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One Nation’s Gain

May 19th, 2020

America’s Obesity Crisis Intensifies.

The number of people in the United States who are overweight or obese has been climbing for years, and that excess weight has serious and costly health consequences. So, the projections from a highly respected team of scientists about obesity in America’s future are disconcerting at best.

After conducting national surveys and correcting for our tendency to underestimate our weight in surveys, the scientists discovered that in as many as 29 states, the prevalence of obesity will exceed 50 percent by 2030. In addition, they project that no state will have less than 35 percent of its residents who are obese.

The bottom line is that within the next ten years nearly one in two adults in the US will be obese. Further, the team projects that nearly one in four Americans will be severely obese by 2030.

The team’s report, Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity, was published in The New England Journal of Medicine in December and suggests that the prevalence of severe obesity is expected to be higher than one in four in 25 states. Further, severe obesity is projected to be the most common weight category among the nation’s women, non-Hispanic, black and low-income adults.

Obesity will exceed 50 percent by 2030. – The New York Times

This study’s results mirror those of a study presented in the September 2012 “F as in Fat” report. That report, released by the Trust for America’s Health and the Robert Wood Johnson Foundation, also predicted that half of US adults will be obese by 2030.

Obesity is dangerous. It is linked to a substantial number of negative health effects, including high blood pressure, type 2 diabetes, heart disease and stroke, sleep apnea and breathing problems, osteoarthritis, gallbladder disease, mental illnesses such as depression and anxiety and certain cancers, including endometrial, breast, colon, kidney, gallbladder and liver cancer.

The “F as in Fat” report projected that there will be as many as 7.9 million new cases of diabetes a year by 2030, compared with 1.9 million new cases a year in 2012. They suggest there could also be 6.8 million new cases of chronic heart disease and stroke each year, compared with 1.3 million cases in 2012.

Obesity is also expensive. A study conducted in 2013 estimated that the medical cost of obesity totaled $342.2 billion per year. The study also determined that the indirect cost of obesity due to lost productivity came to another $8.65 billion per year. And that was in 2013. Those amounts are likely much higher in 2020.

Obesity is a leading cause of preventable illness, disability and life-years lost in the United States. It is responsible for about one in five deaths, nearly as many as smoking. That makes it an official public health crisis in this country. But what makes us obese?

In general, we’re considered overweight or obese when our weight is higher than a normal weight adjusted for height. Body Mass Index, or BMI, is the tool used for measuring this. BMI, which is related to the amount of fat in our bodies, is defined as weight in kilograms divided by height in meters squared. A BMI of 30 to 39 is considered obese. A BMI of 40 or higher is extremely obese. The higher our BMI, the greater our risk for developing the health problems associated with obesity.

There are several factors that contribute to obesity, but the bottom line is that we become obese when we consistently consume more calories than we burn through normal daily activity. What we eat also plays a role. Foods that are high in fat, sugar and salt cause weight gain. And most of us eat portions that are larger than necessary to satisfy our hunger.

Our genes also play a role. Genetics is a factor in how much body fat we store, where it’s distributed and how efficiently our bodies metabolize the food we eat into energy.

Medical disorders such as Prader-Willi syndrome, a genetic condition, Cushing’s syndrome, a hormone disorder, and arthritis can lead to decreased activity and weight gain. In addition, certain medications including some antidepressants, anti-seizure drugs, steroids and beta-blockers can cause an increase in weight.

Lifestyle and behavioral factors such as a lack of physical activity, smoking, lack of sleep and an unhealthy diet also contribute to the development of obesity. Social and economic factors include not having enough money to buy healthy foods or access to stores that sell healthier food options. Another socioeconomic factor is not having access to a safe place to exercise.

Obesity is a major public health crisis in America that impacts more than 100 million adults and children and is projected to increase dramatically by 2030. Fortunately, obesity and the health and financial consequences associated with it are largely preventable, and that should be our goal.

Steps we can take to help prevent obesity include limiting calorie intake from total fats, shifting away from saturated fats to unsaturated fats. In addition, we can increase our intake of fruits and vegetables, legumes, whole grains and nuts and limit our intake of sugar. We also have to boost the number of calories we burn each day by increasing our physical activity. Health officials recommend at least 30 minutes of regular, moderate-intensity activity on most days.

But it will take more than willpower to change the future. There are already federal and state programs in place to educate about making healthy food and exercise choices and to counter fast food and soda marketing. Additional education and more firepower against the big-money fast-food conglomerates is still needed. Our country’s health, now and in the future, depends on it!

Life Expectancy: We’re Losing It

May 11th, 2020

The US was on the upswing for a while. Between 1959 and 2014, life expectancy for Americans, which is the average length of time we are expected to live, increased by nearly ten years, from 69.9 years to 78.9 years. But something started happening in the 1980s, and the increase slowed considerably. By 2010, it plateaued.

By The New York Times | Source: Journal of the American Medical Association

Between 2010 and 2017, death rates for people aged 25 to 64 increased in nearly every state.

Then in 2014, life expectancy in America began reversing, and by 2017, the latest year for statistics, life expectancy in the US had decreased for three straight years to 78.6 years. Our decline persisted despite the fact that the US spends more dollars per capita on health care than any other industrialized nation.

The findings of a comprehensive study that explored the nature of life expectancy in America as well as possible causes for its decline were released at the end of November and published in the Journal of the American Medical Association (JAMA).

For the study, the researchers reviewed more than a half-century of data from the US Mortality Database and the US Centers for Disease Control and Prevention’s WONDER database. That’s an integrated information and communication system for public health practitioners and researchers.

One key finding of the study was that adults ages 25 to 64, or working-age Americans, saw the largest increase in death rates, a rise of six percent. The increase in death rate in this age group was seen in nearly every state in the US.

According to the study, the death rate in working-age Americans from all causes increased from 328.5 deaths per 100,000 people in 2010 to 348.2 deaths per 100,000 people in 2017. The statistics showed this increase occurred across all racial and ethnic groups.

Dr. Steven Woolf, one of the study’s authors, noted this increase in mortality was driven, in part, by “deaths of despair.” Those include deaths from drug overdoses, which reflect the opioid crisis in this country, as well as those from alcohol abuse and suicide.

Spencer Platt/Getty Images, FILE

Men sit passed out in a park where heroin users gather to shoot up in the Bronx borough of New York, May 4, 2018.

The study found that between 1999 and 2017, fatal drug overdoses by working-age Americans increased by 386.5 percent. Deaths linked to alcohol use, including those from chronic liver disease and cirrhosis of the liver, rose 40.6 percent during those years. And suicide rates by that population rose 38.3 percent.

The study also pointed to health conditions such as diabetes, high blood pressure and heart disease as other causes for the death rate increase. It noted that these conditions are exacerbated by unhealthy behaviors such as smoking, being overweight or obese, eating a high-fat diet and living a sedentary lifestyle, problems that are rampant in our society.

And these problems impacted the death rates for working-age Americans. For example, deaths in this age group linked to obesity increased 114 percent between 1999 and 2017. The majority of American adults, about 71 percent, are overweight or obese. And obesity increases the risk for cancer, diabetes, heart disease and other chronic conditions.

Deaths related to high blood pressure increased by 78.9 percent in the 25 to 64 age group during the same time period. And about 80 percent of American adults don’t meet the physical activity guidelines. If we don’t manage chronic conditions better and change our unhealthy behaviors, our life expectancy will continue to decline.

And according to the new study’s findings, the increase in working-age death rates coincided with major shifts in the US economy dating back to the 1970s and 1980s. It was during those years that the US started to lose manufacturing jobs, and the middle class began to shrink, Dr. Woolf noted.

These loses hit certain areas of the country harder than others, and that is reflected in the statistics. The Ohio Valley, which includes Ohio, West Virginia, Indiana and Kentucky, is part of the  nation’s “Rust Belt.” This area was highly stressed economically with the closing of steel mills and auto plants.

The Ohio Valley, as well as northern New England, which includes New Hampshire, Maine and Vermont, experienced the largest relative increases in working-age mortality rates in the US. Both of these areas were hit hard by the opioid crisis and by declines in their economies

Dr. Woolf said it’s noteworthy that the largest increases were seen in these areas. The people living there have gone through long periods of economic stress, which can lead to a set of consequences that can affect health in many ways.

People struggling financially are more likely to turn to drugs, alcohol or suicide, he said. In addition, they may not be able to afford routine or emergency medical care, prescription medications or healthy food. And they are less likely to effectively manage chronic conditions such as diabetes and high blood pressure. These factors can lead to increases in mortality rates.

It’s pretty clear that reversing the downward trend in life expectancy will take a combined effort on the individual, community and national levels. As individuals, we must commit to changing unhealthy behaviors and eat healthier, exercise more and pay closer attention to our overall health. And we need to put our pride aside and seek help for substance abuse disorders.

Communities must work harder to increase local access to health education and services. And as a nation, we must continue to focus on battling the opioid crisis, tackling the obesity epidemic and increasing economic opportunities, especially in distressed areas. There’s a lot more to be done, but these steps are a good starting point. After all, our lives depend on our action.

Exercise For Mind and Body

May 6th, 2020

The benefits of exercise on physical health are pretty well established. It’s been shown in study after study that regular physical activity helps prevent heart disease and stroke, reduce high blood pressure and cholesterol, control glucose levels associated with diabetes, manage weight and prevent obesity, avoid osteoporosis, and relieve many types of pain, including back pain.

Regular exercise also helps us manage the stress in our lives.

But have you given as much thought to the benefits of routine physical activity on your mental health? It actually has a huge impact. For one thing, exercise releases “feel-good” chemicals such as endorphins and serotonin. These chemicals work to improve mood and reduce feelings of loneliness and isolation. Exercise helps relieve symptoms of mental health conditions such as depression and anxiety and helps with recovery from mental health issues.

In some studies, regular exercise appears to be as effective as existing medication therapy in treating a wide range of mental health conditions, including mild to moderate depression, dementia and anxiety. It has also been shown to help reduce the cognitive issues related to schizophrenia.

Exercise is effective because it works directly on the brain. It increases the volume of certain regions of the brain by pumping extra blood to them. That improves the health of the brain’s nerve cells, or neurons, because more blood means more that oxygen and nutrients are supplied to the neurons. Improved blood flow also increases certain factors that support neuronal functioning.

For some adults, poor mental health may be linked to their lack of exercise as kids. A new study, released February 12 in Lancet Psychiatry, shows that young people who were sedentary between the ages of 12 to 16 had a higher chance of developing depressive symptoms at age 18 and beyond.

During this study, researchers followed 4,257 adolescents for six years starting at age 12. Participants wore accelerometers for seven days at a time that tracked the amount and intensity of their physical activity, and the information was gathered every two years from age 12 to age 18. Participants were screened for depressive symptoms every two years during that time.

Study results showed that higher amounts of time spent doing sedentary activities, such as watching TV, playing video games and surfing the net, were associated with higher depression scores by age 18. The study found that one additional hour of sedentary behavior per day increased depression scores by ten percent.

On the other hand, the study shows that time spent engaging in moderate-to-vigorous physical activity protected adolescents against developing depression later in life.

At this point, most of you are probably thinking, All of the physical and mental health benefits of exercise are great, but how much do I really need to work out to reap them? The answer may surprise you.

The Physical Activity Guidelines for Americans, issued by the US Department of Health and Human Services (HHS), recommends that for substantial health benefits, adults should perform at least 150 to 300 minutes of moderate intensity or 75 to 150 minutes of vigorous aerobic activity per week. The exercise can also be an equivalent combination of moderate intensity and vigorous activity spread throughout the week.

But in its second edition of the guidelines, HHS recognized the value of shorter intervals of exercise as well. And studies conducted over the past several years have borne that out. A French study from 2015 looked at exercise’s effect on the elderly. It found that even low levels of exercise have a protective effect. It led researchers to recommend 15 minutes of “light” activity five days per week to help improve health and longevity in seniors.

In another study on the benefits of short intervals of activity on health, researchers at the University of Utah School of Medicine found that individuals who got up and moved around for at least two minutes for every hour of sitting had a 33 percent lower risk of dying.

The researchers in that study defined “light-intensity” exercise as activities such as walking around the office, using the stairs instead of the elevator, or taking a short walk at lunchtime or while on a coffee break.

Finally, a January 2019 study suggested that short but intense bursts of physical activity offers cardiovascular health benefits. In this study, healthy but sedentary young adults were asked to climb three flights of stairs three times per day three days per week for six weeks. After six weeks, the participants’ aerobic fitness improved by five percent, and they had 12 percent more strength on a cycling test.

Don’t dismiss the health benefits of walking. The results of a 13-year study of 139,000 adults showed that people who fit in just two hours of walking per week were 26 percent less likely to die than sedentary people. Walking can be an excellent way to explore and enjoy your neighborhood as well.

So, don’t fret if you’re not a gym rat. You can still reap the physical and mental health benefits of exercise by simply getting up and moving more. Why not give it a try!

Pink Eye? It Could Be the Coronavirus

April 24th, 2020

The most common symptoms of the coronavirus that has stopped the world in its tracks are fever, coughing and breathing difficulties. But doctors are finding that the respiratory disease known as COVID-19 can also cause an eye infection called conjunctivitis.

The discovery of conjunctivitis in COVID-19 patients is rare. As of mid-April, doctors believed that only 1 to 3 percent of all the people who could contract COVID-19 would also suffer from conjunctivitis, most likely during the middle phase of the illness.

According to one report in the Journal of Medical Virology, a study of 30 COVID-19 patients in China showed that only one had ocular secretions or tears containing SARS-CoV-2 RNA, which is the carrier of the coronavirus’s genetic information.

But another study detailed in the New England Journal of Medicine Journal Watch claimed that a third of the COVID-19 patients in that study had confirmed cases of conjunctivitis, a finding that has since been challenged.

Also known as pink eye, conjunctivitis is what develops when the clear tissue that lines the inside of the eyelid becomes inflamed. The result is red, itchy and swollen eyes, and while conjunctivitis is not a serious condition, it is highly contagious.

Children are highly susceptible to conjunctivitis, which is known to spread easily throughout schools and day care centers. However, having conjunctivitis alone does not mean a person also has COVID-19.

Though it can develop as a result of exposure to viruses, conjunctivitis can also be caused by exposure to certain bacteria as well as more common irritants such as shampoo, dirt, smoke, pool chlorine and eye drops.

Though it’s best to be treated for conjunctivitis by an ophthalmologist, home remedies such as warm compresses and over-the-counter medicines can treat its symptoms. No matter the approach, it usually takes about two weeks for conjunctivitis to disappear.

During that healing period, several steps can be taken to expedite the healing process and protect your eyes from further damage. For example, if you wear contact lenses, wear glasses instead until the conjunctivitis is completely healed.

And don’t rub your eyes. Granted, that’s easier said than done, but treating your itchy eyes with moistening drops or dabbing them with a tissue and immediately throwing the tissue away can help you avoid spreading the condition.

Because conjunctivitis is highly contagious, it can be transmitted by the hands just as the coronavirus can, so washing your hands regularly and avoiding handshakes is another way to avoid spreading the infection.

Melbourne Retirement Community Embraces Virtual Normal

April 20th, 2020

With seniors among the most vulnerable to the spread of the coronavirus, retirement communities are having to step up their efforts to keep residents safe. The real trick, though, lies in not just keeping residents safe but in maintaining a sense of normalcy within such communities.

One community that has managed to meet those two objectives is Hibiscus Court of Melbourne, where the new normal can best be described as a virtual normal. For example, in place of personal visits from family members, Hibiscus Court is conducting virtual visits using video conferencing software such as Zoom.

“We’ve all seen the viral posts of people meeting at windows, and we started with that, but we’ve actually found that it’s better for our residents and their families to have these meetings through Zoom,’’ says Charisse Durham, director of sales and marketing at Hibiscus Court of Melbourne.

“So what we’re doing is teaching the families how to use the Zoom technology, and once we’ve done that, we set up a Zoom meeting for them. During that visit, we are there with the resident to help them navigate through it or translate if they have any trouble hearing or seeing their family members. It’s working out really well.”

Another example of the new virtual normal at Hibiscus Court of Melbourne took place last week, when the community changed up its regular Rolling With Laughter event. When the Hibiscus comedy troupe, “Off Their Rockers” had to cancel its event, the community held a virtual Rolling with Laughter event.

“We accepted submissions from residents, family members, referral sources and care partners,” Charisse explains. “All of them sent in different jokes and we had several different showings for small groups where our programming director and residents presented the jokes.

https://www.facebook.com/HibiscusCourtMelbourneAssistedLiving/posts/1102321070143949

“It went over very well, and for some of our residents who could not attend one of the showings, we went to their rooms and shared the jokes with them individually. We also printed some of the jokes that were short and sweet and took photos of our residents with the joke and a smile then posted them on our Facebook page to share them that way.”

One of the biggest challenges retirement communities now face comes at meal time, when residents typically gather en masse to dine and socialize. Social distancing guidelines prohibit such mass gatherings, however, so at Hibiscus Court of Melbourne, residents are now served the same meals they would receive in the dining room in their own suites or in small, adequately spaced common areas.

That said, socializing is not a thing of the past at Hibiscus Court of Melbourne. Just as it did with its comedy show, the community now conducts several exercise and activity periods each day where small groups of six residents gather and participate while maintaining a safe social distance from one another.

“Another thing we did recently was hold a virtual 99th birthday party for one of our residents,’’ Charisse explains. “We also had a no-contact pet parade, where local participants came and walked their dogs around our parking lot and we let our residents know so they could watch from their rooms or at a safe distance.”

It’s not just the residents of Hibiscus Court of Melbourne who are getting special attention during these difficult times. The community’s staff members, who are working extra hard each day to ensure residents are safe and comfortable, have not been forgotten.

“We’ve had families provide lunch for the entire team; other families have sent gourmet caramel apples or bulk boxes of treats,” Charisse reports. “They know our team works tirelessly to provide the best care for their loved ones. Many families’ have taken the opportunity to say thank you. Even though we’re not in a hospital or skilled setting, we are providing health care and life care and many are working additional hours and occasionally double shifts.

“Our leadership team is also committed to thanking our direct caregivers daily with some item of appreciation. Somebody every day is doing something to say thank you to our team, because they know that we’re here trying to protect people and that our care team also has to take additional measures to protect themselves and their families when they leave, because they can’t bring the virus back into our community.

“It’s a difficult time for everyone but everyone is pitching in and doing what they can to help each other out. The dedication to our residents’ care and the creativity in that is truly remarkable. I’m inspired every day.”

Fort Myers Vein Specialist Answers Call For PPE

April 16th, 2020

The “Hats 4 Heros” program was started by Dr. Joseph Magnant of Vein Specialists and his wife Patty.

Patty Magnant was already busy sewing scrub hats for some local hospital nurses when her husband, a Fort Myers vascular surgeon, learned just how critical the shortage of personal protective equipment (PPE) caused by the coronavirus really is.

“My sister is an emergency room doctor and she shared with me that at hospitals everywhere right now, they’re running low of surgical hats, gowns and masks,” shares Joseph Magnant, MD, FACS, RPVI.

“That’s their equipment and they need it badly, and that got Patty and I thinking that we should start making more of these reusable cloth scrub hats for the nurses and doctors in the ERs and ICUs.”

Dr. Magnant, the founder and CEO of Vein Specialists, which is dedicated to the minimally invasive treatment of leg vein disorders and has offices in Fort Myers and Bonita Springs, began his initiative in early April.

He is one of a host of medical professionals across the state of Florida who are devoting time to helping others during the coronavirus crisis, and within days of he and his wife beginning their initiative, it was already expanding.

“So our initial thought was to make these surgical hats that were more durable, that the doctors and nurses could take home and

Dr. Joseph Magnant is using his surgical skills to produce personal protective equipment for medical professionals fighting on the front lines of the coronavirus pandemic.

wash and wear the next day,” Dr. Magnant explains. “But then we came up with another idea, another way to help out during this crisis.

“When the CDC (Centers for Disease Control and Prevention) came out the other day and suggested that people start wearing face coverings whenever you’re outside of the home, we came up with a way to make those as well.”

Dr. Magnant’s idea for a face covering was inspired by the buffs he’s seen at area sporting goods stores. He and Patty made their first few “re-buffs’’ out of old t-shirts but soon began making them out of a better grade of material they purchased online.

“They’re tubular knit cloths that you can pull up and cover your mouth and nose with,” Dr. Magnant says. “We gave the first few away to friends and neighbors and my parents, and now we’re making them to sell to benefit the Ronald McDonald House Charities.

“I’ve supported the Ronald McDonald House Charities for years, and because volunteers are not allowed to help them cook meals at this time, what they really need right now is money. So, we came up with this idea that we’re calling Hats 4 Heros.”

Every $10 donated to the Ronald McDonald House Charities of Southwest Florida, Hats 4 Heros will donate one hand-sewn surgical cap to a doctor or nurse fighting on the front lines against the coronavirus.

Through the Hats for Heros program, Vein Specialists will donate one hand-sewn surgical scrub hat to an emergency and acute care medical professional somewhere in Southwest Florida for every $10 donated to the Ronald McDonald House charities.

For every $5 donation to the Ronald McDonald House charities, Vein Specialists will donate a hand-sewn Re-Buff to anyone in need of facial protection. A $5 donation can feed one family in need, while a $10 donation can feed two families.

“My expertise is in cutting the patterns,” Dr. Magnant says of his role in the production of the hats and buffs. “Patty does the sewing, and like anything it takes time, but it’s starting to take off.”

Patty and Dr. Magnant have also started a GoFundMe account in an attempt to bring awareness to their cause. It can be found at gofundme.com.

Lighting the Way to More Comfortable Eyes

April 12th, 2020

We all shed tears. Our eyes produce tears continually, and when we blink, those tears spread across the front surface of our eyes to lubricate them. Tears also clear our eyes of debris and protect them from infection. But in some people, tears don’t work the way they’re supposed to and dry eye disease is the result.

If you’re one of those people, you’re not alone.

In the United States, more than 16 million people suffer from dry eyes.  That’s nearly seven percent of the population. And that figure is likely much higher because not all people with dry eye symptoms see a doctor for treatment. But about 33 percent of patients who visit eye doctors complain of dry eye symptoms.

Symptoms of dry eye can be very uncomfortable and include decreased vision or occasional blurry vision, dryness, redness, itching, burning, eye fatigue and the feeling there’s something in your eye. And believe it or not, some people with dry eye experience excessive tearing.

There are two types of dry eye disease. There’s the aqueous-deficient type, which is when your eyes don’t make enough tears. Then there’s the evaporative type, which is when your tears don’t stay on your eyeball long enough to keep it properly lubricated.  Evaporative dry eye disease is the more common of the two.

Most of the time, evaporative dry eye occurs when the eye’s oil glands, the Meibomian glands, become clogged and can’t release the oils necessary for healthy tears. The oil component of tears helps keep them from evaporating off the surface of your eyes.

When the Meibomian glands are clogged, inflammation and an overgrowth of bacteria on the eyelids can also occur, which makes dry eye symptoms even worse. These conditions make it difficult for the Meibomian glands to work properly, which is referred to as Meibomian gland dysfunction, or MGD.

Treatment for MGD typically begins with artificial tears, warm compresses and eyelid cleansing. When these steps fall to improve MGD, and subsequently your dry eye symptoms, there’s a newer treatment available called intense pulsed light, or IPL.

IPL was originally designed for use in dermatology to treat conditions such as rosacea and acne but was introduced into ophthalmology a few years ago. IPL is the use of short bursts of powerful light in various wavelengths to treat MGD. The wavelengths chosen for your treatment depends on your skin color and tone.

The IPL light generates heat below the skin of the eyelids, warming and thinning the thickened oil, or meibum, blocking the glands. Once the meibum is thinned, it can more easily be removed through Meibomian gland expression or MGX. During MGX, the doctor uses a cotton-tipped applicator and manual pressure to squeeze out the meibum from the glands.

In addition to thinning the meibum, IPL also closes the small blood vessels on the surface of the skin that contributes to inflammation. The heat IPL generates also kills the problematic bacteria flourishing on the eyelids. All of these functions have beneficial effects on MGD and, as a result, dry eye symptoms.

During an IPL treatment, the doctor will first place shields on your eyes to protect them from the light. The doctor will also place a thin layer of cooling gel on the areas of skin to be treated. The pulses of light are delivered from the outer area of the right eye, across the cheeks and nose to the outer area of the left eye.

You may feel a warm sensation during treatment, but that’s all. IPL treatment is not painful. A typical treatment consists of about 30 pulses and takes 15 to 20 minutes to complete. Afterward, you may be instructed to use low-dose anti-inflammatory eye drops for a few days.

Many people experience improvement in their symptoms after one IPL treatment, but for best results, a series of four treatments over four months is typically recommended. Maintenance treatments are also recommended every six months to a year.

A number of studies confirmed that IPL reduces both signs and symptoms of MGD and dry eye. In one study, more than 90 percent of patients improved in the three areas used to assess MGD. Results are validated subjectively through your report of symptom improvement and objectively when your doctor examines the surface of your eyes under a light.

Florida Clinic Pitches In To Help Volusia Residents Fight Coronavirus

April 3rd, 2020

The staff at Coastal Integrative Healthcare in Edgewater specializes in physical medicine and stem cell therapy, but when the impact of the coronavirus hit their community this week they put their skills to work in another way.

Bea Johnson fills a container with Coastal Integrative Healthcare’s own home-brew of hand sanitizer.

After learning that many of the people in and around Edgewater were running out of hand sanitizer, the Coastal Integrative Healthcare staff created a homemade version of the disinfectant that is offered up for free to area residents.

“We started hearing about a lot of at-risk people who didn’t have hand sanitizer or ran out of it, and because you can’t find it in the stores right now, we decided to make it ourselves to help people out,” says Timothy Steflik, DC, at Coastal Integrative Healthcare.

Using a recipe that one of their staffers knew, the CIH staff created about six gallons of hand sanitizer by mixing four gallons of isopropyl alcohol with two gallons of aloe gel. They then added some scents to it to erase the clinical odor of the alcohol.

“The isopropyl alcohol is what kills the viruses and mixing in the aloe gel gave it some consistency,” Dr. Steflik states. “The different scents make it smell nice, and once we had it made up, we set up a tent in our parking lot and distributed it from there.”

“We set up the tent so that people wouldn’t have to come into our building and touch the doorknobs and stuff, so it was just like some of the restaurants and places like that offering curbside service.”

Coastal Integrative Healthcare began distributing its homemade hand sanitizer this past Tuesday at 2:30 p.m. Shortly before that, a line of people, many of whom had brought their own containers, had assembled to take advantage of the giveaway.

“We also gave out some small containers that we made up ourselves to people who didn’t have one,” Dr. Steflik says. “The people we served were really happy because they literally couldn’t find it any of the stores.”

Coastal Integrative Healthcare’s giveaway also benefitted a nearby medical clinic that had run out of the disinfectant.

Coastal Integrative Healthcare remains open during the coronavirus crisis.

“We had several nurses and nurse practitioners come over from the Florida Health Care facility that’s just two businesses away from us,” Dr. Steflik confirms. “And that was important because they’re one of the eight testing centers for COVID-19 in our county and they had run out of it. So we filled up the bottles they brought and then gave them some more.”

Dr. Steflik says he is hoping to make another batch of hand sanitizer to give away to area residents and businesses next week. He’s worried, though, that a shortage of one of the key ingredients will prevent that from happening.

“We’re having a hard time buying isopropyl alcohol right now,” he says. “We have access to it through a distributor that most people don’t have and that’s how we got enough to make the first batch.

But it’s getting harder and harder to find. You can’t even buy it on Amazon right now, but we’re going to keep looking because we want to continue to do what we can to help the people in our community in some way.”

 

 

 

 

Anxiety Amid COVID-19

April 3rd, 2020

A national survey conducted March 18 and 19 by the American Psychiatric Association (APA) showed that the COVID-19 pandemic is significantly affecting the nation’s mental health. In the survey, half of US adults reported high levels of anxiety.

Among the survey respondents, 48 percent reported feeling anxious about the possibility of contracting COVID-19 themselves, and 40 percent said they were anxious about becoming seriously ill or dying from the virus. In addition, 62 percent reported being anxious about the possibility of a loved one contracting the illness.

The president of the APA, Bruce J. Schwartz, MD, suggests that this level of anxiety is appropriate given the current circumstances in this country. But he warns that the rate of mental distress in America could surge if the COVID-19 crises continues much longer.

It’s the uncertainty surrounding the COVID-19 pandemic that can cause the physical, emotional and mental reactions in people. If you have a high level of anxiety, you may experience feelings such as anger, rage, confusion, helplessness, sadness, depression and guilt. Other symptoms of anxiety that may occur include:

  • Tenseness or nervousness
  • Constant exhaustion
  • Difficulty sleeping
  • Difficulty concentrating
  • Increased heart rate
  • Stomach upset
  • Constant crying
  • Isolation
  • Heavy use of alcohol and/or drugs

When these feelings don’t go away after a few weeks or get worse, it may be a good idea to seek professional help. Seek help from a trained professional if you or a loved one is unable to return to a normal routine, feel helpless, have thoughts of hurting yourself or others, or begin to use alcohol and drugs to excess.

People with pre-existing mental health conditions are especially vulnerable to stress and anxiety during crisis situations. During this current COVID-19 crisis, these individuals should continue with their treatment and be aware of new or worsening symptoms.

Here’s one example of worsening symptoms. A British charity for people with obsessive-compulsive disorder reports that it has received an increase in calls and emails from people with the disorder who were developing a new fixation on the coronavirus.

For help coping during these anxious times, try these tips, courtesy of HelpGuide article Coronavirus Anxiety:

  • Stay informed, but don’t obsess —  It’s important to check the news to stay informed about what’s going on, especially as circumstances change daily. You need to follow the news to know what to do to stay safe and help slow the spread of the virus. But there’s a lot of misinformation circulating and sensational reporting can fuel anxiety and fear, so be discerning about what and how much you read and watch.
  • Focus on things you can control – There are many things out of your control right now such as how long this crisis will last and how others will respond to it. Focusing on questions without clear answers will make you feel drained, anxious and overwhelmed. Try focusing on things you can control, such as following the recommended steps for preventing the spread of the virus.
  • Plan for what you can do – If you’re worried about your workplace closing, your children being home from school, having to self-quarantine or about a loved one getting sick, make note of these worries. Then, make a list of possible solutions and draw up an action plan. Concentrate your efforts on problems you can solve.
  • Stay connected – It’s been shown that social distancing is helping to curb the spread of the coronavirus, but being physically isolated can add to stress and anxiety. Make it a priority to stay in touch with family and friends. Schedule regular phone calls or chat via video or Skype. Connect with family and friends via social media. But don’t let the coronavirus dominate every conversation.
  • Take care of your body and spirit – The rules of staying healthy are especially important during times like these. Be sure to eat healthy, get plenty of sleep and exercise regularly. Practice a stress-relieving technique such as yoga, deep breathing or meditation to help keep stress at a minimum. Be kind to yourself if you’re experiencing more depression and anxiety than usual. Take time out for activities you enjoy, and try to maintain a normal routine while you’re stuck at home.
  • Help others – Focusing on others in need supports your community, and this is especially true in times of crisis. People who focus on others tend to be happier and healthier than those who act selfishly. Focusing on others can also make a positive impact on your mental health. Doing kind and helpful acts for others can help you regain a sense of control over your life and add meaning and purpose.

Remember, we’re all in this together!

The CBD Story

March 23rd, 2020

It seems like everywhere you look these days, there are ads for products containing CBD. I get emails almost every day hawking these products. But what do we really know about CBD and how does it work? Here’s a little overview of what I’ve learned about it, and it just touches the surface of the CBD story.

CBD, an abbreviation for cannabidiol, is one of the major active ingredients of cannabis, essentially marijuana. CBD is a vital constituent of medical marijuana, but it’s actually derived from the hemp plant, a close relative of the marijuana plant. Unlike its common co-ingredient tetrahydrocannabinol (THC), CBD doesn’t cause a “high.” CBD and THC are called cannabinoids.

In recent years, CBD has been reported to have beneficial effects on a wide variety of health disorders, including epilepsy, Parkinson’s disease, post-traumatic stress disorder, anxiety and chronic pain. Researchers are still studying CBD’s exact method of action on the body, but one thing they’ve uncovered is its effect on the body’s natural endocannabinoid system (ECS).

The ECS is a complex cell-signaling system in the body. It plays a role in regulating a range of functions and processes including sleep, mood, appetite, memory, and reproduction and fertility. There are three main components involved with the ECS: endocannabinoids, receptors and enzymes.

Endocannabinoids, or endogenous cannabinoids, are molecules that are similar to plant cannabinoids, but are made naturally by the body. The two key endocannabinoids are anandamide (AEA) and 2-arachidonoylglyerol (2-AG). These molecules work to keep the body’s internal functions operating efficiently.

There are special receptors found throughout the body that the endocannabinoids can bind to, signaling the ECS to perform a function. The main receptors are CB1 and CB2. CB1 receptors are found primarily in the central nervous system, the brain and spinal cord. CB2 receptors are located primarily in the peripheral nervous system and immune cells.

CB1 and CB2 act as a lock, and the endocannabinoids are the keys. AEA and 2-AG can bind to either receptor, but their effects depend on where in the body the receptor is located and which endocannabinoid binds to it.

Benefits of activating CB1 receptors include relieving depression, reducing fear and paranoia, and lowering inflammation, blood pressure and anxiety. Targeting a CB1 receptor in a spinal nerve may also ease pain.

Changes in CB2 receptor function affects many human diseases including cardiovascular, gastrointestinal, neurodegenerative, psychiatric and autoimmune. Targeting a CB2 receptor in the immune cells can alert you that inflammation is present, which is common with many autoimmune disorders.

In addition, activating CB2 receptors induces immune system cells called macrophages to destroy the beta-amyloid protein that makes up the plaque found in the brains of people with Alzheimer’s disease.3

THC and CBD work on these endocannabinoid receptors as well. THC can bind to either CB1 or CB2 receptors. By doing that, THC has effects on the body and brain. Some of these effects are positive and some are not so positive. THC can bind to receptors and help reduce pain and stimulate appetite, but it can also make you paranoid and anxious.

The way CBD interacts with the ECS is still being investigated, but researchers do know that CBD doesn’t bind to CB1 or CB2 receptors directly. Most researchers believe CBD works by preventing AEA and 2-AG from being broken down, allowing them to have a stronger effect on the body’s proper functioning.

One of the indirect ways CBD induces therapeutic effects is by activating special receptors in the body called TRPV1 receptors. These receptors are involved in regulating pain, body temperature and inflammation.

CBD also inhibits fatty acid amide hydrolase (FAAH), which creates higher levels of the cannabinoids such as AEA, also known as the “bliss molecule.” It plays a role in the neural generation of pleasure and motivation. It also performs other important functions related to eating and embryo implantation during pregnancy.

Because CBD has an effect on the ECS, it helps to promote balance, or homeostasis, in the body. It also reduces the sensation of pain and inhibits inflammation. Research continues on the methods of action of CBD on the body. And as more information is uncovered, more practical uses for CBD may also be discovered. Stay tuned!

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