Help for the Holiday Blues

It’s the most wonderful time of the year
With the kids jingle belling
And everyone telling you “Be of good cheer”
It’s the most wonderful time of the year
It’s the hap-happiest season of all
With those holiday greetings and gay happy meetings
When friends come to call
It’s the hap- happiest season of all

For many this truly is the happiest and most wonderful time of the year. But for those who have lost a loved one, the empty chair at the table or fewer presents under the tree can be a painful reminder of our loved ones who are no longer with us.

“There are so many traditions associated with the holiday season that it can be an emotional roller coaster for someone who has recently lost a loved one,” says Nancy Kiel, bereavement coordinator for Loyola University Health System. “Many people wish they could just fast forward through the holidays, but getting through the season is possible if you give yourself permission to be flexible.”

So for all those who are grieving and mourning the loss of someone this Holiday season here’s some tips that might help make the holidays a little brighter.

1. Discuss holiday plans as a family. Everyone is feeling the loss, so talk about what you are going to do and be willing to compromise. If you don’t like the change you made, next year you can always go back to the way you did it before.
2. Skip the mall. Christmas shopping can be stressful even when not dealing with grief. Consider giving gift cards or shop online to avoid the mall madness. Remember it’s not just about the presents, but about the presence of caring and supportive people.
3. You can say no. The party invitations and social gatherings might be more difficult this year. You can say no or give yourself some breathing room by asking to RSVP at a later date. If you do go, drive yourself. This will allow you the freedom to leave at your discretion. Also, try to avoid “should people” who say “you should do this or you should do that.”
4. Honor your loved one. Start a new tradition to honor and remember your loved one. You could light a special candle, at dinner have everyone at the table share a favorite memory or all take part in a loved one’s favorite holiday activity. Do something that would make your loved one smile.
5. Be gentle with yourself. Do what you need to do and pamper yourself. If you need to take a nap, take a nap. Exercise is a great stress reliever, so bundle up and take a walk.
6. It’s OK to change traditions. Do something different this year. Take a vacation somewhere hot. Skip the cooking and go to a restaurant, volunteer with those even less fortunate.

“Grief is hard work and it can be exhausting, but it is something we must do,”  advises Kiel. “If you put it on a back burner you’ll never heal. You can’t go around, over or under grief – you have to go through it. So find someone who will listen unconditionally and tell your story.”

For more information, visit www.loyolamedicine.org or call Nancy Kiel at (708) 216-1646.

Sleeping Your Way to Success

As the fall semester winds down at colleges and universities, countless students will doubtless be pulling all-night study sessions to prepare for upcoming exams. Fueled by Red Bull, Monster energy drinks, or sheer fear of failure, last minute cramming will be going on in dorm rooms, libraries around the world.

Ironically, as it turns out, the loss of sleep during these all-nighters could actually work against students performing well.

Dr. Philip Alapat, medical director of the Harris Health Sleep Disorders Center, and assistant professor at Baylor College of Medicine, recommends that students study throughout the semester instead, and get at least 8 hours of sleep the night before exams.

“Memory recall and ability to maintain concentration are much improved when an individual is rested,” he says. “By preparing early and being able to better recall what you have studied, your ability to perform well on exams is increased.”

College-aged students ideally should get 8-9 hours of sleep a night. Truth is, most students get much less.

“Any prolonged sleep deprivation will affect your mood, energy level and ability to focus, concentrate and learn, which directly affects your academic performance,” Alapat adds.

All-nighters, especially when coupled with caffeinated beverages lead to a risk for developing insomnia and sleep disorders, including apnea, restless legs syndrome, narcolepsy and chronic fatigue syndrome.

Alapat’s recommendations:

• Get 8-9 hours of sleep nightly (especially before final exams)
• Try to study during periods of optimal brain function (usually around 6-8 p.m.)
• Avoid studying in early afternoons, usually the time of least alertness
•  Don’t overuse caffeinated drinks
• Recognize that chronic sleep deprivation may contribute to development of long-term diseases like diabetes, high blood pressure and heart disease

Good advice!  Excuse me while I go to bed – I have an Advanced Cardiac Life Support (ACLS) exam in the morning!

Spa Therapy

Uggghhh! Monday morning after a long holiday weekend. Not quite feeling the whole work thing today? Feeling guilty about those Thanksgiving pounds you packed on over the 4-day eating orgy?

Maybe what you need is a spa break! In case, you’re not yet in agreement – here’s another reason to consider swapping your business suit for a bathing suit.  According to a pilot study from the Jefferson-Myrna Brind Center of Integrative Medicine a weeks retreat at a spa is not only relaxing and nourishing, but can lead to marked changes in physical and emotional well-being.

The research evaluated 15 participants before and after their visit to a health and wellness spa in Desert Hot Springs, California.  The week-long program included meditation and colonic hydrotherapy, hatha and Vishnu flow-yoga programs, and a very low calorie diet of approximately 800 calories per day. Stress management was provided through daily structured meditation and personal meditation encouraging deep breathing, heightened awareness and a calming effect.

In preparation, participants were asked to modify their diet three to four days prior to arrival by replacing a normal diet with fruit, sprouts, raw and steamed vegetables, salads, vegetables, herbal teas, prune juice in the morning, laxative teas or herbal laxatives nightly and avoiding pasta, meat, cheese, caffeine, alcohol and processed foods.

The participants, 13 women and two men between the ages of 21 and 85, with no history of significant medical, neurological or psychological conditions each underwent a physical evaluation including weight, height, Body Mass Index (BMI), blood pressure and an EKG. They also received a complete blood count (CBC), liver function tests, tests measuring cholesterol and triglycerides, thyroid hormone testing, and the concentration of metals such as mercury and lead. In addition, psychological and spiritual measures before and after their arrival were measured.

An evaluation of the results showed that undergoing a spa program resulted in a weight decline of an average of 6.8 lbs., a 7.7% decrease in diastolic blood pressure as well as a decrease in mercury, sodium and chloride levels and a 5.2% decline in cholesterol level and mean BMI. Hemoglobin increased 5.9 percent. No statistically significant changes in liver or thyroid function and no EKG changes were noted.

No serious adverse effects were reported by any individual, but the study noted changes in the participants’ sodium and chloride concentrations, suggesting that those interested in going to a spa program should check with their physician to make sure they do not have any medical problems or medications that could put them at risk for electrolyte disturbances.

Improvements in anger, tension, vigor, fatigue and confusion were also noted as was a statistically significant improvement in anxiety and depression levels measured by the Speilberger Anxiety Scale and the Beck Depression Index.

Participants also reported significant changes in their feelings about spirituality and religiosity.

“Programs such as these have never before been formally evaluated for their safety and physiological effects,” says Andrew Newberg, MD,  lead author on the study.

While beneficial, it is not possible to differentiate the effects of each of the individual elements of the program to determine which components were responsible for the changes observed. “This,” says Newberg “will require an evaluation of one or more elements—such as yoga, very low calorie diet or colonics—in isolation to determine which elements have the most significant effects.”

In the future, Newberg and colleagues plan to study the effects of a spa stay on specific disease population, i.e. diabetics.

Complete findings will be available in the December issue of Integrative Medicine, A Clinician’s Journal.

In the meantime, it’s back to our desks. We can but daydream of downward dogs and diets!

Black Friday Fitness

After a day of over-indulging on family, food and football, now it’s time to turn your thoughts to Holiday shopping. But before heading out to join the Black Friday frenzy, SRxA’s Word on Health is here to make sure you’re prepared.

First, you need to recognize that Black Friday shopping is a sport and a dangerous sport at that!  You need to prepare with the thoroughness of an Olympic athlete to outperform your competition.

And while it might be too late to get in shape for the 2012 holiday shopping season, it’s never too early to begin next year’s preparations!

The workout plan below will help you get ready to take on both the stores and the other shoppers by improving your agility to grab the best deals.

Warm Up

• 5-minutes on the treadmill or elliptical will help warm up your muscles in preparation for the door-opening and mad stampede that follows

Workout

• 25  x Jumping Jacks – will help to reach those must-have items on the top shelves
• 2  x Agility Ladder runs – be ready to make sharp turns while maintaining speed and control to help you avoid crowds and crush injuries
• 10 x Box Jumps – to develop lower body power and elevate your heart rate and prepare you for both the physical exertion and psychological stress of a long day of shopping
• 25 yard Bear Crawls – to help strengthen your back and core in preparation for carrying home all those bargains
• 5 x Suicide Runs –  to build up your endurance and agility
• 25 x Walking Lunges – to tone up your glutes, hamstrings and quads, so you look good while you shop
• 45 x Pick Pockets. Help yourself to evade pick-pockets through these abdominal twists and turns
• 15 Push-ups. Work out all the muscles in your upper body and build optimal strength in your forearms, wrists, upper arms, shoulders and chest. All important for pushing carts and maximizing parcel carrying power.
• 10 Dumbbell Deadlifts – work your back, butt, hips and legs, ready for taking steps three at a time and gaining headway on those standing in line for the elevator

Cool Down: 

• Stretching out, eyes closed, on the recliner or arms raises with a cold adult beverage

After all – if you make it out of the mall, with body and finances still relatively intact – you’ve earned it!

Wishing You a Safe and Healthy Thanksgiving

On the eve of Thanksgiving, we are thankful for many things not least you – our readers. So we’d like to help keep you and your family safe and healthy this holiday with a few seasonal safety tips.

While we all know the dangers of Thanksgiving over-indulgence, did you know that cooking, rather than eating is the number one cause of accidents and illness over the holiday!  So whether you plan on deep frying the turkey or stuffing it, here’s some basic advice to help keep you safe.

Food Poisoning 

• Wash hands thoroughly when handling uncooked meat
• Keep cooked and uncooked meats separate from each other…and other food
• The turkey should be completely thawed before cooking
• When oven cooking a turkey, the oven temperature should be no lower than 325^°
  
• Ideally, cook stuffing outside the turkey, but if you choose to stuff, make sure the stuffing reaches a minimum temperature of 165^°

Burns 

• Turkey fryers should always be used outdoors, on a solid level surface a safe distance from buildings and flammable materials.
• Never use a fryer on a wooden deck, under a patio cover, in a garage or enclosed space.
• Don’t overfill the fryer.
• Never leave the fryer unattended because, without thermostat controls, the oil will continue to heat until it catches fire.
• Never let children or pets near the fryer when in use or after use as the oil can remain hot for hours.
• Use well-insulated potholders or oven mitts and safety goggles to protect from splatter.
• Keep all-purpose fire extinguishers nearby.
• If a turkey fryer fire occurs, call 911 immediately.
• Avoid wearing lose clothes. A dangling sleeve can easily catch fire.
• Make ovens and fryers a “Kid Free Zone”.
• Keep pot handles toward the back burners to reduce risk of knocking pots over.

Cuts

• Stay focused when slicing food.
• Give the carving duty to the most experienced carver. No first timers allowed!

Heartburn – many people eat too much, too fast on Thanksgiving which can quickly cause heartburn, indigestion and create chest pain. This can feel like a heart attack which leads people to seek medical attention.

• Eat slowly
• Take breaks in between courses
• Keep antacids on hand

A happy and healthy Thanksgiving to all!

Beans, Broccoli and Bluefin could help new moms beat the “Baby Blues”

According to an article published last week in the Canadian Journal of Psychiatry, postpartum depression may be caused by low levels of omega-3 fatty acids.

For the 70-80% of all new mothers who experience some negative feelings or mood swings after the birth of their child could the answer lie with legumes?

Women are at the highest risk of depression during their childbearing years, and the birth of a child may trigger a depressive episode in vulnerable women. Postpartum depression is associated with diminished maternal health as well as developmental and health problems for her child.

Symptoms of “baby blues” include:

• Weepiness or crying for no apparent reason
• Impatience
• Irritability
• Restlessness
• Anxiety
• Fatigue
• Insomnia
• Sadness
• Mood changes
• Poor concentration

Gabriel Shapiro of the University of Montreal and the Research Centre at the Sainte-Justine Mother and Child Hospital says “The literature shows that there could be a link between pregnancy, omega-3 and the chemical reaction that enables serotonin, a mood regulator, to be released into our brains.”

Because omega-3 is transferred from the mother to her fetus and later to her breastfeeding infant, maternal omega-3 levels decrease during pregnancy, and remain lowered for at least six-weeks following the birth.

Furthermore, in addition to the specific circumstances of pregnant women, it has been found that most people in the US do not consume sufficient amounts of omega-3. “These findings suggest that new screening strategies and prevention practices may be useful,” said Shapiro.

And while there are plenty of commercial omega-3 supplements, don’t forget that these clever little fatty acids are also present in seafood, (especially salmon, anchovies, tuna and sardines) as well as in oils, beans, nuts and seeds, winter squash, broccoli and my personal favorite – cauliflower.

Although Shapiro’s study was preliminary and the further research is needed to clarify the link, new moms could do worse than use salmon to stave off sadness or anchovies as the answer to anxiety!

Beating the Mets?

As fans of the New York Mets know all too well, in recent years they’ve been all too easy to beat.  However, another type of mets have remained somewhat harder to beat.

Metastatic cancer, more commonly referred to as “mets” is cancer that has spread from the place where it first started to another place in the body. The process by which cancer cells spread to other parts of the body is called metastasis.

Although some types of metastatic cancer can be cured, most cannot. In general, the best that can be done is to control the growth of the cancer or to relieve symptoms caused by it. In some cases, metastatic cancer treatments may help prolong life, but sadly, most people die of metastatic disease.

Now it seems there may be a way to beat the mets off the baseball field as well as on it.

Researchers are harnessing viruses to infect and subsequently destroy cancer cells without affecting normal tissue. Several types of viruses have been developed to date: adenovirus, poxvirus and picornavirus.  Even the herpes simplex virus is under consideration.

As are reoviruses, which are currently being studied by the National Institutes of Health (NIH).  Early results indicate that reoviruses could be especially effective in treating metastatic cancers.

Reoviruses are found everywhere in nature. They have been isolated from untreated sewage, river and stagnant waters. These viruses choose to colonize certain types of mutated cancer cells while sparing normal cells that lack these mutations. Approximately two-thirds of human cancers have the mutation that makes them a prime target for reoviruses.

One of the new drugs based on reovirus is known as REOLYSIN^®, an acronym for Respiratory Enteric Orphan Virus, which is widely found in the environment. By adulthood, most people have been exposed to this reovirus. As it is non-pathogenic, infections are typically asymptomatic.

REOLYSIN^®  was developed, based upon research conducted by Dr. Matt Coffey.  He found that the reovirus was able to infect and selectively destroy cancer cells. When a normal cell is infected with the reovirus, an antiviral response is activated, which prevents the virus from replicating within the cell. However, inside a cancer cell with one or more mutations on a growth pathway called the Ras pathway, there is an aberrant antiviral response that is unable to prevent the virus from replicating. This abnormality allows the reovirus to multiply to an extent that is fatal to the cancer cell.

Additionally, reovirus appears to spread particularly easily to organs where metastasis is common, so a concentration of the drug can be built up in those regions of the body.

REOLYSIN is currently being studied in combination with the chemotherapy drugs in six of the ten most common cancers diagnosed in men and five of the ten most diagnosed in women, including patients with head and neck cancer, non-small cell lung cancer, colorectal cancer, castration-resistant prostate cancer, drug-resistant ovarian cancer and pancreatic cancer. All of these indications are associated with metastatic disease.

The American Cancer Society estimates there will be more than 1.6 million new cancer cases diagnosed in the United States alone in 2012; more than 1,500 people a day are expected to die from the disease.

So, could a sewage water virus be the answer? SRxA’s Word on Health will be watching out for the results of these studies and let our readers know if they’ve truly found a way to  “beat the mets.”

Doctors Deficient in Anaphylaxis Care

Having just returned from the American College of Allergy, Asthma and Immunology (ACAAI) annual meeting, we’re spoiled for choice of news. But among all the science there was one stand out shocker.  In a session on Sunday, physicians presented the results of a survey, sponsored by the Asthma and Allergy Foundation of America (AAFA). During this, they revealed that a disturbingly high proportion of primary care and emergency physicians don’t know how to treat anaphylaxis.

Interviews with 318 physicians indicated that:

• substantial numbers do not always provide epinephrine to patients – even those  they believe are having anaphylactic reactions
• they often fail to refer anaphylaxis patients for follow-up care
• they believe incorrectly that some patients should not receive epinephrine auto-injectors

Myron Zitt, MD, says the results reveal “likely deficiencies in physician knowledge,” and corroborate results from earlier chart review studies.

In the telephone-based survey, researchers conducted interviews lasting an average of 19 minutes with approximately 100 emergency room physicians, 100 allergists, 50 adult primary care physicians, and 50 pediatricians.

82% to 99% of respondents in each group said they had treated at least one anaphylaxis case.

Although epinephrine is supposed to be given to all patients having such reactions, about 10% of emergency room physicians and 20% of primary care and pediatric physicians said they had done something else.  These “something else’s” included prescribed another drug, sending the patient to a hospital, or an “other” action.

Prescribing of auto-injectors for patients to take home also was far from universal. Barely 60% of emergency room physicians said they did. In fact, emergency physicians were generally bad at all phases of follow-up care. They rarely referred patients for diagnostic tests, they almost never demonstrated use of an auto-injector, and seldom explained that auto-injectors have an expiration date.

Another disturbing finding from the survey, Zitt said, was that many physicians of all types – even the allergists – mistakenly believed that some patients should never receive epinephrine.

In the same session, Akhil Chouksey, MD, reported that anaphylaxis care in a major teaching hospital usually failed to meet guidelines established by a consortium of allergy societies including the ACAAI.  In a 10-year review of anaphylaxis cases only 15% met the standards of care recommendations i.e. that epinephrine be administered within 30 minutes of triage, that auto-injectors be prescribed at discharge, and that patients be referred to an allergist or immunologist for follow-up investigations and treatment.

The review also found that in 26% of cases in which anaphylaxis was definitively confirmed, the patients never received epinephrine.  Antihistamines, such as benadryl (diphenhydramine), were given in nearly all cases but epinephrine was omitted in one-quarter. In fact, epinephrine was only the third most commonly administered medication, with corticosteroids such as methylprednisolone, taking the second spot after antihistamines.

During the question-and-answer period, an audience member suggested that, when patients present with relatively mild symptoms, the treating physicians may decide that epinephrine isn’t needed at that point.  Zitt countered, that this was a very dangerous approach.

The national guidelines state explicitly that there are no absolute contraindications to epinephrine. Nevertheless, 16% of the pediatric allergists and 32% of the other allergists said there were such contraindications, as did 38% of adult primary care and emergency physicians.

Also common were beliefs that schools, restaurants, and ambulances always stock epinephrine. In fact, Zitt said, there are no general requirements for schools or restaurants to do so, and approximately half of all ambulances do not have epinephrine on hand.

Clearly there is much work still to be done in terms of education.  SRxA’s Word on Health suggests a first step would be to instill a healthy fear of anaphylaxis into doctors and the general public while simultaneously removing the fear of epinephrine.

Or as Dr Zitt says, “Give epinephrine first, ask questions later.”

Honoring All Who Served

Although yesterday, Sunday November 11, was Veterans Day in the US, many federal employees will be observing today in the honor.

SRxA’s Word on Health would like to join that group and pay tribute to those who have risked their lives to preserve the liberty of our nation. Whether veterans of World War I or II, or the current conflicts in Iraq and Afghanistan, we proudly honor those who have served for their patriotism, love of country, and willingness to protect our freedoms.

The tradition of honoring America’s Veterans officially began in November 1919, when President Woodrow Wilson proclaimed November 11 as the first Armistice Day. Honoring our nation’s Veterans is just as important and relevant today as it was 93 years ago.

Join us, as we honor Veterans Day. We invite you to share with us, and the nation your personal stories of service and sacrifice as well as efforts to honor and assist these men and women who have served.

OMG! Smartphone Sex Risk for Teens

Teenagers and their phones!  As any parent or indeed observer of human life knows, the mobile phone has become the most important adolescent accessory.  Texting has even taken over from talking as their preferred form of communication. 72% of all teens and 88% of teen cell phone users text-message at least once a day.

And while they may not all rival world record texter, Fred Lidgren, who sent 566,607 text messages during a one month period, I know several who are not far behind. And for those of you still doing the math, yes that’s a staggering 18,887 texts per day or 787 per hour or 13 texts each minute. LOL!

Not only does smartphone use kill the art of conversation, it has a decidedly most sinister side-effect.  According to new research just presented at the American Public Health Association meeting, smartphone use among teens is associated with an increased likelihood of being solicited for sex and having sex with an internet-met partner.

According to a 2011 survey among almost two thousand Los Angeles high school students, young people with smartphones are one and a half times as likely to report being sexually active, almost two times as likely to have been approached online for sex, and more than twice as likely to engage in sex with an Internet-met partner compared with those who do not access the internet on their cell phones.

Additionally, those being solicited online for sex are also found to be engaging in unprotected sex. Five percent of the participants reported using the Internet to seek sex partners and 17% of the participants reported being approached online for sex by someone they did not know.

“We, parents, health educators, physicians, must recognize that cell phones are yet another new way for adolescents to meet sex partners,” said researcher Hailey Winetrobe, MPH. “Parents and school health professionals should talk to their teens about being safe in meeting people online and in using condoms to prevent sexually transmitted infections and unplanned pregnancies.”

While we’re not suggesting that parents take their teenagers cell phones away, maybe it’s time to put those smartphones to good use and create apps and websites for adolescent-targeted sexual health programs.

What do you think?