A little well-being goes a long way

…Today HA got a “Time for Me” catalogue, supposedly “Dedicated to the Art of Well-Being.” The art? Isn’t it a “state”? Dorky usage aside, maybe some well-being wouldn’t hurt, so HA started leafing.

…Weight loss products, weird vegetation from Africa. Well, many Africans are skinny, but probably not from voluntarily dieting or scarfing nearby bushes. This reminds HA she is a queenly person.

…Miracle eye serum. Check: Wrinkled.

…Age spot remover. One, it never works, and two, it implies age spots. The only thing more unappealing is “liver” spots.

…Magnifying mirror. Omigod, those are horrible and have nothing to do with well-being, you sadists!

…Cellulite remover. Hey, most of it’s in the back. You can have well-being if you don’t peek.

…Thyroid stimulator. It IS glandular!

…Leg cramp pills. Ooo-something still to come.

…Personal amusement products. For facial massaging, of course.

…Maybe HA should get blackhead remover to go with that. Or pore reducer for those now yawning facial craters.

…Shampoo to make your hair curly. How about genetics to make your hair curly?

…Room freshener, nipple disguisers, supports to keep your pierced earrings from turning you into a Ubangi.

…Cream goggles for your time-ravaged eye sockets.

…"Support" bike shorts.

…Lip puffers.

…Well-being? HA was almost in tears. She never thought of herself as a flabbery, thin-lipped, pitted, cramped, wrinkled, dimpled, sexually underserved crone with a smelly house and deformed earlobes.

…Bring back the delusions of adequacy, thank you.

Women going bare

…Nearly one in five non-elderly women (meaning no Medicare) were uninsured in 2004.

…In Texas, make that 29 percent.

…Two-thirds of women have job-based coverage, but only 38% are insured through their own jobs.

…Lower income women are more likely to rely on Medicaid or be uninsured.

…Yet women need and use more health care services.

…Disconnect!

…For more info, contact Usha Ranji at the Kaiser Family Foundation, uranji@kff.org.

Smart cookie chips in on snacks

…HA’s dog won’t eat taco chips as the result of an encounter with a particularly aggressive lime chip as a puppy.

…But most snacks are OK with him! And with most other “people.”

…HA is not a cracker-eater, but when her kid gets some, well, they are sitting right there.

…Charles Stuart Platkin, MPH, writer of the syndicated “The Diet Detective” column (www.dietdetective.com) and author of four books on nutrition, says not all snacking is a no-no.

…While studies show that heavier people tend to snack more, healthy snacking is a way to keep hunger in check and blood sugar even.

…Cookies are about 100 to 150 cals an ounce. Calorie-wise an oatmeal cookie is about the same as a chocolate chipper.

…But Keebler Country Style Oatmeal is smaller than a Chips Ahoy Chunky Cocolate Chip, so is 60 cals versus 80 cals. The oatmeal fiber is also more filling, so you may be able to quit eating sooner.

…Are Animal Crackers and Graham Crackers healthy? Animal crackers have about 130 cals an ounce and grahams about 120. You do the math.

…Fig Newtons also are no health food at 55 cals each, Platkin notes.

…Low fat and low carb cookies? As high in cals as the rest!

…(This sucks.)

…So choose whole grain cookies. The whole grains have detectable nutrients and make you feel fuller.

…Maybe chips are OK. Ya think? Bagel chips and pita chips have 130 cals per ounce. Baked chips come in a little lower.

…Try a one-ounce bag of chips. Ripping open that second bag with a crazed gleam in your eye is social suicide.

…OK, what’s the bad news on Ritz Crackers? Sixteen cals apiece! Triscuits are 20 but are 100% whole grain.

…Whole grain. See a theme developing here?. Hairiness and small portions.

…At HA’s crib, we call the stuff in there “noobies.” Use it in a sentence? “Mom, this bread has noobies!”

…Yuuuum, noobies.

…Shut up, Homer.

Do you know the anti-jerk salute?

…When those online dating ads come on with people crooning about their first kiss, couldn’t you bang their goony heads together?

…HA is having a bad brain day.

…Studies show married people are healthier. This health consciousness must account for the new wrinkle on the dating sites—asking that the would-be mate have health insurance.

…The Pentagon has now gotten into the act, giving classes on how to pick the right spouse and not a “jerk.”

…56,000 military couples have come undone since the war in Afghanistan kicked off.

…People are also coming back with horrible injuries that take much understanding and TLC.

…Soldiers are urged to study F.A.C.E.S—meaning family background, attitudes, compatibility, experiences in the previous relatinships and skills they would bring to the marriage.

…Soldiers are asked not to let sex exceed commitment.

…The no-jerk salute is one hand on the heart, another at the brow…Use brain and heart.

…If only HA had known this sooner.

No-fear, no-memory dentistry

…They call it full sedation dentistry, which is pretty self-explanatory.

…HA feels about dentists the way her dog Spencer feels about the UPS man. They both become junkyard poodles.

…Writing about this in the East Valley Tribune here in Phoenix, Mike Gossie tells of a woman who would rather have a baby again than go to the dentist.

…Another had to be led into the office blindfolded (whether she got a last cigarette was not recorded).

…HA will go but demands so much novocaine her ears and hairline check out.

…She also has to cough and mumble when they ask when she last had her teeth cleaned. If she tells the truth, the dentists will grab a clipboard and the Mercedes dealership phone number and start working out a “treatment plan.”

…HA has had procedures that come out to $800 an hour. (See above for reason.)

…Now she has heard about this triazolam stuff that puts you to “sleep,” or at least makes you forget what happened. It lasts between two and four hours and is not cooked up in a mobile home or anything. Dentists have to be specially trained to use it (there can be respiratory surprises).

…The FDA says this is for people 19 and up only.

…The upside is that you can get a ton of work done at once and minimize blindfolded trips across the tarmac.

…Should you consider this? Talk to your dentist. If you have respiratory problems, you might want to talk to your regular doctor, too.

…Would HA go this route? She is not a fan of the hurt now-forget later plan, but others might well prefer to get away from it all and wake up when it’s over.

…Dentists do have pretty good parting gifts like flowers, toothbrushes and teeny bottles of mouthwash.

They don’t call it a “horse-pital” for nothing

…Comes today a story locally about a miniature horse who visits hospital patients.

…Man, those hospital patients have ALL the luck!

…Every time HA is confined in the “place,” she pines for her puppy. What fun is it to put your legs anyplace you want in the bed? And someone has to bite the nurse and HA may be too weak.

…Of course, dogs are the standard issue, not horsies. A controlled study recently showed that anxiety dropped 24 points for heart patients when the pooch showed up.

…The investigator said people’s stress hormones dropped 17% when visited by a person and a dog and only 2% when the person came alone.

…They probably were wondering about the dog. If it’s not here, is it sick or something?

…HA’s sister’s husband thought about smuggling their greyhound into the hospital, but couldn’t think of a good cover story. “That little mechanical rabbit ran in here”?

Ta-ta to breast cancer?

…HA saw “Inside Man” over the weekend (save your money). Many of the women in it were particularly well-endowed. Charmingly, the cops even identified people by cup size.

…American females, on the other hand, share the desire not to lose their lives or the outward symbols of their gender to breast cancer.

…In her book, Waking the Warrior Goddess: Dr. Christine Horner’s Program to Protect Against and Fight Breast Cancer, the activist/surgeon presents a 30-step program to safeguard breast health.

…She sees younger and younger women getting breast cancer. Studies also show that African-American women tend to get an aggressive form of the disease—and get it younger.

…Breast cancer has gone up 21% in the last four years!

…Our environment is toxic, many foods are covered with pesticides. Breast cancer is also genetic.

…Horner says many natural spices and herbs can help protect women. She lists green tea, turmeric, grape seed extract, garlic, flax seeds, CoQ10, soy, rosemary, miatake mushrooms, wakame, and mekabu seaweed, vitamin D, and many substances found in veggies.

…For instance, DIM found in cruciferous veggies (broccoli, cauliflower, the smelly ones), shuts off a key enzyme allowing cancer to grow, Horner says.

…Calcium-Glucarate in lettuce and oranges stops the liver from spitting out toxins.

…There is some evidence that maitake mushroom arrests the growth of tumors (though they can thin blood).

…Green tea, similarly, delivers a jolt of anti-inflammatories and has been shown to lower the likelihood of breast cancer.

…Turmeric improves the breakdown of toxins by the liver and does a laundry list of powerful things, such as stopping tumor cell grow and turning on the tumor suppression gene. Some say it also promotes weight loss.

…Like everything on this website, these comments should be checked out by your doctor or Google before pounding in the substances.

…Ya gotta drink something, though, so how about more iced green tea and less chemical-laced diet soda this summer?

…Horner also suggests laughing a lot. Maybe thinking of the look on a woman’s face if she downed all this stuff might bring a smile.

…For this reason, Dr. Horner has collaborated with Enzymatic Therapy to make a pill with a lot of this stuff in it. Check our http://www.protectivebreast.com/.

…Save your life or a loved one’s, make Spike Lee happy, and perk up American males everywhere—what a win-win-win.

The anti-drug detailers

…Ever sit in a doctor’s waiting room and see people in Navy blue suits (who never meet your eye) whip past the wretched sick people and go right in? Those are the drug salespeople. Sometimes they even bring lunch and shiny trinkets for the whole staff.

…Now some state governments are hiring ex-detailers to meet with doctors to persuade them to use older, more generic therapies that work comparably well.

..In a story in the WSJ, March 13, one such former drug company employee brought the word according to the state of Pennsylvania, using a Harvard program to push evidence-based therapies.

…As patents expire, perfectly good drugs are now cheaper. The detailers track the doctor’s prescribing practices through the pharmacies and usually push the expensive drugs. The “unsales pitches” are for the generics.

…Sometimes, the unsales woman from Pennsylvania said, she is aced out by drug detailers with their logo-spangled notepads and pens (not to mention food).

…Her counterattack: Some hoagies she had scored in downtown Philly.

…Yes, those docs are all about the health food.

What if you don't LIKE veggies?

…It’s a dirty little secret in HA’s family. We do not luuuuv the veggies.

…Even dietitians tell ya that some plants are bitter on purpose—to keep bugs off—and need a lot of dressing to become palatable. How do you think dressing even got started, much less butter, salt, and olive oil?

…We know veggies improve internal workings, prevent birth defects, keep teeth and bones strong, lower cholesterol, improve vision, and boost memory—not to mention walk the dog and take out the trash.

…But a big salad at our house leaves our jaws aching and intestinal memories that linger for days.

…OK, you don’t like the veggies and fruits you’ve tried. Great news--there are 400 kinds!

…HA once did a story in which she had to eat some weirdies like starfruit, horned melon (that’s him in the mugshot), and Ugli fruit. Let’s just say she earned her money that week.

…So how to get some of the darned things down? Slip a slice of something—tomato, fried eggplant, mushroom, or avocado—into every sandwich.

…When you have soup, even Campbell’s, throw in some frozen veggies. Or tomato puree.

…Dip bitter or weird-tasting veggies into good tasting dips. Have you noticed the produce department now has caramel and other dip mixes? Verrry interesting.

…Make smoothies.

…Drink veggie juice one day a week or more.

…Dredge fruit into yummy sauces for dessert.

…Twelve servings a day? HA highly doubts it—and she counts her lunch banana and any unsuspecting catsup that might come her way.

…Ideas, readers?

If Bird Flu went to school

…The Feds say it’s time for schools to plan for a possible outbreak of H5N1, that nasty Bird Flu.

…We don’t know if it’s coming…Some scientists weighed in last week in the New York Times say it is less likely to mutate to human-to-human form than some thought, but that to prepared for “something” was common sense.

…Who coordinates the closing of the schools? the Feds asked. Can kids keep up at home—and how? Who will feed kids who count on school meals?

…School buildings may have to become quarantine centers or be closed because too many people are too sick to come to work.

…Children 5 to 18 tend to be the biggest disease-spreaders. Schools may be closed just for that reason and kids sent home.

…For now, schools are working on getting kids in the habit of covering coughs and washing hands.

…And you thought Snow Days were bad. How about Deadly Virus Days? Some schools are setting up call centers or phone trees.

…For tips on preparing your home for a possible epidemic, see right to get The Bird Flu Preparedness Planner.

…The Centers for Disease Control also has a website describing possible social disruptions we could expect and how to prepare. Go to http://www.pandemicflu.org/.

…Brrr, a government website with “pandemic” in it. Freaky?

Squeamish? Oh, do read on

…Is disgust like what the Supreme Court said about pornography? You know it when you hurl?

…No, babies, disgust is quite a delicate deal. And it may underlie all food choices, appetites, and other aspects of health.

…Bunmi O. Olatunji, a grad student at the Univ of Arkansas, shows people pictures of maggots and open wounds for a living. He studies anxiety disorders, and in particular, the role of disgust in phobias and obsessive-compulsive disorder.

…Not all disgust triggers are the same. Disgust elicitors such as injections and blood draws are different from elicitors like rotting food and bugs.

…He has divided them into “core disgust” and “animal reminder disgust.”

…Core disgust is triggered by offensive things like body waste products and rotting foods. These may trigger OCD because of irrational fears of contamination.

…Animal reminder triggers remind us of our animal origins and include blood draws, dead bodies, wounds, hygiene factors, and inappropriate sexual acts.

…We need to know this why? Well, if phobic people are to be exposed to their source of their phobia, this is good to know.

…For one thing, animal reminder disgust is most likely to cause fainting. Remember that at your next bood draw. HA knows she will.

…Note to self: Do not to watch “Fear Factor” or handle maggots on the same day.

Help for stuttering

…People who stutter are not slow or developmentally disabled or whatever term is in these days.

…Repeating syllables or having difficulty getting certain words out usually starts around age 2-5. One out of 30 children suffers from this disorder.

…Start treating it early. It gets harder after age 6.

…The first step is a speech therapist. Your child’s school is required to provide help, too.

…Reduce the pressure to communicate. Instead of saying, “How did it go today?” Say, “You look happy.” If the child wants to elaborate, he or she can.

…If there are other kids in the family, have a “no interruptions” rule. Give each child time.

…Talk slowly and calmly yourself. Show the child how it’s done. Do not finish the child’s sentences.

…Many children outgrow this. But it should be treated to give the child more confidence and understanding and help him or her do better in school.

…And don’t get impatient. Half the people on cable cannot communicate clearly. And they don’t have a good reason.

…For more info, check out the Stuttering Foundation’s website at www.stuttersfa.org.

Are women falling out of love with the scalpel?

…According to Newsweek (Mar 27), the facelift is no longer among the Top Five on the plastic surgery hit parade.

…Personally, HA has been completely grossed out by forcing herself to watch show after show on cable showing screws being put in people’s skulls and flesh stretched up and wired to them.

…Not to mention the painful walletectomy that follows.

…More people are turning to Botox to paralyze wrinkle-producing nerves above the nose level and face spackle type stuff to fill in wrinkies in the nasal and lip area.

…But some are trying a third technique—beauty vitamins.

…Will Omega-3 and other substances keep you from wrinkling? Doctors are skeptical.

…Some intrepid gals from Shop Etc. mag started downing these concoctions, containing such “vitamins” as Ester-C Alpha Lipoic Collagen Support. One said about 30 days into a 60-day treatment, she saw less sagging in her chin area. Another said her nails looked shiny like she had buffed them A third’s hair started growing like mad—just in time for her wedding.

…”Where are you hiding your crows feet?” they said they asked a colleague (a question HA doubts was ever asked—anyplace on Earth!).

…Yet another mentioned the word “nausea.” That can’t be good.

…Yes, beauty comes from inside. But it may not come directly from pills you put inside.

…We also, some of us, avoid people who want to carve us up like a silly goose.

…As for sticking needles in your eyes, didn’t that used to have a negative connotation?

Food fads waning

…According to a story in USA Today in October 2004, carb-counting peaked two years ago, although some people still tend to eat some foods because they are billed as low carb or low glycemic index.

…Families serve fewer side dishes, due to their lack of time and interest in cooking.

…Crock Pot use is up (duh, the pot does the “work”).

…Yogurt is king.

…Eggs are also back. The nutritionists decided they are not causing higher cholesterol, a theory they tried out on us for decades.

…Breakfast is the least changing meal. Supper has the most variety.

…What happened to low carb? Bread happened. When people found out bread was a carb, ooops, not thrilled.

Yes, there's accounting for tastes

…At the University of Arkansas, an assistant professor of food science named Jean-Francois Meullenet is finding ways to translate taste from tongue to factory.

…Consumer panels of 1,500 individuals provide personal and consumption info to the scientists and about 60 are chosen for each outing. The questionnaires are so detailed the researchers were able to find 60 people who like to drink muscadine juice.

…The university has also added a professional tasting panel, which can define gradations of taste according to a detailed profile of flavor and texture.

…To test yogurt, for instance, the profs pick people who like yogurt, which cuts down on the yucks.

…Brands are masked, of course. Actually, that is not easy. They wanted to keep the yogurt in its tub because the unit might affect taste, but had to make a shielding box to go around it.

…Leave this to the professionals, please. They don’t think yum or yuck, but quantify, say, chalky, on a numerical scale.

…”Feel it on your back teeth,” advised one.

…What about “mouth coat,” the amount that remains after..er, spitting it out?

…Aftertaste…aroma…tenderness….chicken used to be cooked whole, which allowed muscle contractions after the killing to relax. If you chop it off the bone and cook it, those muscles may create toughness. The testers decided deboning 6 hrs after death made it tender enough.

…But on the processing line, some chicken got tenderer in 3 hours, some in 6. The researchers figured out a way to aim a puff of air at a filet and see how it fluffed out or rippled.

…HA is glad someone (else) out there is doing this work, but what do you think? Is this story a pretty decent diet plan?

Sneaky old grapefruit juice

…Docs have thought for a while that grapefruit juice was creating more than a pucker.

…It seems to make some drugs stronger or affect how they work.

…The key seems to be an enzyme called CYP-3A4, which metabolizes toxins or makes them be excreted quicker.

…Grapefruit juice apparently interferes with its ability to do that.

…Lipitor, Mevacor, and Zocor can become stronger when mixed with grapefruit juice and cause muscle disorders.

…Mixing it with Prozac can also cause problems.

…Yet, you can’t just swig the juice to up your dose of the drug—it’s not that reliable.

…The elderly seem to be most affected by the breakfast drink. Of course, older people seem to like grapefruit juice, too.

…Wouldn’t you know.

Timing is everything with allergies

…Time was, sickly and allergic people went to the desert to “take the air.” Now people in Phoenix are wheezing and carrying on with all the other locales. We can thank the people who wanted lawns and the trees they saw back east. Golf courses! It’s their fault.

…Even the little ones are affected, but out here they get allergy shots and can run out and play like normal youngsters. This is important because allergies can set off asthma in some kids.

…Yes, it’s the fault of the ‘rents. If both Mom and Dad suffer from allergies, as many as three out of four of their kids will, too.

…Pets can also set eyes to watering. Fifteen percent of Americans are allergic, 11 mill of those to cats. Even if you are not suffering now, you could develop an allergy at any time, experts say.

…Weirdly, studies show that babies and toddlers exposed to pets before age 2 usually do not have pet allergies later in life.

…Short course in minimizing the miz. Don’t let pets in the bedroom during the day or at night. Shut the door.

…Buy a HEPA filter.

…Remove carpets. Install wood or tile (or do what HA did—paint the concrete under the carpet. HA is not allergic, she just thought it looked bitchin’).

…Wash your hands after playing with the pet.

…Wash the pet a lot, too. If you are afraid of blood loss (that would be yours) from bathing your cat, here are towelettes for this purpose. Sadly, HA can report most cats have no use for those, either.

…Buy a hybrid pet. People swear labradoodles and peagles (or whatever they call pug/beagles) are great for allergic people. Not all allergists agree.

…Allergy shots are still the gold standard, although drops you put under your tongue are making their way from Europe.

…According to research from the National Jewish Medical and Research Center, allergies ebb and flow in sync with your Circadian rhythms.

…Chronopharmacology is a field governing how to match the taking of medicine to these cycles. Hay fever symptoms peak in early morning. Thus hay fever sufferers should take their medicine before going to bed.

…Asthma symptoms kick up around 4 a.m. Nearly three-quarters of asthmatics wake up at least once a week gasping. Inhaled steroids work best if taken the afternoon before, between, 3 and 5:30 p.m. Since most take several doses, research has not shown when to pace the others.

…Since the alternatives--not going outside, not smelling the roses in life, and especially stopping breathing-- are not attractive, it may be time to give some thought to your allergies and talk to the sawbones.

Are Scotch-drinkers part Monty Python and part Norman Mailer?

…Eric Felton, writing in the WSJ, March 18, recounts a jaunt to Edinburgh to check out the wacky inconsistency Scotch can have depending on where the barrel was stored.

…I can hear you thinking, “Finally! Something worthwhile on this thing!”

…The intrepid scribe (makes HA proud to be a journalist) went with some members of the Scotch Malt Whiskey Society (27,000 members worldwide) to savor some peaty elixir from various barrels.

…”The full-strength nose has smoky bonfires, harbour smells, dusty-musty bookshops, and Brasso” they wrote on one cask.

…Gosh, HA hates to be picky, but harbor smells? Doesn’t that cover a lot of…seagull leftovers and stuff smooshed between wet cobblestones?

…”Smoldering slag heaps with brown sauce from the fish-and-chips shop…”

…”Creosote and sheep dip”

…”Strong sweetness reminiscent of Bazooka Joe bubblegum—a floral combination of roses and carnations with the rubberiness of school erasers”

…”Bacon fat cooking in a tractor shed”

…If you are not actively retching, the Society can be reached at www.smwsa.com. Membership comes with a bottle of Scotch, sweat socks coated with Buffalo sauce optional.

First Class or with clot?

…Deep Vein Thrombosis. HA does not want it.

…Being a queenly person, she disdains the child carseats they call coach and will do (almost) anything to fly first class.

…Now comes the news that painful or fatal blood clots can also be caused by low pressure and low oxygen levels in the plane cabin, not just by jamming your legs into an aching wad for four hours.

…Researchers in Holland got to wondering if this clotting deal could occur just as often in someone squashed into a car or sitting in a movie theatre for long periods.

…Turns out something in the plane made it more likely.

…Women taking birth control pills may be at more risk of DVT.

…People should avoid taking sedatives and drinking too much, too, if they want to avoid these unpleasant surprises.

…It also helps to walk around if they’ll let you and do some stretches.

…Rats! People in first class can also get clots, because the darn things have a genetic component. Maybe the free drinks will cut the pain.

Many docs not with the program

…HA could barely drag herself jadedly to the computer to mock the latest news: All Americans are getting mediocre health care.

…This is supposed to be encouraging for African-Americans and women, who thought they were the only ones getting so-so attention. No! Good news! Everyone is!

…“Equal opportunity defects” was a term used to describe the findings of this study, reported in the New England Journal of Med on March 16. “Woefully mediocre…”

…Apparently some people somewhere have figured out the best recipes for care and treatment of most major problems, but the docs wing it on their own and don’t follow the program. Overall, patients got a little over half of the recommended tests, drugs, and treatments.

…(Sometimes, too, HA assumes patients research these approaches and don’t comply.)

…Blacks and Hispanics actually did better in getting evidence-based care than whites by a thin margin.

…It didn’t seem to matter if a person was rich or poor—the care was about the same.

…There’s a book out by John Lantos, MD, a pediatrics prof at the University of Chicago, called—provocatively—“Do We Still Need Doctors?”

…He says doctors could to a large degree be replaced by computers. “People who follow set rules do better than people who make case-by-case judgments,” he asserts.

…Where you need doctors, Lantos says, is where the cases are complicated and the medicines work the least well. This is where the “art” in the “art of medicine” comes in.

…So first let us fire all the doctors? Never happen, Lantos says. Computers can land planes, but we still have pilots.

..And seriously, be honest, wouldn’t you miss the tug of war in trying to keep a doctor in the room to talk to you when he or she is on to the next patient?

…And the waiting—hasn’t that taught you the serene patience of a Buddha and made you a better person?

…And how about the woman, inevitably named Debbie, who screws up your paperwork? She’s still entertaining, right? Would you have the heart to replace her with a computer?

Men and doctors--not so much

…Knight-Ridder reporter Doug Wourgal takes on the thorny issue of why men won’t go to the doctor.

…HA is not a man and feels the same way.

…One doctor said men see their body as being like a car. If there is nothing wrong, no need to go. A defect is a sign of weakness. (And your point is…?)

…The question is, how to get hubs to go get his blood pressure checked without elevating it with an argument.

…Suggestions: Say a checkup is reasonable and let the idea sink in. DO NOT say he’s a mess and needs to go. DO NOT threaten death and misery (he is already afraid of this and would prefer it be a surprise, Wourgal sez).

…Appeal to his love of family (don’t be insulted, but this one is slow-acting).

…Have a friend intervene. (Let me know how that turns out, willya?)

…Make an appointment and say if he won’t go, he has to cancel it (what is this guy, 5?).

…DO NOT offer to go with.

…But you knew that last, didn’t you, MOM!

…Anyone else have good ideas?

...P.S. HA was going to use her image of the doctor donning a rubber glove to illustrate this, but then said naw.

Feeling down--eat pharmafoods

…Food is cheaper and more widely available than medicine.

…No, not just Haagen Dazs!

…Connie Midey, writing in the Arizona Republic (Mar 14) talks about food and mood.

…Carbs raise the feel-good brain chemical serotonin. Zip! Self-medication with a Snickers.

…Ooops, make that a whole grain bagel. Sugar tends to give you a zotz, then drop you into the toilet.

…A nice piece of fish (Omega 3) and a salad rich in anti-oxidants can also gently raise mood.

…Studies also show that removing sugar and caffeine can perk you up.

…For HA, perked coffee perks her up. Don’t go by her.

…The key is to keep blood sugar levels level. Eat breakfast, don’t wait too long between meals, keep putting healthy fuels in.

…Who can be too depressed when a little snackie is waiting?

Mom and fetus duke it out

…Why is pregnancy such a struggle? Women die of it. Millions suffer injuries, infections or disabilities.

…According to the New York Times, David Haig, a biologist at Harvard, thinks the whole process could use some work.

…Mom and baby, he says, may be working against each other—competing.

…Evolution-wise, he says, the child that can get more resources than the parents want to give tends to live and reproduce.

…First thing, the fetus grows aggressive blood vessels to extract nutrients.

…Haig says 6% of women get high blood pressure (pre-eclampsia). Haig says the fetus may be injecting some substance to up the return of nutrients from the mother’s blood. Indeed a protein has been found in the blood of mothers with the condition—and this protein tends to keep the mother from repairing her vessels, thus her BP rises.

…Haig also explains the shutting down of genes from one parent over the genes of the other from an evolutionary standpoint. Depending on which genes are not expressed, the baby will be a weak feeder or timid about exploring new environments.

…In mouse brains, at least, the exploring new territory genes are the mother’s, not the father’s. In general, Haig says, the mother’s genes tend to benefit the group, the father’s the individual.

…That is what generated the hate mail. Hey, he says, we’re talking science here.

Medical system getting under your skin?

…According to Washington Post reporter Rob Stein (March 15), some docs are recommending people be “chipped” like dogs.

…Pretty soon, if these visionary-entrepreneurs have their way, the ED doc will be able to pass a wand over you and get the scoop.

…It’s called the VeriChip, and the manufacturer has zeroed in on the nation’s capital, equipping EDs to read the things.

…Doesn’t this sound a little “Minority Report”-ish? These devices are currently implanted in livestock and canines—but Grandma?

…The rice-grain sized doodad is implanted in the back of your arm and generates a 16-digit number the ED doc can tap into on a computer and get your records.

…Getting “chipped” costs about $200 bucks and involves a large-bore needle.

…Large-bore needle. HA is out.

…Oh, yes, and they can be scanned from a distance and people tracked with them, say critics.

...Let’s chip the nice folks at the NSA first.

Are we overtreating heart attacks?

…If your first heart attack does not result in that death thing, at very least it will result in a scary ER run, unsettling tests with tubes running into your groin, and pressure to have artery-reaming surgery or get stents or other devices.

…Don’t forget the $80,000 hospital bill.

…Yet, who is brave enough to say, “Hey, I feel better now, see ya.”

…Some doctors say some of these surgeries are “cosmetic,” making the arteries look nice inside but not addressing the heart disease within the arterial walls that caused the blockage.

…Statistics do not show bypasses or stents reducing the chances of another heart attack, these docs maintain.

…Most evidence does show taking a beta blocker and some form of blood thinner such as aspirin can help prevent another attack.

…Dartmouth economics prof Jonathan Skinner says the areas of the country that spent less on post-attack treatments had better outcomes. He attributes this to the areas being poorer and doctors more likely to ixnay the extra tests and prescribe the beta blocker and aspirin.

…Usually in those areas, specialists are not brought in, racking up extra bills for tests.

…The problem is, patients see this as, “Your money or your life?” They kinda want to choose their life.

…It’s all a gamble, but maybe not as obvious a one as we thought.

…Some physicians now talk about “medical bypasses,” combinations of diet and medication. Lowering cholesterol without joining our big national clinical test on statins is part of this lower tech approach.

…Ask your doctor. As should be abundantly clear, HA isn’t one.

When fun hurts--gadget injuries

…Cell phones, PDAs, joy sticks, Mary L. Mundrane-Zweiacher, a certified athletic trainer at Brown & Associates, a sports medicine center in Dover, Delaware, says kids spend as much as three hours daily on the computer.

…Hey, what about writers?

…A member of the National Athletic Trainers Association, she says for every hour of play, there should be a 10-15 minute rest.

…Hand, fingers or thumbs sore? Make that several hours!

…No matter what you are doing, rest your eyes every 15 minutes by looking away from the screen and blinking your eyes.

…Rest your hands after bursts of typing.

…Stand up every 30 to 60 minutes. Thus avoiding that Tin Man slink HA gets into when she sits too long.

…Keep your feet on the floor, upper arms close to your body.

…Make sure chair seat is not compressing the backs of your knees.

…Don’t forget cross-injuries. For instance, a baseball player who text-messages a lot can get trigger thumb and not be able to use a glove properly.

…OK, you read this. Now, are you going to do it? HA will try if you will.

Even with "hellth" insurance

…What the patoot is happening in Health Care Land? The pundits are gassing on about how cool it is to “own” our health care (meaning finding out costs in advance, comparison shopping, pitting docs against each other, etc., like we have time, and the doc will just send you to the hospital where he or she has privileges anyway).

…Deductibles are arbitrarily invoked. HA’s daughter had to go to the hospital for smoke inhalation. The EMTs insisted.

…Can we have the envelope, please? A whopping $736 bill for the ambulance…$12 cab ride and pair of rubber gloves.

…Deductible? Why has that never been invoked before, co-insurance, copays, yes. Oh, it says in the book—3 pages before discussion of ambulance services—that some “covered” items might be subject to a deductible. Oh, well gosh…got HA there. She wishes now she
carried the book with her at all times and had had it out there on the street with the EMTs crowding around.
Even then, though, it did not say the ambulance was subject to a deductible!

…And get this one! According to the WSJ (March 13), some health plans, notably United and Aetna, are setting up plans to pay docs and then suck the money out of their members’ checking accounts or garnishee their paychecks.

…Those docs and hospitals are getting theirs, babies!

…Of course, this is billed as a convenience for the member. Uh-HUH. Detractors say this does not give patients time to scrutinize bills. Like we could understand them if we did.

…In the last few days, there have been stories about the millions pharmacists chucked out to give sick people their medicine during the onset of that ridiculous drug plan. Now the government is stalling on payback.

…Also a story in HA’s local paper about a nearby hospital, which was so overloaded it closed its doors for a few hours in January, which was against state law. It also was scurrying around trying to find beds for people in Las Vegas (which is not exactly close to Phoenix). One woman’s son found her a bed in San Francisco. The air ambulance would like a check for $50,000, please.

…HA bets they would.

…This is getting to be war.

Girls going smart

…For reasons best not fully explored, the Journal of the American Medical Association surveyed girls to see how much they drank on Spring Break. Eighty-three percent answered “a lot,” and three-quarters said they had a lot of sex, too.

…They reported drinking underage, vomiting, blackouts, unprotected sex, sex with more than one partner, everything but sand under the thong. Gosh, to be young again!

…Women process alcohol differently than men, tut-tutted the researchers.

…Don’t forget those notorious opportunities to be “roofied,” raped, or disappear entirely and inadvertently star in your own series on cable news.

…Still, you need to live, girls. Enjoy yourself. When that little inner voice says, “Uh-oh,” listen. Stay with your GFs.

…Some schools are organizing productive trips, such as building Habitats for Humanity.

…To each her own.

Nexus of fashion, humor, and health

…For a “plus-esque” woman stuck in a little hut in the Arizona desert, HA is unduly interested in fashion. It’s a curse, really.

…5-pound copies of In Style, Harper’s Bazaar, and Allure warp every surface.

…Admittedly, a little of this is for comic relief. A black tulle skirt with a white wife beater and suspenders on top? HA imagines that ensemble sashaying out of Home Depot and the whole day seems to go better.

…Gazing at a $550 handbag is also good for a serotonin-producing guffaw.

…And what medical anomaly accounts for those 5-foot stalk legs on those women? Do you think it’s true that models live on cigs, cocaine, and wet Kleenex?

…Elastic figures prominently in HA’s wardrobe. Not comfy? Don’t wear it.

…HA’s fashion principle is: Put it on and SELL it. If you look good, you feel good…this even works if you just think you look good.

…HA also favors using her sister’s reject potions slathered over with Vaseline—and to prevent wrinkles, she recommends eating food so the fat is already there and doesn’t have to be transferred from your butt, which is costly and let’s face it, pretty uncool.

…Zsa Zsa (HA’s role model) once said, “At some point, dahling, a woman has to choose between her face and her ass.” Who is HA again—Health’s Ass? Or should that be, Ass Ass?

…ANY…WAY, in the March Harper’s Bazaar, some time-saving tips. For a fast manicure, paint on a coating of ridge filler (you do have ridge filler, I assume, ha ha). It looks like pale polish and it dries in 2 mins! Quick, cheap, and improvisey—HA’s top 3!

…To fake fuller lips, take an eyeshadow brush and sweep a taupe shadow onto the skin bordering the lips, stopping short of the corners. Then coat lips with a shiny gloss. HA is not sure on that one—wouldn’t you look like you had been kissing a coal miner?

…HA will share with you her own secret for making up crinkly old-lady eyelids—lipstick! Bronzy or lavender shades are like easy-to-apply cream shadow and moisturize all day without creasing.

…If your nails are yellow from products, massage in whitening toothpaste.

…OK, here is the kind of wacky fine-tuning these mags are known for. A trainer advises spurning dairy on a day you are wearing a tight outfit. “Dairy makes your stomach pouchy,” this guy sniffed. Oh, you’re looking a little bloated yourself! How to you like that, mister man?

…In a pinch, when you need to cover roots, use eyeshadow. Gold for blondes, brown to cover gray on darker heads. A little hairspray first helps it adhere. (HA gets a bad feeling about this one, please let her know how it goes.)

…For disobedient hair, a little Chapstick can smooth frizz. If you get desperate you can also use it on your lips.

…No, actually you can’t. No fashionista would use Chapstick. Oh, my dear, no.

When paper shredders attack

…Since 2000, the Consumer Product Safety Commish has received 50 horripifying accounts of kids or pets getting amputation or lacerations from paper shredders.

….Some people are swapping paranoia about ID theft for sliced up tots.

…Writing in the Washington Post, Caroline E. Mayer says often the kid injuries come when Mom and Dad let the youngster feed in the paper. In other words, when supervised!

…At least five dogs also had their tongues caught in the things.

…“It’s amazingly easy to injure yourself,” said one man.

…”The screams are hard to forget,” another man commented.

…”His fingers looked like ground meat,” said a woman of her son. The shredder had to be removed from her son’s hand in the ED with a tool used to break plaster casts.

…Still sales of shredders are booming. HA was just wondering the other day if there were companies who might shred cartons of old papers for her.

…Calling someone, now there’s an idea.

Going to the hos-SPA-tal

…HA once wrote about some docs who spent part of their week in a beauty shop spritzing in the botox.

…How about bringing the beauty salon to the hospital? Many hospitals are like Banner Desert Medical Center here in the Valley of the Sun—the spa comes with!

…These luxuriously equipped “resorts” are not just for cancer patients who need a fluff and buff, although the fussing often works better to lift spirits than a fistful of pills.

…Cancer patients do find more understanding of their situation in the hospital spas, though, they say.

…These places offer aromatherapy, reflexology (uptown foot massages), touching and smoothing. Some have the warmed stones, the mud baths, the whole niner.

…In fact, mainstream biggies like Memorial Sloan-Kettering and Beth Israel are well into Alternative Med Land, offering shamans and feng-shuied rooms.

…If HA ever relaxed, you would not have this site, and she would probably end up in intensive care all floppy and unattractive. The sacrifices she makes for you…

Worth a try for migraines?

…In September 2005, Health mag had a story on headaches.

…More than half of the 30 million Americans who suffer from the worst pain take over-the-counter remedies or tough it out on nothing.

…Some promising low-tech remedies (meaning no weird side efx) are at hand.

…Docs think people with migraines have low energy levels in their brains, leading to painful overreactions to light and sound.

…Riboflavin, a B vitamin, seems to help solve the prob. The recommended dose for a woman is 1 mg a day, but giant doses of 400 mg cut the frequency of migraines by 60% in one study. If you want to try it, give it a month. Check it out online first, of course, you know the drill.

…A lack of magnesium can also make the brain hypersensitive. Instead of 50 mg a day, study subjs took 800 mg a day, combining it with calcium to cut tummy upset.

…Butterbur is a European herb used to fight fever and inflammation. Some docs recommend an substance from its roots called petasites. Migraineurs who took 75 mg a day for 4 months, cut their number of migraines almost in half. More is not better—those who scarfed 50 mg a day had no improvement! This stuff can make you burp a lot, though.

…The anti-oxidant CoQ10 reduced migraine incidence by almost half in one study. The dose was 300 mg day for two months. This stuff is spendy, though!

…Botox is also being used to shoot up the scalp and block nerve signals from migraines. Oops. It’s a thou per treatment!

…Acupuncture is cheaper and has helped many migraine sufferers alongside their over-the-counter stuff.

…One caveat. Do not try all of the above at once. That would be like eating everything in the health food store. Sounds like a good idea, but is actually, what is the word—incredibly stupid! Naturally, the usual advice applies: Ask your doctor if you can get ahold of him or her.

Ambien…wha, where am I?

…Stephanie Saul, writing in the New York Times (March 8), says we need to get the Ambien-impaired off the roads.

..Some drivers pulled over were “sleep driving” and last remembered being tucked in at home.

…With 26.5 million prescriptions a year being written for this stuff, arrests for driving under the influence of Ambien are on the rise.

…Yes, DUI.

…How about the little note that crept into the Ambien ads recently…something about loss of memory being avoidable if 7 to 8 hours are allowed for sleep after popping the pill?

…Now hallucinations are being mentioned.

…Uh, this can’t be good.

…Officers says the Ambien offenders seem different, too. They can be oblivious to the fact they are being arrested. “Extremely bizarre, extreme impairment,” one authority said.

…Some Ambien users said they apparently got up and drove someplace and didn’t remember it in the morning. In many cases, they started urinating without benefit of toilet, too.

…Obviously chasing the pill with a few belts is also bad. But not all of these cases involved mixing with alcohol. “You shouldn’t even drink a toast,” notes one lawyer.

…Some people even take the pill before they drive home—so they will be sleepy when they get there. Unfortunately, they get really, really sleepy before they get there.

…Then the peeing starts, apparently. And the lightpole and parked car hitting.

Kids? Got milk?

…Half of the kids in the U.S. don’t get enough calcium.

…By the teen years, it’s worse. Eight-five percent of girls and 60% of boys don’t have this important bone building block. What are their bones going to be made of? Cheetos?

…Children 4-8 should be getting 800 mgs, teens, 1300 mgs.

…Experts advise thinking of your kid’s body as a bank. You can keep depositing calcium until your child is 18. By then 90% of the skeleton is in place.

…From then on, bone starts to erode, leading to brittle oldsters and women with humped backs.

…But you don’t even have to wait. More kids are breaking bones now! Teeth and gums are unhealthier than ever! Rickets is even back due to a lack of Vitamin D.

…What can you do, Mom and Dad? Chuck the sodas and load up on skim milk or 1% or 2%.

…Offer cheese, yogurt, and green leafies. Hey, Popeye was cool—and he liked spinach!

Cough, splutter, snark, splah, go home already!

…This just out from the National Foundation for Infectious Diseases: Sick people don’t stay home from work, they prefer to spread the misery around.

…More than a third of workers feel pressured to drag their wracked bods into the office, 60% of them saying they worry that their work won’t get done (eyeroll). Almost half feel guilty (women more than men on that one, shocker).

…Another big motivator—no workee, no checkee. A fourth of those polled did not have sick leave.

….20% were concerned about getting the ax.

…You’ve heard of absenteeism? This insane desire to spread germs is described as “presenteeism.”

…When should you stay home? The NFID has a checklist of how to know if you’re poxy enough to ditch (see at right).

…Is this all some wimp alert? Maybe not. Thirty percent of those surveyed swore they got a bug from a coworker.

…That person should have been home giving it to his or her family. That’s how it’s supposed to be.

No habla

…Eleven million people don’t speak English well enough to tell a doctor symptoms, understand instructions, or read a medicine bottle.

…As a result, each year, 28,600 people die.

…These deaths are utterly preventable.

…The Language Access Network, Inc. (T-LAN) uses real-time video to click on an interpreter in one of 180 languages 24/7.

…Ohio State University Medical Center recently implemented the system. Doctors and nurses say the relief shows in the face of their patients. Someone who “gets” it!

…HA recently interviewed a health care worker who said a Native American she knew refused to get a chemo port because no one had explained to her clearly that it did not mean her throat was being cut. She left four little children behind.

…The company also has a voicemail delivery system and email called Lingo to Go, where patients ask questions or describe changes and doctors can comment and leave instructions. Each in his or her own language.

…Now if they could get the docs to stop speaking Latin, we’d be all set.

Picky eaters—‘cule or cure?

…HA freaks at the sight of blood on bread (au jus, to some).

…Her daughter cannot even say the word “pea” without shuddering.

…Yet her daughter will eat oysters and dissect hard-shell crabs while HA blanches on the sidelines. The spawn was scraping artichoke leaves with her shiny serrated teeth while still in the highchair.

…HA, however, knows a child who will not touch a mushroom because “mush” is in the name.

…The March 4th edition of the WSJ, had a story about picky eaters by Kathy McLaughlin. Apparently in toddlers, this fastidiousness was an adaptive mechanism to keep them from hoovering poison berries and leaves.

…Usually by adulthood, you either are or aren’t. Most adults don’t seek treatment. Sushi or carrots are off the menu, period.

…Lori Ernsperger (co-author of “Finicky Eaters”) advises letting kids participate in making the food. It may take 10-15 times before they take a bite of the offending morsel. Ten to 15 times? Who is eating all that eggplant?

…Other experts recommend working up to the target food in something called “food-chaining.” From chips, to oven-baked slices, to other veggies.

…Or you can just let your kid eat 5 or 10 foods for a lifetime. It could get a little embarrassing, though, for your grown offspring to be in Paris and ask if they have Kraft Dinner.

…If you are abroad, which can give whole new meaning to the term “mystery meat,” they advise you to stick with what you recognize, such as rice.

…Rice? HA’s kid can’t even say the word she hates it so much. She calls it the “R-food.”

...What sets off your ick factor?

Lose the hospital, get topnotch home care

…The AARP Bulletin for March outlines a forward-leaning program in three study centers that allows people with diseases, such as pneumonia or heart disease, to be treated at home—with better and more cost-effective results than hospitalization.

…Lead author Bruce Leff, MD, of Johns Hopkins, says such patients can get IVs, electrocardiograms, oxygen, x-rays, and other tests and treatments—all in their own homes.

…Every breath they take is not loaded with cooties.

…The Portland VA Medical Center, one of the study sites, is now offering such services to its patients.

…In one case, the ambulance pulled into the hospital, then turned around and brought the patient and a nurse back home.

Doctor vs. patient?

…Big no-no in direct marketing: Telling the customer all the things you won’t do.

…HA took her mother to the doctor and the place was plastered with signs saying that due to cuts in reimbursement from Medicare and insurance companies, the doctor would only discuss one ailment per visit. Patients should prepare to make more appointments for each problem.

…Getting a form filled out was another visit, the signs noted.

…What if we paid a couple of copays instead? Wouldn’t that save taking off work, arranging transportation, and disrupting life over and over to get our whole selves treated?

…Shouldn’t doctors be worried about our whole selves? Or is that a quaint notion now?

…What is the point of this? Aren’t we—doctor and patient—in this insurance nonsense together? We are paying more, getting less, and now are being told we are going to be “disciplined” for something that isn’t our fault.

Fat patients "too much work"

…Writing in the Wall Street Journal (Feb 28), Gautam Naik sez overweight patients’ demand for hip and knee replacements is growing—while the number of docs big-minded enough to take on the cases is shrinking.

…Yes, obviously, larger patients can have more trouble with breathing, going under anesthetic, having fat layers stitched together, etc.

…It takes time for joints to wear free of cartilage and scrape painfully, so many of these patients may also be older.

…But--because of their weight, these patients may need joint replacement more than thinner types.

…What to do, what to do.

…The docs interviewed, many of them, said they told patients to lose weight (hey, drop 50 and we’re in business). Don’t you think that if these patients could lose those amounts, they would have? And it’s even harder to do if you can hardly walk, much less exercise.

…HA knows a woman who has been put off her needed back surgery for years until she lost 35 pounds. She is hurting!

…One doc said if a thousand obese people went and sat on the White House steps maybe this would change. (Watch the turnip truck drive away.)

…Or here’s a better idea. These doctors are trained to take care of people. If they need special guidelines as are being proposed, then get them. Get more practice, too!

…The healthism implicit in this could also go: The attitude that you aren’t healthy, in our opinion, so whatever happens to you, well, whatever, you brought it on yourself. So sad, too bad.

…One doctor specializes in these surgeries. Yes, they take two hours instead of one. Yes, he gets the same reimbursement from the insurance company.

…He looks at the difficulties as a challenge. Not an excuse to send someone limping and grinding out of his office without much-needed care.

Strength-training for kids

…HA hated gym! Some youngsters can’t run laps or climb the dreaded rope.

…But now some specialists, say, these kids can train with weights.

…People used to think this was bad, but now that thinking is changing.

… The American Council on Exercise says there is no evidence to support the myths that weight training can stunt growth.

…Of course, kids need to be able to follow instructions, no horsing around, and do the exercises correctly.

…Check out Wayne Westcott’s video “Strength Training for Youth.” HA has interviewed Westcott many times. He’s solid.

…Kids also don’t need a lot of expensive equipment. Pulling against their own body weight in pushups and crunches can be effective home methods.

…Results? Replacing fat with muscle (which may weigh more, but burns calories faster even when the youngster is not active), strengthening bones, and resisting injury.

…Oh, and self-esteem. Finally! Something to be good at.

Poke people who sleep too much with a sharp stick

…Knight-Ridder reporter Linda H. Lamb tells us about people who sleep too much.

…What was the word we used to have for those people, something from the garden, oh, yes, slugs!

…Shawn Youngstedt, PhD, at the University of South Carolina says he found people who slumber more than eight hours a night (if you are awake, you know who you are), have a 50% greater chance of a stroke than those who slept less.

…A large Japanese study also showed the leisurely sleepers also had a greater chance of dying.

…Of course, their relaxed habits may be a result of an undiagnosed ailment, the docs allowed.

…Should the slugs try to get less sleep? The researchers said everyone asks them that. Well, HA wouldn’t want to be left out, so what about it?

…Lack of sleep is still a bigger problem, the docs said. Long sleepers may have a slightly smaller risk of breast cancer.

…Basically, the docs said, if you are bitching about only getting six hours and you feel fine, it may not be such a bad thing.

…You could just make it to the kitchen to grab a cup of java.

You break (your hip), you've bought it

…A friend’s mother was in the hospital with a broken hip and tried to get up--and fell and broke her other one.

…HA’s mother also has been known to take extra little steps and veer around a bit (getting twirly, we call it).

…These little tumbles are costing lives, livelihoods, and lucre, $20 billion in 2000, with hip fractures being the #1 Medicare expenditure.

…Falls aren’t an inevitable part of aging, though, the Center for the Advancement of Health reminds us.

…Jon Pynoos, PhD, codirector of the Fall Prevention Center of Excellence at the University of California, says part of the fault—and the cure—lies close to home.

…"Many people live in 'Peter Pan houses,'” he says, “houses where people never grow old.”

…We need more railings, grab bars, nonskid tile, room for wheelchairs to enter a room, turn around, and exit. And that is just the beginning.

…Phoenix builder Albert Ayala wrote the book on this. It’s called The Right Space (see right). He undertook this when he was thinking of moving his own Mom into his home and saw how complicated the regulations were—even for him and he is a licensed contractor.

…Other ways to prevent falls include better diet, even blood sugar, proper footwear (lose the stilettos, Gram), and regular exercise, including some for balance, such as tai chi.

…An eye exam and trip to the sawbones to check for Parkinson’s and other stuff wouldn’t hurt, either.

…And…could those prescriptions be duking it out and making your head spin?

…Incidentally, another doc says the answer is not to sit on the couch and hope for the best.

…Drat! HA thought that was working.

Sick and sooo far from home

…It happened to HA. Deathly ill with some unaesthetic crap in a hotel room in Madrid and no one on the desk spoke English apparently. “Doc-TOR, no, no.” Click.

…Finally the housekeeper decided HA was sick and summoned help in the form of a nice-looking, English-speaking physician, who gave her an injection and graciously accepted an American C-note. The prescription, delivered by the bellman, cost $2.50 American.

…Now HA carries travel health insurance from American Express. Ten bucks a month. Some regular policies will cover you abroad (Medicare, forget it, except maybe for some of the HMO plans). Check first.

…Some tips for preventing this problem? First, see what shots you need before you go.

….Check the state department website (http://www.travel.state.gov/) for lists of insurance providers and services that can fly you out if you have a problem. A U.S. consular officer can also help, according to State.

…If you have a pre-existing problem or take medications, try to locate a doctor in the area you will be staying before you leave..

…You can even store your medical records online.

…Keep your drugs in their prescription bottles. You don’t want to invite the sort of confusion that could land you in a Thai jail for 15 years.

…If you take over-the-counter meds, don’t count on their looking like the boxes you see at home. Mystifying! Perfume, headache remedy, laxative? Roll the dice.

…Of course, don’t drink tap water in places where this might confer a few more antibodies than a body could stand.

…Eat smart. This doesn’t mean whole grains. It means don’t grab dinner off an outdoor booth overhung with dead protein sources. Leave that stuff to hotdogs like Anthony Bourdain.

…Bring snacks. Those little peanut-butter crackers are lifesavers sometimes.

...Any other tips, readers?

Mona, Mona, tummy ache?

…At the University of Chicago Pritzker School of Medicine, med students hone their observational skills by contemplating pictures in an art museum.

…They stand in front of a picture and ask themselves questions about it. What time of day? Is that person laughing or crying?

…Maybe just coming to rest, focusing the mind, and lasering in on a given subject will make the student a better diagnostician.

…We can hope. At any rate, if your problem is sloppy brushwork your next doc will nail it.

Do-it-yourself Bird Flu nursing tips

…A thoughtful Georgia doctor has made a study of the 1918 Spanish flu pandemic, which pretty much whisked across the country in a month, leaving half a million people dead.

…Ten percent of those who got Spanish flu died. The Bird Flu takes down 50%.

…Gratton Woodson, MD, a primary care doc at the Druid Oaks Health Center in Decatur, Georgia, told HA if the H5N1 Bird Flu hits in human-to-human form, there will be no point in waiting for outside help…because there will be no “outside.”

…He bases his skeptical views on the government’s handling of Katrina. “One area of the country and they knew it was coming,” he notes in that “nuff said” kind of way.

…So, no government help.

…Now what? Hospitals? “We have one million hospital beds in this country,” he says. “The HHS’s Bird Flu plan says 10 million people would seek admission to the hospital in the 10 months to a year the Flu was spreading.”

…The ability of hospitals to deal with this is called “surge capacity.” HA remembers the feds found there was none when they were expecting a WMD attack.

…Sixty to 70% of health care workers may get it, anyway.

….Bum-up. This is starting to sound kinda bad.

….Woodson says our best hope is to care for people at home. Best hope, only hope, way it’s going to be if this thing mutates.

…In his book, The Bird Flu Preparedness Planner (see right), Woodson says households, families or even neighborhood block associations should be organized to deal with the sick at home.

…Dehydration is the big killer (40% of Bird Flu sufferers get diarrhea). He recommends laying in a large stock of water, salt, and sugar to make dehydrating fluids to spoon into the mouths of the sick.

…A quart of water mixed with a teaspoon of salt and 2-4 tablespoons of sugar for adults. A slightly different mixture works better for children.

…”Anyone who’s sick is going to be scared,” Woodson notes. For this and muscle aches, he recommends stocking up on Valium.

…A pneumonia shot might also be indicated. The normal flu shots many had do squat against the Birdie Bug. “Forget a Bird Flu vaccine,” Woodson adds.

…In his book he outlines other prescription drugs you might want to get for pain, nausea, and fever. A sort of bounceback after-infection is also common. For this, antibiotics should be on hand. Over-the-counter stuff like Tylenol, Benadryl and cough medicine might also be stockpiled.

….How about the so-called anti-virals, such as Tamiflu? “Every doctor I know has some,” Woodson says. Getting a prescription for yourself might be tricky. Same for hydrocodone, which Woodson recommends for wracked muscles.

…So who is taking care of whom? Two in five people will get sick, and half the people will show signs of having had a light case or fought it off. One in five will not get it at all. The latter two groups will take care of the others.

…Woodson says this may need to go beyond family. You may need to suck up to the neighbors now. “People nearby,” he says.

….“If Mom is taking care of Dad, and she gets it, she needs to know the neighbor will take care of her, Dad, the kids and feed the dog.”

…He hasn’t met HA’s neighbors.

…Oh, never mind. HA is just being a bird brain.