Health communication about BONIVA

August 25, 2012

“BONIVA has not been proven to stop and reverse bone loss in 9 out of 10 women and is not a cure for postmenopausal osteoporosis” [http://www.stategazetteftp.com/mags/parade/Pg_07.pdf]. This message has appeared in numerous magazines and newspapers. Have you seen or heard it?

I wonder how Sally Field feels about that. She appeared in ads to endorse the product and she read the script that said the research had shown that BONIVA reversed bone loss… I will track down the research and see if we can find what the published research really found. For now, I am reflecting on how many of us heard Sally’s ad versus how many of us have seen or read about the FDA’s retraction. And I am enjoying having the strength, including my bones, to pick up my 4 year old grandson and wrestle him into my lap for a family gathering at a restaurant after church on a warm Sunday afternoon.

Health communication and forest therapy…is this a case of country mouse vs. city mouse?

August 22, 2012

One of my sister’s brought to my attention some research about ‘forest therapy’. I read the article she sent me and was pleased to find that basking in the surroundings of a forest was reported to have positive benefits for human health. I would have to say that I didn’t need any justification for spending time in nature any opportunity that I get, but it was a nice thought to justify my own love of nature.

And then I decided to go on a hunt for the research. Alas, as is too often the case, there was no mention of the actual publication in the news report and so I had to go in search of the research. On PUBMED, I was able to find research on ‘forest therapy’. Sadly, the most recent article–published in the past several months in 2012, is a meta-analysis that examined all previously published articles and concludes that there is no evidence from which to draw conclusions about the effects of forest therapy [see http://www.ncbi.nlm.nih.gov/pubmed/22888281]. The authors conclude that, “Because there was insufficient evidence on forest therapy due to poor methodological and reporting quality and heterogeneity of RCTs, it was not possible to offer any conclusions about the effects of this intervention. However, it was possible to identify problems with current RCTs of forest therapy, and to propose a strategy for strengthening study quality and stressing the importance of study feasibility and original check items based on characteristics of forest therapy as a future research agenda.”

Alas, I remain steadfast in my belief that forest therapy, spending time walking and living and breathing in forest environments, sustains me. But I have at least one very good and close longtime friend who would not agree with me. She basks in the bright lights and fast pace of locations such as New York city in December. That, in fact, was one of the challenges associated with the research. There are unpleasant forest setings that no one would want to spend time in, so not all forests are created equal. And there has to be a great deal of individual variance related to preferences in this regard. Perhaps it is more important to communicate that each of us should take time to identify what environment and setting gives us the most calm and promotes our well-being. And then find time to bask in it.

Restless legs syndrome, summmer heat, and too little of an important thing–salt

July 28, 2012

It is summer time and the heat is overwhelming. Here I am with my niece and granddaughter at the Springfield, Missouri zoo. And we are…hot!

It was so hot going across the midwest to get to our family reunion that the rubber gasket that frames our windshield…melted!

Still, when I returned, it was cooler… 90s instead of 108. I got back to my garden trying to be sure that it would survive the heat and I would have tomatoes and peppers. So for three days in a row, I worked half a dozen hours in the morning and late afternoon. And then I ran out of steam. I drank a lot of water while working outdoors but it still felt like I was dehydrated. Alas, I was. Because I skimp on salt and had been sweating like crazy.

So, I bought a bag of my favorite only eat them at times like this snack chip–FRITOS. And I got some salt back in my system. It helped with muscle contractions, energy, and my restless legs at night.

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Restless Leg Syndrome

Low levels of sodium are also linked to muscle contractions related to the medical disorder known as restless leg syndrome, according to Digitalnaturopath.com. One method of dealing with sodium’s role in this medical condition is making sure the ambient air temperature is comfortable enough to keep you from sweating during the night which causes you to lose sodium. Sodium supplements to treat muscle contractions causing restless leg syndrome should only be considered if your natural intake of sodium is low” [http://www.livestrong.com/article/487350-sodium-and-the-muscles/]. Phewwwwww.

The many uses of the word ‘evidence’: PREVENTION magazine

July 27, 2012

There are few things that frustrate me more than reading advice about health that says, “Based on the evidence…” but there is no reference to who conducted the research or where the research was published or when. I find this to often be the way that Prevention magazine writes about “evidence”. Sometimes, the report or story will include just enough information so that I can search online and find something that seems to be the basis for the claim being made. But I was catching up with some reading in Febrary, 2012 Prevention magazine, and p. 32, there begins a list recommendations for ‘heart health’ with each one including the capitalized subtitle in all caps: THE EVIDENCE. Reading about eating oranges, the article explains that “new research shows…citrus pectin helps neutralize a protein called galectin-3”. I searched PUBMED and googlescholar but could not find the ‘new evidence’. Several sentences later, it says “A 2009 study showed that a diet high in fruits and vegetables decreased the risk of heart failure by 37%”. There were a lot of studies published in 2009. Which one? Decreased risk by 37% for whom–people with high risk of heart failure, older adults, the general population, men, women? Help us out here. Tell us who did the research, where it was published, when, and something about the participants in the study. Communicate about health to increase health literacy…

Health communication and water

July 20, 2012

Are you fearful of being labeled ‘difficult’?

June 12, 2012

I am trying to imagine how my medical doctors perceive me. I tend to ask a lot of questions. I even bring — surprise surprise — information to an appointment and want to discuss it. I find that asking questions and sharing information leads my doctors to use vocabulary with me that I don’t understand and have to ask to have explained. And I am OK with that. But I cannot remember a time when I worried that my doctor, or my childrens’ doctors, or doctors treating my husband would label me ‘difficult’ because I asked lots of questions. But others do have these concerns.

A study published in Health Affairs conducted by Dominick Frosch and collaborators used focus group discussions to learn what barriers limited efforts to share decision-making with their doctors. They learned that participants wanted to be more involved in considering treatment and care options, but concerns that doctors would label them ‘difficult’ kept them from doing so. This suggests to me that doctors may need to make more explicit efforts to invite participation in shared decision-making, thus reducing the perception that participation will make an unfavorable impression.

Read more at: http://content.healthaffairs.org/content/31/5/1030

Applause applause for Disney and ban on junk food ads for cartoons

June 11, 2012

Disney has decided to ban ads for junk food when it comes to kids’ cartoons. That’s some good news when it comes to media exposure and kids’ learning product names. The bad news is that it won’t take effect until 2015. Wow. Why? Contracts?

Read more in the AP story here: http://www.registerguard.com/web/business/28184338-41/disney-ads-junk-ban-sugar.html.csp

Who told me about glutein for eye health?

May25, 2012

After a brief hiatus to complete those piles of undone tasks [which are still not all complete but I’m making progress!], I wanted to share how communicating about health in my family may have helped my vision. I use ‘may’ because it appears to be the case, but I am not a medical doctor and can only tell you my personal experience–with a focus on how talking about health worked in this case.

First, setting the stage, I have low vision. For those of you who have low vvision, you know what this means. For others, it means that limits related to my ability to see are significant. For example, I cannot drive… I see a low vision specialist at least every six months and more often if I feel the need based on some symptom. At any rate, in addition to impaired peripheral sight in both eyes and practically no vision in the left eye, at the last visit–my low vision doctor announced that a cataract had begun to develop. And it was in my so called ‘good’ eye. When I told my parents, my dad asked me if I was taking Lutein. He takes it for his vision. So this family conversation started me on a path.

I looked online at google scholar and found quite a few published scientific articles about cataracts and lutein. Here is a link to one example: http://www.nutritionjrnl.com/article/S0899-9007(02)00861-4/abstract I went to Wal Mart and found lutein in the 20 mg size with zeaxanthin…which some studies specifically mentioned as being important with lutein. I took it 3 or more times each week. And this week, my visual acuity was significantly improved and the start of the cataract waas reversed…not there. Hmm. Sure am glad I talked to my dad…

Interestingly, the doctor wanted to know what I was doing differently because the change was a positive and clinically significant one. I told her. And she said, ‘the National Eye Institute at the National Institutes of Health have found that taking lutein improves eyesight…” She went on with more details but I was lost in the thought that ‘she knew this but she didn’t tell me. My dad told me…’ I have several follow-up questions for the doctor but did not ask them at the time. Why didn’t she tell me? Did she doubt the results? Did she think I wouldn’t take the supplement? She could’ve advised me to eat more fruits and vegetables with the lutein and zeaxanthin. I do eat a lot of these though and probably wouldn’t have changed my eating habits. Brussel sprouts is included in this list, as well as some others. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1722697/

But in the end, she didn’t say anything. I sure am glad my dad did…

Health communication and Dr. Oz’s message about paraben

May 1, 2012

I am in the midst of final exam week and grading. In the background, Dr. Oz started talking about ‘paraben’ and how it acts as an estrogen. I am always on the alert for these kind of messages. Hormones, research, cancer, blood clotting… these all came to mind. I got up from the computer and went to listen carefully. And then I went to my bathroom. My shampoo have five kinds of paraben in it. My two different types of body lotions had multiple forms of paraben as well. I got rid of them. Trash. Not a moment’s hesitation.

Why? Well, one of the facts Dr. Oz shared is that in one research study, 19 of 20 women diagnosed with breast cancer had significant levels of paraben in their breast tissue. I will hunt down the research and share it soon. For now, here is a summary of content from Dr. Oz with the link to the story at the end:

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Flushed Away

We all know about industrial pollution and climate change, but there’s a new threat to the environment much closer to home – pharmaceutical and personal care product pollution (PPCP). Experts are increasingly worried that marine life across America is showing us the harm it’s doing to our planet and ourselves.

What’s Happening to the Environment?

In river basins around the country, the United States Geological Survey has found fish with both female and male sex organs. Intersex frogs are also popping up all over. And experts have found evidence of chemicals called endocrine disruptors, such as atrazine (an herbicide) and Bisphenol-A (BPA) in the country’s water supplies.

What are Endocrine Disruptors?

These chemicals alter the actions of hormones in our body, which can hurt us in 2 ways. First, they can block our hormones from acting as they normally would, and, secondly, they can act like hormones triggering effects that may include early onset puberty in adolescents.

What’s Happening to Us?

Breast cancer rates are increasing, girls are entering puberty earlier, sperm counts and testosterone levels are falling drastically, and certain genital abnormalities are on the rise.

What Should We Watch Out For?

Though the evidence is not definitive, experts fear that products we are introducing into our environment could be to blame, and they are urging us to decrease the use of certain chemicals. Here’s what to look for:

Bisphenol-A (BPA)You may have heard about BPA, the chemical used to make hard plastics, line cans, and create carbonless receipts. It’s proven to raise the risk of breast cancer in rats and the FDA has raised an alarm about the potential harm BPA can cause; Connecticut even banned its use in children’s products.

Ninety-three percent of us have BPA in our bodies. We live with it, and we excrete it when we go to the bathroom, sending the chemical into the environment.

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Phthalates

These difficult-to-pronounce ingredients help fragrance linger on the body after you have applied a lotion or body cream to your skin. They’re also found in toys, floor coverings, detergent, soaps, nail polish, and shampoos. Unfortunately, they mimic the hormone estrogen and have been linked to reproductive problems in rodents, such as lower testosterone and fetal malformation. Often they are not listed on beauty products, so the best rule of thumb is to avoid any products with fragrance.

Parabens

Found in moisturizing shampoos and body lotions, parabens are the most widely used preservatives in the beauty product industry, and they also act similar to estrogen in our bodies. One study found parabens in the breast cancer tissue of 19 out of 20 women studied; experts worry there could be a connection.

Use these chemicals as a litmus test for a healthy product. If you see them listed on the label (often as methylparaben, butylparaben, or propylparaben), it shows that the manufacturer is not concerned about limiting exposure to potentially harmful chemicals.

Leftover Prescription Medicine

The medication we take ends up in our water supply in 1 of 2 ways. We secrete it in our urine (which we can’t control), but many of us also flush unused medication down the toilet, contributing to the rising amount of pharmaceutical pollution found in our water supply. In 2008, the Associated Press found that dozens of pharmaceuticals end up in our water supplies, and eventually, in our tap water. That’s because water treatment plants are designed to neutralize biological hazards, such as bacteria, but not pollutants such as antibiotics. Scientists are now discovering bacteria in the wild that are not only resistant to antibiotics, they can actually live off them.

What Can You Do?

Drink water from stainless steel bottles
Avoid plastics with the numbers 3, 6, and 7 on the bottom
Never heat plastic in the microwave (even if it says it is microwave safe)
Choose frozen and fresh produce over canned
Use BPA-free baby bottles
Avoid any products that contain fragrances; opt for those that get their scent from essential oils
Stay away from parabens
Choose products that are paraben- and phthalate-free
Dispose of leftover medication by throwing it in the trash with coffee grinds or cat litter (to keep harmful medications from being picked from the trash), return the unused portion to your pharmacy, or go online to find your local hazardous waste disposal facility.”

http://www.doctoroz.com/videos/flushed-away?page=2

When is disclosure of a medical test result an obligation?

April 17, 2012

What does it mean to be a public figure like Warren Buffet? It seems that it includes a feeling of obligation to inform the public of medical test results. Which is what he did today. In a way that reflects hope and action. His message is a good example of talking about health.