U The Caribbean Health Digest - Issue 26

JUL SEP 2014 ISSUE 26 TT$35.00 US$5.99

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THE CARIBBEAN HEALTH DIGEST

SUGAR ADDICTION Does this tastemaker deserve its bad boy reputation?

AVIOPHOBIA. THE CAUSES, SYMPTOMS AND TREATMENT FOR THE FEAR OF FLYING IS SUGAR BAD FOR YOU? DOES THIS TEMPTING TASTEMAKER DESERVE ITS BAD BOY REPUTATION?

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BARBADINE. THE GIANT OF THE PASSION FRUIT FAMILY THATS ALMOST TOO GOOD TO BE TRUE 42

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8/8/14 1:53 PM

Y U are what you eat

JUL SEP 2014 • VOL. 3 NO. 26

12 Fear of Flying

30 Barbadine

14 Inflammation

32 Things to Know About Diet Pills

Oh, how we love to travel: see new sights, meet new people, taste new foods. But for some, getting there by plane can be so traumatic that it brings on sweating, nausea, diarrhoea and more.

A swollen, oozing wound might be pretty off-putting, but your body knows what it’s doing. Chances are, the reactions that are grossing you out after a blow or cut are just signs that you’re on the mend.

16 Sugar: Is it Bad for You?

Sugar has been taking a beating these days, shouldering the blame for everything from obesity to metabolic disorders and sluggishness. Does this tempting tastemaker deserve its bad boy reputation? Dietician Michelle Ash gives us some facts on the subject.

22 Legal Highs

Think a drug is safe just because it’s legal?

Don’t be fooled. You may avoid a jail sentence getting high on certain popular party drugs, but that doesn’t mean you won’t end up in Intensive Care...or worse.

26 Bruxism

In publishing and graphic design, lorem ipsum is a filler text commonly used to demonstrate the graphic elements of a document or visual presentation.

Oooh, Barbadine! Doesn’t it just make you long for ice cream like Grandma used to make?

Since it’s a tropical fruit, it’s probably no surprise that it’s even better for you than it tastes.

Need to drop some weight fast? Read this article before you pop those diet pills.

36 Ringxiety

Is that your phone ringing? Is it vibrating in your pocket? Someone may be calling you...or you may have “Ringxiety”, a strange but genuine malady that’s just one of the side effects of living in the cellular age.

40 Denial

As parents, we hate to hear bad news when it comes to our kids’ health, but as Dr. David Bratt writes in this article, it does our kids no good for us to close our ears to difficult truths.

It’s up to us as parents to face up to the challenges of a scary diagnosis and do what’s best for our child.

44 How to Talk to Your Child About Marijuana

From time to time we’re called upon to have difficult conversations with our kids, and drugs are a topic many of us find it hard to broach.

But remember that what we say now can inform the choices they make later. Our newest writer, Charisse Broome, tells us how to have an open conversation with our children about marijuana.

Welcome to our 26th edition of U! We are thrilled to bring to you our eclectic offering of insightful and engaging content for this, the 3rd quarter of 2014.

At a glance, here’s some of what we’ve put together; our cover story is sweeter than ever, focusing on sugar, and peoples’ addiction to it, with compelling information and data.

Staff writers explore two very different topics, but even if you’re too shy to admit it, one, if not both of them, will surely hit home. Firstly, are you are one of those people that hears someone else’s phone ring and instantly reach for your own? Then the new buzzword, Ringxiety, may apply to you.

We explore this, along with people who suffer from Aviophobia, or the fear of flying, in another quite entertaining article.

After much contemplation, we decided to delve a bit into what most may deem a very touchy subject. How should parents talk to their children about marijuana? In this article, newcomer writer to U, Cherisse Broome, looks at this very intriguing and serious subject from all angles.

Our featured fruit is one of the main ingredients used for making a good punch: barbadine. We also look at things you should know about diet pills, and many other interesting articles in this issue.

Enjoy reading and see U next quarter.

SHERINE & STUART

FOUNDING EDITORS

CONDITION

| AVIOPHOBIA

The fear of flying WRITTEN BY

So I’m all packed: my never-worn swim suit, a couple of nice evening dresses, sunglasses, toiletries, of course my passport, and, well, just about anything one would need for a weekend in St. Maarten. A holiday I waited so long to take, hoping that this time would be different; it turned out to be just wishful thinking.

As always, the night before an early flight, we take to bed a bit earlier than usual, hoping to get some good sleep in anticipation of the hassles of travelling.

Not sure why we do that, as we never sleep anyway.

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Always, the fear of waking up too late keeps us alert, so we clock stare, turn and toss, or simply stay awake. So the time finally comes and I get off the bed with some degree of alacrity, pumped and ready to take on the challenges of the trip. Now, depending on the destination, the level of excitement varies. In this instance, St. Maarten was a pretty desirable place to be, and so my excitement was clearing the top of the scale.

STAFF WRITER

We are almost ready to leave the house, and like clockwork it happens again; don’t know why it surprises me every time, but this has been happening to me ever since I can remember. My heart starts to race, I break out in sweat, my breathing increases, nausea takes over, and the list goes on ... sometimes all the way into varying levels of diarrhoea. I’ve always associated this reaction to travelling as the anxieties associated with flying, but learnt recently that my flying phobia is called Aviophobia and refers to the actual fear of flying.

Aviophobia

causes

Now that we know that I have a disorder, let me share some of what I know about it. Aviophobia may be associated with other disorders like: • Claustrophobia — Fear of having no escape and being in closed or small spaces or rooms • Acrophobia — Extreme fear of heights • Emetophobia – Intense irrational fear or anxiety pertaining to vomiting • Agoraphobia — Fear of open or public places

AVIOPHOBIA

Ironically, the first two are at the top of my “Fear” list as well. While research information and data is quite sparse, especially here in the Caribbean, in the 1980s two Boeing researchers found that 18.1% of American adults were afraid of flying and about 12% of them experienced anxiety whenever they flew. Interestingly, only 6% of the people were afraid to fly because they felt it was unsafe to do so.

Studies show that other causes of Aviophobia can range from: • A single traumatic incident – any real event that may have triggered Aviophobia instantaneously, like a one-time experience where there was such extreme fear even for a moment.

• An associated traumatic experience.

• A slow build – where a mild case of Aviophobia escalates over a period of time.

Aviophobia

symptoms I’ve learnt that people who suffer from the Aviophobia can have either very distinct or subtle symptoms, ranging from people never wanting to travel by air or experiencing great distress when someone has to fly, including some of the conditions I mentioned earlier in my own experience. These can be further defined as follows: Physiological reactions to fear or stress, which include muscle tension, heavy breathing, heart palpitations, chest pains, abdominal and intestinal discomfort, sweating, weakness, dizziness, dry mouth and flushed or pale face.

| CONDITION

Psychological symptoms, which include impaired memory, narrowed perceptions, poor or clouded judgment and negative expectations.

Aviophobia

treatment Sometimes educating people with Aviophobia and how safe air travel is can help to diminish their fear.

Helping them to understand the various sounds associated with the airplane and also that an encounter with turbulence is not going to destroy the airplane may be beneficial to someone with Aviophobia.

In some cases, people go to extreme levels to conquer their fear, like sky-diving (effectively removing their fear of the unknown) and others attend courses to achieve the same results.

For mild cases experts recommend staying hydrated and avoiding alcohol, tea and coffee during a flight and recommend deep, slow breathing to help relax and to introduce more oxygen into the body. If all else fails and your case of Aviophobia is more severe, then hypnotherapy is also a consideration that will have to be diagnosed and prescribed by your doctor.

All in all, the world is simply too beautiful to allow a phobia to prevent us from exploring it, so take whatever steps suit you best to overcome your fear of flying. As for me, I’m still a way off from defeating my phobia, but my love for meeting people and visiting new places outweighs it.

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BIOLOGICAL RESPONSE

| INFLAMMATION: THE GOOD, THE BAD AND THE UGLY

Inflammation THE GOOD, THE BAD AND THE UGLY

WRITTEN BY

CAROL QUASH

SO,

YOU HAVE SUSTAINED AN INJURY AND YOU ARE NOW IN PANIC MODE BECAUSE THE AREA HAS BECOME UNCOMFORTABLY WARM, RED, SWOLLEN AND OH, SO PAINFUL. YOU MAY HAVE ALREADY CALLED YOUR DOCTOR, BUT HIS RECEPTIONIST INSISTS HE CAN'T SEE YOU UNTIL TOMORROW. NOW YOU ARE CONTEMPLATING WHETHER THE NEXT CALL YOU SHOULD MAKE IS TO YOUR LAWYER TO ENSURE THE CONTENTS OF YOUR WILL ARE CLEAR, OR TO THE normal circumstances, this defence system is FUNERAL HOME TO GO OVER Under usually short-lived and disappears on its own after a YOUR PRE-ARRANGE D FUNERAL few hours to a few days, depending on how long the DETAILS. PUT DOWN THE body needs it. This is referred to as acute PHONE! JUST STAY CALM, AND inflammation, and non-steroidal anti-inflammatory READ ON. THE SYMPTOMS YOU drugs (NSAIDs) such as aspirin and ibuprofen may be ARE EXPERIENCING MAY BE THE used to help alleviate the discomforting symptoms.

FOUR CARDINAL SIGNS OF Unfortunately, there is also an unhealthy side to this INFLAMMATION – YOUR BODY'S story. It is called chronic inflammation – an NORMAL RESPONSE TO INJURIES over-response that can linger from as little as months OR INFECTIONS. WITHOUT IT, to as long as years. Chronic inflammation occurs INFECTIONS AND WOUNDS when the body's immune system mounts an inflammatory response to foreign substances that are WOULD NOT HEAL. When our bodies get injured, our white blood cells immediately spring into action and release bacteria-killing chemicals to protect us from infections or illnesses, and to begin the healing process. This results in inflammation, part of a biological response to treating with dangerous stimuli.

There are three basic stages in the healing process: ONE

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Irritation Discomfort in a body part caused by a reaction

TWO

Suppuration the discharging of pus - a liquid mixture of dead cells and bacteria

THREE

Granulation the formation of tiny masses of healing tissue in the wound

not there.

The imagination of the white blood cells goes wild; they see abnormality in healthy cells and launch an attack, resulting in the body damaging its own healthy tissues. And the outcome is usually negative. There are a number of diseases that have been linked to chronic inflammation. These include: • Asthma • Autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, and gouty arthritis • Obesity • Cancer • Diabetes • Dementia • Heart disease • Allergies

INFLAMMATION: THE GOOD, THE BAD AND THE UGLY

Some flu-like symptoms such as fever, sore throat, loss of appetite and headaches have also been associated with inflammation.

In his blog on the Huffington Post, Dr Mark Hyman identifies some lifestyle, environmental and communicable factors that may have contributed to some of the illnesses that have been linked to chronic inflammation. These include: • The consumption of too much sugar, refined flours, processed foods, and inflammatory fats such as trans and saturated fats • Failure to exercise • Stress • Chronic infections with viruses, bacteria, yeasts, or parasites • Allergens from food or the environment • Exposure to toxins such as mercury and pesticides • Exposure to mould toxins and allergens Corticosteroids (steroids) are one of the prescription drugs used to treat chronic inflammation. They block the enzymes that trigger the swelling and pain associated with inflammation. Corticosteroids can be administered in a number of ways, depending on the location of your inflammation. You can take your meds orally, by injections, inhalers or intranasal sprays, or topically (creams and ointments). It must be noted that, like most other drugs, they carry the risk of side effects, which are dependent on individual dosage and the length of time for which they are used.

The side effects of oral corticosteroids may include: • Mood swings • Weight gain in the abdomen, face, and at the back of the neck • Retention of fluid • Increase in blood pressure • Increased pressure in the eye in people with glaucoma • Increased risk of skin infections • Osteoporosis The side effects of inhaled corticosteroids may include: • Oral thrush • Hoarseness Prolonged use of topical corticosteroids may result in skin lesions, thinning of the skin, and acne, while injected corticosteroids may cause pain near the injected area, shrinking of soft tissue and loss of skin colour.

| BIOLOGICAL RESPONSE

For those chronic inflammation patients who would prefer to take natural alternatives, David C. Leopold, MD, Director of Integrative Medical Education at the Scripps Center for Integrative Medicine in San Diego, recommends the use of natural pain killers such as turmeric, green tea, ginger, rosemary, cat's claw, devil's claw, capsiacin, and willow bark.

However, he advises that you consult with your doctor before using any type of meds. Supplements such as fish oil, Vitamin D, glocosamine sulfate, magnesium, and acetyl-L-carnitine have also been found to relieve inflammation symptoms.

Dietary and lifestyle changes are also advised.

Dr Hyman recommends the following: • Consume whole foods that are unrefined and unprocessed. Ideally, these should be plant-based, high in fibre, as fresh as possible, and free of trans fat and too much sugar.

• Use healthy monounsaturated fats such as those found in olive oil, nuts and avocados, and omega-3 fats that are found in sardines, herring and salmon.

• Get regular exercise. Research has shown that this helps to reduce inflammation and improves the functioning of the immune and cardiovascular systems.

• Learn to relax, especially your vagus nerve (the longest cranial nerve, which passes through the neck and thorax to the abdomen) This nerve contains numerous motor and sensory fibres, and has the ability relax the entire body. Relaxation techniques such as yoga, meditation and hot baths can help reduce inflammation.

• Avoid contact with allergens as much as possible.

Because allergies are a manifestation of inflammation, learning what triggers your allergies and keeping away from it is one way of steering clear of an allergy episode.

• A healthy digestive system reduces inflammation.

Taking probiotics (bacteria that assist in maintaining the natural balance of the organisms found in the intestines) is a sure way of controlling chronic inflammation. In addition to supplements, foods such as yogurt and pickles are rich sources of probiotics.

So, now that you have the information on inflammation, is your mind at ease? Remember, as long as you know what you are up against and you have options, there is no need to worry. Now go grab yourself a yogurt.

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NUTRITION

| SUGAR: IS IT BAD FOR YOU?

SUGAR IS IT BAD FOR YOU? WRITTEN BY

MICHELLE ASH, MHP, RD, DIP., PG CERT.

The sugar industry has had a bittersweet history in the Caribbean. Sugar was first introduced to the Caribbean between the 15th and 17th Centuries by European settlers, who brought with them sugar cane, a plant native to India. Thence dawned the age of the sugar industry boom, from the 18th to the 19th Centuries, with sugar cane plantations, mills and refineries, along with the slave trade and indentured labourers. Over the last few centuries, sugar has been a major income generator in the Caribbean, and it continues to be a main export for many islands. The influence and history of the sugar industry in the Caribbean has more than likely also shaped our taste buds towards a sweeter appetite.

The abundance and availability of sugar is evident in traditional dishes, local sweets, beverages and condiments that we enjoy today in the Caribbean.

SUGAR: IS IT BAD FOR YOU?

| NUTRITION

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NUTRITION

| SUGAR: IS IT BAD FOR YOU?

WHAT IS SUGAR?

“SUGARS” ARE ANOTHER TERM USED TO DESCRIBE SIMPLE CARBOHYDRATES. THE CHEMICAL NAMES FOR MOST TRUE SUGARS END WITH THE SUFFIX “-OSE”.

THERE ARE DIFFERENT TYPES OF SUGAR, STARTING WITH THE SIMPLEST AND MOST BASIC SUGARS, CALLED MONOSACCARIDES, SUCH AS GLUCOSE, FRUCTOSE (“FRUIT SUGAR”), AND GALACTOSE. THEN THERE ARE ALSO MORE COMPLEX FORMS, COMPRISED OF TWO BASIC SUGAR UNITS JOINED TOGETHER, CALLED DISACCHARIDES. EXAMPLES OF DISACCHARIDES ARE SUCROSE, LACTOSE AND MALTOSE. TABLE SUGAR, ALSO KNOWN AS SUCROSE, IS MADE USUALLY FROM SUGAR CANE OR BEETS. LACTOSE OR “MILK SUGAR” IS MADE UP OF A UNIT OF GLUCOSE AND A UNIT OF GALACTOSE, WHEREAS, MALTOSE OR “MALT SUGAR” COMPRISES TWO GLUCOSE UNITS JOINED TOGETHER.

NEGATIVE EFFECTS OF OVERCONSUMPTION OF SUGAR

• Diets that are consistently high in sugar contribute towards dyslipidemia; particularly increased triglyceride and VLDL cholesterol levels.

• Higher intake of sweetened beverages such as soft drinks has been shown to be associated with obesity and obesity-related illness as well as lower intake of other nutrients.

• A few major studies, such as the Framingham Heart Study, have indicated that consumption of just 1 soft drink per day increases the chances of developing high blood pressure.

• Chronic sugar intake raises insulin levels and may lead to reduced insulin responses by the body as well as insulin resistance. Consistently high insulin levels have also been shown to accelerate the aging process of cells and organs of the body.

SUGAR ADDICTION

RECOMMENDATIONS FOR ADDED SUGAR

Notable research on food addiction has been done by Dr. Bart Hoebel, Dr. Nicole Avena and Dr. Paul J. Kenny.

In their studies, rats were used as experimental subjects and sugar was documented to stimulate similar regions of the brain as addictive drugs such as cocaine. Both trigger a flood of dopamine and feelings of euphoria or a “high”. In both cases, the “high” feeling is short-lived and the brain craves more.

Some examples of the plethora of locally prepared sweets in the Caribbean are

From personal experiences, many persons can be firmly convinced that sugar possesses addictive qualities. While sugar habituation has been confirmed as a recognized public health issue, the jury is still out on this particular subject, and researchers are still debating the question whether sugar can be classed as truly an addictive substance.

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When these pleasure pathways are strongly and repetitively stimulated, the brain adapts and it takes more of the substance to achieve the same high. Abusers will continuously seek that pleasurable feeling despite dangerous and painful consequences. Withdrawal symptoms are another hallmark of chemical addiction; however, for humans, true drug withdrawal symptoms from sugar have not yet been observed.

The World Health Organization recommends that at least no more than 10% of your total daily calories should account for added sugar in the diet. However, in August 2009, the American Heart Association (AHA) released a more detailed recommendation for added sugar.

grater cake / sugar cake, nut cake, chilli bibi / asham / Brown George, Bustamante backbone candy, pinda cakes, wangle / bene balls, paime / duckanoo / tie-a-leaf / blue drawers, pone, plantain tarts, tamarind balls, guava cheese, candied paw paw balls, tooloom, khurma, ladoo, barfi and jelebi.

SUGAR: IS IT BAD FOR YOU?

| NUTRITION

TIPS FOR A HEALTHY BALANCE AND REDUCING YOUR ADDED SUGAR INTAKE The AHA stated their recommended daily limit of added sugar for women as 6 teaspoons (24 g) per day and for men, 9 teaspoons (36 g) per day. Additionally, it must be noted that there are about roughly sixteen to twenty calories (16-20 kcals) in every teaspoon of sugar that you add to your food or drink.

1. Eat more vegetables and fruits on an everyday basis (eating a few fresh, whole fruits every day will not “count” towards your allowed added sugar intake).

Sweetened beverages such as soft drinks, juices and other drinks usually account for large amounts of added sugar in the diet. In the U.S., the American Cancer Society reports that almost half of the sugar in their typical diet comes from sweetened beverages.

3. Use less sugar when making homemade beverages and when cooking (e.g. stewing and baking).

An average 20 oz soft drink contains about 15 teaspoons of sugar in one bottle and thus easily exceeds the sugar recommendation. The American population consumes an average of 23 teaspoons of sugar per day, and burning calories from that would take walking for approximately 1.5 hours or jogging or riding a bicycle for about 45 minutes.

A recent study published in 2012 by the Caribbean Food and Nutrition Institute revealed that soft drink consumption among Caribbean youths is excessively high. The following is the percentage of secondary school students in various Caribbean islands that consume 1 or more bottles of soft drink everyday: Grenada 23.7%, St. Kitts 35.4%, St Vincent 48.5%, and Trinidad and Tobago 62.6%. Packaged snacks, sweets, cakes and candy bars also accounted for a large proportion of the calories in the teenage diet particularly in the case of Trinidad and Tobago.

OTHER NATURAL SWEETENERS

Some popular alternatives to sugar currently for sale on the market are honey, maple syrup and agave nectar. Sweeteners like these do possess some unique attributes and have additional nutritive benefits. It must be remembered, though, that honey and other such similar sweeteners can do just as much damage as white (or brown) sugar — because in the end, they all contain the same amount of sugar per teaspoonful.

So what matters is not which type of sugar you choose but how much of it you're consuming.

Alternative non-nutritive sweeteners and sugar alcohols will be discussed in a future issue.

2. Choose less sweet foods, drinks and packaged foods with added sugar.

4. Also reduce use of honey, condensed milk, molasses, other syrups, jams, jellies and other condiments or sauces made with sugar (e.g. ketchup, barbeque sauce, tamarind sauce, sweet stewed mango and other sweet sauces).

5. Alcohol – make one drink last longer. Alcohol is a product of fermented sugar, and should only be used in very limited amounts.

6. Make water your drink of choice. Drink water several times a day.

HOW TO SPOT ADDED SUGAR IN PACKAGED FOODS

The easiest way to spot added sugar is by looking at the food label. By law, ingredients are listed in order by weight, from the heaviest first and the lightest last.

A product contains a large amount of added sugar if the very first few ingredients on the list is sugar (suffix ending with “–ose” e.g. fructose or sucrose) or is any other sugar-containing ingredient such as any type of syrup, honey, molasses, cane juice or fruit juice concentrate.

Sugar found in common foods and beverages Item Soft drink or sweetened juice (20 oz. bottle) Soft drink or sweetened juice (12 oz. can) Juice box (250 mL tetrapak) Chocolate candy bar, 1 ½ oz Commercial pre-packaged cupcake with icing “Fruit loop” type cereal (1 cup) Ketchup (1 tablespoon) Barbecue flavour chips (1 oz.)

Unsweetened cereal

Teaspoons 15 10 6¼ 5½ 4½ 3½ 1 ½ ⅓

**Feel free to email the author of this article with any of your nutrition questions or concerns and they will be answered in the next issue. Email to: michelle.ash.tt@gmail.com **

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A scar is the body’s natural way of healing, and replacing lost or damaged skin. Scars are areas of fibrous tissue that replace normal skin after injury. They may be formed for many different reasons, including as a result of infections, surgery, injuries, or inflammation of tissue.

Scars can form anywhere on the body, and their composition may vary; appearing flat, lumpy, sunken, colored, painful or itchy.

The final look of a scar depends on many factors, including individual and racial features; skin type, location on the body, the direction of the wound, the nature of injury, age of the person with the scar, the conditions of wound healing and his/her nutritional status.

Two of the most common types of scars are hypertrophic and keloid scarring, both of which present with excessive stiff collagen bundled growth overextending the tissue, blocking off regeneration of tissues. Stretch marks are also a form of scarring. These are caused when the skin is stretched rapidly (for instance during pregnancy, significant weight gain, or adolescent growth spurts), or when the skin is put under tension during the healing process; usually, near joints.

Psychological implications are also evident regarding scarring. Notably, in anxiety, depression, posttraumatic stress reactions, sleep disturbances, loss of self esteem and stigmatization contributing to a negative change in the quality of life. All these problems are more distressing to the individual, particularly when the scar cannot be concealed by clothes.

In the 1980s it was noticed that when silicone sheeting was used under compression garments to evenly distribute pressure, the scar areas directly under the silicone sheeting improved more rapidly. Clinical trials in Europe showed that silicone gel sheeting used alone was equally effective.

This treatment is used in dermatology, plastic surgery and obstetrics/gynaecology, as this therapy for scar management delivers pleasing results for patients. Patient compliance is mandatory to have effective results. It is a simple, easy, convenient and cost-effective solution for scar management.

SCAR MANAGEMENT AND THE BENEFITS OF USING SILICONE GEL & SHEETING What is Silicone?

Silicone gel contains long-chain silicone polymer, silicone dioxide and volatile component. It has a self-drying technology, is spreadable and, when dry, cannot be seen because it is transparent. It has been reported to be effective in producing a reduction in texture, colour and in the height of scars.

How Does it Work?

Whilst the precise mechanism has not been defined, clinical trials have shown the following effects:

Occlusion

Hydration

Elevated Skin Temperature

Continuous Light Pressure

It seals the scar from exposure to air and bacterial invasion, and prevents bacteria-induced excessive collagen production.

It increases hydration of the stratum corneum, thus facilitating regulation of fibroblastic production and reduction in collagen production. The scar becomes softer and flatter.

The skin temperature has been found to be elevated under the silicone sheeting and can have an effect on collagenase kinetics, which may alter scarring.

The sheeting only provides the light pressure when fixed to the scar.

Benefits of Using Silicone Gel and Sheeting for Scar Management The advantages of silicone gel include easy administration, even for sensitive skin and for use on children.

It can be applied to any irregular skin or scar surfaces, the face, joints and flexures.

It can be used on any size of scars.

Silicone gel on its own is self drying, not visible on the skin when dry, and does not require any fixation. It can also be covered with sun block and makeup, which makes it very practical for everyday use.

Medical grade silicone can be obtained without a prescription and is a solution to manage the process of natural scarring, be it from a surgical wound or any other trauma. This can prevent emotional distress, restriction of movement, tightness, itching and general discomfort that often arises from scarring.

While topical self-drying silicone gel can be used alone, for best results it is recommended that the sheeting be used for part of the day (as it has the added benefit of compressing the scar), and the gel used when not wearing the sheeting, to achieve 24-hour effectiveness.

Making an informative decision about your scar by discussing scar management with your doctor, pharmacist, occupational and physiotherapists, esthetician, especially prior to surgical intervention, producing scars no matter how small the potential scar, would be helpful to avoid keloid and hypertrophic scarring altogether.

Silicone comes in reusable sheetings (clear and cloth backing) in different shapes and sizes, and both the sheetings and gel ointments are cost effective and readily available at all leading pharmacies here in Trinidad.

SUBSTANCE ABUSE

| LEGAL HIGHS

THE YOUNG GIRL TURNED BLUE AND THEN COLLAPSED ONTO THE DANCE FLOOR. SHE WAS SWEATING AND BREATHING HEAVILY. BY THE TIME HER PANICKED FRIENDS GOT HER INTO HOSPITAL, AND INTO THE EMERGENCY DEPARTMENT, SHE WAS UNCONSCIOUS. NOBODY KNEW EXACTLY WHAT IT WAS SHE HAD TAKEN - EXCEPT THAT IT WAS A

LEGAL HIGHS

| SUBSTANCE ABUSE

LEGAL HIGH WRITTEN BY

DAVID FENTON

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SUBSTANCE ABUSE

| LEGAL HIGHS

‘She had been with us for about an hour and we had no idea what it was she had actually taken,’ said Eliot Wilkinson, the ED consultant on duty that night. ‘Then finally the police came, and one of her friends admitted they had been using a legal high, but even then it wasn’t much help, because, of course, it was just a name and we had no idea what was actually in it.’

‘The most typical presentation is that the patients seize up,’ he said, ‘so we have full body shaking movements, and in those instances it’s quite difficult to manage their airways, so quite often we end up anaesthetising these patients, intubating them, and letting the drug wear off in an intensive care setting where they are kept sedated.’

The girl eventually recovered, but like many of the young people Eliot sees at his hospital in Portsmouth, she had no idea what it was she had taken or how it was affecting her body. The worrying thing is, neither did the doctors.

But sometimes the patients don’t recover. Last year a 23 year old man from Wiltshire in Southern England died after taking a legal high called AMT. It was a small green pill with a dollar sign on it. His father later said, ‘He hadn’t taken pills on the day this happened.

We know he took pills over the weekend and he felt pain because his internal organs were heating up, and basically cooking.’

And she’s not alone. There is a growing trend of school-age children finding and taking these legal highs.

Legal highs are typically drugs that are not banned, so they can be sold to whoever wants them, usually with the warning that they are ‘Not for Human Consumption.’ In the US they are often sold as ‘bath salts’ or sometimes incense or plant food. They are cheap and readily available — usually online — and they don’t attract criminal prosecution if you’re caught with them, at least not in England. Perhaps that is why they are becoming more popular, especially with school-age children. But the fact that they are not technically illegal does not mean they are safe.

Far from it.

In Portsmouth, in the South of England, one child is now taken to hospital every week suffering from the effects of legal high consumption. ‘I think in the last 12 months we have certainly noticed an increase in the frequency of patients attending hospital suffering from the effects of legal highs, and we’ve noticed a younger population of patients attending as well — sometimes as young as 11 years old,’ said Eliot.

At the Emergency Department one specialist paediatric nurse I spoke to said he had kept a log of all the young patients who turn up after having taken legal highs.

So far, the Government has banned 250 legal high drugs, but 150 new ones have sprung up.

A quick look on the Internet and I found 20 or 30 of them — with names like Blow, China White and Brigadier’s Beak. I spoke to the man who was selling them online. He gave his name as ‘Steve’, and he said business was ‘steady’. ‘We don’t like it when there is a lot of publicity, because then you get kids coming online trying to buy, and this isn’t for children,’ he said.

‘It just causes more problems.’

Many of the products have quite detailed chemical analyses on the packets. Some have molecular diagrams. But while these may look pseudo scientific, often they bear little or no relation to the reality of what is actually inside. One clinical toxicologist, whose job it is to regularly test and analyse legal highs, told me that more often than not the ‘chemical composition’ information given on the packets is completely spurious.

‘The point is that the people who are taking these substances just don’t know what is in them — and often when they are taking them they will be mixed with alcohol or other drugs, so the effects are even more unpredictable,’ he said.

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In the US they are often sold as ‘bath salts’ or sometimes incense or plant food. They are cheap, readily available and don’t attract a criminal prosecution if you’re caught with them

LEGAL HIGHS

‘So, generally, when they arrive in hospital, they are showing one or other of the following signs: they have high levels of anxiety, in other words they’re worried about what is happening to them, they’ve perhaps had insomnia for several days, or they may be suffering from hallucinations.

‘Generally, if they need medical help, they might have collapsed, or have trouble breathing, or be suffering from the effects of palpitations. Those are all quite common, along with people feeling hot, sweaty or getting seizures.’

So how do doctors treat someone for the effects of an unknown substance?

‘Basically, there is no way of analysing what is doing the damage, because you would need a wide range of blood tests and that might take several days or even weeks, so you just have to treat the patient in front of you. That makes things easier because these drugs, like many others, will fall into a familiar category; they are either a stimulant, a neurodepressor or a hallucinatory drug. If you can identify the symptoms, then just treat those.’

| SUBSTANCE ABUSE

restricted, banned or illegal without a prescription. The problem for the authorities is that as soon as they ban one substance, the makers change one element of the drug and put it out on the market again.

But whatever their legal status, one thing is clear. It is definitely not legal for children under the age of 18 to buy them or use them, but that is what is happening, in Portsmouth and elsewhere.

‘We’re seeing a particular problem on school holidays,’ said one Emergency Department specialist. ‘At Easter, Christmas, and those times where perhaps adolescents and older people are indulging a bit more and perhaps having a drink with the family, and the adults are not perhaps paying attention to what their children are up to. Often we see the very young children have been given something to take by an older brother or sister, or perhaps an older friend.’

The fact that these users are so young is worrying in itself. What’s more worrying is that they are now turning up in hospital — and sometimes requiring intensive care — because of it.

Although these drugs are called ‘legal’ highs, in many ways that is a complete misnomer, because sometimes the substances will contain drugs which are either

PARANOIA

CARDIAC ARREST

LEGAL HIGH SYMPTOMS SUICIDAL THOUGHTS

AGITATION

HIGH BLOOD PRESSURE INSOMNIA

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CONDITION

|

BR U X IS M

Bruxism. It’s not a well known term, yet it is a common ailment, affecting a sizeable portion of the population. It describes the act of grinding the teeth

and clenching the jaw, a symptom so common that it normally drew the comment from your elders that “you have worms”, and prompted a panicked dash of some vile-tasting medication down your throat.

SHELDON WAITHE WRITTEN BY

T

he medical reality is that bruxism is caused by a number of non-larvae-based factors, including sleep disorders, as well as stress and symptoms arising from the lifestyle that we lead. Dr. Adèle Jardine, with many years of experience in the United Kingdom and now at the Long Circular Mall Dental Centre, has seen many cases of bruxism and its lasting effects. Regarding the causes, she concurs with the pressures of life being the main factor.

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“High levels of work-related stress can have a significant adverse affect on your sleep, and trigger episodes of sleep bruxism. Being stressed or anxious may also cause you to clench your jaw or grind your teeth.” To differentiate sleep bruxism from awake bruxism, the former constitutes automatic grinding with rhythmic, sustained contractions of the jaw muscle.

The latter is the involuntary clenching of the jaw.

Generally, as one would be conscious and therefore acutely aware, there is usually no tooth grinding with awake bruxism. There are further divisions, with primary bruxism describing the grinding that occurs without any prior medical condition, while secondary bruxism arises as a side effect of the use of anti-depressants or recreational drugs like cocaine, or it can be an indicator of depression, major anxiety, or Parkinson’s disease.

Besides the obvious effect of worn teeth, there is facial pain, tightness in the shoulders, jaw ache and headaches.

Dr. Jardine confirms “Some of the symptoms of bruxism, such as facial pain, will often disappear when you stop grinding your teeth. Others, such as tooth damage, can be permanent.”

B RUX I SM

|

CONDITION

During sleep the force of bruxing can be up to six times greater than normal waking biting pressure, approximately 250 pounds of force per square inch.

T

he direct effect upon your teeth can go to extremes, with ever-shortening teeth becoming sensitive or developing an abscess, requiring root canal treatment or, in a worst case scenario, the eventual loss of the affected teeth.

There is the added concern that children are often seen to be grinding their teeth but Dr. Jardine allays any anxiety related fears. “If your child grinds his or her teeth, don’t be too concerned. Bruxism is not necessarily a sign of a stressed child. A child’s teeth and jaw grow and change so quickly, so bruxism is common and not usually a damaging habit in need of treatment. It usually occurs after they develop their first teeth and again after they develop their permanent teeth. The habit usually stops after the adult teeth are fully formed.”

So how do we treat bruxism and avoid the effect of these symptoms? The most common form of treatment is to protect the teeth with a mouth guard at night. Think of the guards used in boxing or rugby and you will have an idea of the soft rubber or plastic that can be placed in the mouth to prevent the upper and lower teeth grinding. However, a mouth splint, or Occlusal splint, is the better option, made of harder plastic and customised by your dentist for that exact fit.

It is worth noting that while these options are the most common treatments, they only protect the teeth and control the condition, not cure it. As with any problem, the solution is to treat the underlying cause, in this case the reason (or reasons) that you are grinding those teeth and clenching that jaw.

Relaxation techniques, meditation, autosuggestion and hypnosis are effective in reversing the habit. One progressive idea is to help you manage your psychological problems by attempting to change the way you think and act with cognitive behavioural therapy. Yoga, deep breathing, regular massages, even holding a warm towel on your cheek prior to going to sleep, have all been used to tackle the problem. The trick is working out which treatment suits each individual.

If you are suffering with awake bruxism, recording the frequency with which it occurs and analyzing the times will provide insight as to the causes by reference to what you were doing when the grinding occurred. Awake bruxism also provides an opportunity to practice prevention measures such as gently placing the tongue between the upper and lower teeth. Since we have all experienced that unique pain of accidentally biting our tongue, it’s highly unlikely that we will do it consciously!

Medication is not usually used to treat bruxism, though anti-inflammatory drugs may be used to reduce the pain or swelling caused to the jaw from excessive grinding. The key is to consult the specialists in this field, your friendly neighbourhood dentist — whom you visit regularly (we don’t need to reinforce this, do we?).

As Dr. Jardine emphasises, “Talk to your dentist if you think you are grinding your teeth. They will check your teeth and jaw for signs of bruxism, and help you work out the possible causes and suggest appropriate treatment.”

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Fax: 663-2348 Email: info@saphtt.com Web: www.saphtt.com

St. Augustine Private Hospital

RAPID STROKE CARE MAY REDUCE THE RISK OF BRAIN DAMAGE About Stroke To understand stroke, it helps to understand something about the brain. The brain controls our movements; stores our memories; and is the source of our thoughts, emotions, and language. The brain also controls many functions of the body, like breathing and digestion.

To work properly, your brain needs oxygen. Although your brain makes up only 2% of your body weight, it uses 20% of the oxygen you breathe.

Your arteries deliver oxygen-rich blood to all parts of your brain.

IF YOU THINK SOMEONE MAY BE HAVING A STROKE, ACT F.A.S.T.

What Happens During a Stroke If something happens to interrupt the flow of blood, brain cells start to die within minutes because they can’t get oxygen. This is called a stroke. Sudden bleeding in the brain also can cause a stroke if it damages brain cells. A stroke can cause lasting brain damage, long-term disability, or even death.

If brain cells die or are damaged because of a stroke, symptoms of that damage start to show in the parts of the body controlled by those brain cells.

FACE: Ask the person to smile. Does one side of the face droop?

Stroke Signs and Symptoms During a stroke, every minute counts! Fast treatment can reduce the brain damage that a stroke can cause.

By knowing the signs and symptoms of a stroke, you can be prepared to take quick action and perhaps save a life maybe even your own.

• Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.

• Sudden confusion, trouble speaking, or difficulty understanding speech.

• Sudden trouble seeing in one or both eyes.

• Sudden trouble walking, dizziness, loss of balance, or lack of coordination.

• Sudden severe headache with no known cause.

ARMS: Ask the person to raise both. Does one arm drift downward?

SPEECH: Ask to repeat a simple phrase. Is their speech slurred or strange?

ten things to talk about

STROKE 1.

Stroke is the third most common cause of death, after cancer and ischemic heart disease.

2.

It is also the most prominent cause of physical deformity.

3.

Its incidence is accelerating in developing countries due to unhealthy lifestyles.

4.

The risk of stroke more than doubles each decade after the age of 55.

5.

2/3 of stroke victims are above 60 years old.

6.

1/5 of the victims die within a month of its occurrence. Half the survivors become physically deformed.

7.

Damage to the left side of the brain may result in paralysis of the right side of the body; damage to the right side, paralyzes the left side.

8.

Hypertension accounts for 30-50% of stroke risk.

9.

Patients with diabetes are 2-3 times more predisposed to stroke.

10. Stroke can occur due to a disruption in blood supply or due to blood vessel damage.

TIME: If you observe any of these signs, call a hospital immediately.

FRUIT

|

B ARB A DINE

BARBADIN ALMOST TOO GOOD TO BE TRUE

Mmmm.... Barbadine ice cream! As its unique flavour soothes the taste buds after a hearty meal; you can almost feel the goodness in each mouthful, serving to offset the guilt of having dessert. There’s a reason for that feeling of healthiness per spoonful; after all the favourite local delicacy is derived from our barbadine plant, or Giant Granadilla, as it is known globally. It’s the grand giant of the passion-fruit family (paw-paw, guava, etc.), with the trees growing to thirty to fifty feet tall, and the fruit itself attaining the size of small melons.

WRITTEN BY SHELDON WAITHE

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T

hough the plant’s flowers of bright purple and red, and its mixed aroma of lime and strawberry may suggest otherwise, surprisingly, the pulp of barbadine is very bland, with no suggestion of the reasons that make it a much sought-after fruit, capable of making the taste buds water with a mere mention of its name. To bring out the true flavour of barbadine (and therefore its health benefits), it needs to be mixed into other foods or to be eaten with add-ons such as lime juice, sugar or honey. Hence the plethora of uses, from our aforementioned ice-cream through to the ubiquitous barbadine punch.

There is also a high content of the crucial compound, ascorbic acid. Like its relative vitamin C, the acid helps ward off a number of health problems, from the common cold to critical issues such as heart disease.

This is expanded to include the prevention of gum disease and diabetes, and the promotion of eye health. Throw in the lowering of toxicity in the body and the reduction of hypertension, and suddenly the guilt of those extra amounts of barbadine ice cream is partially allayed (only partially, mind you, for there are far healthier options to consume the barbadine goodness, as we will shortly explore).

The pulp delivers an extremely high content of water (or moisture) and is a very good source for two most important minerals, calcium and phosphorous. While it is common knowledge that they represent the building blocks for our bones and teeth — both their development and healthy maintenance — less known is the fact that phosphorous plays a significant role in our bodies’ production of adenosine triphosphate (ATP), the molecule responsible for energy in human cells. So good helpings of barbadine will help with those pesky joint pains as we age, as well as keep the energy levels at the rate required in the modern non-stop society.

As is the case with many of our tropical fruits, riboflavin and niacin are also present, the latter considered a ‘good’ cholesterol, helping to eliminate the bad ones that invariably find their way into our diet. It also helps the body to convert our carbohydrate intake into energy. There are also minimal amounts of fibre in Barbadine; the same applies to its iron content. However, small doses are better than none, which is virtually the amount of fat that exists per serving of barbadine pulp. Additional uses are to treat whooping cough, help alleviate asthma, and as a mild sedative for those suffering with insomnia.

B A RB A D I N E

|

FRUIT

INE So how do we enjoy these benefits? Along with blending it into ice cream, barbadine punch remains the most popular method; the seeds are removed from the pulp and blended with milk, strained, sweetened with sugar, nutmeg added and refrigerated. The mixture is guaranteed to be consumed in record time.

For an even healthier take on the barbadine punch, use it instead of milk with breakfast cereal or muesli.

Delicious!

Boiling or steaming of the barbadine pulp is quite common; the results allow for a number of possibilities, including making jams and jellies. After boiling the pulp and the flesh separately, they are reunited, and lemon juice and sugar added. Once the mixture is left in to sit, it will take on the texture of a jam, to be used as you wish. Perhaps the most novel way to use the barbadine pulp is as a pie filling. The flesh of the fruit is stewed using sugar; the pulp is then added and to create a truly unique concoction. Mashed banana and a few drops of vanilla complete the process.

Slices of barbadine pulp may also be used in a fruit salad, alongside orange, pineapple, mango and banana. As a general rule, to bring out barbadine’s subtle floral flavours, salt, sugar, nutmeg and lime juice are best suited. It’s in keeping with the theme that right on our doorsteps are some of the most nutritious fruits available. Now, to get back to that barbadine ice cream...

Used as a stuffing, it delivers on both healthiness and taste. For a dessert similar to poached peaches, cut pieces of barbadine, drizzle with honey and cook in an oven.

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MEDICINE

| THINGS TO KNOW ABOUT DIET PILLS

THINGS TO

KNOW ABOUT

THINGS TO KNOW ABOUT DIET PILLS

| MEDICINE

DIET PILLS WRITTEN BY

ROBERT TAYLOR & SACHA FORTUNÉ

It is tempting — particularly if you have a weakness for delectable Caribbean food, which (let’s face it), isn’t always the most balanced in terms of nutrition. We like flavour, we like variety — and so, inevitably, if we’re not mindful of it and active in our daily lives, the pounds creep up on us…

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MEDICINE

| THINGS TO KNOW ABOUT DIET PILLS

It is often said that diets “don’t work”, which, to some extent, is true — a “diet” as it is generally understood, is a temporary solution to an immediate problem. Some are able to integrate it into an entire lifestyle change that they can maintain, but many fall “off the wagon” shortly after they hit their goal — or even before!

metabolism and begin losing weight before they further endanger their health.

And then, you run into an old friend who’s lost significant weight, and she tells you her secret; or a guy at the gym flexes a bicep and mentions the success he’s been having with a supplement that obliterates stubborn fat. Or, perhaps the label leaps out at you directly while you are buying medication at a pharmacy….

Finally, diet pills are also not just for “fat people”; athletes often use such supplements as part of their fitness regimen, and implement them successfully to achieve peak performance.

The diet pill: a quick fix, the answer you’ve been looking for, the solution to your problem. But before you jump to conclusions, here are a few things you should know about diet pills.

In a word, yes.

WHO USES DIET PILLS? Firstly, let’s debunk the myth of the imagined ‘pill-popper’. Some think is the lure of laziness that leads the gullible to try just about every diet pill on the market, but this judgment is a bit harsh. Pills can be a last resort for those who have had little success with ample amounts of exercise, or perhaps extensive exercise is not an option for some.

Medical conditions can also affect one’s ability to lose weight. Some of these conditions include polycystic ovarian syndrome, thyroid disorders, diabetes or induced weight gain as a result of necessary medications (e.g. steroids for asthma).

Doctors may also recommend the use of diet pills for those who are obese and need to ‘kick-start’ their

Another common misconception in the Caribbean is that only women use diet pills. In fact, they are used by men and women alike — as the gender-specific products on the market will indicate.

SO… DO THEY WORK? Some work quickly, some take a bit longer for the user to respond, some result in more or less effects than another… but at the end of the day, most will work to some extent. It is unlikely that a product would have made it on the market if there was absolutely no evidence indicating that some benefits are to be derived from its use.

That said, while they do work to achieve a desired result, that does not mean that they are safe to use.

The majority of ads you see in the media are for products that are unregulated, untested and unproven.

How often do we hear of a pill that has been pulled off the market?

Not all dietary supplements are regulated by the U.S. Food and Drug Administration (FDA); in actuality, it is the burden of the FDA to prove that a supplement is unsafe for consumption. Even the ones that are FDA-approved have a long list of potential side effects. Essentially, diet pills fall into that grey area of ‘use at your own risk’.

Diet pills usually work through one or more of the following ways:

PROS AND CONS OF USE

•Blocking your body from absorbing a percentage of the fat in the food that you eat. By inhibiting an enzyme called lipase in your body, fat is removed in bowel movements instead of being broken down and absorbed.

• Suppressing your appetite by affecting chemicals of serotonin and norepinephrine in your brain (products with ingredients such as sibutramine, diethylpropion, phentermine)

While they will target your body through one of these ways, their use can also result in some of the following side effects:

• Boosting your energy (products with ingredients such as caffeine and ephedra can induce thermogenesis, causing you to feel more energised and sweat more)

• Abdominal cramping • Passing gas • Diarrhoea • Headache • Dizziness

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Some of these side effects are temporary and tolerable to the average person, but there are many more serious effects such as heart conditions, and liver and intestinal damage. The truth is that once you take diet pills, you are at risk of experiencing some side effect. Even if you are fortunate enough to have no side effects, the potential for disaster can come after you see success

• Fatigue • Dry mouth • Constipation • Insomnia Do you keep using it?

If you taper off, would you regain the weight?

THINGS TO KNOW ABOUT DIET PILLS

CAN YOU GET THE SAME RESULT WITHOUT THEM? Yes. In most instances, they are not necessary. Let’s think for a minute about two scenarios with two “normal” adults.

Jack and Janet both work out three to four times a week, hitting it hard with cardiovascular and weight training. Both eat what he/she considers to be healthy and in line with weight loss goals, but each still has a 30-40% fat percentage.

Janet visits a nutritionist and hires a personal trainer, analyses her diet and comes up with a solution for a plausible workout regimen and diet plan. Over a six-month period of trouble-shooting and adjusting to suit, she starts to lose fat and gain muscle.

Since diet pills are not regulated, their ingredients are not subject to scrutiny. The side effects of these pills can range from mild to life threatening. Know what you are getting into before you use them.

IF YOU MUST… USE WITH CARE If you do decide to try a diet pill or supplement, please read and do your research, and most importantly, take your time. Here are a few tips:

Jack sees his friend Janet having success, but thinks six months is far too long to wait. He decides to opt for diet pill X. In three weeks, Jack is “jacked” on the pills, dropping weight quickly, and he is thrilled that it is working — best purchase ever!

1. Take it whole with a full glass of water. Never crush diet pills to mix in drinks or soups. Unless you are specifically told to chew them, do not chew them; they are designed to be taken whole. Crushing them might make them more powerful than they should be, making them lethal.

His energy level is through the roof, he is pumping it harder and harder at the gym, the ladies are giving him appreciative glances, and the gym owner even invites him to enter a Mr. Physique competition.

Thanks to the pills, Jack’s life is great.

2. Diet pills cause a person to urinate more frequently due to its diuretic effect. This could lead to dehydration, thus, causing complications. As a precaution, it is best to drink eight glasses of water every day while on diet pills.

Six months later, Jack is still using the diet pill “as recommended on the bottle”… except, now Jack is experiencing slight chest pains, and he sweats after barely doing any activity. At first he thinks, “It can’t be the pills… I’ve been using them so long without any issues”; then he realizes, “Well, it must be the pills… but I don’t want to put back on the weight…”; then he thinks, “Well I probably should stop before my health gets worse, but let me just get to X point first, and then I’ll stop…”

Unlike other drugs that induce chemical dependencies, addiction to seemingly innocent ‘over-the-counter’ diet pills can result from a mental dependency. Although we may know better, and may think we are immune and ‘smarter’ than the woman or man in the classic urban legend of ‘killed by a diet pill’… we are also human.

| MEDICINE

3. Take only the recommended dosage. Taking more than required will not help you lose weight, but will definitely increase the risk of side effects.

4. Monitor your heart rate. Heartbeat should be less than 86 beats per minute. Stop taking the pills if it reaches 90 or higher, and inform your doctor or dietitian immediately.

5. If recommended by a professional, always follow the instructions set by the dietitian and/or doctor — do not only rely on what's enclosed in the box. Also diet pills will only work as expected if a diet plan is being followed.

6. After three months, stop taking the diet pills. This will mitigate against some side effects like addiction. Other diet pills like phenylpropanolamine are safe to use only up to sixteen weeks. Some studies show that it can cause health problems if taken under one month.

FINALLY, REMEMBER… It is entirely possible to get everything you want in terms of health and fitness without venturing down that uncertain path of the diet pill.

If you get there without the assistance of a pill, it is more likely that you will stay there — and your goals achieved will be all the more real and sustainable for your long-term health and wellness.

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CONDITION

| RINGXIETY

RINGXIETY WRITTEN BY

STAFF WRITER

Symptoms can range from mild – where one ringing phone can send everyone in the vicinity on a frantic rush to locate their device, to more serious cases where users claim to hear their phones at concerts and busy city streets. While the exact reason for this phenomenon still hasn’t been fully explained, the good news is that it is preventable. The not-so-good news is that it’s not a habit easily broken.

Hearing is Believing?

Sound emanates as invisible waves from a moving or vibrating source. These sound waves make their way into our ears where they are converted into vibrations, which in turn, are then transported to the brain through a fascinating system of hair cells, fluids, bones and nerves. The brain then converts these signals into what we hear.

Most humans can roughly detect sound waves between the ranges 20 Hz and 20,000 Hz. Within this range is a subset range (1,000 Hz to 6,000 Hz) that we are particularly sensitive to. Scientists believe that many cell phones produce tones that fall into this sensitivity range. Unfortunately, many of our everyday sounds also share this range and as a result, can often trick our brain into believing they came from our phones.

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THESE INCIDENTS TEND TO HAPPEN WHEN WE: • Watch television or listen to the radio, particularly when they are in the background • Drive with the windows down.

• Are in loud or busy environments.

Have you ever found yourself rushing into the other room for a phone you were sure was ringing, only to be realise that it wasn’t? How about rummaging through that handbag you should have cleaned months ago, because you felt your phone vibrate? It didn’t, but you were almost certain it did. If you answered yes, you may be experiencing what is now commonly known as ‘ringxiety’.

Insane in the Membrane?

Ringxiety is also believed to have physiological and neurological roots. Psychologists have observed people who rely heavily on their phones for day-to-day activities, can find themselves in a heightened state of anticipation for calls and messages.

Meet Terry – Self-professed ‘Soup Boss’ by day, barber by night. He owns and runs a small, but very popular lunch spot in East Trinidad. “My phone is my life, but sometimes it drives me mad!” he tells us.

Terry’s phone is the primary means for customers to place their lunch orders. He nods knowingly when we explain the concept of ringxiety. “Its true! If I keep it on me, I find myself checking it constantly. I have to cook, so I leave it outside. When I do that, I always feel as if I hear it ringing!”

This anticipation can become even more problematic when the stakes are higher. For instance, waiting for that job interview response or getting an update on that hospitalised family member. Users soon find themselves tense and on edge. While some may be able to handle it, others can work themselves into a frenzy.

Phantom Vibration Syndrome Similar in nature to premise behind ringxiety, but the user is falsely led into believing their phone is vibrating. A door slamming shut down the hall can cause your desk to vibrate just enough for you to reach for your phone. Sometimes a simple muscle spasm can trick you into thinking you received a text.

RINGXIETY

| CONDITION

SO, WHAT’S THE SOLUTION? • Limit the amount of time spent on your phone – While it may not be as practical for some, try giving yourself an hour off daily as a start.

• Don’t sleep with or place your phone next to your bed - Help minimise the chances of you constantly checking your phone. Your brain should be in shut-down mode to ensure restful sleep.

• Choose a unique ringtone - Sure that latest hit song is all the rage, but chances are that you and several other people may set the same tone. If you find yourself falling into this situation often, it may be time to ‘go different’.

• Avoid the hard surface and ‘vibrate mode’ combination - This is a double whammy where the vibration on the table as well as the sound it makes, can get you. Where possible, try setting your phone on ‘silent mode’ or place your phone on a soft surface.

• Stay healthy - Eating properly. Getting enough sleep. Exercise regularly. These all help reduce anxiety. Give yourself a fighting chance.

OTHER COMMON PHONE-RELATED ISSUES De Quervain's Tenosynovitis Blackberry thumb; Smartphone Thumb; Texting Thumb; Text Claw – While the nicknames seemingly evolve almost as fast as the technology does, this painful condition is caused by overuse of the thumb musculature. Repetitive button pressing/screen tapping combined with the way the phone is held can apply additional stress to thumb tendons. If left unchecked, that pain at the base of your thumb can escalate to loss of grip and wrist weakness.

Prevention • Limit the amount of time spent using your phone!

• Consider using landscape mode keyboards if available • Perform palm, wrist, arm stretching exercises Treatment • Anti-inflammatory medication may help reduce pain and swelling • Application of ice packs • Wearing of wrist braces or splints • Visiting a doctor or physiotherapist if symptoms last for more than a week Computer Vision Syndrome CVS is practically synonymous with electronic device use and it affects everyone in some way, at some point. Experts estimate that over 90% of users that spend two or more continuous hours a day glued to these devices are affected. Symptoms include blurry vision, dry eyes, headaches, dizziness, even long-term nearsightedness over time.

Prevention • Limit the amount of time spent using your phone!

• Maintain a distance of at least 16 inches between eyes and screen • Increase the size of your on-screen font • Remember to blink. Blinking lubricates your eyes.

• Take breaks that will take you away from your phone ‘Text Neck/Tech Neck’ Hours a day spent hunched over your phone, furiously punching away, can never yield desirable results for your body. Holding phones at desk or lap level forces the head down, which can cause excessive muscular stress to the back of neck and upper back muscles.

Recent statistics show a steady increase in the number of patients experiencing neck and back pain as a result of smartphone, tablet and computer use.

Prevention • Limit the amount of time spent using your phone!

• Be aware of your posture. Keep phone directly out and in front of your face. Your chin should not touch or be close to your chest when using your phone.

Treatment • Stretch exercises - Sit up and look straight ahead.

- Turn your head to the left and look over the left shoulder; hold position for five seconds, then release it.

Repeat on the right side.

- Raise your shoulders up to your ears; hold for five seconds, then release.

- Roll your shoulders towards the chest a total of five times. Roll shoulders towards the back a total of five times. Rest.

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MOUTHWASH - YEA OR NAY? | |SOMETHING

HYGIENE RECIPE

MOUTHWASH YEA OR NAY WRITTEN BY

AMIRA MUNGAL

Twice a day, most of us believers clean our teeth, sometimes quite rigorously, and other times just to get it over with, as we know that the last part of this daily routine is like kicking off a great party in your mouth. That’s right; the final swig straight from the bottle of that brightly colored product is like liquid security. We users feel that no matter how well the job was done in brushing and flossing, the mouthwash just finishes off the process in the most complete manner, giving you a WOW start and finish to any day.

Never mind that my dentist does not subscribe to, nor does she encourage the use of mouthwash, and since my mouth is never in a position to ask questions after a visit, I decided to research the pros and cons myself.

Naturally, mouthwash producers say that oral rinses can be chock-full of health benefits other than just kissable breath, but, on the other hand, some people are concerned that alcohol-containing rinses may have a number of health risks attached.

Labels say that your mouthwash can be a teeth whitener, a plaque zapper, a gum disease-fighter, and can even strengthen your teeth. Here’s where we ask ourselves: Are the claims true? Is mouthwash really good for me? Turns out the answer can be both yes and no. This is what you should know.

Pros • Cuts down on cavities • Freshens breath • Fights gum disease • Prevents buildup of plaque • Soothes canker sores • Safeguards pregnancy — Periodontal disease is actually a risk factor for giving birth to preterm, low-weight babies. The bacteria from a gum infection can get into a pregnant woman’s bloodstream and increase inflammatory markers, which in turn can stimulate contractions.

Cons • Masks bad breath • Irritates canker sores • Certain mouthwashes without moisture dehydrate the mouth • Excessive use of mouthwash triggers an imbalance in the growth of natural bacteria present, making it easier to develop the ‘black hairy tongue’ condition.

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BOTTOM LINE Mouthwash has both its benefits and disadvantages, and the use of mouthwash is an added method of maintaining good oral hygiene, but should not ever replace such practices as brushing and flossing. There are many types of mouthwash, but the right one for you is one that meets your dental hygiene needs for the health of your teeth, gums and even taste preference.

SOMETHING

| RECIPE

Grilled Chicken Salad with Avocado and Mango Busda volo qui reribus ciistiost ex eium, ommolor eperfer oritas adipsap idunt.

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Ingredients

Preperation

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2 tablespoons olive oil 2 tablespoons fresh lime juice 2 tablespoons mango chutney 1 tablespoon low-sodium soy sauce 3/4 teaspoon grated peeled fresh ginger 4 (4-ounce) skinless, boneless chicken-breast halves Cooking spray 8 cups mixed salad greens 1 cup diced peeled mango 3/4 cup diced peeled avocado

Prep Time: 15 minutes Cook Time: 8 minutes Yield: 4 servings Nutritional Information Serving size: 1 chicken breast with 2 cups of salad Calories per serving:

185

Fat per serving:

8g

Saturated fat per serving:

1g

Monounsaturated fat per serving:

4g

Polyunsaturated fat per serving:

1g

Protein per serving:

8g

1. Prepare grill.

Carbohydrates per serving:

24g

Fiber per serving:

5g

2. Combine oil, juice, chutney, soy sauce, and ginger in a small bowl. Place chicken on large plate; spoon 2 tablespoons oil mixture over chicken, reserving the rest for the salad. Turn chicken to coat, and let stand 5 minutes.

Cholesterol per serving:

3mg

Iron per serving:

3mg

Sodium per serving:

203mg

Calcium per serving:

112mg

3. Place chicken on grill rack coated with cooking spray; grill 4 minutes on each side or until chicken is done, brushing with oil mixture from plate before turning. Slice chicken crosswise into strips.

4. Arrange greens, mango, and avocado on 4 serving plates. Arrange chicken over greens. Drizzle reserved dressing over salads.

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DEFENSE MECHANISM

|

DE NIAL

DEN

She must have been four months old when I first began to suspect that something was wrong. At her regular visit, I thought her tone was slightly decreased, but there was nothing else I could find. I said nothing. Experience shows that minor findings are common in newly born children and usually temporary. That is not denial.

DENIAL

|

DEFENSE MECHANISM

NIAL

At her next visit, six months, the picture was clearer. At this age, she should have been able to roll over at will, get to a creeping position and even sit, at least when put. She could not.

Alert and sociable when lying on her back, her head rolled around like a rag doll’s when she was pulled to a sitting position, and she had no strength in her muscles and no muscle reflexes. Something was definitely wrong. I informed her parents as gently as I could and suggested we start doing some basic tests. They remained quiet, said little, appeared to agree, left and never returned. They had started, I suppose, the endless trek of going from doctor to doctor seeking another diagnosis or a “cure”, or at least someone to tell them that nothing was wrong with their first baby.

WRITTEN BY DAVID BRATT MD. MPH. CMT

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|

CONDITION BR U X IS M DEFENSE MECHANISM

|

DE NIAL

Although worldwide in scope, there is an enormous problem of denial in the Caribbean and we have not yet come to terms with it. Our culture is to hide our thoughts, hide our opinions, hide things. The thinking seems to be, “If you know something and somebody else doh know, you better off than them, no?” Some will explain this as an expression of growing up in an island society, with little scope for growth and constant competition to succeed. Others, more psychologically minded, might refer to our denial to accept who we are as a people, Naipaul’s “Mimic Men”, constantly striving to forget how we got here in our desire to get over there and be accepted by our former masters. Denial is a way of hiding things about ourselves from ourselves.

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Denial is not limited to any particular section of society or class of disease. It’s almost impossible to tell who is going to react with denial. It’s not as if it’s the poorest or least educated members of society who are affected more. People do have unexpected or unexplained strengths and weaknesses which show up only under stress.

After years of professional contact, a well known and very successful lawyer from my practice disappeared from view as soon as I told him his child had bronchial asthma. Up to that time the only concerns had been the occasional cold and rash, situations easily resolved and accepted.

When something a bit more serious turned up, denial set in and I have never seen the child professionally again.

Sometimes feelings of guilt confuse the scenario.

If you have been suspecting that your child has some sort of disease and resisting it, and then you are told that your fears are correct, it may be very difficult to accept that your procrastination caused unnecessary suffering for your child.

Some parents of children who are only mildly symptomatic will continue to deny the diagnosis.

"There must be a mistake," they tell themselves.

This can lead to refusal to accept treatment, or noncompliance with treatment, which can have devastating results.

It’s particularly difficult for parents to accept a diagnosis of disability of any sort. Many of these disorders, like dyslexia or Attention Deficit Hyperactive Disorder (ADHD), have only recently been described. What used to be considered just “strange” or “unusual” behaviour, which “Dexter will grow out of”, now has a name put to it, with a prognosis and management probabilities. It’s often very harassing for parents to grasp and deal with these new realities, especially in the face of the refusal of older relatives to accept the doctor’s word.

This family type of denial is particularly common in societies, like some East Indian families of Trinidad and Tobago, where people live in large extended family groups. This is usually a positive experience for children growing up, but too much interference from elders can wreak havoc. A particularly disheartening scenario is the child who is not talking by age two and is probably hearing impaired, but whose parents refuse to have tested because family lore says that “Uncle Kareem eh speak until he was four, now yuh cah shut him up”. Or the always popular but normal “tongue tie” diagnosed by the grandmother as a cause of speech delay. These children show up in the office at primary school entry age, five or six, when the school refuses them entry. Social pressure has overcome family denial.

DENIAL

Experts tell us that denial is a defensive mechanism. It should be the start of a process of acceptance.

Denial is the first stage. A little denial is a useful psychological coping mechanism that gives you time to adjust to the bad news, to start to feel hopeful and better about the future. However, it can also have devastating results if you can't get past this initial stage.

Much denial is the result of fear. Fear of the disease. Fear of the suffering and pain that the disease can cause. Suffering that can be not only physical but, perhaps worse, mental and emotional.

And fear of the possibility of death. Ultimately, denial is the refusal to accept that we will all die some day. That no matter how high our hopes and aspirations, one day, one minute, one second, it will all come to an end.

Yet, doesn’t denial also spring from hope? Hope that the diagnosis will be proved wrong. Hope that we will not die or that if we do, that there is something waiting for us beyond death?

|

|

DEFENSE B RUX I SM MECHANISM CONDITION

Sometimes denial occurs because of what the parent is seeking in a doctor. People want their doctors to be “confident, empathetic, humane, personal, forthright, respectful and thorough”. Not an easy thing to be! If you go to the doctor expecting all of this and are given bad news, that can have a traumatic effect on your relationship with the doctor, expressing itself in refusal to accept the diagnosis.

When a parent is in denial, all a doctor can do is to be as professional as possible in this extraordinary moment of fear, anxiety and doubt, and give the diagnosis as simply and straight as possible and try to alleviate the fear that led to the denial. This means appearing fairly confident and reassuring, but not overbearing. The doctor must be prepared for the possibility that the parent will continue to deny, even after the condition has been treated and the condition improved. And what the doctor must never to do is to pass judgment or look at these particular parents as stupid or crazy. Medicine bridges the gap between science and society.

Doctors are one important agent through which that scientific understanding is expressed. If not we, who?

Fear of the treatment itself can be a cause of denial. The treatment of cancers, for example, is never pleasant. It is fear of these proven, conventional treatments that sometimes leads people with treatable cancers to seek unproven or ineffective alternative therapies rather than the less pleasant but more effective conventional therapies. Often this is a fear that alternative medicine practitioners do little to alleviate and all too often exaggerate or spread false information. That is not to say that alternative medicine practitioners are the main reason for this fear (no doubt the fear would exist at nearly the same level if alternative medicine didn't exist), but some of them do exploit it.

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PARENTING

|

HOW TO TAL K TO YOU R C HIL D A B O UT M A R I J UA N A

HOW TO TALK TO YOUR KIDS ABOUT

MARIJU Parenthood is one of, if not the most challenging opportunities that God has afforded to the His highest creation — the human person. It’s an adventure and exceptional learning experience, one of those lessons being of course, how to maintain one’s sanity, and I honestly tip my hat to all responsible parents.

One occasion on which parenthood can be challenging is having that one-on-one talk with your child about the choices he/she makes today that can and will affect their life and yours later. One of those important topics is marijuana.

Marijuana, according to the National Alcohol and Drug Abuse Prevention Programme (NADAPP) Secretariat and the National Anti Drug Plan of Trinidad and Tobago, is the most widely used illegal substance in the country, and the leading drug of choice among the school and national population. Marijuana, a sedative and depressant when smoked or ingested, is considered a gateway drug to other harder drugs like crack cocaine and alcohol. It may also affect cognition in the long term. A large, long-term study in New Zealand showed that young people who began smoking marijuana heavily in their teens lost an average of 8 IQ points, their cognitive abilities not being fully restored in adulthood even if they stopped smoking.

44 | u

Dr. Sandra Reid, Senior Lecturer in Psychiatry at the University of the West Indies and Director of the Caribbean Institute on Alcoholism and other Drug Problems, was able to confirm marijuana’s adverse effects on the young mind, and include a few more important facts about this popular herb, and the parental treatment of it.

Q. What makes marijuana so harmful to children?

A. Apart from marijuana’s illegal status, the biggest concern a parent should have about its use is that it is a psychoactive drug, and affects the developing brain more negatively than the adult brain. Psychoactive drugs affect emotions and behaviour by activation of brain pathways that are concerned with the natural experiencing of pleasure.

Because of where in the brain the drug has its effect, regular or excessive marijuana use has the potential to be addictive and to negatively impact on a person's mental functioning. In a vulnerable adolescent brain that is still developing, the risk is greater.

Q. What are some of the signs of marijuana use in children?

A. Marijuana use among children and adolescents present more negative cognitive effects, like impaired decision-making and negative effects on rational thinking. These changes are also likely to become irreversible when use begins at a young age. The cases of motivational syndrome that I have seen were all among persons who began smoking before 18 years of age.

H OW TO TA LK TO YO UR C H I LD A B O UT M A R I J UA N A

JUANA Another area of marijuana use that has also not been highlighted is its potential to cause motor vehicle accidents. Everyone is aware that driving under the influence of alcohol can lead to motor vehicle accidents, but few persons recognize a similar connection between marijuana use and accidents.

Marijuana affects reaction time, judgment and coordination. In a young inexperienced driver, these impairments are more likely to result in motor vehicle accidents.

Q. How else does marijuana use affect children?

A. Marijuana use can result in severe panic attacks, psychotic breakdowns and addiction. In those who have a genetic risk of developing schizophrenia, one of the most severe mental illnesses, the use of marijuana by children and adolescents can trigger the onset of the illness.

Of great pertinence to children under 18 years, is the association between using marijuana and developing what has been described as the amotivational or demotivational syndrome.

Amotivational or demotivational syndrome can destroy the academic and professional potential of young persons. By its direct effect on the neurochemistry of the brain, in this syndrome, marijuana robs the young person of drive, initiative and passion.

Q. How should parents approach this topic with their child?

A. One sure way that the topic should not be introduced is to tell the young person not to use the drug. At the age when drug use begins, peer pressure and curiosity are powerful driving forces behind youthful behaviour. In fact these are the reasons most commonly given by youth for the initiation of marijuana and other drug use.

WRITTEN BY

|

PARENTING

CHARISSE BROOME

In addition, the illegal status of marijuana has not been a hindrance to its popularity and acceptability among certain peer groups and among the youth in general. The better approach to addressing any kind of risky behaviour among young persons is to educate and empower them to make sensible choices. The possible adverse effects of marijuana should be reinforced, even while acknowledging its popularity.

Data also demonstrates a similarity in the average age for the onset of cigarette and marijuana use — 15 years. Some begin before the age of 10 years. Conversations should therefore take place before the age of 15 years.

Q. What else should parents be aware of regarding marijuana use and their child?

A. Parents should also be aware that some youth use marijuana as a form of coping with adolescent stresses. The parents should therefore be vigilant about recognizing the challenges that their children might be facing, and this comes through the establishment of open lines of communication from a very early age. There should be discussions of the pros and cons of using marijuana to cope with stress and depression, as well as an exploration of healthier ways of coping with stress. Parents should also understand some of the other risk factors for marijuana use, including the need to feel accepted into a peer group, and coping with low self esteem.

Most importantly, parents should be sure that they model the behaviour that they expect from their children. Because of the prevalent use of marijuana in Caribbean societies, many parents omit to emphasize the illegal status of the drug.

A parent cannot effectively do this if he/she is a user of marijuana or appears to tolerate its use.

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THE NEXT U October to December

SELF DIAGNOSING HOW SAFE IS IT?

Antibiotics.

And tings we should know about.

Anti-persperants and deodorants.

Understanding the difference

Pomerac.

The juicy low calorie fruit of the islands

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