Life on the West Side

This 9th installment of the Health Corner is brought to you by your multivitamin!

ALL women of childbearing age (and let’s be honest, besides BIL, everyone else who reads this falls into that category) need to take a multivitamin. Here’s one of the big guns to discuss:

Folic Acid: Folic Acid is a very important vitamin for prenatal development. A lack of folic acid during pregnancy and pre-pregnancy is the leading contributor of serious neural tube birth defects in infants that are associated with infant morbidity and mortality. Folic acid supplementation has been shown to reduce these birth defects by 70% when taken 1 month prior to conception and continued throughout the first trimester. Daily supplementation of 0.4-0.8mg/day is recommended for ALL women of childbearing age, whether planning on a pregnancy or not. This is because neural tube closure in the fetus occurs in the first month of pregnancy, often before the woman is aware she’s pregnant.

But you may be thinking, “But Kate, I’m not trying to get pregnant. In fact I’m trying to prevent it.” BUT did you know that 50% of pregnancies are unplanned? OB/GYN’s, pharmacists and drug companies are aware of this and that’s why many birth control pills have folic acid included in the formula (check the label or talk to your provider to see if folic acid is included in your pill). So even without  planning a pregnancy, it is essential for women to get folic acid. Most women’s daily vitamins include folic acid in them, but can sometimes cause nausea if taken on an empty stomach. So take your multivitamin with a meal or before bed.

Moral of the story: Your mom was right – taking your daily vitamin IS necessary and important for your health. Keep your vitamin bottle right by your toothbrush and make it a habit to take it DAILY.

(Schwartz, 2008)

It’s been a loooong time since the Health Corner popped up, but here I am again. I’ve been sick twice this winter/respiratory season and thought I’d take the chance to talk about upper respiratory infection management. Perhaps it’s a little late in the season, bu since adults get 2-4 colds per year and kids get up to 10, it might be a good refresher.

Most “colds” or upper respiratory infections (URI) are viral – about 90%. It starts with a sore throat, general feeling of “yuck,” and possibly a low grade fever. Then it moves on to congestion, runny nose, and cough within 48hrs. The symptoms of a viral URI peak around day 3-4 and begin to resolve around day 7. Also, we don’t really care about the color of your snot anymore. Yellow or green goo doesn’t tell me it’s a bacterial infection, it just tells me there IS an infection (and again, it’s likely viral)

The BEST way to treat a URI is with symptomatic treatment:

-Nasal Decongestants: The behind the counter REAL sudafed! Take this 2x/day until the congestion subsides

-Saline Nasal Spray: These work really well in clearing out the sinuses. I use the Neti-Pot which is amazing, and I breathe so much better after! A ENT (Ears, Nose, Throat) MD I know told me, “People wash their bodies, and faces and brush their teeth daily, why shouldn’t people clean their sinuses  regularly too?”

-Antihistamines: Zyrtec or Claritin. Take daily to dry out your nose

-Other symptomatic care ~ Cough suppressant (Robitussin), pain reliever (Motrin to decrease nasal and throat inflammation), DayQuil & NyQyil or any other sort of combined cold and flu meds.

I know some people are very anti medicine (hello husband) but the key is to take the medications at the FIRST SIGN of illness. The very first sniffle or cough – get it under control. Controlling the symptoms early will decrease the course of the URI by a couple days. 3 days feeling crummy is wayyy better than 7 days.

-Control the environment ~ Wash your hands! Make your living space free of dust, debris, pet dander, or any other “triggers.” Those who have eczema, asthma and seasonal allergies are at greater risk for developing a bad cold, so control those factors as well. And this is a “duh,” but STOP SMOKING! Smoking really exacerbates any respiratory infection and compromises your immune system.

Since 90% of URI’s are viral infections, there is no need for antibiotics. Let me repeat that – there is NO NEED for antibiotics. So if you’ve heard of the Z-Pack or Amox or anything else, it won’t do anything for a viral infection. If your symptoms persist past 10 days, then there’s a small chance (2.5%) the viral URI has turned into Bacterial Sinusitis and antibiotics are appropriate at that time. But until then, it’s only symptomatic care that will help.

So take home messages – Wash your hands! Treat your symptoms! Love on a Nurse!

This month’s health corner is going to feature airplane health. Considering I just spent over 2 days on airplanes this month and that I hate flying, I thought it would be fitting.

One of the risks with long plane rides is your blood pooling in your legs and forming a clot. This is also known as a Deep Vein Thrombosis (DVT) and can be deadly. If these clots are dislodged, they can travel through your bloodstream up to your lungs or brain and kill you. And ladies, if you’re on birth control, you’re already at risk to form DVT’s. So it is especially important to the women folk to keep their blood from pooling.

The best way to prevent DVT’s is to move it, move it! Although you have limited space in those tiny airplane seats, you can still move. While you’re sitting and dangling your legs, draw the alphabet (capital and lower case) with both feet every hour. This action keeps your blood circulating throughout your body and can help prevent clots. And while you’re already drawing with your feet, move your way up the rest of your body by adding neck circles, shoulder shrugs and stretching out your hands to your alphabet feet routine. These stretches work less to prevent clots, but prevent joint and muscle aches and stiffness.

If you notice a reddened, swollen or painful area in your lower extremities, be extremely cautious. You may already have a DVT. Once one is formed, it is imperative to see a health care provider to administer anti clotting agents or do other interventions. It’s important once you see the reddened area to NOT increase the circulation to that area. Increasing your circulation to the affected area can actually move the clot closer to your brain and lungs and that = BIG trouble.

Another health risk travelers face are pressure ulcers. If you’re sitting in an uncomfortable seat on a bony booty (or even if it’s not, ahem, quite so bony…), you can break down the skin on your bum bum. It is important to change positions every 2 hours. Even if you switch from left cheek to right cheek, that small movement takes the pressure of your bony prominences of your hiney and decreases the risk for skin breakdown. Those who are elderly or malnurished (which, fyi – obese people are considered malnourished because they are OVER nourished) are at a higher risk anyway for skin breakdown, so it is especially important for those groups to move it, move it!

A third problem travelers face is dehydration. I’m a window seat fan myself, and for that reason, I like to dehydrate myself on planes so I don’t have to climb over two people TWICE for one bathroom trip. No thanks. But if you don’t mind annoying your seat mates, I say drink the water they offer you. And ask for more. Be careful with sodas and alcohol as those can also dehydrate you. Add that to the already dry air in airplanes, the salty snacks and processed meals you get, and you quickly become just a dried up sponge.

Just think about it this way… if you’re drinking a lot of water during your travels, that will mean you’d have to climb up and go to the restroom more often (and you better pray there’s no turbulence while you’re on the makeshift pot!). All this up and down climbing over seat mates and finagling yourself into those tiny stalls increases your circulation and you’re movin’ it, movin’ it!

So keep on keepin’ on! Keep moving and have safe and fun travels!

Stay tuned for another health corner episode next month!

As it’s getting warmer out and the days are longer, it’s time to start talking about some summer sunnin’. And by summer “sunning,” I mean summer “no-sunning.”

The number one rule this summer: SUNSCREEN, SUNSCREEN, SUNSCREEN!!! I know how nice it feels to have a tan. I love being tan. BUT that is another story. THIS story is about skin protection. And that means SUNSCREEN, SUNSCREEN, SUNSCREEN! And that is something I don’t break the rules on… I apply, apply, apply.

Sunscreen with a minimum of 15 SPF should be applied daily (most facial moisturizers also contain sunscreen) and if you’re going to be out for a while, it needs to be reapplied every 2 hours. The sun’s rays are the harshest from 10a-3p aka = best tanning time! However, if you must be out between those hours (and you must, I know! Cuz I love being out during the day just as much as the next sista!), then a) wear sunscreen and reapply OFTEN (duh) b) wear a hat and sunglasses with UVB/UVA protection.

Check your skin often, and check your moles/beauty marks/freckles even more often. Some things you must look for, especially after being in the sun for a while are the alphabet: ABCDE

A: Asymmetry – One half is different than the other

B: Border – If the border is irregular, notched, uneven or blurred

C: Color – The color is uneven, or changes. Notice if you have different areas that are tan, dark brown, black, red.

D: Diameter – Note if you have a mole greater than 6mm, or if one is suddenly larger than before

E: Exudate – If there is any drainage or fluid oozing.

All of these signs need to be looked at by your health care provider as soon as possible.

Every year, approximately 1 million people in the United States are diagnosed with skin cancer. Even ONE nasty sunburn increases your risk for skin cancer. If you do find yourself with some lobster skin, try these tricks to alleiviate the pain and help your skin heal faster:

-Take a cool bath or shower.

-Apply an aloe vera lotion several times a day.

-Leave water blisters intact (meaning don’t pop them) to speed healing and avoid infection. If they burst on their own, remove skin fragments, then apply an antibacterial ointment on the open areas and cover the wound.

-Take motrin. This will relieve the pain and also decrease your inflammation

-Drink plenty of fluids.Also, high-protein food (think meats, nuts) will help with tissue repair.

Enjoy summer and remember to practice safe-sunning!

This one’s for the girls ABOUT the girls. Yup, it’s about the Ta Tas. Boobies. Chi Chi’s. Breasties. Whatever you call them.

Let’s talk about the exam. How many of you lovely ladies are doing your self breast exams (SBE)? These should happen once a month and the best time to do it is between days 7-14 of your cycle (Day 1 = the first day of bright red blood). Regular boobie exams allow you to become familiar with your boobies, knowing how they normally feel and look, so you can notice any changes. When you find a change, you should see your Doctor (or Nurse Practitioner, holla!).  Most breast changes or lumps are not cancerous, but only a health care provider can tell you for sure.

In your SBE you are looking for a lump or change that stands out  from the rest of your breast tissue. If you feel a lump in one breast, examine the other one. If both breasties feel the same, the lumpiness is probably normal. As you get to know your boobies better by doing SBE’s you should be able to tell the difference between your normal lumpiness and what may be a change. In addition to lumps, other changes you want to be aware of may include: -skin irritation or dimpling, -nipple pain or  new retraction (nip turns inward), -redness or scaliness of the nipple or breast skin, -any discharge except breast milk.

“So how do I do my SBE?” you may ask… well, excellent question! And you’re in luck cuz I’m here to teach (oh you said, “check’s in the mail”… thanks, I’ll keep my eye out for it!). You can do your SBE in the shower or in front of a mirror raising your arm over your head. Use the pads of your first 2 fingers starting at your nipple, make concentric circles in an outward motion until you reach your armpit. It’s important to continue the exam in the tissue surrounding the boobsters (i.e. “Armpit boob”). Often times lumps and cancers form in your lymph nodes surrounding the breast tissue which is why it’s important to examine that tissue as well. When you’ve finished circling your breasts, come back to the nipple. Squeeze gently in both directions (side-side, up-down). If you notice any pain, discharge or other discomfort, make an appointment to get ‘er checked out. Take a close look at your breasts once you’ve finished examining them with your hands. Lean forward and see how they fall. No sista has equal God-given boobies, so don’t worry if they’re uneven, an inverted nipple (as long as it’s not a NEW finding… and yes, you still CAN breastfeed with an inverted nipple) or if one’s larger than the other. But again, you’re looking for changes or significant differences between the girls (dimpling, skin pulled tight, etc)

Mammograms are recommended yearly for women over 40 years old. That doesn’t mean you can’t request one earlier or talk to your Doctor about your girls if you’ve noticed any changes! Be proactive in your health care, you’re the only one who’s going to lose if you don’t speak up. And don’t be embarrassed. Honestly, she’s seen worse. I promise you.

Only a very small percent of breast cancers is linked to heredity and genes; the majority is associated with lifestyle and environmental factors. So this means, like every other part in your body, physical activity is crucial to breast health. Increased rates of breast cancer have been associated with a sedentary lifestyle. Another correlation is smoking and breast cancer. Drop your ciggie and get moving! Eat your antioxidants and cancer fighting foods (think broccoli, oranges, berries, spinach, etc), do your pilates (or if you want to kill yourself, do your Jillian Michaels). Do your monthly SBE’s. Talk to your health care provider about your concerns and love the twins!

With shows like “The Biggest Loser” and “Celebrity Fit Club” and with my work doing it’s own version of “The Biggest Loser,” I guess it’s time to post on that corner of health.

Did you know obesity increased in 23 states in 2009!? And 2/3 of American adults are now considered obese!? And that childhood obesity rates have tripled over the last 30 years!? The numbers continue to go up leading us further into this obesity pandemic the world is now seeing.

Obesity is defined as “the state of being well above one’s normal weight; traditionally greater than 20% of the ideal body weight with age, gender and race placed into consideration.”

A tool to measure obesity is called BMI (body mass index… to find your BMI, click here .) Healthy BMI’s should range between 18-24.9. An overweight BMI is 25-29.9 and you are considered obese if your BMI is >30. People have claimed that using BMI is not an accurate tool. While those claims are correct in some outlying cases, it is mostly accurate for the average person. What the BMI calculator does not consider is a very muscular person. Look at Tom Cruise for example, he is said to be 5′7″  weighing 175lbs. His BMI is 27, making him overweight. Clearly Tom Cruise is not overweight, which is where BMI is accused of being inaccurate because muscle does weigh more than fat. Again, considering the obesity and overweight statistics of this country, Tom Cruise is clearly an outlier.

I know I’ve already touched on this slightly in my previous health corner post but the health ramifications of being overweight and obese are literally deadly. Being overweight is a significant contributor to multiple health problems including (but not limited to): Diabetes, High blood pressure, Cardiac problems, Certain cancers, Gout, Arthritis, Stroke, Sleep apnea, etc etc. And as always, my cure all is – eat healthy, exercise and drink water!

It is an old school thought that your diet should be 2000 calories/day. For some that may be true, but a more accurate way to figure out how many calories you need to take in per day is by figuring out your Basal Metabolic Rate (BMR). Figuring out your BMR and using the Harris Benedict Equation will give you a more accurate way of measuring energy intake and ouput. It takes approximately 3500 calories in a pound of stored body fat, so do the math… in order to lose 1lb/week it takes removing 50cal/day (either by food restriction or increased exercise). But everyone knows, it’s much easier said than done. And unfortunately your BMR decreases with age, so to maintain or lose weight becomes significantly harder.

The 30 minutes of exercise a day isn’t cutting it either. The more recent recommendation is 60-90 minutes of activity per day. And no wonder the activity minutes keep going up, because pounds keep going up too! It sounds daunting to be out on the treadmill for an hour and a half (and who has the time!) but you CAN break up your workout into 10 minute intervals. And it doesn’t HAVE to be something as grueling as the dread-mill. Get out and garden, walk around the neighborhood, that toilet that needs scrubbing? Scrub it vigorously for 10 minutes (and bonus – you get a sparkly clean potty!). It is also necessary to engage in some weight bearing activity like lifting weights at least 2-3x/week. This is especially important in increasing bone density particularly in women.

Of course this isn’t easy. But then again, most things in life that are worth it, aren’t easy either… Relationships, school, etc. It’s not meant to be easy. It’s meant to challenge us and make us grow. And it’s high time we as a collective whole start taking care of ourselves and those around us.

Anyway, I have plenty more to say on this topic, but I’m running out of blog steam. Maybe more later… Keep keepin it real. I’m out.

Did you know that February is National Healthy Heart Month? After having worked on a cardiac unit in the hospital, I found the number one thing lacking was education. So in honor of the love muscle, here are a few healthy heart facts.,

- Heart disease is the number one killer for men and women. More than 1 in 3 Americans have  heart disease.

- Heart Disease is an umbrella diagnosis that includes myocardial infarctions (heart attack), coronary artery disease, congestive heart failure, cardiomyopathy (heart muscle enlargement),  etc.

- Women often don’t recognize the symptoms of heart attacks and mistake them for panic attacks. Because most people think heart attacks happen like they do in the movies (sharp pain, grab your chest, fall down), women especially can miss key signs of a heart attack.  Women are more likely than are men to have heart attack symptoms without chest pain, such as nausea, vomiting, sweating, dizziness, and fatigue.

- The common symptoms of heart attacks are:  *Chest pain and discomfort which can feel like a tight ache, pressure, fullness or squeezing in the center of your chest lasting more than a few minutes. The pain may be intermittent, or it may be constant. *Body pain which can radiate to the left arm, jaw, stomach. The body pain may or may not accompany the chest discomfort. The stomach pain can also be mistaken for heartburn. *Shortness of breath, which usually occurs before the chest pain comes. *Anxiety and a feeling of impending doom. *Sweating, cold and clammy skin. *Lightheadedness and dizziness. *Nausea and vomiting.

The KEY to treating a heart attack is to catch it EARLY! As we used to say on the cardiac unit, “Time is Muscle.” The longer you wait, the more cardiac muscle you lose. If you are experiencing any of the cardiac symptoms (even if you THINK it’s just anxiety!), call 911 immediately.

The good news is… there are ways to PREVENT heart disease!

- Obviously the 2 that everyone mentions, eat well and exercise often. These 2 are absolutely KEY in keeping your heart happy!

- Prevent and control high cholesterol. You can do this by eating a diet low in saturated fat and cholesterol, high in fiber, keeping a healthy weight and getting regular exercise. You should have your cholesterol checked with your yearly physicals (and yes, you should don that gown and feel uncomfortable in front of your doctor at least yearly!).

- Healthy cholesterol levels should be: Total (serum) cholesterol <200mg/dL. HDL (the GOOD cholesterol), the higher the better (it usually ranges between 40-60mg/dL). Closer to 60mg/dL and higher gives you greater protection against heart disease. LDL (the BAD cholesterol) <100mg/dL. Think HDL for HIGH and LDL for LOW numbers.

- Don’t, PLEASE, whatever you do, DON’T SMOKE!!! Smoking causes your arteries to clog (atherosclerosis), which narrows the blood circulation pathways. The nicotine also stimulates your heart and makes it work harder, which can lead to high blood pressure.

- And speaking of blood pressure, keep yours LOW! Optimal blood pressure is 120/80 mm/Hg.  It’s ok to go lower than 120/80 as long as you’re not feeling dizzy, but higher is bad. Even a BP of 130/90 puts you at serious cardiac risk! Blood pressure can be controlled with exercise and diet (duh… the 2 answers to EVERYTHING! Those and “drink water” are my cure alls!)

- I promise I won’t go on too much longer, but a few more points…. Keep your diet HIGH in fruits, vegetables, fiber. Keep it LOW in fats, sugars, salt… Keep your BMI (body mass index) between 18-25. But, I suppose I’m getting ahead of myself. More on that in another post…

Remember, keep that love muscle of yours happy, and it will love you back!

It’s all going down… in the toilet. Yes, this post is about what happens in the toilet. So for the weak hearted, do not continue reading. Consider yourself warned.

A couple bowel movement facts:

-You should have 1 BM per every complete meal you eat. And at the very LEAST, daily.

-Your stools should be soft and formed. We want LOGS here, not pellets.

-If you’re having pellet poo, that’s a sign of dehydration. Drinking water will soften your stools and make it a more comfortable experience

-And on that note, a person should be drinking half their weight in fluid ounces of water per day. For example, if you weighed 100lbs, you need to drink 50 oz of water. 1 oz = 30ml. 1 cup = 8 fl oz.

-Green Poop! And c’mon, you know you’ve all had it at some point… is a sign of too much fat in the diet. Green poo  can also come from eating too much processed food with additives (think: Lucky Charms) AND also from eating a large amount of green leafy veggies (or drinking green beer on St. Paddy’s day… and yes I have witnessed this!). So if you’re questioning whether your green poo is “healthy” (i.e. a lot of green leafies) or “fatty,” be honest with yourself and take a quick assessment of your diet.

-Bloody poo…. now this IS something to be taken seriously. If there’s just a small smattering of blood on the toilet paper, it’s likely from the straining action. Increasing your water intake will make your stools softer. If however you are losing large clots of blood in your stools, or if they’re turning dark dark brown, almost black, those could be signs of an internal bleed and that must be examined immediately.

-Diarrhea. Ohhhh there’s almost nothing more uncomfortable than RUNNING to the bathroom every 5 minutes. It’s really important to stay hydrated when you have diarrhea. Drink electrolyte balancing drinks (think Gatorade, pediatlye). You also need to stay on the BRAT diet until the diarrhea subsides and you can slowly start adding other solids in. The BRAT diet includes: Bananas, Rice, Applesauce and Toast. Absolutely NOTHING spicy or hard to digest.

-Floaters vs Sinkers: Although it’s obviously much more common for your stool to slurp down the hatch in the royal throne, you can occasionally get a floater. Floating poop can also be indicative of a high fat diet. That, and the amount of gas that was absorbed in the digestion process.

-It is important for adults to get 34-45mg of fiber every day. Hardly anyone gets this much. Fiber has the paradoxical affect that will stop diarrhea as well as start things moving again. Things might be uncomfortable the first little while after adding a significant of fiber back into your diet, but add it in slowly and eventually your tummy will love you!

-The most important fact is that if you’re having bowel movement problems of any sort (funny color, funny odor, painful, etc) or any questions at all contact your doctor. Might be a little embarrassing, but believe me, they’ve seen and heard worse.

Due to my profession, I do a lot of teaching. I’m passionate about health promotion and disease prevention and really enjoy teaching families about these two. So, I’ve decided to dedicate an occasional portion of this blog to teaching health tips. Take them or leave them, but here goes…

Since we’re in the middle of flu season and all the hype about H1N1, here are some flu prevention tips:

-The signs and symptoms of H1N1 and seasonal flu are the same: cough, shortness of breath, fatigue, runny nose, sore throat, muscle aches, chills, headache, vomiting and occasionally diarrhea. The best treatment for the flu is rest and hydration. Load up on nyquil to allow for good sleep and drink plenty of fluids… water, orange juice and chicken soup are mom’s old tricks for anything, and ya know what – they WORK! (Merci Mamman!)

-When coughing or sneezing, don’t use your hands. Instead turn into your shirt at the inside of your elbow. The droplets from the explosion can go up to 6 feet, and a lot of times they either slip through your hands, and even worse – people will TOUCH things after they’ve just sneezed on their hands! Gross! Also once the droplets are stuck to your shirt, it’s harder for them to be transmitted. The flu is passed through those droplets and it’s much more likely to walk into a mist of those drops versus touching someone’s inner arm.

-Wash your hands MULTIPLE times throughout the day! I keep purell in my car before I go anywhere, because your steering wheel is chock full of nasty little buggers! Wash your hands: -before eating -after using the bathroom -after sneezing, coughing, or blowing your nose -anytime they are visibly soiled

-Treat the fever with alternating Tylenol and Motrin, and if symptoms persist or become worse, seek medical attention. Currently Tamiflu is the only treatment for  H1N1 once it has been contracted. As for the H1N1 vaccine… I’m hesitant to recommend it. I feel it is too new and there has not been much research done on it. I did however get the shot due to my profession. I keep myself and others safer by having received it.

Any questions or need to see my references, you know how to reach me!