- Anesthesia: A very good article involving a side effect of surgery was offered in the Wall Street Journal. Many of you may have heard that after surgery people may have some confusion. In fact, it is more delirium, a very serious and expectedly reversible condition. what researchers are finding is that the condition is related to duration and depth of sedation. It is also less fleeting that originally thought. I have seen the phenomena in my professional work and it was as if the person described in the article was the person I had worked with, when in fact, it was not. Some best practice guidelines are promoting a change in the ICU in response to increased problems. What I wanted to add here is that when the statement was made that the problem is worse with older patients it was NOT because they were older it was because they - "multiple risk factors such as high blood pressure, diabetes, chronic heart failure...." That is just one more reason for you to choose a health promoting life style. The pills or interventions may keep you alive but that doesn't mean you'll feel like being here.
- Healthy Everywhere: How can you eat well where you live, work, worship, learn and play? By setting the example yourself. We do model the behavior of those around us, especially if the “others” are esteemed by us. It’s a simple bit of social norming and you might as well be the one to start. If you’re a program manager it is almost derelict not to. People can eat poorly if they choose, however, if meetings and office events provide fruits and veggies then it will likely permeate church and social events as well. So eat low calorie high nutrient foods in reasonable amounts through out the day vs. sitting down to high fat high cal meals once or twice a day that leave you overloaded, lethargic and lazy.
- Continued Physical Activity: The major players in sports medicine are gearing more services towards older persons who are physically active and wish to remain so. Persons like my mother (78) and many of my running pals who are 60+. Some colleges and health organizations are looking at those over 50 even some 40 somethings. The goal is to keep this already fit cohort in the shape they are used to. It will certainly reduce health and nursing home costs for them! It is in keeping with my personal goal to live an active life until I am dropped into the grave. I do not aspire so much to run marathons or win races, but to avoid an early death or an incapacitating slow one. What appears to be a common theme in the field is that cardio activities should continue, balance training should be added and attention to the messages from ones body adhered to. That last bit is to avoid injury because apparently no matter the fitness level, the older body does need more time to recuperate.
- Social Marketing: Here is interesting food for thought from a presentation I attended this past week. More often than not, when a company presents a new and improved version of its well known product we run out and buy it. Think Windows Programs, new running shoes, shampoos, etc. (we get pissed when it’s a new version that costs a fortune and the other one has barely been used, but that is the exception yes?) We don’t generally get MAD at them for using the newest science and advances in technology right, because we want the better product. So how come we get so damn bent out of shape when the researchers tell us that they learned the key for longer life and it’s eating this food and exercising this way. So what it was low carb yesterday, they LEARNED more about that, they were wrong, this is better… Would you rather that the nutritionists didn’t tell you that meat and potatoes could be related to heart disease? Would you rather not know that wheat bread is easier on the pancreas and that smoking in fact will kill you? Maybe you would rather be oblivious, but then, well, why the heck are you reading my blog! Ha ha
- The Pilling of America Rages On: Before I go off on this again, I have to tell you that people I love very much take pills to keep their blood thin, their cancer away and their blood pressure down. These medications may protect their system from the damage that high blood pressure and plaque could cause and I am grateful to the scientists who created these drugs. Would they and I wish they rather not need them, OF COURSE> They are expensive, they interact with other things and they have side effects. This week we hear more about Avandia (diabetes drug) and heart attack risk, we hear that the anti clotting or blood thinning drug that would compete with Plavix is stuttering in trials. Plavix itself is doubling the net income for its maker. The drug makers are working on drugs that one takes FOREVER, to prevent that second heart attack for example. I cannot promise you that watching your weight AND your nutrition, (choosing what you put in your body) while also engaging in daily exercise of some sort will keep you from getting ill, but I can tell you that in aggregate, that in groups of people, that is exactly what proper nutrition, weight and exercise does. It prevents the FIRST heart attack. And if I have one, don’t you dare use that to keep you from living well, because my point is still that in general and in groups, the norm is NOT that people who live well have heart attacks.
Well? Get up and go do something. :)
As I wish you wellness
Saturday, October 27, 2007
Saturday, October 20, 2007
- Earn the $$$$: Some countries which have national health programs such as France and the UK as well as some health insurers (Cigna, Aetna) are requiring or considering requiring satisfaction guarantees from big drug companies. In other words, if a company tells us that X drug will lower cholesterol and people who take X drug will be less likely to have a heart attack but the people on the drug do have normal rates of heart attacks, the NHS or Cigna, get some amount of money back. I like this because what happens in a good random clinical trial doesn’t necessarily play out in the real world. I would hope that agencies and insurance companies would get 100% plus back if they agreed to use a drug for example which turned out to kill people instead of save them, you know, like Vioxx. What would be really cool is if we could also demand that companies not sell us stuff that kills us, I’m thinking cigarettes, for example. Hey what do you think kills more of us a year lead or cigarette smoke? Both are bad, both should be regulated.
- Hormone Treatment and Breast Cancer: I was surprised to read about a recent verdict, one out of seven, regarding Wyeth’s HRT and breast cancer incidence. This one found Wyeth guilty of negligence. This is not unlike what we are talking about in the above example, except that it is. This is not the company guaranteeing the safety of its product but the courts calling the company out for what they feel is a faulty product. I was surprised as much about the verdict as my own response to it, which is HUH? In this case it seemed to me, from the sidelines, that doc’s and women’s groups themselves exploded the market for this compound by their own demand. Even today HRT is sought and prescribed, though some caution has been applied.
- EIEO: Running with a new group these days (thanks Lee Ann) and one fellow mentioned his second career as a personal trainer and cardio instructor. He too said that his clients want the magic pill or even surgery and refuse to change the way they eat. Even when his clients were adding resistance training AND cardio (step aerobics, cycling, running etc) their weight didn’t change because they were eating all the wrong stuff and way too much of it. Let me remind you here, a health promoting way of eating does NOT involve hunger or deprivation. It doesn’t require cardboard tasting food. It is neither bland nor monotonous – heck, variety and bulk are the cornerstone of Volumetrics. If you want to eat and promote your disease fighting capacity don’t go on a diet for goodness sakes, READ Barbara Rolls and Walter Willett, these two are esteemed, degreed individuals at premier academic institutions…. They are NOT Susan Powter (remember her?)
- DID: DID stands for disassociative identity disorder, it’s a newer, but not new term for multiple personality disorder. As you may know, my previous employment was in clinical mental health. My opinion is that you are who you are. There is only one of you and as a clinician I am only going to work with that one person. That is where I stand and stood before I read about a review of studies noted in Scientific American. That publication discussed studies that found some evidence of false memories resulting from therapies used with DID patients. The idea is to get back to the traumatic event that triggered a defense response of creating different personalities. My issue was seeing this type of thing in patients who really had a different disorder, Border Line Personality. (think glen close in fatal attraction) Anyway, I digress. Some clinicians and others use things like hypnosis and drugs to get into the memories. I believe that if a true event was so devastating that it led to a buried memory, there is a reason for that. That is a self preservation mechanism. When I began my career many years ago, my brother told me that sometimes a person doesn’t want to relive their childhood but to live in the adult hood that they have. That to me is a normal healthy response. Many Borderline patients have no present and that is where the psychotherapy might be better used.
- DIETS: Several websites, okay, hundreds if not thousands, offer suggestions for losing weight. Some are crazy, some are dangerous, many are fad based and a few are legitimate and associated with valid nutrition organizations such as the USDA and the ADA. The Wall St Journal noted how some people benefit from the social networking aspect of sites like Calorie Count. What I did like about that one is that people are encouraged to be conscious of their calories. Anyone who supports the science of EIEO is on the right track. One person in the article mentioned being a professional dieter and that indeed has been my beef all along….. No No No.. Diets don’t work. Your body needs optimal fuel, the right kind, the right amount. every day all the time. Consistently.
- YEAH! Fat! I should research this more because I do not know what rendering fat from livestock (from processing livestock) really means, or I know and don’t want to think about it. It could be that I mean to say, BOO FAT BOO. Here is the point though, fat is used as fuel, as biodiesal instead of corn or soybean oil and this can be economically good on several levels. However, when I was thinking of reused fat I thought of fat used after something was cooked in it. I think that is the concept behind Willie Nelson’s biofuel. This article about the expansion of fat as fuel may be talking about extracting fat in the slaughtering process which is quite frankly, gross and well, we don’t have to talk about my vegetarianism right now. Here is the bigger question, if that is indeed what they are doing, can someone “render” fat from us? Yeah that’s it……. Can we use the fat from liposuction to fuel our Hummers!
- Soda and Calcium: Quick note from late story. The question really is, does something in soda keep calcium from being absorbed, or do people drink soda and not take in enough calcium from dairy and other food products? I think that is what it is, but that is because I love my diet soda!
- Overheard: This was priceless. A man was walking near my office building and eating an ice cream. This man was overweight. Another man who wasn’t so overweight came out and chided the ice cream eating man. I assume they were friends. He says, “ Hey so and so, what do you have there a no calorie ice cream. “ WELLLLLLLLLLLLLL (as my friend Angi says). The man being sarcastic was Smoking a cigarette…….. What would DEEDEE Do indeed, I would have said, “Hey, Mister, is that a no cancer cigarette you’re smoking!”
- Diabetes: Very quick story from today. A man went to the doctor a few years ago. Doctor told the man who then weight 350 pounds, you have diabetes and if you do not doing something you’re gonna be dead in a year. That man did what so FEW others do. He changed the way he ate, lost 100 pounds and then began running. I met him recently, I would guess 5’10 170 lb. He runs marathons and also has a cute girlfriend. Oh, no drugs either. Sweet.
Off to Key West
Wishing you Wellness
Saturday, October 13, 2007
- BTC: Last year I spoke out against one of the pharmaceutical company’s efforts to have a cholesterol lowering drug sold without a prescription or over the counter. The drugs have side effects and in my opinion, people should first attempt to lower bad cholesterol or LDL with diet and exercise. Exercise can also raise the good or HDL cholesterol. Now the FDA is taking comments on its website until 11/28 and is having a public hearing on 11/14 for something similar. The issue is not OTC but BTC. Behind the Counter access to some medications that currently require a prescription. The drugs would be dispensed by the pharmacist after he or she speaks with the customer and makes an assessment. Because I have know Pharm Ds who have impressed me with their knowledge of drug mechanisms and caution regarding drug company claims, I support this idea in theory. This is in no way a slur on MDs, DOs, GNPs, etc. They know the body and the Pharm Ds know medication. If however, the pharmacists end up the recipients of all the drug company wining, dining and gifting, we will have a new problem.
- Mercury Disposal: The number one source of mercury pollution is coal fired power plants and those emissions are not territorial. We are all affected. Other sources of mercury include light bulbs, electronics, batteries and computers. Please do not throw those items in the trash. They will poison the ground water and soil. Log onto Earth911 to find recycling options.
- Food Reviews: Oh my gosh. The Wall St Journal pondered the validity of restaurant reviews when the writers were 1) not anonymous diners and 2) treated to their meals by the establishment. HELLO… prescription drugs??? People will read the article in WSJ and say, true, I should temper my enthusiasm for a restaurant based on what could very well be a biased, paid for opinion. So why is this different from being prescribed a medication from a person who has been treated to, well all the things I noted in the first blurb? A doctor with a drawer full of samples from the company that just paid his green’s fees for the year might not be the best judge of medication use.
- Gary Taubes: Mr. Taubes has written several articles and now a book where he discusses the science of weight gain and offers his opinion. Though he leans away from my science based theory EIEO, he does support my qualifiers. That being, it is energy in energy out but certain foods wreck havoc on blood sugars and subsequently the pancreas, as well as blood vessels and then the heart. If your 1500 calories are all from burgers and Twinkies in other words, you are screwed. He does not promote exercise for weight loss, nor does he mention that it is beneficial in raising HDL. So, he does not get added to the list of awesome health gurus to the right there!
- Lastly: It appears that the FDA did pressure the makers of some cold medications marketed for kids, as was mentioned here last week. Some of the pills have been pulled by their own companies.
Wishing you Wellness
Saturday, October 6, 2007
- Colonoscopy: Early research is showing that a CT scan can detect polyps in the colon which may be or become cancerous. This is screening as is the stool sample kit and the colonoscopy. One is gross, and the other is quite invasive. The CT scan may be more expensive, but that is in debate just now. It could change if there became more demand for it and insurers covered it. For me, at 42, there is lots of time for this to get worked out before I need my first of either test. I really hope the CT is standard in eight years, however, I remain constantly wary of radiation and selective about when and how I allow myself to be radiated. Back to the important point. Colonoscopy and colon cancer screenings are effective in reducing incidence and death from this disease. Screens are usually recommended to begin at age 50 and to take place every ten years thereafter. A diet that is limited in red and processed meats is also health promoting.
- Heinz: Hmm. The people at Heinz are currently cultivating and testing a new tomato to use in their ketchup. I use the one carb variety but only because it is lower in sugar and cals per serving. It tastes just great to me. I hope what they are doing doesn’t effect that type of ketchup. The reason that the company is trying to recreate the tomato has to do with the use of corn for ethanol. Again, many rippling effects have occurred and one is the increased cost of high fructose corn syrup, hfcs. Oh My, how can that be bad! Anyway, HFCS is in ketchup and the folks at Heinz are trying to make a tomato that is sweeter so they can do without it. It is a very secretive endeavor so not much is known about the new tomato or if they’ve even got one coming along. I wonder what the end result will be nutritionally speaking. Will their new tomato still have the same make up of lycopene that is health promoting and will the calorie and other nutrition info offered in say the USDA Nutrient Database apply to a Heinz tomato, oh and lastly, will the tomato go from a low GI food to a high one?
- Parents: BOLO-Be On the Look Out for changes on the labels of cold and pain medications marketed for children. The FDA is working on changing the labels to include a warning for children under age 6, four years later than most parents expect. Several physicians are suggesting that children’s colds and pains be treated with non medicinal remedies when at all possible. This is of course a conversation you, as a parent, should have with your own doctor.
- FDA: The director of the agency came out with an interesting statement the other day regarding the regulation of tobacco. He, I believe, said that it would send out the wrong message. And for this I am in stunned agreement. His point being that the purpose of the agency is to keep us all safe and to assure that the medicines we take, the products we consume, that they are safe as well. As all of you know, there isn’t anything safe about tobacco products and tobacco smoke. Thus if the agency regulates something that kills people, well…….. you get the idea.
- FISH Again: A group of women came out at the end of the week with a recommendation for pregnant women to eat more fish. This is in strong contrast to the EPA and FDA suggesting that pregnant women and children limit their seafood intake. I continue to support the current FDA caution and the reason is detailed in my Mercury and Fish power point presentation that you can access on the side panel here. I understand the benefits of fish. I FEAR the effects of mercury and other toxins and I don’t think we know the half of it. Most certainly, choose the fish that is SAID to have the least of these poisons, smaller fish, like tilapia, shrimp and chunk light tuna.
- Germ Fighting 3 to 1: A great story aired on NPR’s health matters some time ago. It discussed what products, techniques or methods might be best for cleaning your produce. To make a long story short, I mean that is why you read this right, fill a spray bottle with three parts water and one part vinegar. Spray the fruit or veggie thoroughly and then rinse with cool water. This works better than any of the products you buy. It works best on smooth fruits and veggies, as opposed to lettuce and or broccoli.
- Omega 3s: Interesting article in this months Runner’s World taught me a couple of things about this most wonderful healthful fat, yes found in fish. It is most readily in Salmon, which is usually low in contaminants, and this form of the fatty acid is easily absorbed while that in vegetables and nuts is not. Omega 3s helps reduce inflammation and may reduce pain. Some people use fish oil capsules, I still shy away from almost any nutrient that is not on a plate………. Except for three things, which can be your quiz…………Any way. Omega 3s in fish are EPA and DHA and in plants it is ALA. If you eat something with 100 mg of ALA by the time it is changed to the other type and absorbed, you might get but a fraction of it. But here is an even more important point. The recommendations for Omega 3s are NOT in milligrams, but grams. So Salmon has say 1 to 1.8 g’s but those products you see that claim omega 3 added or fortified, etc, like eggs, that is milligrams………. Man oh Man, those food labelers are slick…….. Okay Dee’s three non food nutrients are a multivitamin with iron, additional vitamin D and calcium!
Ending this week’s news at poolside from my Sarasota Apartment. It has been a stressful three weeks and a difficult two days. Cat and I are fine though. Work starts Tuesday and wonderful friends in North Carolina have eased my transition. As has my most awesome sister and super brother in law.
Wishing you wellness