Wednesday, September 30, 2015

Pretty soon--falling leaves

I love trees, but they can't seem to keep it together. All the "stuff" falls off many species about this time of year--and guess who gets to rake up the results?

Raking leaves, says Kaixuan Liu, MD, founder and president of the Atlantic Spine Center, requires a lot of movements--twisting, bending, lifting, reaching.

Ouch!

Ways to avoid leaf-related injuries:

--Stretch before a raking session--back, leg, and shoulder muscles, neck. Hold each stretch 30 seconds.

--Avoid twisting. Don't just plant your feet and twist around to get to accumulations. Let your feet do some of it.

--Don't hunch over. Keep legs should-width apart, bend knees slightly. Make sure your rake is the right size to prevent leaning over.

--As you gather leaf piles, bend at the knees. Leaves don't look heavy, but they can be.

--Take a break every 15-30 mins.

--Stretch gently when you are done and headed for the couch.

If you still get aches and pains, esp 24-48 hours later, ice the area for 20 mins.

Another good method is to get your kid to do the raking.

Tuesday, September 29, 2015

The lowdown on blood pressure--sort of

An ideal blood pressure, for years, has been 120/80. Yet, many people have a top number of 140-150, even if on medication.

You probably heard that some researchers think that is passe for people 50 and over---maybe it needs to be even lower to prevent cardio events and deaths.

One in three adults in the US suffers from high blood pressure. Adults over 54 and blacks are particularly vulnerable.

National Institutes of Health did a study called the Systolic Blood Pressure Intervention Trial and was so impressed with the results, they stopped it early so they could share the results.

Apparently many people being treated for hypertension were hitting a top number of 140--not 120. If it could be kept at 120, according to these findings, heart attack, stroke, and heart failure would be reduced by a third. Or so preliminary data show.

So should older people shoot for this? The doctors are being cautious--awaiting the full results.

One doctor says if someone is between 120 and 140, she explores their medication, lifestyle, and other factors to see if it could go lower.

Wouldn't that take a lot of drugs? The cost of drugs, adherence, tolerance--all are factors.

People also should walk 30 mins a day, reduce weight if needed and feasible (5% reduction will help),

I take three modes of BP med for "the family curse." When I get 120 over maybe 85, I think they took it wrong.

I also think older people need SOME pressure to get blood to the top floor.

But what I think is not important--ask your doc.

Monday, September 28, 2015

New type of personal tent on horizon

This could be in the "better mousetrap dept." At the Swiss Textiles Assn's Innovation Day, a new startup called Polarmond presented an all-in-one sleeping system.

It is a sleeping bag, mat, and bivouac in one. The sleeper heated by his or her own body heat at temps down to thirty below.

It is a spacious inner room--not just a sleeping bag. And it's lightweight.

They call it Magic Tent.

They faced many challenges--for one thing, the insulated material does not touch the body to hold in the heat. This means humidity from the body gets in the air. This gets trapped in a liner. What's left gets taken up by the warmed air in the sleeping "cell," even if the outdoor temp varies.

I am not very versed in tents--does this sound new, different, and promising?

It may hit the market in March of 2016.

Friday, September 25, 2015

I am not really a "green" expert...

Gorgeous, huh?
 Go meatless, eat a plant-based diet, everything is melting (or freezing more), all the palaver over environmental issues is hard to unravel. You're a dope, yeah, well you're stupid--I put my hands over my ears!

But in my dealings with city hall here in AZ over my yard--they want me to poison my stray grass--claiming my yard can either be all rocks or all grass, not a mixture--I am getting a little more focused.

Why can't it be a mixture if it's neatly kept? I like green amongst the beige. The beige rocks look like bomb rubble. Ugly.

Even though my daughter pitched a fit saying let them take us to court! WhatEVs...I got the grass poisoned. The landscaper used something called Pin Dee 3.3 T&O to prevent anything from sprouting for (he said) 5 mos.

The day after he did it--turning the ugly beige rocks an evil glowing yellow--I got sick, vomiting. I am sure it was stress--not this concoction (how close is it to Agent Orange, I wondered). But...

The only side efx (besides slaughtering "ornamentals") listed was hives. Didn't get those.

However, in the aftermath, I also read up on the popular weed killer RoundUp. This is the most widely known herbicide. Its main ingredient, "glyphosate" is a known carcinogen--cancer causer.

Used  on genetically modified seeds, this is linked to antibiotics resistance and hormone disruption.

Monsanto introduced this stuff in 1974--it kills weeds by blocking proteins essential to plant growth. Now it's used in 160 countries--I have used it.

Now it has been tweaked so crops tolerate it but weeds still die. It is slathered on both.

What does this mean? We don't know because the US Govt does not test food for pesticide residues.

A recent study by the USGS found it in the rivers and streams of 38 states sampled. It is also in 70% of rainfall samples.

What about the cancer connection? Wishy-washy. "Probably raises the risk of cancer in people exposed."

So the next time you go to Home Depot, you decide.

I still maintain our government, in my case the city, should not be forcing people to slop poison around. Poison has a bad rep. That Bermuda grass never killed anyone.

Thursday, September 24, 2015

What about this year's flu shot?

Not a big horse needle like this.
Some years, I get a flu shot, other years not. My own doctor had a fight with his wife over whether to get them.

I probably will not this year because I have no transportation anyplace anymore--have not been out for eight months.

And it seems pretty often, the strains of flu in the shot don't match what turns up and the protection--never total--is sketchy. (I also had two pneumonia shots and got it.)

A primary care physician at Penn State Hershey Medical Group, Jay Zimmermann, MD, says it looks like the choice of strains this year is good, but the shot may offer protection no matter what strains are in it.

It could make the flu less horrible if you do get it.

The vaccine causes you to generate antibodies--if they are the same ones as the strain you are exposed to, the body responds more quickly and vigorously.

But you will still get antibodies without a strain match--and more if you get the shot every year.

As for whether the vaccine "makes" you get the flu--Zimmermann says you are more likely to get it from someone in his waiting room than the shot.

The injection form is a dead virus--recommended for people 6 mos and up. The nasal mist form is a weakened virus--not for people with immunity issues.

Over age 50, people are told to get a superduper strong shot. I have all sorts of medication issues, and I have had this strong one without incident, but it makes me nervous.

Also I heard that right now they may be injecting last year's--not sure on that one--ask!

So it's up to you... I probably jinxed myself just writing this. By the way, would you take medical advice from a person who believes in jinxes?

Wednesday, September 23, 2015

Hot flash: Young people like peaches

Eighteen to 24-yr-olds are more likely to buy peaches than those 51 to 68.

Young people also like crisp, firm, flavorful peaches. Older people prefer sweet peaches that that melt in your mouth.

This from a survey at the Univ of Florida Gainesville (Hortscience, Aug 2015).

Why do the older people shun peaches...The researchers think it's because they bought bad peaches in the past and turned to other fruits over time.

Overall, consumers like tasty peaches. Well, call the newspapers!

In the study, peaches so sweet no sugar was needed were preferred.

People buy them less for antioxidants than for flavor.

Technically, peaches are categorized as melting, non-melting, or stony hard.  Melting peaches become softer as they ripen and non-melting remains firm and are usually used in canning.

Florida's stone fruit industry has relied on non-melting to the fruit can ripen on the tree. But consumers want melting.

Me, I want cobbler and fresh peach ice cream or a big juicy peach that dribbles juice down my chin.

Tuesday, September 22, 2015

A treatment for your body alone

Mayo Clinic VP Gianrico Farrugia, MD, keynoted the Individual Medicine Conference this month.

He highlighted five ways knowledge of the human genome will impact patient care--potentially that means you.

He calls these "value adds" to medicine.

First, pharmacogenomics--prescribing based on a person's genetic info--is helping avoid harmful medication reactions. Mayo embedded genetic info in its patient's health records--they say avoiding 3500 drug reactions.

Genetics and the  micobiome (makeup of the stuff in your gut) can tell doctors if you are at greater risk for some diseases as well as how well you will recover from them. This knowledge can also treat disease.

Whole exome sequencing---sequencing the core elements of the genome--can offer a diagnosis after years of questions, inconclusives and ineffective treatments.

Technology to sequence cell-free DNA in body fluids to diagnose cancer is rapidly advancing--this means not cutting into the cancer itself for a biopsy.

And, last, new vistas have opened in using non-invasive DNA testing to find genetic alterations during pregnancy.

Farrugia calls all this "precision medicine"--and more precision is usually a huge plus. It will make the old ways look pretty clunky, I suspect.

Monday, September 21, 2015

Geo Washington Univ starts health workforce policy institute

"A robust, trained workforce is an essential component of an effective healthcare system," says Fitzhugh Mullan, a professor of medicine and health policy at the Milliken Institute of Public Health, which along with five other GWU schools, will bring a multidisciplinary approach to health staffng.

Given last week's ignorant-sounding slams at nurses on ABC-TV's "The View," maybe some such efforts are in order.

The GWU effort is being billed as one of a kind.

Of course, the mission contains all the right themes--dialog, consensus, analysis, local and worldwide, etc.

Specifically, it will be trying to find solutions for gaps and shortages in specialties and certain geographical areas, migration and equity between have and have-not nations, worker abuse when personnel are recruited from other nations, the need for teamwork, impact of new technologies, and other issues.

A lot of people will be writing a lot of papers, I expect.

This is not to disparage this--I am a GWU alum (The Elliott School)--but I wonder what the impact will be beyond Congressional testimony and conferences.

We will find out.

Friday, September 18, 2015

Shrink pool shrinking

No--it has not come to this...
I can say "shrink" for psychiatrist because my father was one. (I know--explains so much.)

Anyhow, the demand for psychiatrists has become so great, lawmakers in many states are expanding so-called telehealth--shrinking via computer.

Bruce Japson, Forbes.com, writes about this. He says demand for psychiatrists is almost as great as the demand for primary care doctors.

A recruiting firm, Medicus, says every fourth placement is a psychiatrist.

Efforts are also made to get more doctors-in-training to choose psychiatry. Texas passed a bill to pay off student loans of doctors who work in underserved areas.

What with the seeming increase in weird behaviors, spree shootings, scary Facebook postings, and so on, maybe we should pay not only the tuition to doctors who choose the mental health area, but also give them a big bonus!

So many people--parents--also can't get their kids the mental help to kick drugs and straighten out.

One issue is that insurance companies are not putting mental health services on a level with physical health reimbursements. A psychiatrist visit takes an hour, a physical one 10 mins. Can you reimburse the shrink 6 times as much?

Is telehealth the answer? Maybe it could be part of an answer.

Thursday, September 17, 2015

Do you have orthorexia nervoso?

Calm down--it's just docspeak for a diet that is overly restricted according to what people think is "healthy."

It's not in the official disorder list--but a psychologist at Rutgers says it is coming up more and more.

She is Charlotte Markey, author of Smart People Don't Diet: How the Latest Science Can Help you Lost weight Permanently. (I have                                                         not read it.)

Orthorexia, she says, is maladaptive eating that begins with good intentions. People begin by eliminating "bad" foods--sweets, carbs--and before they know it, more things are eliminated--salt, wheat, diary... This goes beyond being a vegan.

Carbs, she says, have a function--they give us energy. Low energy can put us at risk for depression as we drag around.

Orthorexics usually are obsessed with good--what to eat, what not to eat, guilt, shame.

The quest for a healthy diet takes over their lives. They avoid social occasions involving food.

If you think you have slipped into this mode, what can you do?

Markey says first have a dietitian go over your intake and see if you are being deprived of nutrients.   That person can also help you devise a healthier regimen.

You may also want to consult an eating disorders specialist--this disorder can be related to OCD, which means it can be treated with medication or talk therapy.

Food is fun, food is life--don't turn it into a horrible chore and an endurance contest of deprivation.

Wednesday, September 16, 2015

Kids, kids--don't take these horrible new drugs

Think you're cool now? Give it 10 yrs.
NYU researchers are tracking the use of so-called "novel psychoactive substances (NPS) in the US and worldwide.

These are such things are "Spice"--synthetic marijuana, and "bath salts" such as "Flakka." (Search above on this site.)

A new study in Drug and Alcohol Dependence found self-reported use of 57 different new drugs.

The new drugs were popular among males, whites, older individuals, and those of lower income--and those in cities.

About 1% reported use of the new drugs. Almost all of these also reported lifetime use of alcohol, marijuana, cigs, ecstasy, coke, and LSD.

The old standbys--LSD, cocaine, and ecstasy (Molly) are also commonly used.

Bottom line: The numbers were lower for the new drugs, but overall, a lot of people are taking a lot of stuff.

I am not a prude--I did some drugs back in the day. The key is you need to stop and get on with life. No do-overs.

Tuesday, September 15, 2015

Weight shaming--the last frontier of discrimination

Well, probably not the last frontier--people always want someone to look down on and at the moment, immigrants are in the box. But this dark side of obesity--weight stigma--is still much with us.

Weight-based discrimination in the US rose by 66% between 1995 and 2005. Among young women, it's more common than age or sex discrimination.

It is also the most common cause of bullying among children. One study showed that weight stigma causes juries to be more likely to find someone guilty! Physicians sometimes stop at seeing someone is fat--well, there's the problem!

Does this motivate people to lose weight? No--because if it did, there would be no obesity. Overweight people often counter negativity by eating. They can become depressed, filled with anxiety, and even suicidal.

Over their body size?

Yup--two out of three people reported being stigmatized. And stress can increase the reaction to cortisol--a hormone. Heightened cortisol stimulated appetitite, dampens satiety, prepares the body to store fat and makes palatable foods look even tastier.

All this stigma comes from societal norms--thin is in, fat means you are lazy, sloppy, and incompetent.

But the factor of personal responsibility, say experts, is overstated. Obesity is not a lifestyle choice, Body weight is the result of many complex factors, environmental, genetic, biological and behavioral.

Of the people who do manage to lose weight, 95% regain it--and sometimes more.

I am particularly annoyed with people who toss around the term "morbidly obese." They are not doctors--this is designed to hurt.

And remember--what goes around comes around. My skinnier sister sneers at my body size, but when she hit menopause, she gained quite a bit and was horrified. Oopsie.

And they could lose those awful shows on people who are over 600 lbs. Fat porn.

Monday, September 14, 2015

Should you get a checkup before a wilderness event?

All the youngsters are getting pre-participation exams (PPEs) before football season begins--but how about you not-so-youngsters who participate in wilderness and adventure events? Are you good to go--and to climb, run, dodge bears, roar around all day?

The Clinical J of Sports Med took this on in a special issue. They say there has been a noticeable increase in extreme endurance events out in the back country. And middle-aged or older people are taking part.

The idea of PPEs for this is not to disqualify people--but to identify the risk factors for injury and illnesses during strenuous activities.

In other words, don't underestimate risks or overestimate skills.

Things have to be considered are high altitudes, mountaineering or climbing, deserts, water, extremes of heat or cold, and special populations.

Sounds like a pretty good idea to me. Not that your humble correspondent will be crawling across any deserts--well, maybe to get the mail, but that's it.

Friday, September 11, 2015

Time to throw out old prescriptions

You know you do it--save old drugs "just in case." Kim Cimarelli, pharmacy manager at Penn State's Milton S Hershey Medical Center, says this is a bad idea.

The FDA also warns that older medication can be dangerous.

--The chemical composition can change as it sits in your hot steamy bathroom cabinet--or anyplace. They can become less potent--or sometimes, MORE so.

--Kids can get to those inviting amber bottles if you have them around.

--Older people can get "confused" and take stuff they should not have and do not need.

--And people self-medicate--"Well, this cleared up Mom's infected eye, worth a try..."

--Many of the overdoses from prescription drugs come from using someone else's.

--And you can become the target of a criminal--stealing from people, say during a party, is easier than sticking people up on the street.

But how do we get rid of this stuff?

--Well, don't flush them down the toilet. There is detectable drug residue in our drinking water and streams.

--Instead go to http://dea.com and find a Take Back Event.

--Many police depts also take back drugs--you don't have to talk to any cops, just throw in the bottles. No needles, aerosols, inhalers, liquids, ointments, or creams.

See? Now this is getting too hard. And the pill hoarding continues. Not by my readers, of course.

Thursday, September 10, 2015

Paying women to get mammograms

What to do, what to do
My health plan offered me a $15 gift card to get my mammogram. These payments can range up to $250--the theory being that insurance cos may pay out less in the long run if they can catch breast cancer early.

Harald Schmidt, PhD, an assistant prof of Medical Ethics & Health Policy at the Perelman School of Medicine (Univ of Penn), draws a distinction between paying people to get weight loss or smoking cessation therapy. Incentives support behavior change there.

But he says breast cancer is different. Women need to weigh a lot of variables of benefits and risks.

Screening only reduces chances of dying from breast cancer--screened women do die.

Some cancers identified never develop into lethal forms. The mammogram can lead to over-treatment.

All participants face periods of worry due to false positives and biopsy complications.

The U.S. Preventive Service Task Force's guidelines recommend mammos every two years for average-risk women 50-74. For ages 40-49, there is moderate certainty net benefit is small.

Women receiving brochures and information (this should be incentivized, not the mammos, Schmidt says) are less likely to be screened.

Incentives should support and not distract from informed decision-making, he says.

So what is the bottom line here? Decide for yourself--knowledge of the incidence of false positives and risks of overtreatment is good.

Me, I am suspicious when my insurance company wants to give me money. They only pay 15 cents of my $30 prescriptions. And they also offered me a gift card to get screened for mental decline...or whatever that "wellness" thing is all about. My detector is going ooga-ooga!

Wednesday, September 09, 2015

How to stop nail biting..maybe

I used to bite my nails as a kid...Was told I would damage the nail bed--don't think that happened but my nails do split sideways sometimes--probably some vitamin deficiency or old age or something.

The American Academy of Dermatology says nail biting usually begins in childhood. They cite all the usual reasons you should not do it--damage to nails, infection in the nail area, conveying germs and viruses to your body as a whole.

To kick the habit:

--Keep nails trimmed short.

--Apply bitter-tasting stuff to the nails--ask the pharmacist (no prescription needed).

--Get regular manicures.

--Cover your nails with tape or stickers.

--Replace nail biting with a good habit--like squeezing a stress ball.

--If you have triggers--such as hangnails--fix them.

If you have tried and tried to quit and can't--consult a doctor. I would not call a doctor for this alone--good grief, call a doctor for nail biting? The doctors I know would laugh you out of the office.

I tried that bitter stuff--or my parents tried it ON me. Got used to it. Now, I don't bite. I have a worse habit--overplucking my facial hair with a tweezers. I may go back to nail biting. Haven't decided.

Tuesday, September 08, 2015

Could Vitamin C replace exercise?

A paper at the 14th International Conference on Endothelin suggests that taking Vitamin C supplements daily can have similar cardiovascular effects as regular exercise in overweight or obese adults who find it difficult to walk for exercise.

The blood vessels in these individuals have an elevated activity of small vessel-constricting protein (ET). Because of this high activity, these vessels are more prone to constrict, becoming less responsive to blood flow demand--and more at risk for developing vascular disease.

Exercise reduces ET-1 activity, but if you are overweight, exercising is more difficult.

So, a study at the Univ of Colorado Boulder examined whether Vitamin C also lowers ET-1 activity.

They found that a daily supplement of 500 mg, time release, reduced ET-1-related vessel constriction as  much as walking did.

They pronounced this an effective lifestyle strategy for overweight and obese adults.

There are few side efx from taking Vitamn C--maybe creating expensive urine as most is excreted. There are some interaction problems with other drugs.

Will I get on such a regimen? I will need more info--for one thing, I have heard that older systems cannot break down time release pills as well as younger ones. And I tend to resist most pills.


Friday, September 04, 2015

"Gaydar" may not be scientific

Thinking you can tell whether someone is gay or straight based on appearance--gaydar--was boosted by a 2008 study that seemed to show people could accurately tell based on people's faces.

A new paper in J of Sex Research, challenges this gaydar myth. First, say the researchers at the Univ of Wisconsin Madison, this is stereotyping and can be harmful.

Instead of stereotyping, people call it gaydar, which sounds kind of cute.

They also questioned the earlier study, saying the gay and lesbian pictures were of higher quality. When all were of the same quality, the participants did not choose as accurately.

They also told the study participants three different things. One group was told gaydar was real, another was told it was stereotyping and the third did not define gaydar.

The group that was told it was real picked "gay" people more than did other groups, often based on other clues--such as "he likes shopping."

Stereotyping can encourage aggression--studies also show this.

People can be prejudiced, one researcher said, but not want to seem like they are--they exercise prejudice when they think they can get away with it.

Thursday, September 03, 2015

Guilting teens into exercising does not work

"Get off your butt and go throw throw the ball around outside, you fat ass" is not a recommended way to get pre-teens to exercise more.

It took some scientists at the Univ of Georgia to figure this one out. Their study appears in the Sept issue of Medicine & Science in Sports & Exercise.

Middle school is a crucial period--kids decrease their activity 50% between fifth and sixth grades.

The key is for the kid to see the fun and benefit of exercise--maybe even from a younger age, so they self-identify as a sports kid or athlete when middle school comes.

---This means teaching more structured games in elementary school

--Integrating physical activities into academic lessons

--Or expanding community athletic leagues to give kids more sports opportunities.

Just as some kids are drawn to art, others are drawn to activity. What you want is for all of them to seek out the activity part.

Kids should instigate it--because it's fun, because its competitive (like their video games), and because it makes you feel good. The wrong reasons are because a nagging parent browbeats them into it.

Hackysack--I never got that one. Why would kids kick a little bag up in the air unless it was fun somehow. But they do, so it must be.

Also, I don't know about your neighborhood, but a driveway basketball hoop gets plenty of action where I live.

Wednesday, September 02, 2015

Bicycle riders over 45 leading injury list

Remember Secy John Kerry careening around in France and breaking his leg. He's 72, I think.

A new study at UC San Francisco shows bike accidents on the rise, with the most crashes hitting people over 45.

They looked a info from 1998 to 2013. Hospital admissions for bike mishaps more than doubled--especially head and torso injuries. (Sept JAMA)

The injuries were bad too--not just enough for the ER, but also for hospital admission.

One doctor said if a 25-yr-old and a 60-year-old get an injury, it's likely the 60-year-old's will be worse.

Head injuries went from 10% of the total to 16%.

Why? More speed racing, faster bikes, and maybe meaner cab drivers?

So take a spinning class--no cab drivers would ever go there..

Tuesday, September 01, 2015

Hopefully this may clarify confusion over prostate testing

First, I am not a doctor--this is not medical advice. This is a start at learning more about options for maintaining prostate health.

This advice comes from Michael J Misialek, MD, assoc chair, dept of pathology, and assistant clinical prof in pathology at Tufts. He is the guy who looks at PSA screenings and biopsies.

PSA stands for Prostate Specific Antigen. It's a blood test using the same blood they take for cholesterol screening. PSA testing, however, is not always ordered.

--There is no consensus wbout when to start PSA screening or how often to do it.  The controversy is that is can lead to costly treatment for cancer that may not be aggressive. Misialek recommends at least talking with your doctor about it at age 40.

--Elevated PSA does not always mean you have cancer. It can be a good indicator, but other things cause elevated PSA, too. Eighty percent of cancers have an elevated PSA.

--A biopsy confirms the diagnosis. This will show the type of cancer if it is cancer.

--Request your pathology report. Talk to the pathologist.

--Be part of your care plan. You will make your own decisions.

--Rushing to surgery and intense treatment is not always best. Sometimes it's best to begin a period of active surveillance to monitor the cancer's growth. If surgery is necessary at some point, it can be followed by radiation, chemo or hormonal therapy.

There are some new tests coming, also. The Prostate Health Index--now in early trials--may be more accurate than the PSA.

Genetic testing may also predict risk. The same gene that is thought to cause some breast and ovarian cancers--BRCA1 and BRCA2--may also be linked to early-onset prostate cancer.

These are areas to explore with your doctor. Don't be afraid to ask questions, do some research, and don't just freak out and insist on surgery to get the thing out...

Think before you react.