East Baton Rouge Parish
8742 Goodwood Blvd.
Baton Rouge, LA 70806
(225) 231-7070
Vermilion Parish
121 E. St. Victor St.
Abbeville, LA 70510
(337) 893-0810

Hot Topics

Acid Reflux, Heartburn, & Dyspepsia

Heartburn is usually a burning pain in the lower chest along with a sour or bitter taste in the throat. Some also feel bloated, an upset stomach with burping. It is caused by stomach acid spilling up to oesophagus(reflux), the tube leading from your stomach up to your mouth. Normally, as the food passes into the stomach, the opening between the stomach and oesophagus closes. However, as in the case of hiatal hernia, when upper parts of the stomach squeezes thru the diaphragm (the muscle separating the chest from abdomen) and enters the thoracic cavity, this closure may not work. It can also be caused by certain types of food, habits, and lifestyles increasing stomach acidity as well as medicines and diseases such as ulcers. If it is not prevented or treated, continous irritation of oesophagus can lead to inflammation, bleeding and trouble with swallowing. Therefore, if you have heartburn/dyspepsia as some people perceive as indigestion see your physician if you:

• Are older than 50 years
• Recently lost weight unintentionally.
• Have trouble swallowing
• Have bloody, dark and black stools.
• Have vomiting
• Feel a lump in lower chest or stomach.
• Vomit blood
• Break out in a sweat with chest pain.
• Are dizzy or lightheaded.
• Chest pain going to your neck and shoulder
• Have shortness of breath
• Have heartburn more than 3 times a week ongoing for more than 2 weeks.

Millions of people suffer from heartburn and many take pills, thanks to aggressive pill ads which do not contain any preventive measures! As a matter of fact, heartburn can well be avoided with the following guidelines, which lead to a healthy lifestyle before switching to pills:

• Decrease intake of coffee, alcohol and colas.
• Stop or reduce smoking.
• Avoid acidic, spicy and fatty foods(tomatoes, chocolate, citrus fruit juices).
• Eat frequently small amounts, slowly and chew them well.
• Do not lay down before 3 hours after you eat.
• Take naps on a lazy boy.
• Don't exercise until 2 hours after you eat (cramps).
• Lose extra weight. Being overweight enlarges your belly, increases pressure on the stomach causing reflux.
• Do not wear tight clothes or belts especially under your stomach.
• Elevate the head of your bed by placing 5" blocks.
• Keep away from medicines containing ibupofen, naproxen or aspirin.

If these measures do not help, try some antacids containing both magnesium and aluminum hydroxide. Or you can try over the counter Pepcid, Tagamet and Zantac. However, if you need to use these pills all the time, see your doctor.

Alcohol and Drug Abuse

Many people are not aware of their problem with alcohol, a lavishly, very effectively, and subliminally advertised product (e.g., movies). The industry producing alcoholic beverages and cigarettes together with the media making a living on advertisements regardless of the effects of these products have indeed been very successful in ingraining these drugs into our lives. Thus, we drink when we are sad, when we are mad, when we are happy and even when there is nothing happening and when we are bored. There are about 10 million alcoholics in the US. Alcoholism tends to run in the families. Therefore, children of especially alcoholic fathers should be advised to keep away from alcohol. If you agree with any one of the following statements you may really have a serious addiction problem which needs immediate attention.

• The amounts of alcohol or drugs do not give the same kick or high as they used to. Therefore, you need to consume more to get the same relief.
• You feel guilty about your alcohol and drug use and hide them.
• You feel or someone tells you to cut back on alcohol or drugs.
• You feel upset when someone teases or tells you about your use of alcohol or drugs.
• You need a drink or other drugs to calm you 'eye opener' in the mornings.
• You tend to forget recent events during and after drinking episodes (blackouts)

Alcoholism is protected by the Americans with Disabilities Act. Therefore, if it does not effect the essential functions of your job, you can continue working and your employer will allow you to submit to treatment while respecting your privacy. Alcoholism or drug abuse is a lifelong disease affecting all those who live and work with you. Once you are sober and can successfully abstain from using drugs or alcohol you need to continue to keep away from them for the rest of your life. In the US many support and treatment groups advocate complete abstinence. Unfortunately, many of those who are treated and sober return to drinking. In England however, relapses are said to be much less, where treatment is gradually decreasing the amounts and spacing the intervals between drinking.

Some people frequently visit doctors for pain medications without realizing their problem. Abusing prescriptions or illicit drugs cuts across all races, sexes and social classes. Besides the well known depressants (e.g., opiates, barbiturates), stimulants (e.g., cocaine, amphetamine), hallucinogens (e.g., LSD, mescaline, psilocybin), phencyclidine and marijuana recently the following are also listed under abused drugs.

Inhalants: gasoline, kerosene, toluene, glues, paint and hair sprays, deodorants, air fresheners, spot, paint and polish removers, markers, degreasers, whipped cream, fire-extinguishers, correction and lighter fluids. It is reported that their abuse in children is as common as one in five.
These inhalants contain very toxic chemicals such as butane, fluorocarbon, toluene, acetone and methanol which have been shown to cause irreversible brain damage even after 6 months of use. It takes about 20 years for an alcoholic to produce such a brain damage. Recent studies show that, inhalant use is as common as 20 % among eight graders especially the young white children of middle and upper-middle class families. People are also prone to be physically dependent and abuse other medicines or drugs such as:

• diet pills and ephedrine containing herbal drugs for curbing appetite and weight loss.
• tramadol HCL, a nonsteroidal anti-inflammatory drug (NSAID)
• carisoprodol, a muscle relaxant.
• Betel Quid, Betel nuts which are actually seeds of a Far East palm are mixed with tobacco, and slatted lime and rolled in the leaf of betel vine and chewed for its euphoric effect. The chemical, arecoline it contains causes bronchial constriction and is very addictive. People who frequently chew it are at a high risk for oral cancer.
• GHB, gamma hydroxybutyrate was sold as a muscle builder in health stores until recently when FDA made its use illegal. Although it is said to be a natural stimulant, it causes euphoria, hallucinations and causes coma and seizures in toxic quantities. And it has no antidote. GBC, gamma butyrolactone has similar effects and both of these drugs are used as mood enhancers and also called as date rape drugs.

Marijuana is the most commonly used illegal substance in the US. It is said that about 50% of marijuana (hemp plant) is homegrown. It's often the first drug used, usually leading to the use of other illegal drugs. Adolescents usually begin drug use with legal substances such as alcohol and cigarettes followed by marijuana, and other drugs including prescribed medicines. The primary psychoactive chemical in marijuana is tetrahydrocannabiol (THC). THC reaches blood in about ten minutes and its desired effects lasts about 2-3 hours. However, its adverse effects on coordination can continue for more than 24 hours. THC is stored in the fat tissues and therefore can be detected in the urine weeks or months after use. It is metabolized within the cytochrome P450 enzyme system which also interacts with many medicines such as antibiotics, antifungals, antiacids, antihistamines, antidepressants, antiarryhtmics. Therefore, marijuana use while taking such medicines can lead to serious side effects. Leukemia and other abnormalities have been noted in children whose mothers used marijuana before or during pregnancy. Since it is smoked unfiltered its tar and carcinogenic content is much higher than cigarettes. Marijuana can also be contaminated with fecal matter, bacteria such as salmonella and fungus. Therefore, it can cause significant damage to lungs. Although medical use of THC is still controversial the following side effects are well known:

• Decreased time perception, memory and coordination
  
• Decreased blood flow to brain, muscle strength and libido.
  
• Decreased testicular size and testosterone levels
  
• Enlargement of breasts, infertility, impotence, menstrual abnormalities
  
• Increased appetite, sleepiness, anxiety, confusion, headaches, paranoia, nausea and shakiness
  
• Withdrawal from marijuana can cause nausea, shakiness, perspiration, increased saliva and temperature, behavioral and sleep problems.

Brief information about other abused drugs is given below.
Drug - Serious Effects - Detection Time
Amphetamine High blood pressure, heart failure, stroke 3-5 days
Cocaine High blood pressure, heart failure, stroke 2-3 days
LSD Hallucinations, seizures 5 days
PCP High blood pressure, seizures 10 days
Barbiturates Respiratory collaps 30 days
Benzodiazepins involuntary movements 1-7 days
Heroin Overdose , death 72 hours
Morphine Overdose, death 3 days
Marijuana Reflex slwowing 1-4weeks
Propoxyphene Overdose and death 7 days
Opiates(e.g., codeine) Overdose and death 2-4 days

Treatment of addiction to drugs is more difficult and withdrawal can be life threatening. Many of the illicit drugs are deadly to vital organs such as brain, heart, lungs, kidneys and the liver.

Airborne Infections

Sneezing spreads more germs than coughing because the mucus particles produced by coughing are larger than those produced by sneezing (called droplets).

Large particles or drops do not fly far and fall to the ground, mix with other debris that makeup the house-hold dust. This dust becomes infective when it is moved and mixes into air by drafts, sweeping, walking, shaking rugs linen and blankets. Dust particles are heavier than droplets, settle to the floor faster and carry many germs. Droplets usually carry one germ. The settling speed of dust particles is about 18 " per minute. Whereas droplets settle half an inch per minute. Thus when a 5' 4" tall standing person with viral infection speaks, the droplets loaded with virus discharged from his mouth will remain in the air for about two hours if there is no air movement. And anybody passing by will inhale the germs. These fine droplets are known to shoot more than 20 ' in the air after a strong sneeze. Therefore, proper ventilation of rooms can be very effective in prevention. Even though initially there may be few germs in the room air without proper ventilation their numbers increase very fast since an average adult inhales about 500 cubic feet of air daily. Thus two people working in office 10x10x8 feet will have inhaled and exhaled all of the air in the room before the day runs out.

Our conventional air conditioners make the problem worse by pumping the same polluted air back and sometimes storing the germs in the system (that is how the Legionnaire's disease spread). We must also remember that proper ventilation of living spaces will also prevent accumulation of radon.

Anxiety Disorders / Panic Attacks / Social Phobia

Continuous anxiety, panic disorders, isolated phobias, obsessive compulsive rituals, posttraumatic stress disorder and the newly emerging social phobia are grouped under anxiety disorders. Suddenly when there is no reason to be afraid, you loose control and you feel like you are dying or something horrible is going to happen. Dizziness, shortness of breath, chest pain, chills, tingling and numbness in the hands, fast heart beat and sweating with hot flushes, nausea and a feeling of unreality are very common. You can feel like losing your mind. They can be embarrassing in presence of others make you worry about recurrences and something serious going on with you. Some people with social phobia have a strong fear of being embarrassed when they are with other people especially strangers. They feel as if everyone is watching them and show similar symptoms like panic attacks. Although these attacks last a few minutes and are completely gone within an hour.

Panic attacks tend to run in families their cause is not known. They are also known to be triggered by asthma or cold medicines (e.g. antihistamines, ephedrine), excessive caffeine, stress and emotional climax. People with social phobia and panic attacks believe that their anxiety is a sign of weakness and other people are more competent. Social phobia has certainly been around for a long time. However, it would not be a speculation to say that it has recently increased with the disappearance of the extended family, imposed fear of people, ' strangers' decreasing participation in community activities as virtual communications/relations are taking over.

Some people show anxiety in few situations like public appearances while others can show anxiety in public bathrooms and even in restaurants. These people are usually very concerned of what other people think of them. However, Nevertheless if such attacks and behavior keeps repeating it is considered as a psychological disorder. Priority must be given to psychological treatment such as cognitive behavioral therapy as well as relaxation/ breathing techniques help to reduce the number and severity of the effects. Succumbing to anti-anxiety medicine which are usually addictive before any psychological evaluation and intervention will not only lead to addiction but also deprive the people from developing the ability to cope with their problems.

Prevention and Treatment of Blood Pressure with Foods

If you take the following instructions seriously you may well lower your blood pressure without taking any medicines.

Food and Blood Pressure

Good eating habits will make you lose excess weight which will also lower your blood pressure and cholesterol:

- Eat slowly
- Don't skip meals
- Eat frequently (fruits)
- Avoid fried food
- Trim fat from meat
- Use skim milk
-Use oils which are liquid in room temperature, such as vegetable oils (canola, olive oil)
- Keep away from simple starches (carbs) and high calorie foods (fast foods, chips, sodas, potatoes, white rice, bananas, carrots, beets, cakes, and cookies)
- Do not forget to exercise regularly, 5-6 times a week, 30 minutes each time. Your heart rate must be about 80 % of your max heart rate (220-your age=Max. Heart rate x .80)

Good foods low in salt which contain potassium, magnesium and calcium

-More than 50 % of people with high blood pressure lower their pressures by salt restriction.
-Salt intake is a product of habit, taste and custom than need. Salt has been used to preserve food for centuries.
-You do not have to add salt to your foods before or after cooking, since all the foods we eat have their natural salt.
- Sufficient intake of calcium, magnesium an potassium causes loss of salt (GOOD). Excessive protein intake also increases urinary calcium loss (new fashion diets) leading to kidney stones (BAD).
- Absorption of calcium from the intestines decreases with dietary fat, phosphorus rich foods like milk and products, soda pops, peanuts and eggs (BAD).
- Fruits: Apples , apricots, prunes, dates, pears, nuts
- Vegetables: Legumes, whole grains, beans, Cabbage, Cauliflower, peas, eggplant, pepper, squash, broccoli, asparagus, spinach, radish, greens:mustard, collar and turnip, yams, okra
Good Seasonings with no salt: basil, bay leaves, chives, cinnamon, cloves, rosemary, Onion, dill seed, ginger, lemon, mint, sage, marjoram, oregano, pepper, paprika, parsley, vinegar, mace

HIGH SALT FOODS:

-all canned foods
-Meats: Anchovies, sardines, bacon and ham,chitlins, pork skin, chipped and corned beef, frankfurters, lunch meats and sausage, jerky
-Milk Products: butter, cheese spreads, condensed milk, ice cream. sherbet, processed cheese
-Vegetables: Canned soups, all pickles, sauerkraut, tomato juice
-Snacks: all chips, pretzels,salted nuts, crackers, salted popcorn
-Seasonings: Baking powder and soda, catsup, steak and barbecue sauces, bouillon, chili, garlic salt, horseradish, meat tenderizer, monosodium glutamate

Bad Breath / Halitosis

Bad breath/morning breath/oral malodor/and halitosis all mean offensive odor coming from breath. About 60% of people living in the US will have bad breath at some time in their lives. About $900 million is spent for over-the-counter (OTC) breath fresheners annually.

A great majority of reasons causing bad breath originate from the oral cavity:
- The most common are lack of oral hygiene and unhealthy life styles such as smoking, excessive drinking and diets rich in protein and fats.
- Cavities, dentures, and infection of gums.
- Insufficient saliva leads to bacterial growth and decay of food particles which produce volatile sulfur compounds causing the bad odor. Saliva decreases (xerostomia) with diseases of the salivary glands, dehydration, menopause, aging, mouth breathing, vitamin deficiencies, anemia, diabetes, chemo or radiation therapy.
- Majority of elderly take medications and many of them experience decreased saliva production which leads to bad breath. The following medicines are known to decrease saliva: tranquilizers, antidepressants, antihypertensives, diuretics, amphetamines, nitrates, antipsychotics, iodine based drugs
-Bad breath coming from the stomach or intestines is very rare since esophagus is normally closed and opens only with swallowing and constipation does not cause bad breath as generally perceived (exception reflux).

-Although rare, there some other sources of bad breath: Infection of tonsils or sinuses, nasal foreign bodies, hiatal hernia, chronic lung diseases, tumors, reflux(heartburn)Some other states/diseases cause typical breath odor:

- diabetes: sweet, fruity odor
- chronic renal failure: fishy
- liver cirrhosis: musty breath
- leukemia: old blood
- ovulation and menstruation: mousy breath
- some inherited diseases: fish odor

Many people are not aware of their bad breath which can seriously deter social and intimate relations. Therefore, it is useful to ask those who are close whether one has bad breath. There are also some simple tests to find out:

- Before testing abstain: from antibiotics for 3 weeks; eating garlic, onions or spicy food (salami, pastrami) for 2 days; any kind of cosmetics for a day; from smoking for 12 hours; from breath fresheners, mouth washes, eating, chewing, rinsing, gargling for 2 hours.

-Then one can sniff one's own breath by cupped hands or your dental floss after flossing, a spoon after you scrape the back of your tongue with it (if you gag easily keep your eyes open and look at something close-by while you are scraping. This will definitely prevent you from gagging) or your dried saliva. Lick your wrist and smell it after the saliva dries.

- In order to determine the origin of bad breath, whether it is from the nose or mouth you need to pinch the nose for a couple of minutes before you sniff mouth breath and close the mouth and breath from your nose for a couple minutes and sniff the nose breath.

- You can also ask a person to sniff your breath at about 4 inches close to your mouth. Nasal odor is somewhat different from the oral one. It smells like sour/spoiled dairy products or sharp cheese. When the breath odor is nasal, nasal and upper airways must be examined. If the odor is present both with nasal and oral breath then other body systems/sources or diseases must be ruled out. Nasal skin is very rich in fat (sebaceous)glands and thus very prone to formation of comedones. When nasal skin is gently squeezed some of this fat which also has a bad cheesy odor will come out. Therefore this odor coming from the skin should be separated from the one sniffed from nasal breath.

Prevention/treatment of bad breath of course depends on its cause. The following are effective guidelines for prevention:- Change lifestyles such as: avoid tobacco use, excessive alcohol or caffeine and foods rich in protein and fat.- Keep your teeth healthy by regular exams, replace simple/processed sugars from your diet, with complex carbohydrates and limit intake of carbonated beverages. - Floss/waterpick and brush teeth, gums and tongue twice daily. The front two thirds of the tongue is in constant contact with the hard palate. Therefore, the nipplike projections called papillae on its surface which can trap food particles are very efficiently cleaned during chewing food and even talking. However, the back one third of the tongue where the papillae are longer have contact only with the soft palate offering no resistance for effective cleaning. Thus back of the tongue if not brushed regularly can well store food particles which decay and cause bad odor. If you gag while brushing the back of your tongue keep your eyes open and look at something close-by . As a matter of fact, regular tongue brushing has been shown to decrease oral bacteria including strep counts.- After flossing/water picking and brushing, gargle with an oil-water based mouth wash and swish around for about half a minute before spitting out.

- Clean dentures and other oral appliances properly.
- To keep a satisfactory amount of saliva flow in the oral cavity which controls bacterial growth, drink a lot of water. If your mouth still feels dry chew a sugarless gum. Now, there are gums which also prevent plaque and tooth decay.- If you are a mouth breather, you must notify your physician. If your nose is stopped up try to breath from your nose by keeping your nasal passages open. If you use decongestants or antihistamines keep in mind that they may well chase your sleep away. Therefore, irrigate your nose with warm saline and apply a thin coat of moistener (e.g. mentholated Vaseline, AYR nasal gel) inside the nostrils and make sure that you have sufficient humidity (60%) in the bedroom before you sleep.

Healthy Eating for High Cholesterol and Body Fat

FAT- CHOLESTEROL CONTENT OF COMMON FOODS

Dairy Products:
High Fat: Whole milk, cream, pudding, ice cream, cheeses, eggnog
Low fat: skim milk, low fat yogurt, Cream made with vegetable fat

Eggs & Cereals:
High Fat: Egg yolks, corn
Low fat : Egg white, oat meal

Meats:
High Fat: Pork, goose, duck, hamburger, shellfish, fish canned with oil
Low fat: lean meat, fish, bake and broil

Desserts:
High Fat : Pastries, pies, cakes, chocolate, cookies, potato chips, pudding
Low fat: water ice, gelatin, popsicles, unbuttered popcorn, sherbets

Beverages:
High Fat; Cocoa and sugar containing ones;
Low fat: fruit juices, plain tea, beer

Bread & Grains
High Fat: Baked goods made with milk,eggs, animal fat, doughnuts, pastry
Low fat: whole grain bread, Melba toast, bagel, cracked wheat, rye

Fats & Oils:
High Fat: Butter, palm coconut oil, lard, solid margarine, gravy, salad dressing, cream sauces
Low fat sunflower, corn oils, safflower, canola, olive, soybean

Fruits & Nuts:
High Fat: All nuts, peanuts, peanut butter
Low Fat: All fresh fruits and frozen or canned with no syrup or sugar, fresh chestnuts

Vegetables:
All vegetables, boiled, steamed or braised with vegetable oils are very low in fat

In short, keep away from fast foods and carbonated beverages. The Food Pyramid we are used to is almost obsolete now. The famous DASH diet which lowers blood pressure and melts away the fats is very similar to the Mediterranean Diet.

This diet has almost no fats but a lot of olive oil, rich in non-fat yogurt, fish, vegetables, nuts and fruits. Sugar Busters diet is also very healthy Eating a lot of fiber (psyllium) will increase the transit time in your intestines decreasing absorption of fats. You are taking sufficient fiber, when your stools float in the toilet bowl NOTES: Since our body can change our intake of calories into carbs, proteins and fats according to its needs, it is very important to be aware of our daily calorie intake.

We need about 10 calories for each pound of our body weight at resting. If we are sedentary, we need an extra 400 calories per day. If moderately active 600 and very active lifestyles 800. Thus, if you are 200 lbs and work in an office you do not need more than 2400 calories a day(200 x10 =2000+400=2400).

Just like our ancestors, we need to eat small amounts and frequently. If you eat large amounts or simple sugars (carbs) at one sitting, this will stimulate a more than usual insulin production which will bring down your blood sugar level faster and store it as fat, and thus make you feel hungry again in a short time.

Neither your weight or your Body Mass Index will show how fat you are. The best practical measure, is the waist to hip ratio=WHR (Measure the circumference of your torso between your belly button and the bottom of your breastbone and divide this measurement with the one around your buttocks where it is the largest) when this ratio is above .86 for women and .95 for men it indicates to unhealthy fatness.

Exercising every morning will stimulate your metabolism and lower your blood pressure for the rest of the day burning more calories. Do not be elaborate and obsessional in making an exercise program. Start with 5 min. every day and go up by 2 min. every week and reach 30 min. Just do some partial sit-ups, partial push-ups leaning against a counter top or squat holding the back of a chair. Start lifting some 5 lb. dumbbells or fast walking.

Finally do not forget to take a multivitamin with extra calcium, folic acid an Vit B12 daily.

Runny Nose / Common Colds

Nose usually starts running, when a cold is getting better. After a viral infection, at first the nose produces a lot of clear mucus to wash the virus out from the nasal passages. After a couple of days, the color of the mucus changes from clear to a white or yellow discharge. As the normal bacterial flora of the nasal passages regain control, the discharge turns to green. However, this does show that there is a bacterial infection going on. Therefore, antibiotics are usually unnecessary.

Although it is always useful to get your doctor's opinion, using a vaporizer, inhaling hot steam and over the counter decongestants can be very useful. Do not hurry to reach your doctor, give your body a chance to develop its immunity to whatever is causing the symptoms. Recent research has revealed that, being exposed to such minor infections or allergens in earlier life will protect from serious infections and allergies in later life. Call your doctor, if there is very high fever, severe cough, sore throat, swollen glands and headache. A great majority of colds are viral, therefore antibiotics will not help. There are only a few antiviral medicines and they are used in diseases like herpes, flu (influenza), shingles, and chicken-pox. Using antibiotics in simple colds; will create resistant germs which can lead to use of stronger antibiotics or even administration of antibiotics in the hospital; disruption of gastrointestinal flora causing mouth ulcers, diarrhea, flatulence and yeast infections; disruption of synthesis and absorption of certain vitamins and even birth control pills.

Try to prevent spreading your cold to other people. Do not cough or sneeze to peoples faces. Cover your mouth and nose. Sneezing spreads more germs than coughing. Every time you cough or sneeze, small droplets of your saliva laden with germs will go as far as 20 ft in air and stay floating for about an hour. Best, is to wear a simple, inexpensive facial mask on your mouth and nose like Japanese people do (all the drugstores have them). Ventilate the rooms as often as possible. Do not blow your nose to a handkerchief. Use tissue paper and throw them away. Every time you blow your nose, wash your hands. Separate your eating and drinking utensils and do not let anybody use them. Clean your toothbrush with an antiseptic and change your wash-cloths, towels, bed linen and underwear as often as possible. Stop close contact with people (e.g., kissing) until your cold is gone. Eat a balanced diet. Low intake of vitamins decreases resistance against viruses.

Sometimes a runny nose will go on for months then the following conditions must considered.

Allergic: Seasonal, pollens; Year around, dust mites, animal dander, molds, cockroaches; Chronic allergies, and asthma can lead to nasal polyps.

Chronic Disease: Tuberculosis, sarcoidosis and others.

Structural: Septal deviation, tumors, enlarged adenoids or polyps.

Food Intake: Alcohol, spicy foods.

Medicines: Aspirin allergy, long term use of cocaine and over the counter decongestants.

Hormones: Untreated hypothyroidism.

Infections: Bacterial, viral and fungal.

Others: Cold air, exercise, temperature changes, humidity, irritants and stress.

Re-infection: Getting the same germ repeatedly from those who live or work with you or even pets is very common. Some people may not even show any signs but carry germs.

Condoms

If you have more than one sexual partner or if your partner also has sex with others or if you do not want any unwanted pregnancy or if you are a responsible person and do not want to spread any sexually transmitted diseases you need to use condoms. Many people think of condoms as a means of contraception only. Thus many females who are on birth control pills do not insist on their use by their male partners and become very vulnerable to sexually transmitted diseases. Latex condoms produced in the US are best for this purpose, since they are electronically controlled for any manufacturing errors and holes. Even if you have one sexual partner and you are sure that this person is not having sex with others, insist on using condoms until you get to know this person very well. Some people may not want to use them or neglect them at the spur of the moment. These are the people who are not worth having sex with since they are openly saying 'I don't care about you and your health. I just want a quicky and to enjoy myself at your cost' . However, if you do not use condoms properly they don't work. Here are some tips:

• Make sure that you and your partner are not allergic to latex*. There are other products made from skin and plastic.
• Keep them away from sunlight, heat and oil containing products such as lotions and creams.
• Do not blow air into condoms to see if they have any holes. This may well produce little holes where latex/plastic is weak.
• Do not allow the penis to touch a partner's vagina, anus or mouth without a condom.
• Do not put a condom on if your penis is not hard.
• Before you put the condom, put a couple of drops of spermicidal jelly inside the condom.
• If it appears defected, hard to roll on , sticky and brittle throw it away. Get a new one.
• If you are not circumsized pull the foreskin back before you put on the condom.
• Place the rolled condom on the tip of penis. Leave a little space at the tip to hold the semen but squeeze the air out of this tip. Then slowly roll the condom all the way down to its base by letting out any trapped air bubbles. Finally put some lubricant water-based jelly or spermicide on the condom. Some spermicides can kill AIDS viruses.
• After sex remove the condom immediately while the penis is hard. Otherwise, when the penis is soft the condom is more likely to fall off into vagina. A new condom must used when sex is desired again or in a different place like mouth or anus. The reasons for this precaution is apparent. Not only body fluids of one partner will be introduced to other's body including semen but also oral, vaginal and rectal flora (normally growing bacteria) will be contaminated with each other.
• Finally and a very important point. If the female partner supplies the condoms and if she insists on their use, one should not perceive her as an experienced promiscuous individual but a mature and responsible person. In any case, if you have unprotected sex and the condoms break you can use emergency contraception: You can use some pills within 72 hours after sex or an IUD can be installed within 7 days.

* If you are allergic to latex do not forget to carry a medical alert bracelet and Epi-Pen(self injection kit for adrenalin, a life saver in life-threatening allergic reactions). Many products baloons, pacifiers, bottle nipples, toys, adhesive tapes diapers and rubber bands contain latex which is a protein component of rubber. Certain foods such as avocado, chestnut, kiwi fruit, tomato or bananas cross-react and show allergic reactions among those who are allergic to latex.

Eating Healthy

How you eat

-Overweight people eat faster. It takes about 20 min. for the stomach to inform the brain that it is full. Slow eating 25-20 min, will give our brain a chance to register, that an adequate amount has been eaten, feel full and stop before over-eating. Chewing food slowly and well increases meal-time and helps digestion.

- When the stomach is full, hunger decreases. Thus eating larger portion of low calorie foods with plenty of bulk (fiber) will invite satiety, curb hunger and make us eat less and get fewer calories. Soup and salad or only salad at the start of a meal will bring satiety fast and reduce caloric intake.

-Drinking a glass of water or antacids before meals or eating a hot soup or salad as the first course will make one feel full sooner. Coffee increases gastric acidity which invites hunger.

- Skipping meals always backfires and leads to bingeing. One can't lose weight by dieting alone. When we cut down calories, the body cuts down burning them (slowing down of metabolism, furnace). Thus, weights lost by dieting alone, always comes back. Metabolism can be increased by eating complex carbs frequently, and regular exercise.

Digestion

Digestion starts as food enters our mouth. Therefore, drinking fluids while eating, dilutes the digestive fluids and interrupts digestion. Liquids empty stomach within minutes and smaller particles empty before larger ones. Emptying can last up to an hour with solids. The last to empty are fibers, slowing digestion and absorption of carbs, decreasing their insulin stimulation. Multiple small meals produce much less insulin than two large meals. We tend to eat a lot at dinner. However, most cholesterol is manufactured during the evening.

-Fruit juices increase blood sugar more than the fruit itself. Fruits eaten by themselves are also absorbed and digested better. Fruits should be eaten 1/2 an hour before or 2 hours after meals, because if they are eaten with solids or other carbs, their emptying from the stomach is delayed leading to fermentation and indigestion, decreasing their benefits.

What you eat

-Eating a lot of calcium rich foods, yogurt (skim-milk, no sugar), dark green leaf veggies, and broccoli, burns more calories instead of storing them as fat and helps fat loss. Excess fatty foods and phosphates (eggs, meats, soda pops, colas, processed foods and milk) prevent absorption of calcium. As a matter of fact, high fat diary products contain very little calcium. Protein rich diets increase loss of calcium with urine leading to kidney stone formation.

- Vegetarians are not deprived of proteins, iron and zinc, since nuts, seed, legumes and soy are rich in all three. The so called protein balance can well be maintained by a vegetarian diet

-Body produces more heat with carbs than fats and eating small meals with bulky complex carbs, (fruits & veggies) stokes the metabolic furnace more, producing more heat (Just like our ancestors, grazing and foraging)

- Salt increases blood pressure and insulin, inviting hunger fast. Taste of salt is not natural and its taste is lost after not using it for several months. Thus don't cook foods with salt or add salt later, since all the foods have their natural salt. Try pepper and other spices.

- Artificial sweeteners may well deceive our brain with their sweet taste and increase insulin.

Insulin: Excess insulin secretion which follows ingestion of sugar or simple carbs, stores sugar as fat, stops stored fat from melting away and signals liver to produce more cholesterol. As insulin levels increase, blood sugar levels decrease. This makes one feel hungry earlier than usual (hypoglycemia) eat more and frequently( a vicious cycle leading to obesity). Insulin levels once elevated by eating sugar/simple carb rich and large meals, may remain elevated all day. Eating simple starches/sugars (e.g., hamburgers) with protein stimulates insulin more than usual, more than induced by sugars alone. Thus as low blood sugar levels appear earlier than usual excess insulin stores more fat. Starches/sugar also decrease glucagon, a hormone which works against insulin by maintaining blood sugar levels and melts away stored fat. Complex carbs and protein increases glucagon secretion.

Alcohol: Alcohol if taken on empty stomach, becomes an immediate source of energy, preventing use of energy from stored fat. Like fats, it is rich in calories and delays emptying of stomach, which causes heartburn. (Calories per 1 gr: Fat 9, alcohol 7, protein and carbs 4). Alcohol taken with food is less absorbed, intoxicates less and produces less insulin.

Medicines: Check your meds' side effects (e.g., beta blockers and progesteron containing birth control pills cause weight gain)

Fiber: 1 gr binds 15 gr. of water, increases movement of food in intestines, decrease absorption of fat and other cancer causing foods. Fruits & veggies with highest natural water content have the lowest energy content. Whole wheat doesn't mean whole grain since it may not contain any husk.

Foods containing high fiber:

Bread &Cereals: Bran(100%) cereal, rye and whole grain bread. Fruits: Apple, pear, all berries, plum
Legumes: Kidney, white and pinto beans.
Veggies: Peas, parsnip, broccoli, zucchini, sweet potatoes.

Oils &Fats: Olive, canola. flaxseed and peanut oils, pecans, walnuts and almonds decrease bad cholesterol (LDL) but increase good cholesterol(HDL). Oils liquid at room temperature are not saturated fats (BAD oils: butter,lard, margarine, meat, ice cream).

FOODS TO AVOID: Potatoes(red/white), white rice, corn, carrots, beets, white bread, all refined sugars and processed products such as cookies and cakes, beer.

ACCEPTABLE SUBSTITUTES: Broiled tomatoes+cheese, sweet potatoes(yams), mushrooms, lentils, beans, whole-grain: brown rice, breads(stone ground) without added sugars, pasta; okra, peas, cabbage, cauliflower, asparagus, spinach, squash, celery, broccoli, hearts of palm/artichokes; citrus fruits; sugar-free sherbet and yogurt.

FOODS WHICH WILL NOT INCREASE BLOOD SUGAR MUCH AND FAST: Whole grain products (without sugar/brown sugar/corn syrup/honey/molasses/maltose or dextrose), rye grain, lentils, all kinds of beans, dark green vegetables, tomatoes. Fruits: berries, peache, plum, apple, orange, apricot, cherry, grapefruit; skimmed milk, plain yogurt (without sugar), nuts and peanuts.

FOODS WHICH CONTAIN A LOT OF CALORIES: Mayonnaise, salad dressings, margarine, lard, butter, nuts, potato chips, salami, steaks, chocolate, dried fruits, popcorn, egg yolk, honey, coconut, whole milk, ice –cream, table sugar, cookies, pastry, cream.

Activity: - although body fat distribution is hereditary, heredity is not destiny. -Body will continue to burn energy for several hours only after intense and vigorous exercise.

-Body fat, temperature and appetite are all controlled by the same brain center. Anything which warms the body, exercise, fever and even spices stoke the furnace (metabolism) and melt fats. The less heat body produces, the more insulation (fat) it needs. Exercise and high body temp also decrease appetite.

-Regular resistance exercises every morning, 30 min 5-6 days/week, increasing muscle mass (weights, bars, bands) melts away the fat. These exercises should bring your pulse/heart rate/per min. up to 70 % of your maximal heart rate (220-your age= max. heart rate) and make you sweat a little bit. Lean people burn more calories than those who

are fat even at rest.

SAMPLE DIET

a/b= means a or b

Day 1 : Breakfast : juice, Quaker instant oatmeal 2/3 cup of skim milk, tea. Snack: apple.

Lunch: Turkey on whole grain bread +mustard+thinly spread lite mayo+lettuce/fresh spinach and tomato. Tea or water. Mid afternoon Snack: 1 cup non-fat yogurt

Dinner: 1 bowl of hot spicy lentil soup+large salad + lettuce + tomatoes with olive oil+ vinegar. Dessert: one dozen nuts.

Day 2 : Breakfast: juice, Whole grain Oat+skim milk+strawberries,tea Snack: one pear.

Lunch: Ham and Swiss cheese on whole grain bread+mustard thinly spread lite mayo+ lettuce and tomato, tea/water Snack: handful of berries

Dinner: Grilled/broiled salmon with lemon juice + dill, broiled tomato sprinkled with chopped basil, steamed fresh asparagus or fresh spinach salad with olive oil and vinegar.

Day3 : Breakfast: 1/2 grapefruit, whole grain cereal+strawberry+skim milk, tea. Snack: a peach

Lunch: Tuna fish canned in spring water chopped with celery/hard boiled egg tossed with lite mayo on a bed of lettuce. Tea /water. Snack: low fat cottage cheese + one peach

Dinner: whole wheat pasta + Romano/parmesan cheese, cooked green peas. Large salad cauliflower/cabbage + olive oil + vinegar.Water/tea/lemonade. Dessert: 1 cup yogurt+ fruit

Day 4 : Breakfast: orange juice, Hot oatmeal, coffee /tea. Snack: one apple

Lunch: Lean roast beef on whole grain bread+mustard+lite mayo+lettuce, dill,pickles/olives.

Snack: a handful of berries.

Dinner: Baked chicken and sweet potato rubbed with olive oil, cooked with sliced onion, celery chunks, sprinkle with pepper, rosemary, cooked frozen baby lima beans. Water or tea.

Day 5 : Breakfast: juice, whole cereal + bluberries+skim milk. Coffee/tea. Snack: apple

Lunch: Turkey on whole grain-rye/pumpernickel bread+mustard+lite mayo, lettuce , tomato, celery sticks. Tea/water. Snack: Humus on 3 whole wheat triscuits.

Dinner: Hot spicy tomato soup+ mushroom sauteed in olive oil, cooked spinach, a slice of tomato +thin slices of fresh mozarella+ dressing olive oil, balsamic vinegar, chopped garlic+mustard.

Day 6 :Breakfast: 1/2 grapefruit, whole wheat bran+fresh bluberries+skim milk or 2 medium size buchwheat pancakes+spreadable fruit(applesauce). Coffee/tea.

Snack: a handful of almonds/walnuts/pecans

Lunch: Grilled chicken+melted cheese, lettuce and tomato on a whole grain bun+mustard+lite mayo or with one slice of whole grain bread. Water/tea. Snack: orange

Dinner: 1 bowl of hot spicy bean soup+grilled fresh eggplant slices lightly brushed with olive oil, steamed fresh broccoli, mixed green salad with tomato chunks. Dessert: Chocolate Mousse.

Day 7 : Breakfast: juice, one egg+3 slices of bacon, whole grain toast, tea.Snack:1 cup yogurt

Lunch: peanut butter(without sugar)/fruit spreadable on whole grain bread.Tea/water. Snack: apple

Dinner: Grilled fish+ steamed chunks of peppers, onions, broccoli, garlic and fresh spinach salad with olive oil and vinegar.

Day 8 : Breakfast: 1 orange. Hot oat meal. Coffee/tea. Snack: almonds

Lunch: Turkey+swiss cheese on rye bread+mustard+lite mayo, lettuce, tomato.Snack: apple

Dinner: Grilled fish, whole wheat past with romano cheese, steamed squash/zuccini/spinach, Lettuce salad+olive oil, vinegar, garlic, basil, a dash of mustard.

Day 9 : Breakfast: 1/2 grapefruit, Hot oatmeal, tea. Snack: Humus with 3 crackers

Lunch: Chicken salad+tomato wedges on lettuce, 1 slice whole grain toast, tea. Snack: 1 cup yogurt.

Dinner: 1 cup hot spicy soup+baked/steamed fish+ large salad+olive oil+vinegar.Dessert: 1 peach

Day 10 : Breakfast: juice, whole grain cereal fresh strawberry, tea. Snack: 2 apricots.

Lunch: Tuna fish on whole grain bread+lite mayo, lettuce +tomato. Snack: Humus with crackers

Dinner: Baked turkey breast rubbed ligthly with olive oil+cooked onions celery+ baked sweet potato, steamed fresh beans. Dessert: 2 thin slices of cheese.

Day 11: Breakfast: orange/grapefruit juice, hot oatmeal, tea. Snack: a handful of almonds

Lunch: Salad: slices of turkey, swiss cheese and hard boiled egg, 1 slice whole grain bread

Snack: low fat cottage cheese+ strawberries

Dinner: Hot spicy split pea soup, sauteed mushrooms/cauliflower, a tomato+melted blue cheese.

Day 12 : Breakfast: 1/2 grapefruit, hot oatmeal,tea. Snack: 1 peach

Lunch: Tuna fish+chopped celery/egg lite mayo on whole grain bread. Snack: a handful of almonds

Dinner: Grilled skinless and boneless chicken sprinkled with pepper. Brown rice cooked with chicken broth+chopped ripe tomato heated and placed on rice, black-eyed peas with jalapeno peppers, lettuce salad +artichoke hearts+ olive oil, vinegar.

Day 13 : Breakfast: juice, 1 scrambled egg, 3 slices of bacon, whole grain toast.Snack: 1 cup yogurt

Lunch: Grilled hamburger+cheese on whole wheat bread.lettuce+tomato. Snack: apple

Dinner: Grilled fish+lemon, steamed broccoli, whole wheat pasta+ green salad. Dessert: 3 apricots

Day 14: Breakfast: Orange juice, Cereal/oat meal with skim milk. Snack: nuts.

Lunch: Grilled chicken breast(no bone, skin) in green salad/ on lettuce+tomato. Snack: 1 slice melon.

Dinner: Hot spicy lentil soup + large salad with lettuce +tomatoes olive oil , vinegar

Keep foods safe to eat: Keep raw and cooked foods separate. Cooking at less than 140 F and refrigeration above 40 F invites contamination.

Sleep Problems / Insomnia

Insomnia, inability to sleep is a very common problem in the US (35% of the people). Medical problems related to insomnia, including accidents cost the US public $100 billion annually. It is noted that we sleep about 25 % less than our ancestors. However, there are no available reasons for explaining that they needed more and we need less sleep. And it is not far fetched to say that we are somewhat sleep deprived due to social and economic factors.

Thanks to shift work (25 % of workforce), 24 hour availability of TV and Internet. Sleep is considered sufficient when we wake up rested rather than counting the hours. The daily need for sleep may vary among people. Although, an average of total sleep of 8 hours is sufficient for the majority of people some may need 10 hours. However, when people especially after middle ages, consistently sleep 10 or more hours everyday an underlying medical problem such as hypothyroidism, anemia must be ruled out.

Sometimes, a person is unable to sleep for three to four weeks when under a lot of stress, or experiencing a health problem. This is a transitory stage and people are usually aware of the problems causing their insomnia. Insomnia can present itself as inability to fall asleep, waking up very frequently or waking up very early in the morning. Most common are problems with initiating sleep. All these lead to a restless night and waking up tired, frustrated and edgy. After such a night, one may well feel sleepy all day. Insufficient sleep can impair next-day cognitive and memory functions leading to accidents, absenteeism and lost productivity. However, many people overestimate their sleep problems and actually do not have insomnia. Therefore, insomnia must be objectively documented since people's subjectivity can really mislead both the complainers and their physicians. People who have insomnia usually take longer than half an hour to fall asleep, wake up frequently during the night, wake-up very early in the morning and usually sleep less than 6 hours.

Some people who snore very loudly may also stop breathing for about 10-20 seconds and start breathing again with a gasp many times during the night. This is called sleep apnea. People with sleep apnea tend to fall asleep or become drowsy without their control during day time. This can be very dangerous during certain activities such as driving. Against the general belief, sleep apnea does not occur only among those who are obese. Sleep apnea needs immediate medical attention since it prones to significant cardiovascular problems as well as high blood pressure and stroke. Recently, continuous snoring due to upper airway resistance has been found to be more common in children than adults.

As people get older their sleep becomes more shallow and they tend to sleep less. Elderly tend to get sleepy earlier at night and wake up earlier in the morning. This may well be due to their decreasing metabolic rate and activity, as young people sleep a lot more for needed rest. However, active elderly who exercise regularly usually do not have sleep problems.

There are many causes of insomnia; psychological or medical illnesses, obesity, medicines for high blood pressure, steroids, theophylline, phenytoin, levodopa, decongestants, diet pills, cola, tea, chocolate, excessive intake of nicotine, caffeine or alcohol, large and spicy meals or exercise close to bedtime. Late night snacks must be avoided. However, sometimes and if one is really hungary a light snack before bedtime may help. One of the most common causes is irregular lifestyles such as not going to bed or eating in regular times. Some people drink a lot of fluids before going to bed and wake up all night to go to the bathroom. Eating, reading, watching TV and worrying in bed may also chase one's sleep away.

What are the guidelines and measures for preventing and dealing with insomnia?

- The effect of stimulants causing insomnia such as nicotine, caffeine and rigorous exercise can peak and last as long as 6 hours.

- The effect of excessive alcohol (2 or more drinks at one sitting or drinking more than one shot per hour; one shot=1 oz hard liquor= 12 oz beer) although depressive such as leading to erectile dysfunction or delayed arousal can well chase one's sleep away. Alcohol also leads to low blood sugar which can cause anything from stupidity to violent behavior.

- Try to adopt a regular lifestyle with plenty of exercise, sunshine and omit the common causes mentioned above. Increased physical activity improves sleep patterns.

- A lot of people complain of back pain which is not only due improper ways of lifting, lack of exercise but also more commonly wearing those fancy and unhealthy shoes such as high heels and boots and bad sleeping and sitting postures. Choose a hard mattress. Before you go to sleep bend your knees and put two pillows under your calves. When you want to turn keep a pillow between your legs. These will decrease the stress your spine has suffered during the past day.

- Humans are obligatory nasal breathers. Therefore, try to open your nasal passages before you go to bed. As people get older nasal passages tend to dry. Therefore, irrigating your nose with normal saline water, then blowing gently and then applying a thin layer of pure vaseline or with menthol inside your nose will relieve irritation and make breathing more comfortable during the night.

- Adjust your neck on the pillow so that your neck will remain straight just as when you are sitting or standing and maintain a free flow of air in the upper airways throughout the night.

- Conventional air conditioners do not moisturize and insufficiently filter the room air. They just circulate, heat or cool the same air. Excessive dry air and dust may well irritate the upper respiratory passages and disturb sleep. Therefore, use electrostatic filters, air the rooms frequently (will also decrease radon accumulation) and use vaporizers/humidifiers especially in winter months. Although an average humidity of 50% is comfortable, for a lot of people this can vary from person to person. Buy an inexpensive hygrometer(measures humidity) and find out which humidity level is best for you. Do not forget that as the humidity level increases the effective temperature also increases. In other words with increasing humidity you feel colder or warmer than the actual temperature settings. Dark quiet and cool bedrooms help sleep.

- Try to avoid naps. But if you really enjoy them and if they do not affect your night time sleep, take them early in the afternoon and no longer than half an hour. As a matter of fact people have a natural tendency to sleep twice daily.

- If everything fails, you can try some over the counter medicines containing, valerian, melatonin , diphenyhydramine, doxylamine, lavender tea or sachets under your pillow, ginseng, and linden flower tea.

- If you can't sleep while laying in bed. Don't stay in bed. Get up and sit in a comfortable recliner, read, listen to soothing music or watch TV (something not stimulating, a nature or travel channel maybe) or take a warm bath. Deep breathing exercises also help. Although, it is generally advised not to read in bed since it can interfere with falling asleep for some people it seems to help. Thus, consider your own nature and habits before you make any lifestyle changes. Try help your nature and daily rhythms of your body with regular hours and go to to bed each night and wake-up at the same time each morning

- If your sleep problem has been going on for more than three weeks and is affecting your daily performance, if you are sleepwalking, experiencing frequent nightmares or snoring excessively you need to talk to a physician.

- If you end up going to a physician, do not forget to give a full detailed history of your daily life, sleep patterns and all the medicines you are taking including the over the counter ones. If you are given prescription medications you need to keep in mind that majority of these medicines are addictive, they are not to be used for long term and you and your doctor still need to find out the causes of your sleep problem. Do not keep your sleeping pills close to your bed since you may reach them easily and take more than you need during a bad night.

Contact Dermatitis (Poison Ivy/Oak) / Jellyfish Stings

Poison ivy and a variety of other plants (oak, ragweed, primrose) cause "Contact Dermatitis" like other agents (e.g. nickel, dyes, cosmetics, antiseptics, antibiotics). All parts of the plant contain an oil which produces severe irritation on the skin. Even the smoke from burning poison ivy can be very irritating. The oil can spread to the other parts of the body by rubbing or scratching. It can also be spread by articles such as clothing and pets in contact with poison ivy. The oil will stay on clothing for a long time(years) unless they are washed . Every time you come into contact with poison ivy, you become more sensitized to it. Thus, each consecutive contact shows a faster and greater reaction then the previous one. The blister fluid of poison ivy will not cause the rash to spread and is not contagious. Recently, some creams such as Hollister Moisture Barrier, Hyfropel, Ivy Block and Stoko Gard are shown to be protective if applied before contact. There are no shots, vaccines against poison ivy.

What to do when you contact poison ivy:
1. Wash your body parts which came into contact with poison ivy with soap and water or with dilute hydrogen peroxide within 5 minutes. Wash your clothes and your pet too. Some people use dilute clorox, copper sulfate and gas, all of which are very harmful to the skin. Do not use them.

2. If you are severely allergic reaction to poison ivy, consult your physician immediately.

3. If you are not allergic to poison ivy just observe yourself . The rash, small bumps and blisters may begin to break out in a few hours or several days after contact. After the rash develops and if it is only minimal, that only if it appears in a few places, as a few red spots and bumps(dime size) you can try the following:

a. Apply Calamine lotion or over the counter steroid or benadryl containing ointments.

b. If the rash increases and spreads within a day consult your physician.

c. If the rash involves your eye, consult your physician. Cortisone injections or tablets given for 2 -3 weeks is the treatment of choice.

4. Carefully follow your physician's instructions and notify him/her if any of the following happens:

a. If you develop fever over 100° F

b. If the rash or blisters seem to become infected or spreading to other parts of the body

c. If the prescribed regimen does not bring relief within a few days and rash becomes worse

Other Precautions:
People who have skin rash should keep in mind the following points:

1. When a person has an allergic reaction, it is said that the allergy
threshold is lowered. In other words, sensitivity to other offending substances increases. Therefore, it is advisable to eliminate contact with other offenders during an allergic reaction.

2. Sunlight, heat, sweating and irritants such as detergents can enhance the allergic reaction. Thus preventing contact with direct sunlight, hot baths, and soap is recommended. Brands such as " Dove" and "Ivory" contain minimal irritants. Taking cool baths will decrease irritation and sooth itching. Limit the number of baths as much as you can and do not soak or stay long in water(e.g., swimming). Frequent bathing causes drying of skin by washing away its natural oils. This makes the skin more sensitive and causes itching.

3. Certain foods will enhance any type of allergy especially skin rashes. Listed below are foods that commonly cause allergic reactions: chocolate, coffee, eggs, cheese, spices, chicken, milk, soy, melons, yeast, potato, beef, bananas, nuts, cashews, oranges, corn, pork, alcohol and seafood.

Jellyfish Stings

On contact jellyfish tentacles easily detach and release toxin containing capsules. After a few minutes string-like red/purple burning wheals appear on the skin. Do not try to wash of the area with fresh water. Fresh water will get in the capsules and release more toxin. Best measures are as follows:

- scrape the affected the area with a plastic card and soak it with diluted vinegar. A slurry of baking soda for stings of sea nettle can also help. Then application of ice will decrease the sting and discomfort further.

Mental Health: Criticism, Discussions & Responsibilities

For centuries now, human relations have been so much blurred by crude materialism and ignorance of our capabilities, which can well enable all of us to live in peace and health.

If you notice a behavior that you don't like or appreciate with your beloved one or even a friend; First ask yourself;

1. Is this really an unacceptable behavior or is it only your personal gimmick/view ?

2. Second question to ask yourself , If it is an unacceptable or harmful behaviour are you really serious in correcting it ? Is it your responsibility ?

If you are serious, you must find the most efficient way to correct it. And that is simply 'sweet talk'. Your words should not carry the burden of criticism, show your impish role of observing only for your satisfaction which of course is another way to divert your attention from your very own problems, fanning away your own hate by pinning down your friend.

It is true that, no progress is possible without criticism(Goethe). However, if you are really honest in correcting and drawing the attention of the person, you need to find the best way to do it. There is no other alternative. If you are not sure about your approach, don't even talk about it, since the wrong approach will cause more harm and hurt your relationship with everlasting sour memories. Recent research has shown that criticism by close persons may lead to serious psychological problems. It is like aiming an arrow to a beast threatening to kill you. You miss the heart and wound it, the beast will be more fierce. However, if you aim well you will kill it. Thus, your so called friend or the beloved will be able to realize whatever s/he is doing is wrong and inappropriate and furthermore appreciate and thank you.

During this correction or drawing attention process, you must see to it that it takes place in privacy. Any criticism in presence of others, does not only hurt more, but openly shows that the critic is trying to satisfy his/her ego. Wording is very important too. Thus instead of saying in plain and cold language' you are driving to fast' you can say 'honey, could you please slow down'. Or change 'don't talk with food in your mouth' to ' Sorry, I can't understand what you are saying, I'll wait until you finish'.

Finally, If you are not able to follow the steps above in your relations, it is time to re-think and evaluate your relationship. An old adage: 'Sweet words can even make the serpent yield'.

And Goethe also said 'If you don't participate in the solution of a problem, you become a part of it'. This reminds us our ultimate responsibility in dealing with our social problems which cannot really be separated from those of individuals. Thus, and furthermore, nowadays in the midst of serious political debates, social problems, and media cover-ups, we might well take very different stands. When discussing these issues, one must again be very careful not make the discussion personal. Asking or challenging with statements such as ' What would you do ' or other abrasive statements with useless adjectives such as trash/garbage without challenging the reality, are quite irrelevant. Just stick to facts and reliable sources and keep on learning from each other, one of our most neglected innate endowments.

Osteoporosis

Osteoporosis is caused by both decreased mineral content (calcium and phosphate salts) and bone matrix (collagen fibers). An earlier stage osteopenia is caused by decreased bone density which diminishes bone strength. Bone tissues are renewed continously,replacing old bone with new. However, as we get older break down of old bone tissue becomes faster than it is replaced. Thus, unless treated bones become weak, porous, look like sponge and break very easily. Lost bone strength causes severe increases of the already existing curvatures of the spine causing back pain and shortness. Osteporosis in men, non-white and premenopausal women is seen much less than postmenopausal white women. It tends to run in families and in slender people. According to a recent report there are about 5 million white women with osteoporosis and 15 million with osteopenia in the US. In short there are about 30 million Americans with osteoporosis.There are also about 1 million annual fractures due to osteoporosis. Although the most common causes of osteporosis are lack of exercise, and diets deficient in calcium, vitamins D and C especially during younger years the following are also listed:

• Hormone deficiency: estrogen in women and androgen in men. Excessive exercise interrupts the menstrual cycle increases osteoporosis.
• Hormone excess: steroids, thyroid, parathyroid and excess vitamin D administration.
• Prolonged immobilization/inactivity (being bedridden for months)
• Malignant tumors/cancers invading bones.
• Genetic metabolic diseases. Also: Diabetes, Liver disease, Alcoholism, arthritis, Heparin therapy, Severe malnutrition,Vitamin C and copper deficiency The National Osteoporosis Foundation in the US (NOF) recommend measurement of bone mineral density (BMD) only when the results could change treatment. Therefore they do not recommend BMD in women who are taking estrogens. They do recommend BMD in any postmenopausal women > 65 years who has a fracture and any postmenopausal women <65 years who have other risk factors for osteporosis such as history of fractures, current smoking, low body weight. They recommend treatment of those with positive findings at BMD and present with hip or vertebral fractures. Recommended treatments are hormone replacement therapy (HRT), alendronate, raloxifene and calcitonin. Whereas, Royal College of Physicians in Great Britain (RCP) does not recommend routine screening with BMD in any age group. They recommend BMD only if risk factors are present even in women > 65 years of age.

Important preventive/ treatment measures are:

• Watch for unexplained backaches, loss of height and spontaneous fractures. Notify your physician if you experience any wrist, rib, hip and back pain after coughing, sneezing and falls. As a matter of fact, many cases are diagnosed from x-rays taken for other purposes.
• Start regular balance, weight-bearing and muscle-strengthening exercises as early as possible. Walking, climbing stairs and dancing are very good for this purpose. It has been shown that active females who have been regularly exercising since their youth rarely suffer from osteoporosis. As a matter of fact, foundation of bone mass is laid during the growing years by regular exercise.

One must also prevent from trauma or falls causing fractures which leads to more bone loss with extended immobilization especially in the elderly. The following are guidelines to prevent falls:

• Have your vision and hearing checked regularly.
• Ask your doctor to evaluate/review your medicines: If you feel dizzy when you get up suddenly (postural hypotension) avoid sudden movements or getting up and compression stockings can help; especially when you get up from bed during the night or in the morning sit on the side of the bed for a minute or two so your blood pressure can adjust to getting up from laying down for a while; or if you can't respond and move as you need to avoid sleeping pills (see sleep problems /Insomnia); or if you have depression.
• If you use the bathroom often at night use a commode on your bedside.
• Protect your eyes from glare but always maintain a sufficient light source. Light switches must be available at room entries. Install night lights to your bedroom, kitchen (for night eaters), bathroom, stair and hallways. If you are a mid-night kitchen regular put a glass of cold water and some fruits close to your bed.
• Use a cane or walker if your gait is not steady or if you have dizzy spells.
• Avoid over-size clothes not to step on them and rubber soles (hold fast on floors and slips on wet surfaces).
• When you fall move slowly a avoid putting your weight on the injured part. If you have ba fracture, usually you can't move that body part. Do not try to move or let anyone help you to move. Wait until professional help arrives. Thus keeping a phone in all possible rooms at your home or even better carrying a mobil phone can be very helpful especially if you are elderly. When the phone rings people tend to rush and trip over things. Avoid cables, cords or low furniture on the floor. Thus keeping a phone close by at all times helps. It is not very unusual to trip over a pet too. Pets at home should be trained to sleep or lay down only at certain parts of the house and certainly not in hallways, stairs and doorways.
• Stairways, bathtubs and toilet bowls must have sturdy handrails or grab bars on both sides. Avoid uneven steps on stairs.
• Place friction mats under rugs on slippery surfaces.
• Keep frequently used clothes, equipment and kitchen items within very easy reach.
• Do not try to reach high shelves or closets. Use a sturdy step-ladder and when you are climbing it, support yourself by holding on a wall, counter or cabinets or have someone to help you. Otherwise, do not climb a ladder at all. Avoid high shelves, chairs without armrests and furniture unable to support leaning.
• Finally do not be disappointed or depressed when you start falling now and then as you get older. It is only natural to lose your balance. A single isolated fall is not always a sign of a serious problem. However, frequent falls must be medically evaluated. -Depression has been shown to be a risk factor for falls, low bone density and freguent fractures.

Avoid smoking and moderate alcohol and caffeine consumption.

Make sure that daily dietary intake if calcium is 1200 mg and Vit.D 400-800 Units (or 15-20 minutes of sunshine daily) . Daily calcium need increases to 1,500 mg (or 4 cups, 8 oz of yogurt or 5 cups of milk) after sixties. However many calcium tablets are not well absorbed in the intestinal tract. Tablets containing calcium carbonate and citrate are well absorbed especially if they are taken with meals.

If you are taking estrogen, have regular breast exams and mammograms. Take estrogen with a progestin if you are menopausal and but still have your uterus. Phytoestrogens (soy-based proteins) can also decrease breast cancer risk, bad cholesterol (LDL), prevent Alzheimer's, colon cancer and osteoporosis

If your doctor prescribes alendronate do not take it with food. Otherwise it won't be absorbed. Do not take it, when you are laying down since it may cause esophageal ulcers.Take it while standing up with a large glass of water. Call your doctor if you feel heartburn while taking it.

Those who can not use estrogen can take calcitonin as nasal spray or injection.

Pink Eye / Conjunctivitis

Pink eye is redness of the white part of eye surrounding the cornea and linings beneath the eyelids. It can be caused by bacteria, viruses, allergies and irritants. Sometimes it occurs with other infections such as colds. Eyelids may be swollen and eyes become itchy, burning, painful with movement and irritated by strong light.

Sometimes, it feels like there is sand or some other particles in the eye. Bacterial pink eye usually starts in one eye and causes a green or yellow discharge. Viral or allergic pink eye usually starts at both eyes and and the discharge is clear. Allergic pink eye is often seasonal. Both bacterial and viral pink eye are very contagious. Therefore, hand-washing, keeping hands away from eyes and not sharing beds or towels with others is very important in its prevention.

Warm wet compresses, taking off contacts, protection from strong light helps along with the eyedrops or medicines prescribed.

Heat Rash / Diaper Rash / Intertrigo

It is a skin eruption due to irritation, heat and moisture. It is commonly seen in infants with diapers or in armpits and groins of adults in hot and moist environments. Keeping these areas clean and dry will resolve the irritation in a few days. In infants stools and urine of course are very irritating to their tender skin. Therefore, diapers must be changed as often as every two hours. They should be changed even in the evening when the infant wakes up for any other reason. Infants usually become somewhat irritated when they urinate and have bowel movements. They try to let us know about this with sounds and movements. Sometimes you can hear or smell the bowel movements. Prompt response is in order since the infant is trying to communicate. Delay will not only lead to crying but also install it to the infants primitive vocabulary for seeking attention.

Diapers must be loose and permit air circulation. Now there are some new diapers which contain petrolatum jelly and form a gel like layer when wet protecting the infant's skin from urine. On-going rash and irritation will usually lead to yeast infections. Infants should be cleaned only with warm water and mild gentle soaps after they urinate or have bowel movements. Before changing the diaper a thin layer of petrolatum jelly, vaseline or zinc oxide containing ointments can also be applied for further protection.

Human skin lubricates and protects itself with the oils produced from the glands in hair follicles. Frequent washing with irritant soaps, baking soda, powders or mild acids will break this barrier and prone to irritation. This will lead to excessive dry, itchy and scaly skin and dandruff. Shaving under the arms and inguinal are makes them more prone to irritation and rash. The reason for these areas to have a lot of hair and sweat glands is that a lot of big arteries and veins pass under these areas thus making sweating and hair a natural air conditioner.

Restless Leg Syndrome

It is a crampy feeling, a feeling somewhere between dull pain and numbness usually at the calves. It usually starts when you rest your legs and then you want to keep moving your legs. During sleep some people keep moving their limbs and kick their legs. Although, its cause is not known in many cases and it tends to run in families it can be related to anemia and circulation disorders like varicose veins. About a quarter of pregnant women complain of restless legs. Some other cases have been related to nervous system disorders, kidney failure, and iron deficiency. Restlessness may be aggravated by smoking, caffeine intake, fatigue, menopause and menstruation. Certain prescription medicines as well as rubbing the legs and heat application seems to help.

Narcolepsy is a rare disease with recurrent uncontrollable attacks of sleep, and sudden loss of muscle tone called cataplexy usually associated with emotional outbursts such as anger, fear and joy. Some cases also show sleep paralysis when patiens are falling asleep or on awakening they want to move but find out that they can't. Sometimes, narcoleptics experience very vivid sound or visual illusions or hallucinations called hypnagogic phenomena. The cause of narcolepsy is not known. It usually starts in adolescence and is more common in men.

Treatment consists of stimulant drugs and well planned naps.People who have this disorder are strongly advised not to drive or operate machinery and avoid circumstanceslike heights that may pose a danger.

Sleep walking and night eating. Sleep walking and terrors tend to run in families and both can be caused by psychiatric and neurologic diseases, and aggravated by sleep apnea, restless legs, seizures, high fever and alcohol/drug abuse. Night eating usually accompanies sleep walking but it can also be seen with stress, smoking cessation, anxiety, and migraines. Some people are not aware of their uncontrollable urge to eat at night and not knowingly they can even eat pet food. These people and sleep walkers need immediate medical attention. However, there are some others who will wake-up during the night for any reason such as going to the bathroom and also would like to eat something, usually sweets. A small snack before going to bed, limiting fluid intake, alcoholic and caffeine containing beverages 3-4 hours, and emptying the bladder before going to bed will usually control this problem.

Excessive sleep. Some people sleep more than they actually need. Some others have a strong desire for a quick nap often in early the afternoons. However, these naps are completely normal and different from excessive daytime sleepiness. People who routinely sleep more than 10 hours a day may also have an underlying medical or psychological problem. It is not uncommon to uncover diabetes, hypothyroidism, depression or even sleep problems among people who sleep a lot. Excessive sleep has adverse health effects as lack of sleep. As a matter of fact, a recent study has shown that bed rest does not only slow recovery but may even harm majority of patients. Body metabolism which plays a very important role in the healing process significantly slows down during sleep and inactivity. A recent study has shown that people who consistently sleep more 8 hrs a day have shorter life span.

Sea-Sickness

Although many medicines such as scopolamine patches, phenergan, and dimenyhydrinate help, they also have side effects. Real ginger also helps. The following precautions and interventions are also very effective:

• Do not breathe polluted air especially diesel fumes. Get out to fresh air.
• Do not travel with an empty stomach. But try not to eat a lot and drink alcohol.
• If the boat's bow vertically rises and crashes down, lie across the boat, parallel to its width.
• If the boat is rocking from side to side lie parallel to its length.

Sweating, Excessive / Hyperhidrosis

Sweating is a natural body function which is the most important natural cooling mechanism when the body temperature increases above normal. Contrary to general belief, the skin does have any pores but hair follicles which contain both oil and sweat glands. Frequent washing with soap and excessive scrubbing will not open the so called ' skin pores' but will wash away the fine layer of protective oil on the skin making it prone to dryness and irritation.

Excessive and temporary sweating can be caused by overactivity , diseases with fever, migraine, hyperthroidism, hypoglycemia and psychological reasons. Certain medicines such as beta blockers and antidepressants can also cause excessive sweating. However, the cause of on-going excessive sweating is usually not known and it starts in childhood. It usually affects hands, feet and armpits. Iontophoresis (transmitting medicines into tissues with small electric currents) and certain medicines can decrease it. Some people shave their armpits and pubic areas. This can increase sweating in these areas where body heat is usually more and the hair in these areas have a natural cooling function by providing a larger surface for evaporation. The same is true for scalps. Hair provides an excellent insulation for head, protecting it from sunlight, excessive heat and cold. Shaving scalp does not make hair grow stronger as some people think. Thus sweating better than none at all.