New Under the Sun:
Volume 2, Issue 8
Greetings!! For many, August is that last bit of summer before life settles into a more ordered routine. Make sure that your routine will continue to include plenty of exercise and healthy eating. Life’s transitions are more easily dealt with when we are healthy. So keep up the good work!
Physicians and Recommended Guidelines: When we have an appointment with our physician, we expect the he or she keeps up with the latest developments in medical care. While most physicians probably do try to stay on top of their field, it can be difficult to do so. This is highlighted by a recent study where researchers analyzed the medical records of a random sample of patients from 12 US metropolitan regions. They found that the percentage of patients who received care according to standard recommended guidelines varied dramatically. While an average of 78% percent of patients received recommended care for senile cataracts, only about 11% received recommended care for alcohol dependence. The overall average of those receiving care according to recommended guidelines for 30 different conditions was about 55%. This is clearly a cause for concern. E. A. McGlynn, S. M. Asch, J. Adams, J. Keesey, J. Hicks, A.DeCristofaro, and E. A. Kerr. 2003 The Quality of Health Care Delivered to Adults in the United States. NEJM 348:2635-2645.
Comment: Studies such as the one discussed above highlight the importance of patients taking control of their health. That is, patients need to educate themselves on their medical conditions, need to fully discuss the conditions with their physicians, and need to question their physicians if their treatments differ significantly from that recommended for their conditions. Most acute diseases and/or chronic conditions have organizations associated with them which provide extensive material on the condition on a website. Doing a Google search on the condition will bring up a wealth of information. Some care needs to be taken in analyzing the quality of the information, but that provided by government sources or non-profit organizations can usually be trusted. If your physician seems disturbed or annoyed by your educated questioning, then finding a new physician may be an appropriate move. It is also possible that the problem may be that the physician is not really clear on what the patient’s actual concern is, perhaps because the stated reason for the visit is not the true reason. It may also be that the patient views the physician as too busy and/or impatient for extensive comments/questioning by the patient. To alleviate this problem, one physician has proposed using a “Today’s Visit” form. Click here to access a copy of the form and more information on it. http://www.aafp.org/fpm/20030600/59focu.html Even if your physician does not use such a form, there is no reason you cannot bring such a form with you to your next visit. You can download and modify the form to contain the types of information you feel are important. With this form in hand, your next visit to your physician may be more productive and successful.
Herbs can be Drugs:
Due to recent concerns raised about hormone replacement therapy (HRT),
many women are turning to herbal preparations to relieve perimenopausal
symptoms such as hot flashes. Black cohosh (Cimicifuga racemosa) has been
shown to reduce the severity of hot flashes. However, the idea that herbs
are somehow free of safety concerns ignores the fact that plants are the
sources of some very potent drugs. For instance, quinine is made from
the bark of the Cinchona tree; digitalis is from purple foxglove; aspirin
is from willow bark; and Taxol is from the bark of the Pacific yew. These
are only a few of the many drugs made from “herbs.” To conclude that an
herbal preparation is safe because it is called an “herb” as opposed to
a “drug” can result in unexpected and unfortunate side effects. Research
presented this July at the American Association for Cancer Research conference
showed that while black cohosh may relieve hot flashes, for individuals
who have cancerous cells, it may cause those cancer cells to metastasize
or spread to other sites. The research was conducted in female mice who
were fed black cohosh preparations. At death, it was determined from autopsy
that those fed black cohosh did not have significantly more tumors than
those on a control diet. However, in those who had tumors, those fed black
cohosh showed evidence that the tumors had metastasized. The researchers
concluded that women who had breast cancer or who may possibly have undetected
tumors should not take black cohosh. Because something is “natural” does
not make it safe.
Hospital Food and Healthy Diets: The two behaviors/conditions with the highest health costs are smoking and obesity. While virtually all hospitals now prohibit smoking indoors, the obesity issue has yet to be addressed. Telling patients that smoking is bad for them, but allowing smoking in waiting rooms and hospital corridors clearly sent mixed messages. Prohibiting smoking in any but a few selected outdoor areas emphasizes the seriousness of the anti-smoking message. But obesity has yet to be clearly addressed. In a recent essay on Medscape, Howard Markel, MD, PhD, points out that, at least in hospital cafeterias, the profit motive seems to outweigh the health motive. In the past few years it has become common to find fast food outlets in the cafeterias. Granted, many cafeteria meals were not of the highest nutritional value. However, super-sized fast food is definitely not an improvement. One such meal (a quarter pounder cheeseburger and fries) can include 47 grams of fat, 16 of which are saturated fats, and a calorie count of 920 calories. Markel mentions that a cardiologist friend sees some “value” in fast food outlets in hospitals: “…with all these burgers and fries, the patients keep coming and coming as far as the eye can see." Howard Markel, MD, PhD. Fast Food, Obesity, and Hospitals. Medscape Pediatrics 5(2), 2003 Posted 07/15/2003
Cafeteria eating the AnthroHealth way: Avoid eating any breads. If grilled or baked fish are offered, choose that. If fish is not available, choose skinless chicken. Salads are an iffy choice since often the salad “greens” are iceberg lettuce. If one can create one’s own salad and iceberg lettuce is the only “green”, skip it and just make a salad of fresh fruits and vegetables. Skip pasta and potato salads and cheese toppings. Make your meal colorful, especially include red, dark green, and orange fruits and vegetables. Drink water.
Book Review: On February 27, 2003, Fred Rogers, “Mister Rogers” to millions of children and their parents, died. Fortunately, his loving, caring legacy lives on in his television show Mister Rogers Neighborhood, and in his books. This month, The Mister Rogers Parenting Book: Helping to Understand Your Young Child, published in 2002, is reviewed.
Fred Rogers clearly understood the time constraints under which parents of young children operate. Each of the 24 chapters of this slim volume is only about four pages long and concludes with a “Helpful Hints” section. This allows one to read a nugget of wisdom when one has a moment to spare.
Some themes recur throughout the book. Listen carefully to your children. If we want children to feel good about who they are and what they can do, we need to respect them. Empathize with your children, but be consistent in enforcing appropriate rules and behaviors. Children need to know that it is OK to feel angry or sad, but that it is not OK to hurt themselves or others. Children may test our rules, but they feel safer when the rules are consistently enforced. When children feel comfortable talking with their parents about any topic, parents are more likely to find out what fears or incorrect ideas the child might have on a particular topic and are better able to resolve these issues.
As Mister Rogers points out in the Introduction, becoming a parent provides adults with an opportunity to continue their own growth and development while guiding their children’s growth and development. It can be a win/win situation for all involved if we listen, show respect, and behave consistently and lovingly.
AnthroHealth Tip of the Month: In many places, children and teens either return to school this month or begin thinking about the return to school. Obesity is becoming epidemic among school children; therefore, parents need to make sure that their children have a healthy diet. Since monitoring what children who buy their lunches eat at school is difficult if not impossible, the only way to ensure healthy choices is to make sure the school only provides healthy choices. This means that parents need to get involved. They need to find out what types of meals the cafeteria provides. Many schools now offer fast food at lunch. Refined grains, saturated fats (particularly from cheese), and few fresh fruits and vegetables (iceberg lettuce doesn’t count) are common components of school lunches. Improving school lunches will require parental involvement.
© 2001-2009 Kathleen E. Fuller, PhD. All rights reserved.