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********** Health Newsletter ***********
September 19, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Physical activity, obesity and diabetes in women
2. Living with celiac disease
3. Reader submitted Q&A - Sea salt and shellfish allergy
4. Irritable bowel syndrome effect on quality of life
5. Health tip to share - Flexibility problems
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Physical activity, obesity and diabetes in women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
An interesting study was published in the Journal
of the American Medical Association (JAMA) which
looked at both body mass index (obesity) and
amount of daily physical activity and its effect
upon diabetes. Both increased weight and low
amounts of physical activity are known to be
related to diabetes and heart disease events like
myocardial infarction. Since obesity and low
physical activity often tend to travel together,
it is difficult to know which is more important
losing weight or increasing physical activity.
Doctors always tend to recommend both.
The reason this study was so interesting is that
it found that overweight/obesity was worse than
low physical activity for developing diabetes. The
increased risk was as follows:
Category Risk Ratio
normal-weight inactive 1.15
overweight active 3.68
overweight inactive 4.16
obese active 11.5
obese inactive 11.8
In a companion article in the same issue looking
at the relationship between weight, physical
fitness and heart attacks in women who had been
suspected of having heart ischemia (low blood flow
to the heart), authors found that good physical
fitness was more protective against heart attacks
and was independent of weight. This is the
opposite of the effect of physical fitness on
diabetes where weight was the more important
factor.
Physical activity, obesity and diabetes in women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. The journey of Parkinson's disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The average age of onset of Parkinson's disease is
about 65 years although it sometimes can start
earlier as in the case of Muhammad Ali. The course
of the disease is often not well communicated to
newly diagnosed patients. Sometimes the doctors
themselves are not as familiar with the course of
the disease so that anyone who is newly diagnosed
with Parkinson's disease should seek out a
specialist in that treatment. Parkinson's is known
as the "shaking palsy" and it can be caused by
past head trauma, past neurological infections,
arteriosclerosis of certain parts of the brain or
just totally be of unknown cause.
People will ask if Parkinson's will make them to
die earlier. In general it does not shorten life
span unless they develop illness from malnutrition
or infection because they are unable to care for
themselves. The main problem is the eventual
worsening of the shaking symptoms such that a
person has a difficult problem with any self care.
It is a journey that requires someone to help and
the most important aspect is knowing what to
expect.
Sometimes doctors may discuss many of the good
treatments for Parkinson's but they fail to
mention that there is no cure. All of the
treatments are just to control the symptoms as
best as possible and prolong the time to which the
palsy and movement difficulty makes self care
impossible. If you know of anyone with Parkinson's
disease, have them or their family check out this
article from the British Medical Journal.
The journey of Parkinson's disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Sea salt and shellfish allergy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"If I am allergic to fish and shellfish can I
still eat Sea Salt? Or can microscopic pieces of
fish protein be stuck in the Sea Salt? I am a 44
y/o female with food allergies?" -Laura L.
It is fantastic that you understand that your
allergy is to the protein from certain fish or
shellfish rather than to "iodine" as many people
think. People who have these severe allergies may
not only react upon eating the shellfish but even
upon walking through a large seafood market with
fish "particles" in the air. So the question you
ask about the sea salt is interesting.
I honestly do not know the answer to this from
anything in the medical literature. In other
words, no one has reported an allergy to sea salt
nor have doctors tested and found the absence of
allergic reactions to sea salt among those
allergic to fish and shellfish. However I did
learn something about how salt is manufactured
which may help us.
Almost all regular salt and sea salt is produced
by one of two methods: mining salt deposits on
land (originally the salt was probably from sea
water) and solar evaporation of sea water. Salt
that is advertised as sea salt would usually be
from solar evaporation of sea water in which large
pools of sea water are exposed to the sun. Then
when much of the water is evaporated, the saline
suspension is transferred to smaller and smaller
containers until eventually you have only salt
left.
I would guess that most smaller operations of this
sort would not pump water into the initial holding
tanks with any whole fish in the water. To be a
purist, however, you would only want to use sea
salt that had been derived from sea water that had
been run through a particle filter before the
water evaporation process. Some manufacturers also
"wash" the salt once or twice.
I do not think I would hesitate to use sea salt if
I had a shellfish/fish allergy but if I found a
brand that I was successfully able to use, I would
stick with that brand. It is extremely unlikely
that there would be enough fish protein in salt to
cause any sort of a reaction in someone allergic
to that protein.
Does Iodine Allergy Mean a Shellfish Allergy
Too?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Irritable bowel syndrome effect on quality of life
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Irritable bowel syndrome (IBS) is a poorly
understood condition in which the large bowel
undergoes altered muscle function such that one
has diarrhea or constipation along with crampy
bowel, lower abdominal or pelvic pain and
bloating. Often the discomfort worsens or improves
with a bowel movement but not always.
There is some evidence that individuals who have
food allergies, especially with IgG antibodies to
specific foods, are a part of the overall
population that has IBS. Unfortunately, IBS
sufferers have more than abdominal pain and bowel
dysfunction; they often have other debilitating
symptoms that significantly affect their quality
of life.
A recent study in Los Angeles examined over 700
people with IBS to look at what factors most
affected the physical and mental quality of their
daily living activities. Frequent visits to the
doctor (more than 5 visits a year), tiring easily,
low energy and severe symptoms were the most
significant predictors of altered physical quality
of life. Feeling tense, feeling nervous, feeling
hopeless, difficulty sleeping, tiring easily, low
sexual interest, IBS symptom interference with
sexual function, and low energy were the
predominant predictors of altered mental health
status.
This study indicates that the quality of life in
patients with IBS is primarily related to non
gastrointestinal symptoms rather than altered
bowel function or pain per se. Whether the IBS
condition causes depressive symptoms or whether
depression can cause IBS, those symptoms of low
energy, hopelessness, anxiety, tenseness and
decreased libido are the major reason that
patients with IBS feel bad. Perhaps treatment
needs to be primarily directed toward the
depressive/anxiousness symptoms rather than just
the pain or constipation etc.
IBS effect on quality of life
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Flexibility problems
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Many physically challenged women probably have
the same difficulty I do putting on their
brassiere in the morning. I have discovered that
with a front closing bra it works best to turn the
bra upside down and backwards in front of you, put
your arms through the arm holes.then flip it over
your head, pull it down in back and fasten in
front. This prevents having the bra twist on you
when you put your arms through the arm holes. A
back closing bra is easier to put on if you just
put your arms through the arm holes and fasten it
in back before you put your breasts in.
If you have trouble reaching things on the floor
or on shelves or in your clothes dryer and you do
not have a regular reacher, barbecue tongs are a
good temporary solution." Gladys L.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Marriage Seminar"
While attending a Marriage Seminar dealing with
communication, Tom and his wife Grace listened to
the instructor, "It is essential that husbands
and wives know the things that are important to
each other."
He addressed the man, "Can you describe your
wife's favorite flower?"
Tom leaned over, touched his wife's arm gently and
whispered, "It's Pillsbury, isn't it?"
The rest of the story gets rather ugly, so I'll
stop right here.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
October 3, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Physical therapy for low back pain
2. Healthy lifestyle for the elderly
3. Reader submitted Q&A - Continuous BC Pills
4. Knee injury especially ACL ligament
5. Health tip to share - Heart attack symptoms
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Physical therapy for low back pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Low back pain is a common problem and often
doctors will refer patients for physical therapy
to improve the discomfort of low back pain.
Physical therapy consists of exercises, massages,
heat and other non surgical modalities. While low
back pain sufferers often feel better after such
physical therapy, there is question as to whether
it really results in any improvement of physical
limitations from the pain, i.e., can you perform
functions you were previously unable to because of
the level of pain.
A recent study in the UK looked at over 280
patients with low back pain for at least six weeks
with or without leg pain or neurological signs.
They excluded patients with serious conditions,
including systemic rheumatological disease,
gynecological problems, ankylosing spondylitis,
tumors, infection, past spinal operations, and
treatment for physical problems in the previous
month. They gave half of the patients five or more
30 minute physical therapy sessions and to the
other half they only gave a one hour assessment
and educational (advice) session on how to self
treat with exercises.
While the group who had the standard physical
therapy multiple sessions claimed that they felt
better than the advice only group, there was no
difference in the disability measures one year
after treatment between the two groups. Multiple
physical therapy sessions were not an advantage
over only one educational instruction session. In
other words once you know what to do, that is as
good as having multiple visits to the physical
therapist.
Physical therapy for low back pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Healthy lifestyle for the elderly
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
While hundreds of articles have looked at the risk
of dying by analysis of diet, physical activity,
drinking and smoking, they have not always been
able to simultaneously control for every factor to
see which factors are the most important. A recent
study reported in the Journal of the American
Medical Association (JAMA) looked at the combined
results of two long term European studies that
followed a cohort of over 2300 men and women aged
70-90 followed for 10 years or more. They looked
at the specific risk factors in all of these
elderly people.
Low risk factors include:
1) a Mediterranean diet which is low in meats
except fish and high in fruits, vegetables and the
ratio of mono unsaturated to saturated fat has been
shown to be heart healthy.
2) moderate daily physical activity
3) moderate alcohol consumption has also been
shown to be good for the heart.
4) non-smoking - smoking of course, is bad for the
heart.
Since many of these elderly people died during the
length of the study, investigators were able to
calculate which of these factors would put a
person at the lowest risk for dying. They found
that individuals who had all 4 low risk factors
died at only a 35% rate compared to those who had
none or one low risk factor.
Number low risk factors Risk ratio
Zero/none 1.0
One low risk factor 1.0
Two low risk factors .62
three low risk factors .45
four low risk factors .35
Basically, the more of these low risk factors that
apply to you when you are over age 70, the longer
you can expect to live.
Healthy lifestyle for the elderly
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Continuous BC Pills
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I recently skipped my period by not taking the
sugar pills in the pack of oral contraceptives. Is
it normal to still receive some bleeding by
tricking the body into thinking it is not
menstruating?"- CW
The answer is yes. You can still have some
bleeding even though you skip the placebo sugar
pills and just start the next pack of pills so
that you are taking continuous estrogen and
progesterone. Many women will skip menses when
taking the continuous pill regimen but
approximately 30-40% will have some bleeding
ranging from spotting to full menses.
Traditional birth control pills have 3 weeks of
active hormone and 1 week of inactive pills. Your
menses usually starts during the week of no
hormones. Even though you are off of the active
pills for a week, you are still protected from
pregnancy as long as you do not go longer than the
7 days with no hormones. A newer regimen of
continuous pills, 3 months of active, hormonal
pills, is used by many women to avoid problem
menses such as severe cramps, heavy bleeding, and
severe PMS symptoms. You can also use it like you
did in an abbreviated form over two cycles just to
skip a menses because of your other activities. It
is not a perfect regimen, however, hence the
breakthrough bleeding which you had.
There are now pills (Seasonale(R)) that are
packaged with 3 months of active pill. Then you
are off of them about 4-7 days and resume another
continuous pack. About 60% of women will stick
with that regimen over time while the others drop
out presumably due to problems such as break-
through bleeding. DepoProvera(R) the contraceptive
shot also functions similar to this.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Knee injury especially ACL ligament
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
With sports or exercise regimens there is always a
risk of injury to the knees. A common injury is to
tear the ligament which holds the thigh bone
(femur) against the shin bone (tibia). This
ligament is called the anterior cruciate ligament
(ACL) of the knee. It is often injured with a
sudden overextension of the knee joint or a
twisting motion of the joint. Once torn, the
ligament does not heal.
While you would think in this day and age that
surgical repair of the ligament is easy, it is
not. Any knee surgery can potentially cause more
long term pain than it cures and the knee joint
will still be more subject to injury if you
continue with high risk sports activities such as
skiing, soccer, football and basketball.
Rehabilitation from knee surgery can also put you
out of work for a longer time than the non
surgical treatment. You will need to decide if it
is possible to alter your activities for the rest
of your life so as not to put the knee joint at
risk whether or not you have surgical treatment of
the joint.
The non surgical treatment of ACL injury usually
involves leg exercises to make the muscles around
the knee joint so strong that they keep the joint
stable and without pain even with the torn ACL. If
the joint cannot be made stable and the cartilage
becomes injured then there may be no choice but to
have surgery to repair the ligament. Professional
athletes also may choose surgical repair so they
can continue their livelihood albeit at increased
risk for re injury at a later time and even more
permanent damage.
There is no advantage to having the ligament
repaired surgically right away after injury so you
should take your time to decide about it. Let the
swelling go down. Get started on the leg
exercises. Surgery at a later time is always an
option. See this article at Mayo Clinic for help
in deciding.
Knee injury especially ACL ligament
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Heart attack symptoms
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Heart attack symptoms are often different in men
than in women. Men tend to have the traditional
chest pain or "crushing pain" with or without
radiation of the pain down the left arm. On the
other hand, women may be more likely to have more
subtle symptoms such as nausea, sweating,
lightheadedness, Vomiting, breathlessness, neck,
shoulder or abdominal discomfort. They may
manifest unusually extreme fatigue or sleep
disturbances during the weeks before a heart
attack."- FRJ
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Athena"
During a museum tour the guide explains, "Here you
can see the beautiful statue of Athena...".
"Excuse me, madam," a visitor interjects. "Who is
that man behind her? Is he her husband?"
"No, Athena wasn't married. . . She was the
g~ddess of wisdom."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
October 17, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Ask about X-ray risk
2. Gallstones
3. Reader submitted Q&A - Work up for menopause
4. Obesity surgery risks and benefits
5. Health tip to share - Ginger for GI upset
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Ask about X-ray risk
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We are bombarded almost daily about the risk of
"this" medicine or "that" dietary habit. Sometimes
both the writer of an article or the reader of
that article lose perspective on whether a two
fold increase in risk means a jump from 1/1000 to
2/1000 or from 25% to 50%. "A risk of death of one
in one million is generally ignored, since we face
many risks of such magnitude every day, from
travelling 100 miles by car or 1000 miles by
aeroplane." However when you get up to a risk of 1
in a thousand, it becomes pertinent to you as an
individual.
Many x-ray (radiological) procedures can induce
eventual cancers that can be fatal. Most people
forget that radiation exposure causes cancers and
doctors tend to minimize these risks or sometimes
be totally unaware of the magnitude of these
risks. As doctors are ordering more and more
radiological studies because of their fear of
being sued for missing a condition and patients
are more and more demanding of radiological
studies to be performed because they are
distrustful of the physician's diagnosis, it is
very important for both parties to know the risk
of the procedure such as its cancer induction
risk.
For example a CAT scan of the abdomen is probably
equivalent to 500 chest xrays and has a risk of
inducing a fatal cancer of about 1/2000 people. A
thallium scan for the heart has an induced cancer
risk of greater than 1/1000. Many fluoroscopic
exams have a risk of 1/1000 also. The graph that
accompanies the article in the British Medical
Journal below is a very good representation of
those risks.
The point is that those studies may well be worth
the cancer risk depending upon circumstances but
in any case, both the patient and the doctor
should know how much risk is involved. Be sure to
ask about this when a bone scan, CAT scan,
thyroid, liver, lung or gallbladder scan are
recommended.
Ask about X-ray risk
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Gallstones
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The gallbladder connects to your intestines and
forms bile salts that help digest the food as it
passes through. Gallstones are solid deposits of
cholesterol or bile salts that form in the gall
bladder in some people. Most people who have
gallstones never even know about them because they
do not cause any symptoms.
It is estimated that 1 in 12 people have
gallstones but it is more common in women, older
individuals and people who are obese. Post
menopausal estrogen replacement therapy also
predisposes to gallstones.
About 20% of people who have gallstones will
develop symptoms and have one or more gall bladder
attacks if the stones plug up the flow of bile
salts needed by the intestines. Typical symptoms
of a gall bladder attack are nausea and a moderate
to severe pain in the right upper abdomen or in
the upper middle abdomen. Other symptoms include
chronic indigestion, bloating and rarely, yellow
jaundice or gray clay colored stools.
Gallstones are diagnosed by ultrasound scans, CAT
scans and radionucleotide scans. Your doctor can
order one of these if gallbladder disease is
suspected. There are some non surgical treatments
of gallstones but they do not tend to work as well
as surgery. Nowadays, laparoscopic surgery is the
procedure of choice for removal of the gall
bladder and its stones.
Chronic loose stools or diarrhea can be a
consequence of gall bladder removal so surgery is
not usually recommended unless you are having
symptoms for gall stones. If they diagnose
gallstones in you but you are not having symptoms,
carefully discuss your treatment options with more
than one doctor to see if you really need surgery.
Gallstones
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - DX Workup for menopause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Could you review the medical testing/work up for
the diagnosis of menopause? I never had the
typical hot flashes.
I am a 44 year old female. Could being on two
years of Lupron(R) for endometriosis cause early
menopause?" - kms
The medical test performed for diagnosis of
menopause is a blood serum FSH level (follicle
stimulating hormone). If your doctor orders it, a
value of more than 30 IU/L is usually accepted as
an indication of menopause; a value of under 20
IU/L would indicate that a woman is not yet
menopausal. Between 20 and 30 IU/L is
indeterminate. it could represent menopause or
just perimenopause. There have been cases
especially in infertility work-ups with FSH values
above 30 IU/L in which women have still have some
more ovulations, i.e., they were not totally
menopausal.
Home tests for menopause usually turn positive at
25 IU/L which splits the difference but as you can
see, it can occasionally lead to an incorrect
diagnosis. Also it is important to avoid any
testing, either at home or at the doctor's office,
at about two weeks after bleeding like a menses.
That is because there is a midcycle surge in FSH
that can often get above 20 IU/L.
Many doctors treating endometriosis with Lupron(R)
have anecdotal cases of women who had permanent
suppression of menses after discontinuing
Lupron(R). Sometimes the women are menopausal,
sometimes not. However it is not a common side
effect of Lupron(R) and there have been no studies
that I could find that have objectively looked at
this.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Obesity surgery risks and benefits
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Now that there is a national push against obesity
as a health problem and insurance companies are
starting to cover bariatric surgery (gastric
stapling and by-pass surgery) in their policies,
we need to look closely at the risks of surgery
for obesity. Many people will turn to surgery just
because of multiple diet failures. On the other
hand, this is serious surgery and people can die
from it.
A recent study in JAMA (Journal of the American
Medical Association) looked at studies in the
literature of bariatric surgery to summarize the
benefits of the surgery and also the risks. They
found:
Benefits
overall weight loss 61.2% of preoperative weight
gastric banding 47.5%
gastric bypass 61.6%
gastroplasty 68.2%
biliopancreatic diversion or duodenal switch 70.1%
Diabetes completely resolved in 76.8% of patients
Hyperlipidemia improved in 70% of patients
Hypertension completely resolved in 61.7%
Sleep apnea resolved or improved in 83.6% of patients
Risks
Death rate
gastric banding 0.1% (1/1000)
gastric bypass 0.5% (5/1000)
biliopancreatic diversion or duodenal switch 1.1% (11/1000)
The article did not mention it but patients
undergoing any of these surgeries tend to have
gastrointestinal symptoms such a nausea or
diarrhea the rest of their lives. Sometimes the
symptoms are major problems, sometime minor
problems, but they persist because of the
permanent rearrangement of the stomach and bowel
structure.
Obesity surgery risks and benefits
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Ginger for GI upset
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"After taking ibuprofen for two months for
bursitis in my shoulder, my hands and feet began
to swell. I discontinued using it, then, started
taking a ginger root capsule 550 mg two or three
times a day (sometimes making a tea) for its anti-
inflammatory benefits.
Prior to taking the ginger, I had abdominal
cramping and watery stools after eating head
lettuce or milk products. I especially had this
problem after eating at restaurants. To my
surprise, I could eat anything at any restaurant
or buffet while taking even a maintenance dose of
one capsule a day without the cramping, etc." - MH
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Classes For Men"
Classes for men at the learning center for adults
-registration must be completed by Nov 5th.
Note: due to the complexity and difficulty level
of their contents, class size will be limited to 8
participants maximum.
Class 1: How to Fill Up the Ice Cube Trays. Step
by Step, with Slide Presentation.
Meets 4 weeks, Monday and Wednesday for 2 hours
beginning at 7:00 PM.
Class 2: The Toilet Paper Roll. Does it Change
Itself?
Round Table Discussion. Meets 2 weeks, Saturday
12:00 for 2 hours.
Class 3: Fundamental Differences Between the
Laundry Hamper and the Floor. Pictures and
Explanatory Graphics.
Meets Saturdays at 2:00 PM for 3 weeks.
Class 4: After Dinner Dishes. Can They Levitate
and Fly Into the Kitchen Sink?
Examples on Video. Meets 4 weeks, Tuesday and
Thursday for 2 hours beginning at 7:00 PM
Class 5: Learning How to Find Things - Starting
with looking in the right places instead of
turning the house upside down while screaming.
Open Forum. Monday at 8:00 PM, 2 hours.
Class 6: Health Watch - Bringing her flowers is
not harmful to your health.
Graphics and Audio Tapes. Three nights; Monday,
Wednesday, Friday at 7:00 PM for 2 hours.
Class 7: Real Men ask for Directions When Lost.
Real Life Testimonials.
Tuesdays at 6:00 PM, location to be determined.
Class 8: Is it genetically impossible to sit
quietly while she parallel parks?
Driving Simulations. 4 weeks, Saturday's noon, 2
hours.
Class 9: How to be the Ideal Shopping Companion.
Relaxation Exercises, Meditation and Breathing
Techniques.
Meets 4 weeks, Tuesday and Thursday for 2 hours
beginning at 7:00 PM.
Class 10: How to Fight Cerebral Atrophy -
Remembering Birthdays, Anniversaries and Other
Important Dates and Calling When You're Going to
be Late.
Cerebral Shock Therapy Sessions and Full
Lobotomies Offered. Three nights; Monday,
Wednesday, Friday at 7:00 PM for 2 hours.
Class 11: The Stove/Oven - What it is and How it
is Used. Live Demonstration. Tuesdays at 6:00 PM,
location to be determined.
Upon completion of any of the above courses,
diplomas will be issued to the survivors.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
October 31, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Common Cold
2. Daily exercises can help dizziness
3. Reader submitted Q&A - Morning neck stiffness
4. Thyroid Cancer
5. Health tip to share - Shingles
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Common Cold
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
With over a billion colds a year in the U.S. and
the average child having 3-8 colds per year, you
can see why it is called "common". Symptoms
generally include nasal congestion, a runny nose
and sneezing. With only those symptoms, you might
not be able to tell a cold from allergies. However
with a cold, there are often other symptoms such
as a sore throat, headache, cough or muscle aches.
Colds are caused by over 200 different viruses and
as such, antibiotics are not helpful at all. The
first 2-3 days are the most contagious so it is
best to stay home rather than going to work to
spread the germs. If you do have to go out, do not
hesitate to wear a surgical type face mask to
prevent infecting other people. You can also wear
one at home to protect your family. It is not
inevitable that all family members must catch the
same cold.
The nasal drainage collects in the windpipe
(trachea) and lungs causing a cough. This means
that the best treatment for a cold is a nasal
decongestant that dries up the secretions so you
do not cough them up as much. You can get a
decongestant at a pharmacy or grocery store
without a prescription. Don't run to the doctor's
office just to be told to take a decongestant and
drink plenty of fluids. Even a yellowish or
yellow-green nasal discharge does not require
antibiotics unless you have a lung problem such
asthma or bronchitis.
A common cold is usually over all by itself in
about a week. Sometimes a cough can persist for
another week. If it lasts longer, consider another
problem, such as a sinus infection or allergies.
You should see the doctor if you start running a
fever (for an adult), if the drainage lasts 10 or
more days or if the throat really hurts with
swallowing for more than 2-3 days. Once you have a
cold it is too late to start taking herbs or
vitamins thought to prevent colds so save your
money at that point. Lay in a supply of surgical
masks to have at home.
Common Cold
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Daily exercises can help dizziness
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dizziness or loss of balance is very common after
the age of 75. While there are various medical
causes of dizziness (vertigo), most often there is
no obvious explanation for its cause. No matter
what the cause of dizziness, physical therapy for
balance control is common to all treatments for
it.
The exercises are very simple for someone without
dizziness but very hard for a person who gets
light-headed every time they move their head.
Physical therapy patients have to turn their head
from one side to the other side and to lower or
raise the head while keeping eyes open (and either
simultaneously focusing or not focusing on an
object) or keeping them closed. At first, these
movements were are made slowly while sitting, then
faster, and finally while standing or walking.
After 3 months of performing these exercises,
individuals have significant improvement in their
symptoms.
Daily exercises can help dizziness
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Morning neck stiffness
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"When I wake up in the mornings my neck is almost
stiff and my lower back hurts a little bit.
Doctors say I should correct my sleeping position
and stop tilting my neck before it becomes a
permanent problem which will cause problems with
my nerves. THE MAIN PROBLEM IS: I can't control my
sleeping position. I wake up many times at night
trying to do so, but it's becoming quite
irritating and useless. PLEASE TELL ME HOW TO
CONTROL MY SLEEPING POSITION." - anonymous
The question you ask is almost impossible to
answer because no one that I know of has a
prescription to control movement during sleep.
Neck position, however can sometimes be controlled
by special cervical pillows that are shaped
slightly different than conventional pillows and
also made of new age foam materials that better
accommodate the shape of the head and neck to
provide more even support. With these special
pillows you do not unconsciously contract your
neck muscles at night as much when you sleep.
There was a recent article in Prevention Magazine
that looked a different pillows to see which ones
gave their staff more restful sleep with the least
neck pain. As I remember, the best pillow they
chose was the ObusForme(R) UltraFoam Deluxe
Pillow. I have used that and it seems to be quite
helpful for morning neck pain.
The neck pain itself usually comes from uneven
sustained muscle contraction of one or several of
the many neck muscles. Pillows that are too high
(plump) or too thin can cause uneven muscle
contraction of the front muscles if you are laying
on your back while sleeping or uneven contraction
of the side neck muscles if you are laying on your
side. A pillow that keeps your head and neck in an
unbent position relative to your shoulders will
help alleviate morning neck pain.
Sometimes the uneven neck muscle contraction
during sleep can come from stress, sleeping
disorders, or even daytime muscle stress from
work, school or home lifting or positional strain.
Even sitting for a long time during the day
looking at a computer monitor that is not straight
ahead of you can result in uneven night time neck
muscle contraction.
People who have chronic neck pain (cervical
dystonia) usually have weakened neck muscles and
exercises to strengthen your neck may also help
relieve some of the morning stiffness. Each
evening before bed, try about 5 repetitions of the
following neck muscle exercises from
preventdisease.com :
1. Hold one hand against the side of your head.
Use your hand to resist the movement as you try to
touch your shoulder with your ear. Hold this
posture for a count of 5. Repeat to other side.
2. Hold both hands against your forehead. Try to
move head forward, but resist the movement with
your hands. Hold this posture for a count of 5.
3. Place both hands behind your head. Try to move
head backwards, but resist the movement with your
hands. Don't tip chin. Hold this posture for a
count of 5.
4. Hold one hand against the side of your head.
Use your hand to resist the movement as you try to
rotate your head to one side until your chin is
lined on top of your shoulder. Hold this posture
for a count of 5. Repeat to other side.
Also consider acquiring a cervical pillow even
though they can be somewhat expensive.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Thyroid Cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Thyroid cancer has been in the news recently but
it is not one of the more common malignancies. It
is, however, a very curable cancer (greater than
90% cure with surgery) so it is important to know
the signs and symptoms of this.
Most of the thyroid cancers present as a "lump" in
the thyroid gland just below the "Adam's Apple" on
the front of the neck. While most lumps in the
thyroid are benign nodules (non-cancerous), about
1 in 20 (5%) are malignant. Sometimes a neck lump
is not noticed as the first symptom but rather
presents other symptoms such as voice hoarseness,
difficulty swallowing, trouble breathing, swollen
lymph nodes in the neck, or pain in your throat or
neck which sometimes spreads up to your ears.
Both benign and malignant thyroid nodules can
produce these symptoms so just because they are
present does not mean you have cancer but it does
mean you need to have the nodule evaluated.
The diagnosis of whether a thyroid nodule is
benign or malignant is either by a fine needle
biopsy or sometimes by a surgical biopsy or
excision. Prior to that a thyroid scan is usually
performed to visualize the entire extent of the
nodule. Also a blood test measurement of thyroid
function such as the TSH is drawn to determine
whether the nodule is over functioning in its
thyroid hormone secretion or not. Sometimes a CT
scan or MRI scan needs to be performed to
determine if the cancer has spread to the lymph
nodes or the windpipe (trachea).
While the predominant manner of treating thyroid
cancer is surgical excision, sometimes radiation
therapy must be used and sometimes medical
chemotherapy such as that with radioactive iodine
must be given.
Thyroid Cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Shingles
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I would like very much to share a health tip on
shingles/herpes. Exercise is very important to
prevent breakouts. It took me 10 years to realize
what a difference this would make in controlling
breakouts. Since I started to workout at the gym
3-4 days a week, I have not experienced a breakout
in 6 months. Usually I have a breakout every 2
months. I also take a multivitamin. This really
works for me. I hope I can help someone with
sharing this info." - Mellissa
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Signs"
At a Santa Fe gas station:
"We will sell gasoline to anyone in a glass
container."
In a New York restaurant:
"Customers who consider our waitresses uncivil
ought to see the manager."
On the wall of a Baltimore estate:
"Trespassers will be prosecuted to the full extent
of the law. --Sisters of Mercy"
On a long-established New Mexico dry cleaners:
"38 years on the same spot."
In a Los Angeles dance hall:
"Good clean dancing every night but Sunday."
In a Florida maternity ward:
"No children allowed."
In a New York drugstore:
"We dispense with accuracy."
In the offices of a loan company:
"Ask about our plans for owning your home."
In a New York medical building:
"Mental Health Prevention Center"
On a New York convalescent home:
"For the sick and tired of the Episcopal Church."
On a Maine shop:
"Our motto is to give our customers the lowest
possible prices, and workmanship."
At a number of military bases:
"Restricted to unauthorized personnel."
On a display of "I love you only" Valentine cards:
"Now available in multi-packs."
In the window of a Kentucky appliance store:
"Don't kill your wife. Let our washing machine do the
dirty work."
In a funeral parlor:
"Ask about our layaway plan."
In a clothing store:
"Wonderful bargains for men with 16 and 17 necks."
In a Tacoma, Washington men's clothing store:
"15 men's wool suits, $10. They won't last an
hour!"
On a shopping mall marquee:
"Archery Tournament -- Ears pierced"
Outside a country shop:
"We buy junk and sell antiques."
In the window of an Oregon store:
"Why go elsewhere and be cheated when you can come
here?"
In a Maine restaurant:
"Open 7 days a week and weekends."
On a radiator repair garage:
"Best place to take a leak."
In the vestry of a New England church:
"Will the last person to leave please see that the
perpetual light is extinguished."
In a Pennsylvania cemetery:
"Persons are prohibited from picking flowers from
any but their own graves."
On a roller coaster:
"Watch your head."
On the grounds of a public school:
"No trespassing without permission."
On a Tennessee highway:
"When this sign is under water, this road is
impassable."
Similarly, in front of a New Hampshire car wash:
"If you can't read this, it's time to wash your
car."
And apparently, somewhere in England in an open
field otherwise untouched by human presence, there
is a sign that says, "Do not throw stones at this
sign."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
November 14, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Will exercise with sore muscles hurt you?
2. Which calcium supplements for bone density?
3. Reader submitted Q&A - Rosacea
4. Dry mouth
5. Health tip to share - Gingivitis
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Will exercise with sore muscles hurt you?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Muscle soreness after any physical activity or
exercise workout is common unless the muscles have
been working at that level for at least two weeks.
The more out-of-shape the muscles are, the later
the soreness sets in. It is not uncommon to be
sore the day after rather than the day of, any
unusual muscle workout. The question becomes "Is
it safe to push the muscles with more exercise
when they are already sore?"
There is no absolute answer to this because it
depends upon whether there is just generalized
muscle fiber swelling due to the unaccustomed
exercise or whether there is tearing (usually
microscopic) of the muscle fibers. You have no way
of knowing except by the degree of pain when you
resume exercise. If light warm-up exercises seem
to make the pain somewhat less, you are probably
good to go ahead with a workout no greater than
what you did the previous day. If the pain seems
to be made worse or if it localizes to a specific
muscle rather than being generalized then it is
best not to try to "exercise through the pain".
Rather you should confine your workout to muscles
that are not sore or try a light activity like
walking and wait another day before exercising the
very sore muscles.
If you are really going for muscle strengthening
rather than just the aerobic work-out, it is more
important not to stress the same muscles each day.
Usually a muscle group needs a day of rest in
between so that if you exercise, for example, your
abdominal muscles on Monday, wait until Wednesday
to exercise them specifically again. This gives
the muscle time to adapt rather than to be "broken
down".
Will exercise with sore muscles hurt you?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Which calcium supplements for bone density?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Calcium is a basic mineral needed for many bodily
functions other than strong bones. Heart rhythm,
nerve conduction and hormone secretion are among
those physiological functions that need calcium.
Calcium mostly comes from our diet, especially
meat and dairy products but often it is not
enough. Supplements containing calcium come in
different forms with different side effects and
efficacy.
Look on the supplement bottle label for "purified"
or for the USP (United States Pharmacopeia)
symbol. This will help protect against
contaminants. Most experts recommend to avoid
calcium from unrefined oyster shell, bone meal or
dolomite, since these in the past have contained
high lead levels or other toxic metals. Different
forms of calcium include:
calcium carbonate (Caltrate(R), TUMS(R), Coral calcium)
calcium phosphate (Solaray(R))
calcium citrate (Citracal(R) or Solgar(R))
calcium gluconate (Solgar(R))
calcium lactate (Twinlab(R))
While the daily calcium requirements are
calculated at 1000-1200 mg a day, remember that
some calcium always comes from your diet. A milk
product serving, eg., milk cheese, yogurt, cottage
cheese etc. contains about 300 mg of calcium. On
the other hand, you must look at the supplement to
see how much "elemental" calcium is released from
that supplement because only the elemental calcium
counts toward your daily requirement. For example
a 500 mg tablet of calcium carbonate may only
provide 200 mg of elemental calcium (40% is
absorbed). Calcium citrate is better absorbed
(about 60%) because it is more acidic. Calcium
lactate 740 mg may only provide 100 mg of
elemental calcium, however for a specific person
the calcium lactate form may be better tolerated
in the gastrointestinal tract than calcium
carbonate.
Both calcium citrate and calcium phosphate are
less constipating and produce less "gas" than
calcium carbonate but they may be more expensive
forms of calcium. You will have to find the right
form of calcium for you depending upon cost and
side effects.
There is such a thing as too much calcium. Some
people who tend to form kidney stones will need to
watch out. No one should really take in more than
2500 mg of calcium a day.
Calcium supplements for bone density
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Rosacea
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Is there any hope of a cure for rosacea in the
future? I am a 43 year old male who has had
rosacea for 11 years." - SD
To the best of my knowledge there is not a cure
for rosacea on the near horizon but I would not
rule it out forever. The rosacea classic symptoms
are patchy flushing (redness) and inflammation,
particularly on the cheeks, nose, forehead, and
around the mouth. Rosacea typically appears
between the ages of 30 and 50 and affects more
women than men.
Rosacea is a disorder of the blood vessels that
causes them to swell, leading to flushing. There
is a genetic predisposition combined with certain
environmental factors that may irritate the skin.
There can be Clogging of the sebaceous gland
openings with skin mites called Demodex
folliculorum, which live in facial-hair follicles.
Acne, psoriasis, eczema and atopic dermatitis may
look similar to rosacea so it is important to have
this diagnosed by a dermatologist and not just
guess that a reddened face rash is always rosacea.
For people with rosacea, stimulants such as
coffee, tea, alcohol, cigarettes, and excessive
sugar from sweets and soda are vascular dilators
and should be avoided. Diet sodas containing
aspartame and or NutraSweet cause excessive
redness in approximately 30% of rosacea sufferers
and should be avoided. Many rosacea sufferers may
have food allergies or triggers that perhaps do
not cause the rosacea but will aggravate the
symptoms by causing blood vessel dilatation.
Topical skin cleansers, topical antibiotics or
even laser therapy may be recommended by
dermatologists. The treatment can be complex and
be different for different people so it is
beneficial if you can find a dermatologist who
will work with you to try those different
treatments that have been shown to improve
rosacea. Certain brands of cosmetics can be useful
to cover up the redness and these are used even by
men.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Dry mouth
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
You would not think that having a dry mouth is
much of a health problem but it can be. It can
lead to increased tooth decay, it can cause
difficulty in tasting, swallowing or speaking. It
can lead to sores of the mouth or it can be a sign
of adverse medication reaction or disease
conditions. Dry mouth (xerostomia) is due to not
having enough saliva (spit) from the glands of the
mouth.
Causes of dry mouth include:
medicine side effects - there are many medicines
that cause the salivary glands to make less
saliva. Anti-hypertensives and anti-depression
medicines often cause this
diseases - Sjögren's Syndrome, HIV/AIDS, diabetes,
and Parkinson's disease can all cause dry mouth.
radiation therapy - from cancer treatment,
radiation can damage the salivary glands
chemotherapy - drugs used to treat cancer can make
saliva thicker, causing the mouth to feel dry.
nerve damage - head or neck injury can damage the
nerves that tell salivary glands to make saliva
Treatment for dry mouth may include stopping or
substituting any medications thought to block
salivary gland secretion. Sometimes an artificial
saliva may need to be used.
Dry mouth
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Gingivitis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"My dentist told me if I didn't start flossing I
would get gingivitis, (my gums were very red and
sore - I hated to floss), and have to be seen
every 3 months. I started using Listerine(R) or
an alcohol based mouth wash every day morning and
night. It went away and I have had no problems
since. My dentist was amazed." - DS
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Faux HMO memo to all Hospital Staff"
MEMO
To: All Hospital Staff
From: Administration/Groundskeeping
Subject: New Cost Cutting Measures
Effective immediately, this hospital will no
longer provide security. Each charge nurse will be
issued a .38 caliber revolver and 12 rounds of
ammunition. An additional 12 rounds will be stored
in pharmacy. In addition to routine nursing
duties, Charge Nurses will rotate the patrolling
of the hospital grounds. A bicycle and helmet will
be provided for patrolling the parking areas.
In light of the similarity of monitoring
equipment, ICU will now take over the security
surveillance duties. The ward clerk will be
responsible for watching cardiac monitors and
security monitors as well as regular duties.
Food service will be discontinued. Patients
wishing to be fed will need to let their families
know to bring something or may make arrangements
with Subway or Pizza Hut to deliver. Coin-operated
telephones will be available in patient rooms for
this purpose as well as for other calls the
patient may wish to make.
Housekeeping and Physical Therapy will be
combined. Mops will be issued to those patients
who are ambulatory, thus providing range of motion
exercises as well as a clean environment.
Families and ambulatory patients may also sign up
to clean the rooms of non-ambulatory patients for
special discounts on their final bill. Time cards
will be provided.
As you can see on the "from" line above, hospital
administration is assuming the grounds keeping
duties. If an administrator cannot be reached by
calling his/her office, it is suggested that you
walk outside and listen for the sound of a lawn
mower, weed-whacker, etc.
Maintenance is being eliminated. The hospital has
subscribed to the Time-Life "How to..." series of
maintenance books. These can be checked out from
administration, and a toolbox will be standard
equipment on all nursing units.
We will be receiving the series at a rate of one
volume every other month. We already have the
volume on "Basic Wiring," but if a non-electrical
problem occurs, please try to handle it as best
you can until the appropriate volume arrives.
Cutbacks in phlebotomy staff will be accommodated
by only performing blood-related tests on patients
who are already bleeding.
Physicians will be informed that they may order no
more than two X-rays per patient stay. This is due
to the turnaround time required by Photomat.
Two prints will be provided for the price of one,
and physicians are being advised to clip coupons
from the Sunday paper if they want extra sets.
Photomat will also honor competitors coupons for
one-hour processing in emergency situations, so if
you come across any extra coupons please clip out
and send these to ER.
In view of the hot summer temperatures, the
Utilities Dept. has been asked to install
individual meters in each patient room, office,
etc., so that electrical consumption can be
monitored and appropriately billed. Fans will be
available for sale or lease in the hospital gift
shop.
In addition to the current recycling programs, a
bin for collection of unused fruit and bread will
soon be provided on each floor.
Families, patients, and the few remaining
employees are asked to contribute discarded
produce.
Pharmacy will utilize this for antibiotic
production. These will be available for purchase
and, coincidentally, will soon be the only
antibiotics on our HMO's formulary.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
November 28, 2004
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Hair removal 101
2. Over-the-counter wrinkle creams - do they work?
3. Reader submitted Q&A - Baker's cyst of knee
4. Exposure to solvents may affect your baby
5. Health tip to share - Cinnamon vs sugar
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Hair removal 101
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
There are many different ways of removing unwanted
hair. Some methods are cheap (shaving) while
others can be quite expensive (laser removal).
Some of the methods result in permanent hair
removal while with others, the hairs eventually
grow back. Almost all of the hair removal
techniques can produce skin irritation, redness,
increased pigmentation, acne and swelling. With
some techniques, adverse skin changes are worse
than others.
Permanent hair removal techniques include laser,
electrolysis and prescription chemical treatments
such as eflornithine (Vaniqa(R)). Laser hair
removal is expensive but there is not usually as
much skin reaction as with electrolysis or
eflornithine. The downside of laser is that
occasionally there can be some increased skin
pigmentation causing dark blotches. The
prescription cream, eflornithine, stops hair
growth and is approved for treating facial hair
growth in women. Electrolysis is effective but it
should be done by someone who is trained in it,
not just using a home kit which seems to result in
more scarring an increased pigmentation.
Waxing, tweezing and sugaring can remove hair for
2-8 weeks and they tend to be more painful
techniques of hair removal. Sugaring involves
making a sugar paste which is applied to the hair
and when it dries, it is peeled off taking much of
the hair with it. It is not quite as effective as
waxing but there may be less skin burning with it.
Keep in mind that all of these methods of hair
removal should only be used after you have had a
hormone assessment to make sure there is not an
excess of male hormone testosterone in the blood.
If there is, medicines should be taken to reduce
the level otherwise all of the hair removal
efforts will be for naught.
Hair removal 101
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Over-the-counter wrinkle creams - do they work?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Advertising for wrinkle creams that you can
purchase without a prescription, always makes the
product sound too good to be true. "Just rub this
cream on and watch the wrinkles disappear!" But do
they really work? Are the ingredients in them
known to reduce wrinkles?
The web site at MayoClinic.com has a good review
of those ingredients that are effective, possibly
effective and possibly ineffective. Vitamin A and
hydroxy acids are the two main ingredients known
to improve wrinkles. Retinol is a vitamin A
derivative used in OTC anti-wrinkle creams. It is
an antioxidant that is not quite as strong as the
prescription cream tretinoin, but it produces less
skin redness and irritation. Hydroxyacids cause
the outer layer of old dead skin to shed leaving
new skin underneath that is more smooth and evenly
pigmented.
Possibly effective ingredients include:
Alpha-lipoic acid (ALA)
Coenzyme Q-10
Copper peptides
Growth factors such as kinetin
Soy isoflavones (phytoestrogens)
Tea extracts
Vitamin C
Vitamin E
Most of these are strong antioxidants which help
repair and prevent sun skin damage. They have been
shown in animal trials to reduce wrinkles. Some of
them have been shown in medical human trials to be
effective against wrinkles but the evidence is not
overwhelming yet. The biggest problem with over-
the-counter creams is that the levels of these
active ingredients may not be high enough to be
effective. This is especially true with vitamin C
in which very high levels are needed to have a
beneficial effect.
If you are interested in the specific products
which contain these ingredients, be sure to visit
the Mayo Clinic site below.
Over-the-counter wrinkle creams - do they work?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Baker's cyst of knee
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Can you tell me what a bakers cyst is?" - Betty
A Baker's cyst is a swelling of the posterior knee
capsule. It is a fluid reaction to arthritis or
trauma such as a torn meniscus of the knee joint.
The fluid fills the knee joint and pushes out at
the weakest part of the joint capsule, usually at
the back of the knee. It causes a dull aching
pain that is made worse with walking or standing.
On rare occasions the cyst can rupture. Usually,
however, a Baker's cyst will not cause long-term
harm and long-term disability is very rare. Most
cases improve with time or arthroscopic surgery.
The cyst can be diagnosed on physical exam by
feeling it behind the knee joint. MRI (magnetic
resonance imaging) can also be used not only to
diagnose the Baker's cyst but also to see if there
are any tears in the cartilage (meniscus) of the
knee.
Treatment of a Baker's cyst of the knee is usually
non surgical at first. Rest and elevation of the
leg usually give some immediate relief. The key is
to eliminate inflammation of the joint. Avoid
those activities that worsen the pain and swelling
such as "squatting, kneeling, heavy lifting,
climbing, and even running." Use anti-inflammatory
medicines such as naproxen or ibuprofen. A knee
brace may be helpful to reduce pain. Sometimes
heat from a heating pad can also ease the
discomfort and promote healing.
The next step is to strengthen the quadriceps
muscle and knee cap tendon. Strengthening
exercises help keep the knee joint from
unnecessary movement and more pain. If the cyst
does not regress spontaneously in several months
or if it just produces continuous severe pain, one
should consult with an orthopedic surgeon for
possible arthroscopic surgery.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Exposure to solvents may affect your baby
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many women have jobs in manufacturing and
industrial plants in which they are exposed to
organic solvent chemicals such as benzene, carbon
tetrachloride, carbon disulfide, chloroform,
toluene, phenol and others. They are found in jobs
involving painting and plastic adhesives, nail
salons, dry-cleaning operations, and medical
laboratories among others. Solvents are easily
inhaled producing a chronic exposure rather than a
limited one such as if you just spill a solvent on
your ski
