It’s Not What You Do Between Thanksgiving & The Holidays, But What You Do Between The Holidays & Thanksgiving That Makes A Difference For Your Health!

The holidays are on our heels and many of us are already beginning to cast our healthy eating habits aside. With Thanksgiving on the horizon, many of us know that November 26^th will surely mark the beginning of the end. If you’ve been affected by holiday weight gain, you’re not alone. A recent study revealed that Americans gain at least one pound between Thanksgiving and New Years as result of holiday splurging. The holidays are a time for giving, a time for rejoice, a time for family and friends and time to be grateful for what we have and what we have coming to us. Unfortunately, the holidays are also a time for giving in to guilty pleasures. From bountiful thanksgiving feasts to decadent gingerbread cookies and peppermint schnapps, it’s no wonder we can’t just say “no!”

One month of letting loose wouldn’t be so bad if we were proactive about our health for the other eleven months out of the year. It’s time that we move balanced nutrition and regular exercise to the top of our to-do lists. There’s nothing wrong with a little holiday grazing, it’s expected, but it’s important to remember: everything in moderation.

Here are some ways for you to pepper some health into your holiday gatherings:

• Just a little is enough – The holidays bring a lot to the table. Literally. With so many different items to choose from, portion control and self-control for that matter can be difficult. Try just picking the items you really want to try and make sure that you’re not taking heaping portions.
• Skip the Drive-Thru  – In the midst of all the running around and last-minute shopping in the weeks leading up to the New Year, we find comfort in the convenience of fast food and drive thru meals. Although fast-food can be time-saving on the short-term, in the long-run, the fat and refined sugars will catch up with you and your health.
• Break out the Low-Cal – If you’re hosting a holiday gathering, offer some low calorie options for your family and friends to munch on. Set the table with a zesty low-cal ranch dip and serve with some crunchy carrots and celery for a tasty dipping experience. If you plan on visiting someone else’s home for the holidays, bring a healthy dish along with you – the host will surely appreciate it.
• Be Social – Don’t hover over the hors d’oeuvres. Mingle. Chat. Be merry. Chances are, if you’re socializing, you won’t have much time to gorge yourself with holiday offerings.
• Get your H²O – It’s important to stay hydrated, especially if you decide to enjoy some holiday cocktails with your close friends and loved ones. A good rule of thumb is to drink 2 glasses of water for every alcoholic beverage consumed.

Wishing you the best of health and a safe and warm Thanksgiving!

Health
UP-PGH’s Telemedicine

Information Technology (IT) is a great equalizer. How true that statement is turning out to be in the local health sector.
It is what the University of the Philippines-Philippine General Hospital (UP-PGH) looks forward to through the National Telehealth Center’s (NTC) telemedicine program.
The NTC shines with the potential to raise the Philippines’ capability to elevate health service in the boondocks to a high-technology level, particularly on the medical advice aspect, through IT.
At present, UP-PGH-NTC is already integrating into its curriculum the telemedicine program as a move to train future doctors on the use of the technology. It may take five more years, though, to make it part of the standard curriculum.
But even this effort may already take the country into a higher step.
“Even in America, their electronic health record is not embedded in the curriculum, so we will be ahead of them,” said Dr. Alvin B. Marcelo, NTC director.
More important, a telemedicine program can make available health service to isolated, remote areas that do not have any other access to a doctor.
“Having a doctor by telemedicine in an area without a doctor is better than having no doctor at all,” he said.
Telemedicine is of a greater need in the country than elsewhere because of its archipelagic nature.
“We need e-health more than developed countries. By default, our landscape is already disintegrated. I just came from Sri Lanka. They have a very nice health system. When you look at the map, they’re just one island. You just have to take a bus to go anywhere. Here, you have to wait for a banca, for a good weather,” he said.
NTC piloted its telemedicine program three years ago. It reaches out to 54 sites that meet three basic requirements– presence of a text service or SMS (short message service), presence of at least one doctor, and the lack of the rural doctor’s competence to give a medical advice on the case.
The need for a doctor’s service in poverty-stricken rural areas is so abject. There are only about 50 doctors operating in these areas, one doctor for each. Among these sites are Sulu, Batanes, Zamboanga, Tuguegarao, and Ifugao, specifically where the Department of Health (DOH) has assigned doctors under the “Doctors to the Barrios” (DTB) program.
These places used to be doctor-less, until natives requested government for one.
Unfortunately, there is no agency now that has a complete listing of other unreported doctor-less areas in the Philippines. DOH just learns there are areas like these when a request is made.
People may have perceptions that telemedicine involves the sending of Xray, CT (computer tomography) scan, or ECG (electronic cardiogram) images via internet broadband. True, that technology exists. And that’s actually the easy part of telemedicine.
But the hard part is what is NTC’s priority. It is in areas where broadband is not available, where there is only SMS, and where the need for medical advice among poor people is at the utrmost.
“Places where you have broadband are places where you have doctors. So there’s no great need for telemedicine. Those that need it are the islands and the boondocks where they don’t have (specialists) cardiologists, pulmonologists,” he said.
NTC should not really compete with doctors in broadband areas where there are competent specialists, or these doctors could be deprived of opportunities and choose rather “to leave the country,” according to Marcelo.
The mandate of NTC, as much as of UP-PGH, is to serve the underserved, the poorest of the country’s poor. Or those that have money, but have already exhausted their resources in private hospitals in search of a faster and better service, only to get their money drained in the end, leaving them to turn to a government hospital.
It is for the good of the patients too that NTC does not compete directly with local doctors in broadband areas. This way, when emergency occurs, they can turn to these doctors “who can touch them.”
“We don’t want to bypass local doctors. They’re there, they’re good . They can touch the patient, we cannot. They can provide better health care than us. We don’t do telemedicine there, or we’ll even screw up what’s already a screwed up health system.”
In telemedicine, a DTB doctor calls for help via SMS to doctors based at the UP-PGH linked through NTC. He sends to NTC a request for a specialist’s advice or an advice on a medical case he does not have expertise in. He sends this request in a specific format—one that contains an objective, a subjective, an assessment, a plan. A complete referral under the medicine profession requires these.
“That’s why doctors to the barrios are not deployed without training. They can’t just text ‘A 27-year old female with fever. What will I do?’”
The NTC then refers the DTB to a specialist at UP-PGH such as to Dr. Collante on an ear complaint or Marcelo himself on surgery.
NTC then sends back the medical advice to the barrio-based doctor.
Training of doctors in telemedicine is very important and is one area NTC is carefully putting its efforts into. It plans to integrate this training program in a medical education’s curriculum and also plans to get other schools to use this curriculum under a franchising system.
At the scale it has been operating in isolated areas, NTC has observed brisk growth in the need for telemedicine.
From only eight referrals from DTB doctors in 2006, this rose to 600 in 2007.
With an expansion, this can grow exponentially. The real limitation is in the number of doctors in the barrios.

The Community Guide – What Works to Promote Health?
Community Guide Branch, National Center for Health Marketing (NCHM), Centers for Disease Control and Prevention,
1600 Clifton Rd NE, Mailstop E-69, Atlanta, GA 30333, U.S.A

“What is the Community Guide?

The Guide to Community Preventive Services is a free resource to help you choose programs and policies to improve health and prevent disease in your community. Systematic reviews are used to answer these questions:

* Which program and policy interventions have been proven effective?
* Are there effective interventions that are right for my community?
* What might effective interventions cost; what is the likely return on investment?

More than 200 interventions have been reviewed and the Task Force on Community Preventive Services has issued recommendations for their use. Learn more about the guide, our systematic review methods, and the Community Guide team.”

Protect Yourself from the Flu

A leading flu vaccine producer, GlaxoSmithKline (GSK), has generously released this audio-visual presentation, originally developed for their employees, to the public:

GSK flu prevention video

When the new window opens, press the “Next” button on the lower right to continue.

This is the best presentation of its kind available today. Watch it yourself and show it to your family and friends.

If enough people follow the simple, common-sense steps outlined here, it can have a significant effect on reducing the swine flu pandemic. Because pandemic disease transmission follows an exponential pattern, even minor preventive steps like those explained here can have a major impact on total disease incidence.

I just got back from a really nice walk with the hubby and the Bebe (that’s my dog, in Tammy talk). Oh how I love summer nights! Oh how I wish it could be summer year round! Someday, we’re moving down south. Some fine day.

Since Carter and I just moved in to our new home a few weeks ago, we’re still discovering all that this town has to offer. We saw the entrance to a trail near our home tonight, so we decided to try it out. It turns out it went on FOREVER! I’m so excited, because walking with my husband and Kai is one of my favorite hobbies. Walking is such a great workout, and it’s a great way to catch up about anything and everything. Improve your health and improve your relationships all with a pair of sneakers! My kind of activity!

That’s not my pic, but I love any pic with a bichon in it! Here’s one of my bichon “siblings,” Leo. Isn’t he adorable?

I am so relieved to report that my appointment at the dermatologist yesterday went GREAT! I was so nervous on my way there that I thought I was going to have to pull over the car and throw up. I really thought I was going to have to have a whole bunch of moles removed. I’m like a polka dot puzzle, so I was sure there would be at least one mole that had to be removed. The doc was fantastic — kind, gentle and thorough. She told me that none of my moles looked worrisome, and that the most important thing I could do would be to check myself over 3 – 4 times a year and make sure none of the moles are changing. So that’s my skin care lesson for you for the day: changing moles are the ones to watch out for. Keep an eye on them, let your dermatologist know if they change, and go to the derm once a year.

And now for a fun, quick, and easy recipe: Spin-apple mozzarella hummus paninis!

Directions:

1. Choose some really yummy bread. We used Alvarado Street Bakery sprouted wheat raisin bread.

Photo from http://www.alvaradostreetbakery.com/

2. Lay some spinach on one slice of the bread. Top the spinach with a slice of mozzarella cheese.
3. Cut off a thin slice of a Granny Smith apple, and cut that into 3 pieces (so that when you bite into it, the whole thing doesn’t come off the sandwich). Lay the apple slices on top of the cheese.
4. Spread the other slice of bread with 1 T of hummus, and put the bread on top of the spinach, cheese, apple layers.
5. Press the sandwich in the panini press.
6. Chop the remaining apple while the sandwich gets all warm and melty.
7. Serve the panini with the side of apple chunks. So many flavors to excite the taste buds!

I’m going to a tobacco control conference for my job tomorrow, which I’m really excited about. I love these conferences because I learn so much about the field and about addiction and tobacco cessation. It’s so wonderful to finally have a job that makes me excited to hop out of bed in the morning. Never before have I woken up as soon as the alarm goes off . . . and without groaning.

My job experiences haven’t always been so awesome. It took a long time, lots of soul-searching, and lots of trial-and-error, before I found the right fit. Stay tuned for an upcoming post on job satisfaction and how to find it!

How to Eat More Antioxidants for Breakfast, Lunch and Dinner | eHow.com

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In Florida in the summer, this message cannot be stated enough:

WEAR YOUR SUNGLASSES!

The Miami Herald reported that, according to Tim Murray, MD, of the University of Miami’s Bascom Palmer Eye Institute, “both types of ultraviolet radiation — UVA and UVB — can damage various parts of the eye,” which “can cause cataracts and an increased risk of macular degeneration.” In addition, “extreme UV exposure can also cause growths on and around the eyes, and an increased risk of cancer in the tissues around the eye and the eye itself, he said.”

To reduce the risk of sun-related eye damage in children and adults, “the American Optometric Association recommends” sunglasses that “absorb at least 99 percent of UV rays, a number verified by the FDA that can be found on the labels attached to sunglasses.”

And, “for those who spend extended periods of time outdoors,” the AOA “recommends wearing wrap-around sunglasses that cover the temple area, as light can enter the eyes from the sides of the face.” In fact, optometrist Judi Schaffer, OD, “often recommends polarized sunglasses to her patients because they are the best for blocking out harmful rays.” (from AOA first look by Custom Briefings.)

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
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A friend and colleague, optometrist Jeffrey Anshel, appeared on television yesterday to discuss Computer Vision Syndrome.

It is a little light-hearted reminder to pay attention to your eyes when you are at the computer. And if you experience discomfort or fatigue at the computer, be sure to get your eyes examined.

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
Connect with Us:  YelpFacebookTwitter

There can be no doubt that all of us, especially children, are doing hand held work more frequently and more intently than ever before.   All you have to do is look around any restaurant, doctor’s waiting room, or mini-van, and you will see people of all ages do this.  They are reading, playing hand held video games such as the Nintendo DS or the PSP, or using their Iphone or Blackberry to watch videos and keep in touch with others.

All of this technology is great, but it can come with a cost – visual discomfort that can interfere with proper vision.

In addition to using proper posture and taking frequent visual breaks from intensely focusing up closely, another important element is how close  a person is to the object they are looking at in their hands.  A good way to tell if it is the right distance is by using the “Elbow Distance” rule.

Research on human ergonomics has determined that the optimal  visual distance for reading and other close work is the Harmon Distance or “Elbow Distance”.  This distance is measured by placing a closed fist under the chin. The point at the end of the elbow represents the closest distance a person should be from their near work.

The beauty of applying Elbow Distance is that as we grow, so do our arms. You would expect a child to hold objects closer than adults.  So instead of a “one size fits some” rule of a certain number of inches, the “Elbow Distance” can apply to almost everyone.  Go ahead and try it on yourself now and see if you hold a magazine or cellphone at your Elbow Distance or a little further.

Some people get so absorbed in their games or reading that when they get very close to their work, they are placing undue stress on their vision.  I am also very guilty of this.  When I get 4 to 5 inches from what I’m writing, my eyes have to work harder to keep the words clear because of the close distance.  But if I keep the right distance, the visual system relaxes and performs more efficiently – and I can really tell a difference.

If children or adults frequently get extremely close to their books or games, this may just be a bad habit.  But it can also be sign of a visual problem. Either way, it is best to get an exam performed by an eye doctor who specializes in visual efficiency.  They can determine if there is a problem and if glasses or vision therapy might be needed.

Be well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
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This morning, I woke up bright and early to get ready for my 8:15 appointment with the orthopedist. Unlike how I feel before going to some doctors, I was actually excited to visit this one.

Jenna over at Eat, Live, Run has posted about her orthopedic appointments, and after reading several of her posts, I thought to myself, Why should I needlessly suffer through my running pains? All it takes is a little of my time and a little of my money, and pain-free running is definitely worth it.

Here’s a quick summary of the issues I’ve been having. Throughout high school and college, I experienced pain in the outer, lower portion of my right leg after running on the treadmill. Whenever I attempted to run outside, the pain felt much worse. With the discovery of the New Balance 991 sneakers (which then became 992s and then 993s), I seemed to find part of the answer to my problem. I only occasionally experienced pain in my leg, and it didn’t hinder my running.

This has continued to be my running experience since I graduated college back in 2004. Sometimes my treadmill runs are completely pain-free, and other days, I feel so much pain in my right leg that it is tender to the touch. I simply take a few days off running, and I’m almost as good as new. I’ve also found that massaging and icing my leg, weighted heel raises, and the use of an Ace brace all help quite a bit.

However, a few months ago, I started having a very irritating pain in my inner arch of my left foot. It’s not so painful that I can’t run, but why should I have to feel any pain at all? And what if it’s the beginning of a problem that, undiagnosed, becomes progressively worse? And, what if there’s a simple fix that could make running pain-free? I’d love to be able to run faster, more often, and for longer distances.

I shared all of these symptoms with the orthopedist today. He also examined my running sneakers and noticed that I run on the outsides of my feet, because the outsides of my sneakers are worn. Somehow, he could also tell that I pronate inwards. I think it’s so neat that sneakers can be used to tell a story and help form a diagnosis. The doc then had me take off my socks and stand in front of him. “Those are some flat dogs!” he exclaimed. Ha, he called my feet dogs. I love it. In other words, I have extremely flat arches. There’s a great article on flat feet and over-pronation on the British Footlogics orthotics Web site.

Photo from http://www.painfreewalking.co.uk/flat-feet-overpronation.html

In addition to flat arches, running on the outside of my feet, and pronating inward, I have a tight plantar fascia in my left foot (thus the pain in my left foot). The pain in my right leg is an anterior shin splint. After confirming via x-ray that there were not more serious issues, the solution was pretty simple. The replacement of my insoles with Hapad Comf-Orthotic sports replacement insoles should provide the arch support I need and clear up the pain in my shin and my foot in two weeks! I’m keeping my fingers crossed! If I still have pain in three weeks, then it’s off to a physical therapist. Either way, I’m relieved that I don’t have a serious problem that will hinder my running.

The moral of this story: take action. Make the appointments that you need, whether it’s with an orthopedist, a dermatologist, an optometrist, or any other specialist. Prevention is key, and it’s better to take care of problems before the mushroom into something bigger.

With that said, next on my list is making an appointment with a dermatologist. Melanoma runs in my family, and that is not something to mess with! I’m very scared, but I know in my heart that the younger I go, the better.

It feels so good to finally take action of my health. It all started with going to a Registered Dietitian to finally beat my eating disorder. When I accomplished that, I felt like I could do anything. When we face our fears and address our health concerns, we have the potential to live happier and healthier lives AND we can eliminate the stress that stems from worrying about what health problems may or may not plague us. Isn’t it better to know and take action than to wonder, worry, and allow a potentially minor problem turn into a major one? I think so!

What are you going to do to take charge of your health? Get a cholesterol screening? Get your blood pressure checked? Get a bone density screening? Make an appointment with a personal trainer?

Go for it!

I have been telling my patients for quite some time that omega-3 fatty acids are good for the eyes. These essential fatty acids can help people with dry eye disease.

A recent study also shows that it can reduce the risk of sight-stealing macular degeneration, too:

Two studies released this week in the Archives of Ophthalmology show adults who followed a Mediterranean-style diet high in omega-3 fatty acids found in fish, nuts, and olive oil and low in the trans fats found in baked and processed foods have a much lower risk of developing the sight-robbing disease.

This is one more reason to pay attention to your diet and talking to your doctors about omega-3 supplements if you think you don’t get enough.

Eat well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
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Obesity prevention in young children: what does the evidence say? Parliament of Australia – Parliamentary Library Background Note 1 May 2009   13 p.
Dr Anne-marie Boxall, Social Policy Section

The recent swine flu outbreak in Mexico reminds me that, although lately I’ve been working on other things, I should also continue my work in health policy research and related areas.

Here we consider the problem:  in a flu pandemic, what strategies can we use to conserve scarce vaccine?

Let’s assume, for example, that during the first 3 months of a flu pandemic, a country has 1 million doses of flu vaccine.  How can this quantity, which is not sufficient to immunize the entire at-risk population, be used as effectively as possible?

First we need to decide what “as effectively as possible” means.  Is the objective to minimize total mortality, to minimize mortality and morbidity, to maximize what are called QALY’s (quality-adjusted years of life), or to reduce negative economic impact?  All of these are defensible criteria.  This requires some careful analytical modeling and work.

As just one example related to this, should scarce vaccines be direct more towards children, young adults, or older adults?  Older adults are a likely target, as they have the highest mortality rates in a flu pandemic.  However they are, unfortunately, least likely to exhibit a positive immune response to flu vaccines.

Conversely, children respond well to the vaccines; and by potentially saving a child’s life, one theoretically gains  many years of productive life. Further, while this may require further epidemiological study, children, who attend school along with dozens or hundreds of other children, are probably disproportionately both at risk for flu and involved in transmission once they catch it.   However school-age children also tend to have fewer complications and lower mortality rates with flu.

In the end, an optimal allocation of flu vaccine may require a fairly complex analysis and/or computer simulation.  Various parameters that feed these analyses would need to be quantified beforehand.  For this we would have two choices:  (1) either estimate the parameters based on a combination of guesswork and literature review, or (2) to conduct small experimental studies aimed to supply more realistic values.

The choice between (1) and (2) could itself be made by performing mathematical sensitivity analyses within the simulation models; highly sensitive parameters — those for which small differences have a large effect on results — would be worth investing more money to quanity precisely.

In general, it should be noted that everything discussed here — simulations, literature reviews, mathematical analyses, etc. — are extremely inexpensive compared to the costs of large-scale population immunizations.  Half a million dollars, say, buys an immense amount of mathematical research.  And it could easily save tens or even hundreds of millions of dollars by preventing disease or streamlining immunization efforts.

Predicting Individual Response to Vaccine

Another productive area of mathematical modeling here would be to try to predict individual  response to vaccines.  For a given flu vaccine, only a certain proportion of people develop the intended antibodies.  For a particular population and vaccine, for example, this rate may be only 70%.  It would be worthwhile to know in advance whether a given person is among the 70% that respond to a vaccine or the 30% that do not.  If someone won’t probably won’t respond, spare the vaccine dose and give it to someone who will.

Such analyses can be performed using routine predictive statistical methods, like logistic regression, or perhaps more modern techniques.  Possible predictor variables might include:  subject age, sex, immunization history, flu history, ethnicity, overall health, weight.

Other predictive variables might be measured via blood tests or even DNA testing.  The choice concerning how heroically to collect predictive variables would depend on factors unique to the pandemic, such as the virulence of the strain, and the amount of existing vaccine.  In theory, if a flu strain is dangerous enough, and if vaccine is scarce enough, literally every available dose must be directed to someone it can potentially benefit.  In that case even as expensive (currently) a procedure as micro-array DNA screening could be utilized.

Other benefits from mathematical modeling and prediction in a pandemic might come by analyzing cross-reactivity of previously-developed vaccines for the current flu strain.  In the past vaccines have been developed for perhaps dozens of flu strains.  In theory, each of these vaccines is unique.  The usual assumption is that a vaccine for one flu strain offers little or no protection for a new strain.
However, that is not always the case.

The only way to be sure would be to test old vaccines against the new flu strain.  In theory, this could be done using human subjects in only a few days, at the outset of a pandemic.  All that is required is to administer an old flu vaccine to a subject, wait a few days, and then see if their blood contains antibodies effective against the new strain.

Perhaps this is a long-shot, but we might get lucky, and would lose nothing by trying.

An even more elaborate strategy would involve trying to predict cross-reactivity of previous flu vaccines to the new strain in a particular patient.  That is, by considering demographic, biological, or genetic variables of a given subject, we might identify those will exhibit favorable crossreactivity.

In addition, we could probably make some good guesses about crossreactivity simply by comparing the genetic composition of the new strain to previous ones, and applying mathematical or artificial intelligence models.

More broadly, there’s a lot more we can do at the behavioral level to prevent or limit a flu pandemic.  Public information aimed at teaching people how to prevent spread of flu is effective and cost-effective.  The pharmaceutical company GSK, for example,  has produced some excellent web-based presentations that teach people about flu prevention.  People need to learn, for example how to wash their hands correctly (30 seconds; warm water; wash both sides and between fingers).

Personally, I would like to see studies done on the potential preventive effects of wearing surgical masks on airplanes or subways.  Or perhaps, in the case of airlines, does anybody know what’s going on with the air recirculation system?  Is it filtered, and, if so, can the filters trap virus-bearing dust particles?  Airlines might be reluctant to address this issue.  Pictures of mask-wearing passengers isn’t exactly good advertising.  But on the other hand, people now are already avoiding air travel because of flu fears.  If the airlines could show that masks significantly reduce risk of contagion it might actually be good for them.

This week there was no consistent theme but definitely some interesting items.

·        Collaboration

This article from Bloomberg and Harvard Business Review may provide some insight into benefits of an integrated Health IT environment by enhancing collaboration.

http://www.bloomberg.com/apps/harvardbusiness?sid=Hd35c8bed1e982b47e582a4c063220ecc

·        IBM

This is not an endorsement of IBM per se.  I came across some of their case studies of Health IT on their website.  It includes initiatives in Japan for preventive health, in Canada for home healthcare, and with Google and Continua Health Alliance for personal healthcare records.

http://www.ibm.com/ibm/ideasfromibm/us/smartplanet/topics/healthcare/20090223/index.shtml?sa_campaign=message/leaf1/smarterplanet/heathcare

·        Nursing

From Zogby, Cisco is releasing a platform to improve communications between nurses and patients.

http://www.zogby.com/Soundbites/ReadClips.cfm?ID=18816

·        PHR

The NY Times offered this extremely interesting concept: large Hospitals providing PHRs to patients.  There logic is quite sound.  These hospitals usually deal with referrals so PHRs would ensure complete medical histories.  This may be an avenue worth pursuing to get everyone a PHR.

http://www.nytimes.com/2009/04/06/technology/companies/06health.html?_r=1&hpw

·        General Innovation

In a report on the HIMSS Conference, the NY Times discusses a targeted medical alert system sponsored by GE and CDC.  The goal is allow informatics to improve public health.  There also is a discussion about a partnership between IBM and the Mayo Clinic in order to develop a natural processing language.

http://bits.blogs.nytimes.com/2009/04/05/health-care-industry-moves-slowly-onto-the-internet/

·        Kaiser Permanente

This is an article from business week.  It provides a great overview of Kaiser’s approach to Health IT adoption.

http://www.businessweek.com/technology/content/apr2009/tc2009047_562738.htm?chan=top+news_top+news+index+-+temp_news+%2B+analysis

·        North Carolina

This article from Fierce Health IT and the Winston-Salem Journal discusses some of the costs involved with Health IT roll-out.

http://www2.journalnow.com/content/2009/apr/06/shift-may-take-time/

·        White House

The President is putting support behind joint DOD-VA Health Record.

http://www.defenselink.mil/news/newsarticle.aspx?id=53857

V4 Fitness Preview Photo, www.balancedstrength.com/v4fitness/

Most of us have set health & fitness-themed New Year’s resolutions, as we have in years past. Many of us have had difficulty meeting those goals…

I’m plugging a little shameless self-promotion in this blog post, since a project that I have been working on for nearly 6 months will finally go live this week–just in time to give you tools to achieve success in conquering those pesky resolutions!

Balanced Strength, Inc. presents V4 Fitness…a members-only, one-stop, total fitness community that provides you with resources and expert advice on exercise, clinical and integrative nutrition, Habit Reprogramming™, weight loss, injury prevention, and stress management.

We strive to help the busy working professional learn how to get and stay healthy and fit when time is your endangered resource. Your membership entitles you to:

• Communicate with experts in fitness & wellness at your convenience.
• Interact with others in the private blog, “Coaches Corner”.
• Access the comprehensive Exercise Library.
• Receive daily exercises that you can do in your office and at your desk.
• Receive healthy lifestyle tips.
• Be accountable for a daily healthy habits checklist.
• Track your wellness progress.
• Register for online fitness competitions that help you get fit fast.

Sign up on our preview list at http://balancedstrength.com/v4fitness/ before January 1, 2009, and you will receive a free one-month membership upon our launch!

For more information about V4 Fitness and your membership benefits, visit http://balancedstrength.com/v4fitness/.

For the month of January, I am also offering my workshop, “Ready, Set, Fit” free to your corporations! After attending this workshop, you will have the tools to overcoming the obstacles that keep you from meeting your health & fitness goals and set milestones toward achieving your successes. Contact christine.kwok@balancedstrength.com for more information and to book your event.

The cover story on the December 1, 2008 edition of Time Magazine is “Annual Checkup: The Sorry State of American Health.

The Sorry State of American Health

In review, the article identifies the problems of our current healthcare system.  This includes the irregular correlation of having the highest healthcare spending in the world with shorter life-expectancy ages and higher infant-mortality rates (among developed nations).   It stresses that despite the overcoming of smoke addiction, us Americans still do not lead healthy lifestyles.  We also have Americans who do not have insurance / access to a doctor. 

When I am reading these articles on health, I feel like I am reading a recycled newspaper over and over again.  The points that matter on healthcare do not seem to drive home into our country’s agenda.  The talk is always about lowering healthcare costs, mostly by pointing fingers at insurance companies.  I believe this is important, but the most important matter of all is stepping up preventive healthcare.  
Preventive healthcare is the reason why there are less heart attacks. It’s the reason we are more aware of what food causes diabetes. Sure, our medical costs are increasing, but taking the time to learn about preventive health is Step 1.  And it is not just preventive health technology.  It’s also education and awareness of health.  The more I read these articles, I strongly believe Project MINE is set on the correct path in taking one step forward.  As Neil Armstrong said, “One step for man, one giant leap for mankind.” Reinventing and restructuring the American healthcare will have its giant leap in due time, but we must first take steps in the right direction.

We need more preventive health.

The superior doctor prevents sickness;
The mediocre doctor attends to impending sickness;
The inferior doctor treats actual sickness;
-Old Chinese Proverb

Comments: This saying exemplifies the holistic concept of Chinese traditional medicine, whereas Western medicine focuses mainly on curative treatment. If there’s an infection, the Western-trained doctor would focus on antibiotics to knock off the bug, but Chinese medicine would attribute it to imbalance of forces in the person and focus on their general wellbeing and rectifying the imbalance. There is a greater emphasis on prevention; as seen by the omnipresent barefoot doctors promoted by Mao Tse-Tung in the 1960s.

Medical students should not forget that preventative medicine is the backbone of their role as doctors and not over-emphasize curative treatment. The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease, so said Thomas Edison.

Management staff can learn from this too : it is important to pre-empt any problems from arising; by looking out for warning signals, rather than allow untoward events to eventually happen.

People often think about eye injuries related to sports and the 4th of July. And that is a good thought. But also remember that many eye injuries occur around the home.

“Almost 40 percent of eye injuries happen to people doing yard work or gardening at home, yet few people think about wearing eye protection during these times.”

You can follow these  steps from Prevent Blindness America to protect your eyes:

• Wear safety glasses with side protection or goggles when mowing or using a weed eater or power cutting tools, like saws or trimmers.
• Check your yard and remove debris before mowing.
• Turn off power tools when near an unprotected bystander, especially young children. Bystanders and helpers should have eye protection when tools are in use.
• Wear goggles to protect your eyes from fertilizers, pesticides and other yard chemicals, including lime dust.
• Read and follow all product instructions. Obey warnings on yard chemicals and equipment.
• Wear eye protection when using any chemical. After any project, wash hands thoroughly before touching the eyes or face.

You can read more here: http://www.healthday.com/Article.asp?AID=619112

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care

Raindrop technique incorporates massage-like hand work, Native American healing, “Vita Flex” (technique from Tibet) and intensive application of therapeutic quality essential oils on the feet and spine. 

The Raindrop Technique,(RT) uses 7 single therapeutic quality essential oils and 2 blends as well as a high quality massage oil imbued with additional essential oils.  The oils are dropped onto the back like drops of rain from about 6 inches high, and they are feathered and “massaged” along the vertebrae and back musclesOnly the highest quality essential oils should be used to perform any intensive aromatherapy technique; buy your oils from a producer willing to answer some basic questions about their growing, testing and distillation processes. You need to know that you have pure, therapeutic quality oils and not food or perfume quality. (Young Living Essential Oils is the only producer in America that regularly tests both the oils it grows and the oils it purchases to assure that they meet the purity and quality standards required for intensive uses of essential oils. To order them, go towww.YoungLiving.org/tjohnson) See also “Distillation and Purity of Oils”

www.YoungLiving.org/tjohnson) See also “Distillation and Purity of Oils”

The oils include:

• Oreganum compactum (oregano),
  
• Thymus vulgaris (thyme),
  
• Ocimum basilicum (basil),
  
• Cupressus semipervens (cypress), 
  
• Gaultheria procumbens (wintergreen),
  
• Origanum Majorama (marjoram,
  
• (Mentha peperita (peppermint).  
  
• Valor- an energy balancing blend, and
  
• Aroma Seize, a muscle relaxing blend.  
  

Together, these oils work to

• fight bacteria, viruses, and fungi, 
  
• reduce inflammation,
  
• support circulation,
  
• support the immune system, and
  
• relax both voluntary and involuntary muscles.  
  

This allows the spine to relax and allow a natural adjustment to the spine; often the recipient will elongate and measure a bit taller.

The oils also enter the body and act as a natural solvent to help to loosen debris including cellular metabolic debris and accumulated toxins that we experience daily.  Drinking plenty of water is an absolute must when receiving or giving Raindrop. .  Link to Order RT Kit

Link to Order RT Kit

RT was formally developed in 1989 to assist those with scoliosis- based on the theory that germs and micro-organisms can reside in the tissues near the spine, causing deformities. Studies at Western General Hospital in Edinburg, Scotland indicate that virus-like particles are linked to idiopathic scoliosis. At the University of Bonn, it was found that varicella zoster virus can lodge in the spinal ganglia. And in 2001 more research corroborated the existence of infectious microorganisms as a cause of spine pain and inflammation. What we have found over time is that the powerful infection fighters used in RT can help people with many other issues and support the immune system.

In 2001, Dr David Stewart, PhD, circulated a questionnaire to over 200 health practitioners, massage therapists, aroma therapist, and their clients, to gain insight on the results that were accruing from the RT. 422 responses were received summarizing over 14,000 Raindrop sessions. His findings are summarized in his booklet, A Statistical Validation of Raindrop Technique (available from Essential Science Publishing.) Overall the 416 respondents who had received RT rated it positive (97%), pleasant (98%), resulted in improved health (89%) and resulted in improved emotional state (86%). 99.9% of receivers said they would choose to receive RT again. (See also“Before Your Raindrop- Please Take Note”)

“Before Your Raindrop- Please Take Note”)

There are many subtle variations of the technique; ALL variations of true Raindrop Technique make use of the same therapeutic quality oils. This is not the lotions and soaps type of aromatherapy you may have gotten acquainted with.  (see also – “3 Schools of Aromatherapy”)

The full technique with feet and spine takes about 45 to 75 minutes and generally costs from $100 to $120 per session with some luxury resort areas getting $140.

If you can find and attend a class, it is wise to learn and apply RT as a preventive program for the health of your family. If you are a professional massage or body worker, Seewww.RaindropTraining.com for information on the official Center for Aromatherapy Research and Education program which is accepted by the NCBTMB.

www.RaindropTraining.com for information on the official Center for Aromatherapy Research and Education program which is accepted by the NCBTMB.

NOTE- Information contained in this article is not intended to diagnose or replace medical advice, please seek the opinion of your medical practitioner. As always, you are encouraged to arm yourself with education- your health is ultimately up to you.

Postprandial: following a meal

Plunge: to descend precipitously

Perhaps I exaggerate – but plunge was the only p-word that comes close to what happens to me after lunch most days… (and after as little as one glass of wine w. dinner) – I want to get horizontal and shut my eyes.

Supposedly it has something to do with blood sugar levels, but it doesn’t seem to matter whether I eat a low or high carb meal; I just get sleepy.

And then I resist it.  I sit at my computer trying to write, trying to compute, trying to think through a problem — gaining no traction but refusing to succumb.  If I get up and tackle a physical chore I can sometimes barrel through it, but at a detriment to my effectiveness.

Half an hour after a nap it’s as if I rebooted my whole system, and all the resource-hogging resident programs in my brain have cleared out.  My question to myself is this: why don’t I just go with the flow and make room in my schedule for a daily nap?

Napping is a high art in some cultures; there’s no shame attached to it. It’s probably good for your health, as a recent study from Greece indicates.   From that story in the NY Times:

Now, out of Greece, comes permission to do exactly that. A study of more than 23,000 adults shows that those who napped for about 30 minutes each week had a 37 percent lower risk of dying from a heart attack than those who did not.

So this should mean that all working Americans will receive permission from their bosses to close their eyes every afternoon at about 4 p.m., right?

Don’t bet your blankie on it.

This is hardly the first study showing that sleep is more than simply time when we really should be at work. Other studies, though few as extensive as the Greek research, show that short periods of sleep during the day increase productivity and creativity while reducing stress. And even without surveys, we know this from experience.

When you need a nap, you need a nap. Nothing — not caffeine, not a chocolate bar, not a pill — recharges the battery in the same way.

I welcome you to join me…

Two women are washing their laundry by the river. One looks up and sees a basket floating by, and in the basket is a baby! She wades in and pulls the basket to shore.

She’s cuddling the infant when another basket floats by with a baby in it. She wades in and grabs that one too. Then there’s another and another.

She calls to her companion to help, but instead of jumping into the water, the other woman is running upstream along the riverbank.  “Where are you going???” the wading woman yells. “We’ve got to save these babies.”

“I know,” yells back the second woman. “I’m going upstream to find out who’s putting the babies in the water. And I’m going to stop them.”

This story illustrates two very different approaches to solving a serious problem: the bandaid model (symptom relief for individuals), and the public health model (community-wide prevention strategies).

Our current medical system is still primarily based on the bandaid model. Folks get sick or hurt and the doctor fixes them. Take diabetes (please). Diabetes until recently was something that happened to you and then the doctor patched you up with insulin. And while it’s true that some folks have a genetic predisposition to diabetes, it turns out that today’s epidemic is a result of our eating too much (crap) and exercising too little – on a grand scale.

I came around to a public health perspective many years ago through my own personal experience of trying to lose weight. I tried about as many diets as there were weeks in the year, and failed at every one of them. It gradually dawned on me that specific diet programs (eat this, don’t eat that) were bandaids that covered up deeper issues – that only more awareness, an attitude shift and behavioral changes could fix, once and for all. Once I resolved those issues and changed my behavior the need for a special diet disappeared, as did the excess weight.

This got me thinking about how much trouble you could avoid if you could prevent the overeating in the first place. For example, working with kids before they developed bad eating habits, educating their parents about nutrition, improving school lunches and PE programs, and then going back even further in the chain to the suppliers of our food. (I was a few decades ahead of the curve here!).

Instead of trying to help individuals lose weight after they’d gained it, giving them insulin after they got diabetes or statins when their cholesterol was too high (bandaids), where could you shove a stick into the cogs of the machine to effect the greatest preventive benefit to a whole bunch of people?

These questions led me back to school for a masters in Public Health. Ever since, I’ve been the woman running upstream to find out where the babies are coming from.

The public health perspective asks foundational questions: Where does the problem begin? How could we prevent it from occurring in the first place? Here are a small sample of profoundly important measures that have come out of those questions: safe drinking water; sewage treatment systems; vaccinations (small pox, polio, measles, pertussis, hepatitis, etc etc), mosquito abatement projects (malaria), occupational safety regulations, food inspection programs, pre-natal care for women, family planning education programs….

Of course many of our public health problems are not caused by pathogens like polio or cholera. They are caused by money-making enterprises whose products turn out to be toxic. Tobacco. Asbestos. Certain medications like estrogen-replacement therapy. Foods made with trans fats. Leaded gas and paint.

Or they’re a result of toxic by-products of the manufacturing process:  nuclear waste, coal-fouled air, water fouled by all manner of manufacturing processes as well as grazing animals, and so on.

Business hates being told how to conduct itself and rarely ceases a practice unless under threat of penalties and lawsuits. This means the public’s safety is often at the mercy of our elected officials, many of whom (Republicans esp. under this disastrous Bush administration) do not have a public health perspective. For them it’s about the bottom line AND about getting re-elected.

Even Democrats, who are more sympathetic to prevention and regulation, need money to get re-elected. Unfortunately the very toxic industries that need regulating are often the biggest campaign contributors.

That’s the first pickle.

The second pickle is that public health campaigns are long-term investments. What we must pay out today to prevent a future epidemic or catastrophe seems like a huge chunk of change when the payoff could be decades in the future. Often we can’t begin to grasp what the catastrophe might be like that we’re paying to prevent.

When Al Gore suggests an investment of $5 trillion for us to make a switch to 100% renewable energy sources in ten years we balk. But when inaction may cost us the very survival of humans on earth: well, that’s a profoundly ponderous public health pickle.

My Colleague Dr. Dan Fortenbacher maintains a blog called EXCELerated Vision that contains lots of great information on vision and visual development.

Recently, there have been some very useful posts on Infant Vision. The first contains an audio interview with Dr. Andrea Thau, one of the founding members of the InfantSee program. She discusses the importance of infant vision examinations.

There are also recent posts that contain detailed list of ways to encourage proper visual development for babies 0 to 3 months and 4 to 8 months of age. If you have a little one in your life, I encourage you to check this out.

(From the MyVisionTest Newsletter)

A new research study published in the May 2008 edition of the British Journal of Ophthalmology finds that lifetime exposure to sunlight is an important factor in the progression of late AMD (age related macular degeneration. They report that an individual’s sensitivity to sunlight exposure may have a role in AMD progression in addition to total lifetime exposure to sunlight.

In this case-control study of 215 Japanese men aged 50 years and older, facial wrinkle length and area of hyperpigmentation, which are considered to be associated with exposure to the sun, were measured using imaging and computer-based image analysis. Skin tone was also measured on the upper inner arm, which is not exposed to direct sunlight. Early and late AMD association with skin measurements was evaluated.

The researchers found significantly more facial wrinkling and less facial hyperpigmentation was present in late AMD cases. The relationship between skin tone and AMD risk was not statistically significant.

The investigators conclude that lifetime exposure to sunlight is an important factor in the progression of late AMD. An individual’s reaction to sunlight exposure, as reflected through the development of focal hyperpigmentation on sun-exposed skin, may have a role in AMD progression in addition to total lifetime exposure to sunlight.

WHAT IT MEANS TO YOU: There is good evidence that sunlight exposure plays some role in the development of cataract and macular degeneration. The precise nature of this role remains to be defined, but it makes sense to take appropriate precautions to safeguard your eyes when spending time outdoors. These precautions include a broad brimmed hat and 100% UV filtering sunglasses. For additional protection, consider blue-blocker sunglasses. Those individuals that are most sun-sensitive (ie. burn easily, less hyperpigmentation) appear to be most at risk for the damaging effects of sunlight.

SOURCE: http://bjo.bmj.com/cgi/content/full/92/5/630

I(nvolve) started working on a project for the NHS Institute last year looking at how new technology can offer opportunities for people to engage in healthcare more effectively. (Think preventative health agenda and Wanless report/s.)

Needless to say, by the time we’d been through all of the research and written the thing up, you could have added so much more to the final document- it looked like things were going out of date – and fast!

As a result we worked with the Institute to make a webspace out of the document with some interactive elements to encourage sharing of ideas amongst NHS staff - you can comment on reccomendations and themes of the report and also upload relevant projects.

The idea is to introduce a more collaborative way of working into the research and dissemination process – which can otherwise be quite a dry and static experience- and to kickstart the process of moving forward with implementation of new tech/health ideas.

Would be great to have some input into the site and some feedback on how to go forward with the ideas behind the project, and of course, please pass on the info to healthcare types.

Here’s the link to the main site.

According to a report from the American Academy of Ophthalmology, every year in the United States, about 40,000 people suffer sports-related eye injuries. Many of these injuries could be prevented with the proper eye-protection. Some people don’t think they need protection because they won’t get hurt or think of the old-style sports goggles that interfere with vision. But in truth many people do get hurt and sports eyewear is better than ever.

“It’s absolutely necessary for athletes to use protective eyewear because eye injuries can be devastating,” says Ophthalmologist Ruth Williams. “Wearing properly fitted protective eyewear will not harm your performance in a game, and it may save your sight.”

If you play sports, especially sports such as basketball, football or soccer, you should not be wearing your glasses, because they are not designed for sports. Consider getting prescription sport eyewear. They will improve your performance and reduce the chances of injuries.

In a similar topic, check out more info on sports vision and the exercise-myopia connection.

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care