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****** Woman's Health Newsletter *******
January 11, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Mood and food - Understanding the relationship
2. Omega 3 fatty acids and cardiovascular disease
3. Reader submitted Q&A - Is dementia hereditary?
4. Coffee consumption and diabetes
5. Health tip to share - Humidifier in winter
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Mood and food - Understanding the relationship
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Negative moods, such as stress, anger, anxiety,
boredom, sadness and loneliness can often be
counteracted by chemical pain killers that the
body releases when certain foods are digested. The
problem is that we can become addicted to using
these foods to ease our negative feelings. As a
result we eat more calories than we need in order
just to feel better. If we could learn to
recognize our negative moods and and deal with
them by methods other than eating, we might all be
a few pounds lighter.
Fats and simple carbohydrates seem to release the
most pleasurable body chemicals; but who ever
heard of eating just a piece of lean beef or piece
of uncoated fish when we were trying to perk up
from a negative mood. Complex carbohydrates, such
as most vegetables, also take longer to digest and
do not seem to ease negative moods. We might not
immediately feel better if we reached for carrots
and celery but we would certainly not put on as
much weight as when we use chocolate, ice cream,
pasta or bread to boost our moods. Whether we gain
weight when trying to emerge from negative
emotions may also depend upon what's handy to eat
wherever we are.
So what can you do if you seem to be addicted to
eating to blunt or erase a negative mood? Some
suggestions from Mayo Clinic include:
learn to identify quickly when you are having a
negative emotion
learn to recognize true hunger, an empty stomach
rather than a mental need
learn what triggers a mental need for food
look elsewhere or use methods other than eating to
improve your mood
do not keep starchy, high-fat, high-calorie
comfort foods in the house or handy at your p[lace
of work
exercise regularly - it also helps to relieve
negative moods by producing advantageous body
chemicals and it is the opposite of fattening
On the other hand, if you think your depressed,
irritable, anxious or stressed out mood is a
chronic problem, seek medical help for diagnosis
and treatment.
Mood and food
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Omega 3 fatty acids and cardiovascular disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Omega 3 fatty acids from fish and fish oils have
been shown to be protective against coronary heart
disease. This was first discovered because the
Greenland Eskimos had very low incidences of
coronary heart disease in spite of a diet very
high in fat. Since then studies have looked at the
relationships of these polyunsaturated fats and
coronary heart disease. Overall, Omega 3 fatty
acid supplements aid in the prevention of coronary
heart disease.
The fish oil derived fatty acid supplements have
been shown to reduce the risk of sudden death
following initial survival from a heart attack by
about 45% and the overall mortality by about 20%.
This compares very favorably with many of the
statin drugs although how the omega 3's prevent
this is not understood. The supplements also tend
to reduce blood triglycerides if that is a
problem.
The current recommendations of the American Heart
Association are:
Patients without documented coronary heart
disease: Eat a variety of (preferably oily) fish
at least twice weekly. Include oils and foods rich
in linolenic acid
Patients with documented coronary heart disease:
Consume 1 gram of eicosapentanoic and
docosahexanoic acid daily, preferably from oily
fish. Supplements could be considered in
consultation with a doctor
Patients with hypertriglyceridemia: Take 2-4 grams
of eicosapentanoic acid and docosahexanoic acid
daily, provided as capsules under a doctor's care
The side effects of most supplements are very low
and include only occasional abdominal bloating.
Omega 3 fatty acids and cardiovascular disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Is dementia hereditary?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"My mother's sister has dementia, and my mother's
memory is becoming worrying. My grandmother was in
a mental institution for many years and I am now
wondering if she may have had Alzheimer's or
dementia but went undiagnosed back then. I am
concerned that there may be some hereditary
factors? My grandmother also had Parkinson's
disease and deep depression."
"I am age 42, with hypertension, diabetes, and
have complex ovarian cysts" - DLP
Your question centers on a current medical
frontier, i.e., determining the types and causes
of what is known as late onset dementia. To
summarize in general, there seems likely to be
both genetic components and environmental
components in many of the dementias but the
science is far from conclusive at this point. So
far, no one single factor has been identified as a
cause for late onset Alzheimer's disease. It is
likely that a combination of factors, including
age, genetic inheritance, environmental factors,
diet and overall general health, are responsible.
Early onset dementias, occurring before the age of
60-65, often do have genetic differences which
have been described. Fortunately most of these
early onset degenerative brain diseases are
relatively uncommon or rare. There is an early-
onset Alzheimer's disease and a Familial
Alzheimer's disease (FAD) and a Pick's Disease
that fall into this category among others. These
have been found to have definite genetic findings
but their onset is almost always before age 60.
The most common of the late onset dementias is
Alzheimer's disease. Next comes vascular dementia
at about 25% of the cases and the third most
common (10-15%) is Dementia with Lewy Bodies
(DLB). The latter has a 70% association with
Parkinson's Disease. After these types come a
whole host of rarer types of dementias some of
which are known to have a genetic basis; most are
unknown in their causes. In the vast majority of
late onset Alzheimer's, however, the effect of
inheritance seems to be small. If a parent or
other relative has Alzheimer's disease, your own
chances of developing the disease are only a
little higher than if there were no cases of
Alzheimer's in the immediate family.
I would say that right now, the most important
thing would be to be sure what type of dementia
your mother's sister has. This needs to be
diagnosed by a neurologist or a geriatric
specialist. Assuming this turns out to be a late
onset Alzheimer's (you did not mention your Aunt's
age) then it is still very unlikely you will
develop this problem.
Actually you may have to worry more about vascular
dementia at an elderly age because of your high
blood pressure and diabetes. These both have been
associated with with the mini-vascular strokes in
the brain which are associated with vascular
dementia. You should keep you blood pressure and
diabetes under control with medicine and undergo
as much weight reduction as possible since that
will help both diabetes and hypertension.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Coffee consumption and diabetes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
By this time many of our reader's will have heard
news reports indicating that those who drink
coffee have a lower incidence of adult onset
diabetes. As we have cautioned before in this
newsletter, it is important to realize that this
is merely a statistical association and not
necessarily a cause and effect.
Here are some of the facts of the study.
In women, less than 4 cups of coffee per day did
not lower risk of diabetes
At 4-5 cups of coffee per day the risk of diabetes
was 70% as it also was with 6 or more cups a day
(please not that 5 cups (500 mg of caffeine) of
coffee per day is considered caffeine toxicity)
Women who drank 4 or more cups of decaffeinated
coffee a day had an 85% risk of diabetes
I do not think this study should be used either to
start taking in more caffeine in order to prevent
diabetes nor should it be used as justification
for continuing to drink coffee in the range of
caffeine toxicity. It is just an association for
scientists to know about when they perform further
studies. It is not an article to take any action
upon in my opinion.
Coffee consumption and diabetes
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Humidifier in winter
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many conditions are worsened when you are in an
overly dry environment (humidity less than 30%).
This commonly occurs during the winter as heat
comes on indoors. Flu, a sore throat, colds,
bronchitis, sinusitis, asthma, and dry skin or
eyes or nasal linings will all benefit from a
using a room humidifier. Keep it in mind this
season.
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Phone Call"
A woman, calling a local hospital, said,
"Hello, I'd like to talk with the person who gives
the information regarding your patients. I'd like
to find out if the patient is getting better, or
doing as expected, or is getting worse."
The voice on the other end of the line said, "What is
the patient's name and room number?"
She said, "Sarah Finkel, in Room 302."
"I will connect you with the nursing station."
"3-A Nursing Station. How can I help you?"
"I would like to know the condition of Sarah Finkel
in Room 302"
"Just a moment. Let me look at her records. Oh,
yes. Mrs. Finkel is doing very well. In fact,
she's had two full meals, her blood pressure is
fine, her blood work just came back as normal,
she's going to be taken off the heart monitor in a
couple of hours and if she continues this
improvement, Dr. Cohen is going to send her home
Tuesday at twelve o'clock."
The woman said, "Thank heaven! That's wonderful!
Oh! that's fantastic that's wonderful news!"
The nurse said, "From your enthusiasm, I take it
you must be a close family member or a very close
friend!"
"Not exactly, I'm Sarah Finkel in 302! Nobody here
tells me nothing!"
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
January 25, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Everyday muscle aches and pains
2. Internet breast cancer screening info
3. Reader Q&A - Post menopausal vaginitis
4. Chronic pain after surgery
5. Health tip to share - Extra sleep
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Everyday muscle aches and pains
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many individuals In their 40's,50's and older seem
to complain of the new onset of increased muscle
aches and pain. The health question becomes "Does
this mean I am developing a disease"? Many times
there is no disease present but lifestyle habits
may significantly contribute to the problem.
Lack of a proper amount of sleep time is a common
cause of increased muscle aches and pains. In
patients who have fibromyalgia, decreased sleep
time significantly worsens their symptoms. Loss of
sleep does this also in normal people. Recommended
sleep for most people is 7 1/2 - 8 1/2 hours a
night. It is not uncommon for some people to only
get 6-7 hours of sleep a night or less. They think
that is enough or else they are so busy that's all
they can get.
If you are running at 90 miles an hour during the
day and going to bed late and getting up early,
this high stress makes people ache the next day
from too much constant tensing of the muscles. You
can even have muscle tenseness from sitting at a
desk or computer terminal all day just from the
lack of movement and intense concentration and
muscle tensing.
Does exercise help or hinder? It depends upon how
much exercise you are doing. If you are pushing
the muscles further and further with each exercise
session, then they will hurt the next day. If you
reach a steady state of exercise then the muscle
aches and pains improve or go away.
Your mattress and pillow may also make a
difference. Too firm and too soft, sagging
mattresses contribute to daily aches and pains.
Different firmness of pillows can also make a
difference with neck pain.
So what can you do? A hot shower and stretching
exercises in the morning can help. Getting enough
sleep at night is also a cornerstone of
treatment.The important thing is to make sure your
lifestyle is not contributing to the problem
before you seek medical diagnostic tests.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Internet breast cancer screening info
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
All of us look for medical information on the
Internet. The accuracy of that information we find
can be difficult to assess. The site may have
accurate, unbiased information or it may be trying
to downplay risks and overestimate benefits in
order to get us to agree with their point of view.
How do you tell if the information is correct?
In a recent article in the British Medical
Journal, investigators looked at the quality of
information about screening for breast cancer with
mammography on 27 web sites all over the world.
Thirteen sites were from professional advocacy
groups, 11 from governmental institutions, and
three from consumer organizations.
The conclusions of the study were quite
interesting. They felt there was a significant
bias in favor of mammography screening on the
governmental and advocacy group sites; whereas the
consumer sites seemed to present a more accurate
discussion of not only the benefits but especially
the disadvantages and hazards of mammography
screening.
Some of the findings included:
over diagnosis of breast cancer of 33-35% and over
treatment of carcinoma in-situ of 30% were ignored
on many of the non consumer sites
some web sites alleged that breast cancer
screening leads to less mastectomies when in fact
the opposite is true
many sites did not let people know that screening
leads to overuse of radiation therapy treatment
and also downplayed the complications of
radiotherapy
false positive mammography findings were often
downplayed as sometimes merely creating "anxiety"
when in fact "more than 10% of women screened will
at some point experience important psychological
distress for many months"
The authors concluded that as a whole, the
consumer run sites were less biased and tended to
present the pros and cons of breast cancer
screening more accurately while many of the
governmental and advocacy group sites tended to
gloss over the disadvantages and potentially
harmful effects of screening.
This is an interesting article that all women
should read.
Internet breast cancer screening info
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader Q&A - Postmenopausal vaginitis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am 46 years old and am currently being treated
for candidiasis with Nystatin(R). I am also
menopausal having severe night sweats and hot
flashes that kept me up all night. I started HRT
4 months ago to relieve the menopausal symptoms
since none of the natural products had any effect.
The problem I am having is that the hormones feed
the yeast problem, and I am unable to get rid of
the yeast. I am in a real catch 22 situation.
Have you heard of this condition before, and how
do other women handle it?" - anonymous
Yeast vaginal infections (candidiasis) is very
common before menopause but much less frequent
after menopause unless a woman has diabetes.
Actually the most common cause of vaginal
discharge, itching and burning after menopause is
atrophic vaginitis.
Atrophic vaginitis is basically a bacterial
infection when the normal resistance of the
vaginal skin lining is very weak. The "weakness"
is usually from low estrogen levels although it
can also be from antibiotic therapy or high blood
sugar levels just as it can premenopausally. Even
though you are taking hormone replacement, if you
are still having hot flashes then your estrogen
levels are too low. Even if the hot flashes are
controlled on HRT, the vaginal skin lining may
still not be getting enough estrogen to sustain
the normal lactobacillus acidophillus that the
vagina depends on to fight of bowel and skin
bacteria.
Most of the time the doctor's initial therapy for
the problem you describe is to prescribe topical
estrogen cream (eg., Estrace® vaginal cream or
Premarin® vaginal Cream) to the vagina or use the
estrogen impregnated silicone rings (eg. Estring®,
Femring®) that are placed in the vagina to
continually provide estrogen to the vaginal skin.
This therapy is often sufficient on its own to
prevent the vaginal symptoms whether the source of
discharge is bacterial or yeast. In other words,
for this problem women do not necessarily need any
anti-yeast therapy or anti-bacterial therapy
because those are only secondary invaders of a
weakened vaginal lining. After a woman used the
topical estrogen product for several months, it
can be discontinued to see if the problem returns
or not. Many times it does not return even if the
estrogen levels are still low.
Finally, I am not aware of any over-the-counter,
non prescription substitute for this except
perhaps taking lactobacillus acidophilus
supplements. If the estrogen therapy does not
work, then you need to have your doctor take a
specific bacterial culture of the vagina to see
what organism predominates.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Chronic pain after surgery
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When giving you informed consent about an upcoming
surgical procedure, many doctors forget to tell
you that chronic pain can often result from any
surgery about 5-10% or more of the time. The
doctors focus on telling you about curing pain or
curing the symptom for which you are undergoing
operative treatment but neglect to tell you that
sometimes, not often, any body incision can result
in a chronic, daily pain that was not there before
the surgery.
Post operative pain is a significant problem for
many surgeries including gall bladder removal,
hernia repair, breast surgery, hysterectomy,
Cesarean section, lung or heart surgery
(thoracotomy) and most orthopedic procedures among
others. Some procedures have a lower incidence of
post-operative pain while others have higher
incidences. The pain may reside mostly at the
incision or deeper in internal tissues.
No one is absolutely sure what causes the new post
surgical pain but many doctors postulate that
nerve injury in the skin and sometimes in deeper
tissues is the initiating stimulus. As the nerve
or nerves try to heal, they may develop a focus of
electrical irritation that makes the nerve send a
signal to the brain that is painful.
Doctors are working on methods to try to lessen
the incidence of persistent post surgical pain but
for now, the important concept is that you should
be aware that this can happen if you are to
undergo an operation.
Chronic post-surgical pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Extra sleep
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
" I enjoy being an early riser but sometimes on
the weekends I like to just laze in bed. On a
lark, I bought a sleep mask made of silky material
at the Dollar Store and tried it. I could not
believe the difference it made. I slept an extra
hour or two when I wanted to and couldn't believe
the sun was so bright when I woke up at 8:30 a.m."
- dmg
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From Joke Du Jour
"Best Deal Yet"
No nursing home for me. I am checking into the
Holiday Inn! With the average cost for a nursing
home per day reaching $188.00, there is a better
way when we get old and feeble. I have already
checked on reservations at the Holiday Inn. For a
combined long term stay discount and senior
discount, it's $49.23 per night. That leaves
$138.77 a day for:
1. Breakfast, lunch and dinner in any restaurant I
want, or room service.
2. Laundry, gratuities and special TV movies.
Plus, they provide a swimming pool, a workout
room, a lounge, washer, dryer, etc. Most have
free toothpaste and razors, and all have free
shampoo and soap. They treat you like a customer,
not a patient.
$5 worth of tips a day will have the entire staff
scrambling to help you. There is a city bus stop
out front, and seniors ride cheap.
To meet other nice people, call a church bus on
Sundays. For a change of scenery, take the airport
shuttle bus and eat at one of the nice restaurants
there. While you're at the airport, fly
somewhere. Otherwise, the cash keeps building up.
It takes months to get into decent nursing homes.
Holiday Inn will take your reservation today. And
you are not stuck in one place forever, you can
move from Inn to Inn, or even from city to city.
Want to see Hawaii? They have a Holiday Inn there too.
T.V. broken? Light bulbs need changing? Need a
mattress replaced? No problem. They fix everything,
and apologize for the inconvenience.
The Inn has a night security person and daily room
service. The maid checks to see if you are OK.
If not, they will call the undertaker or an
ambulance.
If you fall and break a hip, Medicare will pay for
the hip, and Holiday Inn will upgrade you to a
suite for the rest of your life.
And no worries about visits from family. They will
always be glad to find you, and probably check in
for a few days mini-vacation. The grand kids can
use the pool. What more can you ask for?
So, when I reach the golden age, I'll face it with
a grin. Just forward all my email to:
me@Holiday.Inn
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Health Newsletter *******
February 8, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Breast augmentation and mammography accuracy
2. Red yeast rice for cholesterol lowering
3. Reader submitted Q&A - Nighttime arm numbness
4. Complex carbohydrate low fat diet
5. Health tip to share - Sleep tips
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Breast augmentation and mammography accuracy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
doctors do not believe that breast augmentation is
associated at all with causing breast cancer.
However, some doctors and many patients are
worried that an implanted breast prosthesis makes
it more difficult to diagnose an early breast
cancer using mammography.
In order to test the accuracy of mammography in
patients who have had a breast augmentation,
investigators from several centers across the U.S.
looked at women who had breast augmentations and
who also had mammography and compared them with
women without augmentations. They checked the
outcomes of stage of cancer, size and spread to
the lymph nodes in both groups of women.
The findings showed several things:
mammograms were less sensitive in discovering
cancers in women with augmentations versus in
those without (45% vs 67%)
even though mammograms did not pick up as many of
the breast cancers in women with augmentations,
the severity and size and spread of the breast
cancers when they were finally found were the same
in both groups. In other words, not finding the
cancers as soon did not result in eventually
finding more advanced cancers
there were not more false positive mammography
results when a woman had a breast augmentation
The bottom line of the study is that mammograms
are less accurate when a woman has had a breast
augmentation, but not so low in accuracy that the
breast cancer is significantly more advanced when
it is finally found.If a woman has had a breast
augmentation, she should still have regular
mammograms
Breast augmentation and mammography accuracy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Red yeast rice for cholesterol lowering
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Nutritional supplements containing rice that has
been fermented by a strain of red yeast (Monascus
purpureus) have been shown to have cholesterol
lowering properties by about 20-40%. In fact, red
yeast rice was found to have statin chemicals in
it that are identical to a manufactured drug
called lovastatin (Mevacor(R)).
Apparently the lovastatin was a natural
fermentation product in this preparation and the
FDA challenged that they should regulate its sale
as a drug because this is identical to a drug that
they currently regulate. This position was
initially defeated in the courts and then reversed
so that most of the red yeast rice was removed
from the food supplement market. Since that time
some products have reappeared and are available.
It is important to remember that even though the
red yeast rice is a natural product, the statin
chemical in it has the same risks as the
prescribed statin, ie., possible liver or muscle
toxicity. If someone takes red yeast rice they
also should have their liver enzymes checked
periodically and be sure to report any excessive
fatigue or muscle weakness to their physician.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Nighttime arm numbness
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"About 4 hours into my sleep at night, I wake up
and my right arm is numb. It goes down my whole
arm and into my fingers. My fingers feel tingly. I
have to get out of bed and stand up and wait for
my arm to return to normal. What's going on with
me?" - PJS
Numbness and tingling of any extremity or large
area of the body is commonly due to some
compromise or abnormality of the nerve or nerves
supplying the skin and muscles of the area that
has gone numb or tingly. This can be due to a
nerve being compressed (sleeping on it),
abnormally stretched, or any disease or trauma
that has involved a nerve.
The fact that your symptoms only occur at night
when sleeping and resolve with change in position
make me suspect that there is nerve compression
taking place while you sleep. It might be due
either to your arm position or clothes that band
tightly across the upper arm when you are asleep.
If your right arm is almost always the problem, I
would think you are probably lying on your right
side and somehow putting pressure on the nerves to
your right arm. If the numbness is at the shoulder
or above then the compression is near the spine or
neck. If the numbness starts below the shoulder,
the compression is likely on the upper arm just
between your armpit (axilla) and your elbow. If
this is the case, you might try arranging some
pillows to either force yourself to lie on your
left side or to cushion between your chest/breast
and right arm when you lay on your right side.
Tingling and numbness of the arm are called
paresthesias and can be due to many other reasons,
however. If this persists in spite of making
changes in your sleeping position, you should see
your physician. Conditions such as diabetes,
multiple sclerosis, tumors of the arm or spine,
arthritis or spinal disc problems, vitamin
deficiencies, and circulatory disorders, among
other things, can cause the symptoms you describe.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Complex carbohydrate low fat diet
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
While low carbohydrate diets ala Atkin's are quite
the rage now, they are not tolerated by everyone.
Older adults, especially those over age 60 do not
do well with high protein and fat consumption. In
fact most older adults tend to normally eat more
carbohydrates than younger adults.
Investigators in Arkansas looked at giving a diet
high in complex carbohydrates and low in fat to
men and women (average age 66) with impaired
glucose tolerance. They had two diet groups and
one control group. Both diet groups received a
high carbohydrate diet (18% fat, 19% protein, 63%
carbohydrates, and 26 gm of fiber per 1000 kcal)
and one of the diet groups additionally had an
aerobic exercise program while the other one did
not. The diet groups actually were not restricted
in their number of calories at all but just the
ratio of the protein, fats and carbohydrates.
Both of the diet groups lost more weight (7-11 lbs
on the average over 12 weeks) than the controls.
The diet group with an exercise program lost
slightly more than the diet group not on an
exercise program.
The interesting aspect about this study is that
the people were not restricted in the amount they
were allowed to eat, just in the proportion of
fats and proteins in the diet. Thus this is very
similar to a vegetarian diet that is high in
complex carbohydrates.
Complex carbohydrate low calorie diet
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Sleep tips
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"My proven tips on getting more and better sleep:
1) Make your room dark. Purchase black-out
blinds or simply nail up an old dark blanket.
2) Purchase a 'white noise' device. It will mask
noise such as barking dogs and traffic. (I use an
air cleaner, but a humidifier works well also.)
3) If you live in a colder climate, purchase and
use an electric blanket.
Sleep like a baby!" - Val
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dear Dogs
When I say to move, it means go someplace else,
not switch positions with each other so there are
still two dogs in the way.
The dishes with the paw print are yours and
contain your food. The other dishes are mine and
contain my food. Please note, placing a paw print
in the middle of my plate and food does not stake
a claim for it becoming your food and dish, nor do
I find that aesthetically pleasing in the
slightest.
The stairway was not designed by NASCAR and is not
a racetrack. Beating me to the bottom is not the
object. Tripping me doesn't help, because I fall
faster than you can run.
I can not buy anything bigger than a king size
bed. I am very sorry about this. Do not think I
will continue to sleep on the couch to ensure your
comfort. Look at videos of dogs sleeping, they can
actually curl up in a ball. It is not necessary to
sleep perpendicular to each other stretched out to
the fullest extent possible. I also know that
sticking tails straight out and having tongues
hanging out the other end to maximize space used
is nothing but doggy sarcasm.
When I am playing the pinball machine, jumping up
and trying to grab the ball through the glass is
not helpful. Barking at me because I'm not helping
you achieve your goal does not win you any extra
brownie points.
My compact discs are not miniature Frisbees.
For the last time, there is not a secret exit from
the bathroom. If by some miracle I beat you there
and manage to get the door shut, it is not
necessary to claw, whine, try to turn the knob, or
get your paw under the edge and try to pull the
door open. I must exit through the same door I
entered. In addition, I have been using bathrooms
for years, canine attendance is not mandatory.
The proper order is kiss me, then go smell other
dogs butt. I can not stress this enough. It would
be such a simple change for you guys to make.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
February 22, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Protect your arthritic joints to prevent pain
2. Spider veins - what can be done?
3. Reader submitted Q&A - Zocor concern
4. Risk factors for new onset kidney disease
5. Health tip to share - Numb, tingling arm
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Protect your arthritic joints to prevent pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Our joints wear and tear with aging often causing
some discomfort with certain activities that
stress the joints. Even if age is not a problem
but you have arthritis, the joints may become
quite painful, lasting a long time even with
minimal physical motion at the joint bone
connection. Protection is necessary for not only
the large joints like the hip, knee and shoulder,
but also fingers, wrists, elbows and feet can
benefit from change in our everyday movement
habits in order to function without pain.
The experts at Mayoclinic.com have come up with
some tips to guard those joints from unnecessary
pain and stiffness:
Move each joint through its full pain-free range
of motion at least once a day.
Learn to Understand the difference between the
general discomfort of arthritis and pain from
overuse of a joint.
Be careful how you use your hands - avoid tight
grips; avoid bending the large knuckles of your
hand while keeping the middle and end joints
straight and your thumb parallel to your fingers;
avoid pinching items between your thumb and your
fingers -- rather hold the objects in your entire
palm if possible.
Use proper body mechanics when sitting or
standing for a long time, when lifting or carrying
heavy objects and when picking objects off of the
floor.
Use the strongest joint available for the job.
Avoid keeping the joint in the same position for
long periods of time
Intermix periods of joint rest and activity
during the day.
Do not be afraid to use assistant devices to help
carry, move or open items. You may want to use
utensils with larger handles or add extenders to
knobs or dials for leverage to turn them. You may
even benefit from items to help you get dressed or
even to walk. All of these aids will help protect
the joints from becoming painful or will assist a
stiff joint to still do the job.
Arthritis: Protect your joints to prevent pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Spider veins - what can be done?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Spider veins are small red, blue or violet veins
that often occur on the thighs, calves and ankles.
They may look not only like a spider with "legs"
radiating out from a central body, but also like a
series of lines or branches. Sometimes the veins
may cause aching, burning, swelling or night
cramps although most of the time they do not
produce any physical symptoms. These veins are not
the same as varicose veins which actually are much
larger; usually a 1/4 inch diameter or more. Many
people consider spider veins simply as
unattractive and they may wish to have them
treated.
Doctors are not absolutely sure what causes these
small veins but several factors seem to contribute
to their development: heredity, pregnancy, weight
gain, physically straining occupations or
activities requiring the use of certain
medications.
Even though these small surface skin veins are
part of the larger vein system of the body, they
are not essential to the vascular blood flow. This
allows doctors to go ahead and use lasers or
inject scarring chemical solutions (sclerotherapy)
that seal off the vessel from allowing any more
blood to go through it. When the blood flow is cut
off, the redness of the spider vein on the surface
of the skin disappears.
Sclerotherapy is commonly used by plastic surgeons
and dermatologists to get rid of these veins
although lasers are being used more and more.
There may even be a response from using Vitamin K
cream on the spider veins. With sclerotherapy, the
veins are injected with a chemical to seal off the
vein but it may take more than one session to
effectively do this.
Serious complications are rare but can happen. One
may develop blood clots in nearby veins, severe
inflammation of the skin, or even allergic
reactions to the sclerosing solution and skin
injury that could leave a small but permanent
scar. Less serious, but not rare, complications
include:
some pigmented (splochy) areas that take awhile to
go away and,
developing new spider veins around the previously
injected vein.
If you think you might be interested in this
procedure, check out the article at the American
Society of Plastic Surgeons.
Spider veins - what can be done?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Zocor(R) concern
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am now taking 80 mg. of Zocor(R) (simvastatin).
I hear of the serious side-effects of this drug.
Please give me an herbal alternative." - anonymous
Zocor belongs to a class of drugs called statins.
They are used to lower bad cholesterol (LDL) and
many times they also raise good cholesterol (HDL).
There are studies that show they not only lower
cholesterol but also can reduce adverse
cardiovascular events in people who have risk
factor for heart attacks and strokes. There is
still a question as to whether or not they reduce
the death rate overall in patients who do not have
risk factors other than the high cholesterol.
You are correct that any of the statin drugs can
cause some major complications although not very
frequently. One of the worst complications is
killing off the body's muscle cells
(rhabdomyolysis) which can lead to extreme and
permanent muscle weakness. This probably happens
in about one person per 10,000 or more. Muscle
soreness is more frequent at about 2%. Liver
toxicity is also a rare (less than 0.5%) but
serious problem.
Dietary lowering of LDL cholesterol can be brought
about by following a low saturated fat diet that
includes added fiber, soy protein and almonds.
Red yeast rice has been shown actually to have
statins (lovastatin) in it. We wrote about it in
the newsletter in the last issue. It can lower
cholesterol by about 20-40%. I would not consider
it an herb but rather a nutritional supplement.
You still should have your liver enzymes checked
periodically when using it. This has the most data
with it as a non prescription way of lowering
cholesterol but it probably should be considered
almost the same as the drug lovastatin
(Lipitor(R)).
Red wine with or without the alcohol in it and
grape juice from red grapes lowers the absorption
of lipids from meals as well as raising good
cholesterol (HDL) blood levels.
Other herbs that are in the literature about
lowering cholesterol but of which I have no
experience are:
fenugreek (Trigonella foenum-graecum),
artichoke leaf extract (Cynara scolymus)
red glory bower (Clerodendron colebrookianum Walp
(family, Verbenaceae) from China
Indian gooseberry (amla - Emblica officinalis)
It seems if you are going to go to the trouble of
taking either a medicine or a supplement to lower
cholesterol, it would be smart to permanently
change eating habits to increase fiber as much as
you can and regularly use red grape products,
almonds and soy.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Risk factors for new onset kidney disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Chronic kidney disease is much less common than it
was in the days before widespread use of
antibiotics, yet many individuals still develop
life-threatening kidney disease. If the kidney
impairment becomes bad enough and you lose too
much function, kidney hemodialysis several times a
week is the only way to stay alive. While several
diseases are known to be associated with chronic
kidney disease, the factors associated with the
new development of kidney disease are not well
studied.
In a recent study of over 2500 individuals living
in a community, investigators looked at risk
factors for the development of chronic kidney
problems in individuals who were not known
previously to have kidney problems or active
medical diseases. Both men and women who averaged
43 years of age at the start of the study were
followed for almost 20 years.
Over 9% of the study individuals developed chronic
kidney impairment over that time. The major risk
factors associated with this were diabetes,
hypertension, smoking and obesity. The biggest
risk, however was with preexisting low kidney
blood flow (glomerular filtration rate or GFR).
This is a measurement based on a collection of
urine for 24 hours along with a blood test called
a 24 hour creatinine clearance. It measures GFR on
the average how much blood is being cleared of
waste products by the kidneys.
A mildly reduced GFR (<90 mL/min per 1.73 m2)
predicted a 3-fold chance of progression to kidney
disease. This means to me that kidney impairment
can develop over a fairly long time, many years
before any other disease or risk factor is
present. While doctors do not order this 24 hour
urine test as a screening for future kidney
disease, it appears that maybe they should.
I do not know if you asked your doctor to order
such a test - a 24 hour creatinine clearance -
that he or she would comply with your request, but
it is not an expensive test. It might not hurt to
ask especially if you have high blood pressure,
diabetes or are moderately overweight. If the test
indicated slightly low flow, it might be more
incentive to lower your blood pressure, weight or
blood sugar through dietary or lifestyle
modification than you have at the present time.
Risk factors for new onset kidney disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Numb, tingling arm
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have carpal tunnel syndrome. I would wake up
with a numb, tingling arm. My entire arm was
aching. I bought a special splint designed
specifically for the carpal tunnel syndrome. I
found almost instant relief. I take 100 mg of
vitamin B6, along with other B vitamins. I hope
this information helps others!" Jennifer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"English Nouns, Male or Female"
In many languages, nouns are considered wither
masculine or feminine and take different words as
modifiers. From the Washington Post Style
Invitational in which it was postulated that if
English were to have male and female nouns, and
readers were asked to assign a gender to nouns of
their choice, and explain their reason.
The best submissions:
Detective Novel -- f., because you're not supposed
to peek at its end the minute you pick it up.
Swiss Army Knife -- m., because even though it
appears useful for a wide variety of work, it
spends most of its time just opening bottles.
Kidneys -- f., because they always go to the
bathroom in pairs.
Penlight -- m., because it can be turned on very
easily, but isn't very bright.
Hammer -- m., because it hasn't evolved much over
the last 5,000 years, but it's handy to have
around and is good for killing spiders.
Tire -- m., because it goes bald and often is
over-inflated.
Hot air balloon -- m., because to get it to go
anywhere you have to light a fire under it. And,
of course, there's the hot air part.
Web page -- f., because it is always getting hit
on.
Web page -- m., because you have to wait for it to
reload.
Shoe -- m., because it is usually unpolished, with
its tongue hanging out.
Copier -- f., because once turned off, it takes a
while to warm up. Because it is an effective
reproductive device when the right buttons are
pushed. Because it can wreak havoc when the wrong
buttons are pushed.
Magic 8 Ball -- m., because it gives monosyllabic
answers that usually indicate it did not pay
attention to your question.
Ziploc bags -- m., because they hold everything
in, but you can always see right through them.
Sponges -- f., because they are soft and
squeezable and retain water.
Critic -- f. What, this needs to be explained?
Subway -- m., because it uses the same old lines
to pick up people.
Hourglass -- f., because over time, the weight
shifts to the bottom.
Cars -- f., most of the time they're ok, but if
you mistreat them or don't service them often
enough, they soon break down and/or turn into a
wreck.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
March 7, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Using antibiotics sensibly
2. How long to treat a UTI?
3. Reader submitted Q&A - Weight and OCPs
4. Massages to relieve muscle tension
5. Health tip to share - Too many fluids
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Using antibiotics sensibly
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Why not take an antibiotic when you have a cold,
sore throat or flu symptoms? It can't hurt you can
it? Yes it can hurt.
The overwhelming majority of upper respiratory
tract infections in otherwise healthy people
during the cold and flu season are caused by
viruses. Antibiotics have no effect against
viruses, only against bacteria. The viral caused
cold, flu or sinus drainage symptoms do not go
away any quicker when you take an antibiotic.
Viral infections are usually self-limited and do
go away on their own but the clearing of symptoms
is not because you took an antibiotic.
If you take left over antibiotics or pressure your
doctor to prescribe them when you really do not
need them, you run not only the risk of an
allergic reaction, a bowel infection or vaginal
yeast infection, but also you contribute to
letting other bacteria in your body become
resistant to that antibiotic. The bacteria
themselves form a defense against the specific
antibiotic. The next time you get a bacterial
infection, that antibiotic might not work. It may
take a week or more to find out that the
antibiotic does not work and all the time the
infection causes damage to your body. You may end
up needing hospitalization for the infection or a
more expensive antibiotic; there may not be any
antibiotics that are effective for the infection.
When antibiotics are overused, infections caused
by these bacteria may not respond. Illnesses from
the infection can last longer. Complications from
such an infection and even the risk of death can
rise. Failure of an antibiotic to treat a
particular infection leads to longer periods in
which a person is contagious. That person,
possibly your best friend, has a longer time to
spread the resistant strains to others.
Since most upper respiratory tract infections are
viral, assume that is the case until you have
reason to suspect otherwise. Then if you are not
sure, do not self medicate but rather seek a
medical opinion. If the doctor still thinks
antibiotics are not needed, go along with that
rather than pressuring for an antibiotic
prescription.
Using antibiotics sensibly
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. How long to treat a UTI?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you have ever have had urinary tract infections
(UTIs), you may know that sometimes you receive
antibiotics for 1 day, 3 days, 5 days, 7 days, 10
days or 14 days. You may think it depends upon
which antibiotic the doctor prescribes but many
times it does not. Doctors do not always know the
optimal length of time needed to treat
uncomplicated urinary tract infections.
A recent study in Canada looked at treating
urinary tract infections in older women who did
not have signs of a higher kidney infection
(pyleonephritis), diabetes, recent treatment with
antibiotics, urinary tract abnormalities or
contraindications to the specific antibiotic used.
In other words, they had uncomplicated UTIs. The
drug used was Cipro(R)(ciprofloxacin) and they
tested two doses: 250 mg twice a day for 3 days
and 250 mg twice a day for 7 days. The authors
looked at both immediate treatment success, as
measured by a urine culture two days after
completion of antibiotics and also the relapse
rate of infection by urine culture at six weeks
after treatment.
The investigators found that for the 3 day course
and the 7 day course, the immediate cure rates
were 98% and 93% (yes better in the 3 day group)
and the relapse rates were approximately 15% in
each group. In addition, the group taking only 3
days of antibiotics had significantly less (about
half) side effects from the antibiotics such as
nausea and vomiting, drowsiness, loss of appetite,
headache, abdominal pain or diarrhea.
This study suggests that at least for Cipro(R)
treatment of uncomplicated UTI, the duration of
treatment is best confined to only 3 days rather
than 7.
How long to treat a UTI?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Weight and OCPs
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Recently, my obgyn informed me that I have to
change my birth control pill because I am too
heavy (195 lbs). He informed me that a new study
indicated that heavy patients need to take birth
control pills with high content of estrogen
(35mg). I was using the Ortho Evra(R) patch which
was falling off my skin! Does taking high doses of
estrogen effect my chances of having any side
effects (breast cancer or blood clots formation)?"
"I am 26 years old and do not smoke! I am not on
any medications, I do exercise and am in a good
health" - KRA
The question you raise stems mainly from one
article in 2002 from the University of Washington
that suggests there is a higher risk for oral
contraceptive failure in heavy women (greater than
155 lbs or 70.5 kg). To understand what the
magnitude of risk is to you and whether switching
to a higher dose oral contraceptive (Ortho Evra
has only 20 mcg of estrogen) will lower your
pregnancy rate, you need to know a little
background of what the study actually found.
Failures of contraception that result in pregnancy
are measured in 100 women-years, i.e., 100 women
taking the pill for 1 year or 50 women taking the
pill for 2 years for example. Using that
definition, the overall failure rate of all oral
contraceptives is about 3-4%. This takes into
account all women, even the ones that tend to
forget their pills. The best case failure rate of
women who are "good pill takers" is about 1%
overall.
Most modern oral contraceptives come with estrogen
doses of about 20-25 mcg (very low dose), 30-35
mcg (low dose) and 50 mcg (high dose). Your patch
birth control would be considered very low dose.
In the 1960's, estrogen doses above 80mcg were
linked to increasing rates of blood clots
(vein thrombosis). Average doses came down very
quickly. In the 1990's there became questions
about different progestins (not the estrogen dose)
that seemed to have different blood clot rates. As
far as we know at these modern estrogen doses,
there is no higher incidence of thromboses. In
fact your weight alone is probably more of a risk
for thromboembolism. Also, there is no known
increase of breast cancer with any of these doses
either.
Doctors will still caution you to be on the lowest
dose possible and I agree fully with that. If we
look at the different weight ranges and the
pregnancy rates for the different estrogen doses
in the pills in the above mentioned study we see:
Pregnancy rate/100 women yrs
estrogen dose
(Weight in lbs) 20-25mcg 30-35mcg 50mcg =+
less than 125 1.8 3.2 1.6
125-137 3.4 2.7 3.3
138-155 2.3 2.0 8.2
155 and plus 6.8 5.2 5.4
As you can see, women over 155 lbs have in general
higher pregnancy rates (5-7%) than women under 125
lbs (1.8-3.2%). However, you do not gain very much
lowering in rate (6.8 to 5.2 or 5.4) if you, at
the higher weight, switch to a higher dose pill.
You will need to decide for yourself if these
differences are worth switching contraceptive
doses. Basically you are at slightly higher risk
for pregnancy no matter what you do.
Keep in mind one of the things we have mentioned
before, i.e., that the biggest risk for pregnancy
from pill failure is starting the pills LATE after
you have been off of them for 7 days. If you are
very good about prompt starting of a new pill pack
or patch, you may be a lower risk than the general
population on which this study is based.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Massages to relieve muscle tension
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you know there a quite a few different types
of massages? Different massage types vary in how
the hands are used in the massaging stroke and
the amount of pressure applied to the different
muscles or parts of the body.
Types of massages
Swedish - long smooth hand strokes and kneading
movements along the skin
Deep - slow heavy strokes on deep muscle tissue
Sports - specific muscle directed massage both
deep and superficial
Craniosacral - focuses on the muscles and
ligaments of the head, neck and spine
Neuromuscular - concentrates on painful or trigger
point areas of specific muscles
Rolfing - significant pressure on connective
tissue throughout the body using the hands,
knuckles and elbows
Massages are not only for spa treatments but
medically they can relieve stress and muscle
tension, relieve anxiety, lessen muscle pain and
even stimulate the immune system. They can be
safely performed by licensed health professionals
such as a massage therapist, physical therapist or
occupational therapist.
If you have a massage, be sure to let the
therapist know if you have any skin burns or
wounds, or have had a recent heart attack, cancer,
arthritis flare, unhealed fracture or bone
thinning (osteoporosis). You do not want to have a
serious complication of massage such as internal
bleeding, nerve damage or temporary paralysis
which can rarely happen with an untrained massage
therapist.
Massages to relieve muscle tension
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Too many fluids
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"The traditional advice to treat a cold with
bedrest and plenty of fluids may be at least half
wrong. Recently investigators have found cases in
medical reports in which excessive fluid intake in
people with upper respiratory tract infections has
produced a dangerous lowering of body salts
(hyponatremia). This could possibly result in
congestive heart failure, pneumonia and even
death." - FRJ
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Little Known Illnesses
HAIRPIECE SWIMPLEX
Rash caused by wearing a toupee in a pool.
HERPES CINEPLEX
Rash caused by movie tickets priced at $9.50.
VISACARDITIS
The heart-stopping sensation brought on by
exceeding your credit limit.
OREOPOROSIS
Disorder caused by too many cookies, not enough
milk.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
March 21, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Hypertension drug therapy
2. Is routine use of antibacterial soap helpful?
3. Reader submitted Q&A - Hypothyroidism control
4. Melatonin hormone declines with age
5. Health tip to share - IUCD for heavy bleeding
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Hypertension drug therapy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If a person with high blood pressure is treated
correctly, physicians and friends have high
expectations that future strokes and heart attacks
will be prevented. In practice, those events are
often not prevented because hypertensive
individuals either do not regularly take their
recommended medicines or they are not prescribed
the best regimen to control the blood pressure. In
the U.S. only about 30% of hypertensive
individuals have the blood pressure controlled at
140/90 or less. In Europe the number is about 10%.
The latter issue, that of prescribing the best
anti-hypertensive treatments possible, has been
the subject of several guidelines from the U.S.,
Europe and now from the British Hypertensive
Society. Most of the recommendations in the
consensus guidelines are very similar although
there are some differences of emphasis. Most
importantly, different classes of antihypertensive
drugs seem to have better results and less
complications in different age and ethnic groups.
The recommendations of the British Hypertensive
Society are to initially start non black patients
under the age of 55 on either an ACE inhibitor or
a beta-blocker. Black men and women or non black
individuals over the age of 55 should be started
on either a calcium channel blocker or a diuretic.
The combination of a beta blocker and a diuretic
is avoided because it may be associated with a
higher incidence of diabetes.
If initial single drug therapy is not successful
in keeping the blood pressure below 150/90 (yes
150/90), then other combinations can be tried. The
preferable combinations would be an ACE inhibitor
plus a calcium channel blocker or a diuretic. As
combination therapies are tried, the important
concept is to avoid using a beta blocker with a
diuretic if possible.
Hypertension drug therapy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Is routine use of antibacterial soap helpful?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
There is a plethora of cleaning products available
in stores that advertise antibacterial components.
The antibacterial additives are expected by buyers
to reduce the incidence of infectious diseases in
a household. Unfortunately many infectious
diseases are viral in origin and one would not
expect antibacterial soaps to substantially reduce
those infections.
A study was carried out in inner city New York
households in which half the households were given
unlabeled, antibacterial cleaning, laundry, and
hand washing products. The other half were given
the same products but without antibacterial
chemicals. After almost a year of follow up, the
number of respiratory, fever, vomiting and
diarrhea symptoms were recorded in each group.
There were no statistical differences between
those using antibacterial cleaning products and
those not.
This would imply that at least for most
infections, routine use of antibacterial cleansing
products is not worth any price difference. There
may be a place for them if people are involved in
a lot of food preparation but even that still has
to be proven.
Is routine use of antibacterial soap helpful?
