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Friday, August 31, 2007
Asthma attack like 'breathing through a straw'
A friend has suffered from asthma since he was a little boy. So when I asked him what it was like to have an asthma attack, he had lots of different responses. "It's like drowning without water... like you're breathing through a straw," he said matter-of-factly. Breathing through a straw? "Yeah", he said. "Try it sometime." So I did. I hiked down to the cafeteria, grabbed a straw and started walking back to my office, breathing through the plastic tube. By the time I got to the elevator, I was winded, and when I made it to my desk, I had to sit down. It wasn't easy. In fact, if I had to breathe like that for a long period of time, it would be debilitating.

Twenty-two million people suffer from asthma in the United States, and that number according is growing, according to the American Lung Association. Even though it's treatable, severe asthma attacks can destroy patients' lungs, put them in the hospital, or even in the morgue. The CDC estimates that more than 4,000 people died of complications from asthma in the U.S. last year. And according to pulmonary experts, that doesn't have to happen. They say no one should die from asthma.

In an effort to make sure asthma patients live active, full lives while minimizing the risk of their condition, the National Heart, Lung and Blood Institute of the NIH is recommending new guidelines for doctors and patients on how best to treat asthma. The recommendations are pretty lengthy, but there are a couple of key points. The NHLB wants to make sure doctors stay in touch with their asthma patients, because asthma symptoms can change as people get older. It also is asking patients to make sure they always take their medication, no matter if their symptoms have diminished. And the NHLB wants patients to recognize what triggers their asthma and to keep in touch with their doctors on a yearly basis, to make sure the medications they are using are working to full potential.

So why, you ask, would an asthmatic stop medication? Because the symptoms don't always linger. Sometimes asthma patients can go for years without having an attack. They get a false sense of security; they drop their meds, pitch their inhalers and go on with life. The problem is, asthma is chronic and it does return and when it does, it can be fatal.

Asthma can also be triggered by environmental factors and physical problems. Recent studies have shown that chronic conditions including reflux, obesity, sleep apnea, depression and even stress can cause frequent asthma attacks. And there are lots of things around us that can affect an asthmatic. Allergens are a biggie, because they cause allergic reactions that can set off an attack. Some common allergens are dust mites, mold, pollen and pet dander. And pollutants in the air are also major triggers. Chalk dust, smoke (especially secondhand smoke), even scented candles and perfumes can make asthma patients, especially asthmatic children, miserable. Asthmatics also have to watch how vigorously they exercise, because they become winded easily. Even the weather, especially cold and dry air, can cause asthma symptoms in certain people.

For my friend, asthma is part of his everyday life. He carries an inhaler. His family can handle the situation should he have an attack. The NHLB would like to see more families like my friend's, because they're aware of what the condition can do to their loved one. And according to physicians, knowing more about asthma is the best way to fight it.

Are you an asthmatic? Do you have a loved one who has asthma? Are there any recommendations you can make to help asthmatics live healthier lives? Let us know.
Thursday, August 30, 2007
Are you suffering from brain mold?
Whether you're one of those hot, exhausted people cleaning up after a flood or just fighting the good fight to keep that dark, dank film off the grout in the shower -- mold could affect your mood.

In what's being hailed as a first, a public health study led by Brown University finds a link between regular old household mold and depression.

The study included data from the World Health Organization of nearly 6,000 people in Europe.
Some of the science is intuitive - sure, if you have a moldy home, you're likely to feel out of control - and perceptions of control are linked to depression.

And yes, if you're depressed, you might not be the best housekeeper.

Exposure to mold can produce physical symptoms that are well-documented: For those with allergies, asthma or suppressed immune systems, mold can make you sick- and if you're sick from mold, that could certainly affect your mental state.

But researchers hypothesize there may be another possible pathway: mold on the brain. Molds are toxins - and researchers suspect (but haven't proven) these toxins may impede the function of the frontal cortex, that touchy-feely part of our brain that rules emotion.

As someone slightly household-chore-challenged, I wondered - just how much mold might it take to affect my mood?

It's hard to quantify, says lead researcher and Brown University epidemiologist Ed Shenassa, adding that while a little mold in the bath won't do it, the more mold your have, the more likely it is to impact emotion.

Let's be clear: What we have here is an association between mold and mood-- more research is needed to see whether mold does indeed directly cause depression.

But Shenassa says there is a clear takeaway from this study: "Healthy homes promote healthy lives." That means not letting carpets, wallpaper or ceiling tiles to get wet, and stay wet for more than 48 hours, and giving leaks in the roof, walls and plumbing the immediate attention they deserve, because they're all sources of mold.

The study appears in the October edition of the American Journal of Public Health.

Do you have mold - and has it affected your mind, and body? Tell us your story.
Wednesday, August 29, 2007
Rebuilding a storm-ravaged healthcare system
It is hard to believe that it has been two years since Katrina. I was at Charity hospital immediately after the storm and saw firsthand what happened to patients who had been forgotten. (Watch my 2005 report) Charity hospital was a New Orleans institution, not only training generations of doctors, but also taking care of the poor and indigent. I watched as these patients waited for days on top of a parking deck in the August sun, while doctors tried to keep them alive by pushing air into their lungs for hours on end. Many times, they lost that battle, and I saw patients die - while waiting to be rescued.

Over the last two years, I have been to New Orleans several times, focusing on the medical and health recovery. Truth is, I thought things would be better by now. I learned that Charity would never open again, reportedly too damaged by the floodwaters. I watched as a few hospitals re-opened, three out of seven, with only one near full capacity. I watched as so many mentally ill patients compete for remarkably few resources and still go untreated. Most shockingly, I watched as the death rates continued to go up, not down.

In fact, according to a new study published in an American Medical Association journal, the death rates went up 47 percent for months after Katrina hit. Doctors on the ground attribute it to untreated disease, few resources and absent physicians. Patients, who should have lived died premature deaths. They are still dying. I have spoken to patients, doctors working in the emergency rooms, and the man charged with rebuilding the health care system. While there is a cautious optimism, there is a real sense that too little has been done two years later. What do you think? Will New Orleans be able to rebuild their health care system? Any suggestion how to do that?

For more on the death rate in New Orleans since Hurricane Katrina, watch Dr. Sanjay Gupta's report on Anderson Cooper 360 tonight at 10 p.m. ET
Tuesday, August 28, 2007
Another benefit of statins? Not so fast...
This morning, you may read or hear about statin medications (cholesterol-lowering drugs) being shown to ward off Alzheimer's disease. While this could be welcome news for the millions who are at risk of developing the disease, I am urging caution. True, there is some older research that shows people who take statins may be less likely to develop Alzheimer's dementia. But when we investigated, we found that other touted studies like ACT, the Adult Changes in Thought study, found no apparent real benefit of statin medications on Alzheimer's dementia.

So, why all the fuss? A new study, which was supported by the National Institute on Aging, looked at the brains of people who had received statin medications and those who did not. More specifically, the researchers examined the brains of 110 people aged 65 to 79 after they died. They did find fewer of the tangles and plaques that are so often thought to be a sign of the memory-robbing Alzheimer's disease.

Still, no doctor is likely to be ready to prescribe statin simply for the purpose of preventing dementia. There are a few reasons. First of all, this study was rather small and it also wasn't randomized, meaning a population of people on statins wasn't directly compared with a group not on the medications. It is also important to remember that statin medications, like any drug, could have side effects. Some of the ones to watch out for are muscle pain, liver problems and nausea.

Statin medications are a multibillion dollar business. It seems the makers of these drugs are constantly coming up with new uses for them. What are your experiences with these medications? Did they work and did you experience any side effects? Would you take them to try to prevent Alzheimer's dementia?
Monday, August 27, 2007
Self-censoring linked to higher death risk
When I was in college, I volunteered at a shelter for abused women and children. Over the years, the faces would change, but the stories were similar. A disagreement with a husband or boyfriend often ended with a smack across the face, a shove into a wall or stinging words of hate. To survive, many of these women just took it and kept their mouths shut until they figured out a way to escape. Often women would tell me they didn't feel they had a "voice" in their relationships.

I thought about those ladies while reading about a new study on marriage, communication and death. The study, which appears in the July/August edition of the Journal of Psychosomatic Medicine, found that women who don't express themselves during disagreements with their husbands are FOUR times more likely to die compared with women who express themselves freely. The study's author, Dr. Elaine Eaker, says the 10-year study is the first to look at the effect of marital strain in relationship to the development of heart disease and death. The study also confirmed that marriage is good for men's health, but that unmarried men were twice as likely to die as married men.

So why is it so hard for some women to speak up? "We don't really know why women self-silence," says Dr. Eaker. "It may be some type of protection mechanism." Experts say most girls are taught not deal directly with their feelings. "Girls learn more 'relational forms' of aggression," says psychologist Dana Jack. She teaches at the Fairhaven College of Interdisciplinary Studies at Western Washington University and has written extensively about self-silencing. "Girls tell other girls, 'I won't play with you if you play with her." Boys on the other hand are taught to express their anger openly.

As a result, Jack says, some women are afraid of the consequences of showing anger during quarrels with their husbands. For some women, it's because of the threat of physical violence, but for others, there is a fear that if they speak up, their husbands will leave and their financial security will go out the door with them. So anger builds up and, like stress, it can damage the heart. Jack tells the story of a woman she once counseled in group therapy. "Lisa's" husband left her for a younger woman. One day, the husband showed up and took all the family albums. The new wife wanted them. Members of the group were incredulous when Lisa said she didn't put up a fight. She never did. Lisa told the group her kids knew she was angry only if she raised an eyebrow. After "self-censoring" for so long, Lisa lost the ability to express anger. She died from heart disease.

The bottom line, says Dr. Eaker, is that "self-silencing" women need to learn how to express themselves more constructively and put themselves in an environment where they feel safe to do so.

The Chinese philosopher Lao Tzu said "If there is to be peace in the home, there must be peace in the heart."

I want to know what you think. Do you self-silence in your relationships? Has marriage helped or hurt your health?
Friday, August 24, 2007
Turning up the heat on sunscreen
You may not know this, but sunscreen has been around since the mid 1940s. This product was developed during the height of World War II, when soldiers based out in the Pacific started noticing the dangers of overexposing their skin to the sun. It became widely used in the 1960s. Still, it was only recently that the manufacturers started seriously thinking about UVA rays as well as UVB rays. I was surprised by that, given that UVA rays can be so dangerous. For a long time, many people probably had a false sense of security with their UVB protection alone.

So, SPF means sun protection factor. Most people know that. More specifically, an SPF of 15 means it will take 15 times longer to develop an area of redness on your skin if you wear the sunscreen. That offers obvious protection against sunburns, which are caused by the UVB rays. The problem is the UVA rays dive even deeper under the skin and cause tanning, as well as disruption of collagen, wrinkling and premature aging. Doesn't sound so attractive when I put it that way, right?

Now, new guidelines have been proposed to both mandate UVA protection and to label specific products with the amount of UVA protection they offer. The system will use stars for the ratings, with one star being the lowest protection and four stars being the highest. Products that have no UVA protection will clearly state that there is "no UVA protection" in the bottle. There will also be warnings on the bottles reminding people that too much sun can cause skin cancer. (Full Story)

The fact of the matter is though, no matter the product, people have to actually use it to have any effect whatsoever. (Watch video) You need at least a shot glass amount to cover a normal-sized body and a full teaspoon to cover your face. I have always been surprised by the number of people who improperly use sunscreen. I still see young children with deep, dark tans and adults with sunburns all the time. That's scary given that just a few sunburns can double your risk of skin cancer. So, why do you think that even with all the information about the risks of skin cancer, so few people use adequate sunscreen?
Wednesday, August 22, 2007
Managing diabetes
As it stands now, diabetes is one of the more vexing problems that health care professionals deal with. At once, it is frighteningly common with 20 million carrying the diagnosis and the number still growing. In fact, around 6 million people don't even know they have it. The disease is linked to heart problems, stroke, blindness and kidney disease. At the same time, though, it is an extremely manageable problem, perhaps more so than many other diseases.

For diabetics, there are really five important tips to keep in mind:

1) Know your medications. Be familiar with the medications and understand their interactions and side effects


2) Build a power team of health care professionals, including doctors, nurses and nutritionists. Doctors are important but it is the nurses and nutritionists who will really help manage your disease day to day.

3) Keep levels in check. Certainly, if you are at risk for diabetes because of your weight or family history, get a fasting glucose test. A normal level should be less than 100. If you are diabetic, make sure to get something known as A1C tested which gives a longer-term look at your blood sugars. Of course, know your blood pressure and cholesterol levels. A1C should be less than 7 percent, blood pressure less than 120/80 and cholesterol levels less than 200 - some doctors say even lower. Also, make sure to get a proper eye exam every year and check your feet every day for any non-healing sores.

4) Stay active. Diabetes is not a death sentence. Get active and stay active. A diabetic can benefit from as little as 30 minutes of exercise five days a week.

5) Finally, a good diet. You will read a lot about diabetic diets, and it is important to pay attention to the basics of glucose control. Make sure, though, to get plenty of fruits and veggies and watch your risk factors for heart disease as well.

Truth is, we do have a problem with diabetes in this country and it can lead to heartache and suffering. Still, with what we already know, we can greatly reduce death and disability and give people back normal and healthy lives. Are any of you diabetics? How have you been able to manage your disease?

Tuesday, August 21, 2007
What's that beep?
It was a sound I didn't recognize at first. I batted at the smoke detector with my dishtowel (hey, I'm only 5 feet 2 - what can I do?) but then I realized it wasn't the source of the piercing tone that filled the apartment.

I finally figured it out. The carbon monoxide detector was going off. Now what?

First of all, I'm just glad to know our little monitor - previously ignored, since we didn't even realize our landlord had installed one -- works. The five young Virginia Tech students who were hospitalized after falling ill on Sunday didn't have CO monitors in their off-campus housing, according to Dr. Bret Stolp of Duke University (he's one of the docs who treated the students). Carbon monoxide is an odorless, colorless gas, often called a "silent killer." So the students, and the 18 others affected in the incident, probably had no idea there was a leak before they passed out in their sleep. (Full Story)

Back to the beeping. It made me panic. I knew that if it was the smoke detector, I could be sure there wasn't a fire because I'd smell smoke or see flames or something. But with CO, how do I know it wasn't leaking all night and that I'm not about to pass out any moment? Or potentially worse, suffer any sort of neurological damage?

The first thing you should NOT do is ignore the beeping, advises Stolp. Open all windows and turn off any appliances such as your gas-fired furnace or a running generator. And if you have any sort of symptoms such as headache, nausea, dizziness, or confusion, you must get to a hospital ASAP.

Luckily, it turns out the beeping was the monitor telling us that its batteries needed to be replaced. That's another thing too - you have got to make sure the darn thing actually works, in order for it to protect you and your family.

Have you ever had a carbon monoxide scare? What did you do, and how were you affected? Did the recent carbon monoxide scares prompt you to install a monitor in your home?
Monday, August 20, 2007
Back to VA Tech: PTSD concerns
Today, students at Virginia Tech are scheduled to start their fall semester. It's hard to believe that only about four months ago 32 students and faculty were shot dead by a student who then killed himself.

My mind keeps drifting back to their seemingly idyllic college campus. I was one of the many journalists who came to Blacksburg in the days after the shooting. Now, I keep picturing the students walking along the pathways and rolling hills, trying to get back to normal, trying to get back to life as it was before the tragedy. As much as I can't help but think about that day, I wonder what it must be like for the students who so proudly call themselves Hokies.

Do any of them suffer from flashbacks, intense memories, nightmares, or even terror? How many of them will deal with post-traumatic stress disorder?

PTSD is a complex condition. According to the latest research, one out of every 10 people will develop it in their lifetime. Patients can also suffer from outbursts of anger, emotional numbness, sleep disturbances, depression, anxiety and sometimes survivor guilt. Often, the symptoms are triggered by sights, smells or sounds that remind a person of the trauma.

It's no surprise that most people who endure a traumatic event suffer from some symptoms of PTSD, but the effects will often subside. According to the US Department of Health and Human Services, about 8 percent of men and 20 percent of women go on to develop PTSD and roughly 20 percent of those people develop a chronic lifelong form of it. The condition is associated with other ailments such as increased risk of heart disease in men.

In terms of children, Stanford researchers found that severe stress can damage a child's brain. They looked at children suffering from PTSD as result of severe abuse and found that they often suffered a decrease in the size of the hippocampus - a part of the brain involved in memory processing and emotion. What's even more startling is that this effect on the brain may make it even harder for them to process normal stress for the rest of their lives.

These days, more and more money and attention is being directed towards PTSD research, due in great part to the war. As troops come home from Iraq and Afghanistan, as many as 13 percent are found to have PTSD. There can be thousands more whose conditions go undiagnosed.

Do you or anyone you know suffer from post traumatic stress disorder? Do you think a person can ever fully recover? Do you think more attention needs to be paid to PTSD and other mental conditions?
Thursday, August 16, 2007
Dangers of cold medicine in toddlers
Parents of young children should never give cough and cold medicine to children under age 2, unless instructed to do so by a doctor. This is the gist of a new advisory by the FDA prompted by a CDC report that showed at least three deaths and 1,500 adverse effects in infants and toddlers as a result of taking these medications. Most of the time, the problem seems to be overdosing - either by simply giving too much, too often, or mixing medications with the same active ingredients.

Turns out these medications can have some pretty powerful effects on young children. They can interfere with the heart's electrical system causing an arrhythmia or constrict blood vessels too much causing hypertension. While most of these problems seem to be associated with overdosing, it is possible that a small percentage of kids have an adverse effect even at smaller doses.

Truth be told, a lot of pediatricians hardly ever recommend cold or cough medicines for children that young. The biggest reason is that it is unclear what dose is safe for kids under 2. It is also unclear whether these medications even work. Instead, many doctors recommend using a soft suction tube to irrigate and suction the nose (a little disgusting, but pretty effective), saline nose drops or a humidifier.

If you are still going to use the medication, make sure to give it to your child exactly as prescribed and not to dose more frequently, even if it doesn't appear to be working. Use the measuring dispenser given with the medication, and if there isn't one, get one from the pharmacy. Never use adult-sized teaspoons or tablespoons to give the medication.

Children get colds - lots of them -- six to10 a year, on average. Almost always, they go away on their own. So, are you likely to go to the medicine cabinet if your child gets sick or do you let it run its course? What are some of the best remedies you have found?
Wednesday, August 15, 2007
Lead and toys - what to do
If you're like many parents, you have probably never really thought about lead. Of course, this recent toy recall probably has you surfing the Internet to find out which toys are on the list (see them here) and which ones you will have to get out of your home. As the father of a 2-year-old, I know it is not easy. My daughter is particularly fond of Dora, and my wife and I felt guilty as we removed a few of her toys late last night. It did surprise me though to learn that around 300,000 children a year still suffer from lead poisoning and the number is as high as 16 percent in some communities, especially impoverished ones, where diets rich in calcium, iron and zinc may be lacking.

The biggest culprit, as you might guess, is lead-based paint which was still used up until around 1978. Turns out if a child ate this paint, more specifically a pencil eraser-sized piece every day for 2 to 4 weeks, he or she could suffer from lead poisoning. Children are especially susceptible for a few reasons: First of all, they are more likely to actually eat paint. Also, their little bodies absorb lead at nearly 5 times the rate of adults, and lead affects the central nervous system of a developing body more so than an adult body.

There is a test (Watch Video) to check for lead poisoning, and it involves a finger prick to get some blood (ironically I would always distract my daughter with that same Dora doll when she was getting her blood drawn). If that level comes back high, then more blood is taken to confirm the lead intoxication. The key, though, is knowing whom to check. Often times, someone may develop symptoms long after the lead poisoning has taken place. That is too late - you would like to know before those symptoms ever develop.

Last night, my wife and I talked about getting our own daughter checked (and which toy we would take to distract her). The CDC recommends children get tested every year, especially between the ages of 6 months and 6 years. What about you? Are you planning on getting your child tested? Why or why not?
Tuesday, August 14, 2007
Antioxidants not all they're cracked up to be?
One of the questions I get the most as a doctor has to do with antioxidants. No surprise, given that around a third of the nation's adults take them. The claims about their benefits range from anti-aging to memory preservation to warding off heart disease. Truth is, there isn't nearly as much research into these supplements as I would like. So, for a long time, there were a few small studies that people would use to support their arguments either for, or against, taking antioxidant supplements.

That is why I was so interested in one of the largest studies looking specifically at the effect of three different antioxidants and heart disease in women. The researchers looked at almost 8,200 women who were at risk of heart disease and followed them for almost 10 years. The bottom line: While there was no harm from the antioxidants, there was no benefit as well.

Still, there is no doubt that eating food high in antioxidants is heart healthy. So, where is the disconnect? Well, it most likely has to do with the fact that fruits and vegetables are loaded with all sorts of things. Besides the antioxidants, there is fiber and certain micronutrients that may play a significant role in the way our body absorbs the precious antioxidants. In short, simply taking the "good stuff" out of food and putting it into a pill doesn't seem to work so well, because food packages things much better than we can.

So, why is it that we as Americans continue to spend billions of dollars a year on something that doesn't have a lot of data showing that it even works or is beneficial? Is it blind faith or do you think the science is just slow to catch up?
Monday, August 13, 2007
Left-handedness and your health
I told my wife today is International Left Handers Day. She comes from a long line of them. She, along with her father, brother, sister and aunt are all proud southpaws.

"If the left hemisphere of the brain controls the right side of the body and the right hemisphere of the brain controls the left side of the body, you know we're the only ones in our right mind," she said.

"That must be lefty humor," I said.

From doors, computers, to scissors, there is no doubt that our world is made for right-handed people. Even anthropologists, have found that right-hand preference spans across all human cultures, including ancient civilizations. Even a test of fetuses (using ultrasound) shows 92 percent sucking their right thumbs, according to the Centre for Addiction and Mental Health at the University of Toronto.

In fact, about 1 in 10 people are left-handed, according to the latest research. Also, left-handedness tends to be more common in men than in women. Being a lefty is also a family affair. A Scientific American Mind article states that two-right handed parents have a 9.5 percent chance of having a left-handed child. A mixed couple, with one lefty and one righty, have about double those chances. Whereas, two left-handed mates have a 26 percent chance of having a southpaw baby.

Just last month, Oxford University researchers discovered a gene that increases the odds of being left-handed. That same gene may carry an increased risk of schizophrenia. It's yet another finding that associates left-handedness with poorer health outcomes.

A Dutch study this year found that left-handed women have a higher risk for cancer, stroke and arterial damage. Some older studies have found associations with a long list of chronic ailments: alcoholism, dyslexia, migraine, asthma, hyperactivity, inflammatory bowel disease and mental disabilities. But even with these higher associated rates, no scientist can offer a definitive cause and effect between left-handedness and illness.

Critics of older studies say that the research is biased. They say it has been influenced by antiquated theories based on left-handedness as a disorder - a product of an excess of fetal testosterone or developmental instability in the uterus. The latest research says there is little to no proof of these factors being true.

There is some good news. Last year, an Australian study found that left-handed people are quicker while playing computer games and sports.

Do you think that left-handedness has an influence on health? Why or why not? Do you think it's easier or harder to be a lefty in today's world?
Friday, August 10, 2007
"Look, Daddy, there's a snake under my tricycle!"
By Caleb Hellerman
Senior Producer

My 3-year-old son loves snakes, the ones he's seen in books. After his recent pronouncement, I strolled out of the garage and peered under his tricycle, about a dozen feet away. A stick was lying underneath the pedals. What an imagination! But there was something about it... A few steps closer, I caught my breath, plastered a smile on my face and asked my son if he wouldn't like to step inside for just a moment.


"Look, Daddy, there's a snake under my tricycle!"

From a safe distance, I examined the copperhead in my driveway. I could see that he - or she -- only an expert can tell -- was just two feet long but impressively thick around the middle. I recognized him from a few weeks back, when I accidentally almost grabbed him, or maybe it was his friend, while weeding a patch of ivy. Since I admire these beautiful animals, I let him be - that time. But under the tricycle was too close for comfort. I got an axe and lopped off his head. If you find yourself in the same position, use a shovel or other long object to pick up the dead snake. Even a severed head can still bite, reflexively.

About 8,000 people are bitten each year by venomous snakes in the U.S., according to the American College of Emergency Physicians. Snakes don't seek out humans; the typical victim is a young man who tries to pick up the animal or a hiker who steps on one by mistake. Encounters spike in the summer, when reptiles are more active and people spend more time outside.

What to do if you're bitten? First, forget what you may have learned. Don't use a tourniquet or make cuts near the bite or try to suck out the venom. And don't delay. Unless you're sure it's a non-venomous species, head for an emergency room, says Dr. Brian Daley, a surgeon in the division of Trauma and Critical Care at the University of Tennessee, in Knoxville. If you're in a truly remote area, you can self-treat by immobilizing the bite with a splint and applying pressure with an Ace bandage, says Dr. Eric Lavonas, an emergency physician and toxicologist in Charlotte, North Carolina. The pressure can prevent a dangerous dip in blood pressure, but isn't a long-term solution. Anything that reduces circulation also keeps the body from flushing the toxin, which leaves it concentrated in the bitten area and increases the risk of tissue damage, says Lavonas. Above all, get outside medical help, fast.

The venom of a copperhead, rattlesnake or cottonmouth "is designed to turn a mouse into mush, and it'll start doing the same to your hand," explains Lavonas. The poison causes hemorrhaging and swelling around the bitten hand, arm or foot, and throughout the body in severe cases. Coral snakes, found in Florida and some parts of the Southwest, inject a nerve toxin like a cobra's. Even venomous snakes don't always release poison into the wound, but if they do, expect excruciating pain, warns Daley.

Depending on the bite's severity, and the type of snake involved - a copperhead's bite is generally much less dangerous than that of a rattlesnake -- doctors may give antivenom to neutralize the poison, or simply watch and wait. The downside of antivenom is that it can cause an allergic reaction, though newer versions have sharply reduced that risk, say experts. Nationwide, most years, fewer than 10 bites prove fatal, but many victims complain of lingering pain for months or even years afterwards.

Have you had an encounter with a dangerous creature? Tell us.
Thursday, August 09, 2007
Keeping your cool in a heat wave
Talk about hot! Yesterday's high here in Washington was 102 degrees - a record! The heat index rose to 110 degrees -- that's how the air feels with the combination of heat and humidity. I admit I was working in an air-conditioned office with a jacket on because it was so cold, but my 10-year-old daughter was sweating it out at soccer camp. As the temperature continued to rise I began to get a little concerned about whether this was a day she should have stayed home. I worried -- did she have enough liquids? Would she remember to put on her sunscreen? Should she have worn a white shirt instead of orange? Should I have given her more tips on how to know if you're in heat-related trouble? Things like: if you're dizzy, if you have a throbbing headache, if your skin gets red or feels hot, but you've stopped sweating get to a shady area and get help immediately.
Washington isn't sweltering alone. An oppressive heat wave is sweeping the country, and relief is not in sight for at least a couple of days. So we must ride the wave and do what we can to stay healthy and safe. Those most at risk are children, the elderly and people with chronic health problems, but everyone should know how to cool off.
There are plenty of tips out there. Drinking lots of fluids is a no-brainer; you need to do that even if you're not involved in strenuous activity, and don't wait until you're thirsty. Don't drink alcohol or lots of sugar --- these actually cause you to lose body fluid. Avoid very cold drinks. Cut out the exercise -- and if you can't do that, cut back. And remember, sports drinks can replace the salt and minerals you lose in sweat. If you can, limit outdoor activity to morning and evening hours when it's cooler.
Outside wear lightweight, light-colored, loose-fitting clothing. But if at all possible, stay indoors in air-conditioning. If you don't have air-conditioning at home, you can take a cool shower or bath or seek out a cool place -- the mall or a movie theater or the library -- for a few hours.
Remember, heat, humidity, sunshine and smog equal unhealthy conditions. If the quality of the air you're breathing is bad you're more likely to suffer respiratory problems. About 400 people a year die from exposure to excessive heat. So far thee deaths have been attributed to this heat. But what do you think? Is the heat is serious business? Or are we making too much out of a little sunshine?
Wednesday, August 08, 2007
An ounce of prevention could save lives
by Miriam Falco
Managing Editor, Medical News

I've prepared a lot CNN segments on preventing illness over the last seven years as a medical producer. But according to a new study, not enough of us are getting the message. Not even some doctors. Our health-care system is not necessarily geared toward prevention. But what if it were? (Watch Video)

The Centers for Disease Control and Prevention commissioned a report to determine which preventive measures would have the biggest impact in saving lives. The non-profit health policy group "Partnership for Prevention" (PFP) found that simply increasing the number of people who follow 5 existing prevention recommendations would save more than a 100,000 lives each year. That's more than the population of Green Bay, Wisconsin or Cambridge, Massachusetts.

So what exactly are these five recommendations?

** Right now less than half of Americans who should be taking aspirin daily to prevent heart disease do so. If that number went up to 90 percent, 45,000 additional lives would be saved --at a cost of pennies a day.

** Only about a quarter of all smokers are advised by health care professionals to quit smoking and given tools to do so. If that number were raised to 90 percent of smokers, then 42,000 additional lives would be saved each year.

** Less than half of Americans older than 50 get screened for colon cancer - get that number up to 90 percent and 14,000 additional lives could be saved.

** Each year the CDC says get your flu shot - but only 37 percent of adults older than 50 actually get one. Raising that stat up to 90 percent would save 12,000 more lives.

** Finally, only two-thirds of women older than 40 get screened for cancer every 2 years - if that number increased to 90 percent, almost 4,000 lives would be saved annually. (Full Report).

So why aren't more of us taking aspirin, quitting smoking or getting cancer screenings?

Maybe it's because many of us don't think about going to the doctor when we are healthy, but go only when we're sick. According to the PFP report, many doctors and nurses lack a system to track the patients who need preventive care. And when it comes to telling patients to quit smoking, some doctors aren't always comfortable doing so.

Another hurdle is the cost of preventive services. In many cases, high deductibles have to be met before preventive medicine is covered by insurance. Those who don't have insurance are even more likely not to go to the doctor if they aren't sick. They probably can't afford it. Something has to change. One of the study's authors, Ashley Coffield says it's important to remove financial restraints in order to increase demand for more preventive services.

But Coffield says lawmakers need to make prevention the cornerstone of America's health-care system. "Too many people are dying prematurely or living with disease that could have been prevented," Coffield says. "We could get more out of our health-care dollars if more preventive measures were taken. We can pay now or pay a lot more later."

Have you been screened for cancer? Can you afford to go to the doctor when you're not sick? What preventive measures do you take to stay healthy?
Tuesday, August 07, 2007
The future of food
Gummi bears infused with vitamins, just one display at last week's meeting of the Institute of Food Technologists. The IFT show drew 20,000 attendees.
By Caleb Hellerman
Senior Producer

Food technology: the application of food science to the selection, preservation, processing, packaging, distribution, and use of safe, nutritious, and wholesome food.

I spent last weekend surrounded by food technologists. I was in Chicago, researching an upcoming Dr. Sanjay Gupta special about nutrition and obesity and attending a conference run by the Institute of Food Technologists. The FDA food safety chief was talking about spinach safety. Top execs from General Mills, Kraft and Campbell's were talking about kid-healthy foods. The Army was showing off its new MREs for Afghanistan, and there were sleeping models, a ventriloquist's dummy and a belly dancer. Let's just say that when the IFT puts on a show, it's a big one.

This year, the conference buzzwords were "nutraceuticals" (a combination of the words "nutrition" and "pharmaceutical") and "functional food." IFT spokesman Roger Clemens, also a pharmacy professor at the University of Southern California, predicts that in the not-too-distant future, "functional food" will be a $600 billion market - yes, he said billion with a "b." Even if there's some hyperbole - supermarket food sales as a whole totaled $500 billion last year, according to industry analysts - it's still a big market.

OK, but what are nutraceuticals and functional foods?

In Japan, according to Makoto Shimizu, a professor at the University of Tokyo, more than 650 products are approved as "Food for Specified Health Use," from fighting fatigue to preventing allergies. It's a lot easier to qualify for the label, than it is to get the ingredients approved as medicine in the U.S. But Clemens says the legal and regulatory climate is changing. "Where does food end and the medicine begin?" As the benefits of certain foods are examined more closely, he says, "Maybe the definition will change as to what connotes a drug."

You could find one simple functional food at several exhibitors' tables: vitamin-infused candy. Worthless, a prominent nutrition expert told me, although he didn't want his name used. I'm not sure I agree. Of course it would be healthier to eat a complete diet, full of vegetables, but who has the time? Researchers at the University of California, Berkeley, found that barely 1 percent of children and teenagers meet government guidelines for a healthy diet. Neither they nor I were surprised.

If my kids are munching on candy anyway, is it really so bad if it's giving them their RDA at the same time? Is there a healthy food product you would like to see on the shelves?
Monday, August 06, 2007
Addiction claims another innocent life
Last month, my husband's grandson, Jonathan, killed himself. He didn't use a gun or a rope. He didn't take a bunch of pills. He sat down on a motel bed, rolled up his sleeve and injected himself with not just one, but two lethal drugs. Passers-by noticed him convulsing in the room. He had left the shades open. He wanted to be found. By the time they busted down the door, Jonathan was brain dead. He was rushed to the ER. His mother sped to the hospital to see him, but he never woke up. She was forced to make a decision. Keep him "alive" with tubes and machines or let him go. She chose the latter.

No one should have to bury a child. But every day, parents, loved ones and friends, attend funerals for the very young. Some die because of car crashes. Other lives are cut short by diseases. But many, too many children die from drugs.

Jonathan was 20 years old. In his early days of high school he was a good student, a star athlete (colleges were talking to him about playing football) and a real personality. Handsome, charming, charismatic, he had it all. When he sat down with a group of friends to smoke a little marijuana, he never thought he'd get hooked.

But there was something about Jonathan's personality that seemed to enjoy the high that drugs gave him. He went from marijuana to crystal meth. From there he moved to crack, then heroin. He got so hooked that he began to steal -- from stores, even from his mother. He eventually ended up in jail. Then he went to a halfway house, then to a rehab center. He'd try to stay clean but he'd eventually go back to the "stuff." He lived in parks, with friends, in the alleys of his neighborhood. His mother tried to get him help. He was on a roller coaster through hell and she was being dragged along for the ride. She talked to the legal system, the police, even drug experts asking for their advice. No matter what help she gave him, it just never seemed to work. His situation seemed hopeless.

This story is tragic enough, but here's the twist. Jonathan actually got clean. Back in December, after he served his longest jail term, he decided he was never going back. He got a good job, met a nice girl, went to live with his mom and started taking courses at the local community college. He was on the right track.

But drugs are everywhere, and they found Jonathan again in early July. From there the story gets cloudy. But his mother knew he was using again. She argued with him and he ended up at his girlfriend's home. On July 11, he left a note, drove to a hotel and shot up lethal doses of cocaine and heroin. He never saw his mother or his friends again. He died alone.

I can't tell you the grief that I feel for my stepdaughter. She is a single mom, a hard worker, devoted to her son. He was her only child. He was her world. Jonathan is gone now, and his mother lives with the emptiness and sorrow that only the death of a child can bring. I know she thinks about what she could have done, or what she didn't do. Everyone tells her it's not her fault, and it's not, but still she wonders. Many doctors will tell you that Jonathan had an addictive personality and that no matter what anyone did, drugs would have been in his life. He was a smart young man, he knew he was destroying himself. He just couldn't stop. Unfortunately, the drugs stopped him.

On the day of his funeral, his mother stood in front of a room filled with 300 people. As she thanked everyone for coming she spoke these final words of the service: "For the last four years, I have woken up in the morning, wondering if my son was safe. From now on, I'll wake up and know he's not suffering any more."

Do you know of someone who's addicted to drugs? Are there programs you know of that can help families of drug addicts? Let us know.
Friday, August 03, 2007
Pre-teen body image issues
What would you do if your 8-year-old daughter looked in the mirror and said, "I need to be skinny before school starts"? You might gasp. It's a startling statement coming from a very young mind, but it's not surprising, given our culture's emphasis on being thin. As eye-opening as your little girl's statement might be, your response as a parent, experts say, is very important.

The most critical element of your reaction is perhaps the most difficult to pull off: Be calm. Lynn Grefe, the CEO of the National Eating Disorders Association, says don't be punitive, or outraged, when you respond to a child who says something about her - or his - body image. She says it is important to determine where the "skinny" statement is coming from. "Find out what the source is - ask, 'I am curious why you would say that and why you believe that? Are you feeling bad about yourself?" Grefe says that in most cases there is usually something else going on. She suggests asking children about the magazines and TV they see and talking with them about what is real (the people they see on the street) and what might not be (the airbrushed and made-up people of magazines, movies and TV). Grefe also says it is important to expose young children to role models of all different shapes and sizes.

Fathers play a particularly important role when it comes to body image issues among girls. Grefe says fathers are often in denial about identifying eating disorders in their daughters. She says they will dismiss concerns, often raised by their wives, and tell their daughters they look great - only reinforcing what could be very bad, and potentially deadly, habits. Grefe says fathers must help fight society's emphasis on appearances. "Fathers should focus their talk on the inside - what is inside their children." Grefe says telling daughters that they ARE beautiful is better than telling them they look beautiful.

Parents should also be careful about their own body image issues. Casual remarks such as "I feel fat" or questions like "Do I look fat in this?" are heard by young ears and can plant the seeds in young minds. Grefe says young, normal-size children should not be dieting. Period. Those who are should be talking to someone, perhaps a professional, about how they are feeling about themselves. Grefe says children should be taught to be healthy and strong, regardless of their size or body type.

Are body image issues a problem among the pre-teen set? How would you react to your daughter if she said she needed to be skinny?
Wednesday, August 01, 2007
Institutionalizing people with disabilities
Guest blogger Kay Olson, a self-described thirtysomething disabled feminist who blogs at http://thegimpparade.blogspot.com/, offers her thoughts on the institutionalizing of people with disabilities, such as explored in this story on CNN.com.


Guest blogger Kay Olson
by Kay Olson

My personal thought on what happened 40+ years ago is that it was a tragedy for whole families and has undoubtedly had a lasting impact on how we view developmentally disabled people today. That is, we're still living with the legacy of those folks being segregated, made invisible, and devalued. It has impacted how we view developmental disability and the way we think of difference - we have all been taught implicitly by this history that people who are intellectually or developmentally different do not belong among us because they're dangerous, completely incompetent and lack any ability to contribute to society. And those beliefs are not true.

One example of the historical legacy: The institutionalization of developmentally disabled people in the 1950s and '60s happened before Roe v. Wade and the legalization of abortion, and while I absolutely support full choice in reproductive issues for women, I do believe that the very high rates of abortion of fetuses with known developmental disabilities has some connection to our social history of what has been considered the potential and worth of certain people. Instead of doctors of decades ago telling families who have just had a baby with a disability that they should institutionalize the child, some doctors now are providing the option of never having that child at all. And we don't have much of a modern legacy of integration of developmentally disabled people into our culture to balance those messages with, to make the choices a woman and her family make about these pregnancies complete choices about potential. Because of this history of institutionalization, fear and stigma are a bigger part of that choice than they might otherwise be if acceptance and providing community resources and integration were a bigger part of our social history instead.

And, you know, diagnosing developmental differences is one thing - tricky by itself - but determining how differences affect potential is even trickier. The very act of deciding a person has limited potential can limit their opportunities. I know a few people whose abilities were radically underestimated because of developmental diagnoses, and I've read of or conversed online with dozens of other disabled people whose lives have been seriously affected by judgments - faulty judgments - about their worth and ability.

Overall, I do think things are somewhat better now because institutionalization and abandonment of disabled children aren't considered the obvious solutions for families. And communities are actively struggling with the education of disabled children in public schools, which is a complicated issue but is, I think, much better than silence, shame and automatic segregation.

The daily difficulties that come from raising (or being) a developmentally disabled person and finding the resources and necessary support aren't an aspect of the disability experience I'm intimate with, but my perception is that while things have improved there is still a long way to go.

I think the main thing that nondisabled people don't necessarily know or understand is that developmentally disabled people are not this separate category of human beings. People tend to think, "We can do things. They cannot." And there's no line like that dividing all of us. There are shades of ability, varying talents that surface in surprising places. This is true for physical disabilities as well. Most of us, in the course of our lives, discover we have abilities or affinities for some things and lack talent elsewhere, so this idea that a certain class of people lack value or the ability to contribute inevitably underestimates and wastes a lot of human potential.

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