High on Bath Salts?

They are not the bath salts you use in your bath.

These "Bath Salts," are a new and very popular designer drug that the Drug Enforcement Agency (DEA) is hoping to make illegal in the U.S. In September of this year, the DEA invoked its emergency scheduling authority to make them a controlled substance, and its sale has been banned in 35 states, as the National Poison Control Center has reported more and more calls about this drug. In an article written by Ann Bryant of Maine's Sun Journal, Deputy Chief of Farmington's Police Department Shan Cote reported that 303 calls for bath salts exposure were made to poison control centers in 2010, and that more than 5,000 calls have been made so far in 2011.

What are bath salts?

These bath salts are synthetic stimulant/hallucinogens similar to ecstasy and PCP. They were initially made in France in the 1920's , seen in Europe in the late 2000's, and here in the U.S. during the last few years. It has a number of harmless-sounding names such as Ivory Wave, Purple Wave, Oblivion Bath, Vanilla Sky, Bliss, and Snow White. Their proper names are mephedrone, MDPV (methylenedioxypyrovalerone), and methylone. They are found in mini-marts, smoke shops, and often appear as small bags of crystal white or brown powder. In the past they could be found in convenience stores and head shops next to the 5 Hour Energy products.

Why the name?

They have been marketed at "plant food" and "bath salts" and labeled as "not for human consumption," to avoid being made illegal. While it is banned in many states, it will take a federal law labeling them as a schedule 1 drug ( no medicinal value with a high potential for abuse) to officially declare bath salts illegal. For now, in some areas a small envelope of the drug can cost $25 to $50.

Are bath salts addictive? How are they taken?

It's not currently known if they are addictive but like other stimulants they are expected to cause cravings. It is snorted, injected, and mixed with food and drinks.

What does bath salts intoxication look & feel like?

One's blood pressure and pulse will rise. While high you may feel euphoria, confidence, experience increased alertness, focus, and productivity. The downside consists of depression, anxiety, aggression, delusions of superhuman strength, and a rise in body temperature causing many to remove their clothing. The downside continues with as one can become agitated, paranoid, experiencing hallucinations and suicidal thoughts. Users have been reported to be unaware of a broken limb, and to have damaged ambulances and hospital rooms.

Suicidality has been known to be ongoing after the stimulatory effects have dissipated, and suicides were reported days after use in the media.

Bath salts are part of a trend of drugs designed and named such that they are legal and thus easily obtained for long periods before detected by law enforcement. We must remain vigilant.

Holiday Heart Syndrome: An Unwanted Gift

Now that we are in the throes of the holiday season, I must warn you of Holiday Heart Syndrome, brought on by drinking too much wine, too many beers, and consuming too much sodium. You say you don't have heart disease? It doesn't matter. You can still get it.

What is it?

Holiday Heart Syndrome is not just stress. It is a real condition in which the heart is more vulnerable to disturbances of the heart's normal rhythm. It is a rapid, irregular rhythm your heart can enter when you drink too much alcohol. Most commonly the heart goes into ATRIAL FIBRILLATION, a rhythm characterized by the quivering of the heart's upper chambers called the atria. The atria normally contract in a regular fashion, squeezing blood efficiently into the lower chambers of the heart called the ventricles which send blood to the body. When the atria are merely quivering, that efficiency is lost, meaning not all of the blood will enter the ventricles but will sit in the atria. Blood that is not in motion can thicken, forming lumps called clots which can block circulation, causing strokes and heart attacks, and the loss of fingers or toes based on where they lodge themselves in the body's blood vessels. Other rhythm disturbances the heart can enter include atrial flutter, and premature beats. Premature beats can come from the lower as well as the upper chambers of the heart.

What causes it?

We are not entirely certain of the cause, but it tends to happen when a person has consumed too much alcohol, is stressed and/or is dehydrated. There are theories that it is caused by a rise in one's epinephrine or norepinephrine (adrenaline or noradrenaline) levels. These stress hormones increase heart rate.

Who is at risk?

People who usually have no history of heart disease often experience it.

What are the symptoms of Holiday Heart Syndrome?

The symptoms are caused by the heart entering a rapid and irregular rhythm. This can cause the sensation of palpitations which cause a fluttering in the chest due to the heart racing, pounding, or skipping beats. You may also feel chest tightness, shortness of breath, dizziness, or like you will faint.

How is it treated?

Go the the emergency room. You might need intravenous fluids, medication to slow the heart rate, and monitoring of your heart's rhythm. Usually the symptoms resolve when the offending agent or condition is no longer present in the system. Bring a list of all your medications. Know your personal and family medical history. Be honest when telling of any drugs or alcohol consumed. If you are without heart disease, the symptoms usually resolve within 24 hours and you will be cleared to return home. If there is concern for undiagnosed heart disease, you may need to be admitted to the hospital for additional evaluation and treatment. Underlying heart disease, combined with the symptoms of chest tightness and shortness of breath means a greater chance you may be having a heart attack.

Young Girl with Promising Future Dead over $20.

Kamisha Richards (left), 22 years old, lent $20 to her lifelong friend, sister of her boyfriend, Kayla Henriques (right), 18, for diapers. Kamisha found out Kayla spent it on something else. She confronted Kayla on Facebook with an embarrassing statement. Kayla allegedly said, "Dnt try to expose me mama, but I'm not tha type to thug it out ova facebook ima c u wen u get frm wrk."


"I'm a have the last laugh," said Kamisha.
Kamisha had her last breath later that night.
She was pronounced dead at the Brookdale Hospital.
I think of how I could have had that task....

What happened?
After the Facebook feud, Kamisha went to Kayla's apt and confronted her in her kitchen. The argument ended with Kayla stabbing Kamisha in the chest with a steak knife. Kamisha was 22, with a degree in criminal justice, and worked as a security guard with plans for law school. Kayla is 18, she's a junior in high school, and is the mother of an 11 month old boy.

Controlling your anger can save your own life.

There are 3 ways of dealing with anger:
1. Expression
2. Suppression
3. Calming.

Expression of anger is healthy. The way in which you express it key. Declaring and defending your boundaries without hurting others is difficult. How can one do this? Don't start with the word "you," when expressing unhappiness with a person's behavior. Tell the person how you feel. In this case, Kamisha could have said, " I felt used when I heard that the money was used for something else." Tell that person what you need from them. "I need to know that you will pay me back as soon as you can."
Do not shame that person with hopes the embarrassment will make them come correct. It too often creates more anger. Instead of being shamed into doing right, the person can become defensive, and hurt you even more to deflect that shame, especially when you publicly shame them. This is what happened here. Kamisha's attempt at shame escalated the anger in both of them.

Regardless of what is said, remember: Respect for yourself and the other person must be maintained. Respect prevents threats.

Suppressing anger is when a person holds it inside, and tries to ignore it. This is a popular way to deal with anger. We try to direct that energy in a positive direction. That's not always effective. Energy that isn't released needs somewhere to go. It turns inward and does its damage there, causing conditions like depression, and high blood pressure.
Anger that is not expressed can come out in other destructive ways. It may show up as a nasty attitude, a poor outlook on life, endless criticism, and poor relationship skills. This may irritate others, but they can get away from you. You cannot escape your thoughts and views on your life. Your feelings determine how you experience life. This is why your negativity hurts you the most.
Kamisha could possibly still be here if she had tried CALMING.
Calming can be as simple as telling yourself to, "calm down, take it easy." Taking slow deep breaths with closed eyes, using your diaphragm not your chest and repeating those calming words lowers the heart rate and blood pressure.
After this exercise, think.
What do you want from this person? Do you care if you risk your friendship? How could this person hurt you? Is the money worth it? Is being right worth it? Lastly, ask yourself, "Why are you friends?"
Now speak.
Then listen.
Back to this tragedy. Kayla may have truly felt bad about having to use that money for something else, and intended to pay Kamisha back ASAP. If Kamisha had calmly asked questions, she could have found out this to be the case. Asking questions during an argument slows its pace, and brings focus back to the real issue.

These girls were lifelong friends. Kamisha, who seemed to have made better life decisions over a period of years, paid for a few hours of poor anger management with her life.
When people imagine anger management, they think of protecting others. Controlling your anger can save your life.

Be safe. Be successful.
Rapp, M.D.

Serena Williams Undergoes Emegency Surgery for Pulmonary Embolus

What are pulmonary emboli (PE's)? "Pulmonary embolus" literally means "lung clots." They are blood clots in the lung. These are often formed in the calves or thighs, after long periods of immobilization, broken long bones like thigh and leg bones, and during high estrogen states like pregnancy and cancer. While in the legs and thighs they are called DVT's (deep venous thrombi). They can migrate through the heart to the lungs and if large enough, can cut off circulation and breathing altogether. When this happens, a person can suddenly collapse and die. Those who survive PE's often present to the ER complaining of shortness of breath, chest pain, heaviness, or tightness, or coughing up blood. They may or may not have accompanying leg pain or swelling. They may show a rapid rate of breathing, low oxygenation, and a high heart rate. Diagnosis is confirmed with CT scan of the chest, and a V/Q or ventilation /perfusion scan. Treatment requires blood thinners (anticoagulants) like Heparin, Lovenox, and Coumadin (warfarin) to help dissolve the clot.
Things that put us at risk include frequent and long plane/car trips without enough breaks to walk, stretch and massage the legs, especially when dehydrated, obesity, cancer, smoking, birth control pills, and smoking while taking birth control pills.
So remember, control your weight, avoid smoking, get cancer screenings as appropriate, stay well hydrated, and take frequent breaks to walk during long trips. While taking birth control, keep the symptoms mentioned in mind, so you know when to seek medical attention.