By- Dr. David PrescottThe Tragedy of Lost Time: It would be almost unimaginable to think about breaking your leg and then waiting two years before you went to get it fixed. Yet, two years is the average amount of time that elapses before a person showing clear signs of psychosis receives any type of mental health treatment. Similarly, people diagnosed with bipolar disorder report that 9-11 years passed before they first experienced clinically significant mood swings, and the time they were appropriately diagnosed. Increasingly, the need for early intervention in treating mental health disorders is recognized as critical in minimizing the impact of severe mental illness. Here, we will examine early warning signs for three disorders that typically begin in mid to late adolescence: schizophrenia, bipolar disorder, and alcohol dependence. As with any health problem, if you are in doubt, talk to a psychologist, mental health professional, or your family doctor. 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 Bipolar Disorder: Bipolar disorder, or manic-depression, is characterized by repeated extreme mood swings. During a manic phase, people have excessive energy, grandiose idea, and elevated mood. These manic phases are often followed by sudden onset of depression, characterized by sadness, lack of motivation, and in some cases thoughts of suicide. While distinguishing normal from abnormal mood swings in teenagers is difficult, early warning signs may include: â€¢ History of biological relative with bipolar disorder. â€¢ Abrupt mood swings lasting from several hours to several days. â€¢ Explosive, lengthy periods of rage. â€¢ Hyperactivity, agitation, or distractibilityEarly Signs of Drug or Alcohol Dependence: Often, drug or alcohol dependence begins 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. Joan Marie PellegriniMost of us start thinking about our New Year’s resolution about this time of year. Common resolutions are to lose weight, eat more healthfully, get more organized, etc. The problem with many of these resolutions is that they are too vague and the goals are too lofty. Thus we set ourselves up for disappointment. This year I thought I would compile a list of resolutions that are easy to accomplish.Easy New Year’s resolutions:Advanced directives: On New Year’s day, set a date that you can sit down and address this issue. You will need to decide what you would want done medically if you were unable to make decisions. You will also need to decide who would make decisions for you in that situation. You should address whether you would want to donate organs and tissues if appropriate. You should discuss your decisions and concerns with your doctor at your next doctor’s appointment.Wear a seat belt: If you often forget, New Year’s Day is a good time to put a reminder note on your dashboard.Check smoke alarms: Set aside time on New Year’s Day to do this.Drive more politely: stop when a pedestrian is trying to cross the road. Stop at red lights. Give pedestrians and cyclists plenty of room. If you need a reminder, New Year’s Day would be a good time to put something on your dashboard that would serve as a reminder.Stretch: This cannot be done just on New Year’s Day but it doesn’t require a lot of work. Everyday, either before going to bed or maybe even at work you should do some gentle stretching. Being more limber will help prevent injury and help with chronic back pain.Buy a good pair of shoes: This may require consultation with a shoe sales person who can recommend the right shoe. Poor arch support and lack of appropriate orthotics can contribute to poor posture and back pain.Read my companies safety policies: If you have a job that puts you in danger on occassion, it is always a good idea to brush up on injury prevention.Go through medicine cabinet and throw out old medications: This will help prevent taking the wrong medication or the wrong dose.Update your list of medications: Make sure you have a copy in your wallet in case you need to go to another physician or the Emergency Room. Keep the name and number of your pharmacy on this list also.Check your blood pressure, cholesterol, make appt for checkup: When is the last time you had a health check up?Get vaccines updated for you and your children. This includes the Flu vaccine.Buy and read Unclutter Your Life In One Week: Or, read one motivational book.Go to church this weekend: for some people this can be a stress reliever.Sleep more: Most of us do not get enough sleep. Make sure you get quality sleep. Being well rested leads to bet productivity at work and healthier lives.Be nicer: Studies show that “nice” people are more relaxed and have better performance in their jobs. Being relaxed will help with any health issues also.Eat something healthy each day : I think this is easier than giving up something.Teach children brushing/ flossing: Make is a family routine to have better dental care.Buy a fiber supplement and take it daily: It is easy to remember if it is near your toothbrush or morning coffee. Most of us have inadequate fiber intake. Higher fiber diets help prevent many medical conditions.Take a vitamin supplement: Your physician can help you decide which one is best depending on your other medical conditions. As we head into winter, many of us could benefit from some extra vitamin D.These are just a few ideas. I am sure there are many other good ideas that can be accomplished in just a few days or less.
By- Dr. Amy MoviusKids love toys! And who doesnâ€™t love seeing the excitement and joy of a child playing with a well loved one? Anyone with a child on their holiday list has probably noticed there is a seemingly endless array of toy choices these days. Not surprising when you consider there are an estimated 3 billion toys sold yearly in the United States.Toys arenâ€™t all fun and games, however. Despite mandatory and voluntary safety standards, not all toys are created (literally) equal. In 2009, at least 12 children died from toy-related causes, and more than 250,000 â€“ a quarter of a million â€“ were treated in emergency rooms for toy-related injuries. WATCH (World Against Toys Causing Harm) is an organization devoted to raising awareness and providing information for consumers to use when purchasing toys. They also publish a â€œTop 10 Worst Toysâ€ list yearly. This list is by no means inclusive, but it does illustrate many hazards of currently available toys which unfortunately, are not new. These include (1) choking from small parts (2) strangulation from ropes/cords (3) impact or puncture injuries from rigid/plastic parts (4) electrical injuries and (5) items marketed as toys that shouldnâ€™t be. Some examples follow:1. Choking Hazards 16 of the toys recalled by the CPSC in the last year were because of choking risk related to easily detachable small parts or affixed small parts that easily break. The children most at risk are quite young because they are very oral in their behavior. However these detachable or affixed pieces are not necessarily considered â€œsmall partsâ€ by the toy industry and so may not be labeled as such. 2. Strangulation HazardsThese can result from necklaces, cords, ribbons, etc that can be wrapped around a childâ€™s neck, including items such as guitar straps. The industry standard for maximum cord length for toys designed for cribs or playpens is 12 inches. However there are pull toys (including one of the 10 worst list) marketed for these same very young children with much longer cords.3. Impact/Puncture injuries from rigid partsOne of the toys on the â€œworstâ€ list illustrates this point very well. It is a popular movie figure holding a 4 Â½ inch rigid plastic sword that activates when a lever is pushed. It is marketed to children over 3 and there is a warning of small parts, but no mention of the (obvious) risk of eye/impact injury.4. Electrocution. Sometimes electronic toys, with heating elements, are labeled for children as young as 8 5. Toys that Arenâ€™t ToysAir powered rifles are the prime example. They are actually weapons and not recommended for anyone less than 16yrs. Warning labels, while useful, are not a sole reliable means for determining a toyâ€™s safety. Some warning labels consist of removable sticker labels and others omit some risks or contain warnings that are impossible for the marketed child to adhere to. Examples include:1. A foam bow and arrow, for ages 8 and up, whose warning states bow should not be pulled back at â€œmore that half strengthâ€ and â€œanyone at close distance to the target should be alertedâ€.2. A trampoline, for age 3 and up, whose â€œonly function is for controlled bounce (exercise) in young children.3. An action figure, for ages 4 and up, with a flip open blade up to 2 feet that warns â€œdo not aim toy at anyoneâ€¦do not hit anyone with toyâ€¦do not poke anyone with toyâ€¦do not swing toy at anyoneâ€. How exactly do they envision these toys being used? In some instances, the marketing seems solely targeted at protecting the manufacturer, not the children using it.Likewise, toy recalls are too little, too late. They occur after a marketed toy has been shown to cause harm â€“ i.e. children have already been hurt. Many consumers are never aware a recall notice has been issued for a toy that is in their home. In the past year, there have been at least 28 toy recalls, accounting for over 3.8 MILLION dangerous toys in circulation in the US alone. There are no particularly safe brands or stores either. A quick scan of the CPSC’s list of recalled toys includes items found on the shelves of big-box stores, specialty stores, and dollar stores alike. In the end, families and friends must carefully examine the toys we buy for children, considering the specific toy as well as the nature and maturity of the child for whom it is intended. It is always the season for safety.References1. http://toysafety.org/worst ToyList.shtml2. http://www.cpsc.gov/cpscpub/prerel/catagory/toy.html3. http://www.medscape.com/viewarticle/753842
By- Dr. Anthony NgChristmas holidays are upon us. It is filled with joy, celebration, anticipation of getting together with friends and families. For also many, it is a time of enormous stress, thinking about what to do for the holidays, who to buy gifts for, where do I go to get those gifts, online or waiting in long lines in bad weather as many did for Black Friday. If one is not careful, the stress of the holidays can quickly overwhelm folks and in turn make this holiday season not very fun and enjoyable.First of all, we need to understand what is meant by stress. Whenever we hear the word stress, we only think of negative aspects of it, such as too much to do at work, too many obligations at home, relationship issues, etc., but there are other positive aspects of life that can be â€œstressfulâ€, such as holidays, getting a raise or promotion, going on a first date, or getting married. As joyful and exciting as these events, they are still causing what have been described as positive stress. It is stress that is sustained, uncontrollable and overwhelming, where people canâ€™t figure out options to solve their problems, that is damaging.When a person experiences stress in whatever forms, they may have anxiety, frustrations, happiness and joy or anger. We often tried to cope by various things such as relaxation, reading a book, exercises, spirituality, seeking support from friends and families to name a few. And for those who faces constant stress, they may develop potential negative coping strategies that may include overworking, arguing more with families, friends and colleagues, smoking more, drinking and in some instances using illicit drugs. We process stress in three ways, how we feel emotionally, how we feel physically and how we think. This falls back on the basic principles that human, like all animals, are born with, the â€œFright or Flightâ€ response. When an animal sees a threat from a predator, the brain processes the threat. The brain then attaches an emotion to that threat, such as fear or anger for example. The body then reacts to the threat, either by running away or by fighting it. We humans have evolved enough to now have threats or stresses that are not as visible. Nonetheless, we still behave in a way how our body is genetically imprinted with. We experience a stress. We then interpret the threat in a variety of manners. We then attach emotions to that stress and then our brain instructs our body to respond accordingly. Our body would respond for example by increasing more adrenal hormones to prepare the body for its responses, such as increased heart rate, breathing, muscle tensing to name a few.Our body is designed to handle short bursts of these stresses. We have chemical and hormonal changes to deal with stress. A well know chemical is the stress hormone cortisol which is increased and it leads to an increase of another chemical, adrenaline. The body gears up immediately in the face of stressful stimuli. It goes to our energy stores, and releases glucose and insulin so that our muscles have the energy to deal with the stress.These body chemicals are sustained at high rates to compensate for the stress, and as such, they can impact the body adversely over time. Additionally, the choices we make to handle this stress can influence how those stress hormones affect us. Drugs like alcohol, nicotine and cocaine, and also high-fat, high-calorie comfort foods, are powerful modifiers of the stress system. They will change our stress pathways and affect the way your body is able to control our stress response. And so, after a period of bingeing, our bodyâ€™s stress response system eventually wears out. However, folks will continue to take those drugs and alcohol to compensate a weakened system. This is often what we see in addiction. Research shows that childhood stress can hardwire the brain for a lifetime of higher stress levels. Early traumatic experiences can increase childrenâ€™s susceptibility to a range of high-risk behavior, such as tobacco use, binge eating, and earlier onset of alcohol consumption. It is important to keep in mind that children who see their parents stressed out during the holidays will inherently respond with their own stress and mimic parental stress responses, both good and bad ones.Does that mean we cannot revitalize our stress responses such as the adrenals? In fact, our body is forgiving and they can recover when we take away those toxins. What is not clear is how long that process takes. The problem, though, is that while your adrenals are still recovering, you are more likely to be stressed. And stress affects abstinence and increases chances of a relapse. So then we are caught in a vicious cycle of quickly degenerating health because both the stress and the substances are working together to wear down our body systems and our stress axis, our liver, kidney, heart, blood pressure. All this can also lead to certain types of cancer.We donâ€™t really know which comes first, but we do know that these are all complex multi-factoral diseases. That means they donâ€™t have one single factor that leads to the disease state. And there are factors that can make a person even more vulnerable to stress-related diseases and addiction: early trauma suffered in childhood, cumulative adversity, socio-economic status, education and also things like genetics and personality traits.In addition to the holidays, we live in a society where there are multiple demands on us almost all the time. We need to put greater emphasis on protective factors like sitting down with the family or exercising or putting away all the electronic devices. We also need to focus on mindfulness which we all do in some form or another. Having hobbies is one as well as relaxation. They all provide healthy distractions on stress and allow us to focus on oneself.So as you struggle to find the best bargains, what meals to prepare and who to invite for the holidays, you should take a moment to remember what the holidays is about. It is to share joy with friends, families and others. Make sure you take breathers in your busy schedules to practice stress reductions techniques, such as sitting down at the mall and taking a breather and to relax. Prioritize what you need is an efficient and healthy way to cope. Drink alcohol in moderate amounts. Donâ€™t forget to continue your hobbies and exercises. Remember, your families and friends want you around for many more holidays to share the joy. Happy holidays !!! Reference: CNN Blog: The Vicious Physiology of Stress by Amanda Enayati 11/26/11WedMD Feature: Tips for Overcoming Holidays Anxiety and Stress by R. Morgan Griffin 12/5/2011
Should children with asthma avoid acetaminophen? (Tylenol)By- Dr. Jonathan WoodThe incidence of pediatric asthma increased dramatically between 1980 and 2000. During that same time period, the association between aspirin and the severe neurologic disease, Reye’s Syndrome, became apparent. Consequently, the use of acetaminophen, a non-aspirin pain reliever/fever reliever, increased dramatically.Increased incidence of asthma and increased use of acetaminophen – – is there an association? Perhaps. We, as yet, have no satisfactory explanation for why pediatric asthma incidence has risen and then seemed to level off. The leveling off, by the way, coincides with the leveling off and acceptance of acetaminophen as the primary analgesic/antipyretic in children by the mid-late 1990′s.This coming month, in the journal Pediatrics, John McBride MD, a prominent pediatric lung specialist and researcher has pulled together this data and many other alluring studies to make a strong case that the use of acetaminophen (1) may well be responsible for the increased incidence of asthma and (2) may correlate with increased severity of asthma. The argument is strong and comes from a valid and respected source.For example:Â· An enormous worldwide epidemiologic study looked at more than 500,000 children with asthma and concluded the following:o Children 6-7 yr old using acetaminophen monthly had more than 3-fold increase in asthmao For 13-14 yr olds, it was close 2.5 times the incidenceo For less frequent use (less than monthly, but at least yearly) the increases were still 1.6 and 1.4 times respectively.Â· Other studies have corroborated this data in a variety of cultural, socioeconomic, and geographically diverse settings.Â· Several adult studies apparently demonstrate similar findings These are associations, not proof of causation. Nonetheless, they are worth consideration.And what about asthma severity? Prospective studies have been done comparing acetaminophen (Tylenol) and ibuprofen (Advil) in the context of asthma severity. Again, these suggest an association between more severe pediatric asthma and acetaminophen use: those kids using actaminophen had more severe disease than those using ibuprofen. Unfortunately, no study has ever looked at this with a placebo control, the good standard. Still, while we wait for that, the current data is alluring.What if we could reduce the use of something that would, if eliminated reduce asthma incidence in the population by 35-45 percent? Would we act on this? Yes. How simple would it be for children with asthma to avoid acetaminophen whenever possible? Easy. Are there viable alternatives for most circumstances? Yes. Ibuprofen is one.Would there still be times when the use of acetaminophen is warranted? Yes.My advice? 1 – Keep your eyes open. This issue is going to be discussed more and more.2 – Consider limiting or eliminating acetaminophen use if you or your child has asthmaFever? 1 – Why are we worrying so much about fever anyway? Fever is generally not a bad thing.2 – Review “The Truth About Fever” in the Healthy Living archive.
By- Dr. Jonathan WoodMy work with children and teens with Type I Diabetes Mellitus and its life-threatening acute complications has led me to realize there is quite a bit of confusion about what diabetes is and what the differences are between the two main types. This is important stuff.The confusion is understandable. We use the same word to describe 2 different diseases. Related, yes, but really quite different. Type II or Adult Onset diabetes used to be a disease of older people and generally of overweight people. While it was always a fairly common disease, it has become much much more common in recent years. Many debate the reason for the increased incidence of Type II diabetes, but certainly it is related to some degree to the increased incidence of obesity in the US. And, as we see more and more young obese people, including many children, Type II diabetes has started to occur in younger and younger people. You see where I’m going here – – the terms Juvenile Onset and Adult Onset no longer apply and the crossover has fueled the confusion.Both Type I and Type II diabetes result in high blood glucose or blood “sugar”. That said, the way this happens and the consequences of this is somewhat different in the two diseases.What are the underlying problems in these 2 diseases?Type I Diabetes: lack of insulin. The pancreas stops making insulin. Insulin is critical to the body’s ability to manage and use the fuel glucose. Without insulin, paradoxically, the body tissues can’t “see” all the glucose accumulating in the bloodstream. They therefore turn to different pathways to produce fuel, which causes acute and often severe illness.Type II Diabetes: resistance to insulin. There is insulin, but the body doesn’t recognize it.The body makes insulin, but the tissues can’t “see” the insulin properly. The tissues are partially resistant to the effect of insulin and hence the blood sugar rises.The long-term consequences of high blood glucose (sugar) are largely the same in both diseases. (e.g. eyesight problems, kidney problems, peripheral nerve problems, increased infections)But, additionally, the complete absence of insulin in the Type I diabetics creates a scenario for life-threatening acute problems if day-to-day insulin management isn’t well understood and maintained carefully. This is generally not the case in Type II diabetes.If you have diabetes or a family member with diabetes, learn about their type of diabetes. If you have a young child or teen or grandchild or niece or nephew with diabetes, it is probably Type I. It needs to be well understood to safely provide for that child or teenager.If someone has Type I Diabetes, they need to have insulin given to them at all times. Learn about this! Most of the insulin given is to allow them to handle ingested foods, but a common misconception is that “if they don’t eat anything, they don’t need insulin”. This is a dangerous misconception. Yes, if they are sick or vomiting and not eating, a Type I diabetic needs less insulin, but they still need insulin. To give none is to risk the life-threatening complication of ketoacidosis. The rules governing this important situation are called “sick day rules” – – learn about them.Type I diabetics can lead full and productive lives. They can do all the things that other children can do, but they need to be safe and have family members that understand their disease.A good online review of all this can be found on Wikipedia: http://en.wikipedia.org/wiki/Diabetes_mellitus
American men have about a one in six chance of getting prostate cancer and are especially vulnerable as they get older. But a panel commissioned by the U.S. Government recommends against screening for it. TV5 Health Advisor Dr. Erik Steele joined Jim Morris on TV5 News at 5 to talk about it.
Uncontrollable, violent coughing is one of the key symptoms of whooping cough. It’s highly contagious, also highly preventable. TV5 Health Advisor Dr. Jonathan Wood joined Jim Morris on TV5 News at 5 to help out.
By- Dr. Amy MoviusThere has been a lot of attention in the press lately regarding a certain vaccine. Unfortunately, what should be a cut and dried health issue can be politicized and otherwise distorted: bluntly stated, politicians and newscasters are probably not the best dispensers of medical advice (sorry WABI!).In approaching the subject of vaccinations, I opted to start with what I believe to be 2 undisputed truths:1. We all want what is best for the children in our lives.2. Doctors and other health providers come from a variety of political, religious and cultural backgrounds.Starting from these two assumptions, there is really very little controversy among medical professionals about the benefit and safety of vaccines. A quick look back in time illustrates the benefits. For example, before vaccine availability in the United States in the 1940s, there was an average of 175,000 cases/year of pertussis (whooping cough) or 150 cases/100,000 population. In the 1980s, there was an average of 2,900 cases per year or 1 case/100,000. In 2008 this was up to 13,278 cases. This is in part due to decreased vaccination rates. Unfortunately, in this example, the youngest among us suffer the most from severe illness and even death. Of the 181 pertussis deaths from 2000-2008, 166 were in children less than 6 months of age. All infants of this age are vulnerable to pertussis as vaccine immunity is not fully established until after 6 months of age (vaccine given at 2, 4, and 6 months). These most fragile among us must rely on not being exposed to avoid disease, which in turn depends on the immunity and vaccination status of the population at large. This does not mean that side effects from vaccines donâ€™t exist. They do, and fortunately most of them are mild (pain/swelling at site). Also, some health problems coincidentally overlap with receiving a vaccination – they are unrelated except in time. However, in the US it is not expected that we vaccinate our children on faith alone. There is an organization that REQUIRES reporting of all possible adverse vaccine effects by health professionals and vaccine manufacturers. However, ANYONE can choose to make a report, including a patient (or a parent). Also, the results are public, so EVERYONE can access this information. The sole function of this organization, VAERS (Vaccine Adverse Events Reporting System), is to constantly process and analyze this data for the purpose of public safety. Because of this process, in 1999 the rotavirus vaccine was removed and then replaced. VAERS receives about 30,000 reports every year: 85% involve mild symptoms, 15% of the reports are more serious. Both of these numbers reflect possible vaccine related events, NOT definite vaccine caused events.Vaccinating yourself and your family is not a small matter. It can be very confusing with all the information â€“ and misinformation â€“available. Consider discussing it with a health provider you know and trust. The goals you share should be simple: to keep you and your family happy and healthy.Referencesvaers.hhs.govwww.cdc.gov/features/pertussisdiseases.emedtv.com/whooping-cough/whooping-cough-statistics
By- Dr. David PrescottAbout 1 in 30 people experience Post Traumatic Stress Disorder (or PTSD) in a given year. That risk increases over a lifetime, with 1 in 10 women, and 1 in 20 men, experiencing PTSD at some point in their life. Sadly, many events the past decade have provided psychologists and other mental health professionals with a number of opportunities to learn more about the causes and treatments for post-traumatic stress disorder, or PTSD. More optimistically, knowledge of how to more effectively understand and treat Post Traumatic Stress Disorder has also improved. How is PTSD Diagnosed? While many people feel temporarily depressed or anxious after a very upsetting or traumatic event, Post-Traumatic Stress Disorder involves a number of characteristic behaviors and experiences. First, the trauma must be outside the realm of normal stressful events. Examples would include being exposed to a situation with a true threat of death or serious injury, or a serious violation of a personâ€™s space and body. Symptoms of Post-Traumatic Stress Disorder are typically grouped into 3 categories: 1. Re-experiencing symptoms: Examples of these symptoms include flashbacks, bad dreams, or intrusive frightening thoughts. Words, objects, or situations that are reminders of the event can trigger re-experiencing.2. Avoidance symptoms: Avoidance symptoms include staying away from places or events that are reminders of the experience, feeling emotionally numb, having trouble remembering the dangerous event, or losing interest in activities which used to be enjoyable. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.3. Hyperarousal symptoms: People with PTSD are easily startled, feel tense or â€˜on edgeâ€™, and often have difficulty sleeping or have angry outbursts. In all cases, to be diagnosed with PTSD the symptoms must persist for more than one month after the traumatic event. Does Everyone Exposed to a Traumatic Event Develop Post-Traumatic Stress Disorder?It is difficult, if not impossible to specifically identify which people exposed to a traumatic event will develop PTSD. What we have learned is that the determining factors in the development of PTSD include some factors which increase the risk, and protective factors which decrease the risk. Protective, or Resilience Factors, Include: â€¢ Seeking out support from other people, such as friends and family â€¢ Finding a support group after a traumatic event â€¢ Feeling good about oneâ€™s own actions in the face of danger â€¢ Having a coping strategy, or a way of getting through the bad event and learning from it â€¢ Being able to act and respond effectively despite feeling fear.Factors Which Increase PTSD Risk Include: â€¢ Having a history of mental illness â€¢ Getting hurt â€¢ Seeing people hurt or killed â€¢ Feeling horror, helplessness, or extreme fear â€¢ Having little or no social support after the event â€¢ Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.What Treatments Are Available for Post-Traumatic Stress Disorder? Many, although not all, people who receive treatment for Post-Traumatic Stress Disorder experience some improvement. Statistically, about half the people with PTSD no longer qualify for the diagnosis after one year. There are both short term and long term strategies for coping with PTSD. Short Term Strategies: Short term strategies, immediately after a traumatic event, are really designed to prevent symptoms of PTSD from occurring in the long run. These strategies include: â€¢ Getting immediate support from friends or family. â€¢ Finding a support with others who had the same or similar experiences. â€¢ Finding a way to learn from the event. Longer Term Strategies: â€¢ Counseling: Focused counseling on managing anxiety and changing thinking patterns which increase or perpetuate fear often help. This type of therapy is often termed Cognitive-Behavioral Therapy. â€¢ Medication: Medications are often used to reduce the symptoms of depression and anxiety that go along with PTSD. â€¢ Group Therapy and Support Groups: Particularly after a traumatic event, being with other people who went through the same thing helps reduce the risk of long term problems. MORE INFORMATION: American Psychological Association: http://www.apa.org/topics/ptsd/index.aspxNational Institute of Mental Health: http://www.nimh.nih.gov/healthNational Alliance for the Mentally Ill: http://www.nami.org/
By- Dr. Joan Marie PellegriniAmericans consume about twice the amount of salt that is recommended in our diets. This is approximately a doubling of the amount we consumed forty years ago. We cannot live without salt. Salt contains sodium which is vital to many cellular functions. However, eating more salt than we need can lead to high blood pressure (hypertension). Hypertension is known as the silent killer because there are rarely any symptoms. Also, we do not check our blood pressure except when we visit a doctor. Over time, hypertension can cause heart disease, stroke, and kidney failure among other problems. It is estimated that even a small reduction in our salt intake will dramatically reduce our risk of these diseases.The New York City Department of Health and Mental Hygiene is coordinating a national effort to prevent stroke and heart attack by reducing the amount of salt in packaged and restaurant foods. Only about 10% of our daily salt intake comes from our salt shaker. About 80% comes in processed foods. The American Heart Association and the American Medical Association are also fully supportive of this national effort and have guidelines for salt reduction. The good news is that many large national companies have signed on to the initiative and have pledged to reduce the amount of salt in their products. What should you do to decrease your salt intake? Most of us can name the obvious offenders: potato chips, salted nuts, soy sauce, etc. Unfortunately, there are hidden sources in the foods we buy. A quick visit to the sodium chart from the USDA will show you that one slice of wheat bread from a national chain may contain almost 10% of your daily allowance. That means that the most important thing we can do is look at labels in the grocery store. Buy the brand of food that has the least amount of salt if you can. There are some items that will have a lot of salt no matter what brand you buy: canned soup or dry soup comes instantly to mind. In general, you should aim for a maximum of 2000 mg of sodium a day. If you are eating out, you will not be able to know which food has the lower salt content unless you ask the chef or wait staff. Even then, they may not know. This is why the national initiative would like restaurants to list sodium content on their menus and also to reduce sodium in their offerings.Even though sodium is ubiquitous and hidden in our foods, the good news is that even a small reduction in our intake will give us benefit. The other good news is that there is a national initiative for food manufacturers to decrease the amount of salt in their products and to provide labels to help us know how much salt we are consuming.References:http://www.time.com/time/health/article/0,8599,1884864,00.html Time Magazine printed this article in March 2009 and it is an easy read. It also has the link for the Sodium chart from the USDA.http://www.nyc.gov/html/doh/html/cardio/cardio-salt-initiative.shtml This site has links for Institute of Medicine report on public health priorities to control hypertension. It also has the link for the journal article that is heavily referenced in the Time Magazine article (Bibbins-Domingo K, et al. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease in NEJM 1010: 362.)
TV5 Health Advisor Dr. Erik Steele joined Carolyn Callahan on TV5 News at 5 to talk about “Nerve: Poise Under Pressure.” A book written by Taylor Clark focusing on anxiety.
Teething: Not a source of fever and not an explanation for symptoms of illnessBy- Dr. Jonathan WoodTeething continues to be offered as an explanation for fever or as a reason for a variety of symptoms in infants and young children. An important study published in the September 2011 issue of Pediatrics elegantly dispels this misunderstanding. Researchers (pediatric dentists) visited non-daycare infants repeatedly in their homes and gathered data: symptoms reported by mothers, oral exams, and infant temperatures. This was an excellent study for a variety of reasons: the oral exams were performed by experts, the temperatures were taken by the examiner by two different methods, the exams occurred daily over a period of weeks to months and therefore generated detailed data around the eruption of multiple teeth in each child and over 230 teeth overall.The conclusions:Â· Teething does NOT cause fever (before, during, or after tooth eruption)Â· Minor increases in temperature (less than 0.3 degree F) occur on the day of and the day after eruption, but it is negligible and occurs within the range of normal temperature variationÂ· Minor symptoms – sleep disturbance, irritability, increased saliva, rash, loss of appetite, diarrhea – can occur in the day of and day following eruption. But again, these symptoms are not of a severe nature.Why is this important?Â· Doctors and parents should not invoke teething as an explanation for fever, even low-grade fever. Â· Nor should they invoke teething as an explanation for severe changes in activity or behavior. Â· When teething is used as an explanation for these findings, parents and doctors alike can delay the diagnosis of a more serious illness. In young infants especially, this is important: a true fever can be the only signal that a severe illness is developing and the immature immune system of the infant makes prompt diagnosis and treatment particularly important.What can be done about teething?Â· “Teething tablets” and anesthetic gels are not recommended. Parents can inadvertently deliver toxic amounts of the active ingredients and should avoid these products. They have also never been shown to be effective.Â· Teething rings have been shown to be useful and effective.Â· Gently massaging an infants gums often helps and satisfies the infants urge to chew on somethingFor more information of teething and care for a child’s early teeth, visit the American Academy of Pediatrics’ “Healthy Children” website http://www.healthychildren.org/English/Pages/Register-Email.asp It requires a free registration, but is full of much useful information for parents.
A Newer, Safer Permanent Contraceptive Option for WomenBy- Dr. Joan Marie PellegriniWhen a woman is certain that she no longer wants the option to get pregnant, she has a choice of continuing on with her current contraceptive method or considering a surgical option. The most common choice for permanent sterilization is a tubal ligation (getting her tubes tied). A tubal ligation offers the benefit of being highly successful, relatively safe, and permanent. It is immediately effective and allows for a woman to discontinue her â€œpillsâ€. The pill is hormonal based and there are many women who are at risk of complications if they take hormones. These complications include blood clots, stroke, and increased risk of certain cancers. Because a womanâ€™s fallopian tubes are inside her pelvis, tubal ligation would require anesthesia, at least one incision in the belly, and must to be done in the operating room. The recovery time is several hours in the procedure center and then 1-3 days at home. Some women are not candidates for this procedure because of anesthetic or surgical risks.In 2002, the FDA approved a new procedure called Essure. This procedure is done in the doctorâ€™s office and requires no anesthesia. The doctor inserts coils into the fallopian tubes and these coils cause scarring and blockage of the tubes. The woman can drive herself home or to work after the procedure and there is minimal discomfort. Some other form of contraception (pregnancy prevention) must be used for 3 months after the procedure until a hysterogram (an xray using dye of the uterus) is done to confirm that the tubes are blocked. Many experts feel this procedure is safer than tubal ligation and has a similar failure rate. Neither of these procedures is 100% effective however, the failure rate is extremely low and better than that with hormonal manipulation (the pill).A quick look at the Essure webpage reveals that there are at least 6 gynecologists in the Bangor region that perform this procedure. Clearly, this procedure is becoming well-endorsed by the gynecologic community. There is one another hysteroscopic method that is FDA-approved. It is likely that in the future there will be even more options available and your gynecologist will advise you on which one is best for you.Permanent sterilization procedures should be considered irreversible. Studies show that 3-25% of women eventually regret having a sterilization performed. For more information:www.essure.com This site is supported by the company that makes the coils.http://www.uptodate.com/contents/patient-information-permanent-sterilization-procedures-for-women This site is not industry-sponsored and is an excellent source for non-biased information on sterilization procedures. There are also other excellent resources listed.http://www.americanpregnancy.org/preventingpregnancy/birthcontrolfailure.htmlThis site offers information on all of the methods used to prevent pregnancy. This site is not industry-sponsored.
By- Dr. David PrescottProgress Has Been Made on Suicide Awareness: Thanks to efforts of many groups such as the American Foundation for Suicide Prevention and, more locally, the Maine Youth Suicide Prevention Program, public awareness about suicide and suicide risk factors has improved. However, suicide continues to be a leading cause of death in the United States, and helping people cope with suicide continues to be a significant public health issue. Who is Most at Risk for Suicide? Suicide is the 4th leading cause of death in America for people between the ages of 18 and 65, and the 11th leading cause of death overall. Older adults (75 plus) and adolescents/young adults (15-24) continue to have high rates relative to other causes of death. However, the latest statistics available (through 2007) show a recent increase in overall suicide rates. Most people, about 90%, who commit suicide have a diagnosable psychiatric disorder. Most common are the mood disorders like major depression or bipolar disorder. People who have substance abuse disorders (alcohol or drug abuse and dependence) are also at high risk. What are Warning Signs for Suicide? One of the more common myths about suicide is that people who try to commit suicide do not tell anyone of their thoughts and plans. To the contrary, most people who attempt suicide have talked about it. Any talk about a suicide plan should be taken seriously and the person with the plan should be seen by a mental health professional or call a mental health crisis line. Common warning signs of signs of suicide include: Â· Observable signs of depression such as unrelenting low mood, hopelessness, and social isolation. Â· Increased alcohol or illicit drug use. Â· Recent impulsiveness or unnecessary risk takingÂ· Expressing a strong wish to die Â· Making a suicide plan or giving away important possessionsWhat to Do if You Know Someone Who is Considering SuicideIt is important to realize that no one thing that a person does, or fails to do, makes the final determination about a suicide attempt. Try your best to help, but remember that there are many factors involved in a suicide attempt. Good first steps include: Listen Attentively: Just listening to someone can provide important support and begin to help them feel better. Tell them you are concerned, and find out if they see a mental health professional. Encourage Professional Help: If the person is not seeing a mental health professional, encourage them to do so. Types of mental health professionals include psychologists, psychiatrists, social workers, and licensed professional counselors. You may be able to help them follow through on making a call or keeping an appointment. Mental Health Crisis Lines: Maine like most states has crisis phone lines to help people who are considering suicide. You can call 2-1-1 or 1-888-568-1112. Coping with a Completed Suicide: If someone you know has completed suicide, it is important to talk about it. There are support groups available where you will meet other people struggling with the same issue. It is common to immediately feel shock or numb. This is often followed by feeling sad and depressed, guilty, and angry. For More Information: American Society for Suicide Prevention: www.asfp.org Acadia Hospital: www.acadiahospital.org
Lawn mowers are real useful this time of year, but they can also be very dangerous if used improperly. TV 5 Healthy Advisor Dr. Jonathan Wood joined Jim Morris on TV5 News at 5 to help keep your yard work safe.Almost 80,000 times each year people check into Emergency Departments for lawnmower injuries. More than 9,000 of those victims are children, despite the fact that the American Academy of Pediatrics strongly warns against children being anywhere near lawnmowers, much less operating them. Walk-behind mowers result largely in extremity injuries, while riding mowers often include injuries to other parts of the body, including the head and torso.How can you reduce the risk of serious lawnmower injuries to children? Here are a few common sense ideas, as well as some others you may not have considered. 1. A lawn mower is a dangerous tool. The energy of a mower blade is three times the muzzle energy of a .357 Magnum pistol, one of the world’s most powerful handguns. The blade can throw a piece of debris, like a stone or piece of wire, at speeds up to 100 miles per hour. The result – one fourth of all hand and foot injuries caused by mowers include amputations of fingers, toes, hands, or feet. And the injuries are messy and complicated.2. Children should never ride a mower with an adult. Each year a number of children suffer severe, and in some cases fatal, injuries after falling off a mower and then being run over.3. The American Academy of Pediatrics recommends that a child be at least 12 years old before operating a power push mower, and be at least 16 to operate a riding mower. These age recommendations assume that the child is large enough to physically handle the equipment. Careful instructions and review of the operating manuals should be part of the routine of teaching a child or teenager how to use the mower. Ignorance is an accident waiting to happen.4. Children should not be around a yard being mowed. Debris thrown by a mower can easily cross a yard and strike a child. Additionally, mower noise prevents operators from hearing the usual cues that children are near. Subsequently, 5 percent of lawnmower injuries to children occur when the mower backs over them because the operator does not see them. So – – clear the yard before mowing, of both debris and of children. The American Academy of Pediatrics has issued strongly stated advice about how to best prevent injuries from lawnmowers. Please refer to the following web page for a nice synopsis: AAP Safety TipsBe safe! Donâ€™t bend the rules when it comes to lawn mowingâ€¦ the risks are too great!By- Dr. Jonathan Wood
Staying hydrated in the heat it’s something we all need to do. TV5 Health Advisor Dr. Erik Steele joined Carolyn Callahan on TV5 News at 5 to talk about it.
NOISE AND MENTAL HEALTH: Is chronic noise more than just a nuisance? HEALTH WATCH â€“ July 5, 2011David Prescott, Ph.D. â€“ Acadia HospitalWhy Worry About Noise? In much of Maine we are thankful for our ability to step outside of our homes and hear almost nothing. The peace and quiet of the majority of Maine communities is a benefit of living here. But, for many people across the nation and the world, chronic noise is not only a nuisance but a significant hazard to mental and physical health. The World Health Organization recently reported that over 1 million health years of life are lost each year due to ill health, disability, or early death due to traffic related noise. While most research has been done on the impact of noise that is difficult to control, like traffic or airplanes, there is mounting evidence that trying to reduce the amount of everyday noise in our lives can have important health benefits. How much noise is too much? Noise is measured in weighted decibels. The recommended noise level in a bedroom to help with good sleep is no more than 30 decibels. In a classroom, the ideal level of noise for learning is less than 35 decibels. Standing next to a vacuum cleaner is usually rated at about 70 decibels. While studies of American cities are still not completed, recent research found that about 40% of people in Europe live in a place where traffic noises are at an average of 55 decibels. Noise and Mental Health: The impact of chronic noise on mental health is not quite direct, but not hard to follow. Our bodies react to chronic high levels of noise with responses such as: â€¢ Increased production of hormones that are released in response to stressâ€¢ Decreased sleep. â€¢ Increased blood pressurePoor sleep and chronic stress response are clearly tied to increased risk for depression, anxiety disorders, and a variety of mental health disorders. Also, being in an environment with chronic stress, such as high noise levels, make it harder to recover from health and mental health problems. For example, preliminary research suggests that high noise levels in acute care hospitals is associated with slower progress in recovering from an illness. Noise and Development in Children: Exposure to high levels of chronic noise appears to slow the cognitive and learning development of children. Naturalistic studies of children who live near airports shows a decline in reading levels and long term memory associated with chronic noise. Interestingly, a group of children who had chronic noise removed, due to relocation of airports, showed improvement in the same tests of reading and memory. Are there any simple steps that can be taken to reduce the impact of noise? Obviously, people have limited ability to control things like where airports and roads are built. However, becoming aware of noise levels that you can control may have important health and mental health benefits. Some examples might be: o Consider turning off televisions and stereos in your home that are on â€œall the time.â€ o Be sure to reduce noise levels in the house when children, and adults, are sleeping. o If you work at home or your children study at home, consider setting aside agreed upon times for quiet, when radios, movies, and television are turned off. o Simply being aware of reducing your voice level may help, particularly if someone in your home is recovering from illness or mental illness. For More Information: American Psychological Association: www.apa.org/monitorWorld Health Organization: www.euro.who
By- Dr. Joan Marie Pellegrini It is that time of year and the lakes are warming up. As the temperatures rise, we will be spending more time in the water. Because of this, a few of us will get Swimmer’s Ear. This is an infection of the external ear canal that causes pain, itching, a wet and full feeling in ear, pain with jaw movement, drainage from the ear canal, and sometimes neck soreness (from swollen nodes). The CDC estimates that more than half the cases in this country are in adults. So this is not just a problem for children. The most important risk for swimmer’s ear is the duration of exposure of the canal to water that is contaminated. The water from lakes, oceans, and pools all carry risk. I would have thought that a chlorinated pool would be safer. However, this is not true. The chlorine in a pool causes irritation in the canal by accelerating keratin degradation (keratin is found in the protective layer of cells lining the canal) and actually increases the risk of swimmer’s ear (Medscape). So, what can you do to prevent this? First, I should mention some things that you should not do. Don’t try to clear the ear canal before swimming. The ear canal has a natural mechanism of moving wax and dead cells from the inside to the outside. Attempted cleaning can irritate the canal and make infection more likely. Never insert anything into the ear canal. Lots of swimming can wash away the protective wax coating in the canal. In order to protect the skin in the canal, you may use a mixture of vinegar and isopropyl alcohol. Place 2-3 drops in ear canal before and after swimming. If you are particularly prone to this type of infection you may try using ear plugs when swimming. Specialized petroleum coated plugs are available. However, you must avoid getting an accumulation of petroleum in the canal which could block the water that gets in from draining back out. When you get out of the water, try emptying any water in the canal by tilting the head to each side. Pulling on the ear lobe can help empty the water. Also you may use a hair dryer on the lowest setting. Once you have the infection, there are drops that can be prescribed to treat the infection. By no means should you try to clean out the ear canal with anything (including cotton-tipped swabs). If you are on vacation and will need to fly home, you should strongly consider seeking medical attention promptly so that the infection can be optimally treated. This is because the pressure changes in the plane can cause severe pain and some complications. An infection that is left untreated can cause the infection to spread to the inner ear or bone.A useful website:http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001647/
By- Dr. Amy MoviusMedical care is always changing – and not just scientifically. There is a growing appreciation for the “ripple effect” of illness and hospitalization as we understand more about mind and body connection as well as the havoc being sick can wreak on ones life. Perhaps this is most obvious when children are the patients.Providing medical care requires a medical team. Amid the focus on treatment and procedures that surround a child’s illness, the single most important team member to the child, is often the Child Life Specialist (CLS). Most hospitals that provide pediatric care now have a Child Life Program. In the words of the certified CLS I work with daily, her job is to “do everything I can to make (the child) happy and feel better”. This involves more than “getting along with kids” or “liking kids”. Make no mistake, child life specialists are not fancy playmates: they are consummate professionals who have undergone rigorous study and training. This training focuses on the psychosocial needs of children of all ages. They often use therapeutic play to help them cope with and even conquer some of the challenges of being sick or receiving medical treatment that might otherwise be overwhelming. Children process information and experiences differently than adults and so have different needs to help manage difficult circumstances. Even the adults who love these children the most and have only good intentions may not understand or perceive how separate their child’s experience and needs are from their own: much less, how to explain what is happening while coping with their own stress surrounding their child’s condition. The services a CLS provides are many: a few examples of areas of expertise are below:1. Ease a child’s fear and anxiety with play.2. Foster an child friendly environment. 3. Provide medical preparation and support for children.4. Advocate family involvement/presence.5. Consider needs of siblings or other children affected by the illness.6 Support family with grief/bereavement.Feedback surveys leave no doubt as to the high value patients place on Child Life Services. However, it is not only the right thing to do, it is also good medicine. Research suggests that using child life services helps to contain medical costs by reducing hospital length of stay for children and decreasing the need for pain medicine. Lastly, the healthy coping skills developed during such an experience can be built upon for a lifetime.Reference:1. Child Life Services. American Academy of Pediatrics Policy Statement. Child Life Council Committee on Hospital Care, 20062. Child Life Council, Inc. www.childlife.org