Wednesday, August 31, 2016

The "heartbreak" of psoriasis

The term "heartbreak" was used decades ago in a commercial for some psoriasis cure--and in our family we have called this autoimmune disease "the heartbreak" ever since. In an ironical way, of course.

Yes, psoriasis, a hereditary disorder, can be unsightly--a scaly red rash--and can spread over quite large areas...My sister once had it all over almost, in a terrible outbreak. I have had elbow patches on and off all my life--and a patch on the back of my hand for 30 yrs.

Psoriasis affects 2% to 5% of the population--meaning 16 million people in this country.

It is  not just a skin disease--it's a multi-system inflammatory disease of the immune system, which can also affect the joints.

People with psoriasis are also at higher risk for high blood pressure, diabetes, depression, psoriatic arthritis, inflammatory bowel disease, and obesity. Groan--all my favorites.

But--it is not contagious. It runs in families but they do not catch it from each other.

Time was, there were few treatments. UV light was one--sunlamps. My dad used to train a sunlamp on his patches while shaving.

Now, sufferers may be able to get relief from:

--Topical treatments--corticosteroids, Vitamin D, anthralin, coal tar, and salicylic acid.

--Phototherapy--UV under medical supervision--not a tanning bed.

--Traditional systemi treatments by mouth, injection, or infusion. These include acitretin, cyclosporine, and methotrexate.

--Biologic agents--protein based drugs that target specific parts of the immune system--such as TNF-alphas blockers, or IL-17 inhibitors.

The American Academy of Dermatologists urges people to check out the new approaches. Get checkups for the other, possibly related disorders, and RELAX.

Stress makes psoriasis worse. Great, now I am stressed from writing this.

By the way, the new biologics as advertised on TV seem to have some pretty scary side effects. Check everything out.

Also--those commercials? The people cringing in self-disgust and not being able to get a date--be real.

Tuesday, August 30, 2016

Dental myths

The New York Times "Well" blog recently took on dental "truths." This is gospel we have had "drilled" into us since birth.

First, the surprising news that flossing--the prime guilt producer of dentists--is not really supported by studies saying it makes a big difference in dental health. It may help with bad breath and gum disease, but the evidence is not strong. Apparently, it does not do much to reduce plaque or cavities.

Bam!

Second, there is little need and support evidence-wise for yearly x-rays. Still, dentists recommend them, often from childhood on. If something hurts, yes.

There is a whole journal urging more rigor in examining dental procedures--it's called Evidence-Based Dentistry.

On the plus side, brushing is good and effective--but it is brushing with fluoride toothpaste that produces the anti-cavity results. This has been shown to reduce gingivitis, and plaque, too.

OK--what about powered toothbrushes? Randomized, controlled trials do support those. One review said the rotating kind is best.

Twice-a-day brushing is still supported.

What about twice-a-year cleaning? Evidence-Based Dentistry found eight randomized, controlled trials, but all were rated with a risk of bias--and the results were all over the map. Upshot: Who knows if twice-a-year scaling and cleaning is necessary.

When filling cavities, bonded amlgams--often recommended, are not supported by evidence--and they cost more than non-bonded amalgams.

How about the interdental brush to get a plaque between teeth? Almost no long-term benefits have been supported.

How about the preventive nature of periodic visits themselves? One study following 36,000 children did find these visits were associated with fewer restorative visits in the future--but one a year is probably enough.

But--it may also have been sealants applied to kids' teeth that had the protective effect. This may be able to be applied at lower cost, say by the hygienist. Fluoride varnish is also effective.

How about fluoride? They can't do randomized tests it because they are so sure it is a positive that they can't have controls who don't get it.

Bottom line? Brush twice a day with fluoride toothpaste, preferably with a power toothbrush.  For kids--sealants or fluoride varnish.

As for the rest, you may be a product of your genetics and diet.

Hundreds of NYT readers responded. Many said if they didn't floss, their gums bled. So you can decide on that. Others said fluoride is a poison and to avoid it--again, a poison with good side efx--your call.


Dental myths

The New York Times "Well" blog recently took on dental "truths." This is gospel we have had "drilled" into us since birth.

First, the surprising news that flossing--the prime guilt producer of dentists--is not really supported by studies saying it makes a big difference in dental health. It may help with bad breath and gum disease, but the evidence is not strong. Apparently, it does not do much to reduce plaque or cavities.

Bam!

Second, there is little need and support evidence-wise for yearly x-rays. Still, dentists recommend them, often from childhood on. If something hurts, yes.

There is a whole journal urging more rigor in examining dental procedures--it's called Evidence-Based Dentistry.

On the plus side, brushing is good and effective--but it is brushing with fluoride toothpaste that does produces the anti-cavity results. This has been shown to reduce gingivitis, and plaque, too.

OK--what about powered toothbrushes? Randomized, controlled trials do support those. One review said the rotating kind is best.

Twice-a-day brushing is still supported.

What about twice-a-year cleaning? Evidence-Based Dentistry found eight randomized, controlled trials, but all were rated with a risk of bias--and the results were all over the map. Upshot: Who knows if twice-a-year scaling and cleaning is necessary.

When filling cavities, bonded amlgams--often recommended, are not supported by evidence--and they cost more than non-bonded amalgams.

How about the interdental brush to get a plaque between teeth? Almost no long-term benefits have been supported.

How about the preventive nature of periodic visits themselves? One study following 36,000 children did find these visits were assoicated with fewer restorative visits in the future--but one a year is probably enough.

But--it may also have been sealants applied to kids' teeth that had the protective effect. This may be able to be applied at lower cost, say by the hygienist. Fluoride varnish is also effective.

How about fluoride? They can't do randomized tests it because they are so sure it is a positive that they can't have controls who don't get it.

Bottom line? Brush twice a day with fluoride toothpaste, preferably with a power toothbrush.  For kids--sealants or fluoride varnish.

As for the rest, you may be a product of your genetics and diet.

Hundreds of NYT readers responded. Many said if they didn't floss, their gums bled. So you can decide on that. Others said fluoride is a poison and to avoid it--again, a poison with good side efx--your call.


Monday, August 29, 2016

Normal consumers using sports drinks

I don't mean Gatorade, either. I mean all the hard-core drinks, powders, goos and bars in the sports nutrition arena.

Writing in the August issue of Food Technology, A. Elizabeth Sloan talks about several trends in this space:

--53% of Americans exercised more than 30 minutes a day three or more days a week--an all-time high (Gallup 2015).

--106 million adults are exercise walkers, 56 million exercise with equipment, 45 million do aerobic exercise, and 45 million run (National Sporting Goods Assn, 2016).

--Hispanics and younger consumers are the most likely to exercise regularly.

--Teen sports participation is an at all-time high.

--Energy and sports drinks were among the 10 fastest growing packaged consumer goods in 2015.

--Nearly half of consumers 18-24 consume sports drinks or mixes when not working out. A third of those over 55 do, too.

--45% of adults bought a high=protein sports/energy bar in the last month.

--One in five adults look for products with vegetable protein.

I would offer one caveat--look at all ingredients...Some extreme products used by body builders can be dangerous. Google! Even loading up on too much protein can have side effects.

Friday, August 26, 2016

Oldies but goodies

"Get off my lawn" is the alleged rallying cry of grumpy older people--yet a new study at the University of California San Diego suggests that the mental health of adults gets better over time.

They have an improved sense of psychological well-being.

You can check this out in the August issue of J of Clinical Psychology.

Interestingly, they also noted high levels of stress and symptoms of depression and anxiety in adults in their 20s and 30s.

Usually we think of aging as meaning loss of mental faculties--the old dementia bugaboo. We assume that mental health declines along with cognitive function.

Yet actual findings show mental health trending upward after middle age.

Most epidemiological studies show a decline in mental illness in older adult--dementias being the exception.

One reason might be that as you get older, you learn not to sweat the little things. Older adults may be better at adapting to stressful changes.  Older people may mature more emotionally.

I am getting my bathroom remodeled and have been living in a construction zone all week, so I may not be the one to ask...I feel like I am not as resilient as I used to be.

And--seriously--no one needs to get on my lawn, ever.

But I also have achieved some perspective in my later years. I know as easily as something turns bad, it can flip to good.

"This too shall pass."

But, of course, as a worrier, I still worry. What is it doesn't pass?

Thursday, August 25, 2016

Foodies--48 million foodies

According to an article in Food Technology by A. Elizabeth Stone, 48 million Americans consider themselves foodies--meaning involved with food, interested in food and cooking. This would be the live to eat crowd.

Some morsels about them:

--Over the past five yrs, consumers who want to try a new product first have gone up by 39%.

--Those who want to eat more "gourmet" food--up 27%.

--Foodies are 60% more  likely to buy foods labeled organic and natural--and 40% more likely to buy locally.

--Although they usually buy 10 items or fewer per trip to the store, 47% of foodies spend $100 or more per trip (only 34% of non-foodies do this).

--Foodies shop for groceries four days or more per week.

--Despite this preoccupation, foodies tend to want short cooking times more than non-foodies.

--Still, 47% of foodies bake for fun, compared to 32% of adults overall.

--Core foodies are much more likely to count calories, be on a diet, exercise regularly, and are twice as likely to avoid certain foods because of allergies or intolerances.

--One in five foodies bought food from a restaurant 15 or more times a month.

Foodies--I like the name. It's yummy.




Wednesday, August 24, 2016

Memory Cafes

Recently at the University of Pennsylvania Museum of Archaeology and Anthropology, some people sat around a table with Egyptian artifacts in the center. The museum people explained each item in a highly entertaining way.

One artifact was a brain hook used by Egyptian embalmers to remove the brain.

One of the participants mused, "I wish I could use it to scrape Alzheimer's off my brain."

These participants were members of a Memory Cafe--a program created by the Penn Memory Center for patients with memory issues and their caregivers.

So often, dementia leads to isolation--and this can lead to depression and anxiety,

The Memory Cafe offers a safe place for people to socialize with those who share their concerns.

This Memory Cafe thing started in 1997 in the Netherlands. It pread through Europe and came to the US in 2008.

Today there are more than 100 in this country.

Social connections, friendships are the goal. These are not really a support group gabbing about dementia or caregiving all day.

Sometimes the meetings include music. This is very soothing--everyone enjoys it.

Above all, no one has to worry about acting "weird" or being judged or disdained.

It's probably even fun.

Tuesday, August 23, 2016

Health officials surprised by who keels from heat

Writing on the website ROUTE FIFTY, the site's news editor Dave Nyczepir says some health officials in Pinal County, an Arizona county near where I live, used data analytics to find out who was succumbing to heat-related illness.

They used to comb the death stats for keywords related to heat and try to find out who experienced what that way.

But now, they are matching that data with hospital dischange numbers to see what is happening in real time.

Is heat stress morbidity related to the temperature or a time of year or a special group or gender?

This is how they try to detect epidemics before they get full-blown--how many people come in with a certain rash, say.

They found that heat illness was more common than they thought.

And, interestingly, it seemed to affect younger people more than old, which turns the old assumption on its head.

When it gets to be above 100 degress, the 25-yr-old doing construction is more likely to suffer than the 70-yr-old going grocery shopping.

So construction companies should not only have lots of water available, but start early and quit by 2 PM.

This is not the only ailment that can be prevented or handled with good statistics. Pinal County also has a person whose only job is to work on managing tuberculosis cases in the county.

Technology at work!

Stay well.

Monday, August 22, 2016

Participating in medical studies

Do you ever get those letters saying a medical study is starting--do you want to be in it? Often they offer a decent-sized payment.

I get these pretty often--maybe once a week. I am not very mobile and am skeptical anyway.

The pitch they give is that you will be adding to scientific knowledge to help the next patient like you.  They may also point out that you are already profiting from people who went before you in studies.

A cohort study is a large group of people, such as the Framingham Heart Study, which yielded a huge amount of info on heart disease and stroke (www,framinghamheartstudy.org).  These studies usually run for many year, even decades.

Another type is a clinical study. In these, volunteers receive a new treatment, a medication, procedure or device, for example.  Usually, you are randomly assigned to receive the new rtreatment or a comparison item such as a placebo or existing treatment.

In these cases, the researchers really don't know which is better--the new or the old. Both probably have pluses and minuses.

All clinical trials have specific requirements for participants. Some want healthy people, some want people with a specific condition.

You will undergo informed consent, meaning you will be told what will happen and the pluses and minuses (side effects). This will be overseen by an independent Institutional Review Board.

The FDA also checks out studies--and approves only those where the potential benefit is greater than the possible risk.

And you will receive free medical care during the study and maybe even access to new therapies before others get them.

If you are considering this:

--Ask if there are alternative treatments besides those in the trial.

--How will your safety be monitored?

--After the trial ends, can you stay on the treatment or switchto it if you were a control?

--What happens if you are harmed?

I would advise that if you have a bad condition and want to try a new therapy, you look into all this carefully. What if you are a control--and don't get the treatment and your condition gets worse?

Talk it over with your doctor.

Friday, August 19, 2016

How many sandwiches did you eat this year so far?

The average for a year is 200 sandwiches.

The Fourth Earl of Sandwich, John Montague, really started something in 1762. Legend has it he was playing cards and got hungry. He asked for some meat with bread on both sides so the cards wouldn't get greasy.

The rest is culinary glory.

Within any two-week period, 95% of all American households will consume at least one sandwich.

The National Cattleman's Assn reports that we eat at least 100 burgers a year.

According to Texas A&M University's Steven Reichman, associate professor of health and kinesiology, there is nothing wrong with sandwiches--but you might want to pay attention to both the bread and the meat.

Whole grain bread--lean meat.

Still, Reichman admits he eats hambugers--not the leanest--occasionally. And kids eat 1,500 PB&Js by high school graduation.

McDonald's sells 75 burgers a second.

This is making me hungry--how about you?

Thursday, August 18, 2016

Does your child "bring" lunch to school?

My daughter went to parochial school for many years--and brought her lunch from home. I packed her lunches with varying success. I used to be proud of little salads I put in plastic containers. I once asked her did she like that--and she said no, she traded them.

We also had a continuing battle over "fruit leather," a weird sugary mess I never could quite accept as fruit and could not buy. Oh--did she want it!

Kara Shifler, a registered dietitian with Penn State PRO Wellness Center, said the more a child is involved in buying the lunch food and preparing the lunch, the more will be eaten and enjoyed.

Kids might pack soda, chips and cookies if you let them.

--Sit down with a lis of options in each of the food groups: Fruits, veggies, whole grains, lean protein, low-fat dairy.

--Have the chld pick favorites with a new item to try sometimes.

--By third or fourth grade, they will take more responsibility, even for the shopping.

--Look for quick items--baby carrots, cherry tomatoes, and sugar snap peas.

--Dinner leftovers are also an option. Or make the leftovers into wraps. Have dips for the veggies.

--Pack some the night before.

--Water is the best bev. Even pure fruit juice is sugary.

You probably have more tips than I do.

Just remember--no fruit leather. It doesn't mean you're a bad person.

Wednesday, August 17, 2016

Promising anti-addiction drug now available

The US is in an addiction tsunami. According to the Centers for Disease Control, the number of fatal overdoses reached a new high of over 47,000 in 2014. That's 125 people a day.

Prescription opiods reduce pain and suffering and some people need them to survive and function. But--says Russell Surasky, MD, with the Surasky Neurological Center for Addiction--this class of drugs has a great potential for misuse.

Potential? They are being misused everyplace! (Including by a member of my family and don't even GET me started on the destruction they wreak on a family.)

Surasky says people see addiction as a moral failing--a matter of willpower. However, drugs change the brain in ways that make it difficult to resist the urge to keep taking the drugs and more and more of them at that.

Just deciding to stop taking them is next to impossible, Surasky says.

If the damage to the brain can't be healed, the cravings will persist for the rest of the person's life.

Now, though, there is a relatively effective treatment--naltrexone (Vivitrol(tm).

This is an opiod antagonist--it binds to the receptors in the brain and prevents the opiod from binding to those same receptors. It prevents any physical pleasure from the drugs (including alcohol). The person does not get high, does not get sick, and does not crave drugs.

Vivitrol is injected once a month. Drug use must be stopped 7-14 days before the first injection. How long does this go on? Depends on the person.

However, if you are addicted, take Vivitrol and then go back on drugs, your chance of an overdose is higher.

So there are stakes--and it takes a firm commitment to quitting, along with counseling, and a strong support system.

Still...this could be an option for many people.


Tuesday, August 16, 2016

Summer's end checklist for kids

Even adults get that "back to school" feeling in August--time for a renewal, time to get serious.

Jennifer Caudle, MD, a Rowan Family Medicine doctor, has some tips for the transition.

ADJUSTING THE ZZZZs

Parents need to gradually get children back on a regular sleep schedule. They need enough sleep to learn.

Start changing sleep schedules 2-3 weeks before the start of school. Send the kids to be 15 to 20 minutes earlier each night. Avoid sugary snacks before bed and set a route--say 15 minutes of stories for the little ones, then lights out.

For the older ones, no devices in the room. Maybe books only.

BACKPACKS CAN MEAN BACK TROUBLE

If a child has to lean forward to carry a backpack, it's too heavy, (My daughter used to carry all her books home and back--I picked the thing up once and almost got a hernia.)

Get packs with padded straps and teach kids not to sling it over one shoulder.

A child should not carry more than 10-15% of their body weight. A 30-lb pack carried by a 60-lb child--no!

SOMETHING TO SNEEZE AT

Late summer and early fall hay fever season. Going into unused school buildings can also stir up dust, mites, and other allergens. If your child is sneezy, consult an allergist.

ALSO HEADACHES

If a child complains of a headache, it probably is NOT to avoid school. Headache complaints tend to multiply at the beginning of the school year. This can be because of syress, lack of sleep, worry or diet. Call the doctor if the headache is accompanied by a fever or stiff neck.

COLDS AND OTHER BUGS

A runny nose, fever, sore sinuses or or a sore throat can distract kids from learning.  Other kids can also catch it. If the child has a fever, he or she should definitely stay home.

Kids can also get "pink eye" in school. This is highly contagious--the child should stay home and the doctor can supply drops.

Stomach bugs also pop up in school. If the child vomits or has diarrhea, keep him or her home.  Gradually introduce clear liquids and bland foods. A lot of kids will drink Pedialyte to prevent dehydration.

So--some fun coming...Be brave.

Monday, August 15, 2016

Is cat hoarding a crime or disorder?

You see it in the papers almost everyday--an older person, usually a woman, has 50 cats. I actually knew a woman who did--she took in feral cats.

This kind of thing gives cat owners a bad name.

Some states, like Oregon in 2015, allows lawsuits for violating the state's animal neglect laws.

This is important, say animal activists, because once a hoarder, a person cannot be counted on to not reoffend.

Stopping animal hoarding is way more than filing criminal charges and taking away much loved, though neglected, pets.

Some say prosecuting is criminalizing a mental health disorder. (In 2013, "hoarding disorder" was added to the Statitical Manuel of Mental Disorders.)

Hoarding disorder is a form of obsessive-compulsive disorder, but hoarders often refuse to or cannot see it as abnormal.

So authorities must decide--help the person or the animals. It doesn't always work out well.

Fining someone who already cannot feed their cats is not a solution. Removing the animals is an option--and a nasty job. But it's not like there aren't more cats that will come around.

We have half a dozen "regulars" in our yard alone. Our one remaining cat (from a total of four--only four) watches them from her cozy deal inside.

I am not tempted to let any ferals in. Never never.

Friday, August 12, 2016

Good source of ZIKA info

I have not written about the Zika virus yet, figuring there is so much in the press. But now I want to tell you about a website put up by the American Medical Association.

It's called the Zika Virus Resource Center. You can paste this into your browser:
http://www.ama-assn.org/ama/pub/physician-resources/public-health/zika-resource-center.page

This is aimed at doctors so they will know what to tell their patients, but anyone can access it.

The AMA will update it with the latest from the Centers for Disease Control and Prevention, which is also a good source. Go to http://cdc.gov.

Work on a vaccine is being expedited, but these things take time. In the meantime, the virus, found now in pockets of the country including in Florida, is a danger to pregnant women and people with weakened immune systems.

As you probably know, if pregnant women get infected, it can cause a horrible birth defect called microcephaly--malformation of the baby's head and brain, leading to lifetime dependency.

The virus is transmitted by mosquitoes but can also be passed by sexual contact.

Learn more! Check the site.

Thursday, August 11, 2016

Hey--bring back recess

Remember recess--twice, or at least once, a day outdoor playtime? Run, play, run off energy, stay healthy?

The website Education Dive says USA TODAY reports that in 2014, fewer than two-thirds of middle schools and one-quarter of high schools offered breaks for physical activity outside of PE class.

Schools are busy replacing recess with more "instructional" time.

Parents are fighting back, though. They say free time is essential for kids to stay focused, hang with friends, and maybe work up an appetite (studies show recess before lunch is better).

Legislators in Florida, New Jersey and Rhode Island have introduced bills requiring recess. (New Jersey's made it all the way to the governor's desk, but Christie vetoed it.)

Don't forget teachers also need breaks. In Finland, known for a high performing educational system, students and teachers get a 15-minute break for every 45 mins of instruction. Recess, by the way, does not have to mean going outside--it can be unstructured time in the classroom, too.

Maybe if the emphasis on testing--and cramming for those--eases, recess will make a comeback.

I sure liked recess better than PE. But maybe that's just me.

Wednesday, August 10, 2016

Intelligent food choices start in school

 When students get to college and start making choices outside of what's in the family fridge, fast food, pizza, ramen, and vending machines beckon.

Navigating the food plan can be a challenge. There may not be a nearby grocery store.

These first days of independence can also set the pattern for a lifetime of choices.

Actually, the Freshman 15 is more like 7, not 15, but most college students do gain weight.

Anne Matthews, a University of Florida assistant professor of good science, looked into this.

College students, like other adults, base food choices on taste, price, and convenience.

But they also think in terms of what will make them feel full the longest, and on price.

So here are some tips:

--Keep favorite fruits and veggies on hand.

--Aim for three different foods per meal. Pack some veggies or cheese for snacks.

--Plan ahead of where you will eat.

--In the dining hall, fill half your plate with veggies and fruit--then add the entree.

--Eat protein at every meal--nuts, cheese, seeds, yogurt.

--Buy a great lunch box that fits in your backpack.

--Learn how to make a few simple meals with few ingredients and requiring few utensils.

--If the grocery store in far away, ask for a ride, or maybe ride your bike.

--Buy only what you can eat or store for a few days.

Matthews is part of a team putting together a program called GET FRUVED aimed at getting HS and college kids to eat more plant foods and exercise more.

Fruved? Beats me, Fru=Fruit...VE=Veggies...? Really?

Tuesday, August 09, 2016

Halitosis--remember that?

I remember when some smart ad person substituted halitosis for "bad breath" and made it sound like a serious medical condition.

Well, it is--sort of. Serious in that 80 million people have it all the time.

Nico Guers, DDS, a prof at the University of Alabama Birmingham School of Dentistry, says bad breath results from a coating of bacteria that emits a bad smell.

These bacteria can get all over the mouth surfaces and even come up from the throat, esophagus, stomach and lung air.

They feed on food particles in your mouth.

Brushing twice a day can keep this film from collecting. Brushing and flossing is also a good idea (yes, flossing, don't believe everything you read about how it's useless).

You should also visit the dentist regularly--gum disease in pockets can also emit an even poop-like odor.

Ew.

Diet changes can also fight bad breath. Garlic and onions are well known to make your breath smelly. Diets high in protein and sugar--likewise.

Morning breath is a common form of bad breath--and people with dry mouth tend to get it.

The American Dental Association recommends chewing sugarless gum and brushing twice a day with a fluoride toothpaste.

I use hydrogen peroxide as a mouthwash--it's cheap and no one has convinced me that it's bad for me.

Monday, August 08, 2016

Toddlers at risk for chemical eye burns

Time was, everyone assumed that adult workers in sketchy factories or professions were the ones who would get chemical burns--in the eyes and elsewhere.

According to a Johns Hopkins study, though, the ones most likely to suffer these injuries are toddlers--ages 1 and 2.

According to the findings, published in the August 4th JAMA Ophthalmology, factories and other businesses handling chemicals are subject to safety regs and have goggles and treatments for accidental exposure to chemicals.

Not so much in the kitchen or garage.

Study leader R. Sterling Haring, DO, these are terrible injuries--and entirely preventable.

Chemical burns in the eye are so bad because even if caught, the chemicals continue to burn and can damage internal eye structures beyond repair.

The researchers looked at four years of data across all age groups.  Between 2010 and 2013, there were 144,000 ER visits related to chemical eye burns nationwide. These happened mostly at home, were more common in the bottom half of the income scale, and occurred mostly in the South.

One- and two-year-olds had the most--with one-year-olds twice as likely to get such an injury as a 24-year-old.

These injuries can happen in an instant--as long as it takes for a toddler to open a cupboard and find a loose cap on a bottle or want to spray like Mommy does. Alkaline burns are the worst--and continue to burn and burn. The eyes must be flushed out immediately.

Still, working-age people are also at high risk.

Everyone must be protected against these devastating injuries, the researchers said.

This means safety training, treatment facilities such as eye washing stations at hand, locked up or inaccessible substances, and vigilance.

An eye is a terrible thing to lose--I know, I lost one.


Friday, August 05, 2016

Fun activities for kids on the hottest days

When the thermometer climbs above 90 degrees, kids often want to slump on the couch in the air conditioning and play video games or watch TV.

But as fall approaches and kids need to be energetic and sleep a regular schedule at night for school, it's time to get them moving, heat or no heat.

The trick is to disguise "fitness" with fun.

--Pools are great in hot weather--indoor, outdoor, kiddie type, even a sprinkler. Many pools offer day passes or short-term memberships. I used to "join" a hotel pool when we lived in DC--we swam every evening and then spent all day on weekends--prepaid...and it was great.

--Get everyone up early for the air conditioned mall. Even if the stores are not open, the mall may be--and the kiddie areas.

--Check into indoor trampoline parks or indoor play areas--maybe you can even score a Groupon.
Or how about indoor rock climbing? Some of those places accommodate kids.

--Zumba, karate, yoga? See if your local purveyors have day passes and welcome kids or have kid classes.

--If you go outside, go in the evening and head for shady paths and parks. Being near the water, even a pond, is cooling. Bring sandwiches for dinner.

Also bring water--even for indoor activities. And watch kids to be sure they aren't getting woozy.

You can even add flavor to the water--lemon for example--or bring a juicy snack such as watermelon, celery, cantaloupe, and cucumbers.

My Mom used to freeze orange juice in ice cube trays and give us a cube with a piece of paper towel to hold it with. Beat any popsicle ever made.

Thursday, August 04, 2016

Brighter Bites helps kids in food deserts

Food deserts are areas with limited access to fresh fruits and veggies--say, where the only stores sell liquor and sugary snacks and are not full-service groceries (which may be miles away).

Brighter Bites is a school-based program, which in a study done by the University of Texas Health Science Center in Houston and published in the July 25th Preventive Medicine, improved the intake of fruit and vegetables in first-grade children and their parents--and reduced the consumption of added sugars.

Other benefits: More home cooking and more family mealtimes.

Brighter Bites is a nonprofit founded by Lisa Helfman, who was able to see better eating habits in her own children due to membership in a food coop.

She combined distribution of fresh foods with sampling and fun information. The University of Texas team made the whole thing operational.

In the study, participants got the food and information over a 16-week span. They compared the effectiveness to CATCH--another school-based program developed at UT.

Six schools in Houston received Brighter Bites and six got CATCH. Seventy-one percent of the kids were Hispanic, 24% African-American, and 43% overweight or obese. They saw:

--a 9% increase in fruits with Bright bites--level with CATCH.

--20% increase in veggies with Brighter Bites, 7% with CATCH.

--13% decrease in added sugars with Brighter Bites, versus 2% with CATCH.

--13% increase in fruits among parents with Brighter Bites, 15% decrease with CATCH.

--6% increase in veggie intake by parents with Brighter Bites, 3% with CATCH.

The Brighter Bites families got 57 servings of fruits and veggies a week ($2.65 per family per week).

Eight-seven percent said they ate most or all of the veggies, and 94% ate most or all of the fruit.

The produce, channeled through food banks, is mostly produce that would be thrown away..thus cutting food waste.

Lots of statistics in this one--but the overall picture is a pretty significant positive.

Wednesday, August 03, 2016

Hospitals learning customer service from hotels

Wait--no Jell-O?
The New York Times had a story this week on how some hospitals are emulating hotels in providing tony amenities and service (you know, in addition to saving your life).

At the Henry Ford West Bloomfield Hospital outside Detroit, patients are assisted by valets, enjoy free wi-fi, and can get meals on demand (hospital room service) around the clock.

Such niceties even enhance the clinical outcomes, reducing stress and providing a little pleasure. Patients can focus on "getting better," rather than getting another cup of juice or a tasty snack. Sometimes after a tough procedure, people are not hungry at meal time but may be later on.

Patients can also schedule tests like they do airline reservations.

Hospitals are designed with sound proofing, storage is out of sight, and things look less clinical.

Some had paintings, sculpture, fountains. Some perks are low cost, too--sleep masks, for instance.

Hospitals abroad attract customers (er, patients) by making a spa-like atmosphere. Why not here?

Of course, this also attracts private insurance paying customers. But patients are also happier--and ratings are higher.

Sounds OK to me--not OK enough to want to go to the hospital, but if I had to...

By the way, I don't think any of this is in place around where I live.

Tuesday, August 02, 2016

Getting a second opinion

I always loved the old joke. A guy goes to the doctor and the doctor says, "You have two months to live." the guy says, "I want a second opinion." And the doctor saysm "OK, you're ugly, too."

But I digress.

Barbara Miller, MD, chief of pediatric hematology/oncology at Penn State Children's Hospital, says it's perfectly OK to consult another doctor if you don't have complete trust in your doctor or feel you haven't heard all the options.

Oftem doctors recommend a second opinion if there are treatment options they don't offer.

In a field where therapies are changing quickly, the second doctor may well know of things the first one does not.

In an emergency situation, say a hot appendix, there may not be time to get a second opinion. Or in the case of gallbladder surgery, say, there is little controversy on how to proceed.

But in other cases:

--Check with your insurance company to see if a second is covered.  Many companies do cover seconds--or thirds--if it can be justified.

If you get six opinions--they may not like that.

If you go to a different institution for your second, remember that if you choose that doctor, it may be a hassle to get there. Think it through. But also listen to your intuition.

Remember, two different opinions may not mean one is right and one is wrong.

Your doctor will not be--or should not be--upset if you seek a second. In fact, he or she may be interested in another doctor's take.

Still, patients sometimes feel they are being disloyal. You aren't. You are being smart.

Monday, August 01, 2016

How to garden with bad arthritis in your hands

My grandmother was a wonderful gardener. Her peonies nodded their heavy heads, she grew currants, which with a little sugar, made a memorable dessert, the rhubarb, the vases of flowers--marvelous. Now, I have developed her beautiful silver hair (very techno), but fortunately not her gnarled, painful hands (my arthritis is in my knees).

Leslie Land, on the fun site Next Avenue (check it out), has some workarounds for gardeners with arthritic hands:

--Think of pain free days as money in the bank., This means everything you do on pain free days has a use cost--pet the cat, it may take away from pulling a weed.

--Give yourself a daily allowance. Bake a pie, you can't pick peas.

--Sort tasks into "must be done" and "must be done by me."  Let someone else do the gardening tasks that don't require your artistic "hand."

--Even if you don't have a lot of delegatees, keep a list of tasks for when a likely helper enters the zone.

--Or hire help.  Forget the teenage looking for money--that person is rare these days. You may need to go to TaskRabbit or Craigs.

--Preheat your hands.  In early spring, when the garden is cold, wear rubber gloves and soak in hot water for five mins or use a wax machine.

--Ration hand use by a kitchen timer. Work a certain amount of time--the rest will wait.

--Grab things with your whole hand--not just your fingers, Lift a flowerpot--for example--but support it underneath.

--Keep your tools sharp--less pressure must be applied.

--Take pix with a smartphone--not notes with your hands.

--Bathe your hands in sunshine. Sit for a few minutes.

Ahhhh....