Friday, April 30, 2010

Pamper yourself


For me, pampering is more than three hours of sleep in a row. Ad being able to get back to sleep. Ah, bliss.

But for the spa-minded sybarites (who I know must read this), Erica Sagon wrote about some low-rent (I mean, low cost) ways of doing your own Spa Day (AZ Republic, Apr 30, 2010).

If your bod is…er…not smooth, give it a smoothie. 2 cups full fat plain yogurt, ½ of a ripe avocado, 5 large strawberries (reminds me of a Mel Brooks line), 2 tablespoons of honey, and ripe banana. Blend this up and slather it all over yourself. And pray the doorbell doesn’t ring.

To make your hair shine, mix 1 tablespoon of apple juice and 2 tablespoons of lemon juice, leave on for a minute, rinse.

To exfoliate—rub off the flakes—use a fourth cup of sea salt, a fourth cup of brown sugar, a quarter cup of papaya puree (always on hand, I am sure), and 4 tablespoons of olive oil. Whisk and rub all over you, then rinse.

I also used to separate an egg and put the whites only on my face until it felt tight, then rinse. Most people have an egg--look next to your papaya section.

It did feel sort of good after.

Thursday, April 29, 2010

Age spots, I'll pass


Those dopey liver spots on your hands, chest, and face are not nice little marks of wisdom—they suck.

Rub a lemon? Nada. Those creams? Well, I have seen no difference.

Joshua Fox, MD, a NY dermatologist, says our friend Mr Sun produces these melanin-intensive dots. Along with them come other signs of sun damage—wrinkies, rough skin, little red veins, and thinner, weirder-looking skin. If you notice some new big old thing or something old changes, you should probably see a doc and make sure it’s not cancer. Otherwise, what can you do?

First, the lotions. Dr Fox says you probably won’t see much improvement (see?). Try them for weeks or months—they really have to soak in.

Prescription creams are much the same deal. Used regularly, they may produce a slight fading.

Q-switched lasers—now we’re talking. They vaporize or otherwise remove brown lesions.

Microdermabrasion is also effective—sand the babies off!

Cryosurgery uses extreme cold to “burn” the brown off.

Chemical peels also remove spots and as a bonus, boost collagen and strengthen skin.

Laser skin rejuvenation is the big gun. Zaps everything.

The best approach, though, is prevention. Wear sunscreen, even in winter.

Father Time is a punk. But you knew that.

Wednesday, April 28, 2010

Tips for getting more energy


So, here I am, see, at the desk, staring at the dead weeds in my yard, broke, a teeny glum, disaffected, how can I zip into action?

Dr Thom Lobe, founder and medical director of Beneveda Medical Center in Beverly Hills, has some ideas for sparking creativity and just generally being less of a slug on ‘ludes.

First, draw a picture upside down. We need to get the old right brain going (the left is being logical all the time).

Exercise and stretch in your chair. Arms overhead…anna one, anna two…out to the side…one, two. Twist your wrists.

Laugh reading that. Good exercise.

Every 1.5 to 2 hrs—do something different for 20 mins. Visualize yourself on a mini-vacation (I included a pix to start you off).

Eat a good breakfast—be sure to include protein. Then a healthy bite every so often—cheese, nuts, hardboiled egg.

Minimize caffeine.

OK, lost me there.

One anna two, one anna two….

Oh—speaking of a slug on ‘ludes…Did you see 60 Minutes? College kids take uppers! My gosh…I finally had a chance to say, “Adderall, is that what the kids are calling it these days”?

By the way, you don’t want to be doing that. A million reasons. Brain damage over time being a possibility.

Tuesday, April 27, 2010

Bedsharing with kids on the rise


Starting as a baby, my daughter often slept in bed with us, and then later, with me. It was cozy.

In many cultures, the family bunks together.

I saw some pseudo-medical show where a heavyset woman had rolled over on her infant and killed it. Somehow, with a dam of rolled-up flannel sheets around her, my daughter seemed safe from that. Probably the denial of a new mom.

The National Institute of Child Health and Human Development, the percentage of kids sleeping with parents has doubled since 1993—and is now almost 13%.

Some say it causes Sudden Infant Death Syndrome or SIDS. Others say the mother sleeps less deeply as does the baby and thus the baby does not slack off breathing.

If you do this, have a firm mattress, no water beds. No mushy duvets or banks of pillows.

The kid does not necessarily have to spend every night there. But if he or she creeps in, don’t freak out.

Monday, April 26, 2010

Engagement v compliance at the doc's office


I am at an impasse. I moved to AZ 14 yrs ago and have run into so many physicians I don’t respect and whom I fired or who fired me. I am down to one now, an eye doctor (am blind in my right eye due to another one of those and combination of events).

I also should probably have a cardiologist (atrial fib), but I have failed two huge therapies for that—or rather, they failed me!

So I don’t go to a cardio, because I know I won’t do what he or she says.

Jessie Gruman, head of the Health Behavior News Service, wrote the other day about the difference between “engagement” with your doctor and “compliance.”

With all us patients being more inquisitive, empowered, argumentative and maybe knowledgeable, too, just going to a doctor and getting a prescription does not mean we will comply.

A third of people, Jessie says, who get a script don’t fill it. Half of those who fill it, don’t take it as directed.

They are noncompliant, in other words.

Yet, people are more engaged than ever—they look up their ailments, they check side efx of meds, they check alternatives.

Yet, when many people say we should be more engaged with our care, they really mean compliant.

A lot of us are learning the difference.

Jessie has a new website you might like. Check out the Prepared Patient Forum.
http://www.preparedpatientforum.org/

Any thoughts on this, readers?

Friday, April 23, 2010

Stress--making us better moms and friends?


In any stressful situation—it does not have to be a sabertooth tiger bearing down on you—your brain quickly floods with stress hormones and decides whether to flee or fight.

If you are male.

UCLA did a study several years ago and apparently in women, the choice is “tend or befriend.”

The brain chems in women cause them to turn to their friends and children.

Friends also help women live longer (Nurses Study—Harvard). The more friends, the less likely to get sick.

Not having a close friend can be as big a risk factor for ailments as smoking or the (ever-popular) being fat.

So, my friends, present and future—I toast you!

Thursday, April 22, 2010

Eat from a good book--Vegetarian Slow Cooker


I am a bad cook. Well, not bad. A non-cook would be more accurate. But I can order out and I can heat up and nuke.

I also luuuv my crockpot. Throw Lipton’s Onion Soup mix, water and any meat in, click it, and forget it until it smells so good you get hungry.

So Judith Finlayson’s book, “The Vegetarian Slow Cooker: Over 200 delicious recipes” caught my eye.

Usually you think of veggies being overcooked and slow cookers are all about overcooking, but apparently “plant food” as Finlayson calls it can be cooked all day without anything bad happening. In fact, it can be good!

She points out that cooking times vary from cooker to cooker, so keep that in mind.

Some veggie matter—such as legumes--also requires some breaking down of fibers, so this is good.

She makes cheesecake in this thing, too (sans the Lipton’s, presumably).

She also browns veggies before putting them in…beginning the carmelization process.

Root veggies cook even slower than meat.

Some veggies—peppers, for instance—need to be added at the end or they get bitter.

Whole rather than ground spices do better.

Oh—there are tricks to this. You’ll have to get the book…and bon appetit!

Snarf!

Wednesday, April 21, 2010

Babies do so feel pain


Can any mother doubt it—when they get that first immunization—or even before? That shriek of outrage and pain?

Yet, during circumcision and for other so-called minor procedures, pain control has been minimized—perhaps due to really bad anesthesia techniques following World War II that often killed infants. The idea arose that baby’s pain recognition centers weren’t fully developed.

Someone even pricked some babies with pins and said some didn’t react.

Well, World War II was a long time ago.

In 1998, some physicians got together to take a new look at this. Turns out, babies feel pain pretty darn well!

The drug co AstraZeneca is at the forefront of checking into this—they market EMLA, (Eutetic Mixture of Local Analgesics), a local painkiller that can be used on babies for spinal taps and chest tubes. For circumcision, another technique can be used called a ring block, with a chaser of Tylenol.

Nurses now also offer a pacifier soaked in sugar water and doctors warn against doing too many painful things to babies at the same time—even in a hospital setting. Hugs and swaddling also help.

If babies experience a lot of pain as infants, there is speculation that it can affect how they grow and develop—and react to pain later.

This turns out to be true in rats anyway.

Tuesday, April 20, 2010

Is your little darling a "tomboy"?


A study done in Avon, England, a few years ago and published in Child Development, showed that female behavior at age three-and-a-half correlated to the levels of testosterone mothers had in their bloodstream during pregnancy.

Yes, that is the male hormone—both sexes have some of each.

In both rats and rhesus monkeys, female animals treated with testosterone during critical periods of prenatal life showed increased evidence of “male play” during early childhood.

Of course, “boy” play could also be linked to sibling behavior, the presence of a male in the home, and whether parents treat kids as little boys (trucks) and little girls (dolls).

Of course, being breezy, self-confident and active can be good—in a male or a female.

Maybe the falling out of trees thing will be less inviting to a parent, though.

Too late—it's fated.

Monday, April 19, 2010

Ways to save on health care


Jeff Wuorio, Good Housekeeping, Mar 2010, has some ideas about saving on health care.

You may be able to get vaccines for your kids cheaper than at the pediatrician (under your plan). Go to cdc.gov.vaccinbes/programs/vfc/parents.

Many grocery and drugstores also have cheaper vaccine shots for you, too! Ask at the pharmacy.

Under- or uninsured women can get free breast and cervical cancer screening by going to cdc.gov/cancer/nbccedp.

Dicker with your doctors. Ask for a price break. Before going in, check with the billing office to see if there is a discount for cash.

Ask the doctor for samples—I even go back and get more without even having an appt. Niceness may vary.

Buy drugs at internet sites (check with National Assn of Boards of Pharmacy…www.nabp.net first—95% of internet pharmacies may be bogus.

Check out the rebate program at Hamacher Resource Group in Milwaukee. www.caregiversmarketplace.com.

Join your own pharmacy’s discount program. Mine is way better than my Medicare drug plan!

For eyewear and exams, get out your AAA or AARP card.

For teeth, check out the local dental schools. We have done this!

Friday, April 16, 2010

Pets get spring allergies


Did your dog ever experience “reverse sneezing”? It happened once with my beloved Spencer (now gone on to the snack pile in the sky). Weird—like gasping. It goes away.

Anyhow, Scott Craven, Arizona Republic, Apr 13, 2010, says if your pet is itching, sneezing, lethargic—it could be pollen. Here in AZ, dogs are getting slammed.

The pollen gets in their fur and then into the skin.

The dog or cat may first start biting their footpads…My dog Jim has chewed a square of fur off above his ankle. Very neat—square corners.

If the skin gets raw, though, it can get infected. Even that MRSA! Or hot spots—I dare you to google those and look at the pix.

It’s genetic, just like with humans—some animals are susceptible, some less so.

Even indoor cats can get this—the pollen comes in through screen doors and windows.

An air filter can help.

You can sprinkle the insides of omega-three fish oil tablets on their food—that may help.

Medicated shampoos can soothe.

If you are going to give benadryl—ask the vet first! Dosing is very weird with dogs.

Thursday, April 15, 2010

When your heart attack$ you


Lack of insurance, or worry about cost even if you have it, can make you delay an average of six hours after heart attack symptoms appear.

Well, duh.

This is a study that appeared in the J of the Am Med Assn.

The researchers seemed surprised that even those with insurance worried about costs. Hello—are you new on this planet?

Forty-nine percent of uninsured patients and 45% of insured people with financial concerns delayed getting help for bad heart symptoms. Over a third of patients with no financial concerns and insurance also delayed.

Many’s the time—including this last for my adult kid with MRSA--we put off everything as long as possible because of cost. What about you?

Waiting this long, the docs pointed out, results in longer hospital stays when one does get there—or worse, mortuary visits.

Maybe these patients have heard about the barrage of separate bills you get from radiologists, the ER doc, everyone and his uncle if you cross the threshold of an ER. Some take your insurance, if you have it, some don’t, it’s horrible.

And worst of all, it’s all unknown—the bills start coming.

Will the Health Scary law make this better? It may make more people head for the ER, but it won’t make the system work better once they get there.

Wednesday, April 14, 2010

Dementia behind the wheel


Melissa Healy, LA Times, writes that the American Academy of Neurology has new guidelines on cognitive impairment and driving.

Hold the jokes—yes, everyone out there is impaired.

Seventy-six percent of recently diagnosed dementia sufferers still pass a driving test.

There is no test that measures risk.

Physicians should give the cognitive tests and also consider the driving record.

Also—does the patient avoid driving at night or on the freeway—this avoidance behavior can be a warning sign.

Patients should also ask caregivers about the person’s driving. (Caregivers do tend to downplay problems, the Academy said. Sure—they don’t want to have to take the person everywhere.)

Asking the person is not a good way to go. In one study, 94% of those with mild Alzheimers said they were good drivers, but less than half of this group could pass a test.

I was in the hairdresser once when an old couple came in. In the course of chatting with the husband, I learned he was almost blind. “She can’t think,” he chirped, “but she can drive, so I do the thinking and she does the driving.”

I shuddered.

Tuesday, April 13, 2010

Cheer up, Dads doing double duty is healthy


Our newspaper had about 100 stories about Father’s Day last year and now it's almost upon us again. Man, did they like Father’s Day.

However, Rick Montgomery, McClatchy Newspapers, is worried that working women will soon outnumber men.

It’s this darn recession. One guy was home with the new baby and bleating about being emasculated.

More than 4.2 million men have lost jobs nationwide since 2007. Keep this up and women will outpace men in the workplace—but not, of course, in salary, which is another reason we are all altered economically forever.

They even have a name for it—"man-cession."

Yes, some are glad to have more time with the kiddies, but it’s hard to have quality time when you are glugging underwater.

Only 30% of men said they would leave their jobs if their wives could pay the freight. This used to be almost half.

More men may want to transition into teaching and health care—meaning more education. Who is paying for that? Mom.

Some dads are becoming coaches to meet more dads and network.

Am I too snarky? Maybe I am. I always see dads getting bouquets for doing what moms do everyday. And a lot of Dads don’t do windows.

Around here, they don’t even do yardwork anymore.

We are supposed to feel bad because women will outnumber men in the workplace—hello, doing work as always, people!

Monday, April 12, 2010

Caring for all sides of the patient equation


You haven’t lived—I mean, died—until you have lain in a hospital bed with an empty IV peeping, peeping, peeping to be changed.

But that isn’t the half of it. Laura Landro writes in the WSJ, Mar 16, 2010, that despite the emphasis on medical errors causing deaths in hospitals, people are still succumbing to them at the same rate.

Anywhere between 44K and 98K people die from doctor or caregiver mistakes—it’s hard to pin down. Medication errors claim 1.3 million. Infection in hospitals—another
100K.

Some hospitals have adopted a Care of the Caregiver standard to help caregivers traumatized by making a mistake. This is supposed to be between a blame-free standard and an individual responsibility standard.

Yes, many hospital workers are overstressed, work too long hours, nothing seems to prevent this.

The worker in this story gave a laboring woman a spinal painkiller—in her IV—thinking it was penicillin. She had worked two shifts before a nap in the hospital.

She was so freaked out, she almost took her own life. She was also prosecuted but the charges were knocked down to a misdemeanor. Then she got a job in this group trying to help caregivers who mess up.

Seems pretty sad all around. I don’t know what the answer is, but I know I fear lying in a hospital bed with no one coming. Maybe I should be more afraid if they do come.

Good argument for having someone with you, I guess.

Friday, April 09, 2010

Messy house equals dis-ease?


Chaos=not great. I am not nasty-neat, but I do try to keep clutter down to a dull roar. Except the garage…

Everyone seems to have a junk room, a junk drawer, a solidly packed closet, someplace that could use some weeding.

Some? How about a flamethrower?

The feng shui-ers say clutter may even be impeding your clear thinking and job prospects.

Andrea Petersen and Jennifer Merritt wrote about this in the WSJ, Apr 8, 2010.

Well, not this—but clutter. (See? Bad mind.)

They said the first thing people do it run to the store for nice containers. Nice containers just make more clutter—container piles.

Laura Leist, president of the National Assn of Professional Organizers, says this is a mistake.

Purging—throwing away—is the answer.

Having a coach can help you discard. You can’t stand there vaguely holding each item and then put it down (my specialty). These folks charge $100 an hour, so make it snappy!

Certified Professional Organizers undergo more than a thousand hours of training and hands-on work. They also pass a written test.

They come to your house to check it out—then come back to do it. No pressure.

Clutter is just “delayed decision-making,” one counselor said.

My sort of rule is if you haven’t seen it or used it in years, you won’t even look for it, so heave it all out.

Thursday, April 08, 2010

You are never too old for ADHD


Oh, great. Well, I might have it—I have the attention span of a fruit fly these days.

Melinda Beck, WSJ, Apr 6, 2010, says attention deficit hyperactivity disorder—restlessness, impulsivity—thoughts flitting—can affect oldsters, too.

About 8% of kids may have it—and half outgrow it—so that leaves 4% of adults. Only a fourth of these people know it.

It can go along with depression, too—it’s hard to diagnose.

Some ADHD adults are charismatic and creative and can concentrate on a narrow range of activities—in other words, high functioning.

It’s a neurotransmitter problem, though, that can make life terrible for others. They screw up. They can’t keep it going. They can’t prioritize. They get in car accidents, lose things all the time.

Often they rose high in their profession, then their coping mechanisms stopped working.

There is medication and it’s—weirdly—a stimulant, which works differently in these people. The drugs can bring clarity, focus.

People with ADHD need to break tasks down into steps, manage time, keep organized.

Check out Children and Adults with Attention Deficit/Hyperactivity Disorder at
http://chadd.org. Or http://additiudemag.com (ADDtitude Magazine). To find a test to see if you may have this, go to http://ADDcenters.com.

Wednesday, April 07, 2010

Oh, doctor, we have to run a test on you


Doctors certified in the 1990s must pass a test every six to 10 years to keep their licenses.

Some, in 147 specialties, for the first time since leaving med school, must retest.

Older doctors were “grandfathered in” (strangely appropriate). Now they are being urged to retest voluntarily.

Studies show what doctors think they know is not really what they know and does match what they do.

One cardiologist said he is doing things that came along way after he went to med school.

Some docs already say the tests are not good. Others may retire.

I think this is good—when my dad was practicing, they had continuing medical ed. Are those luxury weekends hosted by drug companies all that passes for that now?

Tuesday, April 06, 2010

Gosh--joggers are pikers!


Jen Murphy writes about a guy named Ryan Kotula, WSJ, Mar 30, 2010.

He plays broomball—ice hockey in sneakers on ice, not skates. Or at least sort of.

He plays lots of it—year-round.

He competes in triathalons. Last year, he did seven.

He has a sports performance coach Mon, Wed, and Fri.

He runs pulling a parachute for resistance.

On in between days, he runs or goes for a 90-minute bike ride.

He eats five times a day, with breakfast his largest meal.

He asks, “If your house was on fire, would you run out as fast as you could at 5 am? So what’s stopping you from running out right now?”

Not sure I get that. But someone may want to take up broomball from reading this.

Monday, April 05, 2010

The NOT Red Bull--calming drinks


Laura Johannes, WSJ, Mar 30, 2010, talks about relaxation beverages.

There have been no clinical trials to speak of, but this stuff does contain ingredients known to calm.

There are a hundred kinds now, with names like Mint Chill, Dream Water, and Vacation in a Bottle.

Mary Jane’s soda (isn’t Mary Jane another calmer?) contains herbal or hormonal preparations, such as kava, which should be used cautiously in people with liver risks.

Dream water contains melatonin, a hormone that can make you sleepy. One company, the maker of Drank. was told by the FDA that this was not an approved additive.

Some drifty soda people say explicitly that their drink does not contain melatonin.

Why do you want to spend this much money to be this calm? Wouldn’t having the money in your pocket make you calmer?

Friday, April 02, 2010

MRSA -- you don't want this


Around Chandler AZ here, people tend to pick up the antibiotic-resistant staph called MRSA for short. This stubborn thing used to run through nursing homes or come from infected IVs or catheters, now it’s out in the community.

It is probably on your skin right now—will enough of it organize to cause you a problem? Who knows.

My otherwise healthy 28-year-old got a little pimple on her leg. Now it’s saucer-sized and filled with crumpled up gauze packing. They had to cut it open with a scalpel.

Antibiotics are great things. My grandfather would probably not died at 60 of pneumonia if they had had them. But they are not a cure all.

The bugs could be winning. MRSA can lead to organ shutdown, even death if it races all through the body.

Someone told me medical-grade honey called Manuka is effective. I am looking at studies.

So far, clindamycin has failed. We are back to an oldie—tetracycline. Others they may try: daptomycin, doxycycline, linezolid, monocycline, bactrim, and vancomycin. A new one called telavancin (Vibativ) has also come to my attention. Am checking into it.

Prevent, prevent, people. Don’t share athletic equipment, towels, or razors with people. Wash hands often. Avoid whirlpools and hot tubs.

You know what else bugs me—all these people you read about saying oh, they are a vegetarian, they exercise constantly, they are fit, they are this and that, so they don’t want to pay for someone else’s bad “lifestyle choices.”

Germs and bacteria are still among us—and this could happen to anyone! My daughter’s bad lifestyle choice was walking around being alive.

Thursday, April 01, 2010

Fretting over your pregnancy can stress the kid


Sue Shellenbarger, WSJ, Apr 1, 2010, says all pregnant mothers are told to “relax.”

But it isn’t the stress over traffic or work deadlines that causes low birth weight or maternal high blood pressure.

Pregnant-specific anxiety may be worse for you. But could sensing something is wrong with the baby actually cause the stress instead of the other way around?

So now—stop obsessing about obsessing. Isn’t that like trying not to think of an elephant?

Some docs send the preggos to groups to talk about their problems. They do the weight and BP checks individually, then let the mothers have at it. This approach is called by the name Centering Pregnancy.

Personally, I had a terrible experience at eight weeks’ gestation—I was a crime survivor. My daughter came shining through, though.

Maybe you can worry about worrying too much. I know I can.

Piece of cake for me.