Wednesday, May 29, 2019

You Are My Sunshine.

Ever feel caught between a rock and a hard place? That's what I'm feeling after reading the JAMA report on sunscreens. First some disclosure: my father died from skin cancer complications and I am your typical fair-skinned, blue-eyed, auburn-haired walking sunburn magnet. Slathering on the sunscreen is second nature to me. Then last year Hawaii became the first to ban certain sunscreens that have been shown harmful to coral reefs. Even though I live inland, there's plenty of waterways around, and who knows what other environments it may affect, so I switched to a mineral-based sunscreen and tried to cover up more. That switch helped to avoid the culprits in the current JAMA report: avobenzone, ecamsule, octocrylene, and oxybenzone. Granted, the JAMA findings are from a trial study by the FDA, a trial used to establish if more research is needed (which it is). There are studies dating back to 1997 that talk about how the active ingredients are absorbed into the blood stream, but the companies producing these products never quite got around to conducting the safety studies. Hopefully, the FDA trial study will get the show on the road.

So, what's the problem with absorbing these ingredients? The Environmental Working Group (EWG) has a wonderful chart on the most common active ingredients and any studies about side effects. Effects tend to be either in the hormone disruption area or in skin allergies. Some inactive ingredients can also cause skin reactions, and these are mentioned in a separate paragraph. Pushing for better absorption studies will give us all a better idea of how much our body is absorbing and if that amount is over the maximum FDA recommendations.

We know that sunscreens help in the fight to prevent skin cancer, so aside from switching sunscreens, what else can you do? Many outdoor companies are taking the clothing route, coming out with their own lines of UPF (ultraviolet protective factor) clothing. Like sunscreen, the protection does not last indefinitely. In the case of clothing, there is a recommended number of washings before the protection is negligible. Even regular clothing provides some protection, so anything that covers your skin will help. Sticking to shady spots whenever possible, along with avoiding the peak sun-exposure hours of 10am to 4pm also cuts down on your risk. Looks like I'll be enjoying my gimlets under the shade of a nice, big umbrella from now on. Cheers!

Wednesday, April 24, 2019

Don't Worry, Be Happy

According to Virgil, “Mens agitat molem,” or mind moves matter. Today we would say mind over matter, and that is the basis of cognitive behavioral therapy (CBT). The theory is positive thoughts bring about positive results. CBT is one form of psychotherapy, also known as “talk therapy.” It is administered by trained professionals and can be one-on-one or in a group. Those suffering from anxiety, depression, PTSD, and a number of other disorders, often benefit from CBT. There is even some evidence CBT can help with insomnia

Although often associated with mental health, CBT can also be used as an adjunct to a physical problem. For example, if someone is experiencing pain, such as backache, CBT can help you change the way your body reacts to pain by changing your thoughts about pain. Many women who have undergone childbirth using the Lamaze Method are familiar with a type of cognitive behavior training, using breath and focal points to help cope with the pain of contractions. (And if you’ve seen any episodes of Call the Midwife, you know what I’m talking about.) An offshoot of CBT, called acceptance and commitment therapy (ACT), is also proving useful for those suffering from chronic pain, as well as those with addictive disorders. 

We started out with Virgil and we’ll end with Epictitus: ”Men are disturbed not by things, but by the view which they take of them.” Make sure the view of yourself is a positive one and if not, learn how you can make it so.

Friday, March 22, 2019

Our Best Friend

I have a friend who suffers from anxiety and depression. One of the things that helps him deal with things is his dog. With a cross-country move coming up, his therapist, knowing the important role the dog plays in my friend's life, designated him an emotional support animal (ESA). This way, with script in hand, he was able to have his dog fly in the cabin with him. But what's the difference between an ESA and a service dog?

Most people think of Seeing Eye dogs when they hear service animal. In the Central NY area, Guiding Eyes for the Blind has a large number of puppy raisers to help socialize the pups before they go for their service training. A service animal does not have to be a dog, but they do have to perform a service or services for the owner. This ADA FAQ explains the ins and outs of service animals. Of particular interest, there is no official certification organization and a service animal can be trained by anyone, so caveat emptor if you or a loved one is in need of a service animal. A good place to start is with a group like Psychiatric Service Dog Partners, where you can ask questions of people who are experienced with owning a service animal. Things can also get muddy as state regulations vary, so be sure to research your state regulations to see what is and is not allowed.

So back to my friend's dog. Why is it an ESA rather than a service animal? Your pet can be designated a psychiatric service animal if, according to the ADA, it is trained to, say, sense an anxiety attack and do something to lessen or prevent it. An ESA helps a person function better, but does not have specialized training to perform a service. Both of these types of animals are, for the most part, exempt from "no pets" policies, with service animals getting pretty much automatic exemptions while ESAs will need permission in certain situations. To make things murkier, we have companion or therapy animals. In terms of pet policies, these animals are legally given little slack. As the name implies, they provide companionship, which in some cases is all the person needs. Organizations like PAWS of CNY go out into the community to help with life's stresses, for example airports during peak travel times or colleges during final exams. The animals offer a calming presence by just being there to be stroked and maybe talked to. Clear Path for Veterans offers a training course for any Veteran who owns or wants to own a canine companion, while other organizations offer no-cost pets or have some financial assistance for veterinary bills.

Whatever your need, there is an animal out there to help you. As Indian author Ruchi Prabhu says: “Pets understand humans better than humans do,” and we all need a little understanding sometimes.

Tuesday, January 29, 2019

Triple A

When is a cold not a cold? No, not the start of a joke; a cold is not a cold when it could be acid reflux, asthma, or allergies. How do you tell the difference? That's for your doctor to figure out, but you can help by keeping a diary of your symptoms. Things like: how long has this been going on; is it worse at certain times of the day; do symptoms start or get worse after exercise, doing certain tasks, or eating certain foods? By being aware of how and when your body reacts, you can help your physician to zero in on exactly what ails you. First, let's look at acid reflux.

This one really seems like the odd man out until you stop to think about that air tunnel called the esophagus. When everything is working right, there are two valves that block off acid fumes and food from coming back up the pipe, so to speak. When the valves are not working, the acid can cause allergy-like symptoms such as itchy eyes, chronic cough, post-nasal drip, etc. It can be a matter of what you eat, when you eat, even how much you eat, so here's one place that diary can come in very handy.

Allergies can be to things outside our body, such as pollen or pets, or things inside our body; food allergies. If you have those cold-like symptoms year round, you may be allergic to something in your home or workplace, or you may eating something you shouldn't. With food, it may be an allergy or it may be an intolerance, and it can be hard distinguishing between the two. Particularly with an intolerance, the symptoms can be reflux like, cold like, or both, so again, a diary may help narrow down the triggers.

Asthma is more often associated with children, but adults can develop asthma and not even realize they have. Like a cold, asthma can trigger coughs and excess mucus. In the case of asthma, that cough may be around for weeks without changing; your mucus may be thicker, making it harder to breathe or swallow. Like allergies, asthma can be triggered by external stimulants like mold or animal fur, but it also can be triggered by an upper respiratory condition, further muddying the waters. Bottom line is, if your "cold" seems to linger on and on, it's time to make note of the three Ws of your symptoms: what, when, and why, then make an appointment with your doctor to discuss triple A.

Friday, January 4, 2019

"First Hang Your Hat on the Bedpost."

As often seems the way, I ended up with a miserable cold over the holidays. My father used to say he had the cure to the common cold. "First, hang your hat on the bedpost or someplace where you can see it. Second, grab a bottle of whiskey and crawl under the covers. Third, start drinking, and when you see two hats, you're cured." I don't know that there is any medical basis in his claim, but there are many home remedies out there when it comes to the common cold. One of my go-to comfort foods is Hot and Sour soup. Yes, I know, it's supposed to be Chicken soup for a cold, but actually, any warm, steamy liquid will help to keep you hydrated and thin the mucus. Tea with lemon and honey is good too, providing fluid with some Vitamin C and something for the cough.

There have been some studies on Zinc, and like Vitamin C, it seems to help some people and do nothing for others. I had a bag of lozenges containing Zinc, which I won at a health fair. I didn't like the aftertaste and it left my throat feeling dry. Natural therapies have been around as long as man, but proving if they really work or not is difficult. The National Institute of Health has a division just for studying these: the National Center for Complementary and Integrative Health. This is always a good place to start if you have a question about traditional therapies. You can find if they have been researching a particular therapy, the current findings, and if there are side effects or interactions with medications you are currently taking. Those last two are really important, as you don't want to try to help one illness while causing problems with your treatment for another. So if you are under a physician's care for any condition, be sure to speak to your physician and/or pharmacist before taking any over-the-counter medication, natural or not. I hope you remain cold-free this season and if not, be sure to have a spare bottle of your favorite tipple handy.

Tuesday, November 27, 2018

Pie in the Sky

My mother loved cookbooks, and in an early American cookbook, she found a pumpkin pie recipe. The recipe made about a dozen pies so she worked it down to a filling that would make 2-3 pies, depending on their size. Our daughters associated pie with grandma to the extent that, when my mom died, our older daughter saw a hand holding out a piece of pie in the clouds on the way home. Everybody, including a good friend from high school, loved that pie, but she did not want to share the recipe she worked so hard on. As she got older and the holiday baking was passed on to me, she finally relented and said I could share the recipe. My friend was very happy, but as often happens with recipes, they never quite come out the same when someone else does them. At Thanksgiving, I bake pies for my sister and our kids and mail them out. This year, I had a spare I was going to give away at Christmas, until I heard from that high school friend’s daughter that she had ovarian cancer. I packed up that pi, mailed it out, and surprised her with it. To say she was happy was an understatement, but what really made me happy was her comment that it was just what she needed. 

Anyone dealing with a chronic disease or medical condition needs acts of kindness, cancer patients more so than some. A Fellow from the Institute for Healthcare improvement stated that “simple acts of kindness can be a potent antidote to negative emotions and may improve outcomes for those experiencing the frightening journey called cancer.” If you play to your strengths, there are so many ways you can help someone get through their therapy. Life happens every day no matter how someone feels, and having a friend come by to cook, clean, garden, chat, or whatever you can do to help is much appreciated. 

For those who like to knit or crochet, there are many projects you can do. For example, not all breast cancer patients can afford a prosthesis after their lumpectomy or mastectomy.  One woman put her hands to work and knitted knockers were born. Any cancer patient undergoing chemotherapy appreciates a chemo cap, not only for the warmth, but often as a fashion statement. Prayer shawls are also a popular item to make, warming both the person who made it and the person who received it. 

Knitting and other hand crafts are also good for the patient, providing a meditative project to get their minds off of their treatment. One small company partnered with Lion Brand yarns to provide knit kits to young adults. If your friend/family member is interested in some other craft, make up your own kit to give them. And don’t forget books, DVDs, puzzles, etc. They all provide much needed relief. When life gives a friend lemons, think about making a lemon meringue pie and serve them with love.

Wednesday, October 31, 2018

Mighty Mite

I have been on allergy meds for many a year, but this year, I started having trouble with my ears. The simple act of blowing my nose would cause my ears to clog up, and they often felt like I had climbed a large elevation. No amount of chewing, yawning, or other tricks did any good, so it was off to the ENT. Since I have no clue as to what exactly I am allergic, testing seemed appropriate. If you have never had this done, consider it good training if you are thinking of getting a tattoo.

After all the poking, the result showed only two things: cat and dust mites. Since the cat said he was going nowhere, I decided to see what could be done to mitigate the dust mites. My big takeaway was that maybe my husband should do the housecleaning, but that's probably not going to happen either, but here's what experts have to say.

Dust mites are related to spiders and ticks, and they live in our homes year round, happily munching on the dead cells we keep flaking off as well as those dust mites who have passed on. Their favorite places to hang out are pretty much the same as ours: beds, upholstered furniture, carpets. For those of you with an inclination to leather, here's your excuse to buy that leather suite you've been longing for. I wonder if it could be called a medical tax deduction, but I digress.

There are many things you can do to cut down on the mite population. Luckily for me, we do not have carpets, so that's one less thing to worry about. For the bed, you want to at least use mattress and pillow encasings that are made for the job. There are also certified sheets and blankets, but simply washing those once a week in hot water should do the trick. And keep the pets and stuffed animals off the bed, unless you want to be washing them weekly also You will want to wash your curtains in hot water more frequently than the seasonally that I tend to do, and if you can get rid of the wall-to-wall carpeting, all the better. Throw rugs can be used if you're willing to wash them frequently.

Invest in a vacuum with a HEPA filter and an upholstery attachment. It will only get the surface mites off the sofa but it's better than nothing. Dusting is best done with a cloth that is damp or sprayed with furniture polish. This way less dust ends up in the air. If you can't convince someone else to do your cleaning, purchase some face masks to wear while you work.

Mites like the same temperatures we do, 65 to 80ish, but one thing you can do is to change your furnace filter often (at least every 3 months) and purchase minimum efficiency reporting value (MERV) filters of 11 or 12. If your furnace has a humidifier, set it below 50, as mites like it moist. 

Some folks can get by with over-the-counter allergy medications such as Allegra or Nasacort. If this type doesn't do the trick, allergy shots may be your next step, although the FDA has just released a new under-the-tongue medication that has seen success. The neti pot is also your friend, especially after you have finished doing anything that stirs up the dust. And remember, your symptoms may be all in your head, but that doesn't mean you're nuts.