Wednesday, December 31, 2014

Here are six baby things you can skip

Time was, all you needed to raise an infant was a crib, diapers, little onesies, and a kitchen sink for washing the tot.

No more! Now you "need" bouncies, swings, car seats that transform into heaven knows what, tricky slings, things that warm, things that cool...on and on.

Lisa Kaplan Gordon, creator of FrugalGarden.com, has some ideas on things you do NOT need to get your own or anyone else's kid.

WIPE WARMER. This one keeps store-bought butt wipes warm. A room temp wipe is not exactly torture.

BABY DETERGENT. If you are so worried about sensitive skin, get any detergent that says free and clear.

BASSINET. This is usable for about a month, then the little bruiser will outgrow it.

BABY FOOD PROCESSOR. If you want to make baby food, use your Cuisinart or any other blender lying around.

EXPENSIVE BEDDING.  Forget those bumpers, kids get tangled. Now they even say forget blankets. I used to get blanker sleepers--feety jams in a fuzzy material--no blanket needed.

BABY BATHTUB. You don't even want to bathe a baby more than 3x a week. The sink works fine. Some bathtubs even go in the big tub--and may encourage you to leave the baby a sec to answer the phone. This is bad.

I would add--those in the doorway bouncy things--at least my daughter hated it and scowled with rage when strapped in the thing--Mom, what the heck?

I did like the towel with the little hoodie in the corner for bath time--nice little thing for their sopping little heads.


Tuesday, December 30, 2014

Listen to Auntie Star--Binge drinking not great for you

You've heard the expression, "New Year's Eve is for amateurs"? Lots of people feel obliged to drink a lot of this one night--especially the younger ones with enough zip to go out and party.

Binge drinking is defined as enough to get you to the 0.08 blood alcohol illegal to drive. Four drinks for women, five for men, in two hours. One in six adults does this four times a month!

But, according to Loyola, binge drinking in young adults can interfere with the immune system.

In the study, published in ALCOHOL, a peer-reviewed journal, binge drinking increased the likelihood of falls, burns, gunshot wounds, car wrecks, and other traumas. One-third of trauma patients have alcohol in their systems.

And, if that were not enough, the alcohol impedes the ability of the body to heal from such injuries and fight off germs and viruses.

You can read the study protocol in the journal, but basically they gave volunteers vodka sufficient to equal binge drinking and studied changes in the immune system (blood tests).

Anyhow, I am sure you know this is probably true--too much of a good things can be a bad thing.

Happy New Year! (Please don't hate me for being an old scold.)

Monday, December 29, 2014

Mothers of allergic kids want more than food advice from dietitians

Shereen Lehman, Reuters, says mothers of kids with food allergies do want menu advice, but they also want hand-holding and encouragement in dealing with their offspring's issues.

Often this is a daily challenge--and in severe cases, the life of the child can be at stake. Pressure!

In a paper in the Annals of Allergy, Asthma and Immunology, Carina Venter, a dietitian and researcher at the Univ of Portsmouth, did some focus groups of mothers.

The mothers wanted more than elimination menus and food advice, including:

Ways to protect their kids and promote a normal lifestyle.

An advocate against health care providers and caregivers who were less sensitive to their kid's needs.

Help reading labels and shopping.

Role playing so the child knows how to respond if offered "bad" things.

I have heard a severely peanut-allergic child can almost die from touching a handrail a kid who had a PB&J for lunch had touched. The mother of that child needs support to feel vindicated for her caution or even what seems to be over-caution.

Wednesday, December 24, 2014

Exercising in the cold

My father jogged before the word was invented--he used to come back with icecicles hanging off him in winter, nose running as fast as his legs had.

The National Athletic Trainers' Association (NATA,org) has some tips on working out in the Hawk.

There is such a thing as "cold injuries." They come in three categories: (1) decreased core temps (hypothermia), (2) freezing of the extremities (frostbite), and (3) nonfreezing injuries of the extremities (chillblains, trench foot).

HYPOTHERMIA. Vigorous shivering, increased blood pressure, core body temp less than 98.6 F. Remove wet clothing and put on warm and dry clothing or blankets and put the person in a shelter. Provide warm, nonalcoholic fluids. Do not massage limbs--this can make frostbite worse if the person has it.

FROSTBITE. Swelling or mottled gray skin, tingling or burning. Wrap the area in warm clothing. If sensation or normal color does not return in a few minutes, immerse area in warm (not hot) water bath for 15-30 mins. So not massage or expose to direct heat such as a heating pad or fire.

CHILLBLAINS. Small red bumps, swelling, tenderness, itching and pain.  Remove wet clothing, wash and dry the area gently, elevate it, and cover with loose clothing or blankets. Do not disturb the blisters or massage or chafe the area.

TRENCH FOOT. This comes from cold, wet environments over 12 hours to 3-4 days. Burning, tingling, itching, blotches, swelling, blisters. Clean and dry the feet, apply warm packs or soak in warm water for five mins.  Put on dry socks.

Always wear layers of clothing in cold weather--be sure to allow evaporation.

Eat a well balanced diet and stay hydrated. Forget the booze.

I will be back with more next Monday--stay safe, warm, and merry, my dear readers.

Tuesday, December 23, 2014

Buddy, can you save a little kid?

I first learned of this effort from the University of Wisconsin magazine called On Wisconsin. Apparently a professor and his family set up a house, guarded by armed guards, to safeguard albino children, believed to be possessed of evil spirits.

Of course, this is condition is genetic, not spiritual.

But these kids are hunted and killed for their body parts. Like a rabbit's foot as a lucky charm...

The kids can never walk around unguarded--Congress even passed a law. But guarding them is the most effective way to get them to adulthood and to where they can fend for themselves.

The goals it to establish a campus in Tanzania for 200 kids--some with albinism and some with other handicaps.

Currently the professors' friend is caring for 35 kids in a house in Lamadi Village. She is turning kids away--which can be a death sentence.

They have the land and have broken ground on the campus. I am convinced this is not some hanky-wringing scam. Any little amount helps.

Go to http://savealbinochildren.org.


Monday, December 22, 2014

How would YOU frame your medical record?

This is a hot button issue with me. How I appear in writing--entombed forever, mistakes and all, in a paper file or database.

One hospital here pegged Mom as diabetic--this came up every time--she was not. They would not change it--they said we could put a minority opinion--but they would not take out something "a doctor" wrote. The doctor did not write this--some gal sat there in the ER and picked things from pulldown menus--I saw her do it, I was there. Mom was old, so hey, must be diabetic. Bam! Click!

Some office nurse once asked my sister how her COPD was--she never had that, not even a cough.

I am always being told "diabetics just get detached retinas"--I am not diabetic, either!

When I went to the ER with pneumonia (it turned out), they said maybe I had congestive heart failure--my own doc said I did not. But it's in there now. My insurance plan called--do you want to be in a special congestive heart failure management program. NO, I DO NOT.

Recently my sister was contacted by a company called INGAGE--they wanted her to fill out a long health questionnaire. She did it! Now I am sure this goes straight to the govt.

Would such an offer be a chance to start over and get all the mistakes (such as the COPD) out of the record? I don't know.

On the flip side--a recent study showed half of patients surveyed withheld sensitive info from their medical records (J of General Internal Med).

A hundred and five people were allowed to withhold certain info from certain providers. Sexually transmitted diseases, substance abuse, other mental health problems--were some of these. They could say which providers saw which.

They also allowed the providers to "break the glass" and get the info anyway.

So...what is the point?

Friday, December 19, 2014

Dunno--would you give these gifts?

Debbie Jansky, assistant nurse manager, Home Health Services, at Gottlieb Memorial Hospital, advises "assistive" gifts for the 133 million Americans with chronic conditions.

Some ideas she has:

Medication organizers--slots for pills for daily or weekly.

Pill cutters are good. I use my teeth--probably not such a hot idea.

Pill punch--gets into those hard plastic packaging shields.

ID bracelet or watch--gives important info, such as DIABETIC or ON BLOOD THINNERS.

Grabber--for long distance reaching.

Adjustable cane that folds down for pocket or purse.

Rollator--a luxurious (?) walker with a basket for shopping and a bench to sit on to rest.

And for the loo--hand held shower sprays, toilet seat benches, safety rails.

Most of these would freak me out--except a high toilet--those are great. I mean the whole toilet, not a thick seat perched on top.

Also--no scales. If you want to live.

You decide--would the person appreciate this or feel creaky and like a hot mess?

Thursday, December 18, 2014

Zen Sports to debut at Boca Bowl

Barbara Schmidt, author of The Practice, will coach both teams in the Boca Bowl on meditation and mindfulness. Apparently the Seattle Seahawks already tried this with some success.

Zen Sports is designed to eliminate negative stressors--which this is connecting to the recent spate of abuse cases.

Meditation, Schmidt says, is "magical" if combined with exercise. You can access a deep source of energy.

The Boca Raton Bowl will feature Marshall (12-1) and Northern Illinois (11-2).

So...we shall see....Ooooommmmmm.

For more info: http://www.peacefulmindpeacefullife.org.

I do wonder--if both teams do it, won't they cancel each other's unstressedness?




Wednesday, December 17, 2014

Oh, those spendy ultrasounds

Doctors love to order ultrasounds--they don't hurt, don't impart radiation, aren't noisy and cramped, don't require disgusting prep, and therefore people will do it (some people, read on) and they can charge some completely arbitrary and huge amount for a machine that is at the low end of cost for the hospital or office.

Elizabeth Rosenthal, NYT, Dec 15, 2014, wrote about a guy who had two echocardiograms--an ultrasound of the heart. One was at a community hospital, the other at a big-woo medical center in Boston. Weirdly, the Boston one, three times as long complete with cardiologist on call, was $1,400. The one in the little hospital was $5,500.

Whew. Crazy Time!

Testing is a profit center, the article stated. Boy howdy, do I agree.

I had an echo once in the doc's office--don't remember what the purported charge was--but it was no big deal. The guy in the story paid $80 on $500 (Medicare).

One doctor said the threshold for ordering an echocardiogram is for the patient to have a heart.

The guy also got the first echo because he was undergoing cataract surgery--that is not even advised--cataract surgery is not total anesthesia. He also had no heart symptoms and was given to long walks.

Another doc in the article said some docs think, I have paid for this machine, the patient is insured, might as well use it.

This is not to say that all ultrasounds are unnecessary--you have to bore in a little and see how dedicated the doctor is to this test. Certainly the ones of babies are exciting!

I was ordered to get an ultrasound of my kidneys recently--I had a cyst 20 yrs ago. When I called for the appt they asked my weight. I said why. They said their table had limits. I said what is the limit? They said 600 lbs. This irritated me so much--this has to be a routine question? I did not get it! Maybe I am endangering myself...but come on!

Tuesday, December 16, 2014

Are you sick of the "deadly" holiday stories?

Every year, I obligingly remind you that you will be lucky to live through the hols.

Now, we are told that not only is this the most wonderful time of the year, it's the busiest for the Suffolk County Colunteer Firefighters Burn Center at Stony Brook University Hospital in NY.

(By the way, when I wrote about not putting wet turkey into a deep fat fryer, someone said it was OK if you dried it first--I am skeptical.)

At Christmas and the concurrent holidays, cooking is a rich source of burns. People are not used to cooking so many dishes at once and for so many people. It can get crazy. People are crowded in the kitchen--you are trying to dump boiling water or sizzling fat...and...

---Keep wooden utensils, towels, and packaging away from the stove top.

--Again, deep fry turkeys outdoors and don't overfill the fryer. Be super careful lowering in the bird.

--Keep children from reaching up to the stove or counter tops. Turn pan handles inside.

--Large dishes are heavier than you are used to--be careful removing them from the oven.

Christmas trees--formerly live ones--crisp up fast. Check for freshness before buying--the needles should resist pulling. Do not place it near the fireplace.

Also do not burn wrappings in the fire place. Never leave candles unattended--this happened to us--the side caved in, wax flowed, and my daughter's room was totaled. No candles or incense EVER in our house now.

Keep kids away from fireplaces.

Good grief, I am getting depressed. Please be safe! I need all my readers.

Monday, December 15, 2014

Feeling blue--instead of red and green?

It's almost a cliche--happy holiday, sad feelings.

Erika Saunders, MD, interim chair of psychiatry at Penn State Hershey, says there are signs to watch for.

--The inability to enjoy things others like.

--Feelings of hopelessness.

                                                      --Changes in sleep or appetite.

If this interferes with social functions, urge the person to get help.

But expressing sadness at this time of year does not necessarily mean a depressive disorder!

We tend to think of those we lost at holiday time. That's because we often saw that person only at the holidays--or they were their most memorable then.

Money woes surface at the hols..people want to separate and start the year fresh..all these can lead to depression.

The amount of sunlight also enters in--seasonal affective disorder.

Of course, the doctor advises talk with a doctor. If you think this is beyond you, do that. One thing that is not so great is to overdo the eggnog and alcohol--the self-med route.

Friday, December 12, 2014

Holiday foods that trigger migraines

A post I did once on migraines attracted the most views and comments ever. In eight years! Apparently many people around the world suffer from these beastly headaches.

The American Migraine Foundation's chair David W. Dodick, MD, is trying to help sufferers avoid trigger foods during the holidays.

These tips can be found at: http://www.americanmigrainefoundation.org/resources-and-links/spotlight-on-tis-the-season/

--Eat regularly--missing meals is a more common trigger than any particular food.

--Avoid eating within a few hours of bedtime and drinking caffeinated beverages after early afternoon.

--Keep a diary and see if you can identify your triggers--foods followed by a migraine at least half the time after your eat them. Avoid those foods.

--Red wine is a major trigger for many people--so choose white or another bev. Drink in moderation, anyway--dehydration is a trigger.

--Limit intake of processed foods high in sugar, caffeine and carbonation.

If you don't know your triggers, Dodick recommends eliminating red wine, processed meats, nuts, chocolate, aged cheese, monosodium glutamate, and gluten-containing foodsto see if you can cut your attacks.

That pretty much takes care of the buffet--but you may have a pain free holiday.

Thursday, December 11, 2014

AMD eye vitamins may be hyped

Have you seen those TV commercials promoting vitamins for aging eyes?

Published in Ophthalmology, the journal of the American Academy of Ophthalmology, study looked at 11 supplements. Seven did not adhere to proven formulas--those validated by research--and 11 were found to have misleading claims.

Take Age Related Macular Degeneration. In 2001 there was a landmark study called AREDS showed that a specific formula of supplements containing high doses if antioxidants and zinc could slow the worsening of AMD in those with intermediate AMD and those with advanced AMD in one eye only.

In 2011, a followup study AREDS2 showed that the fomula was still effective if the beta carotene was replaced by lutein and zeaxanthin. (Beta carotene was suspected of increasing lung cancer risk in smokers.)

A study based a Yale and several other hospitals then looked at the commercial brands of supplements.

--Only four had equivalent doses of AREDS or AREDS2 ingredients.

--Another four had lower doses.

--Four products also had other ingredients and herbs that were not part of AREDS or AREDS2.

All 11 supplements also had promotional claims--such as "support," "protect," "promote."

The science is not there to support routine use of these products for AMD and cataracts. At best, these are for patients with specific stages of these disorders.

Aw, I know...If only there were magic pills.

Wednesday, December 10, 2014

How to deal with diaper rash

Dermatologist Lawrence F. Eichenfield, MD, chief of pediatric and adolescent  dermatology at the University of California San Diego, says the best way to prevent and treat diaper rash is to keep the baby as clean and dry as possible.

This means changing the tot as soon as possible--even if the diapers are only wet.

Be gentle--use wipes that are alcohol and fragrance-free. If the rash is severe, use a quirt bottle of water. Allow the area to air dry.

Apply a zinc oxide diaper cream if the skin is always red. Layer it on like frosting a cake.  Remove it only at the end of the day.

If you see blisters or pus, or the baby is screaming and hard to console, consult a doctor.

Babies wear diapers for three years or so--you need to develop a routine to keep the little rugrats comfy.

I figured I changed 5,000 diapers...You have to be in it for the distance.

Tuesday, December 09, 2014

Are you a worrywort? Go to bed!

I am--a worrywort. I fret, brood--and mostly in bed at night. I can lie awake for hours--and then the next night, sink into slumber so blissfully I see why other people look forward to bedtime.

Researchers at Binghamton University in NY, says people who sleep shorter periods and go to bed late at night are more overwhelmed with negative thoughts than those who keep more regular hours. Check out Cognitive Therapy and Research.

People who have negative thoughts worry too much about the future, delve too much into the past, and endure annoying thoughts. This can be typical of people suffering from generalized anxiety disorder, PTSD, and a load of other "disorders."

These scientists asked 100 young adults to complete questionnaires and two computerized tasks. They assessed how much they ruminated or obsessed. Then they figured out of the students were night or day people.

I guess if you sleep at night you won't be awake worrying at night. But isn't this kind of circular?

Monday, December 08, 2014

Taking care of older people between the settings

Home, assisted care, rehab, hospital, nursing home, hospice--Older people don't necessarily have a health problem, cure it and go back to "normal." Sometimes there are steps.

I wrote a chapter of a book on care between the venues--30 years ago--and apparently these problems still exist.

A team at Johns Hopkins is now looking at this issue. One big problem area is the new "pay for performance" standards under the health care law--if a patient has to return to the hospital in a certain period of time, the hospital has to eat the cost.

I know there are also issues with how long the patient has to be in the hospital to get rehab hospital or nursing home bills reimbursed under Medicare. Sometimes this means a long hospital stay for fiscal reasons.

The handoff can also be garbled. Most people have experienced this--cursory ER directions on what to do when you get home--sometimes older patients (actually any patients) don't know whether to take the prescribed meds in addition to their regular ones or substitute--often this is not clear.

Also patients may not know what home care is available--or what supplies to get and where.

This is the beginning of the list.

I say let's emphasize this more in health care planning. Delirium and confusion can affect older people from being an a hospital setting--especially intensive care. Figuring out what next is a challenge.

Once we took Mom back to assisted care and they gave another patient her pills. Dandy!

Friday, December 05, 2014

Uncle Wiggily redux

One of our favorite board games in the Wayback was Uncle Wiggily.

"The old Rabbit gentleman," as he was referred to often in Howard Garis's 1930ish books, suffered from the "rheumatiz," which I take to be arthritis. He walks with a candy-cane crutch and sometimes canes of the assistive sort..

As he wends his way to the doctor in the board game version, hapless children are directed by cards they draw to put him in the way of various villains--the Skillery Skallery Alligator, the Big Bad Pipsiswah, and the Wicked Skeezix, to name a few.

He is also aided by Nurse Jane Fuzzy Wuzzy and other "good" characters.

What if this were updated to present day?. Even if he could hobble to the doc, he might be late for his appointment and bumped. Or have to fill out a long, irrelevant form with his stiff paws.

What if his medicine was not "covered" by his health plan--no healing herbs for the old rabbit gentleman!

A knee replacement? Only if the Skillery Skallery Alligator were to nip him in the leg. And it would be a copay of 200 carrots.

And that kindly doctor? He would immediately send Uncle Wiggily to a specialist--more walking and limping--maybe a A Rabbit's Foot Specialist--uh-oh, ask questions, how lucky would that be?

And if Uncle Wiggily did not lug along enough carrots, then what? The Big Bad Pepsiswah Collection Agency would hunt down the poor rodent.

Even Nurse Jane could not save him!

Thursday, December 04, 2014

IUDs may affect rheumatoid arthritis risk

Women using IUDs (intrauterine devices) may be at increased risk for producing the antibodies that lead to rheumatoid arthritis (not the bone kind older people get).

RA is chronic, causes pain, swelling and limitation of motion in the joints.  Women get it three times as often as men. It can manifest in young people--child-bearing age.

Researchers in Colo, Neb, CA, NY, and Wash State looked at different forms of contraception. They looked for a substance called anti-CCP that can be found in blood prior to RA becoming evident.

They looked at 976 women with a first degree relative with RA. They checked for anti-CCP and asked about contraceptive use.

--Those currently using in IUD had significantly increased risk of anti-CCP positivity.

--Other studies showed a decreased risk from the pill.

--Pregnancy and breast-feeding did not seem to affect RA.

The scientists think IUDs may increase inflammation in the body and this leads to the autoimmune reaction of RA.

Something to consider anyway.

Wednesday, December 03, 2014

Baby steps diet

Notice I hardly ever write about "diets." By this I mean--the latest reducing brainstorm. In my very extensive experience, these don't last or don't work.

What if you had to make teeny changes only? David Zulberg, author of  THE 5 SKINNY HABITS, suggests:

Week 1. Replace on meal a day with a lighter meal--salad or cereal and milk, maybe eggs and toast.

Week 2. Replace your big meal with protein and veggies--you can have a glass of wine if you want.

Week 3. Eat your third meal as you normally would, proteins, grains. If you want seconds, veggies only.

Week 4. Ten minutes of cardio--3x a week.

Week 5. Replace snack with water, veggies, low-fat dairy or fruit.

He says this does not rule out food groups, teaches habit formation, and allows you to continue life with energy and well-being.

You decide. I just put this out there.

Tuesday, December 02, 2014

How to keep kids healthy this holiday season

You don't need to buy expensive gadgets to keep kids active and entertained, says Allie Matarasso, RD, clinical dietitian, Montefiore Medical Center, New York, NY.

In fact, the much vaunted exergaming equipment has been shown not to affect kids' weight.

Keep it old school. How about a scavenger hunt--hide clues in the house or outside.

Hula-hooping...ball with a balloon, indoor hopscotch (tape on the kitchen floor), dancing, Zumba moves, chores--all keep kids going (and tire them out).

Keep one eye on food consumption--involve kids in meal planning, serve soups at the start of every meal.

Little kids eat little meals. If they take too much, don't insist on plate cleaning.

Make hot chocolate with skim milk and cocoa powder--less sugar than those packets.

Keep nuts, dried fruit, and bars available--not candy or cookies. Save those for dessert.

Kids also get overstimmed during the holidays--keep consistent bed times.


Monday, December 01, 2014

Yipes--you could be allergic to your tree

You know me--I luv the good news! Not.

Doctors at AFC/Doctors Express urgent care are trying to tell us about "Christmas Tree Syndrome."

Respiratory illnesses peak around Christmas and trees don't help. You can be allergic to the pine resin (terpene) or various molds that develop around live trees.

Within 2 weeks of bringing a live tree into your home, mold counts rise.

The result can be asthma attacks, fatigue, sinus infections and more.

Some tips for live trees (which I have had):

--Wear gloves and long sleeves when bringing the tree in--the sap, you know.

--Spray off pollen before bringing in.

--Keep a live tree seven days or less.

Even artificial trees can cause allergies--wipe them off before putting them up. Ornaments, too.

Forget that spray-on snow.

We used to put on fiberglass "snow"--very bad for you. We are lucky to be alive.

I am being sarcastic--but still, trees can attack. Be careful.