Wednesday, September 17, 2008

Tobacco, Taxes, Government- A Team?

Can governments afford to give up their addiction to cigarette taxes? That is the issue this New York Times article raises.

Duncan


....the government has become a financial stakeholder in smoking, some would argue, even as public health officials warn people about its deadly consequences. Smoking declines as cigarette taxes increase, but a core group of smokers hang on to the habit.

The reliance of government coffers on the taxes smokers pay, and on the tobacco settlement money, essentially provides a financial cushion for state governments and could be viewed as a government guarantee for the survival of the tobacco industry. Would politicians shut down an industry that supplies so much money?



http://snipurl.com/3r6e2

Sunday, September 14, 2008

Mammography Dangers To Be Aware Of

While mammograpy has its' uses and benefits, it is not completely benign especially for younger women. Samuel Epstein, author of Politics of Cancer, who has been analyzing cancer for decades, provides information all women should be aware of.

Duncan


Dangers and Unreliability of Mammography: Part 1
by Samuel Epstein, MD

Contrary to popular belief and misleadingly assurances by the media, the National Cancer Institute (NCI), and American Cancer Society (ACS), mammography is not a technique for early diagnosis. In fact, a breast cancer has usually been present for about eight years before it is usually detected.

Mammography poses major risks of which women still remain uninformed. Radiation from routine mammography poses cumulative risks of breast cancer. Contrary to misleading assurances that radiation exposure from mammography is trivial and similar to that from a chest X ray, about 1/1,000 of a rad (radiation-absorbed dose), the routine practice of taking four films for each breast results in some 1,000-fold greater exposure, 1 rad, focused on each breast rather than the entire chest. Thus, premenopausal women screened annually over ten years are exposed to about 10 rads for each breast.

The premenopausal breast is also highly sensitive to radiation with each rad exposure increasing breast cancer risk by 1 percent, resulting in a cumulative 10 percent increased risk over ten years of screening; risks are still greater for "baseline" screening at younger ages, for which there is no evidence of future relevance. Furthermore, cancer risks are up to fourfold greater for the 2 percent of women who are unknowing carriers of the A-T gene, and thus highly sensitive to radiation; estimatedly, this accounts for 20 percent of breast cancers annually.

Click link for more:

http://www.newliving.com/issues/apr_2005/articles/mammography.html

Here is a link to a much more complete though more difficult essay by Epstein on mammography dangers:

http://www.preventcancer.com/patients/mammography/ijhs_mammography.htm

Saturday, September 13, 2008

Wonderful Essay on (Cancer) Statistics

I highly recommend this essay by Stephen Gould for anyone dealing with cancer, or supporting someone with cancer..

Duncan



The Median Isn't the Message by Stephen Jay Gould

My life has recently intersected, in a most personal way, two of Mark Twain's famous quips. One I shall defer to the end of this essay. The other (sometimes attributed to Disraeli), identifies three species of mendacity, each worse than the one before - lies, damned lies, and statistics.

Consider the standard example of stretching the truth with numbers - a case quite relevant to my story. Statistics recognizes different measures of an "average," or central tendency. The mean is our usual concept of an overall average - add up the items and divide them by the number of sharers (100 candy bars collected for five kids next Halloween will yield 20 for each in a just world). The median, a different measure of central tendency, is the half-way point. If I line up five kids by height, the median child is shorter than two and taller than the other two (who might have trouble getting their mean share of the candy). A politician in power might say with pride, "The mean income of our citizens is $15,000 per year." The leader of the opposition might retort, "But half our citizens make less than $10,000 per year." Both are right, but neither cites a statistic with impassive objectivity. The first invokes a mean, the second a median. (Means are higher than medians in such cases because one millionaire may outweigh hundreds of poor people in setting a mean; but he can balance only one mendicant in calculating a median).

The larger issue that creates a common distrust or contempt for statistics is more troubling. Many people make an unfortunate and invalid separation between heart and mind, or feeling and intellect. In some contemporary traditions, abetted by attitudes stereotypically centered on Southern California, feelings are exalted as more "real" and the only proper basis for action - if it feels good, do it - while intellect gets short shrift as a hang-up of outmoded elitism. Statistics, in this absurd dichotomy, often become the symbol of the enemy. As Hilaire Belloc wrote, "Statistics are the triumph of the quantitative method, and the quantitative method is the victory of sterility and death."

This is a personal story of statistics, properly interpreted, as profoundly nurturant and life-giving. It declares holy war on the downgrading of intellect by telling a small story about the utility of dry, academic knowledge about science. Heart and head are focal points of one body, one personality.

In July 1982, I learned that I was suffering from abdominal mesothelioma, a rare and serious cancer usually associated with exposure to asbestos. When I revived after surgery, I asked my first question of my doctor and chemotherapist: "What is the best technical literature about mesothelioma?" She replied, with a touch of diplomacy (the only departure she has ever made from direct frankness), that the medical literature contained nothing really worth reading.

Of course, trying to keep an intellectual away from literature works about as well as recommending chastity to Homo sapiens, the sexiest primate of all. As soon as I could walk, I made a beeline for Harvard's Countway medical library and punched mesothelioma into the computer's bibliographic search program. An hour later, surrounded by the latest literature on abdominal mesothelioma, I realized with a gulp why my doctor had offered that humane advice. The literature couldn't have been more brutally clear: mesothelioma is incurable, with a median mortality of only eight months after discovery. I sat stunned for about fifteen minutes, then smiled and said to myself: so that's why they didn't give me anything to read. Then my mind started to work again, thank goodness.

If a little learning could ever be a dangerous thing, I had encountered a classic example. Attitude clearly matters in fighting cancer. We don't know why (from my old-style materialistic perspective, I suspect that mental states feed back upon the immune system). But match people with the same cancer for age, class, health, socioeconomic status, and, in general, those with positive attitudes, with a strong will and purpose for living, with commitment to struggle, with an active response to aiding their own treatment and not just a passive acceptance of anything doctors say, tend to live longer. A few months later I asked Sir Peter Medawar, my personal scientific guru and a Nobelist in immunology, what the best prescription for success against cancer might be. "A sanguine personality," he replied. Fortunately (since one can't reconstruct oneself at short notice and for a definite purpose), I am, if anything, even-tempered and confident in just this manner.

Hence the dilemma for humane doctors: since attitude matters so critically, should such a sombre conclusion be advertised, especially since few people have sufficient understanding of statistics to evaluate what the statements really mean? From years of experience with the small-scale evolution of Bahamian land snails treated quantitatively, I have developed this technical knowledge - and I am convinced that it played a major role in saving my life. Knowledge is indeed power, in Bacon's proverb.

The problem may be briefly stated: What does "median mortality of eight months" signify in our vernacular? I suspect that most people, without training in statistics, would read such a statement as "I will probably be dead in eight months" - the very conclusion that must be avoided, since it isn't so, and since attitude matters so much.

I was not, of course, overjoyed, but I didn't read the statement in this vernacular way either. My technical training enjoined a different perspective on "eight months median mortality." The point is a subtle one, but profound - for it embodies the distinctive way of thinking in my own field of evolutionary biology and natural history.

We still carry the historical baggage of a Platonic heritage that seeks sharp essences and definite boundaries. (Thus we hope to find an unambiguous "beginning of life" or "definition of death," although nature often comes to us as irreducible continua.) This Platonic heritage, with its emphasis in clear distinctions and separated immutable entities, leads us to view statistical measures of central tendency wrongly, indeed opposite to the appropriate interpretation in our actual world of variation, shadings, and continua. In short, we view means and medians as the hard "realities," and the variation that permits their calculation as a set of transient and imperfect measurements of this hidden essence. If the median is the reality and variation around the median just a device for its calculation, the "I will probably be dead in eight months" may pass as a reasonable interpretation.

But all evolutionary biologists know that variation itself is nature's only irreducible essence. Variation is the hard reality, not a set of imperfect measures for a central tendency. Means and medians are the abstractions. Therefore, I looked at the mesothelioma statistics quite differently - and not only because I am an optimist who tends to see the doughnut instead of the hole, but primarily because I know that variation itself is the reality. I had to place myself amidst the variation.

When I learned about the eight-month median, my first intellectual reaction was: fine, half the people will live longer; now what are my chances of being in that half. I read for a furious and nervous hour and concluded, with relief: damned good. I possessed every one of the characteristics conferring a probability of longer life: I was young; my disease had been recognized in a relatively early stage; I would receive the nation's best medical treatment; I had the world to live for; I knew how to read the data properly and not despair.

Another technical point then added even more solace. I immediately recognized that the distribution of variation about the eight-month median would almost surely be what statisticians call "right skewed." (In a symmetrical distribution, the profile of variation to the left of the central tendency is a mirror image of variation to the right. In skewed distributions, variation to one side of the central tendency is more stretched out - left skewed if extended to the left, right skewed if stretched out to the right.) The distribution of variation had to be right skewed, I reasoned. After all, the left of the distribution contains an irrevocable lower boundary of zero (since mesothelioma can only be identified at death or before). Thus, there isn't much room for the distribution's lower (or left) half - it must be scrunched up between zero and eight months. But the upper (or right) half can extend out for years and years, even if nobody ultimately survives. The distribution must be right skewed, and I needed to know how long the extended tail ran - for I had already concluded that my favorable profile made me a good candidate for that part of the curve.

The distribution was indeed, strongly right skewed, with a long tail (however small) that extended for several years above the eight month median. I saw no reason why I shouldn't be in that small tail, and I breathed a very long sigh of relief. My technical knowledge had helped. I had read the graph correctly. I had asked the right question and found the answers. I had obtained, in all probability, the most precious of all possible gifts in the circumstances - substantial time. I didn't have to stop and immediately follow Isaiah's injunction to Hezekiah - set thine house in order for thou shalt die, and not live. I would have time to think, to plan, and to fight.

One final point about statistical distributions. They apply only to a prescribed set of circumstances - in this case to survival with mesothelioma under conventional modes of treatment. If circumstances change, the distribution may alter. I was placed on an experimental protocol of treatment and, if fortune holds, will be in the first cohort of a new distribution with high median and a right tail extending to death by natural causes at advanced old age.

It has become, in my view, a bit too trendy to regard the acceptance of death as something tantamount to intrinsic dignity. Of course I agree with the preacher of Ecclesiastes that there is a time to love and a time to die - and when my skein runs out I hope to face the end calmly and in my own way. For most situations, however, I prefer the more martial view that death is the ultimate enemy - and I find nothing reproachable in those who rage mightily against the dying of the light.

The swords of battle are numerous, and none more effective than humor. My death was announced at a meeting of my colleagues in Scotland, and I almost experienced the delicious pleasure of reading my obituary penned by one of my best friends (the so-and-so got suspicious and checked; he too is a statistician, and didn't expect to find me so far out on the right tail). Still, the incident provided my first good laugh after the diagnosis. Just think, I almost got to repeat Mark Twain's most famous line of all: the reports of my death are greatly exaggerated.
Postscript By Steve Dunn

Many people have written me to ask what became of Stephen Jay Gould. Sadly, Dr. Gould died in May of 2002 at the age of 60. Dr. Gould lived for 20 very productive years after his diagnosis, thus exceeding his 8 month median survival by a factor of thirty! Although he did die of cancer, it apparently wasn't mesothelioma, but a second and unrelated cancer.

In March 2002, Dr. Gould published his 1342 page "Magnum Opus", The Structure of Evolutionary Theory. It is fitting that Gould, one of the world's most prolific scientists and writers, was able to complete the definitive statement of his scientific work and philosophy just in time. That text is far too long and dense for almost any layman - but the works of Stephen Jay Gould will live on. Especially I hope, The Median Isn't The Message .

Thursday, September 11, 2008

Arthoscopic Knee Surgery Fails the Test

Here is an item on knee surgery from the Wall Street Journal Health Blog. It was also mentioned on NPR today.

Duncan


September 11, 2008, 8:29 am
Knee Surgery No Help for Arthritis
Posted by Jacob Goldstein

Surgeons take it as an article of faith that a chance to cut is a chance to cure. So it's a pretty big deal when a study clearly shows that a common surgery doesn't actually help certain patients. Even more so if the study is confirming similar results from a previous study.

That's what happened this week, when the New England Journal of Medicine published a study that showed arthroscopic surgery doesn't provide any benefit for moderate to severe arthritis of the knee.

Researchers randomly assigned nearly 200 patients to receive either surgery, drugs and physical therapy, or drugs and physical therapy alone. Three months later, patients who had surgery had slightly less pain than those who did not. But there was no significant difference between the two groups at six months, one year or two years. The difference at two years was the main measure the researchers looked at.

A 2002 study had similar results.



http://snipurl.com/3pdn9

Wednesday, August 20, 2008

Fruit Juices that Interact with Pharmaceuticals

You have probably figured out that I am not a fan of pharmaceuticals especially for extended periods of time (like the rest of your life.) Nevertheless if you feel you need them, it is best if you have information on how. Duncan


More Juices Found to Affect Drugs'

Effectiveness: Study

Orange and apple join grapefruit on list of drinks that may pose problems

Posted August 19, 2008

By Kathleen Doheny
HealthDay Reporter

TUESDAY, Aug. 19 (HealthDay News) -- Grapefruit juice, long known to boost the absorption of certain medications, isn't the only juice that doesn't mix well with drugs, according to the Canadian researcher who first identified the ill effects of grapefruit juice.

Other common juices, including orange and apple, may limit the body's absorption of drugs, compromising their effectiveness, said David Bailey, a professor of medicine and pharmacology at the University of Western Ontario, in London, Ontario, Canada.

Bailey was expected to present his research Tuesday at the American Chemical Society's national meeting, in Philadelphia.

"The original finding is that [grapefruit juice] markedly boosts the amount of drug that gets into the bloodstream," Bailey said. He first reported that nearly 20 years ago when he discovered that grapefruit juice increased the body's blood levels of the drop felodipine (Plendil), used to treat high blood pressure.

Since the original finding, other researchers have identified dozens of other medications that could interact adversely with grapefruit juice, Bailey said.

Doctors traditionally warn against drinking grapefruit juice if you're taking certain medications for high cholesterol, high blood pressure and heart rhythm problems, according to the American Academy of Family Physicians.

In his latest research, Bailey found that grapefruit juice, as well as orange and apple juice, can lower the body's absorption of some medications. Those drugs include the anti-cancer drugs etoposide (Etopophos, Vepesid); certain beta blockers like tenormin (Atenolol) and talinolol (Cordanum), used to treat high blood pressure and prevent heart attacks; cyclosporine, which is used to prevent organ transplant rejection; and some antibiotics, including ciprofloxacin (Cipro), levofloxacin (Levaquin), and itraconazole (Sporanox).

Bailey also found that healthy volunteers who took the allergy drug fexofenadine (Allegra) with grapefruit juice absorbed only half the amount of the drug, compared with volunteers who took the medicine with water.

In each case, substances in the juices affected the absorption of the drugs. Some chemicals block a drug uptake transporter, reducing drug absorption; other chemicals block a drug metabolizing enzyme that normally breaks down the drugs, he said.

"We don't [yet] know all the drugs affected," Bailey said.

Michael Gaunt is a medication safety analyst at the Institute for Safe Medication Practices in Horsham, Pa. He said, "If this study holds true [in future research], you are going to have to warn people in a similar fashion" about other juices.

Gaunt's advice for now: "In general, it's safest to take medication with water."

Bailey agreed. If you opt for water, he said, "a glass is better than a sip. It helps dissolve the tablet." And cool water is better than hot, he added, because your stomach empties cool water faster, sending the medication on its way to the small intestine and finally the blood stream.

More information

To learn more about juice and medication interactions, visit the American Academy of Family Physicians.

Monday, August 18, 2008

Practical Ways to Reduce Your Cancer Risk

Below I have posted one of the fact sheets from the Center for Enviornmental Oncology which is at the University of Pittsburg. I learned of the center from a book I am currently reading titled: The Secret History of the War on Cancer by Devra Davis who works at the Center.

There is no way to completely insure yourself against developing cancer but there are ways to significantly decrease the probability.

Duncan





Fact Sheets - Cancer Prevention: 12 Things You Can Do To Reduce Cancer Risk

Until very recently, cancer prevention has largely focused on early diagnosis and treatment, also known as secondary prevention. By the time secondary prevention becomes necessary, the disease in question has already taken hold within an individual, and doctors just want to lessen its impact by finding it and treating it early. Alternatively, primary prevention is the practice of avoiding the causes of a disease in order to prevent getting it in the first place. Not nearly enough attention has been paid to primary prevention of cancer, but we do know some things you can do to reduce the chance that you will develop cancer during your lifetime. Read on to find out about 12 things you can do to avoid cancer.

1. Avoid smoking, overeating, and overdrinking, and keep moving. Take the stairs instead of elevators; find a form of exercise you like and commit to doing it with a friend. Plan to walk instead of drive. When driving, stick with the speed limit to save lives, save energy and reduce cancer-causing pollution; speed kills, pollutes and fuels terror.

2. Use x-rays and other radiation sparingly and keep a record of all x-rays. The excessive use of x-rays in infants and children may be one of the reasons more young people (those under 40 years of age) are getting cancer and can also contribute to cancer in adults. Earlier this year, the American College of Radiology advised against unnecessary and excessive use of diagnostic radiation in children for this very reason. Before ordering x-rays doctors should carefully weigh the risks and benefits of using MRI, or ultrasound, technologies that do not involve radiation.

3. Unless someone in your immediate family has had breast cancer before menopause, hold off getting your first mammogram until at least age forty, or until your doctor advises you start having them—and then have them done sparingly. Mammography does not prevent breast cancer, but can reduce deaths from the disease in post-menopausal women. It is also important to have regular physical exam of breasts by a health professional.

4. Use hormones sparingly. Lifetime use of hormones affects cancer risk. Consider alternatives to chemical contraception such as IUDs and condoms (which also protect against sexually transmitted disease). Avoid long term use of medications that contain hormones, including hormone replacement therapy.

5. Test your basement for radon and if you live in an area with uncertain water quality, use a simple filter. An invisible gas, radon can seep into homes from the ground and increase the risk of lung cancer. It can easily and inexpensively be remedied.

6. Do not consume food and beverages that contain aspartame. Sweeten your food with good old-fashioned sugar or honey, or stevia instead. Despite having FDA approval, aspartame, the sugar substitute, was never given a green light by scientists—all were concerned about its potential to cause cancer. New independent studies raise further concerns about its long term safety.

7. Use cell phones with an earpiece and speakerphone so the phone itself is not held up against your head. Children should not use cell phones. Studies claiming that there is no link between cell phone use and brain cancer were not conducted on people who used cell phones as much as the average person today. Cell phones emit low doses of microwave radiation that destroy rat brain cells and memory and reach one inch into the human brain. While British authorities recommend that children not use cell phones at all, some American firms are pushing phones for five year olds.

8. Buy local foods in season from farmers who use fewer pesticides. Use omega-3-fatty acid supplements free of pollutants and eat a diverse diet, rich in vitamin D, calcium and fiber.

9. Don't put anything on your baby's skin that you can't eat. The materials that create "no more tears" in baby shampoo are banned in several countries, because they cause cancer in animals. In some cases lotions used on the heads of African-American babies caused development of breasts and pubic hair. The FDA has no authority to regulate any of these harmful compounds in personal care products, unlike the European Union.

10. Look under your sink and read the labels on your cleaning products—in general, the fewer ingredients they have, the better for you they are. Baking soda, vinegar, lemon juice, and toothpaste can be used to clean most things around the home. Some room deodorizers and mothballs contain carcinogens.

11. Don't microwave anything in plastic, no matter what the directions say. Some plastic chemicals can leach into food.

12. Unlike nearly all industrial nations of the world, America and Canada have not banned asbestos. Before doing home renovations and repair of attics, roofing, ceiling and flooring tiles, find out if they contain asbestos and hire certified contractors if they do. Zonolite attic insulation and some forms of kitty litter contain asbestos-related materials. Half of all people with a rare form of cancer thought to be uniquely tied with asbestos called mesothelioma have no known workplace contact with asbestos.

Through leading a healthy life and avoiding certain known carcinogens, it is possible to reduce your lifetime risk of developing cancer. It is true that much remains to be learned about the environmental causes of cancer. While researchers continue to explore the causes, we can use what is already known to start practicing cancer prevention today.

http://www.environmentaloncology.org/12reducerisk

http://snipurl.com/3hjgh

Sunday, July 20, 2008

Know Your Food- Not all meat is created equal

What kind of food you eat is very important and how the food was raised is very important. Read the article below. After you do, I'll bet that every time you go to eat pork, you'll want to know how the pigs were raised. What is true here is equally true for beef and poultry- the details will vary somewhat but the general processes will be parallel. -Duncan



SWINE OF THE TIMES
The making of the modern pig
by Nathanael Johnson

This article was originally published in Harpers Magazine, May 2006 and is also available here as a PDF (108 KB).

My interest in pig sex began over drinks at a bar in Burley, Idaho. My friend Becky was telling me that she couldn't stand her job at a big hog farm outside of town. Each day she faced an unending line of sows, filing into the room where she worked. Occasionally one of the over 200–pound pigs broke ranks, knocking Becky down.

"Sometimes they get nervous when you stimulate them," she said.

I set down my beer.

"Stimulate?"

"Yeah, for artificial insemination. Usually if you bring a boar around they'll get in the mood. But if not you just have to get in there and start rubbing away."

At my urging, my friend obligingly laid out the intricacies of coaxing sows to conceive, along with equally piquant methods of harvesting boar semen. It all seemed like an awful lot of trouble for something creatures normally do without encouragement.

I love my prosciutto, my bacon in the morning, and although I'm not usually squeamish about the realities of agriculture, I'm not sure I had ever thought of my food as something that depended upon artificial insemination. It began to make perfect sense, of course, when I started to gather the facts. The science of pork production has made major strides in the last twenty years, and one wouldn't expect to find pigs mating the old–fashioned way at state–of–the–art hog facilities. But, as I was to find, artificial insemination ("AI," in the industry) is more than a sign of modernization. It has served as the enabling technology for a process that has transformed pigs from affable, potbellied forest dwellers to panicky, torpedo–shaped clones that cannot survive outdoors but nonetheless produce monstrous, lean hams.

Previously, any concerns I might have had about hog farming always vanished right about lunchtime. But when I discovered the ubiquity of this breeding technique I became curious: If it takes human–aided swine masturbation to bring the Christmas ham to the family feast, what else is involved in producing America's pork? Although artificial insemination is by no means the worst indignity inflicted on the modern pig in the course of this transformation, it is a fair symbol for all the other indignities we have visited on it.


http://www.porkopolis.org/columns/modernpig.htm

http://snipurl.com/3271s

Fatigue, Anemia, and Nutrition

Below I have posted some excerpts from an article in the New York Times by Jane Brody. I encounter many patients who complain of fatigue. By checking their tongue color, and doing a simple test by using pressure to drain blood out of their palms and seeing how fast the blood returns, it is relatively easy to figure out that they are tending towards anemia.

Nutrition is usually the quickest, safest and most stable way to help build sufficient good quality blood. When you read the excerpt and then connect to the full article, please pay attention to the foods suggested.

Of course, if you are female and have very heavy menstrual bleeding, then I recommend you check with a practitioner such as myself that can help you lessen the amount of menstrual blood and develop a cycle that is less draining.
-Duncan



July 19, 2008
Reporter's File
'Tired Blood' Warning: Ignore It at Your Peril
By JANE E. BRODY

Thanks to advertisements for the once-popular tonic Geritol, most people of a certain age know about "tired blood," a disorder more accurately called anemia, involving a shortage of healthy red blood cells to carry oxygen to body tissues and cleanse them of carbon dioxide.

It is not really the blood of people with anemia that is "tired." Rather, it is anemic people themselves who commonly experience chronic fatigue. Other symptoms may include weakness, shortness of breath, impaired athletic performance, rapid heartbeat, irritability, apathy, dizziness, pale skin, headache and numb or cold hands and feet. But in many people the symptoms are too mild to be recognized, and the anemia goes undetected for years.

Anemia is the most common blood disorder in the United States. Statistics indicate that 3.4 million Americans are anemic, but experts say that this is a gross underestimate and that anemia has been viewed for far too long as an "innocent bystander," considered almost normal in certain groups, like menstruating women and the elderly.

But a growing body of research indicates that anemia can seriously compromise the quality of a person's life, make sick people sicker and even speed deaths, said Dr. Allen Nissenson, a nephrologist and professor of medicine at the University of California, Los Angeles.

.............

Inadequate nutrition is the most common cause of anemia, Dr. Nissenson said. Production of hemoglobin, the oxygen-carrying protein on red blood cells, depends upon the mineral nutrient iron, most prominent in meat and poultry (especially organs like liver and kidneys) and egg yolks.

To a lesser degree, it is found in green leafy vegetables, dried fruits, dried beans and peas and enriched and whole grain cereals and bread. Foods rich in vitamin C help the body to absorb iron.

Also important to the production of healthy red cells are B vitamins, folic acid, B12 and B6. B12 occurs only in animal foods, especially meat, fish, eggs and milk. Dark green leafy vegetables are the best source of folic acid; whole grains are the best source of B6.

These nutrients are often in short supply among women who lose iron in menstrual blood, pregnant women, strict vegetarians, overly zealous dieters and poor people. Increasingly, the problem is found among elderly people on restricted diets.

...........
Doctors have long been aware of the risk of anemia in infants and in
teenage girls and women of childbearing age, but anemia is far more
prevalent in people over 65, studies say. One concluded that the
incidence of anemia among the elderly was four to six times as great as
had been suspected, affecting as many as a quarter of those over 75.

http://health.nytimes.com/ref/health/healthguide/esn-anemia-ess.html?print

http://snipurl.com/3242k

Caesarean Section: No Consensus On Best Technique

Caesarean Section: No Consensus On Best Technique

ScienceDaily (July 19, 2008) — Despite the routine delivery of babies by caesarean section, there is no consensus among medical practitioners on which is the best operating method to use. In a systematic review published in The Cochrane Library, researchers call for further studies to establish the safest method for both mother and infant.

"Caesarean section is a very common operation, yet there is a lack of high quality information available to inform best practice," says researcher Simon Gates of the Clinical Trials Unit at the University of Warwick.

Techniques used during caesarean section operations depend largely on the preferences of individual surgeons. Their personal preference can affect the length of the operation, amount of blood lost, risk of infection and the level of pain experienced by a woman following surgery.

http://www.sciencedaily.com/releases/2008/07/080715204812.htm

http://snipurl.com/31xrb

ScienceDaily (July 19, 2008) — Despite the routine delivery of babies by caesarean section, there is no consensus among medical practitioners on which is the best operating method to use. In a systematic review published in The Cochrane Library, researchers call for further studies to establish the safest method for both mother and infant.

"Caesarean section is a very common operation, yet there is a lack of high quality information available to inform best practice," says researcher Simon Gates of the Clinical Trials Unit at the University of Warwick.

Techniques used during caesarean section operations depend largely on the preferences of individual surgeons. Their personal preference can affect the length of the operation, amount of blood lost, risk of infection and the level of pain experienced by a woman following surgery.

http://www.sciencedaily.com/releases/2008/07/080715204812.htm

http://snipurl.com/31xrb

Acupressure for Childbirth Booklet

Renowned New Zealand Acupuncturist Debra Betts has a very understandable and useful 24 page booklet available at her website.

The booklet provides instruction on how to use acupressure for easier childbirth.

She does not charge for the download but does request that if you find it useful to please make a donation to help her pay the costs of maintaining and running her website.

Thank you, Debra Betts for your generosity. Be sure to check out the rest of her website it is exceptionally good.

http://acupuncture.rhizome.net.nz/acupress/download.aspxure

Saturday, July 19, 2008

Fertiliity Awareness for Planning or Preventing Pregnancy

No matter what political persuasion a woman may adhere to, the subject of pregnancy is very important.

Whether you are a woman or a man, it is very valuable to really understand the menstrual cycle in general and to understand the specific cycle you or your woman partner, wife or friend is experiencing.

Below is a site that does a good job of explaining the basics and providing links to additional sites.

At the bottom of the page that the link below leads to are additional bits of information to explain most of the common birth control methods.






What is Fertility Awareness?

Fertility Awareness Method (FAM) is a collection of practices that help a woman know which days of the month she is most likely to get pregnant. A woman can learn when ovulation is coming by observing her own body and and charting physical changes. She can then use this information to avoid or encourage pregnancy. The most effective way to discover YOUR fertile time is to practice all of the techniques described here.

Fertility Awareness increases a woman's understanding of her body and her menstrual cycle. To be effective as birth control, it requires her to abstain from intercourse or to use a barrier method of birth control during the fertile time, approximately one-third of the month.



http://www.fwhc.org/birth-control/fam.htm

http://snipurl.com/31lm6

Breast Cancer Risk and Vitamin D from Sunlight

Duncan's note: This abstract concludes that increasing Vitamin D through sunlight exposure significantly decreases the risk of developing breast cancer. The authors state that they are not sure how much sunlight exposure, my understanding is that 15 to 20 minutes of sunlight per week is sufficient for attaining healthy levels of Vitamin D.


Breast Cancer Risk and Vitamin D from Sunlight

~ Esther M. John, Ph.D., Northern California Cancer Center, Union City, CA
Gary G. Schwartz, Ph.D., Sylvester Cancer Center, Univ. of Miami School of Medicine
Darlene M. Dreon, Dr. Ph., Children's Hospital Oakland Research Institute, Oakland, CA

Abstract presented at the "Era of Hope" Conference by
the Department of Defense Breast Cancer Research Program,
Washington, DC, USA. October 31 - November 4, 1997

Hypothesis. Vitamin D is produced when sunlight exposure photolyses 7-dehydrocholesterol in the skin to vitamin D. It can also be obtained from certain foods or dietary supplements. We tested the hypothesis that vitamin D reduces breast cancer risk.

Background. Breast cancer mortality rates are higher in the Northeastern United States than in the South and are inversely correlated with ultraviolet radiation. Regional differences in the prevalence of the known risk factors only partly explain the geographic variation in breast cancer mortality rates.

Experimental studies have demonstrated that 1,25-dihydroxyvitamin D [1,25-(OH)2D], the hormonally active form of vitamin D, inhibits proliferation and promotes differentiation of a number of cell lines, including breast cancer cells. The action of 1,25(OH)2D is mediated by intracellular vitamin D receptors which are expressed in many cell types, including breast cancer cells, and regulate the transcription of specific genes involved in cell growth and differentiation.

Few epidemiological studies to date have assessed the role of vitamin D in the etiology of breast cancer. We analyzed interview data from a large prospective cohort study conducted by the National Center for Health Statistics to assess whether sunlight exposure and dietary intake of vitamin D are associated with reduced breast cancer risk.

Study population. We based the analysis on interview data obtained from a cohort of women aged 25-74 years who participated in the first National Health and Nutrition Examination Survey (HNANES 1) from 1971 and were followed prospectively until 1987. We derived several vitamin D-related exposure measures from the interview, 24-hour dietary recall, and dermatological examination conducted at baseline and at the first follow-up interview conducted in 1982-84. Women diagnosed with breast cancer between the baseline interview and the 1987 follow-up survey were identified through self-report hospital records, and death certificates. We based the analysis on 4,881 white women, including 133 women who developed breast cancer during the first follow-up period.

Statistical analysis. We performed Cox proportional hazards regression analyses to estimate age-adjusted relative risks (RR) and 95% confidence intervals (CI), as well as relative risks adjusted for age, education, income, age at menarche, age at first birth, body mass index, family history of breast cancer, alcohol consumption, and physical activity. Age-adjusted relative risks are presented below.

Results. Breast cancer risk was significantly reduced among women who lived in the South at baseline (age-adjusted RR= 0.59, CI=0.35-0.98), compared to women who lived in the North. Compared to women from areas with low solar radiation, we also found significant reductions in risk among women who were born in regions with high solar radiation (RR=0.53, CI=0.32-0.87) or whose longest residence was in regions with high solar radiation (RR=0.58, CI=0.36-0.95). The risk reduction was similar for women who lived for at least 20 years (RR=0.54, CI=0.28-1.02) or more than half their lifetime (RR=0.57) in areas of high solar radiation. Compared to women with little sunlight exposure as assessed by the examining physician, risk was reduced among those with considerable sunlight exposure (RR=0.60, CI=0.33-1.09). Similarly, compared to women with no rare sunlight exposure, those with both frequent recreational and frequent occupational sunlight exposure had a reduced risk (RR=0.54, CI=0.28-1.02).

Considering the presence of actinic (sunlight-induced) skin damage as an indirect measure of sunlight exposure, we found no risk reduction among women with moderate or severe actinic skin damage.

With regard to dietary sources of vitamin D, the reduction in risk was highest for women with the highest intake of vitamin D, although there was no trend of decreasing risk with increasing vitamin D intake. Daily intake or 200 IU or more was associated with a relative risk of 0.63 (CI=0.38-1.03), compared to a daily intake of less than 50 IU. Regular use of multivitamins did not affect breast cancer risk.

Adjustment for potentially confounding variables with slightly changed the relative risk estimates, but resulted in a loss of statistic al significance for several exposure variables.

Discussion. This is the first analytic epidemiological study to assess the relation between sunlight exposure and breast cancer. We found consistent risk reductions for 30-40% for several measures of sunlight exposure and dietary intake of vitamin D. We could not, however, address the question of how much sunlight exposure per day might potentially reduce breast cancer risk. Because the data were obtained prospectively, the results are unlikely to be due to recall bias. They are based, however, on a relatively small number of breast cancer cases and need to be confirmed by other larger studies.

Conclusion. The findings of this cohort analysis support the hypothesis that vitamin D, a potentially modifiable lifestyle factor, reduces breast cancer risk. Future epidemiological studies that include larger numbers of breast cancer causes and use improved methods to assess sunlight exposure and dietary vitamin D intake are clearly warranted.

Note: Vitamin D3 is made with UV-B.

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Breast Cancer and Artifical Light: darkness greatly slows growth of breast tumors

Artificial Light at Night Stimulates Breast Cancer Growth in Laboratory Mice

Results from a new study in laboratory mice show that nighttime exposure to artificial light stimulated the growth of human breast tumors by suppressing the levels of a key hormone called melatonin. The study also showed that extended periods of nighttime darkness greatly slowed the growth of these tumors.

The study results might explain why female night shift workers have a higher rate of breast cancer. It also offers a promising new explanation for the epidemic rise in breast cancer incidence in industrialized countries like the United States.

The National Cancer Institute and the National Institute of Environmental Health Sciences, agencies of the federal National Institutes of Health, provided funding to researchers at the Bassett Research Institute of the Mary Imogene Bassett Hospital in Cooperstown, New York and The Thomas Jefferson University in Philadelphia, Pa. The results are published in the December 1, 2005 issue of the scientific journal Cancer Research.

Recommendations:

Sleep in a dark bedroom. If you live in a city, invest in room-darkening shades. Even an eyeshade can help.

Use night-lights in the bathroom and hallways. Flicking on a light can cause melatonin levels to drop immediately.

Try to go to bed at the same time every day, especially if you work the night shift. This will help keep your pineal gland on a healthy schedule.

click link for the full story




http://www.nih.gov/news/pr/dec2005/niehs-19.htm

http://snipurl.com/31hku

Wednesday, July 16, 2008

Stress & Anxiety Self Care

NUTRITION



A diet high in calcium, magnesium, phosphorus, potassium, and vitamins B and E is recommended. These nutrients are easily depleted by stress.

Encourage the consumption of fruits and vegetables such as apricots, wintermelon, asparagus, avocados, bananas and broccoli in addition to brown rice, dried fruit, figs, salmon, garlic, green leafy vegetables, soy products, and yogurt.

Avoid caffeine (coffee, tea, cola, chocolate), tobacco, alcohol and sugar whenever possible.




LIFESTYLE INSTRUCTIONS



Regular exercise, adequate rest, and normal sleep patterns are beneficial for stress reduction.

Practice meditation exercises at least twice daily. (1 to 5 minutes is a good start)

Get away from the daily routine to do something different and enjoyable to relieve stress whenever possible.

Noise can be disturbing to mental health and cause stress. Noise greater than 65-decibels can cause psychological disturbance, greater than 90-decibels can cause emotional and vegetative consequences, and greater than 120-decibels can cause nervous system and hearing damages.

Shift outlook on life and look at changes in a positive way and as challenges, rather than threats.

Take a rest break. Take a shower or soaking bath and a nap. Many times a 10 to 20 minute nap will provide relieve.

When possible, tell the people around you that you need to take a short break or you need to be alone for a short while.

Headache Self Care

Headaches are common but not normal. They are generally of two types. Those caused by "too much" and those caused by "not enough". An obvious example of a "too much" type is a headache caused by alcohol, heavy sugar consumption or stress. Types of "not enough" are headaches that happen during menses when energy and blood are low; or a headache due to not eating, or lack of sleep.

The location of a headache and the progression of a headache are all important information for your health care practitioner.

Try some of the suggestions below, hopefully, they will provide relief. An occasional tylenol or an aspirin can be helpful but if you find yourself taking them more than 1x per month, I urge you to check with an acupuncturist, herbalist, naturopath etc.

A visit to a physician can be helpful but if all the physician can offer is a pharmaceutical to take regularly, I would suggest you take your diagnosis and find a practitioner who can help you resolve the root of the problem and not just offer you a band-aid.



NUTRITION


Avoid or minimize cold drinks, cold foods, and sour fruits: cold and sour substances constrict vessels, channels and collaterals.

If headaches are food related, the diet must be regulated and controlled to reduce or eliminate triggers. Common triggers are dairy, wheat, corn or soy.

Consume adequate amounts of fruits, vegetables, grains and raw nuts and seeds.

One of the most common causes of headache is caffeine. Gradually decrease and stop consumption of caffeine-containing drinks, such as coffee, tea, cola, and specialty beverages with caffeine.

Avoid foods containing tyramine, which can trigger headaches, such as alcohol, chocolate, bananas, citrus, avocado, cabbage, and potatoes. Also avoid cakes, dairy products (except yogurt), processed or packaged foods (because of colorants, preservatives and other additives), tobacco and junk food.

Monosodium glutamate (MSG) should be avoided by individuals sensitive to it. MSG is generally found in canned soups, TV dinners, some meats, many pre-prepared frozen dishes and restaurant foods.



LIFESTYLE INSTRUCTIONS



Avoid allergens as much as possible, as allergens may trigger headache.

Installing an air purifier will minimize the presence of allergens in the air and reduce the risk of allergy and headache.

Avoid stressful situations and environments whenever possible. Ease tension with massage, warm baths, and an exercise program.

Avoid direct exposure to air conditioning, fans, drafts or wind blowing on the head and neck region.

Tension headaches can be relieved by gentle massage of the neck and shoulders to relax the muscles. A hot epsom salt bath or soaking the feet is also helpful.

Headache due to poor circulation will respond to a vigorous scalp massage.

Regular exercise, adequate rest, and normal sleeping habits are essential for optimal health.

Tuesday, July 15, 2008

Back Pain Self Care Suggestions

Most back pain can be resolved with self care techniques. Because the spinal column is so important the back muscles have quite an elaborate pain receptor system. In most cases, back pain is your body's way of telling you to rest and nourish yourself.

Some back pain is caused by physically abusing the back through trauma of lifting incorrectly or loads that are too heavy, etc. Some is because of allowing one's resources to get run down through poor nutrition, lack of rest, too many drugs or alcohol.

Here are some tips to help resolve back pain.


NUTRITION


Eat a diet with a wide variety of raw vegetables and fruits, and whole grain cereals to ensure a complete supply of nutrients for the bones, nerves, and muscles.

Adequate intake of calcium is essential for the repair and rebuilding of bones, tendons, cartilage, and connective tissues.

Fresh pineapples are recommended as they contain bromelain, an enzyme that is excellent in reducing inflammation. If the consumption of fresh pineapples causes stomach upset, eat it after meals.

To relieve cramps and spasms, eat plenty of fruits and vegetables, especially those high in potassium, such as bananas and oranges. Also drink an adequate amount of warm water.

Adequate intake of minerals, such as calcium and potassium, is essential for pain management. Deficiency of these minerals will lead to spasms, cramps, and tense muscles.

Avoid red meat and seafood in the diet as they contain high levels of uric acid, which puts added strain on the kidneys.

Avoid cold beverages, ice cream, caffeine, sugar, tomatoes, milk, and dairy products.



LIFESTYLE INSTRUCTIONS



Patients are advised to use their knees (instead of bending from the waist or back) when lifting heavy objects.

Stretching and strengthening exercises for the back muscles are essential for long-term recovery. Strengthening the abdominal muscles is also beneficial to reduce strain on the lower back.

Mild exercise such as swimming, yoga, or Tai Chi Chuan on a regular basis is recommended.

For those who are overweight, weight loss is strongly recommended to decrease pressure on the joints and relieve pain.

Proper balance of work and rest is very important. While sitting, make sure the back is straight and the elbows and knees are bent at a 90° angle. Take a break at least once every hour to alleviate pressure on the vertebrae and disks.

Hot baths with Epsom salts help to relax tense muscles and draw toxins from tissues. Rest and relax in the bath 10 to 20 minutes, but avoid becoming over-tired from the heat and soaking. If you can , after the soak, towel off quickly and get into bed to rest.

Using a warm compress can usually provide some relief as long as the back does not feel hot and swollen. You'll know within minutes if heat is appropriate because your back will feel better. In that case, heat is good.

Finally, adequate rest is essential to recovery. It is wise to review the sleeping postures to ensure that the back is being appropriately supported and relaxed.



Suggestions for Smoother Cycles

Suggestions for Smoother Cycles

Many women with menstrual cycles experience a range of problems with pms, and various discomforts during actual menses. It is so common that many women consider it normal. Furthermore, a significant number of women have cycles that are very short, very long or totally unpredictable.

It is not normal to experience anything but some mild discomfort and the cycle should be somewhere between 26 and 34 days long. All too often I find that women are put on the birth control pill simply to bring some predictability to their cycles. Recently, some physicians are promoting shots that prevent cycling for many months, a technique that I feel will lead to significant problems in the future.

There are many ways to work on lessening menstrual pain and regularizing cycles. In this piece, I simply want to present some very simple ideas that any woman can use to gain additional control over her cycling.



NUTRITION


Foods and fruits that are cold or sour in nature should be avoided, especially one week prior to or during menstruation. Cold and sour foods create more stagnation, and may worsen the pain.

Decrease the consumption of salt, red meats, processed foods, junk foods, and foods with high sodium content. Caffeine should be avoided as it acts as a stimulant to excite the central nervous system and as a diuretic to deplete many important nutrients.

Increase the consumption of whole-grain foods, and broiled chicken, turkey and fish.

Drink a large quantity of good quality water daily before, during, and after the menstruation.

Menstrual cramps due to calcium deficiency should be treated with ingestion of foods rich in calcium, such as green vegetables, legumes, and seaweeds.

Ensure there is an adequate intake of vitamin B complex and vitamin E, which are important for production of sex hormones. Deficiency of zinc may also contribute to irregular menstruation.

(I suggest the use of whole food derived supplements such as the ones Standard Process makes. Many vitamin supplements are too strong and do not include the wide range of cofactors needed to balance the vitamins.)

For cramping with sensitivity to cold, a simple ginger tea made by steeping fresh grated ginger and adding a small amount of brown sugar can be quite helpful.


LIFESTYLE INSTRUCTIONS

Avoid sports that may expose the body to cold environments, such as snow skiing or cold water sports.

Hot baths or hot showers aimed at the abdomen help to relieve menstrual pain and cramps.

Hot compresses on the abdomen increase blood circulation, relax abdominal muscles, and relieve pain.

Stress can sometimes lead to irregular or no menstruation. Avoid stressful situations, or engage in stress-reduction activities whenever possible

A regular and healthy lifestyle with adequate rest and relaxation is the basic requirement for a normal menstrual cycle.

Wear cloth that fully covers the body and do not expose the belly or the abdomen to the cold environment. Avoid wearing tight pants.


This is just a small list of the possible ways to improve the menstrual cycle. These suggestions are suitable for many women. For more difficult cases, treatments and self care suggestions are best tailored to the specific woman. There are many acupuncture and herbal formulas I use at my clinic to help with menstrual problems.

John Chen’s Clinical Manual of Oriental Medicine deserves credit for most of the suggestions in this piece.

Sun Exposure- A Question of Balance

This is an informative article on sun exposure from the Wall Street Journal. As with most things, the amount of sun exposure is a question of balance: you can get too much and you can get too little.





Sunshine: Harmful and Healthy

Posted By Jacob Goldstein On July 15, 2008 @ 8:33 am In Heart Disease, Cancer | 1 Comment

Sunshine is bad for you. Getting too much of it increases the risk of skin cancer.

Sunshine is good for you. Getting too little of it — and the vitamin D it produces in your body — puts you at higher risk for big killers like heart disease and several types of cancer, WSJ's Melinda Beck notes today in her Health Journal column.

So what's a health-obsessed American to do? Going out in the sun for a few minutes now and again without sunscreen (gasp!) might not be such a bad idea.

"Sensible sun exposure can provide an adequate amount" of vitamin D, a review article in the New England Journal of Medicine said last year. "Exposure of arms and legs for 5 to 30 minutes (depending on time of day, season, latitude, and skin pigmentation) between the hours of 10 a.m. and 3 p.m. twice a week is often adequate."

Foods such as oily fish like salmon and fortified milk also have vitamin D. But a person sitting outside in a bathing suit in New York City gets more vitamin D in 20 minutes than from drinking 200 glasses of milk, Beck notes.

So vitamin D supplements can also be helpful — particularly for people living above 42 degrees latitude (Northern California out west; Boston in the east), where the sun's rays are too weak during the winter to get our bodies' vitamin D engine cranking.

Not surprisingly, the sun-starved Canadians have been taking a hard look at vitamin D data. One recent analysis pooled data from a number of randomized trials and found that people who took vitamin D supplements had a lower mortality risk than those who took placebos. That finding, published in the Archives of Internal Medicine, was cited last month in this CBC article.

And Canada's cancer society now recommends that people take daily supplements of 1,000 IU of vitamin D during the fall and winter, the article says.

Vitamin-Fortified Bonus: Check out this vitamin D podcast from Quirks and Quarks, a CBC Radio science show that's among the Health Blog's favorites. You can hear an interview with Cannell and get the observations from a passel of Canadian researchers working on vitamin D.

Photo by fdecomite via Flickr

http://blogs.wsj.com/health/2008/07/15/sunshine-harmful-and-healthy/print/

http://snipurl.com/2z043

In my opinion, most of the vitamin D supplements readily available are not the ones to take . Whenever possible, sun exposure is better and if you need a supplement make sure it is derived from whole foods so it comes with the cofactors (such as polyunsaturated fatty acids) it needs to be helpful. I prefer and prescribe Standard Process vitamin D for this reason.