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It’s Bug Season!

‘Tis the season for biting insects. This spring was wetter than usual, and that usually means more puddles for insects to breed in and more insects to spoil your enjoyment of the great outdoors!

Important reasons to avoid bug bites

Most insect bites are just a nuisance, but some insects can transmit diseases. Mosquitos in some parts of the world can carry Zika virus, Dengue fever or malaria. Check travel sites for information on the area you plan to visit, especially if an expectant mother: Government of Canada; USA Centers for Disease Control (see Zika Virus Travel Information section).

Lyme disease is carried by common ticks that are generally found in long grassy areas, especially those frequented by deer who carry ticks. Tick bites can be avoided by wearing long sleeved shirts and pants, tucking in shirt-tales and pulling socks up over pants. Light-coloured clothing helps you to see any ticks that have latched onto you. It is also recommended to shower 1 to 2 hours after a nature outing and to check skin carefully for ticks, especially in folds of skin and even your bellybutton where they may be hiding! Brush your pet before he comes indoors too and check carefully to be sure he hasn’t picked up a tick either. Read my previous blog, Tick Talk, for more information about avoiding and treating tick bites. Note that Lyme disease is now being detected in Canada as well as many parts of US.

How to avoid insect bites

Here’s what Dermatologists suggest to avoid insect bites:

  • Use an insect repellant containing 20-30% DEET. Apply it to clothing and all exposed skin. Reapply as directed on label.
  • If also using sunscreen, apply it first and let it dry before applying insect repellant. Do not use combination sunscreen/insect repellant: sunscreen should be applied liberally and often and this could result in application of too much insect repellant.
  • As mentioned above, wear long sleeves and pants, and tuck shirt-tails into pants and pant bottoms into socks, especially if walking in long grass where insects like to hang out. Insects tend to be attracted to darker colours, so wearing light coloured clothing may help.
  • Have bed nets available to protect you while you sleep. A net can also keep that one elusive mosquito you can’t catch away from you, so it won’t keep you up all night! If the net isn’t long enough to reach the floor, tuck it under the mattress to make sure there are no gaps.

Treating bites

If all the above fails (and it’s quite likely it will on some occasion), here’s what you can do:

  • If it’s a painful bite (like a bee or wasp), take Acetaminophen (Tylenol) or Ibuprofen (Advil, Motrin) as directed on the label.
  • Apply an ice pack for 10 minutes. This can help for painful or itchy bites.
  • Apply Calamine lotion or Hydrocortisone Cream, available at pharmacies.
  • If you have a lot of bites, try a quick-acting antihistamine, like Reactine or Benadryl. Be sure to follow the directions on the label. Note that Benadryl causes drowsiness.
  • If you develop a rash, fever or body aches, see your doctor. Tell him/her about the insect bite you received. If bitten by a tick, remove it carefully with tweezers and store it in a ziplock bag or in a fold of clear tape for a couple of weeks. If you feel unwell within a week or two, your doctor may want to test the tick for Lyme disease bacteria.

My other bit of advice is that insects generally don’t like wind, so pick a windy area to relax in or create your own wind with a strong fan. Planting some citronella, marigolds or rosemary plants around your deck can help too, as insects don’t like their smell (even though we do!). Or you can just throw a few sprigs of rosemary on the BBQ coals or bonfire.

And, if you’re a do-it-yourselfer, here are a couple of recipes you can try:

Yard Spray

1/3 large bottle of blue mouthwash

1 cup Epsom salts (available at pharmacies as “bath salts”)

1 x 12-oz beer (non-alcoholic should work fine too)

Spray in yard, but not on plants or grass (the salt could harm them).

It can last up to 80 days.

Skin Spray (non-sticky, non-oily)

Put a handful of fresh basil leaves in a glass measuring cup.

Add ½ c water and ½ cup vodka or rubbing alcohol.

Heat to boiling in microwave (about 1 minute).

Let sit, covered, for 2 to 4 hours.

Remove basil, squeezing to remove liquid.

Pour into small spray bottle (often available in cosmetic departments or craft stores).

Spray on skin as necessary.

So, there you go… by special request, from a friend and reader who was asking for help with itchy bug bites! Please note: I haven’t tried these recipes yet, but they were highly rated by their sources and sound so interesting! I’m one of those lucky folks who live in a naturally windy place so have little problem with mosquitos… But please let me know if you try these and how well they work for you!

References:

American Academy of Dermatology Association

Accidentally Green

Jeannie’s blog: Tick Talk

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Health

The Heart of the Matter

Do you know the signs of a heart attack? It’s not always the same for everyone, and can be different in men and women…

The classic signs and symptoms include:

  • chest discomfort (pressure, squeezing, burning, heaviness, fullness or pain),

  • sweating,

  • upper body discomfort (pain in the neck, shoulder, back and/or one or both arms),

  • shortness of breath,

  • nausea and

  • light-headedness.

You may only have some of these symptoms.

In women, the signs of a heart attack may be less clear than in men. In some cases, a heart attack in women can mimic severe heartburn. A key difference is that the pain is not relieved by taking an antacid when it is caused by a heart attack. Since men are more likely to have heart disease than women and their symptoms are more classic (such as crushing chest pain), heart attacks are more easily missed in women.

Angina

Pain due to lack of oxygen reaching the heart muscle is called angina. When it occurs predictably, for example when you do a certain level of exercise, it is called stable angina. Stable angina pain does not always indicate that heart damage is occurring. However, if the pain suddenly becomes more severe or frequent, or occurs with less or even no exercise, it is called unstable angina. Unstable angina is a sign that change is occurring in the blood supply to the heart muscle and is a warning sign of a possible heart attack in the near future. Any change in angina is a reason to see a doctor as soon as possible.

Heart attack

A heart attack, also called a Myocardial Infarction or MI, occurs when the arteries around the outside of the heart that bring blood to the heart muscle become blocked enough to cause damage. An area of the heart muscle without blood supply becomes painful, and the muscle cells start to become damaged and die. The pain is sometimes “referred” or felt in a different part of the body, often the neck, jaw and one or both arms (but most commonly the left arm). You can feel tired, lightheaded and short of breath because the heart is becoming damaged and is not pumping blood as efficiently.

If the damage interferes with the electrical conduction system of the heart, this can be seen on an electrocardiogram (ECG). However, a heart attack that doesn’t show on an ECG can also occur. This would be considered a less severe attack because it is not interfering with the heartbeat, but it’s still serious and painful. When the heart muscle is damaged, enzymes are released into the blood. A blood test for these “cardiac enzymes” is used to confirm that a heart attack has happened. Sometimes, especially in women, a heart attack that was mistaken for heartburn is only diagnosed later with this blood test.

Act quickly

It’s very important to get treatment as soon as possible, before serious damage occurs. In some cases, a person will feel mild angina pain that comes and goes, becoming noticeable when exercising or even worrying, and easing up when resting. Waking up with any of the heart attack symptoms above is a reason to seek help immediately – call 911! But even if the pain or pressure is mild and comes and goes, contact your doctor or go to the hospital as soon as possible to get treatment that can prevent possible damage to your heart from a blockage in blood supply.

Treatments

Nitroglycerin is a medicine that comes in small tablets or spray that is put under the tongue and in patches that are put on the skin. It opens blood vessels to help more blood get to the heart muscle and can relieve pain if the artery is not completely blocked. It’s often used to relieve pain and prevent damage while waiting for a procedure that will open the arteries to the heart.

A blocked artery to the heart is treated by cardiac catheterization. This is a procedure where a thin tube is inserted into an artery in either the wrist or the groin and is pushed along the artery until it reaches the coronary arteries that supply the heart. The surgeon squirts a special dye into the coronary artery and can view on monitoring equipment where the blockage is located. Depending where the blockage is, they can treat the problem in several ways. They can remove the blockage with suction, use a tiny balloon to stretch the artery open, or insert a tiny wire tube called a stent to hold the artery open. The whole procedure is done with anesthetic only needed on the wrist or groin where the tube is inserted. The patient is awake, and it takes about 30 minutes, or a little longer if a stent is put in place.

If the blockage is extensive, the surgeon may opt for a Coronary Artery Bypass Graft (CABG, also just called a “bypass”). In this procedure, a piece of artery or vein from another part of the body is inserted to carry blood around the blocked area. This is a more intensive procedure that takes several hours and a much longer recovery time.

Medications

Usually after a heart attack, several medications are given to help the heart heal and decrease the chance of another attack. Blood pressure medication lowers the blood pressure, making less work for the heart while it heals. Anti-clotting medication (also called blood thinners) help prevent blood clots from forming (the most common cause of a sudden blockage in blood supply to the heart). Cholesterol lowering medication (which also has anti-inflammatory, anti-clotting and antioxidant activities) is usually also added to reduce the deposits of fats and calcium (called plaque) inside the arteries, which also cause narrowing and reduced blood flow. Adding several new medications at once can be confusing, so be sure to ask your pharmacist any questions that your doctor hasn’t already answered. Your pharmacist can also help you organize your medication so it’s easier to take (and harder to forget!) as you get used to a new routine.

Other advice

Anyone at risk of heart disease, and especially those diagnosed with it, should work to follow a heart-healthy lifestyle:

  • Don’t smoke

  • Exercise regularly (aim for 30 mins a day, 5 days a week)

  • Follow a healthy diet with 7 servings of fruit or vegetables a day

  • Maintain a healthy weight

  • Reduce stress

Getting treatment soon is key

The key to successful treatment, the “heart of the matter”, is to call for help right away. The sooner treatment is started, the less heart damage will occur. If you seek treatment soon enough, you could avoid damage altogether! Remember, if pain is severe, call 911 – ambulance attendants can start treatment as soon as they arrive, saving precious minutes. They will also take you directly to the emergency department if necessary, avoiding time lost in the waiting room as you wait to be assessed.

This information is in my thoughts this week, as we needed to call 911 for my husband last Sunday morning. The ambulance attendants started treatment immediately and took him directly to the hospital. He just arrived back home today with a shiny new stent to replace a 15-year old one that had blocked up. He’ll need to take it easy for a few days but is already feeling better with the blood supply to his heart flowing well again. It was a worrisome week but it’s great to have a happy ending!

References:

Heart/Emergency Signs – Heart and Stroke Foundation

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Does massage really help reduce pain?

Massaging a sore area is an instinct, a reflex for humans. If we bump an arm or leg, without thinking most of us instantly rub the area.

How does it help?

Scientists say this rubbing helps because we have a type of “gate” for pain… only so many signals can pass into the brain at a time. They call this the “gate control theory”. It’s the principle behind massage and heat/cold therapy. Introducing another sensation, like temperature or pressure, can mean that fewer pain signals reach the brain. Pressure, heat and cold signals travel faster than pain ones so these sensations can dominate, at least for a while, to lessen the number of pain signals that reach the brain.

Another theory of how massage might work for pain, involves the Vagus nerve that communicates between the brain, the spine and organs. It partly controls the calming “parasympathetic” part of the nervous system that counters the “fight or flight” system. They speculate that turning on the calming part of the nervous system through massage, also helps to relieve pain and stress.

And here’s the science…

A 2017 study found that 10 massage sessions spread over 12 weeks resulted in clinically significant reductions in pain scores in people with chronic low back pain. This suggests that the pain blocking effect of a full massage session can last for several days.

Another study, done in 2010, found that a single 45-minute massage significantly reduced a hormone that raises blood pressure and boosted the immune system. Other research funded by the US National Institutes of Health showed massage not only reduced back and leg pain, but also decreased symptoms of depression and anxiety.

Another author suggested that, in addition to the effects of pressure on the skin, just the contact with another human being can be comforting to people, especially those who live alone. Other alternative therapies, like therapeutic touch (where the therapist doesn’t actually touch the patient but passes the hands close over the body) and Reiki (where the hands are laid on parts of the body but do not massage) also show benefits. One could speculate that these work by the closeness and attention triggering the “placebo effect”.

The placebo effect, often triggered by taking a sugar pill with no active ingredients, is not well understood but it’s so significant that scientific studies are not considered valid unless the drug being tested is compared with a placebo, with neither the doctor or patient knowing who received the active pill. Our bodies can make pain-relieving substances similar to narcotics and people can be taught to lower heart rate and blood pressure by their thoughts (called “bio-feedback”) so it’s believed that the placebo effect must trigger the body to produce some action similar to what drugs do.

In medicine, using the placebo effect as a treatment or, essentially, triggering the body to heal itself is sometimes thought of as unethical… that the therapist is tricking the patient or cheating them. But it makes so much sense to use the body’s own defenses as much as possible, when it’s safe to do so. I’m looking forward to the day when milder ailments can be treated by simply turning on our own immune system the same way a placebo does!

But check with your doctor…

So, while you should always check with your doctor when you have a new injury or an unexplained pain, talk to him or her about whether you might benefit from an alternative therapy like massage when it’s appropriate. Its actions, that include pressure, touch and that wonderful placebo effect that turns on your own healing abilities, could add together to reduce your need for medication. Some doctors even give prescriptions for massage therapy!

And keep in mind that there are self-massage techniques that could help too, either as an addition or a substitute for massage therapy. The photo above shows some of the tools you can use for massage… especially useful for those hard-to-reach areas. Physiotherapists and massage therapists often teach self-massage techniques to their patients so they can maintain benefit between appointments.

I have successfully used a text entitled The Trigger Point Therapy Workbook by Clair Davies with clients and myself to treat muscle spasm pain from neck spasms to sore feet (surprisingly caused by a muscle spasm in the calf!) with self-massage techniques described in the book. Check out Abe Books for a used copy, if you’re interested.

References:

The Science-Backed Benefits of Massage

The Trigger Point Therapy Workbook (Clair Davies)

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Health

Blood Pressure Basics

There’s almost always a discussion about your blood pressure when you visit your doctor for a check-up, but how much do you really know about it? Here are a few facts to help you understand why it’s important, how to monitor your pressure and some things you can do to keep your pressure healthy…

What is blood pressure?

Blood pressure (also called “hypertension”) is a measure of the pressure inside your arteries. This pressure increases and decreases with each heartbeat. Your heart pumps out blood with each beat, with enough pressure to send it through the arteries to all parts of the body. This pressure drops between each heartbeat, while the heart relaxes and refills with blood. Your doctor or nurse measures the highest and lowest pressure for each beat, called the “systolic” and “diastolic” measurements.

Blood pressure changes constantly. Exercise, caffeine, smoking, anxiety, stress, and even a full bladder can raise your blood pressure. Relaxing can lower it.

What can high blood pressure do?

Uncontrolled high blood pressure is the number one risk factor for stroke and an important risk factor for heart disease. It can also cause damage to various organs.

Damage to arteries

Under constant high pressure, the inner lining of blood vessels can become damaged and inflamed, allowing fats in the blood stream to collect in the lining. These fatty areas also collect deposits of calcium and are called “plaque”. They can stiffen and eventually block an artery, or they can burst open and cause a blood clot to form, instantly blocking the artery. Some researchers have suggested plaque formation may be the body’s way of protecting and healing damaged areas, somewhat like a scab does on the outside of the body, but this is yet to be proven.

Over time, with constant pressure, a section of artery wall can also become weakened and bulge outward. This is called an aneurysm and, if it bursts, it can cause life-threatening bleeding inside the body. Aneurysms can form in any artery, but they’re most dangerous when they develop in the brain or on the aorta, the body’s largest artery that runs from the left side of the heart down into the abdomen.

Damage to the heart

When blood pressure is high, your heart must work harder to pump blood against this increased pressure. Over time, the left side of the heart that pumps blood through the body can become larger and stiffen because of the extra work it needs to do. This limits the heart’s ability to supply the body with enough blood and to keep up with the blood returning to the heart from the lungs. This is called heart failure (also known as cardiac insufficiency) and it also increases your risk of a heart attack.

Damage to the brain

A stroke occurs when part of the brain is deprived of blood, causing brain cells to die. Uncontrolled high blood pressure can damage blood vessels in the brain, causing them to narrow, burst or leak. It can also cause blood clots to form in the arteries leading to the brain, blocking blood flow and potentially causing a stroke.

Reduced blood flow to the brain can also cause dementia, a result of gradual damage to areas of the brain that control thinking, speaking, decision-making, memory, vision and movement.

Damage to eyes and kidneys

Both the eyes and kidneys contain tiny blood vessels that can become damaged, leading to vision problems and kidney failure.

What is a good blood pressure?

  • Ideal – 120/80

  • Normal – less than 140/90

  • Exceptions:

    • Diabetes – best if less than 130/80

    • Over 80 years – less than 150/90 can be acceptable, especially if frail

      • Note that frail elderly are more susceptible to medication side effects like dizziness and risk of falling, and this need to be taken into account when setting targets

Low blood pressure (less than 120/80) is considered fine unless it is low enough to make you dizzy or lightheaded. A doctor once told me having low blood pressure was “like having extra insurance”.

What can you do to control blood pressure?

Some factors, such as age, ethnicity, and gender, cannot be controlled. After age 65, women are more likely than men to develop high blood pressure. Pregnancy, birth control, and menopause can also increase the chance of developing high blood pressure.

But there is plenty you can do:

  • Eat a healthy diet. Learn about the DASH diet (Dietary Approaches to Stop Hypertension), an eating plan designed to help lower high blood pressure. This diet includes healthy foods and limits salt intake.

  • Be active for at least 150 minutes per week, at least 10 minutes at a time.

  • Maintain a healthy body weight. If overweight, losing even 5% to 10% of your weight can help lower blood pressure and reduce risk of heart attack or stroke.

  • Don’t smoke!

  • Limit alcohol to 2 drinks a day/10 per week for women, and 3 per day/15 per week for men.

  • Find healthy ways to manage your stress.

How to measure blood pressure at home

  1. Read and follow specific instructions for your monitor, then follow these general instructions:

  2. Relax in a quiet area for 5 to 10 minutes. Avoid exercise, caffeine and smoking for 30 minutes before measurement. Empty bladder, if necessary

  3. Slide cuff on arm with lower edge about 1 inch above elbow fold. Fasten snugly but not too tight (should be able to slide 2 fingers underneath). Cuffs come in 3 sizes – be sure to choose the appropriate one for your arm size.

  4. Sit up straight, back against chair, legs uncrossed, arm resting on table, palm up. Relax and don’t talk during the measurement.

  5. If using an automatic monitor, press button now. If not, continue with steps below:

  6. Inflate cuff about 30 points higher than expected measurement, or until the machine says to stop. (some monitors – those without a stethoscope – do the rest automatically).

  7. Loosen airflow valve so that pressure falls by 2 to 3 points with each heartbeat.

  8. With a manual (stethoscope) monitor, listen for the first pulse (heartbeat) sound.

    1. Note the reading on the gauge/screen

    2. This is the upper (systolic) reading

  9. Continue to slowly deflate the cuff

    1. Listen until the heartbeat sound disappears

    2. This is the lower (diastolic) reading

  10. Let cuff completely deflate.

  11. Repeat twice, resting for several minutes between readings. Use the lowest reading.

  12. Record the date, time and lowest measurement. Bring records to your doctor’s visits. Once a year, bring your machine to check its accuracy by comparing with your doctor’s reading. Your doctor, nurse or pharmacist can also check your technique.

High blood pressure can quietly damage your body over a period of years – they call it the “Silent killer”. So, have your doctor check your blood pressure regularly, or check it yourself. Take action if your pressure is consistently increased and prevent blood pressure complications.

References:

High Blood Pressure (Heart and Stroke Association)

Checking Your Blood Pressure at Home (WebMD)

High blood pressure dangers (Mayo Clinic)

Blood pressure targets in the elderly (Journal of Hypertension)

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Rock-a-bye Mommy… Could rocking help adults sleep too?

Generations have rocked their babies to sleep. And we’ve all heard of parents who helped calm a fussy baby by driving them around the neighbourhood. But could motion help adults sleep better too?

Well, it turns out there are a few studies on this question. Researchers studied a group of young adults and found that slow, gentle rocking lengthens sleep and increases the time spent in the deepest stages of sleep. In studies, rocking also shortened the time required to fall asleep and fewer arousals (waking for 3 seconds or longer) occurred.

Rocking also improved memory recall compared to sleeping in a stationary bed, although both groups improved after sleeping. EEGs showed that firings of neurons that are associated with memory consolidation increased with rocking during sleep.

Searching for the mechanism of improved sleep, researchers also did an interesting test on mice. Like humans, they slept better when their cages were rocked. But they also tested mice who were born without the structure in the inner ear that detects motion to see if they responded the same way. It turns out that they didn’t – mice who couldn’t detect motion in the rocking cages slept the same as those in stationary cages. The “otolith” structure in the inner ear that these mice were missing is connected through several other structures in the brain to the thalamus and hippocampus of the brain that control sleep. Researchers suggested this could be how rocking motion influences sleeping and memory.

Of course, since the human studies were done on healthy young adults, they would need to do similar studies on older adults and those with sleeping problems to find out if rocking would help them too. If it worked, it could offer a convenient non-drug way to help solve sleep problems. Studies in Alzheimer’s patients found that sleep helps to clear the amyloid-forming proteins that clog the brain. This made researchers also wonder whether rocking might help to prevent or improve this dreaded brain disease. More research to come!

I expect it will be a while before we see cradles for adults in stores. But meanwhile, you could consider taking naps in a hammock (and maybe bribe someone to keep it rocking while you sleep…). Sleeping on a boat could theoretically give the same effect so, perhaps, a cruise vacation might be relaxing in more ways than you realize. And, who knows, perhaps some time in a rocking chair in the evening might help set you up to fall asleep more quickly, just as it does for our babies!

There is something very soothing about a rocking chair… At my hubby’s family homestead in Miscou Island, there has always been a “competition” to get the rocking chair. Over the years, several of these chairs have been purchased or donated to this family home that’s shared between several siblings for summer vacations. I think there’s at least a half dozen now – so not so much competition – and we all seem to sleep exceptionally well when we’re there! Perhaps rocking has something to do with it… Why not give it a try!

Reference:

Rocking improves sleep and memory in adults

Why Rocking to Sleep is a Matchless Sedative, Scientific American

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Health

The argument for doing “nothing”…

Do you remember being a kid, and having nothing to do for hours? Whole summer afternoons that seemed to last forever, just lazing around, being bored, thinking and daydreaming?

And, now that we’re adults, we make our lists, try to be as productive as possible, and want to squeeze as much “doing” in as we can.

But when is our time to think? If you’re a Big Bang Theory fan you may remember the episode with Amy, reading then just staring blankly off into the distance… When asked if she was OK, she answered: “Yes. I was reading. And now I’m thinking about what I read.” Sometimes we need time to just think, to figure out what to do with all that information coming at us.

Our brains work on several levels to process information. You may have noticed that something you were trying to remember will just pop into your head later when doing something completely unrelated. Especially when engaged in an activity that doesn’t require deep concentration, your subconscious will continue to work on solving a problem even though you weren’t actively trying.

And, even if it doesn’t find the solution for you, you’ll see the problem with fresh eyes and more energy when you return to it. Writers often use this technique to improve their ability to see writing problems – we walk away, take a break from our work, and magically can see lots we can improve when we return. I’m sure this process can work for many tasks and makes a strong case for taking regular breaks from any lengthy project.

The other problems we can have from constant “busyness” with little time to think are fatigue, stress and burn-out. But taking a break from work and spending it reading our devices isn’t really a break for our mind. A really helpful break is more like what Amy was doing: staring off into space. Closing eyes and listening to music or meditating give a similar effect. The Dutch call this “niksen” – doing nothing.

Taking short but regular “niksen” breaks during the day, even if it’s just a few minutes to relax and take a few deep breaths, can help you to be more productive when you return to work at the same time as it’s preventing overload, stress and burnout. Any sort of breathing exercise can help by distracting, giving you something else to concentrate on – I often used this technique to distract patients before giving them their flu shot. It worked well, giving the person something else to focus on besides the needle I had in my hand. Studies say distraction actually lessens the pain experienced during an injection.

Now, I’ve never been able to sit still and meditate without getting antsy, but I have found repetitive activities like knitting or jigsaw puzzles seem to fit the bill, occupying the mind and giving it a break from being busy. The key is creating a break for your mind, letting it wander and giving it time to process.

So, make time to be bored (or at least to do something mindless) on a regular basis – your brain will likely thank you for it!

And, if it’s time to give your brain a break and just do nothing, here’s a link to “The Nothing Song”

Read more here:

The Case for Doing Nothing – The New York Times

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Health

We are all biased…

It drives me nuts that diet researchers keep changing their minds about what foods are good and which are bad for us. Butter and eggs are two that have switched sides several times lately. And red wine? Well, I only believe the reports that say a moderate amount is good for your heart (Do you suppose I could be a little biased? 😊).

We all have biases. That’s how our human brains work. It’s easier to avoid being biased if you are aware of how your opinions can get off track.

So here are some different types of potential biases we can have…

  • Hindsight bias – focusing and rationalizing the past without paying enough attention to current facts. An event that happened to us or someone close to us in the past can influence us more than it should, even if it’s a rare occurrence.

  • Optimism bias – choosing an excessively rosy outlook. We are often influenced by what we hope, sometimes irrationally, will happen in the future

  • Selection bias – “cherry picking” the facts that agree with your theory. Talking only to people with the same beliefs as you can increase your bias while listening with an open mind to those with opposing ideas can lessen it.

  • Funding bias – keeping your sponsor happy so they’ll donate again. If Grandma gives you money for a gift, you might tend to buy something she’d approve of…

  • Self-selection bias – when more people choose to comment or participate because they agree with what is being discussed or measured. This can make it appear that a cause or idea has more support than it actually does.

  • Recall bias – our human tendency to remember the fun parts of an event, especially after some time has passed. Opinion surveys are best done one day after an event: immediately after we want to be kind to the organizer, and a week later we have already forgotten most of the bad parts and remember more of the good.

Scientists, too, need to know about their own human failings and adjust their research to reduce bias as much as possible. However, it’s easy for it to creep in when they aren’t vigilant… To try to prevent bias, studies include a “control” group to compare and measure how much change the factor being tested is creating. Those gathering the information from both groups as well as those being tested aren’t told who is in which group. This is called a “controlled double blind” study. Of course, they can’t do this with diet studies, and perhaps this is one reason why studies often reach opposite conclusions, depending on who is running the study, how accurately people remember and report their diet information, and who paid for the study.

When a researcher or politician has a personal interest in a certain outcome, it can influence how he interprets the information, whether he realizes it or not. The job of a lobbyist is to change the opinion of those who make decisions in favor of whoever is paying them. There are so many factors that can affect decisions that are made and what we see in the news.

It’s the same for us as we make decisions about what type of diet is healthy, who to vote for or whether we should vaccinate our children. We are influenced by personal experiences, who we talk to, what media we choose for our news, and many other factors. If it’s health-related, your doctor is likely the best person to give you balanced advice.

Social media

But, increasingly, social media influences our opinions. Social media follow what we like and post, to gauge what we are interested in, and then send us information that supports what we already believe. I was surprised to learn that, not only is this done with advertising, but with regular posts as well. And, of course, anyone can post whatever they wish – whether it’s facts, opinion or fiction…

So, how can you reduce your own biases and make better decisions? One way is to look for information on both sides of any question. Read what those who disagree with you are saying. Are their arguments valid and based on fact? Search out information from experts and, as much as possible, read facts rather than opinions. Realize that media reports are often sensationalized, because that’s what sells.

Be open-minded

Another way to reduce your bias is to keep an open mind. Winston Churchill was known for beginning a statement with phrases like “I could be wrong, but I think…” or “In my opinion…”, encouraging the person he was conversing with to offer their opinion and leaving room for him to change his if the facts offered warranted it.

Since I’ve retired from active pharmacy practice, I find I have more time to seek out alternative opinions. This has made me question some of my long-held beliefs as a pharmacist. But I try to keep an open mind and keep reading. Things can change quickly in medical circles with the discovery of a new information, but sometimes entrenched ideas can take a long time to change.

A Harvard Business Review article had 3 suggestions to reduce bias:

  1. Question assumptions – don’t just immediately accept what you are reading as truth.

  2. Follow through the writer’s logic – does it make sense and agree with other information you have read? Is the argument supported by scientific evidence or is it presented from a limited personal experience?

  3. Diversify thought – look for other opinions to keep your point of view balanced.

When it comes to diet research, try not to get caught up in the latest fad. Aim for a balanced diet of whole foods, lots of veggies and everything else in moderation – and be skeptical of extreme claims in headlines, especially on the internet! I try to be as unbiased as I can, while sharing health news I find interesting, and I will always include my references so you can see my sources and evaluate them yourself — because, like all humans, I have my biases too… especially when it comes to wine!

References:

Harvard Business Review

Statistical Bias Types Explained

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Health

Lactose Intolerance? – What can you do…

Many humans lose the ability to digest milk after childhood. And essentially all non-human mammals lose this ability after weaning. This suggests the ability of humans to digest lactose in dairy products is actually a quirk of nature or adaptation.

Lactose intolerance varies by ethnic origin. Asian and first nations people are almost 100% intolerant, African origin 60 to 80%, South American 50 to 80% and those of European origin about 20%. Worldwide, approximately 75% of people are lactose intolerant.

What is lactose intolerance?

Lactose is a complex sugar (two smaller sugars attached together) and it needs to be broken down into two simple sugars so it can be absorbed. This is done by an enzyme called lactase.

Because lactose is a sugar, if it’s not absorbed, it becomes food for bacteria in the large intestine. When these bacteria consume sugars, they produce gas. This “air” in the intestine causes the cramps, bloating, flatulence and abdominal pain that are associated with lactose intolerance. The extra lactose sugar also draws water into the bowel causing diarrhea if enough is consumed.

A quick genetic lesson

DNA is composed of genes. Each gene is a code or template for a protein that has a particular action in the body. For example, there are genetic codes to make light detecting proteins in the eyes, and oxygen carrying proteins in the blood. Every cell has a complete copy of your DNA. Individual genes in the DNA are turned on or off as necessary so only the proteins that are needed are produced in each part of the body. This is done by “epigenetic modification” – chemicals inside the cells bind to the gene, blocking it from making its protein. Epigenetic modification of the lactase gene, to turn it off once past childhood, does not happen in lactose tolerate people.

Lactose tolerance is relatively new, in terms of evolution. It is believed to have started around the same time as dairy animals were first domesticated. The change that occurs to prevent lactose intolerance isn’t to the lactase gene itself but to a nearby area of DNA that protects against the normal “turning off” of the gene.

However, if the small intestine is damaged by disease or if large doses of antibiotics are given, a person who was lactose-tolerant can become intolerant later in life.

Microbiome and lactose intolerance

When scientists noticed that antibiotics could create lactose intolerance, they began to investigate whether the bacteria (microbiome) in the intestine had an effect on the lactase gene or on lactose intolerance in general.

Their studies showed that symptoms of lactose intolerance can be relieved in some people by increasing lactose-digesting bacteria in their small intestine. These microbes eat the lactose but produce lactic acid instead of gas. Lactic acid does not produce the unpleasant symptoms of lactose intolerance, and this is one way that some people can tolerate dairy foods without actually producing lactase enzyme. The microbiome tends to be similar in populations, since bacteria are passed from person to person, so it might be part of the explanation of how certain areas have less lactose intolerance than others.

One way to promote the growth of lactic acid producing bacteria in the digestive system, is to “feed” it a complex sugar (or “prebiotic”) it can digest but humans cannot. Studies to find an effective prebiotic that could be produced commercially are in progress.

However, there are many fermented foods available – like yoghurt, kefir, sauerkraut and other pickled vegetables – that can introduce new microbes into the digestive system. While there are no guarantees they will contain bacteria that like to consume lactose, they are a healthy addition to any diet that may improve digestion. Researchers suggest 5 servings weekly that include at least 3 different types of fermented foods.

Do we really need dairy products?

There is an ongoing debate: if we evolved to be unable to digest dairy products as adults, do we really need these foods to be healthy? The nay-sayers point out that many populations (and animals) never drink milk as adults, and we know that many just cannot tolerate it. The pro-milk group tell us about the many nutrients it contains in foods that are easy to consume.

Recent research has found that consuming milk or calcium supplements as an adult does not reduce the chance of a bone fracture. And much of bones’ strength is developed early in life. But milk products do contain many other nutrients and are, overall, healthy foods to consume. Geneticists note that, because the ability to tolerate lactose has increased dramatically in populations who consume dairy products, it must confer an advantage for survival… over centuries, those who ate it (on average) lived longer and had more descendants than those who could not.

So, if you are unable to digest the lactose in dairy products, try improving the health of your gut microbiome with prebiotics and probiotics. If you’re lucky you may be able to increase the microbes that can improve your tolerance to these foods. Remember that the lactose in fermented dairy products, like kefir, yoghurt or cheese, has been mostly digested in the fermentation process, so is easier to tolerate for those who do not produce their own lactase enzyme. And you can always take lactase enzyme as a supplement – it’s available commercially (LactaidÒ) in forms that can be mixed with food to pre-digest it or it can be taken along with lactose-containing food.

After all… what is life without ice cream or cheese?

References:

Do Humans Need Dairy?

National Institutes of Health: Prebiotics for lactose intolerance

Study: Improving lactose digestion and symptoms of lactose intolerance with a novel galacto-oligosaccharide

Categories
Health

Lack of sleep could be killing you…

Lack of sleep is holding us back and shortening our lives! Sleep is a biological necessity – experts say we need 7 to 9 hours a night to maintain our health, feel good and perform our best. Although some of us have trouble getting enough sleep, many choose to stay awake longer, trying to fit in more activities – and accomplish more – each day. But this may not be a good decision…

Studies suggest that those who sleep less than 6 hours a night run a risk of 13% greater chance of dying. Decreased productivity is estimated to cost the economy $411 billion in US, $50 billion in UK and $21.4 billion in Canada. And researchers say the number of people who don’t get enough sleep is rising.

Lack of sleep doesn’t only leave you feeling more tired and less energetic. Memories are processed and stored while we sleep. We need enough time in the deeper stages of sleep to process the day’s events in order to remember them long-term.

So, cutting sleep short to create more waking hours with the goal of achieving more can backfire, reducing achievement both at school and work. As Arianna Huffington, co-creator of Huffington Post says, you need to “sleep your way to the top!” (see link to her TED talk below). Of course, she’s talking about getting enough sleep so you can achieve more at work. She came to this realization when she injured herself, hitting her head on her desk when she passed out from lack of sleep.

The other way to make more time in your day, of course, is to look at your daily activities and decide what’s most important to you. Evening TV? Facebook articles? Emails? Or that project you’ve been wanting to finish? Simplify your life (and email!), and limit time wasting activities to create more free hours to accomplish your passions instead of cutting short your refreshing, health-protecting sleep.

And if you can’t sleep but want to? Here’s a blog I wrote about what you can try for insomnia: Can’t Sleep?

But, if hormone related symptoms are keeping you awake at night, my new book Can I Speak to the Hormone Lady? Managing Menopause and Hormone Imbalances has information you can use. It’s available here.

References:

TED Talk: How to Succeed? Get More Sleep – Arianna Huffington

National Institutes of Health: A prospective study in sleep duration

Categories
Health

Finding Wellness

What does Wellness mean to you? The World Health Organization defines it as: “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” It involves consciously making improvements to lifestyle, outlook, environment, belief systems and values to achieve your full potential and to help those around you do the same at home, in the workplace and in the community.

However, if you search the internet, you will find two types of “wellness” advice:

  • Information on wellness (sometimes referred to as lower case “wellness”) …solid advice on ways to promote health and prevent illness, backed by scientific evidence. It includes good nutrition, exercise, sleep, stress reduction and more, and essentially means the opposite of illness.

  • Promotional material on Wellness Products (Wellness with a capital “W”) …products often making pseudo-scientific health claims with sketchy proof and often marketed with a high price tag! The Wellness business is a billion-dollar industry…

How can you tell the difference when you’re reading a web page? I use two simple ways:

1. Who posted the information?

Is the web page associated with a large health organization, government or university? The goal of these organizations is generally to share information and promote public health. They have no financial incentive to hide negative information or exaggerate the positive effects of a wellness strategy.

Does the author have any credentials or experience as a health professional? While credentials are not entirely necessary (a good writer will get all the facts and present them in an unbiased way), it means they will likely have better background knowledge.

Where did the information originate? Look for references. Is it backed by scientific studies? A well referenced web page will have links to background studies that support what they are saying. Studies usually have a little summary at the beginning, called an “abstract” that is a brief description of the study. I also look at where it was published – many large medical organizations publish journals with information for their members that usually well researched.

2. Who paid for it?

The second thing I look for on a web page is, who paid to publicize the information, and whose advertising is displayed with the article. I learned a good lesson over 20 years ago when the internet was just starting up. The doctors next door asked if I could supply them with information about the herbal medicine, St. John’s Wort. I quickly found what looked like a perfect article on the internet. My pharmacy student, who was more tech-savvy than me, didn’t say a word…she just scrolled down and pointed to the advertisement for St. John’s Wort. An “aha” moment for me!

With a more critical look, I noticed the site described the herb as “safer than aspirin” and, while many would interpret this as saying it is very safe, as a pharmacist I know that aspirin can cause internal bleeding in some people. The site wasn’t being open and honest in an effort to increase sales, and chances were good they were hiding other important, but negative, information. I subscribed to an independent herbal website after that so I could easily access unbiased information about natural medicines.

So, whether your reason for looking for wellness information or alternative medicines is wanting to stay healthy and active as you age, or to address a need that is unmet by the medical system, don’t be taken in by marketing strategies for Wellness products. Know that a vitamin is a vitamin – they are all the same chemical structure – so there is no reason to pay $90 for a month’s supply when you can always buy good quality vitamins from a reputable manufacturer at your local pharmacy. When looking for health information on the internet, choose an academic or health-center site rather than one sponsored by a product manufacturer. Know when you’re being marketed to and be a savvy shopper.

But also make sure any alternative treatment is an addition to good medical care and not a replacement for it. Consider natural treatments as complementary to your medical treatment rather than a true “alternative”. Nothing can replace good medical care.

So, talk to your doctor about any non-prescription medications you are taking, even if they are being recommended by another health professional. While they may not have learned about it in medical school, they can help you evaluate the information you are reading and ensure there is no interference with any health condition you may have. Your pharmacist may be your most accessible health professional and they can help ensure you avoid conflicts with medications you are already taking. They also have access to scientific references on alternative and complementary products. Ask if they can find some solid information to share with you.

Talking with your doctor and pharmacist about non-prescription choices is a great way to start a conversation around your health goals and how best to achieve them. The internet can be a wonderful source of information but it’s best when used in consultation with your doctors, pharmacists, and other health professionals.

References:

The Self-Care Paradox

Definitions of Wellness