Friday, February 27, 2015

Maybe take some of your fruit in juice form?

The Univ of Washington Center for Public Health, as published in the online Nutrition Journal, says Americans eat just under one cup of fruit a day. This should be 1.5 to 2 cups! This according to the 2010 Dietary Guidelines.

Typically, the scientists found, this came in two parts of whole fruit to one part 100% juice.

Kids and adolescents drank less than half a cup of 100% juice a day, adults less than a third of a cup.

Adding more 100% juice did not displace other whole fruit servings.

Low income or minority adults were least likely to eat whole fruit.

Adding 100% juice is a cheaper way to get the fruit onboard.

I don't eat much fruit--do you? I do drink a cup of 100% cranberry juice from frozen concentrate, when we remember to buy it.

I could do better.

Thursday, February 26, 2015

Music may confuse the older worker

There used to be a show on a radio station in DC called ELEVATOR MUSIC FROM HELL. They would take big hits and dim them down into Muzak. Ironical, what?

Now, though, Georgia Tech has found that older adults cannot work as well--they forget names for one thing--in an office with background music trilling on all day.

The music did not seem to affect the younger participants in the exercise. But both groups said the music was distracting.

This info would be good in offices, but also in retirement homes. Don't play the Elevator Music From Hell during explanation of activities.

Things like that.

But what about the grocery store--there is always blah music going there.

Wednesday, February 25, 2015

Losing weight and keeping it off is hard

Well, duh! I have been "the fat one" in my family all my many years. I have lost, regained, lost, regained, lost...finally I gave up and tossed the scale at age 40.

Now--researchers at McMaster University in Hamilton, Ontario, have looked hundreds of weight and obesity studies from the last decade--and I am not alone.

90 studies on preventing obesity among children: Small improvements in weight outcomes. The programs that worked best were in school diet and exercise, and lasted 12 weeks to a year.

Prevention of obesity in adults. Almost no studies on helping normal weight adults maintain normal weight. A single, small study in 1980 showed benefits from a 12-month education and incentive program.

Treating obesity among adults. 68 studies. Doing some activity is better than doing none. Adults in some form of treatment had an average of 7-pound greater loss. Weight loss results, overall, did not differ whether the treatment involved diet, exercise, lifestyle changes, or drugs. Drugs had side efx.

The researchers also found studies showed that a 5-10% loss could positively impact health--I guess meaning measurably.

As for keeping weight off: Eight studies since 2011 found doing SOMETHING to keep weight off, can help at least during the short term. There were no studies involving the long term.

Use of drugs can also maintain a loss of 5% of body weight--no effect on keeping a 10% loss from returning.

So...that was discouraging. All that.

Tuesday, February 24, 2015

Warts and all

Today's subject--warts. Apparently anyone (oh joy) can get these.

They are caused by the HPV virus, which infects the upper layer of skin and forms a hard crusty thing.

Dr Alicia Cool, assoc director of Advanced Dermatology of Park Slope, NY, says warts are especially embarrassing on the face--viz, witches.

But warts come in all shapes and sizes--common ones, plantar warts on the feet soles, flat warts in large numbers, filiform warts with look like long threads and often grow on the face. Genital warts.

Ew. Enough.

Because these can spread, warts should be removed.

--By a solution painted on to blister it so it falls off.

--Electrosurgery, burning it, then cutting it off.

--Excision--coring it out.

--Laser--burns and destroys.

--Immunity--encouraging the body to dry up the wart.

I have heard of keeping duct tape on it until it falls off. Probably a "guy" thing--they love the duct tape.

Ask the doctor whether you will have a scar.

Oh--and yes, they can grow back.

Don't you just love your body?

Monday, February 23, 2015

New "scoring" system to predict pain after surgery

A friend of mine had major surgery and went home on Tylenol. She did not like the nausea and intestinal nastiness of opiates.

I had the same surgery years ago and did take painkillers, as I recall.

People differ.

Now some anesthesiologists in Barcelona are trying to pin down what the risks are for post-op pain.

They looked at 2,929 hernia, hysterectomy, and thoracotomy surgery patients, assessing their pain at 4, 12, and 24 months after the operation.

First, there is substantial risk of chronic pain after surgery--chronic. Eighteen percent developed it after 4 months. More than 5% hurt after 2 years.

They did a scoring system based on:

Type of surgery
Physical health status
Mental health status
Preoperative pain in the area
Preoperative pain in another area

Discussing the pain helps patients decide on the surgery, the doctors said. Appropriate pain plans can be put in place. Pain preventives can be instituted. And there can be a pain monitoring schedule.

They also looked at 90 genetic pain predictors--but they did not seem to play a role.

Sounds good--I think we do need more than, "Don't worry--you will get pain medicine."

They also need to prepare people for those post-surgical slumps and "I am so tired I want to die" moments.

Friday, February 20, 2015

"Aging in place" may not be best

C'mon, honey, there's a dining room.
Older people (and I have a pretty large number birthday coming up) may say they want to stay in their homes, but this may not always be best.

Stephen Golant wrote Aging in the Right Place. He says staying home and as independent as possible may not work for everyone--despite what stubborn older people may request.

Homes may have sentimental value, but be unsafe, lack amenities, have stairs, and require upkeep that boomers cannot supply for their parents--or themselves.

People need to feel that can supply their own needs--including groceries and hiring people.

The problem often is $$$$. Wealthy older people can afford assisted care--$3,000 a month or more. Less well heeled people need to depend on their kids, friends, neighbors, church groups, and so on. Sometimes the kids are old, too.

That was the case with my mother. She could not care for heself (memory) and we could not take her in our homes. She hated animals and we had pets. She had means to go to assisted care for almost 20 years. But this was a struggle--finding a good place and keeping it good. Things tend to change in these institutions.

The best you can expect, Golant says, is to be aware enough to plan your own aging place.

So far, my adult daughter lives in my house--which will be her house eventually. She has her own suite. She shops. But who knows--things change.

My ideal--we used to joke about this--would be older women living Golden Girls style, nice house, cabana boy to get our BP meds, drive us, and make the drinks.

Strangely, I look around--and no cabana boy. No cabana, for that matter. Sad face.

Thursday, February 19, 2015

Why see a doc, when you can ask a friend?

First, we now have "crowd sourcing" to diagnose ailments--even the NYT lets people weigh in on symptoms and try to guess the Disease Du Jour. What fun!

But there is also a site called CrowdMed-- people without a diagnosis for six months can submit their problem and see if someone has had a similar issue.

This site did a study and 77% of 1,500 Americans (not just CrowdMed adherents) said they would consult a non-physician stranger.

73% of those who answered yes would trust a nurse.

74% an alternative medicine practitioner.

84% a retired doctor.

87% a former patient with the same symptoms.

62% a medical student.

CrowdMed says they solved more than 600 cases in months instead of years.

This cost an average of $200 (as opposed to $50K making the doctor circuit).

So...what do you think? I ask around--do you?

The other day, I had to appear at the doctor (actually a physician assistant) to get my pills renewed and basically tell him I had cut some of them out--and my sister whipped off her shoe to show MY doctor some itchy blisters on her foot--in other words, she tried to get a second opinion.

He didn't have one, but it was an idea, I guess.

Wednesday, February 18, 2015

Oh, this is nice--you can get hot flashes for up to 14 years

According to Pam Belluck, NYT, Feb 16, 2015, hot flashes, which affect up to 80% of women in the menopause years, can go on for up to 14 years--not the few years commonly thought. (JAMA Internal Medicine, Feb 16)

They studied 1449 women with frequent "night sweats" and found these went on for a median of  7.4 years.


Overall, black or Hispanic women seem to suffer them longer than white or Asian women.

If you get the flashes before your periods stop, you may be in for a longer siege. Those who get them also have more of a cardiovascular and bone loss risk.

Hot flashes creep onto your face and chest--slathering you with sweat and turning you crimson. Some women carry battery-operated personal fans.

One restaurant server said when she got a flash, she went and stood in the walk-in freezer.

Handy if you have one.

Obviously, these night sweats can also be day sweats.

Tuesday, February 17, 2015

Yoga for your heart

According to a study of 37 other studies, yoga may be as good for your heart as brisk walking or cycling.

Apparently, the relatively gentle stretches and motions lower BP, cholesterol, and other cardio risk factors.

This appeared in the J of Preventive Cardiology--along with a caution that more studies were needed.

Part of the effect may be the relaxation in addition to the poses.

I did yoga a lot over a decade in my twenties and early thirties. It was a social experience as well as relaxing and fun.

Can't hurt.

Well...maybe can't hurt. If I got on the floor now, I would be staying there...

Monday, February 16, 2015

Millennials love that gas station grub

Bruce Horovitz, USA TODAY, says not all "young people" have traded up from Mickey D's to Chipotle.

More than half like convenience stores for their fine dining.

Millennials are cheap, said one expert. Food is fuel to these, not an adventure.

The 18-34 yr-olds of yore went to fern bars. Now they go for those appetizing hot dogs turning slowly, slowly on the grilly thing or whatever they call that hotdog cooker deal.

In fact--say the experts--the food may bring in more money than the gas as time goes on.

There is a joke in there somewhere--I leave it to you.

Me I am eating the devil hot Doritos.

Friday, February 13, 2015

Dandruff--oh no

Ick--regretting this.
Does this seem like a 1950s problem? Somehow you don't hear that much about it anymore.

Never fear. I am here.

The American Academy of Dermatology is still into it.  Adam Friedman, MD, asst prof of dermatology and director of dermatologic research at Albert Einstein School of Medicine, says to control the irksome flaking, don't just brush and brush--use dandruff shampoo and treatments.

--Follow instructions on the bottle. There are many kinds, with different ingredients--they work differently. Some you leave on for five mins, for example, some not.

--Caucasians or Asians should use dandruff shampoo twice a week.

--Be careful if the shampoo contains coal tar. This can discolor blonde, gray or white hair. Tar shampoo also increases sensitivity to UV rays--wear a hat.

Usually dandruff does not require a trip to the doctor. But sometimes the flaking can be psoriasis or seborrheic dermatitis, a fungal infection or eczema. If the shampoo does not do it, see a dermatologist.

There is a video on YouTube called "Dandruff: How to Treat" if you need more info.

So bring back the black sweaters!

Thursday, February 12, 2015

How you and your doctor can reach a decision

I honestly think--or make that, honestly hope--people are not just doing anything a doctor says, as so often happened in the past.

We are told to have some control over our care--so let's have it.

McMaster University has developed a program for an electronic tablet that helps with this shared decision-making. (British Medical Journal.)

It's called SHARE-IT and it presents medical info and evidence summaries in simple formats.

It's designed to invite discussion with the patient. Unlike earlier long, clunky expositions, these are quick and zippy.

Patients are not overwhelmed with info.

This particular system is expected to be found in offices in two years. The docs all peck away at computers now--what are they looking for?

I remember when my right eye filled with blood (caused by a blood thinner some other doc prescribed). I put off surgery--the doc let me.. I said I did not want to be worse...I was scared to death. He said offhandedly "How could it get any worse?"

Well--it could! After four surgeries, I lost sight in that eye--so it was worse--hope was gone, too. A little discussion would have been good. I probably would not have changed things--but certainly his blithe assurance that "you have a 90% chance of seeing with that eye again" would have been examined more closely.

Wednesday, February 11, 2015

You CAN catch up on sleep

Remember when we were kids and had a long night or could not sleep and thought we could catch up if we just got some solid hours? Then the scientists said no, it doesn't work that way.

Well, maybe it does!

While some researchers blatted on about sleep deprivation, interruption of rest because of blue light from devices in the room, people being over stimulated, and so on--other researchers, namely some in France at the Universite Paris Descartes-Sorbonne Paris Cite--say a 30 minute nap can restore the hormonal impact of a night of poor sleep.

This, they say, is the first study that seems to suggest this.

You can look up the study design in the Endocrine Society's J of Clinical Endocrinololgy & Metabolism, but it was a cross-over, randomized study--but of men only.

I am not a man, but I have found--anecdotally--that if I sleep badly one night, I have great hours the next night--to me this means the body takes the opportunity to rebuild some stores of immune chemicals when it can.

Why not during a nap, too?

How's that for science?

Tuesday, February 10, 2015

Now this is love

Who needs a six-foot Teddy Bear or baby doll jammies for V-Day when you can have chocolate and wine?

Many Valentine's Day indulgences have amazing health benefits, according to Kim Sasso, RD, at the Loyola Center for Metabolic Surgery and Bariatric Care.

Dark Chocolate--This contains antioxidants called flavanols, which help lower BP, reduce blood clotting, and lower bad cholesterol.

Look for 70% or more cocoa content.

For more flavanol punch, add a strawberry--an excellent source of Vit C, folic acid, manganese, and potassium. Berries also contain a flavinoid that reduces against heart disease, cancer, and inflammation.

Scientists still like red wine, too--it may reduce the risk of colon cancer by 45% and they still think it's heart friendly.

Just be careful of serving size--a goodness-coated strawberry or two, a glass or two of the vino, a kiss...ah.

Monday, February 09, 2015

Prescribing sight unseen

I am hornetbasket mad! An acquaintance went online to one of those doc in the box sites and got a prescription for Tamiflu AND an antibiotic for her 14-yr-old son, who had been ailing for a few days.

I can see MAYBE asking some unknown doctor you can't check out whether it might be the flu--but for this person to call in a script for an antiviral and an antibiotic (does not work on viruses) is to me going way too far with the cyber convenience stuff!

The "doc" never even talked to the kid--just the mother.

Tamiflu was recently nailed by a big study in Britain as being basically ineffective. Also, it should be given within three days of symptoms if one is going to give it--this was too late. And unneeded antibiotics just dump into the water supply and make people resistant should they really need one, say to save their life.

I emailed the company--they said give us the patient's name--so you should know that confidentiality would not be a long suit there, either.

I did not give the name.

So--la-de-dah--let's just all open our own pharmacies and take everything in sight! I saw Adderall writers, Xanax writers, etc on my internet search.

Basically, you should see a doc before you get a prescription. Maybe if you had five urinary infections, know the signs, and call, you could get a script called in...But new stuff? Go already!

Friday, February 06, 2015

Whoa--Horrible health plan tricks!

I have Medicare HMO and starting this year, have to pay $10 out of pocket for those ever-popular blood tests they want you to get every five minutes. First time.

But that is a pittance compared with a friend who had a test and her Medicare PPO was allowed to charge her a $25 "equipment" fee. All tests have equipment--gloves, needles, other stuff.

But now for the kicker--my sister, who has the AARP United Plan, went for blood tests and they asked for a credit card number to which they intended to charge everything the insurance did not pay! In her case--$109!!

What the heck?

We think Medicare disallows back billing--we are checking.

Anyone else been hit like this? These skeevos are going to gouge everything they can. But can they?

We are not sure.

Thursday, February 05, 2015

Seriously--DIY orthodonture from YouTube?

Before YouTube--thank heavens.
Remember that commercial where the guy prepares to operate on himself with instructions from the doctor on the phone and he says, "Shouldn't you be doing this?"

Recently on the NYT Well Blog, some people were outed as trying to close the gaps in their front teeth by using rubber bands--as seen on a YouTube video.

Some dude actually made nine such videos--he's a fashion design student, not a dentist. There is also a website.

Of course, they had a real orthodontist who pointed out that this approach could have unintended BAD consequences.

Please, please do not do this! Is that clear enough for you?

One guy used the bands on his front teeth to close the gap. The elastic got stuck under the gums, resulting in horribly bucked teeth. He lost both front teeth at the root.

Yes, orthodontists cost a ton (don't EVEN get me started on that), but being free, the YouTube approach costs far more.

Anyhow, a front gap worked for model Lauren Hutton and the Wife of Bath in Canterbury Tales.

Think about it.

Wednesday, February 04, 2015

Potty training and bedwetting

Every parent knows these are issues--for a short time, anyway. Most kids are not wearing Depends to the prom.

But there are a zillion schools of thought on bathroom training for kids. Check out a book called It's Not Your Fault by Joseph Barone, MD.

I love parenting books that say it's not my fault, by the way.

Potty training, Barone says, is an important milestone but when training fails, it is not the parents' or kid's fault. The techniques simply are not based on the science.

Bedwetting, for example, is the biggest urinary concern--but can be eliminated in 90% of kids. Giving it time will work, but there are other ways.

If the child is still having problems between ages 7 and 8, time for expert advice.

Thus this book.

Barone puts in lots of true-life stories, studies, and professional advice.

Not getting this book would BE your fault.

Tuesday, February 03, 2015

For once and for all--attack on measles vaccine is bogus

There is so much half-vast info out there on vaccines--most of it opinion--that kids are not being protected. Sure enough--measles outbreaks in California and elsewhere.

I know, as a parent, that it can be unsettling to shoot your kids up with stuff. I was wary of the diphtheria-pertussis (whooping cough)-tetanus shot for my daughter. My 70-yr old German pediatrician insisted--on the first dose, my kid developed a hump in her leg. I said, "No, no." The doctor said look, she needs it to get into school. So the doctor divided the second shot in half--gave more lumps.

I had polio when I was 4--believe me, that vaccine saved the mental health of many a parent.

But this latest--this measles thing--is based on one totally discredited study--done by some guy named Andrew Wakefield, who is no longer a physician and whose study was RETRACTED by the prestigious journal Lancet.

He drew blood from 12 kids at his son's birthday party. The case reports were things the parents said. Most kids who develop autism had been vaccinated with the MMR vaccine--but it does not cause that!!

Several, scientific, large-scale studies show no cause and effect.

Several followup showed Wakefield manipulated his data, such as it was.

He also filed a patent for a competing vaccine to MMR--think that had any bearing?

In addition, he has refused to try to replicate his findings.

So this is what people are believing. It is not in dispute.

You do not want your kids getting measles. We do not want epidemics of measles. We need to get 85-90% of kids vaccinated to prevent outbreaks.

As a parent, you need to think of other kids, too--and do your homework. I almost went off half-cocked on the DPT--be smarter.

Monday, February 02, 2015

Do you really need Vitamin Water?

How about Vitamin Solids?
Good heavens, we Americans eat and drink a range of foods--including those fruits and veggies. Do we really need to slurp down so-called Vitamin Water?

Heck, milk even contains additional (trendy) Vitamin D! Everything is loaded with extra vits!

The NYT's Anahad O'Connor took this up Jan 30, 2105.

There can be a tendency with all the vitamin-containing or fortified foods to get too much of a good thing, said one nutrition professor.

More than half of all adults in the US take some vitamin pill or supplement.

Many people are exceeding safe levels set by the Institute of Medicine.

One study looked at 46 beverages sold alongside bottled water in supermarkets. Many contained B6, N12, niacin, and Vitamin C in amounts well above the average daily requirement for young adults.

Moreover, these promised performance and "emotional" benefits. beyond conventional nutritional science, as one expert put it.

The irony is also that those who would buy and take a supplement are probably already "eating right,"

The water soluble vitamins--B&C--are excreted, but the fat stored ones--A, D, E, K--can accumulate.

Some studies show that antioxidants such ass beta carotene, Vit A, and E, can increased mortality.

I am skeptical of the current push to get everyone on Vitamin D3. Every woman I know has been told she is "dangerously low."

So far, I decided not to throw down a bunch of pills. I might go outside more. Sunlight makes your body produce it.

By the way--there were hundreds of comments on this story in the NYT--most of the people luv their Vitamin Water.