Get Up and Dance!
You may not want to kick your heels up like a teenager, but dancing is wonderful exercise, a great way to socialize, and a healthy way to challenge yourself physically.
Dr Weil
Health and Healing
Using Cosmetics Safely
by Mary Calvagna, MS
http://www.beliefnet.com/healthandheali ... mc_id=NL44
Ah...the wonders of makeup. When you were a little girl, you stood back in awe as your mother applied her rouge and mascara. As a teen, sparkly blue eye shadow made you feel grown up and so pretty. Even now, as an adult, that rush you feel when you find the perfect tube of lipstick is hard to describe. But makeup, like so many things, has to be used safely and with a bit of common sense.
If you use makeup, the following are some safety tips to help you avoid injury and infection:
Follow the instructions on the label. Always read the label and use the cosmetic according to the manufacturer's instructions.
Never drive and apply makeup. If you are applying makeup while driving, you are not watching the road; this can lead to a serious accident. In addition, you could hit a bump or pothole, which could cause you to scratch your eyeball and lead to injury, infection, and even blindness.
Watch for allergic reactions. Nearly 25% of people who use cosmetics experience some type of allergic reaction. Contact lens wearers and people with allergies or sensitive skin are more likely to confront problems while using eye cosmetics, but anyone is susceptible. Some people are allergic to fragrances or other ingredients in cosmetics such as Rosin (also called colophony), nickel and lanolin. They may develop tearing, itching and redness of the eyes, or swelling and flaking of the eyelids. If you notice any of these symptoms, stop using the makeup immediately. If the reaction does not clear up, contact your health care provider. Allergic persons may need to try different hypoallergenic products until they find one that is safe for them.
Don't share makeup—not even with your best friend. Each person has different skin bacteria. If you contaminate your cosmetics with another person's bacteria, you may get an infection. Also, stay away from shared-use "tester" cosmetics found at cosmetic counters in many stores. Sharing lipstick, for example, may spread herpes simplex infections.
Never use saliva to thin old or clumped makeup or to wet a mascara wand. Your saliva contains bacteria from your mouth.
Throw away old makeup or makeup that changes color or smells bad. Although older makeup probably won't cause any serious harm, replace cosmetics every six months (more often if you wear contact lenses) to avoid excess contamination with skin bacteria. Also, if and whenever makeup changes consistency or smells bad, it's a good idea to just throw it out.
Do not use eye makeup if you have an eye infection. Additionally, throw away any eye makeup you were using when the infection started. Some women develop frequent conjunctivitis (infection of the outer part of the eyeball) due to contamination of their eye cosmetic or makeup applicator.
Natural does not necessarily mean safe, pure, or clean. In addition, hypoallergenic, fragrance-free, non-comedogenic, and natural have no official government definitions. And claims on a label that a product is "dermatologist-tested," "sensitivity tested," "allergy tested," or "nonirritating" carry no guarantee that it won't cause reactions.
Keep makeup out of sunlight and heat. Light and heat can degrade preservatives in makeup. Keeping your makeup away from these things will help preserve its quality.
Keep makeup containers tightly closed. This will help keep contaminants out of our makeup. Plus, your makeup will stay fresh and last longer.
Never use an aerosol spray near heat or while smoking. Aerosol can catch on fire.
Don't inhale hairspray or powders. Intentionally inhaling products like these can lead to lung damage and even death.
For information on how to report an adverse reaction to a cosmetic, call the FDA Cosmetics and Colors Automated Information Line at 1-800-270-8869.
RESOURCES:
Cosmetics Index Page
Environmental Working Group
http://www.ewg.org
U. S. Food and Drug Administration
Center for Food Safety and Applied Nutrition
Office of Cosmetics and Colors
http://www.cfsan.fda.gov
Sources:
Eye Facts. University of Illinois Eye Center. Available at http://www.uic.edu/com/eye/LearningAbou ... tics.shtml. Accessed on October 29, 2004.
The National Women's Health Information Center
by Mary Calvagna, MS
http://www.beliefnet.com/healthandheali ... mc_id=NL44
Ah...the wonders of makeup. When you were a little girl, you stood back in awe as your mother applied her rouge and mascara. As a teen, sparkly blue eye shadow made you feel grown up and so pretty. Even now, as an adult, that rush you feel when you find the perfect tube of lipstick is hard to describe. But makeup, like so many things, has to be used safely and with a bit of common sense.
If you use makeup, the following are some safety tips to help you avoid injury and infection:
Follow the instructions on the label. Always read the label and use the cosmetic according to the manufacturer's instructions.
Never drive and apply makeup. If you are applying makeup while driving, you are not watching the road; this can lead to a serious accident. In addition, you could hit a bump or pothole, which could cause you to scratch your eyeball and lead to injury, infection, and even blindness.
Watch for allergic reactions. Nearly 25% of people who use cosmetics experience some type of allergic reaction. Contact lens wearers and people with allergies or sensitive skin are more likely to confront problems while using eye cosmetics, but anyone is susceptible. Some people are allergic to fragrances or other ingredients in cosmetics such as Rosin (also called colophony), nickel and lanolin. They may develop tearing, itching and redness of the eyes, or swelling and flaking of the eyelids. If you notice any of these symptoms, stop using the makeup immediately. If the reaction does not clear up, contact your health care provider. Allergic persons may need to try different hypoallergenic products until they find one that is safe for them.
Don't share makeup—not even with your best friend. Each person has different skin bacteria. If you contaminate your cosmetics with another person's bacteria, you may get an infection. Also, stay away from shared-use "tester" cosmetics found at cosmetic counters in many stores. Sharing lipstick, for example, may spread herpes simplex infections.
Never use saliva to thin old or clumped makeup or to wet a mascara wand. Your saliva contains bacteria from your mouth.
Throw away old makeup or makeup that changes color or smells bad. Although older makeup probably won't cause any serious harm, replace cosmetics every six months (more often if you wear contact lenses) to avoid excess contamination with skin bacteria. Also, if and whenever makeup changes consistency or smells bad, it's a good idea to just throw it out.
Do not use eye makeup if you have an eye infection. Additionally, throw away any eye makeup you were using when the infection started. Some women develop frequent conjunctivitis (infection of the outer part of the eyeball) due to contamination of their eye cosmetic or makeup applicator.
Natural does not necessarily mean safe, pure, or clean. In addition, hypoallergenic, fragrance-free, non-comedogenic, and natural have no official government definitions. And claims on a label that a product is "dermatologist-tested," "sensitivity tested," "allergy tested," or "nonirritating" carry no guarantee that it won't cause reactions.
Keep makeup out of sunlight and heat. Light and heat can degrade preservatives in makeup. Keeping your makeup away from these things will help preserve its quality.
Keep makeup containers tightly closed. This will help keep contaminants out of our makeup. Plus, your makeup will stay fresh and last longer.
Never use an aerosol spray near heat or while smoking. Aerosol can catch on fire.
Don't inhale hairspray or powders. Intentionally inhaling products like these can lead to lung damage and even death.
For information on how to report an adverse reaction to a cosmetic, call the FDA Cosmetics and Colors Automated Information Line at 1-800-270-8869.
RESOURCES:
Cosmetics Index Page
Environmental Working Group
http://www.ewg.org
U. S. Food and Drug Administration
Center for Food Safety and Applied Nutrition
Office of Cosmetics and Colors
http://www.cfsan.fda.gov
Sources:
Eye Facts. University of Illinois Eye Center. Available at http://www.uic.edu/com/eye/LearningAbou ... tics.shtml. Accessed on October 29, 2004.
The National Women's Health Information Center
Mammogram radiation danger discounted
Published: Wednesday, March 22, 2006
Women who have a high risk of breast cancer because of a genetic mutation can safely have mammograms to screen for the disease, despite doses of radiation used in the test, a Canadian-led international study concludes.
The study of more than 3,000 women found that mammography does not appear to increase the risk of breast cancer in those with what's known as BRCA1 and BRCA2 mutations, said lead author Dr. Steven Narod of the Centre for Research in Women's Health in Toronto.
"The concern was that mammograms, which have radiation . . . may cause breast cancer, particularly for women who are genetically predisposed because the genes that have gone wrong are the genes that are required to repair damage from radiation," Narod said Tuesday.
"There's been a lot of concern that maybe we've been doing more harm than good by doing radiation because it could be damaging DNA and causing breast cancer."
But Narod's team, which included researchers from Montreal's McGill University and the B.C. Cancer Agency in Vancouver, found that BRCA-affected women with breast cancer had experienced no greater exposure to mammograms than those who hadn't developed the disease.
The study compared 1,600 women who had breast cancer with an equal number without the disease.
© The Calgary Herald 2006
***
Cervical cancer vaccine likely by next year
Published: Wednesday, March 22, 2006
An experimental vaccine that protects women against cervical cancer will likely save lives and eventually mean fewer Pap smears, says an Edmonton researcher.
Dr. Barbara Romanowski, an infectious disease specialist at the University of Alberta, is involved in clinical trials of Cervarix, a GlaxoSmithKline vaccine currently being tested.
Results to date have been successful, and Romanowski expects a cervical cancer vaccine to be on the market in Canada by next year.
© The Calgary Herald 2006
Published: Wednesday, March 22, 2006
Women who have a high risk of breast cancer because of a genetic mutation can safely have mammograms to screen for the disease, despite doses of radiation used in the test, a Canadian-led international study concludes.
The study of more than 3,000 women found that mammography does not appear to increase the risk of breast cancer in those with what's known as BRCA1 and BRCA2 mutations, said lead author Dr. Steven Narod of the Centre for Research in Women's Health in Toronto.
"The concern was that mammograms, which have radiation . . . may cause breast cancer, particularly for women who are genetically predisposed because the genes that have gone wrong are the genes that are required to repair damage from radiation," Narod said Tuesday.
"There's been a lot of concern that maybe we've been doing more harm than good by doing radiation because it could be damaging DNA and causing breast cancer."
But Narod's team, which included researchers from Montreal's McGill University and the B.C. Cancer Agency in Vancouver, found that BRCA-affected women with breast cancer had experienced no greater exposure to mammograms than those who hadn't developed the disease.
The study compared 1,600 women who had breast cancer with an equal number without the disease.
© The Calgary Herald 2006
***
Cervical cancer vaccine likely by next year
Published: Wednesday, March 22, 2006
An experimental vaccine that protects women against cervical cancer will likely save lives and eventually mean fewer Pap smears, says an Edmonton researcher.
Dr. Barbara Romanowski, an infectious disease specialist at the University of Alberta, is involved in clinical trials of Cervarix, a GlaxoSmithKline vaccine currently being tested.
Results to date have been successful, and Romanowski expects a cervical cancer vaccine to be on the market in Canada by next year.
© The Calgary Herald 2006
http://www.beliefnet.com/healthandheali ... mc_id=NL44
The Toilet Seat Won't Bite (and Other Women's Health Myths)
by Leanna Skarnulis
You arrive at work one morning to discover an e-mail warning that tampons—and even worse, your favorite antiperspirant—contain various toxins and have been implicated as a cause of cancer. Although overstated and generally incorrect, this misinformation is benign compared with some of the myths that have historically surrounded women's bodies and health.
Thank goodness we know more about reproduction, for example, than did our medieval ancestors, who staunchly believed that the sex of their progeny was determined by the mother. Before medical science discovered that a baby's sex was determined by the father, not the mother, there's no telling how many queens lost their heads for failing to produce a male heir!
Experts warn myths can be especially dangerous if they prevent women, and even the medical community, from addressing true health risks. Below are a few such myths.
Myth: Breast cancer is the leading cause of death among women.
Fact: Heart attacks, strokes and other cardiovascular diseases claim the lives of more than 500,000 women each year compared to 43,000 for breast cancer. But Dale Mintz, MA, formerly with the American Heart Association and now director of Hadassah's National Department of Women's Health, says that women fear breast cancer more than heart disease.
"Historically—although this is usually no longer the case—women who went to a doctor with chest pains were given Valium or antidepressants for anxiety, whereas men would be checked immediately for heart disease," Mintz explains. "And women don't take care of themselves as well as they do their partners and children. They get to the doctor later, when their prognosis may not be as good."
Myth: Breast cancer is the leading cause of cancer deaths.
Fact: Lung cancer kills about 67,000 women annually, half again as many as breast cancer. "We're learning that women are at higher risk of developing lung cancer even if they smoke less than men," says Sherry Marts, PhD, scientific director of the Society for Women's Health Research. "And when women get lung cancer, it's a more invasive form that's harder to treat. One of the best things that women can do to prevent lung cancer it is not to smoke—EVER."
Myth: Getting hit in the breast can cause breast cancer.
Fact: Emphatically NO! This old myth persists because occasionally an injury will cause a benign lump in the breast, which usually disappears in a few weeks. When Mintz makes breast cancer awareness presentations to high school girls, it's not unusual for a girl to ask if it's safe to play sports even though they might get cancer from being hit in the breast. This is one of those myths that's dangerous because it undermines a healthful behavior. "We want them to play sports because exercise is so important to their health," she says.
Myth: Prevention of osteoporosis begins with menopause.
Fact: While the loss of bone mass that affects one out of two women typically begins after menopause, prevention begins much earlier with health habits that promote bone strength. The National Osteoporosis Foundation (NOF) advocates a diet rich in calcium and vitamin D, cautions against smoking and excessive use of alcohol, and has launched the Step On It America! campaign to promote weight-bearing exercise.
Walking, dancing, playing tennis, and lifting weights are weight-bearing exercises; swimming and bicycling, which are excellent for cardiovascular health, do not strengthen bones. An exercise program that combines both weight-bearing and cardiovascular activities will benefit both your bones and your heart.
Myth: A nursing mother can't get pregnant.
Fact: This is an old wives' tale that has at least a kernel of truth in it, says Barry Jacobson, MD, chairman of the Obstetrics and Gynecology Department at Delaware County Memorial Hospital in Pennsylvania and adviser to the National Women's Health Resource Center. The truth is that breast-feeding will delay ovulation. "But a nursing mother will probably ovulate eventually," he says.
Myth: Treatments tested on men are appropriate for women.
Fact: We don't know. Recognizing the gaps in what is known about women's health issues, the National Institutes of Health (NIH) established the Office of Research on Women's Health (ORWH) in 1990. This group has worked to find those gaps and to assure inclusion of women and minorities in clinical studies funded by the various institutes and centers that make up the NIH.
Myth: A "fishy" vaginal odor is normal.
Fact: The odor may be the result of bacterial vaginitis (BV), a condition more common and more serious than yeast infections.
According to the 3M National Vaginitis Association (NVA), if untreated, BV can lead to infertility or pregnancy complications, including pre-term birth. Symptoms of BV include a discharge, fishy odor and itching, which women often mistake for a yeast infection. "It's alarming when you consider the number of women who incorrectly self-diagnose their vaginal infections," says Daron Ferris, MD, of the Department of Family Practice, Medical College of Georgia. "Because there is a lack of information, these women may take matters into their own hands, use an over-the-counter antifungal and incorrectly treat what may be a serious vaginal infection."
Myth: You can get a sexually transmitted disease (STD) from toilet seats.
Fact: "It's OK to sit down," reports Dr. Marts. "Most organisms that cause STDs will not survive for long on a toilet seat." She adds that viruses such as those that cause herpes and hepatitis can survive, but a woman would have to make genital contact with the seat to become infected. "I think this myth dates from a time when it wasn't so much about microbes as it was about vermin, like fleas and body lice," says Dr. Marts.
What about the tampon and antiperspirant rumors?
Do antiperspirants, as the e-mail warns, prevent the release of toxins that can back up and cause breast cancer? All the leading breast cancer organizations, including the Susan G. Komen Breast Cancer Foundation, refute this myth, pointing out that sweat doesn't even contain toxins and that sweat blocked by antiperspirants is excreted elsewhere.
Another email says that leading tampons contain dioxin, a known carcinogen, and therefore you should use all-natural tampons. "There's not a lot of difference between natural tampons and the kind you buy in the grocery store except the cost," says Dr. Marts. She says that dioxins, some more dangerous than others, are found everywhere in the environment, including our bodies, drinking water and food. "[Researchers] are able to detect it now at .02 parts per trillion, and they're not able to detect any in tampons at that level."
Dr. Marts believes the danger of such email warnings is that they scare people who fear they've been damaging their bodies unwittingly for years. "If you read something in an email, don't believe it unless you can confirm it with a physician or a reputable web site," she says. See the resources below for some reputable websites with women's health information.
RESOURCES:
American Cancer Society
http://www.cancer.org
American Heart Association
http://www.americanheart.org
BreastCancerInfo.com, A service of the Susan G. Komen Breast Cancer Foundation
http://www.breastcancerinfo.com
Estronaut
http://www.womenshealth.org
Hadassah, The Women's Zionist Organization of America, Inc.
http://www.Hadassah.org
National Osteoporosis Foundation
http://www.nof.org
National Women's Health Resource Center
http://www.healthywomen.org
The Toilet Seat Won't Bite (and Other Women's Health Myths)
by Leanna Skarnulis
You arrive at work one morning to discover an e-mail warning that tampons—and even worse, your favorite antiperspirant—contain various toxins and have been implicated as a cause of cancer. Although overstated and generally incorrect, this misinformation is benign compared with some of the myths that have historically surrounded women's bodies and health.
Thank goodness we know more about reproduction, for example, than did our medieval ancestors, who staunchly believed that the sex of their progeny was determined by the mother. Before medical science discovered that a baby's sex was determined by the father, not the mother, there's no telling how many queens lost their heads for failing to produce a male heir!
Experts warn myths can be especially dangerous if they prevent women, and even the medical community, from addressing true health risks. Below are a few such myths.
Myth: Breast cancer is the leading cause of death among women.
Fact: Heart attacks, strokes and other cardiovascular diseases claim the lives of more than 500,000 women each year compared to 43,000 for breast cancer. But Dale Mintz, MA, formerly with the American Heart Association and now director of Hadassah's National Department of Women's Health, says that women fear breast cancer more than heart disease.
"Historically—although this is usually no longer the case—women who went to a doctor with chest pains were given Valium or antidepressants for anxiety, whereas men would be checked immediately for heart disease," Mintz explains. "And women don't take care of themselves as well as they do their partners and children. They get to the doctor later, when their prognosis may not be as good."
Myth: Breast cancer is the leading cause of cancer deaths.
Fact: Lung cancer kills about 67,000 women annually, half again as many as breast cancer. "We're learning that women are at higher risk of developing lung cancer even if they smoke less than men," says Sherry Marts, PhD, scientific director of the Society for Women's Health Research. "And when women get lung cancer, it's a more invasive form that's harder to treat. One of the best things that women can do to prevent lung cancer it is not to smoke—EVER."
Myth: Getting hit in the breast can cause breast cancer.
Fact: Emphatically NO! This old myth persists because occasionally an injury will cause a benign lump in the breast, which usually disappears in a few weeks. When Mintz makes breast cancer awareness presentations to high school girls, it's not unusual for a girl to ask if it's safe to play sports even though they might get cancer from being hit in the breast. This is one of those myths that's dangerous because it undermines a healthful behavior. "We want them to play sports because exercise is so important to their health," she says.
Myth: Prevention of osteoporosis begins with menopause.
Fact: While the loss of bone mass that affects one out of two women typically begins after menopause, prevention begins much earlier with health habits that promote bone strength. The National Osteoporosis Foundation (NOF) advocates a diet rich in calcium and vitamin D, cautions against smoking and excessive use of alcohol, and has launched the Step On It America! campaign to promote weight-bearing exercise.
Walking, dancing, playing tennis, and lifting weights are weight-bearing exercises; swimming and bicycling, which are excellent for cardiovascular health, do not strengthen bones. An exercise program that combines both weight-bearing and cardiovascular activities will benefit both your bones and your heart.
Myth: A nursing mother can't get pregnant.
Fact: This is an old wives' tale that has at least a kernel of truth in it, says Barry Jacobson, MD, chairman of the Obstetrics and Gynecology Department at Delaware County Memorial Hospital in Pennsylvania and adviser to the National Women's Health Resource Center. The truth is that breast-feeding will delay ovulation. "But a nursing mother will probably ovulate eventually," he says.
Myth: Treatments tested on men are appropriate for women.
Fact: We don't know. Recognizing the gaps in what is known about women's health issues, the National Institutes of Health (NIH) established the Office of Research on Women's Health (ORWH) in 1990. This group has worked to find those gaps and to assure inclusion of women and minorities in clinical studies funded by the various institutes and centers that make up the NIH.
Myth: A "fishy" vaginal odor is normal.
Fact: The odor may be the result of bacterial vaginitis (BV), a condition more common and more serious than yeast infections.
According to the 3M National Vaginitis Association (NVA), if untreated, BV can lead to infertility or pregnancy complications, including pre-term birth. Symptoms of BV include a discharge, fishy odor and itching, which women often mistake for a yeast infection. "It's alarming when you consider the number of women who incorrectly self-diagnose their vaginal infections," says Daron Ferris, MD, of the Department of Family Practice, Medical College of Georgia. "Because there is a lack of information, these women may take matters into their own hands, use an over-the-counter antifungal and incorrectly treat what may be a serious vaginal infection."
Myth: You can get a sexually transmitted disease (STD) from toilet seats.
Fact: "It's OK to sit down," reports Dr. Marts. "Most organisms that cause STDs will not survive for long on a toilet seat." She adds that viruses such as those that cause herpes and hepatitis can survive, but a woman would have to make genital contact with the seat to become infected. "I think this myth dates from a time when it wasn't so much about microbes as it was about vermin, like fleas and body lice," says Dr. Marts.
What about the tampon and antiperspirant rumors?
Do antiperspirants, as the e-mail warns, prevent the release of toxins that can back up and cause breast cancer? All the leading breast cancer organizations, including the Susan G. Komen Breast Cancer Foundation, refute this myth, pointing out that sweat doesn't even contain toxins and that sweat blocked by antiperspirants is excreted elsewhere.
Another email says that leading tampons contain dioxin, a known carcinogen, and therefore you should use all-natural tampons. "There's not a lot of difference between natural tampons and the kind you buy in the grocery store except the cost," says Dr. Marts. She says that dioxins, some more dangerous than others, are found everywhere in the environment, including our bodies, drinking water and food. "[Researchers] are able to detect it now at .02 parts per trillion, and they're not able to detect any in tampons at that level."
Dr. Marts believes the danger of such email warnings is that they scare people who fear they've been damaging their bodies unwittingly for years. "If you read something in an email, don't believe it unless you can confirm it with a physician or a reputable web site," she says. See the resources below for some reputable websites with women's health information.
RESOURCES:
American Cancer Society
http://www.cancer.org
American Heart Association
http://www.americanheart.org
BreastCancerInfo.com, A service of the Susan G. Komen Breast Cancer Foundation
http://www.breastcancerinfo.com
Estronaut
http://www.womenshealth.org
Hadassah, The Women's Zionist Organization of America, Inc.
http://www.Hadassah.org
National Osteoporosis Foundation
http://www.nof.org
National Women's Health Resource Center
http://www.healthywomen.org
Colon Cleansing: Don't Be Misled by the Claims
by Larry Lindner
"Colon cleansers effectively eliminate large quantities of toxic waste, affecting the condition and vitality of the entire body."
"Colonics...increase the release of old, encrusted colon waste, encourage discharge of toxins and parasites, freshen the gastrointestinal tract and make the whole cleansing process easier and more thorough."
"Cleansing is the first step in a good weight control program."
So read ads and promotional materials for so-called internal cleansers—enemas, laxatives, strong herbal teas, powders, and pills meant to clean out the large intestine, also known as the colon or bowel. You can find these products all over the Internet, at health food stores, and even in some supermarkets and pharmacies.
Growing Popularity
And their popularity is only expanding. "Digestive aids," which include internal cleansers, saw almost 13% sales growth between 1999 and 2000, amounting to almost $83 million in mainstream market and health food store sales, according to SPINS, a San Francisco-based research firm for the natural products industry. Elimination, in other words, is a growth industry.
The Sales Pitch
The sellers of all these colon scrubbers say periodic cleansing is crucial for the body's well-being. The general pitch goes as follows. We live in an age in which toxins easily accumulate in the body—the air we breathe is polluted and the food we eat is laden with pesticides and other harmful chemicals. Our bodies, unequipped to deal with all these poisons, fall behind in eliminating them, and we end up sick.
Furthermore, as one company puts it, certain foods "tend to stick and putrefy in the folds and pockets of the intestines. When your colon isn't eliminating wastes properly, toxins are reabsorbed into the blood, poisoning the entire system and weakening your other eliminative organs." More succinctly stated, "the colon walls are encrusted with stagnant waste."
Misleading Information
Don't believe it, say the experts.
"Things don't crust over" in your colon, says Robert Russell, MD, a gastroenterologist at the Jean Mayer Human Nutrition Research Center on Aging at Tufts University in Boston. "The business about putrefaction is all baloney. There are not pieces of food hanging around in there getting old."
In other words, you don't need a $20-to-$30 product to help nature do its job. The body is perfectly capable of eliminating toxins in a timely, efficient manner. Consider that the cells of your gastrointestinal tract turn over every three days—fast enough so that there's no "crust," or "putrefying" food in your colon. Also, bacteria in the colon naturally metabolize and thereby detoxify food wastes. And mucous membranes lining the intestinal wall block unwanted substances from entering the body's other tissues. The liver works to neutralize toxins as well.
Granted, Dr. Russell says, people do get constipated. "And that makes you uncomfortable," he points out. "But there has never been any indication that there's a higher incidence of colon cancer or any other dreaded disease in constipated people."
"Normal" Bowel Movements are Variable
No matter. In typical quack-like fashion, sellers of intestinal cleansers make consumers their own diagnosticians and tell them signs to look for to determine that their bodies are not up to snuff and need outside agents to, er, get things going. One of these signs is having fewer than two to three bowel movements a day. But that has nothing to do with whether you require a laxative or other cathartic agent. The number of bowel movements considered healthy over a given period of time differs from person to person. It can be anywhere from a few times a day to a few times a week, Dr. Russell notes. Only when your typical pattern changes might something be wrong, and even then it's often just a passing virus or other bug.
Not Useful for Weight Loss
Some companies imply that increasing the number of bowel movements will prevent absorption of enough calories to allow you to shed excess pounds, but that, too, is not true. Just about all calories are absorbed well before food makes its way to the colon, rendering any weight-loss claims for cleansers bogus.
Don't be Tricked by Vague-Sounding Symptoms
Most symptoms of an "inefficient" colon listed by purveyors of internal cleansers are actually much more vague than the one that requires bowel movement counts. In fact, they're vague enough and broad enough to cover virtually every single human being, at least at one time or another.
One company, for instance, says the signals that toxins are building up in your system are that "you may feel sluggish or bloated or you may experience 'brain fog.' You may wake up feeling tired and 'blue.' You may have a case of the 'blahs' that's hard to shake." Among the "13 common symptoms of toxicity" listed by another company: headaches, depression, poor memory, low energy, weight gain, and—I kid you not—"illnesses."
Just as the symptoms of a supposedly poisoned digestive system are, on the whole, vague, so, too are the signs of renewed well-being once a cleanser is taken. "With your body free of harmful toxins, you will feel younger, better, healthier, and happier!" one company says. Another promises that "when the colon is kept clean, disease in the body is very rare." Still other companies make claims of improved mental alertness and increased energy.
Potentially Harmful Side Effects
And they tell you not to worry if taking the cleanser makes you feel sick because that's a sign that the product is working. According to one pamphlet, gas and other gastrointestinal discomfort along with flu-like symptoms such as sneezing and a runny nose are "temporary, positive signs that you body is working to rid itself of the toxin build-up." Literature for another product says, "Do not be alarmed if you pass strings of mucus...for a couple of weeks as this is a good sign that you are detoxifying." Promotional material for yet another tells patrons to "just relax and appreciate your body's cleansing process if you develop any of the following; headaches, bad breath or body odor, dizziness, irritability, skin eruptions...or low energy."
But do not relax. Dizziness could be a sign that you're becoming dehydrated. And strings of mucus—the intestine's response to stimulation—mean the body views the cleanser as a toxin and is trying to get rid of it.
The idea of having to feel worse before you feel better is particularly dangerous in light of the fact that feeling bad is very possibly a sign that a cleanser is disagreeing with you in a serious way. Consider a U.S. Food and Drug Administration report that linked kidney problems and progressive muscle weakness to a cleansing formula that contained herbs and fiber. In another FDA report, a body cleanser that contained clay, cascara, and comfrey was associated with diarrhea, abdominal pain, and vomiting up blood. A woman even ended up in the emergency room with life-threatening heart problems after ingesting an herbal cleansing regimen with tainted ingredients. (Unlike drugs, cleansers do not have to meet standards for quality and purity.)
Traditional Advice Still the Best
Here's a better bet than going through extraordinary means to "flush" your colon:
Drink plenty of fluids.
Eat plenty of high-fiber fruits, vegetables, beans, and whole grains.
Get plenty of exercise.
Let nature take its course. Your colon knows how to do its business.
by Larry Lindner
"Colon cleansers effectively eliminate large quantities of toxic waste, affecting the condition and vitality of the entire body."
"Colonics...increase the release of old, encrusted colon waste, encourage discharge of toxins and parasites, freshen the gastrointestinal tract and make the whole cleansing process easier and more thorough."
"Cleansing is the first step in a good weight control program."
So read ads and promotional materials for so-called internal cleansers—enemas, laxatives, strong herbal teas, powders, and pills meant to clean out the large intestine, also known as the colon or bowel. You can find these products all over the Internet, at health food stores, and even in some supermarkets and pharmacies.
Growing Popularity
And their popularity is only expanding. "Digestive aids," which include internal cleansers, saw almost 13% sales growth between 1999 and 2000, amounting to almost $83 million in mainstream market and health food store sales, according to SPINS, a San Francisco-based research firm for the natural products industry. Elimination, in other words, is a growth industry.
The Sales Pitch
The sellers of all these colon scrubbers say periodic cleansing is crucial for the body's well-being. The general pitch goes as follows. We live in an age in which toxins easily accumulate in the body—the air we breathe is polluted and the food we eat is laden with pesticides and other harmful chemicals. Our bodies, unequipped to deal with all these poisons, fall behind in eliminating them, and we end up sick.
Furthermore, as one company puts it, certain foods "tend to stick and putrefy in the folds and pockets of the intestines. When your colon isn't eliminating wastes properly, toxins are reabsorbed into the blood, poisoning the entire system and weakening your other eliminative organs." More succinctly stated, "the colon walls are encrusted with stagnant waste."
Misleading Information
Don't believe it, say the experts.
"Things don't crust over" in your colon, says Robert Russell, MD, a gastroenterologist at the Jean Mayer Human Nutrition Research Center on Aging at Tufts University in Boston. "The business about putrefaction is all baloney. There are not pieces of food hanging around in there getting old."
In other words, you don't need a $20-to-$30 product to help nature do its job. The body is perfectly capable of eliminating toxins in a timely, efficient manner. Consider that the cells of your gastrointestinal tract turn over every three days—fast enough so that there's no "crust," or "putrefying" food in your colon. Also, bacteria in the colon naturally metabolize and thereby detoxify food wastes. And mucous membranes lining the intestinal wall block unwanted substances from entering the body's other tissues. The liver works to neutralize toxins as well.
Granted, Dr. Russell says, people do get constipated. "And that makes you uncomfortable," he points out. "But there has never been any indication that there's a higher incidence of colon cancer or any other dreaded disease in constipated people."
"Normal" Bowel Movements are Variable
No matter. In typical quack-like fashion, sellers of intestinal cleansers make consumers their own diagnosticians and tell them signs to look for to determine that their bodies are not up to snuff and need outside agents to, er, get things going. One of these signs is having fewer than two to three bowel movements a day. But that has nothing to do with whether you require a laxative or other cathartic agent. The number of bowel movements considered healthy over a given period of time differs from person to person. It can be anywhere from a few times a day to a few times a week, Dr. Russell notes. Only when your typical pattern changes might something be wrong, and even then it's often just a passing virus or other bug.
Not Useful for Weight Loss
Some companies imply that increasing the number of bowel movements will prevent absorption of enough calories to allow you to shed excess pounds, but that, too, is not true. Just about all calories are absorbed well before food makes its way to the colon, rendering any weight-loss claims for cleansers bogus.
Don't be Tricked by Vague-Sounding Symptoms
Most symptoms of an "inefficient" colon listed by purveyors of internal cleansers are actually much more vague than the one that requires bowel movement counts. In fact, they're vague enough and broad enough to cover virtually every single human being, at least at one time or another.
One company, for instance, says the signals that toxins are building up in your system are that "you may feel sluggish or bloated or you may experience 'brain fog.' You may wake up feeling tired and 'blue.' You may have a case of the 'blahs' that's hard to shake." Among the "13 common symptoms of toxicity" listed by another company: headaches, depression, poor memory, low energy, weight gain, and—I kid you not—"illnesses."
Just as the symptoms of a supposedly poisoned digestive system are, on the whole, vague, so, too are the signs of renewed well-being once a cleanser is taken. "With your body free of harmful toxins, you will feel younger, better, healthier, and happier!" one company says. Another promises that "when the colon is kept clean, disease in the body is very rare." Still other companies make claims of improved mental alertness and increased energy.
Potentially Harmful Side Effects
And they tell you not to worry if taking the cleanser makes you feel sick because that's a sign that the product is working. According to one pamphlet, gas and other gastrointestinal discomfort along with flu-like symptoms such as sneezing and a runny nose are "temporary, positive signs that you body is working to rid itself of the toxin build-up." Literature for another product says, "Do not be alarmed if you pass strings of mucus...for a couple of weeks as this is a good sign that you are detoxifying." Promotional material for yet another tells patrons to "just relax and appreciate your body's cleansing process if you develop any of the following; headaches, bad breath or body odor, dizziness, irritability, skin eruptions...or low energy."
But do not relax. Dizziness could be a sign that you're becoming dehydrated. And strings of mucus—the intestine's response to stimulation—mean the body views the cleanser as a toxin and is trying to get rid of it.
The idea of having to feel worse before you feel better is particularly dangerous in light of the fact that feeling bad is very possibly a sign that a cleanser is disagreeing with you in a serious way. Consider a U.S. Food and Drug Administration report that linked kidney problems and progressive muscle weakness to a cleansing formula that contained herbs and fiber. In another FDA report, a body cleanser that contained clay, cascara, and comfrey was associated with diarrhea, abdominal pain, and vomiting up blood. A woman even ended up in the emergency room with life-threatening heart problems after ingesting an herbal cleansing regimen with tainted ingredients. (Unlike drugs, cleansers do not have to meet standards for quality and purity.)
Traditional Advice Still the Best
Here's a better bet than going through extraordinary means to "flush" your colon:
Drink plenty of fluids.
Eat plenty of high-fiber fruits, vegetables, beans, and whole grains.
Get plenty of exercise.
Let nature take its course. Your colon knows how to do its business.
Women, Men, and Medicine: We're Not Equal
by Karen Cuozzo
http://www.beliefnet.com/healthandheali ... mc_id=NL44
Men may be from Mars and women from Venus, but medically speaking, are the sexes really all that different? The answer, according to researchers in the field of gender-based biology, is a resounding yes. Here are their findings:
Women are two times more likely than men to contract a sexually transmitted disease.
Women are two to three times more likely than men to suffer from depression.
80% of the people affected by osteoporosis are women.
Women who smoke are up to 70% more likely to develop lung cancer than male smokers.
Women are more likely than men to suffer a second heart attack within a year of the first attack.
Women wake up faster from anesthesia than men.
Three out of four people who suffer from an autoimmune disease (such as rheumatoid arthritis, lupus, and multiple sclerosis) are women.
Pain medications and other drugs can react differently in women and men.
What Is Gender-based Biology?
Gender-based biology is the field of study that looks at the biological and physiological differences between the sexes. Researchers are looking past the basic XY/XX chromosomal difference that makes a man a man and a woman a woman and are finding variations at the system, organ, tissue, and cellular levels.
Phyllis Greenberger, executive director of the Society for the Advancement of Women's Health Research, comments, "The findings from gender-based biology have the potential to revolutionize the way we understand health and disease for both men and women. The differences extend beyond the obvious to areas such as the reaction to specific drugs, how men and women respond to the same disease, or metabolize the same compounds. The more scientists look for such differences, the more they find, and the more they recognize how important those differences are."
The Male Model of Research
Traditionally, medical research has been conducted using a male model as the basis for clinical studies. Citing concerns of potential harm to unborn children and to reproductive capacity, the FDA has always banned women of childbearing age from participating in safety tests of new drugs. This exclusion became common practice among scientists who claimed that a woman's fluctuating monthly cycle would interfere with their research.
The findings of their studies, nonetheless, were applied across gender, and healthcare providers assumed a one-size-fits all approach in treating both male and female patients. There also was a general inclination to think of a woman's well being in terms of reproductive health. Symptoms of other illnesses were ignored or attributed to hormones, and women often were told that such symptoms were "all in their head."
The Beginnings of Change
Over time, though, scientists began to accumulate evidence indicating that illness and disease may not affect both sexes similarly and that findings obtained from studies based on men may not always apply to women. However, due to the lack of clinical studies involving women, these claims were difficult to substantiate. Washington responded by developing guidelines for the inclusion of women in federally funded clinical studies and in 1990 established the Office of Research on Women's Health (ORWH) at the National Institutes of Health (NIH).
Specifically, the ORWH was charged with the following:
Eliminating gaps in knowledge by determining an appropriate research agenda for women's health.
Ensuring that, regardless of cost, women are represented in NIH clinical studies.
Increasing the number of women in biomedical research careers.
What We're Learning
Although current research efforts in gender-based biology focus primarily on identifying differences, scientists are beginning to find possible biological and physiological explanations. Here are some examples:
Women are more likely than men to suffer from depression due to a lower rate of serotonin synthesis in the brain.
Women produce less of the enzyme that breaks down alcohol in the stomach, which may explain why, on consuming equal amounts of alcohol, they have a higher blood alcohol level than their male counterparts.
Language centers are positioned in different areas of the male and female brain, suggesting a possible answer as to why women suffer less aphasia than men following a stroke.
A Word of Caution
But Greenberger cautions, "We have more questions than answers right now. It would be premature to expect a physician, who, for example, is treating depression, to say that since we know that serotonin synthesis is affected by a woman's cycle, we know that she should receive only a half dose of medication during the luteal phase. More research, in the form of clinical trials, is needed before we can translate what we now know into treatment." She adds that women should share any information they find with their doctors and discuss options.
Putting New Information to Work
The good news is that researchers have made significant progress in understanding cardiovascular disease—the number one killer of both men and women. For example, we now know that of all heart attack victims under the age of 50, women are twice as likely as men to die from the attack.
Studies suggest that this may occur because women are
less likely to take medications or aspirin to prevent heart attacks;
slower to seek treatment at the onset of an attack; and
less likely to receive critical diagnostic procedures, such as angiography or cardiac catheterization, once at the hospital.
Scientists also are discovering some things about women that may help to counter this trend.
Symptoms
Women do not always exhibit the classic male symptoms of a heart attack—severe squeezing pain and uncomfortable pressure or fullness in the center of the chest. Rather, women may experience silent symptoms: shortness of breath, fatigue, discomfort, nausea, dizziness, or pain in unlikely places such as the jaw. Since these symptoms have long been associated with illnesses other than heart disease many physicians may not recognize them as such. Therefore, a woman who suspects otherwise would be right to ask for a full cardiac work-up if she presents with these symptoms and is told that she has indigestion.
Testing
Similarly, we now know that the exercise stress test—long considered the gold standard in diagnostic evaluation—can produce a high rate of false positive results in women. The echo stress test is now recognized as a more precise tool for evaluating the female heart.
Medication
The drug Integrelin, which is used to treat unstable angina, is more effective in women than in men, and women metabolize the drug propranolol (used to treat cardiac arrhythmias) slower than men.
Drugs in the Prozac family, selective serotonin reuptake inhibitors (SSRIs), rise to higher blood levels in women than in men.
The anti-inflammatory drug ibuprofen is less effective in women than in men.
Use of oral contraceptives may affect the action of many other drugs.
Looking Ahead
For the future, Greenberger looks for scientists to continue identifying gender differences and learning how and why they occur. Encouraged by the efforts of the ORWH, she expects greater participation of women in healthcare and medical research, which will add a much-needed second perspective to clinical studies. Lastly, Greenberger hopes that gender-based biology will be seen not only in terms of women's health, but also as a means for better understanding the mechanisms of disease in both sexes. And this, she feels, will help us move beyond health by the books toward health according to our sex.
RESOURCES:
American Medical Women's Association
http://www.amwa-doc.org
Hales D. Just Like a Woman: How Gender Science Is Redefining What Makes Us Female. Bantam Books; 1999.
Office of Research on Women's Health
http://www4.od.nih.gov/orwh
Smith J. Women and Doctors: A Physician's Explosive Account of Women's Medical Treatment--and Mistreatment--in America Today and What You Can Do About It. The Atlantic Monthly Press; 1992.
Society for Women's Health Research
http://www.womenshealthresearch.org
by Karen Cuozzo
http://www.beliefnet.com/healthandheali ... mc_id=NL44
Men may be from Mars and women from Venus, but medically speaking, are the sexes really all that different? The answer, according to researchers in the field of gender-based biology, is a resounding yes. Here are their findings:
Women are two times more likely than men to contract a sexually transmitted disease.
Women are two to three times more likely than men to suffer from depression.
80% of the people affected by osteoporosis are women.
Women who smoke are up to 70% more likely to develop lung cancer than male smokers.
Women are more likely than men to suffer a second heart attack within a year of the first attack.
Women wake up faster from anesthesia than men.
Three out of four people who suffer from an autoimmune disease (such as rheumatoid arthritis, lupus, and multiple sclerosis) are women.
Pain medications and other drugs can react differently in women and men.
What Is Gender-based Biology?
Gender-based biology is the field of study that looks at the biological and physiological differences between the sexes. Researchers are looking past the basic XY/XX chromosomal difference that makes a man a man and a woman a woman and are finding variations at the system, organ, tissue, and cellular levels.
Phyllis Greenberger, executive director of the Society for the Advancement of Women's Health Research, comments, "The findings from gender-based biology have the potential to revolutionize the way we understand health and disease for both men and women. The differences extend beyond the obvious to areas such as the reaction to specific drugs, how men and women respond to the same disease, or metabolize the same compounds. The more scientists look for such differences, the more they find, and the more they recognize how important those differences are."
The Male Model of Research
Traditionally, medical research has been conducted using a male model as the basis for clinical studies. Citing concerns of potential harm to unborn children and to reproductive capacity, the FDA has always banned women of childbearing age from participating in safety tests of new drugs. This exclusion became common practice among scientists who claimed that a woman's fluctuating monthly cycle would interfere with their research.
The findings of their studies, nonetheless, were applied across gender, and healthcare providers assumed a one-size-fits all approach in treating both male and female patients. There also was a general inclination to think of a woman's well being in terms of reproductive health. Symptoms of other illnesses were ignored or attributed to hormones, and women often were told that such symptoms were "all in their head."
The Beginnings of Change
Over time, though, scientists began to accumulate evidence indicating that illness and disease may not affect both sexes similarly and that findings obtained from studies based on men may not always apply to women. However, due to the lack of clinical studies involving women, these claims were difficult to substantiate. Washington responded by developing guidelines for the inclusion of women in federally funded clinical studies and in 1990 established the Office of Research on Women's Health (ORWH) at the National Institutes of Health (NIH).
Specifically, the ORWH was charged with the following:
Eliminating gaps in knowledge by determining an appropriate research agenda for women's health.
Ensuring that, regardless of cost, women are represented in NIH clinical studies.
Increasing the number of women in biomedical research careers.
What We're Learning
Although current research efforts in gender-based biology focus primarily on identifying differences, scientists are beginning to find possible biological and physiological explanations. Here are some examples:
Women are more likely than men to suffer from depression due to a lower rate of serotonin synthesis in the brain.
Women produce less of the enzyme that breaks down alcohol in the stomach, which may explain why, on consuming equal amounts of alcohol, they have a higher blood alcohol level than their male counterparts.
Language centers are positioned in different areas of the male and female brain, suggesting a possible answer as to why women suffer less aphasia than men following a stroke.
A Word of Caution
But Greenberger cautions, "We have more questions than answers right now. It would be premature to expect a physician, who, for example, is treating depression, to say that since we know that serotonin synthesis is affected by a woman's cycle, we know that she should receive only a half dose of medication during the luteal phase. More research, in the form of clinical trials, is needed before we can translate what we now know into treatment." She adds that women should share any information they find with their doctors and discuss options.
Putting New Information to Work
The good news is that researchers have made significant progress in understanding cardiovascular disease—the number one killer of both men and women. For example, we now know that of all heart attack victims under the age of 50, women are twice as likely as men to die from the attack.
Studies suggest that this may occur because women are
less likely to take medications or aspirin to prevent heart attacks;
slower to seek treatment at the onset of an attack; and
less likely to receive critical diagnostic procedures, such as angiography or cardiac catheterization, once at the hospital.
Scientists also are discovering some things about women that may help to counter this trend.
Symptoms
Women do not always exhibit the classic male symptoms of a heart attack—severe squeezing pain and uncomfortable pressure or fullness in the center of the chest. Rather, women may experience silent symptoms: shortness of breath, fatigue, discomfort, nausea, dizziness, or pain in unlikely places such as the jaw. Since these symptoms have long been associated with illnesses other than heart disease many physicians may not recognize them as such. Therefore, a woman who suspects otherwise would be right to ask for a full cardiac work-up if she presents with these symptoms and is told that she has indigestion.
Testing
Similarly, we now know that the exercise stress test—long considered the gold standard in diagnostic evaluation—can produce a high rate of false positive results in women. The echo stress test is now recognized as a more precise tool for evaluating the female heart.
Medication
The drug Integrelin, which is used to treat unstable angina, is more effective in women than in men, and women metabolize the drug propranolol (used to treat cardiac arrhythmias) slower than men.
Drugs in the Prozac family, selective serotonin reuptake inhibitors (SSRIs), rise to higher blood levels in women than in men.
The anti-inflammatory drug ibuprofen is less effective in women than in men.
Use of oral contraceptives may affect the action of many other drugs.
Looking Ahead
For the future, Greenberger looks for scientists to continue identifying gender differences and learning how and why they occur. Encouraged by the efforts of the ORWH, she expects greater participation of women in healthcare and medical research, which will add a much-needed second perspective to clinical studies. Lastly, Greenberger hopes that gender-based biology will be seen not only in terms of women's health, but also as a means for better understanding the mechanisms of disease in both sexes. And this, she feels, will help us move beyond health by the books toward health according to our sex.
RESOURCES:
American Medical Women's Association
http://www.amwa-doc.org
Hales D. Just Like a Woman: How Gender Science Is Redefining What Makes Us Female. Bantam Books; 1999.
Office of Research on Women's Health
http://www4.od.nih.gov/orwh
Smith J. Women and Doctors: A Physician's Explosive Account of Women's Medical Treatment--and Mistreatment--in America Today and What You Can Do About It. The Atlantic Monthly Press; 1992.
Society for Women's Health Research
http://www.womenshealthresearch.org
Male Versus Female Intelligence: Does Gender Matter?
by Alice A McCarthy, MBA
“In the special case of science and engineering, there are issues of intrinsic aptitude [between the sexes].” With these words in January 2005, Harvard University President Lawrence Summers lent new fuel to the contentious debate over whether gender predicts differing aptitude or intelligence in specific areas. But while the politics of gender-based differences rage, the science moves quietly forward to discover the influences on many areas of human health and function, including the study of intelligence, aptitude, and skill.
Brain Biology Differs
While few people would seriously argue that one sex is more intelligent, researchers have found that the brains of men and women do differ physically.
Brain size: Men have larger brains than women by about 8% to10%.
Corpus callosum size: Many researchers believe that a woman's brain has a larger corpus callosum, which is the pathway connecting the right and left cerebral hemispheres. Some researchers claim this larger size enables women to process information more quickly than men between the two sides of the brain.
Cortical thickness and density: Women’s brains possess more folding. Some researchers speculate this is why women’s brains are smaller overall.
A recent study conducted by the University of California at Irvine among 48 men and women of comparable intelligence (as measured by intelligence testing) found that women had nine times more white matter in areas of the brain associated with intelligence than men did, while men had six times more gray matter in these areas. Gray matter is involved in the brain’s information-processing centers, while white matter is in the business of transferring information between parts of the brain.
Not only does the type of brain tissue appear to differ between the sexes, but its location differs as well. The study found that women had about 85% of their IQ-related brain matter—both white and gray—located in the brain's frontal lobes. Comparatively, nearly all of the IQ-related gray matter in men is distributed equally between the frontal lobes and the parietal lobes. But since the men and women achieved similar IQ test results, researchers concluded that the different types of brain architecture lead to comparable intellectual performance. In short, men and women take different paths to reach the same intellectual threshold.
But just when you think you’re born with all the innate ability you’ll ever have, regardless of gender, researchers point out that there is some evidence that the volume of the brain's gray matter can increase with learning, and therefore may be influenced by other factors aside from biology.
Sex hormones, such as testosterone and estrogen, appear to have a role in brain development and function. Researchers have some evidence that sex hormones alter the development of certain brain structures during puberty and that these effects persist into adulthood. For example, if a fetus is exposed to testosterone early in development, the right hemisphere develops more intensively. Hence, the reason why men are sometimes referred to as "right-brained."
Researchers have also found that cognitive abilities in one individual can change along with hormonal fluctuations. This has been documented throughout the menstrual cycle for a woman, and even daily and seasonally in men as testosterone levels change. And the gender differences in the brain may literally be hard-wired from the beginning in our genes. Studies in mice embryos have shown a subset of 50 genes to be differentially active in the brains of males and females even before the sex organs develop. Brain researchers suspect that more than 70 genes contribute to human intelligence though no one knows of any gender differences in the activity of these genes.
IQ and SAT Scores
Many studies consistently show that the average IQ scores of men and women are equivalent. Although most of the common tests, such as the Wechsler Adult Intelligence Scale (WAIS), are intentionally designed to weed out a sex bias, some gender-specific findings persist.
Men tend to perform better on spatial questions.
Women outpace men on reading and other verbal skills.
Men score more at the extremes of IQ scoring—both high and low. More men than women test at the lower end of the IQ scale, and also at the very top. This is consistent with the membership of American Mensa, Ltd, a society whose members test in the top 2% of the population on a standard IQ test. The group reports that 65% of its general membership is male, and 35% female. Yet the Association for Women in Mathematics claims that women earn half of all undergraduate mathematics degrees and one-third of PhD degrees in math.
Similarly, men consistently outscore women by an average of 35 points on the math portion of the college SAT test. Interestingly, some studies show that boys and girls test about the same in math in elementary school. The girls fall behind only later in life, so that by the time senior year in high school arrives, the boys test higher on the SAT. Researchers continue to study whether these findings—and those like it—are the result of gender differences, environmental influences, social pressures, personal beliefs and values, or a combination of all and more.
RESOURCES:
Brain Basics: Know Your Brain
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/
International High IQ Society
http://www.highiqsociety.org/
Mensa International
http://www.mensa.org/
Sources:
Benbow CP et al. (2000). Sex differences in mathematical reasoning ability: Their status 20 years later. Psychological Science. 2000;11:474–480.
Fingelkurts AA et al. Exploring Giftedness. Advances in Psychology Research, Vol.9. Nova Science Publishers. 2002:1377–155.
Haier RJ, et al. Structural brain variation and general intelligence. NeuroImage. 2004;23:425–433.
Haier RJ, et al. The neuroanatomy of general intelligence: sex matters. Neuroimage. 2005;25:320–327.
Leahey E. Gender Differences in Mathematical Trajectories. Social Forces. 2001;80:713–732.
Luders E et al. Gender differences in cortical complexity. Nat. Neurosci. 2000;7:799–800.
Morley KI, Montgomery GW. The genetics of cognitive processes: candidate genes in humans and animals. Behav. Genet. 2001;31:511–531.
Remarks at NBER Conference on Diversifying the Science and Engineering Workforce. Lawrence H Summers, Cambridge, MA, January 15, 2005. Available at: http://www.president.harvard.edu/speech ... /nber.html.
Toga AW, Thompson PM. Genetics of Brain Structure and Intelligence. Annu. Rev. Neurosci. 2005;28:1–23.
by Alice A McCarthy, MBA
“In the special case of science and engineering, there are issues of intrinsic aptitude [between the sexes].” With these words in January 2005, Harvard University President Lawrence Summers lent new fuel to the contentious debate over whether gender predicts differing aptitude or intelligence in specific areas. But while the politics of gender-based differences rage, the science moves quietly forward to discover the influences on many areas of human health and function, including the study of intelligence, aptitude, and skill.
Brain Biology Differs
While few people would seriously argue that one sex is more intelligent, researchers have found that the brains of men and women do differ physically.
Brain size: Men have larger brains than women by about 8% to10%.
Corpus callosum size: Many researchers believe that a woman's brain has a larger corpus callosum, which is the pathway connecting the right and left cerebral hemispheres. Some researchers claim this larger size enables women to process information more quickly than men between the two sides of the brain.
Cortical thickness and density: Women’s brains possess more folding. Some researchers speculate this is why women’s brains are smaller overall.
A recent study conducted by the University of California at Irvine among 48 men and women of comparable intelligence (as measured by intelligence testing) found that women had nine times more white matter in areas of the brain associated with intelligence than men did, while men had six times more gray matter in these areas. Gray matter is involved in the brain’s information-processing centers, while white matter is in the business of transferring information between parts of the brain.
Not only does the type of brain tissue appear to differ between the sexes, but its location differs as well. The study found that women had about 85% of their IQ-related brain matter—both white and gray—located in the brain's frontal lobes. Comparatively, nearly all of the IQ-related gray matter in men is distributed equally between the frontal lobes and the parietal lobes. But since the men and women achieved similar IQ test results, researchers concluded that the different types of brain architecture lead to comparable intellectual performance. In short, men and women take different paths to reach the same intellectual threshold.
But just when you think you’re born with all the innate ability you’ll ever have, regardless of gender, researchers point out that there is some evidence that the volume of the brain's gray matter can increase with learning, and therefore may be influenced by other factors aside from biology.
Sex hormones, such as testosterone and estrogen, appear to have a role in brain development and function. Researchers have some evidence that sex hormones alter the development of certain brain structures during puberty and that these effects persist into adulthood. For example, if a fetus is exposed to testosterone early in development, the right hemisphere develops more intensively. Hence, the reason why men are sometimes referred to as "right-brained."
Researchers have also found that cognitive abilities in one individual can change along with hormonal fluctuations. This has been documented throughout the menstrual cycle for a woman, and even daily and seasonally in men as testosterone levels change. And the gender differences in the brain may literally be hard-wired from the beginning in our genes. Studies in mice embryos have shown a subset of 50 genes to be differentially active in the brains of males and females even before the sex organs develop. Brain researchers suspect that more than 70 genes contribute to human intelligence though no one knows of any gender differences in the activity of these genes.
IQ and SAT Scores
Many studies consistently show that the average IQ scores of men and women are equivalent. Although most of the common tests, such as the Wechsler Adult Intelligence Scale (WAIS), are intentionally designed to weed out a sex bias, some gender-specific findings persist.
Men tend to perform better on spatial questions.
Women outpace men on reading and other verbal skills.
Men score more at the extremes of IQ scoring—both high and low. More men than women test at the lower end of the IQ scale, and also at the very top. This is consistent with the membership of American Mensa, Ltd, a society whose members test in the top 2% of the population on a standard IQ test. The group reports that 65% of its general membership is male, and 35% female. Yet the Association for Women in Mathematics claims that women earn half of all undergraduate mathematics degrees and one-third of PhD degrees in math.
Similarly, men consistently outscore women by an average of 35 points on the math portion of the college SAT test. Interestingly, some studies show that boys and girls test about the same in math in elementary school. The girls fall behind only later in life, so that by the time senior year in high school arrives, the boys test higher on the SAT. Researchers continue to study whether these findings—and those like it—are the result of gender differences, environmental influences, social pressures, personal beliefs and values, or a combination of all and more.
RESOURCES:
Brain Basics: Know Your Brain
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/
International High IQ Society
http://www.highiqsociety.org/
Mensa International
http://www.mensa.org/
Sources:
Benbow CP et al. (2000). Sex differences in mathematical reasoning ability: Their status 20 years later. Psychological Science. 2000;11:474–480.
Fingelkurts AA et al. Exploring Giftedness. Advances in Psychology Research, Vol.9. Nova Science Publishers. 2002:1377–155.
Haier RJ, et al. Structural brain variation and general intelligence. NeuroImage. 2004;23:425–433.
Haier RJ, et al. The neuroanatomy of general intelligence: sex matters. Neuroimage. 2005;25:320–327.
Leahey E. Gender Differences in Mathematical Trajectories. Social Forces. 2001;80:713–732.
Luders E et al. Gender differences in cortical complexity. Nat. Neurosci. 2000;7:799–800.
Morley KI, Montgomery GW. The genetics of cognitive processes: candidate genes in humans and animals. Behav. Genet. 2001;31:511–531.
Remarks at NBER Conference on Diversifying the Science and Engineering Workforce. Lawrence H Summers, Cambridge, MA, January 15, 2005. Available at: http://www.president.harvard.edu/speech ... /nber.html.
Toga AW, Thompson PM. Genetics of Brain Structure and Intelligence. Annu. Rev. Neurosci. 2005;28:1–23.
Simple Pantry Solutions: Ginger
by Laurie LaRusso, MS, ELS
Sometimes all the medicine we need is right there in the kitchen or pantry. From cooking and cleaning to fighting infection, the kitchen has something that can help.
The Medicine in Ginger
Ginger tea, gingerbread, sesame ginger chicken... The list of tasty ginger favorites is endless, but in addition to spicing up your cooking, ginger may help when you're not feeling so well. Although ginger has a long history as a home remedy, researchers have yet to identify its active ingredients and determine exactly how it works.
Healthy Uses for Ginger
Medical research suggests that ginger may help relieve the nausea and vomiting associated with motion sickness, pregnancy, and surgery. Ginger is approved by Germany's Commission E—a governmental agency that evaluates the safety and efficacy of medicinal herbs—for the treatment of indigestion and motion sickness.
Additionally, some herbalists prescribe ginger to relieve cold and flu symptoms, migraine headaches, the inflammation of rheumatoid arthritis, sore throat, minor burns, cramping, and bloating. At this time, there is little scientific evidence to support these uses of ginger, but that should not be taken to mean there is conclusive evidence refuting ginger's effectiveness. It is not unusual for research on herbs to yield contradictory results, due in part to the fact that herbs are available in such a wide range of formulations, purities, and concentrations.
How Much and What Kind to Take
Ginger can be taken in the following forms:
Fresh ginger root chopped or sliced (often used in cooking or served raw with sushi)
Ginger tea
Dried, powdered ginger root or fresh ginger root combined with boiled water (a decoction or infusion)
Tincture (an alcoholic extraction of the herb)
Capsules
To prevent motion sickness it is probably best to take one gram two to four times per day in capsule form before embarking and continuing every day while away.
Precautions when Using Ginger Medicinally
Ginger is a common cooking spice that is unlikely to cause any ill effects. However, for pregnant and nursing women, young children, and people with liver and kidney disease, the safety of taking ginger medicinally has not yet been established. In addition, ginger can reduce the ability of blood to clot. If you are pregnant, undergoing surgery, taking blood-thinning medication, or have a chronic illness, ginger obtained through food is considered safe. However, talk to your doctor before taking ginger medicinally.
Resources:
The Alternative Medicine Foundation
http://www.amfoundation.org
U.S. National Institutes of Health
http://www.nih.gov
U.S. National Library of Medicine
http://www.nlm.nih.gov
Sources:
The American Pharmaceutical Association Practical Guide to Natural Medicines, 1999.
Complementary Therapies: Natural Health Encyclopedia, 2001.
by Laurie LaRusso, MS, ELS
Sometimes all the medicine we need is right there in the kitchen or pantry. From cooking and cleaning to fighting infection, the kitchen has something that can help.
The Medicine in Ginger
Ginger tea, gingerbread, sesame ginger chicken... The list of tasty ginger favorites is endless, but in addition to spicing up your cooking, ginger may help when you're not feeling so well. Although ginger has a long history as a home remedy, researchers have yet to identify its active ingredients and determine exactly how it works.
Healthy Uses for Ginger
Medical research suggests that ginger may help relieve the nausea and vomiting associated with motion sickness, pregnancy, and surgery. Ginger is approved by Germany's Commission E—a governmental agency that evaluates the safety and efficacy of medicinal herbs—for the treatment of indigestion and motion sickness.
Additionally, some herbalists prescribe ginger to relieve cold and flu symptoms, migraine headaches, the inflammation of rheumatoid arthritis, sore throat, minor burns, cramping, and bloating. At this time, there is little scientific evidence to support these uses of ginger, but that should not be taken to mean there is conclusive evidence refuting ginger's effectiveness. It is not unusual for research on herbs to yield contradictory results, due in part to the fact that herbs are available in such a wide range of formulations, purities, and concentrations.
How Much and What Kind to Take
Ginger can be taken in the following forms:
Fresh ginger root chopped or sliced (often used in cooking or served raw with sushi)
Ginger tea
Dried, powdered ginger root or fresh ginger root combined with boiled water (a decoction or infusion)
Tincture (an alcoholic extraction of the herb)
Capsules
To prevent motion sickness it is probably best to take one gram two to four times per day in capsule form before embarking and continuing every day while away.
Precautions when Using Ginger Medicinally
Ginger is a common cooking spice that is unlikely to cause any ill effects. However, for pregnant and nursing women, young children, and people with liver and kidney disease, the safety of taking ginger medicinally has not yet been established. In addition, ginger can reduce the ability of blood to clot. If you are pregnant, undergoing surgery, taking blood-thinning medication, or have a chronic illness, ginger obtained through food is considered safe. However, talk to your doctor before taking ginger medicinally.
Resources:
The Alternative Medicine Foundation
http://www.amfoundation.org
U.S. National Institutes of Health
http://www.nih.gov
U.S. National Library of Medicine
http://www.nlm.nih.gov
Sources:
The American Pharmaceutical Association Practical Guide to Natural Medicines, 1999.
Complementary Therapies: Natural Health Encyclopedia, 2001.
The Dangers of Blood Clots: Thrombophlebitis
by Rick Alan
Some forms of thrombophlebitis can have no symptoms, yet this condition can be deadly. Many people are unaware they have it. Here's what you should know about this condition that generally occurs in people over the age of 40.
Let's start by breaking down this imposing word, thrombophlebitis:
Phlebitis is inflammation of a vein or veins.
Thrombosis is the formation of a blood clot or clots in the veins.
Clotting and inflammation in the veins can damage them permanently. And a clot that breaks loose from the wall of the vein and flows through the veins to the lungs (called pulmonary embolism) can be deadly.
Thrombophlebitis, which is generally found in the legs, occurs in two forms—superficial vein thrombosis (SVT) and deep vein thrombosis (DVT). Superficial veins are close to the skin (surface veins) and deep veins are embedded in the muscles.
Superficial Vein Thrombosis
Superficial vein thrombophlebitis is an inflammation of the surface veins, and almost always occurs in the legs. Usually this inflammation is accompanied by tiny blood clots that cling to the interior lining of the veins. Though often painful, SVT itself generally presents no serious medical danger, but it may be a sign that a person has DVT elsewhere in the leg.
Below are some SVT symptoms:
A vein that is visible through the skin and feels hard and painful to the touch.
Redness, tenderness, and pain on the skin of the affected area.
A sensation of throbbing or burning just below the surface of the skin.
A pain or heavy feeling when lowering your leg.
The factors causing SVT can be numerous:
A blow, fracture, or other injury to the leg.
Prolonged bed rest, especially after surgery (which causes the blood to "pool" in the legs).
Varicose veins
Prolonged inactivity such as sitting in one position for extended periods of time (as on long car, train, or plane trips).
Smoking
Vein injuries caused by injections or intravenous needles.
Pregnancy
Obesity
Cancer
SVT can be treated with anti-inflammatory medication such as ibuprofen or aspirin usually taken for five to seven days, application of hot, moist compresses (20 minutes on, 20 minutes off), and elevation of the affected limb above the level of the heart until the pain and swelling dissipate. In addition, moving the legs is very important. People with a history of DVT or other vein thrombosis may need to take anticoagulant drugs (i.e., Heparin).
"Although thrombophlebitis isolated to the superficial veins is not dangerous, occasionally it can migrate to the deep veins," explains Dr. Cameron Akbari, co-director of Non-Invasive Vascular Medicine at Boston's Beth Israel Deaconess Medical Center. "That can cause a pulmonary embolus, which can be fatal. The risk of pulmonary embolus can be as high as 10% with SVT." Accordingly, patients with signs and symptoms of SVT should seek medical advice to see whether other treatment is necessary.
Deep Vein Thrombosis
Deep vein thrombosis occurs when a large blood clot forms in the deep veins of the leg. But Dr. Akbari points out, "Unfortunately, only 40-50% of patients have obvious signs and symptoms of DVT. When they do occur, the usual symptoms are pain and/or swelling in the calf or thigh area, usually isolated to one leg."
The factors that generally cause DVT can include the same factors that cause SVT, but DVT often presents with no symptoms and it can be life threatening. A deep vein blood clot always poses the risk of breaking free from the lining of the blood vessel in which it forms, and then traveling through the circulatory system as an embolus or embolism. If the embolism lodges in the lungs, the result can be fatal.
When multiple risk factors for DVT are present and if DVT is suspected—either due to the symptoms listed above or in the absence of symptoms—your doctor will almost certainly order an ultrasound to confirm the diagnosis.
If a deep vein blood clot is found (or if not found but is strongly suspected), quick and decisive treatment is necessary. The treatment consists of the following:
Anticoagulation--thinning of the blood, and thus, the blood clot with anticoagulation medication (such as Heparin), followed by three or six months of an oral anticoagulation medication such as Coumadin.
Compression treatment--wearing tight fitting elastic stockings or pneumatic stockings (electrically pumping stockings) to help blood flow. These are usually prescribed several days to weeks after beginning anticoagulation treatment.
Hospitalization--to monitor the patient's condition (and to be able to administer emergency treatment if necessary) until the anticoagulant medication begins working. In some cases, patients can be safely treated on an outpatient basis if they are closely monitored by their physicians. In such cases, anticoagulation treatment begins at home, first with self-injections, followed by oral medication.
Filter--if blood thinning treatment is not possible or complications arise in spite of anticoagulation medication, a filter may be surgically placed in the main abdominal vein (the vena cava) to prevent an embolus from reaching the lungs.
Surgery--in certain extreme situations, surgery may be needed to remove the clot and partially interrupt the vena cava.
Prevention
Although SVT and DVT tend to affect people age 40 and older, all adults should take certain measures to avoid developing these conditions. These preventive measures include the following:
Avoiding sitting in one position for long periods of time.
Moving your legs (standing and walking around for five minutes) every hour or two when traveling.
Not smoking, especially, if you're a woman who takes birth control pills or estrogen.
Not wearing tight stockings or hosiery that restricts blood flow.
Staying physically fit.
Maintaining your proper weight.
If confined to a bed, moving legs as much as possible to prevent blood from pooling in the veins.
If you are at high risk for SVT or DVT, other preventive measures such as long-term anticoagulation medicine may be prescribed by your physician.
There is some evidence that use of the supplement Pycnogenol (alone or combined with natto, made from soy) prior to a long plane flight might reduce the risk of developing DVT.
In addition, anytime you undergo major surgery there is a risk that a DVT will develop during or following surgery. If you are scheduled to undergo major surgery, consult with both your surgeon and anesthetist beforehand to make certain they take proper precautions, including the wearing of compression stockings and/or administering anticoagulation medication during and following surgery.
Finally, if you experience any of the symptoms of SVT or DVT (or if you develop varicose veins), consult with your physician immediately.
RESOURCES:
Belcaro G, Cesarone MR, Rohdewald P, et al. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol(r). Clin Appl Thromb Hemost. 2004;10:373-7.
Cesarone MR, Belcaro G, Nicolaides AN, et al. Prevention of venous thrombosis in long-haul flights with Flite Tabs: the LONFLIT-FLITE randomized, controlled trial. Angiology. 2003;54:531-9.
Phlebitis and thrombosis. Vein Disorders Center website. Available at: http://www.veincenter.com/phlebitis.html.
****
In His Own Words: Living With Obsessive-compulsive Disorder
As told to Debra Wood, RN
Robert is a 69-year-old stockbroker. Although he first felt something was wrong in kindergarten, he wasn’t diagnosed with obsessive-compulsive disorder until 1969. He has not let obsessive thoughts control his life. He has served in the military, married, raised two daughters, and has enjoyed a successful career. Here, he shares his frustrations with and triumphs over the disorder.
What was your first sign that something was wrong? What symptoms did you experience?
Back in 1937, I began to notice a necessity to repeat things. I kept saying over and over, “Now I’m five. Now I’m five.” At about 8 or 10, I started to do rituals and repetitive things and became fearful in social situations. The obsessive thoughts lead you to do rituals as an antidote to the anxiety they create. I didn’t want anyone to see me doing the rituals, so I didn’t want to be around people.
It was hard concentrating in school, because the obsessive thoughts kept grabbing my attention. I had to reread sentences in a book twice. I kept counting up and down. I knocked on every desk in the classroom. I kept thinking something dreadful was going to happen.
The first time I was terrorized by the thoughts was in 1940. I saw my grandmother and mother baking a chocolate cake, and they handed me a cake knife and said I could taste the chocolate. It was exquisite, but this intrusive, uncontrollable thought came into my mind, saying to pick up the knife and stab someone. I ran from the room and put my head between my brother’s and my bed, trying to make a vice that would keep the thought away. I never told my parents about my thoughts and rituals. I was afraid they would think I was crazy.
What was the diagnosis experience like?
When I was 37, I told my doctor about the thoughts. He suggested I see a psychiatrist, who gave me a test. All my symptoms were listed on it, even looking at a knife and wanting to hurt someone. He said I had a severe case of OCD.
What was your initial and then longer-term reaction to the diagnosis?
I thought it was great that millions of people had what I had. A lot of them never talk about it. I studied everything about OCD.
How is your disease treated? How do you manage your disease?
I’m on a small dose of antidepressant and antianxiety medications. With OCD, you can get depression and anxiety at the same time. I was diagnosed before there was behavior therapy. I developed my own behavior therapy and devised ways to stop doing rituals. For example, to ignore cracks in the sidewalk, I started to touch the crack with the tip of my shoe. Then I slowly moved my foot over the crack. One day I stamped on it, and it felt so good. I came up with an idea to use an obsession to fight an obsession. To stop checking if the lights were out, I repeated, “the lights are off” five times and refused to let myself go back to check.
The thoughts still go around. I call them the OC demons. There is no cure, but I don’t have to react and do the rituals. I have to work at it and have trained myself not to pay attention to the thoughts. I use humor. I change my thinking to something else, something beautiful. Spirituality helps. I’ve become more prayerful.
Did you have to make any lifestyle or dietary changes in response to your illness?
No.
Did you seek any type of emotional support?
A year and a half ago, I went to my first support group meeting. I thought I had accomplished a lot on my own, but the members made me see things I didn’t realize.
Did/does your condition have any impact on your family?
I didn’t get married until I was 40. I always wanted kids and decided my social fears were keeping me from finding a lovely person. She gave me two wonderful daughters. I still had a few rituals when we married and was taking medication. My wife comes to the support group, and last summer, we went to an OCD convention.
What advice would you give to anyone living with this disease?
OCD is not your fault. You are a good person who may get terrible thoughts. You can overcome the rituals. Fight it and never give up.
by Rick Alan
Some forms of thrombophlebitis can have no symptoms, yet this condition can be deadly. Many people are unaware they have it. Here's what you should know about this condition that generally occurs in people over the age of 40.
Let's start by breaking down this imposing word, thrombophlebitis:
Phlebitis is inflammation of a vein or veins.
Thrombosis is the formation of a blood clot or clots in the veins.
Clotting and inflammation in the veins can damage them permanently. And a clot that breaks loose from the wall of the vein and flows through the veins to the lungs (called pulmonary embolism) can be deadly.
Thrombophlebitis, which is generally found in the legs, occurs in two forms—superficial vein thrombosis (SVT) and deep vein thrombosis (DVT). Superficial veins are close to the skin (surface veins) and deep veins are embedded in the muscles.
Superficial Vein Thrombosis
Superficial vein thrombophlebitis is an inflammation of the surface veins, and almost always occurs in the legs. Usually this inflammation is accompanied by tiny blood clots that cling to the interior lining of the veins. Though often painful, SVT itself generally presents no serious medical danger, but it may be a sign that a person has DVT elsewhere in the leg.
Below are some SVT symptoms:
A vein that is visible through the skin and feels hard and painful to the touch.
Redness, tenderness, and pain on the skin of the affected area.
A sensation of throbbing or burning just below the surface of the skin.
A pain or heavy feeling when lowering your leg.
The factors causing SVT can be numerous:
A blow, fracture, or other injury to the leg.
Prolonged bed rest, especially after surgery (which causes the blood to "pool" in the legs).
Varicose veins
Prolonged inactivity such as sitting in one position for extended periods of time (as on long car, train, or plane trips).
Smoking
Vein injuries caused by injections or intravenous needles.
Pregnancy
Obesity
Cancer
SVT can be treated with anti-inflammatory medication such as ibuprofen or aspirin usually taken for five to seven days, application of hot, moist compresses (20 minutes on, 20 minutes off), and elevation of the affected limb above the level of the heart until the pain and swelling dissipate. In addition, moving the legs is very important. People with a history of DVT or other vein thrombosis may need to take anticoagulant drugs (i.e., Heparin).
"Although thrombophlebitis isolated to the superficial veins is not dangerous, occasionally it can migrate to the deep veins," explains Dr. Cameron Akbari, co-director of Non-Invasive Vascular Medicine at Boston's Beth Israel Deaconess Medical Center. "That can cause a pulmonary embolus, which can be fatal. The risk of pulmonary embolus can be as high as 10% with SVT." Accordingly, patients with signs and symptoms of SVT should seek medical advice to see whether other treatment is necessary.
Deep Vein Thrombosis
Deep vein thrombosis occurs when a large blood clot forms in the deep veins of the leg. But Dr. Akbari points out, "Unfortunately, only 40-50% of patients have obvious signs and symptoms of DVT. When they do occur, the usual symptoms are pain and/or swelling in the calf or thigh area, usually isolated to one leg."
The factors that generally cause DVT can include the same factors that cause SVT, but DVT often presents with no symptoms and it can be life threatening. A deep vein blood clot always poses the risk of breaking free from the lining of the blood vessel in which it forms, and then traveling through the circulatory system as an embolus or embolism. If the embolism lodges in the lungs, the result can be fatal.
When multiple risk factors for DVT are present and if DVT is suspected—either due to the symptoms listed above or in the absence of symptoms—your doctor will almost certainly order an ultrasound to confirm the diagnosis.
If a deep vein blood clot is found (or if not found but is strongly suspected), quick and decisive treatment is necessary. The treatment consists of the following:
Anticoagulation--thinning of the blood, and thus, the blood clot with anticoagulation medication (such as Heparin), followed by three or six months of an oral anticoagulation medication such as Coumadin.
Compression treatment--wearing tight fitting elastic stockings or pneumatic stockings (electrically pumping stockings) to help blood flow. These are usually prescribed several days to weeks after beginning anticoagulation treatment.
Hospitalization--to monitor the patient's condition (and to be able to administer emergency treatment if necessary) until the anticoagulant medication begins working. In some cases, patients can be safely treated on an outpatient basis if they are closely monitored by their physicians. In such cases, anticoagulation treatment begins at home, first with self-injections, followed by oral medication.
Filter--if blood thinning treatment is not possible or complications arise in spite of anticoagulation medication, a filter may be surgically placed in the main abdominal vein (the vena cava) to prevent an embolus from reaching the lungs.
Surgery--in certain extreme situations, surgery may be needed to remove the clot and partially interrupt the vena cava.
Prevention
Although SVT and DVT tend to affect people age 40 and older, all adults should take certain measures to avoid developing these conditions. These preventive measures include the following:
Avoiding sitting in one position for long periods of time.
Moving your legs (standing and walking around for five minutes) every hour or two when traveling.
Not smoking, especially, if you're a woman who takes birth control pills or estrogen.
Not wearing tight stockings or hosiery that restricts blood flow.
Staying physically fit.
Maintaining your proper weight.
If confined to a bed, moving legs as much as possible to prevent blood from pooling in the veins.
If you are at high risk for SVT or DVT, other preventive measures such as long-term anticoagulation medicine may be prescribed by your physician.
There is some evidence that use of the supplement Pycnogenol (alone or combined with natto, made from soy) prior to a long plane flight might reduce the risk of developing DVT.
In addition, anytime you undergo major surgery there is a risk that a DVT will develop during or following surgery. If you are scheduled to undergo major surgery, consult with both your surgeon and anesthetist beforehand to make certain they take proper precautions, including the wearing of compression stockings and/or administering anticoagulation medication during and following surgery.
Finally, if you experience any of the symptoms of SVT or DVT (or if you develop varicose veins), consult with your physician immediately.
RESOURCES:
Belcaro G, Cesarone MR, Rohdewald P, et al. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol(r). Clin Appl Thromb Hemost. 2004;10:373-7.
Cesarone MR, Belcaro G, Nicolaides AN, et al. Prevention of venous thrombosis in long-haul flights with Flite Tabs: the LONFLIT-FLITE randomized, controlled trial. Angiology. 2003;54:531-9.
Phlebitis and thrombosis. Vein Disorders Center website. Available at: http://www.veincenter.com/phlebitis.html.
****
In His Own Words: Living With Obsessive-compulsive Disorder
As told to Debra Wood, RN
Robert is a 69-year-old stockbroker. Although he first felt something was wrong in kindergarten, he wasn’t diagnosed with obsessive-compulsive disorder until 1969. He has not let obsessive thoughts control his life. He has served in the military, married, raised two daughters, and has enjoyed a successful career. Here, he shares his frustrations with and triumphs over the disorder.
What was your first sign that something was wrong? What symptoms did you experience?
Back in 1937, I began to notice a necessity to repeat things. I kept saying over and over, “Now I’m five. Now I’m five.” At about 8 or 10, I started to do rituals and repetitive things and became fearful in social situations. The obsessive thoughts lead you to do rituals as an antidote to the anxiety they create. I didn’t want anyone to see me doing the rituals, so I didn’t want to be around people.
It was hard concentrating in school, because the obsessive thoughts kept grabbing my attention. I had to reread sentences in a book twice. I kept counting up and down. I knocked on every desk in the classroom. I kept thinking something dreadful was going to happen.
The first time I was terrorized by the thoughts was in 1940. I saw my grandmother and mother baking a chocolate cake, and they handed me a cake knife and said I could taste the chocolate. It was exquisite, but this intrusive, uncontrollable thought came into my mind, saying to pick up the knife and stab someone. I ran from the room and put my head between my brother’s and my bed, trying to make a vice that would keep the thought away. I never told my parents about my thoughts and rituals. I was afraid they would think I was crazy.
What was the diagnosis experience like?
When I was 37, I told my doctor about the thoughts. He suggested I see a psychiatrist, who gave me a test. All my symptoms were listed on it, even looking at a knife and wanting to hurt someone. He said I had a severe case of OCD.
What was your initial and then longer-term reaction to the diagnosis?
I thought it was great that millions of people had what I had. A lot of them never talk about it. I studied everything about OCD.
How is your disease treated? How do you manage your disease?
I’m on a small dose of antidepressant and antianxiety medications. With OCD, you can get depression and anxiety at the same time. I was diagnosed before there was behavior therapy. I developed my own behavior therapy and devised ways to stop doing rituals. For example, to ignore cracks in the sidewalk, I started to touch the crack with the tip of my shoe. Then I slowly moved my foot over the crack. One day I stamped on it, and it felt so good. I came up with an idea to use an obsession to fight an obsession. To stop checking if the lights were out, I repeated, “the lights are off” five times and refused to let myself go back to check.
The thoughts still go around. I call them the OC demons. There is no cure, but I don’t have to react and do the rituals. I have to work at it and have trained myself not to pay attention to the thoughts. I use humor. I change my thinking to something else, something beautiful. Spirituality helps. I’ve become more prayerful.
Did you have to make any lifestyle or dietary changes in response to your illness?
No.
Did you seek any type of emotional support?
A year and a half ago, I went to my first support group meeting. I thought I had accomplished a lot on my own, but the members made me see things I didn’t realize.
Did/does your condition have any impact on your family?
I didn’t get married until I was 40. I always wanted kids and decided my social fears were keeping me from finding a lovely person. She gave me two wonderful daughters. I still had a few rituals when we married and was taking medication. My wife comes to the support group, and last summer, we went to an OCD convention.
What advice would you give to anyone living with this disease?
OCD is not your fault. You are a good person who may get terrible thoughts. You can overcome the rituals. Fight it and never give up.
Last edited by kmaherali on Mon May 01, 2006 1:04 pm, edited 1 time in total.
Tips for Traveling With Medications
by Laurie LaRusso, MS, ELS
Your bags are packed. You’re checking and double-checking that you’ve got everything. Do you have enough of your blood pressure medication? Or allergy pills? Or insulin?
Whatever medications you take, your trip won’t be much fun if you run out, or your medications are lost, or you get sick because you didn’t take them at the right times. Here’s how to make sure you have your medications when you need them while you’re traveling:
Bring More Than Enough Medication
Bring extra supply of your medications with you in case you lose or spill some. This will also ensure that you have enough medication with you if your trip is lengthened for some reason. Some medications in the US are not available in other countries. In particular, it can be difficult to get a prescription filled away from home, especially of you’re outside the US.
Bring the Prescription
If you do need to get more medication while you’re traveling, you’ll have a much easier time if you have the prescription.
Bring a Note from Your Health Care Provider
If you take prescription medications, carry a letter from your health care provider with you explaining your condition, what medication you take, and the dosage. Make sure you have this information for all the drugs you take. With increased airport security measures, you may find that security officers are more concerned about what you’ve got in your bag. This can be of particular concern if you must carry medical equipment, such as syringes to inject your medication.
Plan for Time Zone Changes
Talk to your health care provider about how you’ll adjust your medication schedule to account for changing time zones. When traveling overseas, you can lose or gain as much as a day, so you’ll need to carefully time your medication doses so you don’t miss any.
Pack Medications in a Carry-on Bag
Keep your medications with you while you’re traveling. You may need to take your medications while you’re in transit—on the airplane, in the airport, on the bus or train. Even if you’re traveling by car, keep medications in the car with you. The trunk of the car and the baggage areas of planes and buses are not temperature controlled, and some medications should not be exposed to very hot and very cold temperatures. Plus, if your luggage gets lost, you could be without it for days.
Bring Your Own Water (and Food If Necessary)
“Don’t drink the water!” You’ve no doubt heard this about any number of regions of the world. Although you can feel relatively safe about drinking tap water here in the US, you only have to get Montezuma’s revenge (or worse!) once to think twice about where you drink the tap water. If you need to take your medications with water, bring bottled water or buy bottled water rather than drink the tap water. And if you need to take your medication with food, bring your own snacks. Don’t rely on stores or restaurants to be available or airlines to serve food.
RESOURCES:
U.S. Food and Drug Administration
http://www.fda.gov
Centers for Disease Control and Information – Traveler’s Health
http://www.cdc.gov/travel/
Sources:
American Association of Retired Persons (AARP)
American Society of Travel Agents
by Laurie LaRusso, MS, ELS
Your bags are packed. You’re checking and double-checking that you’ve got everything. Do you have enough of your blood pressure medication? Or allergy pills? Or insulin?
Whatever medications you take, your trip won’t be much fun if you run out, or your medications are lost, or you get sick because you didn’t take them at the right times. Here’s how to make sure you have your medications when you need them while you’re traveling:
Bring More Than Enough Medication
Bring extra supply of your medications with you in case you lose or spill some. This will also ensure that you have enough medication with you if your trip is lengthened for some reason. Some medications in the US are not available in other countries. In particular, it can be difficult to get a prescription filled away from home, especially of you’re outside the US.
Bring the Prescription
If you do need to get more medication while you’re traveling, you’ll have a much easier time if you have the prescription.
Bring a Note from Your Health Care Provider
If you take prescription medications, carry a letter from your health care provider with you explaining your condition, what medication you take, and the dosage. Make sure you have this information for all the drugs you take. With increased airport security measures, you may find that security officers are more concerned about what you’ve got in your bag. This can be of particular concern if you must carry medical equipment, such as syringes to inject your medication.
Plan for Time Zone Changes
Talk to your health care provider about how you’ll adjust your medication schedule to account for changing time zones. When traveling overseas, you can lose or gain as much as a day, so you’ll need to carefully time your medication doses so you don’t miss any.
Pack Medications in a Carry-on Bag
Keep your medications with you while you’re traveling. You may need to take your medications while you’re in transit—on the airplane, in the airport, on the bus or train. Even if you’re traveling by car, keep medications in the car with you. The trunk of the car and the baggage areas of planes and buses are not temperature controlled, and some medications should not be exposed to very hot and very cold temperatures. Plus, if your luggage gets lost, you could be without it for days.
Bring Your Own Water (and Food If Necessary)
“Don’t drink the water!” You’ve no doubt heard this about any number of regions of the world. Although you can feel relatively safe about drinking tap water here in the US, you only have to get Montezuma’s revenge (or worse!) once to think twice about where you drink the tap water. If you need to take your medications with water, bring bottled water or buy bottled water rather than drink the tap water. And if you need to take your medication with food, bring your own snacks. Don’t rely on stores or restaurants to be available or airlines to serve food.
RESOURCES:
U.S. Food and Drug Administration
http://www.fda.gov
Centers for Disease Control and Information – Traveler’s Health
http://www.cdc.gov/travel/
Sources:
American Association of Retired Persons (AARP)
American Society of Travel Agents
Obsessive-Compulsive Disorder (OCD)
by Amy Scholten, MPH
Definition
Obsessive-compulsive disorder (OCD) is an anxiety disorder in which an individual suffers from unwanted repetitive thoughts and behaviors. These obsessive thoughts and compulsive behaviors are extremely difficult to overcome. If severe and untreated, OCD can destroy the ability to function at work, at school, or at home.
Causes
The cause of OCD is not known. It is believed to develop from neurobiological, environmental and psychological factors. An imbalance of the brain chemical serotonin probably plays a significant role in the development of OCD.
OCD is associated with other neurological disorders, including:
Tourette syndrome
Trichotillomania – the repeated urge to pull out scalp hair, eyelashes, eyebrows or other body hair
Body dysmorphic disorder – imaginary or exaggerated defects in appearance
Eating disorders, such as bulimia or anorexia nervosa
Hypochondriasis – unfounded fear of having a serious disease
Substance abuse
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for OCD include:
Age: Late adolescence, early adulthood
Family members with a history of OCD
Other anxiety disorders
Depression
Tourette syndrome
Personality disorder
Attention-deficit disorder
Symptoms
Symptoms of OCD are:
Obsessions – unwanted, repetitive and intrusive ideas, impulses or images
Compulsions – repetitive behaviors or mental acts usually performed to reduce the distress associated with obsessions
Although people with OCD know that their thoughts and behaviors are nonsensical and would like to avoid or stop them, they are frequently unable to block their obsessive thoughts or avoid acting on their compulsions.
Common obsessions include:
Persistent fears that harm may come to self or a loved one
Unreasonable concern with being contaminated
Unacceptable religious, violent, or sexual thoughts
Excessive need to do things correctly or perfectly
Common compulsions include:
Excessive checking of door locks, stoves, water faucets, light switches, etc.
Repeatedly making lists, counting, arranging, or aligning things
Collecting and hoarding useless objects
Repeating routine actions a certain number of times until it feels just right
Unnecessary re-reading and re-writing
Mentally repeating phrases
Repeatedly washing hands
Diagnosis
OCD is usually diagnosed through a psychiatric assessment. OCD is often diagnosed when obsessions and/or compulsions cause an individual significant distress or interfere with the individual’s ability to properly perform at work, school, or in relationships.
Treatment
Treatment reduces OCD thoughts and behaviors, but does not completely eliminate them.
Treatments include:
Medications
Selective serotonin reuptake inhibitors (SSRIs) reduce OCD symptoms by affecting the neurotransmitter serotonin. This function is independent of their antidepressant effects. Common SSRIs include:
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)
Please Note: On March 22, 2004, the Food and Drug Administration (FDA) issued a Public Health Advisory that cautions physicians, patients, families and caregivers of patients with depression to closely monitor both adults and children receiving certain antidepressant medications. The FDA is concerned about the possibility of worsening depression and/or the emergence of suicidal thoughts, especially among children and adolescents at the beginning of treatment, or when there’s an increase or decrease in the dose. The medications of concern—mostly SSRIs (Selective Serotonin Re-uptake Inhibitors)—are: Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), Celexa (citalopram); Lexapro (escitalopram), Wellbutrin (bupropion), Effexor (venlafaxine), Serzone (nefazodone), and Remeron (mirtazapine). Of these, only Prozac (fluoxetine) is approved for use in children and adolescents for the treatment of major depressive disorder. Prozac (fluoxetine), Zoloft (sertraline), and Luvox (fluvoxamine) are approved for use in children and adolescents for the treatment of obsessive compulsive disorder. For more information, please visit http://www.fda.gov/cder/drug/antidepressants
Another medication often used is clomipramine (Anafranil). This is a tricyclic antidepressant drug that alters serotonin levels.
Behavior Therapy (Exposure and Response Prevention)
This helps you gradually confront the feared object or obsession without succumbing to the compulsive ritual associated with it.
Prevention
There are no guidelines for preventing OCD because the cause is not known. However, early intervention may provide help before the disorder becomes severely disruptive.
RESOURCES:
Anxiety Disorders Association of America
http://www.adaa.org
Obsessive-Compulsive Foundation
http://ocfoundation.org
References:
Fauci AS, Braunwald E, Isselbacher KJ, et al. Harrison's Principles of Internal Medicine, 14th ed. New York, NY: The McGraw-Hill Companies; 2000.
National Institute of Mental Health, National Institutes of Health website. Available at: http://www.nimh.nih.gov/. Accessed October 13, 2005.
*******
In His Own Words: Living With Obsessive-compulsive Disorder
As told to Debra Wood, RN
Robert is a 69-year-old stockbroker. Although he first felt something was wrong in kindergarten, he wasn’t diagnosed with obsessive-compulsive disorder until 1969. He has not let obsessive thoughts control his life. He has served in the military, married, raised two daughters, and has enjoyed a successful career. Here, he shares his frustrations with and triumphs over the disorder.
What was your first sign that something was wrong? What symptoms did you experience?
Back in 1937, I began to notice a necessity to repeat things. I kept saying over and over, “Now I’m five. Now I’m five.” At about 8 or 10, I started to do rituals and repetitive things and became fearful in social situations. The obsessive thoughts lead you to do rituals as an antidote to the anxiety they create. I didn’t want anyone to see me doing the rituals, so I didn’t want to be around people.
It was hard concentrating in school, because the obsessive thoughts kept grabbing my attention. I had to reread sentences in a book twice. I kept counting up and down. I knocked on every desk in the classroom. I kept thinking something dreadful was going to happen.
The first time I was terrorized by the thoughts was in 1940. I saw my grandmother and mother baking a chocolate cake, and they handed me a cake knife and said I could taste the chocolate. It was exquisite, but this intrusive, uncontrollable thought came into my mind, saying to pick up the knife and stab someone. I ran from the room and put my head between my brother’s and my bed, trying to make a vice that would keep the thought away. I never told my parents about my thoughts and rituals. I was afraid they would think I was crazy.
What was the diagnosis experience like?
When I was 37, I told my doctor about the thoughts. He suggested I see a psychiatrist, who gave me a test. All my symptoms were listed on it, even looking at a knife and wanting to hurt someone. He said I had a severe case of OCD.
What was your initial and then longer-term reaction to the diagnosis?
I thought it was great that millions of people had what I had. A lot of them never talk about it. I studied everything about OCD.
How is your disease treated? How do you manage your disease?
I’m on a small dose of antidepressant and antianxiety medications. With OCD, you can get depression and anxiety at the same time. I was diagnosed before there was behavior therapy. I developed my own behavior therapy and devised ways to stop doing rituals. For example, to ignore cracks in the sidewalk, I started to touch the crack with the tip of my shoe. Then I slowly moved my foot over the crack. One day I stamped on it, and it felt so good. I came up with an idea to use an obsession to fight an obsession. To stop checking if the lights were out, I repeated, “the lights are off” five times and refused to let myself go back to check.
The thoughts still go around. I call them the OC demons. There is no cure, but I don’t have to react and do the rituals. I have to work at it and have trained myself not to pay attention to the thoughts. I use humor. I change my thinking to something else, something beautiful. Spirituality helps. I’ve become more prayerful.
Did you have to make any lifestyle or dietary changes in response to your illness?
No.
Did you seek any type of emotional support?
A year and a half ago, I went to my first support group meeting. I thought I had accomplished a lot on my own, but the members made me see things I didn’t realize.
Did/does your condition have any impact on your family?
I didn’t get married until I was 40. I always wanted kids and decided my social fears were keeping me from finding a lovely person. She gave me two wonderful daughters. I still had a few rituals when we married and was taking medication. My wife comes to the support group, and last summer, we went to an OCD convention.
What advice would you give to anyone living with this disease?
OCD is not your fault. You are a good person who may get terrible thoughts. You can overcome the rituals. Fight it and never give up.
by Amy Scholten, MPH
Definition
Obsessive-compulsive disorder (OCD) is an anxiety disorder in which an individual suffers from unwanted repetitive thoughts and behaviors. These obsessive thoughts and compulsive behaviors are extremely difficult to overcome. If severe and untreated, OCD can destroy the ability to function at work, at school, or at home.
Causes
The cause of OCD is not known. It is believed to develop from neurobiological, environmental and psychological factors. An imbalance of the brain chemical serotonin probably plays a significant role in the development of OCD.
OCD is associated with other neurological disorders, including:
Tourette syndrome
Trichotillomania – the repeated urge to pull out scalp hair, eyelashes, eyebrows or other body hair
Body dysmorphic disorder – imaginary or exaggerated defects in appearance
Eating disorders, such as bulimia or anorexia nervosa
Hypochondriasis – unfounded fear of having a serious disease
Substance abuse
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for OCD include:
Age: Late adolescence, early adulthood
Family members with a history of OCD
Other anxiety disorders
Depression
Tourette syndrome
Personality disorder
Attention-deficit disorder
Symptoms
Symptoms of OCD are:
Obsessions – unwanted, repetitive and intrusive ideas, impulses or images
Compulsions – repetitive behaviors or mental acts usually performed to reduce the distress associated with obsessions
Although people with OCD know that their thoughts and behaviors are nonsensical and would like to avoid or stop them, they are frequently unable to block their obsessive thoughts or avoid acting on their compulsions.
Common obsessions include:
Persistent fears that harm may come to self or a loved one
Unreasonable concern with being contaminated
Unacceptable religious, violent, or sexual thoughts
Excessive need to do things correctly or perfectly
Common compulsions include:
Excessive checking of door locks, stoves, water faucets, light switches, etc.
Repeatedly making lists, counting, arranging, or aligning things
Collecting and hoarding useless objects
Repeating routine actions a certain number of times until it feels just right
Unnecessary re-reading and re-writing
Mentally repeating phrases
Repeatedly washing hands
Diagnosis
OCD is usually diagnosed through a psychiatric assessment. OCD is often diagnosed when obsessions and/or compulsions cause an individual significant distress or interfere with the individual’s ability to properly perform at work, school, or in relationships.
Treatment
Treatment reduces OCD thoughts and behaviors, but does not completely eliminate them.
Treatments include:
Medications
Selective serotonin reuptake inhibitors (SSRIs) reduce OCD symptoms by affecting the neurotransmitter serotonin. This function is independent of their antidepressant effects. Common SSRIs include:
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)
Please Note: On March 22, 2004, the Food and Drug Administration (FDA) issued a Public Health Advisory that cautions physicians, patients, families and caregivers of patients with depression to closely monitor both adults and children receiving certain antidepressant medications. The FDA is concerned about the possibility of worsening depression and/or the emergence of suicidal thoughts, especially among children and adolescents at the beginning of treatment, or when there’s an increase or decrease in the dose. The medications of concern—mostly SSRIs (Selective Serotonin Re-uptake Inhibitors)—are: Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), Celexa (citalopram); Lexapro (escitalopram), Wellbutrin (bupropion), Effexor (venlafaxine), Serzone (nefazodone), and Remeron (mirtazapine). Of these, only Prozac (fluoxetine) is approved for use in children and adolescents for the treatment of major depressive disorder. Prozac (fluoxetine), Zoloft (sertraline), and Luvox (fluvoxamine) are approved for use in children and adolescents for the treatment of obsessive compulsive disorder. For more information, please visit http://www.fda.gov/cder/drug/antidepressants
Another medication often used is clomipramine (Anafranil). This is a tricyclic antidepressant drug that alters serotonin levels.
Behavior Therapy (Exposure and Response Prevention)
This helps you gradually confront the feared object or obsession without succumbing to the compulsive ritual associated with it.
Prevention
There are no guidelines for preventing OCD because the cause is not known. However, early intervention may provide help before the disorder becomes severely disruptive.
RESOURCES:
Anxiety Disorders Association of America
http://www.adaa.org
Obsessive-Compulsive Foundation
http://ocfoundation.org
References:
Fauci AS, Braunwald E, Isselbacher KJ, et al. Harrison's Principles of Internal Medicine, 14th ed. New York, NY: The McGraw-Hill Companies; 2000.
National Institute of Mental Health, National Institutes of Health website. Available at: http://www.nimh.nih.gov/. Accessed October 13, 2005.
*******
In His Own Words: Living With Obsessive-compulsive Disorder
As told to Debra Wood, RN
Robert is a 69-year-old stockbroker. Although he first felt something was wrong in kindergarten, he wasn’t diagnosed with obsessive-compulsive disorder until 1969. He has not let obsessive thoughts control his life. He has served in the military, married, raised two daughters, and has enjoyed a successful career. Here, he shares his frustrations with and triumphs over the disorder.
What was your first sign that something was wrong? What symptoms did you experience?
Back in 1937, I began to notice a necessity to repeat things. I kept saying over and over, “Now I’m five. Now I’m five.” At about 8 or 10, I started to do rituals and repetitive things and became fearful in social situations. The obsessive thoughts lead you to do rituals as an antidote to the anxiety they create. I didn’t want anyone to see me doing the rituals, so I didn’t want to be around people.
It was hard concentrating in school, because the obsessive thoughts kept grabbing my attention. I had to reread sentences in a book twice. I kept counting up and down. I knocked on every desk in the classroom. I kept thinking something dreadful was going to happen.
The first time I was terrorized by the thoughts was in 1940. I saw my grandmother and mother baking a chocolate cake, and they handed me a cake knife and said I could taste the chocolate. It was exquisite, but this intrusive, uncontrollable thought came into my mind, saying to pick up the knife and stab someone. I ran from the room and put my head between my brother’s and my bed, trying to make a vice that would keep the thought away. I never told my parents about my thoughts and rituals. I was afraid they would think I was crazy.
What was the diagnosis experience like?
When I was 37, I told my doctor about the thoughts. He suggested I see a psychiatrist, who gave me a test. All my symptoms were listed on it, even looking at a knife and wanting to hurt someone. He said I had a severe case of OCD.
What was your initial and then longer-term reaction to the diagnosis?
I thought it was great that millions of people had what I had. A lot of them never talk about it. I studied everything about OCD.
How is your disease treated? How do you manage your disease?
I’m on a small dose of antidepressant and antianxiety medications. With OCD, you can get depression and anxiety at the same time. I was diagnosed before there was behavior therapy. I developed my own behavior therapy and devised ways to stop doing rituals. For example, to ignore cracks in the sidewalk, I started to touch the crack with the tip of my shoe. Then I slowly moved my foot over the crack. One day I stamped on it, and it felt so good. I came up with an idea to use an obsession to fight an obsession. To stop checking if the lights were out, I repeated, “the lights are off” five times and refused to let myself go back to check.
The thoughts still go around. I call them the OC demons. There is no cure, but I don’t have to react and do the rituals. I have to work at it and have trained myself not to pay attention to the thoughts. I use humor. I change my thinking to something else, something beautiful. Spirituality helps. I’ve become more prayerful.
Did you have to make any lifestyle or dietary changes in response to your illness?
No.
Did you seek any type of emotional support?
A year and a half ago, I went to my first support group meeting. I thought I had accomplished a lot on my own, but the members made me see things I didn’t realize.
Did/does your condition have any impact on your family?
I didn’t get married until I was 40. I always wanted kids and decided my social fears were keeping me from finding a lovely person. She gave me two wonderful daughters. I still had a few rituals when we married and was taking medication. My wife comes to the support group, and last summer, we went to an OCD convention.
What advice would you give to anyone living with this disease?
OCD is not your fault. You are a good person who may get terrible thoughts. You can overcome the rituals. Fight it and never give up.
Aspartame cancer risk refuted
European agency clears sweetener as safe to use
Published: Saturday, May 06, 2006
European food safety experts announced Friday the popular sugar substitute aspartame does not raise the risk of cancer.
An Italian study last year wrongly concluded the sweetener led to higher rates of lymphoma and leukemia in rats, said an independent panel of scientists advising the European Food Safety Authority.
The new review found the number of tumours did not increase in relation to the dosage of aspartame fed to the animals. Many of the rats in the study had chronic respiratory disease and that was the most likely cause of the tumours, the panel said.
The findings support a huge U.S. federal study released last month that found no link to cancer in a study of aspartame use among more than half a million Americans.
The European panel said its assessment should put the lid on years of debate over the sweetener found in thousands of products, including diet sodas, chewing gum, dairy products and even many medicines.
"There is no reason . . . to undertake any further extensive review of the safety of aspartame," said Iona Pratt, a toxicologist who headed the panel.
Aspartame came on the market 25 years ago. NutraSweet and Equal are popular brands.
Research in the 1970s linked a different sweetener, saccharin, to bladder cancer in lab rats. Although the mechanism by which this occurred does not apply to people and no human risk was ever documented, worries about sugar substitutes in general have persisted.
They worsened after the Italian study by a group in Bologna called the European Ramazzini Foundation. Led by Dr. Morando Soffritti, it involved 1,800 rats and was the largest done of aspartame in animals.
The rodents were divided into seven groups and fed different doses of the sweetener over their natural lifespan. Some of the rats, especially females, developed more lymphomas and leukemias than those not fed aspartame.
But the European agency, based in the northern Italian city of Parma, faulted the colony of rats used in the study, saying they had respiratory problems.
© The Calgary Herald 2006
European agency clears sweetener as safe to use
Published: Saturday, May 06, 2006
European food safety experts announced Friday the popular sugar substitute aspartame does not raise the risk of cancer.
An Italian study last year wrongly concluded the sweetener led to higher rates of lymphoma and leukemia in rats, said an independent panel of scientists advising the European Food Safety Authority.
The new review found the number of tumours did not increase in relation to the dosage of aspartame fed to the animals. Many of the rats in the study had chronic respiratory disease and that was the most likely cause of the tumours, the panel said.
The findings support a huge U.S. federal study released last month that found no link to cancer in a study of aspartame use among more than half a million Americans.
The European panel said its assessment should put the lid on years of debate over the sweetener found in thousands of products, including diet sodas, chewing gum, dairy products and even many medicines.
"There is no reason . . . to undertake any further extensive review of the safety of aspartame," said Iona Pratt, a toxicologist who headed the panel.
Aspartame came on the market 25 years ago. NutraSweet and Equal are popular brands.
Research in the 1970s linked a different sweetener, saccharin, to bladder cancer in lab rats. Although the mechanism by which this occurred does not apply to people and no human risk was ever documented, worries about sugar substitutes in general have persisted.
They worsened after the Italian study by a group in Bologna called the European Ramazzini Foundation. Led by Dr. Morando Soffritti, it involved 1,800 rats and was the largest done of aspartame in animals.
The rodents were divided into seven groups and fed different doses of the sweetener over their natural lifespan. Some of the rats, especially females, developed more lymphomas and leukemias than those not fed aspartame.
But the European agency, based in the northern Italian city of Parma, faulted the colony of rats used in the study, saying they had respiratory problems.
© The Calgary Herald 2006
Daily Tip
Reduce Your Risk of Skin Cancer
Research shows that people who regularly inspect their skin can reduce their risk of melanoma by as much as 63 percent. That’s an encouraging percentage and a great reason to make checking your body for signs of melanoma part of your daily routine. Use the following information to guide you through your self-examination:
Note any changes in freckles or moles or any new bumps or nodules.
Look for moles or freckles with irregular borders, mixed colors (especially black), signs of inflammation or pallor, and any increase in size.
Pay attention to moles or freckles that are bigger than the size of a pencil eraser, fail to heal after a minor injury, or are scabby or scaly.
If you notice any of the above, schedule an appointment with a dermatologist - he or she can help to determine if treatment is necessary. In addition, you can help to prevent melanoma by simply protecting yourself from the sun with hats, sunscreen, sunglasses, and UV-protective clothing.
Reduce Your Risk of Skin Cancer
Research shows that people who regularly inspect their skin can reduce their risk of melanoma by as much as 63 percent. That’s an encouraging percentage and a great reason to make checking your body for signs of melanoma part of your daily routine. Use the following information to guide you through your self-examination:
Note any changes in freckles or moles or any new bumps or nodules.
Look for moles or freckles with irregular borders, mixed colors (especially black), signs of inflammation or pallor, and any increase in size.
Pay attention to moles or freckles that are bigger than the size of a pencil eraser, fail to heal after a minor injury, or are scabby or scaly.
If you notice any of the above, schedule an appointment with a dermatologist - he or she can help to determine if treatment is necessary. In addition, you can help to prevent melanoma by simply protecting yourself from the sun with hats, sunscreen, sunglasses, and UV-protective clothing.
In Her Own Words: Living With Rheumatoid Arthritis
As told to Jennifer Hellwig, MS, RD
Lisa, a 35-year-old dietitian from Ohio, was diagnosed with rheumatoid arthritis (RA) eight years ago. She has found support and information through the Arthritis Foundation and is now teaching a self-help class for the foundation.
What was your first sign that something was wrong? What symptoms did you experience?
I would wake up in the morning and my feet would really hurt. It would hurt just to walk across the floor. And then I started noticing other symptoms—my hands started to hurt and I couldn’t snap my fingers. I would get pain off and on in different joints in my body.
What was the diagnosis experience like?
I had just joined a gym and was going pretty frequently, so I just thought that I overdid it at the gym. But after having pain for about two or three months, I went to my primary care doctor. I really didn’t want to, because I didn’t want to know that I had something. My doctor examined me and took some blood and did a test for something called rheumatoid factor, which came back negative. She also thought it might be overexertion from exercise and she gave me some high-dose ibuprofen. But after two weeks I was still in a lot of pain, so I went back and she took more blood and we found out that it was RA. She referred me to a rheumatologist, under whose care I manage my condition.
What was your initial and then longer-term reaction to the diagnosis?
I was upset but I was also a little relieved, because at least I knew that there was a reason for the pain I was feeling. But at the same time I didn’t know anything about it, so I was also afraid. Some days I am angry, because I'm sick of being stiff and sore and I hate taking drugs to control pain. But I try to take advantage of when I’m feeling well (I’ll exercise more, do more around the house), because I never know when I'll have a flare and I'll be useless.
How do you manage your disease?
I was started on a series of drugs, some of which are called DMARDs (disease-modifying anti-rheumatic drugs). These are supposed to halt the disease from progressing any further, to prevent you from getting twisted joints and disfigured hands. I was started on methotrexate and oral gold, but I ended up having a bad photosensitive reaction to the gold (I was out in the sun and everything I looked at turned silver and I got bad hives and ended up having to go to the ER). There are also drugs to treat the pain caused by RA, including NSAIDs (nonsteroidal anti-inflammatory drugs), COX-2 inhibitors, and prednisone, which is a steroid.
Since I’ve been diagnosed, my regimen has changed a couple different times for different reasons. After I had the reaction to the gold, I went on sulfasalazine and Plaquenil. I was on those for a while and then I had a reaction to the sulfasalazine. Then I went on a drug called Enbrel, which is one of a newer class of drugs called biologic agents. For the past 8-10 months I was giving myself injections of Enbrel twice a week and that was like a wonder drug—I felt really good on that drug. But now that my husband and I are trying to get pregnant, I’m only on prednisone, because Enbrel is contraindicated for pregnancy.
Did you have to make any lifestyle or dietary changes in response to your illness?
Yes. I had to slow way down, which was difficult, because I’m a really active person. I need to get enough sleep, otherwise my symptoms are worse. I need to make sure I maintain regular exercise, which is hard because a lot of times you don’t feel like exercising because you’re in pain.
Before I got RA, I did a lot of running and in-line skating, but now the best exercises for me are nonimpact or low-impact, such as speed walking, swimming, and bike riding (depending on how my wrists feel). When I was on methotrexate, I had to take folic acid and not drink any alcohol. While on prednisone, I have to take calcium and vitamin D to prevent osteoporosis.
Did you seek any type of emotional support?
At the suggestion of my rheumatologist, I got involved in the Arthritis Foundation. They’re a great resource for information and I also got involved in their self-help class. I took the class and then a couple years later they actually asked me to teach it. The foundation has provided great emotional support.
Does your condition have any impact on your family?
I think the biggest impact is probably on my husband. It’s stressful for him to see me wake up in the morning and limp across the floor or complain that my hands hurt or that my foot is swollen. I think it’s really hard on him.
What advice would you give to anyone living with this disease?
Find out as much as you can about the disease, so that you’re in control of it. Be assertive with your doctor to make sure all your questions are answered. And I definitely recommend getting involved in the Arthritis Foundation.
As told to Jennifer Hellwig, MS, RD
Lisa, a 35-year-old dietitian from Ohio, was diagnosed with rheumatoid arthritis (RA) eight years ago. She has found support and information through the Arthritis Foundation and is now teaching a self-help class for the foundation.
What was your first sign that something was wrong? What symptoms did you experience?
I would wake up in the morning and my feet would really hurt. It would hurt just to walk across the floor. And then I started noticing other symptoms—my hands started to hurt and I couldn’t snap my fingers. I would get pain off and on in different joints in my body.
What was the diagnosis experience like?
I had just joined a gym and was going pretty frequently, so I just thought that I overdid it at the gym. But after having pain for about two or three months, I went to my primary care doctor. I really didn’t want to, because I didn’t want to know that I had something. My doctor examined me and took some blood and did a test for something called rheumatoid factor, which came back negative. She also thought it might be overexertion from exercise and she gave me some high-dose ibuprofen. But after two weeks I was still in a lot of pain, so I went back and she took more blood and we found out that it was RA. She referred me to a rheumatologist, under whose care I manage my condition.
What was your initial and then longer-term reaction to the diagnosis?
I was upset but I was also a little relieved, because at least I knew that there was a reason for the pain I was feeling. But at the same time I didn’t know anything about it, so I was also afraid. Some days I am angry, because I'm sick of being stiff and sore and I hate taking drugs to control pain. But I try to take advantage of when I’m feeling well (I’ll exercise more, do more around the house), because I never know when I'll have a flare and I'll be useless.
How do you manage your disease?
I was started on a series of drugs, some of which are called DMARDs (disease-modifying anti-rheumatic drugs). These are supposed to halt the disease from progressing any further, to prevent you from getting twisted joints and disfigured hands. I was started on methotrexate and oral gold, but I ended up having a bad photosensitive reaction to the gold (I was out in the sun and everything I looked at turned silver and I got bad hives and ended up having to go to the ER). There are also drugs to treat the pain caused by RA, including NSAIDs (nonsteroidal anti-inflammatory drugs), COX-2 inhibitors, and prednisone, which is a steroid.
Since I’ve been diagnosed, my regimen has changed a couple different times for different reasons. After I had the reaction to the gold, I went on sulfasalazine and Plaquenil. I was on those for a while and then I had a reaction to the sulfasalazine. Then I went on a drug called Enbrel, which is one of a newer class of drugs called biologic agents. For the past 8-10 months I was giving myself injections of Enbrel twice a week and that was like a wonder drug—I felt really good on that drug. But now that my husband and I are trying to get pregnant, I’m only on prednisone, because Enbrel is contraindicated for pregnancy.
Did you have to make any lifestyle or dietary changes in response to your illness?
Yes. I had to slow way down, which was difficult, because I’m a really active person. I need to get enough sleep, otherwise my symptoms are worse. I need to make sure I maintain regular exercise, which is hard because a lot of times you don’t feel like exercising because you’re in pain.
Before I got RA, I did a lot of running and in-line skating, but now the best exercises for me are nonimpact or low-impact, such as speed walking, swimming, and bike riding (depending on how my wrists feel). When I was on methotrexate, I had to take folic acid and not drink any alcohol. While on prednisone, I have to take calcium and vitamin D to prevent osteoporosis.
Did you seek any type of emotional support?
At the suggestion of my rheumatologist, I got involved in the Arthritis Foundation. They’re a great resource for information and I also got involved in their self-help class. I took the class and then a couple years later they actually asked me to teach it. The foundation has provided great emotional support.
Does your condition have any impact on your family?
I think the biggest impact is probably on my husband. It’s stressful for him to see me wake up in the morning and limp across the floor or complain that my hands hurt or that my foot is swollen. I think it’s really hard on him.
What advice would you give to anyone living with this disease?
Find out as much as you can about the disease, so that you’re in control of it. Be assertive with your doctor to make sure all your questions are answered. And I definitely recommend getting involved in the Arthritis Foundation.
Benefits of Quitting Smoking
Adapted from the American Lung Association
For all the struggle of quitting smoking, there are equal, simultaneous rewards! When smokers quit, within twenty minutes of smoking that last cigarette the body begins a series of healing changes.
At 20 minutes after quitting:
blood pressure decreases
pulse rate drops
body temperature of hands and feet increases
At 8 hours:
carbon monoxide level in blood drops to normal
oxygen level in blood increases to normal
At 24 hours:
chance of a heart attack decreases
At 48 hours:
nerve endings start regrowing
ability to smell and taste is enhanced
In the first year after quitting
At 2 weeks to 3 months:
circulation improves
walking becomes easier
lung function increases
l1 to 9 months:
coughing, sinus congestion, fatigue, shortness of breath decreases
1 year:
excess risk of coronary heart disease is decreased to half that of a smoker
Long-term Benefits of Quitting
At 5 years:
from 5 to 15 years after quitting, stroke risk is reduced to that of people who have never smoked
At 10 years:
risk of lung cancer drops to as little as one-half that of continuing smokers
risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases risk of ulcer decreases
At 15 years:
risk of coronary heart disease is now similar to that of people who have never smoked
risk of death returns to nearly the level of people who have never smoked
Source:
American Lung Association website. Available at:http://www.lungusa.org. Accessed May 2005.
Link to "Assess your smoking habit" at:
http://www.beliefnet.com/healthandheali ... mc_id=NL44
Adapted from the American Lung Association
For all the struggle of quitting smoking, there are equal, simultaneous rewards! When smokers quit, within twenty minutes of smoking that last cigarette the body begins a series of healing changes.
At 20 minutes after quitting:
blood pressure decreases
pulse rate drops
body temperature of hands and feet increases
At 8 hours:
carbon monoxide level in blood drops to normal
oxygen level in blood increases to normal
At 24 hours:
chance of a heart attack decreases
At 48 hours:
nerve endings start regrowing
ability to smell and taste is enhanced
In the first year after quitting
At 2 weeks to 3 months:
circulation improves
walking becomes easier
lung function increases
l1 to 9 months:
coughing, sinus congestion, fatigue, shortness of breath decreases
1 year:
excess risk of coronary heart disease is decreased to half that of a smoker
Long-term Benefits of Quitting
At 5 years:
from 5 to 15 years after quitting, stroke risk is reduced to that of people who have never smoked
At 10 years:
risk of lung cancer drops to as little as one-half that of continuing smokers
risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases risk of ulcer decreases
At 15 years:
risk of coronary heart disease is now similar to that of people who have never smoked
risk of death returns to nearly the level of people who have never smoked
Source:
American Lung Association website. Available at:http://www.lungusa.org. Accessed May 2005.
Link to "Assess your smoking habit" at:
http://www.beliefnet.com/healthandheali ... mc_id=NL44
U.S. set to approve cancer vaccine
Cervical cancer deaths could be drastically cut
Published: Friday, May 19, 2006
A vaccine with the potential to slash worldwide deaths from cervical cancer, the No. 2 cancer killer in women, should be approved for sale in the United States, a federal panel said Thursday.
A U.S. Food and Drug Administration advisory committee voted 13-0 to endorse the safety and effectiveness of Merck and Co.'s Gardasil, which blocks viruses that cause cervical cancer. The company said the vaccine could cut worldwide deaths from the disease by two-thirds.
However, the anticipated cost of the vaccine, administered in three shots over six months, is $300 to $500 US -- a possible impediment to widespread vaccination campaigns.
The drug protects against the two types of human papillomavirus (HPV) believed responsible for about 70 per cent of cervical cancer cases. It also protects against two other virus types that cause 90 per cent of genital wart cases. All four virus types are sexually transmitted.
The FDA is not required to follow the recommendations of its outside panels of experts, but usually does. An agency decision is expected by June 8.
HPV is the most common sexually transmitted disease. It affects more than 50 per cent of sexually active adults. The cervical cancer it can cause kills about 290,000 women worldwide each year, including 3,500 in the United States where regular Pap smears often detect precancerous lesions and early cancer.
"This is certainly a wonderful, good step in addition to our screening processes" in helping eradicate cervical cancer, said Dr. Monica Farley, who heads the advisory panel. She is a bacterial infectious disease expert at the Emory University School of Medicine in Atlanta.
Early opposition to Gardasil was based on concerns it could encourage sexual activity in preteens and teens. But that largely faded away because of the vaccine's potential for reducing cancer.
Making their case for approval, Merck officials suggested that Gardasil could be the biggest advance in preventing cervical cancer since the Pap test.
"Gardasil has the potential to meet an unmet medical need as the first vaccine to prevent cervical cancer," Merck's Dr. Patrick Brill-Edwards told the Vaccine and Related Biological Products advisory committee.
Several speakers said the vaccine should not replace screening. Merck said the vaccine was not intended to do that but that it could eliminate many of the abnormalities the tests turn up.
"We would like to see the FDA mandate some sort of labelling or other mechanism to communicate to health-care providers and patients the continued need for regular cervical screening," said Amy Allina, program director of the National Women's Health Network.
Merck said the vaccine could be used in females age nine to 26, but would work best when given to girls before they begin having sex.
The company is seeking to license Gardasil in more than 50 countries, said Dr. Eliav Barr, who headed the vaccine program at Merck.
Dr. Nancy Miller, an FDA reviewer, cautioned that Gardasil does not necessarily protect against one or more of the four viruses in people already infected before they get the vaccine, and can increase their risk for precursors to cervical cancer.
Merck, based in Whitehouse Station, N.J., developed the vaccine and tested it in more than 27,000 females and males.
© The Calgary Herald 2006
Cervical cancer deaths could be drastically cut
Published: Friday, May 19, 2006
A vaccine with the potential to slash worldwide deaths from cervical cancer, the No. 2 cancer killer in women, should be approved for sale in the United States, a federal panel said Thursday.
A U.S. Food and Drug Administration advisory committee voted 13-0 to endorse the safety and effectiveness of Merck and Co.'s Gardasil, which blocks viruses that cause cervical cancer. The company said the vaccine could cut worldwide deaths from the disease by two-thirds.
However, the anticipated cost of the vaccine, administered in three shots over six months, is $300 to $500 US -- a possible impediment to widespread vaccination campaigns.
The drug protects against the two types of human papillomavirus (HPV) believed responsible for about 70 per cent of cervical cancer cases. It also protects against two other virus types that cause 90 per cent of genital wart cases. All four virus types are sexually transmitted.
The FDA is not required to follow the recommendations of its outside panels of experts, but usually does. An agency decision is expected by June 8.
HPV is the most common sexually transmitted disease. It affects more than 50 per cent of sexually active adults. The cervical cancer it can cause kills about 290,000 women worldwide each year, including 3,500 in the United States where regular Pap smears often detect precancerous lesions and early cancer.
"This is certainly a wonderful, good step in addition to our screening processes" in helping eradicate cervical cancer, said Dr. Monica Farley, who heads the advisory panel. She is a bacterial infectious disease expert at the Emory University School of Medicine in Atlanta.
Early opposition to Gardasil was based on concerns it could encourage sexual activity in preteens and teens. But that largely faded away because of the vaccine's potential for reducing cancer.
Making their case for approval, Merck officials suggested that Gardasil could be the biggest advance in preventing cervical cancer since the Pap test.
"Gardasil has the potential to meet an unmet medical need as the first vaccine to prevent cervical cancer," Merck's Dr. Patrick Brill-Edwards told the Vaccine and Related Biological Products advisory committee.
Several speakers said the vaccine should not replace screening. Merck said the vaccine was not intended to do that but that it could eliminate many of the abnormalities the tests turn up.
"We would like to see the FDA mandate some sort of labelling or other mechanism to communicate to health-care providers and patients the continued need for regular cervical screening," said Amy Allina, program director of the National Women's Health Network.
Merck said the vaccine could be used in females age nine to 26, but would work best when given to girls before they begin having sex.
The company is seeking to license Gardasil in more than 50 countries, said Dr. Eliav Barr, who headed the vaccine program at Merck.
Dr. Nancy Miller, an FDA reviewer, cautioned that Gardasil does not necessarily protect against one or more of the four viruses in people already infected before they get the vaccine, and can increase their risk for precursors to cervical cancer.
Merck, based in Whitehouse Station, N.J., developed the vaccine and tested it in more than 27,000 females and males.
© The Calgary Herald 2006
Stem cell injection may stop incontinence
Published: Thursday, May 25, 2006
For almost a decade, Sharon Tomlinson didn't dare go out without being prepared for an unexpected sneeze, cough or a hearty laugh.
That's because any of those everyday physical reactions would bring on an unwanted dribble of urine she was unable to control -- the result of stress urinary incontinence. The condition affects millions of Canadians, primarily women, and often occurs as a side-effect of childbirth.
"It was getting bad," said Tomlinson, 58. "I wouldn't go anywhere without a change of clothes in the car."
The solution for the Ontario mother of two grown children turned out to be an experimental procedure, in which a type of stem cell isolated from the muscle of her thigh was injected into her urethra, the tube that carries urine from the bladder to the outside of the body. The stem cells are intended to strengthen the sphincter muscle, which acts as a check-valve against the release of urine.
Tomlinson was one of seven women with the disorder to undergo the injection of muscle-derived stem cells at Sunnybrook Health Sciences Centre, five of whom showed improvement in controlling a leaky bladder, said lead researcher Dr. Lesley Carr, a urologist at the Toronto hospital.
"Other injectable agents to treat stress incontinence, such as collagen, they're injected fairly superficially into the lining of the urethra to actually help it seal," said Carr, whose results were presented at the weekend meeting of the American Urological Association in Atlanta.
The results of the clinical trial in Toronto are "extremely encouraging" for patients coping with stress urinary incontinence, senior author Dr. Michael Chancellor, a professor of urology and gynecology at the University of Pittsburgh School of Medicine said in a release. "These findings suggest, for the first time, that we may be able to offer people with SUI a long-term and minimally invasive treatment."
Six months after her June 2005 injection, Tomlinson was no longer afflicted with unrestrained urine flow.
"Now I don't worry if I'm going to sneeze and it's going to be trickling down my leg."
© The Calgary Herald 2006
Published: Thursday, May 25, 2006
For almost a decade, Sharon Tomlinson didn't dare go out without being prepared for an unexpected sneeze, cough or a hearty laugh.
That's because any of those everyday physical reactions would bring on an unwanted dribble of urine she was unable to control -- the result of stress urinary incontinence. The condition affects millions of Canadians, primarily women, and often occurs as a side-effect of childbirth.
"It was getting bad," said Tomlinson, 58. "I wouldn't go anywhere without a change of clothes in the car."
The solution for the Ontario mother of two grown children turned out to be an experimental procedure, in which a type of stem cell isolated from the muscle of her thigh was injected into her urethra, the tube that carries urine from the bladder to the outside of the body. The stem cells are intended to strengthen the sphincter muscle, which acts as a check-valve against the release of urine.
Tomlinson was one of seven women with the disorder to undergo the injection of muscle-derived stem cells at Sunnybrook Health Sciences Centre, five of whom showed improvement in controlling a leaky bladder, said lead researcher Dr. Lesley Carr, a urologist at the Toronto hospital.
"Other injectable agents to treat stress incontinence, such as collagen, they're injected fairly superficially into the lining of the urethra to actually help it seal," said Carr, whose results were presented at the weekend meeting of the American Urological Association in Atlanta.
The results of the clinical trial in Toronto are "extremely encouraging" for patients coping with stress urinary incontinence, senior author Dr. Michael Chancellor, a professor of urology and gynecology at the University of Pittsburgh School of Medicine said in a release. "These findings suggest, for the first time, that we may be able to offer people with SUI a long-term and minimally invasive treatment."
Six months after her June 2005 injection, Tomlinson was no longer afflicted with unrestrained urine flow.
"Now I don't worry if I'm going to sneeze and it's going to be trickling down my leg."
© The Calgary Herald 2006
What happens during sleep?
Adapted from the National Institutes of Health by HealthGate Editorial Staff
Back to Sleep Center
Many people think of sleep as a passive activity, but our brains are actually very active during sleep. Moreover, sleep affects our daily functioning and our physical and mental health in many ways.
Nerve-signaling chemicals called neurotransmitters control whether we are asleep or awake by acting on different groups of nerve cells, or neurons, in the brain. Neurons in the brainstem, which connects the brain with the spinal cord, produce neurotransmitters such as serotonin and norepinephrine that keep some parts of the brain active while we are awake. Other neurons at the base of the brain begin signaling when we fall asleep. These neurons appear to "switch off" the signals that keep us awake. Research also suggests that a chemical called adenosine builds up in our blood while we are awake and causes drowsiness. This chemical gradually breaks down while we sleep.
Five phases of sleep
During sleep, we usually pass through five phases of sleep: stages 1, 2, 3, 4, and REM (rapid eye movement) sleep. These stages progress in a cycle from stage 1 to REM sleep, then the cycle starts over again with stage 1. We spend almost 50 percent of our total sleep time in stage 2 sleep, about 20 percent in REM sleep, and the remaining 30 percent in the other stages. Infants, by contrast, spend about half of their sleep time in REM sleep.
During stage 1, which is light sleep, we drift in and out of sleep and can be awakened easily. Our eyes move very slowly and muscle activity slows. People awakened from stage 1 sleep often remember fragmented visual images. Many also experience sudden muscle contractions called hypnic myoclonia, often preceded by a sensation of starting to fall. These sudden movements are similar to the "jump" we make when startled.
When we enter stage 2 sleep, our eye movements stop and our brain waves (fluctuations of electrical activity that can be measured by electrodes) become slower, with occasional bursts of rapid waves called sleep spindles.
In stage 3, extremely slow brain waves called delta waves begin to appear, interspersed with smaller, faster waves.
By stage 4, the brain produces delta waves almost exclusively. It is very difficult to wake someone during stages 3 and 4, which together are called deep sleep. There is no eye movement or muscle activity. People awakened during deep sleep do not adjust immediately and often feel groggy and disoriented for several minutes after they wake up. Some children experience bedwetting, night terrors, or sleepwalking during deep sleep.
When we switch into REM sleep, our breathing becomes more rapid, irregular, and shallow, our eyes jerk rapidly in various directions, and our limb muscles become temporarily paralyzed. Our heart rate increases, our blood pressure rises, and males develop penile erections. When people awaken during REM sleep, they often describe bizarre and illogical tales - dreams.
The first REM sleep period usually occurs about 70 to 90 minutes after we fall asleep. A complete sleep cycle takes 90 to 110 minutes on average. The first sleep cycles each night contain relatively short REM periods and long periods of deep sleep. As the night progresses, REM sleep periods increase in length while deep sleep decreases. By morning, people spend nearly all their sleep time in stages 1, 2, and REM.
People awakened after sleeping more than a few minutes are usually unable to recall the last few minutes before they fell asleep. This sleep-related form of amnesia is the reason people often forget telephone calls or conversations they've had in the middle of the night. It also explains why we often do not remember our alarms ringing in the morning if we go right back to sleep after turning them off.
Dreaming and REM sleep
We typically spend more than 2 hours each night dreaming. Scientists do not know much about how or why we dream. Sigmund Freud, who greatly influenced the field of psychology, believed dreaming was a "safety valve" for unconscious desires. The strange, illogical experiences we call dreams almost always occur during REM sleep.
REM sleep begins with signals from an area at the base of the brain called the pons These signals travel to a brain region called the thalamus, which relays them to the cerebral cortex - the outer layer of the brain that is responsible for learning, thinking, and organizing information. The pons also sends signals that shut off neurons in the spinal cord, causing temporary paralysis of the limb muscles. If something interferes with this paralysis, people will begin to physically "act out" their dreams - a rare, dangerous problem called REM sleep behavior disorder. A person dreaming about a ball game, for example, may run headlong into furniture or blindly strike someone sleeping nearby while trying to catch a ball in the dream.
REM sleep stimulates the brain regions used in learning. Like deep sleep, REM sleep is associated with increased production of proteins. One study found that REM sleep affects learning of certain mental skills. People taught a skill and then deprived of non-REM sleep could recall what they had learned after sleeping, while people deprived of REM sleep could not.
Sleep influenced by food, medications, chemicals, temperature
Since sleep and wakefulness are influenced by different neurotransmitter signals in the brain, foods and medicines that change the balance of these signals affect whether we feel alert or drowsy and how well we sleep. Caffeinated drinks such as coffee and drugs such as diet pills and decongestants stimulate some parts of the brain and can cause insomnia, or an inability to sleep. Many antidepressants suppress REM sleep. Heavy smokers often sleep very lightly and have reduced amounts of REM sleep. They also tend to wake up after 3 or 4 hours of sleep due to nicotine withdrawal.
Many people who suffer from insomnia try to solve the problem with alcohol - the so-called night cap. While alcohol does help people fall into light sleep, it also robs them of REM and the deeper, more restorative stages of sleep. Instead, it keeps them in the lighter stages of sleep, from which they can be awakened easily.
People lose some of the ability to regulate their body temperature during REM, so abnormally hot or cold temperatures in the environment can disrupt this stage of sleep. If our REM sleep is disrupted one night, our bodies don't follow the normal sleep cycle progression the next time we doze off. Instead, we often slip directly into REM sleep and go through extended periods of REM until we "catch up" on this stage of sleep.
People who are under anesthesia or in a coma are often said to be asleep. However, people in these conditions cannot be awakened and do not produce the complex, active brain wave patterns seen in normal sleep. Instead, their brain waves are very slow and weak, sometimes all but undetectable.
Source:
National Institutes of Health
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2006 - EBSCO Publishing All rights reserved.
Adapted from the National Institutes of Health by HealthGate Editorial Staff
Back to Sleep Center
Many people think of sleep as a passive activity, but our brains are actually very active during sleep. Moreover, sleep affects our daily functioning and our physical and mental health in many ways.
Nerve-signaling chemicals called neurotransmitters control whether we are asleep or awake by acting on different groups of nerve cells, or neurons, in the brain. Neurons in the brainstem, which connects the brain with the spinal cord, produce neurotransmitters such as serotonin and norepinephrine that keep some parts of the brain active while we are awake. Other neurons at the base of the brain begin signaling when we fall asleep. These neurons appear to "switch off" the signals that keep us awake. Research also suggests that a chemical called adenosine builds up in our blood while we are awake and causes drowsiness. This chemical gradually breaks down while we sleep.
Five phases of sleep
During sleep, we usually pass through five phases of sleep: stages 1, 2, 3, 4, and REM (rapid eye movement) sleep. These stages progress in a cycle from stage 1 to REM sleep, then the cycle starts over again with stage 1. We spend almost 50 percent of our total sleep time in stage 2 sleep, about 20 percent in REM sleep, and the remaining 30 percent in the other stages. Infants, by contrast, spend about half of their sleep time in REM sleep.
During stage 1, which is light sleep, we drift in and out of sleep and can be awakened easily. Our eyes move very slowly and muscle activity slows. People awakened from stage 1 sleep often remember fragmented visual images. Many also experience sudden muscle contractions called hypnic myoclonia, often preceded by a sensation of starting to fall. These sudden movements are similar to the "jump" we make when startled.
When we enter stage 2 sleep, our eye movements stop and our brain waves (fluctuations of electrical activity that can be measured by electrodes) become slower, with occasional bursts of rapid waves called sleep spindles.
In stage 3, extremely slow brain waves called delta waves begin to appear, interspersed with smaller, faster waves.
By stage 4, the brain produces delta waves almost exclusively. It is very difficult to wake someone during stages 3 and 4, which together are called deep sleep. There is no eye movement or muscle activity. People awakened during deep sleep do not adjust immediately and often feel groggy and disoriented for several minutes after they wake up. Some children experience bedwetting, night terrors, or sleepwalking during deep sleep.
When we switch into REM sleep, our breathing becomes more rapid, irregular, and shallow, our eyes jerk rapidly in various directions, and our limb muscles become temporarily paralyzed. Our heart rate increases, our blood pressure rises, and males develop penile erections. When people awaken during REM sleep, they often describe bizarre and illogical tales - dreams.
The first REM sleep period usually occurs about 70 to 90 minutes after we fall asleep. A complete sleep cycle takes 90 to 110 minutes on average. The first sleep cycles each night contain relatively short REM periods and long periods of deep sleep. As the night progresses, REM sleep periods increase in length while deep sleep decreases. By morning, people spend nearly all their sleep time in stages 1, 2, and REM.
People awakened after sleeping more than a few minutes are usually unable to recall the last few minutes before they fell asleep. This sleep-related form of amnesia is the reason people often forget telephone calls or conversations they've had in the middle of the night. It also explains why we often do not remember our alarms ringing in the morning if we go right back to sleep after turning them off.
Dreaming and REM sleep
We typically spend more than 2 hours each night dreaming. Scientists do not know much about how or why we dream. Sigmund Freud, who greatly influenced the field of psychology, believed dreaming was a "safety valve" for unconscious desires. The strange, illogical experiences we call dreams almost always occur during REM sleep.
REM sleep begins with signals from an area at the base of the brain called the pons These signals travel to a brain region called the thalamus, which relays them to the cerebral cortex - the outer layer of the brain that is responsible for learning, thinking, and organizing information. The pons also sends signals that shut off neurons in the spinal cord, causing temporary paralysis of the limb muscles. If something interferes with this paralysis, people will begin to physically "act out" their dreams - a rare, dangerous problem called REM sleep behavior disorder. A person dreaming about a ball game, for example, may run headlong into furniture or blindly strike someone sleeping nearby while trying to catch a ball in the dream.
REM sleep stimulates the brain regions used in learning. Like deep sleep, REM sleep is associated with increased production of proteins. One study found that REM sleep affects learning of certain mental skills. People taught a skill and then deprived of non-REM sleep could recall what they had learned after sleeping, while people deprived of REM sleep could not.
Sleep influenced by food, medications, chemicals, temperature
Since sleep and wakefulness are influenced by different neurotransmitter signals in the brain, foods and medicines that change the balance of these signals affect whether we feel alert or drowsy and how well we sleep. Caffeinated drinks such as coffee and drugs such as diet pills and decongestants stimulate some parts of the brain and can cause insomnia, or an inability to sleep. Many antidepressants suppress REM sleep. Heavy smokers often sleep very lightly and have reduced amounts of REM sleep. They also tend to wake up after 3 or 4 hours of sleep due to nicotine withdrawal.
Many people who suffer from insomnia try to solve the problem with alcohol - the so-called night cap. While alcohol does help people fall into light sleep, it also robs them of REM and the deeper, more restorative stages of sleep. Instead, it keeps them in the lighter stages of sleep, from which they can be awakened easily.
People lose some of the ability to regulate their body temperature during REM, so abnormally hot or cold temperatures in the environment can disrupt this stage of sleep. If our REM sleep is disrupted one night, our bodies don't follow the normal sleep cycle progression the next time we doze off. Instead, we often slip directly into REM sleep and go through extended periods of REM until we "catch up" on this stage of sleep.
People who are under anesthesia or in a coma are often said to be asleep. However, people in these conditions cannot be awakened and do not produce the complex, active brain wave patterns seen in normal sleep. Instead, their brain waves are very slow and weak, sometimes all but undetectable.
Source:
National Institutes of Health
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2006 - EBSCO Publishing All rights reserved.
How to Wash Your Hands Properly
by Mary Calvagna, MS
Chances are, you have been washing your own hands for quite a while. All it takes is a little soap and some water, right? Actually, there is a bit more to handwashing. Below, find out how to wash your hands correctly, and why it matters so much.
Here's Why:
The single most important thing you can do to keep from getting sick and to stop the spread of disease-causing germs is to wash your hands often. By frequently washing your hands, you wash away germs that you may have picked up from other people or from contaminated surfaces. One of the most common ways people catch colds is by rubbing their nose or their eyes after their hands have been contaminated with the cold virus. More frequent hand washing may be able to reduce the spread of the cold virus.
You cannot see germs with the naked eye, so wash your hands often. Especially important times include:
Before, during, and after you prepare food
Before you eat
After you use the bathroom
After you change a diaper
After handling animals or animal waste
When your hands are dirty
More frequently when someone in your home is sick
Here's How:
To properly wash your hands, follow these simple steps:
First wet your hands with warm water and apply liquid or lather up with a clean bar of soap.
Next rub your hands together vigorously and scrub all surfaces. Also clean under your fingernails to help control germs and keep them trimmed and short.
Continue for at least 15 seconds or about the length of a little tune (for example: the "Happy Birthday" song). It is the soap combined with the scrubbing action that helps dislodge and remove germs.
Rinse your hands well and then dry your hands.
Note: When soap is not readily available, alcohol-based hand rubs offer a quick and easy alternative. No water is needed and studies show they’re fairly effective. But washing with soap is still the best.
Source:
The Centers for Disease Control and Prevention
http://www.cdc.gov/
****
How to Keep Your Home Clean—but Not Toxic
by Alice A McCarthy, MBA
Be it at home or at nursery school, both parents and childcare providers struggle to win the infectious disease battle—or at least declare a truce—through regular use of powerful cleaning and disinfecting agents. But while these cleaners may protect your child by defeating the germ bugs, they may also pose a few potential health risks due to the sometimes toxic ingredients they contain. And while you can’t control the toxins that permeate public facilities, you do have a say in the how you choose to keep your own home.
Potential Health Risks of Common Cleaners
Keeping a clean house is a necessary step in providing a safe living environment. Through proper cleaning and disinfection in the kitchen, for example, contact with disease-causing bacteria from raw or undercooked meat, shellfish, fish, and eggs can be reduced. But the products we use to clean the house can also have unintended health consequences.
Most of the research regarding the health risks of cleaning products has focused on adult janitorial staff working with industrial cleaners in settings outside of the home. These workers are known to suffer from high rates of permanent eye damage, scleroderma, major organ damage, and even cancer attributed to frequent exposure to powerful, concentrated cleaning products. While household cleaners tend to be more diluted and less potent than their industrial-strength counterparts, many do contain some of the same potentially harmful ingredients. And while both children and adults are susceptible to the consequences of toxic chemical exposure, children are more susceptible because of their rapidly growing bodies and immature immune systems.
Based on the research mentioned above, of particular concern are cleaners that containing the following:
Ammonia
Aerosol propellants
Chlorine bleach
Hydrochloric acid
Hydrofluoric acid
Isopropyl alcohol
Paradichlorobenzenes (PDCBs)
Petroleum distillates
Phenols
Trichloroethylene (TCE)
These compounds can be found in floor and carpet cleaners, degreasers, toilet/tub/tile cleaners, room deodorizers, oven cleaners, furniture polishes and waxes, and disinfectants.
Asthma
“There are certainly triggers to asthma in some of our household cleaning agents,” says Carol LeBlanc, PhD, of the Toxics Use Reduction Institute at the University of Massachusetts, Lowell.
For example, research shows that a group of chemicals called volatile organic compounds (VOCs)—several of which are found as ingredients in the more powerful household cleaners, such as oven and rug cleaners—are known to increase asthma rates in children. Among other compounds, VOCs include:
Nitrobenzene
Toluene
Methylene
Chloride
Formaldehyde
Ethylene glycol
Because of concern over the increasing incidence of asthma among children, several states are taking action to mandate the use of safer cleaners in schools. New York and Massachusetts are two such states that have passed legislation or have bills pending.
Chronic Endocrine Disruptors
“To me, the chronic exposures are a huge problem because the child does not become obviously sick right away,” says LeBlanc, yet these conditions can be serious. For example, some cleaning products contain chemicals believed to be “endocrine disruptors”—in other words, hormone mimickers. Over time, endocrine disruptors may affect the development and function of the body's organs and hormonal systems. And like any toxin, they may be particularly harmful for developing fetuses, infants, and young children.
In cleaning products, the endocrine disruptors of greatest concern are the nonyl- and octyl-phenols used to make alkylphenol ethoxylate (APE) detergents. APE detergents are, in turn, widely added to liquid laundry detergents, disinfecting cleaners, all-purpose cleaners, and laundry stain removers in order to boost their “dirt-lifting” effectiveness. However, APEs are known in the industry to persist as long-term environmental pollutants. Some manufacturers are even taking steps to remove them from their products. Knowing this, it’s not surprising that APE detergents may linger in household air long after the wash is done. In fact, a recent study of 120 U.S. homes found the presence of 4-nonylphenol, a common detergent additive, in the air of every home tested.
What Can You Do?
The good news is that safer cleaning products are available, and you can also employ safer cleaning techniques to protect yourself, your family, even your pets. To start, be sure to read all labels well. Do not assume a green bottle labeled “natural” is toxin-free. Also consider the following pointers to avoid purchasing toxic cleaners:
Do not use APE-containing cleaners.
Consider products with:
Citrus or plant-based oils: orange and lemon for degreasing, tea tree and eucalyptus for disinfecting, and olive for polishing
Enzymes to break up drain clogs
Choose products that list ALL of their ingredients.
Make your own cleaning products from non-toxic ingredients such as baking soda, club soda, and vinegar.
Focus on cleaning; disinfect only when necessary. “If you clean well, you have to do far less disinfecting,” according to Dr. LeBlanc. “The goal is not to completely abandon disinfectants but use them wisely and judiciously.”
Do not use chemical carpet cleaners.
Use chlorine bleach sparingly. Consider using fragrance-free, non-chlorine bleaches containing hydrogen peroxide instead.
Choose unscented cleaning products. Sometimes fragrances are added to mask the smell of toxic cleaners; furthermore, fragrances themselves can trigger allergic reactions and asthma attacks.
Be wary of concentrated cleaners that advertise safety only when used under certain conditions.
Avoid cleaners carrying a ‘danger’ or ‘warning’ label.
Manufacturers of cleaning products are required to prepare a Material Safety Data Sheet containing information about a product’s health, fire, reactivity, and specific hazards, from a score of 0 (minimum) to 4 (severe) in each category. For household cleaning products, avoid any product with a score higher than 2 in any category. Note, however, that this ranking system is not required to be on the label. Visit the NIH Household Products Database (http://hpd.nlm.nih.gov/index.htm) to search for this and other helpful information on household cleaners.
RESOURCES:
Children’s Health Environmental Coalition
Recipes for Safer Cleaners
http://www.checnet.org/
by Mary Calvagna, MS
Chances are, you have been washing your own hands for quite a while. All it takes is a little soap and some water, right? Actually, there is a bit more to handwashing. Below, find out how to wash your hands correctly, and why it matters so much.
Here's Why:
The single most important thing you can do to keep from getting sick and to stop the spread of disease-causing germs is to wash your hands often. By frequently washing your hands, you wash away germs that you may have picked up from other people or from contaminated surfaces. One of the most common ways people catch colds is by rubbing their nose or their eyes after their hands have been contaminated with the cold virus. More frequent hand washing may be able to reduce the spread of the cold virus.
You cannot see germs with the naked eye, so wash your hands often. Especially important times include:
Before, during, and after you prepare food
Before you eat
After you use the bathroom
After you change a diaper
After handling animals or animal waste
When your hands are dirty
More frequently when someone in your home is sick
Here's How:
To properly wash your hands, follow these simple steps:
First wet your hands with warm water and apply liquid or lather up with a clean bar of soap.
Next rub your hands together vigorously and scrub all surfaces. Also clean under your fingernails to help control germs and keep them trimmed and short.
Continue for at least 15 seconds or about the length of a little tune (for example: the "Happy Birthday" song). It is the soap combined with the scrubbing action that helps dislodge and remove germs.
Rinse your hands well and then dry your hands.
Note: When soap is not readily available, alcohol-based hand rubs offer a quick and easy alternative. No water is needed and studies show they’re fairly effective. But washing with soap is still the best.
Source:
The Centers for Disease Control and Prevention
http://www.cdc.gov/
****
How to Keep Your Home Clean—but Not Toxic
by Alice A McCarthy, MBA
Be it at home or at nursery school, both parents and childcare providers struggle to win the infectious disease battle—or at least declare a truce—through regular use of powerful cleaning and disinfecting agents. But while these cleaners may protect your child by defeating the germ bugs, they may also pose a few potential health risks due to the sometimes toxic ingredients they contain. And while you can’t control the toxins that permeate public facilities, you do have a say in the how you choose to keep your own home.
Potential Health Risks of Common Cleaners
Keeping a clean house is a necessary step in providing a safe living environment. Through proper cleaning and disinfection in the kitchen, for example, contact with disease-causing bacteria from raw or undercooked meat, shellfish, fish, and eggs can be reduced. But the products we use to clean the house can also have unintended health consequences.
Most of the research regarding the health risks of cleaning products has focused on adult janitorial staff working with industrial cleaners in settings outside of the home. These workers are known to suffer from high rates of permanent eye damage, scleroderma, major organ damage, and even cancer attributed to frequent exposure to powerful, concentrated cleaning products. While household cleaners tend to be more diluted and less potent than their industrial-strength counterparts, many do contain some of the same potentially harmful ingredients. And while both children and adults are susceptible to the consequences of toxic chemical exposure, children are more susceptible because of their rapidly growing bodies and immature immune systems.
Based on the research mentioned above, of particular concern are cleaners that containing the following:
Ammonia
Aerosol propellants
Chlorine bleach
Hydrochloric acid
Hydrofluoric acid
Isopropyl alcohol
Paradichlorobenzenes (PDCBs)
Petroleum distillates
Phenols
Trichloroethylene (TCE)
These compounds can be found in floor and carpet cleaners, degreasers, toilet/tub/tile cleaners, room deodorizers, oven cleaners, furniture polishes and waxes, and disinfectants.
Asthma
“There are certainly triggers to asthma in some of our household cleaning agents,” says Carol LeBlanc, PhD, of the Toxics Use Reduction Institute at the University of Massachusetts, Lowell.
For example, research shows that a group of chemicals called volatile organic compounds (VOCs)—several of which are found as ingredients in the more powerful household cleaners, such as oven and rug cleaners—are known to increase asthma rates in children. Among other compounds, VOCs include:
Nitrobenzene
Toluene
Methylene
Chloride
Formaldehyde
Ethylene glycol
Because of concern over the increasing incidence of asthma among children, several states are taking action to mandate the use of safer cleaners in schools. New York and Massachusetts are two such states that have passed legislation or have bills pending.
Chronic Endocrine Disruptors
“To me, the chronic exposures are a huge problem because the child does not become obviously sick right away,” says LeBlanc, yet these conditions can be serious. For example, some cleaning products contain chemicals believed to be “endocrine disruptors”—in other words, hormone mimickers. Over time, endocrine disruptors may affect the development and function of the body's organs and hormonal systems. And like any toxin, they may be particularly harmful for developing fetuses, infants, and young children.
In cleaning products, the endocrine disruptors of greatest concern are the nonyl- and octyl-phenols used to make alkylphenol ethoxylate (APE) detergents. APE detergents are, in turn, widely added to liquid laundry detergents, disinfecting cleaners, all-purpose cleaners, and laundry stain removers in order to boost their “dirt-lifting” effectiveness. However, APEs are known in the industry to persist as long-term environmental pollutants. Some manufacturers are even taking steps to remove them from their products. Knowing this, it’s not surprising that APE detergents may linger in household air long after the wash is done. In fact, a recent study of 120 U.S. homes found the presence of 4-nonylphenol, a common detergent additive, in the air of every home tested.
What Can You Do?
The good news is that safer cleaning products are available, and you can also employ safer cleaning techniques to protect yourself, your family, even your pets. To start, be sure to read all labels well. Do not assume a green bottle labeled “natural” is toxin-free. Also consider the following pointers to avoid purchasing toxic cleaners:
Do not use APE-containing cleaners.
Consider products with:
Citrus or plant-based oils: orange and lemon for degreasing, tea tree and eucalyptus for disinfecting, and olive for polishing
Enzymes to break up drain clogs
Choose products that list ALL of their ingredients.
Make your own cleaning products from non-toxic ingredients such as baking soda, club soda, and vinegar.
Focus on cleaning; disinfect only when necessary. “If you clean well, you have to do far less disinfecting,” according to Dr. LeBlanc. “The goal is not to completely abandon disinfectants but use them wisely and judiciously.”
Do not use chemical carpet cleaners.
Use chlorine bleach sparingly. Consider using fragrance-free, non-chlorine bleaches containing hydrogen peroxide instead.
Choose unscented cleaning products. Sometimes fragrances are added to mask the smell of toxic cleaners; furthermore, fragrances themselves can trigger allergic reactions and asthma attacks.
Be wary of concentrated cleaners that advertise safety only when used under certain conditions.
Avoid cleaners carrying a ‘danger’ or ‘warning’ label.
Manufacturers of cleaning products are required to prepare a Material Safety Data Sheet containing information about a product’s health, fire, reactivity, and specific hazards, from a score of 0 (minimum) to 4 (severe) in each category. For household cleaning products, avoid any product with a score higher than 2 in any category. Note, however, that this ranking system is not required to be on the label. Visit the NIH Household Products Database (http://hpd.nlm.nih.gov/index.htm) to search for this and other helpful information on household cleaners.
RESOURCES:
Children’s Health Environmental Coalition
Recipes for Safer Cleaners
http://www.checnet.org/
Genetic testing helps family take on cancer
Published: Friday, June 16, 2006
Mike Slabaugh doesn't have a stomach. Neither do his 10 cousins.
Growing up, they watched helplessly as a rare hereditary stomach cancer killed their grandmother and some of their parents, aunts and uncles.
Determined to outsmart the cancer, they turned to genetic testing. Upon learning they had inherited Grandmother Golda Bradfield's flawed gene, these were their options:
Risk the odds that they might not develop cancer, with a 70 per cent chance they would; or have their stomachs removed. The latter would mean a challenging life of eating very little, very often.
All the cousins chose the life-changing operation. Doctors say they're the largest family to have preventive surgery to protect themselves from hereditary stomach cancer.
"We're not only surviving, we're thriving," said Slabaugh 16 months after his operation at Stanford University Medical Center in Palo Alto, Calif.
Advances in genetic testing are increasingly giving families with bad genes a chance to see the future, sometimes with the hope of pre-emptive action. People have had stomachs, breasts, ovaries, colons or thyroid glands removed when genetic tests showed they carried a gene that gave them a high risk of cancer.
Experts say that, someday, doctors may do DNA tests as routinely as they check cholesterol levels now, spotting disease risks that can be lowered.
Slabaugh, who lives in Dallas, reunited with his many scattered cousins recently in Las Vegas just two months after the last in the group -- Bill Bradfield of Farmington, N.M. -- had his operation. Several hadn't seen each other for decades while others met for the first time.
They gambled, went to shows and dined in the City of Sin.
"Rather than live in fear, they tackled their genetic destiny head-on," said Dr. David Huntsman of the University of British Columbia, who found the gene mutation in the family.
© The Calgary Herald 2006
Published: Friday, June 16, 2006
Mike Slabaugh doesn't have a stomach. Neither do his 10 cousins.
Growing up, they watched helplessly as a rare hereditary stomach cancer killed their grandmother and some of their parents, aunts and uncles.
Determined to outsmart the cancer, they turned to genetic testing. Upon learning they had inherited Grandmother Golda Bradfield's flawed gene, these were their options:
Risk the odds that they might not develop cancer, with a 70 per cent chance they would; or have their stomachs removed. The latter would mean a challenging life of eating very little, very often.
All the cousins chose the life-changing operation. Doctors say they're the largest family to have preventive surgery to protect themselves from hereditary stomach cancer.
"We're not only surviving, we're thriving," said Slabaugh 16 months after his operation at Stanford University Medical Center in Palo Alto, Calif.
Advances in genetic testing are increasingly giving families with bad genes a chance to see the future, sometimes with the hope of pre-emptive action. People have had stomachs, breasts, ovaries, colons or thyroid glands removed when genetic tests showed they carried a gene that gave them a high risk of cancer.
Experts say that, someday, doctors may do DNA tests as routinely as they check cholesterol levels now, spotting disease risks that can be lowered.
Slabaugh, who lives in Dallas, reunited with his many scattered cousins recently in Las Vegas just two months after the last in the group -- Bill Bradfield of Farmington, N.M. -- had his operation. Several hadn't seen each other for decades while others met for the first time.
They gambled, went to shows and dined in the City of Sin.
"Rather than live in fear, they tackled their genetic destiny head-on," said Dr. David Huntsman of the University of British Columbia, who found the gene mutation in the family.
© The Calgary Herald 2006
Anemia: How Food and Vitamins Can Help
by Bethanne Black
If you're feeling exhausted (despite lots of sleep), have decreased energy, and seem to be unusually pale, the culprit could be some form of anemia.
Although iron-deficiency anemia is by far the most common form of anemia, there are other types. Here, we'll discuss three forms of anemia that are related to nutrition.
More Than Just a Lack of Iron
Anemia is any blood disorder in which the number and/or size of the red blood cells is altered. Red blood cells—with the help of iron-containing hemoglobin—move oxygen from your lungs to bodily tissues, so any change in the size or amount of these cells affects how oxygen is transported within your body.
What Are the Symptoms of Anemia?
"The symptoms of anemia are numerous and affect many organ systems in the body," says Susan M. Lark, MD, of Stanford University, a physician specializing in women's health. "Often the symptoms seem vague and misleading to women and their physicians."
Symptoms of anemia include:
Fatigue and dizziness
General weakness
Shortness of breath
Paleness
Loss of appetite
Brittle and ridged nails
The "Nutritional" Anemias
Iron-Deficiency Anemia
In the United States, 20% of women of childbearing age suffer from iron-deficiency anemia, compared with only 2% of men. It can be caused by the following:
Deficiency of iron in the diet
An accident or trauma that causes acute blood loss
Gradual blood loss (bleeding from the intestines or menstruation)
Other than women of childbearing age, children and teens are the next most likely to suffer from iron-deficiency anemia. And infants whose mothers experienced anemia during pregnancy are more susceptible to developing anemia.
"During an average menstrual period, it is estimated that a woman loses approximately 18 milligrams of iron through the loss of red blood cells," says Dr. Lark. Since iron is responsible for the production of hemoglobin, which carries oxygen, anemia may result if iron is not replenished.
Megaloblastic Anemia
This type of anemia is primarily associated with inadequate intake or utilization of vitamin B-12 and folic acid—two vitamins necessary for cell division. Thus cells that need rapid replenishment, such as blood cells, are most often affected by a deficiency of these vitamins. The result is that fewer red blood cells are produced and available to carry oxygen to the body's cells, resulting in anemia.
A decreased intake of folic acid from food results in megaloblastic anemia. Pregnancy, breast-feeding, and periods of rapid growth, which increase the body's need for folic acid, can also contribute to anemia. Deficiencies of iron, zinc, or vitamin C will make folic acid less available to the body, and heavy alcohol consumption will increase folic acid requirements.
Vitamin B-12 is found in animal products. Thus vegetarians who consume dairy and egg products are not at increased risk for B-12 deficiency, while individuals who are strict vegans (and their breast fed infants) are most at risk for B-12 deficiency.
Aging also affects B-12 status because less acid is produced in the stomach as we age. Acid helps to release the active form of vitamin B-12 in the stomach. From the stomach B-12 travels down the intestines where it is absorbed into the body in the small intestines. Therefore people who have malabsorption are also at risk for B-12 deficiency.
Causes of the megaloblastic anemias include:
Inadequate intake or absorption of foods with a high B-12 content, such as meat, poultry, fish, cheese, milk, and eggs
Inadequate intake or absorption of foods rich in folic acid, such as green vegetables, whole grains, legumes, leafy greens, broccoli, brussel sprouts, asparagus, citrus fruits, strawberries, wheat germ, and brewer's yeast
Alcoholism
Overcooking foods, which destroys folic acid
Deficiencies of vitamin C, iron, and zinc
Low levels of acid in the stomach
Removal of parts of the stomach or small intestine
Gluten sensitivity
Pernicious Anemia
This is another form of megaloblastic anemia caused by the absence of intrinsic factor—a chemical substance secreted by cells in the stomach that makes absorption of vitamin B-12 possible. Lack of intrinsic factor is thought to be caused by a genetic deficiency or an autoimmune disorder. A decrease in intrinsic factor is also seen in individuals with gluten (wheat, oats, rye) sensitivity or in people who have had surgery affecting parts of the small intestine. Vitamin B-12 injections are the treatment for pernicious anemia.
Pernicious anemia usually affects adults. The symptoms of this disorder come on gradually and may not be immediately recognized.
Making the Diagnosis
Your doctor will conduct a full medical examination to diagnose anemia and rule out another significant illnesses. It is important to tell the doctor if you have a family history of anemia, gall bladder disease, jaundice, or an enlarged spleen. Your dietary habits are also extremely important for making the diagnosis of the nutritional anemias. If you are a female, you must tell your doctor about unusually heavy menstrual periods.
You should also report whether you've noticed the presence of blood in your stools (bowel movements). Physicians often perform a rectal exam test for the presence of less obvious blood in your stool—often the cause of iron-deficiency anemia.
Blood Tests and Blood Smears
The basic laboratory tests for diagnosing anemia are a complete blood count (CBC) and blood smears.
A complete blood count is performed to assess the red blood cells. It yields two important numbers:
Hemoglobin - the amount of iron in the red blood cells
Hematocrit - the percentage of red blood cells in the blood
Blood smears involve pricking your finger and smearing a drop or two of blood onto a slide for microscopic examination. A technician will then classify your blood by color, size, and shape. A blood test can also measure the amount of ferritin, an important iron-storage protein. Low ferritin levels indicate chronic iron deficiency.
Treating the Nutritional Anemias
Physicians recommend a diet rich in iron for people who have iron-deficiency anemia.
Iron-rich foods include:
Beef liver
Poultry
Fish
Wheat germ
Oysters
Dried fruit
Iron-fortified cereals
Eggs
Foods high in folic acid include:
Liver
Chicken giblets
Egg yolks
Enriched grain products (including certain breakfast cereals)
Beans and other legumes
Leafy green vegetables
Bananas
Oranges
Peaches
Foods high in Vitamin B12 include:
Liver
Meat
Fish
Eggs
Milk and other dairy products
Felicia Busch, registered dietitian and author of The New Nutrition, recommends the following dietary recommendations for the "nutritional" anemias:
Variety: Choose a healthful variety of foods, especially those rich in iron and folic acid, such as lean red meat, foods fortified with iron and folic acid, and leafy green vegetables.
Vitamin C: Include plenty of foods rich in vitamin C when you eat foods that contain iron. The vitamin C will help absorb more of the available iron.
Cast-iron Cooking: Use cast-iron cookware. Tiny iron particles from the cookware are transferred to food and can provide a significant source of dietary iron.
Don't Smoke: Smoking increases vitamin requirements and has a negative effect on your health in general.
Supplements: In addition to dietary changes, taking iron supplements may be necessary in some cases. First, talk to your doctor to find out if a supplement is advisable for you. Since iron supplements often cause constipation, upset your stomach, and cause nausea, be sure to eat extra fiber and take iron with a full meal.
RESOURCES:
American Dietetic Association
http://www.eatright.org
American Society of Hematology
http://www.hematology.org
Cooley's Anemia Foundation, Inc.
http://www.thalassemia.org
SOURCES:
American Dietetic Association
American Society of Hematology
The New Nutrition: From Antioxidants to Zucchini, by F. Busch. John Wiley & Sons, 2000.
Understanding Anemia, by E. Uthman. University Press of Mississippi, 1998.
by Bethanne Black
If you're feeling exhausted (despite lots of sleep), have decreased energy, and seem to be unusually pale, the culprit could be some form of anemia.
Although iron-deficiency anemia is by far the most common form of anemia, there are other types. Here, we'll discuss three forms of anemia that are related to nutrition.
More Than Just a Lack of Iron
Anemia is any blood disorder in which the number and/or size of the red blood cells is altered. Red blood cells—with the help of iron-containing hemoglobin—move oxygen from your lungs to bodily tissues, so any change in the size or amount of these cells affects how oxygen is transported within your body.
What Are the Symptoms of Anemia?
"The symptoms of anemia are numerous and affect many organ systems in the body," says Susan M. Lark, MD, of Stanford University, a physician specializing in women's health. "Often the symptoms seem vague and misleading to women and their physicians."
Symptoms of anemia include:
Fatigue and dizziness
General weakness
Shortness of breath
Paleness
Loss of appetite
Brittle and ridged nails
The "Nutritional" Anemias
Iron-Deficiency Anemia
In the United States, 20% of women of childbearing age suffer from iron-deficiency anemia, compared with only 2% of men. It can be caused by the following:
Deficiency of iron in the diet
An accident or trauma that causes acute blood loss
Gradual blood loss (bleeding from the intestines or menstruation)
Other than women of childbearing age, children and teens are the next most likely to suffer from iron-deficiency anemia. And infants whose mothers experienced anemia during pregnancy are more susceptible to developing anemia.
"During an average menstrual period, it is estimated that a woman loses approximately 18 milligrams of iron through the loss of red blood cells," says Dr. Lark. Since iron is responsible for the production of hemoglobin, which carries oxygen, anemia may result if iron is not replenished.
Megaloblastic Anemia
This type of anemia is primarily associated with inadequate intake or utilization of vitamin B-12 and folic acid—two vitamins necessary for cell division. Thus cells that need rapid replenishment, such as blood cells, are most often affected by a deficiency of these vitamins. The result is that fewer red blood cells are produced and available to carry oxygen to the body's cells, resulting in anemia.
A decreased intake of folic acid from food results in megaloblastic anemia. Pregnancy, breast-feeding, and periods of rapid growth, which increase the body's need for folic acid, can also contribute to anemia. Deficiencies of iron, zinc, or vitamin C will make folic acid less available to the body, and heavy alcohol consumption will increase folic acid requirements.
Vitamin B-12 is found in animal products. Thus vegetarians who consume dairy and egg products are not at increased risk for B-12 deficiency, while individuals who are strict vegans (and their breast fed infants) are most at risk for B-12 deficiency.
Aging also affects B-12 status because less acid is produced in the stomach as we age. Acid helps to release the active form of vitamin B-12 in the stomach. From the stomach B-12 travels down the intestines where it is absorbed into the body in the small intestines. Therefore people who have malabsorption are also at risk for B-12 deficiency.
Causes of the megaloblastic anemias include:
Inadequate intake or absorption of foods with a high B-12 content, such as meat, poultry, fish, cheese, milk, and eggs
Inadequate intake or absorption of foods rich in folic acid, such as green vegetables, whole grains, legumes, leafy greens, broccoli, brussel sprouts, asparagus, citrus fruits, strawberries, wheat germ, and brewer's yeast
Alcoholism
Overcooking foods, which destroys folic acid
Deficiencies of vitamin C, iron, and zinc
Low levels of acid in the stomach
Removal of parts of the stomach or small intestine
Gluten sensitivity
Pernicious Anemia
This is another form of megaloblastic anemia caused by the absence of intrinsic factor—a chemical substance secreted by cells in the stomach that makes absorption of vitamin B-12 possible. Lack of intrinsic factor is thought to be caused by a genetic deficiency or an autoimmune disorder. A decrease in intrinsic factor is also seen in individuals with gluten (wheat, oats, rye) sensitivity or in people who have had surgery affecting parts of the small intestine. Vitamin B-12 injections are the treatment for pernicious anemia.
Pernicious anemia usually affects adults. The symptoms of this disorder come on gradually and may not be immediately recognized.
Making the Diagnosis
Your doctor will conduct a full medical examination to diagnose anemia and rule out another significant illnesses. It is important to tell the doctor if you have a family history of anemia, gall bladder disease, jaundice, or an enlarged spleen. Your dietary habits are also extremely important for making the diagnosis of the nutritional anemias. If you are a female, you must tell your doctor about unusually heavy menstrual periods.
You should also report whether you've noticed the presence of blood in your stools (bowel movements). Physicians often perform a rectal exam test for the presence of less obvious blood in your stool—often the cause of iron-deficiency anemia.
Blood Tests and Blood Smears
The basic laboratory tests for diagnosing anemia are a complete blood count (CBC) and blood smears.
A complete blood count is performed to assess the red blood cells. It yields two important numbers:
Hemoglobin - the amount of iron in the red blood cells
Hematocrit - the percentage of red blood cells in the blood
Blood smears involve pricking your finger and smearing a drop or two of blood onto a slide for microscopic examination. A technician will then classify your blood by color, size, and shape. A blood test can also measure the amount of ferritin, an important iron-storage protein. Low ferritin levels indicate chronic iron deficiency.
Treating the Nutritional Anemias
Physicians recommend a diet rich in iron for people who have iron-deficiency anemia.
Iron-rich foods include:
Beef liver
Poultry
Fish
Wheat germ
Oysters
Dried fruit
Iron-fortified cereals
Eggs
Foods high in folic acid include:
Liver
Chicken giblets
Egg yolks
Enriched grain products (including certain breakfast cereals)
Beans and other legumes
Leafy green vegetables
Bananas
Oranges
Peaches
Foods high in Vitamin B12 include:
Liver
Meat
Fish
Eggs
Milk and other dairy products
Felicia Busch, registered dietitian and author of The New Nutrition, recommends the following dietary recommendations for the "nutritional" anemias:
Variety: Choose a healthful variety of foods, especially those rich in iron and folic acid, such as lean red meat, foods fortified with iron and folic acid, and leafy green vegetables.
Vitamin C: Include plenty of foods rich in vitamin C when you eat foods that contain iron. The vitamin C will help absorb more of the available iron.
Cast-iron Cooking: Use cast-iron cookware. Tiny iron particles from the cookware are transferred to food and can provide a significant source of dietary iron.
Don't Smoke: Smoking increases vitamin requirements and has a negative effect on your health in general.
Supplements: In addition to dietary changes, taking iron supplements may be necessary in some cases. First, talk to your doctor to find out if a supplement is advisable for you. Since iron supplements often cause constipation, upset your stomach, and cause nausea, be sure to eat extra fiber and take iron with a full meal.
RESOURCES:
American Dietetic Association
http://www.eatright.org
American Society of Hematology
http://www.hematology.org
Cooley's Anemia Foundation, Inc.
http://www.thalassemia.org
SOURCES:
American Dietetic Association
American Society of Hematology
The New Nutrition: From Antioxidants to Zucchini, by F. Busch. John Wiley & Sons, 2000.
Understanding Anemia, by E. Uthman. University Press of Mississippi, 1998.
Behind the Scenes: Maximizing Male Fertility
by Elaine Gottlieb
You may not choose to become a father at age 77, like actor Tony Randall. But from a strictly biological perspective, it is within the realm of possibility. Most men produce sperm for their entire lives, according to Dr. Abraham Morgentaler, the director of the Male Infertility Program at Beth Israel Deaconess Medical Center in Boston and a professor at Harvard Medical School.
The male reproductive system is relatively simple; as a result, it generally functions quite efficiently. Sperm are produced in the testicles and stored within the scrotum in a "sack" called the epididymis. During erection, but before ejaculation occurs, the sperm travel from the epididymis to the vas deferens (the tube that is severed in a vasectomy). The sperm is then propelled to the urethra where they mix with other fluids to form semen, which is ejaculated through the tip of the penis. For sperm, this journey is equivalent to a marathon, says Dr. Morgentaler, but in reality, it takes just two to five seconds!
What Can Stand in the Way of Fertility?
Certain medical conditions can interfere with the proper functioning of the reproductive process. They include:
- Lack of physical structures or blockages: Some men are born without a vas deferens or with tubal blockages. These conditions are easily treated by surgery, according to Dr. Morgentaler.
- Varicocele: The development of varicocele, or varicose veins in the scrotum, which occurs in 10% of men, can sometimes affect sperm production. Removing the veins may boost fertility, though the evidence favoring surgery remains incomplete.
-Retrograde ejaculation: A condition in which semen travels in the wrong direction back into the bladder rather than being released through the penis. This can be caused by prostate and other types of surgery in the pelvic area. Drugs that close the opening from the urethra to the bladder can alleviate this problem.
-Diabetes and multiple sclerosis: These conditions can impair the nerves that promote normal ejaculation.
-Infections: Urinary tract, prostate, or tubal infections can cause blockages that can be treated by antibiotics. Gonorrhea and chlamydia are sexually transmitted infections that can scar the epididymis; however, these scars can be treated with microsurgery.
Maintaining Your Fertility
The average male produces 60–100 million sperm per milliliter (ml) of semen. Low sperm counts are not considered a problem until they get as low as 20 million per ml, which is diagnosed as oligospermia. That may still sound like an enormous number, but statistics show that it is more difficult for couples to conceive at this level.
Conception is difficult at low sperm levels, because even at full count, only a fraction of sperm survive the difficult journey from the vagina through the uterus to the fallopian tubes, where conception takes place. The sperm must be strong swimmers. A man can have a low sperm count but still successfully conceive if his sperm have good motility.
Semen analysis can tell you the quantity and quality of your sperm. If your sperm count is critically low, a drug called clomiphene citrate, which stimulates testosterone production, can sometimes boost sperm creation.
The key to maintaining healthy fertility, according to Dr. Morgentaler, is prevention. There are no magic potions or vitamins that boost fertility. "Men do just fine with their fertility," says Dr. Morgentaler, without any special concessions.
The temperature of the testicles is one of the most significant factors in fertility. Testicles don't produce sperm well at high temperatures. That's why nature, in its infinite wisdom, placed the testicles a few inches from the body. This keeps them cool. Men with undescended testicles have difficulties producing sperm.
Morgentaler reports that men who wear tight pants and/or tight briefs, regularly use saunas, jacuzzis, hot tubs,or whirlpools or even take frequent hot baths can have lower sperm counts. Some of his patients' sperm counts have gone up when they stopped these activities or changed to looser fitting clothing.
Exercise also generates heat but doesn't interfere with fertility. That's because sweating during exertion cools the body. Even marathon runners don't have problems producing sperm, according to Morgentaler.
Other factors that can adversely affect fertility include:
-Sports injuries: Take care to protect your testicles while playing sports. If a sport, like football, requires a cup, it's a good idea to wear one, according to Morgentaler. It's not unheard of for men to be hit in the testicles with a golf ball or a tennis ball, therefore, it makes good sense to wear a cup whenever you participate in physical activity.
-Exposure to chemicals: Herbicides and pesticides can affect fertility. If you use them in your garden, be sure to follow instructions carefully and take appropriate precautions. Pesticide residues in food, however, have not been shown to affect fertility.
-Radiation: Men who are regularly exposed to radiation such as lab technicians may experience fertility problems. If you have x-rays anywhere near the testicles, be sure to have the technician shield your groin area with a lead blanket. The radiation from computer or television screens hasn't been found to be a problem.
-Smoking: A review of the literature clearly indicates that cigarette smoking is associated with modest reductions in semen quality including number of sperm (23% reduction) and motility (13% reduction).
-Prescription medications: Various drugs have been found to affect the number or appearance of sperm in animals and occasionally in humans:
Sulfasalazine (Azulfadine), which is used to treat colitis
Cimetidine (Tagamet), which is used for peptic ulcer
Calcium channel blockers, which are used to treat high blood pressure
Drugs that are used to treat cancer are toxic to all cells, including sperm
RESOURCES:
American Urological Association Foundation, Inc.
http://auafoundation.org/
Male Infertility
American Academy of Family Physicans
http://familydoctor.org/766.xml
Source:
Male Fertility. Atlanta Reproductive Health Center
http://www.ivf.com
by Elaine Gottlieb
You may not choose to become a father at age 77, like actor Tony Randall. But from a strictly biological perspective, it is within the realm of possibility. Most men produce sperm for their entire lives, according to Dr. Abraham Morgentaler, the director of the Male Infertility Program at Beth Israel Deaconess Medical Center in Boston and a professor at Harvard Medical School.
The male reproductive system is relatively simple; as a result, it generally functions quite efficiently. Sperm are produced in the testicles and stored within the scrotum in a "sack" called the epididymis. During erection, but before ejaculation occurs, the sperm travel from the epididymis to the vas deferens (the tube that is severed in a vasectomy). The sperm is then propelled to the urethra where they mix with other fluids to form semen, which is ejaculated through the tip of the penis. For sperm, this journey is equivalent to a marathon, says Dr. Morgentaler, but in reality, it takes just two to five seconds!
What Can Stand in the Way of Fertility?
Certain medical conditions can interfere with the proper functioning of the reproductive process. They include:
- Lack of physical structures or blockages: Some men are born without a vas deferens or with tubal blockages. These conditions are easily treated by surgery, according to Dr. Morgentaler.
- Varicocele: The development of varicocele, or varicose veins in the scrotum, which occurs in 10% of men, can sometimes affect sperm production. Removing the veins may boost fertility, though the evidence favoring surgery remains incomplete.
-Retrograde ejaculation: A condition in which semen travels in the wrong direction back into the bladder rather than being released through the penis. This can be caused by prostate and other types of surgery in the pelvic area. Drugs that close the opening from the urethra to the bladder can alleviate this problem.
-Diabetes and multiple sclerosis: These conditions can impair the nerves that promote normal ejaculation.
-Infections: Urinary tract, prostate, or tubal infections can cause blockages that can be treated by antibiotics. Gonorrhea and chlamydia are sexually transmitted infections that can scar the epididymis; however, these scars can be treated with microsurgery.
Maintaining Your Fertility
The average male produces 60–100 million sperm per milliliter (ml) of semen. Low sperm counts are not considered a problem until they get as low as 20 million per ml, which is diagnosed as oligospermia. That may still sound like an enormous number, but statistics show that it is more difficult for couples to conceive at this level.
Conception is difficult at low sperm levels, because even at full count, only a fraction of sperm survive the difficult journey from the vagina through the uterus to the fallopian tubes, where conception takes place. The sperm must be strong swimmers. A man can have a low sperm count but still successfully conceive if his sperm have good motility.
Semen analysis can tell you the quantity and quality of your sperm. If your sperm count is critically low, a drug called clomiphene citrate, which stimulates testosterone production, can sometimes boost sperm creation.
The key to maintaining healthy fertility, according to Dr. Morgentaler, is prevention. There are no magic potions or vitamins that boost fertility. "Men do just fine with their fertility," says Dr. Morgentaler, without any special concessions.
The temperature of the testicles is one of the most significant factors in fertility. Testicles don't produce sperm well at high temperatures. That's why nature, in its infinite wisdom, placed the testicles a few inches from the body. This keeps them cool. Men with undescended testicles have difficulties producing sperm.
Morgentaler reports that men who wear tight pants and/or tight briefs, regularly use saunas, jacuzzis, hot tubs,or whirlpools or even take frequent hot baths can have lower sperm counts. Some of his patients' sperm counts have gone up when they stopped these activities or changed to looser fitting clothing.
Exercise also generates heat but doesn't interfere with fertility. That's because sweating during exertion cools the body. Even marathon runners don't have problems producing sperm, according to Morgentaler.
Other factors that can adversely affect fertility include:
-Sports injuries: Take care to protect your testicles while playing sports. If a sport, like football, requires a cup, it's a good idea to wear one, according to Morgentaler. It's not unheard of for men to be hit in the testicles with a golf ball or a tennis ball, therefore, it makes good sense to wear a cup whenever you participate in physical activity.
-Exposure to chemicals: Herbicides and pesticides can affect fertility. If you use them in your garden, be sure to follow instructions carefully and take appropriate precautions. Pesticide residues in food, however, have not been shown to affect fertility.
-Radiation: Men who are regularly exposed to radiation such as lab technicians may experience fertility problems. If you have x-rays anywhere near the testicles, be sure to have the technician shield your groin area with a lead blanket. The radiation from computer or television screens hasn't been found to be a problem.
-Smoking: A review of the literature clearly indicates that cigarette smoking is associated with modest reductions in semen quality including number of sperm (23% reduction) and motility (13% reduction).
-Prescription medications: Various drugs have been found to affect the number or appearance of sperm in animals and occasionally in humans:
Sulfasalazine (Azulfadine), which is used to treat colitis
Cimetidine (Tagamet), which is used for peptic ulcer
Calcium channel blockers, which are used to treat high blood pressure
Drugs that are used to treat cancer are toxic to all cells, including sperm
RESOURCES:
American Urological Association Foundation, Inc.
http://auafoundation.org/
Male Infertility
American Academy of Family Physicans
http://familydoctor.org/766.xml
Source:
Male Fertility. Atlanta Reproductive Health Center
http://www.ivf.com
Brain cancer dissected
Michelle Lang, Calgary Herald
Published: Friday, July 07, 2006
University of Calgary scientists have discovered why some patients with the brain cancer oligodendroglioma live for years after their diagnosis while others die within months.
On Thursday, the Calgary researchers said they have confirmed the cancer is actually two diseases with important genetic differences, explaining why patients have diverse responses to the same treatment.
"What we thought was a single disease is at least two diseases at the genetic level," said Dr. Greg Cairncross, the principal investigator in the clinical trial.
The finding -- the culmination of a decade of research -- was published in the June issue of the Journal of Clinical Oncology and is changing how patients suffering from this cancer are treated.
About 2,000 Canadians a year are diagnosed with a cancer that begins in the brain. There are about a dozen different types of brain cancer, with oligodendroglioma being the second most common form.
Oligodendroglioma tumours all look the same under a microscope.
But, about 10 years ago, Cairncross noticed some patients with the brain cancer were very sensitive to drug therapies and responded well to treatment. The same drugs in other oligodendroglioma patients simply didn't work.
Cairncross began looking at the genetic makeup of the disease and found tumours without a specific chromosome were different from other oligodendroglioma tumours.
His recent research involved studying 300 patients from around North America to show the genetic difference between oligodendroglioma diseases predicts who will respond to treatments.
Dr. Jay Easaw, a medical oncologist at Calgary's Tom Baker Cancer Centre, said the findings help physicians target treatments for patients.
"It's a huge observation," said Easaw. "It's now the cornerstone of how we treat this tumour."
The research has also led to an international collaboration among scientists in the area who will work together on future studies, instead of conducting competing research.
The Calgary researchers hope their findings will also influence the way other types of cancer are diagnosed in the future. They say more cancers should be examined at the genetic level.
"This shows the impact of this kind of approach to any disease," said Dr. Chris Brown, director of the Southern Alberta Cancer Research Institute.
A new molecular diagnostics program under development at the Tom Baker Cancer Centre will provide space for testing the genetic composition of brain tumours.
[email protected]
© The Calgary Herald 2006
Michelle Lang, Calgary Herald
Published: Friday, July 07, 2006
University of Calgary scientists have discovered why some patients with the brain cancer oligodendroglioma live for years after their diagnosis while others die within months.
On Thursday, the Calgary researchers said they have confirmed the cancer is actually two diseases with important genetic differences, explaining why patients have diverse responses to the same treatment.
"What we thought was a single disease is at least two diseases at the genetic level," said Dr. Greg Cairncross, the principal investigator in the clinical trial.
The finding -- the culmination of a decade of research -- was published in the June issue of the Journal of Clinical Oncology and is changing how patients suffering from this cancer are treated.
About 2,000 Canadians a year are diagnosed with a cancer that begins in the brain. There are about a dozen different types of brain cancer, with oligodendroglioma being the second most common form.
Oligodendroglioma tumours all look the same under a microscope.
But, about 10 years ago, Cairncross noticed some patients with the brain cancer were very sensitive to drug therapies and responded well to treatment. The same drugs in other oligodendroglioma patients simply didn't work.
Cairncross began looking at the genetic makeup of the disease and found tumours without a specific chromosome were different from other oligodendroglioma tumours.
His recent research involved studying 300 patients from around North America to show the genetic difference between oligodendroglioma diseases predicts who will respond to treatments.
Dr. Jay Easaw, a medical oncologist at Calgary's Tom Baker Cancer Centre, said the findings help physicians target treatments for patients.
"It's a huge observation," said Easaw. "It's now the cornerstone of how we treat this tumour."
The research has also led to an international collaboration among scientists in the area who will work together on future studies, instead of conducting competing research.
The Calgary researchers hope their findings will also influence the way other types of cancer are diagnosed in the future. They say more cancers should be examined at the genetic level.
"This shows the impact of this kind of approach to any disease," said Dr. Chris Brown, director of the Southern Alberta Cancer Research Institute.
A new molecular diagnostics program under development at the Tom Baker Cancer Centre will provide space for testing the genetic composition of brain tumours.
[email protected]
© The Calgary Herald 2006
Shot to prevent cervical cancer approved
Doctors advise having preteen girls vaccinated
Sharon Kirkey, CanWest News Service
Published: Wednesday, July 19, 2006
Health Canada's approval of a new vaccine against a highly contagious sexually transmitted infection that causes cervical cancer is being called one of the most significant events of the past 100 years in the field of cancer control.
"The things that we can do that would actually prevent a cancer, and thereby remove it as a cause of death, are very profound things," Dr. Simon Sutcliffe said Tuesday, after Merck Frosst announced Health Canada approval of Gardasil for females aged nine to 26.
Sutcliffe, inaugural chairman of the Canadian Strategy for Cancer Control and president of the B.C. Cancer Agency, says the shots have the potential to rival radiation therapy for the treatment of cancer, or three-dimensional scans and MRI in the diagnosis of tumours.
Some doctors said Tuesday that any parent who wants a preteen daughter immunized should do so now and not wait for provinces to decide whether they will pay for the vaccine.
"I think the ideal time to vaccine is prior to sexual debut, so that means somewhere from nine onwards," said Dr. Michael Shier, chief of gynecology at Toronto's Sunnybrook Health Sciences Centre.
The new vaccine, which will be available through doctors by the end of August, protects girls or women exposed to human papillomavirus (HPV), but it doesn't help those who already have it.
The second most common cancer behind breast cancer in Canadian women aged 20 to 44, cervical cancer will strike an estimated 1,400 women in Canada this year. Four hundred will die from it.
Worldwide, more than 470,000 women are diagnosed with cervical cancer each year, and more than 233,000 succumb to the disease annually.
The vaccine protects against four subtypes of HPV, of which two -- types 16 and 18 -- cause about 70 per cent of cervical cancers in women who don't clear the infections.
The other two types -- six and 11 -- account for about 90 per cent of genital warts, a "benign" disease that affects both men and women. While not a major cause of cancer, "it's a very major cause of social distress and health-care related costs," Sutcliffe said.
The vaccine is given in three doses over a six-month period, and will cost about $135 per injection.
About three out of four sexually active women will have at least one HPV infection. The vast majority of infections clear up by themselves, but in women who do not clear the infection, HPV invades the tissues of the womb.
Treatments vary from surgical removal of the uterus, with the fallopian tubes and ovaries, radiation therapy and, in more advanced cases, radiation therapy combined with chemotherapy.
As many as 80 per cent of Canadian women of reproductive age will be exposed to HPV in their lifetime.
© The Calgary Herald 2006
******
U.S. OKs birth control implant
Andrew Bridges, The Associated Press
Published: Wednesday, July 19, 2006
Implanon, a rod-shaped contraceptive implanted in a woman's upper arm for up to three years, has received federal approval, U.S. health officials said Tuesday.
Food and Drug Administration approval clears Organon USA Inc. to sell the birth control rod in the United States, agency spokeswoman Susan Cruzan said. Implanon, which can stop menstruation in many women, has been sold in more than 30 countries since 1998.
The matchstick-sized implant releases a low, steady dose of progestin to prevent pregnancy. The rod is inserted by a doctor under the skin of the upper arm. It can be removed at any time, according to the company, a unit of Netherlands-based Akzo Nobel NV.
Progestin is a synthetic hormone similar to the progesterone made in the ovaries. The hormone typically acts on the body by thickening the mucus in a women's cervix, preventing the union of sperm and egg. It also can prevent ovulation, or the release of an egg from the ovaries.
"The history of its use in other countries has indicated this is really a fantastic addition to the array of contraceptives available to women in this country," said Dr. Vanessa Cullins, vice-president for medical affairs at Planned Parenthood Federation of America.
Health Canada said Tuesday Implanon is not approved for use in Canada.
© The Calgary Herald 2006
Doctors advise having preteen girls vaccinated
Sharon Kirkey, CanWest News Service
Published: Wednesday, July 19, 2006
Health Canada's approval of a new vaccine against a highly contagious sexually transmitted infection that causes cervical cancer is being called one of the most significant events of the past 100 years in the field of cancer control.
"The things that we can do that would actually prevent a cancer, and thereby remove it as a cause of death, are very profound things," Dr. Simon Sutcliffe said Tuesday, after Merck Frosst announced Health Canada approval of Gardasil for females aged nine to 26.
Sutcliffe, inaugural chairman of the Canadian Strategy for Cancer Control and president of the B.C. Cancer Agency, says the shots have the potential to rival radiation therapy for the treatment of cancer, or three-dimensional scans and MRI in the diagnosis of tumours.
Some doctors said Tuesday that any parent who wants a preteen daughter immunized should do so now and not wait for provinces to decide whether they will pay for the vaccine.
"I think the ideal time to vaccine is prior to sexual debut, so that means somewhere from nine onwards," said Dr. Michael Shier, chief of gynecology at Toronto's Sunnybrook Health Sciences Centre.
The new vaccine, which will be available through doctors by the end of August, protects girls or women exposed to human papillomavirus (HPV), but it doesn't help those who already have it.
The second most common cancer behind breast cancer in Canadian women aged 20 to 44, cervical cancer will strike an estimated 1,400 women in Canada this year. Four hundred will die from it.
Worldwide, more than 470,000 women are diagnosed with cervical cancer each year, and more than 233,000 succumb to the disease annually.
The vaccine protects against four subtypes of HPV, of which two -- types 16 and 18 -- cause about 70 per cent of cervical cancers in women who don't clear the infections.
The other two types -- six and 11 -- account for about 90 per cent of genital warts, a "benign" disease that affects both men and women. While not a major cause of cancer, "it's a very major cause of social distress and health-care related costs," Sutcliffe said.
The vaccine is given in three doses over a six-month period, and will cost about $135 per injection.
About three out of four sexually active women will have at least one HPV infection. The vast majority of infections clear up by themselves, but in women who do not clear the infection, HPV invades the tissues of the womb.
Treatments vary from surgical removal of the uterus, with the fallopian tubes and ovaries, radiation therapy and, in more advanced cases, radiation therapy combined with chemotherapy.
As many as 80 per cent of Canadian women of reproductive age will be exposed to HPV in their lifetime.
© The Calgary Herald 2006
******
U.S. OKs birth control implant
Andrew Bridges, The Associated Press
Published: Wednesday, July 19, 2006
Implanon, a rod-shaped contraceptive implanted in a woman's upper arm for up to three years, has received federal approval, U.S. health officials said Tuesday.
Food and Drug Administration approval clears Organon USA Inc. to sell the birth control rod in the United States, agency spokeswoman Susan Cruzan said. Implanon, which can stop menstruation in many women, has been sold in more than 30 countries since 1998.
The matchstick-sized implant releases a low, steady dose of progestin to prevent pregnancy. The rod is inserted by a doctor under the skin of the upper arm. It can be removed at any time, according to the company, a unit of Netherlands-based Akzo Nobel NV.
Progestin is a synthetic hormone similar to the progesterone made in the ovaries. The hormone typically acts on the body by thickening the mucus in a women's cervix, preventing the union of sperm and egg. It also can prevent ovulation, or the release of an egg from the ovaries.
"The history of its use in other countries has indicated this is really a fantastic addition to the array of contraceptives available to women in this country," said Dr. Vanessa Cullins, vice-president for medical affairs at Planned Parenthood Federation of America.
Health Canada said Tuesday Implanon is not approved for use in Canada.
© The Calgary Herald 2006
Parkinson's Disease
by Rosalyn Carson-DeWitt, MD
En Español (Spanish Version)
Definition
Parkinson's disease (PD) is a progressive movement disorder that causes:
Muscle rigidity
Tremor at rest
Slowing down of movements (“bradykinesia”)
Difficulty moving and gait instability
Causes
The symptoms of Parkinson's disease are caused by a loss of nerve cells in a part of the brain called the substantia nigra, resulting in a decrease in dopamine (a neurochemical) throughout the brain. This destruction occurs due to genetic, environmental, or a combination of both causes. The resulting lack of dopamine results in the symptoms associated with Parkinson’s disease.
Secondary parkinsonism is a condition with similar symptoms, but symptoms can be traced to several causes, including:
Antipsychotic drugs (such as haloperidol (Haldol), fluphenazine (Prolixin), trifluoperazine (Stelazine) and chlorpromazine (Thorazine))
Carbon monoxide poisoning
Manganese poisoning
Hydrocephalus
Brain tumors
Stroke
Encephalitis
Meningitis
IV drug abuse of MPTP
Reserpine
Insecticide exposure
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Age: 50 or older
Gender: men are slightly more likely than women to develop Parkinson's disease
Family members with Parkinson's disease
Nonsmokers
Exposure to toxins, drugs, or conditions specified above
Symptoms
Symptoms of Parkinson's disease begin mildly and progressively worsen over time.
Symptoms include:
"Pill-rolling" tremor in the hands
Tremors often worsen at rest and are absent during sleep
Stiffness and rigidity of muscles, usually beginning on one side of the body
Difficulty and shuffling when walking
Short steps
Slowness of purposeful movements
Trouble performing usual tasks, due to shaking in hands
Trouble speaking
Flat, monotonous voice
Stuttering
Shaky, spidery handwriting
Poor balance
Tendency to fall
Stooped posture
Increasingly mask-like face, with little variation in expression
Trouble chewing and swallowing
Depression
Dementia
Difficulty thinking, problems with memory
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. There are no tests to definitively diagnose Parkinson's disease. The doctor will ask many questions to rule out other causes of your symptoms.
Tests to rule out other medical conditions may include:
Blood tests
Urine tests
CT, MRI, or PET (positron emission tomography) scans of the head
Treatment
Currently there are no treatments to cure Parkinson's disease or stop its progression. A number of medications are used to improve symptoms. Over time, however, their side effects may become troublesome and they may begin to lose their effectiveness.
Medications
Medications include:
amantadine (Symmetrel)
anticholinergics (benztropine (Cogentin) and biperidin (Akineton))
selegiline (Eldepryl)
Dopamine agonists: bromocriptine (Parlodel), pergolide (Permax), pramipexole (Mirapex), and ropinirole (Requip)
There may be a risk of serious cardiac valve abnormalities when taking pergolide (Permax)
levodopa/carbidopa (Sinemet)
apomorphine (Apokyn)
COMT inhibitors (entacapone (Comtan) and tolcapone (Tasmar))
Surgery
A number of brain operations are available, and many more are being researched including:
Destroying certain areas of the brain (thalamotomy and pallidotomy)–to improve tremor in patients for whom medication is not effective
Deep brain stimulation (which was approved in 1997 by the FDA for treatment of PD)–implanting a device to stimulate certain parts of the brain to decrease tremor and rigidity
Nerve-cell transplants (research only)–to increase dopamine production within the brain
Physical Therapy
Physical therapy can improve muscle tone, strength, and balance.
Psychological Support
Joining a support group with other people who are learning to live with the challenges of Parkinson's disease can be very helpful.
Prevention
There are no guidelines for preventing Parkinson's disease.
http://www.beliefnet.com/healthandheali ... mc_id=NL44
In her own words: living with Parkinson’s disease
As told to Debra Wood, RN
En Español (Spanish Version)
Arlene learned that she had Parkinson’s disease 22 years ago, on her 50th birthday. Despite the disease’s progression, the Florida university professor continued teaching and traveling until a few years ago. Here’s her story.
What was your first sign that something was wrong? What symptoms did you experience?
I started having trouble buttoning the sleeves on my blouses and thought something was wrong with my fingers. I also experienced some difficulty getting out of a chair and moved more slowly than I had in the past. One day, a Parkinson’s donation solicitation arrived in the mail. I had all but one symptom listed, so I made an appointment with the doctor.
What was the diagnosis experience like?
My regular doctor agreed that Parkinson’s was a possibility. He ordered a CT scan to rule out a brain tumor and an EEG. He also sent me to a neurologist. The neurologist took one look at me and diagnosed Parkinson’s.
A friend had read about a Parkinson’s study under way at the National Institutes of Health (NIH), so I called and was interviewed by phone. I traveled to Maryland for a second opinion and stayed a week. They did all kinds of tests as part of a clinical trial to find the best way to diagnose Parkinson’s. I felt good about participating. I thought I’d find out something about my condition, and the study results could be helpful to someone else. I have followed that doctor as he moved on to other university-affiliated medical centers. It’s good to stay close to research, even if I am no longer eligible for a trial.
What was your initial and then longer-term reaction to the diagnosis?
My first thought was “Where can I go to get the truth—that I don’t have this disease.” At the same time, I knew it was the reason for what was happening. Currently, I read everything about Parkinson’s and try to help other people by passing along the information. I stay independent and continue doing things for myself. Sure, it takes longer to cook, thinking through every movement. But it’s worth the effort.
How is your disease treated?
I started on medications shortly after being diagnosed but held off taking Sinemet until 1983. I was concerned about its side effects. The medication made a big difference, but I did develop the unwanted movements that often come with it. And recently I started seeing visual illusions, another adverse effect.
Did you have to make any lifestyle or dietary changes in response to your illness?
I faithfully exercise; even knowing exercise alone won’t do it. But if I didn’t, I’d be in real trouble. We put in a heated pool, so I could exercise daily year round. It keeps my muscles strong. I can really feel the difference and don’t function as well if I don’t exercise for a few days. I gave up gardening, because I fall easily and can’t get up without crawling to the steps. For the Sinemet to be as effective as possible, a low-protein diet is recommended. So I limit my protein intake. I also avoid other food-drug or vitamin-drug interactions.
Did you seek any type of emotional support?
When I learned there wasn’t a local support group, I decided to start one. The doctor offered to notify his patients. More than 50 people came to that first meeting. I didn’t feel I really needed the group, but thought it might help others. It’s amazing how often we see people who have never talked to another person with Parkinson’s. Within a couple of months, they feel better, knowing there is hope.
Did/does your condition have any impact on your family?
Parkinson’s affects every part of our lives. The rigidity and mask face present difficulties. My husband, Bob, always asks me to speak to him, since he can’t read my face. With time, everything gets harder—getting in and out of bed, moving, making love. But we keep going. You can’t give up. In 1997, Bob was diagnosed with Parkinson’s. It’s rare for spouses to develop the disease. It complicated life significantly. We try helping each other. But at times, like when negotiating steep steps, we need a hand from a third party.
What advice would you give to anyone living with this disease?
Pop the pills and persevere. Learn all you can about Parkinson’s, so you can help manage your case. Join a support group. Laugh. Do as much as you can yourself, rather than depending on family members. And at least once a year, see a specialist involved with research or associated with a medical school.
Triage Reviewed by EBSCO Medical Review Board in September 2005
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
http://www.beliefnet.com/healthandheali ... mc_id=NL44
More on diagnosis of Parkinson’s Disease, go to
http://www.beliefnet.com/healthandheali ... mc_id=NL44
RESOURCES:
National Parkinson Foundation
http://www.parkinson.org
Parkinson's Disease Foundation, Inc.
http://www.pdf.org
References:
American Academy of Neurology website. Available at: http://www.aan.com/professionals/.
Merritt's Neurology, 11th ed. Lippincott Williams & Wilkins; 2005.
National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/.
Samii A, et al. Parkinson's disease. Lancet. 2004; 363:1783-93.
Siderowf A, et al. Update on Parkinson disease. Ann Intern Med. 2003; 138:651-58.
Textbook of Clinical Neurology, 1st ed. WB Saunders Company; 1999.
by Rosalyn Carson-DeWitt, MD
En Español (Spanish Version)
Definition
Parkinson's disease (PD) is a progressive movement disorder that causes:
Muscle rigidity
Tremor at rest
Slowing down of movements (“bradykinesia”)
Difficulty moving and gait instability
Causes
The symptoms of Parkinson's disease are caused by a loss of nerve cells in a part of the brain called the substantia nigra, resulting in a decrease in dopamine (a neurochemical) throughout the brain. This destruction occurs due to genetic, environmental, or a combination of both causes. The resulting lack of dopamine results in the symptoms associated with Parkinson’s disease.
Secondary parkinsonism is a condition with similar symptoms, but symptoms can be traced to several causes, including:
Antipsychotic drugs (such as haloperidol (Haldol), fluphenazine (Prolixin), trifluoperazine (Stelazine) and chlorpromazine (Thorazine))
Carbon monoxide poisoning
Manganese poisoning
Hydrocephalus
Brain tumors
Stroke
Encephalitis
Meningitis
IV drug abuse of MPTP
Reserpine
Insecticide exposure
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Age: 50 or older
Gender: men are slightly more likely than women to develop Parkinson's disease
Family members with Parkinson's disease
Nonsmokers
Exposure to toxins, drugs, or conditions specified above
Symptoms
Symptoms of Parkinson's disease begin mildly and progressively worsen over time.
Symptoms include:
"Pill-rolling" tremor in the hands
Tremors often worsen at rest and are absent during sleep
Stiffness and rigidity of muscles, usually beginning on one side of the body
Difficulty and shuffling when walking
Short steps
Slowness of purposeful movements
Trouble performing usual tasks, due to shaking in hands
Trouble speaking
Flat, monotonous voice
Stuttering
Shaky, spidery handwriting
Poor balance
Tendency to fall
Stooped posture
Increasingly mask-like face, with little variation in expression
Trouble chewing and swallowing
Depression
Dementia
Difficulty thinking, problems with memory
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. There are no tests to definitively diagnose Parkinson's disease. The doctor will ask many questions to rule out other causes of your symptoms.
Tests to rule out other medical conditions may include:
Blood tests
Urine tests
CT, MRI, or PET (positron emission tomography) scans of the head
Treatment
Currently there are no treatments to cure Parkinson's disease or stop its progression. A number of medications are used to improve symptoms. Over time, however, their side effects may become troublesome and they may begin to lose their effectiveness.
Medications
Medications include:
amantadine (Symmetrel)
anticholinergics (benztropine (Cogentin) and biperidin (Akineton))
selegiline (Eldepryl)
Dopamine agonists: bromocriptine (Parlodel), pergolide (Permax), pramipexole (Mirapex), and ropinirole (Requip)
There may be a risk of serious cardiac valve abnormalities when taking pergolide (Permax)
levodopa/carbidopa (Sinemet)
apomorphine (Apokyn)
COMT inhibitors (entacapone (Comtan) and tolcapone (Tasmar))
Surgery
A number of brain operations are available, and many more are being researched including:
Destroying certain areas of the brain (thalamotomy and pallidotomy)–to improve tremor in patients for whom medication is not effective
Deep brain stimulation (which was approved in 1997 by the FDA for treatment of PD)–implanting a device to stimulate certain parts of the brain to decrease tremor and rigidity
Nerve-cell transplants (research only)–to increase dopamine production within the brain
Physical Therapy
Physical therapy can improve muscle tone, strength, and balance.
Psychological Support
Joining a support group with other people who are learning to live with the challenges of Parkinson's disease can be very helpful.
Prevention
There are no guidelines for preventing Parkinson's disease.
http://www.beliefnet.com/healthandheali ... mc_id=NL44
In her own words: living with Parkinson’s disease
As told to Debra Wood, RN
En Español (Spanish Version)
Arlene learned that she had Parkinson’s disease 22 years ago, on her 50th birthday. Despite the disease’s progression, the Florida university professor continued teaching and traveling until a few years ago. Here’s her story.
What was your first sign that something was wrong? What symptoms did you experience?
I started having trouble buttoning the sleeves on my blouses and thought something was wrong with my fingers. I also experienced some difficulty getting out of a chair and moved more slowly than I had in the past. One day, a Parkinson’s donation solicitation arrived in the mail. I had all but one symptom listed, so I made an appointment with the doctor.
What was the diagnosis experience like?
My regular doctor agreed that Parkinson’s was a possibility. He ordered a CT scan to rule out a brain tumor and an EEG. He also sent me to a neurologist. The neurologist took one look at me and diagnosed Parkinson’s.
A friend had read about a Parkinson’s study under way at the National Institutes of Health (NIH), so I called and was interviewed by phone. I traveled to Maryland for a second opinion and stayed a week. They did all kinds of tests as part of a clinical trial to find the best way to diagnose Parkinson’s. I felt good about participating. I thought I’d find out something about my condition, and the study results could be helpful to someone else. I have followed that doctor as he moved on to other university-affiliated medical centers. It’s good to stay close to research, even if I am no longer eligible for a trial.
What was your initial and then longer-term reaction to the diagnosis?
My first thought was “Where can I go to get the truth—that I don’t have this disease.” At the same time, I knew it was the reason for what was happening. Currently, I read everything about Parkinson’s and try to help other people by passing along the information. I stay independent and continue doing things for myself. Sure, it takes longer to cook, thinking through every movement. But it’s worth the effort.
How is your disease treated?
I started on medications shortly after being diagnosed but held off taking Sinemet until 1983. I was concerned about its side effects. The medication made a big difference, but I did develop the unwanted movements that often come with it. And recently I started seeing visual illusions, another adverse effect.
Did you have to make any lifestyle or dietary changes in response to your illness?
I faithfully exercise; even knowing exercise alone won’t do it. But if I didn’t, I’d be in real trouble. We put in a heated pool, so I could exercise daily year round. It keeps my muscles strong. I can really feel the difference and don’t function as well if I don’t exercise for a few days. I gave up gardening, because I fall easily and can’t get up without crawling to the steps. For the Sinemet to be as effective as possible, a low-protein diet is recommended. So I limit my protein intake. I also avoid other food-drug or vitamin-drug interactions.
Did you seek any type of emotional support?
When I learned there wasn’t a local support group, I decided to start one. The doctor offered to notify his patients. More than 50 people came to that first meeting. I didn’t feel I really needed the group, but thought it might help others. It’s amazing how often we see people who have never talked to another person with Parkinson’s. Within a couple of months, they feel better, knowing there is hope.
Did/does your condition have any impact on your family?
Parkinson’s affects every part of our lives. The rigidity and mask face present difficulties. My husband, Bob, always asks me to speak to him, since he can’t read my face. With time, everything gets harder—getting in and out of bed, moving, making love. But we keep going. You can’t give up. In 1997, Bob was diagnosed with Parkinson’s. It’s rare for spouses to develop the disease. It complicated life significantly. We try helping each other. But at times, like when negotiating steep steps, we need a hand from a third party.
What advice would you give to anyone living with this disease?
Pop the pills and persevere. Learn all you can about Parkinson’s, so you can help manage your case. Join a support group. Laugh. Do as much as you can yourself, rather than depending on family members. And at least once a year, see a specialist involved with research or associated with a medical school.
Triage Reviewed by EBSCO Medical Review Board in September 2005
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
http://www.beliefnet.com/healthandheali ... mc_id=NL44
More on diagnosis of Parkinson’s Disease, go to
http://www.beliefnet.com/healthandheali ... mc_id=NL44
RESOURCES:
National Parkinson Foundation
http://www.parkinson.org
Parkinson's Disease Foundation, Inc.
http://www.pdf.org
References:
American Academy of Neurology website. Available at: http://www.aan.com/professionals/.
Merritt's Neurology, 11th ed. Lippincott Williams & Wilkins; 2005.
National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/.
Samii A, et al. Parkinson's disease. Lancet. 2004; 363:1783-93.
Siderowf A, et al. Update on Parkinson disease. Ann Intern Med. 2003; 138:651-58.
Textbook of Clinical Neurology, 1st ed. WB Saunders Company; 1999.
Facts About Sexually Transmitted Infections
What You Need to Know to Protect Yourself and Your Family
http://www.beliefnet.com/healthandheali ... mc_id=NL44
by Skye Schulte, MS, MPH
So you know all about protecting yourself from sexually transmitted infections (STIs)? Just use a condom, right? Well, what you don’t know about STIs could hurt you!
Almost 15 million new cases of STIs are diagnosed in the United States each year—approximately one-fourth of them found in teenagers. Because many of these infections do not have symptoms, countless people may not know that they have an STI. Here are some facts about STIs:
STI 101
What Are Sexually Transmitted Infections (STIs)?
Sexually transmitted infections are infections caused by bacteria, viruses, or other organisms. The STIs caused by bacteria can be cured with antibiotics, while viruses cannot be cured (though the symptoms can be treated). Common STIs and their specific treatments and prevention strategies are listed below.
How Are STIs Transmitted?
STIs are usually spread through sexual contact, including vaginal, oral, and anal sex. The viruses and bacteria that cause STIs are normally carried in the semen, vaginal fluids, or blood and will enter the body through tiny tears or cuts in the mouth, anus, or genitals. STIs can be passed from person to person even without having sexual intercourse. For instance, someone can contract herpes or genital warts through skin-to-skin contact with an infected sore or area. Intercourse during menstruation increases the chance of becoming infected with certain organisms.
How Can STIs Be Prevented?
There is only one 100% effective way to be sure that you stay STI-free—no sex or intimate physical contact with anyone. If you are sexually active, you can reduce your chances of getting an STI by avoiding high-risk behaviors like unprotected sex, multiple sex partners, and intravenous drug use. A latex condom (preferably accompanied by a spermicide) should always be used when having sex.
Symptoms of STIs
When to See a Physician Right Away
Abnormal or smelly discharges, pus, or odors from the vagina, penis, or rectum
Boils, blisters, buboes, chancres, polyps, growths, sores, or warts
Burning sensations
Bleeding
Irritation, tenderness, swelling, rashes, itching
Painful intercourse, other pains
Vaginal yeast infections, cervicitis, urine changes
Ulcers
Other Possible Symptoms of an STI
Weight loss that is constant, rapid, or unexplained
Coatings of the mouth, throat, or vagina
Abdominal pain, muscular pain, aching joints, general weakness, feeling run down
Coughs, chills, night sweats, or fevers
Bowel problems, diarrhea, vomiting, appetite loss, nausea,
Vaginitis
Headaches, lightheadedness, vision loss, hearing loss, mental disorders
Discolored skin, hair loss, jaundice
Swollen glands, sore throat, fatigue
Growths
Some Common STIs
Bacterial Vaginosis - Bacterial vaginosis (BV) is caused by a change in the balance of different kinds of bacteria in the vagina. When there are symptoms, they often appear as a form of vaginitis—an irritation of the vagina often associated with a vaginal discharge. BV is not always sexually transmitted, though sexual activity increases the risk.
Treatment: Antimicrobial creams are applied to the vagina.
Protection: Condoms offer good protection against BV.
Chlamydia - When diagnosed, chlamydia can be easily treated and cured. Untreated, chlamydia can cause severe, costly reproductive and other health problems. It can cause bladder infections and serious pelvic inflammatory disease (PID), ectopic pregnancy, and sterility in both men and women. It is the most frequently reported infectious disease in the United States and as many as 1 in 10 adolescent girls tested for chlamydia is infected.
Treatment: Both partners can be treated successfully with antibiotics.
Protection: Condoms offer very good protection against chlamydia.
Cytomegalovirus (CMV) - CMV is a member of the herpesvirus group. Once infected, a person can carry the virus for life, even though they may never have active symptoms. Each year, CMV causes permanent disability, including hearing loss and mental retardation, for 4,000 to 7,000 babies. This virus is also very dangerous for people with weakened immune systems, and can cause blindness and mental disorders.
Treatment: There is no cure, though symptoms may be helped with some medications. Vaccines are still being researched and developed.
Protection: Condoms can provide protection against CMV during vaginal, anal, and oral intercourse, but kissing and other intimate touching can spread the virus.
Gonorrhea - Gonorrhea is caused by the bacterium Neisseria gonorrhoeae, which is transmitted during vaginal, oral, or anal sexual intercourse. It can cause sterility, arthritis, and heart problems in both men and women. More than 600,000 new cases of gonorrhea are reported every year in the U.S.
Treatment: Both partners can be treated successfully with antibiotics. People with gonorrhea often have other STIs like chlamydia. Infections must be treated at the same time.
Protection: Condoms offer very good protection against gonorrhea.
Hepatitis B Virus (HBV) – About 1.25 million people in the U.S. have chronic HBV infection. Each year it is estimated that 80,000 people, mostly young adults, get infected with HBV and 4,000 to 5,000 people die from chronic hepatitis B in the United States. The virus can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.
Treatment: There is no cure, but in most cases the infection clears within 4-8 weeks. Some people remain contagious for the rest of their lives.
Protection: Condoms offer some protection against HBV during vaginal, anal, and oral intercourse, but the virus can be passed through kissing and other intimate touching. Hepatitis B vaccine can prevent this disease and is the first anti-cancer vaccine because it can prevent a form of liver cancer.
Herpes Simplex Virus (HSV) – Both herpes simplex virus-1 and herpes simplex virus-2 can be sexually transmitted (HSV-1 is most often associated with cold sores and fever blisters). One million new cases are diagnosed every year, and like many other viruses, the HSV remains in the body for life. HSV can cause miscarriage or stillbirth during pregnancy. If active herpes infections are present during childbirth, newborn infants may suffer serious health problems, including developmental disabilities and, rarely, death.
Treatment: There is no cure, though symptoms and recurrences may be helped with medications like valacyclovir, acyclovir, and famciclovir.
Protection: Partners should refrain from sexual contact from the time they know the blisters are going to recur until after the scabs have completely fallen off the healed sores. Condoms offer some protection against the virus between outbreaks.
Human Immunodeficiency Virus (HIV) – HIV is a virus that weakens the body’s ability to fight off infections and can cause acquired immune deficiency syndrome (AIDS) — the last stage of HIV infection. This compromised immune system can make a carrier more susceptible to pneumonias, cancers, and a variety of other infections. Currently, almost a million people in the United States are infected with HIV. Like many other viruses, HIV remains in the body for life.
Treatment: There is no cure, though HIV infection and many AIDS-related conditions can be managed to some extent with a variety of treatments. At this time AIDS is fatal to everyone who has had it.
Protection: Condoms offer very good protection against HIV.
Human Papilloma Virus (HPV) & Genital Warts - HPV is a family of more than 100 extremely common viruses. Many types of HPV cause harmless skin warts, such as those on the fingers or feet. HPV is easily spread during oral, genital, or anal sex with an infected partner. Some of these viruses are associated with cancer of the cervix, vulva, or penis.
Treatment: There is no cure for HPV, though genital warts can be treated or removed in a number of ways including: topical medication, application of acid, standard or laser surgery, cryosurgery (freezing the wart with liquid nitrogen) and injection of interferon.
Protection: Condoms may offer some protection against genital HPVs, but the viruses may "shed" beyond the area protected by a condom.
Molluscum Contagiosum - Hundreds of thousands of cases of this virus are diagnosed every year, and it is often transmitted by nonsexual, intimate contact. Small, pinkish-white, waxy, round polyps grow in the genital area or on the thighs, and there is often a tiny depression in the middle of the growth. Molluscum contagiosum belongs to a family of viruses called poxviruses and it is generally spread by skin-to-skin contact. It can be sexually spread if growths are present in the genital area. It is not known to affect any internal organs or cause cancer.
Treatment: Growths may be removed with chemicals, electrical current, or freezing.
Protection: Condoms may offer some protection against molluscum contagiosum, but the virus may "shed" beyond the area protected by the condom.
Pelvic Inflammatory Disease (PID) - PID is a progressive infection that harms a woman's reproductive system. It can lead to sterility, ectopic pregnancy, and chronic pain. PID is often caused by sexually transmitted infections like gonorrhea and chlamydia. More than 750,000 new cases of PID are diagnosed every year in the US, with possibly millions more undiagnosed.
Treatment: Antibiotics, bed rest, and sexual abstinence. Surgery may be required to remove abscesses or scar tissue, or to repair or remove reproductive organs.
Protection: Condoms offer very good protection against infections commonly associated with PID.
Pubic Lice - Every year, millions of people treat themselves for pubic lice. These tiny parasitic insects are also called "crabs" or "cooties" are generally found in the genital area of humans. Pubic lice are usually spread through sexual contact. Rarely, infestation can be spread through contact with an infested person's bed linens, towels, or clothes.
Treatment: Over-the-counter medication is available to treat anyone who may have been exposed to pubic lice. All bedding, towels, and clothing that may have been exposed should be thoroughly washed or dry cleaned, and the home should be vacuumed.
Protection: Limiting the number of intimate and sexual contacts can help.
Scabies - Scabies is an infestation of the skin with the microscopic mite Sarcoptes scabei. It is usually sexually transmitted. However, school children often pass it to one another through casual contact.
Treatment: Over-the-counter medication is available to treat anyone who may have been exposed to pubic lice. All bedding, towels, and clothing that may have been exposed should be thoroughly washed or dry cleaned, and the home should be vacuumed.
Protection: Limiting the number of intimate and sexual contacts can help.
Syphilis – This complex sexually transmitted disease (STD) is caused by the bacterium Treponema pallidum. Many of the signs and symptoms of syphilis are indistinguishable from those of other diseases. It is passed from person to person through direct contact with syphilis sores, which occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. Syphilis cannot be spread by toilet seats, door knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils. If left untreated, the syphilis can remain in the body for life and lead to disfigurement, neurologic disorder, or death.
Treatment: Antibiotics are successful for both partners — but damage caused by the disease in the later phases cannot be undone.
Protection: Condoms offer very good protection during vaginal, anal, and oral intercourse.
Trichomoniasis - "Trich" is a condition caused by a protozoan — a microscopic, one-cell animal. It is a common cause of vaginal infections. Up to five million Americans develop trichomoniasis every year. It is spread through vaginal intercourse.
Treatment: Drugs called 5-notroimidazoles are successful for both men and women.
Protection: Condoms offer very good protection against trich. Spermicide offers some protection.
Urinary Tract Infections (UTI) - UTIs are caused by bacteria that have spread from the rectum to the vagina or penis, and then to the urethra and bladder. They may be transmitted by any kind of sex play that brings fecal material into contact with the vagina and urethra. Unprotected anal intercourse is a very high-risk behavior for urinary tract infection. Severe cases, left untreated, may cause kidney infection.
Treatment: UTIs can be treated with antibiotics and other medications may decrease the symptoms.
Protection: Condoms and avoiding sexual positions that seem to trigger UITs can help.
RESOURCES:
Journal of the American Medical Association STD Information Center
http://www.ama-assn.org
Planned Parenthood Federation of America
http://www.plannedparenthood.org
National Library of Medicine
http://www.nlm.nih.gov/medlineplus/sexu ... eases.html
Sources:
American College of Obstetricians and Gynecologists
Centers for Disease Control and Prevention
Komaroff AL. Harvard Medical School Family Health Guide. New York, NY: Simon & Schuster; 1999
What You Need to Know to Protect Yourself and Your Family
http://www.beliefnet.com/healthandheali ... mc_id=NL44
by Skye Schulte, MS, MPH
So you know all about protecting yourself from sexually transmitted infections (STIs)? Just use a condom, right? Well, what you don’t know about STIs could hurt you!
Almost 15 million new cases of STIs are diagnosed in the United States each year—approximately one-fourth of them found in teenagers. Because many of these infections do not have symptoms, countless people may not know that they have an STI. Here are some facts about STIs:
STI 101
What Are Sexually Transmitted Infections (STIs)?
Sexually transmitted infections are infections caused by bacteria, viruses, or other organisms. The STIs caused by bacteria can be cured with antibiotics, while viruses cannot be cured (though the symptoms can be treated). Common STIs and their specific treatments and prevention strategies are listed below.
How Are STIs Transmitted?
STIs are usually spread through sexual contact, including vaginal, oral, and anal sex. The viruses and bacteria that cause STIs are normally carried in the semen, vaginal fluids, or blood and will enter the body through tiny tears or cuts in the mouth, anus, or genitals. STIs can be passed from person to person even without having sexual intercourse. For instance, someone can contract herpes or genital warts through skin-to-skin contact with an infected sore or area. Intercourse during menstruation increases the chance of becoming infected with certain organisms.
How Can STIs Be Prevented?
There is only one 100% effective way to be sure that you stay STI-free—no sex or intimate physical contact with anyone. If you are sexually active, you can reduce your chances of getting an STI by avoiding high-risk behaviors like unprotected sex, multiple sex partners, and intravenous drug use. A latex condom (preferably accompanied by a spermicide) should always be used when having sex.
Symptoms of STIs
When to See a Physician Right Away
Abnormal or smelly discharges, pus, or odors from the vagina, penis, or rectum
Boils, blisters, buboes, chancres, polyps, growths, sores, or warts
Burning sensations
Bleeding
Irritation, tenderness, swelling, rashes, itching
Painful intercourse, other pains
Vaginal yeast infections, cervicitis, urine changes
Ulcers
Other Possible Symptoms of an STI
Weight loss that is constant, rapid, or unexplained
Coatings of the mouth, throat, or vagina
Abdominal pain, muscular pain, aching joints, general weakness, feeling run down
Coughs, chills, night sweats, or fevers
Bowel problems, diarrhea, vomiting, appetite loss, nausea,
Vaginitis
Headaches, lightheadedness, vision loss, hearing loss, mental disorders
Discolored skin, hair loss, jaundice
Swollen glands, sore throat, fatigue
Growths
Some Common STIs
Bacterial Vaginosis - Bacterial vaginosis (BV) is caused by a change in the balance of different kinds of bacteria in the vagina. When there are symptoms, they often appear as a form of vaginitis—an irritation of the vagina often associated with a vaginal discharge. BV is not always sexually transmitted, though sexual activity increases the risk.
Treatment: Antimicrobial creams are applied to the vagina.
Protection: Condoms offer good protection against BV.
Chlamydia - When diagnosed, chlamydia can be easily treated and cured. Untreated, chlamydia can cause severe, costly reproductive and other health problems. It can cause bladder infections and serious pelvic inflammatory disease (PID), ectopic pregnancy, and sterility in both men and women. It is the most frequently reported infectious disease in the United States and as many as 1 in 10 adolescent girls tested for chlamydia is infected.
Treatment: Both partners can be treated successfully with antibiotics.
Protection: Condoms offer very good protection against chlamydia.
Cytomegalovirus (CMV) - CMV is a member of the herpesvirus group. Once infected, a person can carry the virus for life, even though they may never have active symptoms. Each year, CMV causes permanent disability, including hearing loss and mental retardation, for 4,000 to 7,000 babies. This virus is also very dangerous for people with weakened immune systems, and can cause blindness and mental disorders.
Treatment: There is no cure, though symptoms may be helped with some medications. Vaccines are still being researched and developed.
Protection: Condoms can provide protection against CMV during vaginal, anal, and oral intercourse, but kissing and other intimate touching can spread the virus.
Gonorrhea - Gonorrhea is caused by the bacterium Neisseria gonorrhoeae, which is transmitted during vaginal, oral, or anal sexual intercourse. It can cause sterility, arthritis, and heart problems in both men and women. More than 600,000 new cases of gonorrhea are reported every year in the U.S.
Treatment: Both partners can be treated successfully with antibiotics. People with gonorrhea often have other STIs like chlamydia. Infections must be treated at the same time.
Protection: Condoms offer very good protection against gonorrhea.
Hepatitis B Virus (HBV) – About 1.25 million people in the U.S. have chronic HBV infection. Each year it is estimated that 80,000 people, mostly young adults, get infected with HBV and 4,000 to 5,000 people die from chronic hepatitis B in the United States. The virus can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.
Treatment: There is no cure, but in most cases the infection clears within 4-8 weeks. Some people remain contagious for the rest of their lives.
Protection: Condoms offer some protection against HBV during vaginal, anal, and oral intercourse, but the virus can be passed through kissing and other intimate touching. Hepatitis B vaccine can prevent this disease and is the first anti-cancer vaccine because it can prevent a form of liver cancer.
Herpes Simplex Virus (HSV) – Both herpes simplex virus-1 and herpes simplex virus-2 can be sexually transmitted (HSV-1 is most often associated with cold sores and fever blisters). One million new cases are diagnosed every year, and like many other viruses, the HSV remains in the body for life. HSV can cause miscarriage or stillbirth during pregnancy. If active herpes infections are present during childbirth, newborn infants may suffer serious health problems, including developmental disabilities and, rarely, death.
Treatment: There is no cure, though symptoms and recurrences may be helped with medications like valacyclovir, acyclovir, and famciclovir.
Protection: Partners should refrain from sexual contact from the time they know the blisters are going to recur until after the scabs have completely fallen off the healed sores. Condoms offer some protection against the virus between outbreaks.
Human Immunodeficiency Virus (HIV) – HIV is a virus that weakens the body’s ability to fight off infections and can cause acquired immune deficiency syndrome (AIDS) — the last stage of HIV infection. This compromised immune system can make a carrier more susceptible to pneumonias, cancers, and a variety of other infections. Currently, almost a million people in the United States are infected with HIV. Like many other viruses, HIV remains in the body for life.
Treatment: There is no cure, though HIV infection and many AIDS-related conditions can be managed to some extent with a variety of treatments. At this time AIDS is fatal to everyone who has had it.
Protection: Condoms offer very good protection against HIV.
Human Papilloma Virus (HPV) & Genital Warts - HPV is a family of more than 100 extremely common viruses. Many types of HPV cause harmless skin warts, such as those on the fingers or feet. HPV is easily spread during oral, genital, or anal sex with an infected partner. Some of these viruses are associated with cancer of the cervix, vulva, or penis.
Treatment: There is no cure for HPV, though genital warts can be treated or removed in a number of ways including: topical medication, application of acid, standard or laser surgery, cryosurgery (freezing the wart with liquid nitrogen) and injection of interferon.
Protection: Condoms may offer some protection against genital HPVs, but the viruses may "shed" beyond the area protected by a condom.
Molluscum Contagiosum - Hundreds of thousands of cases of this virus are diagnosed every year, and it is often transmitted by nonsexual, intimate contact. Small, pinkish-white, waxy, round polyps grow in the genital area or on the thighs, and there is often a tiny depression in the middle of the growth. Molluscum contagiosum belongs to a family of viruses called poxviruses and it is generally spread by skin-to-skin contact. It can be sexually spread if growths are present in the genital area. It is not known to affect any internal organs or cause cancer.
Treatment: Growths may be removed with chemicals, electrical current, or freezing.
Protection: Condoms may offer some protection against molluscum contagiosum, but the virus may "shed" beyond the area protected by the condom.
Pelvic Inflammatory Disease (PID) - PID is a progressive infection that harms a woman's reproductive system. It can lead to sterility, ectopic pregnancy, and chronic pain. PID is often caused by sexually transmitted infections like gonorrhea and chlamydia. More than 750,000 new cases of PID are diagnosed every year in the US, with possibly millions more undiagnosed.
Treatment: Antibiotics, bed rest, and sexual abstinence. Surgery may be required to remove abscesses or scar tissue, or to repair or remove reproductive organs.
Protection: Condoms offer very good protection against infections commonly associated with PID.
Pubic Lice - Every year, millions of people treat themselves for pubic lice. These tiny parasitic insects are also called "crabs" or "cooties" are generally found in the genital area of humans. Pubic lice are usually spread through sexual contact. Rarely, infestation can be spread through contact with an infested person's bed linens, towels, or clothes.
Treatment: Over-the-counter medication is available to treat anyone who may have been exposed to pubic lice. All bedding, towels, and clothing that may have been exposed should be thoroughly washed or dry cleaned, and the home should be vacuumed.
Protection: Limiting the number of intimate and sexual contacts can help.
Scabies - Scabies is an infestation of the skin with the microscopic mite Sarcoptes scabei. It is usually sexually transmitted. However, school children often pass it to one another through casual contact.
Treatment: Over-the-counter medication is available to treat anyone who may have been exposed to pubic lice. All bedding, towels, and clothing that may have been exposed should be thoroughly washed or dry cleaned, and the home should be vacuumed.
Protection: Limiting the number of intimate and sexual contacts can help.
Syphilis – This complex sexually transmitted disease (STD) is caused by the bacterium Treponema pallidum. Many of the signs and symptoms of syphilis are indistinguishable from those of other diseases. It is passed from person to person through direct contact with syphilis sores, which occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. Syphilis cannot be spread by toilet seats, door knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils. If left untreated, the syphilis can remain in the body for life and lead to disfigurement, neurologic disorder, or death.
Treatment: Antibiotics are successful for both partners — but damage caused by the disease in the later phases cannot be undone.
Protection: Condoms offer very good protection during vaginal, anal, and oral intercourse.
Trichomoniasis - "Trich" is a condition caused by a protozoan — a microscopic, one-cell animal. It is a common cause of vaginal infections. Up to five million Americans develop trichomoniasis every year. It is spread through vaginal intercourse.
Treatment: Drugs called 5-notroimidazoles are successful for both men and women.
Protection: Condoms offer very good protection against trich. Spermicide offers some protection.
Urinary Tract Infections (UTI) - UTIs are caused by bacteria that have spread from the rectum to the vagina or penis, and then to the urethra and bladder. They may be transmitted by any kind of sex play that brings fecal material into contact with the vagina and urethra. Unprotected anal intercourse is a very high-risk behavior for urinary tract infection. Severe cases, left untreated, may cause kidney infection.
Treatment: UTIs can be treated with antibiotics and other medications may decrease the symptoms.
Protection: Condoms and avoiding sexual positions that seem to trigger UITs can help.
RESOURCES:
Journal of the American Medical Association STD Information Center
http://www.ama-assn.org
Planned Parenthood Federation of America
http://www.plannedparenthood.org
National Library of Medicine
http://www.nlm.nih.gov/medlineplus/sexu ... eases.html
Sources:
American College of Obstetricians and Gynecologists
Centers for Disease Control and Prevention
Komaroff AL. Harvard Medical School Family Health Guide. New York, NY: Simon & Schuster; 1999
Talking to Your Doctor About Your Health
by Mary Calvagna, MS
Finding out you have a medical condition can be scary. Part of what is frightening is all the unkowns—there may be many things that you don't know or don't understand. But, by asking your doctor questions, you can gain a better understanding of what to expect.
Being prepared before you get to the doctor's office will help ensure that your questions get answered. Here are some general tips to get you ready:
*Write a list of concerns and questions. Include any new symptoms you may be having (i.e., a change in appetite, sleeping, energy level, or other daily habits).
*Bring a list of all prescription medications, vitamins, herbal remedies, dietary supplements, over-the-counter medications, and any other nonprescription medicines you are taking.
*Consider bringing a friend or relative with you.
*Be honest, don't just say what you think the doctor wants to hear.
Here are some sample questions to get you started:
About Your Condition:
What is my condition, exactly?
Can you determine a cause?
Can it be treated?
What symptoms or changes should I watch for?
What, if any, lifestyle changes should I make related to:
Diet
Exercise
Smoking
Drinking alcohol
How will this affect my lifestyle?
Can you recommend a support group?
About Your Treatment:
What are my treatment choices?
How successful has this form of treatment typically been?
How long will my treatment last?
What are the benefits of this form of treatment?
Are there any side effects I should watch for?
What are the risks involved with this treatment?
For medications, what should I do if I miss a dose?
Are there any alternative or complementary therapies I should consider?
Should I avoid any foods, drugs, activities, or alcohol?
Will my medication interact with any other prescribed medications, over-the-counter medications, or dietary supplements that I am currently taking?
How will I know if my treatment has been successful?
About your tests:
What kind of tests will I have?
What will these tests tell you?
When will I have the results?
Will you call me with the results?
What do I need to do to prepare for the tests?
Are there any risks associated with the tests?
Will I need more tests later?
If You Don't Understand Your Doctor's Answers:
Ask more questions. Ask the doctor or healthcare provider to explain any words or concepts that you do not understand.
Bring a pad of paper and take notes. Or ask your doctor to write things down for you.
Ask your doctor for any written materials, pamphlets, or videos that may relate to your condition.
Ask where you can get more information.
Try talking with other health care providers who may take more time to explain things to you, such as nurses, physician assistants, physical therapists, and pharmacists.
Depending on your condition, there may be many other questions that you will want to and need to ask. Don't be afraid to speak up, ask questions, and insist on answers—even when the answer is "We don't know." Remember, your doctor is your partner in health care and you both have the same goal, returning you to optimum health.
Resources:
National Institute on Aging
http://www.nia.nih.gov/
National Women's Health Information Center
http://www.4women.gov/
Sources:
National Institute on Aging
National Women's Health Information Center
by Mary Calvagna, MS
Finding out you have a medical condition can be scary. Part of what is frightening is all the unkowns—there may be many things that you don't know or don't understand. But, by asking your doctor questions, you can gain a better understanding of what to expect.
Being prepared before you get to the doctor's office will help ensure that your questions get answered. Here are some general tips to get you ready:
*Write a list of concerns and questions. Include any new symptoms you may be having (i.e., a change in appetite, sleeping, energy level, or other daily habits).
*Bring a list of all prescription medications, vitamins, herbal remedies, dietary supplements, over-the-counter medications, and any other nonprescription medicines you are taking.
*Consider bringing a friend or relative with you.
*Be honest, don't just say what you think the doctor wants to hear.
Here are some sample questions to get you started:
About Your Condition:
What is my condition, exactly?
Can you determine a cause?
Can it be treated?
What symptoms or changes should I watch for?
What, if any, lifestyle changes should I make related to:
Diet
Exercise
Smoking
Drinking alcohol
How will this affect my lifestyle?
Can you recommend a support group?
About Your Treatment:
What are my treatment choices?
How successful has this form of treatment typically been?
How long will my treatment last?
What are the benefits of this form of treatment?
Are there any side effects I should watch for?
What are the risks involved with this treatment?
For medications, what should I do if I miss a dose?
Are there any alternative or complementary therapies I should consider?
Should I avoid any foods, drugs, activities, or alcohol?
Will my medication interact with any other prescribed medications, over-the-counter medications, or dietary supplements that I am currently taking?
How will I know if my treatment has been successful?
About your tests:
What kind of tests will I have?
What will these tests tell you?
When will I have the results?
Will you call me with the results?
What do I need to do to prepare for the tests?
Are there any risks associated with the tests?
Will I need more tests later?
If You Don't Understand Your Doctor's Answers:
Ask more questions. Ask the doctor or healthcare provider to explain any words or concepts that you do not understand.
Bring a pad of paper and take notes. Or ask your doctor to write things down for you.
Ask your doctor for any written materials, pamphlets, or videos that may relate to your condition.
Ask where you can get more information.
Try talking with other health care providers who may take more time to explain things to you, such as nurses, physician assistants, physical therapists, and pharmacists.
Depending on your condition, there may be many other questions that you will want to and need to ask. Don't be afraid to speak up, ask questions, and insist on answers—even when the answer is "We don't know." Remember, your doctor is your partner in health care and you both have the same goal, returning you to optimum health.
Resources:
National Institute on Aging
http://www.nia.nih.gov/
National Women's Health Information Center
http://www.4women.gov/
Sources:
National Institute on Aging
National Women's Health Information Center
Tea 'healthier' drink than water
The researchers recommend people consume three to four cups a day
Drinking three or more cups of tea a day is as good for you as drinking plenty of water and may even have extra health benefits, say researchers.
The work in the European Journal of Clinical Nutrition dispels the common belief that tea dehydrates.
Tea not only rehydrates as well as water does, but it can also protect against heart disease and some cancers, UK nutritionists found.
Experts believe flavonoids are the key ingredient in tea that promote health.
These polyphenol antioxidants are found in many foods and plants, including tea leaves, and have been shown to help prevent cell damage.
Tea replaces fluids and contains antioxidants so its got two things going for it
Lead author Dr Ruxton
Public health nutritionist Dr Carrie Ruxton, and colleagues at Kings College London, looked at published studies on the health effects of tea consumption.
They found clear evidence that drinking three to four cups of tea a day can cut the chances of having a heart attack.
Some studies suggested tea consumption protected against cancer, although this effect was less clear-cut.
Other health benefits seen included protection against tooth plaque and potentially tooth decay, plus bone strengthening.
Dr Ruxton said: "Drinking tea is actually better for you than drinking water. Water is essentially replacing fluid. Tea replaces fluids and contains antioxidants so its got two things going for it."
Rehydrating
She said it was an urban myth that tea is dehydrating.
"Studies on caffeine have found very high doses dehydrate and everyone assumes that caffeine-containing beverages dehydrate. But even if you had a really, really strong cup of tea or coffee, which is quite hard to make, you would still have a net gain of fluid.
"Also, a cup of tea contains fluoride, which is good for the teeth," she added.
There was no evidence that tea consumption was harmful to health. However, research suggests that tea can impair the body's ability to absorb iron from food, meaning people at risk of anaemia should avoid drinking tea around mealtimes.
Tea is not dehydrating. It is a healthy drink
Claire Williamson of the British Nutrition Foundation
Dr Ruxton's team found average tea consumption was just under three cups per day.
She said the increasing popularity of soft drinks meant many people were not drinking as much tea as before.
"Tea drinking is most common in older people, the 40 plus age range. In older people, tea sometimes made up about 70% of fluid intake so it is a really important contributor," she said.
Claire Williamson of the British Nutrition Foundation said: "Studies in the laboratory have shown potential health benefits.
"The evidence in humans is not as strong and more studies need to be done. But there are definite potential health benefits from the polyphenols in terms of reducing the risk of diseases such as heart disease and cancers.
"In terms of fluid intake, we recommend 1.5-2 litres per day and that can include tea. Tea is not dehydrating. It is a healthy drink."
The Tea Council provided funding for the work. Dr Ruxton stressed that the work was independent.
The researchers recommend people consume three to four cups a day
Drinking three or more cups of tea a day is as good for you as drinking plenty of water and may even have extra health benefits, say researchers.
The work in the European Journal of Clinical Nutrition dispels the common belief that tea dehydrates.
Tea not only rehydrates as well as water does, but it can also protect against heart disease and some cancers, UK nutritionists found.
Experts believe flavonoids are the key ingredient in tea that promote health.
These polyphenol antioxidants are found in many foods and plants, including tea leaves, and have been shown to help prevent cell damage.
Tea replaces fluids and contains antioxidants so its got two things going for it
Lead author Dr Ruxton
Public health nutritionist Dr Carrie Ruxton, and colleagues at Kings College London, looked at published studies on the health effects of tea consumption.
They found clear evidence that drinking three to four cups of tea a day can cut the chances of having a heart attack.
Some studies suggested tea consumption protected against cancer, although this effect was less clear-cut.
Other health benefits seen included protection against tooth plaque and potentially tooth decay, plus bone strengthening.
Dr Ruxton said: "Drinking tea is actually better for you than drinking water. Water is essentially replacing fluid. Tea replaces fluids and contains antioxidants so its got two things going for it."
Rehydrating
She said it was an urban myth that tea is dehydrating.
"Studies on caffeine have found very high doses dehydrate and everyone assumes that caffeine-containing beverages dehydrate. But even if you had a really, really strong cup of tea or coffee, which is quite hard to make, you would still have a net gain of fluid.
"Also, a cup of tea contains fluoride, which is good for the teeth," she added.
There was no evidence that tea consumption was harmful to health. However, research suggests that tea can impair the body's ability to absorb iron from food, meaning people at risk of anaemia should avoid drinking tea around mealtimes.
Tea is not dehydrating. It is a healthy drink
Claire Williamson of the British Nutrition Foundation
Dr Ruxton's team found average tea consumption was just under three cups per day.
She said the increasing popularity of soft drinks meant many people were not drinking as much tea as before.
"Tea drinking is most common in older people, the 40 plus age range. In older people, tea sometimes made up about 70% of fluid intake so it is a really important contributor," she said.
Claire Williamson of the British Nutrition Foundation said: "Studies in the laboratory have shown potential health benefits.
"The evidence in humans is not as strong and more studies need to be done. But there are definite potential health benefits from the polyphenols in terms of reducing the risk of diseases such as heart disease and cancers.
"In terms of fluid intake, we recommend 1.5-2 litres per day and that can include tea. Tea is not dehydrating. It is a healthy drink."
The Tea Council provided funding for the work. Dr Ruxton stressed that the work was independent.
Do-It-Yourself Pain Relief
by Debra Wood, RN
More than 50 million Americans suffer from chronic pain. For people who suffer from mild to moderate chronic pain, pain medication may offer short-term relief, but many people find they can gain long-term control over their pain through heat or cold application, music, relaxation, exercise, and a positive attitude.
"For the vast majority of people who have chronic pain, there just aren't any pharmacologic or physical interventions that can totally eliminate the pain," says University of Washington (Seattle) pain management expert Dennis C. Turk, PhD.
"Pain is a chronic condition, just like hypertension or diabetes," Dr. Turk explains. "When you have a chronic condition, you need to do more things for yourself. It's going to last a long time. It's best to help yourself and learn to self-manage and control your pain."
The Options
In addition to traditional pain relievers, nondrug methods of pain relief may help you gain that control. Some techniques—such as imagery and the use of hot and cold—relax the muscles, help you sleep, and distract you from symptoms. Others, such as music, movies, and recorded comedy routines, take your mind off your physical complaints, as does losing yourself in a good book.
While some remedies require little expertise or help from others, some may require instruction from a professional. Dr. Ronald Glick, director of the University of Pittsburgh Pain Evaluation and Treatment Center, recommends that patients seek advice from a chronic pain specialist who can coordinate all aspects of management, including physical therapies and psychological techniques.
While these pain relief techniques help many people with chronic pain, they are not cures for pain.
Heat and Cold
"The most important thing about heat and cold is that it gives a sense of control," Dr. Turk says. "They are things you can do yourself to help relieve the pain, which can immediately reduce the emotional stress."
Direct Application
"Heat and cold can be quite helpful for people with musculoskeletal conditions," says Dr. Turk. "Something as simple as a bag of frozen peas wrapped in a towel can be a useful self-management technique that relieves muscle tension in the back, neck, and shoulders."
Most of us are familiar with holding an ice pack on a twisted ankle or lying on a heating pad for a sore back, but hot and cold treatments can be used in other ways. Moist heat, which is often more effective than dry heat, can be applied with a warm towel or a soak in the tub. An elastic bandage can hold an ice pack in place. A small paper cup filled with water and kept in the freezer becomes an excellent tool for localized cold massage, while iced washcloths can cover a larger area.
Timing
Apply heat or cold therapy for periods not to exceed 15 minutes, and allow the area to return to normal body temperature before reapplying the therapy. Some people obtain added relief by alternating heat and ice. Others use heat before exercising and ice after.
Skin Protection
Always place a towel between the cold or heat and the skin. Never lie directly on a heating pad, and if it feels too warm, take it off. Don't combine heat with pain relieving salves, such as mentholated ointments and aspirin creams.
Relaxation
The "relaxation response," a term coined by Herbert Benson, MD, of the Mind-Body Medical Institute in Boston, is an array of beneficial physiologic effects associated with focused relaxation, some of which may mitigate the perception of pain. For best results, make relaxation a part of your daily routine.
There are a number of ways to invoke the relaxation response, and many audiotapes are available to help. One popular approach is to assume a comfortable position, take several deep breaths, and then focus on your breathing, or a word or sound, while passively avoiding intruding thoughts.
Muscle Relaxation Exercises
Progressive muscle relaxation is a technique that may be effective for both muscle spasm pain and stress reduction.
"Relaxation skills are useful in reducing muscle tension, and can help reduce frustration and some of the stress," says Jennifer Markham, PhD, at the University of Pittsburgh Pain Clinic. Progressive muscle relaxation involves focusing your attention on each muscle group until it feels heavy and relaxed, usually beginning in the feet and gradually progressing upward.
Imagery Exercises
Imagery, which often accompanies the management of pain through relaxation, allows you to visualize what it would be like to "let the pain go." If you know what is causing the pain—for instance a pinched nerve in the spine—the idea is to picture the encroaching vertebral space opening and freeing the trapped nerve. By calling on a variety of senses, you can take yourself to a favorite place, like the beach or the mountains. Music, nature sounds, and instructional tapes make it easier for beginners to escape to a mental paradise.
"Relaxation techniques redirect your thinking from physical pain and onto something else," says Penney Cowan, founder and executive director of the American Chronic Pain Association. "Imagining the beach, the sun on your face, and the warmth of the sand helps divert your mind from how much your head is hurting."
Biofeedback
Biofeedback offers a measurable response to relaxation and imagery techniques. Through the use of sensors connected to a computer, you receive visual or auditory cues that indicate an increase or decrease in muscle tension, heart rate, and skin temperature. Using this feedback, you train yourself to control body functions that you normally don't even think about. Biofeedback may be useful in chronic pain or other conditions associated with muscle spasm or tension, like some headaches.
Exercise
Although you may not feel like getting off the couch because you hurt so much, exercising within the confines of your physical limitations can decrease pain. Why? The reasons are complex, but one prominent theory is that exercise releases endorphins, which are natural pain relieving chemicals in your brain.
"Exercise is absolutely critical," says Dr. Turk. "The type of exercise will depend on the condition, but as a general rule of thumb, the more active you remain and the more you use your muscles, the better off you're going to be."
A physical therapist can tailor an initial exercise plan based on your capacity to exercise, and then gradually make recommendations for increasing how much you do and for how long. Pain experts recommend pacing activities. Overdoing it on good days can come back to haunt you later. It's fine to cut back on your exercise during a flare-up of your pain, but it's important to resume your exercise routine as soon as you feel better.
Attitude and Communication
How you think about your aches and discomforts, your level of anxiety and depression, your expectations, and your ability to cope determines how much pain you feel. Cognitive-behavior modification techniques help change unhealthy attitudes and habits that can develop when pain is chronic.
Concentrate on your abilities and find pleasure in the things you can do rather than dwelling on activities that have become difficult because of your pain. Communicate with family members and explain how you're feeling. Don't expect loved ones to read your mind.
"Psychology helps people begin to understand they do have some control, even if they don't have a magic wand to make the pain go away," says Dr. Markham. "When they realize they have some control [over their pain], it gives them hope."
The transmission of pain: stimulus vs. perception
Adapted from the National Institutes of Health by HealthGate Editorial Staff
Back to Pain Center
Because pain is often associated with injury or disability, it is assumed that pain must be proportional to the severity of the injury. In many instances, however, this is not true. About 65 percent of soldiers who are severely wounded and 20 percent of civilians who undergo major surgery report feeling little or no pain for hours or days after injury or incision. In contrast, about 70 percent of people who suffer from chronic, low-back pain do not show any readily detectable injury. Clearly, the link between pain stimulus and pain perception is highly variable. Injury may occur without pain, and pain without apparent injury.
Pathways of pain
Perception of pain is a multi-step process. It begins at the site of insult with the stimulation of specific nerve fibers known as nociceptors. Some nociceptors react to several kinds of painful stimulation. Others are more selective. Certain nociceptors will react to a pinprick, for example, but ignore painful heat.
After these nerve fibers or nociceptors are stimulated, the damaged cells release chemical mediators of pain and inflammation. These mediators include potassium ions, bradykinin, prostaglandins, serotonin and histamine.
The resulting stimulation of the peripheral nerve endings produces an exaggerated and prolonged sensitivity to later stimuli (peripheral hyperalgesia). Analgesic drugs such as aspirin and ibuprofen block some of these chemical mediators and decrease sensitivity of nociceptors at the periphery.
The pain stimulus is then sent through the peripheral nervous system to the central nervous system, or CNS, where the pain message is processed at several levels. Touching a hot stove causes the pain signal to be routed immediately from the pain site to the dorsal horn of the spinal cord. Here it synapses with a second neuron. The second neuron picks up the signal, passes it to the other side of the spinal cord and up the spinothalamic tract to the thalamus. A message is then sent back down the spinal column to nerve cells that signal muscles to contract. This pathway is used forperception of sharp or acute pain and can be automatic as in a reflex.
An alternative pathway exists in which the neuron at the site of injury enters the dorsal horn of the spinal cord. From there, it transfers its message to the other side of the spinal cord, and then through a series of interconnected neurons. The neurons then transmit and modulate the pain message. The message travels up the spinal cord to the brain stem, the thalamus, and is finally perceived at the cerebral cortex. This pathway allows perception of duller, more persistent pain.
Pain transmission also alerts another major division of the CNS--the autonomic nervous system. This system regulates involuntary processes such as breathing, blood flow, pulse rate, digestion and elimination, adjusting these activities to changing body needs. The autonomic nervous system also signals the release of hormones like epinephrine (adrenalin).
Pain suppressing pathways
In 1965, several scientists speculated that pain-suppressing pathways must exist. Their idea was that when pain signals first reach the nervous system, they excite activity in a group of small neurons that form a kind of pain pool.
When the total activity of these neurons reaches a certain minimal level, a hypothetical gate opens to allow the pain signals to be sent to higher brain centers. However, nearby neurons in contact with the pain cells could suppress the cells so that the gate stayed closed. The gate-closing cells include large neurons that are stimulated by nonpainful touching or pressing of the skin. The gate also could be closed from above by brain cells activating a pathway to block pain.
This theory stimulated research to find the pathways and required mechanisms. For some time, neuroscientists knew that chemicals were important in conducting nerve signals (small bursts of electrical current) from cell to cell. In addition to the neurotransmitter serotonin, scientists have discovered other neurotransmitters that inhibit pain. These include the opioid peptides, beta-endorphin and met-enkephalin.
All of the most potent pain-relieving drugs, called opioids, have the same effect as opium, with similar chemical characteristics and structure. Morphine is the purest, most active alkyloid of opium. The opioid receptors are found near synapses in the dorsal horn of the spinal cord. But these and other neurotransmitters have been traced to receptor sites throughout the body, including pathways in the face, and are believed to be involved in a pain-control network. These opioids serve as ligands or signals that bind with specificity and tenacity to their opioid receptors. In this way, they induce a signal transduction pathway in the responding neuronal cell.
RESOURCES:
American Chronic Pain Association
http://www.theacpa.org
American Pain Foundation
http://www.painfoundation.org
National Institutes of Health
http://www.nih.gov
Source:
Adapted from the National Institutes of Health
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2006 - EBSCO Publishing All rights reserved.
by Debra Wood, RN
More than 50 million Americans suffer from chronic pain. For people who suffer from mild to moderate chronic pain, pain medication may offer short-term relief, but many people find they can gain long-term control over their pain through heat or cold application, music, relaxation, exercise, and a positive attitude.
"For the vast majority of people who have chronic pain, there just aren't any pharmacologic or physical interventions that can totally eliminate the pain," says University of Washington (Seattle) pain management expert Dennis C. Turk, PhD.
"Pain is a chronic condition, just like hypertension or diabetes," Dr. Turk explains. "When you have a chronic condition, you need to do more things for yourself. It's going to last a long time. It's best to help yourself and learn to self-manage and control your pain."
The Options
In addition to traditional pain relievers, nondrug methods of pain relief may help you gain that control. Some techniques—such as imagery and the use of hot and cold—relax the muscles, help you sleep, and distract you from symptoms. Others, such as music, movies, and recorded comedy routines, take your mind off your physical complaints, as does losing yourself in a good book.
While some remedies require little expertise or help from others, some may require instruction from a professional. Dr. Ronald Glick, director of the University of Pittsburgh Pain Evaluation and Treatment Center, recommends that patients seek advice from a chronic pain specialist who can coordinate all aspects of management, including physical therapies and psychological techniques.
While these pain relief techniques help many people with chronic pain, they are not cures for pain.
Heat and Cold
"The most important thing about heat and cold is that it gives a sense of control," Dr. Turk says. "They are things you can do yourself to help relieve the pain, which can immediately reduce the emotional stress."
Direct Application
"Heat and cold can be quite helpful for people with musculoskeletal conditions," says Dr. Turk. "Something as simple as a bag of frozen peas wrapped in a towel can be a useful self-management technique that relieves muscle tension in the back, neck, and shoulders."
Most of us are familiar with holding an ice pack on a twisted ankle or lying on a heating pad for a sore back, but hot and cold treatments can be used in other ways. Moist heat, which is often more effective than dry heat, can be applied with a warm towel or a soak in the tub. An elastic bandage can hold an ice pack in place. A small paper cup filled with water and kept in the freezer becomes an excellent tool for localized cold massage, while iced washcloths can cover a larger area.
Timing
Apply heat or cold therapy for periods not to exceed 15 minutes, and allow the area to return to normal body temperature before reapplying the therapy. Some people obtain added relief by alternating heat and ice. Others use heat before exercising and ice after.
Skin Protection
Always place a towel between the cold or heat and the skin. Never lie directly on a heating pad, and if it feels too warm, take it off. Don't combine heat with pain relieving salves, such as mentholated ointments and aspirin creams.
Relaxation
The "relaxation response," a term coined by Herbert Benson, MD, of the Mind-Body Medical Institute in Boston, is an array of beneficial physiologic effects associated with focused relaxation, some of which may mitigate the perception of pain. For best results, make relaxation a part of your daily routine.
There are a number of ways to invoke the relaxation response, and many audiotapes are available to help. One popular approach is to assume a comfortable position, take several deep breaths, and then focus on your breathing, or a word or sound, while passively avoiding intruding thoughts.
Muscle Relaxation Exercises
Progressive muscle relaxation is a technique that may be effective for both muscle spasm pain and stress reduction.
"Relaxation skills are useful in reducing muscle tension, and can help reduce frustration and some of the stress," says Jennifer Markham, PhD, at the University of Pittsburgh Pain Clinic. Progressive muscle relaxation involves focusing your attention on each muscle group until it feels heavy and relaxed, usually beginning in the feet and gradually progressing upward.
Imagery Exercises
Imagery, which often accompanies the management of pain through relaxation, allows you to visualize what it would be like to "let the pain go." If you know what is causing the pain—for instance a pinched nerve in the spine—the idea is to picture the encroaching vertebral space opening and freeing the trapped nerve. By calling on a variety of senses, you can take yourself to a favorite place, like the beach or the mountains. Music, nature sounds, and instructional tapes make it easier for beginners to escape to a mental paradise.
"Relaxation techniques redirect your thinking from physical pain and onto something else," says Penney Cowan, founder and executive director of the American Chronic Pain Association. "Imagining the beach, the sun on your face, and the warmth of the sand helps divert your mind from how much your head is hurting."
Biofeedback
Biofeedback offers a measurable response to relaxation and imagery techniques. Through the use of sensors connected to a computer, you receive visual or auditory cues that indicate an increase or decrease in muscle tension, heart rate, and skin temperature. Using this feedback, you train yourself to control body functions that you normally don't even think about. Biofeedback may be useful in chronic pain or other conditions associated with muscle spasm or tension, like some headaches.
Exercise
Although you may not feel like getting off the couch because you hurt so much, exercising within the confines of your physical limitations can decrease pain. Why? The reasons are complex, but one prominent theory is that exercise releases endorphins, which are natural pain relieving chemicals in your brain.
"Exercise is absolutely critical," says Dr. Turk. "The type of exercise will depend on the condition, but as a general rule of thumb, the more active you remain and the more you use your muscles, the better off you're going to be."
A physical therapist can tailor an initial exercise plan based on your capacity to exercise, and then gradually make recommendations for increasing how much you do and for how long. Pain experts recommend pacing activities. Overdoing it on good days can come back to haunt you later. It's fine to cut back on your exercise during a flare-up of your pain, but it's important to resume your exercise routine as soon as you feel better.
Attitude and Communication
How you think about your aches and discomforts, your level of anxiety and depression, your expectations, and your ability to cope determines how much pain you feel. Cognitive-behavior modification techniques help change unhealthy attitudes and habits that can develop when pain is chronic.
Concentrate on your abilities and find pleasure in the things you can do rather than dwelling on activities that have become difficult because of your pain. Communicate with family members and explain how you're feeling. Don't expect loved ones to read your mind.
"Psychology helps people begin to understand they do have some control, even if they don't have a magic wand to make the pain go away," says Dr. Markham. "When they realize they have some control [over their pain], it gives them hope."
The transmission of pain: stimulus vs. perception
Adapted from the National Institutes of Health by HealthGate Editorial Staff
Back to Pain Center
Because pain is often associated with injury or disability, it is assumed that pain must be proportional to the severity of the injury. In many instances, however, this is not true. About 65 percent of soldiers who are severely wounded and 20 percent of civilians who undergo major surgery report feeling little or no pain for hours or days after injury or incision. In contrast, about 70 percent of people who suffer from chronic, low-back pain do not show any readily detectable injury. Clearly, the link between pain stimulus and pain perception is highly variable. Injury may occur without pain, and pain without apparent injury.
Pathways of pain
Perception of pain is a multi-step process. It begins at the site of insult with the stimulation of specific nerve fibers known as nociceptors. Some nociceptors react to several kinds of painful stimulation. Others are more selective. Certain nociceptors will react to a pinprick, for example, but ignore painful heat.
After these nerve fibers or nociceptors are stimulated, the damaged cells release chemical mediators of pain and inflammation. These mediators include potassium ions, bradykinin, prostaglandins, serotonin and histamine.
The resulting stimulation of the peripheral nerve endings produces an exaggerated and prolonged sensitivity to later stimuli (peripheral hyperalgesia). Analgesic drugs such as aspirin and ibuprofen block some of these chemical mediators and decrease sensitivity of nociceptors at the periphery.
The pain stimulus is then sent through the peripheral nervous system to the central nervous system, or CNS, where the pain message is processed at several levels. Touching a hot stove causes the pain signal to be routed immediately from the pain site to the dorsal horn of the spinal cord. Here it synapses with a second neuron. The second neuron picks up the signal, passes it to the other side of the spinal cord and up the spinothalamic tract to the thalamus. A message is then sent back down the spinal column to nerve cells that signal muscles to contract. This pathway is used forperception of sharp or acute pain and can be automatic as in a reflex.
An alternative pathway exists in which the neuron at the site of injury enters the dorsal horn of the spinal cord. From there, it transfers its message to the other side of the spinal cord, and then through a series of interconnected neurons. The neurons then transmit and modulate the pain message. The message travels up the spinal cord to the brain stem, the thalamus, and is finally perceived at the cerebral cortex. This pathway allows perception of duller, more persistent pain.
Pain transmission also alerts another major division of the CNS--the autonomic nervous system. This system regulates involuntary processes such as breathing, blood flow, pulse rate, digestion and elimination, adjusting these activities to changing body needs. The autonomic nervous system also signals the release of hormones like epinephrine (adrenalin).
Pain suppressing pathways
In 1965, several scientists speculated that pain-suppressing pathways must exist. Their idea was that when pain signals first reach the nervous system, they excite activity in a group of small neurons that form a kind of pain pool.
When the total activity of these neurons reaches a certain minimal level, a hypothetical gate opens to allow the pain signals to be sent to higher brain centers. However, nearby neurons in contact with the pain cells could suppress the cells so that the gate stayed closed. The gate-closing cells include large neurons that are stimulated by nonpainful touching or pressing of the skin. The gate also could be closed from above by brain cells activating a pathway to block pain.
This theory stimulated research to find the pathways and required mechanisms. For some time, neuroscientists knew that chemicals were important in conducting nerve signals (small bursts of electrical current) from cell to cell. In addition to the neurotransmitter serotonin, scientists have discovered other neurotransmitters that inhibit pain. These include the opioid peptides, beta-endorphin and met-enkephalin.
All of the most potent pain-relieving drugs, called opioids, have the same effect as opium, with similar chemical characteristics and structure. Morphine is the purest, most active alkyloid of opium. The opioid receptors are found near synapses in the dorsal horn of the spinal cord. But these and other neurotransmitters have been traced to receptor sites throughout the body, including pathways in the face, and are believed to be involved in a pain-control network. These opioids serve as ligands or signals that bind with specificity and tenacity to their opioid receptors. In this way, they induce a signal transduction pathway in the responding neuronal cell.
RESOURCES:
American Chronic Pain Association
http://www.theacpa.org
American Pain Foundation
http://www.painfoundation.org
National Institutes of Health
http://www.nih.gov
Source:
Adapted from the National Institutes of Health
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2006 - EBSCO Publishing All rights reserved.