Thursday, June 30, 2016
That's a mouthful.
Here are some:
Blueberries. Packed with phytochemicals, antioxidants, flavonoids, and soluble fiber--plus potassium and vitamin C. Reduce inflammation and have disease-fighting aspects.
Leafy greens. Spinach, Swiss chard, and collard greens deliver more nutrients per calorie than any other food.
Broccoli, cauliflower, brussel sprouts, and cabbage contain cancer-fighting agents, plus a ton of vitamins.
Salmon. The wild kind caught in the Pacific or Alaska is rich in Omega-3 fatty acids. This fish also contains protein and a range of vitamins.
Dried beans, peas and lentils. High energy foods that can curb appetite. Keep you full longer while offering a range of nutrients.
Nuts and seeds. Especially walnuts. High in calories, so a handful a day delivers the benefits.
Whole grains. Rice, oats, barley, spelt, rye, farro, wild rice and some forms of sprouted unrefined wheat. Quinoa is not technically a grain, but contains similar nutrients.
Avocado. Loaded with potassium, fiber, healthy fats, and other substances, including lutein for eye health.
Sauerkraut and kimchi (spicy) are probiotic--promoting the growth of healthy bacteria in the intestines. They also break down carbs.
Chocolate. A one-ounce serving of dairy-free chocolate--70% cocoa--several times a week improves blood flow and can improve blood pressure.
One caution, though--Don't dine on just superfoods--that can be too much of a good thing.
Thanks for all this to Marsha Nunley, a board-certified doctor in internal medicine, geriatrics and palliative care and found ote H.E.A.L.
Wednesday, June 29, 2016
Salon waxing is spendy, so many women do it at home. Jessica K. Krant, MD, assistant clinical professor of dermatology at SUNY, says never wax sunburned or very sensitive skin. Also--do not wax if you have taken isotretinoin in the last six months.
As for the "bikini area," to put it delicately, that is the epitome of sensitive skin, so maybe a salon wax is better there.
If you do opt for home:
--Be sure you hair is 1/4 to 3/4 of an inch long or less. If it's longer, cut it to that length to make it less painful to pull out.
--Avoid retinoid creams (even over the counter ones) 2-5 days before waxing your face--or you may peel off skin.
--To cut the pain, take ibuprofen or apply cold packs to the skin 30 minutes before.
--Wash the area first and dry it.
--Warm the wax. Follow all package directions and check the temp on the inside of your wrist.
--Apply the wax in a small section--spread it in the direction of the hair.
--Then apply the cloth strip. Leave it on 2-3 seconds.
--Then, hold your skin taut with one hand and pull off the cloth in the opposite direction of hair growth.
--Soothe the skin afterward with cold packs. Avoid hot showers right away and apply oil-free or non-comedogenic moisturizer.
If you are still red, swollen or sore after two days, check with your dermie.
I am not very hairy--I am just passing this along.
Tuesday, June 28, 2016
In an article by Ashley Monae, it was revealed that the Report, which surveyed 10,500 women from 13 countries, found that 85% of all women and 79% of girls said they have opted out of an important life activity because they felt less than positive about their appearance.
Nine of the 10 of the women said they forego eating sometimes because of this.
This is a global issue.
Not surprised was Nancy Etcoff, MD, assistant clinical prof at Harvard Med. She cited the increasing pressures women and girls face today. The media and how it depicts women can be a big factor, she says.
The main media, the social media, school, work--the body messages never stop coming.
The messages are all over the map. I saw one the other day that fashion mags should be able to use those super skinny, stork-like women--I didn't know they couldn't. That's all I see in there. In another instance, a Size 4 movie star was reviled as fat.
And when Dove (who did the study) ran their "real women" campaign of non-models up to size 12 (see pix)--people freaked out--they're fat, they're fat.
I don't know what the answer is...I have never been thin and had plenty of men around. I know it's hard sometimes, but just keep on trucking and worry about things that really matter.
Monday, June 27, 2016
Experts say you may have fun building a big castle during the day--complete with deep moats--and that night, a hatch of baby turtles may start scampering for the sea and get stopped by what's left of your tall walls and deep depressions.
It's nesting time now. Sea turtles, by the way, are a protected species.
Naturally, if you find a nest of eggs, you should leave it alone. But you also need to not create an obstacle course for the babies.
Please do this:
--Knock down the castles before you leave and flatten the sand.
--Fill in holes.
--If the kids object, teach them that these structures can trap the babies. Even the mothers can get stuck.
--Also remove tents, umbrellas, toys and chairs at day's end.
Speaking of beaches, if you want a wonderful story on how beaches used to be considered dangerous, disgusting places, but were rehabbed into being a fantastic destination, insert this story from Smithsonian Magazine in your browser.
Friday, June 24, 2016
But for kids, summer is paradise--travel, swimming, the beach, hiking, camping...
The docs at Children's Hospital Los Angeles have some tips for keeping kids safe:
--Use the Water Watcher strategy. When there are several adults around kids who are swimming, formally appoint one a Water Watcher for, say, 15 minutes at a time. Don't assume "someone" is watching. the Watcher should be within "touch" distance--an arm's length.
--Enroll kids in swimming classes and teach them to always swim with an adult present.
--Teach children to never play around the drains at the bottom of pools--they can suck the kids down and hold them there.
--On a boat, kids must wear life jackets. Make sure it fits properly--fasten it and have the kids raise their arms--if the jacket rises to the chin or ears, it is too loose.
--Drink water during all sports--before and after.
--NEVER LEAVE A CHILD IN A CAR, even for a "minute." We have already had some tragic deaths this summer
--For heat in general--kids should wear loose, lightweight and light-colored clothing.
--Strenuous outdoor activities should be scheduled in the early AM and late afternoon.
--Always put sunscreen on kids. Skin damage can occur in 15 minutes.
Kids are small and vulnerable, they make stupid decisions sometimes. It's up to parents to safeguard them.
Thursday, June 23, 2016
She cites a friend's husband's experience in going for a 5-mile run with his border terrier. He brought water, a collapsible bowl, but ended up taking the dog to the animal hospital anyway. By the time they got home, even after plenty of water and rest stops, the little dog was almost unresponsive.
At the vet, his temp was 105 (normal is 101.5). He animal went into intensive care, with meds to raise his heart rate and plenty of IV fluids. A week later, he was fine.
There are no stats on how many dogs suffer heatstroke, but caution is in order. Dogs cannot sweat--so they pant out the heat or sweat through the bottom of their paws.
If the dog is running (say alongside you or alongside you on your bike), they cannot discharge the heat fast enough, especially if it's humid.
A first sign of trouble can be seizures!
The dog's gums and tongue will turn a deep red.
Those flat-faced breeds like pugs and Pekinese are especially heat-prone. Older and overweight dogs are also at more risk.
Also--you may be asking your dog to walk on hot concrete. Hotter than you could stand in barefeet.
If you have your dog out in the heat, pay attention to the animal. Run in the early morning or after sunset.
If the dog slows down or stops--let it rest.
If the animal shows the red tongue, is glazed, or pants like mad, try to get him or her into water or drape with a wet piece of towel or clothing.
If the situation persists, get to the vet. Organ failure can be rapid.
Well, isn't this peppy? I am writing it, though, because in the comment section of the story, many readers said they had never thought of this.
The dog is outside in the heat in a fur coat! Think of this.
Wednesday, June 22, 2016
We have all heard of those cases of a needed medication costing thousands a month. But even more common are the $7 a day anticoagulation or cholesterol pills. Bucks! Are these new meds, especially the ones touted for millions on TV, really a value?
Former Senate Majority Leader Tom Daschle chaired the session. The longest remarks were from the head of the Health Policy Center at Duke--Mark McClellan. In a presentation starring some crammed-full Power Point slides (I am not a fan of PP), he discussed the gradual moves toward determining the value of both Part B (drugs administered in a doc's office, usually anti-cancer) and Part D (prescription) drugs under Medicare. He said this was similar to moves from fee-for-service and the new idea of fee for performance.
Before we get too lost in the weeds here, I was most impressed with the remarks of Lowell E. Schnipper, MD, chair of the American Society of Clinical Oncology (ASCO) Cancer Care Task Group.
Schnipper pointed out that cancer treatment can ruin or bankrupt families. Doctors, he said, need to take this into consideration.
--Patients need to know what they are looking at financially before treatment, he said.
--And they need to know the pros and cons of treatment approaches.
ASCO is developing an app that the doctor and patient can use together to match the patient's priorities to the available treatments. Say the patient prefers a less toxic treatment and is willing to risk some longevity, the app will outline the options, which can then be discussed. Presumably the cost will also be factored in.
Interesting stuff. Of course, I am not facing cancer treatment. That could be a different story from sitting in a webinar.
Tuesday, June 21, 2016
About 10% of those over 65 have some form of dementia--by 85, that figure is 30%-50%..
Geriatric specialist Elizabeth Landsverk, MD, founder of ElderConsult Geriatric Medicine, says we do become more forgetful as we age, but there is no need to become unnerved by every memory lapse. For one thing, dementia is not just about not remembering and involves issues with communicating and reasoning. One early sign is not where you put your car keys, but not knowing how to drive to the store by a route you have taken thousands of times.
Dementia also impairs daily activities.
Examples of things you should worry about and those which are "normal."
--Forgetting where you put your glasses--NORMAL. Putting the bills in the laundry bin--NOT NORMAL.
--Forgetting why you walked into a room--NORMAL. Confusion when writing bills--NOT NORMAL.
--Making an occasional bad purchase or decision--NORMAL. Starting to mismanage money--NOT NORMAL.
--Forgetting where you are headed in the car--NORMAL. Getting lost in your own neighborhood--NOT NORMAL.
--Having a "down" day--NORMAL. Dramatic mood swings, persistent apathy, or a change in personality--NOT NORMAL.
My mother decided to buy her favorite cab driver a car and a gun. NOT NORMAL. She also started using profanity, which she had n ever done in her life--NOT NORMAL.
There are tests you can take--even though some do not show up poor judgment. Why take a test? To me this is a good question. There are support options, if not cures, Landsverk assures.
Her main message? Don't talk yourself into having this if you don't have it.
Monday, June 20, 2016
This team had also hurried to comfort victims, families, and emergency workers--anyone really--after the Boston Marathon attack and Sandy Hook shootings.
The team consists of 12 Golden Retrievers and their handlers. Also known, as emotional support dogs, the canines lend a feeling of safety and can bring out healing and grieving in people.
They visited hospitalized victims in Orlando and were lifted up so people in bed could greet and pet them. The patients, said a spokesperson, started smiling or even crying for the first time. They also started talking.
Comfort dogs are not considered service dogs under the Americans with Disabilities Act, but are often used in nursing homes, college campuses, or airports, according to Jonah Engel Bromwich, NYT, June 16, 2016.
While it is not fully known that the effects of comfort dogs are lasting, they do reduce anxiety and depression and even PTSD.
Sometimes a creature who cannot speak can say it all. Or make a start anyway.
Friday, June 17, 2016
I lost the whole amount two and a half times--but am still large. When I turned 40, I tossed the scale and started just living. My own daughter is not thin--but I rarely if ever say anything. What can I say? We always had healthy food in the house, did not pig out on Hostess, etc. And here we are.
Roni Caryn Rabin wrote about this in the New York Times, June 16, 2016. She cites a study in the Journal of Eating and Weight Disorders that says that parents' careless, though usually well-meaning, comments about weight are often predictors of unhealthy dieting, binge eating, and other disorders.
Comments about weight can stick with a daughter, for instance, even if she is not overweight as an adult.
Girls are especially susceptible to negative comments because they are "expected" to be thin in today's culture.
The study looked at 500 women in their 20s and early 30s who were asked about their body image and also about how their parents commented about their weight. Even the nornal weight women who remembered comments were likely to think they still needed to lose.
One investigator called such comments "a scarring influence."
The study also showed comments from family members stuck more than those from unrelated people.
When parents talked to their kids about losing weight, emphasizing healthy eating rather than weight caused fewer unhealthy behaviors to develop.
Tying weight to the perception of the child makes the child think they are not valued.
So what can a concerned parent do? Suggested were:
--Keeping health food in the house and not buying soda.
--Having family dinners with pleasant subject matter.
--Being physically active as an example.
--Not bemoaning your own weight.
If the child ASKS for help in losing weight, research it and do it. Of course, my mother a retired home economics teacher, did try to help me--but in weird ways--such as saying eat only cottage cheese.
This may not be one you can win.
Thursday, June 16, 2016
|About to toss virtual cookies?|
I have learned, though, that peering into the headsets--Oculus Rift, HTC Vive, SonyPlayStation VR, and Google Cardboard--can cause a conflict between the soaring, flying, or driving the viewer "sees" in the headset and the messages from the inner ear's vestibular system, which governs our sense of motion, equilibtirum, and spatial orientation.
In short--you feel wacky. It's a form of motion sickness.
Now, some researchers from Columbia University have tinkered with changing toe user's Field of View (FOV) can cut the symptoms.
By 2020, there will be 200 million VR headsets in play.
The scientists used a body of theory called change blindnesss--wherein someone does not "see" even an obvious change of scene.
This makes the changes in Field of View invisble to the user.
On the downisde, decreasing Field of View can make the VR experience less vivid. So they found a way to change the Field of View depending on the need.
They tried this out on 30 volunteers. Basically, those with the FOV restrictors stayed in VR longer and were more comfortable.
If I ever try VR, I hope this system is standard--I have already been tested for weird vestibular effects, dizziness especially.
Wednesday, June 15, 2016
The title of this job is Male urogenital teaching associate (MUTA) or gynecologic teaching associate (GTA).
A big emphasis is on how to make such exams more comfortable for the patient. They provide feedback during the exam.
This is considered a better system than using untrained volunteers or as in the old days, a mannequin (although some advanced mannequins are still used).
The emphasis on making the patient feel comfortable during exams of private areas is aimed at encouraging patients to keep up with such exams periodically.
These instructors teach students how to teach patients about their own bodies.
No nursing degree is needed to do this, although many of these instructors do have them.
As for feedback, the program's leaders say students come in terrified, sweating, dreading, and leave happy saying it was an AWESOME way to learn.
I would say having 25 pelvic exams in a day is a lot for these instructors--but I guess it's up to them. I always favor trying something new.
Tuesday, June 14, 2016
Now, for the first time, the American Academy of Sleep Medicine has released official sleep recommendations for babies to teenagers. (J of Clinical Sleep Medicine--June).
--Infants 4 mos to a year: 12-16 hours per 24 hours--naps included.
--Toddlers 1-2 years of age: 11-14 hours per 24 hours, including naps.
--Children 3-5 years old: 10-13 hours per 24.
--Children 6-12 years old: 9-12 hours per 24.
--Teenagers 13-18: 8-10 hours per 24.
It's important to establish sleep habits early in life, in early childhood, said the panel moderator.
The recommendations came from a 10-month long study of the nation's foremost sleep experts.
Sufficient sleep is linked to better health outcomes, improve attention, behavior, learning, memory, regulation of emotions, quality of life, and mental and physical health.
Getting less sleep than recommended can increase the risk of accidents, injuries, hypertension, obesity, diabetes, and depression.
More than a third of all people in the US do not get enough sleep.
Monday, June 13, 2016
These machines use pulsed xenon ultraviolet light to clean the ORs each night. The process takes about 10 minutes.
First, the staff used their usual chemicals to disinfect, then the robots threw the ultraviolet into every nook and cranny.
Hospital-acquired infections are a leading cause of death--75,000 to 90,000 a year.
Using the ultraviolet was thought to have prevented 23 infections--and saved one life (infections claim the lives of 3% of those who get them). This could have saved as much as $478,000.
Xenex Disinfection Services, a San Antonio company whose robot is shown here, said this hospital was the seventh to report reduced infection rates from the robots.
Sure sounds promising--bring them on.
Friday, June 10, 2016
|This could pass for dinner.|
I know, it sounds improbable, but some even "full boat" scholarships do not include the "food plan." The students in the story reported eating one meal in the cafeteria and taking fruit or some other items for "later."
In other words, even at the most fancy-schmancy Ivy League schools, some kids suffered from food insecurity.
Many of the commenters on the story scoffed at this and suggested more ramen or told the complainers to get a job, but I gather this is a legitimate issue.
In ON WISCONSIN, the University of Wisconsin alumni magazine, there was a story on this at the very prestigious University of Wisconsin.
In February, a food bank opened in the student union. It receives funding from student fees for staff and operational fees, but relies on donations placed in bins around campus (student fees cannot be used for food).
Summed up Samantha Arriozola, class of 2017, "When people get to a Big Ten university like UW, they assume everyone automatically turns middle class once they are here, which is not the case."
How about where your kid goes to college? Or what about your kid period?
Thursday, June 09, 2016
But it has been pointed out that the groups are not the same. Writing in JAMA Internal Medicine, a group at the University of Michigan found, among other things, that the groups differed in coverage use in the last six months of life.
The ones in Advantage Plans--operated by insurance companies--were younger and healthier than those in the traditional "fee for service" Medicare.
These users also were more likely to be black, live in cities, and not qualify for Medicaid.
Yet, health policy decisions are made by looking at data from traditional Medicare. It's easier to get that information.
This could mean policy makers are overestimating the severity of illness for Medicare patients in general.
The study team looked at data from 9,285 participants between 1998 and 2012. A fourth of that sample had Advantage.
The upshot is we should not base decisions on 3/4s of the users. Or as it pertains overall--2/3s of the users.
When, oh when, will someone get all this right?
Wednesday, June 08, 2016
Now, UCLA has instituted a program for volunteers to visit patients with few visitors.
When you are in the hospital and feeling lousy and someone only ducks in a few times a day, it gets lonely. Sometimes older people, especially, are not in the same city with their kids and their friends may also be older and unable to run over to the hospital all the time. Also, even if a patient does have caregivers, sometimes those people need a break.
The Geriatrics Unit's Companion Care Program launched a year ago and has 45 companions signed up--the goal is 200.
They wear bright green polo shirts and often read to patients, play games with them, assist with feeding, or perform other tasks.
Some patients even tell the companions their life stories--as part of "The Living History Program."
A lot of the patients suffer from dementia, but still respond to a smiling face.
"They love talking about their lives," one volunteer said. "And I love hearing about them."
Tuesday, June 07, 2016
The study, in Trends in Cognitive Sciences, was done by some psychiatrists from Oxford on emerging research on how cute infants and animals affect the brain.
"Cuteness," of course, triggers protective caregiving, which keeps babies alive.
Infants really lay it on--clicking with all five our our senses. The chubby cheeks, rosebud mouth, the giggle or little grunts, soft skin, and a great baby smell.
Scientists have peered into parental brains and found that cuteness triggered immediate reactions (awww, high squeaky talking) and slower ones, too, such as play, empathy, and even morals.
This is more than simple, instinctive behavior--cuteness affects both men and women and even those without children of their own.
Go, babies--you are on the right track.
Monday, June 06, 2016
Of course, catheters can also CAUSE infections--which a person with an infection does not need.
Now, though, there is a large national effort to show it's possible to reduce catheter use and UTIs at the same time.
More than 600 hospitals are working on this (NEJM).
The program, in more than 10% of US hospitals, shows the system can be changed. Overuse of catheters is partly medical and partly cultural--in the latter case, because "we have always done it."
The program is dubbed (weirdly) ON THE CUSP: Stop CAUTI (don't ask, I don't have room to type why).
It's a bundle of protocols, checklists, training modules, and data sharing practices to encourage:
--Daily checks on patients with a catheter to see if they need it
--Less idwelling catheter use and more use of other means
--Training on urinary management
--Regular use of infection-prevention techniques for those who need a catheter
--Feedback on how it's working
--Coaching calls from regional leaders on how the program is going
Results of the first four cohorts (60% in non-ICU medical and surgical wards):
--A 14% drop in use of catheters
--Infection rate dropped 32%
--ICUs did not see a big effect because patients there are monitored more closely for everything, incl UTIs
Any hospital can now access the toolkit via the Agency for Healthcare Research and Quality (AHRQ. gov).
This could be a boon to older sick people and surgical patients. Yay! Often, we found with Mom, the catheter was put in wrong anyway and the patients felt like they had to "go" the whole time--even though the urine was being collected. Very uncomfortable--even without an infection.
Friday, June 03, 2016
|All fun and games until....|
Talk to any professional food worker and you soon learn knife and burn scars are almost mandatory. They all have them. Think about it--kitchens mean high heat, sharp blades, crowded surroundings, and fast moves.
Well, cooking over open flames outside with guest grabbing attention and kids careening around isn't much different.
Grilling food may smell good and divert the senses, but grills are hot. So are open flames and even light gray banked charcoal.
---Never pour water on coals. Steam flies up and can scald.
--Keep baking powder handy for grease fires--water is no good.
--Keep children and pets away from "fire starter" or lighter fluid. NEVER use gasoline.
--Keep kids and pets three feet away from the grill--at very least. Never leave the grill unattended by an adult if kids are around.
--Don't lean over the grill. Scarves, shirt tails or apron strings can catch on fire.
--Use flame-retardant mitts and long utensils to avoid burns.
--Never move a hot grill out of the way--wait until the next day.
--Also, remember burning charcoal produces carbon monoxide, which can kill in enclosed places. Never grill indoors such as in a garage, tent, RV, camper or other space.
And I would add--don't get so used to grilling you think you are immune to these rules. Big mistake.
Otherwise--when's the party--I will bring the potato salad.
Thursday, June 02, 2016
There is no doubt that barbeque is sweet/salty, fatty, and utterly delicious. But it isn't exactly health food.
Lona Sandon, assistant prof of clinical nutrition at Southwestern, says low-fat does not necessarily mean lower calorie--because if the food is bland (fat is delish), people will eat more to get some satisfaction.
Some ideas to make barbeque a frequent treat:
--Offer taco salad bowls instead of burgers
--Substitute lean ground turkey for beef or cold cuts
--Grill up a lot of veggies to go alongside
Tips for lower cal preparation:
--For chicken wings, take the skin off--bake or grill, don't deep fry
--Make your own hot sauce without the butter and use low-fat versions of cream cheese, sour cream, or bleu cheese or use plain Greek yogurt.
--Try vinegar-based sauces instead of those with lots of brown sugar. Eat chicken and beef--to lower the calorie count. Make kebabs with big chunks of veggies alternating with meat.
--For ribs, beef ribs are leaner than pork ribs. Try baby back instead of normal. Consider brisket.
--Try a rub on veggie, turkey or soy burgers to get the burger taste.
--Use 100% beef franks and wheat buns or tortillas.
How to keep the food safe:
--Refrigerate foods the minute you get home from the store.
--If you are not using the meat for a few days, freeze it. Never refreeze thawed meat.
--Keep meat cold before putting it on the grill.
--Wash hands when handling meat. Also wash cutting boards, and utensils. Use different dishes for raw and cooked meat.
--Use a meat thermometer--don;t guess. Cook ground beef until juices run clear. Meat should reach 145 degrees, poultry 160.
--Pork needs to reach 155 inside to kill the parasite that causes trichinosis.
That last sounds horrible, but the rest sounds pretty darn yummy.
Wednesday, June 01, 2016
First, they point out, cooking beef, pork, fish or poultry with high temperature methods such as grilling over an open flame can increase chemicals that can cause changes in DNA and also increase the risk of cancer.
Red meat and high temp grilling can both up the risks of colon cancer.
So the idea is to minimize the time on the grill:
--Microwave the meat first
--Turn the meat often while grilling
--Remove charred or blackened parts before eating.
How to control calories at BBQs:
--Eat a low calorie snack or salad before going to the party.
--Drink water instead of other drinks.
--Drink water when eating haigh salt foods. Remember, one drink for women, two for men.
--Eat smaller portions.
--Make a plate of little samples.
--Don't stand by the buffet table.
OK--tomorrow...Good nutritional tradeoffs for summer foods and how to keep food safe in outdoor environments.
Look--I know most people won't drink one drink or eat only baby carrots...these are just ideas.