Health Meditations

17 Suggestions for the Health-conscious Host

The Christmas season is here.  You may be planning a family dinner or a gathering of friends and co-workers.  With a little planning and effort, you can bless your guests with health-friendly festivities so they can feast and stay fit.  Here are 17 suggestions to help you be a health-conscious host:

1. For a buffet dinner, use smaller plates.
   Providing your guests with large dinner plates will make it easier for them to overload and overeat.  If the plates are smaller, your guests will take smaller portions.

2. For a buffet dinner, do not make the food the center of attention.
   Put out an attractive mouthwatering spread, but have an even more eye-catching center piece or conversation piece at the opposite end of the room, like the Christmas tree or an animated Christmas village.  Your guests probably won’t make a second trip to the buffet table if their attention is focused elsewhere.

3. For a buffet dinner, arrange the seating so that guests will have their backs to the buffet table.
   The logic is simple: Out of sight, out of mind.  If the collection of tempting treats is not in your guests' direct line of sight, they will be less likely to yield to the temptation for more.

4. At a sit-down dinner or a buffet, do not insist that your guests have a second helping.
   Using small plates will not help if your guests have two or three refills.  If there is food left over at the end of the event, ask your guests to take home a doggy bag.

5. Build serving size into the bounty.
   The rule of thumb is the palm of your hand or the size of your fist.  One serving of meat, fish or poultry should be no bigger than the palm of one's hand (without the fingers.)  One serving of starch or vegetable should fit in the palm of one's hand or should be no bigger than the size of one's fist.  If possible and where appropriate prepare dishes that can be presented as individual servings, such as stuffed fish fillets, salmon steaks or stuffed chicken breasts.

6. Serve more vegetables than starches.
   Include a variety of brightly colored vegetables on your menu.  Go easy on the starches.  Make sure that any starches you do serve are wholegrain.

7. Skimp on the sauces.
   Avoid serving foods that are swimming in sauce or drowning in cheese.  If possible, serve the sauces on the side and modify the recipes to be lower in fat and sodium.

8. Don't make dessert your guests' downfall.
   Don't deny your guest dessert, but help them use restraint.  Pre-slice cakes and pies to reasonable portions; set the slices out on dessert dishes.  Serve desserts that lend themselves to being presented as individual servings like tarts.  When preparing the dessert menu, look for low-fat, low-sodium options.  Always serve fresh fruit as a dessert option.

9. Encourage your guests to savor each flavor.
   If you eat slowly, your guests will follow suit.  Enjoy the flavor and texture of each mouthful.  Ask your guests to see if they can discern the seasonings in the dish they like the most.  (Eating slowly will give their brains time to tell their stomachs when they're full.  A special part of the brain, the satiety center, tells the stomach that it has had enough.  It takes 15 to 20 minutes for the satiety center to kick in.  Eating slowly gives the brain plenty of time to send the stomach the stop signal.)

10. Allow early finishers to sip and sit.
    If one of your guests finishes and others are still eating, offer that guest a glass of water with lemon so they can sip it slowly while your other guests finish dining.

11. Serve plenty of water.
    Serve sparkling water and mineral water before, during and after the meal. 

12. Serve healthy snacks.
    Nibbling on chips, dips and nuts is one way to keep busy when you're uncomfortable or bored in a social situation.  Calories from salty, fat-laden snacks add up, so make the pre-meal munchies as healthy as possible.  Serve low-fat, low sodium wholegrain chips, raw veggies and low-fat dips.  If someone looks bored or uncomfortable, introduce them to someone they may not know and start a conversation. 

13. Discuss while you dine.
    Engage your guests in conversation during dinner.  Since it's rude to talk with your mouth full, your guests will be forced to eat at a slower pace.  This will give their respective satiety centers a better opportunity to communicate with their respective stomachs and determine when they've had enough to eat.

14. Provide calorie-free cocktails.
    Provide sparkling water or club soda with a twist of lemon or lime.  These are good alternatives to the empty calories found in soft drinks and alcohol.

15. Provide other alcohol alternatives.
    For guests who do not drink alcohol but opt not to have water, provide sparkling cider or fruit smoothies.  Sparkling cider is available in a variety of flavors from pear to pomegranate.  Serve  the cider and smoothies in champagne flutes to keep the atmosphere festive.

16. Make sure eating is not the main event.
    Involve your guests in activities that will keep their minds and/or their hands occupied, like playing games, decorating the tree or singing Christmas carols.  Have your guest share favorite Christmas memories or their funniest Christmas mishaps.  Provide the craft materials for each guest to make a Christmas ornament.  At the end of the evening, they can trade ornaments or they can take home their own creations.

17. Send each guest home with a gift that will renew their body, mind and spirit.
    The Christmas season can be stressful.  Some people respond to stress by eating.  Encourage your guests to feed on God's faithfulness instead by give each one a pocket size devotional.  Invite them to spend time with God and thank Him everyday, for giving us His only begotten Son.

Psalm 37:3-4
3 Trust in the LORD, and do good;
Dwell in the land, and feed on His faithfulness.
4 Delight yourself also in the LORD,
And He shall give you the desires of your heart.

John 3:16
For God so loved the world that He gave His only begotten Son, that whoever believes in Him should not perish but have everlasting life.

Share the health.

Deborah White, MD, MBA

18 Easy Ways to Feast and Stay Fit

The Christmas season is here again.  It's time to celebrate and honor the birth of God's only begotten Son with feasting and festivities, so your calendar is filled with family dinners, potluck parties and other opportunities to overeat.  However, it is possible to enjoy the season's festivities and stay fit.  Here are 18 suggestions to help you successfully navigate through tempting high-calorie Christmas treats:

1. Eat breakfast.
   Eating breakfast will influence your appetite for the rest of the day.  Have plenty of whole grains and protein in the morning.  If you eat a good breakfast, you will eat less at lunch and less at dinner.

2. Spoil your appetite before you go to a party.
   If you get to the party with an empty stomach, you will overeat.  Have a small, healthy, light snack before the party to take the edge off your hunger.  Try a combination of a complex carbohydrate and high quality protein.

3. At buffets, use a small plate.
   If your plate is smaller, you will take less food.

4. At buffets, sit as far from the buffet table as possible.
   You probably won't make a second trip to the buffet table if you have to travel farther to get there.

5. At buffets, once you get your food, if possible, sit with your back to the buffet table.
   The logic is simple: Out of sight, out of mind.  If the collection of tempting confections is not in your direct line of sight, you'll be less likely to yield to the temptation for more.

6. At a sit-down dinner or a buffet, do not have a second helping.
   Using a small plate will not help if you refill it two or three times.  No matter what the size of your plate, fill it once and leave it at that.  If your host insists that you have more, ask to take home a doggy bag.  If you are the host, do not insist that your guests take a second helping. 

7. Control your serving size.
   The rule of thumb is the palm of your hand or the size of your fist.  One serving of meat, fish or poultry should be no bigger than the palm of your hand (without the fingers.)  One serving of starch or vegetable should fit in the palm of your hand or should be no bigger than the size of your fist.

8. Choose vegetables over starches.
   Put a variety of brightly colored vegetables on your plate.  Go easy on the starches.

9. Skimp on the sauces.
   Take very small portions of any food swimming in sauce or drowning in cheese.  When possible, have the sauce on the side and use it sparingly.

10. Have dessert, but do so in moderation.
    Don't deny yourself dessert.  You'll feel like you are on punishment if everyone except you is feasting on sweets.  Have dessert, but use restraint.  Have a thin slice of pie or cake.  Offer to share a dessert with someone.  Don't be embarrassed to leave some dessert on your plate.  If you are the hostess,  make sure that fresh fruit is one of the dessert options. 

11. Savor each flavor.
    Eat slowly.  Enjoy the flavor and texture of each mouthful.  Eating slowly will give your brain time to tell your stomach that you're full.  A special part of your brain, the satiety center, tells your stomach that you've had enough.  It takes 15 to 20 minutes for your satiety center to kick in.  Eating slowly will give your brain plenty of time to send your stomach the stop signal.

12. Push away from the table.
    When you push away from the table, it says that you are finished eating.  If possible, excuse yourself from the table.  If you cannot excuse yourself from the table and others are still eating, ask for a glass of water with lemon and sip it slowly while they finish.

13. Drink plenty of water.
    Drink a glass of water before you eat.  Sip water with your meal.  Have a glass of water after you eat.  You'll stay well-hydrated and you will feel full.

14. Avoid mindless munching.
    Nibbling on chips, dips and nuts is one way to keep busy when you're uncomfortable or bored in a social situation.  But these salty, fat laden calories add up.  Find someone else who looks bored or uncomfortable.  (They will be nibbling too.)  Introduce yourself and start a conversation.  It's not polite to talk with munchies in your mouth.  If you are busy talking, you will eat less.

15. Discuss while you dine.
    Again, since it's not polite to talk with your mouth full, if you engage in conversation, you will be forced to eat at a slower pace.  This will give the satiety center in your brain a better opportunity to communicate with your gut and determine when you've had enough to eat.

16. Enjoy a calorie-free cocktail.
    Sip on sparkling water or club soda with a twist of lemon or lime.  It will fill you up and eliminate the empty calories found in soft drinks and alcohol.

17. Maintain your exercise routine.
    Make and take time to exercise.  If possible, schedule a workout before the party.  (Make sure you have plenty of time to shower and dress for the party.)  Exercise is an excellent stress reliever.  It increases the endorphins in your brain.  Endorphins are chemicals that make you feel good and suppress your appetite.

18. Take time to renew your body, mind and spirit.
    Life can be stressful.  You may respond to stress by snacking.  Instead of snacking, spend time with God.  Spending time with God is the ultimate refreshment.  Make and take time to rest, meditate on the word and pray.  Thank God everyday, for giving you a reason to celebrate.

Psalm 118:24
This is the day the Lord has made;
We will rejoice and be glad in it.

Enjoy the Christmas season and ...

Share the health.

Deborah White, MD, MBA

November: National Adoption Month

There is more than one way to have a child.  You can birth one out of your womb or you can take one into your heart.  So many people in the United States spend money to support impoverished children in other countries.  Their generosity is commendable.  Others adopt infants or small children from other countries.  Their generosity is commendable also.  But right here in the United States, there are so many young children and youths who need loving parents.

If you have room in your heart and room in your home to nurture a child, consider adopting a child right here at home.

Share the health.

Deborah White, MD, MBA

November: Prematurity Awareness Month

A premature baby, or preemie, is born before the 37th week of pregnancy. Premature birth occurs in between 8 percent to 10 percent of all pregnancies in the United States. Because they are born too early, preemies weigh much less than full-term babies. They often have multiple health problems because their organs are not completely developed.  The complications of prematurity include respiratory distress syndrome, bronchopulmonary dysplasia and periventricular leukomalacia.

Respiratory Distress Syndrome
Respiratory distress syndrome (RDS) is a breathing disorder that is common in premature infants born about 6 weeks or more before their due dates.  It is one of the most common lung disorders in premature infants affecting about ten percent of premature babies in the United States. In fact, nearly all infants born before 28 weeks of pregnancy develop RDS.

In some premature infants, RDS is an early phase of bronchopulmonary dysplasia (BPD), another breathing disorder that affects premature infants. The main cause of RDS is a lack of surfactant in the lungs. Surfactant is a liquid that coats the inside of the lungs and helps keep them open making it easy to breathe. Premature infants' lungs aren't fully developed and aren't able to make enough surfactant.

Depending on the severity of an infant's RDS, he or she may develop other medical problems, such as lung, blood, or blood vessel complications.

Bronchopulmonary Dysplasia
Bronchopulmonary dysplasia (BPD) is a serious lung condition that mostly affects premature infants. Infants who develop BPD usually are born more than ten weeks before they are due, weigh less than two pounds (about 1,000 grams), have breathing problems at birth, or have an infection during or shortly after birth. The earlier a baby is born before his or her due date and the lower his or her birth weight, the greater the risk of having BPD.

Most babies who develop BPD are born with serious respiratory distress syndrome (RDS), although some infants who have RDS recover and never develop BPD.  If a premature infants still requires oxygen therapy by the time they reach their original due date, they're diagnosed with BPD.  BPD can be mild, moderate, or severe. The severity depends on how much extra oxygen a baby needs at the time of his or her original due date. It also depends on how long the baby needs oxygen therapy.

BPD develops as a result of an infant's lungs becoming irritated or inflamed. A number of factors can damage premature infants' lungs, including mechanical ventilation (that is, breathing support from a ventilator), high levels of oxygen, infections, and other causes. 

Infants who have BPD also may have trouble feeding and may have delayed growth.  In addition, they may develop pulmonary hypertension or cor pulmonale (failure of the right side of the heart). With treatment and time, most babies who have BPD get better. However, they may need to continue treatments for months or even years. They may continue to have lung problems throughout childhood and even into adulthood.

Periventricular Leukomalacia
Periventricular leukomalacia (PVL) is a type of brain injury characterized by the death of the white matter around fluid-filled areas of the brain called ventricles. The damage is caused by a lack of blood flow or oxygen to the affected area.  It is also associated with an intraventricular hemorrhage.  The periventricular area contains nerve fibers that carry messages from the brain to the body's muscles. This area is fragile and prone to injury, especially before 32 weeks of gestation. Although babies with PVL generally have no outward signs or symptoms of the disorder, they are at risk for motor disorders, delayed mental development, coordination problems, and vision and hearing impairments. PVL can lead to cerebral palsy.

PVL is much more common in premature infants than in full-term infants. The more premature a baby is and the sicker a baby is, the higher the risk for PVL. The prognosis for individuals with PVL depends upon the severity of the brain damage. Some children exhibit fairly mild symptoms, while others have significant deficits and disabilities.

Prevention of Prematurity
You can take steps to reduce your risk of delivering your baby prematurely:

• Plan your pregnancy so that you are as healthy as possible before you conceive.
• Control any ongoing medical conditions you have before you conceive; keep them under control while you are pregnant.
• Stop all of your bad habits (smoking, drinking alcohol, using drugs) before you conceive.
• After you conceive, avoid tobacco smoke (including secondhand smoke), avoid alcohol and avoid illegal drugs.
• Try to prevent infections.  Make sure your vaccinations are up to date before you conceive.
• Start prenatal care early (before your 12th week of pregnancy).
• See your doctor regularly during your pregnancy.
• Eat healthy foods.
• Stay well hydrated.
• Take your prenatal vitamins and iron as prescribed.
• Remain physically active unless instructed otherwise by your doctor.
• Follow your doctor's instructions.

The content of this posting is based on information from the National Institutes of Health.

Share the health.

Deborah White, MD, MBA

November: National Healthy Skin Month

November is National Healthy Skin Month.  It's a good time to raise your skin awareness. 

Your skin changes with age. It becomes thinner, loses fat, and no longer looks as plump and smooth as it once did. Your veins and bones can be seen more easily. Scratches, cuts, or bumps can take longer to heal. Years of sun tanning or being out in the sunlight for a long time can lead to wrinkles, dryness, age spots, and even cancer. But there are things you can do to help your skin.

Dry Skin and Itching
Many older people suffer from dry skin, often on their lower legs, elbows, and lower arms. Dry skin feels rough and scaly. There are many possible reasons for dry skin, such as:

• Not drinking enough liquids.
• Staying out in the sun.
• Being in very dry air.
• Smoking.
• Having stress.
• Losing sweat and oil glands (common with age).

Dry skin also can be caused by health problems, such as diabetes or kidney disease. Using too much soap, antiperspirant, or perfume and taking hot baths will make dry skin worse.

Because older people have thinner skin, scratching itches can cause bleeding that can lead to infection. Some medicines make the skin itchier. Itching can cause sleep problems. If your skin is very dry and itchy, see your doctor.

Moisturizers like lotions, creams, or ointments can soothe dry, itchy skin. They should be used everyday. Try taking fewer baths and using milder soap to help your dry skin. Warm water is better than hot water for your skin. Some people find that a humidifier helps.

Bruises
Older people may bruise more easily than younger people. And, it can take longer for the bruises to heal. Some medicines or illnesses cause easier bruising. If you see bruises and you don’t know how you got them, especially on parts of your body usually covered by clothing, see your doctor.

Wrinkles
Over time, skin begins to wrinkle. Things in the environment, like ultraviolet (UV) light from the sun, make the skin less elastic. Gravity can cause skin to sag and wrinkle.

Certain habits like frowning also wrinkle the skin. Some of these habits are easier to change than others. You may not be able to change how you lie when you sleep, but you can quit smoking. Not smoking is a great way to prevent wrinkles.

A lot of claims are made about how to make wrinkles go away. Not all of them work. Some can be painful or even dangerous and many must be done by the doctor. Talk with a dermatologist or your regular doctor if you are worried about wrinkles.

Age Spots
Age spots are sometimes called “liver spots,” but they have nothing to do with the liver. These flat, brown spots are often caused by years in the sun. They are bigger than freckles, flat, and many times show up on areas like the face, hands, arms, back, and feet. Age spots are harmless, but if they bother you, talk to a dermatologist about removing them. Also, a sunscreen or sunblock may prevent more sun damage.

Skin Tags
Skin tags are small, usually flesh-colored growths of skin that have a raised surface. They are a common problem as people age, especially for women. They are most often found on the eyelids, neck, and body folds such as the arm pit, chest, and groin. Skin tags are harmless, but they can become irritated. A doctor can remove them if they bother you.

Skin Cancer
Skin cancer is the most common type of cancer in the United States. The main cause of skin cancer is sun exposure. Sunlamps and tanning booths can also cause skin cancer. Anyone can get cancer, but people with fair skin that freckles easily are at greatest risk. Skin cancer may be cured if it is found before it spreads to other parts of the body.

There are three types of skin cancers. Two types, basal cell carcinoma and squamous cell carcinoma, grow slowly and rarely spread to other parts of the body. These types of cancer are found mostly on parts of the skin exposed to the sun, like the head, face, neck, hands, and arms, but can happen anywhere on your body. The third and most dangerous type of skin cancer is melanoma. It is rarer than the other types, but can spread to other organs and be deadly.

Check your skin regularly, like once a month, for changes that may be cancer. Look for changes such as a new growth, a sore that doesn't heal, or a bleeding mole. Also, check moles, birthmarks, or other parts of the skin for the "ABCDEs." ABCDE stands for:

A = asymmetry (one half of the growth looks different from the other half)

B = borders that are irregular

C = color changes or more than one color

D = diameter greater than the size of a pencil eraser

E = evolving, meaning changes in size, shape, symptoms (itching, tenderness), surface (especially bleeding), or shades of color

Don't wait for the area to hurt—skin cancer usually isn't painful. See your doctor right away if you have any of these signs.

Keep Your Skin Healthy
The best way to keep your skin healthy is to be careful in the sun.

Limit time in the sun. Try to stay out of the sun between 10 a.m. and 4 p.m. This is when the sun’s rays are strongest. Don't be fooled by cloudy skies. The sun's rays can pass through clouds. You can also get sunburned if you are in water, so be careful when you are in a pool, lake, or the ocean.

Use sunscreen. Look for a sunscreen with an SPF (sun protection factor) number of 15 or higher. It's best to choose sunscreens with "broad spectrum" on the label. "Water resistant" sunscreen stays on your skin even if you get wet or sweat a lot, but it isn’t waterproof and needs to be put on about every 2 hours.

Wear protective clothing. A hat with a wide brim can shade your neck, ears, eyes, and head. Look for sunglasses that block 99 to 100 percent of the sun's rays. If you have to be in the sun, wear loose, lightweight, long-sleeved shirts and long pants or long skirts.

Avoid tanning. Don't use sunlamps or tanning beds. Tanning pills are not approved by the FDA and might not be safe.

Your skin may change with age. But remember, there are things you can do to help. Check your skin often. If you find any changes that worry you, see your doctor.

The content of this posting is based on information from the National Institute on Aging of the National Institutes of Health.

Share the health.

Deborah White, MD, MBA

Great American Smokeout on November 19, 2009

Today, Thursday, November 19, 2009 is the Great American Smokeout.  The purpose of this day is to motivate smokers to quit. 

Tobacco smoke contains over 4,000 chemical compounds. More than 60 of these are known or suspected to cause cancer.  In addition to damaging your body, smoking drains your financial resources.  But if these are not reasons enough to quit, consider your loved ones.  If you smoke around people you care about, secondhand smoke is causing them harm. According to the American Cancer Society, In the United States alone, each year secondhand smoke is responsible for:

• An estimated 35,000 deaths from heart disease in non-smokers who live with smokers
• About 3,400 lung cancer deaths in non-smoking adults
• Other breathing problems in non-smokers, including coughing, mucus, chest discomfort, and reduced lung function
• 150,000 to 300,000 lung infections (such as pneumonia and bronchitis) in children younger than 18 months of age, which result in 7,500 to 15,000 hospitalizations
• Increases in the number and severity of asthma attacks in about 200,000 to 1 million children who have asthma
• More than 750,000 middle ear infections in children

The scientific evidence shows that there is no safe level of exposure to secondhand smoke.  If you smoke, protect your loved ones by making yourself and your home smoke-free.

The content of this posting is based on information from the American Cancer Society.

Share the health.

Deborah White, MD, MBA

November: National Family Caregivers Month

November is National Family Caregivers Month.  It is a time to acknowledge and thank caregivers, the unsung heroes who care for, nurture and protect their spouses, parent(s) and/or children.  If you know a caregiver, bless them by offering to help.  Your assistance will help a caregiver protect their own health so they can continue to care for their loved one(s).  Here are some suggestions:

• Offer a ride to or from appointments or other destinations.
• Help with major chores, heavy lifting and/or household repairs.
• Help with routine household chores.
• Help with grocery shopping or other errands.
• Offer to prepare meals from time to time.
• Offer to help with paperwork.
• Offer an ear to listen.
• Offer a shoulder to cry on.
• Check on a caregiver's wellbeing from time to time.
• Offer to spend time with the person needing care so the caregiver can have a respite of rest and relaxation for a few hours or for a weekend.
• Help with specific care-giving tasks.
• Make yourself available if or when an emergency arises.

If a caregiver's loved one has a chronic, debilitating condition, the care-giving responsibilities do not stop until their loved one dies.  Then the mixed blessing of care giving is replaced by a confusing mixture of profound grief and welcome relief.  When this happens, the caregiver will need your help more than ever.  Offer a compassionate heart to understand and let the erstwhile caregiver tell you how else you can help.

Share the health.

Deborah White, MD, MBA

November: National Alzheimer's Disease Awareness Month

Alzheimer's disease develops slowly and causes changes in the brain long before there are obvious changes in a person's memory, thinking, use of words or behavior. The deterioration of the brain eventually affects the entire body.  Stages and changes the person will go through are outlined below.

Common Changes in Mild AD

• Loses spark or zest for life - does not start anything.
• Loses recent memory without a change in appearance or casual conversation.
• Loses judgment about money.
• Has difficulty with new learning and making new memories.
• Has trouble finding words - may substitute or make up words that sound like or mean something like the forgotten word.
• May stop talking to avoid making mistakes.
• Has shorter attention span and less motivation to stay with an activity.
• Easily loses way going to familiar places.
• Resists change or new things.
• Has trouble organizing and thinking logically.
• Asks repetitive questions.
• Withdraws, loses interest, is irritable, not as sensitive to others' feelings, uncharacteristically angry when frustrated or tired.
• Won't make decisions. For example, when asked what she wants to eat, says "I'll have what she is having."
• Takes longer to do routine chores and becomes upset if rushed or if something unexpected happens.
• Forgets to pay, pays too much, or forgets how to pay - may hand the checkout person a wallet instead of the correct amount of money.
• Forgets to eat, eats only one kind of food, or eats constantly.
• Loses or misplaces things by hiding them in odd places or forgets where things go, such as putting clothes in the dishwasher.
• Constantly checks, searches or hoards things of no value.

Common Changes in Moderate AD

• Changes in behavior, concern for appearance, hygiene, and sleep become more noticeable.
• Mixes up identity of people, such as thinking a son is a brother or that a wife is a stranger.
• Poor judgment creates safety issues when left alone - may wander and risk exposure, poisoning, falls, self-neglect or exploitation.
• Has trouble recognizing familiar people and own objects; may take things that belong to others.
• Continuously repeats stories, favorite words, statements, or motions like tearing tissues.
• Has restless, repetitive movements in late afternoon or evening, such as pacing, trying doorknobs, fingering draperies.
• Cannot organize thoughts or follow logical explanations.
• Has trouble following written notes or completing tasks.
• Makes up stories to fill in gaps in memory. For example might say, "Mama will come for me when she gets off work."
• May be able to read but cannot formulate the correct response to a written request.
• May accuse, threaten, curse, fidget or behave inappropriately, such as kicking, hitting, biting, screaming or grabbing.
• May become sloppy or forget manners.
• May see, hear, smell, or taste things that are not there.
• May accuse spouse of an affair or family members of stealing.
• Naps frequently or awakens at night believing it is time to go to work.
• Has more difficulty positioning the body to use the toilet or sit in a chair.
• May think mirror image is following him or television story is happening to her.
• Needs help finding the toilet, using the shower, remembering to drink, and dressing for the weather or occasion.
• Exhibits inappropriate sexual behavior, such as mistaking another individual for a spouse. Forgets what is private behavior, and may disrobe or masturbate in public.

Common Changes in Severe AD

• Doesn't recognize self or close family.
• Speaks in gibberish, is mute, or is difficult to understand.
• May refuse to eat, chokes, or forgets to swallow.
• May repetitively cry out, pat or touch everything.
• Loses control of bowel and bladder.
• Loses weight and skin becomes thin and tears easily.
• May look uncomfortable or cry out when transferred or touched.
• Forgets how to walk or is too unsteady or weak to stand alone.
• May have seizures, frequent infections, falls.
• May groan, scream or mumble loudly.
• Sleeps more.
• Needs total assistance for all activities of daily living.

If someone you love is showing signs of Alzheimer's disease, get help ASAP. 

The content of this posting is based on information from the National Institute on Aging of the National Institutes of Health.

Share the health.

Deborah White, MD, MBA

November: Pancreatic Cancer Awareness Month

Your pancreas is a gland located deep in your abdomen behind your stomach and in front of your spine. Your liver, intestine, and other organs surround your pancreas.  Your pancreas is about six inches long and is shaped like a flat pear. The widest part of your pancreas is the head, the middle section is the body, and the thinnest part is the tail.

Your pancreas makes insulin and other hormones. These hormones enter your bloodstream and travel throughout your body to regulate the use or storage of the energy that comes from food. For example, insulin helps control the amount of glucose your cells absorb from your blood stream.

Your pancreas also makes pancreatic juices containing enzymes that help digest food. Your pancreas releases these juices into a system of ducts leading to your common bile duct. The common bile duct empties into the duodenum, the first section of your small intestine.

Pancreatic Cancer Risk Factors

No one knows the exact causes of pancreatic cancer. However, people with certain risk factors are more likely than others to develop pancreatic cancer. A risk factor is anything that increases a person's chance of developing a disease.

Pancreatic cancer risk factors include:

Age -- The likelihood of developing pancreatic cancer increases with age. Most pancreatic cancers occur in people over the age of 60.

Smoking -- Cigarette smokers are two or three times more likely than non-smokers to develop pancreatic cancer.

Diabetes -- Pancreatic cancer occurs more often in people who have diabetes than in people who do not.

Being male -- More men than women are diagnosed with pancreatic cancer.

Being African American -- African Americans are more likely than Asians, Latinos, or Caucasians to get pancreatic cancer.

Family history -- The risk for developing pancreatic cancer triples if a person's mother, father, sister, or brother had the disease. Also, a family history of colon or ovarian cancer increases the risk of pancreatic cancer.

Chronic pancreatitis -- Chronic pancreatitis is a painful prolonged inflammation of the pancreas. Some evidence suggests that chronic pancreatitis may increase the risk of pancreatic cancer.

Chemical exposure and lifestyle -- Other studies suggest that exposure to certain chemicals in the workplace or eating foods high in fat may increase the chance of getting pancreatic cancer.

Most people with known risk factors do not get pancreatic cancer. On the other hand, many who do get the disease have none of these factors. If you think you may be at risk for pancreatic cancer should, speak with your doctor.

Symptoms

Pancreatic cancer is sometimes called a "silent disease" because early pancreatic cancer often does not cause symptoms. But, as the cancer grows, symptoms may include:

• Pain in the upper abdomen or upper back
• Yellow skin and eyes, and dark urine from jaundice
• Weakness
• Loss of appetite
• Nausea and vomiting
• Weight loss

These symptoms are not sure signs of pancreatic cancer. Other problems could also cause these symptoms. Only a doctor can diagnose the cause of a person's symptoms. If you have these symptoms, see your doctor so that your doctor can identify and treat any problem as early as possible.

The content of this posting is based on information from the National Cancer Institute of the National Institutes of Health.

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Deborah White, MD, MBA

November: Lung Cancer Awareness Month

November is Lung Cancer Awareness Month.  Smoking causes lung cancer.  Lung cancer is the most common cause of cancer death among women in the United States.  Breast cancer is more common, but most of the time women survive breast cancer.  Victims of lung cancer die most of the time.  If you smoke, you literally set fire to hundreds if not thousands of dollars each year as you slowly poison yourself.  If you smoke around other people, you are poisoning them too.  If you smoke, the odds are stacked against you.  If you smoke, Quit!

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Deborah White, MD, MBA