By: Amy Movius MD
It’s been a very active summer, weather-wise in Maine, with frequent thunderstorms. Nationwide, there are around 25 million lighting to ground strikes a year, about 60,000 which occur in Maine. These storms can be fascinating and even beautiful to witness – but make no mistake; every one of them is dangerous.
Josiah Hartley from LA Training was in the studio for Fitness Friday this week. He was speaking to Joy not only of the importance of eating before and after exercising, but how much and what kinds of foods you should be eating to better help your workout regimen.
We had a fresh face in the studio for this week’s Fitness Friday. Josiah Hartley from LA Training was teaching Joy and Wayne some quick variations on tricep extensions. He showed how to do the very quick an easy exercise in different stances to add varying levels of difficulty.
Gallstones: who is at risk of getting them and what can be done about it?
Gallstones and gallbladder issues are one of the most common and costly gastrointestinal diseases in this country. Over the past several decades we have seen an increase in the incidence of the disease. We have seen a sharp increase in the number of cholecystectomies (gallbladder removal surgery) since 1990 when the laparoscopic method was introduced (tiny incisions instead of a large one).
It is estimated that millions of Americans have gallstones or will get them. Depending on your ethnicity and gender you may have up to a 20% risk of developing gallstones (although it is about 10% for the general population). Other risk factors are age over 40 years, use of hormone treatment, obesity, history of multiple pregnancies, rapid weight loss (such as with crash diets or severely restrictive diets), family history, and inactivity. There are also certain medications which can make gallstone disease more common: hormone therapy, octreotide (a GI hormone not commonly used), clofibrate (a drug used for cholesterol treatment), ceftriaxone (an antibiotic commonly used in hospitals). Diseases which are associated with gallbladder disease include diabetes (mechanism not understood), cirrhosis, lipid disorders, spinal cord injury (because it causes a “lazy” gallbladder), and other gastrointestinal illnesses which may induce prolonged fasting or diet changes.
Gallbladder disease in females usually happens during the younger years (30’s-50’s) because this is when the estrogen and progesterone levels are the highest. This is one of the reasons why estrogen replacement therapy may cause a postmenopausal woman to develop gallbladder disease. In men, they are usually older because of the relative increase in those hormones as the testosterone level decreases.
Some of these risks you cannot do anything about. However, many of the risks are modifiable. A patient at risk of gallbladder disease can eat a healthy diet, exercise, keep their weight in the recommended range, and avoid certain hormone treatments. Other things that have been found to be protective are being on statins (a class of drugs used to control cholesterol levels), vitamin C, coffee, and eating vegetable and nuts proteins.
Many people with gallstones have no symptoms and so no treatment is recommended. They may know they have stones because they had a medical imaging study for some other reason and stones were seen as an incidental finding. Gallstones that are symptomatic will usually cause pain in the upper abdomen just under the chest and on the right after eating a fatty meal. This pain may even radiate around to the upper right back. It usually starts an hour or so after eating and may last for a few hours. A severe attack may last for many more hours and may even cause a gallbladder infection. In this case, the patient has usually sought medical attention because of the pain. Sometimes a stone may pass out of the gallbladder and travel into the common bile duct and cause a liver or pancreas problem. In that case, admission the hospital is usually indicated and often surgery is recommended.
Sometimes gallbladder disease can be confused with a heart attack, an ulcer, a back problem, muscle spasm, and kidney stones. A physician will take a careful history to try determining if these other diagnoses are likely or if further workup is needed.
Patients with gallstones often ask if there is a medication they can take to dissolve the stones. In fact there is one medication (ursodeoxycholic acid) available but it only works for certain stones and even then it doesn’t work well. Some studies suggest that certain patients may want to take this medication before undergoing planned rapid weight loss. Patients also ask if the stones can just be removed and the gallbladder left in place. This is not done because the gallbladder just makes more and this is an ineffective remedy that does not get rid of the pain. The gallstone is more just the sign of gallbladder disease but not the cause of it.
In summary, if you have gallstones you do not automatically need surgery. The most effective prevention is eating a healthy diet and maintaining an active lifestyle. If you do need surgery, you can rest assured that it is a very common surgery and quite safe with a low rate of complications and usually a fast recovery time.
The Psychology of Violence: Addressing a Critical Public Health Problem
Healthy Living – August 5, 2014
Dr. David Prescott – Acadia Hospital
Violence, Aggression, and Anger: As a leading cause of mortality for youth in America, combatting violence deserves attention for many reasons. Among them, violence is a leading cause of death and injury, particularly among young people. For certain age groups, violence presents a larger health risk than more traditional health problems like cancer or cardiac illness.
From a psychological standpoint, violence differs from anger and aggression.
· Anger is a normal human emotion that is typically experienced when we are threatened or provoked.
· Aggression involves behaviors associated with anger, typically involving verbal or physical threats and action against another person. Certain situations increase the risk of aggression, such as drinking, insults and other provocations and environmental factors like heat and overcrowding.
· Violence is an extreme form of aggression, such as assault, rape, or murder.
Amy Badger of Bodies by Badger was in the studio for another Fitness Friday this week. She stopped in to speak to Joy about how to prepare yourself if you want to take part in events such as 5K runs or Color Runs.
Amy Badger from Bodies by Badger was back in the studio for Fitness Friday. This week she was teaching Joy and Wayne the proper form and technique to do a dead-lift.
KIDNEY STONES: THE HOTTER IT GETS THE MORE IT HURTS
Research released this past month from Children’s Hospital in Philadelphia has reported an increase in the number of individuals, including children, developing kidney stones. Although there are many factors that can contribute to kidney stone formation, the research showed that there was a direct relationship between the average daily temperatures and the risk of having a kidney stone. Also, after heat waves, medical visits for this stones peak about 3 days later. The researchers reported that if our average daily temperatures increase as most climatologists predict, we will continue to see more kidney stones. Currently there are 70% more kidney stone events than we had 20 years ago with approximately 1 in 10 adults suffering this painful condition.
By: Dr. Joan Pellegrini
Do you know or live near an elderly person who lives alone? Living alone offers the advantage of freedom but may have a unique challenge of limited resources for help when needed. The elderly are at particular risk because of medications and balance issues that can lead to slips and falls. As we get older we develop balance issues because of hearing, vision, and muscle loss and also degenerating nerves and bones. The falls are more likely to cause a broken bone because of osteoporosis. The elderly are frequently on blood thinning medications and this can cause serious bleeding with a simple fall.
Checking in on the elderly offers a support network that will allow them to stay in their home longer and safely. I have a provided a list of some concerns that you and your family or neighbors may want to discuss when discussing how to make sure the person of concern is safe and has a plan.
-) Do a home safety check to make sure rugs are secure and cords are safe, etc. A good reference is the website for Consumer Product Safety (www.cpsc.gov) which has a checklist for the older person’s home safety.
-) Advance planning and scheduling: who is going to check on the person and on what days and at what time? There are automated calling services available in some areas. If you live far away and cannot reach the person, who lives nearby that can be called? I would recommend at least a daily check to make sure they have not fallen or become ill in such a way they cannot call for help. It could be as simple as a daily test message that requires an answer in a certain amount of time before you or someone else goes over to check on the person.
-) Does this person need medication reminders? If so, will someone be able to check the pill counts? Does the person need an alarm to be set for medication reminding? Do they often forget if they took the pill/pills? Perhaps a check box on a calendar would work in that situation.
-) Is a medical alert system needed? These are companies that offer a bracelet or necklace with a button that can be pressed if the person has fallen or cannot otherwise call for help. A necklace may be a better option because a person having a stroke may not be able to move the arm that is necessary to press the button on the other arm.
-) Can this person afford a cell phone that can be used when they are not in their house? If not, there is a service through the Federal Communications Committee that will provide a low cost cellular phone for emergency calls only.
-) If there is bad weather (too hot or too cold) or the power is out then someone should check on this person to make sure they have what is needed.
-) If this person is your neighbor and you are going to a store, they may appreciate your offering to pick up a few things for them.
-) Should this person have an ID bracelet with emergency contact information? People who need this are the elderly with some memory or dementia issues.
-) Is this person safe to still be driving? If not, what can you offer to help them be able to give up their license and yet not suffer too much loss of freedom?
Each elderly person who lives alone has different needs. Some may need more frequent checking in and some may just need a number to call in case of emergency. Even without a formal plan in place, you may know someone who lives alone and could use a little bit of help or checking upon in times of bad weather, etc.
Amy Badger of Bodies by Badger was in the studio for another Fitness Friday this week. She stopped in to speak to Wayne about stretching along with your exercises, and how the way that most of us were taught to stretch, may not actually be the most beneficial way for us to do it.
Amy Badger from Bodies by Badger was back in the studio on Friday for Fitness Friday. This week she was teaching Joy and Wayne some more exercises you can do with gliders right in your own living room.
By: Amy Movius MD
Sneezing. Itchy, watery eyes. Runny nose. Dark under-eye circles. Anyone with allergies is familiar with these symptoms. Allergies often flare in springtime with all the spectacular blossoming and blooming -and pollen production – going on. Allergies don’t take a summer holiday however, and pollen remains the main culprit. The source of the pollen does change though: in spring it’s trees, in summer it’s the more mundane grasses and weeds. Ragweed, a top allergy offender, swings into full gear in August. You don’t have to see it to feel it either, since ragweed pollen can travel hundreds of miles on the wind. Pollen isn’t the only summer allergen. Summer air pollution – think ozone – can worsen allergy symptoms. Higher temperatures and less wind (=summer) increases ozone. Also, there are allergies to beware of an entirely different kind – the kind that stings and bites and seem to be everywhere in summer. Bees and wasps and other stinging/biting insects commonly cause pain and swelling locally. Some people will be terribly, dangerously allergic to them however, even if they’ve never been bit before. Anyone who gets a rash or swelling all over, even the first time after a bite, should be very concerned. These types of allergic reactions frequently get worse each time they occur and can be life threatening. Staying inside all summer wouldn’t be much fun – nor would it protect you from all allergies. Mold loves damp and humid places, a description that applies to probably every bathroom and basement in Maine during the summer J. Also, dust mites – a relentless year-round allergen – peaks in the warm and humid summer months. They don’t bite but rather eat dead skin cells (gross, I know) and so hang out where people do; in beds, pillows, upholstery, and carpet.
Management of summertime allergies includes avoiding and limiting exposure to allergens, removing allergens as much as possible, using over-the-counter medications, and seeking medical advice and sometimes specialized care and treatment when allergies are more extreme. For outdoor allergies, checking pollen counts is a good start. They tend to be higher on warmer, drier and windier days, and peak midday to afternoon. Exercising inside and keeping windows closed can be helpful on high pollen days. Likewise, a good rain can temporarily clear pollen away. If you know you will be exposed to an allergen, taking an over-the-counter antihistamine can prevent symptoms more easily before they start. If pollen sensitive, wearing a hat and sunglasses outdoors will keep some pollen out of the face and eyes. Wear gloves when doing activities such as gardening and avoid touching face. Washing hands when coming indoors and rinsing eyes with cool water is helpful as well. Showering and washing hair at night and changing clothes before getting into bed will also remove any leftover pollen clinging to you from the day. As for stinging insect exposure, avoid going barefoot in areas they inhabit. They are attracted to bright colors and sweet smells so avoid like clothing and scents in these areas as well. Also, don’t drink from open cans outside (they like to fly in for a sip) and keep food covered. Those with severe allergies should always carry an epi-pen with them as prescribed. For indoor mold, keep prone areas as clean and dry as possible, and use dehumidifiers if available. Dust mites are everywhere and just the right size to be inhaled. Vacuuming and just walking on carpet will send them floating into the air. An estimated 90% of people with allergic asthma are dust mite sensitive. Covering mattresses, pillows (polyester ones best), and box springs with airtight dust mite covers is an excellent idea since we spend about a third of our life sleeping. Weekly washing of all bedding in very hot water and drying on high heat is recommended to kill dust mites. For other indoor areas, floors should be damp cleaned or vacuumed with HEPA filter at least weekly. Laundering throw rugs, opting for blinds over drapes, and avoiding dust mite loving collectors such as stuffed animals can also help keep the population down.
1. Summer Allergies. webmd.com
2. Top 5 Summer Allergens – ABC News. abcnews.go.com, May 29, 2012
3. Don’t Let Allergies, Asthma Spoil a Summer Soiree and Keep Your Green Thumb. accai.org
4. Dust (Dust Mite) Allergies: Symptoms, Causes, Treatments. webmd.com>
High Stress and Poor Health: Breaking the Negative Cycle
Healthy Living – July 8th, 2014
Dr. David Prescott – Acadia Hospital
The High Stress/Poor Health Negative Cycle: New research from the Harvard School of Public Health, Robert Woods Johnson Foundation, and National Public Radio, point out the strong relationship between stress and chronic illness. Public health experts and medical researchers have long known that life stress increases people’s risk for heart disease, obesity, and other health problems. However, experts are now noting that coping with a chronic illness, either having the illness yourself, or caring for a family member with a chronic illness, brings on more stress.
ARE GLUTEN-FREE DIETS HEALTHIER FOR YOU?
By: Dr. Joan Marie Pellegrini
People who have celiac disease (CD) cannot eat gluten without it causing damage to their intestines. For an unknown reason, their immune system in the intestinal tract turns on itself when it is exposed to gluten. This disease is rare and affects only 2-3 million Americans according to the National Foundation for Celiac Awareness. It used to be quite difficult to diagnose because there were no blood tests available. Now that it is easier to diagnose, more physicians and patients are becoming aware of its existence.
One of the problems with diagnosing CD is that the symptoms are similar to other diseases. Bloating, headaches, migraines, joint pains, fatigue, “brain fog”, diarrhea, and anemia can all be very nonspecific symptoms and caused by several other illnesses. People with Irritable Bowel Syndrome, other food allergies, bacterial overgrowth, other autoimmune illnesses, and inflammatory bowel syndrome can also have many of these symptoms.
CD is caused by an autoimmune response against gluten which is a group of proteins found in wheat, rye, and barley. Gluten is what gives bread its characteristic texture. In order to treat CD, a patient must maintain a gluten-free diet (GFD) for the rest of their life. Patients who are more likely to develop CD are those with a family history, those with other autoimmune diseases, and diabetics.
When someone has symptoms suggestive of CD, many doctors and patients may simply try a GFD to see if their symptoms improve. However, this is not adequate for making the diagnosis. In order to truly make the diagnosis, a patient must be on a diet containing gluten and then have blood work that confirms the presence of certain antibodies. Once this is done, many patients will then need an endoscopy and multiple small bowel biopsies in order to confirm the diagnosis.
Doctors have known about CD for many years even though it may have been difficult to diagnose. A more recently recognized condition is gluten sensitivity. This is not a true allergy. These patients have the same symptoms but do not have any autoimmune disease that causes damage to the intestinal lining. It is not completely known why they have bloating and diarrhea and why they feel better with less gluten in their diet. Even gluten sensitivity is not that common and is estimated to affect only 18 million Americans.
CD patients almost always have nutritional deficiencies because of chronic malabsorption. However, even with strict adherence to a GFD, they often have problems obtaining enough calories because of limited food options depending on where they live and what they can find in their local grocery store. The good news for patients with CD is that there are now many more options at the market for them. There are breads, pastas, cookies, etc. that are made with rice or oats or other grains that do not contain gluten. Because of this, GFD has become more popular. It has been touted as a “healthier” diet and as a “quick weight loss” diet. A brief Google search revealed many sites even by famous TV doctors recommending GFD as a healthy diet. However, the science does not support this. Processed GFD foods that are available at the market are higher in lipids, trans fats, sugar, salt, and cost. A medical journal called Gut Microbe published a study in 2010 that looked at healthy volunteers (they did not have CD) that were put on a GFD. These study subjects on a GFD had a decrease in the healthy bacteria in their intestines and had an increase in the unhealthy bacteria. They also developed decreased immune function. None of this is good for the person who does not have CD.
Recommendations: if you have symptoms of CD you should discuss this with your doctor and get tested for CD. If you cannot afford to see a doctor, there are direct to consumer tests for CD available on the market but they are not yet approved by the FDA. If you do not have CD you may still have gluten sensitivity. Many patients with irritable bowel syndrome have gluten sensitivity. If you have been diagnosed with CD or gluten sensitivity, you should be referred to a nutritionist that is knowledgeable about GFD so that you do not develop any of the complications of being on a GFD long term. If you do not have CD, remember, there are other conditions which may cause similar symptoms and you will need to continue to work with your doctor to make a diagnosis. If you are just looking to lose weight, avoiding bread may be beneficial because of the extra calories and carbohydrates but you do not need a gluten free diet per se. In fact, there are many better and easier diet plans available to you for weight loss.
Kimberly Merrifield, Race Director of the Pants on Fire 5K Beer Run and Walk, came into the studio on Friday to talk about the fundraising event this Saturday, June 28th.
Cathy Billings, Associate Director for Communications and Development at Lobster Institute, came into the studio on Wednesday to talk to Wayne about the fourth annual ALS Calendar Raffle to fund the Bangor Walk to Defeat ALS coming up August 23rd.
Memory Decline With Aging: Can It Be Prevented?
Healthy Living – June 24, 2014
Dr. David Prescott – Eastern Maine Medical Center Behavioral Medicine
In about 15 years, twenty percent of the American population will be over 65 years old. One of the most common concerns about aging is memory and whether memory difficulties are inevitable as we grow older. In addition, seniors want to know what, if anything, they can do to prevent memory loss.
Amy Badger of Bodies by Badger was in the studio for another Fitness Friday this week. She stopped in to speak to Wayne about sweating during your exercises, and how to effectively replenish yourself.
Amy Badger from Bodies by Badger was back in the studio on Friday for Fitness Friday. This week she was teaching Joy and Wayne some exercises you can do with gliders in your living room.
FDA Warning on Tanning Beds
Amy Movius MD
Late last month the FDA issued a Black Box warning requirement on sun lamps products – which include tanning beds. The FDA is tasked with protecting public health in different ways, including by assessing the safety of medical devices. A Black Box warning is the strictest warning label available.
This warning states:
Tanning bed use is contraindicated in anyone less than 18yrs
Tanning beds must not be used by people with skin lesions or open wounds
Tanning beds should not be used by people with skin cancer or a history of skin cancer
People who are repeatedly exposed to ultraviolet radiation require regular evaluation for skin cancer