YOU Docs Daily The online edition of their daily newspaper column
Need a Tissue? A Few Tears Are Good for You
Whether it’s over a tearjerker movie, a sweet note from your spouse, or a lethal parking ticket, go ahead and cry. Tears are good for you: Just as sweat removes salt, urine removes waste, and mucus traps bacteria, tears have a purpose, too.
Emotional tears, shed in moments of intense feeling, do more than keep the Kleenex folks in business. They also carry stress hormones and are a way of getting rid of them. Needing to cry also signals that you've reached a level of stress that's detrimental to your health.
But here’s the really amazing thing: Emotional tears are just one of three types of good-for-you tears your body makes, and each is chemically different from the other two:
Basal tears are produced continuously to keep your eyes lubricated. That layer of moisture also helps prevent damage from air currents and bits of floating debris.
Irritant tears are produced when things such as flying sand, grit, and insects find their way to your eyes and need to be flushed out. Irritant tears help prevent damage to your eyes from these low flyers.
Emotional tears are released in moments of intense feeling and help wash away stress hormones.
Discounting a few unverified tales of weepy gorillas and elephants (which may, someday, prove to be accurate), it seems humans are the only ones who cry. When you do it, don’t hide it from your friends; showing your vulnerability to them can help soothe the adverse effects of stress.
To get on a roll this afternoon -- and stay there -- power up your lunch with these easy steps:
1. Start with Complex Carbohydrates That Are High in Fiber These are the carbs found in vegetables and whole-grain foods; they’re not the simple ones in sugar and refined breads. Smart choices: Beans; peas; vegetables; 100% whole-grain breads; and toothsome, hearty grains, including quinoa and brown rice. Why it works: These take longer to digest. By getting into your bloodstream slowly, they help sustain your energy. Junk-food carbs, on the other hand, push blood sugar high, then vanish, leaving you with less energy than a used battery.
2. Pair Carbs with a Little Fat, Mostly Unsaturated Smart choices: Use avocado to top your corn tortillas, or add walnuts to a mixed-greens-and-garbanzo-bean salad tossed with olive oil and lemon juice. Why it works: Dietary fat helps you maintain energy and absorb certain nutrients. Fat also helps you feel full longer and prevents your blood sugar from spiking. Unless you get too much, and then fat just sits on your hips and slows you down in every direction.
3. Add Lean Protein to the Mix Smart choices: Skinless poultry, lean meat, fish, tofu, eggs, low-fat dairy products, and legumes. Even better: Make veggies your main choice, and add protein as an accent. Why it works: It provides key nutrients and has a low glycemic index (a measure of how quickly foods raise your blood sugar levels), so it can help balance out the effects of carbs that are more quickly processed.
There’s more to the start of school than the must-have psychedelic book covers and the whining about the math teacher. It’s not too late to give your kids a healthy start with these strategies:
See if they’re just ignoring you. Sometimes, kids really can’t hear or see you well. In school, they get pegged as having learning issues, when, instead, their eyes or ears are the trouble (it’s not always obvious, so get them tested). It’s not that rare. For instance, 2% to 5% of kids have amblyopia, a reversible form of vision loss that could become permanent unless it’s treated.
Ease back into sleep. For most kids -- and parents -- school means earlier bedtimes (as if it wasn’t already hard enough to get them to bed) and earlier mornings. Sleep is critical for optimal health and learning, so adjust the schedule by going to bed just 5 to 10 minutes earlier each night. Limit late-afternoon naps and sugary evening snacks (that goes for you, too!). Kids still yawning? Get to the doc; could be allergies or sleep apnea.
Feed their brains. A healthful breakfast is essential for good school performance. Keep cold (healthy!) cereals, quick oatmeal, yogurt, cottage cheese, and fruit on hand to make the meal go smoothly. Don’t let your kids lose it at lunch; pack the good stuff for them.
Weigh the backpack. Overstuffed backpacks can cause back, shoulder, and neck pain. Kids shouldn’t be carting around stuff that exceeds 10% to 15% of their body weight (but it is smart for them to have a container of hand sanitizer among their things).
The flu -- whether it’s the usual, seasonal flu or the new H1N1 “swine” flu -- is nothing to sneeze at. According to the U.S. Centers for Disease Control (CDC), more than 200,000 people are hospitalized annually because of flu-related complications, and approximately 36,000 people die from flu-related causes each year. Protect yourself with these facts.
Myth #1: You can get the flu or other complications from the flu shot. Truth: That’s about as likely as hitting double zero on a roulette wheel 14 times in a row. If you do get sick after a flu shot, it’s likely that you were exposed to someone with the flu virus or another illness shortly before you got the shot. Flu shots only contain dead viruses (only the nasal flu mist contains an active -- but weakened -- virus). So unless you know how to resurrect the dead (if so, we need you at another part of the clinic), it is highly improbable that you would catch the flu from the shot.
While it’s true that the shot increases inflammation in your body, it’s minor compared with what your body suffers if you get the flu. As for the pain? Tiny, compared with the advantage of being about 25% less likely to be hospitalized for pneumonia.
Myth #2: After December, it's too late to get the vaccine. Truth: The viruses causing the flu have not taken Calendar Reading 101, and it’s likely they’ll extend themselves into the New Year. You can get a flu shot before or during flu season; September is ideal. If for some reason you don’t get one until December or later, you’ll be protected going forward. But it won’t stop a flu bug that’s already enjoying your hospitality.
Myth #3: Only those at high risk should get the flu vaccine. Truth: Everyone should get it. Two reasons: One, immunization is vacation protection: It helps ensure that you won’t have to spend all your PTO on flu days. Two, if you protect yourself from the flu, you’re also protecting others by not spreading it. Some people, however, should not be vaccinated -- you are allergic to eggs (you break out, or worse, can’t breathe at their sight), have a history of Guillain-Barre syndrome, or have had a severe reaction to a previous flu shot. Infants under 6 months old should also not get this vaccine.
Myth #4: Eating pork and pork products will cause H1N1 (swine) flu. Truth: H1N1 flu did originate in pigs but has moved to humans. Now the virus moves from person to person rather than from pig to person. Eating cooked pork and pork products cannot give you swine flu.
Myth #5: The seasonal flu vaccine protects against H1N1, or vice versa. Truth: Oh, we wish it did . . . or that we had a vaccine that was good for both. We could all have a few extra days off (vacation, not sick days). Alas, swine flu is a different strain this year than the seasonal flu, so you need to get the seasonal flu vaccine in September (ideally) and the vaccine for H1N1 when it becomes available, if it is proven safe and efficacious enough (studies are just under way now).
Myth #6: Having the flu already this season protects you from getting it again. Truth: The flu bugs have a lot of relatives: There are usually two types of flu during flu season, influenza A (including H1N1) and influenza B. It is possible to be infected by both during the same season. Even if you’ve already had the flu, you should get the vaccine before you come down with another strain. Don’t worry, we’re telling you the truth -- no vaccine companies contributed to this article.
Another compelling reason to get vaccinated: If you get a flu shot for 10 years in a row, you are about 50% less likely to die in those 10 years from any cause, compared with those who do not get flu shots. That’s because many heart attacks and strokes are triggered by plaque rupture from acute inflammation; and you decrease that inflammation with flu shots.
Myth #7: Avoiding sick people will prevent the flu. Truth: Germs are airborne and can be found on all surfaces, so even if you spend flu season avoiding sick people, you can still catch the flu. No baseball mitt needed.
When Heart Attacks Happen to (Seemingly) Healthy People
Q. I know someone who had a heart attack (she survived), but she had no history of high cholesterol. How can that be? -- Diane, Pacific Grove, CA
A. It is pretty common. First, she may not have been looking at the right cholesterol numbers; and second, cholesterol doesn’t predict your whole heart-attack-or-not future.
Many people look at one cholesterol number -- their total cholesterol. But that doesn’t tell the whole truth. Total cholesterol is made up of LDL (lousy, the kind that blocks arteries) and HDL (healthy). You want your LDL to be less than 100 and your HDL to be higher than 50. And cholesterol isn’t even the only blood fat to look at: Also factor in another called triglycerides, which should be under 100.
With our bodies being as complex and wonderful as they are, all of that isn’t even close to the whole story. More important is high blood pressure. (Your blood pressure should be as close to 115/76 as you can get it, but that’s another column.) Another big reason that heart attacks happen in people who seem otherwise healthy is inflammation. You can’t see or feel it going on in your arteries, but there’s a test called an hs-CRP test that can detect a marker for inflammation (called C-reactive protein). Get a baseline check of your CRP levels in your 20s, again at 35, and annually after your 50th birthday. A CRP under 1.0 mg/L is considered low risk; over 3 is considered high risk.
Q. I’m wondering whether laser resurfacing skin treatments really remove wrinkles. If so, are they safe? It seems like they kind of burn your skin off. -- Margaret, via e-mail
A. With these treatments, dermatologists use a carbon dioxide laser or other laser to remove several layers of damaged skin and allow smoother, less wrinkled skin to emerge. In the process, it also can eliminate visible blood vessels; remove spots of sun damage that can contain potentially cancerous cells; and stimulate the formation of collagen, one of the proteins at the heart of making your skin look supple and young.
The process does sort of “burn your skin off,” but choosing an experienced doc and making sure you’re a good candidate (it’s best for people with fair complexions) should make it safe. It’s nowhere near as easy as a facial: You’ll need a topical painkiller and possibly a sedative. And you’ll want a hat and shades: Not only do you need to keep the sun away, but you’ll also have redness and swelling, and your skin can be somewhat crusty for a few weeks afterward. Within months, your skin should be looking younger.
Still sounds scary or involved? If you haven’t already tried it -- which you should, before considering laser resurfacing -- consider tretinoin cream (Retin A), as long as you are not in the pregnancy-potential years. This prescription cream can reverse wrinkles by increasing the skin’s stretchy fibers, rebuilding some damaged collagen, and replenishing the skin’s natural moisturizer, hyaluronic acid. Even better, we think, is preventing wrinkles and skin aging in the first place. Two big keys: wear sunscreen every day (no excuses!), and if you smoke, quit! And do the other things you know will keep your arteries young; they help your skin, too.
Q. When are hemorrhoids ready for surgery? And who do you tell about them? -- Anonymous
A. If hemorrhoids (swollen veins in the rectum that can hurt or bleed) don’t stop hurting within a couple of weeks, talk with your primary care doc. He or she is used to hearing about and seeing hemorrhoids; just about everyone gets these at some point.
Usually, they’re treated by making sure your poop is soft and by putting moist heat on the hemorrhoids. Most of the time, you don’t need surgery; it’s a last resort only if a hemorrhoid is very large or hanging down or bulging. In some cases, a doc can use rubber band ligation -- yep, a rubber band around the base of the hemorrhoid cuts off blood flow until it withers away. Others can be nixed like some varicose veins are -- by injecting them with a chemical that destroys the vein causing the trouble.
Want to win the account, or the golf or tennis match? Buy your opponent lunch, and make it a nice, big burger and fries.
If people’s bodies react at all like rats’ do (and we know they do in certain ways), your rival will bungle the presentation or be listless at the game while you’re still going strong. Here’s what happened in a recent study when rats spent just 9 days eating a diet that provided 55% of its calories from fat: They ran a third less far on a treadmill and did worse on a cognitive test (a maze, not a crossword puzzle) than rats that got a little more than 7% of their calories from fat.
Think you can get away with just one fatty meal? Check this out: College students who volunteered to eat a single fatty meal right before they underwent tests designed to stress them out (including mental arithmetic and holding one hand under icy water) had sluggish blood vessel reactions to that stress. That indicates less ability to respond to an energy-demanding situation.
Your body, too, reacts like the rats’ and the college students’. That’s not good, because a cardiovascular system that cannot counteract stress means the stress is inhibiting your ability to be your best -- whether you’re responding to questions at a presentation or to the challenge of hitting a ball. So leave those stress-augmenting saturated and trans fats for your competition -- maybe even offer to treat them to an extra order of fries.
When it comes to losing your spare tire, your “bonus,” or whatever you call that extra jiggle, you need more than rice cakes and celery. You need strategies so you can diet smart, not diet hard. Use these to healthfully get you to your ideal size:
Automate the process. Strip away any thinking about eating that can pull you off track. Eat the same thing for breakfast, lunch, and snacks, and only change up your options for dinner.
Stop beating yourself up. That’s why almost all diets fail. Slip up? Make a YOU-turn. In other words, get back on your plan right away.
Have contingency plans. One of the ways you can avoid an all-out chocolate-fest is to activate your contingency plans. These are the ready-made meals and snacks (nuts, carrots, apples) you can turn to -- instead of the vending machine or the candy aisle at the quickmart.
Eat to stay full, not to hit a specific calorie count. If you fill up on the right food and let your body tell you when you’re satisfied and not stuffed, you shouldn’t have to worry much about calories. Can’t hear your body? Try this: For a couple of weeks, rate your hunger on a scale from 0 (“Feels like I haven’t eaten since high school”) to 6 (Thanksgiving full) -- three-quarters full is a 3. Ideally, your tank should always be three-quarters full -- that’s satisfied, not hungry, and definitely not filled to the brim.
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