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I’m so stoked and honored to be contributing regularly to the column “Healthwise Maui” in The Maui News. I enjoy sharing and learning from people from all walks of life and I hope that my contributions here , as a surgeon, will make a difference in someone’s life.
September 12, 2019- METHAMPHETAMINE USE: Q: What can I use instead of methamphetamine to stay awake to work my three jobs?
Here is the published answer: Dr. Stephanie Yan, general, trauma and critical care surgeon, Island Family Surgical Care Center: Believe it or not, I have been posed this question in my surgical practice. I’ve had to delay or postpone several surgeries, so I can further evaluate my patients for the long-term adverse effects of methamphetamine use that might cause complications during and after their surgeries. I’ve also had to take care of many patients after accidents because of methamphetamine use.
Methamphetamine is a highly addictive and illegal psychostimulant drug. Meth first appeared in Hawaii in the 1980s as a recreational drug. However, most of the patients I encounter using meth have resorted to it in order to work longer hours. But meth is not iced coffee. Meth is very harmful. Methamphetamine is neurotoxic and can damage the brain. It may cause structural and functional changes in the brain associated with emotion and memory, severe dental problems, malnutrition, high blood pressure, vascular damage and heart failure.
Consider green tea, yerba mate, ginger root tea, fresh juice, coffee and dark green food for the B vitamins, which will help give you that boost of energy. Working out regularly, at least three times a week, can give you energy as well and will also help you sleep better at night, so you feel refreshed and energized during the day.
Maui has resources available to treat people who are struggling with meth addiction. Please ask your primary care doctor for a referral to these programs here on Maui.
My additional thoughts on the topic: Believe it or not, I have been posed this question in my surgical practice. I’ve had to delay or postpone several surgeries, so I can further evaluate my patients from the long-term adverse effects of methamphetamine use that might cause complications for my patients during and after their surgeries. I’ve also had to take care of many patients after accidents because of methamphetamine use. Methamphetamine use is a widespread epidemic in Hawaii. Methamphetamine is a highly addictive and illegal psychostimulant drug known to the public by its aliases: Crystal meth. Meth. Ice. Speed. Crank. Chalk. Glass. Wash. Pookie. Meth’s pleasurable effects are increased activity, boost of energy, feelings of well-being, decreased appetite ,and euphoria. During World War II, methamphetamine was used to keep military personnel alert and to improve endurance and mood. Meth first appeared in Hawaii in the 1980s as a recreational drug. However, most of the patients I encounter using meth do not do it for fun or recreation. They have resorted to it for longer battery life in order to work longer hours. But Meth is not iced coffee. Meth is very harmful. Methamphetamine is neurotoxic and can damage the brain. It is linked to higher frequencies of unprotected sexual intercourse and violent behavior and may cause structural and functional changes in the brain associated with emotion and memory, severe dental problems, malnutrition, high blood pressure, vascular damage and heart failure. Because of meth use, I’ve had patients in their 30s with heart functions at 10% compared to the average population.
One of the reasons why the meth problem is so harsh in Hawaii is the relative lack of meth addiction treatment. Most addicts in Hawaii don’t know where they can go locally, but Maui has these resources available. Please ask your primary care doctor for a referral to these programs here in Maui.
So what about energy drinks as alternatives to meth to help stay up at your night job? Energy drinks have been found to restrict blood flow and oxygen delivery creating more work for your heart. There have been reported cases of cardiac arrests after energy drinks. They can also cause you to have a life-long problem with your heart rate and heart rhythm. Better alternatives to meth and energy drinks are: green tea, yerba mate, ginger root tea, fresh juice, coffee and dark green food for the B vitamins which will help give you that boost of energy. Working out regularly, at least 3 times a week, can give you boundless energy as well and will also help you sleep better at night, so you feel refreshed and energized during the day.
It is true that we need to implement mass education and awareness campaigns to prevent meth addiction from state governments down to local communities and to our families, but most importantly we have to create youth programs and fight for a living wage here in Hawaii. The cost of living here in Hawaii is soaring beyond people’s ability to afford living here. People are needing to work 2 to 3 jobs or move away. But job creation is not enough, residents must commit to buying locally (less Amazon more Mana shopping). The people of Hawaii must work with the Chamber of Commerce to help create and support small businesses here in Maui. The State of Hawaii must regulate the flood of faceless investors buying up homes and land in these islands in order to reduce the cost of living here in Maui and maybe incentivize outside investors to partner with local entrepreneurs in order to do business here. Locals must also make sure we support each other locally, improve the educational system and train and retain our professionals. Meth is killing more and more people here in Hawaii and the cost of living is driving the people away to the mainland in droves to places like Las Vegas. Saving the sacred lands is not enough. We all must do our part to save and keep its sacred people too.
May 30, 2019- CONCUSSIONS: Q: My son plays sports and I’m worried about concussion. When an athlete is hit in the head, at what point should they be taken to the hospital or see a doctor?
Dr. Stephanie Yan, general, trauma and critical care surgeon, Island Family Surgical Care Center: A concussion is a traumatic brain injury that affects a person’s brain function. It is common in contact or action/adventure/extreme sports. Some concussions can cause a loss of consciousness (“blacking out and not remembering what happened”) but most do not. If your son does lose consciousness for any length of time, he has definitely suffered a concussion and I would recommend having him evaluated. If there isn’t a loss of consciousness but you notice any worrisome signs, such as dizziness, nausea, ringing in the ears, vomiting, headache, slurred speech, loss of balance, unsteady walking, irritability/crankiness, listlessness, delayed response to questions, change in your child’s normal behavior after the trauma, seizure or a feeling of being dazed or confused and/or general fatigue, you should have him evaluated by a physician.
Symptoms of concussions can occur immediately or it may be delayed for hours or days. Depending on his age and the severity of the injury, the physician might perform a neurological exam and check his vision, hearing, coordination, mental status and/or keep your son in the hospital for an observation period. Other tests could include a CT scan or MRI scan of the head and spine to look for signs of trauma.
It is not advisable for your son to return to vigorous activity while signs or symptoms of a concussion are present or until fully evaluated by a physician, just as it is unsafe for an adult to drive or handle dangerous or heavy machinery while signs or symptoms of a concussion are present. Potential long-term complications of concussion include headaches, dizziness and thinking difficulties for days to months after the head injury. Repeated head injury is being actively researched right now and was the subject of the 2015 film “Concussion” starring Will Smith, who portrayed Bennet Omalu, the forensic pathologist and neuropathologist who inspired the movie. If your son suffers multiple brain injuries, these may have cumulative effects and places him at risk of developing permanent and progressive impairments and limited function for his whole life.
The most important thing I can impart to you regarding concussions and brain injury is prevention. Please wear protective gear during sports and other recreational activities, buckle your seat belts, make your home safe from falls by keeping hallways well-lit and floors and stairs free of anything that might cause someone to trip and fall, protect your children by blocking off stairways and pools and installing window guards and checking lanai rails and stair handrails routinely, pay attention to the elderly in the home and community and give them a hand for stability, exercise regularly to strengthen muscles, improve balance and flexibility, and educate yourself and others about injury prevention.