Monthly Archives: June 2012

It’s Hotter Than Georgia Asphalt-Avoid Heat-Related Illnesses

Now that summer has arrived, we are spending more time outside, at the pool, city parks, and sports fields.  Hot weather can affect us before we know it.  When the temperature rises too much, you cannot sweat enough to stay cool.  High temperatures and high humidity increase your chance of getting heat exhaustion and heat stroke.  Your risk is highest if the heat index is more than 90°F.

When your body starts to overheat, you will get heat exhaustion.

You will notice:

  • More sweating
  • Dizziness
  • Confusion
  • Weakness
  • Nausea
  • Headaches
  • Your heart starts beating too fast
When this happens you should:
  • Get into the shade or an air-conditioned building
  • Drink water or other cool liquids
  • Avoid alcohol or soda
  • Take a cool shower or bath.  If you cannot do that, put cool water on your skin.

If you do not feel better in half an hour, contact your doctor or go to the ER.

If you. are not able to cool off and your body gets hotter, you can get heat stroke.

You can get:

  • A fever of 104°F or higher
  • Severe headache
  • Dizziness
  • Flushed or reddened skin
  • Muscle cramps
  • Weakness
  • Nausea and vomiting.
  • Fast heart beat and fast breathing
  • Confusion and anxiety

If you think you or someone you know has heat stroke, call 911.  Get to a cool place as soon as possible.  Putting ice packs in the arm pits, groin, neck, and back can help.

To prevent heat-related illnesses:

  • Wear lightweight, light-colored, loose-fitting clothing.
  • Protect yourself from the sun with a hat or umbrella.
  • Use sunscreen with a SPF of 15 or more.
  • Drink plenty of water. Start before you go out and keep drinking while you are outside.
  • Minimize sodas, tea, coffee, and alcohol.
  • Avoid doing hard work or exercise between 10:00 a.m. and 6:00 p.m.
  • During an outdoor activity, take frequent breaks.

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A Natural Birth: the VBAC debate

I have delivered babies for 13 years as a family doctor.  I enjoyed my Ob Gyn rotation so much I thought I was going to be an obstetrician for the first 6 months of clinical rotations.  If  family medicine did not include obstetrics, I probably would have chosen internal medicine.

In the latest edition of her blog, Dr. Jaime Bowman clearly describes the unintended consequences of the vaginal birth after Cesarean section (VBAC) rules postulated by the American College of Obstetricians and Gynecologists (ACOG).  She has put into words what has been on my mind for years.  My big city hospital does not allow VBAC’s even though we have 24 hour C section capability.  Most VBAC’s at our facility occur because the fetus’s head is crowning and there is no time for a section.  Yet not one of these women has had a uterine rupture.  ACOG’s efforts to eliminate a rare complication have driven C section rates up nation-wide.

She also addresses the negative impact of elective inductions.  Texas Medicaid now requires us to divide all deliveries into 3 categories:

  1. after 39 weeks,
  2. before 39 weeks medically necessary
  3. before 39 weeks not medically necessary.

The next step is probably nonpayment for deliveries before 39 weeks which cannot be medically justified.


From Womb to Tomb – …a small town mommy, md with big ideas and an even bigger voice….

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Making a way outta no way: Inspiring stroke survivor overcomes adversity

Rabbi Cahana suffered a devastating stroke that left him trapped in his own body, unable to speak.  Instead of staying silent, he blinked sermons and letters one word at a time.  His ability to adapt to and overcome his disability shows the rest of us that we can find a way past our challenges even when the outlook is bleak.

Rabbi Ronnie Cahana, broken, but with holy work to do.

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For Asthma Awareness Month

It’s Kinda Hard To Breathe

A ten-year old boy sat  hunched forward on the exam table, taking sharp deep breaths.  This usually active Little League baseball player was coughing and wheezing every day.   High pitched whistling could be heard coming from his lungs with every breath he took.

“Do you cough at night?”

“Yeah, all the time.”

“Have you been using your inhaler?”

“Yeah, but it doesn’t seem to help.”

Asthma affects 8% of children and adults in the U.S.  That’s over 485,000 people in the Greater Houston area alone.

Symptoms of asthma include:

  • Coughing
  • Wheezing (a high-pitched whistling sound when you breathe)
  • Recurrent trouble breathing
  • A tight feeling in your chest
  • Trouble breathing or coughing that is worse at night or when you lie down

Your symptoms can be made worse by:

  • Exercise
  • Viral respiratory infections like colds
  • Contact with furry animals
  • Dust mites
  • Mold
  • Smoke from tobacco or wood
  • Pollen
  • Changes in weather
  • Laughing or crying hard
  • Airborne chemicals or dust
  • Menstrual cycle

If you have asthma, you should see your doctor at least several times a year.  See your doctor sooner if:

  • Wheezing or shortness of breath more than 2 days a week
  • Waking up at night once a month with coughing or trouble breathing
  • Using your inhaler more than 2 times a week
  • Your asthma keeps you from doing your normal activities

You may need a breathing test called a pulmonary function test to track how severe  your asthma is.  You may also need allergy testing if your symptoms  worsen around pets or at certain times of the year.  Many people become so used to feeling short of breath that they don’t realize that treating their asthma correctly can make them feel better.

Troy Fiesinger, MD

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