We must have the stubbornness to accept our gladness in the ruthless furnace
of the world.
Wednesday, August 31, 2011
FUN FACTS
* If a man could run as fast for his size as an ant can, he could run as fast as a racehorse. *
* The average life expectancy of an ant is 45-60 days. *
* Dalmatians are born without spots. *
* Snails can live up to 15 years. *
* The world's largest amphibian is the giant salamander. It can grow up to 5 ft. in length. *
* A slug has four noses. *
* A duck's quack doesn't echo, and no one knows why. *
* The average life expectancy of an ant is 45-60 days. *
* Dalmatians are born without spots. *
* Snails can live up to 15 years. *
* The world's largest amphibian is the giant salamander. It can grow up to 5 ft. in length. *
* A slug has four noses. *
* A duck's quack doesn't echo, and no one knows why. *
Common Antibiotic Treats COPD
Adding a common antibiotic to treatment regimes for some patients with chronic obstructive pulmonary disease (COPD) can reduce sudden intensifying of symptoms, such as worsened cough, wheezing, and labored breathing. It can also improve general quality of life, according to findings from the COPD Clinical Research Network reported in the New England Journal of Medicine.
Study results indicate that the antibiotic azithromycin is effective in reducing the heightening of COPD symptoms, which are typically caused by bacteria, viruses, or a combination of both. Azithromycin is already prescribed for a variety of bacterial infections, including pneumonia and strep throat.
“Exacerbations account for a significant part of the COPD health burden,” said Mark T. Dransfield, M.D., director of the UAB Lung Health Center and associate professor in the Division of Pulmonary, Allergy and Critical Care Medicine. “These promising results with azithromycin may help us reduce that burden and improve the lives of patients at risk of these acute attacks.”
Past studies had hinted that azithromycin might be effective in reducing COPD exacerbations. The study enrolled more than 1,000 subjects. Eighty percent were already taking medications to improve their COPD symptoms, including inhaled steroids and long-acting bronchodilators.
For the study, 570 patients took 250 mg of azithromycin daily for a year in addition to their usual care. They averaged 1.48 acute COPD exacerbations annually, compared to 1.83 exacerbations for the 572 patients who received their usual care without azithromycin. The participants who took azithromycin also believed their overall well-being was improved.
Dransfield says azithromycin may help up to 3 million people in the United States with COPD (12 million have the disease), particularly those with moderate to severe disease who require oxygen or who have a history of exacerbations within the past year.
COPD, a progressive disease of the lungs, recently surpassed stroke and is now the third leading cause of death in this country. There is no cure, though a combination of drugs and lifestyle changes can help manage the symptoms, reduce exacerbations, and improve quality of life.
Study results indicate that the antibiotic azithromycin is effective in reducing the heightening of COPD symptoms, which are typically caused by bacteria, viruses, or a combination of both. Azithromycin is already prescribed for a variety of bacterial infections, including pneumonia and strep throat.
“Exacerbations account for a significant part of the COPD health burden,” said Mark T. Dransfield, M.D., director of the UAB Lung Health Center and associate professor in the Division of Pulmonary, Allergy and Critical Care Medicine. “These promising results with azithromycin may help us reduce that burden and improve the lives of patients at risk of these acute attacks.”
Past studies had hinted that azithromycin might be effective in reducing COPD exacerbations. The study enrolled more than 1,000 subjects. Eighty percent were already taking medications to improve their COPD symptoms, including inhaled steroids and long-acting bronchodilators.
For the study, 570 patients took 250 mg of azithromycin daily for a year in addition to their usual care. They averaged 1.48 acute COPD exacerbations annually, compared to 1.83 exacerbations for the 572 patients who received their usual care without azithromycin. The participants who took azithromycin also believed their overall well-being was improved.
Dransfield says azithromycin may help up to 3 million people in the United States with COPD (12 million have the disease), particularly those with moderate to severe disease who require oxygen or who have a history of exacerbations within the past year.
COPD, a progressive disease of the lungs, recently surpassed stroke and is now the third leading cause of death in this country. There is no cure, though a combination of drugs and lifestyle changes can help manage the symptoms, reduce exacerbations, and improve quality of life.
Conquer Digestive Problems without Drugs
A new book on digestive health offers a simple formula to help you overcome common problems such as gastric reflux, diverticulitis, and irritable bowel syndrome (IBS) — without spending a penny on prescription drugs.
More than 60 million Americans suffer from digestive disorders despite massive amounts spent on proton pump inhibitors (PPIs), used to turn off acid production for reflux, and other medications.
“PPIs are not nearly as safe as most doctors make them sound,” says Dr. Gerard Mullin, Johns Hopkins integrative gastroenterologist, in his new book, “The Inside Tract: Your Good Gut Guide to Great Digestive Health.”
According to Mullin and co-author, Kathie Madonna Swift, registered dietician and culinary nutritionist, the debilitating effects of digestive disorders can be reversed through dietary and lifestyle changes, along with specific nutritional supplements, exercise, and stress control.
Among the “10 principles of nutritional integrity” guiding Mullin and Swift’s overall approach are eating whole, unprocessed foods, avoiding common food allergens, and drinking plenty of water. In teaching readers how to change their diet, the authors stress maximizing nutritional components. For instance, inflammation contributes to certain digestive disorders, such as ulcerative colitis. Instead of turning to anti-inflammatory medication, patients are recommended to increase their ingestion of nutrients that combat inflammation, such as omega-3 fatty acids found in foods like wild salmon, and monounsaturated fats like those found in coconut oil and avocados.
The authors emphasize that you are not what you eat, but what you absorb, and they provide a step-by-step plan to give your body what it needs to function optimally. Their roadmap includes detailed food plans and supplement recommendations based on your specific digestive disorder and symptom severity as determined through assessment tools in the book. Swift, former director of nutrition at the Canyon Ranch spa chain, contributed 50 easy recipes to help patients stay committed.
Here are some digestion-friendly tips from the authors to help you get started:
1. Steam vegetables to retain nutrients.
2. Practice “mindful eating” by chewing food thoroughly.
3. Replace cow’s milk with coconut, oat, or rice alternatives, or switch to cultured foods, such as yogurt and kefir.
4. Whole grains are an excellent source of healthy fiber, but be cautious. Some (such as whole wheat and barley) contain gluten, a problem for celiac sufferers and others who may be gluten-sensitive.
5. If symptoms increase consistently after eating a certain food, eliminate it for a few weeks, then reintroduce it gradually to determine your tolerance.
More than 60 million Americans suffer from digestive disorders despite massive amounts spent on proton pump inhibitors (PPIs), used to turn off acid production for reflux, and other medications.
“PPIs are not nearly as safe as most doctors make them sound,” says Dr. Gerard Mullin, Johns Hopkins integrative gastroenterologist, in his new book, “The Inside Tract: Your Good Gut Guide to Great Digestive Health.”
According to Mullin and co-author, Kathie Madonna Swift, registered dietician and culinary nutritionist, the debilitating effects of digestive disorders can be reversed through dietary and lifestyle changes, along with specific nutritional supplements, exercise, and stress control.
Among the “10 principles of nutritional integrity” guiding Mullin and Swift’s overall approach are eating whole, unprocessed foods, avoiding common food allergens, and drinking plenty of water. In teaching readers how to change their diet, the authors stress maximizing nutritional components. For instance, inflammation contributes to certain digestive disorders, such as ulcerative colitis. Instead of turning to anti-inflammatory medication, patients are recommended to increase their ingestion of nutrients that combat inflammation, such as omega-3 fatty acids found in foods like wild salmon, and monounsaturated fats like those found in coconut oil and avocados.
The authors emphasize that you are not what you eat, but what you absorb, and they provide a step-by-step plan to give your body what it needs to function optimally. Their roadmap includes detailed food plans and supplement recommendations based on your specific digestive disorder and symptom severity as determined through assessment tools in the book. Swift, former director of nutrition at the Canyon Ranch spa chain, contributed 50 easy recipes to help patients stay committed.
Here are some digestion-friendly tips from the authors to help you get started:
1. Steam vegetables to retain nutrients.
2. Practice “mindful eating” by chewing food thoroughly.
3. Replace cow’s milk with coconut, oat, or rice alternatives, or switch to cultured foods, such as yogurt and kefir.
4. Whole grains are an excellent source of healthy fiber, but be cautious. Some (such as whole wheat and barley) contain gluten, a problem for celiac sufferers and others who may be gluten-sensitive.
5. If symptoms increase consistently after eating a certain food, eliminate it for a few weeks, then reintroduce it gradually to determine your tolerance.
Hip fracture risk rises after women stop hormones
NEW YORK (Reuters Health) - When postmenopausal women discontinue hormone therapy, their bone mineral density drops and their risk of a hip fracture climbs, new research suggests.
Among nearly 81,000 postmenopausal women followed for six and a half years, stopping hormone therapy was linked with an overall 55 percent increased risk of hip fracture.
The jump in chances of a fracture was apparent as soon as 24 months after women stopped hormone therapy and was not affected by the use of bone-building bisphosphonate drugs, report Dr. Roksana Karim, from the University of Southern California, Los Angeles, and her colleagues in the journal Menopause.
Millions of postmenopausal women stopped taking hormone therapy after findings from the Women's Health Initiative (WHI) in 2002 suggested it raised the risk of heart disease and some cancers.
Previous research has shown conclusively that menopausal women on hormone therapy have substantially less bone loss relative to women not taking the hormones, Karim told Reuters Health.
"It has also been known for a while that women who do not take hormones after the menopause have a much greater risk of suffering a bone fracture than women who do take hormones," she added.
"This new study," Karim said, "shows quite nicely that when hormone therapy is stopped, the risk for hip fracture goes up substantially. Women halting hormone therapy should definitely be advised by their clinicians about the increased risk of fracture."
The study looked at 80,955 postmenopausal women from the Southern California Kaiser Permanente Health Maintenance Organization who were at least 60 years old and had filled prescriptions for hormone therapy at least once between January and June 2002. The women were followed through December 2008. Most were white (54 percent), and, on average, slightly overweight.
As expected -- because of the WHI results announced in 2002 -- use of hormone therapy dropped off significantly between July 2002 and December 2008 (from 85 percent to 18 percent of women in the study). During this same period, the annual hip fracture rate increased from 3.9 to 5.67 per 1,000 women.
Based on those rates, women who discontinued hormone therapy were one and a half times as likely to have a hip fracture as the ones who continued taking the hormones.
The risk increased as early as two years after hormones were stopped and it kept rising incrementally, from 52 percent increased risk at two years to 77 percent higher risk at five years or longer after ceasing to take the hormones.
A longer time off the medication was also linked to lower bone mineral density.
"Our data confirm the rapidity of bone loss and increased hip fracture incidence with hormone therapy cessation," the authors note in their report.
"Our results should encourage women and clinicians to take a second look at the bone health benefits of hormone therapy," Karim said. "It may be time to rethink the guidelines about hormone therapy for women with an increased risk of hip fracture."
She added, women "should consult their physicians to determine if they are at high risk of bone loss, which may involve bone density scanning and a review of family history of fracture, and may want to consider individualized hormone therapy."
SOURCE: http://bit.ly/odQjrQ Menopause, online July 19, 2011.
Among nearly 81,000 postmenopausal women followed for six and a half years, stopping hormone therapy was linked with an overall 55 percent increased risk of hip fracture.
The jump in chances of a fracture was apparent as soon as 24 months after women stopped hormone therapy and was not affected by the use of bone-building bisphosphonate drugs, report Dr. Roksana Karim, from the University of Southern California, Los Angeles, and her colleagues in the journal Menopause.
Millions of postmenopausal women stopped taking hormone therapy after findings from the Women's Health Initiative (WHI) in 2002 suggested it raised the risk of heart disease and some cancers.
Previous research has shown conclusively that menopausal women on hormone therapy have substantially less bone loss relative to women not taking the hormones, Karim told Reuters Health.
"It has also been known for a while that women who do not take hormones after the menopause have a much greater risk of suffering a bone fracture than women who do take hormones," she added.
"This new study," Karim said, "shows quite nicely that when hormone therapy is stopped, the risk for hip fracture goes up substantially. Women halting hormone therapy should definitely be advised by their clinicians about the increased risk of fracture."
The study looked at 80,955 postmenopausal women from the Southern California Kaiser Permanente Health Maintenance Organization who were at least 60 years old and had filled prescriptions for hormone therapy at least once between January and June 2002. The women were followed through December 2008. Most were white (54 percent), and, on average, slightly overweight.
As expected -- because of the WHI results announced in 2002 -- use of hormone therapy dropped off significantly between July 2002 and December 2008 (from 85 percent to 18 percent of women in the study). During this same period, the annual hip fracture rate increased from 3.9 to 5.67 per 1,000 women.
Based on those rates, women who discontinued hormone therapy were one and a half times as likely to have a hip fracture as the ones who continued taking the hormones.
The risk increased as early as two years after hormones were stopped and it kept rising incrementally, from 52 percent increased risk at two years to 77 percent higher risk at five years or longer after ceasing to take the hormones.
A longer time off the medication was also linked to lower bone mineral density.
"Our data confirm the rapidity of bone loss and increased hip fracture incidence with hormone therapy cessation," the authors note in their report.
"Our results should encourage women and clinicians to take a second look at the bone health benefits of hormone therapy," Karim said. "It may be time to rethink the guidelines about hormone therapy for women with an increased risk of hip fracture."
She added, women "should consult their physicians to determine if they are at high risk of bone loss, which may involve bone density scanning and a review of family history of fracture, and may want to consider individualized hormone therapy."
SOURCE: http://bit.ly/odQjrQ Menopause, online July 19, 2011.
Genetic cancer test often urged for wrong women
NEW YORK (Reuters Health) - Doctors are too quick to recommend expensive genetic counseling or testing for ovarian cancer, but at the same time often fail to refer high-risk women, government researchers say.
In a survey of nearly 1,900 U.S. physicians, they found about 30 percent said they'd refer women at average risk of the disease, although several guidelines discourage that.
By contrast, as many as 60 percent said they wouldn't refer a woman at high risk, which guidelines do encourage.
"Physicians aren't doing as good a job as we should at identifying people who should and should not be referred for counseling or testing," said Dr. Michael LeFevre of the U.S. Preventive Services Task Force (USPSTF), who was not involved in the new survey.
Ovarian cancer isn't very common -- it strikes just one in 71 women, many of them elderly, whereas one in eight women get breast cancer. But because there aren't any good screening tests for ovarian cancer, it's usually not discovered until it's too late.
However, a small percentage of women carry mutations in the BRCA 1 and 2 genes, which make them very likely to develop both breast and ovarian cancer.
Last month, a federal appeals court upheld patents for those two genes by Salt Lake City-based Myriad Genetics. The company charges $3,340 to test BRCA 1 and 2 for cancer-causing mutations, but told Reuters Health that patients usually end up paying only $100 out-of-pocket.
Still, with just one in 300 or fewer women carrying the mutations, testing those at average risk would put needless strain on the health care system, said Dr. Jacqueline Miller, who worked on the new survey.
"You would be over-testing a lot of women, spending a lot of resources and a lot of money," Miller, of the Centers for Disease Control and Prevention in Atlanta, told Reuters Health.
And it's possible there would be a few false alarms, too, exposing women to unnecessary treatment and other harms, she added.
"For a lot of women, just going through the test creates a lot of anxiety," Miller explained.
The survey, published in the journal Cancer, is based on three fictional patient cases -- one at average risk, one at medium risk and one at high risk.
The USPSTF, a federally supported expert panel, advises against routine counseling and testing for women who don't have suspicious cases of cancer in their family, such as two close relatives with breast cancer, one of whom got it before 50.
"High risk is a little bit complicated," acknowledged LeFevre. "Physicians can't be expected to carry all of these nuances around in their brain, but I think they should know what the triggers are."
Indeed, the survey suggests doctors who were better at assessing risk were more likely to follow the guidelines. Yet even when they correctly put a woman in the average risk category, 22 percent of doctors still referred her for counseling or testing.
For those women at high risk, getting genetic counseling and possibly testing may help them decide how they want to deal with that risk.
For instance, 57 percent of women with BRCA 1 mutations get breast cancer by age 70, and 40 percent get ovarian cancer. Choosing to have the breasts and ovaries removed, or taking certain medications, will cut that risk, said Miller.
"Part of the counseling has to be: here are the options," she explained.
To Miller, the most important lesson from the new finding is to make sure that women at high risk are identified so they can get the right counseling.
But she added that women should never agree to get tested without knowing the reasons.
"You should have that conversation with your provider: why do you feel I'm at high risk?" Miller said. "If a physician tells you you should get genetic counseling, you should understand why."
SOURCE: http://bit.ly/nRiSv9 Cancer, online July 25, 2011.
In a survey of nearly 1,900 U.S. physicians, they found about 30 percent said they'd refer women at average risk of the disease, although several guidelines discourage that.
By contrast, as many as 60 percent said they wouldn't refer a woman at high risk, which guidelines do encourage.
"Physicians aren't doing as good a job as we should at identifying people who should and should not be referred for counseling or testing," said Dr. Michael LeFevre of the U.S. Preventive Services Task Force (USPSTF), who was not involved in the new survey.
Ovarian cancer isn't very common -- it strikes just one in 71 women, many of them elderly, whereas one in eight women get breast cancer. But because there aren't any good screening tests for ovarian cancer, it's usually not discovered until it's too late.
However, a small percentage of women carry mutations in the BRCA 1 and 2 genes, which make them very likely to develop both breast and ovarian cancer.
Last month, a federal appeals court upheld patents for those two genes by Salt Lake City-based Myriad Genetics. The company charges $3,340 to test BRCA 1 and 2 for cancer-causing mutations, but told Reuters Health that patients usually end up paying only $100 out-of-pocket.
Still, with just one in 300 or fewer women carrying the mutations, testing those at average risk would put needless strain on the health care system, said Dr. Jacqueline Miller, who worked on the new survey.
"You would be over-testing a lot of women, spending a lot of resources and a lot of money," Miller, of the Centers for Disease Control and Prevention in Atlanta, told Reuters Health.
And it's possible there would be a few false alarms, too, exposing women to unnecessary treatment and other harms, she added.
"For a lot of women, just going through the test creates a lot of anxiety," Miller explained.
The survey, published in the journal Cancer, is based on three fictional patient cases -- one at average risk, one at medium risk and one at high risk.
The USPSTF, a federally supported expert panel, advises against routine counseling and testing for women who don't have suspicious cases of cancer in their family, such as two close relatives with breast cancer, one of whom got it before 50.
"High risk is a little bit complicated," acknowledged LeFevre. "Physicians can't be expected to carry all of these nuances around in their brain, but I think they should know what the triggers are."
Indeed, the survey suggests doctors who were better at assessing risk were more likely to follow the guidelines. Yet even when they correctly put a woman in the average risk category, 22 percent of doctors still referred her for counseling or testing.
For those women at high risk, getting genetic counseling and possibly testing may help them decide how they want to deal with that risk.
For instance, 57 percent of women with BRCA 1 mutations get breast cancer by age 70, and 40 percent get ovarian cancer. Choosing to have the breasts and ovaries removed, or taking certain medications, will cut that risk, said Miller.
"Part of the counseling has to be: here are the options," she explained.
To Miller, the most important lesson from the new finding is to make sure that women at high risk are identified so they can get the right counseling.
But she added that women should never agree to get tested without knowing the reasons.
"You should have that conversation with your provider: why do you feel I'm at high risk?" Miller said. "If a physician tells you you should get genetic counseling, you should understand why."
SOURCE: http://bit.ly/nRiSv9 Cancer, online July 25, 2011.
8 Mental Tricks to Fight Fat
Is your brain sabotaging your diet? Experts say it plays a big role in how and when we eat. So how can we train our brain to make healthier decisions? From turning down the music to stumping your sense of smell, here are 8 ways to stop your head from messing with your waistline. Plus, are you finally ready lose weight? Take our quiz to find out...
Sure, spending time at the gym and counting calories are good for keeping the scale steady. But experts say the key to hitting your goal weight could be all in your head. That’s because your brain – not your stomach – dictates what and how much you should eat.
“Many of the hormones that impact your appetite and weight are either produced or regulated by your brain,” says Svetlana Kogan, M.D., board-certified internist and founder of the medical facility Doctors At Trump Place in New York City.
“So it’s smart for women to step in and stop things like over-eating at the source: their head.”
From stimulating appetite to directing eating habits, your brain is in the driver’s seat when it comes to your diet.
These 8 tips will help keep your weight-conscious wits about you.
1. Don't pump up the volume.
Loud music (88 decibels, or dB) ramps up signals in your brain to drink almost 30% faster than you would if the music were at decibels you didn’t have to shout over (72 dB), according to a 2008 study by the University of Ulster in Ireland.
The scientists found that the louder the music blared, the longer people hung out at a bar, and the more booze they guzzled.
The fix: Wear a watch.
Ever notice the lack of clocks in clubs? It’s for a good reason. The owners don't want you to realize how much time – or money – you’re spending.
The scientists suspect that exposure to loud music changes your perception of how quickly time is passing. So slipping a watch around your wrist or even setting an alarm on your cell phone to go off once an hour will help you stay focused on how long you've been out.
This awareness can make you consume fewer liquid calories, says lead researcher Nicolas Guéguen, Ph.D.
2. Stop thinking about losing weight.
A day of dodging cakes and chips in the breakroom just might make you fall off the diet wagon.
Dieters, or people trying not to think about food, are 30% more likely to give into impulses at the grocery store, according to 2008 University of Minnesota research.
Their theory: Concentrating all that willpower on not eating leaves you vulnerable to impulse buys and, subsequently, food splurges.
The fix: To keep from binging in the checkout line, shop for groceries early in the day, advises lead researcher, Kathleen Vohs, Ph.D., professor of consumer psychology at the Carlson School of Management, University of Minnesota.
Your self-control will be stronger and fresher because it hasn’t been tested that day. Still, have an “if/then” plan for making healthier choices when cravings hit.
“If you’re hungry or fixated on food while shopping, [tell yourself that] you’ll grab a piece of fruit, a handful of protein-packed almonds or a similar low-calorie snack,” Vohs says.
3. Thinking you’re fat makes you heavier.
When Harvard researchers told women working in hotels that their activity satisfied the U.S. surgeon general’s recommendation for an active lifestyle, they lost weight and lowered their blood pressure, BMI and waist-to-hip ratio.
Women performing the same tasks who weren’t told their activity qualified didn’t lose weight. A few even gained a couple pounds (over 30 days). The researchers speculate that mindset determined weight loss.
“If your mind is in a healthy place, your body will follow,” says researcher Ellen Langer, Ph.D., a Harvard professor of psychology.
And your brain may be more apt to keep your body’s levels of hormones that affect weight, such as leptin, at optimum levels.
The fix: Convince yourself you’re active. To drive home just how energetic you are, keep a 24-hour log of how much you’re moving.
Jot down things like trips from your desk to the bathroom or packages you wrap. You just might be pleased at how much you actually move during a typical day!
4. Ditch your scale.
Contrary to what many women think, it’s not always best to know your weight.
In fact, it’s a sure-fire way to psych yourself out of getting fit.
“Most women have a strong emotional reaction to discovering they haven’t lost as much as they want,” says Jessica Setnick, M.S., R.D., a Dallas eating disorder specialist.
To ease their disappointment, they turn to comfort food.
The fix: Although some studies show frequent weigh-ins help dieters stay on track, weight-loss experts say they’re not for everyone.
That's because the scale isn’t always accurate and your numbers can fluctuate from other factors – like muscle tone, water weight and your menstrual cycle. So hide the scale and use your clothes to gauge your progress, Setnick says.
Focus on fit, feel and hang, not what you weigh.
“Pay attention to the need to go down a jean size or two,” Setnick says. “Or having extra slack in your clothes.”
And only allow yourself to step on the scale occasionally: bi-monthly or even monthly.
That increases your likelihood of getting noticeable results so you’ll be more encouraged to stick with your diet, says Setnick.
5. Stump your sense of smell.
Just smelling food can slow production of leptin, the protein hormone that plays a key role in relaying signals between your brain and stomach that you’re full, according to a 2008 Brookhaven National Laboratory’s Department of Medicine study.
That means, smelling something tasty like bacon, popcorn or freshly baked chocolate cookies can make you hungry – even if you just had a meal.
The fix: If you hit the vending machine every time a co-worker nukes microwave popcorn, stop and ask yourself if you felt hungry before you smelled the corn popping.
If not, don’t give in to temptation, Setnick says.
And to keep from pigging out when baking holiday cookies, keep grapefruit essential oil on hand. Sniffing it will suppress your appetite long enough for leptin levels to return to normal, according to a 2007 study by Japanese researchers at Osaka University.
6. Time your antioxidants.
Based on a July 2009 study, researchers at the Yale School of Medicine think they’ve found one reason your stomach and brain aren’t in sync when it comes to the amount you eat.
They believe antioxidants can play a role in weight control because your brain’s appetite center depends on oxygen-free radicals (molecules associated with aging that everyone has) to keep going.
“Minute-by-minute appetite control is regulated by free radicals,” says co-lead researcher Sabrina Diano, Ph.D., associate professor of obstetrics, gynecology & reproductive sciences and neurobiology at the Yale School of Medicine.
That means if you rein in free radicals, you can suppress – or better control – your appetite.
The fix: Add antioxidant-rich fruits and veggies (like leafy greens, carrots, berries and tomatoes) to every meal.
Eating them halfway through a meal revs up production of the hormone ghrelin, which relays the message to your brain that your tummy has had enough.
So have your side salad with dinner, not before. And make a piece of fruit part of your breakfast – but don’t make it your whole meal. Eating antioxidants on an empty stomach can ramp up your appetite.
7. Let go of the perfect you.
The diet-deadly trio – perfectionism, not achieving expected weight goals and the stress of trying to hit your perfect size – raises the chances you’ll binge-eat, says Anna M. Bardone-Cone, Ph.D., a professor in the Department of Psychological Sciences, University of Missouri, and researcher on a 2008 study about the effect of perfectionism on eating habits.
The fix: Focus on your triumphs.
“If you hit the gym faithfully several times a week, pat yourself on the back,” Bardone-Cone says. Don’t beat yourself up about how far you have left to go, because that won’t melt pounds away.
And if you’re tempted to drown your sorrows in a vat of chocolate, take a time-out.
“Stopping to congratulate yourself on your most recent workout or pounds lost can be all it takes to let your logic catch up with your emotions,” Bardone-Cone says.
8. Fight brain fright.
When you’re cutting back calories, your brain may go into a “fight or flight” state because it’s afraid of starvation.
“Dieting stimulates and activates your nervous system, as well as an area in your brain called amygdala,” says S. Ausim Azizi, M.D., chair of neurology at Temple University, who has more than 30 years’ experience researching the brain’s impact on weight and diet.
All that activity can slow production of leptin, leading you to consume too much.
The fix: Eat regularly.
Instead of 2-3 big meals, divvy up your daily calories into five or six small ones.
You’ll keep your tummy from grumbling, which stalls production of ghrelin and lets your brain know to stand down.
Are You Ready to Lose Weight?
Losing weight is a commitment to diet, exercise and behavioral changes. You know you could stand to lose some of those unwanted pounds, but are you ready to make this life-long commitment?
Sure, spending time at the gym and counting calories are good for keeping the scale steady. But experts say the key to hitting your goal weight could be all in your head. That’s because your brain – not your stomach – dictates what and how much you should eat.
“Many of the hormones that impact your appetite and weight are either produced or regulated by your brain,” says Svetlana Kogan, M.D., board-certified internist and founder of the medical facility Doctors At Trump Place in New York City.
“So it’s smart for women to step in and stop things like over-eating at the source: their head.”
From stimulating appetite to directing eating habits, your brain is in the driver’s seat when it comes to your diet.
These 8 tips will help keep your weight-conscious wits about you.
1. Don't pump up the volume.
Loud music (88 decibels, or dB) ramps up signals in your brain to drink almost 30% faster than you would if the music were at decibels you didn’t have to shout over (72 dB), according to a 2008 study by the University of Ulster in Ireland.
The scientists found that the louder the music blared, the longer people hung out at a bar, and the more booze they guzzled.
The fix: Wear a watch.
Ever notice the lack of clocks in clubs? It’s for a good reason. The owners don't want you to realize how much time – or money – you’re spending.
The scientists suspect that exposure to loud music changes your perception of how quickly time is passing. So slipping a watch around your wrist or even setting an alarm on your cell phone to go off once an hour will help you stay focused on how long you've been out.
This awareness can make you consume fewer liquid calories, says lead researcher Nicolas Guéguen, Ph.D.
2. Stop thinking about losing weight.
A day of dodging cakes and chips in the breakroom just might make you fall off the diet wagon.
Dieters, or people trying not to think about food, are 30% more likely to give into impulses at the grocery store, according to 2008 University of Minnesota research.
Their theory: Concentrating all that willpower on not eating leaves you vulnerable to impulse buys and, subsequently, food splurges.
The fix: To keep from binging in the checkout line, shop for groceries early in the day, advises lead researcher, Kathleen Vohs, Ph.D., professor of consumer psychology at the Carlson School of Management, University of Minnesota.
Your self-control will be stronger and fresher because it hasn’t been tested that day. Still, have an “if/then” plan for making healthier choices when cravings hit.
“If you’re hungry or fixated on food while shopping, [tell yourself that] you’ll grab a piece of fruit, a handful of protein-packed almonds or a similar low-calorie snack,” Vohs says.
3. Thinking you’re fat makes you heavier.
When Harvard researchers told women working in hotels that their activity satisfied the U.S. surgeon general’s recommendation for an active lifestyle, they lost weight and lowered their blood pressure, BMI and waist-to-hip ratio.
Women performing the same tasks who weren’t told their activity qualified didn’t lose weight. A few even gained a couple pounds (over 30 days). The researchers speculate that mindset determined weight loss.
“If your mind is in a healthy place, your body will follow,” says researcher Ellen Langer, Ph.D., a Harvard professor of psychology.
And your brain may be more apt to keep your body’s levels of hormones that affect weight, such as leptin, at optimum levels.
The fix: Convince yourself you’re active. To drive home just how energetic you are, keep a 24-hour log of how much you’re moving.
Jot down things like trips from your desk to the bathroom or packages you wrap. You just might be pleased at how much you actually move during a typical day!
4. Ditch your scale.
Contrary to what many women think, it’s not always best to know your weight.
In fact, it’s a sure-fire way to psych yourself out of getting fit.
“Most women have a strong emotional reaction to discovering they haven’t lost as much as they want,” says Jessica Setnick, M.S., R.D., a Dallas eating disorder specialist.
To ease their disappointment, they turn to comfort food.
The fix: Although some studies show frequent weigh-ins help dieters stay on track, weight-loss experts say they’re not for everyone.
That's because the scale isn’t always accurate and your numbers can fluctuate from other factors – like muscle tone, water weight and your menstrual cycle. So hide the scale and use your clothes to gauge your progress, Setnick says.
Focus on fit, feel and hang, not what you weigh.
“Pay attention to the need to go down a jean size or two,” Setnick says. “Or having extra slack in your clothes.”
And only allow yourself to step on the scale occasionally: bi-monthly or even monthly.
That increases your likelihood of getting noticeable results so you’ll be more encouraged to stick with your diet, says Setnick.
5. Stump your sense of smell.
Just smelling food can slow production of leptin, the protein hormone that plays a key role in relaying signals between your brain and stomach that you’re full, according to a 2008 Brookhaven National Laboratory’s Department of Medicine study.
That means, smelling something tasty like bacon, popcorn or freshly baked chocolate cookies can make you hungry – even if you just had a meal.
The fix: If you hit the vending machine every time a co-worker nukes microwave popcorn, stop and ask yourself if you felt hungry before you smelled the corn popping.
If not, don’t give in to temptation, Setnick says.
And to keep from pigging out when baking holiday cookies, keep grapefruit essential oil on hand. Sniffing it will suppress your appetite long enough for leptin levels to return to normal, according to a 2007 study by Japanese researchers at Osaka University.
6. Time your antioxidants.
Based on a July 2009 study, researchers at the Yale School of Medicine think they’ve found one reason your stomach and brain aren’t in sync when it comes to the amount you eat.
They believe antioxidants can play a role in weight control because your brain’s appetite center depends on oxygen-free radicals (molecules associated with aging that everyone has) to keep going.
“Minute-by-minute appetite control is regulated by free radicals,” says co-lead researcher Sabrina Diano, Ph.D., associate professor of obstetrics, gynecology & reproductive sciences and neurobiology at the Yale School of Medicine.
That means if you rein in free radicals, you can suppress – or better control – your appetite.
The fix: Add antioxidant-rich fruits and veggies (like leafy greens, carrots, berries and tomatoes) to every meal.
Eating them halfway through a meal revs up production of the hormone ghrelin, which relays the message to your brain that your tummy has had enough.
So have your side salad with dinner, not before. And make a piece of fruit part of your breakfast – but don’t make it your whole meal. Eating antioxidants on an empty stomach can ramp up your appetite.
7. Let go of the perfect you.
The diet-deadly trio – perfectionism, not achieving expected weight goals and the stress of trying to hit your perfect size – raises the chances you’ll binge-eat, says Anna M. Bardone-Cone, Ph.D., a professor in the Department of Psychological Sciences, University of Missouri, and researcher on a 2008 study about the effect of perfectionism on eating habits.
The fix: Focus on your triumphs.
“If you hit the gym faithfully several times a week, pat yourself on the back,” Bardone-Cone says. Don’t beat yourself up about how far you have left to go, because that won’t melt pounds away.
And if you’re tempted to drown your sorrows in a vat of chocolate, take a time-out.
“Stopping to congratulate yourself on your most recent workout or pounds lost can be all it takes to let your logic catch up with your emotions,” Bardone-Cone says.
8. Fight brain fright.
When you’re cutting back calories, your brain may go into a “fight or flight” state because it’s afraid of starvation.
“Dieting stimulates and activates your nervous system, as well as an area in your brain called amygdala,” says S. Ausim Azizi, M.D., chair of neurology at Temple University, who has more than 30 years’ experience researching the brain’s impact on weight and diet.
All that activity can slow production of leptin, leading you to consume too much.
The fix: Eat regularly.
Instead of 2-3 big meals, divvy up your daily calories into five or six small ones.
You’ll keep your tummy from grumbling, which stalls production of ghrelin and lets your brain know to stand down.
Are You Ready to Lose Weight?
Losing weight is a commitment to diet, exercise and behavioral changes. You know you could stand to lose some of those unwanted pounds, but are you ready to make this life-long commitment?
Tuesday, August 30, 2011
THOUGHT FOR TODAY...
NOTHING IN LIFE IS TO BE FEARED, IT IS ONLY TO BE UNDERSTOOD. NOW IS THE TIME TO UNDERSTAND MORE, SO THAT WE MAY FEAR LESS.
FUN FACTS
* The ant, when intoxicated, will always fall over to its right side. *
* Ants make up 1/10 of the total world animal tissue. The total biomass of all the ants on Earth is about totally equal to the total biomass of all the people. *
* Certain frogs can be frozen solid, then thawed, and survive. *
* If NASA sent birds into space they would soon die; they need gravity to swallow. *
* Many hamsters only blink one eye at a time. *
* The abdomen of the ant contains two stomachs. One stomach holds the food for itself and second stomach is for food to be shared with other ants. *
* An ant brain has about 250 000 brain cells. A human brain has 10,000 million so a colony of 40,000 ants has collectively the same size brain as a human. *
* Ants make up 1/10 of the total world animal tissue. The total biomass of all the ants on Earth is about totally equal to the total biomass of all the people. *
* Certain frogs can be frozen solid, then thawed, and survive. *
* If NASA sent birds into space they would soon die; they need gravity to swallow. *
* Many hamsters only blink one eye at a time. *
* The abdomen of the ant contains two stomachs. One stomach holds the food for itself and second stomach is for food to be shared with other ants. *
* An ant brain has about 250 000 brain cells. A human brain has 10,000 million so a colony of 40,000 ants has collectively the same size brain as a human. *
Anti-clotting Drug Beats Rivals
An experimental anti-clotting drug from Bristol-Myers Squibb and Pfizer saved more lives than standard treatment warfarin in a major study, giving it an edge over rivals in an emerging multibillion-dollar market.
Although Eliquis will be third to market among a wave of new oral anticoagulants, the data presented Sunday at Europe's biggest medical meeting means it could now be viewed as the best in class.
People with dangerously irregular heart rhythms given Eliquis were 21 percent less likely to suffer strokes than those on decades-old warfarin, a problematic drug first developed as rat poison that requires regular blood tests.
It also produced a 31 percent relative reduction in the risk of major bleeding — especially bleeding in the brain — and an 11 percent reduction in risk of death from any cause, results from a 18,000-patient study lasting nearly two years showed.
The mortality benefit only just reached statistical significance, but the finding puts Eliquis ahead of its two key rivals by demonstrating superiority to warfarin on all three counts of effectiveness, safety, and saving lives.
That is likely to be seized on by Bristol and Pfizer in an upcoming marketing fight with Boehringer Ingelheim's Pradaxa — currently the only approved alternative to warfarin in stroke prevention — and Xarelto, from Bayer and Johnson & Johnson, which is expected to be approved shortly.
"It gives a lot of confidence when you see a drug that reduces mortality. That's another feather in the cap," Dr Chris Granger of Duke University Medical Center, who led the study, told Reuters.
The result means that giving Eliquis rather than warfarin for 1.8 years — the average length of the study — would prevent eight deaths for each 1,000 people treated.
All three new drugs are vying for a share of a warfarin-replacement market that industry analysts estimate could be worth $10-$20 billion a year by the end of the decade.
Currently, analysts surveyed by Thomson Reuters Pharma expect 2015 sales of $1.6 billion for Eliquis, or apixaban, which is due to be submitted for approval later this year.
That is less than the $3 billion forecast for Xarelto, and some predict the balance will now shift toward Eliquis.
"The bleeding profile is spectacular, and that's what is going to drive market share," said Mark Schoenebaum, an analyst at ISI Group, who sees Eliquis taking at least 60 percent of the stroke prevention market.
Excitement over Eliquis has grown since June when headline results showed it was better and safer than warfarin. How much better, however, only became clear Sunday when the data was unveiled at the European Society of Cardiology (ESC) annual meeting and published in the New England Journal of Medicine.
In an editorial in the journal, Dr. Jessica Mega of Boston's Brigham and Women's Hospital said the results were "impressive," but she cautioned it was difficult to make comparisons between different drugs, due to variations in the clinical trials.
Doctors attending the ESC meeting said the new drugs would upend the landscape for treating patients with atrial fibrillation, whose irregular heartbeats can cause blood to pool, increasing their risk of blood clots and strokes.
"It is another dagger in the heart for warfarin as an anticoagulation treatment for patients with atrial fibrillation to prevent stroke," said Dr Ralph Brindis.
Brindis, a senior adviser for Northern California Kaiser Permanente and immediate past president of the American College of Cardiology, said Eliquis had scored a "home run," although it and the other new anticoagulants still faced challenges.
In particular, he is concerned about adherence to medical treatment among elderly patients, as doctors may be less able to ensure they are taking drugs correctly once they do not need regular blood tests. For such patients, once-daily Xarelto may be a better bet than twice-daily Eliquis or Pradaxa, providing a niche market opportunity for Bayer and J&J.
Seamus Fernandez, an industry analyst at Leerink Swann, said Eliquis was now "extremely well-positioned" to be the top drug and Pradaxa was the product most likely to lose out. He expects stroke prevention to be a $7-9 billion market globally, with other uses of the new oral anticoagulants worth $3-6 billion.
In a discussion at the congress, Dr Michael Ezekowitz of the Lankenau Institute for Medical Research in Pennsylvania said the Eliquis trial results were a "landmark" that confirmed a new wave of drugs was about to change the medical landscape.
"We're in a new era," Ekekowitz, who was not involved in the latest research, told a packed conference hall in Paris.
Still, many cardiologists said they would not rush to switch existing patients who are well-controlled on warfarin — a cheap generic medicine — to the new and expensive branded products.
Pradaxa costs $6.75 wholesale for a day's treatment in the United States, although it is less in other markets.
Although Eliquis will be third to market among a wave of new oral anticoagulants, the data presented Sunday at Europe's biggest medical meeting means it could now be viewed as the best in class.
People with dangerously irregular heart rhythms given Eliquis were 21 percent less likely to suffer strokes than those on decades-old warfarin, a problematic drug first developed as rat poison that requires regular blood tests.
It also produced a 31 percent relative reduction in the risk of major bleeding — especially bleeding in the brain — and an 11 percent reduction in risk of death from any cause, results from a 18,000-patient study lasting nearly two years showed.
The mortality benefit only just reached statistical significance, but the finding puts Eliquis ahead of its two key rivals by demonstrating superiority to warfarin on all three counts of effectiveness, safety, and saving lives.
That is likely to be seized on by Bristol and Pfizer in an upcoming marketing fight with Boehringer Ingelheim's Pradaxa — currently the only approved alternative to warfarin in stroke prevention — and Xarelto, from Bayer and Johnson & Johnson, which is expected to be approved shortly.
"It gives a lot of confidence when you see a drug that reduces mortality. That's another feather in the cap," Dr Chris Granger of Duke University Medical Center, who led the study, told Reuters.
The result means that giving Eliquis rather than warfarin for 1.8 years — the average length of the study — would prevent eight deaths for each 1,000 people treated.
All three new drugs are vying for a share of a warfarin-replacement market that industry analysts estimate could be worth $10-$20 billion a year by the end of the decade.
Currently, analysts surveyed by Thomson Reuters Pharma expect 2015 sales of $1.6 billion for Eliquis, or apixaban, which is due to be submitted for approval later this year.
That is less than the $3 billion forecast for Xarelto, and some predict the balance will now shift toward Eliquis.
"The bleeding profile is spectacular, and that's what is going to drive market share," said Mark Schoenebaum, an analyst at ISI Group, who sees Eliquis taking at least 60 percent of the stroke prevention market.
Excitement over Eliquis has grown since June when headline results showed it was better and safer than warfarin. How much better, however, only became clear Sunday when the data was unveiled at the European Society of Cardiology (ESC) annual meeting and published in the New England Journal of Medicine.
In an editorial in the journal, Dr. Jessica Mega of Boston's Brigham and Women's Hospital said the results were "impressive," but she cautioned it was difficult to make comparisons between different drugs, due to variations in the clinical trials.
Doctors attending the ESC meeting said the new drugs would upend the landscape for treating patients with atrial fibrillation, whose irregular heartbeats can cause blood to pool, increasing their risk of blood clots and strokes.
"It is another dagger in the heart for warfarin as an anticoagulation treatment for patients with atrial fibrillation to prevent stroke," said Dr Ralph Brindis.
Brindis, a senior adviser for Northern California Kaiser Permanente and immediate past president of the American College of Cardiology, said Eliquis had scored a "home run," although it and the other new anticoagulants still faced challenges.
In particular, he is concerned about adherence to medical treatment among elderly patients, as doctors may be less able to ensure they are taking drugs correctly once they do not need regular blood tests. For such patients, once-daily Xarelto may be a better bet than twice-daily Eliquis or Pradaxa, providing a niche market opportunity for Bayer and J&J.
Seamus Fernandez, an industry analyst at Leerink Swann, said Eliquis was now "extremely well-positioned" to be the top drug and Pradaxa was the product most likely to lose out. He expects stroke prevention to be a $7-9 billion market globally, with other uses of the new oral anticoagulants worth $3-6 billion.
In a discussion at the congress, Dr Michael Ezekowitz of the Lankenau Institute for Medical Research in Pennsylvania said the Eliquis trial results were a "landmark" that confirmed a new wave of drugs was about to change the medical landscape.
"We're in a new era," Ekekowitz, who was not involved in the latest research, told a packed conference hall in Paris.
Still, many cardiologists said they would not rush to switch existing patients who are well-controlled on warfarin — a cheap generic medicine — to the new and expensive branded products.
Pradaxa costs $6.75 wholesale for a day's treatment in the United States, although it is less in other markets.
Few Participate in Cancer Trials
Very few patients who've had cancer surgery end up participating in clinical trials to test new treatments, researchers have found.
And those who do participate are younger and usually white, fueling concerns that new drugs may not fare as well once they hit the market because trial subjects don't match real-world users.
"Are you going to see the same benefits in the average patient?" mused Dr. Monika Krzyzanowska, a cancer researcher at Princess Margaret Hospital in Toronto, Canada.
"Are the risks in the clinical trial truly reflective of the risk in the general population if the enrolled patients are younger and healthier?" added Krzyzanowska, who wasn't involved in the new work.
To get a sense of how often cancer patients enroll in clinical trials, Dr. Waddah Al-Refaie of the University of Minnesota in Minneapolis and colleagues tapped into a California cancer registry. Only 1,566 of nearly 245,000 patients — or about six of every 1,000 — had participated in a trial, according to the report in the Annals of Surgery.
"The rate is abysmally low," Krzyzanowska told Reuters Health. Whether that's because few trials were available, or because patients are reluctant to join them, or something else isn't clear. It's nothing new that clinical trials don't represent the average patients who may eventually end up using new drugs. For instance, fewer than one in 10 people with hay fever would be eligible to take part in the drug trials that end up dictating their care, French researchers said earlier this year.
The new findings are another illustration of the gap between real-world patients and those who participate in trials.
"Should we fix it? I think the answer is yes," said Krzyzanowska. The solution, she said, "is a much harder question to answer."
While there is no universal answer as to whether it would make sense for a particular cancer patient to enroll in a trial, she added, "patients should inquire about what clinical trials are available and figure out if there is something available for them."
And those who do participate are younger and usually white, fueling concerns that new drugs may not fare as well once they hit the market because trial subjects don't match real-world users.
"Are you going to see the same benefits in the average patient?" mused Dr. Monika Krzyzanowska, a cancer researcher at Princess Margaret Hospital in Toronto, Canada.
"Are the risks in the clinical trial truly reflective of the risk in the general population if the enrolled patients are younger and healthier?" added Krzyzanowska, who wasn't involved in the new work.
To get a sense of how often cancer patients enroll in clinical trials, Dr. Waddah Al-Refaie of the University of Minnesota in Minneapolis and colleagues tapped into a California cancer registry. Only 1,566 of nearly 245,000 patients — or about six of every 1,000 — had participated in a trial, according to the report in the Annals of Surgery.
"The rate is abysmally low," Krzyzanowska told Reuters Health. Whether that's because few trials were available, or because patients are reluctant to join them, or something else isn't clear. It's nothing new that clinical trials don't represent the average patients who may eventually end up using new drugs. For instance, fewer than one in 10 people with hay fever would be eligible to take part in the drug trials that end up dictating their care, French researchers said earlier this year.
The new findings are another illustration of the gap between real-world patients and those who participate in trials.
"Should we fix it? I think the answer is yes," said Krzyzanowska. The solution, she said, "is a much harder question to answer."
While there is no universal answer as to whether it would make sense for a particular cancer patient to enroll in a trial, she added, "patients should inquire about what clinical trials are available and figure out if there is something available for them."
Heart Catheterizations Through Wrists Reduce Complications
Most of the 1 million heart catheterizations performed each year in the United States are performed by accessing arteries to the heart through the groin. But interventional cardiologists at the Stony Brook University Heart Center and elsewhere are performing more heart catheterizations by going through the wrist instead of the groin, a process called "transradial access." The procedure has several advantages for patients including reduced complications, increased patient comfort, and quicker recovery time.
“We are expanding our use of transradial access for both diagnostic and interventional procedures to ensure better patient outcomes and comfort,” says Luis Gruberg, M.D., Professor of Medicine, Division of Cardiovascular Medicine, Stony Brook University School of Medicine. “As a general rule, patients and their referring physicians have embraced this procedure, as it enables the patient to be mobile and sitting up much faster after the procedure and with less post-procedure pain.
“Small but significant changes can have a great impact on medical outcomes, costs, and patient satisfaction, and a change in access points for catheterization is one of these,” adds Dr. Gruberg, referring to growing use of transradial access at the Heart Center.
Once the artery is accessed, the diagnostic and interventional procedures are virtually the same for both groin (transfemoral) and wrist (transradial) catheterizations. With groin access, however, the patient must lie flat for four to six hours after the procedure. This is necessary to ensure that there is no bleeding from the puncture site. With wrist access, patients are able to get up almost immediately after the procedure, allowing them to walk, sit upright, use the bathroom, and eat and drink.
The first transradial diagnostic catheterization was performed by Dr. Lucien Campeau, a French/Canadian physician, in the late 1980s. By 1993, a research team in Amsterdam, led by Dr. Ferdinand Kiemeneij, began using the technique for interventional procedures. In recent years, the method for catheterization has grown and is seen by some interventional cardiologists as an optimal choice for a significant segment of the patient population.
Dr. Gruberg emphasizes that transradial access may have special benefits for women, the elderly, those with peripheral vascular disease, and obese patients. For example, he says, while the transfemoral approach is more common in the United States, the entry point is sometimes difficult to access and has a greater associated risk of complications, including bleeding — especially in women. In women and these other patient groups, Dr. Gruberg estimates transradial access reduces the risk of bleeding complications by 50 percent or more in these populations, compared to transfemoral access.
He reports that cardiologists typically see the following benefits of transradial access procedures over transfemoral ones:
• Decreased incidence of major entry site complications, mainly bleeding
• Minimized risk of nerve damage, which is common in the femoral approach due to the close proximity of the femoral artery and nerve
• Easier vascular access for interventional cardiologists and closure of the needle puncture in certain patients, such as those who are overweight or obese
• Significantly decreased time to patient ambulation and discharge, as well as shorter hospital stays
• Improved overall patient comfort and satisfaction
• Reduced post-procedural costs resulting from fewer complications and/or follow-up visits.
“We are expanding our use of transradial access for both diagnostic and interventional procedures to ensure better patient outcomes and comfort,” says Luis Gruberg, M.D., Professor of Medicine, Division of Cardiovascular Medicine, Stony Brook University School of Medicine. “As a general rule, patients and their referring physicians have embraced this procedure, as it enables the patient to be mobile and sitting up much faster after the procedure and with less post-procedure pain.
“Small but significant changes can have a great impact on medical outcomes, costs, and patient satisfaction, and a change in access points for catheterization is one of these,” adds Dr. Gruberg, referring to growing use of transradial access at the Heart Center.
Once the artery is accessed, the diagnostic and interventional procedures are virtually the same for both groin (transfemoral) and wrist (transradial) catheterizations. With groin access, however, the patient must lie flat for four to six hours after the procedure. This is necessary to ensure that there is no bleeding from the puncture site. With wrist access, patients are able to get up almost immediately after the procedure, allowing them to walk, sit upright, use the bathroom, and eat and drink.
The first transradial diagnostic catheterization was performed by Dr. Lucien Campeau, a French/Canadian physician, in the late 1980s. By 1993, a research team in Amsterdam, led by Dr. Ferdinand Kiemeneij, began using the technique for interventional procedures. In recent years, the method for catheterization has grown and is seen by some interventional cardiologists as an optimal choice for a significant segment of the patient population.
Dr. Gruberg emphasizes that transradial access may have special benefits for women, the elderly, those with peripheral vascular disease, and obese patients. For example, he says, while the transfemoral approach is more common in the United States, the entry point is sometimes difficult to access and has a greater associated risk of complications, including bleeding — especially in women. In women and these other patient groups, Dr. Gruberg estimates transradial access reduces the risk of bleeding complications by 50 percent or more in these populations, compared to transfemoral access.
He reports that cardiologists typically see the following benefits of transradial access procedures over transfemoral ones:
• Decreased incidence of major entry site complications, mainly bleeding
• Minimized risk of nerve damage, which is common in the femoral approach due to the close proximity of the femoral artery and nerve
• Easier vascular access for interventional cardiologists and closure of the needle puncture in certain patients, such as those who are overweight or obese
• Significantly decreased time to patient ambulation and discharge, as well as shorter hospital stays
• Improved overall patient comfort and satisfaction
• Reduced post-procedural costs resulting from fewer complications and/or follow-up visits.
Obesity to worsen, weigh heavily on healthcare costs
HONG KONG (Reuters) - Obesity is most widespread in Britain and the United States among the world's leading economies and if present trends continue, about half of both men and women in the United States will be obese by 2030, health experts warned on Friday.
Obesity is fast replacing tobacco as the single most important preventable cause of chronic non-communicable diseases, and will add an extra 7.8 million cases of diabetes, 6.8 million cases of heart disease and stroke, and 539,000 cases of cancer in the United States by 2030.
Some 32 percent of men and 35 percent of women are now obese in the United States, according to a research team led by Claire Wang at the Mailman School of Public Health in Columbia University in New York. They published their findings in a special series of four papers on obesity in The Lancet.
In Britain, obesity rates will balloon to between 41 and 48 percent for men and 35 to 43 percent for women by 2030 from what is now 26 percent for both sexes, they warned.
"An extra 668,000 cases of diabetes, 461,000 of heart disease and 130,000 cancer cases would result," they wrote.
Due to overeating and insufficient exercise, obesity is now a growing problem everywhere and experts are warning about its ripple effects on health and healthcare spending.
Obesity raises the risk of heart disease, stroke, diabetes, various cancers, hypertension and high cholesterol, among other conditions.
Because of obesity, the United States can expect to spend an extra 2.6 percent on its overall healthcare bill, or $66 billion per year, while Britain's bill will grow by 2 percent, or 2 billion per year, Wang and colleagues warned.
OBESITY BOMB TICKING EVERYWHERE ELSE TOO
In Japan and China, 1 in 20 women is obese, compared with 1 in 10 in the Netherlands, 1 in 4 in Australia and 7 in 10 in Tonga, according to another paper led by Boyd Swinburn and Gary Sacks of the WHO Collaborating Center for Obesity Prevention at Deakin University in Melbourne, Australia.
Worldwide, around 1.5 billion adults are overweight and a further 0.5 billion are obese, with 170 million children classified as overweight or obese. Obesity takes up between 2 and 6 percent of healthcare costs in many countries.
"Increased supply of cheap, tasty, energy-dense food, improved food distribution and marketing, and the strong economic forces driving consumption and growth are the key drivers of the obesity epidemic," Swinburn and Sacks wrote.
The health experts urged governments to lead the fight in reversing the obesity epidemic.
"These include taxes on unhealthy food and drink (such as sugar sweetened beverages) and restrictions on food and beverage TV advertising to children," wrote a team led by Steven Gortmaker at the Harvard School of Public Health, which published the fourth paper in the series.
SOURCE: http://bit.ly/qQKhBW The Lancet, August 26, 2011.
Obesity is fast replacing tobacco as the single most important preventable cause of chronic non-communicable diseases, and will add an extra 7.8 million cases of diabetes, 6.8 million cases of heart disease and stroke, and 539,000 cases of cancer in the United States by 2030.
Some 32 percent of men and 35 percent of women are now obese in the United States, according to a research team led by Claire Wang at the Mailman School of Public Health in Columbia University in New York. They published their findings in a special series of four papers on obesity in The Lancet.
In Britain, obesity rates will balloon to between 41 and 48 percent for men and 35 to 43 percent for women by 2030 from what is now 26 percent for both sexes, they warned.
"An extra 668,000 cases of diabetes, 461,000 of heart disease and 130,000 cancer cases would result," they wrote.
Due to overeating and insufficient exercise, obesity is now a growing problem everywhere and experts are warning about its ripple effects on health and healthcare spending.
Obesity raises the risk of heart disease, stroke, diabetes, various cancers, hypertension and high cholesterol, among other conditions.
Because of obesity, the United States can expect to spend an extra 2.6 percent on its overall healthcare bill, or $66 billion per year, while Britain's bill will grow by 2 percent, or 2 billion per year, Wang and colleagues warned.
OBESITY BOMB TICKING EVERYWHERE ELSE TOO
In Japan and China, 1 in 20 women is obese, compared with 1 in 10 in the Netherlands, 1 in 4 in Australia and 7 in 10 in Tonga, according to another paper led by Boyd Swinburn and Gary Sacks of the WHO Collaborating Center for Obesity Prevention at Deakin University in Melbourne, Australia.
Worldwide, around 1.5 billion adults are overweight and a further 0.5 billion are obese, with 170 million children classified as overweight or obese. Obesity takes up between 2 and 6 percent of healthcare costs in many countries.
"Increased supply of cheap, tasty, energy-dense food, improved food distribution and marketing, and the strong economic forces driving consumption and growth are the key drivers of the obesity epidemic," Swinburn and Sacks wrote.
The health experts urged governments to lead the fight in reversing the obesity epidemic.
"These include taxes on unhealthy food and drink (such as sugar sweetened beverages) and restrictions on food and beverage TV advertising to children," wrote a team led by Steven Gortmaker at the Harvard School of Public Health, which published the fourth paper in the series.
SOURCE: http://bit.ly/qQKhBW The Lancet, August 26, 2011.
Gene Testing: Does It Help or Hurt?
Worried about what medical conditions are lurking in your family tree? Breast or ovarian cancer? Huntington's disease? Gene testing, or genetic testing, may offer knowledge but not always comfort. So when is gene testing helpful and when should you steer clear? Read on for the answers...
Seven years ago, when she considered marriage and children, Anna Gorman decided to be tested for the BRCA1 and 2 gene mutations because ovarian cancer killed her grandmother and aunt.
She tested positive for BRCA1, which raises the risk of breast cancer up to 85% by age 70 and ovarian cancer by 55%.
“I wasn’t surprised, but I was upset and overwhelmed,” says Gorman, now a 35-year-old Los Angeles journalist.
So she then married her longtime boyfriend, gave birth to two daughters and had her ovaries removed by age 32. Three years later, she had a double mastectomy.
The surgeries were hard. Still, she was relieved when it was over.
“It’s a dramatic step to take, but … lots of people get cancer and die,” she says. “I could do something about it.”
Like Gorman, many women worry about diseases that lurk in their family trees. In fact, they lead the pack when seeking genetic information.
“Women are drivers of the acquisition of medical care, period,” says Ora Gordon, M.D., M.S., director of the GenRISK Adult Genetics program at Los Angeles’ Cedars-Sinai Medical Center.
In fact, women make up 80% of her practice, she says.
Genetic testing is common for pregnant women and those considering pregnancy, but others anxious about hereditary illnesses — sickle-cell disease (a disorder that affects red blood cells), heart disease and diabetes — are also seeking genetic information in far greater numbers.
Screening for cystic fibrosis numbered in the thousands a decade ago; today millions undergo the testing, says Steve Keiles, M.S., president of the National Society of Genetic Counselors and director of Genetic Counseling at Ambry Genetics in Aliso Viejo, Calif.
In 1999, only 415 labs tested for 704 diseases. Today, more than 600 laboratories worldwide are equipped to test for 1,794 diseases; 1,185 clinics provide counseling, according to GeneTests at NCBI, a medical genetics information resource at the University of Washington in Seattle.
What gene testing reveals
Why do so many women go for testing? Besides diagnosing and predicting diseases, genetic tests also:
Determine if a patient carries gene mutations for disorders that might be passed to children
Assess the health of a fetus (if it is at risk for inheriting a condition)
Screen fertilized eggs before implantation
Screen newborns at risk for genetic disorders that should be treated immediately
Home-testing kits
If you won’t see a physician because of privacy concerns or live in a remote area far from genetic-counseling centers, online companies offer home testing kits for common diseases, such as some breast and colon cancers, autoimmune disorders, macular degeneration and cardiovascular disease.
With the kits, you take a blood test or mouth swab and then send it to a laboratory. (Prices for online kits and mainstream clinical tests vary widely, depending on the services and tests ordered. At-home genetic tests can be pricey, from $295-$1,200.)
But beware: Some online companies offer a look at your genetic background for entertainment, not medical, purposes. And some don’t look for gene mutations, an often vital component when looking for diseases.
Also, home tests may not be accurate for some conditions, such as diabetes.
There’s “no reliable screening for type 2 diabetes,” Keiles says. “You can tell a lot just from your family history."
How online tests work
But there’s more to DNA testing than just getting results. Some tests are tough to interpret because of the procedure’s complexity and multilayered findings. And not all labs have trained genetics counselors to read them.
Navigenics, a San Francisco Bay Area-based online company, offers genetic counseling along with test kits and advises customers to seek tests the company doesn’t offer when appropriate, says Elissa Levin, director of genetics counseling. Counselors also follow up with phone calls after results are sent, she says.
But women with family histories of diseases such as breast and uterine cancer, Huntington’s disease and muscular dystrophy should seek genetic counseling first to make sure they’re proper candidates for testing, genetic counselors say.
For example, during counseling for Alzheimer’s – which you may not get even if you test positive – counselors sometimes find that you’re at higher risk for a more preventable health problem, such as heart disease. So they may recommend relatively inexpensive diagnostic blood tests along with lifestyle and diet changes.
Getting Tested
If you want counseling or testing, the National Society of Genetic Counselors can provide names of counselors by location, as well as guidelines for choosing a professional and getting the most out of the sessions.
Counseling alone costs about $400 and the cost of genetic tests range from $700-$4,000, Gordon says. It typically takes 2-6 weeks to get results, but some are available in days.
You also can ask your doctor for a referral; it may be covered by your health insurance plan.
The results won’t affect your rates because information the tests glean is private: In 2008, Congress passed the Genetic Nondiscrimination Information Act, which protects patients against discrimination by an insurer or employer based on genetic information. For many insurance plans, the law went into effect in May.
Who should be tested?
But genetic tests aren’t for everyone. For one thing, many of the disorders they detect are rare, Keiles says.
“Most testing is targeted to ethnic groups,” for example, Tay-Sachs for people of Jewish descent and sickle-cell disease for African Americans, he says.
And gene testing for most cancers is unnecessary because about 90% of them aren’t inherited, he says.
With some diseases, such as amyotrophic lateral sclerosis — commonly known as Lou Gehrig’s disease — a positive result won’t lead to better treatment or prevention.
“I don’t want to put patients through that if all I’m doing is giving them anxiety,” GenRISK’s Gordon says.
“Sometimes, too much information can be bad,” said Peter Weiss, M.D., a Beverly Hills, Calif. obstetrician and gynecologist. “Patients need to weigh the risks and rewards of the information they get from testing and be ready to deal with [it].”
But that may change with scientific advances. The future of genetic testing centers around whole-genome sequencing, said David Stillman, a pathology professor at the University of Utah.
That process — which may be routine in 10-15 years — will allow scientists to sequence not just for one gene, such as the BRCA mutation or cystic fibrosis carriers, but all of a person’s DNA to get a better picture of the medical problem he or she may face. (The expensive process has been done on only four or five people so far.)
Common Genetic Tests
Here's a guide to the most common genetic tests and those who should consider having them:
1. Down Syndrome
This genetic disorder occurs in one out of every 700-800 infants and causes lifelong mental retardation, developmental delays and other problems.
Screening for Down syndrome is a routine part of prenatal care. Your obstetrician will typically do an ultrasound and blood test in the first trimester, then a “quad screen” blood test at 15-20 weeks.
If tests are positive, the next step is chorionic villus sampling (CVS), in which cells are taken from the mother’s placenta at nine to 14 weeks, or amniocentesis after 15 weeks, in which a sample of amniotic fluid surrounding the fetus is withdrawn with a needle inserted into the woman’s uterus.
Who should have the test? Older pregnant women because the risk of conceiving a Down syndrome baby at age 35 is one in 400. By age 45, it’s one in 35. Also at higher risk are those with a Down syndrome child and men couples who are carriers. The screening is common among pregnant women of all ages.
Pros: Both amniocentesis and CVS are 98%-99% accurate.
Cons: There's a 1-in-200 risk of miscarriage from amniocentesis and a 1-in-100 risk from CVS.
Cost: Both procedures average about $1,500, which many insurance plans cover.
2. Neural tube defects
Neural tube defects — including spina bifada, anencephaly and encephalocele — are openings in the spinal cord or brain and are among the most common birth defects.
They’re detected during pregnancy by one of three tests:
Amniocentesis
A maternal serum alpha fetoprotein (MSAFP) blood test administered at weeks 16-18
A high-resolution ultrasound after 18 weeks
Who should have the test? Women who have had a fetus or baby with neural tube defects. Those with folic acid deficiencies have a higher risk for the defects. Many pregnant women have one of the tests for routine prenatal care.
Pros: Parents can prepare for the special medical care that babies with the defects will need.
Cons: Amniocentesis raises miscarriage risks.
Cost: The MSAFP blood test is about $162 in California; costs may vary in other states. The high-resolution ultrasound costs from $300-$500. Amniocentesis and CVS each costs about $1,500.
3. BRCA1 and BRCA2 genes
The letters stand for breast cancer susceptibility genes 1 and 2, respectively. They are tumor suppressors and mutations have been linked to hereditary breast and ovarian cancer.
The procedure is a simple blood test, which can be done in a doctor’s office.
Who should have the tests: The gene mutations are most common in Jews of Ashkenazi, or Eastern European, descent. Those with a first-degree relative (mother, daughter or sister) or two second-degree relatives (aunt, grandmother) diagnosed with breast or ovarian cancer should consider testing.
Other women with two first-degree relatives diagnosed with breast or ovarian cancer before age 50 should also consider it.
Pros: Learning that you don’t have the mutation can relieve you of worry and avoid costly preventive procedures.
Cons: If the test is positive, you may become anxious and depressed. A counselor can help you consider preventive measures, such as having your breasts and ovaries removed.
Cost: From several hundred dollars to $3,200, depending on the extent of the testing.
4. Cystic Fibrosis
An inherited chronic disease, cystic fibrosis affects the lungs and digestive systems of about 30,000 children and adults in the U.S.
A sweat test is the gold standard for diagnosis; People with CF have a higher level of chloride (salt) in their perspiration. A chemical to induce sweating is applied to an arm or leg. The liquid is then collected and analyzed in a lab.
A blood test can determine if you carry one or more CF gene mutations and how many copies of each.
With a positive test result, the next step is genetic testing to see which mutation you have. Screening newborns for CF is routine in most states.
Who should have the tests? More than 10 million Americans with no symptoms are carriers of the defective cystic fibrosis gene. The blood test helps detect carriers who may pass CF to their children.
To get the disease, a child must inherit one copy of the defective CF gene from each parent. The American College of Obstetrics and Gynecologists recommends that all couples considering having a child — and pregnant women — have the genetic-carrier testing done.
Pros: Carriers can make an informed decision about family planning, with the help of genetic counseling.
By testing their child, they can find out early if he or she has the disease and from which mutations. Early treatment and preventive measures help because symptoms often don’t show up until degeneration has begun.
Cons: Getting a positive CF diagnosis often is stressful and upsetting to parents.
Cost: Sweat tests usually cost about $300 at CF-accredited centers.
A limited mutation panel (23-97 mutations) to see if you’re a carrier typically runs about $400-$500; a comprehensive sequence analysis (more than 1,500 mutations) costs about $2,500.
Mutation testing for those already diagnosed with CF sometimes can be done with the carrier panel, but if that doesn’t find the mutations, a sequence test will cost $2,500-$3,200 for more results.
5. Sickle Cell Anemia
This inherited condition causes a deficiency in healthy red blood cells to carry enough oxygen throughout the body.
A blood test can detect the defective form of hemoglobin that causes the disease. Newborns are routinely screened for it.
In pregnant women, amniocentesis or chorionic villus (CVS) sampling will detect the disease.
Who should have the test? The gene is common among people of African, Mediterranean, Middle Eastern and East Indian ancestry. In the U.S., African Americans and Latinos are more commonly affected.
Both parents must carry a sickle cell gene for their baby to be born with the disease. Carriers — those with no symptoms — may pass it on to their children. Those with a sister or brother with the disease are at higher risk.
Pros: Couples who know they're carriers can seek genetic counseling for prevention information and treatment options.
Cons: If the screening is positive, more tests are needed to determine the number of sickle cells present. There are risks of miscarriage associated with amniocentesis and CVS screenings.
Cost: The hemoglobin test runs about $75; DNA tests are about $300.
Will You See Your 80th Birthday?
What is your life expectancy? Can you rely on good genetics to keep you thriving through the years, or do you need to do more to raise your odds of living longer?
Seven years ago, when she considered marriage and children, Anna Gorman decided to be tested for the BRCA1 and 2 gene mutations because ovarian cancer killed her grandmother and aunt.
She tested positive for BRCA1, which raises the risk of breast cancer up to 85% by age 70 and ovarian cancer by 55%.
“I wasn’t surprised, but I was upset and overwhelmed,” says Gorman, now a 35-year-old Los Angeles journalist.
So she then married her longtime boyfriend, gave birth to two daughters and had her ovaries removed by age 32. Three years later, she had a double mastectomy.
The surgeries were hard. Still, she was relieved when it was over.
“It’s a dramatic step to take, but … lots of people get cancer and die,” she says. “I could do something about it.”
Like Gorman, many women worry about diseases that lurk in their family trees. In fact, they lead the pack when seeking genetic information.
“Women are drivers of the acquisition of medical care, period,” says Ora Gordon, M.D., M.S., director of the GenRISK Adult Genetics program at Los Angeles’ Cedars-Sinai Medical Center.
In fact, women make up 80% of her practice, she says.
Genetic testing is common for pregnant women and those considering pregnancy, but others anxious about hereditary illnesses — sickle-cell disease (a disorder that affects red blood cells), heart disease and diabetes — are also seeking genetic information in far greater numbers.
Screening for cystic fibrosis numbered in the thousands a decade ago; today millions undergo the testing, says Steve Keiles, M.S., president of the National Society of Genetic Counselors and director of Genetic Counseling at Ambry Genetics in Aliso Viejo, Calif.
In 1999, only 415 labs tested for 704 diseases. Today, more than 600 laboratories worldwide are equipped to test for 1,794 diseases; 1,185 clinics provide counseling, according to GeneTests at NCBI, a medical genetics information resource at the University of Washington in Seattle.
What gene testing reveals
Why do so many women go for testing? Besides diagnosing and predicting diseases, genetic tests also:
Determine if a patient carries gene mutations for disorders that might be passed to children
Assess the health of a fetus (if it is at risk for inheriting a condition)
Screen fertilized eggs before implantation
Screen newborns at risk for genetic disorders that should be treated immediately
Home-testing kits
If you won’t see a physician because of privacy concerns or live in a remote area far from genetic-counseling centers, online companies offer home testing kits for common diseases, such as some breast and colon cancers, autoimmune disorders, macular degeneration and cardiovascular disease.
With the kits, you take a blood test or mouth swab and then send it to a laboratory. (Prices for online kits and mainstream clinical tests vary widely, depending on the services and tests ordered. At-home genetic tests can be pricey, from $295-$1,200.)
But beware: Some online companies offer a look at your genetic background for entertainment, not medical, purposes. And some don’t look for gene mutations, an often vital component when looking for diseases.
Also, home tests may not be accurate for some conditions, such as diabetes.
There’s “no reliable screening for type 2 diabetes,” Keiles says. “You can tell a lot just from your family history."
How online tests work
But there’s more to DNA testing than just getting results. Some tests are tough to interpret because of the procedure’s complexity and multilayered findings. And not all labs have trained genetics counselors to read them.
Navigenics, a San Francisco Bay Area-based online company, offers genetic counseling along with test kits and advises customers to seek tests the company doesn’t offer when appropriate, says Elissa Levin, director of genetics counseling. Counselors also follow up with phone calls after results are sent, she says.
But women with family histories of diseases such as breast and uterine cancer, Huntington’s disease and muscular dystrophy should seek genetic counseling first to make sure they’re proper candidates for testing, genetic counselors say.
For example, during counseling for Alzheimer’s – which you may not get even if you test positive – counselors sometimes find that you’re at higher risk for a more preventable health problem, such as heart disease. So they may recommend relatively inexpensive diagnostic blood tests along with lifestyle and diet changes.
Getting Tested
If you want counseling or testing, the National Society of Genetic Counselors can provide names of counselors by location, as well as guidelines for choosing a professional and getting the most out of the sessions.
Counseling alone costs about $400 and the cost of genetic tests range from $700-$4,000, Gordon says. It typically takes 2-6 weeks to get results, but some are available in days.
You also can ask your doctor for a referral; it may be covered by your health insurance plan.
The results won’t affect your rates because information the tests glean is private: In 2008, Congress passed the Genetic Nondiscrimination Information Act, which protects patients against discrimination by an insurer or employer based on genetic information. For many insurance plans, the law went into effect in May.
Who should be tested?
But genetic tests aren’t for everyone. For one thing, many of the disorders they detect are rare, Keiles says.
“Most testing is targeted to ethnic groups,” for example, Tay-Sachs for people of Jewish descent and sickle-cell disease for African Americans, he says.
And gene testing for most cancers is unnecessary because about 90% of them aren’t inherited, he says.
With some diseases, such as amyotrophic lateral sclerosis — commonly known as Lou Gehrig’s disease — a positive result won’t lead to better treatment or prevention.
“I don’t want to put patients through that if all I’m doing is giving them anxiety,” GenRISK’s Gordon says.
“Sometimes, too much information can be bad,” said Peter Weiss, M.D., a Beverly Hills, Calif. obstetrician and gynecologist. “Patients need to weigh the risks and rewards of the information they get from testing and be ready to deal with [it].”
But that may change with scientific advances. The future of genetic testing centers around whole-genome sequencing, said David Stillman, a pathology professor at the University of Utah.
That process — which may be routine in 10-15 years — will allow scientists to sequence not just for one gene, such as the BRCA mutation or cystic fibrosis carriers, but all of a person’s DNA to get a better picture of the medical problem he or she may face. (The expensive process has been done on only four or five people so far.)
Common Genetic Tests
Here's a guide to the most common genetic tests and those who should consider having them:
1. Down Syndrome
This genetic disorder occurs in one out of every 700-800 infants and causes lifelong mental retardation, developmental delays and other problems.
Screening for Down syndrome is a routine part of prenatal care. Your obstetrician will typically do an ultrasound and blood test in the first trimester, then a “quad screen” blood test at 15-20 weeks.
If tests are positive, the next step is chorionic villus sampling (CVS), in which cells are taken from the mother’s placenta at nine to 14 weeks, or amniocentesis after 15 weeks, in which a sample of amniotic fluid surrounding the fetus is withdrawn with a needle inserted into the woman’s uterus.
Who should have the test? Older pregnant women because the risk of conceiving a Down syndrome baby at age 35 is one in 400. By age 45, it’s one in 35. Also at higher risk are those with a Down syndrome child and men couples who are carriers. The screening is common among pregnant women of all ages.
Pros: Both amniocentesis and CVS are 98%-99% accurate.
Cons: There's a 1-in-200 risk of miscarriage from amniocentesis and a 1-in-100 risk from CVS.
Cost: Both procedures average about $1,500, which many insurance plans cover.
2. Neural tube defects
Neural tube defects — including spina bifada, anencephaly and encephalocele — are openings in the spinal cord or brain and are among the most common birth defects.
They’re detected during pregnancy by one of three tests:
Amniocentesis
A maternal serum alpha fetoprotein (MSAFP) blood test administered at weeks 16-18
A high-resolution ultrasound after 18 weeks
Who should have the test? Women who have had a fetus or baby with neural tube defects. Those with folic acid deficiencies have a higher risk for the defects. Many pregnant women have one of the tests for routine prenatal care.
Pros: Parents can prepare for the special medical care that babies with the defects will need.
Cons: Amniocentesis raises miscarriage risks.
Cost: The MSAFP blood test is about $162 in California; costs may vary in other states. The high-resolution ultrasound costs from $300-$500. Amniocentesis and CVS each costs about $1,500.
3. BRCA1 and BRCA2 genes
The letters stand for breast cancer susceptibility genes 1 and 2, respectively. They are tumor suppressors and mutations have been linked to hereditary breast and ovarian cancer.
The procedure is a simple blood test, which can be done in a doctor’s office.
Who should have the tests: The gene mutations are most common in Jews of Ashkenazi, or Eastern European, descent. Those with a first-degree relative (mother, daughter or sister) or two second-degree relatives (aunt, grandmother) diagnosed with breast or ovarian cancer should consider testing.
Other women with two first-degree relatives diagnosed with breast or ovarian cancer before age 50 should also consider it.
Pros: Learning that you don’t have the mutation can relieve you of worry and avoid costly preventive procedures.
Cons: If the test is positive, you may become anxious and depressed. A counselor can help you consider preventive measures, such as having your breasts and ovaries removed.
Cost: From several hundred dollars to $3,200, depending on the extent of the testing.
4. Cystic Fibrosis
An inherited chronic disease, cystic fibrosis affects the lungs and digestive systems of about 30,000 children and adults in the U.S.
A sweat test is the gold standard for diagnosis; People with CF have a higher level of chloride (salt) in their perspiration. A chemical to induce sweating is applied to an arm or leg. The liquid is then collected and analyzed in a lab.
A blood test can determine if you carry one or more CF gene mutations and how many copies of each.
With a positive test result, the next step is genetic testing to see which mutation you have. Screening newborns for CF is routine in most states.
Who should have the tests? More than 10 million Americans with no symptoms are carriers of the defective cystic fibrosis gene. The blood test helps detect carriers who may pass CF to their children.
To get the disease, a child must inherit one copy of the defective CF gene from each parent. The American College of Obstetrics and Gynecologists recommends that all couples considering having a child — and pregnant women — have the genetic-carrier testing done.
Pros: Carriers can make an informed decision about family planning, with the help of genetic counseling.
By testing their child, they can find out early if he or she has the disease and from which mutations. Early treatment and preventive measures help because symptoms often don’t show up until degeneration has begun.
Cons: Getting a positive CF diagnosis often is stressful and upsetting to parents.
Cost: Sweat tests usually cost about $300 at CF-accredited centers.
A limited mutation panel (23-97 mutations) to see if you’re a carrier typically runs about $400-$500; a comprehensive sequence analysis (more than 1,500 mutations) costs about $2,500.
Mutation testing for those already diagnosed with CF sometimes can be done with the carrier panel, but if that doesn’t find the mutations, a sequence test will cost $2,500-$3,200 for more results.
5. Sickle Cell Anemia
This inherited condition causes a deficiency in healthy red blood cells to carry enough oxygen throughout the body.
A blood test can detect the defective form of hemoglobin that causes the disease. Newborns are routinely screened for it.
In pregnant women, amniocentesis or chorionic villus (CVS) sampling will detect the disease.
Who should have the test? The gene is common among people of African, Mediterranean, Middle Eastern and East Indian ancestry. In the U.S., African Americans and Latinos are more commonly affected.
Both parents must carry a sickle cell gene for their baby to be born with the disease. Carriers — those with no symptoms — may pass it on to their children. Those with a sister or brother with the disease are at higher risk.
Pros: Couples who know they're carriers can seek genetic counseling for prevention information and treatment options.
Cons: If the screening is positive, more tests are needed to determine the number of sickle cells present. There are risks of miscarriage associated with amniocentesis and CVS screenings.
Cost: The hemoglobin test runs about $75; DNA tests are about $300.
Will You See Your 80th Birthday?
What is your life expectancy? Can you rely on good genetics to keep you thriving through the years, or do you need to do more to raise your odds of living longer?
Monday, August 29, 2011
THOUGHT FOR TODAY...
THE GREATEST DANGER FOR MOST OF US IS NOT THAT OUR AIM IS TOO HIGH AND WE MISS IT BUT THAT IT IS TOO LOW AND WE REACH IT.
FUN FACTS
* The turkey is one of the most famous birds in North America. In fact, Benjamin Franklin wanted to make the wild turkey, not the Bald Eagle, the national bird of the United States! *
* Most domestic turkeys are so heavy they are unable to fly. *
* When it comes time to give birth, the female shark loses her appetite so she won't be tempted to eat her own pups. *
* Ants began farming about 50 million years before humans thought to raise their own crops. *
* A hummingbird weighs less than a penny. *
* The animal responsible for the most human deaths worldwide is the mosquito. *
* A female ferret will die if it goes into heat and cannot find a mate. *
* Most domestic turkeys are so heavy they are unable to fly. *
* When it comes time to give birth, the female shark loses her appetite so she won't be tempted to eat her own pups. *
* Ants began farming about 50 million years before humans thought to raise their own crops. *
* A hummingbird weighs less than a penny. *
* The animal responsible for the most human deaths worldwide is the mosquito. *
* A female ferret will die if it goes into heat and cannot find a mate. *
The Dangers of Protein: Fact or Fiction?
Is protein dangerous? There’s a lot of debate on the topic. In the last few years, studies have reported that high-protein diets are "hard on the kidneys" or cause osteoporosis. Let’s take a look at both claims:
1. High-protein intake causes renal (kidney and liver) dysfunction. This argument is based on research conducted on subjects who already had some sort of preexisting renal disorder, with absolutely no data showing this to be the case with healthy individuals. Think about it: If high-protein intake really caused renal failure, there would be a nationwide epidemic among athletes, weight lifters and high-protein dieters. No outbreak has yet occurred.
2. High-protein intake leeches calcium from bones and causes osteoporosis. The amount of calcium excreted as a result of high-protein intake is incredibly small – a single glass of milk per week could replenish the calcium loss several times over. Considering that milk, cottage cheese and other dairy products are staples to any high-protein diet, a lack of calcium won’t be a problem! Basically, the link between a high-protein diet and bone loss is an overblown issue.
The idea that a diet rich in protein is dangerous for normal, healthy people is one that has been enormously exaggerated. Don’t believe everything you read or hear!
To your body transformation success,
Joel Marion
To learn more about Joel’s Body Transformation Coaching Program or to download a free copy of his rapid fat-loss report visit Joelmarioncoaching.com
1. High-protein intake causes renal (kidney and liver) dysfunction. This argument is based on research conducted on subjects who already had some sort of preexisting renal disorder, with absolutely no data showing this to be the case with healthy individuals. Think about it: If high-protein intake really caused renal failure, there would be a nationwide epidemic among athletes, weight lifters and high-protein dieters. No outbreak has yet occurred.
2. High-protein intake leeches calcium from bones and causes osteoporosis. The amount of calcium excreted as a result of high-protein intake is incredibly small – a single glass of milk per week could replenish the calcium loss several times over. Considering that milk, cottage cheese and other dairy products are staples to any high-protein diet, a lack of calcium won’t be a problem! Basically, the link between a high-protein diet and bone loss is an overblown issue.
The idea that a diet rich in protein is dangerous for normal, healthy people is one that has been enormously exaggerated. Don’t believe everything you read or hear!
To your body transformation success,
Joel Marion
To learn more about Joel’s Body Transformation Coaching Program or to download a free copy of his rapid fat-loss report visit Joelmarioncoaching.com
Surprising source of omega-3
One of the top sources of a critical fatty acid can be found on the top of a certain terra cotta pot. You know them from the old commercials: ch-ch-ch-chia!
Researchers say chia seeds -- the same seeds used to grow grassy "hair" on Chia Pet heads -- are positively loaded with alpha-linolenic acid, or ALA.
And when you find out all ALA can do for you, you might not waste those seeds on terra cotta pots anymore.
------------------------
Hearts and livers
------------------------
Researchers say chia seeds given to rats on a high-fat diet helped redistribute lipids -- essentially chasing them away from the liver and visceral fat, or the fat that builds up around the vital organs.
In plain talk, the study in The Journal of Nutritional Biochemistry means this stuff can protect your heart and liver by keeping lipids away from the places they'll do the most harm.
Unlike the other omega-3 fatty acids, you won't find ALA in fish oil -- but you will get it from flaxseed, olive oil, walnuts and, of course, ch-ch-ch-chia seeds.
But don't give up that fish oil.
The essential fatty acids in fish -- eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) -- can stop inflammation, protect your arteries, and even beat anxiety.
--------------------------
Fish oil vs. anxiety
--------------------------
I can't think of any group that's more known for their angst and apprehension than medical students. Maybe that's why researchers decided to use them as the guinea pigs in the omega-3 vs. anxiety test.
The researchers gave first- and second-year students either omega-3 supplements or a placebo, and then used psychological surveys to measure levels of stress, anxiety, and depression throughout the school year.
They found that the students who got the real supplements had 20 percent less anxiety, while blood tests revealed a 14-percent drop in levels of the inflammation marker IL-6, according to the study in Brain, Behavior and Immunity.
Think I'm done with the omega-3 news? Not yet.
---------------------------------
Ageless arteries
---------------------------------
Omega-3 fatty acids are already known for their benefits across the cardiovascular spectrum. Now, a new analysis of data from 10 studies shows that they can even stop your arteries from aging.
Researchers say omega-3 fatty acids prevent stiffening -- and since stiffer arteries are older arteries, fish oil could be the fountain of youth your blood vessels have been searching for.
The researchers suggest a minimum dose of 540 milligrams EPA and 360 milligrams DHA to keep your arteries nice and young -- and I say take advantage of this one.
It's not always this easy to turn back the clock.
On a mission for your health,
Ed Martin
Editor, House Calls
Researchers say chia seeds -- the same seeds used to grow grassy "hair" on Chia Pet heads -- are positively loaded with alpha-linolenic acid, or ALA.
And when you find out all ALA can do for you, you might not waste those seeds on terra cotta pots anymore.
------------------------
Hearts and livers
------------------------
Researchers say chia seeds given to rats on a high-fat diet helped redistribute lipids -- essentially chasing them away from the liver and visceral fat, or the fat that builds up around the vital organs.
In plain talk, the study in The Journal of Nutritional Biochemistry means this stuff can protect your heart and liver by keeping lipids away from the places they'll do the most harm.
Unlike the other omega-3 fatty acids, you won't find ALA in fish oil -- but you will get it from flaxseed, olive oil, walnuts and, of course, ch-ch-ch-chia seeds.
But don't give up that fish oil.
The essential fatty acids in fish -- eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) -- can stop inflammation, protect your arteries, and even beat anxiety.
--------------------------
Fish oil vs. anxiety
--------------------------
I can't think of any group that's more known for their angst and apprehension than medical students. Maybe that's why researchers decided to use them as the guinea pigs in the omega-3 vs. anxiety test.
The researchers gave first- and second-year students either omega-3 supplements or a placebo, and then used psychological surveys to measure levels of stress, anxiety, and depression throughout the school year.
They found that the students who got the real supplements had 20 percent less anxiety, while blood tests revealed a 14-percent drop in levels of the inflammation marker IL-6, according to the study in Brain, Behavior and Immunity.
Think I'm done with the omega-3 news? Not yet.
---------------------------------
Ageless arteries
---------------------------------
Omega-3 fatty acids are already known for their benefits across the cardiovascular spectrum. Now, a new analysis of data from 10 studies shows that they can even stop your arteries from aging.
Researchers say omega-3 fatty acids prevent stiffening -- and since stiffer arteries are older arteries, fish oil could be the fountain of youth your blood vessels have been searching for.
The researchers suggest a minimum dose of 540 milligrams EPA and 360 milligrams DHA to keep your arteries nice and young -- and I say take advantage of this one.
It's not always this easy to turn back the clock.
On a mission for your health,
Ed Martin
Editor, House Calls
Prevent Blood Clots Naturally
Question: My husband had a very mild heart attack that was surprising because his blood tests showed perfect health numbers except for LDL of 123. He has very low blood pressure, is not overweight, and isn't stressed. We agree that he should stay on Plavix. What can we do?
Dr. Blaylock's Answer:
Your husband is a perfect example of the type of person who does not fit the cholesterol theory of atherosclerosis. I differ from the medical establishment on a number of issues concerning this condition.
Plavix is a very dangerous and expensive medicine, and it is no more effective in anticoagulation than are many natural supplements such as high-EPA omega-3 oil, garlic, and ginkgo biloba.
Magnesium not only prevents excessive blood clotting, it also improves blood flow, reduces inflammation, and protects the heart and brain. Curcumin, quercetin, and high-gamma vitamin E and tocotrienol also significantly reduce fatty accumulation in the arteries and, more importantly, the hard plaque.
Studies have shown that extreme lowering of LDL cholesterol increases the likelihood of brain hemorrhages and death. Meanwhile, raising HDL cholesterol has been shown to offer no protection against heart attacks.
Dr. Blaylock's Answer:
Your husband is a perfect example of the type of person who does not fit the cholesterol theory of atherosclerosis. I differ from the medical establishment on a number of issues concerning this condition.
Plavix is a very dangerous and expensive medicine, and it is no more effective in anticoagulation than are many natural supplements such as high-EPA omega-3 oil, garlic, and ginkgo biloba.
Magnesium not only prevents excessive blood clotting, it also improves blood flow, reduces inflammation, and protects the heart and brain. Curcumin, quercetin, and high-gamma vitamin E and tocotrienol also significantly reduce fatty accumulation in the arteries and, more importantly, the hard plaque.
Studies have shown that extreme lowering of LDL cholesterol increases the likelihood of brain hemorrhages and death. Meanwhile, raising HDL cholesterol has been shown to offer no protection against heart attacks.
Chocolate doesn't have to derail a diet: study
NEW YORK (Reuters Health) - For chocolate lovers trying to drop a few pounds, new research suggests that it's still possible to lose weight while indulging your sweet tooth every day.
Overweight and obese women who added a bit of chocolate or other sweets on top of a healthy diet plan lost about 11 pounds over four months, on average.
The study was funded by Hershey's, which provided its own candy for snacks, and two of the study authors are company employees.
"Women think about going on a diet and think they have to deprive themselves of their favorite foods, but really that's not the case if you incorporate them in a portion-controlled way," said Kathryn Piehowski, who conducted the research while at Pennsylvania State University in University Park.
An outside researcher cautioned that the study had no "control" group of women who didn't eat a sweet snack, so it's impossible to know how much weight those who abstained from sweets, or ate other snacks, would have lost.
"Chocolate ... is a highly-desired food," said Debra Keast, from Food & Nutrition Database Research, Inc in Okemos, Michigan. But, she added, "I really don't think that it would be as effective as some other type of snack" for weight loss.
Snacks that also pack some fiber and protein, she said, would probably help women stay full until their next meal better than candy.
For the new study, Piehowski and her colleagues tracked the weight loss of 33 overweight and obese women on a reduced-calorie diet. Overweight is defined by having a body mass index (BMI) -- a measure of weight in relation to height -- between 25 and 29.9; obese is a BMI above 30. A BMI between 18.5 and 24.9 is considered normal.
All of the women in the study were premenopausal, with BMIs between 25 and 43.
All attended weekly nutrition sessions and were taught a diet plan based on food exchanges and portion size that aimed for 1,500 to 1,800 calories per day.
Half of them were also given small dark chocolate snacks to eat twice a day (totaling 90 calories each day) and sugar-free cocoa for breakfast. The other women ate fruit-flavored licorice snacks and had a sugar-free non-cocoa drink in the morning.
Twenty-six women completed the study, 13 in each group. After just over four months, women in both groups had lost an average of 11 pounds.
The researchers said that shows that women don't have to totally remove chocolate and other sweet snacks from their diets to see weight-loss success. And the small snacks may reduce cravings for more sweets, they add -- cravings that have been the downfall of many strict diets.
"As soon as someone tells you you can't have something, what do you want? You want that thing," Piehowski, now at Nestle Health Science, told Reuters Health.
A diet with sweet snacks "may provide an effective weight-loss strategy for women who struggle with other more restrictive diet plans," the authors wrote in the Journal of the American Dietetic Association.
"I think allowing snacks and allowing sweets and a reward for exercising or a reward for sticking to your healthy foods is good," Keast, who was not involved in the new study, told Reuters Health.
"But I think there are probably other foods that might be more satiating to eat between meals, if the objective is to hold you over to the next meal so you're not feeling so hungry that you have to gorge when you actually sit down to eat."
She highlighted nuts and low-fat yogurt as two of those ideal snacks, but didn't denounce dark chocolate and its potential health benefits.
For any weight-loss diet -- chocolate-enhanced or not -- "you need to eat small amounts frequently and not be on a restrictive diet where you're starving yourself," Keast said.
SOURCE: http://bit.ly/nWmBBK Journal of the American Dietetic Association, August 2011.
Overweight and obese women who added a bit of chocolate or other sweets on top of a healthy diet plan lost about 11 pounds over four months, on average.
The study was funded by Hershey's, which provided its own candy for snacks, and two of the study authors are company employees.
"Women think about going on a diet and think they have to deprive themselves of their favorite foods, but really that's not the case if you incorporate them in a portion-controlled way," said Kathryn Piehowski, who conducted the research while at Pennsylvania State University in University Park.
An outside researcher cautioned that the study had no "control" group of women who didn't eat a sweet snack, so it's impossible to know how much weight those who abstained from sweets, or ate other snacks, would have lost.
"Chocolate ... is a highly-desired food," said Debra Keast, from Food & Nutrition Database Research, Inc in Okemos, Michigan. But, she added, "I really don't think that it would be as effective as some other type of snack" for weight loss.
Snacks that also pack some fiber and protein, she said, would probably help women stay full until their next meal better than candy.
For the new study, Piehowski and her colleagues tracked the weight loss of 33 overweight and obese women on a reduced-calorie diet. Overweight is defined by having a body mass index (BMI) -- a measure of weight in relation to height -- between 25 and 29.9; obese is a BMI above 30. A BMI between 18.5 and 24.9 is considered normal.
All of the women in the study were premenopausal, with BMIs between 25 and 43.
All attended weekly nutrition sessions and were taught a diet plan based on food exchanges and portion size that aimed for 1,500 to 1,800 calories per day.
Half of them were also given small dark chocolate snacks to eat twice a day (totaling 90 calories each day) and sugar-free cocoa for breakfast. The other women ate fruit-flavored licorice snacks and had a sugar-free non-cocoa drink in the morning.
Twenty-six women completed the study, 13 in each group. After just over four months, women in both groups had lost an average of 11 pounds.
The researchers said that shows that women don't have to totally remove chocolate and other sweet snacks from their diets to see weight-loss success. And the small snacks may reduce cravings for more sweets, they add -- cravings that have been the downfall of many strict diets.
"As soon as someone tells you you can't have something, what do you want? You want that thing," Piehowski, now at Nestle Health Science, told Reuters Health.
A diet with sweet snacks "may provide an effective weight-loss strategy for women who struggle with other more restrictive diet plans," the authors wrote in the Journal of the American Dietetic Association.
"I think allowing snacks and allowing sweets and a reward for exercising or a reward for sticking to your healthy foods is good," Keast, who was not involved in the new study, told Reuters Health.
"But I think there are probably other foods that might be more satiating to eat between meals, if the objective is to hold you over to the next meal so you're not feeling so hungry that you have to gorge when you actually sit down to eat."
She highlighted nuts and low-fat yogurt as two of those ideal snacks, but didn't denounce dark chocolate and its potential health benefits.
For any weight-loss diet -- chocolate-enhanced or not -- "you need to eat small amounts frequently and not be on a restrictive diet where you're starving yourself," Keast said.
SOURCE: http://bit.ly/nWmBBK Journal of the American Dietetic Association, August 2011.
7 Essential Supplements for Women
It’s not enough to slather on sunscreen, moisturizer and the latest anti-wrinkle cream in the quest for a more youthful look. You need protection on the inside too. Check out these seven super nutrients that every woman should consider adding to her diet to support and improve health, vitality and appearance. Plus, find out what supplements are right for your age and lifestyle...
1. Calcium: The Bone Builder
Calcium is an essential mineral found in high amounts in milk and other dairy products as well as fortified foods. Typically, a little more than 1% of a women’s body weight is calcium, which certainly helps us understand why we consider it so important.
Why is calcium important? Almost all your body’s calcium is found in your bones and teeth. And since women are four times more susceptible to osteoporosis than men, getting enough is essential for lifelong bone health. The remaining 1% is critical because calcium plays a role in heart and muscle action, blood clotting and normal cell function.
Who needs it? All adult women, especially the following:
Teens or young women because as much as 90% of adult bone mass is achieved by age 18. Peak bone mass usually occurs in the late 20s.
Women older than 30 because they typically lose bone mass and strength.
Menopausal and postmenopausal women because bone loss tends to accelerate as the body produces less estrogen.
How much should you take? Women ages 50 and younger should consider a daily calcium supplement of at least 500 mg, and eat calcium-rich foods such as milk, cheeses and other dairy foods and fortified products.
If you are older than 50, consider taking a daily supplement of 800-1,000 mg on top of eating calcium-rich foods. And if you take more than 1,000 mg daily, split the dosage and take half in the morning and half in the evening to ensure maximum absorption.
Calcium citrate may be a better choice if you don’t produce a lot of stomach acid. This is often the case for some women as they get older as well as women taking medications that reduce stomach acid production to treat ulcers. If you have a history of kidney disorders or are taking diuretics or other medications chronically, talk to your physician before taking a calcium supplement.
2. Fish Oil: Heart Healthy
Fish, such as mackerel, lake trout, herring, sardines, albacore tuna and salmon, are a rich source of omega-3s, namely EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These highly specialized fats can’t be made in our body, and because many women don’t eat enough fish – they may not like the flavor or may fear heavy metals or contaminants – they don’t get nearly enough of these amazing nutrients.
Why is fish oil important? Omega-3s are important for heart and blood vessel health and for reducing circulating triglycerides to lower heart disease risk. These special fats also support healthy joints, reduce inflammation and optimize brain operations. Some research has tied poor omega-3 intake to moodiness and depression.
Who needs it? All adult women, especially the following:
Women who don’t eat fish several times a week.
Women at increased risk of cardiovascular disease (especially those who have elevated triglycerides).
Pregnant and nursing women to enhance brain development of their baby.
Overweight women with joint tenderness.
How much should you take? One gram of EPA and DHA daily helps most women, but those with elevated triglycerides and under a physician’s guidance can consider 2-3 grams of fish oil daily with a diet low in alcohol consumption and fatty foods. Pregnant women should consider a fish oil supplement containing 1 gram of DHA for the development of their baby’s brain.
Talk to your physician before taking fish oil supplements if you are pregnant, have a history of bleeding disorders or are taking any medications, including blood thinners and blood pressure drugs, as well as any other supplements. Avoid the supplements if you are allergic to fish.
Take omega-3 supplements with food for better absorption and tolerance. To avoid “fish burps,” look for specially processed fish oil supplements that reduce this unpleasant side effect. Only take fish oil supplements certified to be very low in heavy metals, contaminants and research products.
3. Folate: Think Green
Folate is a water-soluble B vitamin. Its name is derived from foliage, as folate is richest in food sources such as leaves (spinach, asparagus) and fruits (cantaloupe).
Why is folate important? You need folate to look healthy. Our cells need it to make DNA, and without DNA, cells wouldn’t function properly. Nor would they make new cells and tissue, such as skin and hair. During pregnancy, especially the first couple of weeks when women often don’t know they are pregnant, folate is critical in preventing neural tube abnormalities in the fetus, such as spina bifida. It’s also involved in supporting normal levels of homocysteine in the blood, a controversial heart risk factor.
Who needs it? All adult women should consider taking a folate supplement, especially during child-bearing years. Pregnant women should take a prenatal supplement containing folate.
How much should you take? Healthy, non-pregnant women should look for a multivitamin supplement providing 400 micrograms daily. Pregnant women should take a prenatal supplement with 400-800 micrograms of folate. Talk to your obstetrician or gynecologist about taking folate along with other key supplements that can support a baby’s development.
4. B Vitamins: The Energizers
The B vitamins include thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5) pyridoxine (B6), cobalamin (B12) and biotin. These are water-soluble essential nutrients found in many foods, including whole grains, fruits and vegetables. Vitamin B12 is found exclusively in meat, fish and milk. Many foods are also fortified with B-vitamins.
Why are B vitamins important? An active woman can burn more than 2,000 calories a day. And B-vitamins are essential for producing the energy necessary to meet the demands of everyday life, whether you’re going to the gym, doing laundry, showering or giving a presentation at work.
Vitamins B6 and B12 protect a woman’s risk of heart disease by helping to keep homocysteine levels low. Biotin has long been recognized for its vital role in healthy hair. Although vitamin B6 is often associated with reduced PMS symptoms, unfortunately, researchers have failed to prove this connection.
Who needs it? All adult women, especially the following:
Women who exercise regularly and break a sweat because burning more calories daily can increase a woman’s need for these nutrients.
Women older than 50 should take a vitamin B12 supplement because age makes it harder to absorb this nutrient from food.
How much should you take? Besides a well-balanced diet containing lean meats, whole grains and fruits and vegetables, a multivitamin supplement should provide at least 50%-100% Daily Value of B-vitamins.
Coenzyme Q10: Age Gracefully
Coenzyme Q10 is a fat-soluble nutrient found in a variety of foods, including meats and fish.
Why is coenzyme Q10 important? It’s a powerful antioxidant as well as a key component in helping fuel the production of energy within cells. This nutrient also helps protect against premature aging and supports a healthy heart and blood vessels.
Who needs it? All women, especially the following:
Women at greater risk of developing heart disease and cancer and those being treated for these diseases. (Talk to your physician first.)
Strict vegetarians because the best sources of CoQ10 are meats and fish (although soybean and canola oils are also good sources).
How much should you take? Usual dosages are 30-100 mg daily. If you’re taking more than 100 mg daily, split the amount into two or more servings to promote better absorption. Take CoQ10 with meals for better absorption. Also, look for oil-based CoQ10 soft gel caps.
6. Vitamin D: Down to the Bone
Vitamin D is a fat-soluble vitamin that can be made in our bodies when exposed to sunlight. It’s also found in vitamin D fortified foods such as milk.
Why is vitamin D important? It helps our bodies absorb calcium from our diet and supplements we may take. Vitamin D also plays a role in the development and maintenance of healthy bones. And researchers are beginning to find that good vitamin D levels are important for general health and the prevention of certain diseases, including osteoporosis.
Who needs it? All women, especially the following:
Women who do not regularly drink milk or eat dairy foods fortified with vitamin D.
Women who don’t receive much direct exposure to sunlight.
Women over 50 years old because age makes the body less efficient at processing vitamin D.
Pregnant and breastfeeding women, so they can promote healthy development of the baby.
How much should you take? Pre-menopausal women should take at least 500 IU of vitamin D a day. (Note 1 microgram equals 40 IU.) Postmenopausal and elderly women should increase their dosage to 800 IU per day. Don’t exceed 2,000 IU from food and supplements daily.
Vitamin D is available in two forms, D2 (ergocalciferol) and D3 (cholecalciferol). Choose a vitamin D supplement that includes calcium, or choose a multivitamin supplement that includes both.
7. Lutein: See the Light
Lutein is part of a fat-soluble class of nutrients call carotenoids. It is found in dark-green leafy vegetables (such as spinach) as well as in various fruits, corn and egg yolks.
Why is lutein important? Lutein is an antioxidant that concentrates in the eyes to help protect them against free radical destruction and resulting age-related macular degeneration (ARMD), a leading cause of blindness in older women. Lutein is found in breast and cervical tissue and seems to support general health of those tissues. It is also found in the skin and may help protect against the sun’s damaging light.
Who needs it? All women, especially the following:
Women with a family history of age-related macular degeneration.
Women who are exposed to direct sunlight and pollutants regularly.
How much should you take? A lutein supplement should include 6 to 10 milligrams of the antioxidant. Take lutein supplements with food for more efficient absorption.
Have a question for Dr. Wildman? Email askdrwildman@lifescript.com. Please be sure to include your first name and last initial. Plus, meet Robert Wildman.
Should You Be Taking Supplements?
Nutrition supplements are so common today that most women are either taking them (and more than half are) or wondering if they should. Add to that the fact that women are vastly different than men, and each woman has different needs based on her diet, age, physical condition, lifestyle and disease risks.
1. Calcium: The Bone Builder
Calcium is an essential mineral found in high amounts in milk and other dairy products as well as fortified foods. Typically, a little more than 1% of a women’s body weight is calcium, which certainly helps us understand why we consider it so important.
Why is calcium important? Almost all your body’s calcium is found in your bones and teeth. And since women are four times more susceptible to osteoporosis than men, getting enough is essential for lifelong bone health. The remaining 1% is critical because calcium plays a role in heart and muscle action, blood clotting and normal cell function.
Who needs it? All adult women, especially the following:
Teens or young women because as much as 90% of adult bone mass is achieved by age 18. Peak bone mass usually occurs in the late 20s.
Women older than 30 because they typically lose bone mass and strength.
Menopausal and postmenopausal women because bone loss tends to accelerate as the body produces less estrogen.
How much should you take? Women ages 50 and younger should consider a daily calcium supplement of at least 500 mg, and eat calcium-rich foods such as milk, cheeses and other dairy foods and fortified products.
If you are older than 50, consider taking a daily supplement of 800-1,000 mg on top of eating calcium-rich foods. And if you take more than 1,000 mg daily, split the dosage and take half in the morning and half in the evening to ensure maximum absorption.
Calcium citrate may be a better choice if you don’t produce a lot of stomach acid. This is often the case for some women as they get older as well as women taking medications that reduce stomach acid production to treat ulcers. If you have a history of kidney disorders or are taking diuretics or other medications chronically, talk to your physician before taking a calcium supplement.
2. Fish Oil: Heart Healthy
Fish, such as mackerel, lake trout, herring, sardines, albacore tuna and salmon, are a rich source of omega-3s, namely EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These highly specialized fats can’t be made in our body, and because many women don’t eat enough fish – they may not like the flavor or may fear heavy metals or contaminants – they don’t get nearly enough of these amazing nutrients.
Why is fish oil important? Omega-3s are important for heart and blood vessel health and for reducing circulating triglycerides to lower heart disease risk. These special fats also support healthy joints, reduce inflammation and optimize brain operations. Some research has tied poor omega-3 intake to moodiness and depression.
Who needs it? All adult women, especially the following:
Women who don’t eat fish several times a week.
Women at increased risk of cardiovascular disease (especially those who have elevated triglycerides).
Pregnant and nursing women to enhance brain development of their baby.
Overweight women with joint tenderness.
How much should you take? One gram of EPA and DHA daily helps most women, but those with elevated triglycerides and under a physician’s guidance can consider 2-3 grams of fish oil daily with a diet low in alcohol consumption and fatty foods. Pregnant women should consider a fish oil supplement containing 1 gram of DHA for the development of their baby’s brain.
Talk to your physician before taking fish oil supplements if you are pregnant, have a history of bleeding disorders or are taking any medications, including blood thinners and blood pressure drugs, as well as any other supplements. Avoid the supplements if you are allergic to fish.
Take omega-3 supplements with food for better absorption and tolerance. To avoid “fish burps,” look for specially processed fish oil supplements that reduce this unpleasant side effect. Only take fish oil supplements certified to be very low in heavy metals, contaminants and research products.
3. Folate: Think Green
Folate is a water-soluble B vitamin. Its name is derived from foliage, as folate is richest in food sources such as leaves (spinach, asparagus) and fruits (cantaloupe).
Why is folate important? You need folate to look healthy. Our cells need it to make DNA, and without DNA, cells wouldn’t function properly. Nor would they make new cells and tissue, such as skin and hair. During pregnancy, especially the first couple of weeks when women often don’t know they are pregnant, folate is critical in preventing neural tube abnormalities in the fetus, such as spina bifida. It’s also involved in supporting normal levels of homocysteine in the blood, a controversial heart risk factor.
Who needs it? All adult women should consider taking a folate supplement, especially during child-bearing years. Pregnant women should take a prenatal supplement containing folate.
How much should you take? Healthy, non-pregnant women should look for a multivitamin supplement providing 400 micrograms daily. Pregnant women should take a prenatal supplement with 400-800 micrograms of folate. Talk to your obstetrician or gynecologist about taking folate along with other key supplements that can support a baby’s development.
4. B Vitamins: The Energizers
The B vitamins include thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5) pyridoxine (B6), cobalamin (B12) and biotin. These are water-soluble essential nutrients found in many foods, including whole grains, fruits and vegetables. Vitamin B12 is found exclusively in meat, fish and milk. Many foods are also fortified with B-vitamins.
Why are B vitamins important? An active woman can burn more than 2,000 calories a day. And B-vitamins are essential for producing the energy necessary to meet the demands of everyday life, whether you’re going to the gym, doing laundry, showering or giving a presentation at work.
Vitamins B6 and B12 protect a woman’s risk of heart disease by helping to keep homocysteine levels low. Biotin has long been recognized for its vital role in healthy hair. Although vitamin B6 is often associated with reduced PMS symptoms, unfortunately, researchers have failed to prove this connection.
Who needs it? All adult women, especially the following:
Women who exercise regularly and break a sweat because burning more calories daily can increase a woman’s need for these nutrients.
Women older than 50 should take a vitamin B12 supplement because age makes it harder to absorb this nutrient from food.
How much should you take? Besides a well-balanced diet containing lean meats, whole grains and fruits and vegetables, a multivitamin supplement should provide at least 50%-100% Daily Value of B-vitamins.
Coenzyme Q10: Age Gracefully
Coenzyme Q10 is a fat-soluble nutrient found in a variety of foods, including meats and fish.
Why is coenzyme Q10 important? It’s a powerful antioxidant as well as a key component in helping fuel the production of energy within cells. This nutrient also helps protect against premature aging and supports a healthy heart and blood vessels.
Who needs it? All women, especially the following:
Women at greater risk of developing heart disease and cancer and those being treated for these diseases. (Talk to your physician first.)
Strict vegetarians because the best sources of CoQ10 are meats and fish (although soybean and canola oils are also good sources).
How much should you take? Usual dosages are 30-100 mg daily. If you’re taking more than 100 mg daily, split the amount into two or more servings to promote better absorption. Take CoQ10 with meals for better absorption. Also, look for oil-based CoQ10 soft gel caps.
6. Vitamin D: Down to the Bone
Vitamin D is a fat-soluble vitamin that can be made in our bodies when exposed to sunlight. It’s also found in vitamin D fortified foods such as milk.
Why is vitamin D important? It helps our bodies absorb calcium from our diet and supplements we may take. Vitamin D also plays a role in the development and maintenance of healthy bones. And researchers are beginning to find that good vitamin D levels are important for general health and the prevention of certain diseases, including osteoporosis.
Who needs it? All women, especially the following:
Women who do not regularly drink milk or eat dairy foods fortified with vitamin D.
Women who don’t receive much direct exposure to sunlight.
Women over 50 years old because age makes the body less efficient at processing vitamin D.
Pregnant and breastfeeding women, so they can promote healthy development of the baby.
How much should you take? Pre-menopausal women should take at least 500 IU of vitamin D a day. (Note 1 microgram equals 40 IU.) Postmenopausal and elderly women should increase their dosage to 800 IU per day. Don’t exceed 2,000 IU from food and supplements daily.
Vitamin D is available in two forms, D2 (ergocalciferol) and D3 (cholecalciferol). Choose a vitamin D supplement that includes calcium, or choose a multivitamin supplement that includes both.
7. Lutein: See the Light
Lutein is part of a fat-soluble class of nutrients call carotenoids. It is found in dark-green leafy vegetables (such as spinach) as well as in various fruits, corn and egg yolks.
Why is lutein important? Lutein is an antioxidant that concentrates in the eyes to help protect them against free radical destruction and resulting age-related macular degeneration (ARMD), a leading cause of blindness in older women. Lutein is found in breast and cervical tissue and seems to support general health of those tissues. It is also found in the skin and may help protect against the sun’s damaging light.
Who needs it? All women, especially the following:
Women with a family history of age-related macular degeneration.
Women who are exposed to direct sunlight and pollutants regularly.
How much should you take? A lutein supplement should include 6 to 10 milligrams of the antioxidant. Take lutein supplements with food for more efficient absorption.
Have a question for Dr. Wildman? Email askdrwildman@lifescript.com. Please be sure to include your first name and last initial. Plus, meet Robert Wildman.
Should You Be Taking Supplements?
Nutrition supplements are so common today that most women are either taking them (and more than half are) or wondering if they should. Add to that the fact that women are vastly different than men, and each woman has different needs based on her diet, age, physical condition, lifestyle and disease risks.
Sunday, August 28, 2011
THOUGHT FOR TODAY...
Whatever you want in life, other people are going to want it too. Believe in yourself enough to accept the idea that you have an equal right to it.
FUN FACTS
* Thailand's capital Bangkok means "city of angels". *
* The first baseball caps were made of straw. *
* Tug of War was an Olympic event between 1900 and 1920. *
* The state sport of Maryland is Jousting. *
* The practice of identifying baseball players by number was started by the Yankees in 1929. *
* The first baseball caps were made of straw. *
* Tug of War was an Olympic event between 1900 and 1920. *
* The state sport of Maryland is Jousting. *
* The practice of identifying baseball players by number was started by the Yankees in 1929. *
Traveling for COPD Patients From Oxygen to Medications, Everything People with COPD Need
Taking a trip is a stressful for anyone, let alone someone with chronic obstructive pulmonary disease (COPD). Difficulty breathing can pose a number of problems – from carting around oxygen to dodging allergens and sick travelers. But with the right supplies and precautions, you can still have a “bon voyage”...
When Bonnie Chakravorty travels, she packs items all travelers need, such as tiny toiletries and several changes of clothes and shoes. But she also totes a few extra ones others don’t: a portable oxygen concentrator, respirator, medications and more.
That’s because the 59-year-old Nashville resident has chronic obstructive pulmonary disease (COPD). Sometimes she needs supplemental oxygen to treat COPD symptoms, such as shortness of breath. But that hasn't stopped her from hitting the road for work and pleasure.
“It’s a hassle, but not too bad,” says Chakravorty, a public health professor at Tennessee State University. “It’s almost like traveling with a dog or cat. You have to make [arrangements] ahead with the airlines, for instance.”
Traveling can be more challenging for COPD patients because they often have extra needs and restrictions and must tote supplemental oxygen tanks (filled with compressed oxygen) or concentrators (which concentrate the oxygen found in surrounding air). And certain destinations can make breathing more difficult.
COPD refers to a family of diseases that includes emphysema, a disease that destroys the air sacs in the lungs, and chronic bronchitis (usually defined as lasting more than three months), which leads to inflammation and eventual scarring of the bronchial tubes.
But COPD patients don’t have to be homebound – as long as they seek advice before they travel.
“Most people with COPD, even those who use oxygen, can travel, but should contact their doctor first,” says Norman Edelman, M.D., chief medical officer of the American Lung Association.
“Have your ducks lined up and know what you’re doing,” Chakravorty agrees.
Whether by sea, air or ground, here are some tips for traveling with COPD.
1. See your doctor
Before your trip, discuss travel plans with your doctor to get an honest assessment of your abilities and needs on the road, Edelman recommends. For example, ask whether you’ll need supplemental oxygen, particularly if you’re flying.
2. Get vaccinations
Make sure immunizations are up to date and get a flu shot (influenza vaccine) and pneumococcal conjugate (PCV13) vaccine to protect against pneumonia, suggests Brian W. Carlin, M.D., a pulmonologist and chairman of the COPD Alliance, which provides clinicians and patients with information about COPD.
“You’re more likely to catch influenza when traveling, especially if you’re in a closed compartment in a plane, train or car for a long period,” says Michael Zimring, M.D., director of Travel Medicine at Mercy Medical Center in Baltimore.
COPD patients are also more susceptible to pneumonia, an inflammation of the lungs, which can result in unexpected hospital stays.
3. Check out your equipment
Have your doctor test the equipment, such as compressors and oxygen concentrators, that you’ll be using while traveling, to prevent possible malfunctions and breakdowns.
Also, get a concentrator before your trip to determine if you can handle it on your own or will need assistance to get to the plane, advises Carlin.
“It can be cumbersome along with your purse and other carry-ons,” Carlin warns.
Portable, battery-operated concentrators about the size of a laptop and weighing 15-20 pounds are available. (The Federal Aviation Administration requires COPD patients to carry battery power for 150% of your scheduled flight time.)
4. Discuss your destination
Tell your doctor where you’re going, advises Carlin.
That’s key if you’re going to a high-altitude place, such as Denver, Phoenix and Las Vegas, because high altitude can trigger shortness of breath, or hypoxemia (low blood oxygen), he says.
The air is thinner and oxygen concentrations are lower at high altitudes, and even COPD patients who don’t use compressors at home may need supplemental oxygen supply in those cities, Carlin says.
“People think of it when flying, but may not think it’s as significant when they go to a higher altitude,” Carlin says. “Then, suddenly you’re sleepy and your blood oxygen levels are out of whack.”
At high altitudes, exercise a little lighter than normal or use supplemental oxygen when you exercise, says Carlin.
5. Prepare for weather
Check weather reports and avoid smoggy regions or seasons, which are particularly a problem in places like Los Angeles, Pittsburgh and Phoenix.
“Smog is irritating to people with COPD, so maybe you shouldn’t go to those areas in summer,” Edelman says.
On car trips, use air conditioning and keep windows closed, especially in smoggy conditions and traffic jams, where exhaust can cause lung irritation, Carlin suggests.
6. Make plans with the airline
COPD patients can’t use their own oxygen compressors (gas in tanks or liquid oxygen) on planes, but airlines allow FAA-approved battery-operated portable oxygen concentrators (POCs).
To use a concentrator, you must show medical necessity and get permission from the carrier, typically at least 48 hours before your flight.
Rules vary by carrier and are subject to change, so call the airline’s help desk a few weeks before your trip. Ask the airline representative what you need to do to get oxygen aboard the plane, Carlin advises.
7. Arrive at the airport early
“The worst thing [for COPD patients] is having to rush through a huge, crowded airport,” says Edelman.
Some carriers require patients with oxygen to check in at least an hour before a flight.
8. Use the special screening line
Your biggest need for oxygen may actually be at the airport, walking around, going through screenings or trying to catch a plane, says Zimring, author of Healthy Travel: Don’t Travel Without It (Basic Health Publications).
The Transportation Security Agency (TSA) allows supplemental oxygen and other respiratory-related equipment and devices, such as respirators and nebulizers, through airport security checkpoints. But you will have to get into a special-needs screening line. Often called “family lanes,” these are available at every checkpoint and should be marked with signs.
To stay connected to oxygen during the TSA screening, you must have a doctor’s note showing medical necessity.
If you normally use an oxygen compressor, the TSA allows you to stay connected to it until you get to the gate. You’ll have to switch to a concentrator on the plane.
You’ll also need to make arrangements for someone to pick up the compressor equipment from you at the gate. That person will need a gate pass, which also needs to be arranged at least 48 hours in advance through the airline.
The same process applies if you have someone with an oxygen supply meet you at your destination or at a layover airport.
Oxygen rules for international carriers vary, so it's extra important to check in advance.
9. Contact the cruise line before sailing
If you are cruising and using supplemental oxygen, tell the cruise company you have COPD at least 4-6 weeks before departure.
Cruise lines require a letter from your doctor, which should include a brief medical history and a current oxygen prescription. You’ll have to make advance arrangements to use oxygen tanks and have them delivered to the ship by a medical supplier.
Even if you don’t need supplemental oxygen, have a brief medical history available to show the shipboard doctor if an emergency arises at sea.
10. Make train and bus arrangements before your trip
Amtrak allows portable oxygen equipment (bottled oxygen and concentrators) that doesn’t rely solely on onboard electrical power. But you need to make a reservation and tell the railroad that you plan to use oxygen at least 12 hours before your trip.
Bus companies typically allow use of portable oxygen equipment, but check with the line before your departure. For example, some companies limit the number of canisters allowed onboard. If you’re traveling internationally, check with the bus or rail line because policies vary.
11. Map out medical suppliers along your route
Using compressed air tanks? On long car trips, plot places to purchase extra tanks along your route in case you have a malfunction or run out. Your medical supplier may have branches you can visit.
12. Avoid COPD triggers in hotels
Triggers for lung irritation are the same on the road as at home. That’s why you should request non-smoking rooms and floors, Edelman suggests. Third-hand smoke can be irritating to the lungs, he says.
If allergens are a COPD trigger, request an “allergen-free” room, which some hotel chains, such as Hilton, offer. It means extra steps have been taken to reduce dust and other allergens, such as wood flooring, shades and hypoallergenic linens.
As of early next year, most cruise ships will ban smoking in all cabins, though some lines still allow smoking on cabin balconies. Check with the cruise line about their policies.
13. Pack essentials
Whether traveling by plane, boat, car, bus or train, experts advise that you take these items:
Extra supplies of your medications in case you get delayed or stranded.
Copies of all prescriptions in case you need a refill or luggage is lost. Put it in your carry-on luggage.
Names of local doctors or hospitals at your destination where you can seek help if needed. Also include a list of phone numbers for your insurance company and health-care providers (e.g., doctor and respiratory therapist).
A written note from your doctor detailing your medication and oxygen needs with a brief description of your condition. You may need this at the airport if you’re taking an oxygen concentrator.
All medications, including inhalers, nebulizers or bronchodilators, in your carry-on in case of delays or lost luggage.
Hand sanitizer, either wipes or gel (3.4 ounces or less to meet TSA requirements), in your carry-on. “If you’re in an airplane where there are probably other people [who are] sick, someone may have coughed and touched the door handle,” Carlin says. “Be aware of that and wash your hands.”
14. Stay home if you’re sick
It’s a good rule for all travelers, “but COPD patients should think twice about” traveling when sick, Carlin advises.
That’s because people with COPD are more susceptible to respiratory infections.
15. Move your body
On long plane, train or road trips, “you don't need to get up and stretch your legs because of COPD, but because of deep vein thrombosis,” a condition in which clots form in veins, Zimring says.
“You must move your legs to avoid clots,” he advises.
For more expert advice and information, visit our COPD Health Center.
How Much Do You Know About COPD?
Chronic obstructive pulmonary disease (COPD) is on the rise, according to the National Institutes of Health. More than 12 million people in the U.S. are currently diagnosed with it, and another 12 million may have it but don’t know.
When Bonnie Chakravorty travels, she packs items all travelers need, such as tiny toiletries and several changes of clothes and shoes. But she also totes a few extra ones others don’t: a portable oxygen concentrator, respirator, medications and more.
That’s because the 59-year-old Nashville resident has chronic obstructive pulmonary disease (COPD). Sometimes she needs supplemental oxygen to treat COPD symptoms, such as shortness of breath. But that hasn't stopped her from hitting the road for work and pleasure.
“It’s a hassle, but not too bad,” says Chakravorty, a public health professor at Tennessee State University. “It’s almost like traveling with a dog or cat. You have to make [arrangements] ahead with the airlines, for instance.”
Traveling can be more challenging for COPD patients because they often have extra needs and restrictions and must tote supplemental oxygen tanks (filled with compressed oxygen) or concentrators (which concentrate the oxygen found in surrounding air). And certain destinations can make breathing more difficult.
COPD refers to a family of diseases that includes emphysema, a disease that destroys the air sacs in the lungs, and chronic bronchitis (usually defined as lasting more than three months), which leads to inflammation and eventual scarring of the bronchial tubes.
But COPD patients don’t have to be homebound – as long as they seek advice before they travel.
“Most people with COPD, even those who use oxygen, can travel, but should contact their doctor first,” says Norman Edelman, M.D., chief medical officer of the American Lung Association.
“Have your ducks lined up and know what you’re doing,” Chakravorty agrees.
Whether by sea, air or ground, here are some tips for traveling with COPD.
1. See your doctor
Before your trip, discuss travel plans with your doctor to get an honest assessment of your abilities and needs on the road, Edelman recommends. For example, ask whether you’ll need supplemental oxygen, particularly if you’re flying.
2. Get vaccinations
Make sure immunizations are up to date and get a flu shot (influenza vaccine) and pneumococcal conjugate (PCV13) vaccine to protect against pneumonia, suggests Brian W. Carlin, M.D., a pulmonologist and chairman of the COPD Alliance, which provides clinicians and patients with information about COPD.
“You’re more likely to catch influenza when traveling, especially if you’re in a closed compartment in a plane, train or car for a long period,” says Michael Zimring, M.D., director of Travel Medicine at Mercy Medical Center in Baltimore.
COPD patients are also more susceptible to pneumonia, an inflammation of the lungs, which can result in unexpected hospital stays.
3. Check out your equipment
Have your doctor test the equipment, such as compressors and oxygen concentrators, that you’ll be using while traveling, to prevent possible malfunctions and breakdowns.
Also, get a concentrator before your trip to determine if you can handle it on your own or will need assistance to get to the plane, advises Carlin.
“It can be cumbersome along with your purse and other carry-ons,” Carlin warns.
Portable, battery-operated concentrators about the size of a laptop and weighing 15-20 pounds are available. (The Federal Aviation Administration requires COPD patients to carry battery power for 150% of your scheduled flight time.)
4. Discuss your destination
Tell your doctor where you’re going, advises Carlin.
That’s key if you’re going to a high-altitude place, such as Denver, Phoenix and Las Vegas, because high altitude can trigger shortness of breath, or hypoxemia (low blood oxygen), he says.
The air is thinner and oxygen concentrations are lower at high altitudes, and even COPD patients who don’t use compressors at home may need supplemental oxygen supply in those cities, Carlin says.
“People think of it when flying, but may not think it’s as significant when they go to a higher altitude,” Carlin says. “Then, suddenly you’re sleepy and your blood oxygen levels are out of whack.”
At high altitudes, exercise a little lighter than normal or use supplemental oxygen when you exercise, says Carlin.
5. Prepare for weather
Check weather reports and avoid smoggy regions or seasons, which are particularly a problem in places like Los Angeles, Pittsburgh and Phoenix.
“Smog is irritating to people with COPD, so maybe you shouldn’t go to those areas in summer,” Edelman says.
On car trips, use air conditioning and keep windows closed, especially in smoggy conditions and traffic jams, where exhaust can cause lung irritation, Carlin suggests.
6. Make plans with the airline
COPD patients can’t use their own oxygen compressors (gas in tanks or liquid oxygen) on planes, but airlines allow FAA-approved battery-operated portable oxygen concentrators (POCs).
To use a concentrator, you must show medical necessity and get permission from the carrier, typically at least 48 hours before your flight.
Rules vary by carrier and are subject to change, so call the airline’s help desk a few weeks before your trip. Ask the airline representative what you need to do to get oxygen aboard the plane, Carlin advises.
7. Arrive at the airport early
“The worst thing [for COPD patients] is having to rush through a huge, crowded airport,” says Edelman.
Some carriers require patients with oxygen to check in at least an hour before a flight.
8. Use the special screening line
Your biggest need for oxygen may actually be at the airport, walking around, going through screenings or trying to catch a plane, says Zimring, author of Healthy Travel: Don’t Travel Without It (Basic Health Publications).
The Transportation Security Agency (TSA) allows supplemental oxygen and other respiratory-related equipment and devices, such as respirators and nebulizers, through airport security checkpoints. But you will have to get into a special-needs screening line. Often called “family lanes,” these are available at every checkpoint and should be marked with signs.
To stay connected to oxygen during the TSA screening, you must have a doctor’s note showing medical necessity.
If you normally use an oxygen compressor, the TSA allows you to stay connected to it until you get to the gate. You’ll have to switch to a concentrator on the plane.
You’ll also need to make arrangements for someone to pick up the compressor equipment from you at the gate. That person will need a gate pass, which also needs to be arranged at least 48 hours in advance through the airline.
The same process applies if you have someone with an oxygen supply meet you at your destination or at a layover airport.
Oxygen rules for international carriers vary, so it's extra important to check in advance.
9. Contact the cruise line before sailing
If you are cruising and using supplemental oxygen, tell the cruise company you have COPD at least 4-6 weeks before departure.
Cruise lines require a letter from your doctor, which should include a brief medical history and a current oxygen prescription. You’ll have to make advance arrangements to use oxygen tanks and have them delivered to the ship by a medical supplier.
Even if you don’t need supplemental oxygen, have a brief medical history available to show the shipboard doctor if an emergency arises at sea.
10. Make train and bus arrangements before your trip
Amtrak allows portable oxygen equipment (bottled oxygen and concentrators) that doesn’t rely solely on onboard electrical power. But you need to make a reservation and tell the railroad that you plan to use oxygen at least 12 hours before your trip.
Bus companies typically allow use of portable oxygen equipment, but check with the line before your departure. For example, some companies limit the number of canisters allowed onboard. If you’re traveling internationally, check with the bus or rail line because policies vary.
11. Map out medical suppliers along your route
Using compressed air tanks? On long car trips, plot places to purchase extra tanks along your route in case you have a malfunction or run out. Your medical supplier may have branches you can visit.
12. Avoid COPD triggers in hotels
Triggers for lung irritation are the same on the road as at home. That’s why you should request non-smoking rooms and floors, Edelman suggests. Third-hand smoke can be irritating to the lungs, he says.
If allergens are a COPD trigger, request an “allergen-free” room, which some hotel chains, such as Hilton, offer. It means extra steps have been taken to reduce dust and other allergens, such as wood flooring, shades and hypoallergenic linens.
As of early next year, most cruise ships will ban smoking in all cabins, though some lines still allow smoking on cabin balconies. Check with the cruise line about their policies.
13. Pack essentials
Whether traveling by plane, boat, car, bus or train, experts advise that you take these items:
Extra supplies of your medications in case you get delayed or stranded.
Copies of all prescriptions in case you need a refill or luggage is lost. Put it in your carry-on luggage.
Names of local doctors or hospitals at your destination where you can seek help if needed. Also include a list of phone numbers for your insurance company and health-care providers (e.g., doctor and respiratory therapist).
A written note from your doctor detailing your medication and oxygen needs with a brief description of your condition. You may need this at the airport if you’re taking an oxygen concentrator.
All medications, including inhalers, nebulizers or bronchodilators, in your carry-on in case of delays or lost luggage.
Hand sanitizer, either wipes or gel (3.4 ounces or less to meet TSA requirements), in your carry-on. “If you’re in an airplane where there are probably other people [who are] sick, someone may have coughed and touched the door handle,” Carlin says. “Be aware of that and wash your hands.”
14. Stay home if you’re sick
It’s a good rule for all travelers, “but COPD patients should think twice about” traveling when sick, Carlin advises.
That’s because people with COPD are more susceptible to respiratory infections.
15. Move your body
On long plane, train or road trips, “you don't need to get up and stretch your legs because of COPD, but because of deep vein thrombosis,” a condition in which clots form in veins, Zimring says.
“You must move your legs to avoid clots,” he advises.
For more expert advice and information, visit our COPD Health Center.
How Much Do You Know About COPD?
Chronic obstructive pulmonary disease (COPD) is on the rise, according to the National Institutes of Health. More than 12 million people in the U.S. are currently diagnosed with it, and another 12 million may have it but don’t know.
Gov’t Panel: Vaccines Are Safe
After a close review of more than 1,000 research studies, a federal panel of experts has concluded that vaccines cause very few side effects, and found no evidence that vaccines cause autism or Type-1 diabetes.
The report, issued on Thursday by the Institute of Medicine, part of the National Academies of Sciences, is the first comprehensive report on vaccine side effects since 1994.
Fears that vaccines might cause autism or other health problems have led some parents to skip vaccinating their children, despite repeated reassurances from health authorities. The concerns have also forced costly reformulations of many vaccines.
"We looked at more than 1,000 articles evaluating the epidemiological and biological evidence about whether vaccines cause side effects," said committee chair Ellen Wright Clayton, professor of pediatrics and law, and director of the Center for Biomedical Ethics and Society at Vanderbilt University in Nashville.
"The big take-home message is that we found only a few cases in which vaccines can cause adverse side effects, and the vast majority of those are short term and self limiting," she said in a telephone interview.
The report was commissioned by the Department of Health and Human Services to help guide the Vaccine Injury Compensation Program, which provides a pool of money to take care of children who experience side effects from vaccines.
The panel looked at eight common vaccines: the combination measles-mumps-rubella (MMR), the diphtheria-tetanus-acellular pertussis (DTaP), varicella for chickenpox, influenza, hepatitis B, meningococcal, tetanus-containing vaccines, and the human papillomavirus (HPV) vaccine.
These vaccines protect against a host of diseases, including measles, mumps, whooping cough, hepatitis, diphtheria, tetanus, chickenpox, meningitis and pneumococcal disease, and cervical cancer.
Side Effects Are Generally Mild
Once again, the IOM found that the MMR vaccine does not cause autism, nor does it cause Type-1 diabetes, Clayton said.
"The DTaP vaccine, which is the pertussis vaccine, does not cause Type-1 diabetes, and the killed flu vaccine does not cause Bell's palsy (temporary facial paralysis), and it doesn't make your asthma get worse," Clayton said.
"The evidence was really quite strong that vaccines don't cause these side effects," she said.
Among the side effects vaccines can cause, Clayton said most are short lived. The panel found that the MMR vaccine can cause seizures in people who develop high fevers after getting the vaccine, but these pass quickly.
"They are scary to be sure, but they do not cause any long-term harm and they are not a sign the child will get epilepsy," Clayton said.
MMR can also cause a rare form of brain inflammation in some people with severe immune system deficiencies.
With the varicella vaccine against chickenpox, some people can develop brain swelling, pneumonia, hepatitis, meningitis, or shingles, but this occurs most often in people with compromised immune systems.
Six vaccines — MMR, varicella, influenza, hepatitis B, meningococcal, and the tetanus-containing vaccines — also can trigger anaphylaxis, an allergic reaction that appears shortly after injection.
But Clayton said this can be addressed with the requirement by doctors to have patients remain in the waiting room for 15 minutes after their shot to make sure they do not have an allergic reaction.
She said the report should help people who are seeking to file claims for vaccine side effects, but it should also reassure many people that vaccines are largely safe.
"Despite looking very hard, it was really hard to find that vaccines cause injuries and the injuries they do cause are generally pretty mild and self contained," she said.
The report, issued on Thursday by the Institute of Medicine, part of the National Academies of Sciences, is the first comprehensive report on vaccine side effects since 1994.
Fears that vaccines might cause autism or other health problems have led some parents to skip vaccinating their children, despite repeated reassurances from health authorities. The concerns have also forced costly reformulations of many vaccines.
"We looked at more than 1,000 articles evaluating the epidemiological and biological evidence about whether vaccines cause side effects," said committee chair Ellen Wright Clayton, professor of pediatrics and law, and director of the Center for Biomedical Ethics and Society at Vanderbilt University in Nashville.
"The big take-home message is that we found only a few cases in which vaccines can cause adverse side effects, and the vast majority of those are short term and self limiting," she said in a telephone interview.
The report was commissioned by the Department of Health and Human Services to help guide the Vaccine Injury Compensation Program, which provides a pool of money to take care of children who experience side effects from vaccines.
The panel looked at eight common vaccines: the combination measles-mumps-rubella (MMR), the diphtheria-tetanus-acellular pertussis (DTaP), varicella for chickenpox, influenza, hepatitis B, meningococcal, tetanus-containing vaccines, and the human papillomavirus (HPV) vaccine.
These vaccines protect against a host of diseases, including measles, mumps, whooping cough, hepatitis, diphtheria, tetanus, chickenpox, meningitis and pneumococcal disease, and cervical cancer.
Side Effects Are Generally Mild
Once again, the IOM found that the MMR vaccine does not cause autism, nor does it cause Type-1 diabetes, Clayton said.
"The DTaP vaccine, which is the pertussis vaccine, does not cause Type-1 diabetes, and the killed flu vaccine does not cause Bell's palsy (temporary facial paralysis), and it doesn't make your asthma get worse," Clayton said.
"The evidence was really quite strong that vaccines don't cause these side effects," she said.
Among the side effects vaccines can cause, Clayton said most are short lived. The panel found that the MMR vaccine can cause seizures in people who develop high fevers after getting the vaccine, but these pass quickly.
"They are scary to be sure, but they do not cause any long-term harm and they are not a sign the child will get epilepsy," Clayton said.
MMR can also cause a rare form of brain inflammation in some people with severe immune system deficiencies.
With the varicella vaccine against chickenpox, some people can develop brain swelling, pneumonia, hepatitis, meningitis, or shingles, but this occurs most often in people with compromised immune systems.
Six vaccines — MMR, varicella, influenza, hepatitis B, meningococcal, and the tetanus-containing vaccines — also can trigger anaphylaxis, an allergic reaction that appears shortly after injection.
But Clayton said this can be addressed with the requirement by doctors to have patients remain in the waiting room for 15 minutes after their shot to make sure they do not have an allergic reaction.
She said the report should help people who are seeking to file claims for vaccine side effects, but it should also reassure many people that vaccines are largely safe.
"Despite looking very hard, it was really hard to find that vaccines cause injuries and the injuries they do cause are generally pretty mild and self contained," she said.
New Early Warning Test For Alzheimer’s
Researchers at the Mayo Clinic have used specialized scans to identify brain changes in older people at risk of Alzheimer’s disease.
Special MRI and PET scans were used among study participants in their 70s and 80s to find changes in the brain that are considered connected to the brain-wasting disease, WebMD.com reports. The tests looked for amyloid-beta plaques, which are thought to be an early link to Alzheimer’s, as well as biochemical changes.
Among the people studied, about one-third had high plaque levels, and those who were reported to have high levels on the PET scan also had biochemical changes evident on the MRI.
"We found that these biochemical changes in the brain of normally aging people were associated with worse performance on tests of mental abilities, including memory, language, and attention," Dr. Kejal Kantarci, associate professor of radiology at the Mayo Clinic in Rochester, Minn., tells WebMD.com.
The work was published in Neurology and funded by the National Institutes of Health.
Brain Scans Show Risk Factor for Alzheimer's---
Changes in Brain Chemistry Linked With Lower Scores on Memory, Language Tests:
Aug. 24, 2011 -- Specialized scans can identify changes in the brains of people at risk of Alzheimer's disease, according to new research.
In the study, researchers used a special MRI scan and a special PET scan in people in their 70s and 80s who were aging normally to help identify those who had brain changes thought to be linked with Alzheimer's disease.
The scans looked for amyloid-beta plaques, one of the early changes linked with the disease, and for biochemical changes, says researcher Kejal Kantarci, MD, associate professor of radiology at the Mayo Clinic in Rochester, Minn.
About a third had high levels of plaques, she found. Those who had high levels of plaques on the PET scan also tended to have the biochemical changes found on the MRI.
"We found that these biochemical changes in the brain of normally aging people were associated with worse performance on tests of mental abilities, including memory, language, and attention," she tells WebMD.
The approach is one of several under study to identify those most at risk for developing Alzheimer's disease. Others are working on blood tests, for example.
The most common form of dementia, Alzheimer's affects about 5.4 million Americans, according to the Alzheimer's Association. While doctors often use brain imaging, evaluation of behavior, psychiatric tests, and other means to diagnose the disease, none is highly accurate.
The new study was funded by the National Institutes of Health. It is published in Neurology.
Test for Alzheimer's: Study Details
Kantarci and her colleagues evaluated 311 people, all aged 70 or older, who were part of the Mayo Clinic Study of Aging. Everyone received a PET scan to look for plaque and an MRI to look for brain metabolites linked with the disease.
They also gave everyone tests of memory, language, and other skills.
Those with the high levels of plaques also tended to have high levels of the metabolites.
However, those who had high levels of the metabolites choline and creatinine had lower test scores, regardless of their level of plaques.
"Although these biochemical changes are associated with amyloid-beta deposits, they are associated with [worse] thinking skills whether or not the person has high amyloids," Kantarci tells WebMD.
She plans to follow the men and women over time for more information.
Test for Alzheimer's: Perspective
The study findings are simply a ''snapshot in time," says Heather Snyder, PhD, senior associate director of the Alzheimer's Association. She reviewed the findings but was not involved in the research.
"This study had a decent-sized population but lasted a relatively short period of time," Snyder says in an email. "Studies such as this provide some valuable insights and generate additional research questions, but long-term follow-up is crucial."
Many people ask the Alzheimer's Association about the value of early detection or prediction, since there is no effective cure or prevention.
However, early detection can help people get care earlier, she says. It can help families plan for care. It can enable patients to join a clinical trial if they wish.
In an editorial accompanying the study, Jonathan M. Schott, MD, of the University College London, writes that a reliable way to predict Alzheimer's will become crucial as the population ages, especially if there are treatment advances.
Schott reports grant support from Alzheimer's Research UK.
Special MRI and PET scans were used among study participants in their 70s and 80s to find changes in the brain that are considered connected to the brain-wasting disease, WebMD.com reports. The tests looked for amyloid-beta plaques, which are thought to be an early link to Alzheimer’s, as well as biochemical changes.
Among the people studied, about one-third had high plaque levels, and those who were reported to have high levels on the PET scan also had biochemical changes evident on the MRI.
"We found that these biochemical changes in the brain of normally aging people were associated with worse performance on tests of mental abilities, including memory, language, and attention," Dr. Kejal Kantarci, associate professor of radiology at the Mayo Clinic in Rochester, Minn., tells WebMD.com.
The work was published in Neurology and funded by the National Institutes of Health.
Brain Scans Show Risk Factor for Alzheimer's---
Changes in Brain Chemistry Linked With Lower Scores on Memory, Language Tests:
Aug. 24, 2011 -- Specialized scans can identify changes in the brains of people at risk of Alzheimer's disease, according to new research.
In the study, researchers used a special MRI scan and a special PET scan in people in their 70s and 80s who were aging normally to help identify those who had brain changes thought to be linked with Alzheimer's disease.
The scans looked for amyloid-beta plaques, one of the early changes linked with the disease, and for biochemical changes, says researcher Kejal Kantarci, MD, associate professor of radiology at the Mayo Clinic in Rochester, Minn.
About a third had high levels of plaques, she found. Those who had high levels of plaques on the PET scan also tended to have the biochemical changes found on the MRI.
"We found that these biochemical changes in the brain of normally aging people were associated with worse performance on tests of mental abilities, including memory, language, and attention," she tells WebMD.
The approach is one of several under study to identify those most at risk for developing Alzheimer's disease. Others are working on blood tests, for example.
The most common form of dementia, Alzheimer's affects about 5.4 million Americans, according to the Alzheimer's Association. While doctors often use brain imaging, evaluation of behavior, psychiatric tests, and other means to diagnose the disease, none is highly accurate.
The new study was funded by the National Institutes of Health. It is published in Neurology.
Test for Alzheimer's: Study Details
Kantarci and her colleagues evaluated 311 people, all aged 70 or older, who were part of the Mayo Clinic Study of Aging. Everyone received a PET scan to look for plaque and an MRI to look for brain metabolites linked with the disease.
They also gave everyone tests of memory, language, and other skills.
Those with the high levels of plaques also tended to have high levels of the metabolites.
However, those who had high levels of the metabolites choline and creatinine had lower test scores, regardless of their level of plaques.
"Although these biochemical changes are associated with amyloid-beta deposits, they are associated with [worse] thinking skills whether or not the person has high amyloids," Kantarci tells WebMD.
She plans to follow the men and women over time for more information.
Test for Alzheimer's: Perspective
The study findings are simply a ''snapshot in time," says Heather Snyder, PhD, senior associate director of the Alzheimer's Association. She reviewed the findings but was not involved in the research.
"This study had a decent-sized population but lasted a relatively short period of time," Snyder says in an email. "Studies such as this provide some valuable insights and generate additional research questions, but long-term follow-up is crucial."
Many people ask the Alzheimer's Association about the value of early detection or prediction, since there is no effective cure or prevention.
However, early detection can help people get care earlier, she says. It can help families plan for care. It can enable patients to join a clinical trial if they wish.
In an editorial accompanying the study, Jonathan M. Schott, MD, of the University College London, writes that a reliable way to predict Alzheimer's will become crucial as the population ages, especially if there are treatment advances.
Schott reports grant support from Alzheimer's Research UK.
Dr. Brownstein: Detox Your Body Using Antioxidants
Can antioxidants — those cell-protective substances found in lots of the fruits and vegetables we eat — actually detoxify our bodies and make us younger in the process?
Yes, and no, says Newsmax health contributor Dr. David Brownstein. Yes, antioxidants safeguard us against free radicals which are produced when our bodies break down food, and toxins in the environment like radiation and tobacco smoke. But antioxidants won’t actually make us younger although they help combat the aging process, he says.
“Antioxidants can’t make you younger, but they can certainly minimize signs of aging and help your body grow old much more appropriately, much more gracefully,” says Brownstein, editor of “The Natural Way to Health” newsletter.
Consider vitamins C and E, the two most important antioxidants available, according to Brownstein. Both have been linked to preserving muscle function in older adults. What’s more, vitamin C is critical for healthy bones, skin, and connective tissue; helps promote healing; and aids in iron absorption. Vitamin E helps us maintain a healthy immune system and works to ensure our metabolic processes are functioning.
Antioxidants may help us fight illnesses like cancer and heart disease, which free radicals seem to play a role in. The best way to get your antioxidants, which also include vitamin A, selenium, lycopene, lutein, and beta-carotene, is by eating whole foods, Brownstein says. Broccoli, greens, tomatoes, red and green peppers, and citrus fruits are great sources of vitamin C. Get your vitamin E by eating leafy greens, nuts, and seeds. Some meats, fish, poultry, and grains also offer antioxidants.
“We are exposed to toxic agents on a daily basis, and antioxidants are used by our body to buffet these toxic agents,” Brownstein says.
Yes, and no, says Newsmax health contributor Dr. David Brownstein. Yes, antioxidants safeguard us against free radicals which are produced when our bodies break down food, and toxins in the environment like radiation and tobacco smoke. But antioxidants won’t actually make us younger although they help combat the aging process, he says.
“Antioxidants can’t make you younger, but they can certainly minimize signs of aging and help your body grow old much more appropriately, much more gracefully,” says Brownstein, editor of “The Natural Way to Health” newsletter.
Consider vitamins C and E, the two most important antioxidants available, according to Brownstein. Both have been linked to preserving muscle function in older adults. What’s more, vitamin C is critical for healthy bones, skin, and connective tissue; helps promote healing; and aids in iron absorption. Vitamin E helps us maintain a healthy immune system and works to ensure our metabolic processes are functioning.
Antioxidants may help us fight illnesses like cancer and heart disease, which free radicals seem to play a role in. The best way to get your antioxidants, which also include vitamin A, selenium, lycopene, lutein, and beta-carotene, is by eating whole foods, Brownstein says. Broccoli, greens, tomatoes, red and green peppers, and citrus fruits are great sources of vitamin C. Get your vitamin E by eating leafy greens, nuts, and seeds. Some meats, fish, poultry, and grains also offer antioxidants.
“We are exposed to toxic agents on a daily basis, and antioxidants are used by our body to buffet these toxic agents,” Brownstein says.
Are You Addicted to Prescription Drugs?
Can’t sleep or shake off stress? Maybe popping one – or three – pills will help. That kind of thinking led to the deaths of Brittany Murphy, Michael Jackson and Anna Nicole Smith. But prescription drug abuse can happen to anyone. Find out how easy it is to get hooked and where to get help. Plus, can you tell if someone you love is on drugs? Take our quiz to find out...
Stress keeping you up at night? A tablet of Valium helps. Suffering from back pain? Those Percodans are a lifesaver.
Taking a couple pills every day may not seem like a big deal. You know you’re in control.
Or are you?
Prescription drug abuse in the U.S. is rising among women and older adults, according to the National Institute on Drug Abuse (NIDA). Nearly seven million Americans used medications for non-medical reasons in 2007 – three million of them women.
The most abused drugs: narcotic painkillers, tranquilizers, anti-anxiety medications and stimulants.
“It’s a slippery slope with some prescription drugs,” says Neil Capretto, D.O., medical director of Gateway Rehabilitation Center in Pittsburgh, PA. “Anyone taking a controlled substance over time will at the very least become physically dependent.”
Women are more likely than men to be prescribed addictive prescription drugs and get hooked on them, NIDA research suggests.
That’s because they’re more likely than men to seek medical treatment, especially for mental health problems, Capretto says. “Women also communicate more with doctors than men do and thus are more likely to be prescribed something.”
Getting Hooked
How easy is it to get addicted?
“It depends on the amount of the substance used, the dose or strength” and how long you’ve been taking it, says Robert Karp M.D., associate medical director for inpatient psychiatric services at Overlook Hospital, Summit, N.J.
Those with certain psychiatric illnesses like depression, anxiety or a genetic tendency for addiction are also likely to get hooked, says Steven D. Passik, Ph.D., a psychologist at Memorial Sloan Kettering Cancer Center in New York.
“People with a family history of substance abuse or a prior history of alcohol or drug abuse are most vulnerable,” he says. “They may also be living with high stress or psychiatric problems, such as mood disorders like bipolar disorder or anxiety.”
In some, the abuse itself can create psychiatric symptoms such as depression, anxiety and even psychosis.
How Prescription Drug Addiction Works
So how do prescription drugs take control so strongly in the first place?
“Drugs literally hijack the reward system in the brain,” Capretto says. “They take over the drive center in the midbrain and increase dopamine, a neurotransmitter that causes pleasure.”
As addiction sets in and your tolerance builds, “that sense of euphoria gets harder and harder to capture,” says Loren Olson, M.D., a psychiatrist in Des Moines, Iowa. You need more of the drug to feel more like yourself and function at work or with family and friends. So you begin popping more pills.
Compounding the problem: withdrawal symptoms – nausea, sweating, cramping and insomnia – so uncomfortable that the only way to avoid them is to go back on the drug, Olson says.
“Physically, you may look like you have the flu in the morning,” Capretto says.
Your looks aren’t the only thing prescription drug abuse affects. It could even cost you your life.
“Opioids can cause severe respiratory depression or even death following a single large dose,” says Adrienne Marcus, Ph.D., executive director for the Lexington Center for Recovery in Mt. Kisco, N.Y.
You may also experience seizures after reducing or stopping some depressants.
High doses of stimulants “can cause irregular heartbeats, dangerously high body temperatures, cardiovascular failure and lethal seizures or can result in intense hostility and feelings of paranoia,” Marcus says.
Taking large amounts of one drug is bad enough. Even worse: mixing meds or taking them with an alcoholic drink, especially in high doses.
Popping Ambien pills after a few glasses of wine, for example, can lead to blackouts, memory loss and erratic behavior.
“Two plus two isn’t four – it’s more like 10,” Capretto says. “You’re pushing your nervous system in different directions at the same time."
Not everyone feels the same effects from these drugs either.
“If you take it and feel like you’re in love – or you feel calm or all warm and fuzzy – that’s a sign you may have a tendency for addiction,” he says.
Recognizing Prescription Drug Abuse
It’s easy to deny that your drug use is out of control. After all, if your doctor prescribed the drug, it must be safe, right?
Wrong, Capretto says. Just because a doctor prescribed the medication doesn’t mean it isn’t addictive, he says.
“Whether a patient gets a drug off the street or is prescribed it by a doctor, the potency and addictive nature doesn't change," he says.
In fact, many people spend years in denial before seeking help. Here are 7 warning signs and symptoms of addiction:
You have strong cravings for the medication.
Your drug use has become compulsive and you’re taking more than the prescribed dose.
You’re on a constant quest to obtain the drug through various means, whether borrowing from friends, shopping around doctors or even theft or forgery.
You continue to use the drug even though it’s hurting your job performance, relationships and other aspects of your life.
Your behavior has changed. You may be more secretive, argumentative and defensive.
You’re mixing drugs to achieve the same effect.
You’ve tried to stop or reduce your usage, but can’t.
If you’re experiencing these signs, it’s time to get professional help. Quitting may require treatment with drugs like naltrexone, methadone and buprenorphine.
Naltrexone blocks the effects of opioid painkillers but doesn’t get rid of withdrawal symptoms. Methadone and buprenorphine, on the other hand, help ease the addiction and prevent the misery of withdrawal.
Many addicts will need behavioral counseling or a recovery program; others require an intervention by family members to force them into treatment.
Using These Drugs Safely
Most people are using prescription drugs properly under supervision of a doctor who’s familiar with their medical history, Passik says.
A good physician should prescribe drugs only for a limited time and in small doses. Some doctors may also require regular urine tests to monitor usage.
“These drugs are all tools, and if they’re used properly, they’re great,” Capretto says.
The Troublemakers
Here are the most commonly addictive prescribed drugs:
Painkillers
What are they? Opioids are used to treat acute or chronic pain, as well as post-surgical pain and to relieve cough and diarrhea. They may be prescribed to treat pain from arthritis, fibromyalgia or cancer.
Common opioids: oxycodone (OxyContin, Percocet, Perdocan), codeine and morphine (Kadian)
How they work: Opioids attach themselves to proteins on the cell surface known as opioid receptors, which are found in the brain, spinal cord and gastrointestinal tract. They block pain messages sent to the brain.
They can also make you sleepy or constipated and induce euphoric feelings by affecting regions of the brain that control pleasure.
“Pain drugs are by far the most common [abused prescription drug] we see,” Capretto says.
Anti-anxiety drugs and sleeping pills
What are they? Central nervous system (CNS) depressants (also known as sedatives and tranquilizers) slow normal brain function. They’re usually prescribed for anxiety, tension, panic attacks and sleep disorders.
Common CNS depressants: benzodiazepines such as diazepam (Valium), alprazolam (Xanax) and chlordiazepoxide HC1 (Librium)
More sedating benzodiazepines, such as triazolam (Halcion) and estazolam (ProSom), are sometimes prescribed for sleep disorders.
Barbiturates such as mephobarbital (Mebaral) and pentobarbital sodium (Nembutal) are also CNS depressants, but aren’t prescribed as often.
How they work: Most CNS depressants enhance the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which decreases normal brain activity. An increase in GABA causes drowsiness and tranquility — the way you feel after a martini or two.
“It calms [people] down so they may feel more confident in groups,” Capretto says.
Nonbenzodiazepine sleep medications
What are they? These drugs are prescribed for insomnia. Though less likely to cause addiction and abuse, they can lead to psychological dependency: Users often believe they can’t sleep without them.
Common sleep drugs: Lunesta (Eszopiclone), Ambien (Zolpidem) and Sonata (Zaleplon)
How they work: Drugs in this category are similar to benzodiazepines and enhance the effects of GABA in the brain, thereby making you sleepy.
Stimulants
What are they? Stimulants are often used to treat attention-deficit hyperactivity disorder (ADHD), narcolepsy and forms of depression that are resistant to other treatments.
Common stimulants: methylphenidate (Ritalin, Concerta) and dextroamphetamine (Dexedrine, Adderall)
How they work: Stimulants boost levels of dopamine, a neurotransmitter that enhances pleasure and focus. These medications are especially popular among college students trying to do more with less sleep.
For more information, visit our Mental Health Center.
Stress keeping you up at night? A tablet of Valium helps. Suffering from back pain? Those Percodans are a lifesaver.
Taking a couple pills every day may not seem like a big deal. You know you’re in control.
Or are you?
Prescription drug abuse in the U.S. is rising among women and older adults, according to the National Institute on Drug Abuse (NIDA). Nearly seven million Americans used medications for non-medical reasons in 2007 – three million of them women.
The most abused drugs: narcotic painkillers, tranquilizers, anti-anxiety medications and stimulants.
“It’s a slippery slope with some prescription drugs,” says Neil Capretto, D.O., medical director of Gateway Rehabilitation Center in Pittsburgh, PA. “Anyone taking a controlled substance over time will at the very least become physically dependent.”
Women are more likely than men to be prescribed addictive prescription drugs and get hooked on them, NIDA research suggests.
That’s because they’re more likely than men to seek medical treatment, especially for mental health problems, Capretto says. “Women also communicate more with doctors than men do and thus are more likely to be prescribed something.”
Getting Hooked
How easy is it to get addicted?
“It depends on the amount of the substance used, the dose or strength” and how long you’ve been taking it, says Robert Karp M.D., associate medical director for inpatient psychiatric services at Overlook Hospital, Summit, N.J.
Those with certain psychiatric illnesses like depression, anxiety or a genetic tendency for addiction are also likely to get hooked, says Steven D. Passik, Ph.D., a psychologist at Memorial Sloan Kettering Cancer Center in New York.
“People with a family history of substance abuse or a prior history of alcohol or drug abuse are most vulnerable,” he says. “They may also be living with high stress or psychiatric problems, such as mood disorders like bipolar disorder or anxiety.”
In some, the abuse itself can create psychiatric symptoms such as depression, anxiety and even psychosis.
How Prescription Drug Addiction Works
So how do prescription drugs take control so strongly in the first place?
“Drugs literally hijack the reward system in the brain,” Capretto says. “They take over the drive center in the midbrain and increase dopamine, a neurotransmitter that causes pleasure.”
As addiction sets in and your tolerance builds, “that sense of euphoria gets harder and harder to capture,” says Loren Olson, M.D., a psychiatrist in Des Moines, Iowa. You need more of the drug to feel more like yourself and function at work or with family and friends. So you begin popping more pills.
Compounding the problem: withdrawal symptoms – nausea, sweating, cramping and insomnia – so uncomfortable that the only way to avoid them is to go back on the drug, Olson says.
“Physically, you may look like you have the flu in the morning,” Capretto says.
Your looks aren’t the only thing prescription drug abuse affects. It could even cost you your life.
“Opioids can cause severe respiratory depression or even death following a single large dose,” says Adrienne Marcus, Ph.D., executive director for the Lexington Center for Recovery in Mt. Kisco, N.Y.
You may also experience seizures after reducing or stopping some depressants.
High doses of stimulants “can cause irregular heartbeats, dangerously high body temperatures, cardiovascular failure and lethal seizures or can result in intense hostility and feelings of paranoia,” Marcus says.
Taking large amounts of one drug is bad enough. Even worse: mixing meds or taking them with an alcoholic drink, especially in high doses.
Popping Ambien pills after a few glasses of wine, for example, can lead to blackouts, memory loss and erratic behavior.
“Two plus two isn’t four – it’s more like 10,” Capretto says. “You’re pushing your nervous system in different directions at the same time."
Not everyone feels the same effects from these drugs either.
“If you take it and feel like you’re in love – or you feel calm or all warm and fuzzy – that’s a sign you may have a tendency for addiction,” he says.
Recognizing Prescription Drug Abuse
It’s easy to deny that your drug use is out of control. After all, if your doctor prescribed the drug, it must be safe, right?
Wrong, Capretto says. Just because a doctor prescribed the medication doesn’t mean it isn’t addictive, he says.
“Whether a patient gets a drug off the street or is prescribed it by a doctor, the potency and addictive nature doesn't change," he says.
In fact, many people spend years in denial before seeking help. Here are 7 warning signs and symptoms of addiction:
You have strong cravings for the medication.
Your drug use has become compulsive and you’re taking more than the prescribed dose.
You’re on a constant quest to obtain the drug through various means, whether borrowing from friends, shopping around doctors or even theft or forgery.
You continue to use the drug even though it’s hurting your job performance, relationships and other aspects of your life.
Your behavior has changed. You may be more secretive, argumentative and defensive.
You’re mixing drugs to achieve the same effect.
You’ve tried to stop or reduce your usage, but can’t.
If you’re experiencing these signs, it’s time to get professional help. Quitting may require treatment with drugs like naltrexone, methadone and buprenorphine.
Naltrexone blocks the effects of opioid painkillers but doesn’t get rid of withdrawal symptoms. Methadone and buprenorphine, on the other hand, help ease the addiction and prevent the misery of withdrawal.
Many addicts will need behavioral counseling or a recovery program; others require an intervention by family members to force them into treatment.
Using These Drugs Safely
Most people are using prescription drugs properly under supervision of a doctor who’s familiar with their medical history, Passik says.
A good physician should prescribe drugs only for a limited time and in small doses. Some doctors may also require regular urine tests to monitor usage.
“These drugs are all tools, and if they’re used properly, they’re great,” Capretto says.
The Troublemakers
Here are the most commonly addictive prescribed drugs:
Painkillers
What are they? Opioids are used to treat acute or chronic pain, as well as post-surgical pain and to relieve cough and diarrhea. They may be prescribed to treat pain from arthritis, fibromyalgia or cancer.
Common opioids: oxycodone (OxyContin, Percocet, Perdocan), codeine and morphine (Kadian)
How they work: Opioids attach themselves to proteins on the cell surface known as opioid receptors, which are found in the brain, spinal cord and gastrointestinal tract. They block pain messages sent to the brain.
They can also make you sleepy or constipated and induce euphoric feelings by affecting regions of the brain that control pleasure.
“Pain drugs are by far the most common [abused prescription drug] we see,” Capretto says.
Anti-anxiety drugs and sleeping pills
What are they? Central nervous system (CNS) depressants (also known as sedatives and tranquilizers) slow normal brain function. They’re usually prescribed for anxiety, tension, panic attacks and sleep disorders.
Common CNS depressants: benzodiazepines such as diazepam (Valium), alprazolam (Xanax) and chlordiazepoxide HC1 (Librium)
More sedating benzodiazepines, such as triazolam (Halcion) and estazolam (ProSom), are sometimes prescribed for sleep disorders.
Barbiturates such as mephobarbital (Mebaral) and pentobarbital sodium (Nembutal) are also CNS depressants, but aren’t prescribed as often.
How they work: Most CNS depressants enhance the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which decreases normal brain activity. An increase in GABA causes drowsiness and tranquility — the way you feel after a martini or two.
“It calms [people] down so they may feel more confident in groups,” Capretto says.
Nonbenzodiazepine sleep medications
What are they? These drugs are prescribed for insomnia. Though less likely to cause addiction and abuse, they can lead to psychological dependency: Users often believe they can’t sleep without them.
Common sleep drugs: Lunesta (Eszopiclone), Ambien (Zolpidem) and Sonata (Zaleplon)
How they work: Drugs in this category are similar to benzodiazepines and enhance the effects of GABA in the brain, thereby making you sleepy.
Stimulants
What are they? Stimulants are often used to treat attention-deficit hyperactivity disorder (ADHD), narcolepsy and forms of depression that are resistant to other treatments.
Common stimulants: methylphenidate (Ritalin, Concerta) and dextroamphetamine (Dexedrine, Adderall)
How they work: Stimulants boost levels of dopamine, a neurotransmitter that enhances pleasure and focus. These medications are especially popular among college students trying to do more with less sleep.
For more information, visit our Mental Health Center.
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