Doc On Duty with Dr. Loewenstine

By: Virginia Loewenstine MD, CEO and Medical Director of Tristate Preventive Health Consultants

SHOULD I BE CONCERNED ABOUT MY LACK OF SEX DRIVE?

Yes. It’s reasonable to be concerned because both physical and psychological reasons can be at play here. Low testosterone is a common cause that can be diagnosed by a simple blood test that should be done whether or not your low libido is bothering you. Testosterone is needed for other functions of the body unrelated to sex drive and low T can be easily treated. If that’s not the cause, try doing a mental inventory of other things that may be causing the problem, such as excessive fatigue, relationship issues, etc. Reach out to mental health professionals who can help with non-physical causes. Sex is an important part of our lives, just like sleeping and eating. Not only does it create pleasure, it also has many health benefits – so it’s best to look into the causes for your lack of sex drive.

IS IT SAFE TO TAKE SLEEPING AIDS REGULARLY? IF I DON’T, I CAN’T SLEEP.

That depends. Obviously, sleeping aids should never be taken while you’re on duty. Over the counter medications that have side effects of drowsiness (e.g. Benadryl) can help when off duty and do not pose any addiction issues. Prescription medications are available, but many may be habit-forming and not ideal if taken regularly. If you do take medicine to help you sleep, watch for drowsiness or excessive daytime sleepiness the following day. Your dose may need to be adjusted or you may need to take your medicine earlier in the evening. Non-pharmaceutical methods to induce sleep can help as well including creating a sleep ritual, not watching TV in the bedroom, doing yoga, and meditating, to name a few. Dietary methods include drinking a glass of milk, or eating turkey, chicken or tuna before bed. These all contain L-tryptophan, which is known to cause drowsiness.

I HAVE READ THAT THERE ARE TESTS THAT CAN NOW DETECT CANCERS BEFORE SYMPTOMS APPEAR. WOULD I BE A CANDIDATE FOR THAT TESTING?

Yes, there is new technology and much research is being done on Multi-Cancer Early Detection (MCED) tests. Two blood tests are now on the market and while neither is fully FDA approved, they should be soon. Because of the increased risk of overall cancers in firefighters, these tests show great promise in screening for possible problems. If an individual had a positive result on the blood test, a work-up with other testing would be done to provide an accurate diagnosis. Some fire departments have already started this testing and I would encourage discussion within your department.

I HAVE BEEN TOLD THAT I SNORE LOUDLY AND MAY EVEN STOP BREATHING WHEN ASLEEP. SHOULD I BE CONCERNED AND WILL THIS AFFECT MY ABILITY TO WORK AS A FIREFIGHTER?

What you are describing may be sleep or obstructive apnea (OA) and you should undergo a sleep study. Most initial sleep studies are now done in the comfort of your home with no one observing you and with a device that allows you to sleep. Sleep apnea is a big concern for firefighters, both male and female. In addition to daytime sleepiness, OA has been known to have negative effects on the body including increased risk for diseases and additional strain on the heart. In the United States, the NFPA1582 recognizes OA as a condition that has to be treated for you to continue as a firefighter. Sleep apnea is easily treated. Most people, once treated, feel much better overall. Because of the negative effects on the body and the number of people who have OA but don’t know it, many fire departments have added Sleep Apnea Screening to their annual physicals.

I AM HAVING FLASHBACKS OF BAD RUNS – SOMEONE MENTIONED THAT “EMDR” MAY HELP ME. WHAT EXACTLY IS EMDR?

Eye movement desensitization and reprocessing (EMDR) is a newer, nontraditional form of psychotherapy shown to be effective in the healing process of PTSD and acute traumatic events. With the help of a trained psychologist, the process is simple and usually quick, unlike traditional talk psychotherapy. To understand EMDR, one needs to understand how the body reacts to an event or memory. When a disturbing life experience happens, the body reacts in a “flight or fight” scenario causing physical symptoms that we are all aware of. Once the event is over, even though the person may feel that they no longer react to the memory, the body still does. This connection between mind and body can cause years, or even a lifetime of distress.

The Rapid Eye Movement (REM) stage of sleep is where the body subconsciously processes memories. Using various techniques to simulate REM, the therapist guides the person through different thoughts and reactions surrounding the event. Some of these techniques include having the individual’s eyes follow the therapist’s finger, listening to drum beats going from one ear to the other, and finger tapping in a specific rhythm, among others. This guiding can be done in person or remotely as more and more trained therapists are offering this over the phone or the internet.

Through the eight protocols used by the therapist, the mind separates the memory from the body’s response. When successful (more times than not), the body no longer reacts when the memory is triggered, it merely recognizes it as just that – a memory.

The book, The Body Keeps the Score by Bessel Van Der Kolk, MD is an excellent read and more info on EMDR can be found at: emdr.com

VIRGINIA LOEWENSTINE MD

Virginia Loewenstine, MD, is the CEO and Medical Director of Tristate Preventive Health Consultants. With over 30 years of experience in Occupational and Preventive Medicine, her focus is improving the wellbeing of First Responders with an emphasis on early cancer detection and mental health. She has received many prestigious honors and awards throughout her career. As an educator to Fire Departments, she presents the latest in medical testing and other advances to assist Fire Departments in the design of their annual physical programs. Founded in 2007, Tristate Preventive Health Consultants provides medical consulting, on-site physicals, and medical testing nationwide.

To learn more about Tristate Preventive Health Consultants visit tristatepreventivehealth.com

To submit your questions to Dr. Loewenstine, email info@crackylbusinessmedia.com