A Village member shares her experience in learning to treat her diabetes with self-injections. Chronic conditions require constant attention even when it is inconvenient, difficult or challenging. There are many differet kinds of insulin and equipment that makes the whole process more manageble. Shots can become a normal part of a better life. But as the video says, "there isn't a choice, if you want to live, you need to take the tools that are on hand."
Dr. Pineda shares his expertise on colon cancer including prevention and treatment.
Colon cancer is quite common but when the cancer is small there are often no symptoms. The best way to detect colon cancer is with a colonoscopy. When detected early, colon cancer can be effectively treated. Adults should get their first colonoscopy at age 50 or even earlier if there is a history of colon cancer in the family. Modern colonoscopy techniques are easy, painfree and highly effective so don't miss your chance to detect colon cancer.
Live better longer....
Quitting is possible, real people just like us really quit and really stay quit. Here's one person;s true story of finding the motivation and seeing it through. It didn't happen right away but in time he really kicked the habit for good and so can you.
Here are some of the key points:
Walking as a medication? Or even better than a medication?
When it comes to keeping pounds off from as we age, walking is better than any pill out there. We’ve known for a long time that runners keep their weight off as the years progress, but what about walkers?
Until recently, there really hadn’t been any research that demonstrated the effect of walking on weight gain age-related weight gain, but a recent study from the American Journal of Clinical Nutrition shows that a regular walking can have significant effects on preventing the weight gain associated with aging.
Participants in the Coronary Artery Risk Development for Young Adults (CARDIA) Study were 18-30 years old when the study began and were re-examined after 2, 5, 7, 10 and 15 years. After accounting for calorie intake and other factors, there was a strong association between walking and the prevention of weight gain; people who walked were less likely to gain weight, and there was predictable dose-response. The more that people walked, the more likely they were to keep off the pounds; two hours of walking per week was better than none, and four hours of walking per week was even better.
There isn’t a pill out there that can even come close to showing that kind of benefit. Commercial weight loss pills are associated with a risk for significant, serious adverse events and their effect seems to plateau at around 3-5 lbs. of weight loss, even when taken over an extended period of time. Walking is free, safe, and the more you do of it, the more benefit you derive. Of course, you’ll want to make sure you walk in a safe place, wear a good pair of shoes that fit you well, and take appropriate precautions with sunscreen, a water bottle, and reflective clothing for nighttime conditions.
Our bodies are literally made to walk and perhaps that’s the reason walking is the exercise of choice for 70% of people. How does walking make you feel? Let me hear from you. And if you aren’t sure, then I’d like to have you strap on a comfortable pair of shoes and let me know.
Health = Friendship and Friendship = Health
Don’t you just hate that trite expression – “It isn’t what you know… it’s who you know?” Well it turns out that it is true in a way that you might not have expected. Just knowing how to make good health choices isn’t enough. You need to be connected to people in your life that care that you make those healthy choices. A strong network of friends is an essential ingredient to achieving your health objectives and that is now being supported by real academic research.
Here is a quote from today’s “Well” article from the New York Times:
“Researchers are only now starting to pay attention to the importance of friendship and social networks in overall health. A 10-year Australian study found that older people with a large circle of friends were 22 percent less likely to die during the study period than those with fewer friends. A large 2007 study showed an increase of nearly 60 percent in the risk for obesity among people whose friends gained weight. And last year, Harvard researchers reported that strong social ties could promote brain health as we age.”
It makes so much sense that eating, exercising, drinking, smoking and managing stress have very strong social dimensions – we do these things as part of our lives with our friends and relations. Just think how many people you know smoke, drink and overeat when at parties or in other social situations. The social norm seems to approve of and support these decisions.
But it doesn’t have to be that way. Why has Weight Watchers and other support-based health improvement approaches had so much success? For one, they are establishing a friendship network that supports eating healthier and exercising more. Because with a strong friendship network that is connected to our shared health, we can all truly live better longer – sound familier?
Genetic Science Not the Holy Grail in Disease Prevention
I was recently at a health conference in Boston where some cutting edge health and life science technologies were being shared with the business and investment community. Incredible presentations were made in social health networking by people like patientslikeme.com as well as some promising medical devises and molecular breakthroughs. There was a lot of hype and sizzle around several genetic ventures that promised an individual road map for avoiding, preventing and erasing chronic disease. That sounded pretty cool, but when I saw the reports, it became clear that these services cost a lot and offered very little beyond common sense and conventional wisdom. Today’s article in The New York Times talks about a series of commentaries in the New England Journal of Medicine that largely reach the same conclusion.
One of the presenters touted the ability to “pinpoint risk” but the risk they cited could be easily identified without spending hundreds of dollars. For example, they showed a genetic pathway and marker linked to heart disease. Well, we can easily identify risk for heart disease and other conditions in the metabolic cluster by asking about family history, measuring blood pressure, measuring body mass index and/or waist circumference and doing a simple blood test. All this for a fraction of the cost of the gene test.
And then you have to ask does the genetic test offer a different “so what?” Whether I have the marker or not, the only realistic options I have to reduce my risk for heart disease are to exercise more, eat more sensibly, stop smoking if I haven’t already and stay on my blood pressure or cholesterol medicine if it has been prescribed by my doctor. It isn’t like there will be a genetic fix to my risk – indeed there are so many pathways and markers to disease that we will all show up on the risk for many, many diseases. To quote David B. Goldstein, a Duke University geneticist whose commentary on the subject appears in the current New England Journal of Medicine;
“In pointing at everything, genetics would point at nothing.”
And what if the test showed no risk for heart disease? Does that mean my being 30 pounds overweight, sedentary and a heavy smoker are now OK? Or will by good genes be trumped by my bad lifestyle? You know the answer there!
I came away from the conference concluding that the genetic approach is useful for simply demonstrating that an individual is a human being and that human beings carry many risk factors for disease. An incontrovertible proof, but one hardly worth the price of the test.
Don’t get me wrong, if you suspect that you carry a genetic marker for aggressive breast cancer or other rare but deadly conditions, a gene test might be best to help you make difficult and critical decisions. But for most chronic conditions, most of us can assume that we have risk, we can even measure and rank that risk and most importantly, we can do something about that risk. While our gene story is interesting, it is not that clinically relevant. To quote Dr. Goldstein again;
“With only a few exceptions, what the genomics companies are doing right now is recreational genomics, the information has little or in many cases no clinical relevance.”
Making Trade-Offs: Priorities When Managing Chronic Conditions
Reading this terrific essay by Lori Berlin who is living with and writing about her experiences with ulcerative colitis got me thinking about the trade-offs we all make in managing our chronic conditions and life-style related health challenges. Lori writes about how managing her chronic condition required a medicine that led to weight gain. Accomplishing one life-essential goal meant giving up on another life important goal – one that is so tied to self esteem and health.
While Lori’s experience is a stark and extreme trade-off situation, we all make trade-offs around catering to, coping with or overcoming our chronic conditions. Giving up on a near-term pleasure for a long-term goal is a more common trade-off for all of us trying to exercise, eat right and keep ourselves “heart healthy.” Many MyHealthVillage.com members regularly adhere to drug therapies that come at the cost of unpleasant side effects – some are much challenging than just unpleasant.
To actively address our health and manage our chronic conditions, we each must figure out our priorities – which goal comes first. Do I pick a health goal because it is most important according to my doctor? Maybe. But I might pick it a particular objective because I have the confidence that I can actually achieve my goal. With success, I might then have the confidence to try the next goal which might be of even greater significance for my health. I might feel that quitting smoking is beyond my current reach, but improving my diet and exercise is more “doable” at the moment. Which is better: continuing to fail at quitting smoking or making some real progress on my weight? Later, when I have proven to myself that I can control what and when and how I eat and that I can find the time for nearly daily exercise, I can probably muster the courage to take on cigarettes too. And having reduced my weight, I might be less frightened by the weight gain that might accompany my quitting.
Trade-offs are a part of all of our lives all of the time. But a little self-discovery and prioritization can make a big difference in your health management progress. Lori describes putting treatment of her ulcerative colitis first – and rightly so because it was life-threatening. When remission was achieved, she could get back to her next goal – keeping her weight in check.
I hope that the support and resources available at MyHealthVillage can help you prioritize your objectives, set appropriate health goals and manage your own trade-offs. You can start by sharing some of your own trade-offs - in a comment here or in a blog post of your own. With the help of your Village, it is easier to live better longer.
Smokers Prepare!!
Yet another study reinforces the anti-smoking campaign. And this study hits where it hurts: your children and grandchildren.
Many smokers have responded to the studies about second-hand smoke and no longer smoke around their children. Now the evidence about third-hand smoke means you need to make even more changes to protect your children and the nonsmokers who share your home and work place.
Third-hand smoke is the residue that remains after the visible second-hand smoke disappears. It settles into carpets and cushions in your home and car. It remains on your clothes and in your hair. Other people in an elevator smell third-hand smoke when a smoker steps in.
Would you knowingly expose your child to arsenic, lead, cyanide, carbon monoxide, or Polonium-210 (the radioactive material that killed a Russian spy in 2006)? Third-hand smoke contains all of these things, including 11 carcinogens. Little ones who crawl or play on the floor are exposed to especially high levels of these residues.
So, smokers, prepare! How will you explain to your children, their grandparents, and their pediatrician if you continue to expose your children to third-hand smoke? How will you explain to your family, your friends, and your coworkers? You better start preparing your answers. The news about third-hand smoke is spreading fast.
EPJ: A Diabetes Visionary
Diabetes was considered an obscure condition in the late 1800’s. (What a difference a century makes!) Elliot Proctor Joslin was the first doctor in the United States to specialize in treating diabetes.
He kept careful notes of his clinical experiences and came to believe that “management matters”. Modern day research has come to the same conclusion: management does matter.
The better diabetes is managed, the lower the risk of developing the devastating long-term complications of this disease.
EPJ, as his team fondly called him, also had a great understanding of why people get diabetes: “Your genes load the cannon and your lifestyle lights the fuse.”
He was also an advocate of diabetes education. As a diabetes educator, I think EPJ was quite a visionary in many different ways.
See the photo page of MyHealthVillage for a look at this physician, researcher, and advocate of nurses as diabetes educators.
Virtual Empathy
I’m new to virtuality. (Reality is a word. Is “virtuality” a word?) Until I joined Longitude Health a few months ago, I had never visited a blog site, much less contributed a post.
I began visiting sites. Each one seemed to have its own “personality”: ones with group hugs and fairy dust; others are irreverent; some are very academic; still others have an angry feel to them. But were any of these sites able to convey empathy?
Recently I experienced reality-based empathy. My dog of 15 years died. Her name was Nora. Knowing how much she meant to me, my family, friends, neighbors, and office-mate all expressed their concern for my feelings. I also got cards, notes, and flowers. Someone even made a generous donation in Nora’s name to an organization that helps displaced animals. All those acts of kindness (in reality) were expressions of empathy.
But what about “virtual empathy”? I blogged about losing Nora. I expected a comment or two since so many people have pets that are dear to them. Why were there no comments? Maybe no one read the post or if they read it, they were too busy to respond. I have a feeling that often people just don't know how to express their empathy.
I hope MyHealthVillage becomes a site “with heart”, a site where people with chronic conditions can not only share tips and experiences, but can also support one another with “virtual empathy”.
A great read: A Path with Heart by Jack Kornfield
The 50 Ways
Do you ever judge a book by its cover? Recently I saw a book (written by two credible authors) called 50 Secrets of the Longest Living People with Diabetes.
I must confess, I did judge this book by the cover and didn’t even pick it up off the book store shelf.
My first (knee-jerk) reaction was “that title sounds like something on the cover of a magazine at the grocery store check-out line.”
It draws you in with the promise of learning the “secrets” but if you look at the article, there are really no “secrets” at all. I seriously doubt that the book mentioned above has any secrets either.
My second reaction was, “It’s not just about living longer.” Here at My Health Village you’ll see the phrase Live Better Longer.
Health is about so much more than longevity.
If any of you do read this book and find some pearls of wisdom, please let all of us here at My Health Village in on the secrets!
Where’s the Beef, Round 2
Let’s do the quiz again, only this time we’ll compare the fat grams.
· DQ Choc. Malt (lg) or Wendy’s Triple Cheeseburger
· DQ Choc. Shake (lg) or BK’s Double Whopper with Cheese
· DQ Choc. Malt (reg) or Jack-in-the-Box Bacon Cheeseburger supreme
This time the beef “wins”. Here are the comparisons:
· 25 vs 68 grams of fat
· 26 vs 64 grams of fat
· 18 vs 46 grams of fat
What much fat should a person have in a day? It depends upon whom you ask. The American Heart Association suggests that on average adults should only eat about 65 grams of fat a day.
But that is total fat.
Is there such a thing as good fat? Although it’s important to be careful about all fats, the trans fats and the saturated fats are much harder on your arteries than monounsaturated or polyunsaturated fats.
For more information, visit the American Heart Association site at www.americanheart.org/presenter.jhtml?identifier=3055397.
Where’s the Beef?
Here’s a little quiz for you. For each pair of foods, select the one with more calories.
· DQ Choc. Malt (lg) or Wendy’s Triple Cheeseburger
· DQ Choc. Shake (lg) or BK’s Double Whopper with Cheese
· DQ Choc. Malt (reg) or Jack-in-the-Box Bacon Cheeseburger supreme
I don’t mean to pick on DQ, but they were the “winners”.
· 1060 vs 1040
· 990 vs 970
· 760 vs 724
These results surprised me. However, personally, I don’t care which order “won” the contest. I think they’re all losers.