By- Dr. Amy MoviusHuman Lyme disease was first described in Connecticut in 1975: In 1987 it hit Maine incidence has been rising ever since. Middle-aged persons and school-age children are most often infected. Lyme disease is caused by bacteria that usually infect animals, but can also infect people. Lyme disease spreads from animals to humans when a tick bites an infected animal, â€œpicks upâ€ the infection, and then delivers or â€œcarriesâ€ the bacteria to a person it later bites. The most common symptom of Lyme disease is an expanding red rash around the bite site. It can occur from days to a month after the bite and is usually not painful. May is the beginning of Lyme disease season and officially Lyme Disease Awareness Month. It is an excellent time to prepare how NOT to become infected with Lyme disease (and other tick borne infections too!) over the coming months. The absolute surest way to prevent Lyme disease is to have no risk of tick exposure. Since this is impossible for many people, preventing and promptly recognizing tick bites is a more practical approach. The Maine CDC recommends following the simple â€œNo Ticks 4 ME” rules:1. Wear protective clothing2. Use insect repellent3. Perform daily tick checks4. Use caution in tick habitatsClothing is our first line of defense. Wearing long sleeves and long pants in outdoor areas where ticks may be present is a good start. If the clothing is light colored, it will be easier to see ticks as well. Pants can be tucked into socks and even taped to prevent ticks from climbing up the inside of pant legs. After clothes are worn outdoors, washing in hot water and drying on high heat should eliminate any ticks you may have missed.Insect repellents containing DEET or picaridin should be applied to the skin. Clothes can also be treated with permethrin, available at outdoors/camping stores, to repel ticks from attaching to them. Treating pets with tick repellents is also very important as they can give a Lyme carrying tick a free ride into your living room.At the end of every day you have been outdoors, take a shower as soon as possible. You should do a tick â€œbody checkâ€ looking for any critters who may have attached themselves despite your efforts. Ticks have to be attached for 24-48 hours before the bacteria can be transmitted to a person, so prompt removal is very protective. If you find a tick, you should carefully remove it by gently pulling it straight out with tweezers. Wash the area well and use a topical antiseptic afterwards. Use of petroleum jelly, nail polish and other home treatments are NOT recommended. Be on the lookout for any suspicious symptoms for the next month. Again removing ticks from pets promptly is also very important. Tick habitats include wooded or bushy areas and locations with high grass or lots of leaf litter. Extra care and vigilance in these environments is warranted.If a tick bite occurs, routine antibiotic use is NOT recommended: rather careful watching of the bite location isâ€¦ for a month! Any rash that occurs at the site should be seen by a health provider, even if you otherwise feel fine, at which time antibiotics can be administered. Many people who receive no treatment for such a rash (because they felt fine) will develop further symptoms, sometimes months later, especially arthritis of large joints. A small number of infected people can develop even more serious symptoms and a few may develop a chronic condition, despite antibiotic treatment.References: www.maine.gov.cdcwww.cdc.govThe Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America. Clinical Infectious Diseases 2006: 43: (1 November)
Does Your Surgeonâ€™s Lack of Sleep Affect Your Surgical Risk?By- Dr. Joan Marie PellegriniSince we are all just a bit sleep deprived because of the time change, I thought it would be appropriate to cover the topic of sleep deprivation for this segment. I have covered this topic before but not as it concern the surgeon and the patient. It is not news nor is it controversial that all of us function better after a full night of sleep. We know that truck drivers and pilots are not allowed to drive/fly after working a determined number of hours and that there is a mandated amount of sleep time between shifts of work. Most of us are also aware of the work hour limits that have been placed on residents in medical training. However, there are no policies regulating how much sleep your surgeon must have before performing your electively scheduled surgery. This is a truly controversial topic because so many people have such strong feeling about it. Unfortunately, although there are strong feelings, there is little data to demonstrate how prevalent or how dangerous is this problem.There is at least one study (JAMA 2009) that demonstrates an increased complication rate when the general surgeon has had less than six hours of sleep. A recent editorial in the New England Journal of Medicine also raises this issue. This editorial addressed the specific issue of elective general surgery cases and how much should the surgeon disclose to the patient about their sleep habits the previous night. Patients and surgeons have several reasons why they may not want their surgery cancelled. Patients have mentally prepared for undergoing a procedure, arranged for time off work, arranged for childcare, etc. The surgeonâ€™s schedule also may not be very accommodating to rescheduling. And, the hospitalâ€™s OR schedule may not have any vacancies in the near future.In concert with the above scheduling issues is the fact that most of us are excellent at denying that sleep deprivation is so dangerous. Many of us, me included, have driven on the highway sleep deprived because we only had a few more miles to go. We say to ourselves: â€œI can do this. Iâ€™m not really going to fall asleep and crash.â€ When we are a patient, we expect our surgeon to be â€œtoughâ€. We believe that surgeons go through such grueling training in order to be able to handle the schedule. We often have no concern about the ability of our surgeon to function on little sleep.What type of elective surgery you are having also has an impact. If it is a minor procedure or one with little risk, then there are little data showing any compromise in care from a sleep deprived surgeon. This is because much larger studies are required to demonstrate a difference in outcomes when there is low risk of complication. My personal opinion is that patients receive excellent care for low risk procedures even when their surgeon is sleep deprived.If you are undergoing a lengthy or risky procedure then you may consider requesting your elective procedure be scheduled on a date that is not a â€œpost-callâ€ day. The day after a surgeon has been on call the night before is commonly referred to as the â€œpost-callâ€ day. Depending on what kind of practice your surgeon is in, their nights of call and covering the Emergency room may or may not be busy. None the less, if you have a choice, it is probably better to avoid a â€œpost-callâ€ day. Fortunately, it is becoming more common for busy surgeons not to schedule elective procedures on post call days. Second, it is permissible to ask your surgeon before your procedure how many hours of sleep they had the night before. This question should be no more controversial than asking your surgeon at your consultation appointment how many procedures they have performed or what their complication rate is. I will admit that it is a rare patient of mine that asks me any of these questions. Iâ€™m not sure if it because they are afraid to know the answer or they are unaware of the risk of surgeonsâ€™ sleep deprivation.It is my hope in the near future that patients and surgeons will become more aware of this issue. The solution will not be simple. Clearly, we cannot mandate a limit to the hours worked by surgeons. There is already a national shortage of general surgeons. Such a mandate would put patients at significant risk and perhaps would limit access to emergency surgical care. Also, surgeons have fluctuating needs for sleep depending on the influence of other stressors is in their life and what point they are in their career.It is my hope the healthcare industry will work toward awareness and solutions before the government becomes involved with mandates. Educated patients who ask intelligent questions of their doctor help ensure better care for themselves and other patients.References:NEJM 2010: 363:2577-2579.JAMA 2009: 302:1565-1572.General Surgery News February 2011.
Mainers with antlophobia are especially fearful this time of year. Antlophobia is a fear of floods.TV 5 Health Advisor Dr. David Prescott spoke with Jim Morris on TV5 News at 5 about phobias and what can be done about them.————–By: Dr. PrescottPhobias – Some are Rare, Some are Common: Phobias are intense, excessive fears about certain objects or situations. The number of people who suffer from phobias is surprisingly high. Phobias affect around 10 million Americans. Only depression and alcoholism rank higher than phobias in terms of common mental health problemsThere have been names given to dozens of different types of phobias. Some examples include: Triskadekaphobia Fear of the number 13Phalacrophobia Fear of becoming baldAntlophobia Fear of floodsChionophobia Fear of snowThe phobias listed above are relatively uncommon, and they rarely cause serious disruption on people’s lives. However, in some cases, people’s anxiety about a certain object or situation can become debilitating. People with severe cases of phobias such as social phobia or agoraphobia often go to great lengths to avoid such things as social interactions or crowds. Common Phobias Which Are The Focus of Mental health Treatment: Some common phobias that may require professional treatment include: Agoraphobia Fear of being in a place or situation where escape is difficult Social Phobia Fear of embarrassment or how one will act in a social situation. Health Related Phobias Fear of germs or sickness: or fear of healthcare proceduresEnvironmental Phobias Fear of heights, water, or fireSocial Phobia or Social Anxiety DisorderSocial Phobia, or social anxiety disorder, affects about 15 million American adults, and is one of the most common phobias. People with social phobia become overwhelmingly anxious and excessively self-conscious in everyday social situations. They usually experience an intense fear of being watched and judged by others and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. In addition to subjective worry, they often experience physical symptoms of anxiety in social situations such as blushing, trembling, nausea, and difficulty talking. Treatment for Phobias is Highly EffectiveSadly, many people with phobias which negatively impact everyday life never get help for their problem. If left untreated, phobias and other anxiety disorders can become increasingly debilitating, since people’s first response is often to avoid an anxiety producing situation. Without treatment this avoidance can become more and more widespread and lead people to become increasingly isolated. Treatment for phobias may involve changing the way you think about anxiety producing situations, changing how you behave in these situations, or taking medication to alter your brain/body’s response to an anxiety producing situation. Effective treatments include: Â· Behavior Therapies: Behavioral therapies involve learning a relaxation response, then introducing the person to the phobic object while they are in a very relaxed state. Doing this very gradually allows the person to gradually overcome their fears. New technologies, such as virtual reality helmets, are proving to be highly useful as an alternative to actual exposure to a feared situation. Â· Cognitive Therapies: Another form of treatment focuses on changing how we think about something we fear. For example, people with social phobia often believe they will say something silly or embarrassing during a conversation. Helping these people change this belief, by perhaps having them practice a brief casual conversation, can help reduce the fear. Â· Medications: Medications such as anti-anxiety medications or a class of medication called SSRI’s, are often effective forms of treatment for anxiety and phobia. For More Information: Acadia Hospital www.acadiahospital.com American Psychological Association Help Center: www.apa.org/helpcenter
Are you at high risk for diabetes?A simple quiz can answer that question.TV5 Health Advisor Dr. Erik Steele spoke to Jim Morris on how to help.
By- Dr. Amy MoviusRespiratory illness season (including influenza) is in full swing AND thereâ€™s a nasty stomach flu â€œgoing aroundâ€.Â I spent most of last night at the hospital attending to such patients while sincerely hoping not to acquire or spread these infections further.Â This involves a lot of hand washing and sanitizing.Â What hand washing, as a subject, lacks in sensationalism it makes up for in usefulness. Whether talking about the common cold or more serious infections, it is often the single most important thing you can do to keep from getting sick.Â Take a moment to think about everything youâ€™ve touched in the past hour, much less the past day.Â Infection causing germs can be transferred to your hands by everything you touch, which can then be transferred into your body by touching your eyes, nose, or mouth.Â Likewise, if you are carrying an infection â€“ knowingly or not â€“ it can be spread to other people in the same manner.Â As a whole, we are not as diligent at hand washing as we think we are.Â Take after using the bathroom, for instance.Â One study found that although 91% adults surveyed reported always washing their hands after using public bathrooms only 83% – or 4 out of 5 – were directly observed to do so.Â In a study of middle and high school students only 58% of girls and 48% of boys cleaned their hands after using the school bathroom.Â Â People admit to hand washing even less at home after using their own bathrooms despite the fact they are still bathrooms.Â Only 32% people surveyed reported washing their hands after covering a sneeze or cough.Â Â Below is a reminder list for when you should wash your hands.Â 1.Â Â Â Â Â After using the bathroom (or changing a diaper).2.Â Â Â Â Â After blowing your nose or coughing.3.Â Â Â Â Â Before touching food (eating, serving, preparing).4.Â Â Â Â Â After touching animals (including pets).5.Â Â Â Â Â After outdoor activities.6.Â Â Â Â Â Before and after visiting anyone whoâ€™s sick: think about using an alcohol sanitizer here as well.7.Â Â Â Â Â Any other time your hands are dirty.Â Below is the proper hand washing technique. Â 1.Â Â Â Â Â Use soap (any type is fine) and warm water.2.Â Â Â Â Â Be thorough â€“ wash hands, fingers, nails, wrists â€“ front and back.3.Â Â Â Â Â Wash at least 15 seconds (one round of â€œHappy Birthdayâ€).4.Â Â Â Â Â After rinsing well, pat dry with a clean towel.5.Â Â Â Â Â Use paper towels to turn faucets and door handles in public bathrooms.Â Frequent hand washing can cause skin to become chapped or dry.Â If you have this problem you still need to wash diligently but pick a mild soap and generously moisturize after each washing.Â If there isnâ€™t a place to wash, waterless hand soaps or scrubs are a good alternative to keep nearby. Please follow these guidelines to protect yourself and those around you.Â Â When needed, gently remind others to do so as well.Â Reference: www.kidshealth.org
Corrections regarding statements about high fructose corn syrup (HFCS): The controversy and common sense.By- Dr. Joan Marie PellegriniLast month I discussed HFCS in this segment. I have been doing this segment since 2000 and have never received any mail commenting on my segment. However, this segment generated two well-written letters from experts in Massachusetts and New Jersey. They wanted to point out a few wrong statements that I made and also wanted to point out that HFCS is safe and no different than any other sugar. It also seems there was some confusion that I may have implied that HFCS is there reason we are having such an obesity epidemic. I agree with the experts on most points. I stated that HFCS is sweeter than table sugar and this is wrong. I also stated that that HFCS has only been around since the 1990â€™s and this is also wrong. It became much more popular then but it has been around since the 1960â€™s.It is quite interesting to me how much controversy this segment generated. I was unaware of the controversy surrounding HFCS until friends of mine pointed out to me there are TV commercials that try to convince the consumer that HFCS is the same as any other sugar. A quick search of the medical literature with the term â€œfructoseâ€ reveals that there is some scientific excitement regarding this molecule. One of the main problems with studying nutrition is that there is little funding available. Pharmaceutical companies only pay for research that will generate a new drug and therefore have a potential for profit. The NIH and USDA have limited funds for nutrition research (probably less than 5% of that spent on cancer and heart disease. I have no study to quote here except a quick Google search.). Much of the â€œnutritionâ€ research that is being funded is looking at supplements and vitamins, not at true nutrition. Another problem with many of the studies is that the study participants are given an unrealistic diet and therefore the conclusions are not translatable to the real world.There are plenty of studies to show that HFCS is no different than any other sugar. However, there are also several studies showing the opposite. Why did the study that I mentioned come to the conclusion that HFCS is worse for you? One of the main problems with that study is that the participants were fed an unrealistic diet of pure fructose. This is quite different than HFCS. Because of the differences in study design, percentage and form of fructose, etc, it is quite difficult to make any certain conclusions from the available literature.Here are some points that are not controversial:1) Americans consume too much simple carbohydrates (sugars).2) Sugared drinks are a major problem .3) Many foods that you buy in the grocery store have sugar, honey, HFCS, or other sugars hidden in them.4) Fructose is absorbed and metabolized differently than glucose.5) A quick look at food labels will reveal the ubiquity of hidden sugars.6) The obesity epidemic is very complex. There is no one issue to blame and there is no one simple solution.When I chose to cover HFCS, I chose this topic as one of several that Iâ€™ve done over the years focusing on various aspects of our diet and goals towards healthy living. Although I made some minor incorrect statements, I stand by my original conclusions: HFCS is controversial and it may or may not be different than other sugars. However, limiting sugars and HFCS is just one small part of the overall program of healthy living. By no means should HFCS shoulder all the blame for Americaâ€™s obesity epidemic.
Early Recognition of Mental Health ProblemsBy- Dr. David PrescottEarly Recognition a Key to Effective Mental Health Treatment: In mental health treatment, as with all of health care, early recognition and treatment is increasingly seen as critical to reducing the suffering associated with psychiatric disorders. The logic is simple enough. The earlier you detect a problem and do something to fix it, the less that problem will impact your life. But, while that logic makes sense to most of us, knowing exactly what to look for may be a little more difficult. When Do You Cross the Line to Needing Professional Attention? Obviously, this is a difficult question and the answer varies from person to person. Two questions that I like to ask in helping someone decide include: 1. Is this bothering you to the point where you want more support or would like it to have less of an influence on your life? 2. Has this problem started to interfere with your life and the things you used to be able to do? That is, are you now unable to accomplish things that you used to accomplish because of the problem? Here are some early warning signs of common mental health and addiction problems. As with any health problem, if you are in doubt, talk to a psychologist, mental health professional, or your family doctor. Early Signs of Depression: Most people know that depression involves recurrent sadness, hopelessness, and lack of energy. It is common to have these feelings for a couple of days every now and then. Signs that the depression may be more serious include: â€¢ 2 consecutive weeks of feeling sad or hopeless. â€¢ In teenagers and some adults, rather than feeling depressed, feeling mostly irritable or short tempered. â€¢ Missing school, work, or significant family events because you feel too sad or donâ€™t have the motivation that you used to have. Early Signs of Schizophrenia or Psychotic Illnesses: The onset of schizophrenia, a mental disorder characterized by disorganization in thinking, excessive suspiciousness or paranoia, or in some cases hallucinations, is typically in the late teens or early twenties. However, warning signs are often present long before the formal onset. These include: â€¢ Withdrawal from friends or family â€¢ Difficulty concentrating, confusion, jumbled thinking â€¢ Suspiciousness, fearfulness or mistrust of others â€¢ Changes in the way things look or sound, seeing or hearing things that aren’t there â€¢ Odd thinking or behavior: feeling odd, like something is wrongEarly Signs of Anxiety Disorders: Anxiety disorders include panic disorder, social phobia, and obsessive-compulsive disorders. The hallmark of each of these problems is debilitating anxiety that leads to avoidance of people and activities. Early signs of anxiety disorders include: â€¢ Repeated episodes of panic (feel like you canâ€™t breathe, like you may be about to die, short of breath). Single episodes of panic are somewhat common and may not indicate a disorder. â€¢ Avoiding important activities (school, work) or situations (going to the store) because of anxiety or fear of an anxiety attack. â€¢ Losing more and more time to activities designed to reduce or cope with anxiety (spending time alone, engaging in checking things or doing things over that you have already done). Early Signs of Drug or Alcohol Dependence: Often, drug or alcohol dependence start off as recreational drinking or drug use. Early signs of drug and alcohol abuse or dependence include: â€¢ Frequent episodes of binge drinking (4 or more drinks for women, 5 or more for men)â€¢ Missing school or work due to drug or alcohol use or feeling hungover. â€¢ Spend increasing amounts of time using substances or with people that drink/use drugs with you. How do I seek help? Seeing a qualified mental health professional, like a psychologist, psychiatrist, psychiatric nurse, or licensed social worker is a good start. Help may include counseling, medication, or a combination of the two. If you donâ€™t know a mental health professional, your primary care doctor is often able to make a recommendation. For More Help: Acadia Hospital www.acadiahospital.orgIn Maine Dial 2-1-1 for agencies that provide counseling.
By- Dr. Amy MoviusWe are on the threshold of a major winter storm, one accompanied by frigid temperatures. Many people (hopefully most) will be hunkering down and riding the storm out at home. Essential workers and others will have to venture out. Everyone needs to be prepared to stay safe from hypothermia and frostbite. It is recommended that people stay off the roads if possible during a major winter storm. However, it is still important to be prepared for the possibility of power loss at home. The following lists necessities for such an event:1. Have a back up heat source such as a wood stove or generator.2. Emergency supplies to have on hand include extra blankets, flashlight, matches, first aid kit, manual can opener, show shovel and rock salt.3. Drinking water, nonperishable food, and medication to last a few days are essential.4. Dress in several layers and wrap in blankets to conserve heat.5. If you are worried your environment isnâ€™t warm enough, go elsewhere (friends, neighbors, shelter) until your home is safe again.People who must venture out in their cars need to be especially careful. Anyone involved in a car accident or breakdown can be very susceptible to hypothermia/frostbite. If you must drive, first and foremost, go slowly and let someone know where you are going and what route you are taking. In addition, follow the guidelines below.1. Be sure your vehicle is in good working condition for storm driving. 2. Have emergency gear with you at all times. This includes a cell phone, flashlight, jumper cables, sand or kitty litter (for tire traction if needed), ice scraper, small shovel, blankets, warning devices such as flares.3. Extra warm clothing and hand warmers in your emergency supplies may also be useful.4. If you are taking a longer trip bring some drinking water, food, and any medication as well.5. IF YOU GET STUCK ON THE ROAD, place a flare in front and in back of your vehicle. While awaiting rescue, stay inside with a window slightly open for air circulation. Also, wrap yourself in blankets and run the heater for a few minutes each hour.Hypothermia occurs when the body temperature is abnormally low. It can happen to anyone though some people are more susceptible to it than others. The poor, elderly, those with substance abuse problems, and children are groups particularly at risk. Hypothermia can happen suddenly or more gradually, and is affected by how cold it is, how long a person is exposed to the cold, and each personâ€™s general health. Hypothermia can kill. The first sign is often some confusion or sleepiness which might not be obvious. Slow/slurred speech can follow as well as excessive shivering or NO shivering at all. Hypothermic people will have slow and clumsy body movements. If you think someone is hypothermic, seek medical attention immediately. If this isnâ€™t possible, move them to a warmer location, wrap them in blankets or lie close to them. Do not rub someone with frostbite or hypothermia – this will cause more damage.
Improved Communication = Improved CareBy- Dr. Jonathan WoodBeing admitted to the hospital is can be scary and traumaticâ€¦ for the patient and for the patientâ€™s family.Being critically ill, needing invasive procedures or having a hospitalized child all accentuate these feelings The medical lingo is difficult to understand, the issues discussed often carry great importance, and there are often unanswered questions. Whatâ€™s more, caretakers often seem to be overworked or in a hurry. And then money is invariably an issue: missed work, inadequate insurance, childcare needs, day-to-day living away from home, etc. More stress.In the end, many people report a sense of â€œloss of controlâ€. What can be done?Arrgghhhh!While I cannot offer a fix for the sometimes beleaguered state of modern medicine, I will suggest one central thing that can help with all the above: improved communication. And much of it is within your control.Some suggestions:â€¢ Ask questionso Who are you? Insist that people introduce themselves and explain their role in your care. Where do they fit in the lists above?o Why are we doing this? Insist on understanding why tests are being done and what is going to happen with the information.o May I speak with my doctor? Ideally there is one doctor orchestrating all of your care. Ideally there is excellent communication between doctors and amongst all the participants in the care team. Insist on a team and a good leader.â€¢ Learn the system (i.e. who are all these people?)Hospitals depend upon a complex system of personnel that is often very confusing and very difficult to understand. Examples:o Primary Care docs (e.g. Internist, Family Practitioner, Pediatrician)o Inpatient Specialists (e.g. Hospitalist, Intensivist)o Specialists (e.g. Surgeon, Psychiatrist, OB-Gyn)o Sub-Specialists (e.g. Cardiologist, Neurologist, Orthopedic surgeon)o Midlevel Providers (e.g. Nurse Practitioner, Physician Assistant)o Nurses (e.g. bedside nurse, charge nurse)o Ancillary Personnel (e.g. Respiratory Therapy, Physical Therapy, Occupational Therapy, Nutritionists, Social Workers, Care Managers)o Trainees (e.g. residents, nursing students, medical students)â€¢ Tell your caretakers your worries â€“ donâ€™t be afraid to tell people what concerns you or what would make you more comfortable. Nothing is off limits!â€¢ Leave your biases at homeo Believe in the system â€“ Much of believing is understanding. Work to understand the system (see above) and increased confidence will follow. o Donâ€™t worry about offending â€“ Doctors are people – – you can talk to them like you talk to anyone. Sometimes people feel intimidated, but it is important to move beyond this. Be yourself. Remember: you are the consumer. Be polite and expect the same in return.o Gender â€“ The days of female nurses and male doctors are long over. Do not make assumptions based on gender and treat all your caretakers with respect. Insist on the same in return.o Teaching Hospitals â€“ Much of the best care in the US is delivered in teaching hospitals. No one is experimenting on you. On the contrary, these are often very concerned, very smart, and often less busy students or residents who can be very helpful in you quest for quality healthcare. Take advantage of the opportunity!o Culture Differences â€“ Maine attracts caregivers from all cultures. These people are invariably well trained and very caring. Treat them with respect and expect the same in reverse. If accents are difficult to understand, be frank, polite, and patient.â€¢ Know what is expected of you and your family when you are dischargedo Ask questionso Get to know your â€œcare managerâ€ or â€œdischarge plannerâ€o Be sure you understand your medications and doses (including changes from when your arrived)o Have instructions repeated as many times as it take to understando Know who you need to see after leaving and where and when.While these suggestions wonâ€™t make being hospitalized fun, they may take some of the unnecessary fear and anxiety out of the process. In the end, remember… communication is the key!
TV5 Health Advisor Dr. Amy Movius spoke to Carolyn Callahan about the dangers of non powder guns such as pellet of bb guns.
What is High Fructose Corn Syrup and why is it bad for you?By- Dr. Joan Marie PellegriniHealthy Living at WABI has in the past covered the dangers of drinking soft drinks because of the hidden sugars and extra calories. However, is it as simple as just extra calories from sugar or is the high fructose corn syrup (HFCS) used as the sweetener that is particularly harmful?First, let me define what the different sugars are: sucrose is our usual table sugar and comes from cane or beet sugar. This is a two-sugar molecule with one glucose and one fructose bonded together. The sugar in our body is glucose. Dextrose is the same as glucose. Fructose is the sugar found in fruit. Fructose has a low glycemic index, which means that it takes a long time for the body to break down, resulting in a slow release of sugar, rather than a sudden rush. For this reason, it is sometimes recommended for diabetics. High fructose corn syrup comes from corn and is a mix of glucose and fructose but with higher percentage of fructose. The sugars in HFCS are single and not bonded together. Regular corn syrup is all glucose.HFCS is less expensive to make and also preserves foods and soft drinks longer than glucose can. It tastes sweeter and has properties than add to food texture. Because of this, food manufacturers prefer HFCS. It did not exist until 1996. All non-diet soft drinks are sweetened with HFCS.All sugars have the same caloric content but the effect on metabolism and hormones may be different. A recent study attempted to look how our bodies may differently metabolize some sugars:Journal of Clinical Investigation, Dr. Peter J. Havel, professor of nutrition at the University of California Davis and lead author of the study randomly assigned 32 overweight or obese men and women to drink three daily servings (25 percent of their daily energy requirements) of a glucose- or fructose-sweetened beverage for 10 weeks. At the end of the study period, both groups had gained similar amounts of weight, but those consuming fructose-sweetened drinks showed an increase in intra-abdominal fat, the kind that embeds itself between tissues in organs, became less sensitive to insulin (the hormone released by the pancreas that controls blood sugar), and showed signs of dyslipidemia-elevated blood levels of lipids. The fructose group also showed increased fat production in the liver, elevated LDL or bad cholesterol and larger increases in blood triglycerides. The group drinking glucose-sweetened beverages showed none of these changes.When fructose is consumed, however, it “appears to behave more like fat with respect to the hormones involved in body weight regulation,” explains Peter Havel, associate professor of nutrition at the University of California, Davis. “Fructose doesn’t stimulate insulin secretion. It doesn’t increase leptin production or suppress production of ghrelin. That suggests that consuming a lot of fructose, like consuming too much fat, could contribute to weight gain.” Glucose helps to control appetite and fat storage.Americans’ obesity problem started about the same time that HFCS came on to the market. It is this association that has led some nutritionists to want to study if HFCS is metabolized differently than regular sugar. Unfortunately there is not much funding for this type of research and therefore there are not that many studies. Also, there are some conflicting studies that seem to come to the opposite conclusion (that HFCS is no worse than other sugars).So, what can I recommend given this controversy? First, it is inconclusive that HFCS is inherently bad. However, because it is present in so many foods and all non-diet sodas, it is an omnipresent source of extra calories. Therefore, you must look at food and drink labels and try to pick the brand that doesn’t have added HFCS. Chances are good that brand will also not have added sugar of any type. It is fair to say that our intake of extra calories is a problem and that the increase in HFCS consumption is not helping. You should avoid food with added sugar regardless of whether it is table sugar or HFCS.
By: Dr. David PrescottCommon Resolutions for 2011: According to a recent survey cited by Time Magazine, the recent worldwide economic recession seems to be impacting people’s wishes for the New Year. Globally, 40% of people cited improving their economic circumstances as next year’s goal. While many Americans share this goal, favorite U.S. resolutions included: Â¨ Developing a healthy habitÂ¨ Losing WeightÂ¨ Getting OrganizedOther common resolutions in our country include quitting smoking, developing a relationship, or getting more education/job qualifications. Do Resolutions Help Us Change? Does setting any type of personal goal make a difference in whether or not we really stick to a change? Research on the impact of resolutions suggests that it does help! However, the majority of people who make some type of New Year’s Resolution find that they don’t make significant progress towards their goal. Psychologists have found that there are some very practical tips for improving your odds of meeting, or at least coming close to meeting, your New Year’s resolution. How Many People Stick to Their Resolution? More often than not, people do not stick to their New Year’s resolution for very long. In one study over two years, about one in five people (20%) are able to keep to their resolution. On the other hand, three in five (60%) dropped their resolution within 6 months. In a recently reported British study, 22% of people reported that they were “very successful” in keeping their resolutions. Interestingly, it doesn’t appear to matter that much what type of resolution you make. For example, people who picked “weight loss” weren’t more or less likely to keep their resolution than people who picked “improve my relationship.” It also doesn’t appear to matter whether you are male vs. female, or old vs. young. Tips for Keeping Your Resolution: What does appear to matter is how you go about specifying your goal, and how you arrange your life to try to meet that goal. Some of the most helpful ways to keep a resolution include the following: Â· Start Small – Just One Goal: It is usually easier to think of goals than to accomplish them. You have a better chance of progress if you stay focused on just one goal. Accomplishing one goal usually makes you feel better than falling short on many goals, no matter how worthy they are. Â· Get Some Support from Others: While the motivation to change often comes from within, sticking to your goal in the long run usually requires some support from others. Share your goal with people who will keep you on track. Other people can provide encouragement, ideas, and emotional energy when you feel your motivation start to wane. Â· Any Action leads to More Action: Doing something is, almost without exception, better than doing nothing when it comes to changing behavior. Changing one small behavior, for example exercising one time a week, usually leads to more and more change. Waiting until you are ready for the “big change” doesn’t work as well as taking one small step. Â· Plan for Relapse: People who make changes and stick to them often slip back to old ways at least once. Plan for this. How are you going to get back to your new ways? For example, if your goal is to exercise more, plan for the time when you miss your exercise. Think of ways that one missed day doesn’t become two. Reward your success, and move on quickly from your disappointmentsÂ· Specify Your Goal: People who are successful in changing an unwanted habit are able to say exactly what it is they will do. People who are vague about their goal have less chance for success. Being specific also helps you actually make a start. Set a date and time to begin your change if possible. For example, saying that you want to “eat better” is a helpful, but setting a goal of eating one fruit and one vegetable at each meal is even better. Starting tomorrow! Or, if you want to get along with your in-laws better, deciding to send them a card once a month would be a more specific step. For More Information: Acadia Hospital Website: www.acadiahospital.org American Psychological Association Web Site: www.apahelpcenter.org
By: Dr. David PrescottBipolar Disorder â€“ As With Many Psychiatric Disorders, Undertreated: A recent story in Florida, concerning a man who entered a school board meeting with a gun, highlights the need to ensure that people with mental illness receive professional treatment. News reports suggest that this man had bipolar disorder, a mood disorder involving wide fluctuations in mood, energy, and activity. But, like many psychiatric disorders, only a fraction of people with bipolar disorder receive proper treatment. Consider these facts: â€¢ Just under 3% of people in the United States experience bipolar disorder in any given year. â€¢ Almost 90% of these people are estimated to experience severe symptoms or disruption in functioning. â€¢ 51% of people with bipolar disorder receive no treatmentâ€¢ Only 39% of people with bipolar disorder are believed to receive adequate treatment. Famous People with Bipolar Disorder: Artist Vincent Van Gogh: performers Carrie Fisher, Dick Cavett, Margot Kidder, and Patty Duke: author Viginia Woolf. All of these well known personalities have, or are thought to have had, bipolar disorder. People with bipolar disorder may experience periods of time where they are creative, driven, and highly energetic. However, in spite of such periods of productivity, the disorder typically causes significant strain on relationships, families, and careers. Characteristics of People with Bipolar Disorder: While all of us experience â€œups and downsâ€ in our mood, people with Bipolar Disorder have mood swings which are extreme. Along with Major Depression, Bipolar Disorder is a psychiatric diagnosis that carries a relatively high risk for suicide or attempted suicide. The characteristic pattern involves periods of â€œupâ€ mood (mania or hypomania) and periods of â€œdownâ€ mood (depression). Current classification of Bipolar Disorder involves Type I (full episodes of mania and depression), Type II (mild episodes of mania and full episodes of depression) and rapid cycling (mood fluctuations occur in time period of a day or even several hours, rather than weeks). Signs and symptoms of Mania (lasts one week or more): â€¢ Excessive energy, activity, or restlessnessâ€¢ Excessive â€œhighâ€ or good moodâ€¢ Rapid and pressured speechâ€¢ Significant decreased sleepâ€¢ Irritabilityâ€¢ Poor judgmentâ€¢ Denial that anything is wrong Signs and symptoms of Depressionâ€¢ Decreased energy or activity levelâ€¢ Sad or depressed moodâ€¢ Preoccupation with death or suicideâ€¢ Lack of interest in activitiesâ€¢ Excessive sleep or difficulty falling asleepâ€¢ Change in appetite (usually diminished)Can Children or Adolescents have Bipolar Disorder? Like many psychological disorders, bipolar disorder is more difficult to identify in children and adolescents. Some experts argue that the disorder does not truly exist in children, while others argue that it is under-identified and treated. Especially with bipolar disorder, a thorough assessment by a licensed mental health provider, like a psychologist or psychiatrist, is a good first step. How is Bipolar Disorder Treated? Author Kay Redfield Jamison, a physician who writes about her own experience with bipolar disorder, talks about the importance of combining medicine with counseling to address bipolar disorder. Treatments for Bipolar Disorder Include: * Medicines such as lithium have proven highly effective in controlling mood swings. Newer medicines, like Depakote or atypical antipsychotic medications may also help some people with bipolar disorder. * Behavioral Treatment to Help Keep Daily Activity and Sleep Routines Consistent: While behavioral treatments do not make bipolar disorder go away, the impact of bipolar disorder can be greatly reduced by helping people maintain consistency in their daily routines (for example, meal times, physical activity) and sleep. * Cognitive-Behavioral Therapy and Education: Recognizing early signs of an extreme mood swing is important in treating bipolar disorder. Counseling can help people with bipolar disorder identify early signs of mood swings, help people adjust to a less energized lifestyle, and help them avoid patterns of thinking which lead to more severe depression or mania. For More Information: National Institute of Mental Health: http://www.nimh.nih.gov/health/publicationsAmerican Psychological Association: http://www.apa.org/topics/bipolarNational Alliance of Mental Illness: http://www.nami.org
By- Dr. Joan PellegriniBody piercing that includes areas other than ear lobes is gaining acceptance. One of the reasons that this is interesting to me as a surgeon is that I am now seeing more patients with complications from these piercings.There are “early” and “late” complications. Early complications occur because of improper sterile technique or improper site selection. Most of these complications can be avoided by choosing a reputable piercer. These complications are usually a local infection around the piercing.Ear piercing: a search of the medical literature does not list many complications. Interestingly, there do not seem to be any more complications with piercing the cartilage (the upper part of the ear) as opposed to the earlobe. Some people form keloids which is a very large scar. If you know you are one of these people, you should avoid piercing all together.Tongue and lip piercing: I suspect that most people who get this type of piercing are not informed about the dental complications. The metal in this type of jewelry can cause gingival recession and tooth trauma. Over time, this can necessitate expensive dental care. The gingival recession will self-correct if the jewelry is removed and good oral hygiene is followed. Trauma to the tooth enamel, however, may be irreversible.Umbilical piercing: The only real complication is infection of the belly button. This can be avoided by frequently cleansing of this area.Intimate piercings: Surprising to me, there are few complications with this type of piercing. A penile ring, although not really a “piercing” can cause a narrowing of the urethra if it is too tight and left on long-term.Nipple piercing: This is the most frequent piercing to cause complications in my practice. I have seen several women with breast infections that have occurred many months after piercing. Some women have even had their piercing removed for months to years before they develop an abscess. A breast abscess is painful. Unfortunately, this abscess is caused by a communication with the duct which can make it more difficult to treat. The mammary ducts all come together at the nipple. A piercing through the nipple can cause an abnormal communication between the skin and one or more of these ducts. Skin bacteria can get into the duct and cause an infection in the breast tissue. Some of these infections can cause breast deformity or may even require surgery to remove the duct and some breast tissue.
Recognizing Stress vs. Effectively Addressing StressBy- Dr. David Prescott Stress in America Survey: Each year, the American Psychological Association teams with Harris Interactive Research to conduct the â€œStress in America Survey.â€ This survey helps identify Americansâ€™ current perceived level of stress, sources of stress and ability to effectively cope with stress. The results reveal that, as a nation, most of us live under moderate to high stress and that we recognize stressâ€™s negative influence on our lives and our health. Why is Understanding Stress Important? Short-term stress can actually be helpful in focusing our energy on an important task, like an exam in school or an athletic event. However, chronic, long-term stress is associated with a number of negative conditions including: ïƒ˜ Heart diseaseïƒ˜ Depression or Anxiety Disorderïƒ˜ Obesityïƒ˜ Overall poor healthïƒ˜ Chronic PainWhat are the Top Stressors for 2010? The top stressors for 2010 were similar to those identified in the 2009 survey, and focus largely on economic factors. They include: ïƒ˜ Money (76% of population)ïƒ˜ Work (70% of population)ïƒ˜ Economy (65% of population)While these factors were similar from last year, some additional stressors were cited that are higher in 2010 than in 2009. These include: ïƒ˜ Job stability is a greater stressor in 2010 (49%) vs. 2009 (44%)ïƒ˜ Employers are viewed as less helpful in assisting employees in balancing job vs. home stress (only 36% are viewed as helpful in 2010 vs. 42% in 2009).Do Kids Know About Parentsâ€™ Stress? Most parents in the survey felt that their stress level has little impact on their children. Our children, however, report otherwise. 69% of parents said that their stress had little or no impact on their children, yet 91% of children said that they know and are affected by their parentsâ€™ stress. Most children were very good at identifying signs of parent stress (e.g., more irritable, not being able to spend time with children, reprimand children more). Children, by and large, felt able to tell their parents about their own feelings of stress. Yet, a third to half of children reported problems falling asleep, having physical symptoms like upset stomach, or unhealthy eating as effects of parentsâ€™ stress. Good News for East Coast: For reasons that are not entirely clear, people who live in the eastern part of the country reported the lowest average stress levels. On a 10 point scale, east coast residents report an average stress level of 5.2, which is the fourth straight annual drop. 35% of those living in the east reported little or no stress, with the next highest region (midwest) being 25%. Knowing What to Do and Actually Doing It: Most Americans readily recognize that high stress levels are associated with poor physical and mental health, unhealthy eating habits, avoiding regular exercise, and harmful coping strategies like smoking or excessive drinking. However, most people also acknowledge that while they know what to do to cope with stress more effectively, they donâ€™t actually do it. The American Psychological Association identifies some good starting points for putting our knowledge about better coping with stress into action. These include: ïƒ˜ Change One Habit at a Time: Start small. Your progress will gain momentum and help you pursue more challenging stress management goals. ïƒ˜ Talk About It: Most people are better able to cope with stress when they talk with supportive others Just expressing some of those bottled up feelings helps reduce stress levels. ïƒ˜ Create a Health Environment: Our stress level and unhelpful coping strategies are often triggered by things around us. Making your work or living space less cluttered and more comfortable reduces stress. Or, having health snacks available reduces the urge to eat â€œjunk foodâ€ when you are stressed. For More Information: American Psychological Association Help Center: www.apa.org/helpcenterAcadia Hospital: www.acadiaohospital.org
There’s a new study that’s been released saying antibiotics have little effect on children’s ear infectionsTV5 Health Advisor Dr. Erik Steele joined Carolyn Callahan to talk about it.
By- Dr. Amy MoviusEnvironmental awareness has increased dramatically in recent years – globally, nationally, politically and in about any other way one can think of. Some years ago, reusable shopping bags made their appearance. They are now a common sight – ready for purchase along side the tabloids and candy bars – at checkout counters of many grocery stores. As these bags have become more popular, they have become more fashionable and can be found in a variety of colors and designs. Attention has recently been directing toward an unwitting consequence of these bags: that some may contain significant amounts of lead.Earlier this month, a newspaper in Florida reported a story in which 2 dozen different reusable bags were obtained from the largest grocery stores in state. Each bag was tested for lead content twice. Some of these bags had lead levels that were quite high. These results are concerning as lead toxicity is no small manner. Lead is a neurotoxin and has been found to harmfully affect children’s IQ. This is why lead level screening of young children has been standard for many years.The (possible) presence of lead in reusable shopping bags poses 2 major concerns. The first is for contamination of food carried in these bags. There is good news on this count! Fortunately, the form the lead takes in these shopping bags is not easily extracted or leached, so the food carried should be unaffected.The second concern is, ironically, environmental. As these reusable bags wear out and are eventually disposed of, the lead can be released into the environment. The lead content of some of these bags was of a level at which the EPA would generally require further testing before accepting as suitable for landfill. There will undoubtedly be more information on this topic to come. In the meantime, however, it is still possible to be an environmentally conscious reusable bag shopper by following the “less is more” rule. In the Florida newspaper article, high lead levels were found in the more elaborately decorated shopping bags, especially those containing yellow or green paint. In contrast, plain nylon bags with little in the way of embellishment from multiple stores had lead levels near zero. If this isn’t reassuring enough, one can always ask for (and then recycle!) paper bags.
By- Dr. Jonathan WoodFor some, the term “family dinner”conjures up a picture of Beaver Cleaver and his parents, Ward (in his necktie) and June (with her pearls). That picture is probably pretty dated, but family dinners are thankfully not a thing of the past. It turns out that the number of families who eat dinner together at least 5 times/week has remained pretty constant at around 60% over the last 10 years. And according to Columbia University’s “Center for Addiction and Substance Abuse”, there are numerous apparent benefits for teens that are associated with this habit.The study, which has been revised and repeated six times since 2001, compares two groups:â€¢ Parents and teens who have dinner together 5 or more times each weekâ€¢ Parents and teens who have dinner together 2 or fewer times each weekIn the 2010 study, over 2000 teens and almost 500 parents were surveyed to generate these results.Teens from families who infrequently eat dinner together had significantly increased experience with substance use:â€¢ Twice as likely to have used tobaccoâ€¢ 89% increase in having used marijuanaâ€¢ 50% increase in having used alcoholâ€¢ Much more likely to report friends who:o Use marijuana (58% increase)o Use Ecstasy (63% increase)o Abuse prescription drugs (50% increase)o Use LSD, cocaine, or heroine (25% increase)Additionally, increased family dinners have a clear positive correlation with improved academic performance. Higher academic performance, in addition to the obvious benefits, is in itself consistently associated with lower rates of substance abuse.Families that eat together on a regular basis report higher rates of general discussion about all aspects of child and adolescent life, including discussions of current events, school and sports, friends and social activities, and family issues or problems.Family dinner also seems to improve general relationships and the sense of wellbeing within families. 70 percent of teens who eat dinner with their parents 5-7 times/wk report that their parents are proud of them compared with 48 percent of teens who dine with their families 2 or fewer times/wk. Furthermore, nearly three quarters of teens (72%) report that eating dinner with their parents is either “fairly important” or “very important”.Whether true “cause and effect” or simply association, these results are too impressive to ignore. Something happens at the dinner table when the opportunity is offered and that “something” is generally very positive. It is too simple to not take advantage of, so think about it.For more information, visit the National Center for Addiction and Substance Abuse website:www.casacolumbia.orgFor the full 2010 report, “The Importance of Family Dinners VI”:www.casacolumbia.org/templates/publications_reports.asp
The New Wonder Vitamin?By- Dr. Joan Marie PellegriniMost of us learned in school that Vitamin D is important for our bone health and that we get it from being in the sun. This is true. The sun on our exposed skin, along with our liver and kidneys, acts to convert the inactive molecule to the active vitamin. We can also get the active vitamin in our diet. Many foods, including milk, are supplemented with vitamin D. Vitamin D is critical in regulating our calcium metabolism. We have known for decades that vitamin D is critical for bone development. However, there is now increasingly significant research into the other biologic actions of this vitamin. These include the immune system (both the innate and adaptive), pancreas (i.e. diabetes) and metabolic homeostasis, heart-cardiovascular (heart disease and hypertension), muscle and brain systems (i.e. dementia), as well as the control of the cell cycle, and thus of the disease process of cancer.I have been telling my patients for years that if they have a problem with colon polyps, that taking Caltrate (calcium) and aspirin my help to reduce the number of polyps. New evidence shows that these same patients would probably also benefit from Vitamin D supplementation.Several conditions such as tuberculosis, psoriasis, eczema, Crohn’s disease, chest infections, wound infections, influenza, urinary tract infections, eye infections and wound healing may benefit from adequate circulating vitamin D levels.Scientists and nutritionists from many countries agree that at present about half of elderly North Americans and Western Europeans and probably also of the rest of the world are not receiving enough vitamin D to maintain healthy bone. This despite very well publicized national guidelines and supplementing our milk and orange juice. It is unclear exactly why our vitamin D levels are low. It could be from reduced dietary intake or less sun exposure or, more likely, a combination. We all live in a northern climate and this means we have less sun exposure than people living near the equator. Also, we tend to use sun screen which blocks the sun’s ability to help our skin make vitamin D.So, should you take a vitamin D supplement? You should evaluate how often you are outside when it is sunny. Is it at least 10 minutes a day without sunscreen? How much vitamin D are you getting in your diet? Dietary sources that are high in vitamin D are milk, orange juice (if the carton says it has added vitamin D), and fatty fish (such as mackerel and salmon). If you think you may not be getting enough, then a supplement of 1000 IU a day during the summer and 200 IU during the winter may be beneficial. If you are someone who seems to get every virus that goes through your office of school, then some experts believe this may be a sign of being relatively vitamin D deficient and that you’d benefit from taking extra vitamin D. If you are on medications or have liver or kidney disease, then you should discuss this issue with your physician before starting vitamin D supplementation.
By- Dr. Joan Marie PellegriniHunting season has arrived and already we have seen hunters seriously injured because of falls from their tree stand. A quick Google search of tree stand accidents will quickly tell you that this is a common problem. Depending on where you live, up to 1/3 to Â½ of all hunting accidents are a result of falling off or out of a tree stand. Of these accidents, 75% result in injury because the hunter was not using a harness or was using a harness improperly. This is really unfortunate because all commercial tree stands come with a fall restraint system (FAS). Also, this topic is covered in all hunter safety courses.Most falls happen when transitioning into the stand or out of the stand. Also, stands must be maintained and examined for wear and tear. Unfortunately, many falls are also related to alcohol intoxication.I have attached a list of safety tips from the Treestand Manufacturers Association and from the Tennessee Wildlife Resources Agency.1. Always wear a safety harness while hunting from a tree stand, including while ascending and descending. Make sure you understand how the harness should be properly used. Do not use a harness that looks worn or is not certified for your weight.2. Never climb into a permanent stand you have not built yourself or carefully checked out. 3. Always hunt with a plan and a buddy. Let someone know where you are going to be and when you plan to return.4. Always have an emergency signal device such as a cell phone, walkie-talkie, whistle, etc.5. Never hunt from tree limbs and make sure the tree is healthy and alive. Dead trees do not make sturdy supports for stands.6. Be sure the commercial stand you have is safe. Practice with it before using it in the woods. 7. Never climb a tree that is too small or too large for your stand to fit safely. 8. Be sure your stand is level at the height you wish to hunt. 9. Always stand up slowly and be sure of your balance. 10. Be sure you are steady and braced before shooting. 11. Always use a line haul line for your gear. Never climb with your equipment. 12. Be more careful than you think you need to be.