florida health news - september 2009 issue

THE BEST INFORMATION IN YOUR HANDSNo. 6 • September • 2009 www.floridahealthnews-online.comSERVING PALM BEACH COUNTYAND SURROUNDING AREAS

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'Organic'May Not Mean Healthier

According to a British review of studies done over the past 50 years, organ-ic and conventionally produced foods have about the same nutrient con-tent, suggesting that neither is better in terms of health benefits. PAGE 8

Selff inflicted abuse ................................................................................2Foods that burns calories! ......................................................................3More Kids Becoming Severely Obese ....................................................45 tips to keep your home safe in an emergency ....................................5'Organic' May Not Mean Healthier ..........................................................6Many Cancer Survivors Don't Adopt Healthy Lifestyle............................7A Visit To The Doctor ..............................................................................8iMedX Announces Acquisition of Medware Inc. ....................................11House health plan to boost taxes on rich..............................................125 Neat and easy ways to burn calories all day, every day! ..................13For Macho Men, Doctor Visits Are Less Likely ....................................14Tips to protect your pet from summer heat ..........................................15

Many Cancer Survivors Don't Adopt HealthyLifestyle. PAGE 7

Analysis: Health care debate a long-runningstory. PAGE 8

Wish Fulfillment? No. But Dreams (and Sleep)Have Meaning. PAGE 13

Also in this issueTips to protect your pet from summer heat.

PAGE 15

2 SEPTEMBER • 2009 FLORIDAHEALTHNEWS-ONLINE.COM

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By Leah James

Self Inflicted AbuseHold on to your health like dear life!! Good

health precedes long life. Let us start withdrugs,medicines and the like, some of

which can be actually deleterious to one’s healthwhen abused as well as have harmful sideeffects.

Now, talking about drug abuse and dying fromoverdosing is a known age old fact. Targetingillegal drug peddlers and illegal manufacturers isone way to curtail the flow of illegal drugs. Anotherpossibly more effective way would be to target,apprehend, and arrest the users and abusers.Why are the lawmakers not making the abuse ofillegal drugs unlawful? In my opinion if a person’sblood sample is tested positive for a street drugwhy should not this person be arrested? Ironicallyif this same individual fails an alcohol breathalyzertest, he/she immediately goes to jail.

When patients get admitted to a hospital withdrug overdose taken recreationally, and found tohave cocaine, cannabinoids (marijuana),barbiturates etc, they are treated and dischargedhome. There is no law that requires the hospitalor the doctors to report this to the lawenforcement. Why not? After all, if the samepatients were seen carrying the same illegaldrugs they would be arrested by law enforcementofficers.

In most cases, as long as the person abusingstreet drugs is proven to be 'sane' then thatperson should definitely be targeted by lawenforcement. This measure will in turn stemthe sale/flow of illegal drugs from outsidesources that prey on the drug users ascustomers for their gainful business.

So, STOP the user from using illegal drugsby combining the efforts of doctors, hospitalsand law enforcement officers. This willdefinitely stem the flow of illegal drugs intothe United States.

Building walls physically on our borders,employing more border patrol and spendingmore on high tech equipment is only going toincrease the costs for the tax payer. Thesebarriers are not going to eradicate illegal drugabuse. As Americans we have to first learn tobe responsible for our actions and quitblaming everyone else.

We all knew that robbing a bank is illegal. Ifwe just use this same simple, logicalreasoning for illegal drug abuse we will all goa long way in improving are society. If thereare as many bank robbers as there are illegaldrug users, I think our financial system wouldtake another beating!!!

The President and Congress Needto Address Defensive MedicinePresident Obama has said

that the health caresystem is broken, and

that we must find insurance for47 million uninsured Americans.Helping uninsured Americans isabout obtaining affordablehealth insurance. Obtainingaffordable health insurance isabout reducing costs.

President Obama has agreedone way to reduce costs is toeliminate waste andinefficiencies. The single mosteasily reducible cost is thatassociated with malpracticeawards. That is why the AMAhas set limiting malpracticeawards as it's highestlegislative priority.

There are two costs associatedwith malpractice awards. One isthe direct cost of malpracitcepremiums. As bad as that is,the more wasteful andinefficient cost is that ofdefensive medicine. Defensive

medicine is the practice ofordering tests and proceduresthat aren't needed to protect adoctor from a lawsuit and hasgreatly increased in recentyears. Defensive medicine isnotoriously hard to quantify, butsome estimates published inthe Wall Street Journal placethe annual cost at $100 billion.

Defensive medicine is the onepart of the broken health caresystem that is the easiest tocorrect. Limits to malpracticeawards and replacing the jurymalpractice system with asystem of expert health courtscan save the $100 billionwasted on defensive medicine.

So what is congress going todo about reducing the wasteful,foolish expense of defensivemedicine? So far, nothing.None of the bills beforecongress address theastonishing waste of defensivemedicine. Congressional

By Mark Schor MD FACP

leaders will not even considerexpert health courts.And what is Obama going to doabout it? The answer is in hisrecent speech to the AMA onJune 16 2009. The Presidentacknowledged that excessivedefensive medicine is a realissue that leads to moretreatment rather than bettercare.

Then he clearly said heopposes limits to malpracticeawards. He said the way toreduce defensive spending is to"explore a range of ideas". Hegot boos from the doctors andprobably a sigh of relief fromtrial laywers. The phrase "arange of ideas" is politicaldouble talk which meansnothing at all.

The reason for the reluctance ofObama and the Democraticcontrolled congress to ignorethe benefits of reducingdefensive medicine is clear: Trial

lawyers are a major contributerto the democratic party.

Eliminating the need fordefensive medicine will help tosave enough money forAmerica to afford universalhealth coverage. As the nationdebates health-care reform,failure to address defensivemedicine is a willful refusal byObama and Congress to dealwith one of the causes ofuninsured Americans. It's nothealth care that is broken,rather it is the President andCongress that are broken,because they answer to thetrial lawyers instead of theneeds of the uninsured.

Mark Schor is board certified inInternal Medicine and is one ofthe partners in U.S.Hospitalists. He sees patientsat Palms West Hospital,Wellington Regional MedicalCenter and JFK MedicalCenter.

Survey Finds Binge DrinkingAmong Older People, Too

Binge drinking isn't just a problemof young people, researchers say.In a nationwide survey of people50 to 64 years old, nearly a quar-

ter of the men and nine percent of thewomen told Duke University researchersthey had engaged in binge drinking in theprevious 30 days.Defined as five or more alcoholic drinks ina short time, binge drinking is consideredextremely risky behavior, and its dangers in-crease with age.The survey also found that 14 percent ofmen and three percent of women 65 andolder reported binge drinking in the previ-ous month.The survey results were published onlineAug. 17 in the American Journal of Psychi-atry."We feel that our findings are important tothe public health of middle-aged and elderlypersons as they point to a potentially unrec-ognized problem that often flies beneaththe typical screen for alcohol problems inpsychiatry practices," Dr. Dan G. Blazer ofDuke, a study co-author, said in a news re-lease. "Clinicians who work with this agegroup would be well advised to ask specif-ically about binge drinking."The researchers examined data on the drink-ing habits of nearly 11,000 middle-age and

older adults from the 2005 and 2006 Na-tional Survey on Drug Use and Health.They found that older binge drinkers weremore likely to use tobacco or illicit drugsthan those reporting no alcohol use. Malebinge drinkers tended to be unmarried andhave higher income than non-drinkers.Women binge drinkers reported higher non-medical use of prescription drugs.Binge drinking, also called extreme drink-ing, has gained notoriety in recent years asexperts have decried the drinking habits ofcollege students and young people. In onestudy, nearly 50 percent of college studentsreported consuming excessive alcohol in ashort time.Binge drinking at any age can lead to alco-hol poisoning, liver disease, neurologicaldamage, injuries and violent crimes.

FLORIDAHEALTHNEWS-ONLINE.COM SEPTEMBER • 2009 3

Fish Oils May Preventand Treat Heart DiseaseA new review shows that theomega-3 fatty acids found incertain fish not only preventcardiovascular disease, but mayeven help treat it.

"A lot of people know that omega-3fatty acids are a good thing, but havethought of them in the area of nutri-tional or health foods," said study au-

thor Dr. Carl J. Lavie, medical director ofcardiac rehabilitation and prevention at theOchsner Clinic in New Orleans. "They don'trealize there is so much data, a lot of datafrom big studies, that they are not only pre-ventive but also help in therapy for a num-ber of conditions, such as atrial fibrillation,heart attack, atherosclerosis and heart fail-ure."The report in the Aug. 11 issue of the Jour-nal of the American College of Cardiologycites four trials with almost 40,000 partici-pants that show benefits of omega-3 fattyacids in primary prevention of cardiovascu-lar disease, in treatment after heart attackand, most recently, in heart failure patients.The benefits of omega-3 fatty acids are suchan old story that such studies can go unno-ticed, Lavie said. "If you polled cardiolo-gists about whether this is a good thing or abad thing, I don't know if they would recog-nize how much has been done in this area,"he noted.As far back as 2002, the American HeartAssociation issued a scientific statementendorsing omega-3 fatty acid intake, fromfish or supplements. It recommended spe-cific amounts of omega-3 fatty acids eachday for people in general, with greater in-take recommended for people with heartdisease."For the general population, it should be500 milligrams a day," Lavie said. "If youhave heart disease, it should be 800 or 1,000milligrams a day."Lavie includes himself in the second cate-gory, because "I have a family history ofheart disease. I eat a lot of fish and take asupplement just to be sure."It's got to be the right kind of fish, the oilyspecies that have a lot of omega-3 fattyacids, Lavie added. "Redfish, trout,salmon," he said. "Salmon is my favorite."Not much effort is needed for most peopleto achieve the recommended intake, Laviesaid. "Five hundred milligrams a day is twofatty fish meals per week," he added.

But too many people eat non-oily fish suchas catfish, Lavie noted. "And they have itfried, which reduces its health benefits," headded.Set against that one trial are the many largerstudies cited by Lavie, and epidemiologicalevidence showing that populations such asAsians and Alaskan Eskimos, whose dietsare rich in fish oil, have a low incidence ofcardiovascular disease.The picture is not complete, the new reportnoted. Studies still must be done to deter-mine the relative benefits of DHA and EPA,the long-chain fatty acids in the omega-3family. And the American Heart Associationsays that Omega-3 supplements should betaken only after consulting with a doctor,because too much can cause excessivebleeding in some people.

She is a leader of the trial, which is now re-cruiting 10,000 men aged 60 and older and10,000 women aged 65 and older. The re-searchers will test not only the effect ofomega-3 fatty acids but also of vitamin D.Both are "very promising nutrients in pre-vention of cardiovascular disease, cancerand other chronic diseases," Manson said. Inthe five-year trial, a quarter of the partici-pants will take both vitamin D and omega-3 fatty acids, a quarter will take the vitamin,a quarter will take the fatty acids and a quar-ter will take a placebo.Enthusiasts shouldn't anticipate the resultsof the trial and start taking large doses ofomega-3 fatty acids, Manson warned. "It'stoo early to jump on the bandwagon andtake megadoses, but moderate doses seemreasonable," she said.

Chewing Tobacco No Safer Than SmokingTobacco users who think it's safer to dipsnuff or chew tobacco than smoke are deadwrong, researchers say.A study has found that taking one pinch ofsmokeless tobacco delivers the sameamount of polycyclic aromatic hydrocarbons(PAHs) as smoking five cigarettes.PAHs are common environmentalcontaminants that are formed as a result ofincomplete burning of wood, coal, fatty meator organic matter, according to informationin a news release from the AmericanChemical Society. For instance, PAHs formduring the grilling of meats. Some areknown carcinogens.The research on PAHs in smokelesstobacco was scheduled to be reported thisweek at the annual meeting of the AmericanChemical Society, held in Washington, D.C.It adds to existing evidence that smokelesstobacco contains two dozen othercarcinogens that cause oral and pancreaticcancers, scientists say."This study once again clearly shows us thatsmokeless tobacco is not safe," said IrinaStepanov, who led the research team. "Ourfinding places snuff on the same list of majorsources of exposure to polycyclic aromatichydrocarbons as smoking cigarettes," she

stated in the news release.Experts hope this evidence helps to end theidea that because it doesn't burn,smokeless tobacco is safer. The marketingand consumption of smokeless tobacco ison the increase, and some estimatessuggest that sales of moist snuff in Americahave doubled since the 1980s."The feeling of safety among somesmokeless users is wrong," said Stepanov,a chemist at the University of MinnesotaMasonic Cancer Center in Minneapolis. "Atotal of 28 carcinogens were identified insmokeless tobacco even before our study.Continued exposure to these over a periodof time can lead to cancer. Now we havefound even more carcinogens in snuff."Until recently, scientists wrongly believedthat, because the tobacco was not burnedwhen used, only trace amounts of PAHexisted in snuff, Stepanov noted.

Foods ThatBurn Calories!Eat Foods High in FiberCelery and cabbage have long been toutedas "calorie burning" foods, simply becausethe energy used to digest these foods isgreater than the energy, or calories, ingestedby eating the foods.

An added benefit of these foods is that theyare fibrous and filling, which means youwill feel satisfied faster and on many fewercalories that other food choices.

Keep in mind, however, that you don't wantyour caloric intake to be too low to cause adrop in metabolism. When your metabolismdrops, you will retain more weight as thebody responds to what it thinks is a periodof malnutrition.

Vitamin C is also believed to be a calorieburner and a weight loss booster. Foods thatare high in Vitamin C and also high in fiberand low in calories include oranges, tan-gerines (fresh, not canned), grapefruit(which are 90 percent water!), limes andlemons.

Eat Low-Fat Dairy ProductsRecent studies have been pointing to thefact that dieters who eat at least two to threeservings of low-fat dairy products a day,like cottage cheese and yogurt, lose weightfaster, keep it off longer, and lose moreweight in the belly area than dieters whodon't include dairy products in their diets.

Easy lunch additions include single-servingsizes of low-fat string cheese, individuallywrapped low-fat cheese wedges, milk car-tons (not just for elementary school cafete-rias anymore) and even fat-free sour creamin place of other condiments.

Choose Foods Rich in B12Eggs, milk, low-fat cheese and cereals thathave been vitamin-enriched are all goodsources of vitamin B12. Some sources statethat B12 increases the body's fat-burningability. Every gram of fat equals 9 calories,so when you burn fat, you burn calories, too.Vitamin B12 is also known to fight fatigueand speed up the metabolism, which arebenefits that can give a boost to any dieter.

By Jennifer Nichol


Low Birth WeightMight Raise AdultKidney Disease Risk

Vitamin D Deficiency Linkedto Heart Risk Factors in Kids

Low birth weight babies have amuch greater risk of developingkidney disease later in life, ac-cording to researchers who re-

viewed 32 observational studies.

The meta-analysis found that people whowere less than 5.5 pounds at birth were 70percent more likely to develop chronickidney disease than those with normalbirth weight. The findings appear in theAugust issue of the American Journal ofKidney Diseases.

"Experimental studies suggest that re-stricted growth of a fetus in the womb caninterfere with normal kidney develop-ment and result in fewer and smaller fil-tering units, or nephrons, at birth," leadauthor Sarah L. White, of the George In-stitute and the University of Sydney inAustralia, said in a news release from theU.S. National Kidney Foundation.

"Those with low birth weight maytherefore be vulnerable to acceleratedloss of kidney function later on as a re-sult of any additional injuries to the kid-ney caused, for example, by accidents,infections or the presence of other risk

factors such as diabetes," she explained.White and colleagues identified signifi-cant associations between low birthweight and both of the principal markersof chronic kidney disease -- protein in theurine (albuminuria) and low estimatedglomerular filtration rate (poor kidneyfunction). The researchers also identifiedan association between low birth weightand subsequent development of kidneyfailure.

"Despite the association between lowbirth weight and risk of chronic kidneydisease in later life, early detection andmanagement of chronic kidney diseaseand its risk factors are highly effective inpreventing adverse outcomes," Whitesaid.

"People who were very small at birthshould avoid obesity that could lead todiabetes, maintain regular physical activ-ity, avoid medications that could be toxicfor the kidneys and see their doctors forsimple assessment of chronic kidney dis-ease including blood pressure measure-ment, a dipstick test for urinary proteinand a blood test of serum creatinine level,"she advised.

Most American youngstersaren't getting enough vitaminD, and that deficiency is asso-ciated with an increased inci-

dence of risk factors for cardiovascularproblems such as heart attack and stroke,two new studies find.Simultaneous publication of both papers inthe Aug. 3 online edition of Pediatrics is co-incidental, the lead authors of the reportssaid. Both used U.S. data from the 2001-2004 National Health and Nutrition Exam-ination Survey, and both were initiated be-cause of a lack of information about thepossible effects of low vitamin D levels oncardiovascular risk in young people.While studies have linked vitamin D defi-ciency to increased risk in American adults,"few studies have looked at whether vitaminD can be associated with increased cardio-vascular disease in children," said Jared P.Reis, who began his study while at JohnsHopkins University. He is now an epidemi-ologist in the division of cardiovascular sci-ences of the U.S. National Heart, Lung, andBlood Institute."Nobody questions that vitamin D defi-ciency causes rickets," said Dr. Michal L.Melamed, an assistant professor of medicineand epidemiology at Albert Einstein Collegeof Medicine in the Bronx, who led the otherstudy. "We wanted to explore other healthoutcomes and noticed that nobody had de-scribed this outcome."The study she led looked at the overall in-cidence of low blood levels of vitamin Damong young Americans aged 1 to 21 in thesurvey. There is no formal definition of vi-tamin D deficiency, Reis said, but many ex-perts believe that a level of 30 nanogramsper milliliter of blood is desirable.The Melamed study found that 9 percent ofyoung Americans -- 7.6 million -- were vi-tamin D-deficient, with blood levels under15 nanograms per milliliter, and that 61 per-cent -- 50.8 million -- were vitamin D-insuf-ficient, with levels between 15 nanogramsand 29 nanograms per milliliter.The high incidence of vitamin D deficiencywas so surprising that "we sat on our datafor six months," Melamed said. "We didn'tpublish until it was confirmed by other peo-ple that we had the right numbers."Children with the lowest vitamin D levelswere more likely to have higher blood pres-sure, high blood sugar levels and low bloodlevels of HDL ("good") cholesterol, thestudy found.

It's not entirely certain that low levels of vi-tamin D early in life will translate intohealth problems in the adult years, Melamedsaid. "But if you have hypertension [highblood pressure] at age 20, you have 60 moreyears of dealing with the consequences,"she noted.The study led by Reis was a detailed cross-sectional analysis of data on 3,577 adoles-cents. It found an average vitamin D bloodlevel of 24.8 nanograms per milliliter. Theaverage level was 15.5 nanograms per mil-liliter in blacks, 21.5 in Mexican Americansand 28 in whites.There was a clear association with cardio-vascular risk factors. The 25 percent ofyoungsters with the lowest levels of vitaminD were 2.36 times more likely to have highblood pressure, 54 percent more likely tohave low HDL cholesterol levels, 2.54 timesmore likely to have elevated blood sugarlevels and 3.88 times more likely to havemetabolic syndrome, a constellation of riskfactors including obesity, high blood fatsand high blood pressure.But the results should not panic parents,Reis said. "I believe we need additional re-search," he said. "Our study is observa-tional, and we need additional studies toconfirm it."Specifically, parents need not turn to supple-ments to provide the recommended intakeof vitamin D, currently set at 200 Interna-tional Units a day for everyone up to age 50,Reis said. Adequate vitamin D intake can beachieved with 15 minutes a day of exposureto sunlight or consuming fortified milk,bread and other wheat products, amongother foods, he said."Parents should focus on modifiable riskfactors," Melamed said. "Children shouldnot always be on the computer or watchingtelevision. They can drink more milk, ratherthan using supplements."

More Kids Becoming Severely ObeseIn the last 25 years, rates ofsevere childhood obesity in theUnited States have tripled, puttingincreasing numbers of children atrisk for diabetes and heartdisease, says a new study.

Researchers looked at NationalHealth and Nutrition Survey dataon 12,384 youths, ages 2 to 19years, and found that the preva-

lence of severe obesity increased from 0.8percent in the period from 1976 to 1980 to3.8 percent in 1999 to 2004. Severe obesitycorrelates to a body mass index that's equalto or greater than the 99th percentile forage and gender.The finding could mean that 2.7 millionchildren in the United States are severelyobese, the researchers said.Black and Mexican-American children hadthe largest increases in severe obesity, along

with children in families below the povertylevel. For example, the percentage of se-verely obese Mexican-American childrenrose from 0.9 percent to 5.2 percent.The researchers also found that a third of se-verely obese children had metabolic syn-drome, a group of risk factors for diabetes,stroke and heart attack. The risk factors in-clude high blood pressure, cholesterol andinsulin levels."Children are not only becoming obese butbecoming severely obese, which impactstheir overall health," Dr. Joseph Skelton, anobesity expert at Brenner Children's Hospi-tal, part of Wake Forest University BaptistMedical Center in Winston-Salem, N.C.,and lead author of the study, said in a newsrelease from the center."These findings reinforce the fact that med-ically based programs to treat obesity areneeded throughout the United States, and in-surance companies should be encouraged tocover this care," Skelton said.


Plastic Surgeons StayBusy in RecessionEarlier this year, Janice Axelrod,an insurance broker in Chicago,visited a plastic surgeon for a"makeover" -- a chemical peel andinjections of abdominal fat underher eyes, around her lips and atthe corners of her mouth.

Axelrod's decision was not moti-vated by concern she might loseher competitive edge in a tight-ening job market. "I would have

done it recession or no recession," she said."It was about my confidence and how I feltseeing clients."But many other women see such cosmeticprocedures as "employment insurance" inthese tough times. The American Society ofPlastic Surgeons reported that nearly 3.5million women in the workforce (3 percent)have already undergone a cosmetic proce-dure as an investment in their careers."Many people are going out on the job mar-ket and want touch-ups," confirmed Dr. SethThaller, professor and chief of plastic sur-gery at the University of Miami MillerSchool of Medicine in Florida. "I have a pa-tient coming in next week who works. Hercompetition is younger, and she's gettingplastic surgery to be more competitive in themarket."According to the ASPS, Botox procedures,which are used to treat moderate to severefrown lines, were up 8 percent in 2008 ver-sus 2007; use of hyaluronic acid fillers forwrinkles and folds increased 6 percent, andchemical peels were up 2 percent.Total cosmetic procedures and minimallyinvasive cosmetic procedures have in-creased since 2007 (3 percent and 5 percent,respectively), while more involved surgicalcosmetic procedures, such as breast aug-mentation and tummy tucks, are down 9percent overall.A standard Botox procedure involving theupper face averages $800, said Dr. LorenSchechter, who performed Axelrod's pro-cedures for about $5,000.Two vials of Restylane, a filler commonlyused around the nose and lower face, cancost $1,200, added Schechter, who is an as-sistant professor of surgery and chief of

plastic surgery at Chicago Medical Schooland an ASPS spokesperson.Other than cost-savings, a major reasonwomen opt for more minor procedures isnot wanting to take time out from a job or ajob hunt."A lot of people don't want to be away fromwork," said ASPS president Dr. JohnCanady, professor of plastic surgery at theUniversity of Iowa in Iowa City."Without a doubt, people are looking forquicker recovery time. That's why Botoxand fillers are so popular: The downtime isminimal to none," agreed Thaller.Axelrod, who took less than a week offwork, said her face was swollen for abouttwo weeks.While three-quarters of practitioners from arecent ASPS poll reported an "increased orstable" demand for these types of minorprocedures, many individual surgeons saythey feel the pinch of the recession."Across the country, there's not a place thathasn't felt the economic impact," Canadysaid.Some filler companies are giving discountsfor their products, Thaller said.And while some patients still will fork over$1,000 or more to boost their employmentprospects, others are opting out of the plasticsurgery market completely.Some people just don't show up for appoint-ments, Thaller said.Others are simply cutting back."People who used to do two or three areas[with Botox] might do one area now, orthey're not coming every three to fourmonths. They're coming every six to 12months," Thaller said. "They're looking fordeals. They don't want to spend $200 or$400, when before they would spend $1,000or $1,200 without batting an eyelash."

Women who take a darkerview of life are more likelyto develop heart trouble thanthose with a cheerful, trust-

ing outlook, a new study indicates.The finding comes from the Women'sHealth Initiative, which has tracked morethan 97,000 postmenopausal Americanwomen for more than eight years."In addition to looking at hormones andtheir effect on heart disease and cancer, thestudy also examined psychosocial and so-cial factors and how they affected the healthof postmenopausal women," said Dr. HilaryA. Tindle, an assistant professor of medicineat the University of Pittsburgh, and lead au-thor of a report in the Aug. 10 issue of Cir-culation. "Fortunately, we have this wealthof information on the psychological profileat the time they joined the study."Optimism was measured by a questionnaireon whether a woman agreed with such state-ments as "In unclear times, I usually expectthe best." The questions measuring cynicismasked about agreement with such statementsas "It is safer to trust no one" and "I have of-ten had to take orders from people who did

not know as much as I did."Women within the highest 25 percent ofoptimism scores had a 9 percent lowerchance of developing heart disease and a 14percent lower chance of dying of any cause.Women with the highest degree of cynicalhostility were 16 percent more likely to diethan those with the most trust in their fellowhumans.The results most likely apply to men as well

as women, Tindle said, citing several previ-ous studies, such as a 2004 Dutch report thatmen who were more optimistic died lessoften of cardiovascular disease.There are several possible explanations forthe new finding, Tindle said. Money mightwell be involved, since "optimism is asso-ciated with higher income and education,"she said. But curiously, "the level of so-cioeconomic status when a woman wasyoung was better associated with outcomethan current status," Tindle said.Beyond that, there are "three broad cate-gories of possibilities," she said.One is related to lifestyle factors. "Opti-mistic women had more stable risk profiles,with less high blood pressure and diabetes,"Tindle said. "They didn't smoke as muchand tended to exercise more. So their lowerrisk might just be associated with livinghealthier."It's also possible that optimists are morelikely to follow their doctors advice morefaithfully. "Previous studies have shownthat optimists tend to follow the diet they aretold to follow," Tindle noted.Or a woman's outlook on life might affect

how she responds to stress, theb researchersaid. Pessimism and cynical hostility mightlead to higher blood pressure, higher heartrate and other physical risk factors, she said.Tindle said she would like to test all ofthose possibilities in a controlled trial. "Wewould recruit individuals who are pes-simistic, and try to alter their outlook andsee if it affects their health," she said.The answer probably would be "yes," Tindlesaid. "Even the most cynical, hostile indi-vidual can change, given the right stimulus,and I see this every day," she said.The report was cheering news for Dr.Suzanne Steinbaum, director of women andheart disease at Lenox Hill Hospital in NewYork City."It turns out that being optimistic is an im-portant part of maintaining health," Stein-baum said.The study shows that "one's view of theworld and your perspective can play an im-portant role in your health," she said. "Thisstudy demonstrates the role and significanceof the connection between the mind and thebody. Its just another reason to try to look atthe bright side of life."

Optimism Good for Heart and Longevity

Over the years, Americans haveendured many different types oftragedies and crises -- from Hur-ricane Katrina and Sept. 11 to

countless tornadoes, earthquakes and othernatural disasters. During these hardships,we have learned to expect the unexpectedand to be ready for anything.

With this in mind, the U.S. Department ofHomeland Security has declared SeptemberNational Preparedness Month in an effort toeducate people about natural and nationaldisaster preparedness and to motivate fam-ilies to plan ahead. In support of this year’s"Ready Campaign," First Alert and TheLehigh Group, makers of home safety andsecurity products, offer some simple tipsfor preparing your home and family to faceunexpected emergencies.

1. Create a preparedness kit When preparing for an emergency or poten-tial disaster, basic survival items like freshwater and non-perishable foods are often atthe top of the list. Just as important are ne-cessities like blankets, a first aid kit, transis-tor radio, flashlights, batteries, cell phonewith charger, prescription medications, cashor traveler’s checks and even a can opener.

2. Set alarms Carbon monoxide (CO) poisoning incidentsescalate during hurricane season and heavywind storms due to more frequent poweroutages when homeowners turn to fuel-burning generators or other fuel sources tocook, light, cool or heat their homes. Toprotect your family from this "silent killer,"

CO alarms should be installed throughoutthe home, including one on each level andoutside every sleeping area.

3. Store valuables in a "safe" place Even if you live in the safest town in Amer-ica, having a safe at home can prove a wiseinvestment when it comes to natural disas-ters. Through fire or flood, a safe can helpprotect important documents, family photosand sentimental keepsakes, as well as jew-elry and other valuables. Look for a safethat is both fire resistant and waterproof, notjust water resistant.

4. Keep security front and center Doors and windows are particularly vul-nerable spots in a home during a majorstorm or national disaster. Proper stormdoors can protect exposed areas of the homefrom wind, precipitation and debris. Forhomes and businesses, vertical windowguards like those offered by Leslie Lockehelp to keep flying debris from breakingglass and exposing a home’s interior to out-side elements. Security screen doors andwindow guards also can help keep homessafe from unwanted intrusion.

5. Secure outdoor items High winds can take a toll on the outside ofa home. At the first sign of danger, secureoutdoor items using rope or other cordageproducts to tie down outdoor furniture,plants, decorative items and more. A newrope innovation called Cordzilla offersbungee-style stretch with vinyl-coatedhooks that help securely tie down itemswithout scratching their surfaces.

5 tips to keep your homesafe in an emergency


'Organic' May Not Mean HealthierFood that beckons from theorganic aisles of grocery storesmay not be any better for you thanwhat lines the rest of supermarketshelves.

According to a British review ofstudies done over the past 50years, organic and convention-ally produced foods have about

the same nutrient content, suggesting thatneither is better in terms of health benefits."We did not find any important differencesin nutrient content between organically andconventionally produced foods," said studyauthor Alan Dangour, a registered publichealth nutritionist with the London Schoolof Hygiene and Tropical Medicine.Nonetheless, the researchers noted, organicfoods continue to grow in popularity. In theUnited Kingdom, the market share for or-ganic foods increased 22 percent from 2005to 2007, they said.Likewise, the market for organic foods inthe United States has grown at about a 20percent rate each year since 1990, reaching$13.8 billion in consumer sales in 2005, ac-cording to the Organic Trade Association.That represents 2.5 percent of total foodsales in the country, the trade group noted."As a registered dietitian, it is good to seethat a systematic review of the literaturesupports what has long been believed -- thatthe nutritional content of traditionally grownfoods and organic foods are comparable,"said Connie Diekman, director of universitynutrition at Washington University in St.Louis and past president of the AmericanDietetic Association. "This report provides

confirmation for consumers that if theychoose conventionally grown foods or or-ganic foods they will be meeting their nutri-tional needs."The review zeroed in on 162 studies thatdealt with the nutrient content of foods.Only 55 were of what the researchers con-sidered to be "satisfactory quality" -- astrong indicator that, overall, the scienceon the subject is not up to snuff.They found no noted differences betweenconventional and organic crops with regardto vitamin C, magnesium, calcium, potas-sium, zinc and copper content. Organiccrops did have higher levels of phosphorus,and conventionally produced crops hadhigher levels of nitrogen.No differences in nutrient content were in-

dicated in the livestock studies, according tothe review. The Oregon-based Organic Cen-ter, which promotes organic food, con-ducted a similar review of the literature,said Charles Benbrook, chief scientist forthe Center. That study yielded results similarto those in the British study, but it also foundhigher levels of healthy antioxidants andpolyphenols in organic foods."Given that some of the most significantdifferences favoring organic foods were forkey antioxidant nutrients that most Ameri-cans do not get enough of on most days, weconcluded that the consumption of organicfruits and vegetables, in particular, offeredsignificant health benefits, roughly equiva-lent to an additional serving of a moderatelynutrient dense fruit or vegetable on an aver-

age day," Benbrook said.And there's another aspect to the organic vs.conventional food debate, said Sheah Rar-back, director of nutrition at the MailmanCenter for Child Development at the Uni-versity of Miami Miller School of Medicine."You have to also look at what you're notgetting" with organic foods, she said."Maybe it's not a big difference nutrition-ally, but conventional products may havemore pesticides."And that's a particularly important issue forchildren, she said."We know that young children are gettingthe nutrition, whatever choice they make,but we also have to look at the pesticide is-sue," Rarback said. "A study published inEnvironmental Health Perspectives foundthat children eating conventionally grownfruit had pesticide residue in their urine,which decreased after just five days on anorganic diet."The production of organic food is subject toa variety of regulations, including those thatgovern the use of pesticides and other chem-icals in fruits and vegetables and the use ofmedicines in animals, the authors of the re-view noted in their study, which will bepublished in the September issue of theAmerican Journal of Clinical Nutrition.Rarback indicated that the ability to getsolid research on organic versus conven-tionally produced products is hampered byvariations in the production process."There are so many variables," she said."Where is something grown? Where is itshipped from? How long was it on thetruck? There are going to be variables interms of nutrition just from productionmethods."

Stress, Bad Bedtime HabitsCause InsomniaBad bedtime habits can keep you up at nightand cause problems during the day, says thehead of a Texas sleep study facility.Stress, worry, caffeine, alcohol andwatching TV in bed -- factors known as"poor sleep hygiene" -- are the major rea-sons why people can't shut down theirbodies when it's time for sleep, explainedDr. Sunil Mathews, medical director ofthe Sleep Center at Baylor Medical Cen-ter at Irving, Texas. Poor sleep hygienecan also lead to taking sleep-aid medica-tions that could interfere with alertnessthe next day, he said.A recent National Sleep Foundation pollfound that 47 percent of people with sleepproblems were likely to use caffeinatedbeverages to compensate for their day-time sleepiness, but these stimulants con-tribute to more difficulties sleeping."Insomnia can turn into a vicious cycle,"he said in a news release from the medicalcenter.To develop good sleep hygiene, Mathewsrecommends the following:Develop a calming bedtime routine. Re-lax body and mind through yoga, biofeed-back and meditation, or take a cup ofwarm milk with nutmeg.Avoid workouts within four hours of bed-time. While regular exercise relievesstress, it also raises core body tempera-ture, which can make falling asleep moredifficult.Avoid caffeine, alcohol or sugary itemswithin eight hours of bedtime.Keep your bedroom dark, cool, quiet andcomfortable.

The longer you live, the happieryou're likely to be, a growing bodyof research shows.

Researchers who spoke at the recently con-cluded annual convention of the AmericanPsychological Association in Toronto saidthat mental health generally improves withage. Given that the world population of peo-ple over 65 is expected to nearly triple by2050, according to U.S. officials, this shouldcome as good news.

Reporting on several studies of aging andmental health, Susan Turk Charles, a profes-sor at the University of California, Irvine,said the findings indicate that happiness andemotional well-being improve with time.

Older adults exert greater emotional control,said Charles. Studies show they learn toavoid or limit stressful situations and areless likely than younger adults to let nega-tive comments or criticism bother them.

Charles added that "we know that olderpeople are increasingly aware that the timethey have left in life is growing shorter.They want to make the best of it so theyavoid engaging in situations that will makethem unhappy. They have also had moretime to learn and understand the intentionsof others, which helps them to avoid thesestressful situations."

Another study conducted over a 23-year pe-riod examined three groups of people atthree different life stages and concludedthat emotional happiness grew with age,she said.

These findings may not apply to older adults

who feel trapped in distressing situationsand those with forms of dementia, Charlessaid. "We know that older adults who aredealing with chronic stressors, such as care-giving, report high rates of physical symp-toms and emotional distress," she added.

In separate reports, Charles and LauraCarstensen, a psychology professor at Stan-ford University, also noted that social rela-tionships -- or lack of them -- influence howolder people respond to stress. Carstensencited a Swedish study that concluded thatpeople with strong social connections wereless likely to suffer cognitive impairmentthan others. It seems social relationshipsinfluence the way that the brain processesinformation, she said. "These changes havea profound impact on health outcomes,"Carstensen said.

To make the most of the coming years,Carstensen offered these tips:Think of ways to enjoy the time ahead andtry to imagine living 100, healthy, happyyears.

Provide daily routines that reinforce yourgoals, both in your home and in your sociallife.

Develop new activities and relationships,and don't invest all of your emotional energyin a job or a single relationship.

Happiness Keeps Growing


Sure, may experience a "silentstroke" and won't even know it,Australian researchers say.

"These strokes are not truly silent, be-cause they have been linked to memoryand thinking problems and are a possiblecause of a type of dementia," study authorDr. Perminder Sachdev, a neuropsychia-try professor at the University of NewSouth Wales in Sidney, said in a news re-lease from the American Academy ofNeurology.

The study, published in the July 28 issueof the journal Neurology, followed 477people aged 60 to 64 for four years. Theresearchers found that 7.8 percent of thegroup had evidence of strokes that do notcause any noticeable symptoms -- knownas silent lacunar infarctions -- in whichblood flow is blocked in one of the arter-ies leading to areas deep within the brain.An additional 1.6 percent of the studygroup had experienced silent strokes bythe end of the study period.

Many Cancer SurvivorsDon't Adopt Healthy LifestyleMost older, long-term cancersurvivors struggle with goodhealth habits, such as regularexercise and a proper diet, a newstudy shows.

Those who did exercise and eat wellafter their treatment, however,tended to have more vitality and abetter quality of life, the study also

found."Our findings point to the potential negativeimpact of obesity and the positive effect ofregular exercise and a healthy diet on phys-ical quality of life outcomes among older,long-term cancer survivors," CatherineMosher, a postdoctoral fellow in psychiatryand behavioral sciences at Sloan-Kettering,said in a news release from the AmericanCancer Society.Mosher and her colleagues examined datafrom more than 750 people who had sur-vived breast, prostate or colorectal cancerfor five years or more. All were 65 or older.Most people expressed interest in pursuinghealthy habits, but only 7 percent actuallymet national guidelines for exercise anddiet. The majority reported exercising anaverage of 10 minutes a week -- far short ofthe recommended 150 minutes of exercise aweek, the study said. Obese survivors had

worse physical quality of life.People aged 65 and older make up morethan half of the estimated 11 million cancersurvivors in the United States, according tothe American Cancer Society.Numerous studies have linked healthy

lifestyle choices with better outcomes aftera cancer diagnosis. In one recent study, peo-ple who had head and neck cancer appearedto have better survival if they exercised,improved their diet and avoided smokingand heavy alcohol consumption.

Those with high blood pressure had a 60percent greater chance of having a silentstroke than those with normal blood pres-sure. Also, study participants with a con-dition called white matter hyperintensi-ties were almost five times more likely tohave a silent stroke than those withoutthis small type of brain damage, the re-searchers found.

Although relatively symptom-free, silentstrokes are a major health problemamong the elderly, according to theAmerican Academy of Neurology. Peo-ple who have had a silent stroke are athigher risk for subsequent strokes andfor an accelerated loss of mental skills. Inaddition to high blood pressure, risk fac-tors include diabetes, heart disease,smoking and older age.

In the event that a person is experiencingany symptoms of stroke, call emergencymedical services immediately, the acad-emy states. Common signs of stroke are:Sudden weakness or numbness of thearms, legs or face, especially on one sideQuick onset of blurred vision in one orboth eyes

Difficulty walking, dizziness, or loss ofbalance or coordination

Sudden confusion or trouble speakingSudden severe headache with no knowncause.

Overburdened doctors are shunningall types of insuranceLike a lot of their patients,doctors are sick of long waits inthe waiting room and dealing withinsurance companies.

That's why a growing number ofprimary care physicians are adopt-ing a direct fee-for-service or "re-tainer-based" model of care that

minimizes acceptance of insurance. Exceptfor lab tests and other special services, yourinsurance plan is no good with them.

In a retainer practice, doctors charge pa-tients an annual fee ranging from $1,500 toas high as over $10,000 for round-the-clockaccess to physicians, sometimes includinghouse calls. Other services included in themembership are annual physicals, preven-tive care programs and hospital visits.

Doctors argue that this model cuts downtheir patient load, allows them to spendmore time per patient and help save the sys-tem money. However, some industry groupscaution that these emerging trends are aconsequence of a health care system badlyin need of reform.

"I had to change the model": Dr. John Kihm,51, an internist based in Durham, N.C., con-verted his solo private practice to a retainer-based model in May. Until then, his dailyschedule was jam-packed. "I was seeing pa-tients every 15 minutes," said Kihm.

He was seeing about 80 patients a week,"many were very sick with multiple systemsand complications," he said. "After 20years, I realized that this was not doable, notsustainable."

His goal is to continue medicine for another20 years, "but I want to practice it the rightway," Kihm said. That means spendingmore than 15 minutes per patients and doinghouse calls. "I had to change the model," hesaid, as he adopted the retainer-based struc-ture.

He now spends 30 minutes on average perpatient. He didn't disclose his annual feesbut said his fees are "less that what it couldcost to smoke a pack of cigarettes a day."His fees covers annual exams, wellness pro-grams and other types of preventative caretypically not covered by insurance. If his pa-tients do have insurance, it would pay forthings like lab tests.

"My income is about the same as before, butI have less overhead costs from half asmany patients and half the amount of sup-plies that I need," he said.

Michigan-based family doctor Dr. JohnBlanchard has been practicing the retainer-based care for eight years. He said his pa-

tients have "unfettered" access to him when-ever they need him for a fee of between$50 to $150 a month.The model has enabled Blanchard to "cutdown on everything by about 25%," includ-ing his patient caseloads and time spent onfiling insurance claims. One industry reportcited that processing claims is the second-biggest area of wasteful expenditure in thehealth care system, costing as much as $210billion annually.

Prevention better than cure: MDVIP, basedin Boca Raton, Fla., is one of the largest or-ganizations of primary care physicians,numbering about 326 nationwide, that prac-tice retainer-based medicine. "We call itpreventive, personalized health care," saidDarin Engelhardt, president of MDVIP."Our premise is if we reconstruct primarycare, what would it look like?'"

According to the MDVIP formula, it meanslimiting its affiliated practices to no morethan 600 patients. For an annual fee of be-tween $1,500 and $1,800, its members re-ceive full health assessment, 24/7 access totheir doctor, including via a doctor's cellphone or e-mail and a personal Web page onwhich they can access their medical records.

MDVIP-affiliated practices do take insur-ance, including Medicare, for other medicalservices such as lab tests and sick visits. En-gelhardt said MDVIP has about 110,000members nationwide, half of whom are overthe age of 65.

"This is a variation of the traditional model,"he said. "We believe it enhances the physi-cian-doctor relationship as well as reducescosts by stressing prevention."


Shekhar V. Sharma M.D.Board Certified in Internal Medicine

A Visit To The Doctorshould be fine!”. After much explaining I convinced the patient to get a stress testdone. My staff has to call his insurancecompany to get an approval for varioustests to be done as well as a referral toanother specialist /imaging center ASAP. I then have to think of other dangeroushealth issues in the patient that could havecaused the chest pain. Could this patienthave had a clot in the lungs? If so, doesthis patient have clots in the legs? Is thispain related to a gastric issue? In themeantime, my staff is put on hold by theinsurance company that denies the stresstest for reasons unknown and later I findout that this insurance company sends aletter to the patient that the physician didnot supply enough information to get thestress test approved. For most insurancecompanies it has always been a matter ofsaving money and appeasing the patient

In the next examination room is seatedanother patient who has come in withsevere fatigue that she has had for acertain period of time. Fatigue is asymptom that should be taken seriouslyand not be simply brushed aside. Iimmediately have to think of all thevarious causes for this symptom. I windup doing labs and an EKG. The EKG is torule out cardiac arrhythmia. Labs are doneto rule out anemia, hypothyroidism,diabetes mellitus etc. At this time, I haveto use my clinical chess mind to make theright moves to come to a diagnosis.Patients often tell the staff that theirproblem can be analyzed in ten minutes.How can a good doctor examine a patient,do the necessary tests, make the requiredreferrals, prescribe the right medications,check the patient’s allergies, medicationsall in ten minutes. That is an impossiblefeat. In the meantime, other patients haveto wait. They may have simple issues orcomplex issues and I will never know thattill I see them in the examination room.The entire day goes on in this mannerwhere some patients have to wait longerdue to the complexity of the problems thatarise in the examination room. Physicianpatient encounters are not likeappointments you may have with anattorney or your beautician. Theencounters are complex in nature and timecannot be an issue. As an experiencedphysician I have to reiterate thatpracticing good medicine is like a game ofchess, and then thinking through acomplex maze and finally hitting the markis not as easy as it may sometimes seem.To all my patients out there who havecome to me with complex issues to solve,I appreciate your patience andunderstanding.

Dr. Sharma is Board Certified in InternalMedicine and his office is located in thePalomino Park Medical Center at 3347State Rd. 7 (2 miles south of theWellington Green Mall) in Suite 200. He is available 5 days a week from 9 a.m.to 5 p.m. For an appointment please callhis office at 561-795-9087. Medicare andmost major insurances are accepted.

Iam writing this article to give readersan understanding of patient doctorinteractions within an examinationroom. Many a time a patient walks

into my office (an unscheduled walk in)with chest pains. In the exam room thepatient states that he is “doing fine”. Thispatient is a cigarette smoker and has had apast history of non compliance with hismedicines. Apparently, he did not like to“see doctors”, eats unhealthily, startstelling me what kind of tests he wants andalso that he is an avid “Google medicalsearch” user. He states he will settle for anEKG (electro cardiogram) and blood testsand nothing further, except anexamination. Further, he also wants me totake care of all his other problems in thisvisit. For a brief moment I think: “ShouldI tackle all this patient’s problems in thisvisit” or should I just do what the patientactually came into my office for: which ischest-pains. I soon come to a decision in asplit second (which I am used to) andopted for the latter. The EKG turned outnormal, the examination was normal toobut the patient had all the signs andsymptoms of angina or impaired bloodflow to the heart that causes chest pain.The patient at this time is disbelievingstating “I have no chest pains now, so I

Ask Dr.Sharma:Q: I am a 65 year old female

with low back pain forabout 2 years and I am rightnow being treated for arthiritisof the lower back of my spine.What do you think?Stephanie from Wellington

A: Considering your age andyour symptoms of lower back

pain, I have to consider thepossibility of you having anabdominal aortic aneurysm whichcan cause lower back pain. If thisis left undiagnosed it can be fatal.I would recommend that you getan ultrasound of the abdominalaorta and see your primary carephysician immediately who willguide you in the right direction.

Q: I have a headache for thepast few weeks when I get

up in the morning. This tendsto go away during the day.What is wrong with me doctor?Jeremiah from West Palm Beach.

A: Jeremiah, you have notmentioned your age in this

question. However there arevarious causes of headaches.Since I do not have your age andmedical history at hand, I wouldconsider the possibility of youhaving uncontrolled hypertensionor otherwise called high bloodpressure. Please call your primarycare physician for a check up.

Questions to Dr. Sharma can be mailed to P.O. Box 542527

Lake Worth, FL 33454-2527

or by email:[email protected]

Analysis: Health care debate a long-running story

President Barack Obama's campaignfor a health care overhaul is an in-tense installment in a long-runningstory, dating to Theodore Roo-

sevelt in 1912.

It did not go well nearly a century ago.Roosevelt made national health insurancean issue in his last, losing campaign for theWhite House, and successive efforts to getit enacted have lost, too.

The basic issue, affordable health care forall Americans, has not changed. But possi-ble solutions have not evolved either, inpart because new proposals seldom build onold ones. Obama's broad, leave-the-details-to-Congress proposal has little incommon with the 1,300-page measure Pres-ident Bill Clinton couldn't even get to avote in a Democratic Senate in 1993.

The Obama strategy was designed to avoidmistakes Clinton made in confronting Con-gress with a massive bill written in theWhite House under the management ofHillary Rodham Clinton and essentiallytelling the House and Senate to take it orleave it. Clinton threatened to veto any bill

that did not deliver universal health care. Hegot nothing to veto.

The Obama team missed part of the lessonwhen the president pressed for passage ofHouse and Senate bills before Congress tookits summer vacation so that they could nego-tiate a final version when they reconvene inSeptember. What he got was narrow com-mittee approval in the House, a preface todebate and action after Labor Day. In theSenate, the Finance Committee was trying tomeet a Sept. 15 deadline to deliver its bill.Obama's push for action before the summerrecess created a goal the Democrats couldn'tmeet and a psychological setback he didn'tneed to risk. He now says that it was no bigdeal and that what he wants is a reform lawby the end of the year, to get all Americansinsured and curb medical costs.

That is a big deal, underscored by his ag-gressive television and traveling campaignto try to build public support and pressurein Congress to enact health care overhaulthis time.

"Now is the hard part because the history isclear every time we come close to passing

health insurance reform, the special interestsfight back with everything they've got,"Obama told a town hall in Portsmouth, N.H.,on Tuesday. "They use their influence. Theyuse their political allies to scare and misleadthe American people. They start runningads. This is what they always do."

Within hours of Obama's comments, theU.S. Chamber of Commerce said it will be-gin airing 30-second ads in about 20 statesWednesday criticizing the Democratic pro-posal to offer optional government health

coverage. The multimillion-dollar ad buywould be one of the largest so far critical ofObama's effort; opponents this year havebeen heavily outspent by supporters ofObama's plan.

Short of enacting an overhaul plan, Obamaand the Democrats could have a major po-litical burden going into the 2010 congres-sional elections, just as Clinton did whenDemocrats lost the 1994 elections after hishealth care failure.

An issue that affects all Americans, theirdoctors, insurers and employers is bound tocarry political risk.

Franklin D. Roosevelt wanted nationalhealth insurance but, even with his power inthe New Deal Congress, he did not dare totie it to Social Security in 1935 lest he losethe whole program. Harry S. Truman pushedit on a Congress that wouldn't buy it.

While Dwight D. Eisenhower balked at na-tional insurance, he tried to get Congress tosupport a reinsurance program to buttressprivate insurers and gain coverage for high-risk patients and the needy.

by blaming ‘The Doctor’. The patient nowwalks out of our office blaming our stafffor something the insurance companyshould be held responsible. The next daythe patient had another episode of chestpains and goes to the emergency room.The ER admits the patient and the costincurred by the insurance company forthis hospital visit amounts to ten timesmore than an outpatient office work up.

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For parents who worry that theirshort child will bepsychologically damaged frommerciless teasing, a new studyprovides reassurance that therewill likely be no lasting effectsfrom any exposure to short jokes.

The study, which appears in theSeptember issue of Pediatrics,found that short children reportedbeing teased only slightly more

than their peers, but such teasing didn't ap-pear to affect their popularity or relation-ships with other children. And, short chil-dren were no more likely than their peers tohave symptoms of depression."The gist of our study is that parents andpediatricians should be reassured by this,"said study author Dr. Joyce Lee, an assis-tant professor in pediatric endocrinology atthe University of Michigan in Ann Arbor."For kids below the 10th percentile [onstandardized growth charts], there didn'tseem to be any significant outcomes interms of popularity or in peer victimizationreported by the teachers."Lee and her colleagues undertook this studybecause many parents are concerned whentheir children fail to grow at a similar paceto their peers. Once medical conditionshave been ruled out, parents often worrythat being significantly shorter than otherchildren the same age will have lasting so-cial or psychological effects on their young-sters, according to the study.This concern may prompt parents to askthat their children be given growth hor-mones, even when not medically indicated.Lee's study included 712 sixth-graders whowere part of the National Institute of ChildHealth and Human Development's Study ofEarly Child Care and Youth Development.The data included information from bothteachers' and children's perceptions of peervictimization or teasing. It also includedmeasures of depression, optimism, popular-ity and social support from peers.According to Lee, the researchers foundthere were really no differences betweenshort children and taller ones. The one fac-tor where shorter children scored slightlyhigher was in the self-report of peer victim-ization. However, the teachers indicated nodifference in peer victimization.Lee said that teachers might miss out on

some of the teasing, or that children mightfocus more on teasing. Also, short childrenmay feel as if they're being picked on solelybecause of their height. The good news,however, is that even with slightly higherlevels of reported teasing, the shorter kidswere still just as popular and had supportfrom their peers, and didn't appear de-pressed or less optimistic due to taunts.As children get older, say in seventh oreighth grade, young teens may have aharder time if they're smaller, Lee said."Adolescence is a particular time when youhave a lot of differences in growth, andone might predict it would be a little moredifficult time if you're of short stature," shenoted.Dr. Jennifer Helmcamp, a pediatrician atScott & White Healthcare in Temple,Texas, said she thought the new study "is avery helpful article for parents. It showsthat even when teased, all children prettymuch come out the same for levels of pop-ularity, acceptance by peers and behavioralproblems."Helmcamp explained that there are threetypes of short stature: familial, constitu-tional and systemic. Familial is the heightpassed down by your parents. If both par-ents are short, then it's likely the child willbe too. Constitutional is when kids are late-bloomers, and they may not get a signifi-cant growth spurt until the end of highschool. Systemic is when there are medicalreasons for short stature, and these oftencan be treated, she said."If you've got familial or constitutionalshort stature, you can be reassured that so-cial outcomes will be on par," Helmcampsaid.If you're at all concerned about your child'sheight, Helmcamp said you should discussit with your child's pediatrician, who can letyou know whether or not your child needsfurther evaluation.

For Short Kids, NoLack of Self-Esteem

Talk to Your Kids aboutTobacco, Alcohol, and Drugs

Talk to your child about the dangers of to-bacco, alcohol, and drugs. Explaining thefacts will help your child make healthychoices.

Kids who don't use alcohol or drugs areless likely to:Have serious trouble in schoolGet hurt in car accidentsBe victims of crime.Research shows that kids do listen to their

parents. Children who learn about drugrisks from their parents are less likely tostart using drugs. If you say nothing, yourchild may think it's okay to use alcohol andother drugs.Start early. By preschool, most childrenhave seen adults smoking cigarettes ordrinking alcohol, either in real life or on TV.

Many kids start using tobacco by age 11 andare addicted by age 14. Between ages 9 and13, kids begin to think that using alcohol isokay. Some children are already abusingdrugs at age 12 or 13.

Explain the facts about tobacco, alcohol,and drugs.Tell your child that you expect him or hernot to use alcohol and other drugs.Teach your child how to say “no” to drugs.


Wellington Regional Medical CenterHosts Residency Graduation DinnerWellington Regional Medical

Center held its Annual Res-idency Graduation Dinnercelebration on June 10, 2009

at the hospital’s new Conference Center.In celebration, graduating residents and in-terns along with family members and guestsenjoyed a beautiful catered dinner.

The evening began with welcoming re-marks and congratulations by Director ofMedical Education, Jeffrey Bishop, D.O.There were four Family Practice Residentgraduates: Danielle Manolakos, D.O.,Daniel Dodson, D.O. Nikerson Geneve,D.O. and Carmen Marrero, D.O. FamilyPractice Residency Director, Dr. RobertCampitelli, presented diplomas and wordsof congratulations, along with Dr. JoannaWiddows, Internal Medicine Residency Di-rector.

Diplomas were presented to graduatingDermatology Residents, Marianne Carroll,D.O. and Patricia Klem, D.O. by Dermatol-ogy Residency Director, Dr. Brad Glick.There were four graduating interns: Jen-nifer Berger, D.O. who accepted a PediatricResidency at Miami Children’s Hospital;Brad Troxler, D.O., going on to a Residencyprogram in Physical and Rehab Medicine atBoston University Medical Center; GregPolar, D.O., who as accepted a PathologyResidency at Baystate Medical Center,Stacy Rosenblum, D.O. who will be doingresearch and Brad Goldstein, D.O., pursu-ing an Internal Medicine.

There were special awards presented to:- Greg Polar, D.O., Most Valuable Intern - Geeta Malhotra, D.O., Most Valuable Res-ident

Special recognition was given to the follow-ing physician mentors for their dedication tothe Residency Programs:- Mauricio Melhado, Golden Apple Award

- Joanna Widdows, D.O., Resident ChoiceAward

The Medical Education Program atWellington Regional Medical Center, that

graduated its first group of residents in1990, is accredited by the American Os-teopathic Association and is affiliated withthe Lake Erie College of Osteopathic Medicine.

The program provides a comprehensivepostgraduate medical education curriculumoffering resident maximum exposure to allareas of osteopathic medicine through a se-

ries of service rotations. Specialty resi-dency programs are offered in Family Prac-tice, Internal Medicine, Dermatology andlater this year, Emergency Medicine.

“We are very proud of our exceptionalphysician graduates, “said Dr. JeffreyBishop. “They leave our program well pre-pared for independent practice with strongfoundations in osteopathic medicine.”

Back row, from l-r: Kevin DiLallo, Chief Executive Officer; Dan Dodson, D.O.; Nikerson Geneve, D.O.; Mohammad Yaqub, M.D., Attending,Internal Medicine.Middle row, from 1-r: Jeffrey Bishop, D.O., Director of Medical Education and Chief Medical Officer; Geeta Malhotra, D.O., Danielle Manolakos,D.O.; James Landero, D.O.; Carmen Marrero, D.O.; Iris Saleh, D.O.; Joanna Widdows, D.O., Internal Medicine Residency Director.Front row, from l-r: Brad Troxler, D.O.; Stacey Rosenblum, D.O.; Brad Goldstein, D.O.; Greg Polar, D.O. Missing from the group: JenniferBerger, D.O.

iMedX Announces Acquisitionof Medware Inc.Will create one of the industry'slargest transcription serviceproviders and offer newopportunities to deliver leadingInternet-based technologies tocombined customer-base.

SHELTON, Conn., - iMedX Inc., aleading healthcare software andservices company, announced to-day that it has acquired Medware

Inc. With this acquisition, iMedX expandsits reach into the hospital market andemerges as one of the largest medical tran-scription companies in the United States.

Based just outside of Orlando, Florida,Medware currently serves over sixty healthsystems across the country, utilizing a laborforce of over 350 US-based medical lan-guage specialists. As a result of this signif-icant acquisition iMedX will benefit fromgreater penetration into the large healthsystem market. Medware's fifteen-years ofexperience providing high quality tran-scription services to leading hospitals andclinics will augment iMedX's reputationas a quality leader in technology-enabledmedical documentation services.

Venkat Sharma, iMedX's President andCEO, along with the current iMedX man-agement team, will continue to lead the

combined companies. Medware will operateas a division of iMedX, with Medware's ex-perienced production and operational teamjoining iMedX to create a stronger com-bined customer-facing organization. "Thisacquisition offers significant advantages toiMedX in terms of strengthening revenueand operational efficiencies and by gainingnew opportunities to deliver leading-edgeInternet-based technology and services toour combined customer base," said Mr.Sharma. "Our customers will benefit be-cause all of our solutions are designed to im-prove their efficiency, accuracy and ulti-mately, the quality of care in the dynamichealthcare industry."

About iMedXiMedX is a leading US-based outsourceprovider of healthcare software and servicesto hospitals and medical practices through-out the U.S. iMedX's innovative Internet-based transcription delivery platform, Tur-boScribe(R) is used by thousands ofproviders across the United States. Highquality transcription services are providedthrough delivery centers in the U.S. and In-dia. iMedX's new TurboRecord(R) elec-tronic medical record service and an e-Pre-scription platform TurboRx(R) allowsdoctors to comply with HIPAA guidelinesand minimize costs. iMedX is headquar-tered in Shelton, Connecticut.For more information please visit:www.imedx.com.

Eat this fish to protect yourskin from sun damage

As a kid I used to spend my sum-mer vacation at the beach soak-ing up the sun. These days, notso much—I’m way too worried

about keeping my skin wrinkle-free. Butmy fiancé Andy’s job keeps him outside inthe sun all day long. Not just in the summer,but all year round. Although he wears sun-screen, he’s kind of given up on trying toward off wrinkles, but skin cancer? That’sscary stuff—and sunscreen can only do somuch.

So to help protect our skin we’re addingmore salmon and tuna to our diet. (Finddelicious salmon recipes here.) The omega-3 fatty acids in oily fish like salmon andtuna can boost your skin’s defenses againstUV damage, according to a recent study inthe American Journal of Clinical Nutrition.

Researchers found that study participantswho ate a little more than 5 ounces ofomega-3-rich fish each week decreased thedevelopment of precancerous skin lesionsby almost 30 percent. Scientists think theomega-3s act as a shield, protecting cellwalls from free-radical damage.

So next time you head to the beach or spendthe day in the garden remember your sun-screen and hat, and cook up one of these

omega-3-rich recipes for dinner: Find moretuna recipes here.

Mediterranean Tuna Antipasto Salad – Alsopacked with protein and fiber, this tuna andbean salad is ready in a flash. Serve withwarm, crusty bread or pack it in a pita for asandwich.

Salmon Burgers with Green Goddess Sauce– The key to perfect salmon burgers is tohandle the fish delicately: don’t overseason,overhandle or overcook it. Serve over a bedof salad greens with the Green GoddessSauce dolloped on top or as a traditionalburger using the sauce as a spread for thebun.


House health plan to boost taxes on richWASHINGTON – House Democratsrolled out a far-reaching $1.5trillion plan that for the first timewould make health care a rightand a responsibility for allAmericans, with medicalproviders, employers and thewealthiest picking up most of thetab.

The federal government would beresponsible for ensuring that everyperson, regardless of income orthe state of their health, has access

to an affordable insurance plan. Individualsand employers would have new obligationsto get coverage, or face hefty penalties.Health care overhaul is President BarackObama's top domestic priority, and his goalis to slow rising costs and provide coverageto nearly 50 million uninsured Americans.Democratic leaders said they would pushthe measure through committee and towarda vote in the full House by month's end,while the pace of activity quickened on theother side of the Capitol.Senate Majority Leader Harry Reid said hewanted floor debate to begin a week fromMonday. Other officials said that timetablewas likely to slip. Even so, it underscored arenewed sense of urgency.The House legislation unveiled by SpeakerNancy Pelosi and other Democrats wouldslow the growth of Medicare and Medicaidpayments to medical providers. From bighospitals to solo physician practices,providers also would be held to account forquality care, not just ordering up tests andprocedures. Insurance companies would beprohibited from denying coverage to thesick. The industry also would face stiffcompetition from a new government plandesigned along the lines of Medicare.The liberal-leaning plan lacked figures ontotal costs, but a House Democratic aidesaid the total bill would add up to about$1.5 trillion over 10 years. The aide spokeon condition of anonymity to discuss theprivate calculations. Most of the bill's costscome in the last five years after the 2012presidential election.The legislation calls for a 5.4 percent tax in-crease on individuals making more than $1million a year, with a gradual tax beginningat $280,000 for individuals. Employers whodon't provide coverage would be hit with apenalty equal to 8 percent of workers'wages with an exemption for small busi-nesses. Individuals who decline an offer ofaffordable coverage would pay 2.5 percentof their incomes as a penalty, up to the av-erage cost of a health insurance plan.With Obama pressing Congress to act onhealth care this summer, House leaderswant to move their bill quickly throughthree committees and to a floor vote beforethe August congressional recess. But agroup of moderate and conservative De-mocrats has withheld support, and no Re-publican votes are expected.The House bill seemed unlikely to winbroad backing in the Senate, where the Sen-ate Health, Education, Labor and PensionsCommittee was expected to finish its ver-sion of the legislation in what was lookingto be a party-line vote. Another panel, theSenate Finance Committee, was striving tounveil a bill by the end of the week.Standing before a banner that read "QualityAffordable Care for the Middle Class,"Pelosi, D-Calif., called the moment "his-

Separately, Obama spoke by telephone withSen. Charles Grassley, the Iowa Republicanviewed as critical to the fate of bipartisannegotiations in the Senate.House Democrats said the income tax in-crease in their bill would apply only to thetop 1.2 percent of households, those whoearn about one-quarter of all income. Thewealthiest 4 percent of small business own-ers would be among them. The tax wouldstart at 1 percent for couples making$350,000 and individuals earning $280,000,ramp up to 1.5 percent above $500,000 ofincome, and jump to 5.4 percent for thoseearning above $1 million.The tax would raise an estimated $544 bil-lion over 10 years.Business groups and the insurance industryimmediately assailed the legislation. In aletter to lawmakers, major business organ-izations branded the 1,000-page bill a job-killer. Its coverage mandate would auto-matically raise the cost of hiring a newworker, they said."Exempting some micro-businesses will notprevent this provision from killing manyjobs," the letter said. "Congress should al-low market forces and employer autonomyto determine what benefits employers pro-vide, rather than deciding by fiat."The business groups also warned that theU.S. health care system could be damagedby adding a government-run insurance planand a federal council that would make some

comes up to four times the federal povertylevel, or $88,000 for a family of four and$43,000 for an individual. Medicaid — thefederal-state health program for the poor— would be expanded to individuals andfamilies up to 133 percent of the povertyline. About 17 million people would remainuninsured — about 6 percent of the popu-lation — and half of them would be illegalimmigrants.The legislation also would improve theMedicare prescription drug benefit by grad-ually reducing a coverage gap known asthe 'doughnut hole.'The individual and employer coverage re-quirements would raise about $192 billionover 10 years, the Congressional BudgetOffice said.Even before the bill was unveiled, theHouse Ways and Means Committee an-nounced it would vote on the proposal. Thepanel is one of three that must act before thebill can go to the full House, probably laterin the month.Some House Democrats privately have ex-pressed concern that they will be required tovote on higher taxes, only to learn later thatthe Senate does not intend to follow throughwith legislation of its own. That wouldleave rank-and-file House Democrats upfor re-election next year in the uncomfort-able position of having to explain their voteon a costly bill that never reached Obama'sdesk or became law.

How HealthInsuranceReform willBenefit FloridaEnding the Hidden Tax – Saving YouMoney: Right now, providers in Florida loseover $3.4 billion in bad debt which oftengets passed along to families in the form ofa hidden premium “tax”. Health insurancereform will tackle this financial burden byimproving our health care system andcovering the uninsured, allowing the 200hospitals and the 58,565 physicians inFlorida to better care for their patients.Health Insurance Premium Relief:Premiums for residents of Florida haverisen 88% since 2000 Through healthinsurance reform, 3,233,600 to 3,741,500middle class Florida residents will beeligible for premium credits to ease theburden of these high costs.5

Strengthening Small Businesses: 298,566employers in Florida are smallbusinesses.6 With tax credits and a healthinsurance exchange where they can shopfor health plans, insurance coverage willbecome more affordable for them.

Reforms that Reduce Your Costs: Underhealth insurance reform, insurancecompanies will be prevented from placingannual or lifetime caps on the coverageyou receive. Insurance companies will alsohave to abide by yearly limits on how muchthey can charge for out-of-pocketexpenses, helping 79,800 households inFlorida struggling under the burden of highhealth care expenses.7

INCREASE YOUR CHOICES:PROTECTING WHAT WORKS ANDFIXING WHAT'S BROKENInsurance Stability and Security: Healthinsurance reform will strengthen oursystem of employer-based healthinsurance, with an additional 165,600people in Florida potentially gettinginsurance through their work. Healthinsurance reform will also ensure that youwill always have guaranteed choices ofquality, affordable health insurance if youlose your job, switch jobs, move or get sick.Eliminating Discrimination for Pre-ExistingConditions, Health Status or Gender: 10%of people in Florida have diabetes9, and28% have high blood pressure – twoconditions that insurance companies coulduse as a reason to deny you healthinsurance. Health insurance reform willprevent insurance companies from denyingcoverage based on your health, and it willend discrimination that charges you more ifyou’re sick or a woman.

One-Stop Shopping – Putting Families inCharge: With the new health insuranceexchange, you can easily and simplycompare insurance prices and health plansand decide which quality affordable optionis right for you and your family. Theseproposals will help the 373,8200 residentsof Florida who currently do not have healthinsurance to obtain needed coverage, andit will also help the 950,800 Floridaresidents who currently purchaseinsurance in the individual insurancemarket.11

Guaranteeing Choices: The largest healthinsurer in Florida holds 24% of the market,which limits the choices that you have forfinding coverage.12 With a competitivepublic insurance option, you will have morechoices and increased competition thatholds insurance companies accountable.

toric and transformative." The bill wouldprovide "stability and peace of mind" bybraking costs and guaranteeing coverage,she said."We are going to accomplish what manypeople felt wouldn't happen in our life-time," said House Energy and CommerceCommittee Chairman Henry Waxman, D-Calif., one of the main sponsors. Obama,who issued a statement hailing the meas-ure, plans to keep up the pressure on Con-gress by delivering remarks in the RoseGarden on Wednesday.Speaking in Warren, Mich., where he waspromoting new spending for communitycolleges, Obama anticipated a congres-sional confrontation over health care."There's going to be a major debate overthe next three weeks," he said, deviatingfrom his prepared text. "And don't befooled by folks trying to scare you sayingwe can't change the health care system.Wehave no choice but to change the healthcare system because right now it's brokenfor too many Americans."

decisions on benefits, as called for in thelegislation. Thirty-one organizations signedthe letter, including the U.S. Chamber ofCommerce, the Business Roundtable repre-senting top corporate CEOs and the Na-tional Retail Federation.The House bill would change the way indi-viduals and many employers get health in-surance. It would set up a new nationalpurchasing pool, called an exchange. Theexchange would offer a menu of plans,with different levels of coverage. A govern-ment plan would be among the options,and the exchange would eventually be opento most employers. Insurers say that com-bination would drive many of them out ofbusiness since the public plan would beable to offer lower premiums to virtually allAmericans.But backers of a public plan — includingObama — say it would provide healthycompetition for the insurance industry.Under the House bill, the governmentwould provide subsidies to make coveragemore affordable for households with in-


Wish Fulfillment? No. But Dreams (and Sleep) Have Meaning

You know that friend, the onewho is always tapping her leg,getting up to straighten thebookshelf, the one who gener-

ally just can’t sit still? She’s likely burn-ing an extra 200 to 300 calories a day ontop of any workouts she does or theamount of calories she burns just beingalive. This process is neatly called NEAT,which stands for “NonExercise ActivityThermogenesis” (say that 5 times fast!),and it’s essential for successful weightloss. Basically, it’s the extra stuff you do,physically, all day long that adds up.Make a point to add more “neat” into yourday and you can zap another 500 calories!Here are a few ideas:

Do crunches in bed:You couldburn about 20 calories in under 5 minutesjust by drawing your knees to your chest25 to 50 times, plus it strengthens yourabs and gets your blood pumping.

Dance around while gettingdressed: Turn up the radio or listen toupbeat music on your iPod (if you can)while doing all your morning rituals—anhour of hip shakin’ can burn about 55calories.

Stand up! Don’t sit when you can beon your feet—you’ll burn about 40%more calories. So just take a stand—whenyou’re on the phone, watching kids at theplayground, making small talk at a party.

Dreams may not be the secretwindow into the frustrated de-sires of the unconscious thatSigmund Freud first posited

in 1899, but growing evidence suggeststhat dreams - and, more so, sleep - arepowerfully connected to the processingof human emotions.

According to new research presented lastweek at the annual meeting of the Asso-ciated Professional Sleep Societies inSeattle, adequate sleep may underpin ourability to understand complex emotionsproperly in waking life. "Sleep essen-tially is resetting the magnetic north ofyour emotional compass," says MatthewWalker, director of the Sleep and Neu-roimaging Lab at the University of Cali-fornia, Berkeley.

A recent study by Walker and his col-leagues examined how rest - specifically,rapid eye movement (REM) sleep - influ-ences our ability to read emotions inother people's faces. In the small analysisof 36 adults, volunteers were asked tointerpret the facial expressions of peoplein photographs, following either a 60- or90-minute nap during the day or with nonap.

Participants who had reached REM sleep(when dreaming most frequently occurs)during their nap were better able to iden-tify expressions of positive emotions likehappiness in other people, compared withparticipants who did not achieve REMsleep or did not nap at all. Those volun-teers were more sensitive to negative ex-pressions, including anger and fear.

Past research by Walker and colleagues atHarvard Medical School, which was pub-lished in the journal Current Biology,found that in people who were sleep de-prived, activity in the prefrontal lobe - aregion of the brain involved in control-ling emotion - was significantly dimin-ished. He suggests that a similar responsemay be occurring in the nap-deprivedvolunteers, albeit to a lesser extent, andthat it may have its roots in evolution. "Ifyou're walking through the jungle andyou're tired, it might benefit you more tobe hypersensitive to negative things," hesays. The idea is that with little mentalenergy to spare, you're emotionally moreattuned to things that are likely to be themost threatening in the immediate mo-ment.

Inversely, when you're well rested, youmay be more sensitive to positive emo-tions, which could benefit long-term sur-vival, he suggests: "If it's getting food, ifit's getting some kind of reward, finding

a wife - those things are pretty good topick up on."Our daily existence is largely influencedby our ability "to understand our societalinteractions, to understand someone else'semotional state of mind, to understandthe expression on their face," says NinadGujar, a senior research scientist atWalker's lab and lead author of the study,which was recently submitted for publica-tion. "These are the most fundamentalprocesses guiding our personal and pro-fessional lives."

REM sleep appears to not only improveour ability to identify positive emotions inothers; it may also round out the sharp an-gles of our own emotional experiences.Walker suggests that one function ofREM sleep - dreaming, in particular - is toallow the brain to sift through that day'sevents, process any negative emotion at-tached to them, then strip it away from thememories. He likens the process to apply-ing a "nocturnal soothing balm." REMsleep, he says, "tries to ameliorate thesharp emotional chips and dents that lifegives you along the way."

"It's not that you've forgotten. Youhaven't," he says. "It's a memory of anemotional episode, but it's no longer emo-tional itself."That palliative safety-valve quality ofsleep may be hampered when we fail toreach REM sleep or when REM sleep isdisrupted, Walker says. "If you don't letgo of the emotion, what results is a con-stant state of anxiety," he says.

The theory is consistent with new re-search conducted by Rebecca Bernert, adoctoral candidate in clinical psychologyat Florida State University who special-izes in the relationship between sleep andsuicidal thoughts and behaviors, and whoalso presented her work at the sleep con-ference.

In her study of 82 men and women be-tween the ages of 18 and 66 who were ad-mitted into a mental-health hospital foremergency psychiatric evaluation, Bern-ert discovered that the presence of severeand frequent nightmares or insomnia wasa strong predictor of suicidal thoughtsand behaviors. More than half of the studyparticipants had attempted suicide at leastonce in the past, and the 17% of the studygroup who had made an attempt withinthe previous month had dramaticallyhigher scores in nightmare frequency andintensity than the rest. Bernert found thatthe relationship between nightmares orinsomnia and suicide persisted, evenwhen researchers controlled for other fac-tors like depression.

by Liz Vaccariello

Laugh: Watch something that’s con-sistently funny (like 30 Rock) and youcould burn about 40 calories if you guf-faw for 10 to 15 minutes straight.

Walk, pace, jog down thehall: In other words, MOVE! Doing lit-tle bits of activity all day—taking thestairs to use the restroom on another floorat work, doing an extra lap around thegrocery store—can help you burn an addi-tional 375 calories a day!

Atransplant surgeon who com-pleted an unprecedented eight-way kidney swap this week saidTuesday he believes such intri-

cate, multistate exchanges can drasticallyreduce the number of patients waiting foreligible donors.

Dr. Robert Montgomery, chief transplantsurgeon at Johns Hopkins Hospital, anddoctors at four hospitals in four states trans-planted eight kidneys over three weeks inwhat he called the largest chain of donationsin history. "We finally beat the 'Grey'sAnatomy' record for domino transplants,"Montgomery joked at a news conferencehours after the last in a series of surgerieswas completed Monday night. "We hopethis creates a movement that encouragesother transplant centers to adopt the modelwe used."

The donor pool in the United States couldfacilitate 1,500 transplants per year if trans-plant centers nationwide participated in

computer modeling that matches donorswith recipients, Montgomery said.

Multiple-kidney transplants occur whenseveral people who need transplants havefriends or relatives who are willing to do-nate kidneys but aren't compatible. A chainof surgeries is arranged in which each donoris matched with a transplant candidate whothey don't know but is compatible with thekidney being given up. The chain of trans-plants typically also involve a so-called al-truistic donor, who's willing to give a kid-ney to anyone and is located through adatabase.

Ten doctors performed 16 surgeries on theeight donors and eight recipients at Hop-kins, Barnes-Jewish Hospital in St. Louis,INTEGRIS Baptist Memorial Center inOklahoma City and Henry Ford Hospital inDetroit. Recipients and donors were equallydelighted to be part of unique procedure."My kidney lives and pees in St. Louis rightnow," said a teary Pamela Paulk, a 55-year-old donor and a vice president of human re-sources at Johns Hopkins.

Paulk joined the group because a co-workerof hers needed a kidney but wasn't compat-ible with hers. Kidneys given by livingdonors are estimated to have double thelongevity of kidneys taken from cadavers,Montgomery said. Surgeons at Johns Hop-kins transplanted six kidneys simultane-ously in April 2008 and performed a quin-tuple transplant in 2006. They have alsocompleted several triple transplants.

Md. Doctor: Kidney TransplantRecord Achieved

Transplant surgeon Dr. Robert Montgomeryfields questions during a news conference, atJohns Hopkins Hospital in Baltimore.


For Macho Men, Doctor Visits Are Less LikelyIt's no secret that men don't liketo go to the doctor, but newresearch finds they're especiallylikely to stay home if they're bigon being macho.

Middle-aged men who are mostdevoted to traditional beliefsabout masculinity are half aslikely as other men to get rou-

tine medical care, researchers report.

It's not clear whether feelings about mas-culinity directly make men avoid doctorvisits; the study only indicates that a cause-and-effect link might exist. Nor do re-searchers know what this might mean formen's health.

Still, the findings suggest that "we couldhelp men's health if we could dismantlethis idea that manhood and masculinity isabout being invulnerable, not needing helpand not showing pain," said study authorKristen W. Springer, an assistant professorof sociology at Rutgers, the State Universityof New Jersey.

Previous research has suggested that "menare less likely to go to the doctor thanwomen, across the board," Springer said --a notion she finds surprising because menare wealthier overall, potentially givingthem better access to medical care.

Springer and a colleague launched theirstudy to determine the role that ideas aboutmasculinity play in the decisions men makeabout their health care.

Springer said she defines masculinity as a"stereotypical, old-school, John Wayne- andSylvester Stallone-style" approach to life.

The researchers examined the results ofsurveys taken in 2004 by 1,000 white, mid-dle-aged men in Wisconsin. The men an-swered questions about their beliefs regard-ing masculinity and disclosed whetherthey'd gotten recommended annual physi-cals, prostate checks and flu shots.

After adjusting the results to reduce thechance they would be thrown off by suchthings as a high number of married partic-ipants, researchers found that men whowere the highest believers in masculine

standards were 50 percent less likely to getthe recommended care than other men.

Springer was unable to provide statisticsabout the percentage of men in each groupwho got the recommended care. Overall,though, fewer than half of all men did, ac-cording to the study.

There was one exception to the rule: Blue-color workers who had a high attachment tomasculinity were more likely to get the rec-ommended health care.

The study has limitations. All participantswere white, and all had completed highschool. And Springer said unansweredquestions remain, such as whether spousesplay a role through "support or nagging."

The findings were to be presented Mondayat the American Sociological Associationannual meeting in San Francisco.

Howard S. Friedman, a professor of psy-chology at the University of California atRiverside, said his research has found thatless masculine men live longer than mas-culine men. But the new study doesn'tshow anything like that because it doesn'texamine long-term effects on health, hesaid.

As for the gap between men and womenwhen it comes to living longer, he said, "itwould be a stretch, going beyond the data,to link it closely to men's increased mortal-ity risk as compared to women."

British Girl's Heart HealsItself After Transplant

LONDON — British doctors de-signed a radical solution to save agirl with major heart problems in1995: They implanted a donor

heart directly onto her own failing heart.

After 10 years with two blood pumping or-gans, Hannah Clark's faulty one did whatmany experts had thought impossible: ithealed itself enough so that doctors couldremove the donated heart. But she also hada price to pay: The drugs Clark took to pre-vent her body from rejecting the donatedheart led to malignant cancer that requiredchemotherapy. Details of Clark's revolu-tionary transplant and follow-up care werepublished online in the medical journalLancet.

"This shows that the heart can indeed repairitself if given the opportunity," said Dr.Douglas Zipes, a past president of theAmerican College of Cardiology. Zipes wasnot linked to Clark's treatment or to theLancet paper. "The heart apparently hasmajor regenerative powers, and it is nowkey to find out how they work." In 1994,when Clark was eight months old, she de-veloped severe heart failure and doctorsput her on a waiting list to get a new heart.But Clark's heart difficulties caused prob-lems with her lungs, meaning she alsoneeded a lung transplant.

To avoid doing a risky heart and lung trans-plant, doctors decided to try somethingcompletely different. Sir Magdi Yacoub ofImperial College London, one of theworld's top heart surgeons, said that ifClark's heart was given a time-out, it mightbe able to recover on its own. So in 1995Yacoub and others grafted a donor heartfrom a 5-month-old directly onto Clark'sown heart. After four and a half years, bothhearts were working fine, so Yacoub andcolleagues decided not to take out the extraheart. The powerful drugs Clark was takingto prevent her from rejecting the donorheart then caused cancer, which led tochemotherapy. Even when doctors loweredthe doses of drugs to suppress Clark's im-mune system, the cancer spread, and Clark'sbody eventually rejected the donor heart.

Luckily, by that time, Clark's own heartseemed to have fully recovered. In February2006, Dr. Victor Tsang of Great OrmondStreet Hospital in London, Yacoub andother doctors removed Clark's donor heart.Since then, Clark — now 16 years old —has started playing sports, gotten a part-time job, and plans to go back to school inSeptember. "Thanks to this operation, I'venow got a normal life just like all of myfriends," said Clark, who lives near Cardiff.

Her parents marveled at her recovery, andsaid that at one point during Clark's illness,they were told she would be dead within 12hours. Miguel Uva, chairman of the Euro-pean Society of Cardiology's group on car-diovascular surgery, called Clark's case "amiracle," adding that it was rare for patients'hearts to simply get better on their own.Still, transplants like Clark's won't bewidely available to others due to a shortageof donor hearts and because the necessarysurgeries are very complicated. In the lastfew years, artificial hearts also have beendeveloped that can buy patients the timeneeded to get a transplant or even for theirown heart to recover. Zipes said if doctorscan figure out how Clark's heart healed it-self and develop a treatment from thatmechanism, many other cardiac patientscould benefit.

At the moment, doctors aren't sure how thatregeneration happens. Some think there area small number of stem cells in the heart,which may somehow be triggered in crisissituations to heal damaged tissue. Expertssaid Clark's example is encouraging both todoctors and patients.

Eating a bowl of your favorite ce-real every day is a great source ofnatural antioxidants, new researchshows.

Joe Vinson, a professor of chemistry at theUniversity of Scranton, in Pennsylvania,and his team have found that nearly allwhole-grain breakfast cereals and manycommon, grain-based snacks contain sub-stantial amounts of polyphenols, a form ofantioxidants that is thought to have majorhealth benefits. Vinson was scheduled topresent his findings Tuesday at the Ameri-can Chemical Society annual meeting, heldin Washington, D.C."Cereals have a plethora of [good things],"said Vinson, who tested more than 30brands and types of breakfast cereals foundin supermarkets. "They all have polyphe-nols."Whole grains are the main source ofpolyphenols in breakfast cereals, and sincenearly all cereals contain at least somewhole grains, it stands to reason that con-sumers should consider making cereals aregular part of their diet, said Vinson,adding that he received no food industryfunding for his study."Early researchers thought the fiber wasthe active ingredient for these benefits inwhole grains -- the reason why they may re-duce the risk of cancer and coronary heartdisease," Vinson noted. "But recently,polyphenols emerged as potentially moreimportant. Breakfast cereals, pasta, crackersand salty snacks constitute over 66 percentof whole grain intake in the U.S. diet," headded."We found that, in fact, whole-grain prod-ucts have comparable antioxidants per gramto fruits and vegetables," Vinson said. "Thisis the first study to examine total phenol an-tioxidants in breakfast cereals and snacks,whereas previous studies have measuredfree antioxidants in the products."Polyphenols occur naturally in plants and

are the most abundant antioxidant. Theyhave anti-inflammatory properties, and sci-entists believe they may reduce the risk ofcardiovascular disease, cancer and other ill-nesses.Nutritionists have recommended regularconsumption of green tea, red wine, fruits,nuts and a few other food categories fortheir antioxidant content. Raisin bran had the most polyphenols -- 3percent by weight; however, Vinson attrib-uted the concentration to the raisins -- likeother dried fruits, a known rich source ofantioxidants.Another high-ranking cereal was a wheat-based blend containing the polyphenol-richspice cinnamon. Vinson declined to namethe brands he tested, but he encouragedpeople to add nuts, raisins and variousspices like cinnamon to their cereal to boosttheir polyphenol content.As for snacks, Vinson found that popcornhad the most polyphenols (2.6 percent), fol-lowed by whole-grain crackers (0.45 per-cent). Sadly, most processed tortilla chips -- Vinson's favorite -- contained negligibleamounts of polyphenols.Registered dietician and nutritionist EvaTo, who practices in White Plains, N.Y.,said she found the study fascinating, but shehad some concerns."Whole-grain cereal is a great replacementfor high-fat breakfast food or as a replace-ment for no breakfast at all, since breakfastis the most important meal of the day," saidTo, who specializes in obesity and diabetesmanagement. "But moderation is the key.Many cereals contain ingredients that maynot be very good for you, such as excessivesugar."Also, she added, "cereals are easy to bingeon. It is very important to follow the servingsize suggestions."

Doctors grafted a donor heart onto HannahClark's own ailing heart. This gave the sickheart a chance to heal itself.

Antioxidants Abound in Cereals, Popcorn, Whole-Grain Snacks


Tips to protect your petfrom summer heatWith summer upon us, warmerweather beckons everyoneoutdoors to enjoy the sunshine.When family and friends gatherfor backyard barbecues andoutings in the park, it is natural towant to include the pets. It iswise, though, to consider thehealth and safety of pets beforetaking them out into the heat forprolonged periods.

Pets cannot tolerate heat the sameway as people. One big reason isthat dogs don't sweat, thereby lack-ing a natural way to cool down. To

help ensure your pets don't suffer from theheat, veterinarian Tracy Chase-Thompson,department chair of the veterinary technol-ogy program at Brown Mackie College inMichigan City, Ind., offers advice. "Heatexhaustion is one of the big things that canoccur," she says. "It happens more withdogs than cats, but it can occur with both."

Heat exhaustion is a dangerous condition inanimals that occurs due to lack of protec-tion from hot weather and humidity. "Itdoesn't take much time for heat exhaustionto develop," says Chase-Thompson. "A dogcan overheat in a hot vehicle in just 10 min-utes." Symptoms of heat exhaustion includeheavy panting, drooling and labored breath-ing. "Gum color is another indicator. Ifgums appear red instead of pink, that's asign of an animal in distress."

Normal body temperature for a dog is be-tween 101 F and 102 F. "A temperaturehigher than 105 F signals heat exhaustion,"says Chase-Thompson. In this case, the dogwould require veterinarian care with IV flu-ids for hydration, and close monitoring ofbody temperature.

Pet owners can take a number of precau-tions to prevent heat stress and exhaustionin pets. If your dog will spend any amountof time outside, Chase-Thompson advisesproviding a shelter so that the dog can ac-cess shade at all times, and walking your

dog before 10 a.m. or after 4 p.m. whensunlight and humidity are less powerful."It is safer to leave your pet at home on hotor humid days rather than in the car, evenwith the windows cracked. If you must takeyour pet, park in the shade, open the win-dow, and don't leave for more than 10 min-utes," she adds.

Another concern among pet owners is howto protect a pet that is afraid of the noisefrom fireworks and thunderstorms. "Somepets have a fear of noise at a young age.Others are fine when they're young, yet be-come bothered by loud sounds as they growolder," says Chase-Thompson. "It's impos-sible to make the noise go away, but thereare ways to minimize or disguise the noise.

"If you leave the dog alone, it could help toleave music playing. Turn on the radio orTV, or even a loud fan or air conditioner,"she advises. "If the animal's reaction is re-ally bad, I recommend staying with yourpet to provide reassurance. There are anti-anxiety medications that a veterinarian canprescribe." Chase-Thompson advises dis-cussing with your veterinarian whetheryour pet is a good candidate. "Medicationscan help, but they don't always work. It isimportant to lessen your pet's fear withother types of comfort," she says.

Can your dog save the planet?We all think our dogs are super, but couldyour dog help save the planet by reducinglandfill waste? How you train your dog hasa big impact on the environment and onyour wallet.

Housebreaking a puppy or dog is never fun,but it’s a necessary part of adding a newmember to the family. There will be un-pleasant messes to clean up, but you’ll needto teach the dog the right and wrong placesto go. So, where does saving the environ-ment come into play?

Many people use training pads (essentiallybig, flat disposable diapers) for housetrain-ing the dog, or to use as a "dog bathroom"indoors. Unfortunately they are dirty, dogscan drag them around the house and theyare definitely not eco-friendly.

Using an indoor dog potty can make house-training much easier. Here are a few othertips to help you and your four-legged friendthrough the process:

* Take your puppy or dog to his bathroomarea immediately in the morning.

* Take him to his area immediately aftereach meal.

* Give him lots of cheerful praise when hegoes in the appropriate place.

* Never punish a dog for a housetrainingmistake; he won’t understand why he’s introuble. If you catch him in the act, tell him"no" firmly and move him to the appropri-ate area immediately.

Once your canine friend gets the hang of it,having a dog toilet in the house will preventhim having to "hold it" all day and you’llappreciate not having to clean up messeswhen you get home.

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florida health news - september 2009 issue

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