Stirton.net » Health Care

Teaching Tenacity

stirton — Tue, 31 Jan 2012 07:24:40 +0000

Probably not a day goes by in which each U.S. citizen is not in some way reminded of the need to exercise. National and community-based exercise promotion campaigns, advertisements from fitness centers and equipment manufacturers, television news and the print media all confirm the validity of exercise for maintaining/improving physical and psychological health. The recently released Surgeon General’s report18 has stated to the public, in no uncertain terms, that a sedentary lifestyle is toxic to health.

Why, then, are individuals largely unable to maintain exercise programs? It can be confidently predicted, through extensive research, that 50 percent of those undertaking regular exercise will quit within six months of starting. How can the fitness industry change this rate, given that a great amount of education is already in place? Possibly, we can learn from past failures. Possibly, education and information are not as closely linked to behavior change for the better as was thought.

I have been critical of the fitness industry for not being sensitive enough to clients’ inabilities to spontaneously adapt to their new exercise situations.1 Although many in the fitness industry seemingly find it hard to believe, exercise is like work for the average new participant. Muscle fatigue, boredom and feelings of exertion are not akin to a pleasurable state for most.

For many, exercise experiences are connected with feelings of discomfort, displeasure and frustration. Couple this with a frequent perception of being out of place, in an arena where everyone appears to know what to do and how to do it, and a high likelihood of dropout emerges.

While education regarding the need for physical activity brings large numbers into an attractive, well-staffed, state-of-the-art facility, keeping sufficiently more clients than are lost requires large-scale, directed efforts that enhance their ability to adapt to exercise. As an industry, let’s take a look at where we have been, where we are and where we need to go.

GhandiaTed Explosion, Part 2

stirton — Thu, 29 Dec 2011 09:11:49 +0000

Reader’s comment: “There are two sides, and although each has responsibility Ted did what was decent and necessary for the energy flow to be restored. Ghandia is stuck in a time warp and must learn to forgive herself and others.”

Given the fact that the cameras were on them all night, I wonder why they didn’t show anything Ghandia mentioned. Is it because Ted really did not nibble her shoulder and rub her hair? Maybe. Then again, recall Clarence and the bean incident. They could’ve showed this as well, but instead they chose to let everyone speculate just as they may be doing now.

Reader’s comment: “According to Lex and Lindsey, in Africa, the cameras are only on them for a little bit at night. That is why no one knew Lex had an autistic child, he only talked about it at night because he didn’t want it on camera. Apparently it is too expensive to run 16 night vision cameras just to watch people sleep, however, since the cameras are on for some of the night-it’s possible the survivors would not know if they were being filmed at that moment or not, which makes Ghandia more believable about the biting, etc. ”

Do I think Ghandia imagined the nibbling and hair rubbing? No.
Is it possible Ted grinded her without realizing it? Yes.
Could Ted unconsciously nibble and rub hair? I doubt it. This is quite a stretch.
Did I believe Ted was sincere when he apologized? Yes.
Will this happen again? No way.
Should Ghandia have simply stopped him when it first started happening? Yes.
Should Ted have done this in the first place? No.
Is either one of them perfectly innocent? No.
Are you as ready as I am to change the subject? I hope so.

The meeting ended. Everyone said it’s a clean slate, yada yada, but I didn’t feel like anything was really resolved. It seemed like Ghandia still thought what she thought and that some people still doubted Ted.

Either way, if I were in that tribe, even if I thought Ted DID try to get with Ghandia, I wouldn’t vote him out because that would increase the chances of my tribe losing immunity challenges, which would, in turn, increase my chances of losing out of a million dollars. Call me selfish. Call me immoral. Doesn’t matter to me. What happened between two people I’ve known but a week would be insignificant to bringing home mega-bucks for my family.

GhandiaTed Explosion, Part 1

stirton — Wed, 21 Dec 2011 08:36:44 +0000

Ghandia went nutso. One of her issues with Ted was that he was going to act like nothing happened. From what I understand about rape victims, not being believed or actually being blamed is far too common, unfortunately. It’s an immense source of pain and it’s easy to see why Ghandia freaked when she heard that Ted denied it.

Ghandia screamed and threw rocks and cursed and name-called and punched a log and chopped a piece of bamboo until the Red Beret took the axe out of her hand. Clay likened her to a 2-year-old throwing a fit who needs a good ass-whoopin’.

Ted stated what seems to be the general consensus of most people on the boards, “Ghandia was making an issue that was very, very small and could’ve been handled in a very professional, one-to-one manner and has exploded it into an issue that goes beyond me and beyond this game.”

Reader’s comment: “Ted’s excuse may be ridiculous, but on two occasions he earnestly confessed to what happened, and appeared to want to reconcile it with Gandhia, and then with the tribe (once she made it public). Can Gandhia shut up long enough to hear his apology, or is she so focused on what she’s saying next that what someone else says doesn’t matter?” – Howard

Another comment: “I have posted quite frequently on RealityTVfans site and have read other contributors’ views. The consensus of opinion seems to be that Robb is an overbearing but intellectually challenged doofus but a great source of entertainment, and that the Ghandia and Ted drama has most people thinking that Ghandia is overreacting and unwilling to take responsibility for her part. It would have been as easy as getting up and walking away.”

I’m not saying that Ghandia’s reaction was wrong. All I am saying is that she reacted irrationally but that her reaction was perfectly understandable.

The fact that she conveniently left out Ted’s apology and painted him in the most negative light possible, well that’s a different story. There’s no excuse for that.

Ted and Ghandia called a tribe meeting. He described without the least bit of prompting or denial how he had grinded Ghandia in his sleep and that when he realized what was happening, he immediately stopped. He explained how he apologized to Ghandia and how it would never happen again.

Ghandia mentioned that he had denied it to Brian, but she refused to hear that just seconds earlier Ted admitted to grinding her.

The argument then shifted to how he nibbled her shoulder and rubbed her hair. He emphatically denied this and said that he is “not even attracted” to Ghandia and that he is 150-200% happy with his wife. (Spoken like a true software guru. I guess this means that he’s really happy with her.)

From Ghandia’s actions (playing with the sand, eye contact only when she speaks, not directly responding to anything Ted said), I’m thinking that Ghandia refuses to accept Ted’s apology and probably STILL thinks that Ted would like to “get with her.”

The FDA Is Doing Its Job. Part 2

stirton — Fri, 09 Dec 2011 17:51:52 +0000

In 1999, two similar agents for diabetes treatment were approved and marketed — SmithKline Beecham’s Avandia, and Lilly’s Actos. Thus far, the liver toxicity that led to 63 deaths among those on Rezulin has not been seen with these drugs.

Last week, as a result of standard post-marketing surveillance, and given the availability of the newer, safer agents, the FDA sensibly requested Warner-Lambert to withdraw Rezulin. But this remedial action came too late to suit Dr. Sidney Wolfe, of the Naderite group Public Citizen. He immediately criticized the FDA for having approved the drug in the first place. He argued that since FDA’s fast-track procedure was initiated, dangerous drugs have been unleashed on the American public, injuring patients. He went on to note that if the agency had acted earlier, as had authorities in Britain, some patients would still be alive.

But many diabetics would be sicker, or dead, without Rezulin, given that its two alternatives were not available in 1997 and 1998. That’s the real lesson — Rezulin’s unique benefits justified its risks. The risk-benefit ratio is as paramount when the FDA evaluates a medicine, as it is when a physician prescribes one. The enviable health and longevity of the American people is in large measure attributable to the professionalism and responsibility of the FDA in evaluating our pharmaceuticals. Of the more than 500 drugs approved since 1980, only 15 (or slightly more than 2 percent) have been withdrawn.

The FDA rightly stands by its approval process on Rezulin. The agency asserts what should be self-evident, even to those aiming at sensation rather than truth: all side effects of a drug cannot possibly be detected in the small-scale clinical trials that precede mass marketing. Rezulin was tested on 2,500 patients before release, and severe liver damage was not detected. Officials of the FDA’s Clinical Drug Evaluation Center pointed out that Rezulin would not have been withdrawn even now if not for the recent availability of the newer, safer insulin-sensitizer drugs. Even the most thorough regulatory process will fail if the appropriate safeguards are ignored when a drug is mass marketed. This is the responsibility of the treating physician.

To pontificate now that the drug should never have been approved amounts to Monday-morning quarterbacking, or “viewing through the retrospectroscope” in medical parlance. Ninety serious reactions out of 1.9 million patients is evidence of a job well done, not of dereliction. All drugs have risks, especially new drugs, and we often need the data from post-marketing surveillance to detect them. There are many drugs on the market more dangerous than Rezulin — it’s all about benefit vs. risk.

The withdrawal or restriction of a drug does not mean that its approval was inappropriate or the process shoddy. To shy away from releasing breakthrough drugs because of fear of unpredictable side effects would cripple the system that has benefited us immeasurably. The withdrawal of Rezulin during post-marketing surveillance shows that the system works.

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The FDA Is Doing Its Job. Part 1

stirton — Fri, 09 Dec 2011 17:48:38 +0000

The recent withdrawal of Warner-Lambert’s diabetes drug Rezulin has provoked the predictable outcry from consumer groups: Food and Drug Administration laxity and haste permits unsafe drugs into the marketplace.

Actually, Rezulin’s withdrawal should not be seen as an indictment of FDA’s drug approval process — quite the contrary. Just because a drug is later withdrawn does not mean it should not have been approved in the first place.

When it was initially approved in 1997, FDA officials and physicians alike viewed Rezulin as a “blockbuster” drug — one with unique and powerful lifesaving properties worthy of FDA’s newly instituted “fast-track” approval protocol. This procedure was instituted several years ago to expedite the often desultory approval process when particularly unique and important new cheap drugs were under consideration. Some liver abnormalities were detected during Rezulin’s pre-marketing phase of testing, but not in sufficient frequency to halt its approval and release.

The disease that Rezulin treats, type 2 diabetes (the form most commonly found in adults), is both dangerous and often resistant to usual remedies. Diabetes is the most common cause of blindness and kidney failure in adults, a major risk factor for heart disease and stroke, and is now being diagnosed more commonly in children as well. It affects 15 million Americans. The FDA estimates that in the short time since its introduction, 1.9 million have been treated with Rezulin. About 750,000 were still on it — until last week.

Why the popularity? Rezulin was the first in a new class of diabetes treatments called glitazones, which have a unique mode of action — enhancing the body’s sensitivity to its own insulin and reducing the amount of sugar produced in the liver. Diabetes experts welcomed such a novel approach to treatment. Additionally, the drug does not cause dangerously excessive lowering of the blood sugar, as do many other diabetes drugs.

Diabetes specialists found Rezulin to be an effective addition to their regimen for many diabetics. But over the course of its three-year lifespan, more liver abnormalities were noted. At the behest of the FDA, warnings to physicians were added to the package label on two separate occasions. The warnings advised physicians to use more frequent blood testing, and then to restrict the use of Rezulin to patients who did not benefit from other medications. Some doctors, however, failed to follow these directions assiduously.

An Artificial Life

stirton — Fri, 12 Aug 2011 12:02:51 +0000

There has been a question on my mind about artificial coloring and flavoring. The question is ‘Why?’ To make a product more visually appealing? To make it taste sweeter without a few more calories?

Wouldn’t you rather eat an all-natural food at any cost? Be it an odd color (or lack of) or the calories equivalent to an extra mile on the treadmill? I know I would. Now that I am nourishing two young children; being extra cautious of the ingredients going into their precious tummies, is second nature.

There are some theorists out there that believe artificial colors and flavors should be avoided at all costs. That theory is based on the human body not knowing what to do with artificial anything entering the digestive system. A theory I tend to agree with.

Our digestive systems are made from all natural ingredients, right? So, if you are an all-natural human (most of us are), how does your body know what to do with unnatural substances? Are you throwing your body a curveball? Causing misguided cell activity and confusion within? Wasting precious cell energy that could be used for your body’s natural healing process?

This is only one woman’s opinion. I have never heard one good thing about dyes used in foods or artificial sweeteners. In fact, a certain sweetener out there cannot be digested by people with phenylketonuria (PKU). People with PKU lack the enzyme needed to digest the artificial sweetener. In a sense, it accumulates, and could cause brain damage. And wasn’t there a certain food coloring that had to be taken off the market because it was linked to cancer? What does that tell you?

My family avoids artificial sweeteners at all costs. However, we still have the occasional fruit snack laden with artificial color and/or flavor. Or a bowl of cereal that wouldn’t be as pretty with out the red and yellow food coloring. You can’t get away from it.

In this fast-paced world, we do not have the time to make everything from scratch. We cannot grow produce year round in our back yards. What we can do is try to eat foods that do not contain artificial ingredients and moderate the ones that do. Just be aware of the ingredients we are ingesting.

If our children had their way, their diet would be refined flour, refined sugar, preservatives and artificial ingredients. We have to be the umpire for their game and make the call. So, be well informed and STAY HEALTHY.

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Places where you can Catch the Flu

stirton — Fri, 01 Jul 2011 10:41:02 +0000

Well, this hasn’t been a truly productive week. I managed to catch some flu going around. I’ve felt lousy most of the week. Armand, I only went line dancing on Monday and did nothing else except take a few really short walks. Since I’m feeling better, I should be able to do a bit more this week. I’m helping friends move today, so that will be a bit of exercise.

Sharon, I only ate beef twice this week. When I eat at places like McDonald’s, I usually only have a few fries, more to enjoy the taste. I don’t eat a lot of them. Usually I try to finish my sandwich first; by that point my boyfriend has wiped out half of the fries. Then I work on some with him, so I never eat a lot at once. I’ve had a few regular Cokes, but I usually drink the diet, caffeine-free ones.

We did a stir fry this week, and it lasted through three lunches. There were a lot of veggies in there. I probably had more vegetables this week than I had during the last three weeks combined.

I had a doctor’s appointment on Thursday morning and was only allowed to have liquids, so jello became dinner. I’d have done an early dinner had I known. The sundae was very small, though I’m sure it looks absolutely horrible on the food log.

I managed to do fairly well while out of town. I ate salads with chicken. I only eat Italian dressing, and it’s usually easy to find a low-fat version. I also tried chicken and broccoli raviolis with marinara sauce. Considering what else there was on the menu, that was really one of my best options. I actually only ate half the meal. I wasn’t terribly hungry.

I forgot to mention my weight. It was 209 last week and today it’s at 208. So I’m slowly losing weight. Even though I’ve had little exercise, I feel like I’m doing fairly well.

Hey, you are losing a pound a week, and still eating things like french fries, sundaes, and M&M’s! It sounds like an ad for some new miracle diet pill! But there is no magic about it; you are making thoughtful food choices meal by meal. The better you take care of yourself, the less extra weight you will have. I can see you are trying strategies that make sense for you — I like your french fries plan! I once had a client that did not eat the potato chips that came with her deli sandwich until the waitress came to take her plate away. Then she would grab one or two just to get the taste.

See how a little bit of cooking can go a long way? I like the way the stir fry worked out. You are also becoming more aware of your hunger level — you did not finish the broccoli ravioli because you were no longer hungry. Eureka! Did you take some home for later?

In order to deal with the larger restaurant portions, some clients find it useful to cut every thing in half with a knife before they start eating. The second half goes home for lunch tomorrow. Ask for the styrofoam plate when the meal arrives! Unfortunately, restaurant meals do not come in female and male portions, so you have to be creative or you will always be overeating.

I hope you feel better soon, and keep up the good work. Good job at reducing beef and increasing vegetables!

Good luck this week!

I am glad to hear you are feeling better after catching the flu. After being sick like that, your energy is zapped for the first couple of workouts upon resuming your program. I suggest you take it easy for a while during your exercise, going more slowly than your normal workout pace.

Also, be careful when you help move your friends’ belongings. Lifting boxes and transporting them can place a lot of stress on your muscles, especially those of the lower back. Use proper lifting techniques such as bending at the knees, keeping boxes close to the front of your body and not bending and twisting when lifting boxes off of the floor. It is a good idea, too, to perform your stretches after the move.

Now that you are feeling better, this week I would like you to attempt three good exercise sessions consisting of 30 minutes of continuous cardiovascular activity, such as your walks, followed by the stretches.

Hope you have a better week!

A Weighty Matter Post 2

stirton — Wed, 04 May 2011 06:53:46 +0000

The third option is a “high-protein/low-carbohydrate” approach that does not count calories or fats, but focuses on reducing the amount of carbohydrates that are ingested. The reason for reducing carbohydrates is because some people have a “thrifty gene” which causes increases of insulin levels in the blood when carbohydrates are ingested. This insulin increase tells the body to store food rather than use if for energy; hence this type of person will often gain weight on a high-carbohydrate/low-fat diet.

So this type of approach increases intake of meat, poultry, fish, dry beans, eggs, nuts, milk, cheese and yogurt, and minimizes intake of bread, cereal, rice, pasta, potatoes, fruit and sugar.

There are excellent books, Web sites and support groups for all of these approaches. Again, I want to emphasize becoming an informed consumer and talking about your decisions with your physician.

The second controllable factor for managing your weight is to increase your activity level. It is best to start a new exercise program two or three months before you make any changes to your tobacco habit. The reason for this amount of preparation is because there can be a variety of logistics, equipment and weather problems to work out when you first begin to exercise. Taking the time to work out these problems and to integrate your weekly or daily exercise regime into your lifestyle is very important.

Exercise has been identified as the factor that will predict the highest levels of success in quitting smoking. But quitting smoking and starting an exercise program at the same time can be very stressful and cause a smoker to either give up on the exercise or relapse back to smoking. It takes about three months to transform a new behavior into a new habit. If you take the time to establish your exercise program before you change your tobacco habit, your exercise program already will be firmly in place to support your efforts.

Exercise is also an excellent stress management tool, and it increases your internal brain chemistry that enhances your sense of well-being. It helps with appetite control, cleanses the body of toxins and helps you to sleep better. It also makes you feel good and look good!

I recommend taking time to learn about the different types of weight management approaches and exercise programs before you reduce or quit your tobacco use. Both of these issues can be a little complicated, and you will have greater chances of successfully changing your tobacco habit if you have already made plans and preparations for both of these areas. Then you will have more confidence to manage your weight as you eliminate tobacco from your life.

A Weighty Matter Post 1

stirton — Mon, 25 Apr 2011 01:13:46 +0000

Fear of weight gain often is a major barrier to quitting smoking, especially for women. The truth is that many, but not all, tobacco users gain weight when they quit, and 23 percent of tobacco users lose weight. Of smokers, 60 percent of men and 51 percent of women gain weight.

The long-term weight gain is often less than many people expect, and averages only 5 pounds. Typically, heavy smokers and tobacco users and older adults gain more weight than lighter users and younger adults. Smokers who eat more and avoid alcohol and coffee are more successful in quitting.

There are several controllable factors that you can use to manage your weight when you reduce or quit your tobacco use. The two most important factors are your food intake and your activity level.

Based upon my own extensive reading about weight management (because I come from long genetic line of Tweedle-Dees and Tweedle-Dums), I have come to the conclusion that there are essentially three ways to manage your food intake that can greatly help with weight management and weight loss. To find out which one works best for you, I recommend educating yourself about all three; be sure to talk with your doctor about which option you think would be best for you.

The food management method that appears to work the best for most people is the “high carbohydrate/low fat” approach. The Food Guide Pyramid (developed by the U.S. Department of Agriculture) represents this type of diet. The plan recommends daily consumption of six to 11 servings of bread, cereal, rice or pasta; three to five servings of vegetables; two to four servings of fruits; two to three servings of milk, yogurt or cheese; two to three servings of meat, poultry, fish, dry beans, eggs or nuts; and only sparing use of fats, oils, and sweets. This approach is especially good for highly active to moderately active people.

A second method uses the same food categories as the Food Guide Pyramid, but is a “balanced diet” approach in which the portions from each food group are of the same size. Eating a variety of foods every day is emphasized, and intake of low amounts of fat and sugar is recommended.

Testing for Hepatitis

stirton — Tue, 28 Dec 2010 07:45:03 +0000

There are specific tests your doctor can do to identify viral hepatitis A, B, and C. Blood banks also screen donated blood for hepatitis A, B, and C, and notify you if you have tested positive.
The hepatitis A test, if positive, indicates a recent infection, or immunity to the virus due to a previous infection.

The tests for hepatitis B (there are several) can identify whether you are infected, if you are recovering from the disease, if you have a chronic infection, or if you are resistant to hepatitis B.

The tests for hepatitis C can show if you are infected with the virus or if you were infected in the past.

If you test positive for hepatitis B or C, there is treatment available for eligible patients, which may be helpful. If you think you may be infected, be sure to consult your doctor immediately.

ALT Test

The alanine aminotransferase (ALT) test measures levels of alanine aminotransferase, a type of liver enzyme that is produced in higher amounts when the liver is inflamed. High ALT levels can be a sign of hepatitis. The test is also used to monitor the treatment of hepatitis, to check the progression or regression of the disease, or to see if a treatment is working.

Tests for Hepatitis B

For hepatitis B, the most common test measures the hepatitis B surface antigen (HBsAg), a small piece of the virus’s outer coat that acts like a “red flag,” signaling that the virus is in the blood. If you are feeling quite ill, and you have a positive HBsAg test, your infection may be new and active.

If you are not feeling badly at all, it may be that you have had the disease for a while and it has become chronic. Your doctor has other tests, such as:
Hepatitis B e antigen (HBeAg)
Hepatitis B core antibody-IgM (anti-HBc-IgM)
Hepatitis B core antibody-IgG (anti-HBc-IgG)
Hepatitis B e antibody test (anti-HBeAg)
Hepatitis B surface antigen antibody (anti-HBsAg)
HBV-DNA test

These tests will help determine if the infection is old or new, whether the body is still successfully fighting it off or if treatment is needed, and if you are still infectious to other people.

Tests for Hepatitis C

For hepatitis C, blood is tested for antibodies to the hepatitis C virus using the enzyme-linked immunosorbent assay (ELISA). An antibody is a type of immune protein molecule that is produced when a virus enters the body. A specific antibody is manufactured against each invader. If antibodies to hepatitis C are found in your blood, you are probably still infected with hepatitis C.

Your doctor may also perform the recombinant immunoblot assay test (RIBA), which is another way of measuring the presence of various antibodies to hepatitis C in the blood, or a polymerase chain reaction (PCR) test may be administered that tells how much virus is in your blood. (The PCR test for HCV is called the HCV-RNA test.) These tests are often used to confirm diagnosis or to see if treatment has worked.

Liver Biopsy

Another common test used to diagnose hepatitis is the liver biopsy, in which a small piece of liver is removed (too tiny to affect how your liver works) and examined under a microscope. Many doctors do a liver biopsy whenever a patient has a high ALT, suggesting the liver is inflamed, to help them confirm what exactly is causing this problem and how serious it is.

Your doctor has other tests available, too. Don’t be afraid to ask what tests he or she has done, what other tests are available, and what the tests may tell you about your condition.

If you have just learned that you have hepatitis, consider asking your doctor about the amount of the virus in your blood, and what this viral level means for treatment. For more information to help you communicate with your doctor about hepatitis and how you will be treated, see the section, Partnering with Your Doctor.