Q: If I’m outdoors a lot, should I be worried about getting Lyme disease?

A: Though the chances of being infected are minimal in Arkansas, there are several tick-borne diseases with an array of symptoms you should keep in mind.

Lyme disease is one possibility, though fairly remote. Lyme disease is caused by the bacterium Borrelia burgdorferi, which is transmitted to humans by the bite of infected blacklegged ticks. There are several more likely tick-borne diseases in Arkansas including tularemia, Rocky-Mountain Spotted Fever and Ehrlichiosis.

Though most tick bites are harmless, if you begin experiencing an unusual skin rash, headache, fatigue or fever, it’d be best to immediately see a doctor. If symptoms go untreated, the infection an spread to the heart, joints and nervous system. Though it could result in more serious problems, most cases of Lyme disease are successfully treated with antibiotics.

Your best bet before heading outdoors is to use insect repellent and to carefully and quickly remove all ticks from your body as soon as a tick is spotted. The best way to remove a tick is by using fine-tipped tweezers to firmly grasp the tick as close to your skin as possible. Pull the tick’s body away from your skin with a steady motion, and then thoroughly clean your skin with soap and warm water.

Q: What is the difference between a shoulder separation and a dislocation?

A: Indeed, these two conditions are often confused with each other. Both injuries occur in the same area but involve different bones.

Most people refer to acromioclavicular joint separation (A/C separation) as a shoulder separation. The shoulder joint is made up of three bones – the shoulder blade (acromion and scapula), the collar bone (clavicle) and the arm bone (humerus) – that come together in place. A shoulder separation occurs when there is an injury to the joint between the collar bone and the shoulder blade. A shoulder dislocation involves the arm bone and the shoulder socket.

Both injuries are usually caused by a fall or from a direct blow to the shoulder. Anti-inflammatory treatments are used to reduce swelling and pain of a separation, and a sling or wrap is placed to immobilize the area. Physical therapy may be recommended and healing usually occurs after several weeks. Surgery may be necessary in severe cases.

For a shoulder dislocation, the ball-shaped top of the arm bone must be put back into the socket of the shoulder blade very soon after it occurs. This is best done at a hospital emergency department, under moderate sedation. A sling is used for immobilization while healing occurs and, again, surgery or physical therapy may be necessary.

Q: How do I know if I’m having a heat stroke?

A: Don’t ignore the warning signs of a heat stroke. It is the most serious of the heat-related illnesses. During a heat stroke your body temperature rises above 103 degrees rapidly but you are unable to sweat or cool down.

The main warning signs are red, hot and dry skin but no sweating, an extremely high body temperature, a rapid, strong pulse, a throbbing headache, dizziness, nausea, confusion and even unconsciousness.

If you are outdoors and think you’re having a heat stroke, get to a shady area and ask someone to call 911. If you are with someone who you suspect is having a heat stroke, guide them to a shady area and call 911 while someone else cools the person down with water from a hose, wet towel or sheet or shower. Make sure to fan the person vigorously. Do this until their body temperature drops below 101 degrees.

If medical personnel are delayed, call 911 for further instructions and get medical assistance as soon as possible. Heat stroke can be a life-threatening situation.

Q: Can listening to loud music cause hearing loss?

A: There is certainly a risk you could damage your hearing, especially if you listen to music for long periods of time with the volume at a high level. With the popularity of portable digital music devices, there is a growing concern about an increase in hearing loss.

Like portable cassette players before them, MP3 players and devices like them have headphones that put music directly into the ear canal. Unlike portable CD players, MP3 players allow large amounts of music to be loaded, meaning that users will sometimes listen for extended periods of time. Generally any noise above 90 decibels can damage the delicate hairs in the ear that transmit sound impulses to the brain. The louder the music, the shorter the time it will take for hearing loss to occur. For comparison, a lawn mower noise is about 80 to 85 decibels and most portable music players can easily top that


MP3 players are fun and useful devices but I urge caution both at the volume level and the length of time you listen. Also, be careful if you are walking, bicycling or driving a motorized vehicle while wearing headsets as this can limit your ability to hear approaching vehicles or dangers.

Dr. Daniel Knight, M.D., is chairman of the Department of Family and Preventive Medicine in the College of Medicine at the University of Arkansas for Medical Sciences. E-mail your health questions to housecall@uams.edu.