Tuesday, June 30, 2015

Sometimes older people discouraged from having pets

I want another dog.

I think.

We once had a dog and four cats. One cat remains--she has been walking around in here forever--we are not even sure how old she is. My daughter was in HS when she came as a kitten--and my kid is now 33. I am writing a cartoon about this cat, and she loves being our one and only, but I miss dogs.

Then I think..vet bills, food bills, tripping risk, can't walk it with my arthritis, attachment. Well, attachment is what I want.

There is a paper in the J of Activities, Adaptation & Aging, reviewing pet ownership by us oldies.

They say older people maybe can get older pets, but older pets mean more vet bills.

The researchers said maybe the IDEA of disability is worse than the actual disability.

Shelters, they said, could match animal to owner better. Meals on wheels could include pet meals. Maybe people could adopt on a trial basis.

Many assisted living places allow small pets--but nursing homes do not. I remember a very yippy-barky Pomeranian at one place Mom lived--it always lunged on its leash in the lobby trying to take a good chomp out of you.

My grandmother loved her dachshund. Years after she moved into a nursing home, she asked after him. Finally my dad said, "Now, Lennie, what would it be like if dogs were running all over in here?"

She thought a second and said, "Heaven."

Monday, June 29, 2015

Ten tips from a nurse on how to stay alive

Alexandra Robbins wrote THE NURSES and offered readers of Everyday Health some tips.

1. Get a second opinion on surgery. As a nurse, she could not speak, but she says she thought 30% of her open-heart surgery patients did not need the operation--and were not told how much rehab they faced and how they might never be the same.

2. Appoint one spokesman for the family. Nurses have more time for the patient if they don't have to answer questions and fill in multiple people.

3. Avoid teaching hospitals in July.This is when the interns start laying hands on humans--stats show medication errors spike 10%.

4. Watch when a staff member enters the hospital room. Be sure they wash their hands or remind them to. Bring your own sanitizing wipes and wipe things off sometimes.

5. Do as much as you can for yourself and the patient. Bring your own food and bevs. Ask if you can help--maybe with tooth brushing, feeding or therapy.

6. Have end-of-life discussions early. Chest compressions break ribs, long times in the ICU poison the body. Know the facts. That chest shocking thing--works only in a small percentage of cases.

7. Have someone stay with the patient 16 hours a day. Try to get visitors to take turns.

8. Don't be afraid to ask questions.Don't worry about annoying or bothering a nurse or doctor. Avoid the word why--don't say why did you give him that medication...Say what does that medication do?

9. Be kind to your nurse. People who are nice get meds on time and maybe some other perks. Human nature.

10.  Be patient--sometimes the nurse cannot answer the call light immediately.

Or--those beeping IVs--I hate to listen to those. Sometimes if you are sick or afraid or probably both, you can get cranky. I have. But try to think of the nurse's side. You will benefit.

Friday, June 26, 2015

Fireworks can hurt kids' ears

It's rare, according to Laura Swibel Rosenthal, MD, a pediatric ear doctor at Loyola, but she has seen hearing loss and perforation of the ear drum.

Fireworks shows can produce 130-190 decibels of sound. The World Health Org recommends children not be exposed to more than 140.

The best thing to avoid trouble is to keep kids a long distance from the fireworks--ate least 500 feet.

Also, you might want to consider ear plugs of headphones.

You know how you parents are already hearing some voices as muffled or half-read lips from loud amps at concerts?   Well, kids are not immune!

Also--ear protection can be useful if children are scared by loud noises.

Thursday, June 25, 2015

Doctors misunderstand opiate drugs

We have prescription drug addiction in our family. Not going into any detail, but it is a bane and a pain.

Johns Hopkins researchers, writing in the June 23 issue of Clinical J of Pain, found that nearly half of the internists, family practitioners, and general practitioners surveyed thought abuse-deterrent pills, such as those that supposedly can't be crushed, snorted or injected--are less addictive than the old stand-bys.

Not true--equally addictive.

The lead researcher said the danger is that doctors will think, well, this is solved, the patient cannot abuse this--but patients still can.

The study also showed a third of doctors surveyed thought the abuse came from taking the drugs in ways other than swallowing them. Nope--ingestion is still the preferred way. Some meds are more likely to be snorted or ingested, but those are still secondary methods.

Prescription drug overdose deaths have tripled since 1990.

More people die unintentionally of them than die unintentionally of auto accidents.

The survey also showed that physicians supported requirements that patients get all prescriptions filled at one pharmacy--cutting down on the doctor shopping and going from store to store.

They also liked "contracts," where patients agree in writing to properly use their meds and not sell them to others.

More than half wanted periodic urine testing to make sure the patients were using the meds and not selling them.

The researchers added, though, that they were not sure how many physicians really meant this stuff--such controls would be troublesome for them to implement and expensive.

I know people who had those "contracts" and went right out and doctor shopped anyway.

I have chronic knee pain--I don't mean to sound cavalier about pain. I think we need better pain drugs with fewer addictive powers--maybe with different mechanisms.

In many cases, what we have creates another issue for people to deal with. Some people are really suffering year in and year out--we need more research!

I think there is a new class of drugs being touted as less addictive--but I also read most Medicare people will continue to get the stand-bys (think the syllable "oxy").

Wednesday, June 24, 2015

Female HS athletes more at risk for overuse injuries

Male softball and baseball players may have quotas on how many times they can "throw," but girls are at much higher risk than boys to get stress fractures, tendonitis, and joint pain from HS sports.

Publishing in the April J of Pediatrics,Ohio State researchers analyzed 3,000 male and female injury cases across a range of sports such as soccer, volleyball, gymnastics, and lacrosse.

The highest rate of overuse injuries occurred in girls track, followed by girls field hockey, and girls lacrosse. For boys, most injuries came in swimming and diving.

Intensity of of athletics has increased over the past decade, with some HS students spending 18 hours a week in such activities, often in more than one sport.

The lower leg is the most common site of overuse, followed by the knee and then the shoulder.

Overuse injuries account for more than twice as many visits to sports doctors than trauma.

Girls (and boys, of course) are developing bones at the greatest rate--they need proper calcium and Vitamin D.

Cross-training in other sports is recommended. So the athlete is not repeating the same motions all the time. Warmups are good. And learning proper form.

Tuesday, June 23, 2015

Indestructible pill dispenser

The Showtime series NURSE JACKIE, about a lying, manipulating, drug-addicted woman who is nonetheless a gifted nurse, is about to end. In last week's episode, Jackie waltzes into the pharmacy of the hospital and asks for some pills. We know these may or may not end up in a patient. The pharmacist hands them right over.

Not so fast, say some students at the Johns Hopkins Whiting School of Engineering.

At least one in 20 people somehow takes a drug meant for someone else. Sixteen thousand people a year die from prescription drugs.

The Johns Hopkins students have invented a tamper-resistant pill dispenser prototype with a fingerprint scanner to vertify the patient and then dispenses only the right amount at the right time.

You can drill it, stab it, or attack it with a drill.

It weighs two and a half pounds and is 9.25 inches high.

Still, if the patient is lying there, weak, and the  nurse hands over the pills--well, you  know Jackie.

Monday, June 22, 2015

Quinoa, quinoa, let's hear it for quinoa

Not Quinn-Noah...KEEN-WAH. I think. I have never eaten it that I know of.

Apparently it is chockful of goodies! The Institute of Food Technologists printed up a list in their pub Comprehensive Reviews in Food Science and Food Safety.

Protein: Big on protein, gluten free. One serving has enough complete proteins to provide 180% of the 10 essential amino acids.

Carbs and fiber. Ten percent of daily fiber,

Lipids. Quinoa seed oil contains polyunsaturated fats  with a higher Omega 3 to Omega 6 ratio than other plant oils.

Vitamins. Rich in Vits !A, B, C and E.

Minerals. Calcium, copper, iron, magnesium, phosphorus, potassium, and zinc.

Saponins. Wha? This means this can be produced without pesticides.

I could go on--think reducing stress, building muscle, promoting digestion, fighting obesity, preventing diabetes--tons of cool advantages.

One description I read was brown rice mixed with oatmeal--fluffy, creamy, crunchy and nutty.

I think you boil it up and lace it with tahini or olive oil or something and add a bunch of veggies...sort of like pilaf. But if you are getting cooking advice from me, you are in big trouble.

Friday, June 19, 2015

If you live long enough, you are getting a cataract

A doctor once told me that in an interview. I have one sighted eye--it has a cataract--they say wait as long as you can to remove it. I had already thought of that.

But--two University of Delaware researchers, using a DNA array on a chip, have identified two genes that govern formation of these lens-clouding nuisances.

So far this is being studied in mice, but there is hope.  As published in Human Genetics, their findings may lead to interventions to prevent cataracts from forming.

According to what I read, the scientists actually said EUREKA when they found the non-expression of these genes led to a cloudy area.

This is the beginning of what could be a breakthrough on a troublesome problem--and grad students did it!

Thursday, June 18, 2015

New wrinkles in Botox

In 2002, the FDA approved the use of injected botulinum toxin Type A for temporary paralysis of wrinkles between the eyebrows.

In 2013--the FDA okayed it for crow's feet.

Now it is used elsewhere everyday as therapy not as cosmetic enhancement.

It paralyzes muscles and is useful where there are spasmodic muscle contractions.

Alicia Cool, MD, of Advanced Dermatology PC, notes some uses:

For migraines. The FDA has approved it for people with more than 14 headaches a month. The injections are given in the temples, forehead, neck, and shoulders. This may reduce the number of these horrible headaches.

For excessive sweating. It blocks the release of the chemical that causes undearm sweating.

For overactive bladder. Injected into the bladder, it can stop frequent urination, nighttime waking, and incontinence.

For cervical dystonia, or clenching of the neck and shoulders.

And for upper limb spasms in people with stroke, traumatic brain injury, cerebral palsy, or progressive multiple sclerosis.

Sometimes it's used "off label" for smiles where too much upper gum is visible.

Remember--the effects are temporary. And always get this from a qualified professional. It's no fountain of youth--and can go wrong.

Wednesday, June 17, 2015

Here's an idea for the ER--ask people if they need pain meds

Once, my mother dislocated her shoulder falling--and she lay in the ER for six hours with no pain med waiting for a doctor. No water either--in case she needed surgery (not how these are fixed). Her tongue was stuck to the top of her mouth and she was so miserable, kept saying it hurt (she had dementia). But no--nothing.

Based on a new study on treating acute pain the ER (Annals of Emergency Medicine), the conditions of most ERs are not conducive to fully individualized pain treatment. Well, boy howdy!

Researchers provided 1 milligram of intravenous hydromorphone to patients reporting severe pain. Thirty mins later, they were asked do they want more. Then this was asked again at 30 minute intervals. One milligram was given if the patient said yes.

Of the 207 patients, 114 received just the first doses, 78 got two doses, nine received three, and six got four.  All but two were satisfied with their pain control in 2-4 hours.

Pain preception is highly subjective and varies by patient. It is not necessarily related to those scores--where they ask, what is your pain from 1 to 10. A yes or no question lets patients decide. They can gauge the pain, think about the side effects--drowsiness, nausea--and make the call.

Yes, ERs are very cagey about people coming in just to get pain meds...but this is usually prescriptions.

Maybe all ERs should look at this.  I wish my Mom had it to do over.

Tuesday, June 16, 2015

Busing in healthy food

The St Louis MetroMarket and St Louis University are converting a Metro transit bus into a mobile farmers' market. It will be fitted out with refrigeration units and aisles wide enough to accommodate the handicapped. It will be wrapped with original art on vinyl.

The MetroMarket is a nonprofit organization to restore access to fresh foods in "food deserts."

Food deserts are often found in lower income neighborhoods, where supermarkets either depart or are not located. Fresh produce, especially, is hard to come by.

The first stop will be in a neighborhood with a median income of around $18,000 and only three small corner stores.

Because this is a university project, data will be collected and some classes will work on the project.

Also in the works: job training and entrepreneurship programs.

Monday, June 15, 2015

Powdered alcohol--what a terrible idea

Oh, we definitely need more ways to ingest alcohol.

Powdered alcohol--flavored in pouches to be mixed with a liquid--is such a wrong-headed idea.

It's legal, but some states have already banned it.

And a majority of the public (60%) in one poll (Mott) favor a complete ban in their states.

Eighty-four percent say--no online sales!

The makers of this stuff say it's for people who love the outdoors and don't want to carry heavy bottles.

Are you kidding me?

Ninety percent of adults think people under 21, not weak woodsmen, will be interested.

Well, d'oh.

And Palcohol is a dumb name, too.

Friday, June 12, 2015

How to not overheat exercising in summer

You may think you are in great shape, know all the tricks, and a 90-degree day with humidity can fell you like a tree in the forest. Bam!

Even walking around, getting in and out of the car, and you can suddenly get light-headed and nauseated. Heat illness!

Even construction workers get it sometimes--I once interviewed a long-time contractor--he felt funny, went home, and went unconscious.

As heat and humidity rises, sweat fails to evaporate to cool the skin. You may even stop sweating, which is very bad.

Some people withstand heat better than others. Which are you?

As the thermometer rises, we all need to expose ourselves to the heat gradually over a period of 10 days to 2 weeks. This may need to be longer for kids, out of shape adults, the elderly, or those on certain meds.

During this period, limit not only your time outside but the intensity of your activities. Have a buddy present.

You need to hydrate--and this does not mean a sip of water when you feel thirsty or dry.

Thirst often comes only AFTER our bodies are experiencing significant fluid loss. The minute you drink, thirst can disappear, but you are still not adequately hydrated. Older people tend not to even experience thirst as much.

Children also need to be asked to drink, even if they don't feel like it.

Check your urine color--if it's light like lemonade, you are probably hydrated. If it's dark or the color of apple juice, you may need more water.

One or two hours before you go out and exercise, drink at least two cups of water or a sports drink.

While working out or playing, drink half to a full cup every 15 minutes.

If you feel sick or crummy, get in the shade and drink water. If you become clammy or confused, dial 911..

Thursday, June 11, 2015

Traveling with a bad back

Millions of people have back trouble. And millions of people also want to travel.

Daveed Frazier, MS, an orthopedic spine surgeon at the Atlantic Spine Center, says travel can be hard on your spine. You have to be mindful of your back:

Bend at the knees, using leg muscles to pick up luggage.

Avoid twisting to grab a kid dashing off or a bag to one side of you.

Carry shoulder bags on alternative shoulders.

Rent a pushcart!

Check in curbside.

You may also be in a car this summer. In a car or plane, use lumbar support on your lower back, even a rolled-up blanket.

Use an inflatable travel pillow to avoid neck strain.

Get up frequently and move.

If you can pack your own pillow.

What do you do if your back does flare up?

Apply a cold pack--even a baggie of ice for 10-15 minutes. Alternate with hot--packa hot water bottle.

Take an NSAID--these are over the counter.

Wear comfortable shoes.

If something hurts on me, and things do, I whine a lot. This is optional.

Wednesday, June 10, 2015

Many new drivers can't drive

Truth: I am a nondriver. Long story. I have had four incredibly scary (and now funny) driving lessons and will never drive. Now, of course, I can't see well enough anyway.

Researchers at The Children's Hospital of Philadelphia and Univ of Penn have devised a Simulated Driving Assessment to check teen drivers' skills. You can check it out in the J of Injury Prevention.

The simulation is 35 minutes long and contains 22 variations of common ways teen drivers crash. Nearly 43% of licensed teens had a crash on it (within 3 mos of getting their license).

For experienced adults, 29% had at least one crash.

Teens could use turn signals, but were wanting in the more advanced skills, braking in hazardous conditions and anticipating and responding to hazards.

The most common crashes involve left turns, rear-end events, and running off the road. This does not even COUNT texting, talking, and having other teens in the car!

This simulation is available to evaluate teen performance over and above the live test.

Sounds like almost a third of adults need this, too!

I sure would have flunked it!

Tuesday, June 09, 2015

Have to skimp on sleep--don't eat a lot in the evening

It sounds counterintuitive--when you have to work late or can't sleep, don't grab a snack to substitute for the shuteye.

Eating less late at night, say rresearchers at the Perelman School of Medicine (Univ of Penn) may help curb the concentration and alertness deficits ccompanying sleep deprivation.

When sleep restricted, adults tend to snarf up 500 additional calories if awake long hours.

They took 44 subjects, 21-50, and gave them unlimited food and water during the day. This was followed by four hours of sleep a night for three nights. On the fourth night, 20 participants still got unlimited food and water, but 24 others were only allowed water from 10 PM to 4 AM, when they went to sleep.

Subjects who fasted (water only) performed better in reaction times than those who had eaten.

Those who ate showed significantly slower reaction time on the fourth night of sleep restriction compared with the first three. The water drinkers did not.

Sleep deprivation also contributes to weight gain, it has been found. Not eating at night also helped with that.

Sooo...awake, tired, and drinking water...Sounds great. Still, if you have to work late, maybe bear it in mind.

Monday, June 08, 2015

Summer--time to think about your kid's physical

Parenthood--the job is never done. I even know people who think their responsibilities end when the child reaches 18. Ha ha, good one!

Heidi Renner, MD, a primary care doctor at Loyola, reminds us that now is the time to schedule the back-to-school checkups.

Some topics you will want to cover:


And yes, your child may need shots--vaccines are a part of keeping your child--and your community--safe. Common childhood diseases are popping up again because kids are not getting vaccinated.

Before kindergarten:

Measles, mumps, rubella--MMR vaccine
Diphtheria, tetanus, pertussis--DPT
Chicken pox

Around 11 or 12 yrs of age:

Chicken pox booster (if the child has not had two by now)
Pertussis (whooping cough), diphtheria, and tetanus booster (Tdap)
Meningitis (not a booster)--but a booster is given at 16

Don't be stupid about vaccines. We need the kids to be immune so these sometimes very serious diseases don't spread to other children--and to adults.

Many decades ago, I recall balking at the DPT for my daughter. My pediatrician, an older German woman, said she needed it to get into school--but how about splitting it in two doses--which we did. She did get a lump at the injection site, but it went away and she was fine.

Friday, June 05, 2015

Best exercises leading to a good night's sleep

Having trouble sleeping? Most health experts mention that getting exercise during the day can improve sleep.

But do they tell you what kind?

A new study at the Univ of Pennsylvania Perelman School of Medicine, recommends walking, as well as aerobic calesthenics, biking, gardening, golfing, weight lifting and yoga/Pilates as most conducive to sleep.

No, not because they are boring!

What activities are not so sleep-friendly? Household chores and child care.

The researchers--who will present their results at the annual meeting of the Associated Professional Sleep Societies this month--said the good sleep results from just walking were a surprise. The others were credited with sleep-enhacing effects because they were organized and "purposeful."

They also said it was "interesting" that home and work and childcare demands were the main reasons people lose sleep.

To me, that was one for The Big Book of Duh.

Chase a toddler around all day--you will be tired and exhausted but too jangled to sleep.

Thursday, June 04, 2015

Pregnant women can get free evaluation of their vitamins

Check out LabDoor.com. Every pregnant woman is prescribed prenatal vitamins in this country. But how can you tell which are best and most effective?

After all, you don't want to be throwing down any old stuff--because it goes directly to the developing fetus.

Take folic acid. the US Public Health Service recommends that all women capable of getting pregnant consumer 400 ug of folic acid daily to insure good calcium and iron levels. This helps prevent neural tube defects and abnormalities of the brain and spinal cord.

Pregnant women need 50% more folic acid than other healthy women.

Her daily requirement for Vitamin B12 and calcium will also increase. Many prenatal supplements also contain DHA, an omega-3 fatty acid to support fetal brain development.

LabDoor analyzed 25 best-selling supplements. They looked at the actual amounts of each vitamin in the preparations.

With folic acid, the amounts ranged from a minus 94% of the recommended amount to more than three times what it said on the label. Vitamins A and C were most likely to fall below what the label said. Minerals were better--varying only 10%.

Some supplements, though, had additives, which moms might want to avoid,

To do this testing, LabDoor went to stores and online and bought the supplements retail.

So when you get your prenatal recommendations from the doctor, why not check them out?

By the way--LabDoor's biggest investor? Mark Cuban of SHARK TANK fame.

Wednesday, June 03, 2015

Do hospital stays disrupt your innards?

A University of Michigan Ann Arbor study shows that a routine hospital stay can so upset the balance of microbes in our bodies that some older people succumb to sepsis within 90 days of leaving the hospital.

Older people are three times as likely to get the sometimes fatal body-wide condition after being in the hospital than at any other time.

The study was in Am J of Respiratory and Crit Care Med.

Researchers have known for some time that antibiotics given in hospitals can encourage that C. difficile stuff by disrupting the body's microbiome (newspeak for the balance of organisms in the gut).

They came to this conclusion after looking at 43,000 hosp stays by 11,000 older Americans over 12 years.

The implications are big, the scientists say. For one thing, antibiotic resistance may not be the only problem.  Overuse of antibiotics, they say, MAY upset the whole balance, allowing many infections to overwhelm the system and shut down organs.

They are also looking at patients who go home--are there diet-based approaches to reset their balance?

My sister had sepsis--and it's no joke. She was in the ICU and so gone, she did not recognize family members. The bad organisms had crossed the brain barrier.

My personal opinion is that the ever-popular Jell-O in hospitals is not exactly health food.

Tuesday, June 02, 2015

Teens access useful health info on the internet

They may be stubborn, reclusive, negative, even, but a recent study showed that teens do check on the internet for health info--if only to avoid asking the parental units.

In a story in the Washington Post by Lena H. Sun (June 2, 2015), one-quarter of the teens surveyed went online looking for health info about themselves or a family member.

A third changed their health habits--such as vaping or drinking soda, based on their research.

They also looked up things such as exercise, diet and nutrition, puberty, drugs, sex, and depression.

Eight-eight percent said they did not feel comfortable with airing these on Facebook.

So the "coach" and the health classes are becoming passe?


A concern, though, is that teens do not always see the difference between a commercially sponsored site (say on eCigs) and an objective one. Teens--and everyone else.

Monday, June 01, 2015

Health breakfasts

 Not healthy breakfasts, though those are good, too--but breakfasts where health issues are discussed.

According to the American Cancer Society, as reported on http://blackhealthmatters.com, the death rate for all cancers combined is a third higher among African-American men than white men. For black men, cancer is second only to heart disease as the leading cause of death.

Some groups are addressing this--notably, Black Men Speak (Oakland, CA), Project Brotherhood (Chicago), Mean of Color Health Awareness (Springfield, MA), and Black Men's Health and Wellness Expo (Orlando).

The University of Michigan Comprehensive Cancer Center held a series of breakfasts from 2008-2014 to improve awareness and promote screening of black men from 51-70.

They got info on the subjects they were interested in, namely nutrition, prostate cancer, colorectal cancer, pain management, and clinical trials.

They followed up with focus groups that showed that black men will attend such breakfasts--so how about one in your neck of the woods?

I also once reported on an initiative for barbershops to educate barbers to encourage screening tests...These initiatives are still going on.