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.