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Mother’s Day – Coping Strategies For Those Who’ve Lost A Mom

May 10th, 2009 by Joseph Banken, Ph.D. in Better Health Network, Health Tips

Tags: Coping, eDocAmerica, Joseph Banken, Mom Passed Away, Mother's Day, Psychiatry, Psychology, Without Mom

Web pages and blogs are full of gift idea do’s and don’ts for your mother. I won’t go there. I think the topic has been covered quite nicely by better shoppers than I could ever hope to be.

You’ve also, no doubt, been bombarded with the plethora of tear jerker emails cautioning you to spend time with your mother while you can. She’s older than you, you know, and may not last until next year for you to make it up to her if you miss this Mother’s Day. That topic’s been covered too.

I’d like to talk with you a little bit about how to get through Mother’s Day after you’ve lost your mother. And I especially don’t want to forget the reverse situation; how to cope with Mother’s Day if you have lost a child, the hardest pain of all to overcome.

So how do you survive this Sunday if half of the equation is missing? You could hide under the covers until Monday. The protective property of the blanket works for monsters under the bed, why not against monsters of the heart as well? You could ignore that the day has any other meaning and treat it like any other Sunday, but that tends to backfire with a nasty trap of emotions smacking you back into reality the hard way at the worst possible time. Don’t let it catch you off guard; the day is coming whether you are ready for it or not. Or you could cry in your beer (over 21, please), but that just makes your eyes red and dilutes the beer.

Here are some coping strategies for bereavement:

• Talk about it with a friend or family member you trust to handle the sensitive and powerful emotions you feel towards Mother’s Day
• Realize that Mother’s Day is only one day out of the year and it has been commercially blown out of proportion and this too shall quickly pass
• Be around friends who understand and can help you cope with the day
• Acknowledge it can be a hard day and distract yourself with a movie or something that has a positive and endearing memory of what this day was initially designed to represent

And remember that your mother will always be your mother no matter where she is. And the same goes for mothers who have lost children. Once a mother, you will always be a mother even if you can no longer hold them in your arms.

If you are an eDocAmerica participant, you can send a message to the ePsych Psychologist for individualized coping strategies. Many people use this helpful option with good results whether it’s Mother’s Day or not.

All comments welcome.

*This blog post was originally published at eDocAmerica*

Alcohol At The Beach

April 29th, 2009 by Paul Auerbach, M.D. in Better Health Network, Health Tips

Tags: Addiction Medicine, Alcohol, Beer, Dr. Paul Auerbach, Drinking, Psychiatry, Swimming

In continuing with the theme of getting ready for the beach and water sports this summer, let’s consider what to do about substance abuse. There is no controversy whatsoever about the fact that persons under the influence of alcohol or any other mind-altering substance have a higher incidence of accidents. In fact, ingestion of alcohol figures prominently as a statistic in falls, drownings, motor vehicle accidents and virtually every variety of activity that has ever been studied. The issue, then, is not whether or not alcohol contributes to illness and injury, but to what extent we are able to control its use by reason and, when necessary, prohibition.

Im June of 2008, Solana Beach, California banned alcohol consumption on its beaches for at least a year. This ban continues. Here is what appears on the city’s website:

Alcoholic Beverages – Alcohol is banned at all beach areas in Solana Beach. Alcohol is also prohibited in the parking lot, community center, viewpoint or any other public place adjacent to the beach. Glass is prohibited as well.

There are similar rules at, among others, Torrey Pines State Beach, Cardiff, San Elijo, South Carlsbad and Carlsbad state beaches.

City officials made this move proactively, to avoid the sorts of tragedies and social problems that have intermittently plagued “wet” beaches. Recognizing that judgment is often an irrelevant factor when it comes to drinking alcohol, they made a strong and, in my opinion, laudable move. Like it or not, judgment is impaired by drinking alcohol, so the concept of “responsible drinking” is an oxymoron when water sports and potentially hazardous surf conditions coexist with beer, wine, and liquor. Of course, the same is true for certain prescription drugs and illicit drugs.

Needless to say, civil libertarians and numerous other individuals are opposed to mandated prohibitions. They cite lack of observation of problems, principles of freedom and personal rights, and even the loss of romanticism. The issue obviously has two sides.

From a safety perspective, it’s a no-brainer. There’s no benefit to drinking alcohol and entering the ocean. It can never make you safer, and can only make you less safe. Even if you are able to drink alcohol at the beach and safely dispose of your metal cans and glass bottles, not litter, not be rowdy or obnoxious, and keep your drinking to yourself, the moment you dip a toe, you are a greater risk to yourself and to the lifeguards and other rescuers entrusted to protect you. You may not believe that to be the case, but the stories and statistics don’t support you. Having pulled intoxicated victims from the water, treated them at the scene, stitched their heads and set their broken bones in the emergency department, and having had to tell their families and friends that they are dead (while knowing that none of this would have ever happened had the victims been sober), I am offering well-intentioned advice. Not every city will mandate that you leave your beer cooler at home when you head to the beach. When you need to be the one to decide, choose wisely.

Preview the Annual Meeting of the Wilderness Medical Society, which will be held in Snowmass, Colorado July 24-29, 2009.

Join me from January 24 to February 2, 2010 for an exciting dive and wilderness medicine CME adventure aboard the Nautilus Explorer to Socorro Island, Mexico to benefit the Wilderness Medical Society.

photo courtesy of www.aquaticsafetygroup.com

*This post, Alcohol At The Beach, was originally published on Healthline.com by Paul S. Auerbach, MD, MS.*

New Research On Eggs

April 28th, 2009 by admin in Better Health Network, Health Tips

Tags: Diet and Nutrition, Eggs, Food and Nutrition, Nutrition, Tara Gidus

A meeting this week called Experimental Biology had some really interesting new research presented on eggs. I have written about eggs in the past and tried to clear up some of the confusion around whether they are good or not. Check out my past blog called The Incredible Edible Egg for more background on nutritional plus’s and minus’s on eggs. I also wrote a fun post on eggs which included some food safety tips. I personally love eggs and my favorite way to eat them is a spinach and feta omelet! Mmmmmm……

Here are some of the findings presented at Experimental Biology 2009 this week:
Eggs for Breakfast Helps Manage Hunger and Calorie Consumption
A study led by Maria Luz Fernandez, Ph.D., professor in the department of nutritional sciences at the University of Connecticut, investigated the differences in post-meal hunger and daily caloric intake when eating a breakfast of either protein-rich eggs or carbohydrate-rich bagels. Although the two breakfast options contained an identical amount of calories, the researchers found that adult men who consumed eggs for breakfast:

• consumed fewer calories following the egg breakfast compared to the bagel breakfast
• consumed fewer total calories in the 24-hour period after the egg breakfast compared to the bagel breakfast
• reported feeling less hungry and more satisfied three hours after the egg breakfast compared to the bagel breakfast

Protein for Breakfast Helps Teens Control Appetite
Researchers from the University of Kansas Medical Center assessed the impact of a protein-rich breakfast on appetite and overall calorie consumption among teens who traditionally skip breakfast. While each test breakfast contained 500 total calories, the researchers examined variables including the protein form (solid food or beverage) and the amount of protein versus carbohydrate in the breakfast.

• Teens consumed fewer calories at lunch when they ate a protein-rich breakfast of solid foods compared with a protein-rich beverage breakfast
• Post-meal hunger was significantly reduced when the teens ate a protein-rich breakfast of solid foods

Cracking Open Heart Health Myths
Florida State University researchers examined the relationship between cardiovascular disease (CVD) risk factors such as body mass index, serum lipids and levels of high-sensitivity C-reactive protein (hs-CRP) (a marker for inflammation), and the degree to which these factors are influenced by dietary intake of fiber, fat and eggs. The study found:

• No relationship between egg consumption and serum lipid profiles, especially serum total cholesterol, as well as no relationship between egg consumption and hs-CRP
• A positive correlation (meaning the more the higher the risk) between dietary trans-fat intake and CVD risk factors, as well as a negative correlation (meaning lowered risk) between fiber and vitamin C intake and CVD risk factors

These studies support more than 30 years of research showing that healthy adults can consume eggs as part of a healthy diet. Eggs are all-natural and packed with a number of nutrients. One egg has 13 essential vitamins and minerals in varying amounts, high-quality protein and antioxidants, all for 70 calories. Eggs are also an excellent source of choline, an essential nutrient vital for fetal and infant brain development but also good for everyone.

For more information, check out the Egg Nutrition Center

What To Do About Excessive Sweating

April 24th, 2009 by RamonaBatesMD in Better Health Network, Health Tips

Tags: Dermatology, hyperhidrosis, perspiration, Plastic Surgery, sweating, treatments

I have a nephew who has excess sweating of his feet which began as a child.   The problem has not gone away as he got older, nor has it spread to other parts of his body.  He has tried the new socks that say they will absorb sweat and keep the feet dry.  None of them work for him.  So this post is for him as I look for ways to help him.

Sweating is the release of a salty liquid from the body’s sweat glands.  Sweating or perspiration is important in cooling the body.   It is common to sweat under the arms, on the feet, and on the palms of the hands.

When the production of sweat is in excess of the amount needed for cooling the body (thermal regulation) it is call hyperhidrosis (excess sweating).

Hyperhidrosis may be primary or secondary.  Primary (essential)  hyperhidrosis is excess sweating in an otherwise healthy individual, like my nephew.

When excessive sweating affects the hands, feet, and armpits, it’s called primary or focal hyperhidrosis. Primary hyperhidrosis affects 2 – 3% of the population.  Less than 40% of patients with this condition seek medical advice. In the majority of primary hyperhidrosis cases, no cause can be found.   It appears to run in families.

Secondary hyperhidrosis is associated with any number of systemic illnesses.  These including pheochromocytoma, thyrotoxicosis, diabetes mellitus, diabetes insipidus, hypopituitarism, anxiety, menopause, carcinoid syndrome, and drug withdrawal.  Nocturnal sweating, in particular, may be a clue to the diagnosis of tuberculosis, lymphoma, endocarditis, diabetes, or acromegaly.  Treatment of the underlying disease will decrease or cease the excess sweating in secondary hyperhidrosis.

Several common medications occasionally produce hyperhidrosis. These include tricyclic and serotonin reuptake inhibitors, opioid analgesics, acyclovir, and naproxen.

When looking for underlying health issues, it is important to know if there are any triggers (stress, anxiety, food, etc), if the sweating occurs mostly at night or during the day, which areas of the body are involved, is there an elevated body temperature, or any other problems.

You should see your doctor, if:

• You sweat a lot or if sweating lasts for a long time or can’t be explained.
• Sweating occurs with or is followed by chest pain or pressure.
• Sweating is accompanied by weight loss or most often occurs during sleep and associated with a fever.

Treatments may include:

• Antiperspirants. Excessive sweating may be controlled with strong anti-perspirants, which plug the sweat ducts. Products containing 10% to 15% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Antiperspirants can cause skin irritation.  The strong doses of aluminum chloride can damage clothing.
• Medication. Anticholinergics drugs, such as glycopyrrolate (Robinul, Robinul-Forte) are rarely helpful.  Beta-blockers or benzodiazepines may help reduce stress-related sweating.
• Iontophoresis. This FDA-approved procedure uses electricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. The electricity is gradually increased until the patient feels a light tingling sensation. The therapy lasts about 10-20 minutes and requires several sessions. Side effects include skin cracking and blisters, although rare.
• Botox. Botulinum toxin type A (Botox) was approved by the FDA in 2004 for the treatment of severe underarm sweating, a condition called primary axillary hyperhidrosis. Small doses of purified botulinum toxin injected into the underarm temporarily block the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms.
• Endoscopic thoracic sympathectomy (ETS). In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended. The procedure is usually performed on patients with excessively sweaty palms. It is not as effective on those with excessive armpit sweating. This surgery turns off the signal which tells the body to sweat excessively. ETS surgery is done while the patient is asleep under general anesthesia.  The surgery takes about a half hour. Patients usually go home the next day, but may experience pain for about a week.  ETS requires special training so make sure your doctor is properly trained. Risks include artery damage, nerve damage, and increased sweating. New sweating occurs in about 50% of patients.

References

Goldman L, Ausiello D. Cecil Textbook of Medicine, 22nd ed. Philadelphia, Pa: WB Saunders; 2004:2365, 2446-2447.

Hyperhidrosis; eMedicine, May 2, 2008; Robert A Schwartz, MD, MPH, Rachel Altman, MD,  George Kihiczak, MD

*This blog post was published originally at Suture For A Living.*

Important reminders for parents of newborns

April 23rd, 2009 by Stacy Stryer, M.D. in Health Tips

Tags: immunizations, newborns, sids, Stacy Beller Stryer, stacy stryer

A big part of pediatrics is what we call “anticipatory guidance” and preventive medicine.  This is where we get to impart our wisdom on parents, particularly the vulnerable, first-time ones.  For them, everything is new, exciting and, yes, anxiety provoking.  We hope that we can teach and guide them to raise medically and psychologically healthy children.  One of the first and most important things we can do is stress the importance of immunizing children on time.  I know – I have talked about this ad nauseum!!  But that is because when newborns, children and, yes, adults, are not adequately immunized, they are at risk of developing serious illnesses.  As you may recall, I blogged a couple of months ago about the haemophilus influenzae outbreak in Minnesota, where several children became ill and one died.  Well, guess what?  Now there are cases of measles in my hometown, Rockville.  It appears that an unimmunized adult contracted it and has infected several others, including an 8 month old child who is too young to have received the routine immunization.
But, believe it or not, I am not blogging about immunizations today.  It appears that this is just an example of what happens years after a successful plan has been implemented.  Because we don’t see many of these infections anymore, we aren’t routinely reminded of the importance of preventing them.   We seem to have forgotten that the reason we don’t see many of these deadly infections is precisely because children have been vaccinated.  So … the vaccination rate drops, and as the vaccine rate drops, the risk of contracting one of these illnesses rises.  I can guarantee that if we had an epidemic of measles here, with kids dying, parents would be lining up to ensure their kids were adequately immunized.
Well … it’s the same with ALWAYS putting your infant to bed on the back.  Multiple studies have demonstrated a significant increase in the risk of sudden infant death syndrome (SIDS) with placing your infant stomach-side down to sleep.  My recollection from when this recommendation first came out is that almost all parents put their infants on their backs to sleep.  Now, however, more and more parents are telling me that they are putting their infants on their stomachs to sleep because they sleep better.  Or, they are watched by a grandparent during the day, who puts them to sleep on their stomachs.  Well … it is even worse to put an infant on its stomach sometimes rather than always (not that I am EVER recommending stomach sleeping).
A study published in this month’s journal, Pediatrics, evaluated 333 infants in Germany over a 3 year period.  As noted in previous studies, those who were placed prone to sleep were at greater risk of dying from SIDS, particularly those who were not used to sleeping prone.  Other factors which increased the risk of SIDS were covers, sleeping at a friend or relative’s house, and sleeping in a living room.  The only factor which decreased the risk of SIDS was the use of a pacifier at night.   With such compelling evidence which supports many other studies on SIDS risk factors, there is no reason to place our infants on their stomachs to sleep – ever.    This includes when they are with any caretaker, including grandparents, nannies, and other relatives.
So let’s not become complacent about treatments that work.  Continue to immunize.  Continue to place infants on their backs to sleep.