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?