Blog Posts

Telemedicine Update

August 31st, 2016


telemedicine is a new way to see a doctor.

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Last year, I wrote about the basics of telemedicine. That’s the health care delivery system with which patients connect with their doctors electronically, such as over the phone or via the computer. It represents a huge shift in how Americans access care and how physicians provide it. The growth of telemedicine in the United States is astounding.

Read these statistics. Last year, there were approximately 800,000 online consultations alone in this country. Right now, about 22 percent of employers with 1,000 or more employees offer telemedicine services, and another 37 percent are planning to add them by the end of this year. It is estimated that by 2018, the number of patients using telemedicine will increase to 7 million. That’s 7 million!

The benefits of an electronic doctor appointment are many. It improves access to your doctor for one. You can see or talk to your doctor quicker, and you don’t have to drive to the office and wait your turn to be seen for a non-life threatening illness. It increases the physician’s availability to see more patients, too, so fewer are left without care. And of course, it costs less.

Still, there are some doctors who aren’t totally sold on the idea. They’re concerned about the quality of the care provided when they can’t examine their patients in person. The patient/physician relationship suffers when there’s no physical touching or direct eye contact, they argue.

In this May 2016 Medscape article, writer James M. Lebret, MD, points out that there will always be a need for hands-on visits, but that, in many circumstances, the quality of care for telemedicine patients can be as good as an in-person visit while providing increased access.

The writer stresses that if the physician determines the patient’s illness requires more care than can be delivered electronically, he or she can take the appropriate steps. Lebret quotes Nathaniel Lacktman, JD, partner and head of the telemedicine practice at Foley and Lardner, an international law firm. Just as different clinics have different levels of care, so do telemedicine services, he notes. “Any practice worth its salt will have processes in place for referrals.”

In making his case for telemedicine, Lebret also quotes Richard Boxer, MD, a urologist at Cedars Sinai Medical Center in Los Angeles and former chief medical officer for a major telemedicine vendor. Boxer points out. “Access to care in America is difficult at best. One hundred million people live in physician shortage areas. If the goal is fast and accessible care, I don’t see a future where telemedicine isn’t a significant portion of care.”

There’s a certain amount of common sense that’s needed for telemedicine to be most effective. A telephone or computer appointment works well for illnesses such as flu, chronic cough, rashes, fever and urinary tract infections; chest pain not so much. You still need a full examination from the doctor and, likely, diagnostic tests for that. There’s a lot that can be done these days electronically, but the average person’s technology doesn’t allow for all the bells and whistles. That will come, I’m sure.

It’s clear that there’s both a need and a desire for telemedicine in this country. If we use it right, it can improve access to care for a lot of people, including you and me. I’m up for making life easier with a telephone or computer appointment, how about you?

A Mumps Message

August 10th, 2016
Mumps across the US and how to prevent it and spot it

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The recent outbreak of mumps back in May in New England got me thinking. When I was a child, some of my friends went through mumps, but I got lucky. I had chicken pox, but was spared mumps.

Still, I wondered about them. How do you get mumps and what are they like? As a kid, I knew you got to stay home from school, but that’s about all I knew. And I didn’t know much more about them as an adult. I decided to get the facts about mumps and share them with you.

Mumps is a highly contagious disease caused by a virus of the genus Rubulavirus. It’s not very common anymore since most children are immunized against it when they are young as part of their routine vaccination schedule. However, the vaccine isn’t foolproof, and mumps can still occur in children and in adults, as it did at Harvard University in Massachusetts and also at Sacred Heart University in Connecticut.

Mumps has a bunch of symptoms, but the one most people recognize and remember is swelling of the salivary glands on the sides of the face. This swelling can leave you with a telltale “hamster-like” appearance. Other symptoms include fever, pain when swallowing, feeling tired and weak, joint pain, nausea and reduced appetite.

The mumps virus is spread from person to person through infected droplets of saliva or mucus from the mouth, nose or throat. Passing the virus can be done in several ways. These include sneezing or coughing, sharing eating utensils, sharing food or drink, kissing and touching a common surface after touching your nose or mouth.

An infected person can spread the virus seven days before and for nine days after his or her symptoms start. People with the virus are most likely to spread it one to two days before and five days after symptoms begin. Since you can spread it before you realize you have it, it’s not hard to imagine how quickly an outbreak can occur.

Diagnosis is pretty simple. The doctor will certainly suspect mumps if you have the “hamster face,” but he or she will still take your temperature and a history of all of your symptoms. He or she might take a blood sample to confirm the diagnosis or rule out other disorders as a cause of your symptoms.

Because a virus causes mumps, antibiotics are useless; and right now, there are no antivirals used to treat it. Treatment is aimed at relieving symptoms until the virus can run its course and the body can develop immunity to it. This usually takes about two weeks.

Getting plenty of rest is very important for a quick, complete recovery. Most doctors will advise drinking plenty of fluids, preferably water; using warm or cool (whichever feels better) compresses on your swollen glands; gargling with warm salt water; and taking over-the-counter pain medication for body aches, if needed. Eating a soft diet may also help if chewing or swallowing is painful.

In rare cases, mumps can lead to complications. These occur more often in adults than in children and can include meningitis, inflammation of the membrane that covers the brain and spinal cord, or encephalitis, inflammation of the brain. The virus can also lead to inflammation of other organs and tissues, including the testicles, ovaries, breasts and pancreas.

Common sense is your best armor in the fight against mumps. Don’t share plates or eating utensils with others, or share food or drinks. Cover your nose and mouth when coughing or sneezing. Wash your hands and common surfaces often. Keep some space when in close quarters with other people.

Now that I know more about mumps, I feel blessed that I didn’t have to suffer as a kid like those friends of mine did. But I’m not totally out of the woods as an adult, and neither are you. The prevention measures for mumps also work for colds, flu and a slew of other illnesses, so be sensible and stay healthier.

Close to Home

August 3rd, 2016


Zika virus officially found in the US and can be very dangerrous

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It happened. The Zika virus has struck in the United States, and it hit close to home. It was recently announced that four Florida residents, three men and one woman, were the first known instances of local transmission of the virus.1 Until now, the cases of Zika virus in the US had come after the people traveled to a country where the virus is being transmitted or had sex with someone who traveled to one of those areas.

Local transmission means it was our own mosquitoes that carried the virus. The four North Miami residents who were infected weren’t bitten by carrier mosquitoes somewhere else and brought the illness home with them. They got it right here in Florida.

The Florida Department of Health (DPH) has yet to find any infected mosquitoes in the neighborhood where the four affected people live. None of the mosquitoes DPH has trapped thus far have tested positive for the virus, but that’s a billion-to-one proposition considering the population of the insects in South Florida this time of year. At any rate, the DPH believes the transmission of the virus occurred several weeks ago.

Officials also believe the area of active transmission is confined to the small neighborhood north of downtown Miami. They are still investigating, including doing a door-to-door canvas requesting information and urine samples to determine if any other residents have been infected. They expect more cases.

It wouldn’t be unusual for people infected with the Zika virus to not know they have it. Many people with the virus experience no symptoms, and many who do experience mild symptoms that don’t overly alarm them. The most common symptoms are fever, rash, joint pain and conjunctivitis (red eyes). They might also experience some muscle pain and headaches.

For most folks, the disease that results from the Zika virus isn’t too bad. It causes those uncomfortable symptoms for a few days to a week. However, for pregnant women, the virus can be devastating. It can be transmitted to the baby during pregnancy and can cause a serious birth defect called microcephaly (“small head”) and other severe brain defects. For older individuals, the virus has been known to trigger an uncommon nervous system condition called Guillain-Barre Syndrome.

Keep in mind that the Zika virus is transmitted through the bite of an infected mosquito, specifically a mosquito of the Aedes species (Aedes aegypti and Aedes albopictus). The Centers for Disease Control and Prevention (CDC) reports that these mosquitoes are aggressive daytime biters. That doesn’t mean you’re safe at night. You’re not. They bite at night as well.

The best prevention against the Zika virus, then, is to avoid getting bitten by a mosquito. The CDC has some advice to help you with that.4 There are a few basic tips for preventing bug bites, including those from Zika-bearing mosquitoes.

Use insect repellant. Use a product that contains at least 20 percent DEET. The higher the percentage of DEET, the longer the protection lasts. This maximizes at about 50 percent. Other products also repel mosquitoes, including picaridin and oil of lemon eucalyptus.

Cover exposed skin. When you can, wear long-sleeved shirts, long pants with socks and a hat. This does double-duty because it saves your skin from the harmful effects of the sun as well.

Avoid bugs where you are staying. Choose to stay in places that have air conditioning or windows with screens to keep the mosquitoes out. If such accommodations are unavailable or if you are staying outside, sleep under a net or in a tent that has been treated with insect repellant.

After the four people were found infected in Florida, the CDC said it expects to see more cases of locally transmitted Zika virus in the US. They stress the importance of taking the noted precautions against getting bit, especially for pregnant women.

Even if you don’t live in Florida, don’t take a chance. Mosquitoes are everywhere. Protect yourself from their bites by following the CDC’s advice and using your common sense.




Inattention Blindness

July 20th, 2016
inattention while driving can be dangerous and cause a sense of blindness

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In today’s busy culture, the ability to multitask is considered one of the most valuable skills to possess. We pride ourselves on being able to handle two or more mental functions at the same time. The thing is, research shows that, in reality, that can’t be done. Our brains are not wired that way. That’s why talking on a cell phone, even a hands-free device, while driving is simply not safe.

Many of us do it and think we’re perfectly capable of holding a cell phone conversation and driving simultaneously. Maybe we’ve done it a hundred times with no negative consequences. Or maybe you’re like me and can see how drivers on the phone are not really paying attention to what they’re doing. It makes me crazy!

If you have any doubts, read this White Paper published by the National Safety Council.1 It’s all about the “distracted brain,” and it explains, with supporting research, why talking on a cell phone while driving is very risky behavior. Part of the problem comes from a condition called inattention blindness.

When it comes to safe driving, vision is critical. Drivers on the phone tend to “look,” but not “see.” In fact, estimates indicate that these drivers fail to see up to 50 percent of the information in their driving environment, including pedestrians and red lights. That’s inattention blindness.

You see, our brains simply cannot perform two complex tasks at one time, like conversing on the phone and driving a vehicle. Rather, they switch from one function to another, performing one task at a time.

It happens very quickly, which gives us the feeling we’re doing two things at once, but there’s a fraction of a second delay as the brain switches focus. A fraction of a second affects reaction time and could mean the difference between a crash and a near miss, a death and a saved life.

Many people think hands-free devices and the built-in Bluetooth features found in most new cars are safer. After all, your hands stay on the wheel and your eyes on the road. Still, and the research cited in the National Safety Council White Paper supports this, your brain is distracted with the conversation and not focused totally on the task of driving. The conclusion: hands-free devices are no cure for inattention blindness.

You’ll find little argument that texting while driving is a serious safety risk, but National Safety Council data show drivers on cell phones are involved in more accidents. Of course, more people talk on cell phones than text. The National Highway Traffic Safety Administration estimates that at any point during the day, nine percent of drivers are using cell phones.

That figure is significant because the danger affects not only those nine percent, but also the hundreds of vehicles on the road with them. Drivers on cell phones are not only inattention blind, they’re also less aware of their presence on the road. They’re more likely to stray out of their lanes and miss important traffic signs, making them a hazard to other drivers as well as themselves.

The research cited in the National Safety Council White Paper concludes that the risk of crashing while driving and talking on a cell phone – handheld or hands-free – is about four times greater than when not using a cell phone. Is that enough for you to hang up until you get home?

Have a Pool? Ways to Keep Small Children Safe

July 6th, 2016
pool safety tips for children

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When a small child falls into a swimming pool and no one is watching, he or she can disappear alarmingly fast. Don’t expect to be alerted of trouble. The child is more likely to sink silently. He or she won’t call for help, or thrash in the water in an attempt at survival.

Knowing pool safety rules can prevent such a tragedy and in Florida they are more important than ever. The statistics about child drowning in our state are tragic. According to the Florida Department of Health, the number of toddlers who drown each year would fill three or four preschool classes.

The guidelines for pool safety aren’t always what you might assume.

For instance, who would normally think to install a lock on a pet door because there is a swimming pool in the backyard? Yet a tiny child can slip through a pet door and fall into the pool. It’s why pet door locks are recommended for households with swimming pools when they have infants and toddlers.

A Florida law first passed in 2000 requires new residential pools to be equipped with pool fences that are at least four feet high. Other safety features must be installed, such as alarms on windows and doors with direct access to the pool, in order for a new pool to pass inspection under building codes.

Florida also has developed public awareness campaigns like WaterproofFl to educate parents and caretakers.

They emphasize the “layers of protection,” including vigilance by caretakers, for keeping children safe around swimming pools.

One of the most important is to realize how easy it is to lose track of a child during a lapse of attention. A study in Florida showed child drowning most often occurred when a parent or caregiver was busy with a routine task, like going inside to answer a phone or check on the laundry. In many cases, children were only missing for 11 to 12 minutes before being found in the pool.

These are recommendations:

+ Assign a “designated watcher” to keep eyes on small children when poolside. It might seem like everyone is watching the children at a pool party, but attention is easily diverted. The safest practice is to assign the job to one adult and rotate the duty as needed.

+ Never leave a baby or small child alone near water, even for an instant. This rule applies to kiddie pools and bathtubs, too.

+ Childproof doors, windows and pet doors that allow access to the pool. Features like door alarms, pool alarms and pet door locks can be found at pool supply companies. Also make sure that gates close automatically and are self-locking.

+ Learn CPR and how to resuscitate a child. If the worst happens, you will be prepared and able to administer CPR while waiting for emergency workers to arrive.

The Florida Suncoast Safe Kids Coalition has more information on its website. The site also has an interactive in-home pool safety check. If you have small children and a backyard pool – or are a grandparent with a pool – be sure to take a look.




The Painkiller Problem

June 22nd, 2016
issues with pain relievers can be serious and lead to overdoses

iStock photo

June is National Safety Month, and in 2016, the organizers decided to focus on four areas: medication safety and prescription painkiller abuse; driving, biking and working safely; first aid and emergency preparedness; and preventing slips, trips and falls. These are all important, but right now, I’d like to concentration on the problem with painkillers.

It’s more than a “problem” actually. Everything I read refers to the issue of prescription painkiller abuse as an American epidemic. The American Society of Addiction Medicine (ASAM) reported on the 21.5 million Americans age 12 or older who had a substance use disorder in 2014, the latest year of available statistics. Of those, 1.9 million had a disorder involving prescription pain relievers.

ASAM tells us further that addiction to prescription painkillers – specifically opioids such as oxycodone, hydrocodone, codeine and morphine – caused 18,893 overdose deaths in 2014. Heroin, which is also an opioid, led to an additional 10,574 overdose deaths. Research has shown that four out of five new heroin users started by misusing prescription painkillers, and four percent to six percent of painkiller abusers transition to using heroin.

According to the US Centers for Disease Control and Prevention (CDC), men are more likely to die of an overdose of prescription painkillers, but the problem is increasing significantly in women. Deaths in women have increased 400 percent since 1999 compared with 265 percent in men. Approximately 18 women die every day from an overdose; and for every one of them, 30 more seek emergency room treatment for abuse or misuse of painkillers.

The CDC points out an interesting fact. Since 1999, the amount of prescription opioids sold in this country nearly quadrupled. However, there has not been a corresponding increase in the amount of pain reported.4 The National Safety Council (NSC) tells us that 70 percent of people who have abused prescription painkillers got them from a friend or relative. The NSC also notes that sharing opioids is a felony. I didn’t know that.

Dr. Sanjay Gupta, chief medical correspondent for CNN, reports on that the prescription painkiller epidemic is a uniquely American problem. He writes that, “As of 2011, 75 percent of the world’s opioid prescription drugs are prescribed and swallowed up in a country that makes up less than five percent of the world’s population, leading to the most common cause of preventable death in America today.”

How did we get here? Some people want to blame the doctors. Some want to blame the insurance providers, and some want to blame the pharmaceutical companies. The reality is we all had a part to play in this mess, including us – the patients. We all wanted the quickest, easiest and least expensive way (compared to a multidisciplinary approach) to treat pain, and pills were the way to go. I can’t speak for the doctors, insurance or pharmaceutical companies, but as a patient, I didn’t see results this damaging coming.

Even now, the CDC and other groups are trying to establish standards for the prescribing of opioids and for providing increased follow-up of patients taking these medications to prevent overuse and abuse. Some physicians view the standards as interfering with their medical practice and with making the most appropriate decisions regarding their patients. I can understand that; I don’t like a lot of rules and regulations interfering with my decisions, either, but can’t we find a common ground on this issue for everyone’s benefit?

Rating the Country’s ‘Fittest Cities’

June 15th, 2016
fit cities in the country and where tampa fits in

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You’ve probably heard this advice about fitness: To get more exercise, get a dog. You’ll be forced to go on walks.

For cities, that adage might include get more dog parks.

The number of dog parks per capita is one of the indicators used in the American Fitness Index to determine fitness scores for the country’s 50 largest metro areas.

The annual index is from the American College of Sports Medicine and the Anthem Foundation. And for 2016, it names Washington, D.C., as the nation’s fittest city. It’s the third year in a row that Washington has earned No. 1 status. The assessment includes Washington’s vast suburbs in neighboring Virginia and Maryland.

Second fittest city, according to the index, is Minneapolis-St. Paul. Third is Denver. At the bottom is Indianapolis, Oklahoma City and Louisville.

Florida cities and their surrounding regions place in the middle and downward. Of the country’s largest metro areas, Tampa is No. 26. Jacksonville is 31; Miami follows at 32; and Orlando is 43.

So what does it mean to be a fit – or less fit – city?

First of all, the American Fitness Index isn’t looking for how many residents are marathoners or have athlete-level lung capacity. Health of residents is important, but so are their health behaviors, such as how many smoke.

Further, urban planning plays a role because the built environment can affect whether a community is fitness-friendly. For example, how easy is it to get around on foot?

The index also identifies target goals for each area and how they are being met.

Part of what puts Washington, D.C., on top are amenities that support active lives. In Washington, a higher percentage of people are cycling or walking to work, and more live within a 10-minute walk to a public park.

The nation’s capital and its suburbs also earned points because fewer people are dying of heart disease and diabetes, and there are fewer smokers.

Ranking Florida

In looking over scores for Florida cities, I can see that the index gives Tampa points for meeting or exceeding target goals for the number of ballparks, dog parks, playgrounds, golf courses, recreation centers and swimming pools.

However, maybe more people should be taking advantage of those recreational facilities. The index notes that Tampa residents could improve in how many get recommended amounts of exercise. They also aren’t meeting target goals for lowering rates of obesity or how many are dying from diabetes.

Miami earned points for lower rates of asthma and cardiovascular disease. It could improve through developing more parkland, ballparks and golf courses. It also could use more farmers markets.

Jacksonville is praised for its higher number of recreational facilities, like swimming pools, and for a higher level of physical education classes. Improvements are needed in the percentage of people using public transportation to get to their jobs and how much is spent on parks.

Orlando also won points for more phys-ed classes, along with more recreation centers. The index recommends nearly 20 areas to prioritize for improvement in the Orlando metro region, including how many people are obese or have asthma, heart disease or diabetes. Also, more dog parks, golf courses and ball diamonds would be a plus for this central Florida metropolis.

By the way, the index relies on the following guidelines from the Centers for Disease Control and Prevention to determine whether adults are getting enough exercise. How do you measure up?

  • Adults: 150 minutes of moderate-intensity aerobic exercise, like brisk walking, every week, or 75 minutes of vigorous-intensity exercise like jogging or running. Strength-training exercise that works all muscle groups at least twice a week.


  • Older adults: 300 minutes of moderate-intensity or 150 minutes of vigorous-intensity aerobics. Strength-training sessions at least twice a week.



Surviving Summer Heat

June 8th, 2016
Summer heat can lead to heat-related illness. Know how to protect yourself

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Summer is almost here, and most of the country will soon be bathed in summer heat. Here in Florida, we’ve already gotten a taste of the warmer temperatures, with more to come. However, prolonged or intense exposure to high temps can lead to a host of heat-related illnesses.

How does this happen? Your body naturally cools itself off through sweating, but it has to work overtime in the extreme heat. As it tries to do this, blood rushes to the surface of the skin, reducing the blood going to your brain, muscles and other organs, ultimately affecting your physical strength and mental capacity, which is why it’s important to understand the effect of heat-related illnesses. Among the more serious heat-related illnesses are heat cramps, heat exhaustion and heat stroke.

Heat cramps are muscle pains that might occur in association with strenuous activity. They can also be a first sign of a more serious heat-related illness, such as heat exhaustion. They are painful muscle cramps or spasms usually in the legs or abdomen. They might also be accompanied by heavy sweating.

Heat exhaustion can result when you lose large amounts of fluids and salt through excessive sweating, which can occur if you’re exercising or doing physical work in the heat. Symptoms of heat exhaustion include heavy sweating; weakness; cool, pale, clammy skin; fast or weak pulse; dizziness; and nausea or vomiting. You might also have muscle cramps.

Heat stroke is serious stuff, and it requires immediate medical attention. If not addressed, it could lead to permanent disability and even death. Heat stroke is the result of the body’s inability to regulate its internal temperature, and excessive internal temperature can damage the brain and other organs.

Signs of heat stroke include changes in mental state, including confusion; hot, red, dry or moist akin; a body temperature above 103 degrees F and a rapid pulse. You also might have a throbbing headache, dizziness and shallow breathing; and in more severe cases, you might faint or lose consciousness.

If you notice symptoms of a heat-related illness, get out of the sun. Move to a shady place outside or go indoors to escape the heat. Loosen any restrictive clothing and apply cool, wet cloths to the skin. Ice or cold packs placed in the armpits, neck and groin areas also helps lower temperature. Slowly drink cool fluids. If you suspect heat stroke, seek medical attention immediately.

With a little advance planning and some common sense, most episodes of heat-related illness can be prevented. Here are a few tips to help you prepare for the hot summer sun. If you’d like more tips or a little more detail, check out this article.

  • Keep yourself well hydrated with cool fluids. Don’t wait until you feel thirsty to take a drink.
  • Dress appropriately in lightweight, light-colored and loose-fitting clothing. And don’t forget your sunscreen.
  • Plan your most strenuous activities for the coolest part of the day.
  • Consider your diet. Try a sports drink to replenish the salt and minerals you lose when sweating. Avoid hot foods and heavy meals to lessen the heat your body naturally produces.
  • If you’re not used to the heat, give yourself time to adjust to it before spending an afternoon in the sun.
  • Don’t forget Fido. Keep pets cool by making sure they have shade if they’re outdoors, and give them plenty of fresh, cool water.

Take the time for a few precautions, and you can survive the summer heat no matter where you live.

What is Pre-Diabetes and How do I Know if I Have It?

June 1st, 2016
iStock photo

iStock photo

Years ago one of my relatives developed Type 2 diabetes. I knew nothing about diabetes at the time. I accompanied him to see a hospital dietitian, where basically he was told: here’s what you can eat, here’s what you can’t; go home, follow the rules and you’ll be fine.

Since then, I’ve learned that diabetes is far from simple. Managing it requires meticulous self-care. Many people are successful, but many are not. A lot of diligence is required to stay healthy.

It’s worth taking the time to learn about Type 2 diabetes, which affects 90 to 95 percent of all diabetics.

One of the most important things to know is whether you are at risk of developing Type 2 diabetes, which affects 90 to 95 percent of diabetics.

It typically won’t appear without warning. Unfortunately, that warning is often silent and only evident in blood tests.

But it’s one you don’t want to miss because there is really good news about the warning stage of diabetes. Health professionals compare it to hazard lights that appear suddenly on an automobile dashboard. Do something instead of waiting for the problem to get worse and you’ll save time and trouble.

Type 2 diabetes occurs when the body’s use of glucose becomes impaired. Glucose, also referred to as sugar, is an energy source derived from food and normally enters cells as fuel.

When that process no longer works like it should glucose levels rise in the blood. Abnormal blood glucose levels can cause all sorts of problems over time from damaging delicate blood vessels in the eyes to blunting wound healing.

The warning stage is pre-diabetes when blood glucose levels are higher than normal but not high enough to diagnose full-blown diabetes. One in three Americans are pre-diabetic, according to the Centers for Disease Control and Prevention, and most don’t know it.

There is really good news about pre-diabetes, however, which is why it’s important to know whether you have it. Pre-diabetes can be reversed through modest amounts of weight loss and exercise.

Health professionals recommend routine screening for pre-diabetes after age 45 or earlier if you are African American or Hispanic, overweight, had the type of diabetes that occurs during pregnancy, have a family history of diabetes and other risk factors of pre-diabetes.

If tests show you’re pre-diabetic, now is the time to take action. More than a decade ago, a landmark study showed it is possible to turn things around. The study found that these two steps stop progression to actual diabetes or delay it significantly:

  • Lose a relatively small amount of weight if you’re overweight or obese; just a 10 percent weight loss can make a big difference.
  • Get more exercise; a brisk, half-hour walk most days can help tune up how your body processes blood sugar.

Of course, changing lifestyles is easier said than done. Humans may have been built to move and eat a variety of nutritious food that doesn’t come in a box or through a drive-thru window. But in today’s world, that can be far from simple.

And because pre-diabetes can occur without obvious symptoms, it’s easy to not think about and put off any intentions to change.

If you find that you’re stalling, there is a program that can help. It’s called the National Diabetes Prevention Program and its “lifestyle change program” offers classes and coaching through places like the YMCA and county health departments.

Check them out – and get a blood sugar test to see where you stand, if you’re at risk.

Regulating e-Cigarettes

May 25th, 2016
regulations on ecigarettes and hookahs

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Good or bad? It depends on what side you’re on. This month, the Food and Drug Administration (FDA) announced that it’s taking regulatory control over e-cigarettes and hookahs. It established rules for the “vaping” business similar to the regulations imposed on tobacco-based cigarettes.

E-cigarettes have consistently grown in popularity over the years. Currently, there are an estimated nine million adult e-cigarette users in the United States. Their use has increased in teens as well, as noted in the National Youth Tobacco Survey. This survey collected data from about 20,000 middle and high school students across the country every year from 2011 to 2015.

Results of the survey indicated that high school students reporting the use of an e-cigarette in the last month rose from 1.5 percent in 2011 to 16 percent in 2015. In middle school students, the increase was from 0.6 percent to 5.3 percent. The use of hookahs also increased, from 4.1 percent to 7.2 percent for high school students and from 1 percent to 2 percent in the middle school group.

Despite the FDA’s move, the public health community is still debating the issue of safety with e-cigarettes. Some say they can help people quit smoking, while others are certain they eventually lead people, especially young people, to move on to traditional cigarettes. And no one wants that. There are 480,000 tobacco-related deaths in the United States each year already.

So, what are the new rules that e-cigarette manufacturers and sellers have to follow. This article3 gives you a down-and-dirty summary of what’s involved and what isn’t, but I’ll address a few of the highlights here.

First of all, the new regulations ban the sale of e-cigarettes to anyone under the age of 18, and that might mean showing a photo ID to prove your age. This comes as some states, including California recently, are increasing the age to buy traditional cigarettes to 21. Vendors who are caught selling e-cigarettes to minors will be fined.

Also, part of the new rules is a requirement that makers and sellers of vaping products provide the FDA with a detailed description of the ingredients in their products, as well as their manufacturing process. They also must be able to prove any claims they make about their products, such as, “They are safer than traditional cigarettes.”

However, advocates for the regulations were disappointed to discover the new guidelines did not include a prohibition against flavored e-cigarettes and cigars. They argue that flavored products appeal to younger people and get them hooked on smoking. It’s possible the FDA will take up this fight at a later date.

You’ll still see ads for e-cigarettes, though. The regulations don’t ban advertising for these products. That seems odd to me. I get a few magazines at home, and there are full-page ads for e-cigarettes in all of them. It makes me wonder. What message are we really sending?







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