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By Matt McMillen
WebMD Health News

Reviewed by Hansa D. Bhargava, MD

May 21, 2015 -- Some call it "$5 Insanity."

Flakka, a new designer drug, is surging in popularity. Poison control centers in states including Florida, Alabama, Mississippi, and Texas are responding to an increasing number of incidents involving it.

Here's what you need to know:

What is flakka?

It's a man-made stimulant called an alphaPVP. It's similar to "bath salts," another dangerous drug that's grabbed headlines in recent years.

Its off-white, coarse crystals sell for as little as $5 a hit. The name comes from la flaca, a Spanish club-slang term for a sexy, skinny girl.

"It looks like aquarium gravel," says Alfred Aleguas, PharmD, managing director of the Florida Poison Information Center, Tampa.

How is it used?

People have tried taking it in a number of ways, says Jeffrey Bernstein, MD, medical director of the Florida Poison Information Center, Miami.

Those ways include:

SnortingMixing with foodDrinking like a teaPressing into pill formInserting it into the rectumVaping in an e-cigaretteInjecting

"With injecting, you're really asking for trouble, because the drug is likely to be cut with ... dirt, with talc, who knows what else -- and you're putting all that in your veins," Bernstein says.

How does it work on the brain?

Users feel a sense of euphoria, Bernstein says. "It plays with your neurotransmitters, [brain chemicals] like dopamine and serotonin."

That can lead to a state called excited or agitated delirium in a high that lasts for several hours.

What are the risks?

People who are high on flakka often lose touch with reality, Aleguas says.

"They don't know what they're doing, they're hallucinating, they're paranoid, they're aggressive, they're super-agitated," he says. "That's why you see news stories of people running down the street naked, banging on cars in traffic and just crazy, crazy stuff."

Other health effects that Aleguas and Bernstein often see include:

Rapid or irregular heartbeatHigher blood pressureSeizures

Another dangerous effect is hyperthermia, or elevated body temperature, which Bernstein says can reach 108 degrees. At that temperature, he says, blood can no longer clot and a person starts to bleed internally.

"They bleed and they go into multi-organ failure," he says. "Lung, liver, kidney, and brain injury can each occur when their temperature stays too high for too long."

In an emergency room, doctors attempt to cool the person, to calm them. They may also use diazepam, midazolam, or another similar drug to slow a user's heartbeat.

"We give them symptomatic and supportive care, try to keep them from hurting themselves and hospital staff," he says.

Who's using flakka?

Bernstein says most users are male and in their teens, 20s, or 30s, although some are older.

"I haven't seen any regular users," he says. "It tends to be used sporadically and is associated with concerts and parties and things like that."

And those users don't always know what they're getting, says Bernstein, who gets a call about flakka every day, and more on the weekends. About one-third of calls are from users looking for help, he says, while the others are from emergency personnel caring for users and looking for guidance.

"There's no quality control on the street, so no one knows for sure what they're taking," he says. "Just because they bought something called flakka, no one knows if that's really what they used, much less what kind of concentration you're getting. It's an unknown drug at an unknown dose, and any dose is abuse."

SOURCES: Alfred Aleguas, BS Pharm, PharmD, D.ABAT, managing director, Florida Poison Information Center, Tampa, FL. Jeffrey Bernstein, MD, medical director, Florida Poison Information Center, Miami.

©2015 WebMD, LLC. All Rights Reserved.

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How Long You Should Wait to Work Out After Getting a Wax, Pedi, and Other Beauty Services Don’t let exercise spoil your skin or hair. Shutterstock

If you’re like most women, you probably keep a regular schedule of beauty appointments—and you’d never miss your monthly bikini wax, right? But when it comes to exercising, some of your favorite workouts—namely the sweat, dirt, and bacteria that can come along with them—could actually interfere with your beauty routine. So follow this advice for exercising post-wax, blow-out, and more.

Laser Hair Removal
Unlike shaving and waxing, laser hair treatments guarantee longer-lasting results. But after a session, your hair follicles become open, making your skin more susceptible to infection caused by dirt, sweat, and bacteria, says Adriana Martino, laser medical aesthetician and cofounder of Skinney Medspa in New York City. “I tell my clients to wait at least 24 hours before working out,” she says. "Although nothing usually happens after receiving such treatments, it’s best to give your skin a rest and keep it free from friction and heat.”

RELATED: The Best Hair Removal Method for Your Sex Life

Shutterstock

Bikini Waxing
Especially popular during the summer months, bikini waxing ensures a hairless pubic line for up to five to six weeks. But after having your hair down there ripped out, you should definitely give your lady parts a break from physical activity, exercise or otherwise. “For bikini waxing, it’s best to wait at anywhere from 24 to 48 hours before you start working out” to avoid infection, says Holly Green, owner of Norabloom Botanicals & Beauty Lounge. Friction and sweat can irritate the skin, which is especially sensitive immediately after being waxed—and you’re more prone to bacteria getting in within the first 24 hours. “Brazilian treatments for example, can be hard on the skin, so it’s wise to give skin a break for a short period of time," says Green. "To help speed up the healing process, use cool stones, ice packs, and aloe gel, as they close up the open follicles and reduce swelling.”

Facials
These pricey treatments make your skin glow—but sweat caused by vigorous workouts can irritate your complexion. “After receiving a facial, it’s best to wait at least 24 hours before resuming your exercise routine,” says Green. “When you steam or receive extractions, it’s important to let the skin heal before working out.” Meanwhile, if you’ve had microdermabrasion or a peel, you should wait at least 48 hours before hitting the gym, says Green, since these types of treatments can cause superficial peeling due to the amount of exfoliation used, leaving you susceptible to irritation.

RELATED: 7 Skin-Care Secrets Aestheticians Swear By

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Blow-outs
You sat in the salon chair for an hour having your hair primped to perfection—and working up a major sweat too quickly afterward could leave your locks limp. “On the day of your blow-out, you might want to do light weights or low-intensity cardio,” says Jet Rhys, owner of Jet Rhys Salon in San Diego. “On the second day, you can do more intense workouts. To help preserve your blow-out, you can always wear super absorbent cotton headbands, as sweat is collected into the band and not your hair.” For a sweat-proof style, opt for a loose bun high off your face. “When working out, it’s important to keep your hair up,” says Rhys. “For a low-fuss style that volumizes your blow-out, simply pile the hair into a loose bun and secure with bobby bins. To avoid sweat from affecting your bun, make sure that your updo isn’t super tight.”

RELATED: How to Make Your Toes Look Less Gross (Pedicure Not Required)

Pedicures
Even the most basic of pedicures may require you to take a workout break since it can take quite a bit longer than you really think for your nails to dry completely, depending on the topcoat used. And all that moving around in your sneakers could cause smudges. “For a basic safety rule, I would wait for at least an hour before starting to work out again,” says Donna Perillo, owner of Sweet Lily Natural Nail Spa in New York City.

Why You Should Stop Wondering if the Pain Is Just in Your Head The mind-body connection is undeniable. Shutterstock

Sometimes, my clients come into my clinic and pretend they’re not in pain. A lot of times, those same clients have had a loved one (or even a doctor!) tell them, “Oh, your pain is just in your head.”  

But I have news for you: Every type of pain exists in your head. It just makes sense, if you really think about it. The brain is command central of the nervous system—so how else would we be able to register it? But that doesn’t mean that pain is fictional. Emotional pain, physical pain, intense pain, chronic pain—all pain, every pain—is real. And sometimes your brain has trouble telling the difference between a pain in your hand and a pain "in your head."

When it comes to pain, there is a major mind-body connection—and I see it at work in my clinic every day. Consider the following:

1. People who have rheumatoid arthritis or fibromyalgia are three times more likely to have been abused than people without those conditions.

2. Up to 80 percent of amputees still experience “phantom pain” in their missing limbs.

3. Taking painkillers (such as Tylenol or Advil) diminishes emotional pain, and taking anti-depressants reduces physical pain.

RELATED: This Common Over-the-Counter Drug Could Be Screwing With Your Happiness

Shutterstock

What’s more, a University of Colorado lab recently used fMRIs (a procedure using MRI technology to measure brain activity) to show that all humans have specific neurological pain “signatures” in the brain that are close to universal. Up until now, we’ve had no lab tests to prove we felt pain—our doctors just had to trust our subjective descriptions. (Hence, all that uncompassionate “it’s all in your head” nonsense you may have heard from others.) But their research also showed something even more empowering: We have another, separate brain connection that interprets our perception and sensation of that pain. In fact, researchers found that the people in the study could increase or decrease the activity of this system and, thereby, increase or decrease their perception of the pain. Pretty cool, right?

RELATED: The Awesome Effect Exercise Has on Your Pain Tolerance

While this research may be new, our neural hardware certainly isn’t. We may not have had fMRI studies to prove how the mind-body connection works with pain, but humans have been using an effective tool to tap into our innate pain-relieving system for millennia: meditation.

 A recent meta-analysis of 47 studies and more than 3,500 subjects in the Journal of the American Medical Association showed that meditation has been definitively proven to decrease pain. One Wake Forest University study found that just four 20-minute sessions of meditation training reduced pain intensity by 40 percent. (Compare that with morphine, which reduces pain by about 25 percent.) Another study found that nine mindfulness meditation classes reduced the severity of women’s IBS symptoms by 38 percent (versus 11 percent for those who just belonged to a support group). Long-term meditators enjoy even more pronounced pain-relieving powers, probably due to the increased gray matter and thickness of their cortex.

RELATED: 6 Benefits of Transcendental Meditation (and How You Can Get Started Today)

Even if your pain is “all in your head,” does that make it any less valid, any less worthy of finding relief? No. But armed with this knowledge, we can help equip ourselves to better manage our own pain.

--

Vicky Vlachonis, the author of The Body Doesn’t Lie, is a European osteopath and wellness consultant in private practice in Beverly Hills, integrating a variety of Eastern and Western treatment modalities to help her patients release their physical, emotional, and mental pain. 

5 Things You Should Never Do Before You Work Out Hitting up the Indian food buffet, for one Shutterstock

Craft a killer playlist. Get dressed in your workout best. Perform a light warm-up. You know what to do to get ready for an awesome workout. But there are some things you should never—and we mean never, ever—do before a workout. Like these five workout-wrecking mistakes:

1. Drink Just One Glass of Wine at Happy Hour
“Any amount of alcohol before working out is too much,” says certified strength and conditioning specialist Mike Donavanik. “Depending on the tolerance level one may have, it may affect some more than others—but either way, you’re looking at possible drowsiness, dehydration, narrowing of your blood vessels, impaired motor function, and a number of other side effects, which just aren’t conducive to working out.” What’s more, drinking even one glass of alcohol can lower your blood-sugar levels, which can lead to everything from shakiness and weakness to flat-out injury, says Georgie Fear, R.D., author of Lean Habits for Lifelong Weight Loss.

 

2. Chug More Than a Few Cups of Water
It’s an hour before your workout, and you just realized you’ve drunk shockingly little so far that day, so you down a bunch of water. We’ve all done it. But if you drink too much, it could backfire. Your kidneys can process close to a liter of water an hour, so if you drink more than that, you could put yourself at risk of a rare but serious condition called hyponatremia, in which the blood becomes diluted and the concentration of sodium ions drops too low, says Fear. Symptoms include a loss of energy, muscle weakness, and cramps, none of which make for a good workout. On the more dangerous end of things, it can cause seizures and coma.

Luckily, it’s unlikely that you’re going to down a two-liter bottle of water before your workout, but Donavanik recommends capping your intake even lower: at to two to three cups of water two to three hours before exercise—for your stomach’s sake. “If you have a stomach full of water and you’re doing intense exercise like sprints, jumps, and inversions, you feel that water moving around in your stomach—and it’s super unpleasant,” he says. “It can also cause you to cramp, feel nauseated, and possibly throw up.”

RELATED: 5 Ways You're Hydrating Wrong

3. Hit Up the Indian Food Buffet
“Eating a big, spicy meal is a no-no if you don't want reflux or heartburn during your workout,” says Fear. It doesn't sound pretty: “Combined with jostling around, a full stomach increases the risk of acidic stomach contents contacting and irritating the inside of the esophagus and giving you that familiar heartburn sensation,” she says. ​“Reflux can torpedo your workout by making it less comfortable to work at your full intensity, giving you a sour taste in your mouth or even causing you enough pain to pack it in early.” ​

Plus, even if you somehow sidestep heartburn (lucky you), you still may have cramping and reduced exercise function to deal with. “If you start to work out while your body is still digesting food, the body now has to also shunt blood into the muscles being worked,” says Donavanik. “So now you aren’t getting enough blood supply to your stomach to help properly digest your food, and you aren’t getting an adequate blood supply to your muscles.” If you’re planning an intense workout, avoid meat, eggs, corn, and anything else that’s hard for your stomach to break down within a couple hours of hitting the gym. Stick with lighter foods, like fruit and carbs, within a couple hours of your workout, he says. Bonus: Since they are easily digestible, your body will actually be able to use them to help you power your workout.

RELATED: The 9 Must-Know Rules of Carbo-Loading

4. Have Crazy, Wild Sex
“If two people are really going at it, sex can be detrimental pre-workout because you’re expending a lot of energy,"  says Donavanik. "Not just that, but during sex, oxytocin is released, which kind of mellows you out and gives you those feel-good vibes. So if you’re planning a hardcore bootcamp workout, skip the pre-workout sex.”

RELATED: Can Sex REALLY Count as a Workout?

5. Try to Touch Your Toes
Static stretching (think: bend and hold) before a workout is a no-go. “When you work out, your muscles need to contract as intensely and forcefully as possible,” says Donavanik. “So when you put them in a stretched state beforehand, you limit their ability to do their job efficiently. It’s like you're taking away their tools for success.” For instance, in one study published in the Journal of Strength and Conditioning Research, exercisers who static stretched before performing a squat reduced their strength by 8.36 percent and lower-body stability by 22.68 percent, compared to those who performed dynamic stretches before getting their squat on.

All gifs courtesy of giphy.com

11 Thrilling Things Every Active Woman Should Try to Do in Her Lifetime We made you a bucket list so you didn’t have to. Courtesy of Aspen Snowmass

In the May issue of Women's Health, we gave you 50 ideas for how to get a fresh perspective on fitness. But because you can never have enough excuses to get outside, we found 11 more items that belong on every active lady's bucket list.

1. Run a bridge. There's nothing like a run that literally lifts you off the ground. While they may seem cliché and obvious, Brooklyn Bridge and Golden Gate are two that should be on your to-run list. 

 A photo posted by @beckaaarea on May 17, 2015 at 6:06pm PDT

RELATED: 25 Gorgeous Hikes You Have to Do in Your Lifetime

2. Do a sun salutation on top of a mountain. Aspen Mountain in the Rockies is pretty much the most idyllic location possible for Hatha yoga (that's it in the main photo above). Classes are offered Mondays, Wednesdays, and Fridays at 10:30 a.m. from June to August (free with the purchase of a gondola foot passenger ticket).

3. Two words: trapeze school. Find them in New York, Washington, D.C., Boston, Los Angeles, and Chicago, and prepare to channel your inner circus performer.

4. Kayak the Maine Island Trail in Portland. The 375-mile waterway connects more than 200 islands, making it one of the best spots for kayaking on the East Coast.

RELATED: 4 Ways Race Junkies Can Take Their Addictions to the Next Level

5. Bet you didn't know you could go white water rafting through the Grand Canyon (it gives you a unique perspective of this natural wonder). Charlotte, North Carolina, home to the U.S. National Whitewater Center, is another perfect rafting option for adrenaline junkies (check out its intense rodeo rafting trips).

6. Hike through the canyons, waterfalls, and sandstone bluffs at Illinois’s hidden gem, Starved Rock State Park. Located on the south bank of the Illinois River, it's a scenic wonderland less than 100 miles from Chicago.

 

 

 

A photo posted by Starved Rock Lodge (@starvedrocklodge) on May 6, 2015 at 9:32am PDT

 

7. Take in a full moon. It's one of the best times to hike California's Mt. Shasta, a 14,179-foot-tall active volcano—or to participate in a yoga retreat at White Sands National Monument in New Mexico. 

RELATED: 5 Things You Need for Outdoor Workouts

8. Go dog sledding on a glacier with Alpine Air Alaska. The excursion comes complete with a helicopter ride onto Punch Bowl Glacier in the Chugach Mountains and a team of Huskies waiting to transport you through one of the most beautiful places on Earth.

 A photo posted by Alpine Air Alaska, Inc. (@alpineairalaska) on Jul 26, 2013 at 10:23am PDT

 

9. You don't have to go to a tropical destination to try your hand at SUP. Practice the water sport in an urban setting with Charles River Canoe & Kayak in Boston.

10. There's no better way to see the vineyard-laced Sonoma County than on horseback. Schedule a sunset ride to make the experience even more memorable.

11. Get up close and personal with various cave formations on a two- or four-hour wild cave tour. What makes a cave "wild"? No handrails, paved paths, or lights—so there will defintiely be crawling and climbing involved. Georgia Girl Guides offer tours in Cloudland Canyon State Park and Pigeon Mountain Wildlife Management Area.

 Posted by Georgia Girl Guides on Monday, March 9, 2015

 

4 Things You Should Know About Cracking Your Knuckles …Including whether it really gives you arthritis. Shutterstock

If you’re a knuckle-cracker, you know how it goes: Sometimes you just don’t feel right until you pull, bend, or push your fingers until they pop and you’re flooded with satisfaction. On the other hand, if you’re not prone to cracking your knuckles, the urge might seem bizarre or even a little gross. Regardless of where you stand, you've no doubt been curious at one point or another about your (or your boyfriend's or your sister's) knuckling-cracking habit and how it's even possible. 

What Causes That Popping Sound?
For decades, scientists have been trying to figure out what goes on physically to elicit that signature popping noise. A recent study in PLOS ONE has cracked, so to speak, the code behind this weird bodily function, revealing that the sound happens as a result of an air bubble that forms when a joint is pulled apart. The process is technically called “tribonucleation,” or the quick separation of two surfaces followed by a cavity formation, say the researchers in the study.

PLOS ONE / University of Alberta

A team of University of Alberta researchers had a study participant place his fingers into a tubular finger trap one at a time. A cable attached to the finger’s tip then slowly pulled until a knuckle cracked. The cracks were caught on MRI video so researchers could investigate what was going on, and each happened in the space of one frame (a.k.a. in 310 milliseconds).

RELATED: How To Get Younger-Looking Hands

While research from 1971 suggested the popping sound was due to the collapse of pre-existing bubbles in joints’ synovial fluid, this finding confirms a 1947 study that found it’s actually the creation of bubbles in the synovial fluid that causes the noise. Think of synovial fluid as the lubricant that exists between two joints. It’s necessary for proper joint and bone movement and comfort.

In the video below of the action in progress, the joint separates, a dark bubble appears in the intervening fluid, and then everything settles back into place. Although the joint looks like it’s back to normal, it has to undergo a refractory period before it can crack again. “The fluid takes time to refill and create the same dynamics it had before," says Michael Suk, M.D., chairman of the department of orthopedic surgery at Geisinger Health System. "It’s like pouring oil through a very small hole in an hourglass—it takes time for it to fill up again."

RELATED: The Super-Common Habit That’s Hurting Your Nails

Why Do People Even Crack Their Knuckles in the First Place?
“There’s both a mental and physical component,” says Suk. “From a mental standpoint, it’s almost a nervous habit for some people, much like drumming their fingers or biting their nails. I think to some degree, there’s a feeling associated with doing it as a mental stress reliever.” Meanwhile, “from a physical standpoint, I think what this study shows is as you create space in the knuckle, you’re decompressing the joint," says Suk. "In many cases, that can result in greater fluid movement in the joint itself, so your finger feels less constrained.”

Are Some People Just Not Capable of Doing It?
Although it seems like some people can crack their knuckles without an issue and others can’t no matter what, that’s likely not the case. “If we understand joints to be what they are, everyone has the potential to crack their knuckles,” says Suk. “The difference is that some people have a lower threshold of pressure for separating them, but others require much more force to create the separation.” Don’t take that as license to apply a ton of pressure just to hear the pop, though. “There have been some reports that people can tear or stretch tendons based on how they crack their knuckles,” says Suk. “Some people pull, while others bend their fingers. Depending on how forcefully you do so, you can injure your hand.”

RELATED: Why You Can’t Stop Picking Your Skin (Or Hangnails, Or Pimples…)

Can Cracking Your Knuckles Really Cause Arthritis?
As for that rumor that you’re going to pay for your knuckle-cracking ways with arthritis, there’s not much truth to it, says Suk. “There’s no scientific merit to that,” he says. “A couple studies have looked at habitual knuckle-crackers and discovered there’s no difference in the quality or quantity of arthritis in their hands.” So even though it’s not the prettiest of habits, contrary to what your parents said when you were little, it likely won’t cause any long-term damage if you’re gentle.

Be aware, though: Although all joints share some common characteristics, they’re not all the same. “It’s probably hard to extrapolate from this study about the safety of cracking all joints across the board,” says Suk. You hear that, habitual back-crackers?

Gif courtesy of giphy.com