Discover Your Stress Personality - James Hubbard's My Family Doctor

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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


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$Office Copay: $35

Prescription Medication: $80

Hospitalization: $,

Staying Healthy: Priceless

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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.

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