Thursday, December 31, 2015

Today's lesson: How to open champagne

Happy New Year!
Ever heard the expression, "It's all fun and games until someone loses an eye?"

Writing in Berks.com, Dan Kelly says getting hit in the eye with a champagne cork is not a joke.

This could happen tonight, New Year's Eve--but of course, my readers are such party animals, it could happen anytime, so listen up.

The National Institutes of Health in DC said of more than 12,000 traumatic eye injuries, 20 percent are caused by champagne corks.

The carbonation in a 750-ml bottle is six times greater than pressure in a car tire.

The cork can fly at 55 miles per hour.

A direct hit can cause a scratched cornea (owie!), or even a detached retina or early onset glaucoma.

You could even get a traumatic cataract.

If struck, the eyeball changes in shape, rearranging all the vital parts.

OK. OK--I am quitting drinking!

How to do it without mishap:

--Chill the champagne to 45 degrees or less. Warmer and the corks may pop unexpectedly.

--Hold the cork down while unwrapping the wire cage.

--Hold the bottle at a 45 degree angle away from you or the guests.

--Place a towel over the top of the bottle and pull the cork slowly.

--Don't shake the bottle...well, you probably knew this.

If you do get hit in the eye, go to the ER or urgent care.

I lost sight in one eye from a badly repaired detached retina. It's nothing to celebrate, believe me.

Wednesday, December 30, 2015

Double trouble

According to a new report from the Centers for Disease Control, the birth of twins reached an all-time high in 2014--33.9 sets per 1,000 births. In 2013, it was 33.7.

Something in the water? Nah--more births to older women, who are more likely to have twins, and more couples using In Vitro Fertilization--which can result in multiples.

This makes it doubly important (like that one?) to get pre-natal care and take care of yourself if you are trying to get pregnant, meaning lots of dark greens for folic acid.

If you are not trying, well, you have been warned.

Tuesday, December 29, 2015

Chiropractic--what do you think?

I got a press release from the American Chiropractic Assn saying holiday shopping was an athletic event and one needed to prepare for it as such--and chiropractors could help.

It seemed like their advice was--overall--helpful for most of daily living. Scott Bautch, DC, was quoted as saying our bodies do no respond well to bursts of unusual activity.

His general advice was to eat right, drink plenty of water, stretch, exercise, and take time to slow down and reflect.

During activities, take breaks every 45 mins.

Wear shoes with plenty of cushioning.

Don't tote around huge heavy shoulder bags, How about a fanny pack or backpack?

If something hurts, apply ice.for 20 mins, then remove for a few hours.

I have never been to a chiropractor, but people I know go occasionally. My takeaway--and I could be wrong--is that they are encouraged to come frequently and over long periods of time.

To me, this means the relief or changes from the manipulation is not lasting or even accumulates to permanent change.

I could be wrong, as I said...what do you think?

Monday, December 28, 2015

When a medical catastrophe strikes

Last evening, I was watching a favorite show--Alaska: The Last Frontier--about the Kilcher family whose patriarch founded their homestead in Alaska many decades ago. Basically, it concerns the hunting and ingenious living of two older brothers and their spouses and several of their sons and theirs.

Suddenly, the wife of one son, Atz Lee, was crying and talking about a horrible call she had gotten. Her husband had fallen 40 feet off a cliff on a hike and was in intensive care. Turns out, he had broken 25 bones, all his ribs, his shoulder, his pelvis...He needed 4 surgeries to stabilize him and will be looking at a lot of rehab.

Will he be able to ever live in the faraway homestead of his own he had been building? Make the cattle drive each year, fish, hunt, and provide for his family? Apparently Azt Lee and Jane have a decent net worth and can weather this. Or I hope they do.

His wife Jane, whom viewers have come to know as a sort of free spirit, was "overwhelmed," she said from his bedside (in the show--he is now home).

How do you begin to cope? Each year, 2.1 million patients in the ER are sent to the ICU. A Loyola licensed clinical social worker named Kelly McElligott, who works at the Burn Center, has some tips:

At Loyola, she says, a team of not only doctors and nurses, but also physical therapists, dietitians, psychologists, chaplains and social workers stand at the ready. This would be true of most hospitals.

--Take care of yourself, she cautions relatives with a patient in intensive care. You don't need to be at the hospital 24/7--people there will care for your loved one. You need to be with friends, eat, sleep, and exercise some of the time.

--You need to pay attention to other family members, too. Life does not stop.

--Accept help from the community. Coming home to food and a clean house is a comfort.

--Ask a lot of questions. You won't know what to expect--but the professionals do.

--Use a notepad of laptop when talking to the pros.

--Share your experience, how you are feeling. This will reduce anxiety and increase confidence.

--Maybe join a support group.

"The transformations that can happen once the shock wears off are amazing," McElligott promises.

My heart goes out to Jane and to Atz Lee. And their kids.

And might I add that internet trolls have been plying their hateful ways hoping Atz Lee the worst...I often wonder about this Internet thing.

Thursday, December 24, 2015

Merry Christmas, ya'll

You know that Blitzen.
Couple of things--my presents to you.

--We are still a great country despite what "some people" say. Yes, our present govt is aloof, stealthily trying to "change" everything, and so on. But the people are still, by and large, open, generous, love their families, work hard or want to work hard, get satisfaction from a job well done, and just generally carry on in their communities, churches, clubs, gyms, everyplace.

---Sure, we are loud, like parades, support the troops, give to charities hand over fist, and are a mixed lot--not blending together so much as being tossed together like elements in a salad.

--It's OK if you don't get along with everyone in your family. People somehow get the idea that if a person is "family," you must love and respect them. Sometimes you don't. It's sad, may feel like a failure, but it is life.

--Friends are not always lifelong, either. Sometimes someone comes into your life for a specific time--it has a lifespan, this relationship.

--Even children. You have such high expectations, you project some of you onto them, but it does not always turn out--they are not always little mini-yous. They have their own destiny.

This sounds so dire, so downbeat--but also remember...

YES THERE IS A SANTA CLAUS, AND HE REALLY COVERS THE GLOBE IN ONE NIGHT, AND HE IS JOLLY DESPITE THE COLD, LABOR ISSUES WITH THE ELVES, RUDOLPH'S SINUS PROBLEMS, AND BLITZEN'S HATRED OF AUTHORITY.

When Santa says, "On Donner and Blitzen," that rascal stops dead. He's like that. A lot of Americans are, too.

Wednesday, December 23, 2015

Stupid hospital tricks

Marty Makary, MD, professor of surgery and health policy at the Johns Hopkins School of Medicine and author of "Unaccountable: What Hospitals Don't Tell You and How Transparency Can Revolutionize Health Care," says  hospitals are gaming the system, among other problems with our health care system.

How? They make their readmission numbers look good by putting patients who return with problems after a procedure in a special observation area instead of showing them as readmissions. A report from the Agency for Healtcare Research and Quality shows a reduction in complications--but it is because of the way hospitals "code" those ailments.

Sure, there have been improvements in health care--but this is not really tracked. Patients get a new heart, but this isn't followed once they go home--that sort of thing. Or we try to determine the success of knee surgery by readmission rates--not how the patient is walking in three months.

Only about 1% of medical care is tracked, according to Makary.

He also decries the medical culture--it's see something, DON'T say something.

He recommends doctor groups and others deciding on ways to measure outcomes.

Who would benefit? Maybe you!

Tuesday, December 22, 2015

What if an older relative is acting strangely

The holidays are a time of many generations gathering. Sometimes, an older family member may seem "changed," not his or her old self. This is especially noticeable because you may not have seen this person for a year.

If he or she does not remember everyone's name--including all those grandchildren--it does not necessarily mean they are demented. Misplacing a name comes to almost everyone as the decades roll on.

If the person suddenly starts disrobing in the living room--that may be another story.

Some signs it might be clinical dementia (not all dementias are Alzheimer's, by the way):

--Asking for the same info over and over and struggling to remember their own birthday.

--Not being able to follow a recipe--say putting in salt twice.

--Not being able to drive to the store--mystified about it...where is the store?

--Giving lots of money to people who call, telemarketers or charities.

--Poor hygiene.

--Suddenly fearful or suspicious.

My own mother had a dementia diagnosis--not Alzheimers. She could not remember something you told her five minutes before. She also lost a lot of inhibitions--and started swearing all the time (never when we were kids). She also gave $50,000 to a horrible cab driver who exploited her--bought him a car and a gun. We stopped it. She lived on like this for 18 years and died at 95.

It is horrible to deal with and worse to think about its happening to you. But it's life. Even at the holidays.


Monday, December 21, 2015

Ha ha--veggie diet may increase carbon emissions

Why does she hate the earth
so much?
With all the crunchy granola folks snooting around about their veggie and vegan ways, I laughed at a recent Wash Post story by Peter Whoriskey (Dec 18, 2015).

This anti-meat bias, of course, has found its way into the national Dietary Guidelines, which tout veggies, fruit, whole grains, legumes, nuts and seeds. T-bones, not so much.

A paper from Carnegie Mellon, though, found that the plant-based stuff takes a greater environmental toll than the typical American diet. Adopting the Guidelines would increase energy use by 38%, water by 10%, and greenhouse gas emissons by 6%.

Needless to say, the profs expected to find the opposite.

While beef eating may indeed have a bad environmental impact--the amount of grain to raise a steer plus their methane-loaded um...farts, well, it does impact the biosphere.

Of course, the crunchies leapt on this immediately...oh no! The impact of different foods varies widely...Lettuce generates three times the greenhouse gases as pork. so maybe all this is sort of ...relative.

But one figure stands out--40% or more of fruit goes to waste...only 33% of meat does. Does that count for anything?

Mercifully, kale was not mentioned.

I see this as like the hybrid car or electric car thing--they run on electricity, true--but electricity runs on coal and natural gas...

Everything is a tradeoff.

Friday, December 18, 2015

Make the most of your next doctor visit

I hate going to the doctor--there I said it! It means dipping my mind into "Sick World," feeling scared and vulnerable--or furious and irritated. I stretch out the visits as long as they will let me have my BP meds...But sooner or later, I go...

Will I have worse kidney numbers? What about those weird barnicles growing on my skin? I brought a list of four things--the rest I call "Live with Its" (LWIs).

As I peered at the list with my damaged vision (an LWI), the doctor leaned over and took the list to see how long it was. Yes, it's that kind of world now.

As I searched for a dermatologist to get referred to (those skin thingies), I read awful Yelp reviews--worst doctor ever, said I could only ask one question, indifferent, didn't care, would not do things insurance didn't cover, waited way more than an hour, staff mean, on and on,

Dawn Davis, MD, a Saint Louis University family care physician and professor of family and community medicine, says she tells patients to put everything in a brown paper bag. Prescriptions, over-the-counter, herbs, supplements--whether they came from that doctor or not.

If you are not taking something prescribed--bring this up, too.

She tries to prescribe the lowest cost drug, but if the cost seems, outlandish, call the doctor back.

If you are coming for a specific ache or symptom, think about it--when is it worse, does any activity make it worse. How long have you had it?

Doctors are not there to judge, she says. I say they do. But whatever--if you smoke or don't exercise, be honest.

---Have your paperwork done.

---Make a list of every doctor you've seen in the last year and why.

--Know your health history.

--Don't wait until the doctor stands to leave to bring up new concerns.

--Make sure you understand your action plan or next step.

Repeat it back to the doctor if you need to.  Then follow through.

Don't know if all this would help if the doc is "indifferent" or even hostile. But you can try it--might help.

Thursday, December 17, 2015

Recommended dietary guidelines--foreign edition

According to Julia Belluz, VOX, the Dept of Agriculture in the United States seems to never tire of tweaking the way Americans should eat. But does this obsession reach to other countries? Of course! Bureaucrats around the world love to sling the diet advice.

ITALY

Fruit, veggies and water are at the bottom of the pyramid (meaning eat lots). But biscotti (cookies), riso-pasta (rice and pasta) and salumi (cured meats) are food groups.

CANADA

Canada breaks it down as to what people should eat based on gender and age. BUT--foods like chocolate milk and pudding make it on the list of healthy choices.

JAPAN

This chart is upside down by our standards--the top is the foods people should eat the most of. Here we find grain-based items (rice, bread, noodles, pasta). Hey--don't we usually hear that Japanese people scarf the veggies?

BRAZIL AND SWEDEN

Brazil is impressive. They don't emphasize nutrients, calories or weight loss. They focus on meals and encourage people to cook at home and resist the seduction of Big Agriculture (special interests). They say things like do not substitute packages soups for freshly prepared dishes.

Sweden is even more trusting of its population. "People know perfectly well what they should eat," the Swedes say. "It's no secret vegetables are good for you and sugar isn't."

Bon apetit!

Wednesday, December 16, 2015

Ouchless snow shoveling

It's snowing in some places so here comes the usual story on how to shovel without ruining your back.

Snow is heavy--it looks light--but isn't.

Kaliq Chang, MD, of the Atlantic Spine Center, says the white stuff landed 28,000 people in the ER in 2014.

Back strain!

Some tips for avoiding:

--Warm up. Light stretching or calesthenics.

--Shovel, scrape, repeat. Don;'t let it pile up--during a storm, clear the snow periodically.

--Right equipment.  A bent-handled, ergonomically correct shovel takes stress off your back. Make sure the shovel fits your height and strength.

--No throwing. Do not toss the snow over your shoulder.

--Push, don't lift.. If you must lift, use your legs.

--Wear proper boots. You can also injure your back from falling. Boot up!

What if you do this wrong, and your back gets sore?

--Rest. A few days can do the trick. But inactivity can also make things worse.

--Ice or heat. Either can increase blood flow.

--Medication. Ibuprofen or naproxen can reduce inflammation. Be sure these don't interact with other meds.

--In extreme cases, steriod injections can be given into the muscles or minimally invasive spine surgery may be indicated.

My advice--Go slow on the latter--and get a kid to shovel for you. But you know how I am.

Tuesday, December 15, 2015

Christmas is about food--but don't eat any

Like a bowl full of jelly--right.
Yes--the holiday paradox. Foods are comfort and joy, traditional, delicious--but here come the nannies with their articles on how to not eat a lot at a buffet or how to make low-cal fruitcake.

Finger wagging all around.

I try to steer clear of the "diets" on this site--I have tried them all and regained. But I did see a story from Texas Tech on holiday food "myths."

Of course, it started with how the "it's only once a year" rationalization contributed to the obesity epidemic," blah blah.

They said people gain 1-2 pounds between T-Day and C-Day. And they don't lose it---which means 10-20 pounds over 10 years (is this a word problem?).

Myth: It's only once a year. Texas Tech nutritional science gurus say oh--but it isn't once a year anymore--we binge all the time. And at the holidays--this can be a month or more of bingeing.

Myth: Splurging on high-fat foods is always a bad idea. Wrong! It can be OK if you eat small portions. Pick a special treat and stick with that, they say. No seconds.

Myth: If the host puts the food away too soon, people will eat more of it. You can't eat what isn't there,.

Myth: The end of November is a good time to start a diet. Sure--want to fail, go ahead.

Myth: Liquid calories don't count. Oh, they count and they add up, our Texas gurus tell us. Have a favorite drink, then switch to water. Water, got it.

Myth: Skipping meals will allow for party time. Well, we know this one isn't true.

Myth: You can't have fun without gaining weight. They say potluck is fun--and bring a healthy dish like fruit salad. Make everything look beautiful--people will eat it.

They also said something about making unhealthy treats healthier--using low-fat dairy, whole wheat flour instead of white, reduced sugar--I sort of zoned out...

I suppose the no seconds thing could help. What about it, Santa, you eat millions of cookies.



Monday, December 14, 2015

Don't drench the tot in olive or sunflower oil

Not a salad.
Apparently many midwives recommend these two "natural" oils for new-born baby skin.

The incidence of eczema in babies has gone from 5% to 30% since the 1940s.

But new research at the University of Manchester (England) has found that these two oils may damage the barrier that prevents water loss and blocks allergens and infections.

Of course--they did a study. They looked at 115 infants--three groups--olive oil, sunflower, no oil.

At the end of 28 days, they looked at the lipid lamellae--the "mortar" holding skin cells together. The oil apparently left cracks in this, letting water out and infection in. Or at least it developed more slowly--resulting in eczema.

They did say sunflower oil can kill microbes, so for babies in underdeveloped areas, might be OK--but for healthy babies in Britain, best to avoid.

What about nice-smelling baby oil--the go-to of yore? Not tested.

Friday, December 11, 2015

Eating disorders can be a challenge this time of year

Food, food--everyplace... Cookies, cakes, roasts, plum pudding (whatever that is). This can trigger bulemic behavior (bingeing and purging),

Those with anorexia--refusing food or keeping it to the barest of minimums as a self-control mechanism--can also see their perfectionistic tendencies challenged.

The holidays are a time when people say, "Eat, eat," but also a time where people then switch to talking about weight. This according to Dr Martha Levine, director of the eating disorders programs at Penn State.

She suggests her patients seek out a supportive family member ahead of time who can divert the conversation when it turns to filling up the plate or offering seconds.

When food appears at unexpected times of the day:

--Go for a walk.

--Suggest a game everyone can play.

Emotions are like weather, Levine tells her patients--they pass.

As for guests--remember, saying things like "You look healthy" to a person with an eating disorder is like saying "You look fat." Try to concentrate on inner qualities--you are so peppy these days.

Remember also--saying nothing after the eating disorder has been known for a while, can also be a trigger.

Thursday, December 10, 2015

How about that altitude sickness?

Skiers and snowboarders are heading for the hills--and being felled by altitude sickness.

I had it once as a kid--in the Rockies. Bad, bad headache, nausea, dizziness,  Takes a day or two to go away.

Karen Schwartz, NYT, Dec 8, 2105, says many vacationers don't want to wait and lunge for the oxygen and other even less-proven remedies, such as oils, pills, and wristbands.

Actually this can be more than a vacation-killer--32 people have died in Colorado from the effects of high elevation. Last year, 1,350 people also sought ER care.

Not everyone gets it. In a Colorado survey, 22% of those staying at 7,000 to 9,000 feet succumbed. At 10,000 feet, that number rose to 42%. (NEJM, July 2001)

The obese and those over age 60 tend to be most affected. Being out of shape seems to not be a factor.

One woman said she felt as if her head were being split in half--she almost felt almost delirious.

A drug called Diamox (acetazolamide) has been proven to help (500-1000 mgs daily beginning 24 to 48 hours before ascent). But this can have bad side effects--it makes you breathe more and accelerates acclimatization, which can make you feel shaky.

Other remedies that have been tested, without solid evidence that they work, are ibuprofen, ginkgo biloba, and nitric oxide.

Yet, preparations of these can be purchased in ski towns and on the internet.

And of course, you have to beware of the scammier approaches--such as massages and oxygen-enriched structured water.

"High Altitude Body Oil" from ISUN Alive &Ageless Skincare, says it's based on textbook info on oils and herbs. Textbook info--OK. Forth bucks!

Also the pure oxygen often offered is really 40% oxygen.

Of course, you could rent an oxygen concentrator for $300 a week...

Or you could...

--Ascend gradually and stop at a lower altitude or go down lower to sleep.

--Avoid alcohol.

--Take it easy for the first 48 hours.

If you get worse instead of better over a day or two, go to the ER. Lady Gaga had to.

Wednesday, December 09, 2015

Fight the winter blues

From the site Black Health Matters comes advice for people of all races on how to counter the cold and dreary weather blahs. You may be flat, eat a lot of caloric comfort food, and just generally blob around.

But there are some steps you can take, if you can muster the pep to try them.

--Exercise! You knew I would say that, right? Ignore the temptation to stay in bed--get up and take a brisk walk. This also boosts your immune system. Come on--two and a half hours a day of moderate activity--you can do it.

--Eat healthy foods. You may want starch, sugar, and fatty staples. But these can only perk you for awhile--then the moodiness returns in force. Try more beans, nuts, fruits, whole grains even.

--Maybe this is even the time for sun therapy. Go out while the sun is shining. This wakes up your body and regulates your sleep cycle. Positive thinker Norman Vincent Peale used to say that even thinking about the sun, it's size, it's golden beauty and warmth, could be enough.

--Make a point to socialize. Family, friends, coworkers. You will laugh more.

--Practice relaxation. Five minutes of meditation can help you step back from stress.

--Sleep. You need your 7-8 hours--just not 12-14.

I am sitting here freezing typing this...but I do see the sun out the window. It's a little thin, a little light lemony, but I know it's a good thing.

Tuesday, December 08, 2015

Away from home and headed to the drugstore?

The holidays are a time when people often self-doctor--they are away from their usual providers, pull a muscle playing unusual sports, or catch a bug from weird food or sick relatives.

Jane Brody, NYT, Nov 30, 2015, cautions on over-the-counter medicines.Sure, they are convenient, no doc or prescription needed, but they ARE medicines and do affect you.

There are more than 300,000 OTC drugs products on the market. Since 1975, more than 100 products (or indications or dosages) have transitioned from prescription to readily available.

Using OTC products usually is fine--if you do it appropriately--meaning for the condition indicated, proper dosage, and no longer than the recommended period of time.

Yet, 20% of adults don't do this. (I bet it's more.)

Even if you do everything according to the label, there can be problems. Some drugs are not good for people with certain conditions--say a painkiller that raises blood pressure.

Acetaminophen--Tylenol--is not only used for pain and fever, but is contained in many other products--cold and allergy meds, cough medicine, and prescribed drugs such as Vicodin and Percocet.

Overdoses of acetaminophen result in 30K hospitalizations a year because of acute liver failure.  A study in 2012 (J of Gen Int Med), said as many as 24% of people taking it would exceed the so-called safe limit of 4,000 mg over 24 hrs. Forty-six would OD taking it and other meds that contain it. (That 4,000 mg is also under consideration.)

Some OTC drugs also try to treat several conditions with one pill. You may not need this.

Forty percent of OTC dugs are used by people over 65--who also can't metabolize or manage drugs as carefully, putting them more at risk.

--Laxatives are OTC, but they can really screw you up if you take them everyday.

--OTC sleeping pills with antihistamines can lose effectiveness over time--so people take bigger doses. Do not use these more than 2 weeks.

--People with heartburn take antacids (Tums), but these can cause diarrhea or block other drugs. The H2 blockers (Pepcid, Zantac) or proton-pump inhibitors (Nexium, Prilosec, Prevacid) can cause bone fractures and magnesium deficiencies if taken long term.

--NSAIDS like aspirin, ibuprofen, and naproxen, if taken too long, can cause bleeding ulcers or kidney or liver problems--even an increased risk of heart attack and stroke.

So read labels, limit time you take something, and talk to your doc or pharmacist. Best to limit the number of drugs you take overall--but ask the doctor about that.

I recently heard about a gal who spent week in the hospital from ibuprofen--an ulcer. These things are not Tic-Tacs.

Monday, December 07, 2015

Give safe toys this Christmas

Monroe Carell Jr Children's Hospital at Vanderbilt offers some safety tips for toy buyers.

Recalls of outrageously bad toys are dropping, but you still need to think before you buy.

Keep the child's age in mind--but also the ages of all other kids in the household.  Read labels carefully.

--Be sure there are no small parts or other choking hazards if there are small children in the house.

--Look for quality construction--stuffed animal eyes that don't pull out, little accessories that fit in mouths.

--Check toys lying around for chipped paint, missing parts, or sharp edges.

--Make sure crayons and markers are labeled non-toxic.

--Avoid marbles and balls with a diameter under 1-3/4 inches.

--Balloons should be Mylar, not latex. Never allow children to blow them up or deflate them.

--New bike--don't forget the helmet.

--Scooters, skateboards and other riding toys--also helmets.

--Electronics--those button batteries are harmful if swallowed.

--New TV--wall mount it--don't put it on a shelf where it can be pulled over.

--Projectile toys such as air rockets, darts, and slingshots--no for any age.

--Chargers--can burn children.

--BB guns. These are not toys.

Just stop and think. Children are masters at using toys for results not intended. You need to stay ahead of their "creativity."

Friday, December 04, 2015

Hanging lights can hurt your....feet

Many people fall from ladders while putting up lights--and land directly on their feet, fracturing the heel bone. This bone, called the calcaneus, connects the rest of the leg bones to the foot and anchors the Achilles tendon. In other words--you need it.

A heel bone fracture is a life-changing event, says Pedro Cosculluela, MD, a Houston Methodist orthopedic surgeon. Fracturing it can also lead to infection in surrounding soft tissues.

Even if the break does not come through the skin, signs of fracture are a blueish color of the skin or tenting of the skin. Surgery with plates and screws if often necessary.

Ouch!

Take extra precautions with those lights.

--Inspect the ladder prior to climbing it.

--Extend the latter at least three feet above the roof--never stand on the top step.

--Secure the latter to the house--or have someone spot you and hold it.

If it's icy up there--well, the answer is obvious.


Thursday, December 03, 2015

Protect your back on the slopes

You hear a lot about broken legs on the ski slopes--but ruined backs? Kaixuan Liu, MD, founder and president of the Atlantic Spine Center, says many back problems from skiing can be averted by care before setting off to the mountains.

You should condition long before ski season arrives, he says. (Ooops--time's a wastin'.)

Actually, of course,many injuries can result from skiing--knees, shoulder and head, in addition to the back. More than three-quarters of these come from falls.

Skiiers need to bend, twist and turn quickly.

If you feel yourself starting to fall, Liu says, go with it, as gently as possible. Also wear a helmet to protect the neck as well as the head.

But what about that pre-conditioning?

--Build flexibility. Each day stretch the hamstrings, quads, hips, calves, and trunk.

--Work on the core--including lower back and abdomen. Use dumbells or resistance bands to strengthen the upper body. Squats, lunges or leg presses are good for the lower half.

--Increase your endurance with cross training such as rowing, hiking, stair climbing or running.

--Build speed. Quick side-to-side movements are needed for skiing. Hop back and forth over a book or pillow, keeping the upper body balanced.

Try to do all this six weeks before setting off.

Perfect for the January ski trip?

Wednesday, December 02, 2015

Calorie counts on menus--FAIL

"Give me that whatever...the 600 one."
Aaron E. Carroll, NYT, Nov 30, 2015, reminds us that we are very overweight--blah blah.

Oh, the powers that be have tried SO HARD to help us change. A while back, they decided we did not know which foods were caloric. Thus evolved the "calorie counts on menus" idea.

By the end of next year, these will be required on the menus of all chain places.

They looked at some restaurants who posted counts and some that did not. The ones that posted had items with 139  average calories less. Did this mean posting made them make lower cal food? No--they concluded--it just meant the ones with lower cal food wanted to post.

Then they looked at Walmart's healthier food deal. Over the yrs, customers did buy lower cal food, but that started before the program. So...what?

In NYC, menus had to be labeled as of 2008. Back then, people said they used calorie counts more often than people that went to unposted restaurants. Over time, though, people ignored the counts.

Actually, the calorie police have known all this for years. These studies are not new.

There may be increased awareness, but no decrease in cals ordered.

Also, the counts are often not accurate. A 2011 study found many items were at least 100 cals more than listed. The ones with lowest calories, moreover, were most likely to be incorrect.

Now, the suggestion is that servers should also ask diners if they would like to downsize starchy sides.

I expect that will go over like lead fries.

Tuesday, December 01, 2015

Not really recommending this book

It's called Doctored: The Disillusionment of an American Physician by Sandeep Jauhar (pron. Joe-har).

Since I have atrial fib, a rhythm disorder, the "approaches" to which (1) almost killed me, and (2) may have been responsible for a clotting disorder that destroyed by right retina despite four operations, I was tugged into this story and probably just want to transfer it to you.

This book is a hot mess. The author does not really seem to want to be a cardiologist--his brother, the favorite son he tells us, became one, so he did. He says he became a salaried doctor at a hospital so he could run a "congestive heart failure" program and not give patients unnecessary procedures like cardiologists in private practice do (his contention, he deems them crooks). His brother works at the same hospital but makes twice as much, because he installs stents.

Despite trying to sound compassionate about the "very sick" people he "cares" for, he gives unnecessary procedures or else rather curtly suggests to people that they sign a Do Not Resuscitate on themselves then and there.

He writes in excruciating detail about organ systems failing, people drowning in their own fluids, etc---and this is the part hat got me... Ugh. If I did end up in a cardiac critical care unit, would I want this dude taking care of me?

He describes patients with contempt--"Her remaining tooth looked like a fang..."

He bleats constantly about private practice cardios piling on the tests, for which they make a ton more money than he does. Don't we understand, he needs more money--for an expensive preschool, for all the IVF that went before, a bigger NY apt, etc?

I have had eight cardiologists in my life--all kept recommending the tests. I even had one that was installing pacemakers he bought on eBay--a huge scandal at the time.

I also, on my eighth, refused a chemical stress test. I already know my heart beats wonkily--I don't need a simulated heart attack followed by an "antidote."

Is this guy a whistleblower--or a rich crybaby in the wrong business?

You can decide if this interests you. But I will tell you one thing--the next doctor I go to, I will be wondering if he or she is listening or just had a big fight with the spouse and is drifting. Does he think I am just a big, fat, noncompliant pig with heart trouble? Is he or she under pressure to order expensive tests to make money for the hosp or practice? Do I need another Holter? Why?

And most importantly--if I end up with congestive heart failure, will the doctor give a flip?

Monday, November 30, 2015

Despite pre-travel advice, people getting just as ill

You've heard all the advice, I am sure. Drink bottled water, don't eat street food, eat fruit with an intact peel only, on and on.

But, despite all this, researchers at the Umea University in Sweden say, people are getting sick at the same rate they always did, risk-taking younger people the most, older people the least.

Diarrhea and respiratory diseases lead the list.

Health care students got sick the most often, despite the most advice beforehand. They took more risks and encountered resistant bacteria.

One reason given for the fairly constant rate of illness among travelers was poor restaurant hygiene. Guess you can't count on everything being boiled to a fare-thee-well.


Friday, November 27, 2015

Hmmm...mobile dentist

I hate going to the doc and the dentist because I need to find a ride and then walk long distances on my horrible knees. I stall, dread, and blow off.

However, Case Western Reserve's School of Dentistry has renovated a 38-foot van into a dentist's office.

Dental students, supervised by faulty, provide oral exams, x-rays, cleanings, fillings, dentures, extractions, and cancer screenings for older people, many of whom had not seen a dentist in years.

They set up outside senior centers and assisted living--and for those who can't get into the van, they set up chairs inside.

Among dentists, the notion that seniors are harder to treat, the program's leader says. He says they want to take dentists out of their comfort zone of ignoring seniors.

Time was, he adds, old people just lost their teeth...But now, more of them are keeping more of their teeth and need specialized care.

I have used mobile pet grooming in a truck outside in front--why not a dentist?

PS I still hate that word "senior"--I always think of high school.

Wednesday, November 25, 2015

Pumpkin dog cookies

Over the hols, we must remember our furry buds. Not that they would let us forget. My cat was SQUACKING like mad this morning.

So while you are whipping up holiday treats, make some Pumpkin Treats for Fido (how come no dogs are ever named Fido or Rover, yet those are the typical go-to name for dogs?).


Some veterinarians at Colorado State approved this recipe.

2-3 slices of bacon (if your dog is chubby, you can omit)

1 cup pumpkin puree (not pie filling)

2 eggs

1 cup whole oats

2-12/ cups whole wheat flour

Preheat oven to 350. Line a baking sheet with parchment paper or a silicone baking mat (lets me out--no idea what that is)

Heat a large skillet. Add bacon and brown it  until crispy (6-8 mins).

Crumble it up and keep the extra fat.

In a large bowl, mix pumpkin puree, eggs, and bacon fat. Add the oats and 2 cups of the flour. Mix, then add the rest of the flour until dough is no longer sticky.  Blend in the bacon.

Turn the dough out on a lightly floured surface. Knead it few times to make it pliable, then roll out to 1/4 inch thick.  Cut out shapes with a cutter or knife and place them on the baking sheet.

Bake until edges are golden brown--20-25 mins.  Cool before "serving" to er...Fido.

As for the human treats--no chocolate for dogs! No raw dough--uncooked yeast can upset their insides.

No grapes, raisins or nuts! Grapes can even cause kidney failure.

No xylitol--this sweetener can lead to liver failure in dogs.

No ham--too salty.

Keep the turkey carcass away from pets. Wolfing down fatty leftovers can lead to pancreatitis.

Oh, well--the mutts can console themselves with the special cookies. Doesn't sound too bad.

Tuesday, November 24, 2015

Baby bed bumpers

Bumperless=safer
You know what bumpers are--those pillowy strips you tie around the crib bars encircling the tot. My daughter had some darling ones with alligators on them (we were very cynical in those days--more than now even).

Problem is, even a baby a few days old will squirm their way to the sides to get their head against something solid--and those loosely tied bumpers can tangle the child into the folds and...well, not good.

Deaths and injuries due to this bedding are up, according to a professor emeritus of pediatrics and two researchers with the Consumer Products Safety Commission.

Bumpers caused more tragedies than blankets, pillows, and stuffed animals.

Still, the numbers are low--two digits, maybe a few a year. But the researchers say this data is not reliable. (J of Pediatrics, Nov 24, 2105)

When the baby's mouth and nose are covered with a bumper, they can suffocate or expire from breathing oxygen-depleted air. Or get brain damage from the latter.

At first, bumpers were used to keep a baby's head from getting caught in the slats of the crib.  Since 1973, though, requirements are that the slats be close enough together that a head cannot get through.

Which reminds me--if Grandma is getting an old crib out of the attic for a holiday visit--say something.

And don't just put in crib bumpers, either. They are even banned for sale in Maryland and the city of Chicago.

Monday, November 23, 2015

A doc talks cold weather and viruses

Donald Kennedy, MD, a professor of internal medicine at Saint Louis University, says there may never be a "cure" for the common cold because it doesn't kill or even affect the economy much, since most people work despite having one.

Also--there are many viruses that can cause colds--so there is not just one to focus on.

Colds can come at any time of year--but seasonal influenza is different. It usually hits for six weeks between Oct and Feb (in the US), and infects 60 to 70 million people a year. Forty thousand die of it.

What is the difference between flu and a cold? Kennedy says if you have to ask, you don't have flu.

Flu makes you feverish, with chills, muscles aches all over, fatigue, cough, sore throat and a headache.

The term "feel like crap" was invented for flu.

You can get some of these with parainfluenza, too--usually children or older adults. The flu shot does not prevent this.

Should you stay home? If you have a cold, wash your hands a lot, bring your tissues, and carry on, Kennedy says.

What about with the flu or that para stuff? Fever over 100.5--significant. You may need to stay home also if you are completely miserable. How considerate of your workers are you? You decide. Could you really get a lot done at work?

Why does this stuff hit in winter? Kennedy thinks maybe because we are indoors more...but no one knows.

Why are some people sicker than others with the flu? It depends on how much virus you get--sitting next to someone on the bus may give you some, sleeping next to someone will give you a lot more. If you are run down or have a weakened immune system, you are likely to get sicker.

What about Tamiflu or Relenza? Taken early these reduce symptoms slightly, Kennedy says. But the viruses are getting resistant.

So how does that shot look now?

Friday, November 20, 2015

Asian flavors come to America

Two-thirds of people eat a wider variety of cuisines compared with five years ago. Check out the Food Network--often weird (to us) spices and fruits and veggies are included in the ingredients on CHOPPED, sprinkled into dishes even on an Oklahoma ranch on PIONEER WOMAN, and thrown in with almost every dish made on THE KITCHEN.

I even make a weird Thai-sort-of spaghetti that includes rice vinegar , soy sauce, peanut butter, and a spice called Chinese Five Spices (groc store).

According to a story in Food Technology mag, here are some Asian influences mainstreaming here.

--Filipino food. This, in turn, is influenced by Chinese, Malaysian, Indonesian, and Spanish flavors.  The result is such things as lumpia, banana ketchup, adobo, and halo-halo.

--Gochujang. A fermented chili paste used in Korean food.,

--Korean BBQ. Tabletop grilling, with garlic, veggies, and assorted spices.

--Asian citrus. Calamansi lime (mandrarin orange meets a kumquat) gives meat a sharp acid flavor.

--Fish sauce. This is a popular Asian condiment made of fermented anchovies and salt.

--Region-specific chili peppers.

--Ramen. No longer the province of poverty-stricken students, this is now featured,

--Soy sauce. Cures bacon, adds complexity to cookies and cakes, and enhances choc syrup.

Are you going to be adventuresome? Check out the weird, gnarled fruits and veggies on the shelf above the iceberg.

Thursday, November 19, 2015

Actually for real--pigeons reading mammograms

Hey! Who you callin' a bird brain?
I checked--not April Fool's Day.

In a paper on PLOS One, researchers at the Univs of Iowa and California (Davis) used training and food reinforcement to teach pigeons to read mammograms. And--the birds performed as well as humans in categorizing digitized slides of both benign and cancerous breasts.

The pigeons learned to sort the images by color or absence of color as well as by degrees of image compression. They also correctly identified cancer-related micro-calcifications on the mammograms.

What they did not so as well was classify suspicious masses--a task that is difficult even for human radiologists.

Although a pigeon's brain is no bigger than the tip of your index finer, the neural pathways operate very similarly to those in the human brain. Or better--they apparently can discriminate between benign and cancerous in breast images all all magnifications--a task that humbles humans.

They also can distinguish identities and emotions on human faces, letters of the alphabet, misshapen capsules, and even paintings by Monet and Picasso.

Will pigeons eventually find a role in radiology depts? That may be a stretch...

But maybe they have retired the insult of being "flying rats."

Wednesday, November 18, 2015

Try non-antibiotic remedies for kids's minor stuff

My own kid, who is 33 not 3, is complaining about an earache. I suggested half water/half rubbing alcohol, in, then out... Someone else said maybe antibiotic ointment to melt in without going through the whole body. I also read vinegar, in, out, stopped the pain immediately.

She was not impressed--saying she had even put garlic in there. What? How many things has she tried...? The pain was OK now, she added.

I do know they already have backed off the amoxicillin 10 day thing from when she was a kid. All because of antibiotic resistance...Take too much of this stuff and the bugs get immune to it and can really wallop you or someone who catches what you have.

Stony Brook Children's Hospital in New York, agrees with the CDC that this resistance is a public health threat.

First rule: Antibiotics only cure bacterial infections. Not the flu, not bronchitis, most sore throats, or runny noses.

Second. Antibiotics can also kill the healthy bacteria in your intestines--allowing more harmful tupes to get a foothold. The result? Diarrhea.

Treat minor ailments at home first! Get plenty of rest, drink plenty of fluids (imagine them washing out the crud), avoid smoking, secondhand smoke, and take acetaminophen (as directed!) or ibuprofen (also OK for kids over 6 mos) to relieve fever or pain. Sooth throats with lozenges (older kids), ice chips or popsicles.

If it's an allergy--you definitely don't need antibiotics.

Discourage kids from sharing toys and snacks

Wash hands a lot...Get vaccines on time...

You know all this.

I would add one thing--don't try too many home remedies at once. It sounds like my daughter made a salad in her ear.

Tuesday, November 17, 2015

For heaven's sakes, protect those eyes

As most people here know, I am missing sight in one eye--bad surgeries for detached retina. You want both eyes, believe me.

The American Academy of Ophthalmology reports that hospital costs for eye trauma are up 62% in the last decade. You are doing a bad job of eye protection!

What are the causes of this ocular mayhem? Falling and fighting.

Fighting--brawling...how tacky is that?

Serious eye injuries include fractures of the bone around the eye and being pierce by sharp objects.

The average injury costs $20,000 to treat, is painful to the max, and leaves lasting "memories."

And--most are preventable.

The leading cause is falling. And most of those are suffered by people 60 and over. Falling down stairs--a major cause.

And fighting--the top cause for ages 10 to 59. Good grief--why all the fighting? Is this one big fIGHT Club?

Kids get injured in vehicle accidents and by sharp objects. (At my eye surgeon, I saw a youngster with a tree branch sticking out of his eye--his mother was holding it steady.)

Why are such injuries so expensive? Drug costs, speculate the docs. Maybe administrative costs, meaning what I have no idea.

If you are wobbly--try exercises for your core. Put grab bars outside the shower (I need to) and handrails on the stairs. Pick up slippery area rugs. Don't move furniture around.

Your eyes come with a spare--but take it from me--two work better than one.

Monday, November 16, 2015

No holiday illnesses!

Isn't this the saddest?
For people with allergies, the holidays, with the importation into the home of weird plant matter and scents and substances, can be sneezy-wheezy.

Most people are allergic year-round, says Allergist Bryan Martin, DO, president of the Am Coll of Allergy, Asthma and Immunology (ACAAI). When pollen season dies down, mold,dust and dander step in or are more noticeable...and then come the hols.

The key is know your triggers and try to avoid. Some triggers are:

Cold, dry air.Cover  your mouth and nose with a scarf or mask.

Strange rooms in homes or hotels.  Ask about allergy-free rooms. Be sure to lug along all your meds when traveling.

The tree. Ornaments and decorations from the attic may be dusty. Clean thoroughly before using. Then store in air-tight boxes. If you get a "real" tree--know that terpene (in the sap), along with mold spores that can ride in on trees, can be a risk.

Food prepared by other people. You may be aware of your or your kids' allergies in cooking at home, but others are not. Give the host or hostess a headsup or stay alert yourself. Kids can also be on the lookout. And google for allergy-free recipes--start a new tradition of not feeling crummy.

This should not ruin Christmas--just keep it in mind. Why suffer?

And remember pets, too--mistletoe is poisonous--stick with plastic. Once a cat I had ate one holly berry--and almost died.

From that year on, the vet called him Mr Holly Berry.


Friday, November 13, 2015

Pharmacists--an accessible professional

Thought you could use a laugh,
I got a flu shot this year. Some years I don't. But I heard they had matched the vaccine to the strains coming in pretty well. My pharmacist administered it.

You know how hard it is to "ask your doctor"? Well, it's easy to ask a pharmacist.

SafeMedication.com reveals the importance of knowing your meds.

--It's dangerous to just throw down pills without know what they are for--and the potential side efx.

--You need to keep a medication list.

--You need to know how to tell if the meds are working.

--And you need to take it as prescribed--not when you think of it, or every other day to save money, and things like that.

Some appalling facts:

---60% of people misunderstand the instructions on the bottle. Does four a day mean every six hours even at night?

--50% of hospital medication errors occur because patients forget to tell the doctors all of their meds, including supplements and over-the-counter.

--The time you take a medication can be crucial--some blood pressure meds should be taken at night.

There are 290,000 pharmacists in the country. They spent a lot of time in school. They can even answer questions doctors can't.

And they are right there a few blocks from you--no appt needed.

Thursday, November 12, 2015

Beautiful skin on a budget

The American Academy of Dermatology says you don't need spendy products to have healthy, glowing skin.

Skin care requires three steps: cleanse, treat, prevent.

First you need to decide your skin type:

--Sensitive. May sting or burn after product use.
--Normal. Clear, not sensitive.
--Dry. Flaky, Itchy, rough.
--Oily. Shiny, greasy.
--Combination. Dry in some areas, oily in others.

Buy products formulated for your type--expensive ones are not necessarily better.

--Pay attention to ingredients. Acne prone? Look for benzoyl peroxide or salicylic acid. Fine lines and wrinkles--retinol.

--Consider using dual products--moisturizer with sunscreen (SPF 30 or more).

--Cleanse before using products or going to bed..

--Apply moisturizer when the skin is damp from the shower--it locks in the moisture.

--Limit the number of products you use--a lot can irritate.

--Consider using Vaseline on hands and nails or other dry areas. On the face, it can cause breakouts.

I use Cetaphil as a night cream. No eye cream. I know, I know, horrifying.
 ;

Wednesday, November 11, 2015

Are the holidays worth dying over, ladies?

You know us women. We like our traditions, our holiday fun and travel. Everything has to be perfect.

A cardiologist at the Houston Methodist DeBakey Heart & Vascular Center, says sometimes women come in with stress-based cardiomyopathy from the short time and huge amount of stress in the pre-holiday weeks.

Usually in their late 50s to 70s, these women suffer from the stress hormones weakening the heart's main pumping chamber (left ventricle) causing it not to pump normally.

Symptoms might be chest pains or shortness of breath. In most cases, this is treated with drugs after an echocardiogram (sonogram of the heart).

Blood pressure can also spike during the holidays. If a woman has high blood pressure, staying on meds and monitoring it are especially important.

Remember, women may have different symptoms than men--sometimes just nausea or an unwell feeling. Vomiting or dizziness an be other signs of trouble.

Please let up on yourself in this stressful time. Meals can be pot luck, The older kids can wrap presents for the younger ones. You don't need to go to every open house or party.

I am sure you can think of a dozen more ways to alter the holiday routine in your favor.

Tuesday, November 10, 2015

Book on "medical reversals"

Know what a medical reversal is? You do--but not by that term. Medical reversals are when long-accepted medical practices are abandoned because they are proved to be ineffective.

Vinayak K. Prasad of the National Center Center and Adam S. Cifu of the University of Chicago, who wrote Ending Medical Reversal, say these reversals are distressingly common. They looked at the New England Journal of Medicine from 2001-2010 and 40% of the articles were about new or recently adopted practices that were "reversed."

This is not--they emphasize--because a drug or procedure worked and then stopped working--this is when it never worked in the first place.

In short, doctors prescribe or do procedures without robust research behind it. This results in higher health costs and no change in health.

Why does this happen in the age of "precision medicine"? The nature of clinical trials, medical education, funding, and drug approval.

Take osteoporosis--bone weakening. Trials may focus on bone density--while they should focus on how many people get fractures...The fractures, not the density--are the issue.

The book zeroes in on screening tests--because these are given to healthy people. The evidence that these prevent cancer death are pretty weak.

Individuals are also guilty of self-medicating--say with vitamins and supplements--without evidence of effectiveness.

Want to learn more about what means what and the ins and outs of various types of trials--this is your book.

Monday, November 09, 2015

Mindfulness training can help "bad guts"

I am sorry--were you eating?
For more than 30 years, I have had "unreliable innards." At times, it is horrible--events after every meal or snack. At other times, a week or more of normal, then the squeezing gets going--the pain! Once, I was hospitalized with giardia, a parasite--was given some awful meds to kill it. Another time with adhesions from old surgeries. Yick!

Anyway, I am now off dairy, Tylenol (for my knees), and coffee--have some pretty good weeks... Google "FODmap" to find an elimination program.

But I have also learned to make myself relax during these bouts when they do occur. I may be almost crying, but I hark back to my many years of yoga and relax each muscle group. Still, I often have to chew a half an imodium to stop the pain.

Now, the Crohn's & Colitis Foundation has published a study on inflammatory bowel diseases that recommends mindfulnesss as a helpful intervention for patients with IBD. I have had tests at various times, but no real diagnosis--I figure irritable bowel syndrome. Or just touchy insides.

Anyway, in the report, Australian psychiatrist named David Castle, MD, studied mindfulness techniques.

They took 60 adults with Crohn's or ulcerative colitis with an average of 11 years of suffering.  Twenty-four had active disease at the time of the study.

The Mindfulness-Based Stress Reduction program consisted of eight weekly group sessions plus a day-long intensive. Included were guided meditations, other exercises to increase mindfulness, and group discussions.

Thirty-three people agreed to do this and 27 went the distance.The other 27 were controls in a way (did not want to participate).

This wasn't a random study.

The researchers rated mental health, quality of life, and mindfulness.

The people who did the exercises had great reductions in anxiety and depression, as well as improvement in quality of life. This persisted at least six months.

So you may want to consider meditating if you have these problems. I personally have never gotten into meditation, but I do think it's a good thing.

Friday, November 06, 2015

Soda and junk food may not be the big villains

If you read any NYT or WashPost comment section, the self-righteous harp cruelly on how they see overweight people stuffing in the Big Macs or buying the Big Gulps. Tsk tsk tsk.

So some professors at Cornell examined national data from 2007-8, describing people's eating habits based on their body mass index (BM). Surprise! Those with a healthy weight ate identical amounts of the "forbidden" foods as those who were obese.

If you take out both ends--chronically underweight and morbidly obese--the remaining 95% of the population were not affected by fast food and sugary sodas.

Basically, they CAN make you fat, but that doesn't mean they ARE.

The culprits are a sedentary lifestyle and a lack of veggies and fruits.

Concentrating on sodas and fast food--say by taxing them--squanders public health resources, the docs say.

Make of this what you will. Like most "memes" that get going, this one will die hard. People just love to judge too much--look at that guy eating that Big Mac, "Krispy Kreme" Christie," her cart is full of chips, etc.

Thursday, November 05, 2015

Gee..this sounded so good

You know those cellphone apps that track exercise, calories, and weight loss goals...Well, researchers at Duke University found they don't help young adults achieve meaningful weight loss.

Sad face.

Thirty-five percent of 18 to 25-yr-olds are overweight or more, according to Laura P. Svetky, MD, professor of medicine at Duke.

They thought this tech savvy group would be likely to benefit from a high tech electronic aid.

The researchers looked at 365 people in this age group, all of whom had weight issues. One group used a free Android app called CITY (Cell Phone Intervention for You), designed for this study by people at Duke and Northeastern University.

CITY tracks calorie intake, activity, and goals, and offers tips and ways to get social support.

On average, the CITY users lost 2 pounds after two years. This was no more than the control group--which received paper handouts about exercise and nutrition.

They also studied personal coaching--the coaches met with participants weekly for six weeks then phoned once a month. The coached group lost about 8 pounds in a year, the control group in that study, 5 pounds.

After two years, neither group was using a cellphone app or coach.

They also tested commercial weight loss apps rather than CITY. No difference.

Maybe the app wasn't interactive enough, they said. Back to the drawing boards.

Wednesday, November 04, 2015

Lack of food for kids ongoing problem in US

I have a strange and wonderful relationship with Fox blowhard Bill O'Reilly. Before roundly scorning him, I watched his top-rated show for a few years to get the gist. He had many similar experiences to mine growing up, he's funny, he's bossy, and he's adamant.

The adamant part can be a problem. He got in a food fight with Kirsten Powers over whether there are starving kids in the US. He insisted with all the social programs--food "stamps," WIC, etc, if kids were going hungry, it was the parents' fault. Of course, that does not make them any less hungry, but that was his stance.

Now comes the American Academy of Pediatrics--please note, Bill--recommending that pediatricians screen all kids for food insecurity.  The doctors, according to the AAP, need to spend time familiarizing themselves with all the social resources and advocate for access to nutritious food.

Fifteen million US children live in households still struggling with hunger. True, the number of children regularly getting enough food is the highest since 2007. This is a testament in favor of WIC, SNAP and school lunch and breakfast programs. But fifteen million is a lot of hungry kids--some of whom only get food when at school. In some areas, summer programs to feed them have been put in place.

Kids in food insecure households get sick more often, recover more slowly and learn less well. They are likely to be iron-deficient.

Studies show this insecurity has left the confines of the inner city and reached into the suburbs and rural areas.

Pediatricians need to take a proactive stance, the report says.

Pediatricians--and maybe O'Reilly, too? He is usually all about kids--why not this time?

Tuesday, November 03, 2015

No, Mr Bond, I expect you to suffer from slurred speech

Sure you feel OK now, Jim.
Remember the iconic line where James Bond says, "Do you expect me to talk?" And the villain replies, "No, Mr Bond, I expect you to die."

Well, some scientists are looking at all the head injuries movie heroes sustain and decided to get real.

Assaults often result in injuries to the brain, which sort of sloshes abruptly in the skull, loosening all connections and impairing the brain matter itself. If the skull casing gets "broken", a blood clot can form.

A real human might vomit, suffer from dizziness or blurred vision or slurred speech. Jumping in a Ferarri and driving off would be next to impossible. A limb could be weakened. His sense of smell could be affected.

The head injury could even--gasp--render our hero impotent. Aw, disappointed Bond Girls.

Emotions could be affected if the amygdala is affected. Instead of cool, Bond could run hot and aggressive.

Bond could even lose his job. Many victims of traumatic brain injury do. No more flirting with Moneypenny?

Even if you are not a spy, fighting or sustaining about a thousand blows to your football helmet could put a dent in your life, too. A brain is a terrible thing to waste.

Monday, November 02, 2015

Important if you are hospitalized

Laura Landro, a journalist I respect, writes about "shift change," the time in hospitals when one batch of nurses goes home and another arrives. How do they do the hand-off?

Studies show that discussing each patient at the bedside rather than down at the nurses' station helps nurses communicate better and helps prevent falls and incompatible transfusions and other horrors.

Talking about issues in front of the patient and family is considered a core safety strategy,

Some nurses resist this, saying nearby patients can hear confidential info. But when this is done, patients say who can be in the room and designate things they don't want discussed.

One patient's wife reported that this discussion was the only time she got info on her husband's condition.

With training in this form of shift change, nurses can hand off three to six patients in half an hour.

Patients also like this--one said she could hear nurses and doctors talking outside her room, as if she weren't even there. It made her feel uncomfortable.

I remember a little whiteboard in my hospital rooms--with info on me--but not this sort of changeover.

Good idea.

Friday, October 30, 2015

Pretty scary--in time for Halloween

Medical errors during surgery--some creepy news here. A new study shows that a mistake may be made in half of all operations.

This from a paper presented at the recent Anesthesiology 2015 conference.

The study ran over 2013 and 2014 and focused on drug errors during surgeries--drug labeling,  incorrect dosing, drug documentation mistakes, and failing to note changes in vital signs. Supposedly this is the first large-scale look at this.

An adverse drug event was found in 124 of 277 surgeries.  Two-thirds were seen as "serious." Two percent were life-threatening.

The researchers found the results disturbing but not surprising--meaning they expected screwups in a large number of cases.

Good thing patients are asleep. I had three major eye surgeries--you have to be conscious for those, but they knock you out for 10 minutes to stick needles in your eye. Then you wake up. When they started on cut on my first one, I felt it and went...ahhhh and ZAP! I was knocked out again for another dose.

This is why I recommend avoiding cutting into yourself if you possibly can. Once you mess with the goo, it's never the same. It can be better, can be worse, but it's not the same.

Thursday, October 29, 2015

A prescription video game?

Evo is a prescription strength video game for kids with ADHD.

Developed by Akili Interactive Labs in Boston, Evo is made for mobile devices and acts as daily therapy for those with brain disorders such as attention deficit hyperactivity disorder.

Five to 11% of kids may have this problem, which can continue into adolescence and even adulthood. Many take Ritalin or Adderall, but these drugs can cause side effects such as nervousness, loss of appetite, insomnia and increased heart rate and blood pressure.

Evo helps kids concentrate by thrusting into a world of split-second decisions. They tune out distractions and guide a spacecraft through a canyon. To move a ship, they must find the red fish and tune out the other color fish. As the child plays the game, the difficulty is increased.

Pfizer is involved, a study is pending...My question is why prescription?

Wednesday, October 28, 2015

Householders--Pls don't hurt allergic goblins & ghosties

Chocolate bars, peanut butter cups, nutty treats--you don't want the kids keeling in the driveway.

The most common food allergies are milk, eggs, and peanuts, says Tracy Fausnight, a pediatric allergist at Penn State (er) Hershey.

Kids with milk allergies cannot eat most types of chocolate. Peanut allergy--this takes in a lot of candy. Those with egg allergies must avoid nougats (Milky Way, Three Musketeers). Even SweeTARTS have egg.

Older kids can dump the treats and sift out the bad actors. Some parents also let allergic kids dress up, but substitute a goodie bag when they get home.

Those warnings that an item was manufactured in a facility also processing say, peanuts, are not really reliable, Fausnight says.

What's safe?

--Skittles, Smarties, Starburst, Dum Dums, Haribo gummy bears.

--Stickers, pencils, bubbles, crayons, friendship bracelets, balls, and bookmarks. Also  money.

Some houses also display a sign--Safe for allergic trick or treaters.

Interesting to me is that this seems to have shifted from the mean lunatic stuffing treats with razor blades to a medical theme.

But still, kids do have sensitivities--and I guess it's up to everyone to look out for them. It takes a village and all that.

Of course, on Saturday that village will be Salem, Mass. Bwaaa-ha--ha.

Tuesday, October 27, 2015

Some docs and nurses ignore health advice

Na Bare, writing on TribLive, says a Mayo report revealed that while the incidence of obesity, heart disease and diabetes is lower in medical professionals, it is still common and rises along with the rest of the population.

Dr Anupam Jena a health policy researcher at Harvard, was quoted as saying the same societal and environmental factors that affect the rest of us affect them, too.

The researchers looked at nationwide surveys between 2002 and 2013 asking respondents about their profession and health. Three percent of the 150,000 were health professionals--doctors, dentists, nurses, chiropractors, pharmacists, and physician assistants.

They were less likely to smoke and more likely to exercise that people in other jobs--but also more likely to report moderate to heavy alcohol consumption.

Of course, the behaviors were self-reported. And some health jobs might encourage better choices--they were all lumped together.

But, the researchers concluded, these people were role models and still, though, were human. "Healthy choices are not easy to come by," Jena said.

Maybe it's me, but I trust a chubby doctor more--at least he or she knows the struggle and won't automatically indict weight as the cause of every complaint you have. They might look beyond.

Monday, October 26, 2015

Candy is dandy

Remember that Ogden Nash couplet? "Candy is dandy but liquor is quicker?"

Beth Kimmerle sought to dispel some myths about candy in the Oct 23rd Washington Post.

First, it's a myth that natural and sugar-free alternatives are healthier than candy. Candy, while not the enemy, is not exactly health food, so people look for alternatives. But protein bars, granola bars, energy bars, etc, can have more sugar and cals than a candy bar. The oats, fruit, flax, and nuts are often bound together by corn syrup or chocolate. A choc-dipped granola bar (Target's Pantry Party) contains 15 gr of sugar and 140 cals. A Fun Size Snickers is 8.5 grams or sugar and 80 cals. (A medium-sized apple has 19 gr of sugar.)

Sugar-free gummies are made with sugar alcohols--which can cause diarrhea.

Another myth is that old candy should be thrown out. There is no sell-by date for candy. Candy is cooked to high temps. But if it contains butter, nuts or chocolate, think a year maybe. Brittle old candy can also break teeth.

Remember how dark chocolate is good for you? Fine print: This is in powdered, unsweetened form...not luscious bar form.

Many people also think candy recipes are kept consistent--yet the product can vary country to country. Cadbury bars: First ingredient in the US is chocolate, in Britain, milk.  Chocolate itself varies from place to place.

Was Halloween invented by the candy companies? Nah--it goes way back a Celtic harvest festivals where the spirits were thanked for the harvest. This evolved into All Souls Day, where families handed out sweet cakes in exchange for prayers for the dead.

So--boo!

By the way, 75% of adults eat candy at least once a week.

Friday, October 23, 2015

Should fast food have warnings in commercials?

That new glistening doublepatty treat looks so good on TV! We all know that (well, all but the most confirmed vegans nibbling at their lettuce wraps).

There is a new study in the journal Appetite that posits that the rise in commercials for such high-fat, high-sodium, high-calorie treats is warping our teens.

Some researchers at the American University's Kogod School of Business surveyed 1,000 teens about their eating and viewing.

To me surprisingly, heavy TV viewers who did not eat fast food much were desensitized to its negatives, but those who regularly ate it, did know about how it might affect them but ate it anyway.

In other words, as exposure on TV goes up, actually eating a lot of fast food could increase sensitivity to the risks.

But the researchers concluded that maybe fast food ads should be monitored and perhaps regulated. And maybe there could be mention or even ads for healthier foods.

I am not sure what all this proves, if anything. Are we going to see ads that end with...

Please do not eat the burger shown without consulting your doctor. Side effects include weight gain, acne, sluggishness, cardiovascular and heart disease, diabetes, abdominal fullness, and bad breath from the onions.

Thursday, October 22, 2015

Dementia Friendly America--kind of weird term?

Stat, a Boston Globe health policy publication, says local programs tied to a project called Dementia Friendly America are starting to be rolled out.

Sometimes I think about the political scene and think this IS Dementia Friendly America, but I snark.

Anyway, test programs are bring launched with state money and grants to help first responders, police officers, bank tellers, caregivers, and road sign makers, among others, to better handle the growing number of citizens who suffer from dementia.

The number of Americans with Alzheimer's is 5.3 million and there are other forms of dementia, or senility, as it used to be called.

By 2050, this will be 16 million.

I spent 18 years caring for my mother, who had simple, garden-variety memory issues.  We ran into many officials and even a couple of hospital nurses who seemed puzzled by her not making sense, her flares of anger (and swearing--a no-no when we were kids), and generalized non-tracking.

Doctors would ask her, not us, my sister and me,  what was wrong with her. She would cheerily say, "Nothing, why do you ask?" I remember a bank official who handed the phone to her to talk to Social Security--she could hardly figure out which end to put to her ear--and I had power of attorney.

I think people in the public and health sectors can use some more education on this subject.

Wednesday, October 21, 2015

Those grandkids may be lengthening your life

Actually, there are two schools of thought on that, in my opinion. Mixing of the age groups stimulates both--and the screeching and spinning in place makes you yearn for death.

However, we have an assistant prof at Saint Louis University, Angela Sanford, MD, a geriatrican (old people's doc), who says no one can be unhappy around little kids. She has three under 3 herself.

She also thinks the little ones adore and look up to their grandparents, which is good for the older folks' self-esteem. Older people, she says, can make the tots into better people.

I don't mean to be totally cynical--I have no grandkids and often wistfully wish I did. I like little kids. But my sister, who has little grandkids, can barely stand it.

Sanford says boomers are enthusiastic grandparents, as enthusiastic as they would greet a Led Zeppelin concert (best not to try those metaphors).

The pluses of grandparenting:

--Play, exercise. Tag, pushing a swing, walking around the zoo.

--Cooking. You eat more healthy things if you cook. Sanford says. Chopping, stirring and lifting heavy pots helps arthritis. Sharing family recipes with kids also strengthens bonds.

--Playing games and doing puzzles. Cards, chess, I spy with my little eye--help older people.

--Being busy busy. Kids like variety--grandparents must think up different things to do.

--Napping. OK, now you're on to something. Nap when the kids do.

--Kids also help older people stay flexible--maybe the kids' mother wants them to do something besides what you planned--Sanford says this will help you be more flexible in dealing with change.

--Prayer. If you are so inclined, you can pray with kids.

Being a grandparent turns your focus outward, she says. No time for a pity party.

So that is what older people do all day--have a pity party?

Dunno about this--maybe she has some good points. But others seem to be really reaching for a positive.

I would say hang with the kids because they are funny and you get to eat the cookies you bake. When their parents come home, say bye and have a drink.