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Chilblains (CHILL-blayns) OVERVIEW _CAUSES AND TREATMENT

Overview – Chilblains
Chilblains (CHILL-blayns) are the painful inflammation of small blood vessels in your skin that occur in response to repeated exposure to cold but not freezing air. Also known as pernio, chilblains can cause itching, red patches, swelling and blistering on your hands and feet.

Chilblains usually clear up within one to three weeks, especially if the weather gets warmer. You may have recurrences seasonally for years. Treatment involves protecting yourself from the cold and using lotions to ease the symptoms. Chilblains don’t usually result in permanent injury. But the condition can lead to infection, which may cause severe damage if left untreated. The best approach to chilblains is to avoid developing them by limiting your exposure to cold, dressing warmly and covering exposed skin.

Pathophysiology
The pathophysiology and pathogenesis of pernio remain still largely unknown due to the rarity of the condition. However, the thinking is that there is some association with vasospasm as the primary pathophysiologic finding, particularly when the patient becomes exposed to cold, damp conditions for a prolonged period. In a small study by the Mayo Clinic, researchers exposed five patients with known pernio to ice-water immersions and analyzed the patients’ vascular response. They found that all of the patients demonstrated vasospasm when exposed to the ice water bath, potentially discovering a target for pharmacologic therapy in patients with pernio.

What causes chilblains?
Chilblains are the result of an abnormal reaction to the cold. They’re common in the UK because damp, cold weather is usually in the winter.

Some people develop chilblains that last for several months every winter.

When the skin is cold, blood vessels near its surface get narrower. If the skin is then exposed to heat, the blood vessels become wider.

If this happens too quickly, blood vessels near the surface of the skin can’t always handle the increased blood flow.

This can cause blood to leak into the surrounding tissue, which may cause the swelling and itchiness associated with chilblains.

Risk factors of Chilblains
Some people are more at risk of chilblains than others.

This includes people with:

Poor circulation
A family history of chilblains
Regular exposure to cold, damp or draughty conditions
A poor diet or low body weight
Lupus – a long-term condition that causes swelling in the body’s tissues
Raynaud’s phenomenon – a common condition that affects the blood supply to certain parts of the body, usually the fingers and toes
People who smoke are more at risk of chilblains as nicotine constricts blood vessels.

Chilblains can also occur on areas of the feet exposed to pressure, such as a bunion or a toe that’s squeezed by tight shoes.

What are the symptoms of chilblains?
Chilblains occur several hours after being exposed to the cold. You may get just one chilblain but often several develop. They may join together to form a larger swollen, red area of skin.

Chilblains are very itchy. A burning sensation is also typical. They are usually red at first but may become purple. Pain and tenderness over the chilblains often develop.

Common places for chilblains to develop are:

Fingers
Toes
Ear lobes
Nose
Cheeks
Heels
Shins
Thighs
Hips
Typically, each chilblain lasts for about seven days and then, gradually, goes away over a week or so. Some people have repeated bouts of chilblains each winter.

Complications of chilblains
If you have severe or recurring chilblains, there’s a small risk of further problems developing, such as:

Infection from blistered or scratched skin
Ulcers forming on the skin
Permanent discolouration of the skin
Scarring of the skin
It’s often possible to avoid these complications by:

Not scratching or rubbing the affected areas of skin
Not directly overheating the chilblains (by using hot water, for example)
You can also help reduce your risk of infection by cleaning any breaks in your skin with antiseptic and covering the area with an antiseptic dressing. The dressing should be changed every other day until the skin heals.

If the skin does become infected, antibiotics may be prescribed to treat the infection.

Differential Diagnosis
The primary disorder that merits consideration when diagnosing pernio is chilblain lupus erythematosus (CHLE). CHLE is a rare dermatology condition often confused with other forms of pernio or vasculitic processes. Due to the implications of familial genetic inheritance and the possible association with systemic lupus erythematosus, a specific diagnosis of chilblains lupus becomes a priority when a patient presents with pernio-like symptoms. CHLE is largely idiopathic, but familial variants are associated with several different genetic mutations, including TREX1, SAMHD1, and STING.

Treatment is often symptomatic with steroids, but literature has shown the possibility for systemic medications such as JAK inhibitors as effective treatments.  While the progression to systemic lupus erythematosus (SLE) is low in CHLE, further workup is the recommended course due to the implications of long-term undiagnosed SLE.

Other conditions, particularly vasospastic conditions, that the clinician should consider in the differential include:

Raynaud phenomenon
Acrocyanosis
Cryoglobulinemia
Cold panniculitis
Treatment and medication
The first line of treatment for chilblains generally includes measures to keep hands and feet warm and dry, such as keeping your indoor environment warm and dry, using gloves and socks, and changing damp gloves and socks when needed.

If your chilblains don’t clear up with these home remedies, your doctor may recommend medication, including:

Nifedipine (Procardia). This type of blood pressure medication treats chilblains by helping to open up blood vessels and improve circulation. Side effects may include flushing, nausea, dizziness and swelling in the hands or feet.
A topical corticosteroid. Applying a corticosteroid cream to chilblains may help the lesions go away.
Lifestyle and home remedies
Chilblains usually clear up in one to three weeks after cold exposure. In the meantime, you can take steps to ease your signs and symptoms, including:

Rewarming affected skin gently, without massaging, rubbing or applying direct heat
Avoiding cold exposure whenever possible
Keeping your affected skin dry and warm, but away from sources of heat
Applying lotion to alleviate itching
Making sure the affected skin is cleaned with an antiseptic and gently bandaged to prevent infection
Avoiding scratching
Quitting smoking, as smoking can constrict your blood vessels and slow wound healing
Preventing chilblains
The following advice may help prevent chilblains:

Stop smoking. Nicotine causes the blood vessels to constrict (get narrower), which can make chilblains worse.
Avoid medicines that may constrict blood vessels, such as caffeine and decongestants.
Keep active. This helps improve your circulation.
Wear warm clothes and insulate your hands, feet, and legs. Wearing long johns, long boots, tights, leg warmers or long socks will help. If you get cold feet in bed, wear a pair of clean socks.
Avoid tight shoes and boots as these can restrict the circulation to toes and feet.
Moisturize your feet regularly. This stops them from drying out and the skin cracking.
In cold weather, eat at least one hot meal during the day. This will help warm your whole body.
Warm your shoes on the radiator before you put them on. Make sure damp shoes are dry before wearing them.
Warm your hands before going outdoors by soaking them in warm water for several minutes and drying them thoroughly. Wear cotton-lined waterproof gloves if necessary.
Turn up the central heating. Try to keep one room in the house warm and avoid drafts.
If you are diabetic, give yourself regular foot checks (or ask someone else to do this). Diabetics may not be able to feel their feet and could have septic chilblains without realising.

Elton John Bought ‘A Ton’ Of The Goop Vagina Candles

Elton John Bought ‘A Ton’ Of The Goop Vagina Candles
by Jamie Samhan
Gwyneth Paltrow’s sold-out “This Smells Like My Vagina” candle was a surprising hit and it turns out one major celebrity is one of the biggest fans.

While speaking to The Cut, Goop collaborator Douglas Little revealed that Elton John bought “a ton” of the candles.

“Elton John bought a ton of them. Like a lot. Like, a lot a lot. He’s a fan. We have been hounded and stalked by so many people [trying to get one]. I saw the candle being sold on eBay for a ridiculous price,” Little said.

RELATED: Ozzy Osbourne Releases ‘Ordinary Man’ Duet With Elton John: ‘It’s F***ing Epic’

He added, “Just saying the word — vagina! — is shocking to some people. Why the f**k is that? There’s no reason. It’s this beautiful, sacred thing and yet in our society and in many societies there is a lot of stigma and shame. I think people are sick of that.”

He also commented on Martha Stewart’s statement on “Watch What Happens Live” where she assumes “horny men” are why the candle sold-out.

RELATED: Gwyneth Paltrow Explains How Her Sold-Out ‘Vagina’ Candle Came To Be

Little added, “I would say that about 92 per cent of our customers for this product are female. When was the last time a bunch of horny guys were out buying scented candles?”

If you are one of the many who are looking to get their hands on the Goop candle, they are back in stock as of Friday. But hurry, they likely won’t last long.

[tp_video id=”f0eb8e7c-31a0-11ea-9e42-72a9caf8ced0″]

Jamie Samhan | January 24, 2020 at 5:18 pm | Tags: Celebs, Douglas Little, Elton John, Gwyenth Paltrow, Vagina Candle | Categories: Celebs | URL: https://wp.me/p7yNEY-2r5l
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Not Just How To Make Money But How To Save It.

This post isn’t how to make money but how to save it, which is sometimes just as good. We use credit our entire lives so it makes sense to maximize it to make the best of your financial situation.

And one way to save 10s of thousands of dollars over the course of your life is by building a good credit score!

Luckily, it’s surprisingly easy to build a good credit score over time. Keep reading so you can copy exactly what I did to get an 800+ credit score at the age of 23.

If you don’t know your credit score sign up on Credit Karma to check and monitor your score for free

How Does Good Credit Save You $1000s?
Credit is what banks and lenders look at to see if you are responsible with money. Whether we like it or not, a bad credit score will cost you 10s of thousands of dollars over the course of your life.

A bad credit score means you will pay higher interest if you get a loan. This will cost you A LOT if you get a house (mortgage) one day. It also costs you more for financing a car, getting insurance, some utility bills and so on. If you have really poor credit, you won’t even be approved to get loans. 

This can all be avoided and you’ll save a ton of money if you know how to use credit properly. Your future self will be thanking you.

How I Got an 800+ Credit Score at Age 23
Luckily it’s simple to build a good credit score. You just have to do the following things and your score will get higher and higher over the years.

1. Find out what your credit score is – Step one is to know what your score is in the first place so you can track your progress. You can sign up on Credit Karma to check and monitor your credit score for free, for life. Checking your score does not impact it.

2. Use credit cards like a debit card – It must be said, don’t buy anything if you don’t have the money to pay it off right away. Being in debt is obviously going backwards and hurting your score.

3. Pay for everything with a credit card (unless it doesn’t make sense to) – This will build your score over time. You also accumulate points which is like more money. If you make purchases with debit or cash, stop because it has zero benefits! 

It doesn’t matter how small your credit card transactions are either. Every transaction shows lenders you are responsible as long as you are paying it off. 

4. Start building credit right away – The longer your credit history the higher your score will be. For example, banks prefer someone with a 5 year track record over someone with a 5 month track record. So get a credit card as soon as you can to start building that history.

Also, NEVER cancel a credit card because it will delete some of that track record and lower your score. If a credit card has no annual fee, always keep it open. It doesn’t matter if you use it or not.

5. Get multiple credit cards – More cards builds your credit history but is also helps with something else. You want to use as little of your credit limit as possible. This is known as your Utilization Ratio and it effects 35% of your credit score.

Even though you are approved for a certain credit limit it hurts you if you use 100% of it!

For example, if your credit limit is $1000 and you spend $900 that will actually lower your score because you are spending 90% of your limit. But if you spend $900 on a $10,000 limit you are using only 9% of your credit which will improve your score.

So it’s a good idea to increase your credit limit so you have a low utilization ratio. Aim for under 10% ratio.

6. Try to always keep your balance at $0 – The more you have your balance at $0 the more credit companies like that. Yes you can pay off your balance in full on the last day and you’ll have a good score. But this is also about the utilization ratio above. It is better if you pay off your purchases earlier or ideally right after you buy something so your balance is always at $0. 

7. Keep learning about credit – I was able to get a 800+ score with just these tips but learning more will always get you further. Keep educating yourself about credit. One way to do that is download my app: Credit Score Advice or just find info on Google.

The Bottom Line
A good credit score can open many opportunities for you. On the contrary, a bad credit score can cost you a LOT of money because you’ll be getting high-interest rates and unfavorable credit terms. 

The good news is that improving your credit score doesn’t take any work after a little setup. You don’t need an 800 score either to see the benefits. Anything above a 700 score is great! 

I don’t have a mortgage, or a crazy spending limit. I’ve just been using credit cards for 5 years, building history, being responsible and using the advice above to build an 800+ score which means you can do it too. 

Once again, if you don’t know your credit score sign up on Credit Karma to check and monitor your score for free!

How to treat a cold with fever

How to Treat a Cold with a Fever
Co-authored by Erik Kramer, DO, MPH
Updated: January 22, 2020

While there’s no real cure for the common cold, there are ways you can help reduce the symptoms, such as a fever, until it runs its course. Choose a pain relieving medicine to help reduce the fever, depending on your age or the age of a child who has the cold. There are also lots of home remedies you can use to treat your cold and fever, such as taking sponge baths, staying hydrated, and keeping the room temperature comfortable. If you or your child has had a fever for more than 3 days, call your doctor for medical advice.

Method 1 of 2:
Using Medicine to Relieve Your Symptoms

1
Avoid giving cough or cold medicine to children under 6 years. These medicines don’t usually help with their symptoms, and they can actually cause negative side effects in younger kids like stomach pain or vomiting. Instead of using a cough or cold medicine, look for a children’s pain reliever to help ease their symptoms, if desired. [1]
It’s especially important to avoid giving medicine to a baby younger than 6 months as there is a high risk of accidental overdose. This is because these medications are based on a child’s weight, not their age.

2
Give acetaminophen to kids younger than 6 months to help with fever. Acetaminophen, such as Infants’ Tylenol, is safe to give to your child if they’re under 6 months old. If you’d like to help your child’s fever go down, look for Infants’ Tylenol at your local drugstore or big box store. Make sure you’re using a type specifically for children, following the instructions on the label to know how much to give them.[2]
Follow the dosage instructions depending on the exact weight of your child. For example, the suggested dose for a baby who weighs between 6–11 lb (2.7–5.0 kg) is 1.25 mL (0.042 fl oz).[3]
Wait the amount of time suggested on the instructions before giving your child another dose.
Take children younger than 3 months old to the doctor if they have a fever of 100.4 °F (38.0 °C) or higher, and take children ages 3-6 months to the doctor if they have a fever of 102.2 °F (39.0 °C) or higher.

3
Use acetaminophen or ibuprofen for kids older than 6 months old. To help treat a fever in kids older than 6 months, look for Children’s Motrin, Children’s Tylenol, or Children’s Advil. Only choose one to give to your child, and follow the dosage instructions to know exactly how much to give them.[4]
Don’t give your child multiple medicines with the same active ingredient—this could lead to an overdose. Use one medicine at a time to prevent combining the wrong ingredients.
Wait the proper amount of time according to the dosage instructions before giving your child another dose.
Kids ages 6 months to 3 years should go to the doctor if they have a fever of 102.2 °F (39.0 °C) or higher.

4
Take acetaminophen, ibuprofen, or aspirin for a fever if you’re an adult. Pain relievers that are listed as helping reduce fevers are safe for adults to take, such as Aspirin, Tylenol, or Motrin. Follow the dosage instructions and wait the appropriate amount of time before taking another dose, as listed on the medicine’s packaging.[5]
Never given Aspirin to people 19 years old or younger because it can increase the risk of contracting Reye’s syndrome, which causes damage to the brain and liver.

5
Try using nasal drops or sprays to help with congestion. Nasal drops can be put in children’s noses to help them breathe more easily when they have a cold. Adults and children over the age of 6 can use nasal sprays as well. Follow the instructions on the specific type of nasal spray or drops to know how to use them properly and safely.[6]
Look for decongesting nasal drops or sprays at your local drugstore or big box store.
Method 2 of 2:
Using Home Remedies

1
Drink plenty of fluids to stay hydrated. This includes things like water, juice, or drinks with electrolytes. Fevers often make you feel dehydrated, so it’s important to continue drinking liquids throughout the day.[7]
Stay away from caffeinated drinks, as these can make your dehydration worse.
To soothe a sore throat and help with hydration, drink tea or warm lemon water with honey. However, this is only suitable for adults and children over 1 year. Never give honey to a child under 1 year old.
For kids, try giving them diluted fruit juices, Jell-O, or popsicles if they’re not motivated to drink water.

2
Give sponge baths to younger kids to help reduce fever. Fill a tub with 1–2 in (2.5–5.1 cm) of lukewarm water, or water that’s roughly 85–90 °F (29–32 °C). Use a clean washcloth to gently spread the water over their arms, legs, and rest of the body. If they start to shiver, take them out of the tub and wrap them in a towel—shivering can increase a fever.[8]
Sponge baths are useful for reducing fever if you or your child is allergic to pain relievers.
Never use cold water or ice to help reduce fevers—these cause chills can make the fever worse.
Using a sponge bath for 30-45 minutes can reduce a fever by 1-2 degrees.

3
Stay at a comfortable temperature by dressing lightly. Hiding under lots of blankets or heavy clothing won’t help a fever go down. Instead, dress in light layers that can easily be removed if you’re hot or cold, and use a thin blanket or sheet if necessary.[9]
Adjust the room temperature if needed so that you’re at a comfortable temperature and don’t need lots of blankets.

4
Eat chicken soup to help loosen congestion. Chicken soup is a common cold food because it’s warm, contains protein, and actually helps loosen up mucus to help with any congestion you’re feeling. Warm up chicken soup or a different kind of broth to eat when you have a cold.[10]
Soups and broths are also a great way to stay hydrated as they’re mostly liquids.

5
Soothe a sore throat by gargling with saltwater or using lozenges. Mix salt with water and gargle to help relieve a sore throat, or suck on medicated lozenges that help soothe a sore throat instead. Look for lozenges or throat sprays designed to help sore throats at your local drugstore or big box store.[11]
Children under 6 years shouldn’t use these methods—they likely can’t gargle well, and lozenges are a choking hazard.
Take an over-the-counter medicine to help with your sore throat like ibuprofen.
Visit the doctor if your sore throat isn’t getting better after 2 days and you have a fever higher than 101 °F (38 °C).

6
Run a humidifier in your home, especially at night. This may help to loosen congestion and prevent a sore throat from breathing in dry air. If you don’t have a humidifier, try taking a warm shower and inhaling the steam while you’re in there.[12]
If you don’t have time for a shower, fill your bathroom sink or a bowl with very hot water and lean over it with a towel over your head. Inhale the steam for about 10 minutes to help loosen congestion.

7
Rest as much as possible. It’s likely that you’ll feel more tired than usual when you have a cold and fever. Try to sleep and take it easy as much as possible to help your body recover faster. Spend time napping, sitting and reading, watching television, or other restful activities.[13]
This doesn’t mean that you have to stay in bed the entire time, just don’t overexert yourself by doing things like exercising or going lots of different places.
Tips
Avoid spreading your cold to others by washing your hands after you sneeze, cough, or blow your nose.
Use a humidifier to keep a room from getting too dry.
If your nose is feeling raw from blowing it so often, rub petroleum jelly on the sore areas to help soothe it.
Warnings
If your child is 6 months old or younger and has a fever warmer than 100.4 °F (38.0 °C), call your doctor.
Contact your doctor if your child has a fever for more than 3 days.
Never give children multiple medicines that have the same active ingredients, such as antihistamine, decongestant, or pain reliever.
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About This Article
Erik Kramer, DO, MPH
Doctor of Osteopathic Medicine
This article was co-authored by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in weight management, diabetes, and internal medicine. He received his Doctorate in Osteopathic Medicine (D.O.) from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.
Co-authors: 8
Updated: January 22, 2020
Views: 558
Article Rating: 20% – 1 votes
Categories: Fever Care | Alternative Health
References
↑https://www.onhealth.com/content/1/treat_cold_fever_children
↑https://newsnetwork.mayoclinic.org/discussion/home-remedies-cold-remedies-that-work/
↑http://www.premiere-pediatrics.com/wp-content/uploads/2013/03/tylenol-child-dosage-pediatrics-pediatrician.jpg
↑https://www.mayoclinic.org/diseases-conditions/common-cold/diagnosis-treatment/drc-20351611
↑https://newsnetwork.mayoclinic.org/discussion/home-remedies-cold-remedies-that-work/
↑https://www.mayoclinic.org/diseases-conditions/common-cold/diagnosis-treatment/drc-20351611
↑https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/Treating-a-Fever-Without-Medicine.aspx
↑https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/Treating-a-Fever-Without-Medicine.aspx
↑https://www.onhealth.com/content/1/treat_cold_fever_children
More References
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