Sunday, May 29, 2011

Journal/News Watch May 29

Prescribe Fewer Tests for Better Care: Ordering fewer tests and prescribing fewer antibiotics will not only curb healthcare spending but also improve the quality of primary care, a large group of U.S. doctors said Monday. After soliciting input from more than 250 members, the National Physicians Alliance (NPA) came up with 15 recommendations it believes will help doctors practice medicine more efficiently. The group's report follows concerns over the growing use of new technologies, such as CT scans, that in many cases don't have a clear medical value. The report lists five evidence-based recommendations in three areas: family medicine, internal medicine and pediatrics. The gist of the advice? Leave well enough alone. Archives of Internal Medicine, online May 23, 2011

CDC Warns Against Exposure to Mad Dow Like Brain Diseases: .U S. researchers have new information about how humans are exposed to "prion" diseases, which are rare, progressive conditions that affect brain function, such as variant Creutzfeldt-Jakob disease, chronic wasting disease and bovine spongiform encephalopathy, commonly known as "mad cow disease." The study found that eating wild deer meat (venison) is one of the most common ways people are exposed to these serious, debilitating diseases. Journal of the American Dietetic Association, June

NIH Stops Study of Niacin: On Thursday the National Institutes of Health halted a major study of high-dose niacin, a type of B vitamin, more than a year ahead of schedule because of the lack of benefit. It was the latest setback in the quest to harness good cholesterol to fight the bad kind. A study of 3,400 statin users some of whom received Niaspan or a placebo, found that while the HDL levels rose and triglycerides dropped in the Niaspan group, the combination of statin and Niaspam didn’t reduce heart attacks, strokes or the need for artery-clearing procedures such as angioplasty, the NIH said. NIH

6.5 percent of adults active enough at work: Health researchers say only about 6.5 percent of U.S. adults meet physical activity guidelines while they're working. And those that do are disproportionately Hispanic men and men with less than a high school education. Morbidity and Mortality Weekly Reports

Lists of Prescription Meds' Side Effects Keep Growing: Lists of the side effects for prescription medications on drug labels, packaging and advertisements have mushroomed up to an average of 70 per medication, a new study reports.
Cautions about side effects were designed to inform doctors and consumers of potential hazards, but this expansion may have more to do with worries about litigation rather than actual health concerns, say the study authors, who argue the information could be presented much more efficiently. Archives of Internal Medicine May 23

With Calcium, More May Not Be Better: Getting enough calcium for bone health is essential, but getting more than that doesn't appear to confer any additional benefit, Swedish researchers have found. BMJ May 24

Omega 3 Fatty Acids May Help Heart Patients with Stents: Combining omega-3 fatty acids with blood-thinning drugs may reduce the risk of heart attacks in patients who've had stents placed in their coronary arteries, a new European study suggests. While other research suggests that foods rich in omega-3s, including fatty fish such as salmon, help reduce the risk of heart problems in those with existing coronary artery disease, the new study is thought to be the first to look at the effect of the omega-3s on those treated with blood-thinning medications after stent placement. May 26, 2011, Arteriosclerosis, Thrombosis and Vascular Biology: Journal of the American Heart Association

Special Tinted Glasses My Stymie Migraines: Precision-tinted glasses seem to help prevent migraines in people whose pain is triggered by certain visual patterns, new research indicates. May 26, 2011, Cephalalgia

A Cultured Man is a Healthier, Happier Man: Both men and women who engaged in sports, religious and cultural events reported better health and satisfaction with life than those who were less engaged. But men, especially, saw benefits. Men who attended cultural activities were 9 percent more likely to report being in good health than men who didn't attend, while women who attended cultural activities were 3 percent more likely to report good health. May 23, 2011, Journal of Epidemiology and Community Health.

Heart Failure Risk Lower in Women Who Often eat Baked/Broiled Fish: The risk of developing heart failure was lower for postmenopausal women who frequently ate baked or broiled fish, but higher for those who ate more fried fish This study showed that they type of fish and cooking method may affect heart failure risk. The researchers found that dark fish (salmon, mackerel and bluefish) were associated with a significantly greater risk reduction than either tuna or white fish (sole, snapper and cod). In a similar analysis, eating fried fish was associated with increased heart failure risk. Even one serving a week was associated with a 48 percent higher heart failure risk. Circulation: Heart Failure

Mexican Flu Pandemic Study Supports Social Distancing: Eighteen-day periods of mandatory school closures and other social distancing measures were associated with a 29 to 37 percent reduction in influenza transmission rates in Mexico during the 2009 pandemic. NIH Press Release

New Tests of US Airport Scanners Find Radiation OK: New tests of full-body scanners deployed at airports found that the radiation they emit was within acceptable levels, the Transportation Security Administration said on Tuesday after previous checks found some anomalies in results. Reuters

Regular Brisk Walks May Protect Prostate Cancer Patients:
Prostate cancer patients who take brisk walks on a regular basis fare better than those who don't, a new study suggests. They not only lower their risk for disease progression, they lower their chances of dying from the disease, the researchers reported. Cancer Research

CT Heart Scans No Benefit to Patients without Symptoms: For people who show no symptoms of heart disease, there is little short-term benefit to having their heart vessels scanned for plaque buildup, a new study suggests. Archives of Internal Medicine 5/23/11

Eating Less Fat May Cut Diabetes Risk: For the study, published online May 18 in the American Journal of Clinical Nutrition, the researchers put 69 overweight people at risk for diabetes on diets for eight weeks with only small reductions to their fat or carbohydrate intake. Those in the lower-fat group consumed a diet comprised of 27 percent fat and 55 percent carbohydrate. The low-carb group's diet was 39 percent fat and 43 percent carbohydrate.

Significant Benefits of Yoga in People with Rheumatoid Arthritis: Individuals with rheumatoid arthritis who practice yoga showed statistically significant improvements in disease activity, according to a small study presented at the EULAR 2011 Annual Congress.

Losing More than 15% of Body Weight Significantly Boosts Vitamin D Levels in Overweight Women. Overweight or obese women with less-than-optimal levels of vitamin D who lose more than 15 percent of their body weight experience significant increases in circulating levels of this fat-soluble nutrient, according to a new study by researchers at Fred Hutchinson Cancer Research Center. American Journal of Clinical Nutrition, 2011

Saturday, May 28, 2011

Rapture Follow Up-What Happens When Things Don’t Work Out as Planned

In follow up to last Saturday’s post on the Rapture and Millerites, it’s now a week later and Harold Camping’s prophecy was as accurate as William Miller’s in 1844-nothing happened. So what is the relevance for people with chronic conditions?

There are several things that strike a cord with me about this situation: People with chronic disease are often fearful and thinking of “worse case scenarios” makes them very vulnerable to medical sales pitches. This is similar to religious fundamentalism, where fear lies at the heart of many of these groups.

When the plan fails- May 22 arrived with no rapture, the “miracle cure” produces no cure-what does one do?

In the case of the followers of Miller, there were three common practices after the “Great Disappointment”: they went back to their original churches and lives; they continued on with Miller, believing the next rapture date; or they rationalized the events. In the case of a Millerite named Hiram Edson, he became convinced that what was meant by Daniel 8:14, (that section of the bible Miller used for selecting his rapture date) was actually Christ's entrance into the second chamber of his sanctuary (in 1843-44) to examine the lives of all mortals living and dead. This "investigative judgment," said Edson, when completed, the great day of the Second Coming would dawn. Ultimately, this belief became the foundation for the Seventh Day Adventists.

What happened to the Millerites, and now the followers of Camping, isn’t all that different than what happens to people who engage in a health practice, which they are sure is “going to work” and provides no benefit- they go back to previous health practices; continue to believe that it will work, even though the evidence doesn’t support it; and/or rationalize why it is helping them form a new approach to their treatment plan. Fortunately, the situations aren’t completely identical, as sometimes treatments do provide significant relief, even if it’s just the placebo effect.

Last week’s events are once again a reminder that fearful people can be very vulnerable to someone who is charismatic and has a message that may resonant with us. So some “take home” points from these last few weeks:

• Keep fear in check: We are not at our best making decisions when we come from a place of fear. This will be the focus of next week’s post.

Know how to recognize a scam-the quick way is if it sounds too good to be true, it probably is and if they tell you there is a cure for a condition, such as AIDS, when no cure has been found.

Focus on well being versus the elusive cure.

Wednesday, May 25, 2011

Take a Break: Paper Mobiles/Chains

This past weekend, I was visiting with a friend and noticed that she still had the chains of paper snowflakes, we made last December fluttering in her windows. Using punches, some were 3-D. These were made by cutting small slits and sliding one snowflake into the other. Since snow is big business in Vermont, we had a variety of punches in various sizes. Simply cut from white paper, and strung on thread, they are beautiful to see, even if it’s black fly season.

I could understand why she didn’t want to take them down because what could be as lovely? Well this weekend is Memorial Day and the official start of summer, so below are ideas for chains or mobiles, your choice.

Five-Pointed Star: Start with two sheets of paper. Use one to make the star, following the directions for a 5-Pointed Star in One Snip. The second sheet cut in half horizontally. You will now have two rectangles. Make a five-pointed star from one of the rectangles and cut the second in half. Again make a star from one of the rectangles and cut the other in half. Keep working until you can no longer divide and fold.

You can then chain them by size, mix and match with other designs, or stack them together to make an interesting multi layered star.

Five-Pointed Star Outline: Make some of these using the technique described above to provide an various sized star outlines for your star mobiles. You can also link these together in a chain, by cutting one of the star tips, linking it through another star outline and then tape or glue where you made your cut. Once they are hanging, no one can tell that you used glue or tape.

Fold an Origami Butterfly: Use colorful origami paper and these will look delightful floating in a gentle breeze. The goldfish is a good design that lends itself to a mobile or chain.

Punches/Cookie Cutters: Martha Stewart offers a wide array of paper punches that work well. They’re expensive, so try to get them on sale. If you have cookie cutters, just trace and cut.

Modern Colorful Mobiles: This project calls for strips of vellum sewn together, but you can achieve something similar by using paper and gluing or taping. I work in the First Aid Room at my local ski area in the winter and we made a variety of hanging mobiles using hearts, snowflakes etc. It’s amazing what you can do with a glue stick and tape. Unless you look up close, you can’t tell.

Sunday, May 22, 2011

Journal/News Watch 5/ 23/11

Putting a price on blood tests can save money: Letting doctors know how much money they spend ordering blood tests may help rein in unnecessary healthcare spending, researchers report. They found weekly announcements of the previous week's costs to surgery staff at a Rhode Island hospital produced savings of about $55,000 over less than three months. Archives of Surgery, May 16, 2011

Can Selenium Lower Cholesterol: Taking high doses of selenium may help slightly lower cholesterol levels -- but it's still not recommended in the United States, where most people get plenty of the mineral, according to the authors of a new study. Still, the finding is "reassuring" because previous research had linked high selenium with higher cholesterol levels, said study author Dr. Eliseo Guallar, from the Johns Hopkins Bloomberg School of Public Health in Baltimore. Annals of Internal Medicine, online May 16, 2011

Genetic Link to Depression: Scientists say they have discovered the first solid evidence that variations in some peoples' genes may cause depression -- one of the world's most common and costly mental illnesses. And in a rare occurrence in genetic research, a British-led international team's finding of a DNA region linked to depression has been replicated by another team from the United States who were studying an entirely separate group of people. American Journal of Psychiatry May, 2011

Medicare to Exhaust Funds Sooner: Two of the government's most popular programs for the elderly, Medicare and Social Security, will run out of money sooner than thought earlier as a slow-growing economy saps revenues, a report on Friday said. Trustees for the two funds said the Medicare trust fund is projected to exhaust its funds in 2024, not 2029 as estimated last year, and that the Social Security retirement program will run out of money in 2036, not 2037 as previously thought. Reuters

Hospice Care More Common in Wealthier Areas: The availability of hospice care for dying patients in the United States is strongly associated with a local area's average household income, a new study says. Journal of Pain and Symptom Management

Tai Chi Prevents Falls, Boosts Mental Health in Seniors: Tai chi helps reduce the risk of falls in older people and also improves their mental health, a new study has found. However, the ancient Chinese martial art/exercise does not help ease the symptoms of cancer or rheumatoid arthritis, according to researchers who analyzed 35 reviews assessing the health effects of tai chi. British Journal of Sports Medicine May 16

Pills, surgery both effective for chronic reflux: Both surgery and popular medications such as Nexium, Prevacid or Prilosec can successfully treat the discomfort of chronic reflux, according to new research funding by Astrazeneca, the makers of Nexium. JAMA May 18

The Mystery of Chronic Pain: We think of pain as a symptom, but there are cases where the nervous system develops feedback loops and pain becomes a terrifying disease in itself. Starting with the story of a girl whose sprained wrist turned into a nightmare, Elliot Krane talks about the complex mystery of chronic pain, and reviews the facts we're just learning about how it works and how to treat it. TED Conference

Few Docs, Hospitals Exchanging Patient Information: Health information exchange -- a process that aims to simplify and improve patient care by connecting doctors and hospitals -- hasn't been catching on as fast as policymakers hoped, a new survey finds. The results also show that organizations responsible for coordinating the digital exchange of patient records are rarely financially viable, and only a few support the type of information exchange that the government deems necessary. , Annals of Internal Medicine, online May 16, 2011

Smoking linked to age-related blindness: The research, by scientists in Japan and the United States, shows that Japanese smokers face four times the risk of age-related macular degeneration, or AMD, than non-smokers.Ophthalmology, April 22, 2011

Hospital ratings miss many high performers: Looking for hospital ratings on the internet or in magazines may not serve patients' best interests, suggests a study of HealthGrades and U.S. News & World Report. It shows that for three types of cancer surgery, "America's 50 Best Hospitals" as ranked by internet-based HealthGrades are no better than the other hospitals once the number of patients they treat is taken into account. Archives of Surgery, May 17, 2011

Screening Patients for Cancer: Two big studies suggest possible new ways to screen healthy people for cervical or prostate cancers, but a third disappointed those hoping for a way to detect early signs of deadly ovarian tumors.
Researchers found:
_For women 30 and over, a test for the virus, HPV, is better than a Pap smear for predicting cervical cancer risk, and those who test negative on both can safely wait three years to be screened again.
_A single PSA blood test at ages 44 to 50 might help predict a man's risk of developing advanced prostate cancer or dying of it up to 30 years later. The PSA test is notoriously unreliable, but using it this way separates men who need a close watch from those who are so low-risk that they can skip testing for five years or more.
_Screening women with no symptoms for ovarian cancer with a blood test and an ultrasound exam is harmful. It didn't prevent deaths and led to thousands of false alarms, unneeded surgeries and serious complications. American Society of Clinical Oncology

Crossing your arms may help relieve pain: Crossing your arms across the middle of your body confuses the brain and helps reduce the intensity of pain. Scientists from University College London (UCL) who reported the finding in the journal Pain said they think the reason for the phenomenon is conflicting information between two of the brain's maps -- one for the body and one for external space. Pain, June 2011

Treating Back Pain May Reverse Its Impact on Brain: Treating chronic lower back pain can reverse pain-related changes in brain activity and function, according to a new study of patients who had lower back pain for more than six months and underwent either spinal injections or spinal surgery to treat the pain. Journal of Neuroscience May 17, 2011

Saturday, May 21, 2011

Today’s Rapture and the Millerites

For quite some time, there has been considerable press given to today’s reported rapture. Because of my role with our local historical society, I have been fascinated by a very similar event in the 19th century. While at first blush, it may not appear to have anything to do with living with chronic conditions-and yes, I did stretch it a bit because I wanted to write about the Millerites-many people with chronic conditions form very strong beliefs about what’s going to happen because of their diagnosis. When the events they were so sure of don’t transpire-the cure didn’t happen, they continue to live long after they expected to die-it can be very difficult.

I watched a number of people with AIDS run up amazing debt because they believed they would die and not have to pay it back. The problem was so significant that I attended a workshop after the protease inhibitors were introduced. People were getting healthy and many started returning to work. However, what to do with the debt? The short response was bankruptcy but there were a number of people that were grateful for a “second chance” as they saw it so did work out payment plans to pay it off.

Living in Vermont, I am acquainted with the story of the Millerites, since this was one of the states where the founder lived. Similar to Harold Camping, the 89 year-old retired civil engineer who has built a multi-million-dollar nonprofit ministry based on his apocalyptic prediction for today, Baptist preacher William Miller predicted Jesus was going to return to earth on Oct. 22, 1884. In Miller’s Lecture XIX he writes "Can ye not discern the signs of the times?" Will God's word fail of being accomplished? Can you show a single instance? Why not listen, then, to the warnings and admonitions, to the calls and invitations, to the examples and precepts contained therein? "Can ye not discern the signs of the times?" Will God cut off the unbelieving Pharisee for not discerning the signs of the times, and let you, with twofold more light, go free? No; how can ye escape, if you neglect this great salvation? Watch, then, "the signs of the times." I say, Watch.

Estimates very, but between 50,100 and 500,000 people were convinced that on this date, the “saints,” those who believed in the rapture, would be taken into the New Jerusalem while fire destroyed the world. The newspapers covered stories of the Millerites prior to the day of rapture and after. An article in the New York Herald, March 24 1843, made the link between Millerism and insanity: We lately published a statement that a Mr. Shortridge, of New Hampshire, had run mad with Millerism, and attempted to ascend to Heaven from an apple-tree, but found the attraction of gravitation too strong for his celestial aspirations, and came to the ground with such momentum as to cause his death. We have just seen two letters of late date from different sources in Portsmouth, N. H., stating that letters had been received there from this same Mr. Shortridge, making no mention of his 'ground and lofty tumbling' or death-circumstances so remarkable that they could hardly have escaped his notice had they actually occurred. We have heard from another source that this same Mr. S. was crazy ten years ago. So in the case of the woman who poisoned her children and attempted to commit suicide some weeks since—her insanity was attributed to Millerism, but entirely without reason. Doubtless the like has been the case in many other instances. Those who know any thing of Insanity are aware that it very commonly takes its hue from the most exciting topic of the hour, so that hundreds of persons have been reported as victims of 'religious mania,' when in fact their insanity was caused by functional disorders, often having its seat in the digestive organs and only by sympathy affecting the brain. Of those who are currently reported as rendered insane by 'Revivals' or 'Millerism,' a great portion would be found, on due inquiry, to have been constitutionally disposed to insanity, and often to have inherited that malady. In other cases, physical derangement consequent on personal excesses, such as intemperance, gluttony, and other forms of sensuality, was the true cause.—We cannot exclude from our columns accounts of remarkable casualties, but our readers will know how to make due allowance for the causes to which they are often mistakenly attributed.

Like today, many Millerites gave up jobs, sold their property and divested themselves of all things worldly. Gathering at the highest peaks where they lived, wearing white ascension robes and some sitting in metal wash tubes, they believed that when the great triumph from heaven sounded, they would be a good position to ascend.

The Millerites were most common in the Northeast. The Akron Historical Society in Ohio writes the following about what happened to the Millerites when the day of rapture came and went. For the faithful, heavy depression set in. This day was perhaps the greatest disappointment to befall the church in the history of the New Dispensation. Fifty thousand of Miller’s followers had found it impossible to stay in fellowship with their former congregations. These fifty thousand now had to face the truth. They hadn’t been taken into glory. The wicked still weren’t destroyed by fire. One by one, they retreated back into their lives.

Humiliated by what has been called "The Great Disappointment," some Millerites shucked their faith completely. Led by Miller, others formed the Adventists. The majority returned to more traditional churches.

Shortly afterward, Miller wrote a letter to his followers: “Brethren hold fast; let no man take your crown. I have fixed my mind on another time, and here I mean to stand until God gives me more light, and that is today, today, and today, until he comes.” (Bliss, Memoirs, p. 278)

Many of those, that didn't learn the first two times, resorted to believing that Jesus Christ had returned to earth on October 22, 1844, and that he is invisible. This particular theory was that it would take an additional three and a half years after Christ’s invisible return before his kingdom would be thoroughly established, which led to setting another date in 1848. What happened in 1848? You guessed it.

For more than five years, William Miller went back to the book of Daniel and Revelation, he went back to his prophetic chart and his numbers, still pondering why he had missed the truth about Christ's Second Advent.

Washington Morse of Northfield, Vermont wrote about the Great Disappointment as follows: “The day came and passed, and the darkness of another night closed in upon the world. But with that darkness came a pang of disappointment to the advent believers that can find a parallel only in the sorrow of the disciples after the crucifixion of their Lord. . . to turn again to the cares, perplexities, and dangers of life, in full view of jeering and reviling unbelievers, who scoffed as never before, was a terrible trial of faith and patience. When Elder Himes visited Waterbury, Vt., a short time after the passing of the time and stated that the brethren should prepare for another cold winter, my feelings were almost uncontrollable. I left the place of meeting and wept like a child.”

While Miller died not long after the failed rapture, two groups continue based on his teachings the Jehovah Witness and the Seventh Day Adventists.

Wednesday, May 18, 2011

Take a Break: Create Mindfulness Reminders

As an anecdote for stress and the feelings of frustration or agitation that can accompany living with a chronic condition, mindfulness reminders can help us stop, take a breath or two, be mindful of our surroundings, smile or do whatever is helpful in being aware of the present and not worrying about past events or obsessing about future fears. This reminder should be something that you encounter on a regular basis throughout the day. It can be something that engages one or more of the five senses-hear, taste, touch, smell, or see -that is your “ahhhhh” moment. How many, what type and whether you’d like to have different ones each day, are up to you.

Today’s “take a break” is about identifying and making mindfulness reminders for your self.

Sounds are an excellent reminder to stop and be mindful. These can include:
• The ringing of the telephone, cell phone or doorbell

• Jewelry such as a charm bracelet that makes a sound when you move your wrist
• A clock that chimes (or sounds like a loon at my house) on the hour or half hour, or a mindfulness bell that rings. You can download a mindfulness bell for your computer for free.
• If you are lucky to live near a large body of water, fog horns, waves, sea gulls
• Sounds from nature. It’s spring here in Vermont, so the peepers (tiny frogs) are creating a lovely serenade and the morning doves coo throughout the day.

I have a particular pair of earrings that I love wearing. As I move my head and I hear them quietly tinkling, it causes me to pause, even for a second. If I’m particularly stressed, these are the right earrings for me to wear.

This is a bit different than aromatherapy, which uses essential oils to help with mood. Think about smells that are part of your daily life:
• The scent of a certain shrub or flower,
• Coffee,
• Certain foods, such as dinner preparation
• Seasonal smells, such as holiday baking, Christmas trees, burning leaves in the fall, lilac in the spring and honey suckle in the summer

While I’ve already discussed how wearing a favorite pair of earrings that make a delicious tinkling sound is an important mindfulness reminder, I also make “remembering” bracelets. These are used to help families and friends think about a loved one that is undergoing a major event. A red, white and blue bracelet is an easy reminder to think about a loved one in the armed forces, or a multi colored one can support someone going through chemotherapy or the final few weeks of pregnancy. The bracelets can be worn, left on a desk, bedside stand or someplace where you will routinely see it, so you will stop and send a quick prayer or thought.

This same approach can be used in making a mindfulness bracelet for your self. To help in selecting colors, the following color table is provided:
• Green- healing and stability
• Blue- calming and tranquility
• White-spirituality and safety
• Red-energy
• Brown-wholesomeness
• Yellow-clear thinking
• Purple-spirituality

There are many things that you see on a daily basis that can become good mindfulness reminders. There are certain birds and items in my house, favorite tea mug for example, that are good items to remind me to slow down, stop and breathe.

Aaahh the first taste of chocolate in your mouth. Hmmmmm. Definitely a good reminder for me. There is a lot of discussion about how mindful eating is a lot healthier for us. However, taste doesn’t need to be just associated with food. When I’m at the ocean, I can taste the saltiness of the air as well as smell it.

The feel of a T-shirt, stroking a pet, holding a stone, or the feel of sunshine on your skin can all be daily reminders. I’m particularly fond of rocks and keep them on my desk. I will notice them and then have to pick them up.

Keep in mind that involving more than one sense can make the reminder all the more meaningful. Whatever you choose, add some aaaahhh moments today.

Sunday, May 15, 2011

Journal Watch/News 5/15/11

Lifestyle, diet have little effect on Alzheimer’s: Experts called together by the National Institutes of Health examined scores of studies about whether diet, exercise, nutritional supplements and chronic diseases like diabetes or hypertension affect a person's risk of getting the fatal, brain-wasting disease. They found some signs that diabetes, high cholesterol and smoking could raise the risk of Alzheimer's. And they found that eating a Mediterranean-type diet -- high in healthy fats, fruits and vegetables -- and taking folic acid, cutting back on alcohol and keeping the brain and body fit appear to lower the risk. But in every case, the evidence was not strong enough to say for sure, the panel found. Archives of Neurology

Acetaminophen Tied to Blood Cancers: New research shows chronic users of acetaminophen, a top-selling painkiller known as Tylenol in the U.S. and paracetamol in Europe, are at slightly increased risk for blood cancers. Yet the risk remains low, and it's still uncertain what role the drug plays. Journal of Clinical Oncology, May 9, 2011

Even a little exercise may protect against colon polyps: Even a little exercise may ward off polyps in the colon, which are sometimes precursors to cancer. In fact, just an hour a week of low-intensity exercise -- even such seemingly trivial activities as walking on the street or climbing stairs -- reduced risk, especially among individuals who are obese or overweight, according to new research slated to be presented Sunday at Digestive Disease Week in Chicago.

Many People May Benefit from Going Gluten-Free: Researchers screened 3,031 healthy people who were related to someone with celiac disease, a disorder that causes digestive problems in the small intestine when the person eats gluten, but had no symptoms themselves, and selected 40 people who tested positive for antibodies specific to celiac disease. By random selection, members of that group were either put on a gluten-free diet or told to continue with their normal diet, containing gluten. People on a gluten-free diet reported improved gastrointestinal health as well as an overall improvement in their health-related quality of life, compared with the others, according to the study. "We found that regardless of the clinical presence of celiac disease, most screen-detected patients benefited from early treatment of a gluten-free diet," Digestive Disease Week conference

Mindful Meditation Might Ease Irritable Bowel Syndrome: A study, done at the University of North Carolina at Chapel Hill, found that women with irritable bowel syndrome who practiced "mindful meditation" had more than a 38 percent reduction in symptoms, far surpassing a nearly 12 percent reduction for women who participated in a traditional support group. Moreover, meditation helped reduce psychological distress and improved quality of life, the study found. Digestive Disease Week

Jenny Craig Tops Consumer Reports Diet Ratings: Comparing Atkins, Jenny Craig, Ornish, Slim Fast, Weight Watchers and the zone, the overall winner is Jenny Craig, the widely-advertised commercial program that combines personalized motivational counseling with a meal plan consisting of its branded single-serving entrees and snacks, supplemented with sides and beverages you supply yourself. But that doesn’t mean it’s right for you. That’s because the best diet is the one you’ll stick with, and different diets appeal to different people. So the real trick is to find the one the matches your preferences. Consumer Reports

Doctors Rush to Heart Procedure Before Proven Drugs: Fewer than half of Americans with stable heart disease get guideline-recommended medicines before being rushed off for an invasive heart procedure, researchers said Tuesday. Yet the costly procedure, called percutaneous coronary intervention or PCI, offers few proven benefits over drug therapy and puts patients at risk of side effects. Journal of the American Medical Association, online May 10, 2011

Fond Memories of the Past Make for a Happier Present: People who remember the past fondly are more likely to experience greater happiness in the present, according to a new study. Similarly, researchers found that people who tend to focus on regrets and negative experiences are not as satisfied with their lives as those who maintain a rosier view of the past. Personality and Individual Differences -

How Fear Changes What we Hear: The new research, published in Nature Neuroscience, sought to explore this "generalization" of fear and its connection with learning. Emotional experience typically improves learning - that's why you remember your first love better than first grade. But in the case of fear, the brain seems to say "better safe than sorry." Rather than fine-tuning the connections you make while under the influence of emotion, fear instead reduces your ability to discriminate between potential threats, impairing learning about them. Time 5/10/11

With complex prescription routines, fewer filled: Patients on heart drugs are less likely to fill their prescriptions if they have to make more trips to a pharmacy or have multiple doctors prescribing them drugs, according to a new study. Archives of Internal Medicine, online May 9, 2011.

Selenium Doesn’t Prevent Cancer: A meta analysis of 65 studies found no convincing evidence that taking high doses of selenium -- a popular dietary supplement -- can prevent cancer. Some of those trials raised the question of whether high doses of selenium might be dangerous, such as by increasing the risk of diabetes. The Cochrane Library, online May 10, 2011

FDA Warning: Don’t buy drugs marketed as antimicrobial dietary supplements: The FDA is warning consumers not to use products marketed as dietary supplements that also claim to be antimicrobial (antibiotic, antifungal or antiviral) drugs. These illegal products are falsely promoted with claims to treat illnesses such as upper respiratory infections, sinusitis, pneumonia, bronchitis and the common cold.

FDA Warns about counterfeit Entenze dietary supplements:
The U.S. Food and Drug Administration is warning consumers about a potentially harmful product represented as “ExtenZe,” a dietary supplement for male sexual enhancement. The counterfeit product looks similar to the actual product, but contains hidden ingredients that can cause serious harm to consumers. The counterfeit product has the following lot numbers on the packages:
• LOT 1110075
• LOT F050899

Doctors Prescribing Meditation, Yoga More Often: Mind-body therapies such as yoga, meditation and deep-breathing exercises appear to be gaining more acceptance in mainstream medicine, according to a new study. Archives of Internal Medicine May 9

Saturday, May 14, 2011

Do we stereotype and make ourselves sicker in the process?: Part II: Epigenetics

As a follow up to last week’s post about how external cues and previously held ideas can impact how we think of ourselves. This week we explore the idea that we are more than our genes.

There is a growing new field of research called epigenetics. Translated epigenetics means “above the genome.” An easy way to understand this is think of it in terms of how a computer works. The genome is like the computer itself and the software, which determines how the computer functions, is similar to the epigenome.

Simply put, genes can express themselves differently based on environment. Studies of identical twins, where they both have the same exact genes, show that epigenetics explains why one twin may develop a disease that the other doesn’t. If one twin smoked and drank, and the other didn’t, that would be a sufficient environmental change to cause how genes expressed themselves.

A recent study of elderly men in Boston Environmental Health Perspectives found that long term exposure to certain air pollutant altered DNA methylation, a mechanism that controls gene expression. These decreases may lead to changes in gene expression and altered risk for diseases that become more common with aging.

The take home point of the last two posts is that how we view and treat ourselves, for better or for worse, can be impacted by:

a) Preconceived ideas of what people are like if they have certain conditions and/or are elderly. Often these can be traced back to how our parents, grandparents may have acted and what we saw growing up;

b) External cues that help us heal or make us feel worse; and

c) Our environment (what we eat and drink, exercise, stress, toxic chemicals, such as those used for cleaning, where we live, whom we associate with and whether we live mindfully) can play an important role in how our genes express themselves.

As powerless as it can sometimes feel to be living with a chronic condition, there are things you can do to help yourself heal. For ways to do that, check out Healing the Whole Person: Ways to Increase Well-Being.

Wednesday, May 11, 2011

Take a Break: Stargaze

                                                       UPDATED 5/10/14

While I’m a little late in celebrating Astronomy week (May 2-8) and the day itself May 7, there are lots of wonderful things to observe in the night sky. Whether you live in the country or city, try to get outside this evening and enjoy. Want to know what to look for? The following links will help you identify what’s in the sky where you live:

Star Date: From the University of Texas McDonald Observatory

• Your Sky: An on-line interactive planetarium where you can make your own sky map

• Stellarium: Free planetarium for your computer. It shows a realistic sky in 3 D, just like what you see with the naked eye, binoculars or a telescope. Set your coordinates and enjoy.

While it’s not the same as lying back in one of those special chairs at the local planetarium, you can observe the sky digitally, pause to find out more about a constellation and pretend your are any where in the world stargazing via Neave Planetarium.

Find a Club, Museum, Observatory, Planetarium near you
Astronomy Clubs

Night Sky Network from NASA

Sky and Telescope

Want to do more than observe stars for a night? NASA’s Citizen Scientists has established programs where people can volunteer to help the astronomy community. Such programs include: Be a Martian, improving Martian maps; HiWish, deciding where the Mars Reconnaissance Orbiter will point its camera; Lunar Impacts, monitor the rates and sizes of large meteoroids striking the moon’s dark side. You can also sign up for NASA’s e-mail updates on a variety of topics.

Sunday, May 8, 2011

Journal News/Watch 58/11

Eating Less Salt Doesn’t Cut Heart Risks: Using data from two different studies, incorporating a total of about 3,700 Europeans who had their salt consumption measured through urine samples at the start of the studies. Staessen and his colleagues broke the participants up into three groups: those with highest and lowest salt intakes, and those with average intake. None of the participants had heart disease at the outset, and two thirds had normal blood pressure. They were followed for an average of 8 years, during which researchers determined how many of them were diagnosed with heart disease, and in a smaller group, how many got high blood pressure. People who ate lots of salt were not more likely to get high blood pressure, and were less likely to die of heart disease than those with a low salt intake. JAMA, online May 3, 2011.

Grape tomato products recalled for salmonella: Products using the recalled tomatoes were sold in Albertsons, Raley's, Safeway, Savemart, Sam's Club and Walmart stores in Arizona, California, Nevada, Oregon, Washington, New Mexico, Idaho, Montana, Colorado, South Dakota, Wyoming, Nebraska, Utah, according to a statement from the Food and Drug Administration. FDA

Fish Oil May Not Prevent Depression in Women: A ten year study of 55,000 nurses , women, between 50 and 77 years old, were free of depression when the study began in 1996. Over the next decade, five percent of them eventually developed clinical depression. But the risk was the same regardless of how much DHA and EPA -- two omega-3 fatty acids -- women got from eating fish. Fish rich in omega-3s include salmon, trout, sardines and herring. The researchers did find preliminary signs that a plant-based omega-3 called alpha-linolenic acid could play a role in mood. For every increase of half a gram in daily intake of the substance --common in walnuts and canola oil, for instance -- there was an 18-percent reduction in the risk of depression. American Journal of Clinical Nutrition, April 2011

Socializing May Keep Elderly Minds Sharp: Being sociable can help keep your brain healthy as you age, researchers report. The team at Rush University Medical Center found that elderly people with the highest levels of social activity -- doing things such as visiting friends, going to parties or attending church -- showed much lower levels of cognitive decline than those who were the least socially active. The study included 1,138 adults, average age 80, who are participants in the ongoing Rush Memory and Aging Project. At the start of the study, none of the participants had any signs of cognitive impairment. Over an average of five years, those who were the most socially active experienced only one-fourth the rate of cognitive decline as those with the lowest levels of social activity. The effect was independent of other factors that can play a role in cognitive decline, such as age, physical activity and general health. April 8 in the Journal of the International Neuropsychological Society.

Hot flashes may last a decade or more: Hot flashes that are common during and after menopause may last an average of more than 10 years, suggests a new study. Women who start getting hot flashes before menopause or in the early stages of menopause will have them for longer, on average, than women who don't have their first hot flashes until later. Obstetrics & Gynecology, May 2011

Group Checkups: Shared checkups aim to help patients who are battling certain chronic diseases, and they're far from the typical 15-minute office visit. They're stretched over 90 minutes or even two hours, offering more time to quiz the doctor about concerns, learn about managing the disease — and get tips from fellow patients. What's in it for the doctor? A neurologist found he learned more about how his Parkinson's patients were faring by watching them interact with others than when he had them one-on-one. It's a small but slowly growing trend that promises to get more attention with the tight supply of primary care physicians, who find it hard to squeeze in time to teach their patients how to deal with complex chronic illnesses like diabetes. An American Academy of Family Physicians survey found more doctors trying the group approach — about 10 percent of its active members in 2009, up from fewer than 6 percent in 2005. Group appointments don't replace the patient's annual in-depth physical. Associated Press

Online Gaming with Real-World Friends is Healthier: Contrary to what some might think, spending hours online playing video games and interacting with others through avatars may contribute to emotional health, if virtual gaming partners or opponents include real-world family members, findings from a new data analysis suggest. Communication Research

Supplements don’t prevent Prostate Cancer: Canadian researchers found that vitamin E, selenium and soy, taken daily for three years, provided no benefit to men who were at a higher risk of developing the disease. The findings come three years after a larger study of men, who were at no increased risk of prostate cancer, also found no benefit of selenium or vitamin E supplementation. Journal of Clinical Oncology, online May 2, 2011

Study Adds Weight to Link Between Calcium Supplements and Heart Problems: New research published online in the British Medical Journal adds to mounting evidence that calcium supplements increase the risk of cardiovascular events, particularly heart attacks, in older women. The findings suggest that their use in managing osteoporosis should be re-assessed. Calcium supplements are often prescribed to older (postmenopausal) women to maintain bone health. Sometimes they are combined with vitamin D, but it's still unclear whether taking calcium supplements, with or without vitamin D, can affect the heart. BMJ 2011; 342 (April 19 1)

Saturday, May 7, 2011

Do we stereotype and make ourselves sicker in the process?: Part I

Ellen Langer, a Harvard psychologist, turned the clock back for a group of elderly men. Converting a hotel to appear as if it were 20 years prior, the 70 and 80 something year old men were told, to live as if it were 20 years ago and not reminisce about the past. After one week, as compared to a match control group, no intervention, these men had more flexibility, increased mental acuity and improved gait and posture. Those that saw pictures of the men, thought they were considerably younger than their matched controls.

Langer has continued to run experiments along similar lines and continues to show that there is a strong link between self-perception and health. She discusses her findings in “Counterclockwise: Mindful Health and the Power of Possibility.” We are all victims of our own stereotypes about aging and health. Without thinking, we are continually bombarded with messages that make us feel older and less healthy. The more mindless we are in our approach to life, the more we are impacted by these cues that we are not well, old or sick.

Living with a chronic disease, there can be many reminders of health issues-medications, medical supplies, people asking if we’re okay etc.. According to Langer signals also lock all of us—regardless of age—into pigeonholes for disease. We are too quick to accept diagnostic categories like cancer and depression, and let them define us. Doing so preempts the possibility of a healthful future.

That’s not to say that we won’t encounter illness or bad moods—or that dressing like a teenager—will eliminate those things completely. But if we’re open to the idea that the common beliefs we hold don’t have to be correct, and begin exercising the control we have over our health, we just might feel as healthy as we did when we were younger.

Langer suggests the following strategies for self- healing : First, we should take medical information about our health with a grain of salt. Medicine is not an exact science and only tells us what may be true for most people under the tested conditions, and may not be true for any of us individually—none of us is the norm. Second, realize that nothing stays the same. Even if we think we have some symptom—an ache, depression, etc.—all the time, sometimes it’s less than at other times and sometimes it’s not there at all. We need to become aware of when it changes and ask why now and not then. Third, we need to recognize that full health is possible and take small steps towards that healthy goal rather than accept helplessness. Fourth, while we are doing each of these we should recognize that we are not our diseases, they don’t define us and they shouldn’t limit our potential.

If we remove our negative mindsets regarding health and presumed limits we may create all sorts of possibilities for ourselves.

While I would agree with most of what Langer has written, I would not tell people to take medical information with a grain of salt. Unfortunately, I’ve witnessed way too many patients that did just that and ended up in a world of hurt. I would suggest that you be first and foremost mindful of the source of information, particularly that which your medical provider gives you after completing tests etc. You are the captain of your healthcare team and the medical provider is an important crew member. How you use the information they are providing is up to you.

Information obtained from the internet can be very helpful. But as I have written before, there are a lot of snake oil salesmen on line, so buyer be ware. If it sounds to good to be true, it probably is.

Since we mindlessly accept cultural cues that we are our diagnosis, the key is to identify what those cues might be for you and either eliminate them or try to reduce their impact.

Several months ago, I spent the night as a patient. I was horrified by all the subtle cues that were making me feel worse rather than better. Staring at me was a pain sign-how much pain do you have? It ranged from a happy face (0) to someone looking pretty darn miserable (10). I wasn’t feeling pain, but seeing the sign reminded me that pain was a definite possibility. The sign was there for the convenience of the hospital staff. It wasn’t there to help me or other patients feel better.

What are some cues that you might be experiencing? How might you deal with them?

Next week we will be discussing the fact that our biology is only part of the picture and that how you think impacts how your brain changes.

Wednesday, May 4, 2011

Take a Break: Fascinators

What does the recent wedding of Kate and William have to do with this week’s “take a break” post? Since the Kentucky Derby is Saturday, followed by Mother’s Day on Sunday, how could I not learn how to make those outrageous “hats,” known as “fascinators?” Forget Westminster Abby, wedding vows and a queen, I was glued to the pictures of the hats. Ho do they keep them on their head?

Whether you want to surprise your “Mum” with a fascinator or not, you’ll have a lot of fun learning how these are made. The key seems to be the more outrageous the better, and the more they appear to be suspended on the wearer’s head, the best.

There are a variety of ways to make these, but there is one basic-you’ll need a base to start your construction. Side combs, headband, clips, or a fascinator base (these should have a side comb attached) all work as the foundation for feathers, rhinestones, jewels, objects or whatever you feel inspired to glue, tape or sew. Watch “How to Wear Hair Fascinators,” and you’ll have a good understanding of how they are designed

I was so inspired Friday night that I took a butterfly hair clip, and inserted a piece of Styrofoam onto one side of it (glue definitely helps it stay in place) and started gluing and sticking items into it. I was going for totally outrageous, so used things like curling ribbon stuck into the Styrofoam with pins. My goal was to make it so big and bold that once it was in my hair, the curling ribbon and other stuff would hide the clip. I have yet to finish it though.

I’ve also experimented with more conservative measures in the past. I was going to a wedding and I needed something for my hair. I took a side comb, found some silk flowers that matched my dress, and sewed them on to the comb. It worked just fine.

Hats and Fascinators- Royal Wedding Fashion: If you didn’t have a chance to see some of the fascinators worn at last week’s Royal wedding, The Telegraph has an interesting selection. In viewing these hats, some of which seem to defy gravity, think lots of pins, side combs and elastic.

Fascinator How to Guide: Make Your Own Fascinator for the Races

A zipper fascinator tutorial

How to Make Hair Fascinators from The Beading Gem’s Journal: Lots of links to a variety of sites.

How to Make A Fascinator: From the UK’s Largest Millinery Supplier (Video) Don’t think they’re into using glue guns.

Fascinator Hat Tutorial-Whitney Sews (video): This one is all about the glue gun and items you have around the house.

Sunday, May 1, 2011

Journal Watch/News 5/1/11

FDA Warns of Contaminated Swabs in First Aid Kits: If you own a first-aid kit made by Atwater Carey, be careful. The U.S. Food and Drug Administration is warning that the disinfecting iodine swabs included in certain kits might actually cause life-threatening infections.

World Health Organization (WHO) Warns of enormous burden of Chronic Disease: Chronic illnesses like cancer, heart disease and diabetes cause more deaths than all other diseases combined, WHO warned this week. Heart disease, cancer, diabetes and respiratory conditions, accounted for 36 million, or 63 percent, of the 57 million deaths worldwide in 2008. The WHO said three priorities for action were surveillance -- to monitor chronic diseases, prevention -- to let people know the about risks and help them adapt lifestyles, and healthcare -- to improve treatment and access for those who are sick. It listed its top 10 "best buys", including banning smoking in public places, enforcing tobacco advertising bans, restricting access to alcohol and cutting salt in food, and said these steps should be taken now to produce "results in terms of lives saved, diseases prevented and heavy costs avoided".

Depression Reported by 25 Percent of Caregivers: One in four caregivers for ill or elderly relatives and friends said in a survey released on Tuesday that they suffer from depression, a figure far higher than for the U.S. population in general.
By comparison, 9 percent of all Americans are estimated to suffer from depression, according to a study released last year by the U.S. Centers for Disease Control and Prevention in Atlanta. The California-based company, a website for caregivers that commissioned the online survey of 400 respondents, said the high level of depression reported by those attending to a loved one comes as many face their own health issues. The survey also found that a third of family caregivers spend more than 30 hours a week in that role, and 77 percent are concerned about the impact of their duties on their savings. Most of the caregivers were attending to an infirm parent, while the rest were caring for a spouse, relative or friend.

Early anti-smoking drug start seems better: Getting a head start on Pfizer's anti-smoking drug Chantix may help smokers kick the habit, according to a preliminary study funded by the company. More than a third of smokers who started on the drug a month before quitting were still completely smoke-free 3 months later. That compared to about one in seven of those who only started Chantix the recommended one week before they quit. Although researchers warn the study was short and needs to be confirmed, they say it hints that decreasing smoking pleasure -- one of Chantix's effects -- early on might help smokers stay off cigarettes over the long haul. Archives of Internal Medicine 4/25/11

Low Vitamin D Levels Linked to Diabetes: After following more than 5,000 people for 5 years, the researchers found those with lower than average vitamin D levels had a 57 percent increased risk of developing type 2 diabetes compared to people with levels in the recommended range. "Studies like ours have suggested that blood levels of vitamin D higher than what is recommended for bone health may be necessary to reduce the risk of developing type 2 diabetes," said lead author Dr. Claudia Gagnon, a fellow at the Western Hospital at the University of Melbourne in Australia when the study was done. Diabetes Care, online March 23, 2011

Low Vitamin D Levels Linked to More Aggressive Breast Cancers: Breast cancer patients with low levels of vitamin D have more aggressive tumors and poorer outcomes, a new study finds. Experts say the new findings support what many oncologists have long suspected. American Society of Breast Surgeons Meeting

Low Vitamin D Levels Tied to Obesity in Kids: In the study, researchers checked vitamin D levels in 237 healthy obese and non-obese white and black children, aged 8 to 18. They found that most of them were vitamin D deficient. Low levels of vitamin D were associated with higher body mass index and fat levels, and lower levels of "good" high-density lipoprotein (HDL) cholesterol. Among those with vitamin D deficiency, white children were more likely to have higher levels of fat between their internal organs (visceral adipose tissue), while black children were more likely to have higher levels of fat just under the skin (subcutaneous adipose tissue), the investigators found. Journal of Clinical Endocrinology & Metabolism May

When Docs own MRIs, Back Pain Scans increase. Doctors are far more likely to refer patients complaining of lower back pain for an expensive MRI scan if they own or lease such imaging equipment, a new study indicates. The Stanford University School of Medicine researchers also found that after orthopedists bought MRI equipment, their patients were significantly more likely to have back surgery within six months of seeing the orthopedist for back pain. The study author noted that MRI and surgery for lower back pain "are quite controversial" because there are no proven benefits. Health Services Research.April

Americans May Not Consume Enough Calcium: A new study finds that Americans may not be consuming enough calcium. Researchers analyzed data from 9,475 adults who took part in the National Health and Nutrition Examination Survey of 2003 to 2006 and found that self-reported calcium density was not sufficient to meet recommended levels. Reported calcium supplement use increased with age in both men and women, but median dietary intake among those aged 81 and older was lower by 23 percent among men and by 14 percent among women, compared to those aged 19 to 30. Journal of the American Dietetic Association May