps to do first. I’d take no more than 30 seconds to look for an AED machine. CPR needs to be started as soon as possible.

    >> Special circumstances: Click here for special instructions for resuscitating someone who was drowning in cold water.

    Those [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: June 23, 2014, 10:00 am

    James Hubbard, MD, MPH

    Every year even good swimmers drown. Some are in an accident or become unconscious due to a seizure, alcohol, or another reason. Some drown trying to help others. And some just don’t know how to swim as well as they thought.

    According to a survey done by the American Red Cross, 80 percent of Americans say they can swim, but only 56 percent can complete all five critical water safety skills that make up what’s known as “water competency.”

    Could you? The skills are:

  • Step or jump into the water over your head.
  • Return to the surface and float or tread water for one minute.
  • Turn around in a full circle and find an exit.
  • Swim 25 yards to the exit and exit from the water.
  • If in a pool: Exit without using the ladder.
  • If you’re not absolutely sure you can perform these skills, consider taking lessons.

    And those guidelines are just for keeping yourself alive. What if you were the only one around who could save another person from drowning?

    Just the other day I was asked what to do if you [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: June 16, 2014, 10:00 am

    James Hubbard, MD, MPH

    Father’s Day is close at hand. How about getting the old man something a little different this year? Something he can use—that might even help him avoid or treat an injury.

    Here are seven Father’s Day gifts that I think any man would relish. Since Father’s Day is close at hand, I made sure you could buy them all through Amazon Prime because if you sign up for a free trial, you can get many of them within a couple of days. The last on the list, if you wish, you can get directly from me.


    I can’t count the number of times I’ve treated someone who’s had their day ruined by being in their yard, or with machinery, and getting a speck in their eye that they can’t get out. Everyone needs a good pair of goggles. This is a pretty cool-looking pair.

    SAM Splint

    I love these things. They’re light, and you can store or pack them virtually anywhere. Cut to size, and your father can make about any type of splint he needs.


    Everyone needs a radio in [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: June 9, 2014, 9:44 am

    by James Hubbard, MD, MPH

    Here’s a simple, easy to remember tip that could save your feet if you have to work in wet weather. If you don’t have rainboots, you can waterproof your shoes with duct tape.

    This is an excerpt from my new book, Duct Tape 911: The Many Amazing Medical Things You Can Do to Tape Yourself Together.

    Chapter 18

    Waterproof Clothing

    Being wet makes being cold worse. Wet skin or clothing conducts heat away from the body very fast, possibly leading to frostbite or hypothermia. And keeping your feet in cold, wet socks and shoes for a long time can cause tissue damage.

    Trench foot is an example of the latter. It’s been a problem in wars, like World War II and the Vietnam War, when soldiers have had to stand hours upon hours in cold water. The result can be permanent tissue damage. Wearing wet socks can cause trench foot also. That might happen if you’re dealing with the aftermath of a flood, for example.

    And flood water poses more dangers than wetness. No matter how clear it looks, it’s contaminated with whatever [... continue reading]

    Author: LAwordsmith
    Posted: June 2, 2014, 10:00 am

    by James Hubbard, MD, MPH

    In the Deep South right now, it’s about heat wave time, otherwise known as the season of year when you step outside and right into a sauna. I know because I grew up in Mississippi.

    If you also grew up in an area that gets really hot, you may think you know everything there is to know to beat the heat. But you haven’t read this post! I bet I can surprise you—at least once?

    Even people used to working in the heat all day can suffer dangerously come that first heat wave—when the temperature and humidity suddenly soars 5–10 degrees or hotter. And imagine having to be outside after a disaster or while stranded in the wilderness, with no chance for air conditioning.

    Here are some Survival Doctor tips, facts, answers and more—all to help you beat the heat.

    Hmmm. Very Interesting.

    4 surprising beat-the-heat facts

  • That fan may not be cooling you, even if it feels good. Once the temperature reaches the 90s, fans have questionable effectiveness in cooling your core. Some people think fans can make you hotter by constantly bombarding you with [... continue reading]
  • Author: James Hubbard, M.D., M.P.H.
    Posted: May 27, 2014, 10:00 am

    Typical measles rash. (Click to zoom.) Usually starts on the face three to five days after symptoms begin. Travels down the body.

    by James Hubbard, MD, MPH

    One of the worst U.S. measles outbreaks in years is going on in Ohio. So far, around 70 people have been infected. Another outbreak, in California, has involved about 60 people.

    Though the measles is considered essentially eradicated in the U.S., there are a few cases here every year. This is a big year for them though, with 187 cases nationwide as of May 9, according to the Centers for Disease Control and Prevention.

    So this is a good time to bone up on your knowledge. Here are seven FAQs about this very contagious viral infection.

    What’s That You Say? There’s a Big Outbreak in Ohio?

    It seems that some unvaccinated Amish missionaries were working in the Philippines, which is having a large outbreak—over 26,000 suspected cases as of April 20, according to the CDC. When the missionaries went back home, four came down with measles. This has now spread to around 70 people.

    Could I Get It?

    If you’re around someone with the measles, here are some [... continue reading]

    Author: James Hubbard, M.D., M.P.H.
    Posted: May 19, 2014, 10:00 am

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