Drink More . . . Water?

Thirsty yet? That’s your body sending you a message. Summer means outdoor fun, construction work, heat, thirst, and . . . dehydration. Most of us are more aware during the summer of the need to maintain body fluids, but we can still get into trouble without noticing. First, a word about the benefits of proper hydration and then some suggestions on how to cope.

Our Bodies and Water

Water comprises approximately 60% of our total body weight (within a range of 45-75%) and is vital for proper functioning of all bodily organs and tissues. Some of the more important benefits include

·      Cushioning our joints and keeping them lubricated

·      Maintaining body temperature within tolerable limits

·      Eliminating waste through urine, bowel movements, and sweat

·      Improving kidney function

·      Preventing constipation

·      Maintaining healthy skin

·      Improving energy level and mental functioning

To obtain these and other benefits, we must maintain a proper balance between total fluid intake from all sources and fluid outflow through urination, sweating, breathing, bowel movements, metabolic processes, and evaporation. If fluid intake does not keep up with outflow to a serious degree, dehydration occurs which can result in mental confusion, muscular weakness, overheating, seizure, coma, and death—depending on severity.

Remember that we acquire water for our bodies from several sources, including fluids that we drink as well as fruits and vegetables that we eat. That means that the common advice for adults to drink eight 8-ounce glasses of water a day need not be rigidly followed. In fact, there is no clear scientific evidence to support such advice.

The trick is to consume a sufficient amount of fluids from all sources to offset the elimination of fluids. Obviously, maintaining that balance and avoiding dehydration depends on several factors: the external temperature of our environment, the intensity and duration of exercise, our general state of health (meaning an absence of fever, diarrhea, urinary tract infection, etc.), and the type of fluids that we consume.

Warning: It is possible to drink too much water under certain conditions. Doing so can lead to severe consequences. Athletes and others who engage in intense, prolonged exercise can create a situation of dangerously low sodium and electrolytes by drinking too much plain water too quickly. Such a deficiency causes a condition called hyponatremia. This condition causes headache, fatigue, nausea, vomiting, frequent urination, mental confusion, and several known cases of death. To prevent hyponatremia, persons who exercise intensely for a long time should drink a beverage such as Gatorade™ or Powerade™ that replaces sodium and electrolytes. Moreover, if too much fluid is consumed too quickly, the body’s cells become overloaded with water—a particularly dangerous situation when neurons in the brain swell where there is no room. (For a good discussion of hyponatremia, see “Strange but True: Drinking Too Much Water Can Kill” in Scientific American.)


What to Drink?


The best answer to that question is water. Under most conditions (see warning about hyponatremia above), water is the most efficient beverage for maintaining hydration without unwanted or unhealthy side effects. Even with water, however, there are some things to bear in mind.


While most municipal water is safe to drink, current water treatment systems are not designed to remove all impurities or contaminants. If your home is supplied by a municipal or regional water system, check the annual quality report for a list of what is or is not removed during the treatment process. As in the case of Flint, Michigan, and other cities, even lead has remained in the water supply at harmful levels. Municipal water treatment sometimes adds a large amount of chlorine, which some people find objectionable.

If you live in a rural or suburban area where you obtain your water from a ground well, you need to be especially careful about making sure that harmful contaminants are not present. Nearby industrial pollution, farm runoff, and shallow water tables can pose significant hazards. Get your well water tested regularly.

For these reasons, many people have turned to filtered or bottled water for drinking and cooking. Most bottled water is safe, but some have estimated that 40% of bottled waters are simply packaged tap water. Further, the FDA regulates bottled water as a food, but it lacks the monitoring capacity of the EPA to check on public water systems. Always check to see if your bottled water is filtered. Many bottled waters also contain artificial sweeteners or other ingredients to enhance taste. If you prefer a flavored water, try adding your own squirt of lemon or lime juice.

Water filtration systems come in many sizes and formats. No single system will remove all contaminants, and all need to be maintained so that contaminants don’t build up in the system. Usually reverse-osmosis filters, when combined with carbon filters, will remove heavy metals (arsenic, lead, mercury), bacterial contaminants, and residue from pesticides most effectively. But prices and effectiveness of different types can vary widely. Check the Environmental Working Group’s buying guide for additional information on water filters.


Although clean, safe water is best for staying hydrated, many of us prefer a little variety in what we drink. So what about the other alternatives?

Fruit Juice.

Always a favorite with kids, fruit juice can be a welcome alternative. Many commercial fruit juices are fortified with extra vitamins and some minerals. But most popular fruit juices—orange, apple, cranberry—contain high concentrations of sugar, either naturally or, in many cases, added. High amounts of sugar in any form are harmful for both children and adults, leading to various chronic conditions such as type-2 diabetes. Therefore, monitor consumption of fruit juices closely for sugar content, and drink them in moderation, not as a routine alternative to water.


By the way, commercial vegetable juices often contain high concentrations of sodium that can also be harmful. Read labels!


Tea and coffee are popular alternatives to water around the world. Most are available in caffeinated and decaffeinated forms. While there is some controversy over whether caffeine is beneficial, most studies show that there are some benefits to moderate consumption of caffeine—say, the amount found in about 1-3 cups of coffee or tea per day. Some people, however, cannot tolerate caffeine, even the minute amounts remaining in decaffeinated coffee or tea. Many herbal teas naturally contain no caffeine and, therefore, offer a pleasant alternative to plain water.


When considering variations on coffee or tea, such as those containing cream or sugar, remember that you are adding calories and sugar to your daily intake. Be careful!


Commercially available smoothies are delicious! Especially on a hot day, they can be very refreshing. But remember that they nearly always come loaded with sugar from both the fruit juices (see above) and the ice cream in them. You’re always better off preparing your own smoothies at home where you can control exactly what goes into them.


Vegetable smoothies made at home are a good alternative, but don’t overdue the sodium or sugar for them.


Americans consume billions of dollars’ worth of soda every year, and it is disastrous for their health. Soda is the largest contributor of sugar to the American diet, and that amount of sugar is creating an epidemic of obesity and related health problems from heart disease to diabetes. We are paying a very steep price in terms of poor health and money for our addiction to sugar.

Artificially sweetened soda does not help. The long-term effects of many artificial sweeteners have not yet been determined. Moreover, it now appears that they alter brain chemistry in a way that causes the body to crave additional intake of calories to match the sensation usually caused by sugar. In other words, artificially sweetened soda causes people to eat more and thereby leads to increased obesity.

Bottom line: if soda is your main beverage of choice, try to cut back or eliminate it altogether. This recommendation is especially important for children’s health as well.


A cold beer on a hot day, a glass of wine with dinner, or a cocktail at the end of the day can be very appealing. For most people and taken in moderation, alcoholic beverages can be a pleasant diversion. Some studies claim that a glass of red wine or a cocktail can carry some health benefits. But alcohol also introduces some genuine risks:

·      Mental or physical impairment, even when consumed in moderation

·      Addiction (alcoholism)

·      Ill effects on specific organs such as the liver

·      Unwanted increase in sugar intake (all alcohol converts to sugar)

·      Mild increase in dehydration due to increased elimination of fluids from the body

Such risks make alcoholic drinks a poor alternative to other beverages, especially in order to maintain hydration.

A Word about Containers

Most people are now aware that they should avoid plastic bottles that contain BPA (bisphenol A). Many countries now ban BPA, and manufacturers increasingly avoid using it. Do not purchase plastic bottles that do not contain a BPA-free label. Other chemicals used in the production of plastics such as PET (polyethylene terephthalate) might also be harmful by imitating the effects of estrogen.

While you should avoid plastics containing these compounds, you must also avoid reusing most plastic bottles. The reason is that reuse increases the likelihood of leaching harmful chemicals into whatever liquid the bottle contains. Rule: use your plastic beverage bottle once and then recycle it.


The safest beverage containers are made of glass or stainless steel. Glass is inert and is safe for nearly any beverage. Stainless steel, especially “food-grade” stainless steel, is also safe. In the case of stainless steel water bottles, however, be sure that any lining is glass, not plastic.


Maintaining proper hydration is vital for your mental and physical well-being. If you are thirsty, pay attention and drink something.

Dehydration, on the other hand, can be debilitating and even dangerous. If you or someone else becomes dehydrated, be sure to provide water for them to drink slowly over a period of time. If you or they have been exercising intensely, do not drink large quantities of plain water. In those instances, drink a beverage that will help restore electrolytes and sodium.

If someone becomes severely dehydrated so that they become confused, have severe headache, develop a fever, or lose consciousness, take them to an urgent care center. Under such conditions, intravenous administration of fluids might be necessary, and they should be carefully monitored. At Kathy’s Urgent Care, we’re ready to help.

Authored by Dr. Tom Brown

Keep Your Kids Safe for a Fun Summer!

We all want our kids to have a fun summer. And most of the time they do without much help from us. Some of your happiest times were probably spent outdoors with your childhood friends. Your children are no different. They love to go to the beach, play at the park, swim in the pool, jump on the trampoline, camp out with relatives, hike in the woods, and so forth. Such activities help them develop physically and emotionally.

But as parents, we need to prevent injuries that can turn a fun summer into a painful time or even a life-altering tragedy. Here are 6 ways to help your kids have an enjoyable summer season.

1.     Prevent Sunburn

These days, you’re probably aware of the hazards of too much sun exposure, especially for infants and children. But it never hurts to be reminded of a few tips to prevent painful sunburn or worse.

  • Keep children out of direct sunlight or cover them completely between 10:00am and 4:00pm when UV rays are strongest. Infants under 6 months of age should avoid all sun exposure.
  • If children play outside during midday, apply a sunscreen with SPF strength of 30 or higher at least 15-30 minutes before sun exposure and have them wear protective clothing (wide-brimmed hats, sun-protective clothing that covers arms and legs, and sunglasses with UV protection).
  • For children playing in water, apply a water-resistant sunscreen every 2-3 hours.
  • If both sunscreen and insect repellant are required, apply the sunscreen first and then apply the insect repellant. Do not use a combination product.


To treat a mild sunburn at home, try applying cool cloths or taking cool showers. Lotions containing aloe vera can help ease pain. Acetaminophen (Tylenol™) can help soothe a headache. It is also important to drink water to prevent or relieve dehydration. Avoid using topical steroids on young children unless directed by a physician.

More extreme sunburns that involve blistering, high fever, severe headache, dehydration, confusion, or nausea require the sort of medical attention that urgent care centers provide.

2.     Police the Playground and the Beach


Playgrounds and beaches provide places for good exercise and lots of fun. They can also be dangerous.

Make sure that your favorite playground has well-maintained equipment. Rusty metal equipment can lead to metal splinters and nasty infections. Untreated wooden equipment can produce splinters and unpleasant scrapes. Loose bolts are accidents waiting to happen. You might also check for poisonous plants such as poison ivy and infestations of bees or other pests.

Beaches are always a favorite with kids, but you should be aware of potential hazards. It goes without saying that you should always watch children in the water. Water depth and wave action can change rapidly. Also watch out for various critters—jellyfish, sea urchins, sting rays, even sharks—that can injure unsuspecting children and adults. Remember that the water and beach are these animals’ primary habitat, not yours. Medical attention might be needed for stings and bites.

A word about trampolines. If you’re thinking of getting one for your home, don’t. Citing nearly 100,000 injuries per year, the American Academy of Pediatrics discourages recreational trampoline use for the home, even when all the safety rules (listed below) are followed. Kids are often injured when bumping into others, trying stunts like somersaulting, falling or jumping off the trampoline, or just landing wrong. Very serious and sometimes life-threatening injuries result, including broken bones, concussions, neck and spinal cord injuries that can lead to paralysis or even death.

If you already have and use a trampoline at home, follow these rules:

  • Allow only one jumper at a time.
  • Do not allow stunts, especially somersaults.
  • Adults who are willing and able to enforce safety rules must supervise at all times.
  • Make sure that safety netting and padding is in place and maintained.
  • Check your homeowner’s insurance policy to make sure that you’re covered for trampoline-related injuries.

3.     Avoid Insect Bites and Stings


Insect bites and stings can interrupt summer fun. Ticks are plentiful this year, and they carry debilitating, sometimes lethal, diseases [insert link to blog post on ticks]. Always check for ticks on anyone who has been outside, and remove them immediately. Using an insect repellant with at least 20% DEET can help.

Insect repellants are usually effective to keep mosquitoes in check. An occasional mosquito bite is seldom cause for concern, but being covered by mosquito bites will ruin any hike or camping trip in short order.

Bee and wasp stings can be dangerous, especially for persons who are allergic to them. For anyone who is allergic and at risk of anaphylactic shock, take the following steps:

  • Call 911.
  • Use an EpiPen™ to inject epinephrine into outer muscle of the thigh, not into hands or feet.
  • Go to an urgent care facility or emergency room immediately after an EpiPen™ injection, even if symptoms subside, since there can be a delayed allergic reaction.

If there are no symptoms of allergic reaction, do the following:

  • Remove the stinger by scraping with a flat edge. Do not pinch or use tweezers since that will inject more poison.
  • Apply ice or cold compress.
  • If stung on an arm or leg, elevate the area.
  • Take acetaminophen (Tylenol™) for pain or an antihistamine (Benadryl™) for itching. Do not use aspirin.
  • Follow up with a visit to an urgent care facility in 2-5 days if necessary.

If you have any questions or concerns after a bee sting, call or visit an urgent care center.

4.     Patch Up Those Cuts and Scrapes

Most minor cuts and scrapes can be treated at home. However, if the wound is deep, dirty, or caused by an animal, a tetanus shot (or booster) might be needed.

Remember the following steps:

  • Wash your hands.
  • If bleeding doesn’t stop, apply pressure with a clean bandage for a few minutes.
  • Clean the wound with clear water. Do not get soap or other cleansers into the wound, but use them as necessary to clean around the wound.
  • If any debris remains in the wound, try removing it with (disinfected) tweezers. If you cannot remove the debris, go to an urgent care facility.
  • Apply an antibiotic cream and cover the wound with a sterile bandage.
  • Change the bandage once a day or if it gets wet.
  • After the wound scabs over, stop applying the bandage.

It’s always a good idea to keep a well-stocked first aid kit handy for these situations.

Deep cuts or wounds that won’t stop bleeding might require stitches. Visit an urgent care facility for that sort of treatment.

5.     Attend to Head Injuries, Sprains, and Fractures

Bumps on the head are common for children and usually do not require medical attention. Nevertheless, if the following symptoms occur, you should go to an urgent care facility:

  • Unconsciousness, confusion, or disorientation.
  • Vomiting.
  • Persistent, severe headache.
  • Persistent irritability.
  • Memory loss.
  • Visual impairment.

If severe head trauma has occurred (immediate loss of consciousness; severe bleeding from head, nose, or ears; weakness in arm or leg; loss of balance, slurred speech, seizures, repeated vomiting, persistent crying, or cessation of breathing), CALL 911. Keep the victim still, lying down, and quiet. Do not move the victim unless absolutely necessary to get the victim out of further harm’s way. To avoid further spinal injury, do not move the neck. If the victim is wearing a helmet, leave it in place.

Sprains and fractures are sometimes difficult to distinguish. If your child merely rolled an ankle, then it might be a mild sprain. In such cases, the child might be able to put weight on the ankle, although sometimes there can be impressive swelling and pain. Rest, ice, and elevation will generally produce a good result in a few days.

P – Protect
R – Rest
I –  Ice
C – Ice
E – Elevation

If, however, there is major swelling, pain, numbness, or if it is extremely difficult for the ankle to bear any weight, a break might have occurred. Broken ankles, wrists, or other bones always require medical attention. Bear in mind that severe sprains can take longer to heal than some fractures.

Because it is difficult to tell a broken bone from a severe sprain, don’t take any chances. Go to your nearest urgent care center to get a professional diagnosis. Most have X-ray equipment on site and are prepared to treat broken bones and sprains.

6.     Keep Allergies in Check

During the summer, the weeds and grasses that developed during the spring continue to spread pollen that causes allergic reactions in children and adults. Sometimes, over-the-counter antihistamines such as Zyrtec™ can control these reactions.

But often, allergic reactions to pollen or molds can be truly debilitating with the potential to ruin a summer of fun. If you or your child suffer from seasonal allergies, ask a health professional to evaluate the situation. They can offer tips and medications that will help you avoid a summer filled with sniffles and runny eyes.

For all of these situations and if you are located near us, call or come to Kathy’s Urgent Care so that we can help you and your children enjoy a fun summer. Remember, we’re here to help you 7 days a week. No appointment needed!

Authored by Dr. Tom Brown

Ticks Can Make You Sick!

Because of the larger number of active ticks throughout the US, tick-borne diseases are on the rise. A warm, moist spring caused adult ticks to become active in April which is much earlier than normal. If you or your family spend time outside in the woods, your lawn, or around bushes and other foliage, you are at risk. More on prevention below, but first some information about ticks and the diseases that they carry.


How Ticks Infect People and Pets

There are several varieties of ticks, and they all carry specific diseases. The blacklegged tick or “deer tick” (pictured here) carries Lyme disease, Powassan virus (POW), and other diseases. It is especially common in New England. Other varieties of ticks can infect people with Rocky Mountain Spotted Fever (RMSF), a serious disease that is sometimes fatal.

Ticks spread various bacteria and viruses by injecting them into humans and animals when feeding. Typically, this happens when an adult tick attaches its head and begins to ingest blood. Since a mild anesthetic is also injected into the bite, people often feel nothing.

How to Prevent Tick Bites

For people, there are three major ways to prevent tick bites and infection.

1.     Wear protective clothing, including long-sleeved shirts and long pants with the legs tucked into socks. Closed footwear is essential. Do not wear shorts and flip-flops into the woods or grass!
2.     Whenever you go outside or into wooded areas, consider using an insect repellent with at least 20% DEET, picaridin, or IR3535 formula. Also treat clothing and gear with a product containing 0.5% permethrin. Permethrin remains effective through several washings. For help in selecting effective products for you and your family, use the Environmental Protection Agency (EPA) tool.
3.     Examine every part of your body as soon as you return indoors. Ticks can attach themselves to any area of your body: under arms, in your hair, between your legs (crotch area), in your belly button, and other nooks and crannies. Ask relatives or friends to help you check areas that you cannot see. Don’t be bashful about this! Also remember to check the bodies of your children thoroughly.

You should also thoroughly check any pet, dog or cat, that has been outside. Check every time they come in. Ticks often burrow into an animal’s fur, making them hard to see. Once a tick gets into your home, it can then transfer to people. Medications are available that prevent ticks from hosting on dogs or cats, and they generally work. But be careful, since some medications that work for dogs are toxic to cats.

Tick Removal

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Remove ticks as soon as you discover them. The best way is to grasp the tick as close to the head as possible with tweezers and lift straight up.

If you need assistance with removing a tick or if your attempt is unsuccessful, come to Kathy’s Urgent Care. We’ll be happy to help you and to answer your questions.

Medical Risks

Lyme Disease: Infection can occur within 24 to 48 hours of a tick’s being attached to your body. Symptoms can appear from 3 to 30 days after a tick bite. Common symptoms include a distinctive rash, weakness of facial muscles, and swollen or painful joints, particularly if fatigue and low-grade fever are also present.

Accurate diagnosis of Lyme disease sometimes requires a blood test. Do not self-diagnose! If you think that you or a family member has been infected, be sure to check with us to have the blood test performed if necessary and so that treatment can begin.

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It is important to begin treatment as soon as a diagnosis can be confirmed. Lyme disease can have very serious and long-term consequences.

Powassan virus (POW): Infection can occur within 15 minutes of a tick’s bite. Early symptoms can appear within 1 week to 1 month. Symptoms can include fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, and seizures. Unfortunately, many people who are infected exhibit no early symptoms, making detection very difficult. This is why prevention of tick bites is so important.

The POW virus can infect the central nervous system, causing encephalitis or meningitis. There is no known cure and no vaccines or medications to prevent or treat infection. About half of those infected with POW develop permanent neurological problems such as headaches, memory problems, or muscle weakness.


If you think that you or a family member has been bitten by a tick or if you need assistance in removing a tick, come to Kathy’s Urgent Care or other medical facility. Time can be important, and we’re open 7 days a week!

Enjoy your summer, but be careful!

Authored by Dr. Tom Brown

The following links can provide additional information:

It’s Men’s Health Month! So Get Healthy!

Hey, guys! Before we get to some health tips, here’s important information you should know.

Leading Causes of Death

According to the Centers for Disease Control and Prevention (CDC), the 10 leading causes of death for all men of all ages during 2014 (latest year data) are

1.     Heart disease

2.     Cancer

3.     Unintentional injury

4.     Chronic lower respiratory diseases

5.     Stroke

6.     Diabetes

7.     Suicide

8.     Alzheimer’s disease

9.     Influenza and pneumonia

10.  Chronic liver disease

Health Tips for Men’s Health Month

Since conditions leading to these afflictions overlap, here are 5 things to do that will improve your health and help you live better longer.

1. Lose the Smokes

We all know that smoking can lead to cancer. It also leads to heart disease and respiratory problems. So, if you smoke, stop. Losing the smokes will improve your health over the long term.

And while you’re at it, cut back on alcohol. No need to grow a beer belly or enlarge the one you have. Besides, alcohol is a depressant, and that doesn’t help your mental or emotional health.

2. Eat Healthy

Summer is the time for steaks on the grill, but don’t forget the veggies. Increasing green vegetables while reducing the size and frequency of red meat will do wonders for your health, your waistline, and your mood. And it wouldn’t hurt to limit intake of carbs such as bread, potatoes, and processed snacks. Eat fresh!

3. Exercise Smart

Couch potatoes and guys who sit at desks all day shorten their lives. Don’t succumb to the so-called “sitting disease.” Stand up, move around, even a little. Go for walks. Start a cardio workout routine (check with your health care provider). Include strength-building activity.

Also remember that smart exercise includes stretching, flexibility, and meditation. As we age, we begin to lose flexibility and mobility. Yoga and controlled breathing can help to increase and preserve a higher quality of life.

5.Get Quality Sleep

More men than women have difficulty breathing and, therefore, sleeping at night. Many suffer from sleep apnea, a very serious and potentially deadly disorder. You might not even know that you have it. Snoring is a common symptom, and your spouse or partner can probably tell you if you snore. If you have symptoms of sleep apnea, have a specialist examine you immediately.

Beyond that, you can follow a routine that will result in better quality sleep. Go to bed at the same time each night. Reduce screen time on computers, mobile devices, or TV before bedtime. Avoid alcohol and caffeine late at night. Many other suggestions are published online that people have found helpful.

5. Get Checked Out

Finally, guys, when did you have your last medical checkup? More than a year ago? Then you’re due for a visit to Kathy’s Urgent Care!

We provide thorough physical exams, and we’re open 7 days a week and during evenings. No appointment needed! And we accept most insurance plans. So don’t put it off any longer!

Authored by Dr. Tom Brown