Meet Our Hosts on MASLD and MASH
Lance Stein, MD
An expert in treating MASLD and MASH, Stein is a transplant hepatologist. He's the medical director of Piedmont Healthcare's hepatology and liver transplant program. He's also a clinical assistant professor of medicine at Mercer University.
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Forbes
28 minutes ago
- Forbes
Lyme Disease Nearly Ended Justin Timberlake's Tour: What You Need To Know
Yesterday, pop star Justin Timberlake revealed he has been battling Lyme disease throughout his recent world tour, describing it as "relentlessly debilitating" and explaining how he experienced a "massive amount of nerve pain" and "crazy fatigue" while performing. His announcement puts a spotlight on a disease that the Centers for Disease Control and Prevention estimates to affect hundreds of thousands of Americans every year, making it the most common vector-borne illness in the United States. Despite its prevalence, many remain unaware of this potentially serious condition until it's too late. Understanding Lyme disease—its causes, symptoms, testing, and prevention—could make the difference between a quick recovery and years of chronic health problems. What Causes Lyme Disease? Lyme disease is caused by the bacteria Borrelia burgdorferi, which is transmitted to humans through the bite of infected Ixodes species ticks, also known as deer ticks. These ticks, often no larger than a sesame seed, pick up the bacteria when they feed on infected animals, such as mice or deer. When an infected tick later attaches to a human and feeds for at least 36-48 hours, it can transmit the bacteria into the bloodstream. The disease is most common in the northeastern, mid-Atlantic, and north-central United States, where these ticks thrive in wooded and grassy areas. Peak transmission occurs during warmer months when ticks are most active and people spend more time outdoors. Recognizing the Symptoms Lyme disease symptoms typically appear in stages, though not everyone experiences all phases. Early recognition and diagnosis is critical for effective treatment. Early Stage (3-30 days after bite): The hallmark sign of Lyme disease is erythema migrans, a distinctive "bull's-eye" rash that appears at the bite site in 70-80% of cases. This circular rash, often with a clear center, gradually expands outward and may have the characterstic bull's-eye appearance. However, the rash may be uncharacteristic and appear as a solid red patch. Other early symptoms may include a fever, chills, headache, fatigue, and muscle and joint pain. These flu-like symptoms are often dismissed, allowing the infection to progress. Later Stages (days to months later): If untreated, the bacteria can spread throughout the body, causing severe headaches, neck stiffness, facial palsy (loss of muscle tone on one side of the face), arthritis with severe joint pain and swelling, irregular heartbeat, and nerve pain. Late Stage (months to years later): If untreated, chronic symptoms can include severe arthritis and neurologic symptoms, such as numbness and tingling in hands and feet and problems with concentration and memory. Testing for Lyme Disease Diagnosing Lyme disease can be challenging because symptoms often mimic other infections. There's no single definitive test, and early-stage infections may not be detected by standard blood tests. The CDC recommends a two-step serologic testing process for Lyme disease to identify antibodies that have been produced in response to the infection. These antibodies may take 10-14 days to become detectable, which limits the ability to diagnose early infections. The most common diagnostic approach uses a two-step testing process: These tests detect the body's immune response to the infection, not the bacteria itself, which means they may remain positive for months or years after successful treatment. For this reason, doctors typically diagnose based on symptoms, potential tick exposure, and physical examination, using blood tests as supporting evidence. Molecular, or PCR-based tests are also available, but have limited sensitivity for diagnosing the infection. In early-stage disease with the characteristic rash, doctors often begin treatment immediately without waiting for test results, as early treatment is most effective. Prevention: Your Best Defense The good news is that Lyme disease is preventable with the use of proper precautions: Avoid tick habitats: When hiking, stay in the center of trails, avoid tall grass and brush, and choose open, sunny areas for outdoor activities, when possible. Dress appropriately: Wear long pants, a long-sleeved shirt, and closed shoes. Tuck your pants into socks and consider wearing light-colored clothing, which makes ticks easier to spot. Use repellents: Apply EPA-registered insect repellents containing DEET, picaridin, or permethrin. Treat clothing and gear with permethrin-containing products. Perform daily tick checks: Examine your entire body after outdoor activities, paying special attention to the underarms, in and around ears, belly button, behind knees, between legs, around the waist, and in your hair. Check your children and pets too. Remove ticks promptly: Use fine-tipped tweezers to grab the tick close to the skin and pull upward with steady pressure. Do not place anything hot, such as an extinguished match on the tick, as this may actually increase the chances of acquiring the infection. Clean the bite area with rubbing alcohol or soap and water. While Lyme disease can be serious if left untreated, early detection and appropriate antibiotic treatment typically lead to a complete recovery. Patients who are not diagnosed and treated early may experience prolonged symptoms, but after receiving the recommended treatment, persistent symptoms are not believed to be due to continued infection. Clinical trials of new vaccines are currently underway. By taking simple preventive measures and knowing what to watch for, you can enjoy the outdoors this summer while protecting yourself from this increasingly common disease.
Bloomberg
a day ago
- Bloomberg
Colombia's Petro Decrees State Control of Health Care
By President Gustavo Petro is seeking to push through his controversial health care plan by decree, bypassing lawmakers that have so far blocked his repeated attempts to expand state control over the system. The decree published by the health ministry practically eliminates the role of public and private-sector health insurers in favor of regional governments.
Yahoo
5 days ago
- Yahoo
I Was Told I Might Never Walk Again—so I Hiked a Volcano in Guatemala
I didn't let my lupus diagnosis stop me from hiking one of the highest peaks in Central America. It was Christmas morning when I blinked awake to the mechanical beeping of a heart monitor. At first, I thought I was dreaming. My heart thumped loudly in my chest. I tried to roll over and orient myself, but my limbs were numb, and everything around me was a blur of pale light and quiet panic. The voices outside my hospital room faded in and out until one finally broke through the fog. A man rushed in—the one who changed everything. His face said it before his words did. 'It's lupus,' he said. I didn't know what that meant. I only knew it wasn't good. I was 22 and had just been accepted to William & Mary, a top public university in the U.S. I had been the picture of health. A hiker. A wild-hearted, barefoot-loving soul who spent her weekends chasing sunrises and meaningful conversations. I had always been a thinker—someone who mapped out dreams and imagined every possible 'what if' scenario life could throw at me. But even with all that imagination, nothing prepared me for the moment I stepped out of bed one morning and collapsed into my new reality. Lupus is a chronic autoimmune disease. A body turned against itself. In a cruel twist of irony, after years of mentally picking myself apart, now my immune system was doing it for me—attacking perfectly healthy organs like they were intruders. It was a full-on war and I was losing. I was diagnosed with the worst class of it and told multiple times I might die. I almost did. The fatigue was relentless. The joint pain, unbearable. I received over nine blood transfusions just to keep me alive. The list of symptoms and restrictions, well, they were longer than my age. Tied with IVs to the hospital bed for more than a month, I remember the doctor rattling off day in and day out what I could no longer do: no more sun exposure, swimming, hugging friends, eating at restaurants, playing with animals, gardening, and walking in dirt. Even walking unassisted, they warned, might not be in the cards. I had a compromised immune system and was supposed to live in a sanitary bubble if I was to live at all. It was like someone had compiled a list of everything that made me me, then crossed it all out. I was a girl who ran and danced toward her dreams, tripping sometimes, but never stopping. Now, I was being told to sit still. But I've never been very good at doing what I'm told. And that's how I ended up 13,000 feet in the air, climbing Volcán Acatenango, one of Central America's highest peaks. The decision made no rational sense. Just months after being told I might never walk unassisted again, I was hiking into the sky on a path of volcanic ash and cloud-thin air. At the same time, it was one of the most logical decisions I ever made. Travel is so much more than movement and cool pictures in new places. It's how we reclaim pieces of ourselves. It's how we stretch beyond discomfort and fears and find out who other people are beyond our presumptions and who we are when no one else is around to define us. I started the hike alongside a group of strangers—fellow adventurers whose names and stories I didn't know, but whose silent grit matched mine. There was something exhilarating about trekking next to people who knew nothing of my diagnosis, only my determination. After our bus dropped us off at the beginning of the trail, my heart sank. From the start, it was a slow, burning, upward climb. I am so glad I had no idea what lay ahead because I might have turned around right then and there. We passed through five microclimates in a day—humid jungle, alpine forest, wind-swept ridges, dry volcanic fields, and a cloud-pierced summit. Each shift was like stepping into another world entirely. As we climbed, Acatenango's landscape shifted beneath our feet. The farmlands gave way to dense forests. The air thinned. My legs burned. My lungs ached. I slowed. And slowed again. I was often last in line, stopping frequently to rest, my legs almost crumbling under me. And yet, I was still moving. Stray dogs are abundant in the farmland, and a beautiful chocolate shepherd shared the journey with us. I soon realized what I hadn't shared with anyone, he probably knew. Out of the 20 of us, he stuck by my side, stopping when I paused and walking together with me when I began again. When we reached base camp at 12,000 feet, I was shaking. My body throbbed. The trail narrowed and a dark windy fog quickly set in. I was surprised when our guide said our camp was just ahead because I could see nothing, not even a glowing light. It was icy cold. Where was Fuego, the elusive pillar of angry fire? We had been told there would be accommodations at the top. I didn't know whether to laugh or cry when I saw a stack of used mattresses, box springs, and shared sleeping bags. There was nothing sanitary about it, but it felt more healing than the hospital bed. We sipped hot chocolate around a flicker of a flame. I had come to see lava and was shivering around fading coals. But our guide was confident and told us we should wake up at 4 a.m. if we wanted to hike the remainder of the way to see Fuego up close and active. I had plenty of experience staying awake through the night from my weeks in the hospital. I had no idea how I would pull myself out of bed this time. Luckily, I didn't even have to set an alarm. At 2 a.m, I awoke to cold, wet slobber. The puppy that walked with me had curled up on my pillow. Having shared the trek, he wanted to share the warmth, too. I was more than a little annoyed and sat straight up, trying to drag him off my corner of the mattress. I kicked open the wooden door of our makeshift hut to shove him out and came face-to-face with Fuego. In the deep mist of the night, I had no idea our camp was clinging to a slab of cliff right in front of the summit. The earth growled and Acatenango's fiery twin erupted in the distance. It was bright and brilliant and alive and somehow almost outdone by the thousands of shimmering stars framing it. The deep fog that had suffocated everything was peeled back like a curtain and I realized all the beauty that had been hiding underneath. We rose for the summit. The final push. The hardest part. What seemed so close was a full three hours away still. A pillar of lava burst into the sky, glowing against the dusk. Around me, others gasped. Many reached for their phones and cameras. I stood in stunned silence. I wanted this image and memory etched in my mind before I tainted it with a camera lens. The eruption lit up the sky again and again throughout the night and early morning. I had barely slept. It was pitch black, and we were pushing through heavy sand and ash now. Two steps forward, a half step back. Mounds of crumbling dirt rose on either side, forming a slithering trail as we dipped down into the ravine and steadily rose up the other side. There was a moment, somewhere above the clouds, when I paused and turned around. The mountain where we camped, Acatenango, towered behind me, massive and ancient. Beneath its surface were deep, dark scars—grooves cut through the rock by old lava flows, now overgrown with stubborn green. I stood there, breathless from exertion and awe, already dripping sweat. I realized something that made me pause: The looming walls of dirt both engulfing me and forming my own path were the same. From the fog of sickness and the sting of IV needles, I was now coursing through the hazy vein of the mountain. The same burning force that had once destroyed this path had also shaped it—created it, even. And now, I traced it. My own body, too, bore scars—seen and unseen. Pain had carved through me, but it had also made this journey possible. I wasn't walking despite my pain. I was walking with it and becoming something through it. I was, by every definition, weak. But I was so strong. I was breathing hard—nearly wheezing—as the icy wind whipped against my face. My legs were leaden. My fingers were stiff and swollen. I stopped more than I moved. But I wasn't alone. Step by step, I made it to the top. There—at 13,045 feet—the sun rose above the world in every color imaginable—and some not even the most creative mind could fathom. We stood in silence as clouds drifted below us and light spilled across the neighboring volcanic ridges—Agua Volcano to the left, Pacaya to the right. I was standing on Fuego in the shadow of Acatenango. Ironically, the name means 'Walled Place,' and here, I felt the walls placed around me come crumbling down. All I kept thinking was how everyone told me I couldn't—and how they weren't here to see this view. I reached my grimy, dirt-covered hand down to pet the dog in blatant defiance of my instructions not to be around or touch animals. I didn't ever want to descend. The way down was almost harder than the trail up. I was slipping, sliding, and tumbling, joy erupting inside me. Whether or not we realize it, we each travel every day—through grief, joy, and fire. We each have our own personal Fuegos and Acatenangos to face. Mine just happened to be a real one. When I returned from Guatemala, my lupus didn't vanish. But I proved that 'can't' is just a word. Acatenango didn't cure me, but it reminded me my journey didn't end in a hospital bed. It started there. It was Christmas morning when I blinked awake to the beeping of a heart monitor, my body a battlefield and my future a blur. But it was through the mist of the mountain where I really opened my eyes. They told me I'd never hike again. That I might never walk unassisted. That I would have to live a smaller life, if I lived at all. But they weren't there when the sky split open and fire danced across it. They didn't see me rise through ash and altitude, gasping and shaking, clinging to a mountain that had known its own share of eruptions. They didn't see the girl with IV scars, windburned cheeks, and dirt under her fingernails reach the summit with a dog by her side and a defiant heart in her chest. I didn't conquer the mountain—I bled into it. Walking on the wounds it once carried, I learned how to live with mine. And when Fuego erupted, lighting the sky like a pulse, I knew I would never be the same. Not because I reached the summit, but because I learned I could keep rising—even while breaking. Read the original article on Travel & Leisure Solve the daily Crossword
