Doctors “Bending” Ethical Norms to Best Serve Their Patients who can’t Bend their Joints

ethical-medical-dilemmasRheumatic diseases, such as rheumatoid arthritis and lupus, are a common cause of disability. they affect all sectors of the population, diminish quality of life and have a significant social impact.

Yet, despite the benefits of early treatment and effective therapies, access to rheumatologic services may be difficult, involving long wait times, even difficulties finding providers.

C. Ronald MacKenzie, MD, a rheumatologist at Hospital for Special Surgery in New York City conducted a survey among rheumatologists entitled “Bending’ Ethical Norms to Serve Patients’ Interests:Tensions in Medical Professionalism,” to examine the medical, moral and ethical dilemmas doctors face when trying to do what’s best for their patients in the current health care environment.

The study was published in the October issue of the journal Arthritis and Rheumatism. When people receive a diagnosis, the cost of effective treatment may render it unaffordable for many,” says Dr. MacKenzie. “While an optimal or fair system would mitigate these impediments to care, our survey of the American College of Rheumatology members suggests that this is often not the case. In fact, physicians report they frequently find themselves in situations of ethical conflict in an effort to best serve their patients.”

The survey consisted of 14 closed-ended and two open-ended questions and was sent to 5,500 members of the American College of Rheumatology.

Physicians reported ways in which they see themselves as ‘bending’ ethical standards and presented justifications for doing so. Examples included ‘embellishment’ of symptoms to help patients obtain prior authorization from insurance companies; stretching the truth to obtain diagnostic tests and necessary medications and or physical therapy.

rheumatismThe delivery of medical care takes place in a particular social context, and when this context includes conditions that are unfair, healthcare practitioners may be forced to struggle with ethical conflicts, making trade-offs that may go unrecognized or are not adequately discussed.”

Medicine is not merely the scientifically based treatment and care of illness. It also involves ethical issues of right and wrong. In some cases, tough ethical dilemmas force doctors and other health care providers to make difficult decisions, all while upholding the Hippocratic oath to which all doctors are bound.

In today’s health care world, where the number of health care options can be great, medical ethics is of particular concern.Awareness of this problem and its consequences is only the first step in finding solutions to the challenges that physicians face.

Fixing the system in which physicians feel they have to ‘bend’ ethical norms and compromise ethical principles in order to provide the care their patients need, is clearly what’s so desperately needed.

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Dying for an energy drink?

early-morning-workout-tips-300x200As someone who gets up at 4:30 am most days to go to the gym and who rarely, if ever, eats carbs, I know there is no easy way to stay fit and healthy.  But, there are others who may be tempted to look for an easier or quicker way…and to them we say- beware!

Before you reach for a weight loss supplement, or energy drink, you may want to think again. According to four separate case reports just presented at the American College of Gastroenterology’s 78th Annual Scientific Meeting in San Diego, consumption of some of these can lead to hepatitis, severe liver damage, liver failure and even death.

energy drinksUse of herbal and dietary supplements is widespread for a variety of reasons. But many patients don’t disclose supplement use to their physicians, and as such important drug side effects can be missed.

The first case report documented a case over liver toxicity and fulminant liver failure associated with the use of SlimQuick™, a weight loss supplement containing green tea extract.

A 52-year old female patient was admitted to the emergency room after one week of vomiting and progressive jaundice. The patient reported she had ingested SlimQuick™ for two days, while fasting three weeks prior to admission. Her liver biopsy was consistent with hepatic necrosis She was started on steroids but these were discontinued after two days, as liver function worsened and mental status deteriorated to the point she needed to undergo liver transplantation two days later.

In the second paper, Khadija Haroon Chaudrey, MD, presented a rare case of black cohosh-induced hepatotoxicity leading to early cirrhosis. Black cohash is often used by menopausal women to control hot flashes and other associated symptons

A 44-year-old female had developed jaundice for one month, and initial lab work revealed elevated liver function tests (LFTs). The patient had no history of alcohol intake, IV drug use, unprotected sex, recent travel outside the United States, NSAID ingestion or blood transfusions. After an unsuccessful outpatient trial of steroids, she was referred for inpatient evaluation because of gradual progression of her symptoms.

cirrhosis1The patient then reported she had started taking black cohosh about one month prior. “Her ultrasound abdomen showed nodular contour of liver consistent with cirrhosis,” said Dr. Chaudrey. “Given patient’s history of black cohosh use and the timing of her abnormal liver chemistries, it was clinically evident the culprit agent was black cohosh.”

Once the patient stopped taking black cohosh, her symptoms improved and her LFTs normalized.

The third case described acute liver failure following consumption of Rockstar® Sugar Free energy drink.

Brian Huang M.D., Chief Resident of the Internal Medicine Residency Program at Cedars Sinai Medical Center, presented a case involving a 36-year-old male without prior medical history. He sought medical attention after symptoms of right upper quadrant abdominal pain, jaundice and fatigue. After abnormal lab work, he was brought to the hospital. The patient admitted to binge drinking (10 beers in a three-hour period) prior to symptom onset. He denied consuming herbal supplements, but admitted to having three Rockstar® Sugar Free energy drinks, on a daily basis for the past year. He too, required a liver transplant.

According to Dr. Huang, “The patients’ pathology reports showed massive hepatocellular necrosis and parenchymal collapse consistent with drug-induced liver injury. We believe his prior history of binge drinking may have provided initial damage on his liver, making him more susceptible to develop liver failure. Although the patient had a history of weekend binge drinking, his liver biopsy was not consistent with alcoholic hepatitis. Thus, they determined that the liver failure was linked to the long-term energy drink consumption.

A fourth case of drug-induced liver injury was found to be associated with the advanced weight loss supplement, Ripped Fuel®. This supplement contains herbal extract with 60% flavinoids, caffeine and cacao.

scleral icterusA 36-year old female with history of depression and no prior liver disease was seen after having one week of abdominal pain, anorexia and nausea. On physical examination, she had jaundice and yellowing of her eyes. The patient had started to take Ripped Fuel® three weeks prior to developing these symptoms, to lose weight. She denied use of other herbal medicine, supplements or acetaminophen. There had been no recent changes in her depression medication.

There is a lack of knowledge about the status of Food and Drug Administration regulation of dietary supplements,” said Dr. Halegoua-De Marzio, author of the first paper. “Currently, dietary supplements are not required to have safety or efficacy studies before they are marketed to the public, and they remain popular among consumers despite reports of hepatotoxicity. 

These cases serve as a reminder of how even minimal use of dietary supplements can lead to liver failure and liver transplant. It is important that patients talk with their doctors before starting any new dietary supplements.

Or better yet, stick with the old fashioned way of healthy diet and exercise.  So who wants to join me in the gym at 5am tomorrow?

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Birds do it. Bees do it. Even butterflies and chimpanzees do it.

Chimpanzees Self-Medicate With FoodSRxA’s Word on Health was intrigued by a story we read this week in National Geographic.

It seems we could have a lot to learn from the abovementioned animals.  It turns out that they, and many other species self-medicate, using plants and other surprising materials to improve not only their own health but also the health of their offspring.

video of capuchin monkeys at the Edinburgh Zoo shows them rubbing onions and limes on their skin and into their fur as an antiseptic and insect repellent.

Biologists have noticed that parasite-infected female monarch butterflies are more likely to lay their eggs on anti-parasitic milkweed, giving their offspring instant medication, while uninfected females show no preference. And urban birds who incorporate cigarette butts into their nests may be doing so because chemical properties in the smoked cigarettes may repel parasites, according to a 2012 study.

cigarette birds nestsWhile cigarette-butt wallpaper may not appeal to most of us, other ways that animals self-medicate might be worth watching.

Mark Hunter, a University of Michigan ecologist who was involved in the monarch research, says there is plenty to be learned from observing the way animals use the entire outdoors like one big drugstore. It’s something our own species probably once did – and might do well to revisit with modern pharmaceutical engineering and computer modeling techniques.

It’s not the only way, but it seems to me that a sensible way would be to watch what animals do in nature to see how they exploit the natural products, the pharmaceuticals that are available to them in the environment, and try to learn from them,” he says.

Earlier this year, Hunter spent time with people of the Shangaan tribe in South Africa.

shangaan tribeIf you go for a walk with somebody, every plant you pass has a cultural or medicinal significance, and many of those have been learned from watching animals,” Hunter says. The bark of the black monkey thorn tree, for example, is used as a stomach medication, a choice based on watching how elephants behave.

Not long ago primates were thought to be the only animals smart enough to self-medicate. But now we’re learning that ground squirrels chew rattlesnake skins and then lick their fur, a trick likely to deter that particular predator.

Insects have been found to be prolific self-medicators, too. Take the arresting case of the fruit fly Drosophilia melanogasterwhich uses alcohol to protect itself against parasitic wasps. The wasps lay their eggs in the fruit fly larvae; the developing wasp grubs will eventually eat the flies from the inside out and burst forth from their dead bodies. Larvae that consume high doses of alcohol from fermented fruits, however, are less likely to be infected—and if they are, the invading wasp grubs die quite nastily with their internal organs being ejected out of their anus.

Moreover, fruit fly mothers who see female parasite wasps nearby will give their young instant protection by laying their eggs in alcohol-soaked environments – which means they see and remember their nemesis.

Not a bad defense,” says Hunter, adding that this demonstrates the idea that “the cost we’re willing to pay for a medicine depends on the consequences of not using it.” While the alcohol isn’t necessarily good for the flies, they will die if parasitized.

The alcohol has worse effects on the parasites than it does on them. So it’s worth laying your eggs in a high-alcohol environment if it will save your offspring,” he says.

Do animals learn to self-medicate, or is it pure instinct?

monarchWell, plenty of intelligent animals self-medicate, so it’s not always clear. But in the case of the monarch butterfly the mothers don’t hang around to see what happens to their babies, so there’s no learning involved. In this case, the only possibility is that it’s a genetically determined behavior or instinct.

So the next time you’re on your way to the drugstore and pass a monarch hovering around a milkweed, or a bird who seems to have taken up a smoking habit, consider that they might actually be running an errand, just like you!

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10 Brain Damaging Habits

brain damageAccording to the World Health Organization here’s 10 habits that can severely damage your brain:

No Breakfast1.  No BreakfastSkipping breakfast in order to lose weight or save time is totally wrong and directly affects our brain. Those who don’t take breakfast or take unhealthy breakfast having lower blood sugar level and sometime it may cause overweight.

2. Overreacting – causes hardening of the brain arteries, leading to a decrease in mental power.

3. High Sugar consumption – Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development by reducing the production of Brain Derived Neutrotrophic Factor, without which the brain cannot learn.

Smoking4. Smokingcauses brain shrinkage, damages memory, judgment, learning and thinking powers and may even lead to dementia and Alzheimer’s disease.

5. Air PollutionThe brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping – Sleeping with the head covered decreases available air space and forces you to start breathing carbon dioxide instead of oxygen. This leads to a rise in intracranial pressure and results in brain hypoxia which may lead to brain damaging effects.

8. Working your brain during illness – Working hard or studying with sickness may lead to a decrease in effectiveness of the brain. When we are sick the brain is at its weakest and becomes more easily stressed. This stress can also affect memory.

9. Drinking too little water – Water is the main source of energy and is essential for brain function and activity of neurotransmitters. Dehydration can lead to anger, stress, exhaustion, depression and lack of mental clarity.

Talking Rarely10. Rarely Talking – Intellectual conversations help to train and promote efficiency of the brain. Conversely, lack of stimulating thoughts may cause brain shrinkage. Reading SRxA’s Word on Health and discussing the content with friends is an excellent way to avoid this!  So grab a glass of water and subscribe today. Consider it free brain fuel!

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Is Your Student Safe?

teacher-running-with-aedThe beginning of another school year means the beginning of school sports including football, soccer, cross country and swimming. All too often, school sports result in injuries to athletes and, in some cases, incidents of sudden cardiac arrest (SCA). Although SCA in athletes makes the headlines, it’s important to know that SCA can happen to anyone including a seemingly healthy child.

Sudden cardiac arrest in a young person usually stems from a structural defect in the heart or a problem with the heart’s electrical circuitry. The most frequent cause, accounting for about 40% of all cases, is hypertrophic cardiomyopathy or HCM.

HCM is a genetic heart condition that affects 1: 500 individuals, including men, women and children of all ages. HCM is characterized by a thickening of the heart muscle and can lead to sudden cardiac arrest.

sca incidenceApproximately 50% of individuals with HCM experience no symptoms, and don’t even know they have the condition, until tragically, sudden cardiac arrest occurs.  In 9:10 cases the outcome is fatal, resulting in unimaginable grief for families and fellow students.  Yet better outcomes can be achieved with early electrical stimulation of the heart – delivered by a small, fully automated, easy to use box.

Given that educational institutions house more than 20% of the American population every day, you’d think they would be fully prepared for this eventually. But sadly, they are not.

At the time of writing, only 19: 50 states in the U.S. require that at least some of their schools have automated external defibrillators [AED’s].  In some states, AEDs are required in public, but not private schools. In other states, AEDs are required in high schools, but not elementary schools. Some states require AEDs only in schools offering athletics. Only two states – Hawaii and Oregon – require AEDs in colleges.

To find out whether your state requires AEDs in schools, click here to view an interactive map.

Chain of Survival full sizeAlthough schools and colleges are ideal and obvious locations for AED deployment, concerns regarding legal liability and litigation have been perceived as a barrier to purchasing and deploying AEDs.  Fortunately this is slowly changing.  Recognition of the need to protect youth from sudden cardiac arrest is gaining momentum in many states:

In Pennsylvania, Sen. Andrew Dinniman has sponsored Senate Bill 606, Aidan’s Law, named for Aidan Silva, a seven-year-old Chester County resident who succumbed to SCA in September 2010.  Aidan had no symptoms of a heart condition prior to his death. Aidan’s Law will help ensure that every public school in Pennsylvania has an AED that is up to date and ready to use.

Rep. Connie Pillich, of Cincinnati, has introduced a bill focused on SCA in student athletes. House Bill 180 requires the Ohio Department of Health and the Ohio Department of Education to jointly develop guidelines and materials to educate students, parents and coaches about SCA. The measure bans a student from participating in a school-sponsored athletic activity until the student submits a signed form acknowledging receipt of the guidelines and materials created by the health and education departments. Individuals would not be allowed to coach a school-sponsored athletic activity unless the individual has completed, within the previous year, a sudden cardiac arrest training course approved by the health department.

John Ellsessar, whose son Michael died during an Oxford High School football game in 2010 from cardiac arrest, believes automated external defibrillators should be as readily available at school settings as fire extinguishers.

Ellsessar, is pushing for legislation to require all schools to have defibrillators, said he and his wife were horrified when they learned that at most schools that have the medical devices, but they are locked away in nurses’ offices, instead of being ready for emergencies.

CPR-AED-lgAnd in Rhode Island, high school seniors will be required to be trained in CPR and the use of a defibrillator before they can graduate. Under the legislation signed into law by Gov. Lincoln Chafee, students will receive training that includes a hands-on course in cardiopulmonary resuscitation and an overview of the use of an AED.

The National Parent Teacher Association has also adopted a resolution calling for public schools to develop emergency response plans that include summoning help, performing CPR and using automated external defibrillators to save lives. The PTA also called for ongoing CPR-AED training in schools and legislation that would fund placement of AEDs in every school, while providing immunity for people who use the lifesaving devices in good faith.

To learn more about sudden cardiac arrest and how you can help please visit http://www.sca-aware.org

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Sleep Better, Look Better

wake up beautifulGetting treatment for a common sleep problem may do more than help you sleep better – it may help you look better too. So says new research study from the University of Michigan Health System and Michigan Technological University.

And it’s more than just being being bright-eyed after a good night’s rest.  For the first time, researchers have shown specific improvement in facial appearance after at-home continuous positive airway pressure [CPAP] treatment for sleep apnea.

Sleep apnea affects millions of adults, many of them undiagnosed.  It is a condition marked by snoring and breathing interruptions and can put sufferers at higher risk for heart-related problems and daytime accidents.

Using a sensitive “face mapping” technique usually used by surgeons, and a panel of independent appearance raters, the researchers detected changes in 20 middle-aged apnea patients just a few months after they began using CPAP to help them breathe better during sleep and overcome chronic sleepiness. CPAP also helps to stop snoring, improve daytime alertness and reduce blood pressure.

patient_cpap_frustratedWhile the research needs to be confirmed by larger studies, the findings may help sleep apnea patients comply with their treatment.  Compliance is a challenge for some because of the cumbersome breathing mask they have to wear to bed.

Sleep neurologist Ronald Chervin, M.D., M.S., director of the U-M Sleep Disorders Center, led the study, which has just been published in the Journal of Clinical Sleep Medicine.

Chervin says the study grew out of the anecdotal evidence that sleep center staff often saw in sleep apnea patients when they came for follow-up visits after using CPAP.

The common lore, that people ‘look sleepy’ because they are sleepy, and that they have puffy eyes with dark circles under them, drives people to spend untold dollars on home remedies,” notes Chervin. “We perceived that our CPAP patients often looked better, or reported that they’d been told they looked better, after treatment. But no one has ever actually studied this.”

They teamed with U-M plastic and reconstructive surgeon Steven Buchman, M.D., to use a precise face-measuring system called photogrammetry to take an array of images of the patients under identical conditions before CPAP and again a few months after.

The technology used in this study demonstrates the real relationship between how you look and how you really are doing, from a health perspective” says Buchman.

sleepyfacehires1The researchers also used a subjective test of appearance. 22 independent raters were asked to look at the photos, without knowing which were the “before” pictures and which the “after” pictures of each patient. The raters were asked to rank attractiveness, alertness and youthfulness – and to pick which picture they thought showed the patient after sleep apnea treatment.

About two-thirds of the time, the raters stated that the patients in the post-treatment photos looked more alert, more youthful and more attractive. The raters also correctly identified the post-treatment photo two-thirds of the time.

Meanwhile, the objective measures of facial appearance showed that patients’ foreheads were less puffy, and their faces were less red, after CPAP treatment. The redness reduction was especially visible in 16 Caucasian patients.

However, they didn’t see a big change in facial characteristics often associated with sleepiness. “We were surprised that our approach could not document any improvement, after treatment, in tendency to have dark blue circles or puffiness under the eyes,” says Chervin. “Further research is needed, to assess facial changes in more patients, and over a longer period of CPAP treatment.”

I don’t have sleep apnea but if CPAP makes you look younger, more attractive and alert, tell me where do I sign up?!?

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A Call to End Religious Nutrition

lowcarbQ: “How can you tell if a friend is on a gluten-free diet?”

A: “They’ll tell you.”

Again and again and again… Same joke goes for paleo, low-carbvegan and pretty much any organized dietary strategy that has a defining name and movement behind it.

Along with politics, gun rights, religion and abortion, is one of those areas where people feel comfortable not only sharing their views but do so with incredible conviction, passion and certainty. And yet, nutrition is anything but certain.  Sure, we know there are patterns of eating that help in minimizing the risk of various chronic diseases, but those patterns are far broader and less drilled down than most nutrition gurus and zealots believe.

So, we were very interested in fellow blogger –Yoni Freedhoff’s – recent blog in which he calls for an end of nutrition as religion.  More so, because Yoni is not just another disillusioned dieter. No siree!  He is the Medical Director of the Bariatric Medical Institute and assistant professor of family medicine at the University of Ottawa.  Dr. Freedhoff has also been called Canada’s most outspoken obesity expert and his award winning blog, Weighty Matters, has at times been ranked the world’s top health blog by blog ranking service Technorati.

So what does Dr Freedhoff have to say?

First, he suggests that practitioners of dietary religion risk alienating friends through strict adherence to their religious commandments.  Second, he states that diet adherents tend to use their online platform to frown upon any and all dietary strategies beyond their house of worship. To question their program or guru’s plans is akin to questioning their religious beliefs; and yet, unlike actual religious questioning (which would almost certainly lead to a thoughtful discussion), question dietary dogma online, and you can bet it will lead to a highly heated debate where anger and indignation can easily descend into name calling and personal attacks.

jesus toastAnd even if you religiously avoid all cyber nutrition nuts, you may still be at risk. According to Freedhoff, although you may not have a stranger’s zealous scrutiny to watch out for, you’ve still got yourself. Dietary dogma, almost by definition, dictates blind faith and absolute loyalty, where breaking a dietary commandment is akin to committing a sin. And with sin, comes guilt. And if you feel guilt often enough, you might well decide to abandon your entire healthier-living, guilt-inducing effort.

Nutrition as religion demands perfection, yet perfection is an impossible goal. Remember, food is not simply fuel. Since the dawn of humankind, food has been used for comfort and celebration, and if your newly found dietary religion forbids foods you enjoy, my bet is you’re not long for that diet.

diet tapemeasureSo what’s the solution?  Freedhoff advises : the easiest question to evaluate any dietary plan or religion is simply, “Could I happily live like this for the rest of my life?” where the most important word in that question is “happily.” If the answer’s “No,” you’ve either got to get comfortable with adding in some sinning, or find another way to go.

Add in some sinning in the form of thoughtful, “worth-it,” dietary imperfections, and suddenly new lifestyles may transform from the merely tolerable to the actually enjoyable. Enjoy your lifestyle, albeit imperfectly, and maybe you’ll even stick with it.

Nutrition isn’t religion. Eat the healthiest diet that you can enjoy, because if you’re not enjoying it, it isn’t going to last, and tolerable isn’t good enough.

Go on, sin a little, on us. The good doctor will forgive you enough to forgive yourself.

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In Vino Veritas?

GEICO camelHappy Hump Day!

While we may not be able to make you laugh quite as much as the GEICO camel, we do bring you news that should at least make you smile.

A new Spanish study suggests that drinking wine might help you avoid depression.

Although drinking a lot of wine or other alcohol may be a sign of depression or other mental health problems, alcohol in moderation may benefit mental health according to the study authors.

One drink a day, preferentially wine, may help prevent depression,” said lead researcher Dr. Miguel Martinez-Gonzalez, chair of the department of preventive medicine and public health at the University of Navarra, in Pamplona.

red-wine_0Researchers followed more than 5,500 light-to-moderate drinkers, aged between 55 and 80 for up to seven years.  None of the individuals had suffered from depression or had alcohol-related problems at the start of the study. Over seven years, with medical exams, interviews with dietitians and questionnaires, the researchers kept tabs on participants’ mental health and lifestyle.  Wine was the most popular drink and participants who drank two to seven glasses a week were the least likely to suffer from depression, compared to nondrinkers. These findings remained significant even after the researchers took factors such as smoking, diet and marriage into account.

But before you start reaching for the corkscrew, we need to warn you that not all experts agree with the findings and even the research team, only saw benefit in moderate drinkers.

Martinez-Gonzalez thinks the apparent benefit of wine in preventing depression may work the same way that moderate drinking helps prevent heart disease.

Depression and heart disease seem to share some common mechanisms because they share many similar protective factors and risk factors,” he said. However, he added that depression prevention is not a reason to start drinking.

If you are not a drinker, please don’t start drinking,” he said. “If you drink alcohol, please keep it in the range of one or less drinks a day and consider drinking wine instead of other alcoholic beverages.”

Tony Tang, an adjunct psychology professor at Northwestern University, in Evanston, Ill., said the new research “is consistent with other studies suggesting modest health benefits of very modest drinking.”

red wine glassesBut, Tang said other factors may be at work in the potential connection between wine and depression. He noted that compared to nondrinkers, those in the Spanish study who drank a moderate amount of wine were more likely to be married men who were also physically active.  Being single or divorced, living alone and being sedentary are well-established risk factors of depression. Thus, he suggests, the correlation between modest drinking and depression is a coincidence caused by these other known factors.

An adequate social life is the most important factor we know that protects people from depression,” Tang said. “Perhaps not drinking is a sign of serious social isolation in Spain while drinking a glass of wine a day is simply a sign of having a normal social life.”

red wine with friends 2Wine with friends anyone?

Cheers!

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The Jaws of Life!

national dog dayIn case you missed it, Monday was National Dog Day – also known as: International Dog Day & National Dog Appreciation Day.

National Dog Day serves to help galvanize the public to recognize the number of dogs that need to be rescued each year, and acknowledges family dogs and dogs that work selflessly each day to save lives, keep us safe and bring comfort. Dogs put their lives on the line every day – for their law enforcement partner, for their blind companion, for a child who is disabled, for our freedom and safety by detecting bombs and drugs and pulling victims of tragedy from wreckage.
Founded in 2004 by pet lifestyle expert and author Colleen Paige, National Dog Day was created to honor dogs more than we currently do, to give them “a day”, to show deep appreciation for our long connection to each other – for their endearing patience, unquestioning loyalty, for their work, their capacity for love and their ability to impact our lives in the most miraculous ways.

National Dog Day wishes to encourage dog ownership of all breeds, mixed and pure – and embraces the opportunity for all dogs to live a happy, safe and ”abuse-free life”.

As our regular readers know, we’re big dog lovers here at SRxA’s Word on Health, so it seemed fitting to bring you a happy and healthy tale (or perhaps that should be waggy tail) for the weekend.

dogs and house firesEach year, in the U.S., thousands of people lose their lives to fire.  Unfortunately, we have become accustomed to hearing about these tragedies, but there is another tragedy that occurs in which we rarely hear about – the hundreds of thousands of cherished family pets who suffer injury or death due to smoke and flames.

Government statistics estimate that there are around 400,000 home fires are reported annually. And 62% of these homes will own at least one pet -meaning some 300,000 animals are at risk of smoke inhalation.

Although firefighters and their heroic efforts attempt to save a pet’s life during a burning building, the damage a pet sustains from inhalation of smoke or carbon monoxide overwhelms many of the animals that often die en route to a veterinarian.   But if fire and rescue crews are able to provide life-saving oxygen for animals, as they do for humans, more animals would be saved.

Of the 30,000 or so fire departments in the US, only 1,700 have some type of pet oxygen delivery device.  In Word on Health’s home state of Virginia, there are 24 fire departments with such equipment, including Fairfax, Arlington, Sterling, Chesterfield, Spotsylvania, and Stafford.

Previously, in Prince William County, Lake Jackson Volunteer Fire and Rescue Department was the sole company, within the fire and rescue system, that provided this device.  But now, thanks to a generous donation provided by Prince William SPCA (Society for the Prevention of Cruelty to Animals), firefighters have an opportunity to assist pets who are experiencing respiratory distress or failure due to a fire and potentially save more lives.

WAGN_FirstResponder_Banner_v2PWSPCA purchased 42 of the WAG’N 02 FUR LIFE delivery system/devices –each worth approximately $3,000 and has provided 2 kits to each of the 21 fire and rescue stations in the county.

I was honored and privileged to be asked to coordinate the introduction of the pet oxygen kits at Nokesville Volunteer Fire and Rescue Department and to ensure that all fire and EMS personnel are trained in the use and maintenance of the devices – a process we fittingly began on National Dog Day and hope to have fully operational by the Labor Day holiday weekend.

Dog-with-Oxygen-MaskThe pet oxygen delivery devices work similar to equipment manufactured for humans suffering from smoke inhalation except this device is used solely for four-legged animals.  The device has a cone shaped design with a rubber seal that creates a snug fit over the animal’s nose and mouth making the oxygen delivery more effective than oxygen masks designed for humans.

And while we hope that we never have to use them, we are confident  that by carrying the pet O2 kits on our fire trucks and ambulances that we can minimize the number of animal fatalities that occur due to fire.

What better way to mark dog appreciation day?

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Adrenaline Junkie

punch1Although we repeatedly hear about the negative health effects of stress, today we’re here to tell you that stress isn’t necessarily all bad. Like food, sex, and shoes, it’s quality, not quantity, that determines whether stress helps or hurts!

Beneficial stress comes in the form of an acute, stimulating surge, like when your raft starts to overturn in some seriously churning rapids. The resulting single adrenaline (epinephrine) burst that comes and goes very quickly is a good thing because it gives you energy and gets you ready to mobilize for immediate action.

Physiologically, the adrenaline created by an abrupt blast of stress sends a flood of oxygen-rich red blood cells through your body, boosts your immune system, and signals your brain to start releasing painkilling endorphins.

stressed-womanBad stress, on the other hand, is intense and drags on and on. This constant grind causes your adrenal glands to leak a slow, steady stream of another stress hormone: cortisol. And unlike adrenaline, which tends to hit your system in a flash and then dissipate, cortisol often wears out its welcome by hanging around in your bloodstream, driving up blood pressure, suppressing your immune system, and making you more susceptible to a slew of stress-related ailments, including colds, irritable bowel syndrome, migraines, and even heart disease and stroke.

So how do good stressors battle the bad ones? It all comes back to the positive power of adrenaline. In addition to all of its performance-enhancing effects, it triggers the release of dopamine and endorphins, two neurotransmitters that make you feel good – really, really good.

It also makes me feel good – really, really good, given the activities I have planned this weekend. But more of that later…

skydivingFor now, let’s return to our favorite stress hormone – epinephrine. If you’ve ever tried skydiving, bungee jumping or heli-skiing, you’ll probably remember literally flipping out during your first attempt. But once you landed safely you probably experienced a euphoric, fist-pumping high thanks to dopamine flooding your brain’s pleasure center, giving you. During the next jump, you may still have felt all the same physiological stress responses such as a pounding heart and sweaty palms but instead of being terrifying, it’s exhilarating, because your mind’s already anticipating the thrill of that dopamine reward.

And the more times you do it, the less anxiety you’re likely to feel and the more fun you’ll have. That’s because your brain’s tagging the experience as a positive one.

And the benefits persist.  Before long, your body can start to develop an almost Pavlovian response to stressful situations. If your nerves are tingling, your stomach is clenching, and you can barely breathe, then it’s tricked into thinking something really awesome is about to happen!

white-water-canoeing-18990699That’s what researchers at Texas A&M University found when they put a small sample of men and women through a series of purposely stressful outdoor adventure tasks. Some subjects – the fittest ones who were already comfortable with physical challenges fared better than others. The researchers discovered that those participants had a reduced stress response (including lower blood levels of cortisol) when facing demanding activities like whitewater canoeing or rock climbing. Essentially, they were more confident and less stressed out, even though the tasks were potentially hazardous. This may be because their past experience blazing through strenuous situations made them less likely to perceive new challenges as stressful or difficult. And according to the researchers, it’s possible to transfer that oh-so-cool-and-collected response to life’s other nerve-racking events.

Better still, you don’t have to scuba dive with great whites or BASE jump off the Empire State Building to reap the stress-busting perks of adrenaline. Whether you hit the bunny slope or the double-black-diamond mogul fields, as long as you’re taking a giant step outside your comfort zone, you’ll give your body that adrenaline kick and when you do it regularly and keep testing your edge, you’ll change your relationship with stress for the better.

So next time that little voice inside your head starts clamoring, no freaking way, just go for it and be prepared to reap the rewards.

dropcoaster

bull runWhich brings me back to my weekend. Keen to test the above theory for myself and readers of SRxA’s Word on Health, I will be spending tomorrow riding some of the longest, highest, fastest most insane rollercoasters in the country…and the following day I will be running with the bulls. If being pursued by twenty-four 1,000-pound bulls doesn’t set my adrenaline firing on all cylinders, then I guess nothing will.

I”ll let you know (hopefully) on Monday!

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