Discover Your Stress Personality - James Hubbard's My Family Doctor
James
Hubbard’s
The Magazine That Makes Housecalls
MAR/APR 2008
Discover Your Stress
Personality, p.14
In this issue
12 Women Versus Men
Our most fascinating differences.
(This, you haven’t heard.)
17 Your Exercise Personality
Make it work for you!
Housecalls
22 At the Doctor Fingernails.
2 3 Chronic Disease Packed-in nutrition.
2 4 Nutrition Additives.
2 5 The Teeth Whitening strips.
2 6 Alternative Health Acupuncture.
Regular Features
10 So You Wanna … Prevent cancer.
1 1 Alternate Reality Capsaicin.
2 0 The Great Debate Media violence.
2 9 How Does It Work Antihistamines.
3 0 To the Test Nasal irrigation.
VOL 5, NO 3 $7.00
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 1
Straight From
the Experts!
James Hubbard’s My Family
Doctor is published and written
by health-care professionals.
Our mission is to help empower
you to live your healthiest life.
Within these pages, you’ll gain
in-depth knowledge about
how your body works, advice
to help you make informed
decisions about your wellbeing,
and solid information
based on proven evidence, not
fickle fads.
Positive, proactive, utterly
reliable and just plain fun …
that’s what we strive to be here
at James Hubbard’s My Family
Doctor.
To let us know what you think,
contact us through www.
MyFamilyDoctorMag.com.
Thanks for reading!
About the
Charities
The nonprofits and other
organizations featured in
James Hubbard’s My Family
Doctor are for informational
purposes only. If you are
concerned about a charity’s
stance on or funding of certain
controversial things, such as
embryonic stem-cell research
or organizations that provide
abortions, we encourage you
to research the charity before
donating money. To start, you
might ask for a list of grants
it has given in the last year
and whether it has a position
statement on any issues that
concern you.
James
Hubbard’s
Publisher & Editor-in-Chief
James Hubbard, M.D., M.P.H.
Managing Editor
Leigh Ann Hubbard
Art Director
Carra Hewitt
Production Manager
Garreth C. Blackwell
Advertising
(719) 576-2353
ads@familydoctormag.com
PHOTOGRAPHERS
Roman Chmiel, Lise Gagne, Iryna
Kurhan, Andrejs Pidjass, Erik Reis, Jowita
Stachowiak, Tatjana Krstic Tiki
COVER PHOTO
Izabela Habur
Illustrator
Vanda Grigorovic
The Magazine That Makes Housecalls
Publishing Consultant
Samir Husni, Ph.D.
Contact James Hubbard’s
My Family Doctor:
www.MyFamilyDoctorMag.com
877-DOC-IS-IN (877-362-4746)
P.O. Box 38790
Colorado Springs, CO 80937
James Hubbard’s My Family Doctor is published
bimonthly by Hubbard Publishing, LLC,
(ISSN 1553-4960) (USPS 022-609) at 5736
Adrienne Court, Colorado Springs, Colorado,
80906. Periodicals postage paid at Colorado
Springs, CO, and additional offices. Postmaster,
send address changes to James Hubbard’s
My Family Doctor, P.O. Box 38790, Colorado
Springs, CO 80937-8790.
Subscription rate is $42 per year. Copyright
©2008, all rights reserved. No part of this publication
may be reproduced or transmitted in any
form or by any means or stored in any information
storage or retrieval system without prior
express written permission of the publisher.
The editorial content of James Hubbard’s My
Family Doctor: The Magazine That Makes
Housecalls is meant to increase your knowledge
of current medical developments and beliefs.
It cannot take the place of regular professional
health care. Consult your health-care
provider about individual concerns. Because
medical information changes rapidly and James
Hubbard’s My Family Doctor cannot guarantee
the accuracy or currency of our content, always
consult your health-care provider before using
any information or advice contained herein.
Editorial Board
Fitness: Rita Beckford, M.D., boardcertified
family doctor; host, fitness and
weight-loss DVD Home With Dr. B (www.
HomeWithDrB.com); certified personal
trainer and group fitness instructor.
Family medicine: Eva F. Briggs, M.D.,
board-certified family physician, Auburn
Memorial Hospital urgent-care centers
in Auburn and Skaneateles, N.Y.; author,
medical legal thriller Crystal Crazy.
Pharmacology: F. James Grogan,
Pharm.D., pharmacist, Heartland
Regional Medical Center, Marion, Ill.;
over 25 years of experience.
Internal medicine: Kevin O. Hwang,
M.D., board-certified internist; instructor,
University of Texas Medical School at
Houston.
Pediatrics: Kari Kassir, M.D., boardcertified
pediatrician and pediatric
critical-care physician, Children’s Hospital
of Orange County, Mission Viejo, Calif.
Family medicine: Kevin S. Liu, M.D.,
board-certified family doctor, Keller,
Texas.
Family medicine: Susan Louisa
Montauk, M.D., board-certified
family doctor; professor, clinical family
medicine, University of Cincinnati
College of Medicine.
Orthopedics: Premier Orthopedics,
fellowship-trained orthopedic surgeons
in Colorado Springs, Colo.: David L.
Walden, M.D., David M. Weinstein,
M.D., Timothy S. O’Brien, M.D.,
Timothy S. Hart, M.D., Roger D. Sung,
M.D., William J. Ciccone II, M.D., John
S. Xenos, M.D., John Shank, M.D.,
Anthony Sanchez, M.D.
Gastroenterology: Patricia L.
Raymond, M.D., F.A.C.P., F.A.C.G.,
board-certified gastroenterologist, Simply
Screening, Chesapeake, Va.; author,
Colonoscopy: It’ll Crack U Up!; assistant
professor, clinical internal medicine,
Eastern Virginia Medical School.
Infectious disease: Emmanuel
Rodriguez, M.D., M.P.H., infectiousdisease
specialist, NorthReach Internal
Medicine Clinic, Marienette, Wis.;
attending physician and hospital
epidemiologist, Bay Area Medical Center;
board certified in internal medicine.
Emergency Medicine: John Torres,
M.D., board certified in emergency
medicine; attending physician, Sky
Ridge Medical Center, Lone Tree, Colo.;
medical anchor, KDVR-TV (Fox) in Denver.
Obstetrics and Gynecology: Susan
Warhus, M.D., board-certified ob-gyn
(now teaching and writing); author, Darn
Good Advice: Pregnancy and Fertility
Demystified.
2 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
FROM THE DOC
What do you think
Write us any time—and don’t forget to include your medical
questions for our Housecalls section (page 22)!
Send letters to: P.O. Box 38790, Colorado Springs, CO
80937. Or e-mail through www.MyFamilyDoctorMag.com.
(Click on “Contact Us.”)
5 Fav Tips
Dr. Hubbard’s favorite tips from and about this issue
Healthy Debates
You will be hearing a lot about health this
political season. There will be new ideas,
and old plans in new presentations. Probably,
you won’t here much about how you can
improve your own health. That’s where we come
in.
The absolute most cost-effective plan is to
have personal knowledge and act upon it. Everyone
can do it.
Have you checked out our new Web site at
www.MyFamilyDoctorMag.com Please read a
QuickBlog (middle of the home page), article or
blog that interests you and post a comment or
e-mail us feedback.
On page 4 of this issue, you’ll see a comment
from a reader who doesn’t like our new
emphasis on added-value Web material. What
do you think Do you think our magazine is
giving you enough print information As I said
before, we are trying to make the Web an added
value for our readers, while continuing to publish
a complete, valuable magazine that you find
worthwhile in and of itself.
Have a wonderful spring. See you in May in
print and sooner in cyberspace.
Best Wishes for Great Health,
1. When reading our articles on your exercise and stress
personalities (pages 17 and 14), you may or may not fit perfectly
into a category. If you don’t, then try to find the closest one to you.
Better yet, ask a person who knows you well to help.
2. Look at our nutritional guide to salad greens (page 9). If you have
a choice, try a top pick.
3. Man cannot live on greens alone. Liven up a salad with almost
any kind of fruit or vegetable. If that is not filling enough, try
sprinkling on some nuts. The main nutritional warning is to go light
on the dressing, which adds little nutrition and tons of calories.
4. So many people have sinus problems. Try the nasal irrigation
(page 30). It is so simple but works so well for many people if done
properly and early.
5. Hot pepper capsaicin is not new (page 11), but all of the ways
to use it may be new to you! Ask your health-care provider about
recommendations.
Easy Renewal!
To help reduce a little of the mail you receive (and keep your renewal
costs down), we invite you to renew your subscription in advance
by visiting www.MyFamilyDoctorMag.com, calling 877-DOC-
IS-IN (877-362-4746) or faxing or mailing your payment with the
form on page 27. (To find out when your subscription is up, just
e-mail questions@familydoctormag.com.)
James Hubbard, M.D., M.P.H.
publisher and family doctor
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 3
on the
Web
We Want
You!
Do you like to get free stuff
… and tell everybody else all
about it
We’re looking for product
testers to be in the
magazine! Just fill out
the simple application
in your Premium
Subscribers Section
at the new www.
MyFamilyDoctorMag.
com.
Poll Results
What’s your favorite winter activity
A brisk walk through the woods: 42%
From Our Inbox
Constructive Criticism
“I don’t like what your mag has
become, which is an ‘index’ for
the Internet. I’ve been a long time
buyer of your mag from when
you first started. When I read
an article, I like it to be in full. I
don’t want a generalization or
tease, then you telling me to go
to your Web site for more info
on the subject.”
—Paul, via e-mail
Dr. Hubbard’s Response:
Thank you for sharing your
concerns. The Web content
is meant not to complete
articles but to provide
additional resources—to
help you learn more about
topics that especially
interest you. (Actually,
there are more words per page—and thus sometimes
per article—in this new print format than there were
previously.) Your letter made us realize that we may not
be getting that idea across effectively. With this issue,
we’ve begun labeling all the Internet additions “Web
Extras.”
Making snow angels: 29%
Snowball fights!: 29%
What Do You Think
Do you agree We’d love to hear your feedback on this or anything
else. Write us any time through www.MyFamilyDoctorMag.com
(“Contact Us”) or at P.O. Box 38790, Colorado Springs, CO 80937.
This Month’s Polls
(Vote in your Premium Subscribers Section.)
Which totally “Random Question” do you want us to
answer in the June/July issue (See page 6 for this
time’s.)
a. If soap doesn’t say “antibacterial,” what good does it do
b. Why do hot tubs and saunas have signs warning you not
to stay in for longer than a certain amount of minutes
Does that apply to hot baths and showers, too
c. What’s the difference between an MRI and a CAT scan
In Your Premium
Subscribers Section
Keep an eye out for “Web Extra!” content
throughout this issue, including:
• links to refreshing fruit compote recipes
(p. 7).
• related previous articles, on subjects like
hypnosis (p. 26), sleeping pills (p. 26) and
allergies (p. 29).
• a place to share your opinions about media
violence (p. 20).
4 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
a. Chalazae
b. Chardonnay
c. Slinkies
Trivia
by David Brinn
Eggstraordinary!
Easter time’s a-comin’! How much do you know about the holiday’s
favorite treat (See answers below.)
1. What determines eggshell color
a. The hen’s diet
b. The hen’s breed
c. When the egg is laid
2. Egg yolks are a good source of
this bone-building nutrient.
a. Vitamin D
b. Agave
c. Ethanol
3. In Dr. Suess’s classic “Green Eggs
and Ham,” the narrator refuses
to eat the title meal in each of
the following scenarios except:
a. In a box or with a fox
b. On a boat or with a goat
c. On a log or in the fog
4. The egg yolk is also known as
the:
a. Vanadium
b. Vitellus
c. Verawang
5. What is the process of laying an
egg called
a. Oxidation
b. Stemming
c. Oviposition
6. The American Heart Association
recommends consuming no
Answers: 1. b (typically, a white-feathered
hen lays white eggs, while a red- or brownfeathered
hen lays brown eggs), 2. a, 3. c, 4.
b, 5. c, 6. b (according to the USDA Nutrient
Database of Standard Reference), 7. a, 8. c,
9. b, 10. a (caviar is a popular type of roe; the
other choices are fruits)
more than 300 milligrams of
cholesterol a day. How much
cholesterol does an average
large egg contain
a. 56 milligrams
b. 212 milligrams
c. 501 milligrams
7. These two strands (one on
each end) are responsible for
anchoring the yolk in the egg’s
center.
8. The USDA
uses each of the
following sizes when
grading eggs except:
a. Peewee
b. Jumbo
c. Mammoth
9. In a classic scene from the
film Cool Hand Luke (1967),
which actor bets he can eat 50
hardboiled eggs in an hour
a. Mark Hamill
b. Paul Newman
c. J ames Dean
10. Fish produce this usually edible
egg.
a. Roe
b. Pawpaw
c. Durian
How’d You Do
1-3 correct: Eggscrutiating
4-6 correct: Not eggactly
impressive
7-8 correct: Eggcellent
9-10 correct: Eggceptional
Name That doohickey!
(See answer below.)
Answer: Intubation tube (left) and laryngoscope. To help you breathe during
an emergency or while under general anesthesia, a health-care provider can
use the laryngoscope to push your tongue out of the way and find the trachea
(airway), which is just in front of the esophagus. The tapered (not sharp) laryngoscope
has a dull blade on the top and bottom and a kind of moat between. This
allows the provider to guide the tube into the appropriate passageway. Then, he
or she can attach a manual airbag or machine to blow air in at intermittent times.
The handle, by the way, holds the battery for a light that shines into your throat.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 5
Random
QUESTION
Tooth Loss
by John T. Grbic, D.M.D., M.M.Sc.
Q What makes you lose your teeth
as you get older Does it happen to
everybody
A The primary reason for tooth loss
in adults is periodontal (gum) disease.
Bacteria in the space between
your gums and teeth multiply and
release toxins that cause the gums to
become inflamed. If untreated, this
inflammation can result in the destruction
of tissues and bone around
the teeth and eventually lead to tooth
loss.
Signs of periodontal disease include
bleeding while brushing, gum
recession, tooth loosening and bad
breath.
Tooth loss is not inevitable. Many
people have a mouth full of teeth into
their 80s and 90s. Good oral hygiene
and frequent visits to the dentist
are keys to maintaining your pearly
whites.
Jo h n T. Gr b i c, D.M.D., M.M.Sc., is
director of the Division of Oral Biology and
the Center for Clinical Research in Dentistry
at the Columbia University College of Dental
Medicine.
You Decide!
What question do you want
us to answer in the June/
July issue
a. If soap doesn’t say
“antibacterial,” what
good does it do
b. Why do hot tubs and
saunas have signs
warning you not to
stay in for longer than
a certain amount of
minutes Does that
apply to hot baths and
showers, too
c. What’s the difference
between an MRI and a
CAT scan
To vote, visit your Premium
Subscribers Section at www.
MyFamilyDoctorMag.com.
“Antibiotics
Hype
don’t help
sinus
infections.”
by Jordan S. Josephson, M.D.
or
Right
researchers, who published their findings
in the December 5, 2007, The
Journal of the American Medical Association,
studied people who they thought
probably had a bacterial infection.
But there’s no definitive test for that,
so it can be hard to determine.
The decision regarding antibiotics
is up to your health-care provider’s
judgment. If you’re feeling miserable;
if it’s getting worse, or if it lasts
more than 10 days or so, you may
have a bacterial infection. In this
case, your provider may decide that
an antibiotic is the way to go. But if
not, don’t worry. In all likelihood, the
infection will go away on its own.
In a recent study, researchers
found that the antibiotic amoxicillin
may not help sinus infections.
But, despite what some
media reports might have suggested,
that doesn’t mean that all antibiotics
don’t help. It simply means
amoxicillin—granted,
Hype
one of the
most prescribed for such infections—
may not.
Many sinus infections are caused
by a virus, which no antibiotic will
treat. These usually clear up within
seven to 10 days on their own. The
Jo r d a n S. Jo s e p h s o n, M.D., is the author
of Sinus Relief Now and director of the
New York Nasal and Sinus Center in New
York City.
6 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
InSeason
Edible Flowers
by Carol M. Bareuther, R.D.
What’s Good About Them
There’s not been much nutrition
research on edible flowers since
they rarely show up on everyday
or even special occasion
grocery lists. But what we do know
seems good. Roses, rose hips, dandelion
blossoms and dandelion leaves
are rich in vitamins C and A. Certain
other flowers seem to have nutritional
benefits, too.
More is not always better,
though, as eating too many daylilies,
for example, can have a laxative effect.
Talk with your health-care provider
before taking flower extracts as
a supplement.
Buying Tips
Not all species of flowers—or all
flowers within a family—are
edible, cautions Chef Eric Arrouze,
a Canadian who teaches cooking to
the world through 911cheferic.com.
“If purchasing flowers at a farmer’s
market, ask where they come from
and if they’re edible. Don’t buy from
a florist, as the flowers will have been
sprayed with pesticides. The best bet
is to purchase flowers clearly marked
‘edible’ from containers or displays at
the market. Look for flowers that are
brightly colored, moist and not dry or
wilted.”
Grocery stores sometimes
sell small packages
of the flowers in their produce
section.
Storage Tips
Flowers are highly perishable
and best used immediately.
If you can’t use
what you’ve purchased in
one meal, says Chef Arrouze,
“wrap the flowers in
several sheets of damp paper
towel; then tuck them
in a plastic bag and seal
with a Ziploc top. They will stay good
up to five to seven days this way.”
Yum!
The use of flowers in cooking dates
back thousands of years, says Kitty
Morse, author of Edible Flowers: A
Kitchen Companion With Recipes. “For
example, the Romans used borage—
Web Extra!
Find links to yummy fruit compote
recipes in your Premium Subscribers
Section, www.MyFamilyDoctorMag.
com.
an edible herb with a faint cucumber
taste and pretty blue flower—to make
wine. They believed drinking it would
increase strength.”
Today, people use flowers in a
variety of ways. “Try zucchini flowers
stuffed with lobster mousse,” suggests
Chef Arrouze. “Cornflowers taste
like lettuce and are excellent tossed
into salads.” Add a few pansies for
some fun color, but remove the bitter
stem first, he recommends.
Ca ro l M. Ba r e u t h e r, R.D., is a nutritionist
with the Special Supplemental Nutrition
Program for Women, Infants, and Children in
St. Thomas, U.S. Virgin Islands.
IF YOU LIKE …
pie à la mode
buttermilk biscuits
sweets
TRY …
baked apple or fruit compote with fruit sorbet,
for more fruit and fiber and less sugar, saturated
fat and calories.
substituting whole-wheat pastry flour and using
half canola oil and half butter (instead of all
butter), for more fiber and less saturated fat.
mixing together 1 tablespoon of chocolate chips,
2 tablespoons of dried fruit and ¼ cup Honey
Nut Cheerios, for fewer calories and more fiber
than many other sweet treats.
The Experts
Pie and biscuits: Melanie Hingle,
M.P.H., R.D., senior research
specialist, University of Arizona.
Sweets: Pamela M. Nisevich, M.S.,
R.D., L.D., nutrition consultant,
Nutrition for the Long Run,
Dayton, Ohio.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 7
Jargon Watch
Free Range and Cage Free
Want some omega 3s Buy some special eggs! Extra vitamin E Eggs again!
The only difference What the hen that laid them ate. And that doesn’t
necessarily have anything to do with how it was housed.
“Cage-free eggs are from hens that typically live on the floor of a barn
or a poultry house,” says Diane Storey, spokeswoman for the industry group United Egg
Producers. “Free-range hens … have at least some access to the outdoors.”
Despite rumors to the contrary, most experts agree that neither housing option
offers a nutrient boost in and of itself. Instead, in order to get special eggs, you have
to feed special food. Flax seed or algae flakes, for example, result in eggs with hearthealthy
omega 3 fatty acids.
“Cage-free” and “free-range” labels are more about animal welfare. So, “you may
want to choose it for other reasons,” says
nutrition professor Julie Miller Jones, Ph.D.,
C.N.S., L.N., of The College of St. Catherine
in Minnesota, “but as far as I’m concerned,
I haven’t seen any data that would indicate
that it makes sense from a nutritional reason.”
charity
Spotlight
How to Donate
Wisely Part Two
Do you support embryonic stem-cell research Animal
testing Abortion Universal health care Do you know
if your charity does
“A well-run charity is always eager to answer questions from its donors,”
says Sandra Miniutti, vice president of marketing for the watchdog
group Charity Navigator. Though you probably won’t find support of
controversial issues splashed across those “please donate” letters, a little
digging should reveal just where your money’s going. “Charities that are
unable or refuse to articulate this information should be avoided,” Miniutti
says.
Web Extra!
Read part one of this series—how
to make sure a charity spends
its money wisely—through your
Premium Subscribers Section, www.
MyFamilyDoctorMag.com.
Web Extra!
What’s the more humane option
The egg farmers and animal activists
have quite a debate going on. Find
links to their arguments in your
Premium Subscribers Section,
www.MyFamilyDoctorMag.com.
Visit the Web site; request the
annual report; read the newsletters,
she recommends. You can also ask if
the group has a position statement on
an issue that concerns you.
Store It
Healthy, freezable, delicious
Frozen
Fruit
Crunchies
1 med. banana,
peeled and cut
into 12 slices
12 fresh
strawberries
¼ cup Grape-Nuts cereal
3 Tbsp. pecans, finely chopped and
toasted
¹⁄3 cup reduced fat strawberrybanana
yogurt
Combine the cereal nuggets and
pecans; stir well, and set aside.
Place the strawberries and banana
slices on wooden picks; dip the fruit
in the yogurt, coating halfway up
the sides of the fruit pieces.
Roll the yogurt-coated portion of
the strawberries and bananas in
the cereal mixture. Place them on a
baking sheet lined with wax paper.
Cover and freeze for 45 minutes to
1 hour, or until firm.
Per serving (six pieces): 121 calories, 4 g fat
(sat. not published separately), 3.6 g fiber, 57
mg sodium
Courtesy NutriFit Founding Director, Jackie
Keller, www.NutriFitonline.com.
Freezability
Probably a few months (safe indefinitely
but quality will lessen)
To Toast the Pecans …
Dice them up. Put them in a dry
skillet and shake over medium heat
until they’re fragrant and slightly
browned.
8 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
The
Chart
Salad Greens
by Mary Ellen Bingham, M.S., R.D., C.D.N.
Looking to load up on tasty salads this season Leafy greens can fill you up without filling you out.
Spinach and arugula may be top picks on this list of common greens but if you want even more variety,
taste some kale, Swiss chard or a mesclun mix and savor the flavor.
Next Time
Salad
dressings
Greens Cal.* Fiber* Other Notables* Dietitian’s Take
Spinach 7 1 g 30 mg calcium; 0.81 mg iron; 167
mg potassium; 8.4 mg vitamin C;
58 mcg folate; 2,813 IU vitamin A;
antioxidant-rich
Romaine
“Cos”
Butterhead
“Boston”
“Bibb”
8 1 g 11.3 mg vitamin C; 2,729 IU vitamin
A; 64 mcg folate; antioxidant-rich
7 0.6 g 0.68 mg iron; 131 mg potassium;
1,822 IU vitamin A
A TOP PICK! A nutritional powerhouse, spinach
is a great source of vitamins C and A, plus other
antioxidants.
A close second behind spinach, romaine offers a
delicious and nutritious choice, often used in Caesar
salads.
Packed with vitamin A, this tender leaf is a great
option with a mild flavor.
Arugula 4 0.4 g 32 mg calcium Easy to find in grocery stores, arugula provides a
unique peppery taste.
Red Leaf 4 0.3 g 2,089 IU vitamin A; antioxidant-rich Add some color to your dish while also getting loads
of vitamin A.
Iceberg
“Crisphead”
10 0.9 g Limited vitamins and minerals Iceberg is the most common lettuce. While low in
nutritional value, it is convenient and adds texture
to your salad or sandwich.
* Per 1 cup, raw (equals one serving)
Registered dietitian Ma ry El l e n Bi n g h a m, M.S., R.D., C.D.N., is a nutrition counselor in New York City.
Source: USDA National Nutrient Database for Standard Reference
Worth it
Produce
Washes
Do they make
you safer or just
lighten your
wallet
Experts weigh in
on the evidence.
he FDA and USDA recom-
washing with cold, “Tmend
drinkable water. Soaps and produce
cleaners are not deemed necessary. In
fact, their effectiveness in reducing
bacteria is not significantly different
than that of using a cold-water wash.
“Bottom line: Eat those fruits
and vegetables! Wash them first and
enjoy!”
—Vickie A. Va c l av i k, Ph.D., R.D.,
assistant professor of clinical nutrition,
UT Southwestern Medical Center,
Dallas, Texas
tudies performed on produce
“Swashes showed that a minimum
amount of dirt, soil and bacteria
were removed. Instead, thoroughly
wash all produce with cold running
water, placing produce in a sanitized
strainer. Do not wash items bathtubstyle
in a filled sink as this contributes
to cross-contamination.”
—Je f f Ne l k e n, B.S.,M.A., food safety
expert, Woodland Hills, Calif.,
www.foodsafetycoach.com
everal scientific studies have
“Sclearly documented the effectiveness
of water washing of fresh
produce to reduce the levels of pesticide
residues and general filth. Commercial
produce washing solutions
generally do not have a meaningful
impact over what can be achieved
by rinsing with water alone. So, save
your money; wash with water; and
scrub firm produce with a clean produce
brush.”
—Do u g l a s L. Ma r s h a l l, Ph.D.,
associate dean, College of Natural and
Health Sciences, University of Northern
Colorado
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 9
SO YOU WANNA …
Prevent
Cancer
Though some are unavoidable, “a
huge portion of the cancers that are
around are very preventable,” says
board-certified medical oncologist
Peter Tothy, M.D., of the Block Center
for Integrative Cancer Treatment
in Evanston, Ill.
Good to know, Dr. Tothy. Do
tell …
JHMFD: We hear a lot about cancerfighting
foods. What’s the numberone
thing we should be eating
PT: It does seem that the whole-grain
breads and cereals, the higher intake
of fruits and vegetables, limiting the
high-fat foods—butter, whole milk,
fried foods, red meat—these all
seem correlated with reducing cancer
risk. …
I don’t subscribe to having massive
amounts of one vegetable or
fruit. I think having a balanced assortment
makes sense to complement
each other.
Web Extra!
In your Premium Subscribers Section:
• Read more of our interview with
Dr. Tothy (including his thoughts on
genetic testing and full-body scans).
• Read our previous article on skin
cancer and moles.
• Find a link to your cancer-screening
recommendations.
(At the new www.MyFamilyDoctor
Mag.com.)
JHMFD: What about chemicals
Should we be concerned about dayto-day
exposure
PT: I think the higher the exposure to
certain chemicals, the more likely the
risk. … Again, I think not one thing is
going to drive towards cancer. It’s going
to be multifactorial. So, although
an exposure on one side may increase
a risk, doing several other things may
compound and make it worse.
JHMFD: Does radiation from X-rays
and other preventive tests cause or
contribute to cancer
PT: I think currently it’s unknown.
… However, the screening has benefited
and saved countless lives. This
is where weighing the small potential
risk but also the potential gain of
finding a precancer or cancer [comes
into play].
… I think this is where patients
should share with their doctors their
concern and talk about how they can
minimize the risk from radiation—
what are some alternative testings
JHMFD: Are there any myths or rumors
you’d like to debunk
PT: The fear of cancer is a huge business,
and you put it in the Internet,
you’re going to find tens of thousands
of claims to prevent or cure cancers.
Dr. Tothy’s
Cancer
Prevention
Tips
“It’s not too late to start.
It’s never too early to
start.”
• Eat a healthy diet.
• Avoid tobacco and excessive
alcohol.
• Maintain a healthy weight.
• Exercise regularly—even “just a
few hours per week. ... There’s
thoughts that it changes the
metabolism and may modify
growth factors that promote
cancer.”
• Limit unprotected sun exposure.
(“Probably 15 minutes gives you
enough vitamin D.”)
• Wear a mask and protective
gear when using chemicals (such
as paint, asbestos, pesticides,
solvents).
• Protect yourself from viruses like
human papilloma virus, hepatitis
and HIV, which can lead to
cancer. (These can be sexually
transmitted; condoms can help
prevent transmission but don‘t
guarantee protection.)
• Get screened as appropriate
for your age, family history and
lifestyle.
And I voice a lot of skepticism
and believe that really there’s not one
single magic bullet. There’s not one
vitamin, one tablet, one juice that’s
going to make the biggest impact.
You have to work to try to prevent
cancer, maintaining a healthy lifestyle,
and do screening.
I’d say be healthy skeptics out
there, and don’t assume that the easiest
path is the most effective.
10 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
Alternate
Reality
Hot Pepper
Cream
Burn that pain away!
by Andrea E. Gordon, M.D.
Ever rubbed your eyes after chopping
hot peppers So you know
the burn isn’t limited to the
taste buds!
Though it feels far from beneficial,
believe it or not, peppery pain
on various parts of the body can help
relieve arthritis, headaches and more.
It all has to do with a little thing
called capsaicin.
Hot, Hot, Hot
Capsaicin (cap-SAY-i-sin) is the
chemical that makes peppers hot. It
doesn’t damage your tongue or skin.
It just fools your
body into thinking
it’s injured by
causing certain
nerves to release
a chemical called
substance P. (Substance
P tells the
nerves to send out
pain signals.)
Applying capsaicin
can use up
the substance P in
that area, thus relieving
the underlying
pain. Don’t
worry, though; you’ll still hurt if you
get injured because other nerves can
carry pain signals, as well. And you
do have to keep using the capsaicin
because the body continues to make
substance P.
Relief!
Capsaicin cream seems to help with
arthritis, post-shingles pain and
diabetic neuropathy (severe nerve
pain in the feet and legs). It may
also help some other conditions,
including:
• psoriasis. (Use only
with your healthcare
provider’s supervision;
don’t put
it on broken skin.
The same caution
applies when using it
for shingles.)
What about
the sprays
Capsaicin nasal sprays, such
as Sinol and Sinus Buster, are
marketed as natural remedies for
things like headaches, allergies and
sinus congestion. They do burn. If
you decide to try one, I’d suggest
giving it a trial longer than one or
two doses.
• cluster headaches (excruciating,
one-sided headaches that
come in groups,
or “clusters”). The
effects can last
up to one month.
However, it’s not
rubbed on the
head but placed
in the nose. (The
nerves in your
nose are pretty
much in a direct
line to those in
your head.) This
is very painful and
only a health-care
provider should do
it. (Capsaicin in the nose may also
work for migraines.)
• non-allergic rhinitis (runny
nose) and possibly some allergies,
though the evidence for this is
mixed and the discomfort (putting it
in the nose) makes it less useful.
• back pain.
Capsaicin cream is available
Caution
Do not put capsaicin
cream in your nose! It
will hurt a lot! Only a
health-care provider
should do this.
over-the-counter under different
names and strengths. A lower potency
is usually recommended for
musculoskeletal pain, while
a higher one is for nerve
pain.
The main side effect
is the burning sensation,
but in some people
it can cause redness
or swelling. (Get any extreme
reaction evaluated.)
The effects may lessen as
you continue to use the cream.
Talk to your health-care provider
before using capsaicin, especially if
you’re pregnant or breastfeeding. In
general, the most important caution
is to keep it out of your eyes. Capsaicin
oleoresin is an oily extract used in
pepper self-defense sprays!
Board-certified family doctor An d r e a E.
Go r d o n, M.D., is director of integrative
medicine for the Tufts University School of
Medicine Family Medicine Residency program
at Cambridge Health Alliance in Malden,
Mass.
Web Extra!
Find a link to a discount coupon
for Zostrix, one brand of capsaicin
cream, in your Premium Subscribers
Section, www.MyFamilyDoctorMag.
com.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 11
Women Vs. Men
Doctors’ picks for the most fascinating differences between the sexes
Men and women are different.
Bet you didn’t know that.
OK, so some of the differences are kind of
apparent—enough that the claim that half of
us are from Mars and the other half from Venus seems
somewhat plausible. But then there are the things you
can’t detect—things only science or medicine could discover—the
hows and whys and even some of the whats.
We asked doctors to share their picks for the most
fascinating differences between the sexes. This stuff, we
bet you haven’t heard.
Great Date
I like the GI story of alcohol.
The stomach wall contains an enzyme that metabolizes
some of the alcohol you drink. Men happen to have
loads of it; women less.
Thus, when a guy downs his alcoholic libation of
choice, much of it is broken down in the gastric lining,
leaving less to get into the bloodstream and cause intoxication.
So women, assuming a smaller body-size-to-alcohol
ratio, two-for-one happy hour and nefarious dating activities,
get a huge dose compared to their dates.
It ain’t fair, but so it is.
—Raymond
His Feminine Side
If you compare a healthy 70-year-old man and a healthy
70-year-old woman, who has the higher estrogen level
It turns out the man does—by two to three times!
Men and women both make estrogen (and testosterone,
although in different proportions) throughout their
lives. When women go through menopause their estrogen
production goes down significantly, but men maintain relatively
stable levels.
Come to find out, this is an important factor in men’s
bone health, as researchers have discovered over the past
decade. It’s a key reason women are much more likely to
get osteoporosis.
—Taxel
Faint I’ll Show You Faint!
Since disaster medicine is such a new specialty, it draws
information from prior studies in other disciplines. And it’s
revealed some unexpected differences between the sexes.
A recent reexamination of coping and resilience data
found that while women are stereotypically seen as more
prone to emotional breakdown and emotional injury, the
reality is that women tend to be more resilient in the face
of disaster and catastrophe. Anecdotal data even suggests
women tolerate dehydration and starvation better than
men (both physically and emotionally).
—Ramirez
12 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
Kick ‘em to the Curb
The difference between women and
men in athletics is notable. Scientific
studies show that adolescent females,
unlike males, who actively participate
in sports, are less likely to have unwanted
pregnancies or multiple sexual
partners.
Athletics gives both male and
female athletes higher levels of selfesteem
and confidence. This increase
is thought to empower women to make
better choices when it comes to choosing
when to have sex. (If females start
sports before age 10, they’re more likely
to continue.)
—Trojian
Mottled Abs
Men and women carry belly fat in different
ways. This can impact the ease
of surgery.
Obese women often carry their fat in their abdominal
wall just under their skin, requiring an incision sometimes
several inches thick before reaching the abdominal cavity
where the organs are located. They may have relatively
little fat surrounding their organs. But even severely obese
men often have an abdominal wall only a few centimeters
thick, carrying their fat internally around their organs.
For example, pound for pound, a laparoscopic nephrectomy
(kidney removal) is usually easier in a female due to
the relatively sparse amount of fat surrounding her kidney.
Fortunately, this doesn’t really impact the patient; it’s
just something we surgeons have to work around.
—Oberle
One at a Time, Please
When my wife, Barb, and I were researching our book, His
Brain, Her Brain, we came across research from McMaster
University showing that women possess a far greater density
of nerves in an area of the brain associated with language
processing and comprehension.
Another brain-imaging study showed that men listen
with only one side of their brain but women use both at
the same time. Yet another study found that women can
listen to, comprehend and process as many as seven separate
auditory inputs (such as conversations) at the same
time, whereas men can usually only follow one.
One possible reason for this is women may have a
larger corpus callosum, which connects their brain’s left
and right hemispheres and could enable them to use several
highly connected hearing centers in both sides of the
brain simultaneously.
Simply put, women may be better designed to receive
and process multiple auditory inputs at the same time.
When it comes to hearing, it’s possible that the hemispheres
of a man’s brain are connected by some very thin
twine between two tin cans.
I have to admit that my wife is better at both listening
and hearing than I am. And in the
vast majority of women, this is not a
learned ability but an inborn skill. The
innate differences in hearing ability can
be demonstrated when boys and girls
are very young.
At one week of age, girls can distinguish
their mother’s voice from the
sounds made by another baby. Boys
can’t.
Scientists who do this work have
found that young girls can hear much
softer sounds than those audible to
young boys. Girls have a sense of hearing
that is two to four times better than
boys (depending on the frequency tested).
This difference is present as early
as children can be reliably tested.
All this helps explain why a woman
can talk to a friend on the telephone
at the same time she listens to the radio,
to a child reading out loud at the
kitchen table, and to another child and what he is watching
on TV in another room!
And it also helps us understand why a man, to talk on
the phone, often needs to turn off the TV, turn down the
music, and ask the kids to be quiet before he can answer it.
—Larimore
The Doctors
Walt Larimore, M.D., board-certified family doctor
now teaching and writing; co-author, His Brain,
Her Brain: How Divinely Designed Differences Can
Strengthen Your Marriage.
Warren T. Oberle, M.D., urologist, Mercy Medical
Center, Baltimore, Md.
Maurice A. Ramirez, D.O., C.N.S., C.M.R.O.,
board-certified attending ER physician, Florida Hospital,
Flagler; author, You Can Survive Anything, Anywhere,
Every Time; founder, consulting firm High Alert.
Patricia Raymond, M.D., F.A.C.P., F.A.C.G.,
board-certified gastroenterologist, Simply Screening,
Chesapeake, Va.; author, Colonoscopy: It’ll Crack U
Up!; assistant professor of clinical internal medicine,
Eastern Virginia Medical School; member, JHMFD editorial
board.
Pamela Taxel, M.D., board-certified endocrinologist
specializing in osteoporosis; associate professor of
medicine, University of Connecticut Health Center Division
of Endocrinology and Metabolism.
Thomas H. Trojian, M.D., director, Sports Medicine
Fellowship, and Injury Prevention and Sports Outreach
programs, University of Connecticut Health Center.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 13
Learn what’s good
about your tendencies
… and how to avoid
their pitfalls.
by Scott Haltzman, M.D.
In 20 years of psychiatric practice,
I’ve seen a lot of personalities.
Pretty much every type has
walked into my office at some
point.
And guess what. Not everybody
likes yoga.
Nonetheless, everybody
can learn to deal with life’s inevitable
stresses in healthy ways—ways that
fit our own unique selves—ways that
help not only us but everyone who
has to put up with us!
The common stress types I’ve
created below are not actual psychiatric
diagnoses and not supported by
scientific literature (although some do
use terms frequently reserved for psychiatric
classification). They simply
reflect my clinical practice. And I’m
betting you’ll recognize yourself—
and a loved one—somewhere in here.
Obsessive-Compulsive
If you’ve got the OC stress personality,
you’re probably reading this article
with a pen and paper in hand to take
notes—better yet, a pencil so you can
erase in case you make any mistakes.
You’re the one who shows up
exactly five minutes early for your
appointments, with neatly polished
shoes; a crisp, clean shirt; and a
slightly annoyed expression. Why
the sour puss The person you’re
meeting is late—failing to meet your
standards.
When you’re stressed, you do
what you do best: organize. You clean
up desktops and check and recheck
that all is in order. Keeping your
ducks in a row makes you feel you
have control.
Advantages: You’re predictable,
keep your emotions under control
Your Stress
Personality
How do you deal
and always have the phone charged
in case of emergencies.
Disadvantages: Face it: Many
stressful situations are simply out
of your control. You’re prone to
be frustrated with others who just
don’t seem to pull it together during
times of duress, and you’re likely to
confuse them because you hold your
emotions so tight to your chest. Your
friends may think your attention to
detail signals that you just don’t care,
but nothing could be further from the
truth. You’re simply trying not to let
events control you, by trying to control
events.
Healthy Tips: When you’re absorbed
in a tense situation, take a
moment and ask the people around
you what emotions they’re experiencing.
That will pull you away from the
problem itself and steer you toward
the human side of events. It will also
give others the message that you care
about their feelings.
Stress Busters: You don’t need
this article to tell you how to reduce
14 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
Doing something unexpected can be good for you!
stress; you probably already have a
file on that. One helpful tip you’ll
never read, but that works perfectly
for you, is to indulge yourself with
unhealthy or unexpected things from
time to time. Go for a run without a
destination; read a book that has no
moral message; eat a chocolate volcano
dessert. Breaking a rule every now
and then can be good for you.
Attention-Deficient and
Hyperactive
Are you the ADH type If so, you’ve
probably already begun to read this
article at least twice and no doubt
misplaced the magazine once in the
process. You live each moment as it
comes. You may try to plan, but a distraction
or procrastination foils you
time and again.
When you’re stressed, you busy
yourself with physical distractions
(going from place to place or striking
up random conversations) or mental
distractions (flipping through television
stations). When you experience
intense distress, you’re likely to verbalize
your annoyance and can be
passionate! But you’re also likely to
let go of your frustrations as quickly
as they came.
Advantages: You give and attract
energy. You’re able to distract yourself
from stressful events and easily let
go of them once they pass.
Disadvantages: Sometimes you
produce a lot of motion but get few
results. Your activity can unsettle others
and occasionally heighten their
own stress level.
Healthy Tips: Plan realistically,
thus reducing your stress and that
of those around you. For example,
to make sure you arrive on time for
appointments with friends, give yourself
plenty of time between planned
events. Always assume that things will
last longer than expected and getting
to the next place will take longer than
planned. Your friends will shower
When It’s Unhealthy
If you bite your nails to the quick or are on three different
ulcer medications, it may be hard to believe that
stressful events can actually be good for you. But in
moderation, they can beef up our coping strategies and
expand our bag of survival tricks.
Stress becomes unhealthy when you can’t control
your environment to reduce the cause (for instance, being
a prisoner of war), when it consumes too much of
your energy (as in checking your e-mail every 30 seconds
because you don’t know if you may have offended a
co-worker) or when you cease to function normally (for
example, stopping eating or sleeping).
While medications can be used to help manage
some kinds of stress (such as mild sedatives for a funeral
or antidepressants for social anxiety), often, the first
step is to use behavioral and cognitive—or thinking—
strategies.
Behavioral approaches include meditating, listening
to music, calling a friend and going for a walk. If you
want to reduce daily stress, you can implement a regular
exercise regime or join a support group. Any action that
gives you a sense of structure and purpose can help put
a dent in your stress response.
Cognitive strategies involve using rational thought
to counter an impulse to panic. Here are some common
thinking errors and solutions.
• Arbitrary Inference: With one small upset, you assume
the worst possible scenario. A remedy: Remember
that you can choose a whole host of possible explanations
for bad news, and you can opt to see positives
rather than negatives.
• Magnification: You think that because you got
one question wrong on a test, you’ve failed the whole
thing. A remedy: Instead of seeing one bad aspect
as evidence that the whole thing has gone to pot, tell
yourself that there’s good and bad in everything—and
you’re as entitled to good things as anyone else!
• Overgeneralization: When one bad thing happens,
you tell yourself that everything that ever happens to
you is negative. A remedy: Abolish the words “always,”
“never,” “everyone” and “no one” from your
vocabulary. Leave yourself open to other more positive
ways of seeing things.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 15
you with praise when you show up on
time, and you’ll feel more part of the
action.
Stress Busters: There’s a world of
stress reducing choices out there for
you; your problem is that you jump
from one to another. You may take
better care of yourself if you can
stick to one thing. Spend a week trying
out different hobbies or exercise
regimes; then choose one. Schedule
time for yourself every day: Plug it
into your computer or cell phone.
When the time comes to engage
yourself, turn off all distractions (like
the Internet and phone) and get to it.
Me-Versus-the-World
If you’re one of those people who
sees the world through an eat-orbe-eaten
mentality, you’re reading
this article and thinking, “He really
doesn’t understand me,” or, “I could
write an article 10 times better!”
People with this kind of personality
tend to feel that the world is an
unsafe place. And they either feel like
victims in it or become overly assertive
to keep from becoming a target.
With this style of interacting, you
tend to personalize stressful events
and blame others for the problems
that rain down on you.
Advantages: No potential problem
escapes your attention, and you’re
usually anticipating ways of avoiding
danger.
Disadvantages: Sometimes you get
stressed out over problems that aren’t
there or tend to interpret events in
the wrong way, causing friction between
you and the people you care
about.
Healthy Tips:
When the walls feel
like they’re caving
in, ask your friends
to help you interpret
what’s happening.
If they’re
not alarmed, be
prepared to lower
your guard. That
way, you’ll be better
company and have
more fun.
Stress Busters:
When your caution circuits get lit,
take out a pen and paper and write
down all the evidence that you’re in
danger, along with all the evidence
that you’re safe. If you’re honest with
yourself, you’ll see that usually the
only thing you have to fear is fear itself.
(Apologies to FDR.)
Zen
Just the opposite of the Me-Versusthe-World
type, you Zen folks aren’t
usually ruffled by stress. You roll with
things as they come.
Occasionally, your personality
style is learned (as with Buddhist
monks) or even
drug-induced (for
instance, regular
marijuana use can
dull responsiveness).
But some people are
just born with tranquility.
Advantages:
Things don’t ruffle
you the way they do
other people, so you
stay levelheaded in
times of crisis.
Disadvantages:
Because your
threshold for panic
is low, you may not
be as alert to real
danger as you ought
to be. Also, other
people may view
your serenity as disinterest
and feel like
you don’t take their
concerns seriously.
Healthy Tips: If you occasionally
show some outrage or unbridled enthusiasm,
that’s actually OK—and
may even help in your relationships.
When you shout or circulate highfives,
your friends will connect with
you over your apparent connection to
what’s happening. You can go back to
your meditative state afterwards.
Stress Busters: Let’s face it; you’re
a master of stress reduction. But it’s
essential that you keep your physical
health on par with your mental
strength. Engage in a regular exercise
regimen, even if you don’t need it to
help with stress.
In fact, yoga might just be your
cup of tea!
Board-certified psychiatrist Sc o t t Ha lt z-
m a n , M.D., is co-author of The Secrets
of Happily Married Women: How to
Get More out of Your Relationship by
Doing Less; an assistant professor at Brown
University; and medical director of NRI Community
Services, a behavioral-health provider
in Woonsocket, R.I.
Yoga’s not your thing How ‘bout a little kickboxing to beat the day’s
worries away Any type of exercise helps.
16 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
Your Exercise Personality
Whether you think exercise is boring, daunting or just too time-consuming,
our experts have a solution tailor-made to fit you.
Spring is in the air! It’s
time to get moving!
Can’t do it, you say Maybe tomorrow
Nay, nay, say our experts. The
time is now!
We asked two fitness folks to help
us all get motivated—no matter our
personality (cough, excuse, cough).
Michelle May, M.D., is a
board-certified family doctor and “recovered
yo-yo dieter.” She founded
the “non-diet” company Am I Hungry
and wrote the book by the same
name.
Charla McMillian, J.D.,
C.S.C.S., a former Marine Corps
officer, runs FitBoot: Basic Training
for Professionals, which incorporates
training based on military techniques.
Our bodies are crying out for
movement. Here’s a little help getting
our brains on board—right now.
Easily Bored
“Exercise … blech.”
McMillian:
I don’t know anyone who says, “Man,
I can’t WAIT to brush my teeth!”
every morning. But we all get up and
do it because we understand the consequences
if we don’t.
You need to take a hard look at
what activities do interest you. If you
Quick Tips
from personal trainer Lisa Corsello, C.P.T.,
C.Y.I., owner of Equilibrium Personal Training
in San Francisco, Calif.
To make exercise more fun:
• Switch up machines (10 minutes on
the treadmill, 10 on the bike, five
rowing, five on the stair climber)
• Try different classes and find an instructor
who inspires and challenges
you.
• Listen to music that makes you feel
like moving. (Dance in your living
room or create a music mix to listen
to at the gym.)
• Walk or jog different routes each
week to change things up. Enjoying
nature makes exercise seem like less
of a chore.
like to dance, choose a dance class.
If you enjoy watching acrobatics, try
gymnastics. Like skiing Hire a trainer
with experience in strength and
conditioning for the sport. Traveling
Begin a cardio and strength program
on a schedule designed to peak at the
start of your venture to Machu Picchu.
But bottom line: You might not
ever come to relish your training
time. I’ve told many clients of this
personality type that they simply
need to embrace the need to complete
some tasks for their personal
health and benefit—even if it’s not
always a party.
May:
Find activities that are convenient,
comfortable and fun so you’ll stick
with it. Break exercise into small sessions;
find a partner; try new activities
and new routes; set small, achievable
goals and reward yourself for
reaching them to make exercise more
enjoyable.
Constantly Busy
“I don’t have time!”
May:
If you’re too busy for exercise, you’re
too busy.
The reality is that it will only take
one-forty-eighth of your whole day to
exercise for 30 minutes. Most people
waste a lot more time than that
watching TV or surfing the Internet.
Besides, you probably make time
for grooming routines like bathing,
putting on makeup and washing your
clothes. Exercise will do even more
for your appearance. Plus, it’ll increase
your stamina so you’ll become
more productive and feel great. Who
knows A little exercise may help you
save time in the long run!
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 17
McMillian:
You don’t have time Really Then
I guess you’ll be too busy to lie in
the hospital recovering from that
heart attack, or check your glucose
levels and give yourself insulin injections
for diabetes, or work with
your speech therapist after that highblood-pressure-induced
stroke.
Smarten up. Carve out space in
your home or office that permits you
to stretch and execute some pushups
and crunches; put in a treadmill; map
out 1-, 2- and 3-miles distances on
the streets around your home or office;
or join a facility with operating
hours that match your free time.
Web Extra!
Learn more about these experts and
their services in your Premium
Subscribers Section, www.
MyFamilyDoctorMag.com.
Daunted
“I have so far to go!”
McMillian:
“A journey of 1,000 miles begins with
a single step.” Start by determining
your final goal; then break down the
steps.
Have progress check-ins every
month or few weeks. Maybe your
goal is 5 to 10 pounds per check-in.
Perhaps it’s a dress or pants size;
certain number of miles completed;
consecutive minutes walked, run,
biked, or swum; or number of reps
performed. Any failure to meet a particular,
small milestone is recoverable
without much bother.
May:
If you don’t choose to start somewhere,
don’t be surprised when
you’re still out of shape months
from now. On the other hand, if you
choose to start this week by increasing
your movement and physical activity,
little by little, you will become
leaner, stronger, more energetic and
healthier.
Physical activity doesn’t have to
be hard or hurt to be beneficial. Simply
increasing your activity throughout
the day really adds up. Taking
the stairs, walking a little faster and
working or playing more actively every
day is a great place to start. Any
activity over your usual level counts,
so be on the lookout for opportunities
to move more.
Perfectionist
“I must exercise 60
minutes a day, with
my heart rate at this
amount, plus this
much weight lifting,
plus ... oh forget it!”
May:
Perfectionism leads to all-or-nothing
thinking. Quitting your exercise program
because you missed a day (or
week), or believing you have to exercise
for 60 minutes, five days a week
or not at all makes as much sense as
eating the whole bag of cookies because
you ate three.
No person and no schedule is
ever perfect, but thinking you have
to do it perfectly will derail you every
time. In order for physical activity to
become part of your life, be as consistent
but as flexible as possible.
McMillian:
Knock it off! For this extreme type-
A personality, chances are you have
everything in your life organized and
squared away … everything but your
fitness. And it’s making you crazy.
Well, do what you best and get
on the right track.
For starters, check your facts:
Yes, you need vigorous activity for
about 45 to 60 consecutive minutes
on most days of the week. Yes, you
need to include both strength and
cardio work for all-around benefit.
No, it doesn’t require as much complicated
planning or procedures as
you’ve probably fabricated.
For 45 minutes, four days a
week, do something that involves
your arms and legs and has you moving
at your perceived level of moderate
to moderately high intensity. You
should begin to see tangible improvements.
Don’t get bogged down in some
abstract concept about what exercise
has to be. Just find an enjoyable
activity, and be sure to incorporate
work that involves all your limbs for
strength; your abs for support, stability
and endurance; and your heart for
aerobic endurance.
Procrastinator
“Next week will be
better ... or next
month ...”
McMillian:
Crises and ongoing obligations don’t
have a place in your datebook; you
simply give them the attention they
need.
Treat your training time even
better: Put it in the schedule. Your
appointment with yourself cannot be
broken. Better to take care of your
health and fitness before you become
the crisis on someone else’s calendar.
“If you keep waiting
for free time instead of
just scheduling what
you know you need,
the right time will
never come.”
— McMillian
May:
It’s easy to put off starting an exercise
program if you have negative
thoughts and feelings about it. Sometimes
these come from past experiences
like being chosen last for teams;
having boring exercise routines; or
feeling discomfort or pain from doing
too much, too fast. Some people only
exercise when they’re trying to lose
weight, so they think of it as a punishment
for overeating.
However, the past does not predict
the future. This time, focus on all
the great things physical activity does
for you and how wonderful you feel.
Find fun activities that suit your personality
and lifestyle. Most importantly,
start slowly and allow your body to
adjust gradually and comfortably.
It will be different this time if you
think it will be.
18 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
My
Best
Tip
Yours
… for what to do—besides eat—
in front of the TV
“Give yourself a manicure, pedicure or foot or hand
massage. With all the cream on your hands you will
not be able to eat your chips.”
—Elizabeth Desouza, Deltona, Fla.
“Do your birthday cards for the month.”
—Shari Goldstein, Melville, N.Y.
“I buy the small Sudoku magazines you can find at
the supermarket checkout counter, and I do those
instead of stuffing my face with food. I find that it
keeps me from eating by keeping my hands busy—
which is really all I want, not the actual food.”
—Maria Perez, Bayonne, N.J.
“I chew sugar-free gum, both at work and when
watching TV—gobs of the stuff.”
—Brian Olson, Highlands Ranch, Colo.
“I took up knitting and it cured the TV munchies.
You have to use both hands, and if you put your
knitting down, you lose your place or drop a stitch.”
—Lisa Everitt, Arvada, Colo.
What’s Your Best Tip
How do you motivate yourself to exercise Share your ideas on this and lots more through your Premium Subscribers
Section at the new www.MyFamilyDoctorMag.com. Then keep an eye out! You may appear in the magazine or online!
5
benefits
of …
experts’
“I have clients create a game with their family to see
who can do the most of a particular exercise during
the commercial breaks.”
—Doug Holt, C.S.C.S., M.F.S., personal trainer,
Conditioning Specialists, Santa Barbara, Calif.
“Stretch! A single commercial (about 30 seconds)
is the perfect length of time to hold a stretch, and
after several commercial breaks you’ll have reduced
stress and tension in the whole body.”
—Kelly McGonigal, Ph.D., health psychologist,
yoga instructor, Stanford University
“Hold light hand weights and do several sets of
different lifts during each commercial.”
—Susan Watson, M.S., R.D., clinical nutrition
specialist, The Heart Institute of the Greenville
Hospital System, South Carolina
“Rub your child’s or partner’s back. (This multitasks as
great cuddle time!)”
—Susan Bartell, Psy.D., psychologist; author, Dr.
Susan’s Kids-Only Weight Loss Guide
“Crowd in vegetables with what I like to call Veggie
Grab Bags. Just pack up small plastic bags with baby
carrots, cherry tomatoes, snow peas, red pepper
chunks or whatever is in season.”
—Barbara Storper, M.S., R.D., author, Janey
Junkfood’s Fresh Adventure!
Strawberries!
by Pamela M. Nisevich M.S., R.D., L.D.
• Strawberries are a great source of fiber (2 grams in five large berries). Gram for
gram, they surpass most oranges in vitamin C and beat out carrots tenfold!
• They’re an excellent source of antioxidants, which may help fight cancer and
inflammation.
• For the caloric cost (380) of three fast-food chicken strips, you could eat 4 cups
of sliced strawberries topped with 1 cup of low-fat whipped topping.
• They can liven up your next drink. Simply freeze fresh ones and use in place of
boring ice cubes.
• They’re one of the easiest fruits to grow. If you plant in the spring, you’ll be
enjoying about 1 quart of berries per plant by early summer.
Pa m e l a M. Nisevich, M.S., R.D., L.D., is a dietitian with Nutrition for the Long Run in Dayton,
Ohio.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 19
Media
Violence
The Great
DEBATE
Rules of Engagement: We invited each
participant to write an argument, then read the opponent’s
argument and, if desired, write a rebuttal. Neither was
allowed to read the other’s initial argument before writing
his own, and neither could read the other’s response before
rebutting.
For: Keith D. Kanner, Ph.D.,
A.P.C., clinical child, adolescent
and adult psychologist and psychoanalyst,
Rancho Santa Fe, Calif;
assistant clinical professor of psychiatry,
University of California,
San Diego, School of Medicine.
Against: Christopher J. Ferguson,
Ph.D., assistant professor of
psychology, Texas A&M International
University.
In 1952, while Lucy was causing a ruckus and
the Lone Ranger was keeping the peace …
Congress was scratching its head.
Real-world juvenile delinquency was up.
Television and radio were popular. Was one
connected to the other
June of that year saw the first congressional
hearing on media violence and its potential effect on
young people. Nothing much was decided.
But the debate was far from over. …
“The debate is over.” OK, so that’s from Healthy-
Minds.org, an American Psychiatric Association site.
Over half a century after that first hearing, maybe
they’re right. After all, they say, three decades of research
shows “that exposure to media portrayals of
violence increases aggressive behavior in children.”
The American Academy of Pediatrics agrees that
it “can contribute to aggressive behavior, desensitization
to violence, nightmares, and fear of being
harmed,” according to their 2001 policy statement.
So the controversy seems to have come to a
logical, studied conclusion.
… Not so fast, says a relatively smaller but firm
group of researchers who take issue with some of
these contentions. In his 2002 book Media Violence
and Its Effect on Aggression, University of Toronto
professor Jonathan L. Freedman contends, “the results
of the research generally do not demonstrate
that exposure to media violence causes aggression.”
Last year, when the Federal Communications
Commission released a report about media violence
(including negative effects), Freedman responded
in part, “Those who propose that media violence
causes aggression have greatly overstated the results
of the research, and have generally ignored findings
that contradict their views.”
We asked two psychologists to share their opinions.
What do you think
Web Extra!
In your Premium Subscribers Section:
• Learn more. Find links to arguments on both sides.
• Share your thoughts. Talk with other readers, and
see what they have to say.
(At the new www.MyFamilyDoctorMag.com.)
20 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
Recent clinical and behavioral research
has now demonstrated connections
between children playing
For
violent videogames and problems
with aggression. Such findings are not too surprising given
that previous studies have also shown a 10 to 12 percent
increase in aggressive behavior after children watch violent
television.
The combined results of the research in this area led
the American Psychological Association to formally conclude
three major effects of watching or playing violence
in the media.
1. Children exposed to media violence may become less
sensitive to the pain and suffering of others.
2. Aggressive media can cause children to be more fearful
of the world around them.
3. Children may be more likely to behave in aggressive
or hurtful ways toward others when exposed to violent
media.
In addition to these findings, one must also consider that
there are certain times in a child or adolescent’s development
when exposure might be even more influential. For
example, children between 2 and 5 are still primarily conceptualizing
their world in magical ways. When faced with
aggressive scenes, a child in this age range could believe
what they’ve viewed is real and may happen to them and
their family, creating intensified fear and anxiety.
Adolescents are also particularly vulnerable. Because
of increasing levels of hormones, intensifying drives, and
desires to be powerful, exposure to overly aggressive material
can lead to impulsiveness and poor judgment.
Taken together, while media exposure to violence is
not the only cause of aggressive or violent behavior, research
and clinical material has shown that it can play a
significant factor in most children.
Throughout history
people worried that
Against media from the Bible,
jazz, rock, Betty Boop,
Harry Potter and Dungeons and Dragons would harm
youth. These scares have turned out to be moral panics.
Today’s concern about media violence, fueled by politicians
and bad science, is one more example.
The research field on media violence is one of the
most politicized and poorly executed in social science (and
that’s saying something!). Does the research say that viewing
media violence leads to aggression or violence No,
and here are several reasons why.
Most aggression measures used don’t measure
aggression, such as fighting, verbal taunts or violence.
Examples include popping balloons with pins, finishing the
ending of fairy tales, rating how likeable others are or giving
a willing opponent non-painful noise bursts. Research
indicates that these are not valid predictors of real-world
aggression. A few do look at actual aggression or violence,
but these find the weakest effects.
The research is inconsistent. Contrary to what
many politicians and even scientists suggest, the research
does not consistently document negative effects. Some
studies claim to find effects; many others do not.
In my own research, correlations between media violence
and aggression are usually due to underlying
family violence or personality issues. At most, media
violence is a symptom, not a cause. Its effects, even assuming
the research was valid, are among the weakest in criminal
justice research, behind personality, childhood abuse,
poverty, genetics and other influences.
Media violence theory doesn’t fit with realworld
data. Violence among adults and children is currently
at the lowest level since the early 1970s. This would
be like discussing the perils of global warming while iceskating
in the Everglades. Suggesting this reality doesn’t
matter is simply lazy pseudoscience.
Dr. Ferguson’s
Meta-analyses of the research suggest
that media violence exposure
overlaps between 0 and 4 percent
with aggressive behavior, not 10
to 12 percent. At the top end, would you notice if you
were 4 percent more aggressive today than yesterday
Even this result assumes that these studies are methodologically
sound, which they are not.
To put this in perspective, genetics can account for
50 to 55 percent of the variance in aggression. The effect
size for smoking and lung cancer is 81 percent.
The belief in media violence effects on aggression is
the product of dogma and bad science. The only conclusion
we can make is that social scientists, like many
other people, indulge in moral panics.
Rebuttals
Dr. Kanner’s
Statements that concerns are “fueled
by politicians, and bad science”
are an insult to the many
dedicated individuals who seek
to make society a better and safer place. Furthermore,
statements that the multiple studies on the connection
are “all bad” are insulting to the highly regarded editors
who guide organizations such as the American Psychological
Association and the American Academy of Pediatrics,
who both have cautioned parents and educators
about the “proven” negative influences.
Certainly, at the least, the fact that so many studies
have found associations—whether causational or
influential—should result in safeguarding children and
adolescents from experiencing material that could negatively
affect them. To ignore such important information
is ignorant and potentially dangerous.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 21
housecalls at the doctor
Nail That Diagnosis
by Jonathan Rich, D.O.
QCan my fingernails and toenails
tell me anything about
my health
Answer Long, short, thin, fat,
white, black, red, yellow. Nails come
in as many different varieties as their
proud wearers. They can be admired
or, in my profession, examined very
easily.
To a physician, nails can be an
integral part of a comprehensive
physical. They’re ideally suited for
exam. They’re usually uncovered,
easily viewed and can provide a lot of
useful information about what may
be going on inside a person.
We like to consider several different
aspects of the nails.
• Color. Are they yellow or white
This may clue you in to infection,
kidney disease or liver disease.
• Texture. Are they brittle and splitting
This could mean you have a
Ann McGrath
thyroid problem. Are they rough
and pitted Perhaps you have a skin
problem, such as psoriasis. Vertical
ridges on nails are normal, but
horizontal ridges may indicate other
Common Potential Diagnoses
Spooned (flat or with depressions): iron deficiency, thyroid disease
Pitted (tiny indentations, making a rough surface): eczema, psoriasis
Clubbed (exaggerated curve): chronic lung or heart problems, cirrhosis
Yellow: fungus, diabetes, psoriasis
White: fungus, liver disease
These are just samples of many possible diagnoses—and then there’s the skin under
the nails! Have your health-care provider check out anything that concerns you.
underlying issues, like malnutrition,
liver disease or kidney disease.
• Shape. Are they bowed out and
shaped like a club This could indicate
a lung ailment such as emphysema
or even lung cancer. Are they
depressed and shaped like a spoon
This could mean your iron levels
are low.
Nails can serve as wonderful
magic balls. Usually, they don’t require
more than a thorough visual
inspection, but there are other diagnostic
tests your health-care provider
can do. For example, your provider
might scrape the nail for a sample to
send to a lab to be cultured. Or he
or she could conduct a biopsy (cut
a small piece out) for a sample a lab
pathologist can examine under a microscope.
Of course, what may appear to
you to be quite worrisome could be
completely benign. For instance, onychomycosis
(nail fungus) is quite common.
This can be distressing because
the nail may become very thick, discolored
and distorted.
Fortunately, the majority of
cases are benign. It can be treated
with a prolonged course of an oral
anti-fungal medication or, in some
instances, a medicated nail polish. Of
course, treatment takes time and can
be quite expensive. Some insurance
companies consider this condition so
benign that they won’t even cover the
expense of the medications because it
is considered “cosmetic.”
So think long and hard before
getting that French manicure prior to
your next doctor’s appointment. You
never know what may be lurking behind
those windows to the inner you.
Clubbing
Onychomycosis, or fungus
Jo n at h a n Ri c h, D.O., is a board-certified
internist at Mercy Medical Center in Baltimore,
Md.
22 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
housecalls chronic disease
When Eating’s a Chore
by Jill Weisenberger, M.S., R.D., C.D.E.
QBecause of recent health
problems, eating has
become an issue. I no
longer care to eat because
it upsets my stomach so
much and just does not
seem worth it. I am
looking for menu planning
help that does not have so
much food that I can’t get
it all down, but is healthy
enough to keep my doctors
happy. Is there any help
you could offer
—Li nd a , v i a
w w w .MyFa m i l yDo c t o rMa g.c o m
Answer Eating should be pleasurable,
so I’m very sorry to learn that it
has become a chore for you.
Nutrition—good or bad—affects
most every part of your life, from
mood to memory; from immune
system to appearance. Your goal has
to be not just to keep your doctors
happy but to protect your health and
keep yourself happy, as well.
The only way to get the protein,
carbohydrates, fats, fiber, vitamins,
minerals and phytochemicals your
body needs is to eat a varied diet.
Please consult a registered dietitian
who can assess your individual needs
and food preferences.
Here are a few general tips.
Tip #1: Get the most nutrition in
the least amount of food.
➤ Stock up on dried fruits, such as
raisins and dried apricots, and
healthful-fat sources like nuts and
olive oil.
➤ Spread peanut butter, almond butter
and other nut butters liberally
on whole-grain toast and waffles.
Dab some on apple and banana
slices.
➤ Sauté meats and vegetables in generous
amounts of olive or canola
oil.
➤ Pour extra olive oil over salads and
pastas.
➤ Dip breads into olive oil flavored
with garlic and basil.
Tip #2: Sip your nutrients.
Drink 100-percent fruit or vegetable
juices with meals and between meals
to see if one time is more comfortable
for you. Again, go for a variety.
Try orange, cranberry, pomegranate,
blueberry, peach nectar and any
others you can find. (Skip the juice
drinks and punches.)
Tip #3: Experiment with liquid
supplements like Ensure and
Boost.
Drink them between, but not instead
of, meals.
Web Extra!
Visit www.eatright.org to find a
registered dietitian in your area.
(Link directly through your Premium
Subscribers Section at www.
MyFamilyDoctorMag.com.)
Tip #4: Keep it healthy but fun.
Resist any temptation to add extra
calories with fatty meats, whole milk,
or cheeses made with whole milk. A
little is OK, but a lot is not, or you’ll
get an unhealthy dose of saturated
fats.
A little sugary foods and other
junk is OK, too. You should please
your taste buds with your favorite
sweets and treats. Just don’t let cookies
and French fries displace nutrientdense
food.
Tip #5: Be your own detective.
Keep a food journal for at least a
week. Record the food eaten; the
amount; the time; and how you felt
just before, during and after eating.
Write down spices, too, if you think
they may be a factor in your comfort.
You may find that certain foods
or times of day are more tolerable.
Make these the hours in which you
optimize your food and nutrition
intake. Also, take your food journal
to your meeting with your registered
dietitian.
Keep a positive attitude; continue to
work with your health-care team; and
be open to new meal-planning ideas.
In time, you should have it figured out.
Ji l l We i s e n b e rg e r, M.S., R.D., C.D.E.,
is a registered dietitian with Hampton Roads
Center for Clinical Research in Norfolk, Va.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 23
housecalls nutrition
What’s in Your Food
by Jeff Geller, M.D.
QJust what exactly are
additives, anyway, and
what’s so wrong with
them
Answer Believe it or not, you put
additives in your own food all the
time. In fact, additives are basically
anything added to food—from simple
seasonings like salt and pepper to all
those crazy ingredients you see on
labels that you couldn’t in a million
years pronounce.
The FDA reminds people that
humans have been using natural additives
for, well, just about ever. Even
the modern man-made ones aren’t
just thrown into food for no good
reason; each has a purpose, like enhancing
flavor or making the food
last longer.
But the question is: Are they
safe The FDA says yes. Integrative
physicians like myself tend to take a
bit more skeptical view.
Safety Code
In 1958, the FDA added the Food
Additives Amendment to their Federal
Food, Drug, and Cosmetic Act.
Additives used prior to this time
are considered safe, “through either
scientific procedures or experience
based on common use in food.”
In other words, any substance in
use before 1958 may not have been
rigorously evaluated unless it was a
noticed public-health concern. Substances
put into use after the amendment
must be evaluated through
more-rigorous scientific procedures.
Safety Scare
The additive MSG (monosodium
glutamate) is a natural substance
often made from a fermented starch.
It has no flavor but rather enhances
the taste of certain foods, including
meats. Since MSG predated the
amendment, the FDA allowed it in
foods.
By the early 1990s, public concern
about rumored nervous-system
damage from foods containing MSG
prompted the FDA to contract an
independent group of scientists for
further analysis.
The group’s 1995 report found
no connection between MSG and
nervous-system damage or any other
chronic diseases, according to an
FDA backgrounder from the time.
However, it did identify an infrequent
condition dubbed MSG symptom
complex. This can cause any of a
long list of symptoms, including
headache, numbness and drowsiness.
People with “severe, poorly controlled
asthma” may be among those prone
to the complex, says the backgrounder,
and may additionally “suffer temporary
worsening of asthmatic symptoms
after consuming MSG.”
Safety Relativity
So any additive can be bad for some
people, even if, like MSG, it is FDAapproved
and natural.
In general, foods and additives
are tested for major problems and are
safe in that way. But if you aren’t feeling
well, you’d be well served to track
what you’re eating.
Physicians like me, who practice
integrative medicine, recommend
people buy foods with few ingredients
or make meals from scratch; avoid
pesticide residue by going organic,
washing fruit well (some evidence
suggests vinegar may help a bit) or
growing your own food; and read the
labels. We cannot simply accept that
because something is labeled safe, it
cannot cause symptoms or bad outcomes
in anyone.
We all respond differently to the
foods we eat, so I recommend keeping
yours simple.
Je f f Ge l l e r, M.D., is director of integrative
medicine at Greater Lawrence Family
Health Center in Massachusetts.
24 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
housecalls the teeth
Whiten Up!
by Brad Brittain, D.D.S.
QWhat is your opinion about
tooth whitening strips Do
they cause damage to the
enamel How long can one
use them safely Is there
any difference between the
store brand and the more
expensive name brands
—El i z a b e t h, v i a
w w w .MyFa m i l yDo c t o rMa g.c o m
Answer Tooth whitening has rapidly
become one of the most widely
discussed topics in the dental field.
This is no longer a fad but rather
a part of life. People of all ages are
coming into my office and inquiring
about whiter teeth. Many, many high
school students are looking into the
benefits prior to activities like proms
and senior pictures, just as many older
adults are seeking whitening before
reunions or children’s weddings.
Recognizing this desire for a
brighter smile, dentists have started
offering special shade guides that
include bleach shades. In my office, I
routinely allow patients to help select
an ideal color. The one they choose is
most often on the extreme white end.
So, with all these technological
advances, how are the naturally
beautiful smiles supposed to compete
The first solution to which most
people look is whitening strips. Why
One reason only: They’re cheap.
But Are They Good
I’ve seen people come into my office
with a lighter smile and report that
they did it completely with whitening
strips. However, for every one
of those, I see four or five who say
they’ve tried whitening strips and
toothpastes and “just can’t seem to
get them to whiten.” They inevitably
ask about the difference between the
strips and the whitening we use in the
office.
It’s very simple. Practicing dental
professionals are allowed to use stronger
substances. It is the difference between
an over-the-counter painkiller
and a prescription-strength one.
So Sensitive
The greatest concern industry leaders
are working on is the sensitivity whitening
treatments produce. Many—
perhaps most—people who whiten,
either over the counter or in a dentist
office, will experience at least mild
sensitivity. It tends to lessen as treatment
progresses, and no one has reported
sensitivity of a lasting nature.
Another common concern is
whether the process harms enamel.
Researchers have conducted many
studies on this matter. The best analogy
I’ve come across is that a whitening
treatment’s effect is quite similar
to that of drinking a Coke. Therefore,
it is easily believable that you
could go through a lifetime of usedas-directed
whitening treatments with
little to no threat to your enamel.
Companies are constantly working
to improve their products and
beat out the competition. But to date,
I guess the adage, “You get what you
pay for,” is true again—at least when
you compare OTC to prescription
whiteners.
But you asked about brand-name
versus generic OTC products. Their
What About
Toothpaste
Whitening toothpastes are
meant to remove surface
stains, not actually bleach the
teeth. For most people, they
have little noticeable effect, if
any. There’s also some concern
that prolonged use may harm
the enamel. If you use one,
make sure it says it’s approved
by the American Dental
Association.
effectiveness really shouldn’t differ, as
long as the hydrogen peroxide percentage
and wearing time is the same.
Keep in mind that there are different
percentages even within one brand.
To find the best fit for you, compare
those percentages, along with things
like length and frequency of wear
and how long the manufacturer
claims the whitening will last.
Good luck and may you always
have a bright and beautiful smile.
Br a d Brittain, D.D.S., treats patients at
his Dentistry of Old Town Scottsdale clinic in
Arizona.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 25
housecalls alternative health
Needling Pain
by Kimberly Aikens, M.D.
QMy husband is diabetic and
suffers from neuropathy.
We went to the neurologist
and she thought he had
restless leg syndrome. She
ordered a medication. The
side effects were terrible.
We thought acupuncture
may be another outlet for
relief. Have you heard of
this being used for his
problem
—Ja n i c e, v i a
w w w .MyFa m i l yDo c t o rMa g.c o m
Answer Though we’re still not
sure how it works, acupuncture has
been shown to help with certain types
of pain and other problems. Unfortunately,
there’s no solid proof it will
help with either of your husband’s
conditions. Fortunately … there are
at least hints that it might.
Similar But Different
Both diabetic neuropathy and restless
legs syndrome can cause leg discomfort.
To some extent, one disorder
could actually be mistaken for the
other!
Diabetic neuropathy is nerve
damage from uncontrolled high
blood sugar. It may cause weakness,
loss of reflexes and reduced sensation,
especially in the legs. The pain
might be burning, deep aching or
stabbing. Tests and exams can help
diagnose it.
By contrast, there’s no definitive
test for restless legs syndrome.
We usually don’t even know what
causes it. It involves a sensation in the
legs, sometimes described as crawly,
that makes you want to move them.
Symptoms tend to get worse at night
and when you’re at rest.
Not everyone with RLS needs
medicine. It depends on the symptoms’
severity and frequency. Many
people benefit from appropriate sleep
hygiene practices. Consistent, relaxing
bedtime routines—such as taking
a warm bath every night—can be
helpful. Exercise can, as well. (Check
with your health-care provider first,
especially considering the neuropathy
and chest pain you mentioned in
another part of your letter.) Caffeine,
nicotine and alcohol may worsen
symptoms.
Rest Less No More
I couldn’t find any studies on acupuncture
for RLS. But that doesn’t
mean it won’t work. Some data suggests
it may help manage diabetic
neuropathy long-term. Much of the
literature comes from China, which
can make judging quality difficult.
If you decide to try acupuncture,
ask about the provider’s qualifications,
including state licensing. You
might consider seeing someone certified
in traditional Chinese medicine,
which features acupuncture training.
(He or she may consider using herbal
therapy, as well.) As a physician
trained in mind/body medicine, I
might also suggest massage (check
with your provider first because of
the neuropathy), biofeedback and
clinical hypnosis. Never underestimate
the power of the mind/body
connection!
Yikes!
“When not delivered properly,
acupuncture can cause serious
adverse effects, including infections
and punctured organs.”
—National Center for
Complementary and Alternative
Medicine
Be sure to find a licensed, welltrained
provider!
Tell your regular health-care provider
about any alternative therapies
you might choose. If they aren’t helpful
enough, various medications are
available, not all of which cause the
same side effects.
Board-certified internist Kim b e r l y Ai k e n s,
M.D., specializes in integrative medicine at
her clinic, Pursuit Health, in Petoskey, Mich.
Web Extra!
In your Premium Subscribers
Section, find links to:
• locate a provider trained in
traditional Chinese medicine.
• read related articles, including
one on hypnosis and our candid
interview about sleeping pills.
(At the new www.
MyFamilyDoctorMag.com.)
26 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
For holidays, birthdays and just to show you care.
James Hubbard’s
My Family Doctor
The Magazine That Makes Housecalls
The gift that gives a lifetime.
c I want to subscribe! Send me one year (six issues) for only $28.* (That’s a savings of 33% off the cover price!)
c I love the mag! This is a renewal ($24*).
c My check or money order is enclosed.
c Bill my Visa or MasterCard.
Send my subscription to:
Name ____________________________________________________
Address __________________________________________________
City ________________________________ State _____ Zip ________
Phone _______________________________ Date _______________
E-mail address _____________________________________________
(for Web site information)
Billing information for credit card:
Visa or MC # ______________________________________________
Exp. date _______ Signature __________________________________
Name on card _____________________________________________
Address __________________________________________________
City ________________________________ State _____ Zip ________
Please mail this form, with payment, to P.O. Box 38790, Colorado Springs,
CO 80937, or fax (credit-card orders only) to 719-576-2353.
Physicians: For bulk rates, call 877-DOC-IS-IN (877-362-4746).
877-DOC-IS-IN (877-362-4746)
www.MyFamilyDoctorMag.com
Call or log on to give more gifts or subscribe with your credit card!
Please allow up to 90 days to receive your first magazine. Advance payment required.
*In Canada, new subscriptions are $43 U.S., and renewals are $39 U.S.
c I want to give a gift! Send one-year
subscriptions (six issues), plus gift cards, to the following people.
c Bill my Visa or MasterCard. (I’ve completed the billing information at
left.)
c My check or money order ($28* for each subscription) is enclosed.
From (name for gift card) _____________________________________
Your phone number (in case of questions) _________________________
Gift One:
Name ____________________________________________________
Address __________________________________________________
City ________________________________ State _____ Zip ________
Gift Two:
Name ____________________________________________________
Address __________________________________________________
City ________________________________ State _____ Zip ________
Gift Three:
Name ____________________________________________________
Address __________________________________________________
City ________________________________ State _____ Zip ________
$Office Copay: $35
Prescription Medication: $80
Hospitalization: $,
Staying Healthy: Priceless
James
Hubbard’s
The Magazine That Makes Housecalls
Helping you stay healthy, get the most from your treatments and save money.
To subscribe, renew or give a gift, call 877-DOC-IS-IN (877-362-4746),
visit www.MyFamilyDoctorMag.com or mail or fax the form on the back of this page.
How Does
It Work Antihistamines
by Daniel P. Hays, Pharm.D., B.C.P.S.
Histamine is your friend.
Sometimes.
It helps regulate sleep,
helps your stomach make acid and,
when you’re allergic, makes you
sneeze, makes you itch, makes your
nose run ….
Histamine turns out to be not so
useful when it’s striving to fight off
something as harmless as pollen. So
you bring out the counter weapons:
antihistamines. But once you gulp
them down, just what exactly do they
do in there
Check out
our “To the Test”
article on page 30
for an allergy-med
alternative.
Why You’re Sneezing
Here’s how allergies work, using pollen
as an example.
1. For some reason, your body decides
pollen is an enemy. To warn
itself of future invasions, it makes
specific antibodies.
2. The antibodies bind to special cells
called mast cells, which contain
histamine.
3. When the antibodies encounter
pollen, they trigger the mast cells
to release the histamine.
4. The histamine binds to special
receptors on other cells and causes
allergic symptoms.
To the Rescue!
But if something gets to those special
receptors first or is strong enough
to beat out histamine for the rightof-way,
you’ve got the makings of a
sniffle-free season. And that’s exactly
what antihistamines do. I think of
it as a lock and key. Once one key
is in, another won’t fit. Histamine is
left out in the cold, and your nose is
happy and clear.
One problem with some antihistamines
is they can make you
quite sleepy. Certain reactions in
the brain require histamine to perk
things up. The older antihistamines
(like Benadryl, Chlor-Trimeton, Tavist
and their generics) can get into
Web Extra!
Learn more about allergies and
what to do for them through our
archived online articles. (Visit your
Premium Subscribers Section, www.
MyFamilyDoctorMag.com.)
the brain easily and will block these
reactions. The newer ones (including
Allegra, Claritin, Zyrtec and their
generics) aren’t as able to and thus
aren’t as likely to cause drowsiness.
Antihistamines work best if you
take them before histamine reaches
the receptors—that is, before allergies
start. So allergy doctors often recommend
that certain people take them
throughout allergy season. Talk to
your health-care provider if you think
you might benefit from that.
Da n i e l P. Hay s , Ph a r m.D., B.C.P.S., is
an emergency pharmacist and director of the
Emergency Medicine/Critical Care Pharmacy
residency program at the University of Rochester
Medical Center in Rochester, N.Y.
What about
decongestants
Decongestants basically come in and
clean up the mess histamine makes.
Histamine can dilate blood vessels
and actually cause them to leak fluid. So
when you have allergies, you may get a
runny, stuffy nose and/or watery eyes.
Decongestants help shrink the blood
vessels by working at certain receptors
to tighten them down.
This is not so good for people with
high blood pressure; oral decongestants
can make that problem worse. In that
case, one option your provider may
suggest is a nasal spray. This works
directly in your nose, so you don’t get
the effect in your whole body. Don’t use
them more than three to five days in a
row, though, because you can develop
rebound congestion and become
dependent.
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 29
To the
Test
Nasal Irrigation
What It Is: Ear, nose and throat
doctors have been recommending
nasal irrigation for years. Common
methods involve leaning over a sink
and pouring or squirting warm saltwater
into one nostril. The liquid
flows out your other nostril, flushing
out the yucky stuff in between. Then,
you switch sides.
Irrigating often—maybe once
or twice a day—can help prevent
or treat allergy symptoms and even
ward off a sinus infection.
Methods and Results
We asked two readers and one ENT
doctor to test the following products.
• Grossan Hydro Pulse: electrically
powered wand that directs a
gentle stream.
• SinuCleanse Neti Pot: based on
the original Indian system of pouring
saltwater into the nostril.
• SinuCleanse Squeeze: soft bulb
you squeeze.
“I am surprised how different it feels
before and after using the systems,
especially since it doesn’t take long to
do,” said Susan. Our readers’ favorite
was the Hydro Pulse. The neti pot
came in second. They described the
Squeeze system as “messy” but not
useless.
Average Ratings
Hydro Pulse
Easy to use:
Worth the price:
Neti Pot
Easy to use:
Worth the price:
Squeeze
Easy to use:
Worth the price:
Grossan Hydro Pulse: $97,
www.hydromedonline.com
Testers’ Takes
Susan, New York, N.Y.,
homemaker
I had no idea of what to
expect while doing this.
I found it did bring relief
but was sort of gross to do at the
same time. The processes were awkward
at first, but I’m fairly sure there
is a learning curve.
I would recommend that anyone
with a sinus problem try one of
these systems since they all
worked, but not all equally.
I think a person’s budget
and commitment to actually
using them will be a
big factor in determining
which system to buy.
Robbie, Killen, Ala.,
office manager
The Hydro Pulse System
is really nice, very
easy to use, and leaves
the sinus and throat areas feeling very
clean. I plan to continue to use this
on a regular basis, hopefully daily.
I have problems, especially in the
winter months, with clear drainage,
SinuCleanse: $14.99 (Neti Pot) or $10.99
(Squeeze), www.sinucleanse.com, (888) 547-5492
and this system has already helped
with that. The neti pot will be a great
help when traveling and is my second
choice.
Expert’s Take
Want
to be a JHMFD
product tester Apply
through your Premium
Subscribers Section at
the new www.My-
FamilyDoctorMag.
com.
Jordan S. Josephson, M.D.,
New York, N.Y., author,
Sinus Relief Now; director,
New York Nasal and Sinus
Center
I recommend all three systems. The
Hydro Pulse is worth the expense
with more resistant sinus problems or
allergies, and for people who are
around sticky dust (like cement
workers, sanitation
workers and carpenters).
You can make
your own saltwater
by adding ¼ to 1
teaspoon of salt to an
8-ounce glass of water
and warming the solution to
room temperature. But the packages
that come with these systems are
inexpensive and easy to work with
and, I believe, worth the money.
Some little kids love irrigating.
I have had children as young as 4
use the neti pot and irrigator. Many
people are afraid until they start doing
it. Then they tell all their friends
about it.
30 | James Hubbard’s My Family Doctor | The Magazine That Makes Housecalls
I had three
nursing
friends who
stopped contacting
me.
People I knew well. My husband
called them and said, “What’s
wrong with you” Each of them
said, “What happened to her
could happen to me, and if I
get her on the phone I’m
going to cry.” …
So I thought about how to
neutralize the discussion. When
I got fitted for my breast prosthesis,
I took my mother with
me. On the way I said, “Mom,
getting a prosthesis is like getting
a puppy. She’s going to be
my bosom buddy. I’m going to
take her everywhere I go, so
she should have a name.” We
selected the name “Betty
Boob,” and I sent out adoption
notices to these nurses
and to my best friends that I
had gotten “Betty Boob.” I also
took a photograph. Those three
nurses each called me and said,
“How is Betty doing” Really
they were saying how are you
doing with cancer. Betty did
neutralize it. When I needed
the second mastectomy, I called
friends and said, “Betty Boob is
getting a roommate, and I need
your help in selecting a name
for her.” Perhaps one day I
will learn ventriloquism
and my breasts will speak
to the public to promote
breast cancer awareness.
—Li l l i e Sh o c k n e y, R.N., B.S.,
M.A.S.
Choices in Breast Cancer Treatment,
Kenneth D. Miller, M.D. (editor),
Johns Hopkins University Press,
January 2008, $18.95
The next time you’re in a hospital,
surgery center, nursing home, or other
medical institution, make sure you are being watched. If someone
(or something, e.g., security camera) is watching you, then hopefully
they are also watching others. For all of our safety, it is important
that our medical institutions are under appropriate surveillance at all
times. Likewise, if you are finding that you can wander around your local
hospital or emergency room at two in the morning without being
stopped and questioned, something is very wrong.
Jihad and American Medicine: Thinking Like a Terrorist to Anticipate Attacks Via
Our Health System, Adam Frederic Dorin, M.D., Praeger Security International, November
2007, $49.95
Graphs
Paragraphs
from books
we like
Our children
drink us up like little
sponges. They watch us, they sense
us, they model who we are and what
we do. ... There is no such thing as
creating a comfortable emotional
atmosphere for your child while being
constantly at war with yourself
or your spouse. The family is the
family. It operates as a whole. Every
time we resolve our own
unconscious conflicts, generations
of people benefit. Tending
to our relationships, our personal
lives, and our bodies are all the right
thing to do, not only for us, but for
our kids.
Emotional Sobriety: From Relationship
Trauma to Resilience and Balance,
Tian Dayton, Ph.D., Health Communications,
December 2007, $14.95
Throughout the United States,
there is a nursing shortage. If you plan a
hospital stay, find out what the patient-to-nurse ratio is. Ask your surgeon
or a nurse manager at the hospital. Studies have shown that patient
safety suffers when nursing staffing is low, because nurses have too
many patients to take care of adequately. Nurse ratios typically depend on
multiple factors, including the number of patients in the unit, the patients’
care needs (postoperative recovery, intensive care, general inpatient, and so
on), and the nurses’ skill level and experience.
Ask your surgeon if the ratio of nurses to patients is appropriate and
adequate for the type of procedure you are having and for your needs. The
ratio should be adequate, not just during the day but also at night.
I Need an Operation … Now What, Thomas R. Russell, M.D., F.A.C.S., Thomson
Healthcare, January 2008, $19.95
Mar/Apr 2008 | www.MyFamilyDoctorMag.com | 31
New Name
New Look
New Site
… and still the best content around.
James
Hubbard’s
The Magazine That Makes Housecalls
www.MyFamilyDoctorMag.com
Health information you and your family can rely on
—straight from the experts.
To subscribe, renew or give a gift, call 877-DOC-IS-IN (877-362-4746), visit www.MyFamilyDoctorMag.com
or send in the form on page 27.
Subscription rates: $28 for one year/six issues (save 33% off the cover price!) or $24 for renewals. In Canada: $43 U.S. or $39 U.S. for renewal. Physicians: Please call
for office bulk rates. To subscribe by mail, send a check or money order to P.O. Box 38790, Colorado Springs, CO 80937. To subscribe by fax, fax your Visa or MasterCard
number to 719-576-2353. Include in all orders: your name, address, phone number, date and signature. Advance payment required.
Please allow up to 90 days to receive your first magazine.
Change language