6 Things to Know About Your Hair – Keeping an Eye on Grooming

A Journey of 1,000 Miles Begins With a Single Step, So Said the Wise Chinese Philosopher Lao-tzu - How Walking Can Help Diabetics

Having a Type D Personality May Spell Real Danger for Your Heart

The Research Is In: A Study Verifies That Catholic Hospitals Currently Give the Best Treatment

More Studies Link the Lack of Vitamin D to Parkinson's, Diabetes and Other Diseases

If You Are Getting Ready to Apply for Medicare Coverage, Absolutely Read This Article Carefully

Will a New Treatment Help Lead Us in Discovering the Cause and Cure for Multiple Sclerosis?

Doctor and Patient: Letting Patients Read Their Doctors' Notes in No Easy Task

Here Are Some Simple, Drug Free, Ways to Treat Your Arthritis

There Is a Very Good Reason Why You Should Avoid Going to Hospitals in July

Common Painkillers Increase Heart Risk in Healthy People as Well as Those With Heart Disease

Is There a Way to Treat Children With ADHD Without Drugs? Well, Yes There Is - Advice From Dr. Weil

America's Social Security Trust Fund Is Flagging and Will Need a Shot in the Arm in 2012 - Talk About a Bummer

This article about the woes of the Social Security Trust Fund first appeared in The Boston Globe. If you do not qualify for social security payments, you may not be interested in taking the time to read this article; if you do receive payments, you would be wise to find out about what lies ahead.

New "Liberation Procedure" Might Offer Some Hope for the 500,000+ People Who Suffer From Multiple Sclerosis - The Jury Is Out

This article by Marie McCullough originally appeared in The Philadelphia Inquirer on June 16, 2010, and details some new hope for people who suffer from multiple sclerosis (MS), a disease which has no known cure.

What's Ailing Health Care? New York City Doctor Reveals the 18 Biggest Problems With Today's Modern Medicine Practriced by Most Physicians

Thought You Should Know - Early Warning Signs: When to Call the Doctor About Alzheimer's, and What to Do When You Are Alone and Cannot Help Yourself

Chocoholics Rejoice! New Study Says Tea and Chocolate May Deter Strokes and Even Brain Damage

This guest article by Craig Weatherby first appeared online in the Vital Choices Newsletter.

What's Your Pain Tolerance? Everyone Struggles With Pain at Some Point in Their Life, But How You Tolerate Pain Can Be Up to You

The guest article by Katrina Woznicki was first posted as a WebMD Feature. WebMD is one of the best sources for medical information on the Internet.

Ann Pietrangelo on Improving Your Mood and Self-Esteem With Green Exercise

Ann Pietrangelo is both a victim and an advocate for the prevention and cure of multiple sclerosis. She is posted here because her message is one of not just hope, but positive action. May God bless Ann and all of those who suffer from MS. In honor of Ann, I have coined the phrase "Greenercize" to label Green Exercise, so be a "Greener when you exercise".

University of Rochester Study Says That Workplace Stress Can Make You Fat - Your Job May Be Killing You

The Elusive "Six-Pack" Abs - Here Is the Best Way to Trim Away That Ugly Belly Fat and Look a Whole Bunch Better While Getting Healthier

This guest article by Kathleen Zelman first appeared on the WebMD web site.

Satatins for Healthy People: Why Does This Sound Like a Really Dumb Idea? Should Healthy People Have Preventive Drug Treatment?

This guest article by Duff Wilson from the New York Times explores the merit of healthy people undergoing drug treatment for a condition they do not have.

John Hicklenton, a Multiple Sclerosis Activist and Famous Comics Artist, Ends His Life at an Euthanasia Clinic

Ann Pietrangelo is both a victim and an advocate for the prevention and cure of multiple sclerosis. She is posted here because her message is one of not just hope, but positive action. May God bless Ann and all of those who suffer from MS.

Important, Frequently Asked Questions About How the Health Care Reform Bill Will Affect You - A Blessing for Some, A Curse for Others

The source of this article is WebMD Health News.

Non-Medical Therapies for Alzheimer's Disease Finally Gets Some Scientific Backing - Research Suggest New Treatments

This article by Chris Haines originally appeared in the AARP Bulletin on March 12, 2010. For those of us that have lived at least 6 decades, it is likely that we have had a family member, or know of someone, who has contracted Alzheimer's disease.

We Look at Other People Who Are Morbidly Obese and Think, "I'm in Great Shape Compared to Them" - We Deceive Ourselves

Ann Pietrangelo is a freelance writer and multiple sclerosis patient advocate. Her staunch belief in affordable and accessible health care for all fuels her passion for
health care reform.

The Truth About Red Meat - Does Eating Red Meat Increase the Risk of Dying from Heart Disease or Cancer?

(Ed's Note: This WebMD feature examines the health dangers and benefits of eating red meat.)

The Truth About Fat - Everything You Need to Know About the 5 Different Kinds of Fat, and Why It Matters That You Do Know the Difference

Most people who carry too much weigh think that fat is just a blob to get rid of. This WebMD Feature reveals everything really important that you need to know about fat, including an explanation of what kind of fat is worse—belly fat or thigh fat. Read on, hopefully at a speed that will cause you to lose weight!

Why Do We Say Cats Have 9 Lives?

3 Simple Steps to Help Prevent Alzheimer's Disease

Dr. Andrew Weil is a licensed physician who specializes in holistic and integrated medicine; meaning, natural cures to medical problems are oftentimes better than man-made solutions involving prescription drugs, surgery, etc. Here Dr. Weil gives some tips on how to help prevent Alzheimer's Disease.

Multiple Sclerosis by the Numbers, But Who Really Cares, and Who Is Really Counting?

My sister Loretta contracted Multiple Sclerosis and it contributed to her premature death. For some reason, we do not know exactly how many of our fellow Americans are affected by this disease, and no one seems willing to actually find out. Learn why it matters. The source of this article is Ann Pietrangelo; I have edited the article to add more information and clarity.

Health Care Reform: Why Are We Treating the System, and Not the Underlying Cause?

The following guest article was written by Dr. Andrew Weil and appeared in the Huffington Post. If you care about your health care in the future, this is a good article to read.

Alan Romatowski - A Model for a Positive Attitude Despite Contracting Alzheimer's

If you were just diagnosed with Alzheimer's, what would your reaction be? Find out how a role model for being position handles the negative news about his future.

In the Old-Time Remedies Department, Some Say Cinnamon and Honey Works

I have no idea if what I am sharing with you here works or is just plain bunk. A lot of things float around the Internet, some interesting and some not. I just know that the gene pool I came from is rife with arthritis and I am no exception. I have been a writer for 48+ years and someday I will not be a writer because the osteoarthritis in my hands is so bad I cannot lift more than 10 pounds; I have bones and nerves in my fingers but no apparent fluid for the joints. I am going to try this because arthritis is not curable and the pain is evident. I am desperate enough to try anything for relief. I am not editing this article. I will let you know if honey and cinnamon does anything for me.

Secrets of the Super-Healthy: People Who Never Get Sick

In times of economic crisis and uncertainty about your personal financial future, it is important to stay positive and healthy. The following article is written by Jennifer Strong and is a WebMD feature on how to stay healthy.

When Cancer Strikes, Your Life Depends Upon Your Support Team

This article is a WebMD Feature by R. Morgan Griffin, reviewed by Paul O'Neill, MD. Cancer has been referred to as "the silent killer" because there is often no warning when we discover its insidious presence in our body. Having a diverse support team to help fight your battle is an excellent idea. Here is some good information to help you wage war on the enemy.

Could the Way Food Looks Give Real Clues as to What Is Really Healthy for Us to Eat?

The next time you sit down to lunch or dinner, you may be surprised to learn that many of the foods that we eat look similar to vital organs in our body, and in fact provide nutrients that actually help the organ in question function. Carrots, tomatoes, grapes, oranges, figs, walnuts, kidney beans and onions are just a few examples. Find out more.

Loss of Odor Perception Might Signal Alzheimer's

Imagine my recoil when I read the above Associated Press headline recently.  The story went on to detail the first study that linked loss of smell to Alzheimer's. Difficulty identifying odors was associated with a higher risk of progressing from mild cognitive impairment to Alzheimer's. As someone with very little sense of smell and taste, perhaps I should be worried.


February 14,2011

6 Things to Know About Your Hair – Keeping an Eye on Grooming

1) Genetics accounts for 95 percent of hair loss.

2) Light brushing—a few strokes here and there—gives locks luster by distributing the scalp’s natural oils down the hair shaft. Excessive brushing, however, especially if you tug too much, can weaken strands, causing them to break.

For gentle grooming, choose a brush with ball-tipped plastic bristles or long, widely spaced natural boar bristles, and use it only to detangle and style hair.

3) Hair cuticles, which resemble shingles on a roof, lie flat when splashed with cold water. As a result, the smoothed cuticles reflect more light, making hair appear shinier and healthier (hot water leaves it rough and lackluster).. The effect is temporary,

however unless you dry and style your hair properly.

4) The number of hairs in each follicle is genetically determined (typically it ranges from one to four strands in each), and simply tweezing stubborn grays won’t increase that number.

Still, plucking is a bad habit: If you pull out the same strand repeatedly, you can damage the roots so it won’t grow back.

5) Too much tugging and tension from tight hairstyles such as cornrows and weighty extensions can bring on traction alopecia, a form of hair loss that is common among black women. It’s preventable, though: Avoid stressful styles and switch the positions of your braids (ponytails and headbands, too) to alleviate tension.

6) Why does it seem like your shampoo suddenly stops doing its job? It doesn’t, but after a month of the same hair routine, buildup from conditioners and styling products can leave locks dull and lifeless, so rotating shampoos is not a bad idea.

Suds up with a clarifying formula (look for key words like "balancing" or "anti-residue") to refresh your locks. Warning: Such formulas clean deeply, so they can strip hair of its natural gleam. Use them in moderation; once or twice per month is optimal. Did you know? You lose 50 to 100 strands daily—which are continually replaced.

January 31, 2011

Great News: How Walking Can Help Diabetics

A Journey of 1,000 Miles Begins With a Single Step, So Said the Wise Chinese Philosopher Lao-tzu

(Ed's Note: Stacy Federico shares her story about how walking 10,000 steps every day improved her insulin sensitivity in a couple of months.)

By Stacy Federico

Taking 10,000 steps daily (or walking about 5 miles) is incredibly healthy, and could extend your life.

I started walking 30 days ago. I wake up every day at 5:30 and walk about 5 miles (with my new puppy).

I'm so pleased with myself. Recently a buddy asked, "What are you currently doing for exercise?" I informed her about the walking, and she said, "Yeah, but precisely what are you doing for exercise?"

She stated that walking does not get the heart rate up sufficiently and won't do one thing to further improve my overall health or my waistline and, that if I needed to lose any weight, I needed a true workout.

And so I shared with her that this 10,000 steps philosophy isn't new, the good news is the 10,000 steps regimen has been connected to an increase in insulin sensitivity in more than 50 adults.

In a 5-year Australian review of nearly 600 adults averaging 50 years age, walking a lot more steps was connected with reductions in BMI (Body Mass Index), waist to hip ratio, and insulin sensitivity.

The analysis, authored by researchers from the Murdoch Children's Research Institute in Melbourne, was released within the British Medical Journal (BMJ). (Available here:

The authors calculated that a sedentary person who modified behavior for 5 years in order to meet the 10,000 daily step criteria can have a threefold improvement in insulin sensitivity compared to someone that walked up to 3,000 steps 5 days weekly.

In line with the experts, the relationship of step activity with improved insulin sensitivity was principally accounted for by a lower body mass index, which uses a person's weight and height to calculate their body fat.

And You? Are you still reading this report? Get out and walk!

Here is what you could use, and how you could find opportunities to walk in your daily routine:

1. Have a pedometer.

2. In case you have a desk job, stand up and walk every hour.

3. Park farther away from entrances.

4. Put down the telephone, eliminate or reduce your email activity, and walk.

5. Walk or jog in place during your preferred television show.

6. Consider the stairs.

7. Pacing.

8. Go ahead and take puppy for a walk.

9. Hit the nearby mall.

10. Make use of the Nike slogan, Just Do It.

(Ed's Note: Find Stacy Federico at, her personal blog about tips to help individuals stop Diabetes, and enhance their awareness of healthy eating.)

September 24, 2010

A Type D What?

Having a Type D Personality May Spell Real Danger for Your Heart

(Ed's Note: Sixty-six years of living on planet Earth and I did not even know there is a Type D personality. Thank the easy access of the Internet for being a source of constant new information. This article originally appeared in the AARP Bulletin. Nissa Simon is a health writer from New Haven, Connecticut.)

By Nissa Simon

For years researchers have warned that those with type A personalities -- driven, competitive, work-obsessed -- are more prone to heart disease. Now, a new study says that heart patients with a type D personality face a greater risk of a recurring problem, primarily heart attack or death from heart disease.

But what is type D? First defined in the 1990s, type D denotes a generally anxious, irritable and ill-at-ease personality type. These men and women lack self-assurance, hesitate to share their feelings with others and fear disapproval -- rather like Winnie-the-Pooh's gloomy friend Eeyore.

Type D adults who have already been diagnosed with a heart problem are significantly more likely to face future heart difficulties than those with sunnier dispositions.

An analysis of studies involving more than 6,000 heart patients noted a threefold increase in long-term risk of additional cardiac issues -- including narrowing of the arteries, heart attack and heart failure -- among those with type D "distressed" personalities.

They also are more likely to need angioplasty or bypass surgery and to die prematurely.

Senior author Johan Denollet, a medical psychologist at Tilburg University in the Netherlands, points out that those with a type D personality tend to have heart problems
independent of traditional medical risk factors such as high blood pressure and high cholesterol.

The reasons for the higher risks are not clear, but type Ds seem to respond to stress differently. They show artery-damaging inflammation as well as increased levels of the stress hormone cortisol, which is linked to high blood pressure.

In addition, they are less likely to have medical check-ups, pay attention to their doctors' recommendations or take prescribed medications.

A type D personality profile can be determined using a brief test of 14 statements such as: "I find it hard to start a conversation" and "I often find myself worrying about something."

Type D is not depression. "It's a combination of normal personality traits that make it hard to change your life," says Denollet, "and it's quite common." Screening heart patients for type D could provide a chance for doctors to help them learn new strategies to reduce their level of distress.

"We're beginning to understand that emotional state is an important component of overall health, and we need to be aware that personality does matter," says Clyde Yancy, M.D., medical director of the Baylor Heart and Vascular Institute in Dallas and past president of the American Heart Association.

"But we must never lose sight of the fact that traditional risk factors such as obesity, high blood pressure, physical inactivity and poor diet trump everything else when it comes to heart disease," Dr. Yancy added.

August 20, 2010

The Research Is In: A Study Verifies That Catholic Hospitals Currently Give the Best Treatment

(Ed's Note: This article apparently appeared in Kaiser Health News and was originally picked up from The Wall Street Journal Health Blog.)

A study by the Society of Actuaries has put the cost of medical errors in 2008 at nearly $20 billion. The study was carried out by the actuarial and consulting firm Milliman, [and] is based on insurance claims data.

The cost estimate includes medical costs, costs associated with increased mortality rate and lost productivity, and covers what the authors describe as a conservative estimate of 1.5 million measurable errors.

The report estimates the errors caused more than 2,500 avoidable deaths and more than 10 million lost days of work.

Bed sores – which are always considered to be the result of an error -- produced the largest annual error cost, at almost $3.9 billion, followed by post-op infections
($3.7 billion), device complications ($1.1 billion), complications from failed spinal surgery ($1.1 billion) and hemorrhages ($960 million).

To come up with those figures, researchers found the total cost of a given type of injury and estimated how often it was caused by an error.

Another study, Crain's Detroit Business reports, has found that Catholic hospital systems deliver higher-quality care than other systems.

The study was released by Thomson Reuters and "reviewed 255 U.S. health systems with two or more hospitals and grouped them into four types of ownership: Catholic, other church-owned, non-profit and for-profit.

Of the four ownership types, for-profit health systems had the lowest performance, the study found that Catholic-owned systems had the highest quality.

The study looked at mortality, complications, patient safety, length of stay and readmission rates among others to make its determination.

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

August 16, 2010

It's Your Life and Your Health

More Studies Link the Lack of Vitamin D to Parkinson's, Diabetes and Other Diseases

(Ed's Note: This article originally appeared in the Vital Choices Newsletter.)

By Craig Weatherby

Vitamin D continues a run of positive research . . . a string of successes attributable to its unique, hormone-like nature and long-overlooked role in sustaining many vital bodily functions.

The results of two new studies add weight to researchers’ urgent calls to raise the recommended daily allowances for vitamin D.

First, a diet-health population study from the Netherlands supports prior indications that vitamin D helps deter key players in the cluster of 6 unhealthful blood fat, body fat, sugar control, and other signs called "metabolic syndrome" or MetS.

The Dutch team found that the people with the lowest vitamin D levels were 40 percent more likely to develop MetS, which raises the risk of developing diabetes and/or cardiovascular disease.

Second, a population study from Finland found that the participants with the lowest levels of vitamin D were three times as likely to develop Parkinson’s.

Conversely, the Finnish volunteers with the highest vitamin D blood levels were two-thirds (67 percent) less likely to develop the brain disease.

Sockeye Salmon Are Excellent for Vitamin D

In addition to getting vitamin D from supplements, certain fish rank among the very few substantial food sources of vitamin D, far outranking milk and other D-fortified foods.

Among fish, wild Sockeye Salmon may be the richest source of all, with a single 3.5 ounce serving surpassing the US RDA of 400 IU by about 70 percent:

Vitamin D per 3.5 ounce serving*

Sockeye Salmon 687 IU

Albacore Tuna 544 IU

Silver Salmon 430 IU

King Salmon 236 IU

Sardines 222 IU

Sablefish 169 IU

Halibut 162 IU

The current US RDA for people from infancy through age 50 is only 200 IU, and a skimpy 400 IU for people aged 51 to 70.

Even with sun exposure considered "adequate" for internal manufacture of
vitamin D – which often proves inadequate – these dietary amounts are proven unable to raise blood levels into the range associated with optimal health (80-120 nmol/L or 35-48 ng/mL).

Most researchers call for the RDA to be raised to at least 1,000 IU and many recommend an adult RDA of 2,000 IU or more.

Let’s take a quick look at both studies.

High Vitamin D Levels Linked to Lower Parkinson’s Risk

Parkinson's disease is a degenerative condition that impairs movement and balance and afflicts more than one million Americans annually … a figure expected to rise as the baby boom generation ages.

The disease affects nerve cells in several parts of the brain, particularly those that use the chemical messenger dopamine to control movement.

An epidemiological (diet-health) study by researchers from Helsinki, Finland was the first to look for associations between people’s vitamin D levels and their risk for developing Parkinson’s disease.

The Finnish team employed blood tests to confirm people’s vitamin D levels in 3,173 Finnish men and women aged between 50 and 79.

Over an unusually lengthy 29-year study period, the researchers documented 50 cases of Parkinson's disease, and found that the participants with the lowest levels of vitamin D were three times more likely to develop Parkinson’s, compared to those with the highest levels..

Why Would Vitamin D Deter the Brain Disease?

We know that cells in the part of the brain affected most by Parkinson's, called the substantia nigra, have unusually high numbers of vitamin D receptors, which suggests vitamin D may be important for normal functions of these cells.

The authors suggested that vitamin D may also deter Parkinson’s through its antioxidant activities and its role in regulation of calcium levels, detoxification, modulation of the immune system, and enhanced conduction of electricity through neurons (brain cells).

The Finnish team said their results need to be confirmed in larger studies, because of the small number of Parkinson’s cases versus the number of people in the study, and the possibility that other, unknown factors associated with having high vitamin D levels might be responsible for the link.

In an accompanying editorial, Marian Evatt, MD, MS, from Atlanta’s Emory
University described the study as, "… the first promising human data to suggest that inadequate vitamin D status is associated with the risk of developing Parkinson's disease."

Low Vitamin D Levels Linked to Metabolic Syndrome in Seniors

Dutch researchers presented encouraging findings about vitamin D and the risk of metabolic syndrome at The Endocrine Society’s 92nd Annual Meeting in San Diego.

Metabolic syndrome (MetS) is a condition characterized by abdominal obesity, hypertension, and abnormal glucose and insulin metabolism. MetS has been linked to increased risks of both type-2 diabetes and cardiovascular disease.

The study involved 1,289 white Dutch men and women aged 65 and older.

Almost half were vitamin D deficient, and about 37 percent had the cluster of physical signs called metabolic syndrome.

After they drew blood samples from the volunteers, the team’s analysis showed that those with the lowest vitamin D levels were 40 percent more likely to have metabolic syndrome (MetS).

People with blood levels of vitamin D lower than 50 nanomoles per liter (nmol/L) were likelier to have the metabolic syndrome than those whose vitamin D levels exceeded 50 nmol/L.

Most researchers consider blood levels below 50 nmol/L "insufficient". Note: There are two common measures of vitamin D status: 50 nmol/L is the same as 20 nanograms per liter (ng/mL).

No differences in risk were found between men and women.

The study supports previous findings, including a report last year, showing that about 40 percent of elderly Chinese people with MetS had insufficient or deficient levels of vitamin D. (See "Vitamin D Seen to Stall Pre-Diabetic Syndrome" and "Vitamin D Clinical Trial Detects Anti-Diabetes Benefits".)

Other research indicates that links between vitamin D levels and risk of metabolic syndrome are scientifically plausible.

Vitamin D deficiency has previously been linked to impaired insulin secretion in animals and humans, and has also been linked to insulin resistance in healthy people.

And another study present at the 2010 Endocrine Society meeting links higher
vitamin D levels to higher (healthier) levels of insulin sensitivity … decreases in which precede and predict development of diabetes.

In addition to a potential link to an increased risk of MetS, vitamin D deficiency may promote or exacerbate osteopenia, osteoporosis, muscle weakness, fractures, common cancers, autoimmune diseases, infectious diseases and cardiovascular diseases.

There is also some evidence that high levels of the vitamin may reduce the risk of type-1 diabetes and several types of cancer.

August 12, 2010

Yes, It Can Go Terribly Wrong

If You Are Getting Ready to Apply for Medicare Coverage, Absolutely Read This Article Carefully

(Ed's Note: Social Security can screw you up and wreck havoc with your retirement life when applying for Medicare health coverage. My New York Editor knows this for a fact. She found out what heartache can really mean when you least need more aggravation in your life. This article by Patricia Barry originally appeared in the AARP Bulletin and details what can go terribly wrong in the process.)

By Patricia Barry

Bill Bregar thought he was doing everything right. With his former employer’s health insurance due to run out in May 2009, he believed that his visit with his wife to the Social Security office to sign up for Medicare would be routine. He was wrong.

They were told they wouldn’t be able to get Medicare coverage until July 2010. Suddenly, in their late 60s, they faced the prospect of 13 months without health insurance. "My reaction was disbelief," he recalls. "My wife went into shock."

Bregar, a former software engineer from Lake Oswego, Oregon, and his wife, Ruth, had run afoul of an obscure rule that is little understood by Medicare beneficiaries, employers, health insurance companies and even some Social Security and Medicare officials.

And their experience has led directly to their congressman, Rep. Kurt Schrader, D-OR, proposing legislation to have the rule changed.

Obscure Rule Hurts Beneficiaries

Under current law, working Americans with employer health coverage can postpone signing up for Medicare until after 65. When they retire, accept a buyout or are laid off, they then get an eight-month special enrollment period to sign up for Medicare Part B (which covers doctors visits and other outpatient services) immediately and without penalty.

But many people in these circumstances are able to extend their employer coverage for a year or two under a 1986 law known as COBRA, which is what Bregar did.

What they may not realize is that waiting until their COBRA coverage expires to enroll in Part B disqualifies them from the eight-month grace period.

Instead, they must wait to sign up during open enrollment, from January 1 to March 31 each year, and their coverage won’t begin until the following July. They also get hit with a late penalty, an extra charge added permanently to their Part B premiums.

The COBRA Catch

Social Security officials explain that under the law, people can postpone signing up for Part B without penalty only while they have group health insurance provided by an employer for whom they or their spouses are still working. Therefore, time on COBRA—used after employment has ended—does not entitle them to special enrollment.

Although this rule is 24 years old, in recent months AARP and other consumer help organizations have both seen a significant uptick in the number of calls complaining about it.

The Medicare Rights Center, which tracks calls involving Part B enrollment problems, reports that this year more than 21 percent of these relate to the COBRA issue.

The timing may be due to the fact that when the economic recession hit in 2008, more older Americans lost their jobs and opted for COBRA coverage without thinking to sign up for Part B—and are only now facing the consequences. Nobody yet knows how many people are affected.

Confusion, Even Among Experts

"It’s clear from the number and types of calls we get on our hotlines that there is a lot of confusion about how Medicare works with COBRA," says Joe Baker, president of the Medicare Rights Center. "Not only are individuals confused, but employers are as well, and the price of the confusion can be devastating for some."

Yet the crucial Medicare regulation barring a special enrollment period for people whose COBRA coverage is ending is rarely publicized. It is not mentioned in the Department of Labor’s guidance for people considering COBRA.

It is mentioned briefly on page 24 of the official handbook, "Medicare & You 2010" – but without any warning of a delay in Part B coverage. It isn’t included in Social Security’s general website information on enrolling in Medicare or in its frequently-asked-questions section – though entering "COBRA" into the site’s search engine leads to an explanation.

But many people don’t go to these sources. Instead, they rely on information from their employers, their insurance company or Social Security officials.

Bregar, who accepted a voluntary retirement package from the Hewlett Packard Company in 2007, consulted all three. On an earlier visit to the local Social Security office when he turned 65, he says the official told him he didn’t need to sign up for Part B until his employer insurance ended.

"What he didn’t say," Bregar adds, was that this wasn’t true "if I stopped working at any time even if my health insurance were still in effect."

After the bombshell landed, Bregar repeatedly called Social Security. Among some 15 conversations with officials, he says, "two of them told me exactly the same wrong information as I was given in the first place."

But one suggested he apply for "equitable relief." This little-known option allows Social Security to investigate cases and reverse decisions if it finds an official has given faulty information. Bregar wrote a letter applying for relief and took it down to the office.

"The lady there said: ‘Well, I’m happy to forward this on, but I can tell you I’ve been here for 26 years and I’ve only seen one case resolved in favor of the applicant’," he recalls.

At that point, Bregar called the office of his congressman, Schrader. His staff, who’d never heard of the rule either, became interested. Their calls resulted in a "congressional inquiry" label attached to the Bregars’ Social Security file.

Meanwhile the couple, frantically trying to find insurance, discovered that only one policy—costing around $1,700 a month—was available to them.

On the day they were due to sign up, Bregar received a call from Social Security. He says the official said simply: "When do you want your Medicare insurance to begin?" He said: "Next week?" "Done," she replied. The power of a congressional inquiry had paid off.

Unlucky Victims Caught in the Trap

Many others in the same situation are not so lucky. Harvey Fine, of Woodstock, Georgia, had planned to retire from his job as a packaging company executive upon reaching age 70 in October. But last summer he was laid off and now he and his wife, Lucille, are covered under COBRA until December.

He, too, was stunned to discover last month that they’d fallen into the unforeseen trap and would have to wait until next July for Medicare. Everyone had told him that COBRA was simply an extension of his employer’s group coverage – "same policy, same card, same everything," he says. "The hidden point to me was this eight-month window. You lose out unless you know these things."

Fine, too, complained to Social Security that he’d been given wrong information, but at a review he was denied because he couldn’t remember the name of the official he’d visited a year ago.

There was a record of his visit, but "they said the person didn’t enter anything into my file," he recalls. The agency confirms that an investigation cannot be opened unless the applicant can provide the name of the official and the date and place of the conversation.

And an applicant making a formal appeal is unlikely to succeed, because ignorance of the law is not a defense.

Fine wonders why he is being penalized when, by taking COBRA for 18 months, he has actually saved Medicare money. "There seems no logic in this rule," he says.

The confusion is compounded by the fact that Medicare Part D, the prescription drug benefit, has a different rule: People whose COBRA benefits expire are allowed a two-month special enrollment to sign up with a drug plan without penalty.

No Medicare for Months

Many older Americans who fall into the Part B-COBRA trap aren’t so concerned about the late penalty, but say the prospect of no insurance for months is frightening.

Like most others, Fine’s insurance options after COBRA ends are limited. With a history of diabetes, high blood pressure and high cholesterol – which his current medications keep in check – he is unlikely to find individual coverage.

He isn’t eligible for insurance under the new health care law’s high-risk pools that accept people with preexisting medical conditions, because to qualify people must have been uninsured for at least six months.

He may be able to get coverage under another law that allows people who have had continuous coverage from an employer plan and COBRA for at least 18 months to buy insurance regardless of preexisting conditions, but this is usually very expensive.

Fine is exploring all possibilities, but the process "is like Russian roulette," he says. "My worst case scenario is to bite the bullet and dig into whatever savings I have."

A Proposed Change in the Law

It was Bregar who suggested to Schrader that the law should be changed. Schrader agreed.

His bill, entitled the Medicare Enrollment Protection Act of 2010, proposes to allow people a special enrollment period of eight months after COBRA benefits run out to sign up for Medicare immediately and without penalty.

The bill would also create continuous enrollment for people who miss their Part B deadlines for other reasons. They, too, would get coverage the month after they applied, but would pay an appropriate late penalty.

That’s to prevent people gaming the system and deliberately failing to sign up and pay premiums until they have serious medical issues, Schrader says. "Seniors have earned these benefits and need to be covered," he adds.

AARP, the Medicare Rights Center and other consumer organizations support the bill.

August 9, 2010

The Doctor Knows Best

Will a New Treatment Help Lead Us in Discovering the Cause and Cure for Multiple Sclerosis?

By Andrew Weil, M.D.

Question: What do you think of the new treatment for multiple sclerosis (MS) that involves expanding narrow veins in the neck and chest? Is it a worthwhile

Answer (Published 7/29/2010):

You're referring to a theory and treatment being advanced by a vascular surgeon in Italy, Dr. Paolo Zamboni, who has suggested that MS may be due to narrowed veins in the neck and chest that block drainage of blood from the brain. He believes that expanding these narrowed areas in blood vessels can relieve symptoms of the disease.

I have read a New York Times report about Dr. Zamboni's work and about how word of his treatment has sped around the world on the Internet, generating demand for it.

Understandably, many MS patients are frustrated by a disease for which there's no cure and no reliable treatment. MS is one of the most baffling of all afflictions -- we know very little about what triggers it and what factors influence its progression and outcome.

MS begins with localized inflammatory changes of the myelin sheaths surrounding nerve fibers as a result of an attack by the immune system. The resulting damage interferes with nerve impulses and can lead to symptoms such as muscle weakness, loss of vision, and a variety of other neurological impairments.

Although considered an autoimmune disease, it is not clear what prompts the immune system to attack nerve sheaths as it does in MS.

Pressure from patients has led to a number of studies aimed at determining whether or not Dr. Zamboni is onto something. He has reported finding narrowings in the chest and neck veins of MS patients but not of healthy individuals.

He has tried opening the narrowed blood vessels with balloons and found that some patients with relapsing remitting MS recover fully (including his wife, according to what he told the Times) but that some aren't helped.

In a study published in December 2009 in the Journal of Vascular Surgery, Dr. Zamboni reported that his treatment lessened fatigue in patients with the progressive form of the disease but resulted in no changes in mobility.

The only way to determine for sure whether this unconventional treatment works is with clinical trials that compare treated patients to controls who get a sham procedure (neither patient nor doctors knowing who gets the real thing).

Studies have just begun, so it will be a while before we get results. The Times reported that even in the absence of proof, patients have been seeking out doctors worldwide who are willing to perform Dr. Zamboni's "liberation" technique, but it is a procedure I cannot recommend yet.

I like to work with MS patients because of the disease's variability and potential to go into remission, as well as its responsiveness to an integrative approach including stress reduction, mind/body therapies and changes in diet and lifestyle.

August 6, 2010

Some Attempts Are Doomed

Doctor and Patient: Letting Patients Read Their Doctors' Notes in No Easy Task

(Ed's Note: My New York editor says, "It's my body and my life; I should have the right (demand the right) to my own medical records. And the way they get around it to prevent me from having my records, is to charge a high per-page fee for Xeroxing. This even when I am asking for the records to be transferred to another doctor." This article originally appeared in the New York Times.)

Their request seemed simple enough: the patient and his wife, both in their 70s, wanted a copy of what I'd written in their medical file. During their visit, I had watched them refer to a well-thumbed collection of doctors' notes and medication lists, so when they asked for a copy of my note just before leaving, I assumed it would simply be added to the others.

But when I mentioned the request to one of the nurses outside the exam room a few minutes later, her eyes grew wide.

"Oh no, you can't do that," she said, shaking her head. "I don't think it's legal." The other doctors and nurses, attention piqued, moved closer to listen. "Send them to medical records," she urged. "He can sign the release papers there."

Another nurse in the growing crowd offered her own advice. "Do you know what's going to happen if you give them a copy now?" she asked. "They're going to start calling and e-mailing you with questions about what you wrote."

The doctors and nurses began clucking in agreement. "Think about it for a second, Pauline," one doctor said with voice lowered. "Maybe they are thinking of suing you."

There was a collective gasp from the group now gathered around me; and I could guess what they were thinking as they craned their necks to peer into the exam room where my elderly patient was busy fussing with his papers as his wife stood adjusting the canvas fishing hat on his head.

The barbarians are at the gate.

For 40 years, the tension over patient access has been playing out in hospitals, clinics and doctors' offices. Although medical records have always been accessible to clinicians, payers, auditors and even researchers, it was not until the 1970s that a few states began giving patients the same rights.

While a handful of physicians were vocal supporters of these early efforts, the majority of doctors were far less enthusiastic. They worried that their notes might become a source of unnecessary stress for patients. Read without an experienced clinician's interpretation, slight abnormalities like an elevated cell count from a viral infection could turn into a life-threatening cancer in the eyes of patients.

Even routine abbreviations and jargon like "S.O.B." (shortness of breath) and "anorexic" (a general lack of appetite, not the disease anorexia nervosa) could be confusing at best and inadvertently demeaning at worst. Doctors, already pressed for time, shuddered at the idea of suddenly being responsible for the worries of a reading public.

In 1996, despite these concerns, the Health Insurance Portability and Accountability Act, or HIPAA, gave all patients the legal right to read and even amend their own medical records. At the time, a group of national health care experts hailed this new transparency as a necessary component of better and safer care.

But today, few patients have ever laid eyes on their own records. And those who try often come back from their missions with tales of bureaucratic obstacles, ranging from exorbitant copying costs to diffident administrators.

The same concerns from 40 years ago come up again and again, with little evidence to support or refute the claims of either side.

Should medical records be shared as interactive documents between patients and physicians? Can transparency work, or will it end up worrying patients, muddling the patient-doctor relationship and adding more work to an already overburdened primary care work force?

Now, according to the latest issue of the Annals of Internal Medicine, the answers to these questions may finally be answered in a year's time.

This summer, researchers have begun the largest study to date of open access, aptly named Open Notes, involving more than 100 primary care physicians and approximately 25,000 patients from three health care centers -- the Beth Israel Deaconess Medical Center in Boston, the Geisinger Health System in Danville (PA), and the Harborview Medical Center in Seattle.

In the study, patients who have just seen their doctors will receive an e-mail message directing them to a secure Web site where they can view the signed physician notes. Patients will receive a second e-mail message two weeks prior to any return visit, reminding them that the notes from their previous visit are available for review.

Over the course of the yearlong study, funded by the Robert Wood Johnson Foundation, the Open Notes investigators hope to analyze the expectations and experiences of patients and physicians, as well as examine the number of additional phone calls, e-mail messages and visits that may arise as a result of more patients viewing their doctors' notes.

In addition, a public survey on the journal's Web site will assess the opinions of any patient or doctor not enrolled in the study.

"We have one simple research question," said Dr. Tom Delbanco, a lead investigator who is a primary care physician at the Beth Israel Deaconess Medical Center. "After a year, will the patients and doctors still want to continue sharing notes?"

While enrolling patients in the study has not been difficult, finding physicians who are willing to participate has been more challenging. A few doctors were quick to sign on, but "most physicians were ambivalent at best," noted Jan Walker, a registered nurse and health services researcher at Beth Israel Deaconess who is the study's other lead investigator. Many physicians were worried about workload and issues of clarity.

"The note is really a story," said Dr. Sara B. Fazio, a primary care physician at Beth Israel Deaconess who hesitated at first but is now one of the participating doctors. "The meaning of a story depends on the storyteller. Just because I write something down as my version of the facts doesn't mean that they will be the absolute facts or that another person could not interpret those facts differently."

While physicians recognize that such differences in interpretation occur frequently, particularly across different specialties, patients may not. "A doctor's note could come across in a very unexpected way to a patient even when the doctor wrote it with the best of intentions," Dr. Fazio said.

The researchers are hopeful that their study will help to settle many of the longstanding issues regarding open access, but one thing has already become apparent. For at least a few of those involved, the once sharply demarcated lines of the decades old tension have begun to fade. It is no longer so clear who exactly stands on what side of the medical records wall.

"In the end," Dr. Fazio said in an e-mail message, "we are all patients -- if not now, then someday -- and from that perspective it is easy to see the many reasons why this is a step in the right direction."

She added, "I suspect the physician in me will eventually be won over by that perspective given a little time."

July 26, 2010

Arthritis Sufferers Take Note

Here Are Some Simple, Drug Free, Ways to Treat Your Arthritis

(Ed's Note: Andrew Lange N.D. is a Naturopathic Physician. He served as Chair of the Department of Homeopathic Medicine and Supervising Clinical Physician at Bastyr University in Seattle.)

By Andrew Lange

Most articles on arthritis try to recommend drug treatments rather than natural ways you can help your body heal.

Both orthodox and alternative treatments have shown success in treating the symptoms of arthritis. It is crucial to learn how our daily habits affect the inflammatory processes that contribute to arthritis.

The most common treatments for arthritis are those that affect an inflammatory chemical known as Cyclooxygenase or COX. Pharmacological inhibition of COX can provide relief from the symptoms of inflammation and pain. Non-steroidal anti-inflammatory (NSAIDs) drugs, such as aspirin and ibuprofen, exert their effects through inhibition of COX.

Unfortunately NSAIDs drugs used for these treatments were also found to have side effects.

NSAIDs can make the overall disease process of arthritis worse, by depleting the very nutrients necessary for joint repair, including iron, folic acid and zinc. COX-2 inhibitors have been found to have serious cardiovascular effects, increasing the risk of atherothrombosis even with short-term use.

A 2006 analysis of 138 randomized trials and almost 150 000 participants showed that selective COX-2 inhibitors are associated with a moderately increased risk of vascular events, mainly due to a twofold increased risk of heart attacks, and also that high-dose regimens of some traditional NSAIDs such as diclofenac and ibuprofen are associated with a similar increase in risk of vascular events.

What are the simplest ways to reduce inflammation in the body?

1. Keep Moving.
Even though pain and stiffness can make you feel like skipping your exercise routine, research shows that staying active can help keep arthritis symptoms under control.

2. Diet.
 The Mediterranean diet consists primarily of fish, fruit, vegetables, cereals, and beans and contains less red meat and dairy products than Western diets. In a recent study of Rheumatoid arthritis patients, those consuming the Mediterranean diet had a
statistically significant 56 percent decrease in disease activity.

3. Omega 3 Oils.
The research is solid. We have a preponderance of Omega 6 oils, which we do need, from polyunsaturated oils, such as olive and canola. Saturated fats from meat contribute to inflammation.

You can reduce inflammation by reducing or eliminating saturated fats in the diet. By increasing Omega 3 oils from fish or algae sources, we can alter the balance of our body's chemistry to reduce inflammation.

4. Repair Your Gut. Having healthy intestines makes sure that the primary part of your immune system is working properly. Allergies, antibiotics and a lack of healthy bacteria called probiotics can alter the integrity of the gut lining.

A poor gut integrity allows substances, such as allergens and other inflammatory substances to pass through the gut into the blood, which can affect our health systemically. Eating fermented foods, such as sauerkraut and yogurt helps to establish a healthy intestinal environment.

Remember that a lot of underlying conditions can cause arthritis.

Help in the differential diagnosis and prognosis of arthritic disorders clarifies what steps you need to take in treatment. To find out more about testing and how you can save on health care, go to >< and click on products and then arthritis-panel. It will give you a start in your path to good health.

July 18, 2010

Find Out Now

There Is a Very Good Reason Why You Should Avoid Going to Hospitals in July

(Ed's Note: This article is from the WebMD website, the place to go for medical information. Sid Kirchheimer writes about health and consumer issues.)

By Sid Kirchheimer

July is near, so consider the advice of some seasoned doctors: Avoid the hospital if you can.

Why? Because on or around July 1, fresh, inexperienced interns, residents, nurses and other new health care workers first report to work at many of the nation's hospitals, eager to start practicing medicine-on you.

In medical circles, it's known as the "July effect" and there's evidence -- along with popular opinion -- that it's a month with more medical errors in hospitals.

"You may get more personal attention, but the skill level isn't there," explains veteran physician David Sherer, M.D., past director of risk management for a large insurance provider and co-author of Dr. David Sherer's Hospital Survival Guide.

"You have newcomers arriving at hospitals-often placed in a sink-or-swim situation-and they don't know where anything is or how anything is done. July is not the time to have elective surgery or another procedure that could be postponed."

As a group, these physicians-in-training are "universally supervised," says Christopher Landrigan, M.D., who teaches at Harvard Medical School and oversees residents at Children's Hospital Boston.

But individually, "from day one, residents are writing medication orders and doing certain procedures and diagnostic tests with relatively little direct supervision, so there's always an opportunity for something to slip through the safety net."

The Month for Medication Mistakes

That's not to say that midsummer is the only time for potential problems. After all, some 100,000 Americans die from hospital medical errors each year -- thousands every month. "But there is good evidence that errors are somewhat more common when residents first begin to work," notes Landrigan.

Until now, most studies exploring the July effect have focused on seasonal error rates at specific hospitals. But the latest and largest study to date examines the July effect on a national level, and some indicate that, indeed, more medical errors of various types occur in July and early August than other months -- specially at teaching hospitals, which train medical interns and residents and are connected with medical schools.

But July is also a popular month for others, fresh from college, to begin their health care careers at all types of facilities-including nurses, pharmacists and allied health technicians and therapists.

The latest and largest study to date examines the July effect on a national level-with an alarming finding.

After analyzing more than 62 million death certificates issued across the country from 1979 to 2006, researchers found that fatal medication errors consistently spiked in July by about 10 percent -- but only in U.S. counties with many teaching hospitals -- and then subsided in August to levels on par with other months.

Yet there was no measurable increase in counties with facilities that don't employ residents, such as community hospitals.

Here Is the Difference

"We were looking for all causes of death occurring in hospitals," explains study leader David P. Phillips of the University of California, San Diego, whose research was recently published online in the Journal of General Internal Medicine, "and found no increase in death from surgical errors, hospital-acquired infection or other causes in any type of facility -- only in fatal medication errors at teaching hospitals."

His theory: "With surgery, you have a whole team of people working together, so there's a lot of redundant checking. But residents prescribe or hand out medication alone."

Still, others say there are other concerns in July beyond the possibility of getting the wrong medication or the wrong dose.

"Whether it's assisting in surgery or giving an intravenous line, there's a necessary learning curve that occurs over time," says Sherer, a practicing anesthesiologist near Washington, D.C.

"I've seen it myself: The success rate for first-time IVs is not there among new residents and nurses." Central-line infection rates, which occur from improperly placed IVs, account for nearly 30,000 hospital deaths a year.

Try to Protect Yourself

1. Bring your own health records (including a "Personal Medication Record").

2. Ask a friend, relative or other health advocate to stay with you.

3. To lessen the chance of mix-ups, state your name to anyone providing you with care.

4. Know the name of the doctor who is ultimately in charge of your care.

July 13, 2010

Denmark Study Has Merit

Common Painkillers Increase Heart Risks in Healthy People as Well as Those With Heart Disease

(Ed's Note: The following article by Nissa Simon originally appeared in the AARP Bulletin.)

By Nissa Simon

Healthy adults who reach for common painkillers to ease the twinges of everyday aches and pains could be setting themselves up for a heart attack or stroke, according to recent research.

Past studies clearly showed that long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), including Advil, Motrin and Aleve, to relieve pain was linked to an increased risk of heart attack or stroke in those who already had heart disease.

But now a study from Denmark reports that short-term use in healthy men and women who take those drugs for minor complaints also raises the risk.

"If you use NSAIDs regularly to control chronic pain, talk with your doctor about reducing your other risks for heart disease with a heart-healthy diet, a good exercise program and possibly statins," says Richard Stein, M.D., a cardiologist at New York University School of Medicine.

The painkillers are widely used to ease the discomfort of everything from arthritis to headaches and muscle strains. Five such drugs were included in the study: ibuprofen (Advil, Motrin), diclofenac (Cataflam, Voltaren), naproxen (Aleve, Anaprox), celecoxib (Celebrex) and rofecoxib (Vioxx), which was taken off the market in 2004 because of heart risks.

"People should be aware that NSAIDs are not risk-free with respect to the cardiovascular system," says research fellow Emil Loldrup Fosbøl, M.D., the study’s lead author.

In the United States, naproxen and ibuprofen come in both prescription and over-the-counter versions while diclofenac and celecoxib are prescription only.

The researchers tracked more than 1 million healthy Danes from 1997 to 2005. Since low-dose ibuprofen is the only NSAID available in Denmark without a prescription, they could track and compare those who took the drugs, most of them daily for about two weeks, with those who did not. Risks from different painkillers varied widely.

Although the percentages of increased risk were large, the actual number of those affected was small. The researchers found:

Ibuprofen: A 29 percent greater risk of fatal or nonfatal stroke.

Diclofenac: Almost double the risk of death from heart disease.

Celecoxib: Results were inconclusive.

Naproxen: No greater likelihood of heart-related problems and a slightly lower risk of death, leading the researchers to conclude that naproxen could be a safer alternative to other such painkillers.

If you routinely take one of these painkillers, bring up the question of whether you need to continue and, if so, at what dose.

The study appeared in the June 8 online edition of the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

June 22, 2010

Advice From Dr. Weil:

Is There a Way to Treat Children With ADHD Without Drugs? Well, Yes There Is

Question: My nephew, age 8, was just diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and his pediatrician recommended drug treatment. The problem seems to be that he doesn’t much like school and is restless (not disruptive!) in class. Drugs seem a bit drastic to me. Any recommendations?

Answer: Yes. My advice is to read an impressive new publication on the subject, ADHD Without Drugs, by my colleague Sandy Newmark, M.D., a California-based pediatrician on the faculty of the Arizona Center for Integrative Medicine.

I wrote the foreword to the book because I think the information and prudent advice it contains can be an enormous help to the millions of parents and children who are confronting this diagnosis.

Over the past 25 years, ADHD has become epidemic to the point where six to eight percent of all kids, and more than 10 percent of the boys, in the United States are labeled as having a serious neurodevelopmental disease.

Worse, 2.5 million kids are taking psychostimulant medication, an approach that Dr. Newmark and I think is vastly overused.

The big mystery is why so many more children are affected now than in the past. Dr. Newmark believes that something has altered the neurological development of kids today resulting in more youngsters whose brains are "wired" differently than was the case a few decades ago.

He blames the environmental toxins that are increasingly prevalent in our lives, poor nutrition and the amount of time kids spend watching TV, using computers and playing video games. All these electronic activities have the effect of shortening kids' attention span.

He notes that every study on the subject has shown that the more hours of television a child watches, the more likely he or she is to have ADHD.

If your nephew really has ADHD (Dr. Newmark lists a number of disorders, ranging from depression to iron deficiency to problems at school that parents may not recognize, which can be misdiagnosed as ADHD), it can often be treated successfully without drugs.

He believes that one of the single biggest factors contributing to ADHD is the poor quality of the foods our kids eat -- too many containing artificial colorings and other additives.

Other possibilities include food allergies and sensitivities that can be identified via an elimination diet and deficiency of omega-3 fatty acids (Dr. Newmark and I both feel that every child with ADHD would benefit from taking a daily omega-3 fatty acid supplement).

Deficiencies of the minerals iron, zinc and magnesium have also been linked to ADHD.

June 21, 2010

Talk About a Bummer

America's Social Security Trust Fund Is Flagging and Will Need a Shot in the Arm in 2012

(Ed's Note: This article about the woes of the Social Security Trust Fund first appeared in The Boston Globe. If you do not qualify for social security payments, you may not be interested in taking the time to read this article; if you do receive payments, you would be wise to find out about what lies ahead.)

From The Boston Globe

Let's start with your annual letter from the commissioner of Social Security. It recaps your work record and projects your future retirement benefits. It also warns that
benefit payments will exceed employment tax collections by 2016.

Worse, it says the Social Security Trust Fund will be exhausted by 2037. When that
happens, employment taxes will cover only 76 percent of promised benefits. As it turns out, the letter is optimistic.

Benefit payments already exceed employment tax collections. According to the Congressional Budget Office, a crush of retirees and fewer workers has turned the expected surplus of employment taxes over benefit payments into a shortfall.

Fortunately, it's estimated at only $29 billion this year, piffle in government finance. The piffle, however, is expected to continue. There will be a need to find cash, and we will be talking about it in 2012.

Some readers will say, "Gee, isn't that what our Social Security Trust Fund
is for?'' It's a reasonable, if naive, idea. While it is true that anyone who worked between 1983 and today has shoveled some extra money into the trust fund, it's not sitting there like dollar bills in Scrooge McDuck's vault. The trust is just a collection of IOUs from the Treasury.

In 1983, when Alan Greenspan led a commission that reformed Social Security, federal debt was only $1.4 trillion. Our reformed Social Security was supposed to be solvent for a full 75 years. Its accumulating surplus, held in trust, would cover the hefty cost of the baby boomers when they retired.

But the commission missed the mark. Today the unfunded liabilities of Social Security alone are $5.3 trillion. And the surplus is no more. Worse, Treasury debt is now $12.4 trillion -- which includes $2.3 trillion of IOUs held by the trust fund.

So when Social Security goes to redeem its IOUs and cover that $29 billion shortfall, it will go to the Treasury. Sadly, the Treasury is empty except for its tax revenue and whatever it can borrow.

And what does that mean?

You can get an inkling by reading a recent report from the Senate Committee on Aging. It provides an extensive menu of steps to address the problem. Here are two extremes on the list:

1) "Increase worker and employer contributions by 1.1 percent.'' Since worker and employer now pay 12.40 percent of payroll in employment taxes, the 2.2 percentage point increase in the tax would be a 17.7 percent increase on all workers, including those working short shifts at McDonald's.

2) "Reduce benefits by 5 percent for new beneficiaries in 2010 and later." That's a hefty cut, but hardly enough. It would cover only 30 percent of the projected 75-year shortfall. Between those two extremes, the Senate committee lays out a list of tools and calls it "modernization.'' The bottom line is that more will be going in and less will be coming out -- at least to the people who paid it in.

June 19, 2010 2nd Article

The Jury Is Out

New "Liberation Procedure" Might Offer Some Hope for the 500,000+ People Who Suffer From Multiple Sclerosis

(Ed's Note: This article by Marie McCullough originally appeared in The Philadelphia Inquirer on June 16, 2010, and details some new hope for people who suffer from multiple sclerosis (MS), a disease which has no known cure.)

By Marie McCullough

Nasha Smith knows that skeptics would say her multiple sclerosis got better after an unorthodox treatment at Lankenau Hospital simply because she believed it would.

But the 40-year-old Reading resident also knows the "placebo effect" can't explain her transformation. Practically overnight, she went from being homebound -- disabled by foot numbness, fatigue, balance problems, and painful bowel spasms that left her incontinent -- to being able to complete a three-mile fund-raising walk for MS.

"I know there's a lot of controversy about this, but I don't know why," Smith said. "The procedure was so simple, yet life-changing."

The procedure, balloon angioplasty, is routinely used to open clogged heart arteries. But MS patients around the world are seeking what they call "the liberation procedure" to widen veins.

Groundbreaking research by an Italian vascular surgeon suggests that narrowed veins are common in MS patients, causing blood to drain improperly from the brain.

For a disease long blamed on out-of-control immune cells that attack the central nervous system, the blocked-vein theory is a radical departure -- one that experts say remains speculative.

To begin to confirm it, the National MS Society and the MS Society of Canada on Friday awarded $2.4 million to 7 groups. They will study the diagnosis and frequency of poor vein drainage but will not treat patients who have the problem.

"We certainly feel the patients' sense of urgency," said Patricia O'Looney, vice president of the National MS Society. "But there are conflicting reports from scientists. The appropriate action is to bring clarity to the question" of whether veins play a role.

Patients are not waiting for more clarity. Dissatisfied with the marginal benefits and serious side effects of standard therapies, they are turning to interventional radiologists like Lankenau's Joseph Bonn, who treated Smith.

At least, until hospital lawyers step in.

In April, they ordered Bonn to stop performing balloon angioplasty on MS patients pending approval by officials at the Wynnewood hospital.

Zamboni's Discovery

It's not clear who coined the catchy term liberation procedure, but it stems from the work of Paolo Zamboni, a vascular specialist at Italy's University of Ferrara.

While trying to help his wife's MS, he discovered that the three main veins that channel blood from the brain back to the heart -- the jugulars and the azygos -- are often twisted, bent, compressed, or otherwise constricted in MS patients. He gave this abnormality a distinctly uncatchy name, "chronic cerebrospinal venous insufficiency," or CCSVI. His first paper on the condition was published only a year ago.

Neurologists, the specialists who usually treat MS, as well as others, see holes in his out-of-the-box thinking.

For one thing, poor vein drainage doesn't bother everyone who has it. Zamboni found it in the majority of MS patients, and few of the healthy people he checked. But then he and University of Buffalo neurologist Robert Zivadinov did a larger study of 500 patients. CCSVI showed up in 60 percent with MS, 43 percent with other neurological conditions, and 22 percent of healthy controls.

Another thing: Not all MS patients get better after angioplasty. And the veins often re-narrow within a year. Zamboni found this happened in up to 47 percent of jugulars, although azygos veins usually stayed open.

Stanford University researchers tried to combat the re-narrowing with stents designed to prop arteries open. One patient needed open-heart surgery when the stent dislodged, and another died of brain bleeding while taking a blood thinner prescribed with the metal devices.

Still, Zamboni's maverick work offers a neat explanation for the central mystery of MS: why immune cells run amok, attacking nerves in the very body they are supposed to protect.

Zamboni found that blood backs up in the brain, or "refluxes," as it creates new drainage patterns to circumvent the blocked veins. Iron settles out of refluxing blood and, like toxic pollution, irritates delicate brain tissue. In theory, this signals immune cells to seep out of the blood and try to clean up the mess.

Normally, vessels in the brain are impermeable, so immune cells can't access that all-important organ. But the constricted veins develop high blood pressure, making them stretch and spring microscopic leaks. In theory.

Angioplasty techniques are so well-established for treating vessel abnormalities that MS patients feel they are being discriminated against. In their view, they have little to lose and much to gain from trying to get better blood flow.

CCSVI is diagnosed with ultrasound imaging, followed by special X-ray and MRI imaging. Balloon angioplasty, performed under sedation, involves inserting a tube through a small incision, threading it deep into the vein, and inflating the balloon tip to expand a narrow spot. Serious complications -- rupturing the vein or a dangerous blood clot -- are rare.

Bonn, who does procedures on heart, kidney, and cancer patients, knew virtually nothing about MS until two months ago. Then, at a medical convention, he vaguely heard about the blocked-vein theory and made a note to learn more. Just two days later, he saw Janet Grieco, 53, an MS patient who had called out of the blue seeking treatment for CCSVI.

"He pulled out his BlackBerry and showed me the note he made at the convention," the Chalfont resident recalled.

Soon, Bonn was getting calls from MS patients near and far as their online community added him to the list of doctors willing to help.

He treated only three MS patients, including Smith, but the results were good.

Relief From Headaches

Grieco had suffered from chronic migraines, balance problems, and fatigue that was intensified by insomnia.

"By the time I got to recovery after the procedure, I didn't have a headache," she said. "When you have a headache for three years and then it's gone, it's remarkable."

That day, she strolled her neighborhood with her husband and stopped needing her nightly sleeping pill.

Denise Graff, 43, of Somerset, (NJ), experienced a phenomenon that other patients have reported.

"My toes were like icicles" because of foot numbness, she said. "During the procedure, I could feel them warm up just after he ballooned the first vein."

Bonn's fourth patient, Paulette O'Leary, 41, of Toronto, was minutes from being wheeled into the angioplasty suite when the hospital lawyers interrupted.

"I don't know who was more shocked -- Dr. Bonn, or me and my husband," O'Leary said.

Bonn is now designing a clinical trial, the gold standard for studying safety and effectiveness. Patients with CCSVI would be randomly assigned to balloon angioplasty with -- or without -- the inflation that opens veins. The trial must be approved by the hospital's review board.

As a scientist, Bonn sees the need for rigorous studies. But he also understands patients' frustration.

"They suffer for decades on a slow downhill course," he said, "with few options in terms of medications or procedures. So this has been a real roller-coaster ride for them."

O'Leary stayed on the roller coaster. Last month, she paid $13,000 for liberation at Albany State Medical Center, where a trial was already under way.

Now, she said, she no longer uses a cane, clings to a wall to climb stairs, or suffers from incontinence.

Balloon angioplasty is not a cure, not even close, she said. But it offers quality-of-life improvements that are impossible with any of the 7 approved MS drugs, as well as a new one, Novartis (NYSE:NVS) ' fingolimod', that was recommended for approval last week. All the drugs modify the immune system.

Still, as patients travel to India, Bulgaria, Poland, and other countries for angioplasty, they may underestimate the skill and savvy it requires.

"I did my first MS patient at the end of last year. It didn't work out too well," said Salvatore Sclafani, chair of radiology at SUNY Downstate Medical Center in Brooklyn. "The anatomy was much more complicated than I expected. I did the balloon, but she developed a [blood clot]. I sent her home on anticoagulants and said, 'I'll try again after I get more experience.' "

Since then, he's done about 20 patients -- a few with "miraculous" results -- and become beloved for contributing to an online MS forum.

Indeed, when he was ordered a few months ago to stop doing the procedure outside of a clinical trial, "there was an outpouring of grief, and of compassion for me," he said. "Then they got angry. So we started to dialogue about the trials and what we want to learn from them. Now they're participating in the development of the research.

"I was ready to retire," added Sclafani, 63. "But this has touched me. Now my practice will be all MS."

June 16, 2010 - 2nd Article

What's Ailing Health Care?

New York City Doctor Reveals the 18 Biggest Problems With Today's Modern Medicine Practiced by Most Physicians

(Ed's Note: Frank Lipman MD, is the founder and director of the Eleven Eleven Wellness Center in New York City, a center whose emphasis is on preventive health care and patient education rather than just treating an illness than has already occurred.)

Dr. Frank Lipman

What are the biggest problems you see with the way Medicine is practiced today? Here is my list, I am sure there are more:

1. Modern Western Medicine is based on a narrow "scientific" model, and arrogantly ignores and rejects therapies and entire medical systems that do not fit this model.

2. Doctors are trained in hospitals in "crisis care" medicine, not to take care of the "walking wounded," which is the majority of people. They need to be trained to take of the "walking wounded" as well.

3. Instead of treating the underlying causes or imbalances, Doctors often merely manage symptoms.

4. Symptoms are seen as something to be suppressed rather than a pointer to some underlying imbalance.

5. Doctors see the human body as a machine with separate parts that can be treated independently rather than as an integrated whole. In addition the mind and body are also seen as separate independent entities and emotions are often ignored.

6. Man is not seen as part of nature, and how what happens in nature effects humans.

7. We look for a magic bullet instead of all the possible factors that make up the total load which are causing the underlying imbalance. There is no understanding of the total load.

8. No belief that the body has a self-healing capacity and no ways to boost that capacity.

9. Everyone with the same disease gets treated the same way, patient uniqueness ignored

10. We treat the disease, not the patient.

11. There is a reliance on numbers and tests rather than how the patient is feeling and what is found on examination.

12. We don't take into account the importance of diet and lifestyle on health. How could we? We get a total of 6-8 hours of nutrition lectures in medical school.

13. We do not recognize or understand the correct use of supplements to optimize health.

14. We do not recognize the importance of toxicity on our bodies nor know how to boost the body's own detoxification systems.

15. The Doctor patient relationship is not emphasized and the role of the patient as a partner in their own health care not encouraged.

16. The placebo has a negative connotation and ignored. The placebo is really the body healing itself and should be encouraged.

17. The Drug Industry is too enmeshed in the medical system. The Pharmaceutical Industry has WAY TOO MUCH power and is "bribing" Doctors to use their drugs and researchers to produce positive results for their drugs.

18. More than 80 percent of all medical treatments used have been untested by rigorous peer reviewed study, yet the Medical establishment insists that alternative health treatments must undergo these before they can be used. The system of evaluation needs to be changed.

June 15, 2010

Thought You Should Know

Early Warning Signs: When to Call the Doctor About Alzheimer's, and What to Do When You Are Alone and Cannot Help Yourself

Copyright © 2010 Ed Bagley

This article from WebMD tells how to recognize the onset of Alzheimer's among family members and friends, and what to do when you do see signs that indicate trouble ahead.

It also raises an important question: What if you are alone and do not recognize the symptoms yourself, or recognize the symptoms but choose to ignore them?

For singles, many times family members are not living with you, or they are not near enough to you to maintain sufficient observation of your activities.

The best answer to this problem is have friends who care about you and see you frequently. And, to have friends, you must be a friend. Friendship is a two-way street, it starts and ends with your contact with people. When people cannot find you, you must reach out and find them.

Here is the WebMD article:

Are you worried about an older loved one's memory or behavior? Has your mom been getting lost while running errands? Has your dad started to ask the same questions, over and over? Signs of the early stages of Alzheimer's disease aren't always clear-cut -- after all, it can be hard to distinguish them from the normal memory changes that come with age.

To help guide you, here are the Alzheimer's warning signs to watch for, along with advice about seeing a doctor and getting a diagnosis.

Alzheimer Disease Warning Signs

Many people confuse Alzheimer's disease with dementia. What's the difference? Alzheimer's is a disease; dementia -- which results in memory loss and disorientation -- is a symptom of the disease. However, dementia isn't always caused by Alzheimer's disease; it can be result from other conditions as well.

Although some memory changes are normal as you get older, memory problems that interfere with daily life are not. According to experts, common early signs of Alzheimer's disease or other dementias include:

1) Short-term memory loss. Although older memories might seem unaffected, people with dementia might forget recent experiences. Anyone can forget details from a recent event or conversation. People with dementia might forget the entire thing.

2) Repetition. People with dementia may repeat stories, sometimes word for word. They may keep asking the same questions, no matter how many times they're answered.

3) Language problems. We all struggle to remember a word occasionally. People with dementia can have profound problems remembering even basic words. Their way of speaking may become contorted and hard to follow.

4) Personality changes. People with dementia may have sudden mood swings. They might become emotional -- upset or angry -- for no particular reason. They might become withdrawn or stop doing things they usually enjoy. They could become uncharacteristically suspicious of family members – or trusting of telemarketers.

5) Disorientation and confusion. People with dementia may get lost in places they know very well, like their own neighborhoods. They may have trouble completing basic and familiar tasks, like cooking dinner or shaving.

6) Lack of hygiene. Sometimes this is the most obvious sign of Alzheimer's disease. People who have dressed smartly every day of their lives might start wearing stained clothing or stop bathing.

7) Odd behavior. We all misplace our keys from time to time. People with Alzheimer's disease and other dementias are prone to placing objects in odd and wholly inappropriate places. They might put a toothbrush in the fridge or milk in the cabinet under the sink.

If your loved one is exhibiting any of these Alzheimer's warning signs, don't panic. Having these symptoms doesn't mean that your loved one necessarily has Alzheimer's disease. But you need to schedule an appointment with the doctor for an evaluation.

Seeing the Doctor With Alzheimer's Disease Concerns

For a first appointment, you can start with your loved one's normal internist. Or you might go right to a specialist, like a psychiatrist or a neurologist. Over time, you may have a number of experts involved in your loved one's care.

Unfortunately, there's no definitive test for Alzheimer's disease. So doctors can use a number of different techniques to come up with a diagnosis. In addition to a typical physical exam and blood and urine tests, these could include:

1) Mental status tests. The doctor may ask a series of questions that assess a person's mental function. They test a person's short-term memory, ability to follow instructions, and problem-solving skills. Specific tests include the mini-mental state exam (MSE) and the "mini-cog."

2) Neurological exams. In checking for signs of Alzheimer's, doctor will also check your loved one's neurological function, including speech, balance, coordination, and reflexes.

3) Imaging tests. CT scans, MRIs, and PET scans can help rule out other causes for the symptoms -- like tumors or strokes.

Make sure to do your part. The doctor will need some basic information from you, so go in prepared with details about:

1) The Alzheimer's symptoms you've noticed and when they began.

2) Other health conditions your loved one has.

3) The daily medications she uses, including supplements and alternative treatments.

4) Your loved one's diet and alcohol use.

5) Any important changes in your loved one's life -- like retirement, a recent move, or the death of a spouse.

Unfortunately, there are still some doctors out there who are dismissive of Alzheimer's symptoms. They might not spend the time to come up with a proper diagnosis. They might write off the Alzheimer's warning signs as typical of old age.

If you're not satisfied with the doctor's assessment, get a second opinion. Your loved one deserves a thorough exam and a clear diagnosis. Alzheimer's disease can go on a long time, and during those years you'll need to work closely with a doctor. It's key that you find a caring, sympathetic healthcare professional you trust.

Don't Ignore Alzheimer's Warning Signs

Of course, you might not want to see a doctor yet. You might want to wait and see if things get worse. That's a bad idea. Many people put off consulting an expert for years -- long after they've noticed obvious symptoms of Alzheimer's disease. Why?

1) People worry that their loved ones will be offended or angry if they mention their memory problems.

2) Considering that Alzheimer's disease has no cure, people might assume that there's no point in rushing off to get the bad news.

3) Deep down, people don't want to admit to themselves that something might be wrong.

These are all very understandable, very human reasons to put off seeing an expert. But they're not good enough. If you suspect your loved one might have Alzheimer's, you need to see a doctor soon. Here's why:

1) Your loved one may not have Alzheimer's disease. Don't assume the worst. Even if your love one has dementia, it might not be Alzheimer's.

Lots of other conditions can cause dementia or similar symptoms. They include vitamin deficiencies, thyroid problems, depression, drug interactions, and alcohol abuse. Many of these conditions are treatable. Putting off a trip to the doctor could leave your loved one suffering pointlessly.

2) The sooner you get treatment, the more effective it will be.

Alzheimer's disease isn't curable, but it is treatable. Drugs like Aricept or Razadyne can slow down the development of Alzheimer's symptoms. However, these drugs work best when started early on in the course of the disease.

Later on, they have less of an effect. Early diagnosis may also make your loved one eligible for clinical trials, in which new, cutting-edge Alzheimer's treatments are available.

3) The sooner Alzheimer's disease is diagnosed, the sooner you can plan for it.

Accepting that a loved one has Alzheimer's is terribly difficult. But the sooner you do, the better off you are. The earlier you catch it, the more time you'll have to learn about the condition and prepare for what's ahead.

For your loved one's sake -- and for your own -- don't ignore the possible warnings signs of Alzheimer's disease. Don't wait until there's a crisis before you see a doctor. If you have any concerns about your loved one's memory or behavior, schedule an evaluation now.

(Ed's Note: There is no mention in this article about the benefit of having spiritual development and prayer. In many cases, people who care for a loved one with Alzheimer's, do so essentially alone. People may check in now and then, but the primary caregiver may have a 24/7 responsibility for years before the patient must go elsewhere for care. Without spiritual development and prayer, caring for an Alzheimer's patient and retaining your sanity can be difficult at best, and impossible at worst. God's guiding hand and the power of the Holy Spirit can be a lifeline you can touch with real feeling.)

May 12, 2010

Chocoholics Rejoice!

New Study Says Tea and Chocolate May Deter Strokes and Even Brain Damage

(Ed's Note: This guest article by Craig Weatherby first appeared online in the Vital Choices Newsletter.)

By Craig Weatherby

Foods rich in antioxidants called flavanols appear to reduce the risk of developing or dying from cardiovascular disease.

This effect is attributed in part to their anti-clotting powers and ability to increase production of nitric oxide, which helps keep arteries relaxed and open.

The only common foods high in flavanols are green tea, white tea, cocoa, and dark chocolate.

Now, a review of the existing epidemiological (health-and-diet) evidence suggests that habitual enjoyment of tea, cocoa, or dark chocolate may help people avoid stroke.

And a study in mice shows that the key flavanol antioxidant in tea and cocoa can reduce stroke-induced brain damage after the fact.

Study #1 - Evidence review links chocolate to reduced stroke risk.

Last month, Canadian researchers linked regular chocolate consumption to reduced risk of stroke.

Their review of the existing evidence turned up three relevant population studies, two of which showed an association between eating chocolate and reduced risk of stroke.

The first study involved 44,489 people, and those who ate one serving of chocolate per week were 22 percent less likely to have a stroke than people who ate no chocolate.

The second study, conducted in 1,169 people, found that those who ate 50 grams (1.7 oz) of chocolate once a week were 46 percent less likely to die following a stroke, compared with people who ate no chocolate.

The third study showed no link between eating chocolate and risk of stroke or death.

Of course, no epidemiological study can prove that any food reduces the risk of stroke . . . such studies only show an association.

But new evidence from a mouse study shows that the main antioxidant in cocoa – and in green or white tea – shields nerve cells from stroke-induced damage.

Study #2 - Tea/cocoa antioxidant protects brains of stroke-stricken mice.

Researchers at Johns Hopkins University in Baltimore have discovered that the main antioxidant compound in green tea and dark chocolate may protect the brain after a stroke.

The flavanol-class antioxidant – called epicatechin (ep-eh-cat-eh-kin) – does it by increasing cellular signals known to shield nerve cells from damage.

Ninety minutes after feeding mice a single modest dose of epicatechin, the scientists induced an ischemic stroke by essentially cutting off blood supply to the animals' brains.

The animals fed epicatechin suffered significantly less brain damage than the ones that had not been given the compound.

Most treatments against stroke in humans have to be given within a two- to three-hour time window to be effective.

Likewise, epicatechin appeared to limit further neuronal (brain cell) damage when given to mice 3.5 hours after a stroke, but had no effect when given to them 6 hours after a stroke.

Lead author Sylvain Doré, Ph.D., says that epicatechin stimulates two previously well-established pathways known to shield nerve cells in the brain from damage.

When the stroke hits, the brain is ready to protect itself because these pathways – called Nrf2 and heme oxygenase 1 – are activated.

As further proof that these are the pathways thought which it protects brain cells, epicatechin had no significant protective effect in mice that lacked them.

Eventually, Doré said, his research could lead to insights into limiting acute stroke damage and possibly protecting against chronic neurological degenerative conditions, such as Alzheimer's disease and other age-related cognitive disorders.

And Doré says the amount of epicatechin needed could be quite small, because the suspected beneficial mechanism is indirect: "Epicatechin itself may not be shielding brain cells from free radical damage directly, but instead, epicatechin, and its metabolites, may be prompting the cells to defend themselves." (AAN 2010)

The epicatechin simply "jump-starts" the protective pathway that is already present within the cells.

Not all dark chocolates are created equally, cautioned Dr. Dore: "The epicatechin found in dark chocolate is extremely sensitive to changes in heat and light. In the process of making chocolate, you have to make sure you don't destroy it. Only few chocolates have the active ingredient. The fact that it says ‘dark chocolate’ is not sufficient." (AAN 2010)

The amount of dark chocolate people would need to consume to benefit from its protective effects remains unclear, which would require clinical trials.

Chocolate and heart health: Processing kills the benefit.

Harvard scientists led by Norman Hollenberg, M.D., have been investigating the potential heart-health benefits of epicatechin by studying Panama’s Kuna Indians, who live on remote islands, drink copious amounts of cocoa and have a very low incidence of cardiovascular disease.

Dr. Hollenberg’s team found nothing unusual in the Kuna tribe’s genes, and realized that when they moved to the mainland they were no longer protected from heart problems.

Researchers soon discovered that the Kuna regularly consume a very thick, bitter cocoa drink that’s rich in epicatechin, but lose access to it when away from home.

Unfortunately, most cocoa is treated with alkali to reduce its bitterness and darken it.

This process, called "Dutching", destroys most of cocoa’s epicatechin . . . and almost all chocolate is made from Dutched cocoa powder.

Dark chocolate – defined as containing 60 percent or more cocoa solids – has twice the antioxidant capacity of milk chocolate.

And dark chocolate made from non-Dutched cocoa has more than twice the antioxidant capacity of dark chocolate made from Dutched cocoa.

This is why Vital Choice brand Organic Extra-Dark chocolate is made from non-Dutched cocoa.

And independent lab tests show that it is in fact high in epicatechin and other antioxidants in cocoa . . . including heart-healthy procyanidins, which give berries and grapes much of their antioxidant power.

May 7, 2010

What's Your Pain Tolerance?

Everyone Struggles With Pain at Some Point in Their Life, But How You Tolerate Pain Can Be Up to You

(Ed's Note: The guest article by Katrina Woznicki was first posted as a WebMD Feature. WebMD is one of the best sources for medical information on the Internet.)

By Katrina Woznicki

Why is back pain or a knee injury annoying to one person and sheer agony to another? Turns out, an individual's tolerance to pain is as unique as the person, and is shaped by some surprising biological factors, as well as some psychological factors that we can actually try to control.

Feeling Pain

There are two steps to feeling pain. First is the biological step, for example, the pricking of skin or a headache coming on. These sensations signal the brain that the body is experiencing trouble.

The second step is the brain's perception of the pain -- do we shrug off these sensations and continue our activities or do we stop everything and focus on what hurts?

"Pain is both a biochemical and neurological transmission of an unpleasant sensation and an emotional experience," Doris Cope, MD, an anesthesiologist who leads the Pain Medicine Program at the University of Pittsburgh Medical Center, tells WebMD.

"Chronic pain actually changes the way the spinal cord, nerves, and brain process unpleasant stimuli causing hypersensitization, but the brain and emotions can moderate or intensify the pain." Past experiences and trauma, Cope says, influence a person's sensitivity to pain.

Managing pain and people's perceptions to their symptoms is a big challenge in a country where more than 76 million people report having pain lasting more than 24 hours, according to the American Pain Foundation. Persistent pain was reported by:

30% of adults aged 45 to 64

25% of adults aged 20 to 44

21% of adults aged 65 and older

More women than men report pain (27.1% compared with 24.4%), although whether women actually tolerate pain better than men remains up for scientific debate.

Pain Rising

Pain produces a significant emotional, physical, and economical toll in the U.S. Chronic pain results in health care expenses and lost income and lost productivity estimated to cost $100 billion every year.

Pain may be on the rise in the U.S. because age and excessive weight contribute to pain and discomfort. Americans are living longer into old age, and two-thirds of the population is either overweight or obese.

The most common type of chronic pain in the U.S. is back pain; the most common acute pain being musculoskeletal pain from sports injuries, says Martin Grabois, MD, professor and chair of the department of physical medicine and rehabilitation at Baylor College of Medicine in Houston.

What Drives Your Pain Tolerance?

Pain tolerance is influenced by people's emotions, bodies, and lifestyles. Here are several factors that Grabois says can affect pain tolerance:

1) Depression and anxiety can make a person more sensitive to pain.

2) Athletes can withstand more pain than people who don't exercise.

3) People who smoke or are obese report more pain.

4) Biological factors -- including genetics, injuries such as spinal cord damage, and chronic diseases such as diabetes that cause nerve damage -- also shape how we interpret pain.

Your Sensitive Side

Some surprising biological factors may also play a role in pain tolerance. For example, recent research shows that one side of your body may experience pain differently than the other side.

A study published in the December 2009 issue of Neuroscience Letters showed that right-handed study participants could tolerate more pain in their right hands than in their left hands. This study also showed that women were more sensitive to pain than men; but women and men were equal in their ability tolerate pain intensity.

A dominant hand -- your right hand, if you're right-handed, for example -- may interpret pain more quickly and accurately than the nondominant hand, which may explain why the dominant side can endure longer. Hand dominance may also be linked to the side of your brain that interprets the pain, the researchers note.

Redheads More Sensitive to Pain?

Another surprising factor is that hair color may reflect pain tolerance. In 2009, researchers reported in the Journal of the American Dental Association showed that redheads were more sensitive to pain and may need more anesthesia for dental procedures.

Why redheads in particular? Redheads, the researchers say, tend to have a mutation in a gene called melanocortin-1 receptor (MC1R), which is what helps make their hair red. MC1R belongs to a group of receptors that include pain receptors in the brain. The researchers suggest that a mutation in this particular gene appears to influence sensitivity to pain.

"We have different receptors for pain in our body, and those receptors respond differently, whether you're taking aspirin or acetaminophen," Stelian Serban, MD, director of acute and chronic inpatient pain service and an assistant professor of anesthesiology at The Mount Sinai Medical Center in New York, tells WebMD.

Getting Better at Handling Pain

A person's biological makeup can affect whether he or she develops resistance to pain medicines, which means a treatment that once worked no longer eases the pain. This can be a "vicious circle" to break, Serban says. "You use more treatment and become more tolerant and you become less active and have more pain."

We can't change our genetic receptors, and not even changing your hair color or which hand you write with can rewire your sensitivity to pain. However, there are coping mechanisms that can influence the brain's perceptions of pain.

Researchers have focused on trying to alter the psychological interpretations of pain by retraining the mind. "You can change the perception [of pain] on the brain," Grabois says. "You haven't changed the perception on the nerves."

Alternative remedies, such as relaxation techniques like biofeedback, teach people
how to divert their mind from zeroing in on the pain.

People can empower themselves by learning relaxation techniques, such as breathing practices during natural childbirth, Cope says. When it comes to pain, mind over matter can work. "Meditation, distraction, and a positive attitude are things people can do themselves to lessen pain," she says.

May 5, 2010

Go "Greenercize"

Ann Pietrangelo on Improving Your Mood and Self-Esteem With Green Exercise

(Ed's Note: Ann Pietrangelo is both a victim and an advocate for the prevention and cure of multiple sclerosis. She is posted here because her message is one of not just hope, but positive action. May God bless Ann and all of those who suffer from MS. In honor of Ann, I have coined the phrase "Greenercize" to label Green Exercise, so be a "Greener when you exercise".)

By Ann Pietrangelo

Forget the gym. If you want to elevate your mood and self-esteem while exercising, think green, and blue.

In a previous article, Walking Your Way to a Healthier Mind, Body, and Soul, I wrote that walking outside is a good way to calm and declutter your mind and let your thoughts roam freely.

A recently published study by Jules Pretty and Jo Barton of the University of Essex (in the United Kingdom), as reported by the Environmental Science & Technology Journal, says that there is evidence to support the claim that green exercise - that is physical activity in the presence of nature - leads to positive short and long-term health outcomes.

In a study of 1,252 participants, both men and women had improvements in self-esteem after green exercise. The greatest change was in the youngest participants, with diminishing effects as we age. With regard to mood, the smallest change is in the young and the old; and the mentally ill, as a group, had one of the highest self-esteem improvements.

The best news of all is that the study showed that every green environment improved both self-esteem and mood, with water generating the greatest effects. In a meta-analysis of 10 studies, researchers found that getting outside and moving for as little as 5 minutes at a time remarkably improves both mood and self-esteem.

The study confirms that the environment provides an important health benefit. The Journal further reported that several years ago, Jules Pretty and his colleagues had volunteers exercise on a treadmill while watching scenes projected on a wall.

Participants who watched pleasant environments showed greater improvement in blood pressure and mood, and thereby increasing the positive effects of exercise, than those who watched unpleasant scenes or just exercised.

If you are a busy person living in a stressed environment, take a few minutes each day to go green and reap the rewards. Even a few minutes can change your perspective.

Take a walk or ride a bike in the park.

Lacking a park, take a walk or ride a bike outdoors on a tree-lined street. (If you live near a body of water, lucky you - don't waste the opportunity!)

Start a small garden in your yard.

Create a simple stretching routine that you can do outside on your deck or patio.

If you work in an indoor environment, try to get outside during lunchtime for some walking or stretching.

Play outside with your children, or with the pets.

If you exercise indoors, bring the outside in, with plenty of plant life or an indoor garden, or position yourself in front of a window with a pleasant view.

The gym has it's place, but going green will provide added mood and self-esteem boosters.

Ah, mother nature. She's worked things out pretty well.

May 4, 2010

Your Job May Be Killing You

University of Rochester Study Says That Workplace Stress Can Make You Fat

(Ed's Note: This guest article by Bill Toland first appeared in the Pittsburgh Post-Gazette.)

By Bill Toland

It's no exaggeration - your job is slowly killing you.

Years of research have shown that your job can help make you fat – sitting in front of a computer all day, eating bad cafeteria food. But your workplace stress level also can have an effect on your weight, according to a study from the University of Rochester.

Worse, the stress and corollary weight gain can increase chances of cardiovascular disease, depression and anxiety, according to the study's main author, Diana Fernandez, of the University of Rochester Medical Center's department of community and preventive medicine.

And all that stress means you're likely to collapse on your couch when you get home, watching too much TV and "vegging out."

"In a poor economy, companies should take care of the people who survive layoffs and end up staying in stressful jobs," Fernandez said, in a news release publicizing the study.

Workplace stress "affects how people sleep, which means they drink too much caffeine" at work, said Eric Braverman, a professor of neurological surgery at New York Presbyterian Hospital and weight loss columnist for the Huffington Post. "The carbs make them fat, the salt makes them tired," and all of that leads to lethargy after work and the potential for weight gain.

Doctors and dietitians say most people need to eat better at work - and that takes planning ahead, keeping healthful snacks, meals and vitamins at the ready.

Unfortunately, "they're not really set up to strategically think of health" while at work, Braverman said.

So will keeping apples and fiber bars at your desk do the trick? Surprisingly, the Rochester study also reported that trying to eat more fruits and vegetables during the day didn't help much to curb weight gain among chronically stressed employees. Instead, exercise "seems to be the key to managing stress and keeping a healthy weight," the study said.

Other recent studies, though, show that even exercise does little to curb weight gain (even if it does have other benefits, like reducing incidence of certain illnesses). A 2009 study in the Public Library of Science journal followed 464 overweight women who didn't regularly exercise, and randomly assigned them to one of four groups.

Women in the control group kept to their usual physical-activity routines and diets. The results?

"The women who exercised - sweating it out with a trainer several days a week for six months - did not lose significantly more weight than the control subjects did," the study found.

That might be because strenuous activity makes people hungry and thirsty, and more likely to overeat after exercise, counteracting the effects of the workout.

For the University of Rochester report, researchers studied 2,782 "mostly sedentary" employees at a manufacturing facility in New York, but said the results were applicable to most jobs and workplaces.

April 29, 2010

The Elusive "Six-Pack Abs"

Here Is the Best Way to Trim Away That Ugly Belly Fat and Look a Whole Bunch Better While Getting Healthier

(Ed's Note: This guest article by Kathleen M. Zelman first appeared on the WebMD web site.)

By Kathleen Zelman

Having a flat belly or so-called "six-pack abs" is a dream of most adults.

If you are middle-aged, have ever been pregnant, or sometimes indulge in too much food or one too many beers, you probably have a spare tire you would like to get rid of. So what is the best strategy for banishing belly fat? Is it as simple as adding certain foods to your diet, or doing particular exercises?

WebMD turned to the experts for answers on belly fat -- and the best ways to lose it.

The Answer to Flatter Abs

Don't despair; you can lose that spare tire, experts say. But there is no secret formula.

"There is no magic bullet, diet plan, specific food, or type of exercise that specifically targets belly fat. But the good news is belly fat is the first kind of fat you tend to lose when you lose weight," says Michael Jensen, MD, a Mayo Clinic endocrinology specialist and obesity researcher.

Whether you are an "apple" shape with excess belly fat, or a "pear" with wide hips and thighs, when you lose weight, you will most likely lose proportionately more from the abdominal region than elsewhere.

"Ninety-nine percent of people who lose weight will lose it in the abdominal region before anywhere else -- and will lose proportionately more weight from the upper body," says Jensen, also a professor of medicine.

And why is that? "Visceral fat, the kind tucked deep inside your waistline, is more metabolically active and easier to lose than subcutaneous fat under the skin, especially if you have plenty of it," explains Penn State researcher Penny Kris-Etherton, PhD, RD.

And the more weight you have to lose, the more quickly you are likely to start losing your belly fat, experts say.

"People who are significantly overweight may see quicker results in their belly than someone who has less to lose in that area, such as a postmenopausal pouch," says Georgia State University nutrition professor, Christine Rosenbloom, PhD, RD.

Can Whole Grains Help You Lose Belly Fat?

A recent study in the American Journal of Clinical Nutrition showed that a calorie-controlled diet rich in whole grains trimmed extra fat from the waistline of obese subjects.

Study participants who ate all whole grains (in addition to 5 servings of fruits and vegetables, 3 servings of low-fat dairy, and 2 servings of lean meat, fish, or poultry) lost more weight from the abdominal area than another group that ate the same diet, but with all refined grains.

"Eating a diet rich in whole grains while reducing refined carbohydrates changes the glucose and insulin response and makes it easier to mobilize fat stores," says study researcher Penny Kris-Etherton, PhD, RD, a distinguished professor of nutritional sciences at Penn State University.

"Visceral fat is more metabolically active and easier to lose than subcutaneous fat, especially if you have plenty of it and the right conditions are met, such as the ones in our study."

When you eat refined foods like white bread, it triggers a series of events, starting with elevated blood sugar levels followed by an increased insulin response, which can cause fat to be deposited more readily. But eating a diet rich in whole grains (which also tend to be higher in fiber) helps improve insulin sensitivity. This, in turn helps the body more efficiently use blood glucose, lowers blood glucose levels, and reduces fat deposition.

The U.S. Department of Agriculture's 2005 Dietary Guidelines recommends that half of your grain servings come from whole grains.

"Eating whole grains exclusively may be difficult and unrealistic for many people," says Rosenbloom. Instead, she recommends, "work toward consuming more whole grains, as they tend to be high in fiber, which satisfies hunger for longer periods and helps you eat less than refined grains."

Can Monounsaturated Fats Banish Belly Fat?

A recent diet book called The Flat Belly Diet posits the idea that you can lose belly fat by eating a 1,600-calorie diet rich in monounsaturated fats.

Most people will lose weight on a 1,600-calorie diet. And there is little question that when it comes to choosing fats, the monounsaturated fatty acids (MUFAS) found in avocados, nuts, seeds, olives, soybeans, chocolate, olive and canola oils are among the best choices, with proven health benefits, such as reducing the risk of heart disease.

But these are not magic foods capable of targeting belly fat, experts note. While the MUFAS are healthy fats, they are still fats, with nine calories per gram -- more than twice that of carbohydrates and proteins, which have 4 calories per gram.

"Fats have to be controlled, because it is easy to overeat nuts or guacamole -- which can undo the health benefits by packing on the pounds," cautions Rosenbloom.

Can Exercise Flatten Your Abs?

Hundreds of crunches each day will not flatten your belly if you need to lose weight. If your abdominal muscles are not covered with excess fat, strengthening them can help you look tighter and thinner. But spot exercises will not banish belly fat.

"If you want to lose weight and keep it off, you must eat a healthy, controlled-calorie diet and get regular exercise -- around 60 minutes a day of moderate activity, like brisk walking," says Rosenbloom.

And the harder you exercise, the more belly fat you may lose. Jensen suggests that people who engage in high-intensity aerobic exercise tend to be leaner around the abdomen.

The Risks of Excess Belly Fat

Why is it important to lose belly fat? Carrying around extra pounds in your midsection is serious business. Extra weight in your midsection is more dangerous than fat around your hips and thighs, as visceral fat is worse for your health than the subcutaneous fat that sits under the skin.

"Extra weight around the midsection is associated with inflammation and a higher risk of health problems such as cardiovascular disease, diabetes, metabolic syndrome and more," Jensen says.

According to a recent study in Circulation, belly fat appears to boost inflammation and is linked to hardening of the arteries.

Is Your Middle Too Big?

Beyond the body mass index (BMI), waist circumference has been touted as a simple and reliable test to measure health, weight status, and hidden fat, says Rosenbloom.

To assess your risk, use a soft tape measure. Lie down and wrap it around your natural waistline, located above your hip bone and below your belly button. Take the measurement without holding your breath or holding your stomach in.

If your waist is larger than 40 inches (for men) or 35 inches (for women), you have too much belly fat and are at risk for heart disease and other conditions. And one of the best things you can do for your health is to lose weight, says Rosenbloom.

The Bottom Line About Belly Fat

So what's the bottom line about belly fat?

Most scientific evidence suggests that a calorie-controlled diet rich in fruits, vegetables, whole grains, low-fat dairy, beans, nuts, seeds, lean meat, fish, eggs, and poultry is the foundation for a diet that provides all the nutrients you need while helping to whittle your waistline.

The real secret to losing belly fat is to lose weight on a balanced, calorie-controlled diet and exercise at least an hour a day.

April 5, 2010

"Statins" for Healthy People:

Why Does This Sound Like a Really Dumb Idea? Should Healthy People Have Preventive Drug Treatment?

(Ed's Note: This guest article by Duff Wilson from the New York Times explores the merit of healthy people undergoing drug treatment for a condition they do not have.)

By Duff Wilson

With the government's blessing, a drug giant is about to expand the market for its blockbuster cholesterol medication Crestor to a new category of customers: as a preventive measure for millions of people who do not have cholesterol problems.

Some medical experts question whether this is a healthy move.

They point to mounting concern that cholesterol medications - known as statins and already the most widely prescribed drugs in the United States - may not be as safe a preventive medicine as previously believed for people who are at low risk of heart attacks or strokes.

Statins have been credited with saving thousands of lives every year with relatively few side effects, and some medical experts endorse the drug's broader use. But for healthy people who would take statins largely as prevention – which would be the case for the new category of Crestor patients - other experts suggest the benefits may not outweigh any side effects.

Among the risks raising new concerns, recently published evidence indicates that statins could raise a person's risk of developing Type 2 diabetes by 9 percent.

"It's a good thing to be skeptical about whether there may be long-term harm from healthy people taking a drug like this," said Dr. Mark A. Hlatky, a professor of health research and cardiovascular medicine at the Stanford University medical school.

There is also debate over the blood test being used to identify the new statin candidates. Instead of looking for bad cholesterol, the test measures the degree of inflammation in the body, but there is no consensus in the medical community that inflammation is a direct cause of cardiovascular problems.

The Food and Drug Administration approved the new criteria last month for Crestor, which is made by AstraZeneca and is the nation's second best-selling statin, behind Lipitor by Pfizer. AstraZeneca plans soon to begin a new marketing and advertising campaign for Crestor, based on the new FDA-approved criteria.

Under those criteria, an estimated 6.5 million people in this country who have no cholesterol problems and no sign of heart problems will be deemed candidates for statins. That is in addition to the 80 million who already meet the current cholesterol-based guidelines - about half of whom now take statins.

The new Crestor label says it may be prescribed for apparently healthy people if they are older – men 50 and over and women 60 and over - and have one risk factor like smoking or high blood pressure, in addition to elevated inflammation in the body.

Some patients have long complained of muscle aches from taking statins. And doctors periodically check patients on the drugs to make sure liver enzymes are not abnormally high. Doctors, though, have generally seen those risks as being more than offset by the drugs' benefits for people with high levels of "bad" cholesterol and a significant risk of cardiovascular disease.

But then came the unexpected evidence linking statins to a diabetes risk, reported last month in the British medical journal The Lancet. That report was based on an analysis of most of the major clinical studies of statins - including unpublished data and the results of the Crestor study that the FDA reviewed. "We've had this drug for a while, and we're just now finding out that there's this diabetes problem with it?" said Dr. Hlatky.

The FDA acknowledged the diabetes risk, and told AstraZeneca to add it to Crestor's label. But the agency nonetheless approved the new use on the basis of the clinical study, which showed a small but measurable reduction of strokes, heart attacks and other "cardiovascular events" among people taking the statin, compared with patients taking a placebo.

"It's an important milestone for the company and for the patient," said Jim Helm, AstraZeneca's vice president for cardiovascular products. "We are already discussing this with physicians."

Dr. Eric C. Colman, a deputy director of the FDA center for drug evaluation, said the decision provided an option, not a mandate, for doctors and patients. "It's good to hear that physicians are debating the potential benefits and risks of drugs," Dr. Colman wrote via e-mail on Tuesday.

An FDA advisory committee had voted 12-4 in favor of expanding the usage in December, with some dissenters questioning the value of the test measuring elevated levels of inflammation.

The new Crestor guidelines continue a steady expansion of the number of people considered candidates for statins over the last decade. The recommendations and guidelines have been expanded by various advisory panels - many of whose members have also done paid consulting work for the drug industry.

Another of those panels is now preparing statin guidelines due next year, which are expected to further expand the number of candidates for the drugs.

The clinical trial on which the FDA approved the new Crestor use was a global study of nearly 18,000 people. It looked only at patients who had low cholesterol and an elevated level of inflammation in the body as measured by a test called high-sensitivity C-reactive protein, or CRP. It was the inventor of the CRP test, Dr. Paul M. Ridker, a Harvard medical professor and cardiologist at Brigham and Women's Hospital in Boston, who persuaded AstraZeneca to pay for the statin study, which he then led.

Dr. Ridker said his proposals for such a study had been turned down by the National Institutes of Health and at least two other companies. One was Pfizer, whose statin Lipitor will lose patent protection next year and will be sold in inexpensive generic forms. The other was Bayer, whose statin Baycol was removed from the market in 2001 after it was linked to 52 deaths from a rare muscle disorder.

Compared with those companies, AstraZeneca had more of a business interest in sponsoring Dr. Ridker's study. Crestor, which had sales of $4.5 billion last year, will not be subject to generic competition until 2016 - and so the company has more years to benefit from expanded use of the product at name-brand prices. The drug, taken as a daily pill, sells for at least $3.50 a day, compared with only pennies a day for some generic statins.

Dr. Ridker, meanwhile, receives undisclosed amounts of royalties from the CRP test. For a decade, he has argued that his test is sometimes a better diagnostic tool than cholesterol scores. And he says the Crestor study proved his case.

"We found a 55 percent reduction in heart attacks, 48 percent reduction in stroke, 45 percent reduction in angioplasty bypass surgery," Dr. Ridker said recently. "I felt I had one shot at a controversial hypothesis," he said, "and it worked really well."

So well, in fact, that the study was halted after following patients an average of 1.9 years instead of the planned five years. With such improvement, a data monitoring board concluded it would have been unethical to continue the trial.

"I don't understand the antipathy out there," said Dr. Steven E. Nissen, chairman of cardiology at the Cleveland Clinic, who has consulted for AstraZeneca among many other companies but says he donates the money to charity. "If somebody comes into my office and meets the criteria, am I going to deny them a drug that reduces their chance of a heart attack or stroke by 40 or 50 percent?"

But critics said the claim of cutting heart disease risk in half – repeated in news reports nationwide - may have misled some doctors and consumers because the patients were so healthy that they had little risk to begin with.

The rate of heart attacks, for example, was 0.37 percent, or 68 patients out of 8,901 who took a sugar pill. Among the Crestor patients it was 0.17 percent, or 31 patients. That 55 percent relative difference between the two groups translates to only 0.2 percentage points in absolute terms - or 2 people out of 1,000.

Stated another way, 500 people would need to be treated with Crestor for a year to avoid one usually survivable heart attack. Stroke numbers were similar.

"That's statistically significant but not clinically significant," said Dr. Steven W. Seiden, a cardiologist in Rockville Centre, NY, who is one of many practicing cardiologists closely following the issue. At $3.50 a pill, the cost of prescribing Crestor to 500 people for a year would be $638,000 to prevent one heart attack.

Is it worth it? AstraZeneca and the FDA have concluded it is.

Others disagree.

"The benefit is vanishingly small," Dr. Seiden said. "It just turns a lot of healthy people into patients and commits them to a lifetime of medication."

April 1, 2010 - 2nd Article

There Is No Cure

John Hicklenton, a Multiple Sclerosis Activist and Famous Comics Artist, Ends His Life at Euthanasia Clinic

(Ed's Note: Ann Pietrangelo is both a victim and an advocate for the prevention and cure of multiple sclerosis. She is posted here because her message is one of not just hope, but positive action. May God bless Ann and all of those who suffer from MS.)

By Ann Pietrangelo

Make no mistake about it. John Hicklenton triumphed over multiple sclerosis. I say this in spite of the fact that he ended his own life because of it.

Mr. Hicklenton, a graphic artist known for his illustrations, most notably, Judge Dredd comics, struggled with the ravages of MS for a decade. A resident of Brighton, East Sussex in the United Kingdom, he passed away in a Swiss assisted suicide clinic on March 19 at the age of 42.

His 2008 award-winning documentary, Here's Johnny, chronicled his life with MS and how he turned to drawing for respite. The Telegraph U.K. quotes Mr. Hicklenton as saying:

"Drawing is my walking now, I run with it, I fly with it. It's keeping me alive. I have a thing with it. I can't wait to get a piece of paper with a pen because it's what I can control. I haven't got MS when I'm looking at my pictures and I haven't got it when I'm drawing them either. It gives me an ability to express that fear."

(Ed's Note: Judge Joe Dredd is a comics character whose strip in the British science fiction anthology 2000 AD is the magazine's longest running (having been featured there since its second issue in 1977. Dredd is a law enforcement officer in a violent city of the future where uniformed Judges combine the powers of police, judge, jury and executioner.)

John Hicklenton's struggle with MS was not a mild course of the disease. Johnny lived with a particularly brutal progressive form of MS, referring to it as "this terrorist illness," yet refusing to yield to bitterness. Feeling somewhat abandoned by the medical establishment, he struggled to bring attention to the misunderstood neurological condition.

He boldly used his fame to invite the world to observe the bleak realities of his life.

This quote speaks volumes, and is something most of us with MS can relate to, at least to a certain extent: "Yes, I could walk 500 yards and I could fake a normal walk, but it was just agony. You could never take the tension out of my face. To you, that is a few cobbles, a bit of uneven surface and a couple of gates. To me that is the ninth circle of f***ing Hades and pain."

Euthanasia was something he planned on long ago in anticipation of the worst. It was the only escape from what he called torture. His plan was to persevere until he could no longer and then take control, to "go" his way. Knowing that he had this final plan actually gave him the strength to go on longer.

"I don't like the term 'committing suicide,'" he said. "It makes it sound like a crime. I think taking your own life is a very brave thing to do." His death was described as a peaceful one.

However you feel about assisted suicide, Mr. Hicklenton was a brave man, one who lived life to its fullest potential and faced death with dignity. I don't toss around the word hero lightly, but Johnny Hicklenton qualifies. May he rest in peace.

(Ed's Note: Our condolences go out to Johnny Hicklenton's family, friends, fans and readers of 2000 AD comic strip.)

March 31, 2010

A Blessing for Some, A Curse for Others

Important, Frequently Asked Questions About How the Health Care Reform Bill Will Affect You

(Ed's Note: The source of this article is WebMD Health News.)

By Andy Miller

March 22, 2010 -- The yearlong, often ugly journey toward health care reform reached a historic milestone late Sunday night, with the House approving legislation that would extend coverage to 32 million more Americans and impose new restrictions on the insurance industry.

Here are answers to some frequent questions about what reform will mean to consumers:

What provisions begin soon?

Starting this year, children up to age 26 would be allowed to remain on their parents' health plan. People with pre-existing medical conditions would be eligible for a new federally funded "high-risk" insurance program. Small businesses could qualify for tax credits of up to 35% of the cost of premiums. Insurance plans would be barred from setting lifetime caps on coverage and would no longer be able to cancel policies when a patient gets sick. Health plans would also be prohibited from excluding pre-existing
conditions from coverage for children.

When do the main reform changes kick in?

In 2014. That's when insurance marketplaces, or exchanges, would be set up in states to offer competitive pricing on health policies for individuals and small businesses that don't have coverage. People with a pre-existing condition would no longer be denied coverage, and all lifetime and annual limits on coverage would be eliminated. Medicaid would be expanded to cover more low-income Americans.

What are the requirements for individuals to buy insurance?

Starting in 2014, a person who did not obtain coverage would pay a penalty of $95 or 1% of income, whichever is greater. That penalty would rise to $695 or 2.5% of income by 2016. The bill would exempt the lowest-income people from that insurance requirement.

Medicaid would be expanded to cover those under age 65 with an income of up to 133% of the federal poverty level (below $29,327 for a family of four).

To make coverage more affordable, the legislation would offer premium subsidies for people with incomes more than 133% but less than 400% of the federal poverty level ($29,327 to $88,200 for a family of four).

In addition, people in their 20s would have the option to buy a lower-cost "catastrophic" health plan.

How will small employers be affected by the changes?

Employers with 50 or more workers would face fines for not providing insurance coverage. Businesses with smaller workforces, though, would be exempt. Companies would get tax credits to help buy insurance if they have 25 or fewer employees and a workforce with an average wage of up to $50,000.

I'm covered by a large employer. How will it affect me?

Large employers would run their health plans as they do now, so there won't be much change. Even though they have more insurance-buying clout, large businesses have seen steadily rising insurance premiums over the past decade without reform, as medical costs have increased. That pattern isn't likely to change much, at least immediately.

How does the bill affect Medicare recipients?

Seniors will get immediate help on the "doughnut hole"—a gap in their coverage for prescription drugs. This year, those reaching that hole would get $250 to help pay their drug costs. Next year, they would receive a 50% discount on the cost of brand-name drugs in the doughnut hole. Meanwhile, preventive screenings would be free to beneficiaries beginning this year.

But federal payments to Medicare Advantage plans would be cut substantially, starting in 2011. So seniors in those plans may lose some extra benefits, such as free eyeglasses.

What changes will occur in Medicaid?

Individuals and families with incomes up to 133% of the federal poverty level (below $29,327 for a family of four) will gain coverage. The federal government will pay all the states' costs for the newly eligible Medicaid beneficiaries for three years. And primary-care doctors treating Medicaid patients will get an increase in their fees.

Will reform reduce health insurance costs?

Many health care experts say that while it contains some cost-cutting provisions and pilot programs, the legislation doesn't go far enough to tame rising costs. People with chronic medical problems, though, generally would see their premiums decrease because of the new ban on pre-existing condition discrimination.

How will the $940 billion price tag (over 10 years) be paid for?

Wealthier families will pay more in taxes. Starting in 2013, families with annual incomes above $250,000 (and individuals earning more than $200,000) would pay an additional 3.8% tax on investment income, and also face a higher Medicare payroll tax. Expensive, "Cadillac" insurance plans would draw a new tax starting in 2018. And the Medicare program would receive substantial cuts, including a $132 billion reduction in funding for
Advantage plans run by private insurers.

What are some reform provisions that have gone under the radar?

A new, voluntary long-term care benefit would help people who become disabled. Indoor tanning sessions will face a new tax. And the bill requires chain restaurants with 20 or more outlets to post calorie counts on menus and menu boards.

March 14, 2010

Research Supports New Treatments

Non-Medical Therapies for Alzheimer's Disease Finally Gets Some Scientific Backing

(Ed's Note: This article by Chris Haines originally appeared in the AARP Bulletin on March 12, 2010. For those of us that have lived at least 6 decades, it is likely that we have had a family member, or know of someone, who has contracted Alzheimer's disease.)

By Chris Haines

As a cure for Alzheimer's disease continues to elude scientists, non-drug treatments—including mental and physical exercise and even caregiver support—are emerging as the best proven medicine for the disease, according to many of the latest studies presented at the recent 25th Conference of the Alzheimer's Disease International.

Although the impact of these approaches has been understood anecdotally for years, the arc of Alzheimer's disease research has finally reached a point where non-drug treatment studies have continued long enough to constitute evidence-based research. That means these approaches are proven tools for those working to help people with the debilitating illness, which affects 5.3 million people in the United States, and 26 million people worldwide.

An irreversible brain disorder, Alzheimer's robs people of their memory and eventually impairs most of their mental and physical functions.

The proof that these therapies really work may also be good economic news: Non-drug therapies can save money, for individual families as well as state and local governments, by delaying entrance into nursing homes for those suffering from dementia, experts say.

Sharing and Remembering

"Psychological therapies have been used with people with dementia for at least 50 years," says Robert Woods, a professor at Bangor University in Wales, whose presentation highlighted the fact that behavioral approaches have fewer side effects than drug therapies.

Two of the common therapies are known as "cognitive stimulation" and "reminiscence therapy." Cognitive stimulation involves a small group of people with dementia meeting a couple of times a week with a care worker, to take part in a range of activities—from word games to a group baking session.

The sessions are intended to involve those with Alzheimer's in activities that are mentally stimulating and enjoyable.

Woods cites studies that found cognitive stimulation groups can actually improve a person's scores on tests of memory, language and thinking-similar to the changes seen with the currently available medications for Alzheimer's disease.

"More importantly," Woods says, "participants also reported improved quality of life. Behavioral approaches have been shown to be effective in a number of domains including improved mood."

Reminiscence therapy groups are similar, but focus on activities and discussions of personal events and experiences. Carefully selected pictures, objects, sound and video recordings are used to evoke old memories.

Caregivers reported improved behavior in those with Alzheimer's, without the use of drugs. And the patients reported a better quality of life. Both these results help keep men and women at home with their families, rather than in a nursing home.

"Dementia is a complex set of conditions," he adds. "Building on the person's life history is always a good starting point, as a guide to their values, interests and preferences. Engaging the person in a positive, constructive approach may be more effective than tackling problem behavior head-on."

Thinking and Walking

Identifying the presence of dementia early appears to be the best weapon in delaying its severity. Even without expensive medical exams, there are markers that might indicate a problem.

"We all forget where we left the keys or remote control from time to time," says Michael Valenzuela of the University of New South Wales in Sydney, Australia, and author of It's Never too Late to Change Your Mind. "If, however, we were to forget what the remote control is for, then this is a more serious type of memory issue that would require follow-up investigation."

In his presentation, Valenzuela cited two studies that demonstrated that brain training using computer programs and physical exercise can delay—and even improve—cognitive decline.

In a study conducted in Italy, researchers found that four weeks of computer brain training helped improve the overall cognitive abilities of those with Alzheimer's disease. Significantly, these improvements in a group that was at high risk for dementia continued for three months after the training stopped.

The second study found that six months of simple, self-directed physical exercise resulted in a modest, but persistent, improvement in mental abilities as long as one year later.

"The potential preventative effects of brain training and physical exercise are much stronger before a person is diagnosed with dementia," Valenzuela cautions. "After diagnosis, these strategies may have some value, but are qualitatively different and lead to less consistent outcomes."

Caring for the Caregiver

Shifting the focus from patient to caregiver, Mary Mittelman of the Center for Excellence on Brain Aging at New York University's Langone Medical Center reported on a 20-year study of how giving caregivers support helped delay a patient's entry into a nursing home.

Mittelman's team monitored Alzheimer's caregivers (usually family members) who were given counseling and training on how to deal with their patients—and compared them to caregivers who received no such support.

The results were encouraging, and showed that support had a significant effect on the caregivers' emotional and physical health, and even their reactions to their patient's behavior, which could be distressing and trying. That helped translate to the patients remaining at home about a year and a half longer.

Caregivers, Mittelman says, need ongoing support and help. "Alzheimer's disease doesn't remain static," she says. "It changes over time. What you learn to deal with today is not what you're going to confront a year from now."

February 22, 2010

We Deceive Ourselves

We Look at Other People Who Are Morbidly Obese and Think, "I'm in Great Shape Compared to Them"

(Ed's Note: Ann Pietrangelo is a freelance writer and multiple sclerosis patient advocate. Her staunch belief in affordable and accessible health care for all fuels her passion for health care reform.)

By Ann Pietrangelo

Sorry, but it's not me . . . it's you. Despite evidence to the contrary, most Americans believe they are managing their own health well, while those around them clearly are not. Only 17 percent of us recognize that our own health is going in the wrong direction and we're pointing fingers.

A study commissioned by GE Healthcare, The Cleveland Clinic, and Ochsner Health System, and reported in HealthDay News, asked more than 2,000 Americans and their doctors to rate the country's health. Apparently, the way we see ourselves, and the way our doctors see us, are at different ends of the spectrum.

We think our eating habits are healthy; our doctors do not. We believe we get enough exercise; the doctors say it ain't so. Many of us don't know or understand our blood pressure or cholesterol numbers, even though we recognize that they are important to overall good health. And we see a lot of folks who are heavier and appear to be more out-of-shape than we are, thus giving the impression that we are healthier.

You feel fine, so you must be healthy, right? Wrong. Many killers are silent before they strike -- heart attack, stroke, and diabetes are a few that often give little or no clue of what is to come. Lifestyle choices, including diet and exercise, can help prevent problems from occurring in the first place.

There is much we can do to invest in our own health and wellbeing, so why don't we? It is human nature to give ourselves the benefit of the doubt, easier to make excuses for our own shortcomings, even while casting a critical eye on everyone else. We sneak in that extra sugary snack and conveniently dismiss it as just a little treat. Ten minutes of exercise seems like 30 when you're the one doing the exercising. You smoke, but you're tapering off.

We are not taking responsibility for those things within our control, and whether we admit it or not, we're setting a ghastly example for the next generation, a generation expected to have a shorter life expectancy than our own.

Given the debate on health care reform, I found this item in the survey of particular interest:

"Ninety-five percent agreed that regular checkups with their physicians were important, even though 70 percent said they had taken actions to avoid their doctors, such as hoping their health problems would go away on their own, or asking a friend for medical advice instead."

The report gives no explanation for the respondents' answers and I'm not sure that this particular point speaks to the issue of Americans purposely neglecting their health, but rather to the problem of soaring health care costs and lack of adequate medical insurance. Hoping health problems take care of themselves, turning to friends for advice and to internet medical sites is what you do when you can't afford medical care.

In any case, it's time to stop the finger pointing. Maybe it's not just you . . . maybe it's me, too.

February 15, 2010

The Truth About Red Meat

Does Eating Red Meat Increase the Risk of Dying from Heart Disease or Cancer?

(Ed's Note: This WebMD feature examines the health dangers and benefits of eating red meat.)

By Elizabeth Lee

Does eating red meat increase the risk of dying from heart disease or cancer?

It is a question that keeps coming up, fueled by research and high-profile campaigns by advocacy groups on both sides of the debate.

WebMD asked the experts, looking for answers about disease risk, health benefits, and what role red meat should play in the diet.

Here is what they had to say.

1) Does eating red meat increase the risk of cancer and heart disease?

For heart disease, the answer is pretty clear. Some red meats are high in saturated fat, which raises blood cholesterol. High levels of LDL cholesterol increase the risk of heart disease.

When it comes to cancer, the answer is not so clear. Many researchers say the effect of eating red meat does raise the risk, especially for colorectal cancer.

A recent National Institutes of Health-AARP study of more than a half-million older Americans concluded that people who ate the most red meat and processed meat over a 10-year-period were likely to die sooner than those who ate smaller amounts. Those who ate about 4 ounces of red meat a day were more likely to die of cancer or heart disease than those who ate the least, about a half-ounce a day. Epidemiologists classified the increased risk as "modest" in the study.

The meat industry contends there is no link between red meat, processed meats, and cancer, and says that lean red meat fits into a heart-healthy diet. A meat industry spokeswoman criticized the design of the NIH-AARP study, saying that studies that rely on participants to recall what foods they eat cannot prove cause and effect. "Many of these suggestions could be nothing more than statistical noise," says Janet Riley, a senior vice president of the American Meat Institute, a trade group.

But many studies have found similar links. Another one that followed more than 72,000 women for 18 years found that those who ate a Western-style diet high in red and processed meats, desserts, refined grains, and French fries had an increased risk of heart disease, cancer, and death from other causes.

"The association between consumption of red and processed meats and cancer, particularly colorectal cancer, is very consistent," says Marji McCullough, PhD, a nutritional epidemiologist with the American Cancer Society.

After a systemic review of scientific studies, an expert panel of the World Cancer Research Fund and the American Institute for Cancer Research concluded in 2007 that "red or processed meats are convincing or probable sources of some cancers." Their report says evidence is convincing for a link between red meat, processed meat, and limited but suggestive for links to lung, esophageal, stomach, pancreatic, and endometrial cancers.

Rashmi Sinha, PhD, the lead author of the National Cancer Institute study, points to a large number of studies that link red meat consumption with chronic diseases.

"The level of evidence is what people look at," Sinha says. "If there are 20 studies that say one thing and two studies that say the other thing, you believe the 20 studies."

2) If eating red meat does increase the risk of cancer, what is the cause?

That is not clear, but there are several areas that researchers are studying, including:

Saturated fat, which has been linked to cancers of the colon and breast as well as to heart disease.

Carcinogens formed when meat is cooked.

Heme iron, the type of iron found in meat, may produce compounds that can damage cells, leading to cancer.

3) Are there nutritional benefits from eating red meat?

Red meat is high in iron, something many teenage girls and women in their childbearing years are lacking. The heme iron in red meat is easily absorbed by the body. Red meat also supplies vitamin B12, which helps make DNA and keeps nerve and red blood cells healthy, and zinc, which keeps the immune system working properly.

Red meat provides protein, which helps build bones and muscles.

"Calorie for calorie, beef is one of the most nutrient-rich foods," says Shalene McNeil, PhD, executive director of nutrition research for the National Cattlemen's Beef Association. "One 3-ounce serving of lean beef contributes only 180 calories, but you get 10 essential nutrients."

4) Is pork a red meat or a white meat?

It is a red meat, according to the U.S. Department of Agriculture. The amount of myoglobin, a protein in meat that holds oxygen in the muscle, determines the color of meat. Pork is considered a red meat because it contains more myoglobin than chicken or fish.

5) How much red meat should I eat?

Opinions differ here, too. Most of the nutritionists that WebMD contacted suggested focusing on sensible portion sizes and lean red meat cuts, for those who choose to eat it.

Ask yourself these two questions, recommends Alice Lichtenstein, DSc, professor of nutrition at the Human Nutrition Research Center on Aging at Tufts University.

1) Are you taking in more calories than you're burning off?

2) Is red meat crowding out foods such as fruits, vegetables, and whole grains?

"People don't need to give up red meat," says Christine Rosenbloom, PhD, RD, a nutrition professor at Georgia State University. "They need to make better selections in the type of meat they eat and the portions."

Government guidelines in MyPyramid suggest 5 to 6 1/2 ounces daily of protein from a variety of sources, including lean meats, nuts, and seafood. So if you are planning on eating a burger for dinner, it should be a 3-ounce hamburger patty, about the size of a standard McDonald's burger.

The American Institute for Cancer Research, a nonprofit that focuses on cancer prevention through diet and physical activity, advises no more than 18 ounces of cooked red meat a week. The group recommends avoiding all processed meats, such as sausage, deli meats, ham, bacon, hot dogs, and sausages, citing research that shows an increased risk of colon cancer.

6) What are some of the leanest cuts of red meat?

For the best red meat cuts, look for those with "loin" in the name: Sirloin tip steak, top sirloin, pork tenderloin, lamb loin chops.

Beef: Also look for round steaks and roasts, such as eye round and bottom round; chuck shoulder steaks; filet mignon; flank steak; and arm roasts. Choose ground beef labeled at least 95% lean. Frozen burger patties may contain as much as 50% fat; check the nutrition facts box. Some grilling favorites are high in fat: hot dogs, rib eyes, flat iron steaks, and some parts of the brisket (the flat half is considered lean).

Pork: Lean cuts include loin roasts, loin chops, and bone-in rib chops.

7) What are the criteria for a lean cut of red meat?

Meats can be labeled as lean if a 3-ounce serving contains less than 10 grams of total fat, 4.5 grams or less of saturated fat, and less than 95 milligrams of cholesterol.

If you are buying beef, check the U.S. Department of Agriculture grading, too. Beef labeled "prime" is the top grade but is also highest in fat, with marbling, tiny bits of fat within the muscle, adding flavor and tenderness. Most supermarkets sell beef that is graded as "choice" or "select." For the leanest red meat, look for a select grade.

8) Is grass-fed beef a leaner red meat choice than grain-fed?

Grass-fed beef is leaner than grain-fed, which makes it lower in total fat and saturated fat. Grass-fed beef also contains more omega-3 fatty acids. But the total amount of omega-3s in both types of beef is relatively small, says Shalene McNeil of the National Cattlemen's Beef Association. Fish, vegetable oil, nuts, and seeds are better sources of omega-3s.

9) Can grilling red meat cause cancer?

High-temperature cooking of any muscle meat, including red meat, poultry, and fish, can generate compounds in food that may increase cancer risk. They are called heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs).

10) How can you reduce potential cancer-causing compounds when grilling?

Several steps help prevent these compounds from forming or reduce your exposure to them.

Choose lean red meat cuts when grilling to reduce the chance of flare-ups or heavy smoke, which can leave carcinogens on the meat.

If grilling, cook over medium heat or indirect heat, rather than over high heat, which can cause flare-ups and overcook or char meat. Limit frying and broiling, which also subject meat to high temperatures.

Do not overcook meat. Well-done meat contains more of the cancer-causing compounds. But make sure that meat is cooked to a safe internal temperature to kill bacteria that can cause food-borne illnesses. For steaks, cook to 145 to 160 degrees Fahrenheit; for burgers, cook to 160 degrees.

Marinate. Marinades may reduce the formation of HCAs. Choose one without sugar, which can cause flare-ups and char the meat's surface.

Turn meat frequently. Use tongs or a spatula rather than a fork to avoid releasing juices that can drip and cause flare-ups. Do not press burgers with a spatula to release juices.

Do not grill as much meat. Instead of a steak, try a kabob that mixes meat, fruit and vegetables. Plant-based foods have not been linked to HCAs.

Trim fat from meat before cooking, and remove any charred pieces before eating.

Consider partially cooking meats and fish in the oven or microwave before finishing on the grill.

February 9, 2010

The Truth About Fat

Everything You Need to Know About the 5 Different Kinds of Fat, and Why It Matters That You Do Know the Difference

(Ed's Note: Most people who carry too much weight think that fat is just a blob to get rid of. This WebMD Feature reveals everything really important that you need to know about fat, including an explanation of what kind of fat is worse—belly fat or thigh fat. Read on, hopefully at a speed that will cause you to lose weight!)

By Kathleen Doheny

For most of us, body fat has a bad reputation. From the dimply stuff that plagues women's thighs to the beer bellies that can pop out in middle-aged men, fat is typically something we agonize over, scorn, and try to exercise away.

But for scientists, fat is intriguing—and becoming more so every day. "Fat is one of the most fascinating organs out there," says Aaron Cypess, MD, PhD, an instructor of medicine at Harvard Medical School and a research associate at the Joslin Diabetes Center in Boston. "We are only now beginning to understand fat."

"Fat has more functions in the body than we thought," agrees Rachel Whitmer, PhD, research scientist at the Kaiser Permanente Division of Research in Oakland (CA), who has studied the links between fat and brain health.

To get the skinny on fat, WebMD asked four experts on fat—who, not surprisingly, prefer not to be called fat experts—to fill us in.

Fat is known to have two main purposes, says Susan Fried, PhD, director of the Boston Obesity and Nutrition Research Center at Boston University and a long-time researcher in the field.

1) Fat stores excess calories in a safe way so you can mobilize the fat stores when you are hungry.

2) Fat releases hormones that control your metabolism.

But that is the broad brushstroke picture. Read on for details about various types of fat—brown, white, subcutaneous, visceral, and belly fat.

Brown Fat

Brown fat has gotten a lot of buzz recently, with the discovery that it is not the mostly worthless fat scientists had thought.

In recent studies, scientists have found that lean people tend to have more brown fat than overweight or obese people—and that when stimulated it can burn calories. Scientists are eyeing it as a potential obesity treatment if they can figure out a way to increase a person's brown fat or stimulate existing brown fat.

It is known that children have more brown fat than adults, and it is what helps them keep warm. Brown fat stores decline in adults but still help with warmth. "We've shown brown fat is more active in people in Boston in colder months," Dr. Cypess says, leading to the idea of sleeping in chillier rooms to burn a few more calories.

Brown fat is now thought to be more like muscle than like white fat. When activated, brown fat burns white fat.

Although leaner adults have more brown fat than heavier people, even their brown fat cells are greatly outnumbered by white fat cells. "A 150-pound person might have 20 or 30 pounds of fat," Dr. Cypess says. "They are only going to have 2 or 3 ounces of brown fat."

But that 2 ounces, he says, if maximally stimulated, could burn off 300 to 500 calories a day –enough to lose up to a pound in a week.

"You might give people a drug that increases brown fat," he says. "We are working on one."

But even if the drug to stimulate brown fat pans out, Dr. Cypess warns, it will not be a cure-all for weight issues. It may, however, help a person achieve more weight loss combined with a sound diet and exercise regimen.

White Fat

White fat is much more plentiful than brown, experts agree. The job of white fat is to store energy and produce hormones that are then secreted into the bloodstream.

Small fat cells produce a "good guy" hormone called adiponectin, which makes the liver and muscles sensitive to the hormone insulin, in the process making us less susceptible to diabetes and heart disease.

When people become fat, the production of adiponectin slows down or shuts down, setting them up for disease, according to Fried and others.

Subcutaneous Fat

Subcutaneous fat is found directly under the skin. It is the fat that is measured using skin-fold calipers to estimate your total body fat.

In terms of overall health, subcutaneous fat in the thighs and buttocks, for instance, may not be as bad and may have some potential benefits, says Dr. Cypess. "It may not cause as many problems" as other types of fat, specifically the deeper, visceral fat, he says.

But subcutaneous fat cells on the belly may be another story, says Fried. There is emerging evidence that the danger of big bellies lies not only in the deep visceral fat but also the subcutaneous fat.

Visceral Fat

Visceral or "deep" fat wraps around the inner organs and spells trouble for your health. How do you know if you have it? "If you have a large waist or belly, of course you have visceral fat," says Dr. Whitmer, the researcher. Visceral fat drives up your risk for diabetes, heart disease, stroke, and even dementia.

Visceral fat is thought to play a larger role in insulin resistance—which boosts risk of diabetes—than other fat, Dr. Whitmer tells WebMD. It is not clear why, but it could explain or partially explain why visceral fat is a health risk.

Dr. Whitmer investigated the link between visceral fat and dementia. In a study, she evaluated the records of more than 6,500 members of Kaiser Permanente of Northern California, a large health maintenance organization, for an average of 36 years, from the time they were in their 40s until they were in their 70s.

The records included details on height, weight, and belly diameter—a reflection of the amount of visceral fat. Those with the biggest bellies had a higher risk of dementia than those with smaller bellies. The link was true even for people with excess belly fat but overall of normal weight.

She does not know why belly fat and dementia are linked, but speculates that substances such as leptin, a hormone released by the belly fat, may have some adverse effect on the brain. Leptin plays a role in appetite regulation but also in learning and memory.

Belly Fat

Belly fat has gotten a mostly deserved reputation as an unhealthy fat. "Understand that belly fat is both visceral and subcutaneous," says Kristen Gill Hairston, MD, MPH, an assistant professor of medicine at Wake Forest University School of Medicine, Winston-Salem, (NC).

"We don't have a perfect way yet to determine which [of belly fat] is subcutaneous or visceral, except by CT scan, but that's not cost-effective," says Dr. Hairston.

But if you have got an oversize belly, figuring out how much is visceral and how much is subcutaneous is not as important as recognizing a big belly is unhealthy, she says. How big is too big? Women with a waist circumference more than 35 inches and men with a waist circumference more than 40 inches are at increased disease risk.

Abdominal fat is viewed as a bigger health risk than hip or thigh fat, Dr. Whitmer and other experts say. And that could mean having a worse effect on insulin resistance, boosting the risk of diabetes, and a worse effect on blood lipids, boosting heart and stroke risks.

Thigh Fat, Buttocks Fat

While men tend to accumulate fat in the belly, it is no secret women, especially if "pear-shaped," accumulate it in their thighs and buttocks.

Unsightliness aside, emerging evidence suggests that pear-shaped women are protected from metabolic disease compared to big-bellied people, says Dr. Fried, another researcher. "Thigh fat and butt fat might be good," she says.

But the benefit of women being pear shaped may stop at menopause, when women tend to deposit more fat in the abdomen, referring to that area's stores of subcutaneous fat.

Weight Loss and Fat Loss

So when you lose weight, what kind or kinds of fat do you shed? "You are losing white fat," Dr. Fried tells WebMD. "People tend to lose evenly all over."

The results change a bit, however, if you add workouts to your calorie reduction, she says. "If you exercise plus diet you will tend to lose slightly more visceral fat from your belly."

"We are at an exciting point in science," says Dr. Whitmer, echoing the input from other scientists in the field.

Dr. Whitmer and others expect more discoveries about fat of all types to be made in the near future.

December 19, 2009 - 2nd Article

Why Do We Say Cats Have 9 Lives?

According to Brewer's Dictionary of Phrase & Fable, a cat is "more tenacious of life than many animals." Atum-Ra, the Egyptian Lord of Life, was associated with the cat and held to be the creator of 9 gods. In fact, the number 9 is thought to have originated in Egypt, where cats were revered.

November 12, 2009 - 2nd Article

3 Simple Steps to Help Prevent Alzheimer's Disease

(Ed's Note: Dr. Andrew Weil is a licensed physician who specializes in holistic and integrated medicine; meaning, natural cures to medical problems are oftentimes better than man-made solutions involving prescription drugs, surgery, etc. Here Dr. Weil gives some tips on how to help prevent Alzheimer's Disease.)

Dr. Andrew Weil

To help preserve mental function and protect against age-related cognitive decline including dementia and Alzheimer's disease, consider implementing these healthy lifestyle strategies:

1) Get 30 minutes of physical activity per day. Regular physical exercise, specifically aerobic exercise, can help slow memory loss and improve mental function.

2) Develop healthy habits in all aspects of life. Not smoking, drinking only in moderation, staying socially involved, managing stress, getting adequate rest, and cultivating a positive attitude and outlook—have all been associated with a lowered risk of Alzheimer's.

3) Keep an active mind. "Use it or lose it" applies to mental as well as physical health. Enjoy crossword puzzles, mind games, challenging reading, and take educational classes.

September 27, 2009 - 2nd Article

Guest Article:

Multiple Sclerosis by the Numbers, But Who Really Cares, and Who Is Really Counting?

(Ed's Note: My sister Loretta contracted Multiple Sclerosis and it contributed to her premature death. For some reason, we do not know exactly how many of our fellow Americans are affected by this disease, and no one seems willing to actually find out. Learn why it matters. The source of this article is Ann Pietrangelo; I have edited the article to add more information and clarity.)

More than a million people in the United States have multiple sclerosis, or is it half a million, or a quarter of a million, but then again, who's counting?

When I was first diagnosed with MS, I was stunned by the number of acquaintances who said they were related to, or knew someone with MS. It seems like everybody has a story, yet most sources indicate that only about 400,000 people in the U.S. have MS. With a population of more than 304,000,000 people, that would make MS quite rare.

In April 2009, the Christopher and Dana Reeve Foundation announced the results of a study conducted by the University of New Mexico's Center for Development and Disability, that indicated that 939,000 people in the United States have some degree of MS-related paralysis. That would mean that the actual number of people with MS is much higher than that.

Current estimates from reputable sources vary:

It's 250,000 to 300,000 according to the National Institutes of Health - National
Institute of Neurological Disorders and Stroke.

It's 350,000 to 500,000 according to the Multiple Sclerosis Foundation.

It's 400,000 according to the Multiple Sclerosis Association of America, and National
Multiple Sclerosis Society

It's 1,000,000 according to the Montel Williams MS Foundation.

From the low estimate of 250,000 to the high estimate of 1,000,000, could 750,000 sufferers of MS be uncounted in their misery?

So how many people in the United States actually have multiple sclerosis, why don't we know, and does it matter?

We do not know the exact numbers because MS is not tracked by the Centers for Disease Control or any other federal agency. In fact, there is no coordinated effort at all to track the incidence of MS in the United States. The last national study of MS rates took place in 1975, and much has changed since then.

Both the Senate and the House have pending legislation that, if passed, would create separate registries for two devastating neurological conditions—Parkinson's disease and Multiple Sclerosis—at the Agency for Toxic Substances and Disease Registry (ATSDR) at the Centers for Disease Control and Prevention.

If the legislation passes, the information collected will provide valuable insights into MS regarding the gender ratio, age at onset, geographic clusters, etc.

Tracking the numbers may also help researchers gain insight into pediatric multiple sclerosis. MS, for all its variations and symptoms, is an extremely difficult disease to confirm in any case. Typically, MS is diagnosed in people over the age of 35, so pediatricians generally do not look for symptoms in children. Mild symptoms in children, especially if they come and go, are easily missed—or dismissed without official notice.

The introduction of magnetic resonance imaging (MRI) has enabled physicians to pinpoint lesions in the central nervous system, leading to a diagnosis of MS sooner, and in younger patients, more than ever before.

The National Multiple Sclerosis Society reports that "up to 10,000 of the estimated 400,000 Americans who have MS are children or adolescents. At least that many children also have experienced at least one symptom suggestive of MS. Increasing evidence suggests a slower disease course in children with MS, but significant disability can accumulate at an earlier age compared to individuals with adult onset MS."

Is the incidence of pediatric MS increasing, or is it that doctors are getting better at diagnosing MS in children?

Some research suggests that MS is caused by a combination of genetics and pinpointing the number of children with MS, in the early stages of the disease, could help researchers find important new leads in the search for a cause, better treatments, and a cure.

Understanding how many people are affected by MS, and who they are, may also have an impact on funding for research and community programs that assist the disabled.

The numbers matter, and if you are diagnosed with multiple sclerosis, or know someone who is, the numbers should matter to you. Go online and Google "multiple sclerosis", "senate bills", and "house bills" to find out more information, and how to take action for yourself or others.

August 12, 2009

Health Care Reform: Why Are We Treating the System, and Not the Underlying Cause?

(Ed's Note: The following guest article was written by Dr. Andrew Weil and appeared in the Huffington Post.)

By Andrew Weil

I'm worried -- and if I'm worried, you should be, too.

The reason I'm worried is that the wrong diagnosis is being made.

As any doctor can tell you, the most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely, a bad diagnosis usually means a bad outcome, no matter how skilled the physician.

And, what's true in personal health care is just as true in national health care reform: Healing begins with the correct diagnosis of the problem.

Washington is working on reform initiatives that focus on one problem: the fact that the system is too expensive (and consequently too exclusive). Reform proposals, such as the "public option" for government insurance or calls for drug makers to drop prices, are aimed mostly at boosting affordability and access. Make it cheap enough, the thinking goes, and the 46 million Americans who can't afford coverage will finally get their fair

But what's missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what's even worse than its stratospheric cost is the fact that American health care doesn't fulfill its prime directive -- it does not help people become or stay healthy.

It's not a health care system at all; it's a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction
more broadly.

It's impossible to make our drug-intensive, technology-centric, and corrupt system affordable. Consider that Americans spent $8.4 billion on medicine in 1950, vs. an astonishing 2.3 trillion in 2007. That's $30,000 annually for a family of four.

The bloated structure of endless, marginal-return tests; patent-protected drugs and "heroic" surgical interventions for virtually every health problem simply can't be made much cheaper due to its very nature. Costs can only be shifted in various unpalatable ways.

So, a far more salient question that must be addressed is: Are we getting good health for our trillions? Unfortunately, the answer is a resounding, "No." The U.S. ranked near the very bottom of the top 40 nations – below Columbia, Chile, Costa Rica and Dominica -- in a rating of health systems by the World Health Organization in 2000.

In short, we pay about twice as much per capita for our health care as does the rest of the developed world, and we have almost nothing to show for it.

I'm not against high-tech medicine. It has a secure place in the diagnosis and treatment of serious disease. But our health care professionals are currently using it for everything, and the cost is going to break us.

In the future, this kind of medicine must be limited to those cases in which it is clearly indicated: trauma, acute and critical conditions, disease involving vital organs, etc. It should be viewed as a specialized form of medicine, perhaps offered only in major centers serving large populations.

Most cases of disease should be managed in other, more affordable ways. Functional, cost-effective health care must be based on a new kind of medicine that relies on the human organism's innate capacity for self-regulation and healing.

It would use inexpensive, low-tech interventions for the management of the commonest forms of disease. It would be a system that puts the health back into health care. And it would also happen to be far less expensive than what we have now.

If we can make the correct diagnosis, the healing can begin. If we can't, both our personal health and our economy are doomed.

Politicians aren't going to resolve this issue overnight. Any health care reform bill that gets jammed through Congress in the next month or two will be dangerously flawed. Washington needs to take a step back and re-examine the entire task with an eye toward achieving the most effective solution, not the cheapest and most expeditious.

July 30, 2009

Alan Romatowski – A Model for a Positive Attitude Despite Contracting Alzheimer's

Three years ago, when Alan Romatowski was diagnosed with younger-onset Alzheimer's at the age of 55, he was a pilot for USAirways, a profession he had enjoyed for the past 30 years.

"The diagnosis put a sudden stop to my career as an airline pilot," Alan says. "The news that I had Alzheimer's was, of course, initially devastating. But as time passes I am finding more and more to be thankful for."

Today Alan volunteers at a local Specialty Care Center, working in the physical therapy department and escorting Alzheimer's patients to and from medical appointments. Alan also delivers Meals on Wheels and works part time at a gas station.

"I became involved with the Alzheimer's Association shortly after my diagnosis," Alan says. "I turned to the Association for help and began participating in one of their support groups."

It was not long before Alan's natural leadership abilities came to the forefront. In 2008, Alan was appointed to the National Early-Stage Advisory Group, a leadership body of individuals living with Alzheimer's. In this role he serves as an advocate, traveling to speak about his experiences and rally others with Alzheimer's to help defeat this disease by participating in clinical trials of new treatments.

"I just completed a term with the Early-Stage Advisory Group for the Alzheimer's Association," Alan says. "I now work with the local Pittsburgh office and will once again be participating in Memory Walk. Recently I was elected to the Greater Pennsylvania Chapter Board of Directors."

"After my diagnosis I had a choice of either surrendering to Alzheimer's or go on fighting. I chose to fight," Alan says. "My wife and I stand shoulder to shoulder to fight this disease, and I appreciate and cherish my wonderful family more than ever."

When Alan is not working to advance the fight against Alzheimer's, he enjoys volunteering and working part time at a local gas station. He is also applying to volunteer at the Pittsburgh Zoo cleaning the shark tanks!

January 28, 2009

Count Me In

In the Old-Time Remedies Department, Some Say Cinnamon and Honey Works

(Editor's Note: I have no idea if what I am sharing with you here works or is just plain bunk. A lot of things float around the Internet, some interesting and some not. I just know that the gene pool I came from is rife with arthritis and I am no exception. I have been a writer for 48+ years and someday I will not be a writer because the osteoarthritis in my hands is so bad I cannot lift more than 10 pounds; I have bones and nerves in my fingers but no apparent fluid for the joints. I am going to try this because arthritis is not curable and the pain is evident. I am desperate enough to try anything for relief. I am not editing this article. I will let you know if honey and cinnamon does anything for me. I sincerely hope this article is not written by the combined honey and cinnamon lobbies.)

Today's science says that even though honey is sweet, if taken in the right dosage as a medicine, it does not harm diabetic patients. Weekly World News, a magazine in Canada, has given the following list of health issues that can be helped, if not cured, by honey and cinnamon, as researched by western scientists:

Make a paste of honey and cinnamon powder, apply to bread, (instead of peanut butter), and eat it regularly for breakfast. It reduces the cholesterol in the arteries. Also those who have had a heart attack, if they do this process daily, they are kept miles away from the next attack. Regular use of the above process relieves loss of breath and strengthens the heartbeat. In America and Canada, various nursing homes have treated patients successfully and have found that as you age, the arteries and veins lose their flexibility and get clogged; honey and cinnamon revitalize the arteries and veins.

Arthritis patients are encouraged to drink one cup of hot water with two spoons of honey and one small teaspoon of ground cinnamon, daily, both morning and evening. If taken regularly, even chronic arthritis can be lessened. In a recent research conducted at the Copenhagen University, it was found that when the doctors treated patients with a mixture of one tablespoon honey and half teaspoon ground cinnamon before breakfast, they found that within a week, out of the 200 people treated, 73 patients were totally relieved of pain. Within a month, many of the patients who were immobile, or unable to move about because their arthritis, began walking without pain.

Mix two tablespoons of ground cinnamon with one teaspoon of honey in a glass of lukewarm water and drink it. It destroys the germs in the bladder.

Two tablespoons of honey and three teaspoons of ground cinnamon mixed in 16 ounces of tea water, given to a cholesterol patient, was found to reduce the cholesterol level in the blood by 10 percent within two hours. As mentioned for arthritic patients, if taken three times a day, any chronic cholesterol is cured. According to information received in the said Journal, pure honey taken with food daily reduces cholesterol.

Those suffering from common or severe colds should take one tablespoon lukewarm honey with 1/4 spoon ground cinnamon daily for three days. This will cure most chronic cough, cold, and clear the sinuses.

Honey taken with ground cinnamon cures stomachache and also clears stomach ulcers.

According to the studies done in India and Japan, it is revealed that if honey is taken with ground cinnamon the stomach is relieved of gas.

Daily use of honey and ground cinnamon strengthens the immune system and protects the body from bacteria and viral attacks. Scientists have found that honey has various vitamins and iron in large amounts. Constant use of honey strengthens the white blood corpuscles to fight bacteria and viral diseases.

Ground cinnamon mixed with two tablespoons of honey taken before food relieves acidity and digests the heaviest of meals.

Honey contains a natural 'Ingredient' which kills the influenza germs and protects the patient from flu.

Tea made with honey and ground cinnamon, when taken regularly, arrests the ravages of old age. Boil three cups of water with four spoons of honey, one spoon of ground cinnamon to make a tea. Drink 1/4 cup, three to four times a day. It keeps the skin fresh and soft and arrests old age.

Three tablespoons of honey and one teaspoon of ground cinnamon to make paste.
Apply this paste to the pimples before sleeping. Remove it in morning with warm water. If done daily for two weeks, it removes pimples from the root.

Mix equal parts of honey and ground cinnamon, then apply to the affected areas will cure eczema, ringworm and other skin infections.

Each morning, one half hour before breakfast. on an empty stomach and at night before bed, drink honey and ground cinnamon boiled in one cup of water. If taken regularly, it reduces the weight of even the most obese person. Also, drinking this mixture regularly does not allow the fat to accumulate in the body even though the person may eat a high calorie diet.

Research in Japan and Australia show that advanced cancer of the stomach and bones have been cured successfully. Patients suffering from these kinds of cancer should daily take one tablespoon of honey with one teaspoon of ground cinnamon for one month three time s a day.

Recent studies have shown that the sugar content of honey is more helpful rather than being detrimental to the strength of the body. Senior citizens, who take honey and cinnamon powder in equal parts, are more alert and flexible. Half tablespoon of honey in a glass of water and sprinkled with ground cinnamon, taken daily after brushing teeth and in the afternoon at about 3:00 P.M. when the vitality of the body starts to decrease, increases the vitality of the body within a week.

After brushing the teeth in the morning, gargle with one teaspoon of honey and ground cinnamon mixed in hot water, so the breath stays fresh throughout the day.

Daily morning and night, honey and ground cinnamon, taken in equal parts, restore hearing.

December 14, 2008

Secrets of the Super-Healthy: People Who Never Get Sick

(Editor's Note: In times of economic crisis and uncertainty about your personal financial future, it is important to stay positive and healthy. The following article is written by Jennifer Strong and is a WebMD feature on how to stay healthy.)

Are you secretly envious of your co-workers and friends who, like superheroes, never seem to get sick? You know, the ones glowing with good health while everyone around them is sneezing, sniffling, and coughing like villains.

Don't hate the healthy people. Instead, steal the secrets of people who manage to stay above the sickroom fray and take steps to boost your body's immunity.

Training for the Body

Jennifer Cassetta, a martial arts instructor in New York City, claims she never gets sick, and neither do her father and grandmother, who also teach martial arts. "I believe it is the holistic approach to exercise that calms the mind and relieves stress," she says. "And the cardio, strengthening, and conditioning help boost the immune system."

Cassetta says her health has changed dramatically after she picked up martial arts eight years ago. Before then, she was a smoking, take-out-every-night, espresso-drinking girl in her 20s.

"As I started to train, I started to change my habits drastically," she says. "I cleaned up my diet, trained more, and quit smoking. Now in my 30s, I have more energy, I look better, and am stronger than I ever have been."

One bout of vigorous exercise can increase circulation, says Christiane Northrup, MD, author of Women's Bodies, Women's Wisdom. "Whenever circulation is increased, you get far more white blood cells," she says, "so they check for foreign germs and are far more apt to be able to gobble them up."

Pay Attention to Your Mouth

Chicago public relations consultant Joanna Broussard says gargling regularly with an antiseptic mouthwash has helped improve her dental health and may have helped fend off other illnesses.

Twelve years ago, Broussard's dental hygienist convinced her to gargle consistently after brushing her teeth. "So I made the effort and got into the habit every morning," she says, "Since then I have not had colds. When people all around me have colds or the flu, I seem to be immune."

Another reason to bone up on your brushing and gargling is that poor oral hygiene and gum disease have been linked to more serious illnesses, including diabetes.

An Apple a Day Really Works

Your mom may have been right when she said, "An apple a day keeps the doctor away." A natural antioxidant called quercetin, found in red apples as well as broccoli and green tea, may give an immunity boost to individuals under stress.

In a study conducted by David Nieman, PhD, professor at Appalachian State University, results showed that only 5% of cyclists who took 1,000 milligrams of quercetin every day for five weeks reported upper respiratory illness during a two-week period following extreme exercise, whereas 45% of the cyclists who took a placebo reported illness following extreme exercise. However, there were no significant differences in measures of immune system function in the two groups.

Additionally, researchers found that athletes taking the quercetin supplement maintained better mental alertness and reaction time over the placebo group. So go ahead, stock up on those red apples and you may be thanking Mom later.

Don't Worry, Conquer Stress

Stop worrying about getting sick. The fear and expectation of having something adverse happen actually lowers immunity, says Northrup. "When people are worried about it all the time," she says, "they literally scare themselves to death."

Constant worrying causes cortisol and epinephrine levels to rise - and these stress hormones can weaken the body's overall immunity. "The immune system plummets when cortisol levels are chronically high," she says. "Your own body produces high levels of steroids when you're under constant stress."

Up Your Vitamin Intake

We have a worldwide epidemic of vitamin D deficiency, says Northrup. Everybody needs vitamin D, which can be found in foods like sockeye salmon, eggs, and milk.

Hyla Cass, MD, an integrative medical practitioner and author of 8 Weeks to Vibrant Health, adds that certain prescription drugs like acid blockers can deprive the body of nutrients like vitamin D.

Surveys show that Americans don't get enough vitamin C, says Elisabetta Politi, RD, MPH, CDE, nutrition director at the Duke Diet & Fitness Center.

Citrus fruits are a good source of vitamin C. "It's a myth that vitamin C prevents the cold," she says. "But having an appropriate amount of vitamin C from fruits and vegetables can boost immunity."

Mind Over Body

Atlanta interior designer Melissa Galt believes in a "mind over medicine" attitude. "I don't have time for sickness in my life," says Galt, who travels frequently and doesn't take anything to fight germs. "I don't believe in it and don't acknowledge it."

Every thought is accompanied by a chain of biochemical reactions in your body, says Northrup. So a positive attitude can increase levels of nitric oxide, which help to balance neurotransmitters, improve immunity, and increase circulation, she says.

"Whenever nitric oxide levels are high -- from anything ranging from positive thought to exercise -- you're actually improving your resistance to disease," she says.

Just Say Om

Santa Monica, Calif., yoga therapist Felice Rhiannon credits her meditation and breathing practices for improving her physical and emotional health. "Meditation practice helps to calm my nervous system and allows the immune system to function with less interference," she says. For Rhiannon, "A calmer mind means a calmer body."

"The greatest change is in my peace of mind and sense of ease," she says. "I don't get colds as often as I did when I was younger. My sleep is better and my ability to cope with life's inevitable stresses has improved."

In a study published in the journal Psychosomatic Medicine in 2003, researchers at the University of Wisconsin and Harvard University found that volunteers who participated in eight weeks of mediation training produced significantly more flu-fighting antibodies than those who didn't meditate.

Increase Your Social Ties

There are personality factors associated with individuals who are resistant to getting colds when they're exposed to a virus, says Sheldon Cohen, PhD, professor of psychology at Carnegie Mellon University whose research examines the effects of stress and social support on immunity and health.

For example, extroverts are less likely than introverts to get colds when exposed to a virus. "We actually control for their immunity," he says. "The explanation isn't that extroverts interact with more people, and therefore have immunity to that virus. There's something about being extroverted that seems to protect people."

Having a diverse social network is equally important, says Cohen. Individuals who belong to multiple social groups are less likely to develop colds when exposed to a virus. There's convincing literature in epidemiology that people who have more diverse social networks are also less likely to get heart disease and live longer, he adds.

Accentuate the Positive

Cohen's research suggests that people who have a positive emotional style -- described as happy, enthusiastic, and calm -- are less likely to catch colds.

Cohen and researchers at Carnegie Mellon University interviewed 193 healthy adults daily for two weeks and recorded the positive and negative emotions they experienced each day, and then exposed the volunteers to a cold or flu virus. Those with positive outlooks reported fewer cold symptoms and were more resistant to developing an upper respiratory illness.

"It's a stable characteristic of individuals," he says. "It's not driven by how happy they are on the day they get exposed to the virus."

Wash Your Hands – Over and Over

Hand washing may sound like obvious advice for combating germs, but surveys suggest that most of us are not vigilant about washing our hands after using the restroom.

"In order to prevent illness, it's important to wash your hands frequently," Cass says. "During cold and flu season, wash your hands with soap many times during the day because you're in contact with all kinds of pathogens -- door knobs, stair railings, other people. You really want to have clean hands."

According to the CDC, proper hand washing for 20 seconds is the most effective way to avoid the 1 billion colds that Americans catch each year, not to mention other infectious diseases.

Get Your ZZZs

Sleep is one of the best ways to stay healthy, Northrup says. "People who get a solid eight hours per night absolutely do better."

Sleep efficiency is the key, Cohen says. People who get into bed and fall asleep right away and stay asleep are more protected against colds than those who wake up repeatedly through the night.

A good night's sleep will restore the immune system, Northrup says, because when you get a good night's sleep, melatonin levels rise and that improves immunity.

And best of all, there are no side effects.

October 24, 2008

Make Wise Choices

When Cancer Strikes, Your Life Depends Upon Your Support Team

(Editor's Note: This article is a WebMD Feature by R. Morgan Griffin, reviewed by Paul O'Neill, MD. I have heard cancer referred to as "the silent killer" because there is often no warning when we discover its insidious presence in our body. Having a diverse support team to help fight your battle sounds like an excellent idea. Here is some good information to help you wage war on the enemy.)

If you have just been diagnosed with cancer, you are probably still reeling. You may be grappling with issues that are profound -- like life and death -- and mundane -- like who will do the laundry when you are in the hospital?

But you will not fight this alone. Of course, you will have your family and friends. And you will have your doctor. But your medical care will not just be in the hands of a single MD. Instead, you will need a whole cancer support team to help you through this. “Good cancer treatment always requires a lot of people,” says Jan C. Buckner, MD, chair of medical oncology at the Mayo Clinic in Rochester (MN).

Of course, you may be wondering how this system works. How can you -- when you are probably feeling overwhelmed already -- pick an entire cancer support team? Here is what you need to know.

Why You Need a Cancer Support Team

Treating cancer often requires more than one approach -- not just chemotherapy for instance, but surgery or radiation, too. That usually means more than one doctor.
But good medical care is more than just treating the cancer itself. Cancer can affect every aspect of your life: your mood, your diet, and your family, to name a few.

So you may need nurses, dietitians, therapists, and other experts on your cancer support team. People you may never meet -- like pathologists and anesthesiologists -- also help while working behind the scenes.

Having all of these experts on your cancer support team is invaluable. “Each member of the team can each bring a different perspective to diagnosis and treatment,” says Terri Ades, MS, APRN-BC, AOCN, director of cancer information at the American Cancer Society in Atlanta. “With more people on your team, you get more options.”

The Heart of Your Cancer Support Team: Your Doctor and Nurse

First things first: you need to start with a doctor. Usually this will be a medical or surgical oncologist, a doctor who specializes in treating cancer. Given the stakes, settling on an oncologist can be nerve-wracking. However, Harold J. Burstein, MD -- a staff oncologist at the Dana-Farber Cancer Institute in Boston and an assistant professor of medicine at Harvard Medical School -- urges people not to fret too much.

"The essential part of picking a doctor is finding someone whom you can trust and with whom you can communicate. If you feel the doctor is being clear, and understands your needs, that is a good sign. Fortunately, there are many outstanding physicians around the country. In cancer medicine, as in most types of complex medical care, experience matters, and clinics or physicians with extensive familiarity with your kind of cancer can often provide care with insights not always available everywhere," says Dr. Burstein.

There are other things you should consider. For instance, see a doctor who has been recommended, either by your personal physician, family, or friends. Also, make sure that your doctor has a lot of experience in treating your specific type of cancer.

In many cases, your oncologist will work closely with an oncology nurse or nurse practitioner. You may find that you deal with your nurse the most.

"Doctors are often very focused on delivering treatment with a high degree of technical accuracy. Oftentimes, nurses who know the patient well will have additional insight into how the patient is doing from a broader point of view. That is why it is so important to have an effective team of providers -- doctors, nurses, administrative staff -- all working together in your care," Dr. Burstein says.

Ades says that for many people, the duo of the oncologist and nurse forms the core of the cancer support team. They should guide you through your treatment. Just make sure you know who they are.

“When they get diagnosed with cancer, people see so many experts so quickly that some do not even know who their doctor is,” says Dr. Buckner. That is a problem. If you have any doubt, just ask. It may seem like a silly question, but you have to know who is coordinating your treatment -- and whom to call with questions.

Other Specialists on Your Cancer Support Team

For some cases, that core team of an oncologist and an oncology nurse may be the only experts you need for your cancer support team, says Ades. But most of the time, you will need the help of more specialists.

So who else do you need to see? That depends entirely on your case. Many people may need to see a radiation oncologist for radiation treatments. If you need surgery, you may see a surgical oncologist or general surgeon who specializes in treating cancer.

Experts other than doctors also play a vital role in forming your cancer support team. “The care for someone with cancer always starts with the medical staff, but it quickly expands beyond that,” says Dr. Burstein. Cancer treatment is not only about treating cancer – it is about keeping the person feeling as well as possible during treatment.

For instance, during treatment, you need to pay attention to your overall physical health. A dietitian can make sure that you are getting all of the nutrients you need during treatment -- which can be hard, especially if you are nauseated by chemotherapy. A physical therapist can help you keep your strength up during treatment or build it back up afterward.

Getting through treatment will be a lot easier if you stay emotionally healthy, too. Although you might not think of a therapist or social worker as being important in cancer treatment, they often are. Cancer can have profound psychological effects. Many people become depressed or anxious during treatment. Talking through some of these issues can make a huge difference. Sometimes, family members may also need to meet with a therapist or social worker.

Complementary treatments -- like acupuncture and massage -- are also becoming increasingly common for people with cancer. These complementary therapies are not usually intended to treat the cancer itself. But they can ease side effects and improve quality of life. They may even reduce the amount of medicine you need for treatment. At some hospitals and cancer treatment centers, acupuncturists or massage therapists are actually on staff and can coordinate treatment with your doctor.

Building Your Cancer Support Team

While having the collected expertise of a cancer support team may seem great, you may be anxious about having to choose all of its members. Luckily, you do not have to.
"There are so many people who will be involved in your care that it is virtually impossible to research every one of them,” says Dr. Burstein.

That is why it is so important to have a doctor that you like and trust, since he or she will be pointing you toward specific experts. This can be an advantage, since your cancer support team is likely to work most efficiently if all of the experts have collaborated before.

“Usually, your doctor will already have a group of people that he or she works with all the time,” says Dr. Burstein. “So you do not need to track down each person yourself.”
That said, if you already have a specific person in mind -- a surgical oncologist that your sister loved, or a dietitian you’ve worked with before -- talk to your doctor.

If it would make you more comfortable, ask to have this person brought onto your cancer support team. By the same token, if you are not comfortable with one of the experts your doctor has referred you to, tell your doctor. Ask to see someone else.

The important thing is that your cancer support team runs smoothly. “Having a team of people who can work well together is invaluable for someone with cancer,” says Dr. Burstein.

One advantage of getting care at a specialized center or large hospital is that you might be able to see everyone -- from oncologist to dietitian to therapist -- under one roof. It can make things easier for you and reduce the odds of miscommunication between health care providers, says Dr. Buckner.

Still, you can get excellent medical care even if you do have to go to different medical centers. Just check in with your doctor to make sure that everyone on your cancer support team is working well together.

Asking for What You Need From Your Cancer Support Team

Part of your cancer support team’s job is to make sure that you are getting the care that you need. Your caregivers should be regularly checking in to make sure that you are doing as well as you possibly can, both physically and mentally. But that does not mean you should leave everything up to the experts. You need to take an active role in your treatment. You are not just a patient – you are a vital member of the team.

“Our goal is to make treatment as easy, comfortable, and successful as possible,” says Ades. “But patients have to tell us what they need.”

When you are in treatment for cancer, things may change from day to day or week to week. Yesterday, you felt great, but today, the side effects are awful. Or you may suddenly realize that your chemotherapy schedule just doesn’t fit in with the rest of your life. As long as you keep your doctor up to date, your cancer support team can tweak your treatment, or add new experts as you need them. Do not be shy about asking for help.

So never underestimate your own role in making your treatment work. If you need something that your cancer support team is not giving you, speak up.

June 20, 2008

Could the Way Food Looks Give Real Clues as to What Is Really Healthy for Us to Eat?

Copyright © 2008 Ed Bagley

The next time you sit down to lunch or dinner, you may be surprised to learn that many of the foods that we eat look similar to vital organs in our body, and in fact provide nutrients that actually help the organ in question function.

Upon learning the specifics of this interesting fact, you just may ponder about whether this phenomena is a happy coincidence or a planned occurrence. Here are the facts:

A sliced carrot looks like our human eye. The pupil, iris and radiating lines look just like our human eye, and science shows carrots greatly enhance blood flow to our eyes and the function of our eyes.

A tomato has four chambers and is red. Our heart has four chambers and is red. Research shows tomatoes are loaded with lycopene—a red carotenoid pigment present in tomatoes and many berries and fruits—and are indeed pure heart and blood food.

Grapes hang in a cluster that has the shape of our heart. Each grape looks like a blood cell and research shows grapes are also profound heart and blood vitalizing food.

A walnut looks like a little brain with a left and right hemisphere, similar to our upper cerebrum and lower cerebellum. Even the wrinkles (folds) on the nut are just like our neo-cortex. We know that walnuts help develop more than 30 neurotransmitters for our brain function, allowing a chemical substance to help fibers in our brain communicate with each other.

Kidney beans look like our human kidneys, and actually heal and help maintain our kidney function.

Celery, bok choy and rhubarb look like our bones. These foods specifically target bone strength. Bones are 23% sodium (salt) and these foods are 23% sodium. If you do not have enough sodium in your diet, the body pulls it from the bones, thus making them weak. These foods replenish the skeletal needs of our body.

Avocados, eggplant and pears target the health and function of the womb and cervix of the female—they even look like these organs. Research shows that when a woman eats one avocado a week, it balances hormones, sheds unwanted birth weight, and prevents cervical cancers. It also takes 9 months to grow an avocado from blossom to ripened fruit. There are apparently more than 14,000 photolytic chemical constituents of nutrition in each one of these foods; modern science has only studied and named about 141 of these.

Figs are full of seeds and hang in twos when they grow. Figs increase the mobility of male sperm, increase the number of sperm, and can help overcome male sterility.

Sweet potatoes look like the pancreas and actually balance the glycemic index of diabetics.

Olives assist the health and function of the female ovaries.

Oranges, grapefruits, and other citrus fruits look like the mammary glands of the female, and actually assist the health of the breasts and the movement of lymph in and out of the breasts.

Onions look like our body cells. Research shows that onions help clear waste materials from our body cells. As we have found out, onions even produce tears that wash the epithelial (outer) layers of our eyes. A working companion, garlic, also helps eliminate waste materials and dangerous free radicals from our body.

Read my 5-Part series on Distance Running that involves dieting, weight loss and physical conditioning:

"Wheat Products and Sugar Can Be the 'Kiss of Death' When Trying to Lose Weight - Part 1"

"How Lectins (Proteins in Foods) Are Very Negative in O Positive Blood Types - Part 2"

"Gluten in Wheat Products Bind to the Small Intestine Lining and Turn to Fat - Part 3"

"How Popular Running Magazines Are Constantly Giving Very Poor Diet Advice - Part 4"

"There Is an Inescapable Correlation Between Weight and Cardiovascular Efficiency - Part 5"

July 11, 2007

First Study Ever on Subject

Loss of Odor Perception Might Signal Alzheimer's

Copyright © 2007 Ed Bagley

Imagine my recoil when I read the above Associated Press headline recently.

The story went on to detail the first study that linked loss of smell to Alzheimer's. Difficulty identifying odors was associated with a higher risk of progressing from mild cognitive impairment to Alzheimer's.  As someone with very little sense of smell and taste, perhaps I should be worried.

These kinds of medical studies rarely offer a cheery report.

Lead author Robert Wilson of Chicago's Rush University Medical Center did concede that a diminishing sense of smell is not cause for panic. Thank goodness.

Perhaps I would be less interested if I had not just celebrated my 63rd birthday, and for years have had a profound loss of two very important senses: smell and taste.

A sporting accident some 40 years ago (I was playing right field and tried
to catch a fly ball in the sun with my nose) and a traffic accident some 30 years ago (I was rear-ended in my VW at a stoplight in a hit-and-run accident by someone doing 50 to 70 miles per hour) left me with a deviated septum.

For years I walked around with 50% breathing capacity in one nostril and 10% in the other. The result was that I was taking up to 16 Sudafed and 16 Ibuprofen a day for some time before I came to my senses and developed suffering to an art form. I have better medications now.

Years later I was reading a health book and learned that Sudafed does
a really good job of allowing you to breath and at the same time causes some folks to lose their sense of smell and taste. It happened to me. I now have virtually no sense of smell or taste.

If there was a fire in my house, I would figure it out when I saw the smoke. If there was a great tasting food I would be more sensitive to its texture than its taste. I would probably do great in England where the food is so bland.

The boyhood joy of selecting the perfect tasting candy to buy is now lost on me. There is no candy that does much for me now. The pure joy of being a kid in a candy store is gone forever.

I used to love the licorice taste of Good 'n Plenty, Butterfinger and Snickers bars,
spearmint hard candies, Christmas ribbon candy and peanut brittle with caramel and peanuts.

It is the same with soda (carbonated water drunk alone or with liquor or wine), pop (informal for soda pop) and soda pop (a carbonated soft drink). I find very little taste between them, or flavors among them.

Be advised. A lot of medications we take as we get older have trade-offs.

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