Staying Healthy this Halloween

SRxA’s Word on Health wishes all of our readers a Happy and Healthy Halloween.  For the 50 million or so people living on the Atlantic Seaboard of America affected by Mondays’ Frankenstorm we hope you are staying safe and recovering from the devastation wreaked by Sandy.

Although the United States experiences hurricanes almost every year and most people have a rudimentary knowledge of the dangers, there are a number of health risks that people seem to forget about in every storm. And frequently, it’s these things that cause unnecessary deaths, injuries, and illnesses.

While many people believe that high winds are the greatest risk from a hurricane, that’s simply not true. According to Ready.gov the majority of deaths are from flooding.   Flooding deaths often result from people trying to wade or drive through moving water or water of unknown depth.  Six inches of water will stall most vehicles – a foot of water may float a vehicle. Sadly, many flood deaths happen as a result of misadventure. Victims who chose to ignore warnings and drive around barricades set up to restrict travel in flood danger areas.

Other deaths happen when people walk or drive through flood water and discover that the ground has been washed away or the water is too deep to cross. Falling trees and tree limbs are another cause of hurricane deaths and injuries. Wait until the storm passes to begin any work on these hazards, even if they have fallen on a house or car. And even then take extreme care.  The Centers for Disease Control (CDC) warns that tree parts can move without warning by a mistaken cut of a saw.  If in doubt call your local fire department or check out the CDC’s advice on preventing chain saw injuries.

High winds and flood produces power outages and electrical dangers. Electrical providers suggest that all downed wires should be considered as live. Stay ten feet away, at minimum. And remember don’t touch tree limbs, fences or other objects that a power line is touching since they can conduct electricity, sometimes for hundreds of feet.

Flooded homes and flooded appliances inside homes represent another electrical hazard. Don’t use power outlets or lights in a building that was flooded until the electrical system has been inspected by an electrician. Carbon monoxide poisoning is another oft overlooked danger after a hurricane. Carbon monoxide is colorless and odorless and exposure can be deadly. Please remember that generators, charcoal grills, hibachis and other similar cooking methods should only be operated outside.

And even when the worst of the storm is over, as things start to dry out, those that got wet in the flooding will begin to mold. The CDC offers a web page about how to reenter a flooded home and another on dealing with the dangers of mold. You should also keep in mind that any surface that was flooded, especially basements may be contaminated with sewage.

Also consider the dangers from food spoiled by loss of power. If the power is out for less than 2 hours, then the food in your refrigerator and freezer should be safe to consume. However, if the power is out for longer than 2 hours, then you should remember the following:

A freezer that is half full will only hold food safely for up to 24 hours. A full freezer will hold food safely for 48 hours. Beyond that you will need to toss the contents.

So whether you hunkering down, bailing out or trick-or-treating today, please stay safe and healthy.

Halloween Health Hazards

While fake blood and creepy costumes help make Halloween a howl, this October 31, beware of the hidden hazards that can turn the night downright dangerous. SRxA’s Word on Health shares these top tips from top docs, to keep you safe.

While there’s few things that says Halloween like a Jack-O’-Lantern, the American Academy of Pediatrics caution that pumpkin carving is no craft for children. Instead, they suggest that young kids limit themselves to drawing designs that adults can cut out. And rather than using candles to light your lantern, they suggest you consider glow sticks to get that long-lasting luminosity.

The American Academy of Ophthalmology, warns that if you want to see another Halloween you shouldn’t turn a blind eye to the increasingly popular crazy colored contact lenses on sale in party stores.  Although cat-like contacts may look cool, these over-the-counter lenses aren’t worth the risk. They can cause serious eye disorders and infections that could result in blindness.

And it’s not just contact lenses. Other parts of your Halloween costume can also be hazardous to your health. Over-sized costumes can quickly turn trick-or-treating into trip-and-tumbling.  And to avoid having to drop and roll, the  U.S. Food and Drug Administration recommends you only wear costumes made from flame-resistant fabrics.

Similarly, choose your mask carefully. Whether you chose “The Scream, Frankenstein, or Romney, make sure so you can see what’s coming. Some masks limit peripheral vision, so much so that you may end up being the thing that goes bump in the night.  But before you decide to skip the mask in favor of  makeup, don’t forget this has its own hazards too.  Sure, well-applied makeup can transform seven the most perfect skin into ghoulish festering  wounds, warts and scars, but it can also leave a rash that lingers into November. The FDA suggests testing the makeup on a small patch of skin a couple of days before using it on your face. And check out the agency’s list of approved makeup additives. If the makeup contains unapproved ingredients, toss it.

Finally don’t get tricked by your treats! The FDA recommends that children have their Halloween loot  inspected by an adult who can remove risky treats and anything that isn’t commercially wrapped. If you’re not sure what it is – get rid of it.

Whatever you do, please stay safe out there this Halloween.

Test Your ER IQ

As many of our regular readers know, I spend most of my spare time working as a volunteer EMT. The long hours and sacrificed sleep are a small price to pay for the camaraderie, sense of community service and the knowledge that you’re helping people during their worst moments.

Not to mention it satisfies the needs of my inner adrenaline-junkie!

Not knowing what the next call is going to be is both exciting and challenging. Not knowing who or what you’re going to find when you arrive on scene keeps things interesting.  From minor toothache to major trauma, you just never know.

It’s not always high drama. Many calls are probably unnecessary and leave us thinking “You called 911 for that?!?”  Sometimes we may even toss in the odd silent expletive or two!

But we never say it out loud. We’re trained to accept that it’s an emergency to the patient / family even if we don’t regard it as such.  And we accept that sometimes people just don’t know better.

New parents especially, seem to find it difficult to decide whether to take their child to the emergency room in the middle of the night or to wait until morning to see their child’s doctor, or even to recognize that something like crying, in a newborn, is perfectly normal.

Not surprising then that children under 4 account for about 10% of the 115 million emergency room visits a year.  Which is why we welcome a recent initiative by ProMedica Toledo Children’s Hospital.

Through a series of interactive videos, doctors and nurses guide parents through several common medical scenarios including ear pain, asthma attack, ankle pain, allergic reaction,  laceration, sore throat, abdominal pain  and mosquito bites.

In each video, you make the decision to go or not to go to the ER. The expert then explains which choice makes the most sense .  Click on the links above to see if you would make the right decisions.

Should this be mandatory viewing for all parents?  Let us know what you think.

Pediatricians Propose Policy to help Hollaback Girls

It’s official!  Cheerleading – love it or hate it –  isn’t just about short skirts, big smiles and pompom waving.  According to a new policy statement from the American Academy of Pediatrics (AAP), cheerleading is just as athletic and potentially as dangerous as a sport and should be designated as one.

In addition, to making it a sport, the AAP urges coaches, parents and school officials to follow injury-prevention guidelines, develop emergency plans and ensure cheerleading programs have access to the same level of qualified coaches, medical care and injury surveillance as other sports. They also recommend better supervision including on-site athletic trainers, limits on practice time and better qualified coaches.

“Not everyone is fully aware of how cheerleading has evolved over the last couple of decades. It used to be just standing on the sidelines and doing cheers and maybe a few jumps,” said Cynthia LaBella MD, a sports medicine specialist at Chicago’s Lurie Children’s Hospital.

Injuries have increased as cheerleading has become more popular.  Over the last two decades, the number of cheerleaders injured has climbed dramatically. Hardly surprising given that cheerleaders engage in stunts such as creating human pyramids that reach 15 feet high or more.  Common injuries include severe sprains, broken arms and legs, neck injuries and concussions.

Last year alone, there were almost 37,000 documented emergency room visits for cheerleading injuries among girls aged 6 to 22.  That’s a 400% increase from the 1980.  And while the overall injury rate in high school cheerleading is lower than in other girls sports, such as gymnastics, soccer and field hockey, the rate of catastrophic injuries like skull fractures and spinal paralysis is higher.  In fact, cheerleading accounts for 66% of all catastrophic injuries in high school female athletes.

Data suggest there are more than 3 million cheerleaders nationwide, most of them girls.  While most belong to traditional cheerleading squads that support schools’ athletic teams, many schools have also created competitive cheering teams.
Some schools and state high school sports associations already consider cheerleading a sport and require the kind of safety oversight that the academy is recommending. But many do not, says Jim Lord, executive director of the American Association of Cheerleading Coaches & Administrators.

Lord and the AAP agree on a number of safety recommendations including limiting the height of human pyramids in high school cheerleading to just two people and banning routines that include pyramids, tumbling or tosses from being performed on hard surfaces.

Lisa Kluchorosky, a sports medicine specialist who works with the academy and the National Athletic Trainers Association, believes the new policy will not only help to reduce injuries but also help erase misconceptions that cheerleading is not very athletic.

What do you think?

Nightmare on Allergy Street?

With Halloween rapidly approaching, do you have more than ghosts and ghouls and things that groan in the night to worry about?  If you suffer from seasonal allergies then your answer is almost certainly yes.

Seasonal allergies occur when outdoor allergens such as mold spores, tree, grass and weed pollen are inhaled and cause an allergic reaction.

This year allergy sufferers were subjected to the “perfect storm” of a mild winter, including an unseasonably warm February, and an early spring caused trees to pollinate earlier than normal.

“This has been a very strange year for allergies,” says Dr. David Chudwin, an allergist from Crystal Lake, IL. “It’s been the strangest year in the 30 years that I’ve been practicing.”

The early spring was followed by a hot dry summer that kept pollen counts high, day after day.  Then in late summer and early autumn, record-breaking mold counts resulted in county wide air-quality alerts that resulted in even mild allergy sufferers dreading the outdoors.  Although mold is typically associated with dampness, mold spores also are associated with dying vegetation.

Many molds grow on rotting logs and fallen leaves, in compost piles and on grasses and grains. Unlike pollens, molds do not die with the first killing frost. And mold counts can change quickly, depending on the weather. Certain spore types reach peak levels in dry, breezy weather. Some need high humidity, fog or dew to release spores. This group is abundant at night and during rainy periods.

To makes things worse, retreating indoors may not be the answer. For, those bothered by indoor, as well as outdoor, allergens, the season of suffering is just beginning.  As we start to run furnaces and our pets elect to curl up in front of the fire, dust and dander levels start to rise.

According to most of the country’s leading expert on allergies, more Americans than ever are sneezing, sniffling and itching. The Asthma and Allergy Foundation of America, estimates 450 million Americans suffer from allergies.

As previously reported by SRxA’s Word on Health, our squeaky clean lifestyle is probably to blame for the rising numbers.  According to the hygiene hypothesis – Children that lead too clean a life are not exposed to enough germs to properly adjust their immune system.

“People who are less prone to allergies include children from large families, children who live on farms, children in underdeveloped countries,” Chudwin said.

If you don’t fall into any of these categories, we suggest a trip to your local allergist, who can help prepare you for sneeze-free trick-or-treating and the other joys of fall and winter.

iPods help Seniors re live their past and regain memories

For as long as humans have pounded drums and plucked strings, listening to music has affected people’s sense of well-being, lifting their spirits, and calming their nerves.  Now, a new film suggests that the right music can change the lives of people suffering from Alzheimer’s and dementia.

The documentary “Alive Inside” shows the transformative power of music as several elderly dementia patients are given iPods loaded with their favorite music.

The film follows social worker Dan Cohen, who decides on a whim to bring iPods to a nursing home.  To his and the staff’s surprise many residents suffering from memory loss seem to “awaken” when they are able to listen to music from their past.  The previously unresponsive seniors quickly start to tap their toes, swing their hands, and, incredibly, start having long discussions about their passion for music and its role in their lives.

One man – Henry – becomes especially impassioned when he is asked what music means to him. “It gives me the feeling of love, romance,” he says. “I figure right now the world needs to come into music. The Lord came to me and made me holy, I’m a holy man. So he give me these sounds.”

With great excitement, Dan turns to renowned neurologist Dr. Oliver Sacks, and the film follows them both as they investigate the mysterious way music functions inside our brains and our lives.

Sacks best known as the author of 12 books, including: The Mind’s Eye, Awakenings, The Man Who Mistook His Wife for a Hat and Musicophilia says “Music imprints itself on the brain deeper than any other human experience. Music evokes emotion and emotion can bring with it memory and the feeling of life when nothing else can.”

Besides telling a moving story, the film’s producers hope it will encourage widespread adoption of personalized music programs in nursing homes and that it will inspire and educate the millions of people burdened by diseases that affect memory.  They also hope to create a grassroots demand for music therapy and potentially help not only patients but also caregivers across the globe.

Although Alive Inside focuses on one man’s journey, it raises many questions about what it means to be Alive Inside. It questions when we stop being human, and what it takes to re-start a life that has faded away. It asks questions about how we see our elderly, and how we are going to treat an epidemic of these degenerative diseases.

The filmmakers have had an early trailer online for more than a year, but it recently premiered in New York and interest has exploded in recent days, thanks to social media sites such as Facebook and Reddit  They have also been able to raise over $50,000 to make an edited version of the film and obtain copyright approval for songs heard on the film.

Producer /  Director Michael Rossato-Bennett says following the work of Cohen and Sacks was one of the most fulfilling things he has done during his 30-year filmmaking and photography career.

“Usually when you make a film you wait for a moment to make you cry and it might take three months,” he said. “On the first day of filming I cried like five times. There is something in seeing another person awaken. That does something to all of us.”

For more information about the film and music and memory please click here.

Dance Away Diabetes

As anybody who’s been following the news over the last year or so will know, there is a growing epidemic among American children – type 2 diabetes.

It’s a problem that is both confronting and confounding more doctors, families, and health care professionals every day.

Until 15 years ago, type 2 diabetes was never seen in young people. Now it’s occurring with alarming frequency. And, type 2 diabetes appears to be more aggressive in young people between the ages of 10 and 17, putting them at great risk for life-threatening illnesses typically associated with seniors. Doctors know that a major risk factor is obesity. Beyond that, they are mostly in the dark.

Worse still, the standard treatment for type 2 diabetes in children is ineffective because metaformin – a drug which is effective in adults, has a high failure rate among children.

When it comes to preventing type 2 diabetes, more exercise and a healthier diet are key but doctors know young peoples’ habits are tough to change.

Which is why SRxA’s Word on Health was interested to learn of the “Dance for Health” program being pioneered by Professor Terri Lipman, a nurse practitioner and professor of pediatric nursing at the University of Pennslvania.  Dance for Health encourages children and adults to ward off the disease and hip-hop their way to good health.

Penn Nursing has partnered with Philadelphia’s Sayre High School and the Bernett Johnson Sayre Health Center to assess and improve physical activity among school-aged children, with the goal of lowering the risk for obesity.

Busting cool moves across a wooden gym floor, the Sayre High School dance team led children through one hour of dancing weekly for one month. Using pedometers, the research team found that the students averaged twice as many steps on days they danced.

At the same time, researchers noted that the children had elevated resting heart rates after exercise, indicating that they were not physically fit. Dance for Health aims to change that.

“Dancing is not only free, culturally relevant, and fun,” says Dr. Lipman, “it is also an easily accessible way for children to lead a more active lifestyle. Through this program, we aim to promote to schools and healthcare providers the benefits of incorporating dance into children’s lives to improve their overall health.”

The partnership between Penn Nursing and Sayre High School has yielded other benefits. Dr. Lipman now hosts weekly evening dance classes for children and adults ages 5 to 91!

At the same time, they are educating the neighboring community, demographically at high risk for diabetes, about prevention through good nutrition, exercise, and recognition of warning signs. In addition to taking basic measurements such as weight, height, and waist circumference, the students also check for acanthosis nigricans, a darkening of the skin associated with obesity and diabetes.

“Our partnership with Sayre has opened the door to a strong relationship with residents of the community around Penn,” says Dr. Lipman. “It has allowed us to work with individuals, schools, and community groups to fight diabetes together.”

Do you know of any similar initiatives?  Ballroom Dance for bulimics?!? Samba for stroke?!? Share your stories with us.

Should new drugs wear a ‘Proceed with Caution’ label?

SRxA’s Word on Health was alarmed to read a new study showing that almost a quarter of prescription drugs approved in Canada over 16 years were later slapped with serious safety warnings or yanked from the market for safety reasons. As Canada’s drug safety agency operates much like the U.S. Food and Drug Administration (FDA), the study may reflect the state of drug safety in the United States as well.

When assessing a new drug, regulators at Health Canada and the FDA are entrusted with making critical and difficult scientific judgments that can affect the health of hundreds of thousands of patients in a matter of months after product launch.

And the cost of error may be high given that the number of people exposed to unsafe drugs may be in the millions.

University of Toronto health policy researcher Dr. Joel Lexchin looked at the 434 drug approvals that moved through Health Canada’s drug-safety arm from the start of 1995 to the end of 2010.

About a quarter of the drugs approved in that period received a fast-track deliberation known as a “priority review” which lasts 180 days instead of the typical 300 days.

Lexchin found that drugs approved this way were 50% more likely to end up with safety warnings, compared with drugs approved according to the customary deliberation period.

And while you might assume that the most-risky drugs would be those those fast-tracked for approval for life-threatening diseases such as cancer and HIV, Lexchin discovered they were no more likely to have safety concerns than drugs fast-tracked for less serious illnesses.

That was a surprise, because regulators could be expected to accept some heightened risks when approving new medications to treat serious illness.

In an accompanying editorial, Thomas J. Moore of the Institute for Safe Medication Practices suggests that new drugs should carry special labeling for their first three years on the market, so that doctors are reminded to prescribe with caution.

“Getting faster access to newer, less-thoroughly tested drugs is at best a mixed blessing,” said Moore. “For the first three years after approval, new drugs should carry a special warning akin to the black triangle used in Britain. It should be prominent and mean to every physician, ‘New Drug: Caution Indicated.’ ”

That caution may be worth remembering by both physicians and patients when considering switching to new drugs.

The Elephant in the Pink Room

October, as I’m sure you’ve noticed by the sea of pink sweeping the US is Breast Cancer Awareness Month – an annual campaign to increase awareness of the disease.

How times have changed. Thirty years ago, when I lost my first friend to the disease “breast cancer” was rarely discussed. Women didn’t openly talk about it because it was considered a death sentence. Today, we not only speak openly about breast cancer we talk about living with it, rather than dying from it.

However, while this is good news, approximately 30% of patients with breast cancer will develop metastatic disease. By this we mean cancer that has spread beyond the breast.  Ultimately around 97% of those patients, 40,000 a year, will die of the disease. Yet only about 5% of total cancer research funding goes toward metastatic disease of any cancer type and less than 2% to metastatic breast cancer.

And those women living with metastatic breast cancer, also referred to as stage IV breast cancer, face a unique set of concerns.  It’s the most advanced stage of disease and one for which there is no cure.  But it is considered treatable.  The goal of treatment is to delay the progression of symptoms.

While few programs are devoted to these concerns hopefully this will start to change tomorrow.

National Metastatic Breast Cancer Awareness Day was officially recognized by the U.S. Congress on October 13, 2009, and has been an annual feature on the breast cancer calendar since then.  It’s a day that aims to recognize and raise awareness about the approximately 156,000 U.S. women living with metastatic breast cancer.

“While there have been advances in the treatment and management of metastatic breast cancer, the disease continues to end the lives of patients each year,” says Shirley Mertz, board member of the Metastatic Breast Cancer Network (MBCN) and a metastatic breast cancer patient since 2003. “Women living with this disease need it to be recognized, no longer ignored and misunderstood. We need more resources and support as we try to live each day while being in constant treatment.”

MBCN is a national, independent, nonprofit, patient advocacy group dedicated to helping people living with metastatic breast cancer.

The organization raises awareness of metastatic breast cancer by putting a public face on the metastatic experience. By giving those living with stage IV disease a greater voice and visibility in the breast cancer community, the medical community, the research community, and with the public-at-large.  Their education and advocacy programs help to end the experience of isolation, ease the fear of the disease, provide information to enable patients to participate in decision making with our medical team, and defy the myths of stage IV breast cancer.

Their driving mission is to take the metastatic breast cancer population out of the shadows and have them be acknowledged, accepted, and heard.  So join with us in recognizing National Metastatic Breast Cancer Day, this Saturday.  Maybe together we can move this elephant.

The Peak Time for Everything

Not enough hours in your day?  So much to do…so little time?  If you’re anything like me, these will be familiar expressions.

And in which case, you should be interested to learn that maybe, just maybe, you could pack more into each day if you did everything at the optimal time?

A growing body of research suggests that paying attention to your body clock, and its effects on energy and alertness, can help pinpoint the different times of day when it’s best to perform at specific tasks.

Most people organize their time around everything but the body’s natural rhythms.

But workday demands such as commuting, social events and kids’ schedules inevitably end up clashing with the body’s natural circadian rhythms of waking and sleeping.

And as difficult as it may be to align your schedule with your body clock, it may be worth a try, because there are significant potential health benefits.

Disruption of circadian rhythms has been linked to problems such as diabetes, depression, dementia and obesity.

When it comes to doing cognitive work, for example, most adults perform best in the late morning, says Dr. Steve Kay, a professor of molecular and computational biology at the University of Southern California.  As body temperature starts to rise just before awakening in the morning and continues to increase through midday, working memory, alertness and concentration gradually improve. Taking a warm morning shower can jump-start the process.

The ability to focus and concentrate typically starts to slide soon thereafter. Most people are more easily distracted from noon to 4 p.m.

Alertness tends to slump after eating a meal, and sleepiness tends to peak around 2 p.m.  But you may want to rethink taking a nap at your desk.  It turns out, somewhat surprisingly, that fatigue may boost creative powers.

For most adults, problems that require open-ended thinking are often best tackled in the evening when they are tired. According to a 2011 study when students were asked to solve a series of two types of problems, requiring either analytical or novel thinking, their performance on the second type was best when they were tired.

Mareike Wieth, an assistant professor of psychological sciences at Albion College in Michigan who led the study says, “Fatigue may allow the mind to wander more freely to explore alternative solutions.”

Of course, not everyone’s body clock is the same. Morning people tend to wake up and go to sleep earlier and to be most productive early in the day. Evening people tend to wake up later, start more slowly and peak in the evening.

Communicating with friends and colleagues online has its own optimal cycles, research shows. Sending emails early in the day helps beat the inbox rush.  6 a.m. messages are most likely to be read.

Reading Twitter at 8 a.m. or 9 a.m. can start your day on a cheery note. That’s when users are most likely to tweet upbeat, enthusiastic messages, and least likely to send downbeat tweets steeped in fear, distress, anger or guilt.

Other social networking is better done later in the day. If you want your tweets to be re-tweeted, post them between 3 p.m. and 6 p.m., when many people lack energy to share their own tweets and turn to relaying others’ instead. And posts to Facebook  at about 8 p.m. tend to get the most “likes,” after people get home from work or finish dinner.

When choosing a time of day to exercise, paying attention to your body clock can also improve results. Physical performance is usually best, and the risk of injury least, from about 3 p.m. to 6 p.m.

Muscle strength tends to peak between 2 p.m. and 6 p.m. as does lung function which is almost 18% more efficient at 5 p.m. than at midday.

Is there a best time to eat? Experts suggest limiting food consumption to hours of peak activity to keep from packing on pounds.  Perhaps we are not only what we eat, we are when we eat!