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A Comprehensive Look at Measles

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A Comprehensive Look at Measles


On Tuesday, the Chicago Department of Public Health (CDPH) confirmed there were 3 more reported measles cases, bringing the total number to 8 in that area.1

This does not include the ongoing outbreaks happening around the United States. As of March 7, 2024, the Centers for Disease Control and Prevention (CDC) reported a total of 45 measles cases in 17 states.2

One of the ongoing issues is that these are not just one-off cases but as Saskia Popescu, PhD, recently wrote, these is transmission happening.

In local communities this can present a real problem explains, Patricia A. Stinchfield, RN, MS, CPNP, president, National Foundation for Infectious Diseases (NFID).

“When those rates go below 95%—and this is really about in a specific community, what is the rate in the daycare? What is the rate in a high school? In a city? In a state?” Stinchfield explained. “To just take a big global number and say that’s pretty high, we’re good, is not okay. When a local community gets below 95%, that gives measles an ability to make an entrance and spread in that community.”

She also makes the point that there are people who are vulnerable to measles including babies who are too young to be immunized, those who are immunocompromised, and people who are on various therapies that might make them more susceptible to the disease.

Interview Highlights

4:12: Likelihood of people developing severe measles

8:13: Groups that are more at risk for contracting measles

10:50: Vitamin A treatment

14:27: Is the MMR vaccine still efficacious in protecting people post-exposure?

17:27: Should anyone get vaccinated again?

Contagion spoke to Stinchfield in a wide-ranging interview, and she discussed rising case rates, the symptoms and severe effects of measles, how NFID led the charge on getting more clinicians to offer vitamin A treatment, and strategies to prevent the disease.

To learn more about measles prevention, treatment and clinical resources, check out the NFID site and its dedicated measles section.

[Contagion covered some of the challenges associated with the ongoing measles outbreaks.]

References

1. Measles Update: Chicago Department of Public Health reports three new cases, continues efforts to curb spread. Chicago Department of Public Health. March 12, 2024. Accessed March 13, 2024.
https://www.chicago.gov/city/en/depts/cdph/provdrs/health_protection_and_response/news/2024/march/cdph-press-release-03-12-2024.html

2. Measles. CDC. Updated March 7, 2024. Accessed March 13, 2024.

https://www.cdc.gov/measles/cases-outbreaks.html



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Honey Garlic Air Fryer Salmon Bites

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Honey Garlic Air Fryer Salmon Bites


This website may contain affiliate links and advertising so that we can provide recipes to you. Read my disclosure policy.

Cooked in less than 10 minutes, these perfectly glazed honey garlic air fryer salmon bites are so delicious. This is such a quick dinner, you will never want to cook salmon any other way!

We love salmon at our house! It’s healthy, cooks fast, and everyone looks forward to dinner when salmon is on the menu! Be sure to also try my Easy Salmon Croquettes, this incredible Brown Sugar Garlic Air Fryer Salmon, or this Baked Parmesan Garlic Herb Salmon!

Top view of cooked salmon bites in the air fryer garnished with green onions.

Air Fryer Salmon Bites Recipe

These glazed honey garlic salmon bites will knock your socks off! The bite-sized salmon pieces get crispy and golden on the outside but stay flakey and moist on the inside. The marinade is a mixture of soy sauce, honey, garlic, and fresh lemon which make it similar to a teriyaki sauce.

Cooking in an air fryer is my favorite because of how convenient it is. With only 6 minutes in the air fryer, you’ll be eating in no time. I am convinced that the air fryer is the BEST way to cook salmon, and I can’t wait for you to try it. For more delicious air fryer recipes, check out my Tender and Juicy Chicken, this Perfect Air Fryer Steak, and these Homemade Air Fryer French Fries.

Ingredients Needed

This air fryer salmon bites recipe has the perfect mixture of sweet and savory. It marinates in an Asian-inspired sauce that is SO tasty! To find the exact measurements of ingredients, check out the recipe card at the bottom of the post.

  • Skinless Salmon Filet: Atlantic, king, and sockeye salmon are the most common. Cut the salmon into 1-inch cubes.
  • Salt and Pepper: Season to taste with salt and pepper.
  • Soy Sauce: Low-sodium soy sauce, tamari, or coconut aminos are all great alternatives for soy sauce in this recipe.
  • Honey: Add sweetness to balance out the flavors in the marinade.
  • Garlic: Fresh minced garlic is best!
  • Lemon: The juice of one lemon for acidity in the marinade. Lime would also be delicious!

How to Make Air Fryer Salmon Bites

Making these air fryer salmon bites could not be any easier! This fail-proof recipe will be your go-to recipe for a fast weeknight meal.

  1. Cube and Season the Salmon: Cut the salmon filet into one-inch cubes and season with salt and black pepper.
  2. Mix the Marinade: In a medium-sized bowl add the soy sauce, honey, garlic, and lemon. Whisk together until smooth. Reserve 2 tablespoons of marinade to brush on the salmon during the cooking process.
  3. Marinate the Salmon Bites: Add the salmon cubes to the marinade then toss to coat them evenly. Marinate for 20 minutes.
  4. Cook in the Air Fryer: Place the marinated salmon bites in a single layer into the air fryer basket. Cook at 390 degrees Fahrenheit for 3 minutes. Open the air fryer and brush the reserved glaze on the salmon bites. Close the basket and cook for an additional 3 minutes. The internal temperature for salmon should be 125-130 degrees Fahrenheit.
  5. Serve: Enjoy the salmon over rice with a side of vegetables!
First photo of the salmon cut into bite-sized pieces. Second photo of the marinade mixed in a glass bowl. Third photo of the salmon marinating in the marinade. Fourth photo of the salmon bites lined in the air fryer before cooking.
A bowl of marinade with a whisk.
Salmon bites in a glass bowl with marinade.
Salmon bites in the air fryer basket ready to cook.

Tips for Perfect Air Fryer Salmon Bites

Don’t let the air fryer intimidate you! It is my absolute favorite way to cook salmon. Follow my tips below to make these glazed honey garlic salmon bites a success.

  • What is the Cooking Temperature for Salmon? Salmon should be cooked to an internal temperature of 125 to 130 degrees Fahrenheit. There is nothing like perfectly cooked salmon because it is flakey and moist! Cooking salmon bites in the air fryer is a very fast method. Watch it closely so you don’t overcook them.
  • Fresh or Frozen Salmon: Fresh salmon filets are best, but if you need to use frozen salmon make sure to thaw it overnight in the refrigerator. To thaw salmon quickly, you can place frozen salmon in a sealable Ziplock bag and submerge it in COLD water for 30 minutes or until thawed. However, make sure the salmon stays cold.
  • How to Serve Salmon Bites: These air fryer salmon bites are so versatile. They are super high in protein and can be served in many ways. Enjoy them on a salad, in a bowl, as tacos, or with a side of rice and veggies. You could even serve these as an appetizer! Double the recipe so you can enjoy them all week long.

Close view of a wood spatula lifting up salmon bites in the air fryer.

Storing and Reheating Leftover Salmon

These glazed honey garlic salmon bites can last for up to 3-4 days when stored properly in an airtight container in the refrigerator. When you are ready to eat your leftovers, reheat them in the air fryer at 350 degrees Fahrenheit for 4-5 minutes. It keeps the texture perfectly flaky every time!

Close view of chopsticks lifting up a salmon bite in a bowl with rice and broccoli.

More Salmon Recipes to Impress

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  • Cut the salmon filet into one-inch cubes and season with salt and pepper.

  • In a medium-sized bowl add the soy sauce, honey, garlic, and lemon. Whisk together until smooth. Reserve 2 tablespoons of marinade to brush on the salmon during the cooking process.

  • Add the salmon to the remaining marinade and toss to coat. Marinate for 20 minutes.

  • Place the marinated salmon bites into the air fryer. Cook at 390 degrees Fahrenheit for 3 minutes. Open the air fryer and brush the reserved glaze on the salmon bites. Close the basket and cook for an additional 3 minutes. The internal temperature for salmon should be 125-130 degrees Fahrenheit.

  • Enjoy the salmon over rice with a side of vegetables!

Serving: 5gCalories: 190kcalCarbohydrates: 37gProtein: 9gFat: 2gSaturated Fat: 0.3gPolyunsaturated Fat: 1gMonounsaturated Fat: 1gCholesterol: 16mgSodium: 1634mgPotassium: 231mgFiber: 0.4gSugar: 35gVitamin A: 12IUVitamin C: 1mgCalcium: 16mgIron: 1mg

Nutrition information is automatically calculated, so should only be used as an approximation.





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Why Immersion in Very Cold or Hot Water Can Be So Healthy

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Why Immersion in Very Cold or Hot Water Can Be So Healthy


March 13, 2024 – There’s a good chance you’ve come across this popular 10-second social media narrative:

Hard-bodied individual looks into the camera. Zooms out to show they’re wearing only a beanie and a bathing suit. Hey, I’m about to dunk myself in freezing water. Voluntarily! Because I love-hate-love-hate it! Really! You should too. 

Should you?

Everywhere we look, someone is dunking something somewhere. Hot water. Ice water. Faces. Feet. Full bodies. 

And for good reason: Water – in many forms and in many ways – heals.

More and more research is finding that water immersion can help ease muscle pain, boost relaxation, and improve circulation, among other benefits, said Judy Ho, PhD, a clinical neuropsychologist and associate professor at Pepperdine University in Los Angeles.

“It makes sense in so many ways because water is an easy way for people to have a sensory experience to tap into mindfulness,” she said. 

Plus, there are biological underpinnings. Submersing yourself in water influences many body systems – cardiovascular (your heart and blood vessels), respiratory, endocrine (glands that make hormones), and more. “It’s probably the gestalt of all of them that makes [water immersion] helpful, beneficial, and useful,” said Bruce Becker, MD, a clinical professor at the University of Washington School of Medicine in Seattle who has researched and lectured on aquatic therapy. 

We asked Becker, Ho, and others to explain the science behind five popular methods. Ready? Let’s dive in. 

Cold Plunge

Though research is in its early stages, pilot studies have linked cold-water immersion to improvements in blood pressure, mood, and depression, said Heather Massey, PhD, a senior lecturer at the University of Portsmouth in the U.K. who studies cold-water immersion. A variety of reasons could be involved, including reduction of inflammation and stimulation of the vagus nerve, “which can make the heart rate and body calm down – and provide the spaces to be in the moment as opposed to being a thousand miles an hour,” Massey said. 

Other research has linked cold-water immersion with reduced body fat and improved insulin sensitivity, though most of these studies are small and inconclusive. 

Keep in mind an icy plunge is not without risks. The cold can trigger a shock response, increasing blood pressure, breathing rate, and heart rate in the first 30 seconds before the effect subsides. That can raise the risk of problems with your heart and blood vessels, such as arrhythmias, and the risk of drowning. 

If you have such risks, talk to your doctor before trying a cold plunge. Get in gradually (don’t jump in to get it over with) to reduce the effects of cold shock and so you don’t block an airway underwater if you reflexively gasp, Massey said. 

While there’s no ideal “dose” of cold immersion, “we know that colder and longer are not better; in fact, the shorter immersions may be responsible for lifting mood,” Massey said, adding that lower temps, even if not freezing, can lead to vascular and nerve injuries, especially in the extremities. One good starting point if you’re new to it: About 5 minutes at temps between 50 and 59 F.

If you do not have access to cold-plunge pools, do-it-yourself models can include soaking in a cool or cold bath (add ice if you can tolerate it) or taking cooler showers.

Hot Tub

Besides being, well, a lot more comfortable than cold plunges, heat therapy is also linked to cardiovascular health, said Tom Cullen, PhD, an assistant professor at Coventry University in the U.K. who has studied heat therapy.

“Passive heating” may mimic some effects of exercise on the body, according to Cullen’s review of studies in the Journal of Applied Physiology. “We think a lot of it is due to the increase in blood flow to the skin, which is forcing a large volume of blood through to our arms and legs,” Cullen said. This stresses the heart and blood vessels, strengthening the cardiovascular system in a way similar to exercise. It may also reduce anxiety and lower stress hormones, he said. 

To see the cardiovascular effects, you need about 30 minutes in water heated to 102 F, Cullen said. “You can probably go shorter – 15 minutes – and slightly cooler if you just wanted the improvements in mood, relaxation, and a slight drop in blood pressure.” 

Face Dunking in Ice Water

Touted as a quick way to relieve anxiety, this TikTok hack does have some science behind it: When you’re in fight-or-flight mode, your body temperature, heart rate, and stress hormones increase to prepare your body for the literal or symbolic bear you’re facing. Cold water activates your parasympathetic nervous system – the one linked to rest and relaxation – to trigger a biological response that tells you to calm down, Ho said. 

Why dunk the face? “There are so many nerves in the face, so it’s the quickest way to activate the response,” she said. “And just the proximity to the brain. It’s the idea that we’re just trying to get that message to the brain as quickly as possible.”

Caveat: You shouldn’t ever feel overly uncomfortable or be gasping for breath. Splashing cold water on your face, putting a cold pack on your neck, or just holding an ice cube somewhere on your face can have similar effects, Ho said. 

Foot Bath

A foot soak in warm water doesn’t just feel good but may also help you sleep and manage pain. One possible reason: It affects the thermoregulation systems of the body, which can influence core body temperature. After a warm foot bath, body temp goes down, which can promote quality sleep.

A 2023 study found a warm footbath improved sleep quality in patients who’d just had back surgery. Another study in the Journal of Caring Sciences found that sleep quality in older men improved with nightly 20-minute footbaths (the study lasted 6 weeks). Other research shows similar results in menopausal women and has found that footbaths can ease pain that comes with menstruation.

Swimming

This may be the most obvious one, but there’s a specific reason swimming is an ideal exercise beyond just cardiovascular benefits and low impact on joints. 

Swimming can increase both heart rate and the volume of blood being pumped by the heart (both good things during exercise) better than other forms of activity because of the hydrostatic pressure, Becker said. That’s the force of the water pressing against you, and it helps drive fluid through the body. (One interesting area of emerging research, he said, is the effect on the brain of swimming and vertical-water exercises like underwater running, as increased blood flow may help improve thinking skills as we age.)

As with cold plunging, more people are taking to cold, open-water swimming. Though people swam in cold water before the pandemic, the practice got more popular when people were forced away from doing their normal activities, said Massey, a lifelong cold-water swimmer. “Many have remained a cold-water swimmer or dipper ever since,” she said. 

Again, following precautions is important because it does come with risks, especially for those new to the experience. An article in the British Medical Journal reported a significant increase in lifeguard calls and deaths related to an increase in cold-water swimming.

But when done safely, the activity may have similar health benefits as cold plunging. In addition, a recent study in Post Reproductive Health showed that menopausal women had symptom relief with cold-water swimming. 

Another benefit: It forces us into a state of being uncomfortable. “When we do experience discomfort, that’s how we maintain our health and well-being,” said Massey, adding that exercise (cold-water or not) is a form of discomfort. “Putting ourselves in a position of discomfort helps us adapt and maintain some elements of health.”



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TherVacB’s Journey Against Hepatitis B (HBV)

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TherVacB’s Journey Against Hepatitis B (HBV)


The development of a therapeutic vaccine for Hepatitis B (HBV) has been challenging over the past 20 years due to the virus’s impact on specific immune cells. Advancement was made with the start of TherVacB’s first human clinical trial on January 25, 2024. There are plans to start a phase 1b/2a trial for chronic HBV patients, focusing on the vaccine’s safety and efficacy across Germany, Italy, Spain, England, and Tanzania.

“TherVacB is based on a deep understanding of the challenges of the immune system in chronic HBV infection and is the result of years of dedicated research here in Munich,” says Ulrike Protzer, the leading scientist behind the vaccine. “Our approach is designed to induce exactly the type of immunity required and cover a broad spectrum of over 95% of HBV strains worldwide.” 1

This phase 1a, open-label, dose-escalation study aims to test the safety and immunogenicity of TherVacB in 24 healthy volunteers aged 18 to 65. Part I involves 11 participants receiving protein prime vaccinations on days 0 and 28, followed by an MVA-based boost on day 56. The participants are divided into three groups receiving varying doses of HEPLISAV B and HBcoreAg for prime vaccinations, and different doses of MVA-HBVac for the boost. Part II consists of 13 participants who will undergo 2 protein prime vaccinations and an MVA-based boost but with varied doses of HBsAg, HBcoreAg, and adjuvants across 3 groups.

3 Key Takeaways

  1. TherVacB represents a significant advancement in therapeutic vaccines, designed to combat HBV by enhancing the body’s immune response specifically against the virus, covering over 95% of HBV strains globally.
  2. The phase 1a trial of TherVacB focuses on its safety and immunogenicity in healthy volunteers, marking a crucial step toward understanding its efficacy in treating chronic HBV infections.
  3. The development of TherVacB is aligned with the WHO’s urgent goal to eliminate HBV as a public health threat by 2030.

TherVacB is a type of therapeutic vaccine. In contrast to prophylactic vaccines, these therapeutic vaccines are developed to treat an existing disease, like a chronic infection. These vaccines enhance the body’s immune response to combat the disease.2

“The study deciphers the effect of the individual vaccine components and provides the first direct evidence that efficient activation of HBV-specific CD4 T cells is indispensable for initiating immune control of HBV. It also determines which components are required for a successful therapeutic HBV vaccination and gives important insights into the rational design of therapeutic vaccines for the urgently needed clinical application.”3

Based on previous reporting from Contagion, The World Health Organization (WHO) has called for the elimination of HBV as a public health threat by 2030, but this progression toward elimination has stalled. Nearly 300 million people globally live with HBV, making it the most common chronic infection. Despite stable mortality rates, 2 people die from HBV every minute. 4

WHO’s goals towards eradication include preventing new infections through vaccination and improving testing, clinical management, and treatment. The Centers for Disease Control and Prevention (CDC) recommends a vaccination of 2 or 4 doses depending on the vaccine or patient’s condition. While the goal is to treat 80% of eligible individuals by 2030, only 2% have received treatment. Treatment eligibility relies on HBV DNA testing, but this test is unavailable to many. Simplifying guidelines for non-specialists is crucial to effectively care for those with HBV, given the lack of access to specialists.

All in all, the development of TherVacB fits into public health strategies for combating, prevention, testing, and treatment strategies for HBV. The estimated primary completion date for the TherVacB therapeutic vaccine study is February 2025, with the overall study expected to conclude by August 2025.

References

  1. A Heterologous Protein Prime/​MVA Boost Therapeutic Hepatitis B Vaccine Candidate. Published February 9, 2024. Accessed March 11, 2024. https://clinicaltrials.gov/study/NCT05727267?term=ThervacB&rank=1
  2. EurekAlert. Therapeutic Vaccine for Chronic Hepatitis B Enters Clinical Trial. Published February 22, 2024. Accessed March 11, 2024. https://www.eurekalert.org/news-releases/1035328
  3. Unraveling Key Determinant of Successful Therapeutic Vaccination Against Chronic Hepatitis B. Published December 22, 2022. Accessed March 11, 2024. https://www.helmholtz-munich.de/en/newsroom/news-all/artikel/unraveling-key-determinant-of-successful-therapeutic-vaccination-against-chronic-hepatitis-b
  4. Abene S. What it Will Take to Eliminate Hepatitis B Virus. Contagion. Published January 24, 2024. Accessed March 11, 2024. https://www.contagionlive.com/view/what-it-will-take-to-eliminate-hepatitis-b-virus



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5 Minute Homemade Taco Seasoning Recipe

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5 Minute Homemade Taco Seasoning Recipe


This website may contain affiliate links and advertising so that we can provide recipes to you. Read my disclosure policy.

This Homemade Taco Seasoning is so flavorful and takes less than 5 minutes to make. You will never buy taco seasoning from the store again!

Want to know what to make with this seasoning? Try these Taco Stuffed Peppers, this classic Taco Soup or this Rotel Dip with this homemade taco seasoning.

A white bowl of taco seasoning with a wooden spoon.

Taco Seasoning Recipe

Isn’t it the worst when you go to cook and don’t have the seasoning that you need for the recipe. That’s where homemade seasonings come in! If you don’t have store bought taco seasoning on hand, this recipe can be made in less that 5 minutes from classic seasonings that we all have in our pantry!

Once you try out this homemade recipe, you will never buy store bought again. These flavors make any taco have more flavor and make them taste SO much better! Try it out with this easy Taco Ring. It takes even the most simple recipe to the next level.

What is Taco Seasoning Mix Made of?

Taco Seasoning is made up of simple spices that, when they are mixed together, make the best flavor. Check out the recipe card at the bottom of the post for all of the exact measurements.

  • Chili Powder: This gives it some kick. Add more if you like your seasoning extra spicy!
  • Garlic Powder: The garlic powder complements all of the other flavors without being too overpowering.
  • Onion Powder: This is a subtle onion flavor that really stands out.
  • Dried Oregano: The oregano brings in a spicy but sweet flavoring.
  • Paprika: Paprika has a smokey flavor and helps add color to the taco seasoning.
  • Ground Cumin: This unique flavored seasoning adds lots of flavor with a little spice.
  • Salt and Black Pepper: These enhance all of the flavors in the recipe.
The top view of ingredients, each in separate bowls and labeled with what is in them.

How to Make Your Own Taco Seasoning

You can also change the flavor up to have more or less heat depending on your preference. That’s the beauty of homemade seasonings, you can customize them to be however you want!

  1. Mix spices together: Combine all the seasonings together in a bowl.
  2. Store: Place the mixture in an airtight container.

How much homemade taco seasoning equals one packet?

A standard store-bought packets of taco seasoning holds about 2 tablespoons of seasoning.

The top view of taco seasoning in a bowl with a wooden spoon scooping out some seasoning.

How much taco seasoning for 1 pound of meat?

I use about 2 tablespoons in one pound of ground turkey or ground beef. This is such a simple recipe and it all comes together quick and easy for you to make several taco dishes! The recipe can easily be doubled and use more or less to taste.

Tip: I also like to add 1/2 cup of water to the meat and seasonings to make the meat more moist.

How long does taco seasoning last?

This is the best part! When you store your seasoning, make sure to keep it in a cool, dry place in an airtight container and it will last up to 6 months.

A plate of soft tacos grilled with meat and topped with shredded cheese, olives, lettuce, tomatoes and sliced avocados.

Want more taco recipes?! Try these ones!

Who doesn’t love a good taco? I’ve gathered up a few of my favorites for you to try with this seasoning!

 

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  • Combine all of the seasonings in a bowl and stir to combine.

  • Store in an airtight container for up to 6 months.

  • This recipe can easily be doubled! To use the seasoning, cook 1 pound of ground beef in a skillet until no longer pink. Add 2 tablespoons of taco seasoning to the ground beef along with 1/2 cup of water.

Originally Posted on August 27, 2019 
Updated on March 12, 2023 

Calories: 12kcalCarbohydrates: 2gProtein: 1gFat: 1gSaturated Fat: 1gPolyunsaturated Fat: 1gMonounsaturated Fat: 1gSodium: 616mgPotassium: 70mgFiber: 1gSugar: 1gVitamin A: 731IUVitamin C: 1mgCalcium: 19mgIron: 1mg

Nutrition information is automatically calculated, so should only be used as an approximation.

 

 





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Powering better health care through data analytics

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Powering better health care through data analytics


This involves using techniques, tools, and systems that help:

  • Gather and compile data points from an array of sources
  • Identify and clarify data patterns, trends, changes, and opportunities
  • Determine the correct action to achieve the best possible health outcomes

Actionable Insights and Customized Solutions

Our data, compiled from claims and internal reporting as well as vendor dashboards, enables us to have a complete and real‑time picture of our members’ health stories. This provides us with valuable insights that allow us to target unique, customized solutions for each member at each stage of their health care journey. For example, we can help answer questions like:

  • Since preventive health screenings can catch problems before they become more serious (and expensive), could members benefit from receiving screening reminders?
  • Are there any gaps in the care that members are receiving, such as annual A1C tests, biannual retinal exams, and kidney function testing for those diagnosed with diabetes?
  • Can members shift some of their health consultations from more costly settings (such as the emergency room) to less costly settings, such as urgent care centers, retail health clinics, and even telemedicine visits?

With insights from reports, dashboards, trends, benchmarks, and descriptive analysis, we can use what we’ve learned from the past to plan for future outcomes. We can also use techniques like predictive modeling, which can highlight relationships between events and issues and can help anticipate future occurrences.



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How Exercise Can Help Ease Osteoarthritis Joint Pain

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How Exercise Can Help Ease Osteoarthritis Joint Pain


March 12, 2024 — It hurt to walk. So Dianne Rosenbluth saw a surgeon that friends recommended at the Duke University School of Medicine, had an X-ray, and found out she has osteoarthritis. 

Rosenbluth’s pain went away after a hip replacement, but she struggled to get her stamina back. She knew she had to “keep going and keep moving” to get better, including after a second hip replacement about 10 years ago. When the Duke Health & Fitness Center opened in nearby Durham, NC, the real estate agent, entrepreneur, and former teacher signed up. 

Rosenbluth, now 81, gets regular steroid injections in her knees to treat her joint pain and is scheduled for knee surgery this summer. “As long as I can take care of things with good medical advice, that is a privilege,” Rosenbluth said. 

Exercise has helped ease her osteoarthritis pain and improve her mobility. “It’s about setting goals for myself.” To keep up her routine, Rosenbluth sets out exercise clothes the night before. “That way if I see the clothes and I don’t exercise, I feel guilty all day.”

It may sound counterintuitive at first – suggesting that people with joint pain exercise and move more in general. But experts agree with Rosenbluth that physical activity can lessen the symptoms of osteoarthritis. 

“Someone with joint pain is often concerned that exercising will exacerbate their pain and they are hesitant to start engaging in any physical activity,” said Leigh F. Callahan, PhD, associate director of the Thurston Arthritis Research Center at the University of North Carolina, Chapel Hill.

There is a lot of evidence from medical studies that a “measured approach” to exercise can help, noted Callahan, who is also director of the Osteoarthritis Action Alliance. For example, people who are inactive should start with a low-intensity activity like walking and slowly increase their distance over time. 

The potential benefits go beyond improving joint pain. There are multiple well-conducted trials that show physical activity and exercise improve a range of arthritis and joint-related symptoms, including pain, stiffness, swelling, and the ability to perform activities of daily living, Callahan said. “In addition to the improvement in arthritis symptoms, exercise and physical activity provide mental health benefits and improve overall quality of life.”

“It can seem surprising, but gentle exercise is actually a great way to manage osteoarthritis pain,” said Nick Turkas, senior director of patient education at the Arthritis Foundation. Regular movement keeps joints flexible, preventing stiffness and increasing a person’s range of motion, he said. 

The 2-Hour Rule

Like anyone beginning a new exercise routine, check with your doctor first and start slowly, Callahan recommended.

“No pain, no gain” does not apply to exercise for people with osteoarthritis. Exercise should be challenging but not cause sharp pain, Turkas said. “We have a 2-hour pain rule. If your pain is worse 2 hours after exercise, dial it back next time.”

People may feel some pain or discomfort if they were inactive before starting to exercise, Callahan said. “However, sharp pain, pain in a new area, and pain that lasts more than 2 hours after exercising are “some of the signs they might be overdoing [it] or something is wrong.”

Common Misconceptions

Turkas dispelled some common myths people have around osteoarthritis and exercise. For example, people with joint pain might hesitate to increase their physical activity level because they worry exercise will just make their pain worse. “This is a concern,” he said, “but gentle exercise is actually proven to reduce pain and stiffness in the long run.”

Another mistaken belief is people cannot exercise because they are too stiff. Turkas recommended that people focus on their range of motion and start with small movements that they increase over time. 

And no, exercise will not “wear out” a joint, he noted. “Our joints aren’t machines. Movement builds joint strength — stronger muscles, tendons, and ligaments, support proper joint alignment for efficient movement and stability.”

Fluid and Flexibility

One of the key factors in greater flexibility is synovial fluid, a thick liquid within the knees, hips, and other joints that keeps them lubricated. Healthy joint cartilage acts like a sponge, Turkas said, absorbing synovial fluid for smooth movement.

In addition to creating more synovial fluid around the joints, exercise can increase circulation of nutrients to joints, reduce inflammation, and increase blood flow to joints. Exercise also “promotes weight loss, which is helpful for joint pain and improves balance and coordination,” Callahan said. 

Physical activity can also strengthen the muscles around the joints. Strong muscles around the joint act like natural braces, taking pressure off the joint itself, Turkas said. “Exercise strengthens these muscles — improving stability and potentially reducing pain.”

When to Seek Specialty Care

Knowing when to manage osteoarthritis joint pain at home and when to seek specialty care is essential. “If you’re experiencing joint pain for more than 2 weeks, it’s important to consult a doctor to discuss the best course of action,” Turkas said. Specialists can confirm if arthritis is causing your symptoms, and they can help diagnose the specific form you have. There are more than 100 forms of arthritis, and a proper diagnosis is the key to the best treatment, he said. 

Callahan recommended arthritis-appropriate evidence-based interventions (AAEBIs) for people who want to learn more about exercise. There are 14 AAEBI exercise programs. The Arthritis Foundation offers a “Walk with Ease” program that leads people through appropriate steps for setting goals, warming up, walking, cooling down, and stretching properly. 

The Osteoarthritis Action Alliance and the CDC recognize these AAEBIs because they increase physical activity and improve arthritis symptoms. Many are offered virtually as well as in-person in community settings.

Still wondering how to get started? The Osteoarthritis Action Alliance also offers guidance on how people with joint pain can think about starting physical activity. 

As for Rosenbluth, “I need to keep going,” she said. “If I keep moving and build my stamina, I can do more.”



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New Mexico Man Succumbs to Bubonic Plague, Cause Not Reported

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New Mexico Man Succumbs to Bubonic Plague, Cause Not Reported


This digitally colorized scanning electron microscopic (SEM) image depicts a number of yellow-colored, Yersinia pestis bacteria, that had gathered on the proventricular spines of a Xenopsylla cheopis flea. These spines line the interior of the proventriculus, a part of the flea’s digestive system. The Y pestis bacterium is the pathogen that causes bubonic plague.

Image Credit: National Institute of Allergy and Infectious Diseases

The New Mexico Department of Health (NMDOH) announced last Friday that a state resident died from the bubonic plague. The man was from Lincoln County, which is in the lower central portion of the state, and was hospitalized prior to his death.1

“This tragic incident serves as a clear reminder of the threat posed by this ancient disease and emphasizes the need for heightened community awareness and proactive measures to prevent its spread,” State Public Health Veterinarian Erin Phipps, DVM, MPH, said in a statement. 1

The plague is a bacterial disease carried by rodents and is generally spread to humans through the bites of infected fleas. It can also spread by direct contact with infected animals, including rodents, wildlife, and pets.1 In addition, dogs and cats that are allowed to roam and hunt can bring infected fleas from dead rodents back into the home, putting household members at risk.1

In fact, a person contracted plague through cat-to-human transmission last month in Oregon. Health officials from that state announced that the resident and the cat received treatment but the animal did not survive the illness. The patient and close contacts received medication, with health officials stating no broader community risk.2

Disease Prevention, Diagnosis, Treatment

The NMDOH offered some preventative measures to avoid contracting bubonic plague including:

  • Avoid sick or dead rodents and rabbits, and their nests and burrows
  • Prevent pets from roaming and hunting
  • Talk to a veterinarian about using an appropriate flea control product for pets as not all products are safe for cats, dogs or children.
  • Have sick pets examined promptly by a veterinarian
  • See a physician about any unexplained illness involving a sudden and severe fever
  • Clean up areas near the home where rodents could live, such as woodpiles, brush piles, junk and abandoned vehicles
  • Put hay, wood, and compost piles as far as possible from the home
  • Don’t leave pet’s food and water where rodents and wildlife can get to it

In terms of signs, CDC reports that the most common symptom is the “rapid development of a swollen and painful lymph gland called a bubo. A known flea bite or the presence of a bubo may help a doctor to consider plague as a cause of the illness,” the federal agency reports.

People who live or traveled to the western US or any places where the plague is endemic and are experiencing symptoms of the plague should seek medical care immediately, CDC writes on its site. The plague is diagnosed with a test and can be treated with antibiotics.

For the New Mexico man, it has not been reported why he contracted the plague, but according to CDC, between 1970 and 2020, there has been more reported cases (253) in that state than any other in the US.1,3 The last human plague case in New Mexico was in a Torrance County resident in 2021. In 2020, there were 4 human plague cases: 1 in Santa Fe County, 2 in Torrance County and 1 fatal case in Rio Arriba County.

The New Mexico Department of Health is conducting outreach to Lincoln County area residents and an environmental assessment will be conducted in the community to look for ongoing risk with this latest case.1

References

1. Department of Health reports death of man from plague. NMDOH press release. March 8, 2024. Accessed March 12, 2024.
https://www.nmhealth.org/news/information/2024/3/?view=2071

2. Abene S. Rare Case of the Bubonic Plague Identified in Oregon. ContagionLive. February 14, 2024. Accessed March 12, 2024.
https://www.contagionlive.com/view/rare-case-of-the-bubonic-plague-identified-in-oregon

3. Plague. CDC. Last reviewed November 26, 2019. Accessed March 12, 2024.
https://www.cdc.gov/plague/diagnosis/index.html



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Guinness Chocolate Cake Recipe | The Recipe Critic

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Guinness Chocolate Cake Recipe | The Recipe Critic


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Celebrate St. Patrick’s Day (or any day) with this delicious Guinness Chocolate Cake! It has the most wonderful fudgy flavor and tender texture that is complemented by a Bailey’s buttercream filling and a rich ganache frosting.

This dessert is a MUST try. If you’re a chocolate lover, like me, you will go crazy for every bite of this incredible sweet treat! If you want to try more unique chocolate desserts, we have so many good ones. Try this nostalgic ho ho cake, this fun whoopie pie cake, or this almost sinful tuxedo cake.

Serving a slice of Guinness chocolate cake.

Guinness Chocolate Cake Recipe

This Guinness Chocolate Cake is decadent and sweet with the perfect boozy kick. If you’re looking for a dessert to celebrate St. Patrick’s Day, this is it! The recipe features Guinness beer in the cake and the ganache frosting, and Irish cream in the buttercream filling. This is one of those recipes that’s absolutely heavenly, and one that you’ll be thinking about long after you’ve taken the last bite.

The Guinness gives the cake a fluffy texture and adds a slight malt flavor that pairs well with the chocolate without being overpowering. The buttercream spiked Bailey’s Irish cream tastes incredible and the creamy spiked ganache is the perfect finishing touch. If you’re making a full St. Patrick’s Day spread, be sure to check out our collection of all of the best St. Paddy’s Day recipes!

Ingredients Needed

The ingredient list for this Guinness cake recipe might look a bit long, but the ingredients are simple and mostly pantry staples. Plus, one bite of this flavorful, fluffy cake and you’ll see that it is so worth it! Exact measurements can be found at the end of the post in the recipe card!

Cake

  • Guinness Stout: Guinness extra stout or draught may be used. You can also use any favorite stout beer!
  • Sugar: Granulated sugar will perfectly sweeten the cake without overwhelming the flavor.
  • Cocoa Powder: Use regular unsweetened cocoa powder, not dutch process, to add depth and richness.
  • Vegetable Oil: For an extra moist crumb.
  • Eggs: Two large eggs will help bind all of the ingredients together. It’s best if they are room temperature for easy mixing.
  • Sour Cream: Use full-fat sour cream for the most wonderful moist texture.
  • Vanilla Extract: Adds warm subtle sweetness.
  • Flour: All-purpose flour will give the cake structure while keeping it nice and soft.
  • Baking Soda: Helps the layers rise properly while baking.
  • Salt: To balance the sweetness and bring out all of the delicious flavor.

Ganache

  • Chocolate: Use a high-quality semi-sweet chocolate like Ghirardelli or Guittard.
  • Heavy Cream: Makes it super creamy and irresistibly rich.
  • Guinness: For extra Irish flavor in the frosting.

Bailey’s Buttercream Filling

  • Salted Butter: Use softened butter as the foundation for the buttercream filling.
  • Powdered Sugar: Makes the buttercream sweet and smooth.
  • Bailey’s Irish Cream: Complements the Guinness cake with rich chocolate and vanilla flavors. 

How to Make a Guinness Chocolate Cake

Grab all of the ingredients and get ready to make one of the best cakes ever! This is such a special dessert and will be the hit of any party. Here’s how it all comes together:

Cake

  1. Prep: Preheat oven to 350 degrees Fahrenheit and spray two 8-inch round cake pans with pan spray and a parchment round, if desired.
  2. Heat Guinness: In a small saucepan, heat the Guinness, sugar, and cocoa powder together over medium heat until all the sugar is dissolved, about 3 minutes. Remove from the heat and let it cool for 5-10 minutes.
  3. Mix Wet Ingredients: In a separate bowl, whisk together the oil, eggs, sour cream, and vanilla. Once smooth whisk in the oil until fully combined.
  4. Combine: Whisk the egg mixture into the sugar mixture until combined. Gently whisk in the flour, baking soda, and salt.
  5. Bake: Divide the batter evenly into the two prepared cake pans and bake for 40-45 minutes, until the center of the cakes spring back when lightly pressed on or a toothpick comes out clean.
  6. Cool: Let the cakes cool completely before wrapping them with plastic wrap and chilling them in the refrigerator for at least 2 hours before assembling the cake. Cold cake is significantly easier to frost than warm or room-temperature cake.

Ganache

  1. Simmer the Guinness: While the cake bakes, prepare the ganache by simmering the Guinness over low heat until reduced by half to ¼ cup. Add the cream to the pan and simmer until steaming.
  2. Combine with Chocolate: Add the chocolate to a large bowl and pour the steaming liquid over it. Let the chocolate sit for 2 minutes before whisking until smooth and shiny. Cover the bowl and place it in the refrigerator to chill until the cakes are cooled and ready to be frosted.

Bailey’s Buttercream Filling

  1. Mix: Use a hand mixer to beat the butter, powdered sugar, and Bailey’s together in a medium bowl until combined. Start with 3 tablespoons of Bailey’s and add a little more at a time until the buttercream is soft and fluffy, but not runny.

Assembly

  1. Add Buttercream: Once the cakes are chilled and ready to be frosted, place one layer bottom side down on a cake plate or serving plate. Top with the buttercream and spread it evenly over the cake, leaving ¼-½ inch space around the perimeter of the cake so the buttercream doesn’t interfere with the ganache. Place the second layer of cake topside down on the buttercream.
  2. Whip Ganache: Whip the chilled ganache with a hand mixer until soft and fluffy. Use it immediately to frost the cake, as it will set up and harden the longer it sits. If it becomes stiff as you are frosting, use the hand mixer to beat it again until it is soft.
  3. Spread Ganache: Add a couple of large dollops of ganache to the top of the cake and use an offset spatula to spread it around, letting it go over the edges. Use the spatula to push the overhanging ganache down onto the sides, adding more from the bowl as needed. Try not to lift the spatula straight up off the cake, as that can cause the ganache to pull off from the cake bringing crumbs with it. Instead, move the spatula in a swiping motion to stop contact with the ganache.
  4. Smooth Ganache: Once the cake has been covered in an even layer of ganache, you may use the offset spatula or a bench scraper with a straight edge to smooth it. I like to run my metal tools under very hot water and dry them thoroughly before using the hot metal to smooth the ganache.

Use a 9×13 Pan

You may also bake this cake in a 9×13-inch pan. Spray the pan well with pan spray with flour in it or use regular pan spray and dust the pan with flour and tap out the excess. Bake for 35-40 minutes.

Combining wet and dry ingredients together.
Chocolate Guinness cake batter.
Adding the cream layer to the cake
Adding chocolate chips into the frosting mixture
Whipping up the frosting for the chocolate Guinness cake
Frosting the Guinness cake

Tips and Variations

Use these helpful tips and options to make an amazing chocolate Guinness cake!

  • Beer Options: If you are not going to use Guinness beer, it may be substituted for any other stout beer. If you would like to leave out the beer completely, I recommend using this recipe for chocolate cake instead.
  • Use Butter: You may substitute the oil for butter if you would like to. Add the butter to the saucepan with the beer, sugar, and cocoa powder. Cook it until the sugar is fully dissolved and the butter is completely melted. If you use salted butter, reduce the salt in the recipe to ½ teaspoon.
  • What if the Cakes Sink? Don’t be alarmed if your cakes sink a little! The best way to avoid this is to let the cakes bake undisturbed as long as possible since opening the oven door causes a drop in temperature and that can make the cakes fall. These cakes bake longer than a standard cake, so try to wait until 40 minutes. If the cakes do sink a little, let them cool completely before using a serrated knife to carefully level off the cake. If it is just a slight dip in the center, invert the warm cake upside down on the cooling rack right out of the oven. Letting it cool upside down will often help level out the dip.
  • Frosting Option: You may omit the Bailey’s buttercream filling and just use ganache instead.
  • Irish Cream Option: If you don’t have Bailey’s you may use an equal amount of Irish Cream flavored syrup or 1 tablespoon of vanilla extract instead.

Serving a slice of cake.

Storing Leftovers

  • Room Temperature: Store leftover cake at room temperature for up to 3 days in an airtight container.
  • In the Refrigerator: To keep fresh for up to 5 days, place in an airtight container in the fridge.
  • To Freeze: The unfrosted cake rounds may be baked and frozen for up to 3 months. Let the cakes cool to room temperature before wrapping each layer tightly in 2-3 layers of plastic wrap. They may be used directly from the freezer, or thawed in the refrigerator. I recommend frosting them while either frozen or chilled.

A slice of chocolate Guinness cake on a scalloped plate.

More Chocolate Cake Recipes

If you love chocolate and cake, you’re in the right place! We have so many tried and true chocolate cake favorites that you’re definitely going to want to try! No matter the occasion, these are always a hit!

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Bailey’s Buttercream Filling

Cake

  • Preheat oven to 350 degrees Fahrenheit and spray 2 8-inch round cake pans with pan spray and a parchment round, if desired.

  • In a small saucepan, heat the Guinness, sugar, and cocoa powder together over medium heat until all the sugar is dissolved, about 3 minutes. Remove from the heat and let it cool for 5-10 minutes.

  • In a separate bowl, whisk together the oil, eggs, sour cream, and vanilla. Once smooth whisk in the oil until fully combined.

  • Whisk the egg mixture into the sugar mixture until combined. Gently whisk in the flour, baking soda, and salt.

  • Divide the batter evenly into the two prepared cake pans and bake for 40-45 minutes, until the center of the cakes spring back when lightly pressed on or a toothpick comes out clean.

  • Let the cakes cool completely before wrapping them with plastic wrap and chilling them in the refrigerator for at least 2 hours before assembling the cake. Cold cake is significantly easier to frost than warm or room-temperature cake.

Ganache

  • While the cake bakes, prepare the ganache by simmering the Guinness over low heat until reduced by half to ¼ cup. Add the cream to the pan and simmer until steaming.

  • Add the chocolate to a large bowl and pour the steaming liquid over it. Let the chocolate sit for 2 minutes before whisking until smooth and shiny. Cover the bowl and place it in the refrigerator to chill until the cakes are cooled and ready to be frosted.

Bailey’s Buttercream Filling

  • Use a hand mixer to beat the butter, powdered sugar, and Bailey’s together in a medium bowl until combined. Start with 3 tablespoons of Bailey’s and add a little more at a time until the buttercream is soft and fluffy, but not runny.

Assembly

  • Once the cakes are chilled and ready to be frosted, place one layer bottom side down on a cake plate or serving plate. Top with the buttercream and spread it evenly over the cake, leaving ¼-½ inch space around the perimeter of the cake so the buttercream doesn’t interfere with the ganache. Place the second layer of cake topside down on the buttercream.

  • Whip the chilled ganache with a hand mixer until soft and fluffy. Use it immediately to frost the cake, as it will set up and harden the longer it sits. If it becomes stiff as you are frosting, use the hand mixer to beat it again until it is soft.

  • Add a couple of large dollops of ganache to the top of the cake and use an offset spatula to spread it around, letting it go over the edges. Use the spatula to push the overhanging ganache down onto the sides, adding more from the bowl as needed. Try not to lift the spatula straight up off the cake, as that can cause the ganache to pull off from the cake bringing crumbs with it. Instead, move the spatula in a swiping motion to stop contact with the ganache.

  • Once the cake has been covered in an even layer of ganache, you may use the offset spatula or a bench scraper with a straight edge to smooth it. I like to run my metal tools under very hot water and dry them thoroughly before using the hot metal to smooth the ganache.

Calories: 899kcalCarbohydrates: 98gProtein: 9gFat: 53gSaturated Fat: 24gPolyunsaturated Fat: 11gMonounsaturated Fat: 14gTrans Fat: 0.4gCholesterol: 84mgSodium: 533mgPotassium: 429mgFiber: 7gSugar: 67gVitamin A: 666IUVitamin C: 0.2mgCalcium: 69mgIron: 5mg

Nutrition information is automatically calculated, so should only be used as an approximation.

Leftovers Callout Title

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.





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Shingles Vaccination Is So Worthwhile

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Shingles Vaccination Is So Worthwhile


There are so many vaccinations we’re supposed to make sure we receive. The flu, RSV, COVID-19, pneumococcal pneumonia…these are all important and could save your life. But there’s one vaccination I want to make sure you don’t overlook: Shingles!

This infection is rarely life-threatening, but it really hurts! In some people, the pain sticks around for a long time after the telltale rash disappears. And in a few unfortunate individuals, the pain never goes away.

I’ve had shingles three times — because I didn’t get the vaccine when I should have. I’ve now been vaccinated, and I haven’t gotten it since.

But, believe me, three times is more than enough!

What is Shingles?

Shingles, also known as herpes zoster, is a condition caused by the varicella-zoster virus — the same infection that causes chickenpox. More than 99 percent of people born in the U.S. before 1980 have had chickenpox. If you’re one of them, varicella zoster has lain dormant in the nerves of your body ever since, and it’s there to stay. Then, for reasons that aren’t well understood, it sometimes wakes up…and causes you to have shingles, a form of nerve pain.

About a third of all people in the U.S. will develop shingles at some point in their lifetimes, but it’s more commonly diagnosed in:

  • White people
  • Women
  • People who are immunosuppressed

But anyone who has had chickenpox can get it and your risk of getting shingles increases with age. About 50 percent of new shingles cases affect people who are 60 or older. So, just because you haven’t had it yet, don’t assume you’re in the clear!

What Are the Signs of Shingles?

Shingles starts with pain, burning, itching, or tingling on one side of your torso or your face. At first there may be no other symptoms. The pain can be so intense, you might even think you’re having a heart attack.

You could also experience:

  • Fever
  • Headache
  • Sensitivity to light
  • Fatigue

But then, usually within a few days, a blistery skin rash appears in that area. The blisters may break open, ooze fluid, then crust over.

People who haven’t previously been exposed to the varicella-zoster virus can catch chickenpox from you at that point. So, stay away from others who can catch it until the blisters have scabbed over. People who are susceptible are:

  • Anyone who has never had chickenpox (unless they’ve been vaccinated)
  • Babies under 12 months old
  • Those who are pregnant, or who have a serious health condition like cancer or AIDS

A small percentage of people never get the rash, which makes diagnosis harder. But if you’re ever in severe pain, see your doctor immediately anyway, no matter what the cause!

Can Shingles Be Treated?

There is no cure for the varicella-zoster virus. Once it’s in your body, it’s there to stay. However, the good news is that shingles is treatable.

Once shingles develop, it can last between three and five weeks or longer! The sooner treatment begins, the better it will work. So get yourself to your primary care practitioner at the first sign that something is wrong.

They’ll likely give you an antiviral drug to help make the rash go away sooner. They may also give you a steroid medication to reduce your risk of postherpetic neuralgia — a complication in which the pain sticks around even after the rash is gone (sometimes for months or more!).

Aside from those treatments, your doctor may recommend acetaminophen or ibuprofen for the pain, and Calamine lotion or something similar if you’re itching.

The Best News? Shingles Can Be Prevented!

Getting vaccinated against shingles is a much, much better move than treating it after it begins. The vaccine, called Shingrix, is more than 90 percent effective in preventing shingles and postherpetic neuralgia. And the CDC recommends it for anyone over the age of 50. Vaccination is also recommended to prevent herpes zoster and related complications in immunodeficient or immunosuppressed adults aged 19 or older.

You can get Shingrix in most pharmacies. And if you have a Medicare prescription drug plan (Part D), vaccination won’t cost you a thing.

But for the vaccine to work properly, you have to get it in two doses, anywhere between two and six months apart. So, set a reminder on your phone or mark your calendar — you don’t want to forget that second dose! Better still, make the appointment for the second dose while you’re getting the first one.

You may have some side effects from the vaccine. Most people get a sore arm where the shot was administered, and possibly redness and swelling. Some people also feel tired or have a headache, fever, stomach pain, or nausea. But these symptoms go away in about two to three days — which is a lot better than the weeks of misery that shingles can bring!

By the way, chickenpox is preventable now too — thanks to the chickenpox vaccine, which has cut chickenpox cases by 97 percent in the last 25 years! And obviously if someone never gets infected with the varicella-zoster virus in the first place, they’re very unlikely to get shingles later. So, encourage the parents of young children to get this and all other recommended vaccinations.

Shingles Is No Joke

I sincerely hope you never have to experience this condition. If you’re over 50 years old, please get yourself vaccinated (if you haven’t already) — even if you’ve already had shingles! I’m living proof that you can get it more than once. And spread the word about the shingles vaccine to your family and friends.

If you do develop this condition, get to your doctor’s office immediately! Timely treatment could make all the difference between suffering for weeks and suffering for months.



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