May 12th, 2014 | The Blog
Midwives have been doing it for decades. That is, delivering babies in water to ease birth pain and speed up the delivery time.
This practice is called aquatic labor. It is not considered a standard choice but, rather, an alternative birthing method.
A woman who is pregnant needs to make a choice about her delivery options, given that it is expected to be a normal delivery. Her options include:
The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) report that there is scant scientific information about underwater births coupled with several reports of near drowning over a ten-year span, which keep this birthing option from becoming more common.
While water births are increasing in popularity, there is no accurate count of the number of babies born via this method in the U.S
According to water birth supporters, these are the benefits:
There are the skeptics who list the following as detriments of a water birth:
Pro or con, there are certain guidelines established for a water birth that must be followed to safely delivery the baby. They include:
Where Can a Water Birth Take Place?
A water birth can take place at home, in a birthing center or in a hospital. The delivery can occur in a bathtub, hot tub with temperature turned down or any other pool of water.
In a hospital setting, there are medical care devices like an underwater Doppler to monitor the fetal heartbeat and also the option to have an intravenous (IV) inserted to receive medication as needed.
Who Should Be Excluded From This Birthing Option?
There are certain populations that should not attempt aquatic labor. They include:
A Compromise for Now
Some researchers agree that sitting in a tub of warm water during the early stages of labor can be beneficial in easing a woman?s pain. There needs to be more research done to determine if actually giving birth underwater has enough benefits and few enough risks to allow it to be a recommended method of giving birth, rather than an alternative option.
So for now, laboring in a warm pool of water can be beneficial but a woman should discuss the risks and benefits of actually delivering her baby underwater before making the final decision.
May 5th, 2014 | The Blog
Everyone has heard of the 5-Second Rule. Is it really true? There are scientific study results dealing with this dropped food issue.
The famous 5-Second Rule states that any food dropped on the ground is okay to eat if it has been there for five seconds or less.
5-Second Rule Facts
The popular Mythbusters group proved in the past that bacteria could be transferred to dropped food in as few as two seconds. This remains a fact, in some cases, but other groups, which offer some interesting information, have done further studies.
Another group at Ashton University School of Life and Health Sciences in England have come up with the following. They studied the transfer of E. coli and Staphylococcus aureus from the floor to the dropped food in three to thirty seconds.
There were several important variables in the study:
Who Follows (or not) the 5-Second Rule?
Interestingly, the majority of Americans already follow the 5-second rule, scientifically proven or not. Here are the numbers:
Here is a real truth, the population is more likely to eat a dropped cookie or candy but not so much, dropped cauliflower or broccoli.
Bacteria, including E. coli, are everywhere, which can cause foodborne illnesses like fever, diarrhea and flu-like symptoms. These illnesses can present within 24 hours and up to a week after exposure. With the time of onset varying so much, many people do not relate a 5-Second Rule food drop with an illness that occurs up to a week later.
Foodborne illnesses are not usually serious for the majority of the 76 million Americans who suffer from them each year. But, there are some serious cases, according to the U.S. Centers for Disease Control and Prevention (CDC).
Annually, about 300,000 of the affected public are hospitalized and 5,000 die from such an illness. The deaths are most common among young children, elderly and those with a weakened immune system.
The Bottom Line
Here are a few final thoughts and scientific findings about the 5-Second Rule:
There is no guarantee that there are no bacteria on dropped food. There will always be that risk. So, the longer the food is on the floor, the more bacteria it will attract.
The best advise: eating a piece of toast off of a carpeted surface is the safest choice. The 5-second rule is real.
April 28th, 2014 | The Blog
Everyone and everything dies, eventually. That is the reality of life itself.
What does it mean to die? How many people actually discuss their feelings about death with loved ones and friends? The subject is uncomfortable to discuss but help is available.
People need to talk about death.
Death Cafe Origin
The concept of a death cafe started in England in September 2011. John Underwood, a self-appointed death entrepreneur, hosted the first cafe. He based the gathering on an idea of Bernard Crettaz, a Swiss sociologist, who stated that talking about death leads to authenticity. Moving forward with the concept, John Underwood says that, death cafes exist because of a belief that more authenticity is needed in the world. Death denial is an omnipresent feature of Western consumer capitalism.
The general feeling is that the more death is discussed, the more fully a person can live without fear. The fear of death leads the present culture to turn away from aging and live in a youth obsessed world.
The idea and development of death cafes is slowly spreading across the U.S. Awareness is spreading on the Internet, especially at? www.deathcafe.com
Death Cafe Concept
The basic concept of a death cafe includes the following points:
Attendees are split into groups of 5 to 8 people. They talk for several hours. Facilitators circulate and listen to the ongoing conversations. If a participant is identified by the facilitator as needing further counseling, they are given information about where to seek more help.
Some participants are those who have survived cancer, other serious illnesses or those who have had brushes with death. If their family members do not want to talk about death with them, a death cafe offers an outlet to openly talk to others.
Participants are people of all ages, usually more women than men, aging baby boomers, children who need to talk about grandparents death, those who are working or retired and beyond.
The purpose is to get people to talk about death so they are not afraid when the time comes, either for themselves or those they love.
Cafe topics vary. Some popular topics, which are discussed at death cafes include:
Why Eat Cake at the Meeting?
Eating is a life-sustaining process so eating cake at the death cafe is important. It makes things normal.
It is important to note that death cafes offer an opportunity for discussion about death but are not meant to provide grief or personal counseling or act as end-of-life planning sessions.
The Future of Death Cafes
There is an Association for Death Education and Counseling (ADEC) in the U.S., that is an information resource about death cafes.
Currently, there are about 560 death cafes throughout the world. They are in 40 cities in the U.S. The concept of death cafes is spreading but will take some time.
Most people envision dying in a comfortable setting, surrounded by family members and friends. They want to be grateful for the life they lived and thank those who shared their life. They do not want to be lying in a hospital bed, filled with tubes and hooked to a respirator. They need to talk about death, what it means to them and how they want to face it head-on. Death cafes are the vehicle for such a discussion.
April 21st, 2014 | The Blog
Cardiac pacemakers save lives. That is a fact. The traditional cardiac pacemaker is placed in the upper left chest with wires or leads threaded into the heart, where the pacing occurs. The traditional device is a visible and palpable under the skin on the chest wall.
All that is about to change with the debut of the newest, smallest pacemaker, Medtronic’s Micra Transcatheter Pacing System (TPS). This new device will change the world of the cardiac healthcare industry.
The Specifics of the Device
The Transcatheter Pacing System is small, in comparison to the traditional device. It is 1/10th the size of a traditional pacemaker or about the size of a nickel or 5-cent coin. The new device is an all-inclusive, one piece system with no generator or traditional wires or leads. It has a long, 10-year, battery life.
The new pacemaker is implanted through the femoral vein via catheter and is placed inside the heart.
The Benefits of TSP
There are many benefits to the new cardiac pacemaker, which include some of the following:
How the Device Works
The TPS is placed inside the heart via a femoral vein catheterization. The tiny pacemaker attaches onto the endocardial tissue or heart wall with tines. It can be repositioned within the heart, if needed.
Pacing signals or the delivery of electrical impulses that pace the heart rate are sent through the electrode tip at the end of the implanted device.
The End Result
The Medtronic?s Micra Transcatheter Pacing System brings implantable cardiac devices to a whole new level. Both the patient outcomes and device efficiency are significantly improved with this cardiac device update and new technology.
April 14th, 2014 | The Blog
Getting a new printer has just gone to a whole new level. The 3-D printer can make wonderful arts and crafts projects but it can also produce so much more. That so much more has to do with life-changing health issues.
3-D printing, also called additive manufacturing, is changing the medical world in several ways. The printed objects are used in real time and also used as prototypes for practice and to fine-tune upcoming complicated surgical procedures.
3-D Printing Explained
3-D printing technology and uses have dramatically changed and multiplied over the past several years. The high-resolution, plastic 3-D models, some of which provide down to 16 microns accuracy or the size of a miniscule droplet in a cloud, are works-of-art.
Since a variety of materials can be used to mimic the different structures in the body like bone, skin and blood vessels, the 3-D printer has many applications. The 3-D renditions are printed from a patient’s computed tomography (CT) scan images. This helps to capture the unique anatomy of each patient.
Who makes 3-D printers?
There are several companies who provide this 3-D capability with their product. Two popular manufacturer options include:
There are also companies, such as Shapeways, from which a client can order completed 3-D printing services.
How It Works
The actual 3-D printing is done this way:
Benefits of the 3-D Printer
There are many uses and benefits for 3-D printing. They include:
Some healthcare facilities are making 3-D printed models as standard protocol for every patient being treated in their clinic. This is especially popular in cerebrovascular surgery centers. Many physicians call this capability the cutting edge of neurosurgery. It makes impending surgery safer and minutely accurate.
The 3-D printer has been used for many different things, some of which include:
A Supported Windpipe
A population of babies have benefited by 3-D printing. Fragile, underdeveloped windpipes are supported by a flexible, plastic 3-D splint to hold the airway open until it is strong enough to work on its own.
A Look at the Prosthetic Hand
A prosthetic hand is exorbitantly expensive, especially as a child grows and the hand needs to be adjusted to their changing body size. Depending upon the quality of the prosthetic, the cost can be $10,000-$80,000. Many patients cannot afford the cost.
Out of financial necessity, the dad of a young son became inventive and created a $5.00 prosthetic hand. The $5.00 covers the materials to actually print the hand. Then, add on $150 in other necessary parts. This is still a real bargain, thanks to their MarkerBots 3-D printer. Every new hand requires 3 or 4 printings, each of which takes one to two hours to print. Each new version of the hand has better capabilities.
There is a website called www.thingiverse.com, where there are designs for toys, mechanical parts and medical devices in the 3-D printer world. This is the cutting edge of the future in some medical fields.
April 7th, 2014 | The Blog
So, you are with a patient, friend or family member or caring for a patient when they get the news. They have cancer. It does not matter where the cancer is located or what stage of cancer the doctor tells them. The fact is that, they have cancer. What now?
A patient’s response to getting the news of a newly diagnosed or recurrent case of cancer varies but is most often not a happy one. No one ever wants to hear those words.
A group of breast cancer patients being treated at Massachusetts General Hospital, in Boston, MA, recently participated in an online survey to discuss their emotional response to receiving the news that they have the dreaded disease. Their participation has brought this survey option to light.
Cancer Patient Registry
The online survey is called the Cancer Experience Registry. The link to the site is: https://csc.cancerexperienceregistry.org.
A non-profit patient advocacy organization, the Cancer Support Community, manages the registry. The site has been up and running for nearly one year. There are over 6,000 cancer patients registered in the national registry.
Personal information from the survey is not publicly shared. Researchers analyze the information and the general results are shared with the medical professionals caring for cancer patients.
The hope is that the information from the surveys will provide the healthcare community with information about where in the cancer care process there is a lack of patient support and information.
The purpose of the registry is to encourage cancer patients to share their personal experiences with cancer.
The survey takes each patient 30 to 45 minutes to complete. The questions posed to the patient include information about:
The Cancer Experience Registry site plans to add a caregiver’s section by June 2014. This will add another and very necessary dimension to bettering the care of cancer patients.
The Survey Outcome
The three main results, so far, show the following:
The registry will ultimately benefit the greater community of cancer patients and survivors. The information collected will serve to give healthcare providers the data they need to improve the overall physical and emotional well being of their patients. Questions that are not asked in a routine office or clinic visit are found on the survey. This survey goes beyond the routine clinical questions and looks at the personal and emotional aspects of a cancer diagnosis.
March 31st, 2014 | The Blog
As the Major League Baseball (MLB) season ramps up, the baseball world is evaluating and tweeking the nutrition status of its players. You are what you eat, or that is what they say.
Let’s take a look at what the sports nutrition experts, specifically those working with the Boston Red Sox, suggest for the pros. There are a few simple and valuable lessons to learn.
First, the main do not’s:
Now, the main to do’s:
The MLB has a pretty strict policy of what is allowed, with regard to nutrition supplements. Allowable supplements must be stamped with NSF International’s NSF Certified for Sport Program seal. This guarantees that the product was tested and does not contain any banned substances.
While the public sector need not be quite as vigilant about the MLB nutrition rules and suggestions as the players, it is wise to follow their healthy and substance-free choices. The general philosophy is this: the best way to get nutrition, specifically vitamins and minerals, is through fortified foods, not supplements.
The MLB nutrition team offers these relatively simple and healthy diet tips:
The end result of eating fresh fruits, fresh vegetables and nuts, according to the MLB nutrition specialists is:
With the baseball season close to starting, aka Opening Day, perhaps the fans should also take an important lesson from the sports nutrition specialists who guide the players of America’s favorite pastime. Make the right food choices and eat healthy. Play Ball!
March 24th, 2014 | The Blog
Menopause is the end of a long hormonal journey for women. At this time, menstrual periods stop. This transition is accompanied by some other physical changes of the body and their associated, and sometimes bothersome, symptoms.
Once menstrual periods stop for one full year, a woman is considered to be post-menopausal. How do women get to the other side of menopause? Every woman experiences different symptoms, which can include:
How to Deal With the Symptoms
Here is a look, one-by-one, at each aforementioned menopausal symptom and how to deal with it.
First, keep track of what might initiate an episode; write it down. Does caffeine, stress, alcohol or an overheated room set off a hot flash. Take slow, deep breaths, in through the nose and out through the mouth to help a hot flash pass.
A typical hot flash during the night can last about 3 minutes. If night sweats are becoming routine, switching to lighter PJs will help. A lighter blanket and a tabletop fan will also help reduce the frequency of the episodes.
There are a few ways to increase and enhance sleep. Meditation, including yoga and tai chi, can help with relaxation. Regular exercise helps but be sure to stop exercising 3 hours before bedtime. Drinking warm milk, which contains tryptophan, induces sleep.
If it is hard to fall asleep, get out of bed and read until sleepiness sets in.
There is one do not that affects sleep: skip any alcohol before bedtime. It actually causes sleeplessness later on in the night.
Menopausal hormone changes cause the vagina to become dryer and develop a thinner wall. This can result in painful sex. Water-based, over-the-counter vaginal lubricants can help. There are also prescription-strength hormonal vaginal creams and rings that can be used.
More frequent sex increases the blood flow to the vagina, which also helps reduce the overall complaints.
This is a common symptom of menopause. Making time for sex, amid everyone’s busy life and schedule, will help. Discuss the issue with a physician to rule out any other physical causes.
There has been a link found between bad PMS (premenstrual syndrome) and more severe mood swings during menopause. Low dose birth control pills (BCP), antidepressants and other medications can help relieve the symptoms.
Migraines can increase during menopause or appear for the first time. Keeping a diary of what triggers a headache can help to avoid or, at least, relieve them. Some common triggers include: hunger or lack of sleep.
A woman?s hair can shed or thin faster during menopause. That is a bad enough consequence but hair can also appear in unwanted places. Some women find hairs on their chin or cheeks. A few things can be done to try and preserve hair: use hair color without harmful chemicals and avoid the sun, which causes drying.
Facial hair can be bleached, plucked, waxed or lasered away.
Using gentle, oil free face products, including moisturizer, sunscreen, cleansers and make-up, will pamper aging skin.
Interestingly, women who experience more hot flashes also report more memory issues. It is important to challenge the brain function to keep it sharp. Lowering the stress level can help curb mental fogginess and fuzzy thinking.
It is important to discuss any long-term menopause-related concerns with a physician.
March 17th, 2014 | The Blog
Atrial fibrillation affects 2.3 million Americans. There are 200,000-300,000 new cases of atrial fib diagnosed every year in the U.S. An estimated 12 million people will be diagnosed every year by 2030. Why the spike? Simply stated, the rate of obesity in America.
Atrial Fibrillation 101
Atrial fibrillation is a cardiac arrhythmia, which translates into an irregular heartbeat. The two upper chambers of the heart, the atria, beat in a fast, disorganized and irregular manner. It is an electrical conduction problem.
Atrial fibrillation symptoms vary among patients but most commonly include some of the following:
This arrhythmia usually delivers uncomfortable physical symptoms for the sufferer. It also increases the risk of stroke and other cardiac problems.
The U.S. Centers for Disease Control and Prevention (CDC) consider the body-mass index (BMI) to be a good indicator for overall weight management.
Atrial fibrillation is greatly impacted by body weight. The newly recognized body weight risks, specifically the person’s BMI, revolving around atrial fibrillation include:
Interestingly, there is a 4% to 5% increased risk of atrial fibrillation for each 1-point increase of a person’s BMI. Clearly, being overweight has an impact on the function of the upper chambers of the heart.
Obesity also increases general inflammation in the body, which can cause thickening of the wall of the heart. This leads to less efficient heart function and an increased risk of developing atrial fibrillation.
Overweight people suffer from sleep apnea, hypertension or high blood pressure and metabolic syndrome. These factors each increase the risk of developing atrial fibrillation.
Other risk factors for developing atrial fibrillation include:
The Treatment for Atrial Fibrillation
Popular treatments for atrial fibrillation include medications, electr0-cardioversion and/or a cardiac ablation procedure.
The newest treatment recommendation for atrial fibrillation is, depending upon the person’s BMI:
Lose an average of a little over 30 pounds
Many people who lost a significant amount of weight while awaiting an invasive ablation procedure never had to undergo the procedure. The weight loss was treatment enough to control their irregular heart rhythm.
Strict weight management resulted in a five-fold decrease in atrial fibrillation episodes. It is important to note that some people with atrial fibrillation are intermittently in the arrhythmia while others are constantly in the irregular heart rhythm. There were fewer and less severe episodes of atrial fibrillation reported by those patients who lost significant weight.
Patients who lost weight are less likely to need further procedures like an ablation to control atrial fibrillation.
Weight management, exercise and good nutrition are the basics of a generally healthy lifestyle. The addition of an atrial fibrillation diagnosis is a valid reason to imminently work on the weight management.
March 10th, 2014 | The Blog
Lice. The word scares every parent, teacher and school nurse. In the big picture, what does it really mean?
Parents feel a true sense of embarrassment when they get that call or note from the school nurse stating that their child or some other child in the class has lice.
The tiny glossy lice eggs embed in the hair along the scalp surface. Most schools have a no-nit policy. Let the lice removal or picking begin.
One-third of cases with nits, when left untreated, continue on to have an issue with lice.
The Current Treatment
Most lice-treating products involve an initial shampoo treatment followed by a second medicated shampoo one week later.
The New Recommendations
Head lice pose no health threat to the individual, according to public health experts. The new thought is that a no-nit policy is unnecessary.
The American Association of Pediatrics (AAP) has voiced concern about young students unnecessarily missing a week or more of school under the current no-nit policies. The AAP has worked at getting schools to adopt the new, more liberal policy for over ten years.
The AAP makes their point about getting rid of the current school lice policies by stating that checking for lice on every child is futile. Schools do not routinely check for strep throat or chicken pox, both of which are more dangerous than lice.
Some school systems have taken the new recommendation and discontinued the no-nit policies. How are lice findings handled?
Recent statistics show that about 60% of childhood head lice are resistant to over-the-counter chemical treatments, according to the New England Journal of Medicine.
Lice do respond to the newer treatments available, many of which are prescription strength. Malathion or Ovide is one such lice treatment. Unfortunately, many health insurance companies do not cover these treatments and they are costly, about $100 for a usual course of treatment.
Some health insurance companies require a child to undergo the readily available over-the-counter treatment before they will cover a prescription strength treatment. If lice survive the OTC treatment, some insurance companies will then pay for the prescription.
The Bottom Line
The earlier the treatment for lice begins, the more effective and the easier the situation is to control. Vigilance is a key factor. Parents should screen their children regularly, about weekly, for lice. Young children can be readily checked during bath time or when their hair is being combed or braided for school.