The Abuse, Addiction, and Affliction of Alcohol: It's in the Stars...

"Oh no, I just said I wanted to die because I was drunk. I'm not really suicidal"

"I just cut myself when I drink."

" I punched the wall and broke my hand because I had a few drinks."

" I didn't really mean to threaten her life. I was drunk."


These are just a few quotes from actual patients I have had.

Approximately 190,000 ER visits by people under the age of 21 occurred in 2008.

Alcohol is the key to Pandora's box. It makes us MORE likely to be in fatal car accidents, get STD's, have unwanted pregnancies, feel depressed, act wrecklessly due to the depression, be perpetrators and victims of violence, commit suicide, and LESS likely seek help for ANY of these problems.
It made a patient in my St. Joseph's Hospital ER more likely to set her exam room on fire 5 months ago, while the department was filled with doctors, patients, even police. She had been told that if she left the ER while intoxicated, she would go to jail. So, she set the fire, and earned a visit to the psychiatric ward before going to jail.

For people engaged in underage drinking, add disruption of normal growth and development.

While underage drinking (drinking alcohol before age 21) is illegal, according to the CDC, people aged 12-20 drink 11% of all alcohol consumed in the U.S. and more than 90% is consumed during binges. Youth drink more during binges than adults.

The Abuse, Addiction, and Affliction

What is Addiction?

According to the Encarta World English Dictionary, it is "a
physical or psychological need: a physical or psychological need to use a drug or other substance regularly, despite the fact that it is likely to have a damaging effect."

What is Abuse?
It is the "excessive consumption or misuse of substance: the excessive consumption or misuse of a substance for the sake of its non-therapeutic effects on the mind or body, especially drugs or alcohol."

According to Webster's 1913 Dictionary, Affliction is
n. 1. The cause of continued pain of body or mind, as sickness, losses, etc.; an instance of grievous distress; a pain or grief.
2. The state of being afflicted; a state of pain, distress, or grief.
Some virtues are seen only in affliction.



Would this include repeated incidents of public drunkenness, drunk driving, drinking heavily while already in trouble with the law,
calling police officers degrading names, writing "F U" on your middle finger, knowing you are going to court?

Yes.
The rich and famous culprits of the moment are, two in particular whose judgment has been so flawed that they cannot keep their issues from becoming public, overwhelming even the interest of the public in their troubles.

Now while these rich and famous folks, when presented with the title role model, shrug it off, I would say that they, especially at their worst, are the best role models through their negative reinforcement. We want the absence of such embarrassment and punishment so we act to avoid it. Many of us respond more to negative reinforcement, meaning we are more likely to abstain from underage drinking and alcohol abuse to AVOID the grief that comes with it. We look to celebrities for so much. Why not look to them to learn what not to do?

Know What to do When a Person Chokes

You and a friend are laughing it up over lunch. She/he starts to choke. What do you do?

1. Ask, "Are you choking? Can you speak?"

This sounds silly but if the person can cough, and/or speak, give them a chance. Strong coughing can dislodge the food.

If the person can do neither...

2. Stand behind him/her and wrap your arms around their waist

3. Make a fist with one hand, with the thumb side just above the person's navel, not touching the breastbone.

4. Grasp the fist with your other hand.

5. Make quick, upward and inward thrusts with your fist.

6. Continue these thrusts until the object is dislodged or the person becomes unconscious.

If this happens, it is not your fault. This is an effect of the lack of oxygen getting to the brain caused by blockage of the airway. Keep working, and work or get help fast!

What to do next?

7. Help the person to the floor.

8. Call 911

9. If you see something blocking the airway, try to remove it. Remember, only do this if the person is not conscious.

If the person is pregnant or obese....

1. Wrap your arms around the person's CHEST.

2. Place the fist in the middle of the breastbone between the nipples.

3. Thrust firmly in a backward motion.

How do you prevent choking? Take your time, chew your food thoroughly. Do not drink alcohol or if you are legal, avoid eating while intoxicated. If the person is eating with poorly fitting dentures, advise against it. For this and more information, I recommend checking out Medline Plus, or the American Heart Association.

Be safe, be successful,

RAPP M.D.

Don't Fry or Die: Be Safe in the Sun

Remember Corey Stringer? He was an All pro defensive tackle for the Minnesota Vikings football team who died at 27 due to heat stroke in August, 2001 during football practice. He was surrounded by sports professionals, plenty of water, sports drinks and ice, and still met an untimely, unnecessary death due heat stroke. This need not happen to you or your loved ones.

Heat illnesses form a continuum meaning one illness gradually progresses into the next. Heat cramps present as achy, stiff muscles or muscle spasms occurring during heavy exercise in hot environments. Muscles groups most often involved include the calves, abdominal wall, arms and back although no muscle group is immune. Treatment requires stopping the exercise, getting to a cool area, gently stretching the muscles, and drinking cool water or an electrolyte drink.

Heat syncope (fainting in the heat) typically occurs during the 1st five days of adjustment to a new activity. Teens and young adults who are beginning summer practice sessions are vulnerable to this. Weakness, fatigue and fainting are how it presents itself.

According to the American Academy of Orthopedic Surgeons, there are 2 types of heat exhaustion. One is that due to water depletion. This involves heavy sweating which starts to decrease. Danger: your body is losing its ability to cool itself. Once the sweating slows, you become dehydrated, and the body's temperature goes to about 104 degrees. You may experience excessive thirst, weakness, headache, and even loss of consciousness. The second is heat exhaustion due to salt depletion. You are at risk for this when you fail to replace normal body salts and minerals lost in the sweat. This can happen during extended exercise sessions during which you drink water alone instead of sports drinks containing electrolytes like sodium and potassium.

Treatment for heat syncope and exhaustion is the same. Get to a cool area sheltered from the sun. Take off tight clothing. If the affected person is conscious, have them drink the fluids mentioned, not soda or energy drinks. Use a fan and icy towels to lower the core body temperature, and get that person to an ER.

The most severe form of heat illness is heat stroke. This occurs when the sweating stops and the body's core temperature exceeds 104 degrees. Confusion, nausea, seizures and coma are possible at this point. It can also present without signs of heat cramps or heat exhaustion. This is indeed an emergency. Call 911.

Don't allow a beautiful sunny day turn into one of tragedy. Knowing the progression of heat illnesses from heat rash, to heat cramps, to heat exhaustion, and finally to heat stroke, should allow you and your family to enjoy fun in the sun for many days to come.


Be safe. Be successful.

RAPP M.D.

Health and Trends in Pop Culture: A look into Lady Gaga's Eyes

Lady Gaga's doe-eyed look in her "Bad Romance" video has caused a dangerous trend to catch on among teens in the U.S. Teens are purchasing "Circle Lenses," colored contact lenses that make the colored part of the eye (iris) appear larger. These lenses are illegal in the U.S. but are readily available on the Internet, so teens and young adults are buying them without seeing an eye doctor, having their eyes fitted for the lenses to ensure a proper fit, and without instruction in proper use. Poor use can cause scratches, called corneal abrasions, tears (lacerations), and infections of the eye, even blindness in rare cases.

To have even a corneal abrasion is a painful and inconvenient experience. I had it as a med student while on a trauma surgery rotation and they let me out for the day! The eye becomes extremely sensitive to light. and your vision is blurred. It causes one to feel unable to open the eye, because of the sensation that a tiny but sharp object is on the eye. The eye often waters constantly, and the more you rub and blink your eye, the worse pain becomes. The pain can be excruciating. It requires a doctor's visit for an exam and anesthetic, anti-inflammatory, and antibiotic eye drops or ointment and then follow up with a specialist. In terms of infections, even contact lenses prescribed by a doctor put people at risk for infections when not handled properly. Imagine the damage you could do using contact lenses that do not fit you and without proper instruction. The American Academy of Ophthalmology has discouraged the use of nonprescription cosmetic contact lenses which have been illegal in the U.S. since 2005.

For media inquires about Dr. Rapp's expertise, please contact Bridgett S. Joe at 713-498-0552 or via email at bhjoe@scprelations.com.

Have a question for Rapp M.D.? Send them to Kadisha.Rapp@yahoo.com!

Avoid a Summer Tragedy. Avoid Drowning Episodes

RAPP Tips
During the Summer months, people are more prone to drowning. Take these precautions to avoid unintentional drowning.







RAPP TIPS

- Supervise closely enough to touch the person
- No phone use, reading, yard work, card playing, etc.
- Never swim alone or without a life guard present
- Don’t drink before swimming or any other water activity
- Learn to swim
- Get CPR training!
-One of the most effective interventions
-Significantly affects survival
- Don’t use inner tubes, water-wings or noodles in place of life jackets

Residential Pool Safety:

- Remove all toys from your pool area after use
- Their presence entices children to enter the water with them
- Four-sided pool fencing
- At least 4 feet high
- 2/3 of 4 year olds can climb a smooth 4 foot barrier in 2 minutes!

Safety around Natural Bodies of Water :

- Be aware of local weather conditions
- Wear U.S. Coast Guard approved life jackets for all boat trips regardless of distance
- Know and obey colored beach flags
-Double Red= Closed to the Public
- Single Red= High Hazard
- Yellow= Medium Hazard
- Green= Calm conditions but caution still is necessary
- Purple + Red or Yellow= Dangerous marine life (not sharks)
- If caught in a rip current, swim parallel to shore until free, then swim toward shore.

Exported Article: Kidult Youth Leadership Conference

The following is an article written about my personal experience and professional conclusion regarding Pharrell Williams' 1st Annual Kidult Youth Leadership Conference, which was held on June 26, 2010 in New York City.

The Conference

“It is the small decisions we make in our everyday lives, which contribute to our mental and physical safety, and allow us to either continue on, or be derailed from, the road to our dreams.” This was the message given by K.B. Rapp M.D. to attendees at Pharrell Williams’ 1st Annual Kidult Youth Leadership Conference held on June 26th in New York City.

While the attendees of Pharrell Williams' 1st annual Kidult Youth Leadership Conference held in NYC June 26th were being educated, inspired, motivated and entertained by Pharrell, Mimi Valdes, award winning former editor-in-chief of Vibe Magazine, and others regarding creativity, technology and entrepreneurship, their experience was rounded out by a basic reminder: "It is the small, everyday decisions that you make regarding your mental and physical safety that allow you continue on, or be derailed from, that road to your dreams."

The Doctor, The Message and The Presentation

In the Kidult exhibitor hall was a board certified emergency physician named Dr. K.B. Rapp. As a doctor with ten years of experience in treating victims of emotional and eating disorders, STD's, unwanted pregnancies, drug and alcohol abuse, and violence, she felt the obligation to travel to the conference from Houston, Texas to spread the message of maintaining mental and physical integrity in order to achieve success in life. Her need to spread this message to youth stems from her belief that no matter how smart, creative or talented a young person may be, their efforts will go to waste if they do not protect their health by being aware of dangerous people, situations and emotions.

To explore these messages, Dr. Rapp created a PowerPoint presentation titled of "Health and Wellness in Teens and Young Adults.” While the PowerPoint ran in auto play in the background, she discussed and distributed brochures about a range of topics, such as Teen Esteem, Weight Control, Keeping Clean, and 101 Ways to Deal with Stress to STD's, Dating Safety, and Violence Prevention.

Many audience members received her presentation’s messages with an open mind and a learning spirit. Some youth and exhibitors came by to ask about becoming a physician, while others inquired about information for their own projects. Likewise, Rapp had the attendees fill out a “Health and Wellness Quiz” so she could obtain feedback, and so that she could measure effectiveness of her presentation. Feedback from youth was obtained by surveying them on pressing issues which concerned them.

The Results

Out of the eighty-one surveys completed, the top two issues proved to be Violence with 31 votes, and STD’s with 29 votes. Conflict Resolution, Emotional Disorders, Dating Safety, and Abstinence followed. The least recognized issue was Eating Disorders. Three youth filled in the "Other" slot and noted “drug and alcohol abuse”, “being the best me" and "poverty-related illnesses” as their primary concern.

The Conclusion

Dr. Rapp’s efforts at Pharrell Williams’ 1st Annual Kidult Youth Leadership Conference were a success. Not only was she afforded the opportunity to connect with youth and other audience members over her message, but she was able to gather invaluable information that she could carry back to Houston, Texas. The results and feedback she received will be used to better service her young patients and to help her better focus on the primary issues and concerns of young people today.

Dr. Rapp hopes to be apart of many other conferences and conventions aimed towards strengthening the quality of life for youth in America. In doing this, she helps sustain the livelihood and future of America.

The Truth About Propofol: A Year After Jackson's Death

About a year ago, music legend, Michael Jackson, tragically lost his life due to using lethal levels of the drug, Propofol. Propofol is a short-acting, intravenously administered hypnotic agent. It is used for sedation for mechanically ventilated adults and for regular, procedural sedation. Propofol is also found in veterinary medicine.

While this drug has been approved for medical use in more than 50 countries, and is assumed safe when prescribed or administered by a licensed physician, the improper use of Propofol is increasingly responsible for ending the lives of many people each year.

As an emergency physician out of Houston, Texas, I have used Propofol for patients for the past six years to reduce dislocated shoulders, assist Oral Surgeons in removing teeth, and reduce fractures. I have also seen it used in the operating room.

After the death of Michael Jackson last year, many of his fans, media representatives and medical professionals blamed Conrad Murray, Jackson’s personal doctor, for his death. They agreed that Murray knew the consequences of administering and allowing the administering of Propofol at dangerously high levels. While Dr. Rapp agrees that Murray was in part responsible for his overdose and death, she disagrees with those who suggest Jackson’s death to be fully his fault.

Dr. Rapp practices medicine on the platform, Safety for Success, which delegates to the public precautionary awareness, health tips, basic common medical knowledge, and the responsible use of both medical information and prescriptions. In her opinion, Jackson’s decision to continue using the prescribed drug above recommended levels was equally as harmful as Murray’s allowance of it.

Jackson’s death caused alarm throughout the United States and the world—but it proved to be even more influential to people prescribed the drug and physicians who administer and prescribe it. Rapp has noted precautions in using the drug—including the medical field’s recent attempts to phase out use because of its side affect of lowering blood pressure rapidly and significantly. While Rapp agrees it should be monitored, she simultaneously believes that Propofol is helpful in the medical field when used responsibly by patients, surgeons, medical doctors, and dentists.

Dr. Rapp’s expert advice provided by her medical experience has helped her develop guidelines and information under the following themes:
1) Pre-existing conditions
2) Post-existing affects
3) Use of Propofol in the Medical field (On-site administering)
4) Self-administering Propofol
5) Safety First (Precautionary)
6) Safety First (Emergency and Overdose)

We urge you to encourage your audience to be proactive about the potential aftermath of abusing Propofol, as well as other drugs that have the same potential fatal outcome. Media coverage has proven to help raise awareness among its audiences and motivate education.


For media inquires about Dr. Rapp's expertise, please contact Bridgett S. Joe at 713-498-0552 or via email at bhjoe@scprelations.com.

Have a question for Rapp M.D. ? Email them to Kadisha.Rapp@yahoo.com.

Get to Know Dr. Kadisha Rapp

Dr. Kadisha Rapp

Board Certified Emergency Medicine Physician

Kadisha Rapp, M.D., is a practicing Board Certified Emergency Medical Physician with close to 20 years of combined education, training and practice in the field of medicine. Currently living and practicing medicine in Houston, her humble beginnings originate in Washington, D.C., where she was born on September 10, 1972.

Dr. Rapp took an early interest in Journalism and Fine Arts, but decided on studying medicine during her Junior year in college after considering her life goals and personal skills with her supportive mother and grandmother. Soon after making this decision, Kadisha was accepted into The Johns Hopkins University, where she faced a daunting and controversial four years as she witnessed JHU's administration fight against Black study programs. However, she used her strength and will to succeed to overcome educational adversity, and graduated in 1994.

Soon after graduation, Kadisha worked as a lab technical assistant and took Pre-Med courses at Howard University, where she initiated her “hands on” experience and received all A’s for two full semesters.

In 1996, Kadisha continued her studies at the University of Maryland’s School of Medicine with the goal of either being a psychiatrist or a surgeon. But after discovering her love for using her hands, she decided not limit herself to a specific field of medicine, and decided on Emergency Medicine. This field of medicine would allow her to respond to medical emergencies by using her hands to heal various critical conditions.

In May 2000, Kadisha received her M.D. and began her residency in Emergency Medicine at Howard University Hospital. She graduated from the residency program in 2003, and entered a Sports Medicine fellowship at Allegheny General Hospital. Here, she helped care for the Pittsburgh Pirates baseball team in the Orthopedics Department.

The following year, Dr. Rapp was recruited to the Department of Emergency Medicine at Thomas Jefferson University Hospital in Philadelphia. And after one year of academic medicine, she entered community practice at the Lower Bucks County Hospital in 2005.

Dr. Kadisha Rapp relocated to Houston, Texas in 2008 where she continues to practice medicine at First Choice Emergency Room in the Copperfield area.

Have a question for Dr. Rapp? Send them to her at Kadisha.Rapp@yahoo.com .

Please direct all media inquiries to Bridgett Joe at bhjoe@scprelations.com, or Andrea Harden at aharden@scprelations.com.