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February 2016

» What is a clinical trial? Can anyone volunteer? » I often feel dizzy or unsteady on my feet. Could this be something serious? » How worried should I be about an abnormal Pap test?

What you need to know about heart palpitations Heart palpitations are a feeling that your heart is beating too hard or too fast, skipping a beat, or fluttering. You may notice heart palpitations in your chest, throat, or neck.

Heart palpitations can be bothersome or frightening. They usually aren't serious or harmful, though, and often go away on their own. Most of the time, they're related to stress and anxiety or to consumption of stimulants such as caffeine, nicotine, or alcohol. Palpitations also often occur during pregnancy.

In rare cases, palpitations can be a sign of a more serious heart condition.

Therefore, if you have heart palpitations, make arrangements to see your doctor.

And seek immediate medical attention if along with palpitations, you experience shortness of breath, dizziness, chest pain, or fainting.

After taking your medical history and conducting a physical exam, your doctor may order tests that can either confirm or rule out an underlying cause.

If an underlying cause is found, the right treatment can reduce or eliminate palpitations. If your palpitations are not related to an underlying cause, lifestyle changes, including stress management and the avoidance of common triggers, can help prevent them.

Causes of Heart Palpitations Many things can cause heart palpitations. In the vast majority of cases, the cause is either related to your heart or is unknown. Non-heart-related causes of palpitations include:

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Strong emotions such as anxiety, fear, or stress; palpitations often occur during panic attacks Vigorous physical activity Caffeine, nicotine, alcohol, or illegal street drugs such as cocaine an amphetamines Medical conditions, including thyroid disease, a low blood sugar level, anemia, low blood pressure, fever, and dehydration Hormonal changes during menstruation, pregnancy, or the perimenopausal period; sometimes, palpitations during pregnancy are signs of anemia

• • • •

Assessment of Heart Palpitations Your doctor will conduct a physical examination, take your medical history, and ask about your current medications, diet, and lifestyle. The doctor also will ask when, how often, and under what circumstances palpitations occur.

Sometimes, a blood test can reveal the presence of anemia, electrolyte problems, or thyroid abnormalities and help identify the cause of palpitations. Other useful tests include:

• Electrocardiogram (ECG) An ECG

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• Medications, including diet pills,

decongestants, asthma inhalers, and some drugs used to prevent arrhythmias (a serious heart rhythm problem) or treat an underactive thyroid Certain herbal and nutritional supplements Abnormal electrolyte levels

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Some people experience palpitations after eating heavy meals that are rich in carbohydrates, sugar, or fat. Sometimes, eating foods with high levels of monosodium glutamate (MSG), nitrates, or sodium can bring them on.

If you have heart palpitations after eating certain foods, the problem could be food sensitivity. Keeping a food diary can help you identify which foods to avoid.

Palpitations can also be related to underlying heart disease. When they are, palpitations are more likely to represent arrhythmia.

Heart conditions associated with palpitations include:

• Prior heart attack • Coronary artery disease • Other heart problems such as

congestive heart failure, heart valve problems, or heart muscle problems

• •

can be done either while you are at rest or while you are exercising. The latter is called a stress ECG. An ECG records your heart's electrical signals and can detect abnormalities in the heart's rhythm.

Holter monitoring A Holter monitor is worn on the chest. It continuously records your heart's electrical signals for 24 to 48 hours. It can detect rhythm abnormalities that weren't identified during a regular ECG test.

Event recording An event recorder is worn on the chest. You use a handheld device to record the heart's electrical signals when symptoms occur.

Chest X-ray Echocardiogram This is an ultrasound examination of the heart. It provides detailed information about the heart's structure and function.

If necessary, your doctor may refer you to a cardiologist for additional tests or treatment.

February is Heart Awareness Month

Source: Healthday

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Ask Rowan Medicine

What is a clinical trial? Can anyone volunteer?

Mary Hammond, BSN, program manager of the Office of Clinical Trials Management at the Rowan University School of Osteopathic Medicine, replies: Clinical trials involving human volunteers are essential to the development of new therapeutic approaches to combating illnesses or injuries.

While clinical trials often investigate new drugs or medications, they can also involve studies of new medical devices, new procedures or the impact of changes in behaviors such as diet and exercise.

Without human volunteers, clinical trials and our ability to safely find new ways to combat disease would, essentially, come to a halt.

Clinical trials are conducted under strict regulations. For clinical trials involving a drug or medication, the U.S. Food and Drug Administration (FDA) has established four phases of testing, involving human volunteers, that must be completed before that drug can become available to the public.

New drugs that show promise in laboratory testing must successfully complete all four phases of clinical trials before earning the FDA’s approval.

These clinical trials determine the drug’s safety and correct dosage. They also measure its effectiveness against the targeted condition, as well as its relative effectiveness compared to already existing methods of treatment.

At the Rowan University School of Osteopathic Medicine, we actively engage in clinical trials either as a principal site, or by working as one of dozens of sites across the country that collaborates on large-scale studies.

Every clinical trial we conduct is first approved by an Institutional Review Board (IRB). An IRB is typically composed of physicians, nurses and pharmacists, along with non-medical individuals, who evaluate the proposed clinical trial to confirm that it is safe for the patient, and that the study design is necessary from a scientific and medical viewpoint.

The IRB is also responsible for monitoring the safety of the trial until it is completed. The first and

foremost goal of all clinical trials is the safety of the patients participating in the study. Individuals who volunteer for a clinical trial The MILESTONESM Study is looking at the safety and effectiveness are closely monitored so of a potential new medication for the treatment of walking that any possible side effects problems in people who have had a stroke. of the study therapy are spotted immediately.

You may be able to take part if you: Although the researchers • are 18 years of age or older who designed the study • have had an ischemic stroke and the IRB members • have walking problems as a result of the ischemic stroke who confirm its safety are essential, the most important The study will last about 5 months and will involve approximately people in any clinical study 10 visits to a study center. are the people who volunteer to participate.

All study-related visits, assessments, and study medication will be provided at no cost to you. In addition, compensation for time Each clinical trial develops and travel may be provided. standards that outline who can volunteer. Some studies To learn more about the MILESTONESM Study, please contact the will seek volunteers who Office of Clinical Trials Management 856-566-6003 have the specific illness or condition that is being studied. Other studies will look for volunteers who are healthy or who are without a scientist develops a new drug and the patient’s any illness related to the one being studied. bedside where that new medication can lead to a People choose to participate in clinical trials for a cure. Without human volunteers, clinical trials would variety of reasons. Those with the medical condition not be possible and innovative research discoveries being studied may volunteer for the chance to take would never cross that gap to a patient’s bedside. advantage of the new medications, or because they You can learn more about clinical trials – or know their participation could ultimately help others how you or a family member can participate – by with the same condition. Healthy individuals may contacting the Office of Clinical Trials Management volunteer because they know someone with the at the Rowan University School of Osteopathic disease being studied or because they want to help Medicine at 856-566-6003. speed the development of the cures of tomorrow.

The aim of any clinical trial is to successfully bridge the gap between the laboratory bench where

Walking problems following a stroke?

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March 12 NeuroMusculoskeletal Institute (NMI) 42 East Laurel Road Suite 1700 Stratford, NJ 08084 Contact us to schedule an appointment: OMMClinic@rowan.edu or 856-258-0905 DISCLAIMER: There is no obligation to use any doctor affiliated with Rowan University School of Osteopathic Medicine or any other OMM doctor after being treated at the OMM Clinic. The OMM clinic is not an alternative to long-term management of an issue. The Clinic can deny treatment to any patient for any reason.

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Ask Rowan Medicine

I often feel dizzy or unsteady on my feet. Could this be something serious?

I’m 60 years old and take blood pressure and cholesterol medicines.

Dr. Claudine De Dan, a Rowan Medicine family physician responds: Although most people would just ignore it, even occasional dizziness is a symptom that you should make note of (when it happened, how long it lasted and what you did when you felt that way) and mention to your physician during your next visit.

However, because you indicated that you are having this feeling often, you should make an appointment to discuss this with your physician as soon as possible. Keep in mind, too, that if you are frequently feeling dizzy, it would be safer if you arrange for someone to drive you to that appointment.

During your visit, a blood pressure check could quickly identify a cause. Low blood pressure or a drop in blood pressure when standing up could cause you to feel dizzy or unsteady. If you are currently taking medicine because you were diagnosed with hypertension (high blood pressure),

it could be that your dose needs to be adjusted. This could be the case if you’ve lost a lot of weight since the medicine was first prescribed or if you have made some positive lifestyle changes by exercising more or eating a healthier diet.

Assuming your blood pressure is normal, your physician may ask about your diet and look for signs that you are dehydrated. This may be a little more difficult to determine, but a quick check of your skin’s elasticity, reports of recent diarrhea or vomiting, or indication of a fever or rapid heartbeat could point to dehydration as a potential cause.

If you are taking any medications prescribed by another physician or any over-the-counter supplements, let your physician know. Every medication or supplement has the potential to cause side effects and the other substances you are taking could be working in concert with your blood pressure medicine, causing your pressure to be too low.

Inner ear infections are a common cause of dizzy spells. Tiny structures, called vestibular organs, that are located in the inner ear send continuous messages to the brain to help regulate balance.

Any disturbance or infection of the vestibular organs can affect call 856-208-1300. balance or cause

Introducing Dr. Claudine De Dan We are proud to introduce Dr. Claudine De Dan to the Rowan Family Medicine team.

A graduate of the Robert Wood Johnson Medical School, Dr. De Dan is board certified in Family Medicine. She is skilled in the diagnosis and treatment of common illnesses and chronic conditions, and has a special interest in women’s wellness.

Dr. De Dan will see patients in our Sewell location beginning March 14.

To make an appointment with Dr. De Dan,

dizzy spells. Fortunately, once this condition is diagnosed by your physician, it is usually easy to treat.

You can help your physician to diagnose the cause of your dizzy spells by being able to describe what happens when you feel this way. For example, does the feeling come and go or does it persist for a longer period of time? Your physician will also be interested to know when the dizzy feeling occurs and if you also experience any other symptoms, such as blurred vision, ringing in the ears or headache.

If an initial review doesn’t reveal the cause of your dizzy spells, your physician may prescribe some additional blood tests to check for such things as low iron or blood sugar levels.

Finding and treating the cause of both recurrent and occasional dizzy spells will also help protect you from serious injury that could result from a fall. According to government statistics, among individuals 65 years and older, falls are the leading cause of fractures, hospital admissions for trauma, loss of independence and injury deaths.

Usually, the underlying causes of dizzy spells are easily treated by your primary care physician. Be aware, however, that you should seek immediate medical attention if you have dizzy spells that are accompanied by chest pain, shortness of breath, a severe headache, persistent vomiting or a sudden change in your speech, hearing or vision, as these could indicate a serious medical condition.

Dr. Claudine De Dan is a Rowan Medicine family physician and a faculty member at the Rowan University School of Osteopathic Medicine. To schedule an appointment at the Rowan Family Medicine office in Sewell, please call 856-218-0300.

MedicaLink Ask Rowan Medicine

How worried should I be about an abnormal Pap test?

Claire Smart, DNP, CNM, a Rowan Medicine nurse midwife responds: The Pap test was developed nearly a century ago and remains an important element of women’s health care. During the test, a small number of cells are taken from the surface of the cervix to be examined for indications of cancer or for abnormal cells that could possibly evolve into cervical cancer.

In most cases, cervical cancer tends to develop slowly, with cells first showing signs of abnormal development and gradually becoming cancerous.

Regular testing is essential because the signs of cervical cancer – including abnormal vaginal bleeding, heavier or longer periods, bleeding or spotting between periods, unusual vaginal discharge and pain during sex – can be subtle or be mistaken for some other condition.

Although having a Pap test can be uncomfortable, it’s important for women to continue appropriate screenings. Cervical cancer is highly treatable when detected in its early stages and, because it is generally a slowly developing cancer, regular Pap tests will greatly increase the chance of early detection.

Your gynecologist, physician or midwife can advise you on when you or your daughters should begin screening for cervical cancer and how often that test should be repeated, but there are some guidelines to follow.

The United States Preventive Services Task Force (USPSTF) guidelines, published in 2012, recommend that women have their first Pap test when they reach 21 years of age and continue to be tested every three years through age 29. Between the ages of 30 and 65 women can continue Pap tests every three years or opt for the combined Pap and human papillomavirus (HPV) test every five years. Depending upon the results of your previous tests and your level of sexual activity, your doctor or midwife may determine that you no longer need routine screening beyond the age of 65. If you have had a partial or total hysterectomy, your health care provider can advise you on the need for regular Pap tests.

An ‘abnormal’ Pap test result is reason for concern, not alarm, but you do need to discuss the specifics with your physician or midwife. Your detailed test report may indicate certain benign abnormalities related to infection or inflammation, the presence of precancerous cells or even that the sample specimen was unsatisfactory for examination, meaning you should repeat the test.

Follow-up to an abnormal Pap test result can range from ‘watchful waiting’ to more testing.

Watchful waiting requires nothing more than following a schedule of additional Pap tests to closely monitor for any changes to the cells on the surface of the cervix.

Depending on your particular findings and your health history, however, your physician may recommend a colposcopy, an examination that uses magnification and lighting to examine the vagina and cervix more closely. During a colposcopy, your physician may also take a small tissue sample for microscopic examination.

Your physician may obtain an HPV test rather than the colposcopy. HPV is a virus spread through sexual contact. There are about 40 types of this virus and two of those virus types cause about 70 percent of cervical cancers. An HPV test involves the removal of a small number of cervical cells which are then sent to a lab where they are examined for the presence of the virus.

Please keep in mind that no diagnostic test is accurate 100 percent of the time. An abnormal finding means only that you need to consult with your physician or midwife to determine the best course of action for you.

Claire Smart, DNP, CNM, is a Rowan Medicine nurse midwife and a faculty member at the Rowan University School of Osteopathic Medicine. To schedule an appointment, please call her Sewell office at 856-589-1414.

Compassionate, Gentle Care

Compassionate, for Women of AllGentle Ages Care for Women of All Ages

Our experienced midwives care for women in all stages of life, from your first gynecological exam to your first baby to your first signs of menopause.

We partner with each of our patients, providing individualized care for your specific needs.

Victoria Asturrizaga, CNM, MSN Diane Reynolds, CNM, MSN Elizabeth Sandifer, CNM Claire Smart, DNP, CNM

Sewell 856-589-1414 Stratford 856-566-7090 Mullica Hill 856-256-5800

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Today’s midwives offer a variety of health care options

Know your numbers

for good health

FREE Health Screenings provided by members of the Student National Medical Association (SNMA)

Q:

• • • •

What services can midwives provide?

For many people, the mention of midwives brings to mind the image of a woman assisting in a natural childbirth in a home setting. While that may have been the norm a century ago, the services midwives provide today are much more varied.

A certified nurse-midwife (CNM) is a registered nurse who has also graduated from an educational program accredited by the American College of Nurse-Midwives and who has passed a national certification exam.

Currently, there are more than 11,000 CNMs in the United States.

Certified Nurse Midwives bring a different perspective to health care for women. Working as a health partner with their patients, CNMs focus on health promotion, illness prevention and wellness. To a CNM, pregnancy is a normal lifecycle process and not a medical condition that requires treatment. During pregnancy, a CNM acts more like a “tour guide for the birth experience” than someone who intervenes in this process. Of the more than 300,000 births assisted by midwives each year in this country, nearly all occur in a hospital setting.

Another misconception about midwives is that they only assist with natural childbirths. Women who choose to deliver their babies with the assistance of a midwife have the same access to options that they would have with a physician, including the use of electronic fetal monitoring, pain medications and epidurals.

If complications arise during pregnancy or delivery, the CNM will continue to help provide care, but will refer the mother-to-be to the collaborating obstetrician, often a physician from the same office as the nurse midwife, and high-risk pregnancies are co-managed with the Maternal Fetal Specialist.

Probably the most common misconception about nurse midwives is that only pregnant women can take advantage of their services. Although many women do wait until pregnancy before consulting with a midwife, CNMs also provide routine gynecological care throughout all life stages and many women appreciate the midwives’ focus on wellness, education and prevention.

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DASH diet best overall eating plan

By MARY ELIZABETH DALLAS HealthDay

For the sixth year in a row, a panel of health experts has named the heart-healthy DASH diet the best overall eating plan, according to U.S. News & World Report's 2016 Best Diets ranking.

The DASH (Dietary Approaches to Stop Hypertension) diet was designed to lower blood pressure and cholesterol levels by limiting fats, red meat and sugar in favor of healthy grains, poultry, low-fat dairy and nuts, the U.S. National Heart, Lung, and Blood Institute says.

"Our rankings put hard numbers on the belief that no one diet is ideal for everybody, but the best food plans overall are sustainable," Angela Haupt, senior health editor at U.S. News & World Report, said in a news release from the media company.

Every year, U.S. News & World Report asks experts to rank various diets to help the tens of millions of dieters in the United States and around the globe make informed dietary decisions that can help them achieve healthier lifestyles.

The panel of experts — including nutritionists and doctors specializing in diabetes, heart health and weight loss — scored each diet for short-term and long-term weight loss. They also considered how easy each diet was to follow, as well as safety and nutritional value.

"Besides the rankings and data, each diet has a detailed profile that includes how it works, evidence that supports or refutes its claims and a nutritional snapshot — tools that, along with the advice of a physician or nutritionist, can help consumers invest in diets that suit their lifestyles and further their health and wellness goals," Haupt said.

The MIND, Mediterranean and Fertility diets also get high marks for health

The panel evaluated 38 of the most popular or trendy diets this year. After ranking them in nine categories, the experts found the MIND diet tied for second place for best overall diet with the cholesterol-lowering TLC diet. The MIND diet includes some features of the DASH diet and Mediterranean diet, such as high consumption of fruits, vegetables and fish, but focuses on foods that promote brain health.

The MIND diet ranked first in the "Easiest Diet to Follow" category in a three-way tie with

Weight Watchers and the Fertility diet, which asserts that certain dietary changes can boost fertility.

The Fertility diet, which calls for the elimination of trans fats, also ranked as the best diet for diabetes, the report revealed.

The Biggest Loser diet and the DASH diet came in second and third, respectively, in the diabetes category.

The DASH diet scored highest when it comes to healthy eating, followed by the TLC diet. The Mediterranean and the MIND diet tied for third place in this category.

The Weight Watchers diet ranked highest out of all weight-loss diets but tied with the Mayo Clinic diet as the "Best Commercial Diet."

When it comes to speedy weight loss, the HMR program and Biggest Loser diet shared the top ranking, followed by the Atkins diet in second place and Weight Watchers in third.

On the opposite end of the list, the Whole30 diet — a 30-day program that bans processed foods, legumes, grains, dairy, alcohol and added sugar — ranked as the worst overall diet on the list, the new report said.

The Raw Food diet and low-carb Atkins diet also scored poorly overall and ranked low in categories like "Best Diets for Healthy Eating."

The Raw Food diet was also considered the most difficult diet to follow, though it was one of the top ranked weight-loss diets, the panel found.

Health Tip:

A vegetarian diet for your child?

The Academy of Nutrition and Dietetics says the child's diet should include:

• Vitamin B12, found in eggs and

milk. If the child is on a strictly vegan diet, fortified soy products and fortified cereals are good sources.

Vitamin D and calcium, found in fortified milk and dairy products, such as cheese and yogurt.

Iron, found in daily supplements and fortified cereals.

Protein, found in beans, fortified cereals and soy milk. Yogurt and eggs also are good choices.

Fiber, found in fortified and whole-grain breads, pastas and cereals, as well as avocados, nuts and seeds.

• • • •

Source: HealthDay

MORE INFORMATION The U.S. Centers for Disease Control and Prevention has more about healthy eating for a healthy weight at www.cdc.gov.

Vitamins and minerals: How much should you take? measurement you'll find on food and supplement labels. That's because space is limited, and there's a need for one single reference number. That number is the amount of a vitamin or nutrient that you should get for top health from a diet of 2,000 calories a day. The DV is sometimes the same as the RDA.

How Much Is Too Much?

You stroll down the pharmacy aisles on what seems like a simple mission: pick up some vitamins. But a quick glance at a bottle's label can send you running for a dictionary. Things like "RDA" or "DV" are just a few examples of an alphabet soup that's on many packages. But don't despair. We'll help you demystify supplement guidelines.

What are dietary supplements?

Dietary supplements include such ingredients as vitamins, minerals, herbs, amino acids, and enzymes.

Dietary supplements are marketed in forms such as tablets, capsules, softgels, gelcaps, powders, and liquids.

Benefits of dietary supplements

Some supplements can help assure that you get enough of the vital substances the body needs to function; others may help reduce the risk of disease. But supplements should not replace complete meals which are necessary for a healthful diet — so, be sure you eat a variety of foods as well.

Unlike drugs, supplements are not intended to treat, diagnose, prevent, or cure diseases. That means supplements should not make claims, such as “reduces pain” or “treats heart disease.” Claims like these can only legitimately be made for drugs, not dietary supplements.

Some common dietary suplements include the following:

• Calcium • Echinacea • Fish Oil • Ginseng • Glucosamine • Chondroitin Sulphate

• Garlic • Vitamin D • St. John’s Wort • Saw Palmetto • Ginkgo • Green Tea

What the Numbers Mean

Many of the terms you see on labels or supplement web sites can help you understand how much of the vitamin or mineral you should take. For example, here are some guidelines set up by the Institute of Medicine: The RDA (Recommended Dietary Allowance) and the AI (Adequate Intake) are the amounts of a vitamin or mineral you need to keep healthy and stay well-nourished. They're tailored to women, men, and specific age groups.

The UL (tolerable upper intake level) is the maximum amount of daily vitamins and minerals that you can safely take without risk of an overdose or serious side effects.

For certain nutrients, the higher you go above the UL, the greater the chance you'll have problems.

The DV (Daily Value) is the only

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Because high doses of some supplements can have risks, how do you know when it's okay to take more than the RDA or DV? One way is to look for the UL (tolerable upper intake level) of a nutrient. With many vitamins and minerals, you can safely take a dose much higher than the RDA or DV without coming close to the UL. For instance, the average person can take more than 50 times the RDA of vitamin B6 without reaching the upper limit. But some people develop symptoms of nerve pain with these higher levels of B6. So, you should always be cautious. Here are some things to keep in mind: Some supplements are riskier than others. With some vitamins and minerals, the upper limit is pretty close to the RDA. For example, a man who takes just over three times the RDA of vitamin A would get more than the upper limit.

High doses of vitamin A — and other fat-soluble vitamins like E and K — can build up in the body and become toxic. Other risky supplements include the minerals iron and selenium.

Supplements are designed to be additions to your diet. Popping pills is not the answer to good health. Experts say you should eat a well-balanced diet and take supplements to fill in any nutritional gaps. Or you can take a once daily multivitamin with minerals for nutritional insurance.

The UL is often the limit for all sources of a nutrient. It can include the amount you get from both food and supplements. So when you figure out whether you've reached the UL on a particular nutrient, take into account the food you eat.

You won't find the UL on food

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nutrition labels or on your vitamin bottle. It's not a number that most people know about. But you'll see it on government web sites.

Most supplements don't have a UL — or RDA or DV. The government has only set levels for a fraction of the vitamins and supplements available.

For most of the supplements you see on the shelves, experts really don't know the ideal or maximum dose. Many nutrients, in too high a dose, can be dangerous. To be on the safe side, steer clear of the UL for any nutrient. And if you have a health condition, check with your doctor before you take supplements.

He can tell you if they have side effects or interfere with other medicines you use.

Know the risks

Many supplements contain active ingredients that have strong biological effects in the body. This could make them unsafe in some situations and hurt or complicate your health.

For example, the following actions could lead to harmful — even lifethreatening — consequences.

• Combining supplements

Using supplements with medicines (whether prescription or over-the-counter) Substituting supplements for prescription medicines Taking too much of some supplements, such as vitamin A, vitamin D, or iron.

Some supplements can also have unwanted effects before, during, and after surgery. So, be sure to inform your health care provider, including your pharmacist, about any supplements you are taking.

• • •

• •

Source: U.S Food and Drug Administration

MORE INFORMATION The U.S. Food and Drug Administration has more information on vitamins and supplements at www.fda.gov.

Home remedies for the common cold Don't let that nasty cold get the best of you.

Take charge with simple do-it-yourself treatments that clear up your stuffy nose and soothe your scratchy throat.

Drink Up! Get plenty of fluids. It helps break up your congestion, makes your throat moist, and keeps you from getting dehydrated.

Most people should drink at least eight to 10 eight-ounce glasses of fluid every day.

Need ideas for something to drink? Try water, sports drinks, herbal teas, fruit drinks, or ginger ale. Your mother’s chicken soup might help, too!

Make It Steamy!

You can loosen up your stuffy nose if you breathe in some steam. Hold your head over a pot of boiling water and breathe slowly through your nose. But be careful— don’t let the heat burn your nose.

You can also get some relief with a humidifier in your bedroom. Also try to take in some moisture from a hot shower with the door closed.

Blow Your Nose It’s better than sniffling mucus back into your head. But make sure you do it the right way. If you blow hard, you’ll send germ-carrying phlegm back into your ear passages, which can lead to an earache.

The best technique? Press a finger over one nostril while you blow gently to clear the other.

Stay Warm and Rested It’s especially important to get rest when you first come down with a cold or the flu. It helps your body direct its energy to fighting off your infection. This battle taxes your body. So give it a little help by lying down under a blanket to stay warm if necessary.

Gargle With Warm Salt Water It moistens your sore or scratchy throat and brings temporary relief. Try a half teaspoon of salt dissolved in eight ounces of warm water four times a day.

To calm the tickle in your throat, try a gargle made from tea. Or, use one that’s has honey in it.

Drink Hot Liquids They relieve your congestion and soothe the inflamed lining of your nose and throat. If you’re so congested you can’t sleep at night, try a hot toddy, an age-old remedy.

Use Saline Spray or Salt-Water Rinse Both can help break up the congestion in your nose. If you go the rinsing route, try this recipe: Mix three teaspoons of iodide-free salt and one teaspoon baking soda.

Place in an airtight container.

Add one teaspoon of this mixture to eight ounces of lukewarm boiled or distilled water.

Next, fill a bulb syringe with this solution (or use a Neti pot).

Lean your head over a basin and gently squirt the salt water into your nose. Hold one nostril closed by applying light finger pressure while squirting the mixture into the other nostril. Let it drain.

Treat the other nostril.

• • • • • •

Here’s how: Make a cup of hot herbal tea.

Add one teaspoon of honey and one small shot (about one ounce) of whiskey or bourbon if you wish (adults only).

• •

Limit yourself to one, though. Too much alcohol inflames the membranes in your nose and throat.

Use Mentholated Salve Try a small dab under your nose. It opens up breathing passages. Menthol, eucalyptus, and camphor all have mild numbing ingredients that may help relieve the pain of a nose rubbed raw.

Put Hot Packs on Your Sinuses You can buy reusable ones at a drugstore, or make your own. Take a damp washcloth and heat it for 30 seconds in a microwave. Test the temperature first to make sure it’s right for you.

Try an Extra Pillow Under Your Head Do this at night when you sleep to help relieve congested nasal passages. If the angle is too awkward, place the pillows between the mattress and the box springs to create a more gradual slope.

Source: WebMD

Always use distilled, sterile, or previous boiled water when you make this solution. Otherwise you might get an infection. Also, rinse the bulb or Neti pot after each use and leave open to air dry.

MORE INFORMATION The American Academy of Family Physicians has more about flu prevention at www.aafp.org.

Twelve steps to childproofing your home Each year, children are injured by hazards in and around the home The good news is that the risk of injury can be reduced or prevented by using child-safety devices and reminding older children in the house to re-secure safety devices after disabling them.

Most of these safety devices are easy to find and are relatively inexpensive. You can buy them at hardware stores, baby equipment shops, supermarkets, drug stores, home improvement stores, on the Internet and through mail order catalogs.

Safety devices should be sturdy enough to hinder access and yet easy for you to use.

To be effective, they must be properly installed. Follow installation instructions carefully. Remember, too, that no device is completely childproof; determined youngsters have been known to overcome or disable them.

Here are some child safety devices that can help reduce injuries to young children.

1. Use safety latches and locks for cabinets and drawers in kitchens, bathrooms, and other areas to help prevent poisonings and other injuries.

Safety latches and locks on cabinets and drawers can help prevent children from gaining access to medicines, household cleaners, matches, or cigarette lighters, as well as knives and other sharp objects.

Even products with child-resistant packaging should be locked away and kept out of reach. This packaging is not childproof. Look for safety latches and locks that adults can easily install and use, but are sturdy enough to withstand pulls and tugs from children.

2. Use safety gates to help prevent falls down stairs and to keep children from entering rooms and other areas with possible dangers.

Look for safety gates that children cannot dislodge easily, but that adults can open and close without difficulty. For the top of stairs, only use gates that screw to the wall.

Use safety gates that meet current safety standards.

3. Use door knob covers and door locks to help prevent children from entering

rooms and other areas with possible dangers. Door knob covers and door locks can help keep children away from places with hazards.

Be sure the door knob cover is sturdy, and allows a door to be opened quickly by an adult in case of emergency.

4. Use anti-scald devices for faucets and shower heads and set your water heater temperature to 120 degrees Fahrenheit to help prevent burns from hot water. Anti-scald devices for regulating water temperature can help reduce the likelihood of burns.

5. Use smoke alarms on every level of your home, inside each bedroom, and outside sleeping areas to alert you to fires.

Smoke alarms are essential safety devices for protection against fire deaths and injuries.

Check smoke alarms once a month to make sure they’re working. Change batteries at least once a year or consider using 10-year batteries for alarms.

6. Use window guards and safety netting to help prevent falls from windows, balconies, decks, and landings.

Check these safety devices frequently to make sure they are secure and properly installed and maintained. Limit window openings to four inches or less, including the space between the window guard bars. If you have window guards, be sure at least one window in each room can be easily used for escape in a fire. Window screens are not effective for preventing children from falling out of windows.

7. Use corner and edge bumpers to help prevent injuries from falls against sharp edges of furniture and fireplaces. Be sure to look for bumpers that stay securely on furniture or hearth edges.

8. Use outlet covers and outlet plates to help prevent electrocution. Outlet covers and outlet plates can help protect children from electrical shock and possible electrocution.

Be sure outlet protectors cannot be easily removed by children and are large enough so that children cannot choke on them. If you are replacing receptacles, use a tamper-resistant type.

MORE INFORMATION The Consumer Product Safety Commission has more information at www.cpsc.gov.

9. Use a carbon monoxide (CO) alarm to help prevent CO poisoning. All consumers should install CO alarms near sleeping areas in their homes. Change batteries at least once a year.

10. Use cordless window coverings in homes with young children to help prevent strangulation. Children can wrap window covering cords around their necks, or can pull cords that are not clearly visible, but are accessible, and become entangled in the loops.

If you have window blinds from 2000 or earlier and you cannot afford new, cordless window coverings, call the Window Covering Safety Council at 800-506-4636 or visit WindowCoverings. org for a free repair kit. Window blinds that have an inner cord (for raising the slats of the blinds) can be pulled by a child and form a potentially deadly loop. Consumers should immediately repair these types of blinds. Consumers should know that WCSC’s retrofit kits do not address the dangling pull cord hazard associated with many common window blinds.

11. Use anchors to avoid furniture and appliance tip-overs. Furniture, TVs and ranges can tip over and crush young children. Deaths and injuries occur when children climb onto, fall against or pull themselves up on television stands, shelves, bookcases, dressers, desks, chests and ranges. For added security, anchor these products to the floor or attach them to a wall. Free standing ranges and stoves should be installed with anti-tip brackets.

12. Use layers of protection with pools and spas. A barrier completely surrounding the pool or spa including a four-foot tall fence with self-closing, self-latching gates is essential. If the house serves as a side of the barrier, doors heading to the pool should have an alarm or the pool should have a power safety cover. Pool alarms can serve as an additional layer of protection.

Sliding glass doors, with locks that must be re-secured after each use, are not an effective barrier to pools.

Source: The Consumer Product Safety Commission

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