Sunday, March 31, 2013

Two die in China from bird flu strain not previously seen in humans-Xinhua

Two people in Shanghai, one of China's largest cities, died this month after contracting a strain of avian influenza that had never been passed to humans before, the official Xinhua News Agency reported on Sunday.  

The two men, aged 87 and 27, became sick late February and died in early March. Another woman in nearby Anhui province also contracted the virus in early March and is in a critical condition, Xinhua said, quoting the National Health and Family Planning Commission (NHFPC).

The strain of the bird flu virus found in all three people was identified as H7N9, which had not been transmitted to humans before, the commission said.

The three cases were confirmed to be human infection of the H7N9 strain by experts from the NHFPC, based on clinical observation, laboratory tests and epidemiological surveys, Xinhua said.

All three cases showed symptoms of fever and coughs that later developed into pneumonia.

Calls to the NHFPC on Sunday were not answered.

It is unclear how the three victims were infected. The virus does not seem highly contagious because no health abnormalities were detected among 88 of the victims' close contacts, Xinhua quoted the commission as saying.

There are no known vaccines against the H7N9 virus. (Reporting by Melanie Lee; Editing by Paul Tait)


Tuesday, March 26, 2013

‘black henna’ tattoos not so temporary after all

Spring Breakers, beware. That henna tattoo might really not be henna at all. And it might not be as temporary as you think.

File photo. (Fareed Khan / AP)

File photo. (Fareed Khan / AP)

The Food and Drug Administration warned Monday that the popular temporary tattoos, in which ink is applied to the skin in intricate patterns that last from several days to several weeks, can actually last a lot longer. And not in a good way.

“Just because a tattoo is temporary it doesn’t mean that it is risk free,” Linda Katz, director of FDA’s Office of Cosmetics and Colors, said in a consumer update.

The agency said some consumers have reported a range of adverse reactions that can outlast the tattoos themselves and, in some cases, have led to emergency room visits. Among them: Skin redness, blisters, raised red weeping lesions, loss of pigmentation, increased sensitivity to sunlight and even permanent scarring.

Traditional henna is a reddish-brown coloring made from a flowering plant found in parts of Asia and Africa. For centuries, people have ground henna into a paste and used it to decorate everything from leather to hair, fingernails and skin. The FDA attributed many of the problems that have occurred to the use of “black henna” that often is used in place of the more traditional henna. It can include hair dye with p-phenylenediamine, or PPD, which can cause an ugly range of skin reactions. A study last August in the Journal of the German Society of Dermatology found that PPD in hair and eyelash dye caused allergic reactions in a group of people.

Black henna often can be found in temporary tattoo kiosks common in tourists areas, such as beach boardwalks. The FDA noted that while some states have put in place regulations governing temporary tattooing, others have not.

So be careful with those henna tattoos out there, kids.

A few examples of bad reactions can be found on Twitter:




Tuesday, March 19, 2013

Tired in the Afternoon? Here’s What You Can Do

by Samantha Montpetit-Huynh

Sometimes I think I am obsessed with it and I can’t get enough. Add the fact that it “seems” like this is the winter that will never end, and the thought of curling up on the couch with a giant bowl of buttered popcorn and a movie sounds like bliss.

However, we ALL know how we feel after we binge.

Put crap in and guess what??? Get crap out. Never mind the feeling of guilt than can take over faster than you can get off that couch, but after you’re initial high from all the butter and starch, you get a nice crash that just begins the domino effect of trying to stay awake. And we wonder why we’re tired!

Energy comes from two main things; exercise and food. I would even say food is the predecessor as it has the vital role of whether or not you keep your blood sugar levels steady (awake) or up and down (crash).

Ever wonder why you tend to grab crackers, cereal or other sweets when you are tired? You could say that it’s “just a snack”, but when quick fixes are what you “crave” before any thought is put in it, you are in survival mode.

So how does one curb this? How do you take energetic throughout the day without a “treat” in the afternoon and buckets of coffee at your disposal?

Well just like the rest of it; it’s REALLY complicated. Not. No rocket science here. It’s plain and simple planning. Shocking I know.

Here are 4 ways to boost your energy in the afternoon:

4 ways to boost your energy in the afternoon

1. Out of sight, out of mind.


If those unhealthy snacks are not in the house, you are way more likely not to eat them. JUST DON’T BUY THEM!

2. Plan your meals and snacks.

I never leave my house without my lunch and at least two snacks. Yes I am human and once in a while I don’t crave what I have but I eat in anyway because half the time it’s just hunger; thus the craving is gone.

3. Don’t over-eat.

Ever wonder why you crave sweets after a big meal? If you are eating a meal high in protein and low in carbohydrates (which is good for weight loss), you could be decreasing your serotonin levels (the happy hormone). Serotonin is increased following a sugary, carbohydrate diet. Eating too large of a meal can increase this risk and drive you towards a “fix” after.

4. Protein protein protein!!!

Yes I know I just said too much can lower serotonin, but “too much” of anything is never a good idea. Balance is key. If you have some protein with every meal AND snack, you balance your blood sugar because protein slows down the digestive process, slowing down the production of insulin thus lowering the amount of sugar that is released in the blood. The slower the process, the fuller you feel longer and less likely to crash.


Now none of this is new but sometimes people need a friendly “kick in the pants” as to why they would rather nap at 3pm than finish that last report.

And here’s a nice little FYI… for all of you trying desperately to stay awake on coffee; you’re almost doing yourself a disservice as caffeine lowers serotonin too.

Don’t say I didn’t warn ya.

Samantha Montpetit-Huynh is the mother of two beautiful girls and the founder of Core Expectations, Toronto‘s only full services wellness team that delivers personal training, abdominal rehabilitation and other support services to the homes and offices of pregnant women and new moms across the GTA.




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CrossFit Review

By Michael Esco, PhD, HFS, CSCS*D
WebMD Expert Review

Preparing the body “not only for the known, but also the unknown” is the mantra for CrossFit, one of the fastest growing strength and conditioning programs today. It is not a traditional, specialized training program like doing isolated weight lifting for a certain muscle or aerobics.

“Our specialty is not specializing," says CrossFit founder and former gymnast Greg Glassman.

woman doing pushups

It's also a very tough workout -- not one to take lightly, especially if you're not active right now.

Here's what you should know before you get started.


What is CrossFit?

CrossFit combines strength training, explosive plyometrics, speed training, Olympic- and power-style weight lifting, kettle bells, body weight exercises, gymnastics, and endurance exercise.

By doing this, CrossFit targets what it calls the major components of physical fitness: cardiorespiratory fitness, stamina, muscular strength and endurance, flexibility, power, speed, agility, balance, coordination, and accuracy.

Training the CrossFit way requires you to work out 3 to 5 days per week. The workouts are highly intense and short, taking about 5 to 15 minutes to complete.

CrossFit workouts typically combine explosive exercises done in a circuit format: One exercise follows right after the next, with very little rest in between.  

The main CrossFit exercises involve the whole body and include pushing, pulling, running, rowing, and squatting.

There are hundreds of CrossFit exercises. Here are a few examples:

  • Power Cleans: Pulling a weighted bar from the floor and bringing it up to and in front of your shoulders in a quick and forceful manner.
  • Burpees: This is a body-weight-only exercise that involves beginning in a standing position, quickly dropping to the floor and doing a push-up, then coming up to a squatting position and explosively jumping straight-up.
  • The Snatch: A weighted bar is rapidly pulled from the floor to directly over your head with the arms held straight.
  • Thruster: This exercise begins with standing upright with weighted bar held in front of your shoulders. You squat down to the point where your thighs are parallel to the floor, then quickly standing back-up and pressing the weighted bar over your head.

Other examples are variations of push-ups, sit-ups, and pull-ups. CrossFit also often uses kettle bells (a weighted bell with a handle on top), medicine balls, climbing ropes, jump ropes, and rowing machines.

The CrossFit WOD

CrossFit posts a Workout of the Day (WOD) on its web site. Some of the WOD are specially named after women or military heroes. The WOD changes each day and there are a lot of them. And they can be quite demanding.

  • The Barbara involves five circuits of 20 pull-ups, 30 push-ups, 40 sit-ups, and 50 body weight-only squats performed in order, while only resting at the end of each circuit for a 3-minute period.
  • The Angie - 100 pull-ups, 100 push-ups, 100 sit-ups, 100 bodyweight-only squats to be accumulated (not performed in a row, unless you are fit enough) during the entire workout.  
  • The Murph - a timed 1-mile run, followed by 100 pull-ups, 200 push-ups, 300 body weight squats, finished off by another 1-mile run.
  • The Jackie - 1,000 meter row, 50 thrusters with a selected weight, and 30 pull-ups: preferably performed without any rest between each exercise.  


Banish the Bags Under Your Eyes

Noticing bags or dark circles under your eyes? You're not alone.

Dermatologists and plastic surgeons get asked about dark circles and under-eye bags all the time. "I hear patients voice complaints several times a day," says dermatologist Valerie Goldburt, MD, PhD, of NYU Langone Medical Center.

Good news: There are fixes for under-eye flaws. The first step is figuring out just what the problem is.


Morning-After Puffy Eyes

Seasonal allergies, a cold, a sinus infection: These are some of the things that can lead to water building up under the eye.

"We have the thinnest skin around our eyes, so it's the area that's most influenced by the in-and-out flow of fluids," Goldburt says.

A dinner heavy with salty food or a night of crying while watching a tearjerker movie can also cause morning-after puffiness. The reason is osmosis. "Water always travels from areas in the body where there's low salt concentration to tissues where there's more salt, Goldburt explains. That principle holds true whether the salt comes from tears or from soy sauce.

Simple Fixes for Under-Eye Bags

Addressing the underlying cause will help treat these temporary eruptions of puffiness.

Here are steps to try:

  • Treat hay fever, if that's the problem. There are non-sedating, over-the-counter allergy medications that may help. If you have or suspect hay fever, talk with your doctor about how to treat it (whether or not it's affecting your eyes' appearance).
  • Try a neti pot. Irrigating the nasal cavity with a neti pot -- a device that looks like a small teapot -- can help relieve fluid buildup caused by allergies, sinus congestion, or a cold.
  • Switch your sleep position. Your sleep position may be contributing to under-eye bags. Thanks to gravity, sleeping on your side or stomach can encourage fluids to collect under your eyes. If you're a side sleeper, you may notice a heavier bag on the side you sleep on. Goldburt advises her patients who wake up with puffy eyes to sleep on their back and add an extra pillow under their head.

Changing your sleep position takes some getting used to, says Goldburt, a self-described "former eye-bag sufferer" and stomach-sleeper herself. Still, she says, "The earlier you start changing your sleep position, the better, because after a few years under-eye bags can became permanent."

Other everyday habits, including rubbing your eyes frequently, going to bed with makeup on, and excessive drinking, can contribute to under-eye bags, too. "Sleeping in eye makeup can irritate your eyes, causing fluids to pool," Goldburt says. Heavy alcohol drinking causes dehydration. That weakens the delicate skin around the eyes, making it more likely to sink into a pouch.

Eye bags are very common, and are usually not related to your health. But if your bags appear suddenly and you're not suffering from allergies, a sinus infection, or a cold -- and they don't ease up when you try the lifestyle steps mentioned above -- it's a good idea to see your doctor. Some thyroid or kidney problems can cause under-eye fluid retention, notes New York dermatologist Craig Austin, MD.



Tired of being told you look tired? Here's how to get rid of eye bags, puffiness, dark shadows, and circles.
By Shelley Levitt
WebMD Feature
Reviewed by Hansa D. Bhargava, MD


Doctor-Patient: The Niacin Discussion


Many physicians are finding themselves fielding a barrage of patient questions about heart disease this week due to headlines coming out of the American College of Cardiology's annual meeting in San Francisco. What has patients most concerned are results from the landmark HPS2-THRIVE study showing that niacin has dubious value in preventing heart disease and may even cause harm.

There had been high hopes for the extended-release niacin/laropiprant used in THRIVE. Studies showed it significantly raises high density lipoprotein (HDL) without causing the flushing that makes other forms of niacin difficult to tolerate.

And doctors like the idea of raising HDL with niacin. Spencer King, a colleague at Emory, said of niacin, "We have been pouring it on low HDL." The hope was that niacin would reduce the risk of cardiovascular events.

HPS2-THRIVE dashed that hope.

To recap, 25,673 high-risk patients were randomized to either placebo or Tredaptive (extended-release niacin plus laropiprant, an anti-flushing agent), in addition to background therapy with simvastatin or simvastatin/ezetimibe (Vytorin).

LDL levels dropped an average of 10 mg/dL and triglycerides fell 33 mg/dL. HDL levels increased 6 mg/dL. According to the study authors, "such lipid changes might translate into a 10% to 15% reduction in vascular events."

That didn't happen. Major vascular events -- a composite of nonfatal MI or coronary death, any stroke, or any arterial revascularization -- occurred in 13.2% and 13.7% of the niacin and placebo patients, respectively (P=0.29).

Worse, there were 31 serious adverse events for every 1,000 niacin-treated patients over 3.9 years of follow-up. And we're not talking about flushing: These were serious adverse events that led to people being hospitalized -- a significant increase in hemorrhagic stroke, serious infections, and new onset diabetes, as one researcher pointed out.

When your patients call, be prepared to spend some time talking with them. It will be time well spent. The lessons to be learned apply not only to this study, but others as well.

Merck has stopped all development of Tredaptive and pulled it from the market in Europe. But other formulations of niacin are still available. In fact, last year, 5.3 million prescriptions costing $1.1 billion were written for just one of those products, Niaspan, according to IMS data provided to the Milwaukee Journal Sentinel/MedPage Today.

The average patient might think, upon reading results of the THRIVE study, that the risks of niacin clearly outweigh the benefits when it comes to preventing heart disease. It's our job to explain that it's not that simple.

The findings are based on a large population study and, as such, tell us a whole lot about the population and very little about the individual patient.

Surrogate endpoints also deserve discussion. Patients might not understand biomarkers, but they know if they feel better. A growing number of medications -- even foods -- are being heavily marketed based on the fact they improve some surrogate measure of health such as blood cholesterol levels. But as THRIVE so clearly shows, what's the use of boosting HDL if it doesn't prevent heart attacks or death? Put in those terms, your patient will apply a new standard the next time he or she sees an ad shouting "This Product Improves Your Cholesterol!"

There are other things to discuss too. Will other HDL-boosting drugs work to prevent heart disease? That will have to await the results of ongoing trials of other HDL-raising agents -- anacetrapib and evacetrapib.

Meanwhile, Clyde Yancy, the former American Heart Association president who now heads cardiovascular medicine at Northwestern's Feinberg School of Medicine probably said it best: "We have drugs that work -- they are called statins. Why take chances on therapies that have no evidence of benefit?"

Finally, THRIVE offers yet another opportunity to drive home the fact that just because something is a vitamin or supplement, it isn't necessarily safe. No matter how many times we share that lesson, it keeps bearing repeating!

Monday, March 18, 2013

Study: Radiation for Breast Cancer Can Harm Hearts


Women treated with radiation for breast cancer are more likely to develop heart problems later, even with the lower doses used today, troubling new research suggests. The risk comes from any amount of radiation, starts five years after treatment and lasts for decades, doctors found.
Still, the study reveals that the potential harm from radiation runs deeper than many medical experts may have realized, especially for women who already have cardiac risk factors such as diabetes.

And it comes amid greater awareness of overtreatment - that many women are being treated for cancers that would never prove fatal, leading to trouble down the road such as heart disease.

Some chemotherapy drugs are known to harm the heart muscle, but the new study shows radiation can hurt arteries, making them prone to harden and clog and cause a heart attack. Women who receive both treatments have both types of risk.

The study "will raise the antenna" about the need to do more to prevent this, said Dr. David Slosky, a cardiologist at Vanderbilt University, one of the growing number of medical centers with special "cardio-oncology" programs for cancer survivors.

With today's lower radiation doses, "it is less of a problem, but it is not going away," he said.

The artery-related problems that the study tracked may be just the most visible of many risks because radiation also can cause valve, rhythm and other heart troubles, said Dr. Javid Moslehi. He is co-director of the cardio-oncology program at the Dana-Farber Cancer Institute in Boston.

Like cancer, heart disease develops after "a number of strikes that go against you," such as high cholesterol, he said. "The radiation is just another hit."

He wrote in an editorial that appears with the study in Thursday's New England Journal of Medicine. British government agencies and private foundations paid for the research.

Breast cancer is the most common cancer in women - more than a million cases are diagnosed each year worldwide. When it's confined to the breast, most women get surgery to remove the lump, followed by several weeks of radiation to kill any lingering cancer cells and sometimes hormone or chemotherapy.

What heart disease risks come from what specific doses isn't known. The new study, led by Dr. Sarah Darby of the University of Oxford in England, sought to measure that.

It involved 2,168 breast cancer patients from Sweden and Denmark diagnosed between 1958 and 2001 and treated with radiation. They included 963 women who suffered a heart attack, needed an artery-opening procedure or died of heart artery-related causes in the years after their radiation treatment. The other 1,205 were similar patients who did not develop these heart problems.

Researchers compared the women's radiation exposures using gray units, a measure of how much is absorbed by the body. They used hospital records and treatment plans to figure how many gray units actually reached each woman's heart and one artery often involved in heart attacks.

Most women treated today get doses that result in 1 to 5 gray units reaching the heart - more if the cancer is in the left breast. Patients in the study got an average of five gray units; the doses ranged from 1 to 28.

The risk of a heart attack, need for an artery-opening procedure or dying of heart disease rose about 7 percent per gray unit and no "safe" level was seen. The risk started to rise within five years of treatment and continued for at least 20 years.

What to do?

Don't forgo radiation if it's recommended because it is lifesaving and doctors increasingly have ways to shield the heart from exposure, said Dr. Bruce Haffty, associate director of the Cancer Institute of New Jersey and president-elect of ASTRO, the American Society for Radiation Oncology.

"Whatever cardiac risks may be there, they are outweighed by the cancer benefit," he said.

Some centers have special tables that women lie on face-down with holes for the breast to hang through. That allows radiation to be delivered just to that tissue rather than the wider chest area that gets irradiated when a woman lies face-up on a table.

Women need to tell any doctor treating them about radiation they have received in the past. It may mean they should avoid diagnostic tests that use radiation and instead have ultrasounds and MRI, or magnetic resonance imaging, whenever possible, Slosky said.

Some places are starting to use electronic medical records to track radiation exposure over a patient's lifetime, so the cumulative dose is known regardless of who ordered what test and when.

"I'd like to have a personal record like a personal dosimeter" for each patient, Slosky said. "Then you'd know" what risks they face and what tests are safe for them in the future.

Patients shouldn't panic - radiation has improved cancer survival, and that is the top priority, doctors say. The chance of suffering a radiation-induced heart problem is fairly small.

For example, 4 to 5 of every 100 women who are 50 years old and free of heart risks will develop a major cardiac problem by age 80, and radiation treatment would add one more case, the research suggests.

Women also can do a lot to cut their risk by keeping weight, cholesterol and blood pressure under control.

Saturday, March 16, 2013

Scientists diagnose intestinal worms -- using an iPhone microscope


An Apple product may help keep the doctor away in Tanzania.

In a discovery that provides doctors in remote areas with an alternative, scientists recently created a microscope using an iPhone, tape, flashlight and camera lens.

They then used it to diagnose intestinal worms in about 200 students in Pemba Island, off Tanzania's eastern coast. .

"To our knowledge, this is the first time the mobile phone microscope had been used in the field to diagnose intestinal parasitic infections," said Isaac Bogoch, an internal medicine specialist at Toronto General Hospital.

Bogoch, who conducted the study with colleagues, used his iPhone 4s.

However, he said, the approach can work with any smartphone that has a good camera and a zoom feature.

African markets are flooded with low-cost smartphones made by Chinese companies, some selling for as low as $80. With mobile phone growth skyrocketing in the continent, price-based competition is becoming vital to tap into the African market share.

From cell phone to microscope

To convert the phone into a microscope, scientists put double-sided tape over the iPhone camera lens. They then pierced a hole in the tape and centered a tiny $9 lens over the phone's camera lens.

Using a flashlight for illumination, they held up stool samples against the lens using the double-sided tape to hold slides in place, and studied them for intestinal parasites through the phone's screen.

Bogoch said they diagnosed 70% of the infections when compared with the results of a conventional laboratory microscope.

Convenience in remote areas

The scientists plan to tap into technology to make the results more accurate.

The mobile phone microscope is convenient because it allows testing for intestinal worms immediately and in close proximity with the patient, Bogoch and his colleagues wrote in their findings.

Innovative approaches that are portable and easy to assemble are vital in far flung areas, where labs are a rarity.

"The idea was to have a cheap solution in remote settings where equipment such as a microscope and electricity are not that easily available," said Benjamin Speich, a corresponding author and scientist at the Swiss Tropical and Public Health Institute.

Mobile phones are popular in Africa, where penetration rates remain high even in remote areas.

'Cheap solution'

Nearly 1.5 billion people -- 24% of the world's population -- suffer from helminth infections, commonly known as intestinal worms, according to the World Health Organization.

Most of those at risk are children, with most infections reported in Africa, the Americas and Asia.

Intestinal parasites are transmitted through contact with infected feces, which can lodge in the soil and spread though poor sanitation.

The study was published this week in the American Journal of Tropical Medicine and Hygiene. It was conducted by scientists from the United States, Switzerland, Tanzania and Canada.

First time in the field

This is not the first time scientists have converted a smartphone into a microscope, but past experiments have been limited to the lab, Bogoch said.

Two years ago, scientists at the University of California, Davis improvised a microscope using an iPhone.

They inserted a small ball lens into a rubber sheet, which they taped over the smartphone's camera.

At the time, researchers said they planned to validate the device for use in the field.

Tuesday, March 12, 2013

Too Many Colonoscopies in the Elderly


Bill Fullington doesn’t remember exactly where he read that all adults over age 50 should be screened for colon cancer. A magazine? Maybe the local paper?

In any case, Mr. Fullington, a retired teacher in Birmingham, Ala., takes excellent care of his health; he never smoked, doesn’t drink, hits the gym daily. “Everybody thinks I’m 30 years younger than I am, because of my zip,” Mr. Fullington said in an interview. So he dutifully arranged to have a colonoscopy in 2008, when he was 80.

The doctor removed two small polyps — “the size of BBs,” Mr. Fullington said — and sent him home to recover. The next day, “I woke up screaming in pain.”

At the emergency room at Brookwood Medical Center, tests showed that the procedure had perforated his colon. Mr. Fullington underwent a colostomy and spent a week in intensive care — and that was just the beginning.

March is Colorectal Cancer Awareness Month, so you may be reading and hearing a lot about the importance of screening. You may even get to walk through the eight-foot-high inflatable simulated colon that makes appearances around the country — and see what polyps look like from the inside. But you may not hear much about when colon cancer screening should stop.

Even the Fight Colorectal Cancer Web site, from the major advocacy group working to make Americans aware of the disease and its prevention, says that all adults over age 50 should be screened. “Don’t wait. Talk to your doctor,” it urges.

But in 2008, just a few months after Mr. Fullington’s colonoscopy, the United States Preventive Services Task Force reviewed years of research and recommended against routine screening for colorectal cancer in adults over age 75 and against any screening in those over 85.

Let’s be clear: Screening those over age 50, the group most at risk, makes complete sense. Removing the polyps that may become cancerous years later (but also may not) can prevent the disease. But while colonoscopy is underused by the poor and uninsured, it’s overused by the elderly.

Dr. James Goodwin, a geriatrician at the University of Texas Medical Branch in Galveston, has led much of the overtesting research. In 2011, using a 5 percent national sample of Medicare beneficiaries, his team showed that older people underwent colonoscopies too often. Medical guidelines call for a repeat test 10 years after the first negative colonoscopy, but their study found that nearly half of patients with negative colonoscopies had another in less than seven years, often within three or five. About a quarter took place without any clear medical indication.

Now, using Medicare data for every patient over age 70 who had a screening colonoscopy in Texas in 2008 or 2009, Dr. Goodwin and company have found that 23 percent were “potentially inappropriate” because the patients were over age 75 or because they had a repeat screening too soon after the last one for no clear medical reason. The study appeared on Monday in the journal JAMA Internal Medicine.

Gastroenterologists more likely to perform inappropriate colonoscopies were older, male, graduates of United States rather than overseas medical schools, and working in high-volume practices. “There are these factories that do colonoscopies on everyone they see,” Dr. Goodwin said.

Why not screen everyone? Because, he explained, at older ages the benefits diminish. “It’s difficult to have this conversation, to say, ‘You don’t need this because you’re not going to live long enough to benefit,’” he acknowledged. But colon cancer develops slowly, and in the many years it takes for small polyps to evolve into cancer, if they do, most old people will have died of other diseases.

Meanwhile, the risks increase. Mr. Fullington, who’d lost 30 pounds, returned to the hospital two months after his perforation to have his colostomy reversed. Discharged, he developed a painful “crimp” in the stomach. Doctors call it ileus, and it’s not uncommon after bowel surgery at older ages.

He returned to the hospital, where the ileus uncrimped without further surgery. But trying to get to the bathroom, “I sat up and went headfirst onto the floor,” Mr. Fullington said. Bloodied and bruised, he needed head X-rays and stitches.

He’s fine today, happily. And complications like his are very rare.

But, Dr. Goodwin noted, for older patients the prep for the colonoscopy itself can cause weeks of cycling between diarrhea and constipation. “It’s not death, it’s not hospitalization, but it’s feeling sick and humiliated and helpless,” he said. “That is a big price.”

Yet public health campaigns have done such a persuasive job that some people, data to the contrary notwithstanding, believe they need routine mammograms and Pap smears and colonoscopies forever. As another study in this week’s JAMA Internal Medicine shows, older adults may feel “a strong moral obligation” to continue testing and are skeptical of government panels and statistics telling them to stop.

Bill Fullington, however, vows he’ll never have another colonoscopy. And at 85, he’s not a candidate for one. “This whole thing would’ve killed 9 out of 10 80-year-olds,” he said. “I’m one tough nut.”

Sunday, March 10, 2013

Natural Health Care: The Diverticulitis Diet Defined


Diverticulitis develops from a condition called diverticulosis. If you're older than 40, it's common for you to have diverticulosis - small, bulging pouches (diverticula) in your digestive tract. In the United States, more than 50 percent of people older than 60 have diverticula. Although diverticula can form anywhere, including in your esophagus, stomach and small intestine, most occur in your large intestine. Because these pouches seldom cause any problems, you may never know you have them.
A low-fiber diet is considered to be the main cause of diverticular problems. First diagnosed in the United States in the early 1900s, and now common throughout developed countries, the emergence of diverticular disease coincided with the introduction of low-fiber processed foods (eg. branless refined flour). Even now, the disease is rare in Asia and Africa, where people eat high-fiber vegetable diets.
In the past, many doctors recommended that people with diverticulosis avoid seeds and nuts, including foods with small seeds, such as tomatoes and strawberries. It was thought that these tiny particles could lodge in the diverticula and cause inflammation (diverticulitis). But there is no scientific evidence that seeds and nuts cause diverticulitis. In fact, eating a high-fiber diet - which may include nuts and seeds - reduces the risk of diverticulitis. It is now believed that only foods that may irritate or get caught in the diverticula cause problems.
A low-residue Diverticulitis Diet is recommended during the flare-up periods of diverticulitis to decrease bowel volume so that the infection can heal. An intake of less than 10 grams of fiber per day is generally considered a low residue Diverticulitis Diet. If you have been on a low-residue diet for an extended period of time, your doctor may recommend a daily multi-vitamin/mineral supplement.
Once your symptoms improve, start to add about 5 to 15 grams of fiber a day to allow your digestive system to adjust to the higher fiber intake.
Although there is much conflicting information, even in the medical world, about what constitutes a good Diverticulitis Diet, the basic principle of healthy eating remains the same. Most people have no symptoms and only find out that they have Diverticulosis when they've had a colonoscopy done. If you fall into this category, the guidelines suggest that you start on a high fiber and high fluids diet as soon as possible. You should also avoid constipation at all costs.
In general, treatment depends on the severity of your signs and symptoms and whether this is your first attack of diverticulitis. If your symptoms are mild, a liquid or low-fiber diet and antibiotics may be all you need. But if you're at risk of complications or have recurrent attacks of diverticulitis, you may need more advanced care. A high-fiber diet is very important in preventing future diverticulitis attacks. As you increase your fiber intake, increase your fluid intake as well.
Many people don't realize the harm that a low fiber diet can do to you, and the Diverticulitis Diet is really a necessity to everyone, not just those with the disease. We must remember to keep high-fiber healthy diets to allow ourselves the nutrition we need to support our bodies and allow for proper nutrition. Even if you do have diverticulitis, the Diverticulitis Diet will help you get your bodies nutrients on track and allow you to be healthy again.

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