U.S. Panel Backs Routine Lung CT Scans for Older, Heavy Smokers

Yearly testing will prevent some lung cancer deaths, experts conclude

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

MONDAY, Dec. 30, 2013 (HealthDay News) -- A highly influential government panel of experts says that older smokers at high risk of lung cancer should receive annual low-dose CT scans to help detect and possibly prevent the spread of the fatal disease.

In its final word on the issue published Dec. 30, the U.S. Preventive Services Task Force (USPSTF) concluded that the benefits to a very specific segment of smokers outweigh the risks involved in receiving the annual scans, said co-vice chair Dr. Michael LeFevre, a distinguished professor of family medicine at the University of Missouri.

Specifically, the task force recommended annual low-dose CT scans for current and former smokers aged 55 to 80 with at least a 30 "pack-year" history of smoking who have had a cigarette sometime within the last 15 years. The person also should be generally healthy and a good candidate for surgery should cancer be found, LeFevre said.

About 20,000 of the United States' nearly 160,000 annual lung cancer deaths could be prevented if doctors follow these screening guidelines, LeFevre said when the panel first proposed the recommendations in July. Lung cancer found in its earliest stage is 80 percent curable, usually by surgical removal of the tumor.

"That's a lot of people, and we feel it's worth it, but there will still be a lot more people dying from lung cancer," LeFevre said. "That's why the most important way to prevent lung cancer will continue to be to convince smokers to quit."

Pack years are determined by multiplying the number of packs smoked daily by the number of years a person has smoked. For example, a person who has smoked two packs a day for 15 years has 30 pack years, as has a person who has smoked a pack a day for 30 years.

The USPSTF drew up the recommendation after a thorough review of previous research, and published them online Dec. 30 in the Annals of Internal Medicine.

"I think they did a very good analysis of looking at the pros and cons, the harms and benefits," Dr. Albert Rizzo, immediate past chair of the national board of directors of the American Lung Association, said at the time the draft recommendations were published in July. "They looked at a balance of where we can get the best bang for our buck."

The USPSTF is an independent volunteer panel of national health experts who issue evidence-based recommendations on clinical services intended to detect and prevent illness.

The task force has previously ruled on mammography, PSA testing and other types of screening. It reports to the U.S. Congress every year and its recommendations often serve as a basis for federal health care policy. Insurance companies often follow USPSTF recommendations as well.

source : U.S. Panel Backs Routine Lung CT Scans for Older, Heavy Smokers

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Unhealthy Cholesterol Levels Might Raise Alzheimer's Risk

Keeping cholesterol under control may help brain as well as heart, study suggests

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

MONDAY, Dec. 30, 2013 (HealthDay News) -- Keeping "bad" cholesterol in check and increasing "good" cholesterol is not only good for your heart, but also your brain, new research suggests.

A study from the University of California, Davis, found that low levels of "bad" (LDL) cholesterol and high levels of "good" (HDL) cholesterol are linked to lower levels of so-called amyloid plaque in the brain. A build-up of this plaque is an indication of Alzheimer's disease, the researchers said in a university news release.

The researchers suggested that maintaining healthy cholesterol levels is just as important for brain health as controlling blood pressure.

"Our study shows that both higher levels of HDL and lower levels of LDL cholesterol in the bloodstream are associated with lower levels of amyloid plaque deposits in the brain," the study's lead author, Bruce Reed, associate director of the UC Davis Alzheimer's Disease Center, said in the news release.

"Unhealthy patterns of cholesterol could be directly causing the higher levels of amyloid known to contribute to Alzheimer's, in the same way that such patterns promote heart disease," Reed said.

The study, which was published in the Dec. 30 online edition of the journal JAMA Neurology, involved 74 men and women recruited from California stroke clinics, support groups, senior-citizen facilities and the UC Davis Alzheimer's Disease Center. All of the participants were aged 70 or older. Of this group, three people had mild dementia, 33 had no problems with brain function and 38 had mild impairment of their brain function.

The investigators used brain scans to measure the participants' amyloid levels. The study revealed that higher fasting levels of LDL cholesterol and lower levels of HDL cholesterol both were associated with more accumulation of amyloid plaque in the brain.

Exactly how cholesterol affects amyloid deposits in the brain remains unclear, however, the researchers said.

In the United States, cholesterol is measured in milligrams of cholesterol per deciliter of blood, or mg/dL. HDL cholesterol should be 60 mg/dL or higher, the researchers said in the news release. LDL cholesterol should be 70 mg/dL or lower for those at very high risk for heart disease.

Reed and his colleagues said it's important to maintain healthy cholesterol levels in those who are showing signs of memory problems or dementia, regardless of their heart health.

"This study provides a reason to certainly continue cholesterol treatment in people who are developing memory loss regardless of concerns regarding their cardiovascular health," said Reed, who also is a professor in the UC Davis department of neurology.

"It also suggests a method of lowering amyloid levels in people who are middle-aged, when such build-up is just starting," Reed said in the news release.

"If modifying cholesterol levels in the brain early in life turns out to reduce amyloid deposits late in life, we could potentially make a significant difference in reducing the prevalence of Alzheimer's, a goal of an enormous amount of research and drug-development effort," he said.

source : Unhealthy Cholesterol Levels Might Raise Alzheimer's Risk

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Savvy Styling That Won't Harm Your Hair

You work hard to make your hair look fabulous. So make sure the steps you take -- like styling and coloring -- aren't working against you.

Heat from blow dryers, curling irons, and flat irons can make hair brittle and cause breakage. Chemical processing -- think color and straightening treatments -- can rob hair of natural moisture, leaving it dry and frizzy.

These gentler styling techniques will help you get the look you want while warding off damage.

Treat Wet Hair Tenderly

Go easy on your hair when it’s wet. Wrap it in a towel. Don’t rub it dry. That causes frizz.

Use a wide-tooth comb instead of a brush on wet hair. If it’s straight, let it dry a bit before combing. If it's curly, comb when it's still damp.

Don't tug or pull wet or dry hair. One hundred strokes a day? That’s an old wives’ tale. Too much brushing can cause split ends.

Take a Holiday From the Heat

Let your hair air dry when you can. Heat-free days boost its natural recovery process.

For shiny hair without heat, wash it at night and sleep on it, says Patrick Melville, co-owner of the Patrick Melville Salon in New York. His clients include Heidi Klum, Halle Berry, and Catherine Zeta-Jones. “After your shower, brush your hair out and put a braid in it," Melville says. "Don’t blow-dry the braid.”

Turn Down the Heat

When using a blow-dryer, start on the lowest setting and gradually turn it up. If you see steam, you’re probably scorching your locks. Keep the dryer moving and hold it 6 inches from your hair.

Work fast. “The quicker, stronger, and faster you are, the better it is for your hair and the less damage you create,” says Jonathan Antin, star of the Bravo TV series Blow Out and co-owner of Jonathan & George Salon in Beverly Hills, Calif.

Divide your hair into sections, Antin says. Focus on drying each section for about 3 minutes, then clip it and get it out of the way so it’s not exposed to extra heat.

Use Hair Tools With Care

If you use a heated device like a hot comb, curling iron, or blow-dryer, choose one that’s temperature controlled and limit the time it touches your hair.

Set your curling iron to low or medium heat and leave it in place for just 1 or 2 seconds.

“Don’t melt your hair with a flat iron,” Antin says. "Use it only when your hair is properly dried and run it through your ends only."

For bouncy curls without a curling iron, try wrapping your hair in Velcro rollers. “Put the rollers in your hair for about 20 minutes and you’ll get lots of volume and a smooth wave with no heat,” says Lisa Lobosco, lead stylist at Ecru New York whose styles have walked the runway at New York Fashion Week.

source : Savvy Styling That Won't Harm Your Hair

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Conquering Changes in Hair Texture

The hair texture you grow up with becomes part of your identity. You learn to style it in a way that flatters you and fits your lifestyle. It can be unsettling if it changes. Over time, your hair may become curly, straight, thin, or coarse.

Many things can make hair change texture. Some you can't control. Others you may cause without knowing it.  

Read on to see why your hair texture may be changing and what you can do to make the best of it.  

The Cause: Graying

Gray hair grows when hydrogen peroxide builds up in your hair follicle. "This causes hair to bleach itself from the inside out," says Debra Jaliman, MD, a dermatologist in New York and spokesperson for the American Academy of Dermatology. Gray hairs are thicker and wirier, so your hair gets coarser as they multiply.

You can't do anything to stop graying -- it's something you inherit. But you can tame gray hair with a good hairstyle and special care.

Solutions: Shampoo and condition your hair with products designed for dry hair. Use a leave-in conditioner to help smooth coarser strands.

Occasional home or salon deep-conditioning treatments can also help, says Eugene Toye, senior stylist at Rita Hazan Salon in New York. He has styled hair for Sofia Vergara and Neil Patrick Harris.

Some hairstylists use keratin treatments to improve the rough texture of gray hair. But they are expensive and may contain unsafe levels of formaldehyde, which is known to cause cancer.

Toye suggests getting a cut that works with your new texture. "Don’t try to fight your hair," he says. "If it’s wavy, don’t try to get it stick straight."

The Cause: Chemotherapy

Chemotherapy can cause big changes in your hair texture or none at all. If you lose your hair during treatment, it may grow back thicker, curlier, or straighter all over or just in some spots.

Solutions: Over time, your hair may return to its pre-chemo texture. But the first hair that grows back is especially fragile. Avoid chemical processes like coloring or straightening for a while. And it's not just the early hair that's prone to damage. The skin on your scalp may be sensitive for 6 months or more after treatment.

Condition your post-chemo hair to help it grow back healthy. If you're not used to short hair, think of the grow-back period as a time to try out shorter styles. If you're really unhappy with hair that is coming in thin or patchy, Toye suggests wearing a hairpiece or wig while it continues to grow in.

source : Conquering Changes in Hair Texture

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Am I Ready to Date After My Divorce?

By Lisa Fields
WebMD Feature

Reviewed by Michael W. Smith, MD

If you’re divorced, or have ended a long-term relationship, well-meaning relatives and friends may encourage you to start dating again soon. But how will you know when you're ready for a new relationship?

“This wildly varies from person to person,” says Judith Sills, PhD, a Philadelphia-based psychologist and author of Getting Naked Again: Dating, Romance, Sex, and Love When You've Been Divorced, Widowed, Dumped, or Distracted. “Everyone ends a relationship by grieving the emotional investment. For some people, that happens before they move out. Others are still emotionally married after the divorce is final.”

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Dena Roché started dating while waiting for her divorce papers to come through.

“It helped, because I got to see what 'normal' looked like,” Roché says. “I also saw that my ex wasn't the only guy who would want to be with me. It bolstered my confidence for dating.” 

Claudia Barnett needed some alone time to heal before seeking a new relationship. 

“Your marriage has died; you need to grieve that loss,” Barnett says. “To move forward, I had to be whole emotionally, financially, mentally, and spiritually. After I accomplished some set goals, I knew it was time.”

Here's what experts say you should consider before dating:

Go by your feelings, not the calendar

Some people are ready to date after 2 months; others may need years. Don't rush. It's important to experience the emotions associated with divorce.

Give yourself “a little time to think, a little time to grieve, a little opportunity to find someone else,” Sills says.

The ex factor

If you're still thinking about what your ex is doing or whom he's dating, you're too distracted to begin a healthy relationship.

“Some people date and even marry to try to prove something to an ex,” says Edward M. Tauber, PhD, a California-based divorce counselor and co-author of Find the Right One After Divorce. “You wouldn't date somebody who's still tangled up with an ex emotionally. Why offer that to somebody else?”

Are you open to new experiences?

If you were in a committed relationship for a long time, the idea of beginning a new romance may seem scary. If you've recently tried other activities that bring you out of your comfort zone, you could be ready to date.

“Have you done something that's an affirmation of yourself and your life -- made a new friend, taken up a new sport, gotten a haircut?” Sills asks. “You open your heart to new relationships when you're resilient enough to endure the minuses of dating to get the pluses.”

Accept yourself as an individual

Your identity has nothing to do with your dating status. Rather than jumping into a new relationship to avoid being alone, give yourself a chance to explore life on your own terms.

“You can't heal unless you're on your own,” Tauber says. “You need to find single friends to have a social life with.”

source : Am I Ready to Date After My Divorce?

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FDA Rejects MS Drug Lemtrada

By Kathleen Doheny
WebMD Health News

Reviewed by Michael W. Smith, MD

Dec. 30, 2013 -- The FDA has rejected the new multiple sclerosis drug Lemtrada, saying the drugmaker didn’t show the drug's benefits outweigh some serious risks.

The agency asked the maker, Genzyme, to test the drug in more clinical trials.

The drug was to be used for relapsing-remitting MS, the most common type.

MS affects about 400,000 people in the U.S. Blurred vision, balance problems, slurred speech, and memory problems of MS can be disabling.

Genzyme says in a news release it plans to appeal the FDA’s decision on Lemtrada (alemtuzumab).

The drug has been approved in Canada, the European Union, and Australia. In the U.S. it received a mixed review from an FDA advisory committee in November. At that time, several members raised concerns about its safety.

The FDA had earlier approved the drug to treat leukemia, marketed as Campath.

Lemtrada is given as an infusion. It was expected to be used in MS patients who did not respond to other treatments.

Lemtrada's Side Effects a Concern

"We're disappointed by the decision," says Timothy Coetzee, PhD, chief advocacy, services, and research officer for the National Multiple Sclerosis Society. He says he's concerned about what this means for U.S. patients with MS.

In two clinical trials, Lemtrada reduced relapse rates over 2 years by about half compared to patients on another MS drug, Rebif (interferon beta-1a), Coetzee says. That reduction in relapses, he says, "is a pretty big deal."

A patient who relapses must go to the doctor and take time off work. Recovering from a relapse can also take some time, Coetzee says.

But the powerful impact of Lemtrada also can have downsides.

One potential side effect is called immune thrombocytopenic purpura, or ITP. This causes low platelet counts in the blood and can lead to dangerous bleeding. In the clinical trials, one patient died of ITP.

Genzyme put a special patient safety monitoring program in place after the death.

In the later research studies, most patients treated with the drug had mild to moderate infusion-related reactions, Coetzee says, including headache, rash, nausea, and fever. He says about 30% of those on Lemtrada developed thyroid-related problems. But those conditions, if caught early, can often be treated, he says.

Infections are another potential side effect, including shingles and upper respiratory, urinary tract, and sinus infections.

Coetzee says the National Multiple Sclerosis Society will continue to monitor the situation and to gather more information about the FDA's decision.

source : FDA Rejects MS Drug Lemtrada

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Federal Health Insurance Marketplace Reports Surge in Enrollments

By Karen Pallarito

HealthDay Reporter

SUNDAY, Dec. 29, 2013 (HealthDay News) -- After a disastrous introduction back in October, the federal government's HealthCare.gov insurance coverage website saw a surge of enrollments in December, government officials said Sunday.

More than 1.1 million people enrolled in a qualified health plan through the federally operated marketplace, or exchange, from Oct. 1 through Dec. 24. More than 975,000 of those enrollments came in December, Marilyn Tavenner, administrator for the Centers for Medicare & Medicaid Services, said in a blog post.

"Our HealthCare.gov enrollment nearly doubled in the days before the Jan. 1 coverage deadline compared to the first few weeks of the month. December enrollment so far is over seven times that of October and November. In part, this was because we met our marks on improving HealthCare.gov: the site supported 83,000 concurrent users on Dec. 23 alone," Tavenner said.

"We expect to see enrollment ramp up over time, much like other historic implementation efforts we've seen in Massachusetts and Medicare Part D," the federal government's prescription drug program, she added.

Sunday's announcement made no mention of the 14 exchanges that are run by states, independent of the federal website, as part of the Affordable Care Act, the Obama Administration's massive overhaul of health care. Some states -- such as California, Connecticut, New York and Washington -- have said their websites are operating well, while other states have encountered problems.

It's also not clear how many of the new enrollees are young adults. Their financial participation through insurance premiums is considered crucial to the success of the Affordable Care Act, sometimes referred to as Obamacare. Young adults typically have fewer health insurance claims than older adults, who tend to become sicker as they age. So premiums from younger adults are needed to help fund the program.

Sunday's announcement also marked some rare positive news about the rollout of the insurance enrollment process. HealthCare.gov was plagued for weeks with computer glitches that frustrated consumers who weren't able to sign up for coverage.

As recently as Tuesday, Dec. 24, the Obama Administration once again extended the deadline for people to register for health insurance coverage on Healthcare.gov. The extension followed a 24-hour "grace period" that was granted on Monday, Dec. 23 -- beyond the original enrollment deadline of Monday, Dec. 23 at 11:59 p.m. -- for benefits that would take effect Jan. 1.

In most states, Monday, Dec. 23 had been the deadline for selecting a plan that would take effect on the first day of the new year.

Under the Affordable Care Act, most adults will pay a $95 penalty -- or 1 percent of income -- in 2014 if they don't have health insurance coverage. The penalty rises to $695 -- or 2 percent of income -- by 2016.

source : Federal Health Insurance Marketplace Reports Surge in Enrollments

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Peer Pressure May Influence Your Food Choices

Researchers found people were more likely to eat what they thought others were eating

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

MONDAY, Dec. 30, 2013 (HealthDay News) -- Peer pressure might play a part in what you eat and how much you eat, a new review suggests.

British researchers said their findings could help shape public health policies, including campaigns to promote healthy eating.

The review was published Dec. 30 in the Journal of the Academy of Nutrition and Dietetics.

"The evidence reviewed here is consistent with the idea that eating behaviors can be transmitted socially," lead investigator Eric Robinson, of the University of Liverpool, said in a journal news release. "Taking these points into consideration, the findings of the present review may have implications for the development of more effective public-health campaigns to promote healthy eating."

In conducting the review, the researchers analyzed 15 studies published in 11 different journals. Of these, eight analyzed how people's food choices are affected by information on eating norms. Seven studies focused on the effects of these norms on how people decide what they are going to eat.

People who were told that other people were making low-calorie or high-calorie food choices were much more likely to make the same choices themselves. The review also revealed that social norms affect how much food people eat. People who are told that others are eating large quantities of food are more likely to eat more.

The researchers said people's food choices are clearly linked to their social identity.

"It appears that in some contexts, conforming to informational eating norms may be a way of reinforcing identity to a social group," Robinson said.

The researchers said the influence is present even if people are not aware of the association -- or if they are eating alone.

"Norms influence behavior by altering the extent to which an individual perceives the behavior in question to be beneficial to them," Robinson said. "Human behavior can be guided by a perceived group norm, even when people have little or no motivation to please other people."

source : Peer Pressure May Influence Your Food Choices

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Tips for a Better Sleep Temperature

By Alice Lesch Kelly
WebMD Feature

Reviewed by Michael W. Smith, MD

You've followed every tip known for how to sleep better. Relaxing bedtime routine? Check. Dark room? Check. Complete quiet? Check. Then you get in bed and realize the temperature is causing you to toss and turn.

Here are answers to common questions about the best temp to snooze.

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What’s the best temperature for sleeping?

“The right temperature -- typically a bit on the cool side -- can help with sleep quality immensely,” says W. Christopher Winter, MD, director of the Charlottesville Neurology and Sleep Medicine Center in Virginia.

Sleep can be disrupted by temperatures anywhere below 65 or above 75. The sweet spot for great sleep is between 68 and 72 degrees. “That’s really optimal for sleep,” says Michael J. Breus, PhD, author of Good Night: The Sleep Doctor's 4-Week Program to Better Sleep.

For most people, heat interferes with sleep more than cold.

What can I do to sleep well when I can’t control the temperature?

Coping with heat is tougher. Breus faces that problem on a regular basis. He lives in Arizona, where temperatures soar to 114 degrees and higher. “Even with air conditioning, trying to cool a house down to 75 degrees can be extraordinarily difficult,” he says.

Here are his tips for sleeping well in a warm room.

• Take a cool shower before bed.

• Keep a bottle of ice water on your nightstand. A few sips can cool you down.

• Place a cool, wet towel on your forehead. Heat tends to leave your body through your head, and a wet towel can speed up heat loss.

• Use a thin sheet, even if it’s very warm. “Almost everyone needs some small bit of tactile sensation to help them relax,” Breus says.

Is the best sleep temperature different for different people?

Most people have a comfortable sleep-temperature range of several degrees. That range can vary from person to person. Your perfect sleep temperature may be too high or too low for someone else.

Your preferred temperature can also change as you get older. Aging thins the layer of fat just under your skin, which naturally insulates against heat and cold. Your best temperature range at age 50 may be narrower than it was at 30.

Health issues, such as the circulatory problem Raynaud's disease, can make you chilly.

What about a man's vs. a woman's sleep-temperature needs?

Men tend to have a steady body temperature, so one consistent sleep temperature tends to work well for them.

Women’s body temperatures can vary based on their menstrual cycle. Once menopause begins, hot flashes and night sweats can leave a woman feeling too hot one minute and too cold the next.

source : Tips for a Better Sleep Temperature

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Peer Pressure May Influence Your Food Choices

Researchers found people were more likely to eat what they thought others were eating

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

MONDAY, Dec. 30, 2013 (HealthDay News) -- Peer pressure might play a part in what you eat and how much you eat, a new review suggests.

British researchers said their findings could help shape public health policies, including campaigns to promote healthy eating.

The review was published Dec. 30 in the Journal of the Academy of Nutrition and Dietetics.

"The evidence reviewed here is consistent with the idea that eating behaviors can be transmitted socially," lead investigator Eric Robinson, of the University of Liverpool, said in a journal news release. "Taking these points into consideration, the findings of the present review may have implications for the development of more effective public-health campaigns to promote healthy eating."

In conducting the review, the researchers analyzed 15 studies published in 11 different journals. Of these, eight analyzed how people's food choices are affected by information on eating norms. Seven studies focused on the effects of these norms on how people decide what they are going to eat.

People who were told that other people were making low-calorie or high-calorie food choices were much more likely to make the same choices themselves. The review also revealed that social norms affect how much food people eat. People who are told that others are eating large quantities of food are more likely to eat more.

The researchers said people's food choices are clearly linked to their social identity.

"It appears that in some contexts, conforming to informational eating norms may be a way of reinforcing identity to a social group," Robinson said.

The researchers said the influence is present even if people are not aware of the association -- or if they are eating alone.

"Norms influence behavior by altering the extent to which an individual perceives the behavior in question to be beneficial to them," Robinson said. "Human behavior can be guided by a perceived group norm, even when people have little or no motivation to please other people."

source : Peer Pressure May Influence Your Food Choices

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What Yoga Can and Can't Do for You

Sure, it's a stress-buster, but it also helps with anxiety, depression, insomnia, back pain and other ills, experts say

WebMD News from HealthDay

By Serena Gordon

HealthDay Reporter

MONDAY, Dec. 30, 2013 (HealthDay News) -- Chances are that you've heard good things about yoga. It can relax you. It can get you fit -- just look at the bodies of some celebrities who sing yoga's praises. And, more and more, yoga is purported to be able to cure numerous medical conditions.

But is yoga the panacea that so many believe it to be?

Yes and no, say the experts. Though yoga certainly can't cure all that ails you, it does offer significant benefits.

"Yoga is great for flexibility, for strength, and for posture and balance," said Dr. Rachel Rohde, a spokeswoman for the American Academy of Orthopaedic Surgeons and an orthopedic surgeon for the Beaumont Health System in Royal Oak, Mich. "Yoga can help with a lot of musculoskeletal issues and pain, but I wouldn't say it cures any orthopedic condition," she said.

Most practitioners would tell you that yoga isn't just about building muscle or strength.

"One of the issues in this country is that people think of yoga only as exercise and try to do the most physically hard poses possible," explained Dr. Ruby Roy, a chronic disease physician at LaRabida Children's Hospital in Chicago who's also a certified yoga instructor. "That may or may not help you, but it also could hurt you," she noted.

"The right yoga can help you," Roy said. "One of the primary purposes of a yoga practice is relaxation. Your heart rate and your blood pressure should be lower when you finish a class, and you should never be short of breath. Whatever kind of yoga relaxes you and doesn't feel like exercise is a good choice. What really matters is, are you in your body or are you going into a state of mindfulness? You want to be in the pose and aware of your breaths."

Roy said she uses many of the principles of yoga, especially the breathing aspects, to help children sleep, reduce anxiety, help with post-traumatic stress disorder, for asthma, autism and as support and pain management during procedures. "I may or may not call it yoga. I may say, 'Let's do some exercises to relax you for sleep,'" she said.

Bess Abrahams, a yoga therapist with the Integrative Medicine and Palliative Care Team at Children's Hospital at Montefiore in New York City, also uses yoga to help children who are in the hospital for cancer treatment and other serious conditions.

"Physically, yoga helps to strengthen the muscles that have been weakened from a lack of movement, and the stretching in yoga helps with muscular tightness," she said. "It also helps with discomfort from lying in bed or discomfort from a procedure."

Abrahams said that older children find that the meditative aspects of yoga can help reduce anxiety.

source : What Yoga Can and Can't Do for You

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The New Heart Tests: Which Ones Should You Have?

By Renee Bacher
WebMD Feature

Reviewed by James Beckerman, MD, FACC

Researchers are developing new ways to check your heart health. Two tests are available now; an interesting third is on the horizon.

Corus CAD test (or CardioDx)

This blood test checks 23 genes to suggest whether or not you have heart disease. It may help doctors need fewer tests with more risks, including angiograms, one study shows. It takes 3 days to get your results.

Who should have it? In research studies, people with chest pain and without diabetes were tested. It's not a commonly recommended test.

Pros: Some insurers will cover the cost. All it takes is a small blood sample.

Cons: If your insurer doesn't cover the cost, it may set you back about $1,200.

Hemoglobin A1c

This blood test for diabetes isn't new, but the idea of using it to check for heart disease in people with diabetes or prediabetes is new. 

The A1c is a measure of blood sugar levels over the last 3 to 4 months. An A1c around or below 7% has been shown to lessen the complications of diabetes that can damage arteries. If you can lower your A1c soon after you're diagnosed with diabetes, you may also lower your long-term chances of developing coronary artery disease.

Who should get it? People with diabetes. The test should be done two times a year if your blood sugar is well-controlled, four times a year if it isn't.

Pros: You can get this done as a routine blood test. Unlike the oral glucose tolerance test, another common diabetes test, you don't have to fast beforehand or make a special trip to the lab.

Cons: Some studies show the A1c test may not work well in all cases.

Plaque Scan (Carotid Intima-Media Thickness Testing, or CIMT)

This test is similar to a carotid ultrasound. That test uses sound waves to detect blockages in the carotid artery, the main artery that supplies blood to the brain. A plaque scan uses complex software to measure the thickness of the lining of the carotid artery.

"An increase in the thickness of the lining indicates the patient is at higher cardiovascular risk, even if no … plaque is present," says Mark F. Sasse, MD. He's an associate professor of cardiovascular medicine at the University of Alabama at Birmingham School of Medicine.

Who should get it? "The plaque scan is a very new technology," says Sasse. "I suspect it is many years away from it being used in the clinical arena." Tests like this are typically for patients with medium risk and a strong family history of early-onset heart disease, he says.

Pros: Early detection. The test allows doctors to spot thicknesses in the artery lining much earlier. That might lead your doctor to prescribe a statin medication to help lower blood cholesterol and prevent plaque buildup.

Cons: The test isn't yet available to the public.

source : The New Heart Tests: Which Ones Should You Have?

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Counselors Give Smokers Best Chance to Quit: Study

Nicotine replacement treatment alone doesn't improve odds of kicking the habit, researchers found

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, Dec. 27, 2013 (HealthDay News) -- Smokers who work with a counselor specially trained to help them quit -- along with using medications or nicotine patches or gum -- are three times more likely to kick the habit than smokers who try to quit without any help, a large new study finds.

Over-the-counter nicotine-replacement products have become more popular than smoking cessation services and are used by millions of smokers, the researchers pointed out. However, these products alone do not appear to improve the odds that smokers will actually quit, they found.

They used information compiled in a survey of smokers and former smokers to examine the effectiveness of services to help people stop smoking offered by the U.K.'s National Health Service (NHS). They analyzed the success of 10,000 people living in England who tried to quit smoking in the past year.

The study, published online in Dec. 20 in the journal Addiction, revealed that smokers who used smoking cessation services have the best chance of quitting successfully. The researchers also found that smokers who use nicotine-replacement products to stop smoking without the help of a trained health professional are no more likely to quit than smokers who try to stop smoking without using any products or medication.

"When you think that stopping smoking saves six hours of life for every day of smoking avoided, investing an hour or two over a six-week period to see an NHS stop-smoking advisor seems like a good investment," study leader Robert West, a professor at University College London, said in a journal news release. "They can provide cheaper medicine than is available in shops and advise how to use it properly."

"It's crazy that not all smokers who want to stop do it," West added. "As far as nicotine products bought from shops are concerned, there is an urgent need to understand what is going on because we know that if these products are used properly they can be effective."

source : Counselors Give Smokers Best Chance to Quit: Study

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Achieve Health Goals With Optimism/Positive Thinking

By Sara Reistad-Long
WebMD Feature

Reviewed by Brunilda Nazario, MD

You're working hard to quit smoking, eat healthy, or exercise more. You're truly committed. Then you make one tiny misstep and the temptation to give up pokes at you -- hard. How you talk to yourself in those moments can help you stay on course or take a discouraging detour.

Consider this study: One group of water polo athletes used positive self-talk while they learned a new task. Another group didn't.

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The athletes who fed upbeat thoughts to their brains improved more than those who didn’t. They also had fewer interfering thoughts and were able to focus more on what they were learning.

When you find your thoughts veering toward the negative, how do you bring yourself back to a sunnier outlook? Try one of these tactics.

If You Can't Say Something Nice...

“If a friend came to you feeling down, would you beat them over the head? Probably not --yet that’s what we often do to ourselves,” says Sofia Rydin-Gray, PhD. She is director of health psychology at Duke Diet and Fitness Center in Durham, NC.

As you try to become more positive, start by simply noticing how often you talk down to yourself.  If the voice you hear in your head belongs to someone you would never want to be around, it's time to replace it.

"Then next time you beat yourself up, ask: If I was talking with my best friend right now, how would I encourage them? Speak to yourself just as gently as you would a person you love,” Rydin-Gray says.

Hold Onto the Evidence

In a bad moment, it’s possible you will dismiss all the hard work you’ve done. “But if you track your success, you have tangible evidence of your efforts and behavior change,” says Rydin-Gray. 

Your weight is one thing you can track. But relying on that record alone might not be your best choice, especially if you have a lot of weight to lose.

Track several behaviors, like your daily physical activity, how often you eat breakfast, whether you make it to a gym class, and even the number of times you choose a healthy snack, suggests Rydin-Gray.

That way when a moment of self-sabotage strikes, you can pull out your records -- and celebrate every single healthy choice you've made.

Have Fail-Proof Habits

You may have heard the saying, "No failure, only feedback." That means instead of feeling bad about something that didn't turn out like you wanted, you look at what happened from a more objective, less emotional place.

Say for instance your weight is up 2 pounds. You could say, "Well, that was a lost week. I'm going to be overweight forever." That's called a failure response.

Or you could say, "My weight is up. I wonder if the salt in the soy sauce last night could have made a difference. I won't do that next week." That's called a positive feedback response.

Another way to look at the concepts of failure or feedback is to consider these two kinds of mindsets described by Carol S. Dweck, PhD, a psychology professor at Stanford University.

• A “fixed mindset” is the belief that your qualities or talents can’t be changed.
• A “growth mindset” is the belief that you can always develop more.

The second view is about always hoping.

When you take the idea of failure out of the equation of your goal, what you’re left with is success and learning.

source : Achieve Health Goals With Optimism/Positive Thinking

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Make Healthy 'Me Time' a Priority

By Karen Asp
WebMD Feature

Reviewed by Michael W. Smith, MD

Say it loud, and say it proud: Me, me, me! OK, maybe you don't want to shout it, but it is that important.

Fitting in time for yourself is essential to do your healthy habits. Take charge of your health and happiness, and you'll lower your stress, become more productive, and have more energy.

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You may think "it's all about me" is selfish. But consider this: Other people benefit from your "me time," too. Do things that feed you mentally, emotionally, and spiritually, and you'll bring greater patience and a more positive attitude to your relationships. You’ll become a better parent, spouse, and a more effective team player at work.

Book It

Take a page from your calendar, literally. Every week, look at your calendar and book some me time.

Can't find an hour to devote to yourself? Even 5-15 minutes can work, if you stick to it. 

Don't use the time to fold laundry or catch up on email. It may even seem more stressful at first to leave things undone, but you'll have more energy if you take a little time off.

Where to find the time?

• Take advantage of the kids' reading or nap time.
• Get up 10 minutes earlier.
• Ask your kids (and spouse) to do the dishes.
• Turn off the smartphone.
• Claim a Saturday morning or Sunday afternoon for yourself, even if that means adjusting your family’s schedule.

Gimme 5

If 5 minutes is all you've got, you'd be surprised at how much you can make it count.

• Just breathe. Really focus on taking deep breaths. Your mind may wander -- that's OK, just gently lead it back from thinking about everything that's on your to-do list.
• Stretch. Get up from your desk and energize your muscles.
• Do nothing. Sit quietly. Resist the urge to jump up and clear the table or pick up the kids' toys. Let your mind and body rest.

A Few Minutes More

At least once a month, carve out a little more time for yourself -- say 30 minutes to an hour. Get a pedicure. Or a facial. Go somewhere you've never been (a certain museum or a walking trail, perhaps). Write down your dreams and goals in a journal.

Say No, Gracefully

You don’t have to tell your friends and family what you’re doing. But if their demands cut into your time, it's okay to create a buffer. 

Tell them you can help but that you need a quick 20 minutes (or whatever amount of time feels right) before you can do it.

Stick to It

Unless it’s crucial, don’t cancel me time. It’s tempting and easy to forgo this time. But if you do it too often, you won't have any me time left!

Stick up for yourself, and you'll find it pays off for those around you, too. You'll be happier and more able to help them.

source : Make Healthy 'Me Time' a Priority

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FDA Warns Consumers Against Body-Building Supplement

Agency says Mass Destruction is linked to case of liver failure

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, Dec. 27, 2013 (HealthDay News) -- Consumers should not use Mass Destruction, a dietary supplement used to stimulate muscle growth, the U.S. Food and Drug Administration warned Monday.

The body-building product, available in retail stores, fitness gyms and online, contains potentially harmful synthetic steroids and anyone currently using it should stop immediately, the FDA said.

The warning was prompted by a report from the North Carolina Department of Health and Human Services involving a serious injury related to use of Mass Destruction. A healthy 28-year-old man who used the product for several weeks experienced liver failure, which required a transplant, according to the FDA.

"Products marketed as supplements that contain anabolic steroids pose a real danger to consumers," Howard Sklamberg, director of the Office of Compliance in the FDA's Center for Drug Evaluation and Research, said in an agency news release. "The FDA is committed to ensuring that products marketed as dietary supplements and vitamins do not pose harm to consumers."

The FDA explained that liver damage is a known risk associated with use of anabolic steroids and steroid-like substances. Although Mass Destruction's ingredients are undergoing additional analysis, the FDA said it contains at least one synthetic anabolic steroid, according to the product's label.

An investigation is also under way to identify the manufacturer of Mass Destruction, which is produced for Blunt Force Nutrition, based in Sims, N.C.

Anyone who believes they are experiencing problems related to Mass Destruction or other body-building products is advised to see their doctor right away and report adverse reactions to the FDA. Warning signs of health issues that could arise include the following:

• Unexplained fatigue
• Abdominal or back pain
• Discolored urine
• Any other unexplained health changes

Long-term consequences of anabolic steroid use may also include adverse effects on blood fat levels and increased risk of heart attack and stroke, according to the release. Women who use anabolic steroids may also become more masculine. Meanwhile, men may experience shrinkage of the testicles, breast enlargement or infertility. Anabolic steroids can also affect children's growth, the FDA said.

source : FDA Warns Consumers Against Body-Building Supplement

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Couples With Different Parenting Styles Can Learn to Agree

By Lisa Fields
WebMD Feature

Reviewed by Arefa Cassoobhoy, MD, MPH

Do you worry how you and your partner’s different parenting styles will affect your kids? Relax. It doesn’t have to be a bad thing. You can raise well-adjusted kids with your different styles, as long as you both regularly discuss your positions, decisions, and concerns.

 “I like to talk about having parents being on the same chapter, because being on the same page is a little much to ask,” says Kyle Pruett, MD, clinical professor of child psychiatry at Yale School of Medicine and co-author of Partnership Parenting.

“I think the problem comes when parents aren't able to compromise,” says family therapist Lisa Dunning, author of Good Parents Bad Parenting. “They're so rigid: 'My way is right, your way is wrong,' and they're not willing to work on a happy medium.”

Experts recommend the following advice for parenting together with different styles.

Make Some Decisions in Front of the Children

It’s OK for you and your partner to disagree respectfully about small matters when the children are around. It's helpful for them to listen to you find solutions together, using calm voices and facts, rather than emotions.

“One thing we need to teach our kids is how to problem-solve when we disagree,” Dunning says. “A lot of kids don't know how to compromise because they don't see their parents doing it.”

Agree to Disagree on Small Issues

You can't control every situation, so learn to accept the fact that things will go differently when your partner is in charge.

“Moms may say, 'No sledding on that hill, ever,' or 'No skateboarding,'” Pruett says. “Dads often allow a little more risk-taking. It's more important for parents to agree about [bigger] safety issues like seat belts and holding hands while crossing the street.”

Support Each Other in Front of the Children

You should know which issues each of you aren't willing to compromise on, like safety and curfew, and agree to be flexible about other issues.

If your partner has made a decision you don’t agree with, let him know in private; don’t disrespect the parent to your child.

“It's very important that parents do not criticize or blame the other parent,” says family psychotherapist Fran Walfish, author of The Self-Aware Parent. “Kids need to know parents support each other, love each other, and are a united team.”

“If Johnny needs to go to bed early, and the other parent thinks, 'I don't agree,' and behind Dad's back says, 'Come out and watch a little TV,' it undermines the other parent's authority to the kids,” Dunning says. “It will cause problems in parenting and eventually the relationship of the couple.”

Be Positive When Kids Question Differences

If your children wonder aloud about your different parenting styles, let them know it’s OK that you don’t agree on everything, and that it may help you both parent more effectively.

Aim for Consistency After A Split

If you and your partner separate, it’s good to maintain some of the same rules in each house, such as homework and bedtime routines. But that’s not always possible, especially if you aren't on good terms with your ex. Remind yourself that you can only control what happens in your household, and make sure your children know what you expect from them.

“It's best for the parents to be honest with the children, saying something like, 'At Mommy's house, bedtime is earlier than at Daddy's,'” Walfish says.

source : Couples With Different Parenting Styles Can Learn to Agree

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H1N1 Flu Spreading in South-Central U.S.

This flu strain tends to hit younger adults harder than older adults, CDC says

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, Dec. 26, 2013 (HealthDay News) -- This year's flu season may be off to a slow start nationwide, but infection rates are spiking in the south-central United States, where five deaths have already been reported in Texas.

And the predominant strain of flu so far has been H1N1 "swine" flu, which triggered the pandemic flu in 2009, federal health officials said Thursday.

"That may change, but right now most of the flu is H1N1," said Dr. Michael Young, a medical officer with the U.S. Centers for Disease Control and Prevention's influenza division. "It's the same H1N1 we have been seeing the past couple of years and that we really started to see in 2009 during the pandemic."

States reporting increasing levels of flu activity include Alabama, Louisiana, Mississippi and Texas, he said.

Young noted that H1N1 flu is different from other types of flu because it tends to strike younger adults harder than older adults. Flu is typically a bigger threat to people 65 and older and very young children and people with chronic medical conditions, such as heart disease and diabetes, he said.

"This year, because it's an H1N1 season so far, we are seeing more infections in younger adults," Young said. "And some of these folks have underlying conditions that put them at risk for hospitalization or death. This may be surprising to some folks, because they forget the population that H1N1 hits."

The good news, Young said, is that this year's flu vaccine protects against the H1N1 flu. "For people who aren't vaccinated yet, there's still time -- they should go out and get their vaccine," he advised.

Flu activity is expected to increase nationwide during the next several weeks, Young pointed out. "We usually see flu activity peak in January and February," he said.

The CDC recommends that everyone 6 months of age and older be vaccinated against the flu.

Over the 30 years from 1976 to 2006, estimates of deaths from all strains of flu in the United States ranged from a low of about 3,000 to a high of about 49,000 people, according to the CDC.

Young said it's doubtful that the H1N1 flu will reach a pandemic level like in 2009. There are several reasons for optimism, he noted.

First, millions of people have already been vaccinated against H1N1 flu, and millions of others have been exposed to it since 2009, he said.

In 2009, the new type of H1N1 flu appeared in the United States for the first time, according to health officials.

For a flu strain like H1N1 to become pandemic it has to "find a group of people that has never seen anything like it before. We don't have that population anymore," he added.

source : H1N1 Flu Spreading in South-Central U.S.

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Concussions Linked to Alzheimer's Risk in Study

Brain scans found seniors with both poor memory and prior head injury have more plaque buildup

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

THURSDAY, Dec. 26, 2013 (HealthDay News) -- Older adults with memory problems and a history of concussion have more buildup of Alzheimer's disease-associated plaques in the brain than those who also had concussions but don't have memory problems, according to a new study.

''What we think it suggests is, head trauma is associated with Alzheimer's-type dementia -- it's a risk factor," said study researcher Michelle Mielke, an associate professor of epidemiology and neurology at Mayo Clinic Rochester. "But it doesn't mean someone with head trauma is [automatically] going to develop Alzheimer's."

Her study is published online Dec. 26 and in the Jan. 7 print issue of the journal Neurology.

Previous studies looking at whether head trauma is a risk factor for Alzheimer's have come up with conflicting results, she noted. And Mielke stressed that she has found only a link or association, not a cause-and-effect relationship.

In the study, Mielke and her team evaluated 448 residents of Olmsted County, Minn., who had no signs of memory problems. They also evaluated another 141 residents with memory and thinking problems known as mild cognitive impairment.

More than 5 million Americans have Alzheimer's disease, according to the Alzheimer's Association. Plaques are deposits of a protein fragment known as beta-amyloid that can build up in between the brain's nerve cells. While most people develop some with age, those who develop Alzheimer's generally get many more, according to the Alzheimer's Association. They also tend to get them in a predictable pattern, starting in brain areas crucial for memory.

In the Mayo study, all participants were aged 70 or older. The participants reported if they ever had a brain injury that involved loss of consciousness or memory.

Of the 448 without any memory problems, 17 percent had reported a brain injury. Of the 141 with memory problems, 18 percent did. This suggests that the link between head trauma and the plaques is complex, Mielke said, as the proportion of people reporting concussion was the same in both groups.

Brain scans were done on all the participants. Those who had both concussion history and cognitive [mental] impairment had levels of amyloid plaques that were 18 percent higher than those with cognitive impairment but no head trauma history, the investigators found.

Among those with mild cognitive impairment, those with concussion histories had a nearly five times higher risk of elevated plaque levels than those without a history of concussion.

The researchers don't know why some with concussion history develop memory problems and others do not.

The research was funded by the U.S. National Institutes of Health, among several other supporters.

The study adds valuable information for experts in the field, said Dr. Robert Glatter, director of sports medicine and traumatic brain injury in the department of emergency medicine at Lenox Hill Hospital, in New York City. Glatter, who is also a former sideline physician for the National Football League's New York Jets, reviewed the new study findings.

source : Concussions Linked to Alzheimer's Risk in Study

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Surgery With Follow-Up Radiation Best for Tongue Cancer: Study

Patients who started with chemotherapy had worse response, researchers say

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

THURSDAY, Dec. 26, 2013 (HealthDay News) -- People with tongue cancer who undergo surgery before receiving radiation treatment fare better than those who start treatment with chemotherapy, according to a small new study.

Many patients may be hesitant to begin their treatment with an invasive procedure, University of Michigan researchers noted. But advanced surgical techniques can improve patients' chances for survival, the authors noted in a university news release.

The study was published online Dec. 26 in JAMA Otolaryngology Head and Neck Surgery.

Nearly 14,000 Americans will be diagnosed with tongue cancer this year and 2,070 will die from the disease, according to the American Cancer Society.

"To a young person with tongue cancer, chemotherapy may sound like a better option than surgery with extensive reconstruction," study author Dr. Douglas Chepeha, a professor of otolaryngology-head and neck surgery at the University of Michigan Medical School, said in the news release.

"But patients with oral cavity cancer can't tolerate induction chemotherapy as well as they can handle surgery with follow-up radiation," Chepeha said. "Our techniques of reconstruction are advanced and offer patients better survival and functional outcomes."

The study involved 19 people with advanced oral cavity [mouth] cancer. All of the participants were given an initial dose of chemotherapy (called "induction" chemotherapy). Patients whose cancer was reduced in size by 50 percent received more chemotherapy as well as radiation therapy.

Those who did not respond well to the first dose of chemotherapy underwent surgery. After surgery these patients also received radiation.

The researchers reported that their study was stopped early because the results were so dismal. Ten of the patients responded to chemotherapy. Of these people, only three were cancer-free five years later.

Only two of the remaining nine patients who underwent surgery after the initial dose of chemotherapy were alive and cancer-free after five years, the researchers found.

After examining a similar group of patients who had surgery and advanced reconstruction followed by radiation therapy, the researchers found dramatic improvements in survival rates and other outcomes, according to the news release.

However, the new findings contradict the typical course of treatment for people with larynx (voice box) cancer, the news release noted. These patients are given an initial dose of chemotherapy to determine whether or not they should proceed with surgery. This approach has led to improved outcomes and survival rates for these patients.

"The mouth is a very sensitive area. We know the immune system is critical in oral cavity cancer, and chemotherapy suppresses the immune system. If a person is already debilitated, they don't do well with chemotherapy," Chepeha said. "Despite the proven success of this strategy in laryngeal cancer, induction chemotherapy should not be an option for oral cavity cancer, and in fact it results in worse treatment-related complications compared to surgery."

Although the study found an association between receiving surgery before radiation therapy and improved outcomes for patients with tongue cancer, it did not prove a cause-and-effect relationship.

source : Surgery With Follow-Up Radiation Best for Tongue Cancer: Study

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Study Questions Value of Common Knee Surgery

Procedure to repair a torn meniscus worked no better than a fake one to ease lingering pain

WebMD News from HealthDay

By Brenda Goodman

HealthDay Reporter

THURSDAY, Dec. 26, 2013 (HealthDay News) -- Improvements in knee pain following a common orthopedic procedure appear to be largely due to the placebo effect, a new Finnish study suggests.

The research, which was published Dec. 26 in the New England Journal of Medicine, has weighty implications for the 700,000 patients who have arthroscopic surgery each year in the United States to repair a torn meniscus. A meniscus is a C-shaped pad of cartilage that cushions the knee joint.

For a meniscal repair, orthopedic surgeons use a camera and tiny instruments inserted through small incisions around the knee to shave damaged tissue away. The idea is that clearing sharp and unstable debris out of the joint should relieve pain.

But mounting evidence suggests that, for many patients, the procedure just doesn't work as intended.

"There have been several trials now, including this one, where surgeons have examined whether meniscal tear surgery accomplishes anything, basically, and the answer through all those studies is no, it doesn't," said Dr. David Felson, a professor of medicine and public health at Boston University. He was not involved in the new research.

For the new study, doctors recruited patients between the ages of 35 and 65 who'd had a meniscal tear and knee pain for at least three months to have an arthroscopic procedure to examine the knee joint. If a patient didn't also have arthritis, and the surgeon viewing the knee determined they were eligible for the study, he opened an envelope in the operating room with further instructions.

At that point, 70 patients had some of their damaged meniscus removed, while 76 other patients had nothing further done. But surgeons did everything they could to make the sham procedure seem like the real thing. They asked for the same instruments, they moved and pressed on the knee as they otherwise would, and they used mechanical instruments with the blades removed to simulate the sights and sounds of a meniscal repair. They even timed the procedures to make sure one wasn't shorter than the other. Patients weren't told if they'd had their knee repaired or not.

"It's a wonderfully designed study, amazing," said Felson.

Both groups improved after surgery. Remarkably, those who'd had the sham procedure reported improvements in pain and function that were nearly identical to those who'd had actual meniscal repairs. Average improvement for both groups ranged from about 20 to 30 points on 100-point pain scales.

What's more, most patients in both groups were satisfied with their results. The study found 77 percent in the surgery group said they were happy with the outcome versus 70 percent who had nothing done, and 89 percent in the surgery group reported improvement in their knee pain compared to 83 percent in the placebo group. Nearly all said they'd be willing to repeat the procedure again -- 93 percent of the surgery group versus 96 percent of those who'd had the fake procedure.

source : Study Questions Value of Common Knee Surgery

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When Your Mom Sides With Your Ex

By Marianne Wait
WebMD Feature

Reviewed by Michael W. Smith, MD

Breaking up is hard to do, as the old song goes. But some of the stress can come from an unexpected source: the loved ones you still want in your life. When Lee (who asked that only her middle name be used), a mother and health care communications specialist from Williamsburg, VA, split from her husband, she nearly lost her mom in the process.

She and her mother didn’t always get along, says Lee, but after the divorce, her mom’s ties with her ex added extra strain. Though it happened years ago, Lee remembers one incident like it was yesterday. Shortly after the divorce papers were signed, her mom got free tickets to the circus.  She took Lee’s 3-year-old son -- and his father, her ex son-in-law. Lee found out after the fact, from the excited toddler.

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“I felt hurt. Then I felt angry,” says Lee. “I’m not saying I’m a better person than [my ex] or anything, but I’m her daughter. Inside I felt that she should always be taking my side.”

It’s not unusual to feel betrayed by the people close to us post-divorce, says Judith Margerum, PhD, a clinical psychologist.

“Divorce is a very significant event in your life. It affects people’s self-esteem, their sense of who they are.” And when a loved one appears to choose sides, Margerum says, “that’s a wound on top of a wound.” 

Friendships can suffer. One study suggests that women can lose up to 40% of their mutual friends after a divorce. Some people stay loyal to the person they were friends with first. Some couples don’t know how to include a single person in their social mix, says Marie Hartwell-Walker, EdD, a marriage and family counselor.

Friendships also fizzle for practical reasons.  “Sometimes it’s just too hard for a third party to stay friends with both because there are only so many hours in a day,” Hartwell-Walker says.

Tips for Coping

To survive a breakup with most of your relationships intact, experts suggest these strategies.

Be realistic. While it may be tempting to ask family and friends to drop contact with your ex, you don’t have that right. “You can’t legislate other people’s relationships,” says Hartwell-Walker. “It’s important to not expect everyone else to fall in line when either you like someone or you don’t.”

Set appropriate boundaries. You can’t ask people to stop seeing your ex, but you can tell them you don’t need to know when he or she gets a new job or starts dating someone new.

Don’t take it so personally.  The truth is, it’s not always about you, Margerum says. Instead of thinking, "If my mom has a relationship with my ex, she doesn’t care about me," think, "They’ve been friends for 20 years."

source : When Your Mom Sides With Your Ex

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Clearing Away MS Brain Fog: Understanding It, Learning to Focus

By R. Morgan Griffin
WebMD Feature

Reviewed by Arefa Cassoobhoy, MD, MPH

If you have MS, you may have had bouts of brain fog. You’re having a conversation, and suddenly you can't remember the right word -- or the wrong words come tumbling out of your mouth. You're cooking dinner, the timer's going off, but you can't remember why you set it.

When brain fog clouds your thinking, you're bound to feel frustrated and maybe embarrassed. With your doctor's help and some new techniques, you can learn ways to work around it.

4 Brain Fog Basics

Brain fog is a catchall term for all sorts of brain changes that can come with MS. Here are four things to know.

1. It's common. About half the people with MS experience these issues at some point, says Rosalind Kalb, PhD, a clinical psychologist and vice president of clinical care at the National Multiple Sclerosis Society. For most, the cloudy thinking is mild and manageable. Only 5% to 10% of people with MS have issues with their thinking that seriously affect their day-to-day life or career.
2. It can affect your short-term memory, attention, and concentration. It can muck up your ability to retain new information and plan.But it doesn't usually affect your intelligence, reading comprehension, or long-term memory.
3. It may get worse over time, but it may not. Once you have episodes of brain fog, they usually don't go away completely. They are more likely to progress slowly.
4. It can have many causes. Sometimes the fog is triggered by actual changes in the brain caused by MS. But it can also be brought on by other issues -- like depression, fatigue, and side effects from medication.

Tips for Managing Brain Fog

Pinpoint the cause. Talk to your doctor. You could have an underlying and treatable condition -- like depression -- that's to blame for your fuzzy thinking. Medications for bladder problems and difficulty sleeping can also leave you foggy, says Cindy Richman, senior director of patient and health care relations at the Multiple Sclerosis Association of America.

Get organized. If your memory is unreliable, stop relying on it. "You really have to replace your memory with organization," Kalb says. Get in the habit of writing everything down.  

Have a family calendar. Hang it in the kitchen or another central place where you and the rest of your family will see it many times a day. "Everyone in the family from age 6 or 7 and up should be responsible for adding to it," Kalb says.

Use tech. Your smartphone can be an ally. Try out MS-specific apps as well as alarms to keep you on track. You can set reminders to go off right where you need them -- like the supermarket or drugstore.

Cut down on distractions. Brain fog can make it harder to filter out background noise and other things that can take your attention. So if you need to concentrate on a task or conversation, turn off the TV or go to a quiet space.

source : Clearing Away MS Brain Fog: Understanding It, Learning to Focus

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