Central Carolina Health & Life - Fall 2009

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Central Carolina Hospital

Fall 2009

health&life T H E G O O D

L I V I N G

M A G A Z I N E

f r o m

C E N T R A L

C A R O L I N A

H O S P I TA L

What you don’t know about ‘healthy’ fast food KEEP YOUR CHILD GERM-FREE

Surgery helps a man enjoy holiday dinners

Plus Which pop remedies rea lly work?

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health&life

Contents

THE GOOD LIVING MAGAZINE from CENTRAL CAROLINA HOSPITAL

Central Carolina Hospital Staff CEO DOUG DORIS CFO

KERRY TOLLESON COO

KEVIN ZACHARY CNO

URSULA LAWRENCE CMO

RICK EBKEN, M.D. CHRO

TOM MACKLIN compliance & privacy officer

MISHELLE FRIAS director of business development

DANYL BUTLER director of marketing & public relations

MARGARET MINUTH

Central Carolina Hospital 1135 Carthage Street Sanford, NC 27330 Main Phone: 919-774-2100 Physician Referrals: 1-800-483-6385 www.centralcarolinahospital.com www.breastnavigator.com

WAINSCOT STAFF

Central Carolina Hospital

health&life

fall 2009

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Something to be thankful for

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Alphabet soup

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Sodium: What you need to know

editor in chief RITA GUARNA

Holiday dinners will be happy once more this year for one 66-year-old, thanks to surgery for diverticulitis. And laparoscopic techniques made his recovery speedy.

art director SARAH LECKIE

What do the different initials after clinicians’ names mean?

senior editor TIMOTHY KELLEY

managing editor JENNIFER CENICOLA

assistant editor KRISTIN COLELLA

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Don’t forget to check out this ingredient when you’re making a “healthy” fast-food choice.

Fad or fact?

Which of these 5 ballyhooed remedies actually work?

Central Carolina Hospital Health & Life is published by Wainscot Media, 110 Summit Avenue, Montvale, NJ 07645, in association with Central Carolina Hospital. This is Volume 1, Issue 2. © 2009 by Central Carolina Hospital. All rights reserved.

Material contained herein is intended for informational purposes only. If you have medical concerns, seek the guidance of a healthcare professional.

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Germs vs. your child

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In the news

We offer back-to-school advice for preventing illness.

Updates on staying well 3 big health stories—and what’s new since the headlines

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Don’t mix these 6 These combinations of foods, drugs and herbs spell trouble.

COVER IMAGE : MASTERFILE

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James Thomas can enjoy family holiday feasts once more, thanks to a surgical procedure he had early this year. And the laparoscopic method the surgeon used made his recovery speedy.

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SOMETHING to be thankful for HOLIDAY DINNERS WILL BE HAPPY ONCE MORE FOR THIS CAROLINIAN BECAUSE OF SUCCESSFUL LAPAROSCOPIC SURGERY FOR DIVERTICULITIS

LAST THANKSGIVING WAS A DAY TO REMEMBER FOR 66year-old James Thomas. His wife Valinda had prepared a wonderful meal for the family, but he was unable to enjoy it. “I couldn’t eat anything—I had no appetite,” says Thomas. It wasn’t the food, family or festivities that would be most memorable that day, but a trip to Central Carolina Hospital’s Emergency Room with severe stomach pain and a fever.

This wasn’t Thomas’ first time being treated for severe pain.

He had a history of diverticulitis and had been treated with antibiotics just 10 days earlier by his family physician. “The antibiotics had worked for me four other times, but not this time,” he recalls.

Diverticulitis is a swelling and inflammation of an abnormal pouch (diverticulum) in the intestinal wall. These pouches are usually found in the large intestine (colon). Diverticula are thought to develop as a result of abnormal pressure in the colon. High pressure Roger Ernest, D.O. against the colon wall causes pouches in the intestinal lining to bulge outward through small defects in the wall that surround blood vessels.

The ER physician performed a CT [computed tomography] scan of Thomas’ abdomen and called in general surgeon Roger Ernest, D.O., concerned about the possibility of a rupture in Thomas’ colon. Though there was no rupture, Thomas was admitted to the hospital for four days of IV antibiotics and bowel rest to see if the colon would begin healing. After discharge, he was placed on a strict low-residue diet. “I couldn’t eat anything ‘good,’” Thomas recalls. “I had to stick to pudding, yogurt and mashed potatoes—lots of mashed potatoes. I lost 23 pounds.”

Dr. Ernest referred Thomas to a gastroenterologist for additional tests. With the results of those tests and a previous colonoscopy, Thomas returned to Dr. Ernest to discuss his options. It was clear that his past treatment had provided only temporary solutions; the colon wasn’t going to heal on its own. And there was still the risk of the diverticula rupturing. Had they ruptured, Thomas would likely need emergency surgery requiring a

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completed laparoscopically. He was in the hospital only colostomy (in which the bowels would empty through four days. Dr. Ernest says he was the “perfect” patient: the abdominal wall into a bag).

“He was highly motivated to get better; he was in good Thomas had undergone six operations before, physical shape and he followed my post-op recommenranging from an appendectomy to neck surgery, but none dations, which enabled him to recover quickly.” of them had been performed by Dr. Ernest, who is boardIf a patient meets the criteria, Dr. Ernest prefers to certified in general surgery by the American Osteopathic do laparoscopic procedures. “It’s better for the patient, Board of Surgery. “I’ve never had a doctor as caring as he because recovery is usually quicker, the smaller incisions is, the way he looks after his patients,” says Thomas. mean less pain, and he or she is able to get up and be He and Dr. Ernest decided that his most approprimobile faster.” ate option was a hand-assisted laparoscopic surgery that Thomas was pleased with the outcome of his minwould remove the sigmoid colon. With this minimally imally invasive surgery. He received only four shots for invasive surgery, Dr. Ernest would make two small incipain in the hospital and had no sions of about one-half inch each on Thomas’ abdomen— The laparoscopic difference other pain medications from then on. “Another benefit of laparoone above his navel and one to scopic surgery is that fewer narthe left. These would be the cotics are typically needed,” says Dr. sites/ports where the tiny camera Ernest. “Narcotics slow down the gas(laparoscope) and surgical instrutrointestinal system, and after surgery, ments would be inserted. A third we keep patients in the hospital until incision about 4 inches long their bowel function returns to norwould be made horizontally along mal. Fewer narcotics mean the GI his pelvic line. Dr. Ernest would system returns to normal faster, and insert his hand at this incision to the patient can go home sooner.” remove the part of the colon that As a semi-retired, selfhad caused Thomas so much employed electrician, Thomas is pain. “Laparoscopic procedures active and enjoys deer hunting, fishmean smaller incisions than ing and spending time with his family ‘open’ surgeries,” Dr. Ernest says. and his friends from church. He had There is always a chance the ability to be flexible with his time, with any laparoscopic surgery that but his illness had interfered too an “open” procedure will have to much with his quality of life. “I may be performed instead, requiring a be retired, but I like to work, and I roughly 10-inch incision made had missed a lot of work,” he says. “I vertically along the abdomen feel great now. I can eat anything, above, around and below the and I’m enjoying having things back navel. “It’s a much larger incision to normal.” with an ‘open,’” Dr. Ernest says.

Thomas looks forward to “And that usually means a longer Thanksgiving this year with this wife recovery time and more discomfort of 42 years, his daughter and son, for the patient. With a laparofive grandchildren and his nephews. scopic procedure, the hospital stay And as part of his holiday meal, he is about three to five days instead plans to enjoy his wife’s mashed of the six to seven days required Traditional “open” surgery requires the long potatoes—all the more because with the open surgery.” vertical incision shown in the top drawing. The they’re no longer the only kind of Fortunately, Thomas’ Janlaparoscopic method uses the smaller incisions in food he can eat. ■ uary 26 surgery was successfully the second image. Result: quicker recovery.

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a Doctor of Dental Medicine (DMD) and Doctor of Dental Surgery (DDS) can perform this and other general dentistry procedures because the two degrees are exactly equivalent. The title simply varies among dental universities.

NONPHYSICIAN PROVIDERS: P.A. VS. N.P. Both physician assistants

(P.A.s) and nurse practitioners (N.P.s) have graduate degrees and perform many services once reserved for physicians. P.A.s work with a physician on the premises; they can prescribe medications, examine patients and even assist in surgery. N.P.s, usually found in primary care, have more potential independence—unlike P.A.s, they may practice by themselves, and North Carolina law lets them prescribe under a physician’s supervision. Of course, complex conditions should be seen by a doctor.

EYE DOCTORS: OPTOMETRIST VS. OPHTHALMOLOGIST These

Alphabet soup YOU TRUST YOUR FAMILY’S CARE TO THESE PROFESSIONALS—BUT DO YOU REALLY KNOW WHAT THOSE LETTERS AFTER THEIR NAMES MEAN? HERE, A PRIMER

ALAMY

PHYSICIANS: M.D. VS. D.O. Both Doctors of Medicine

(M.D.) and Doctors of Osteopathic Medicine (D.O.) are fully licensed physicians—they simply differ in philosophy. M.D.s treat specific symptoms and diseases using modern remedies; D.O.s (just 6 percent of all U.S. physicians) focus on the body as a whole and are trained to use hands-on “manipulative” therapy to ease pain and promote healing, in addition to conventional treatments.

DENTISTS: DMD VS. DDS Need a cavity drilled? Both

doctors differ in education and scope of services. Optometrists (O.D.s) attend a four-year college of optometry and provide primary eye care (giving eye exams, diagnosing some eye diseases and visual conditions, prescribing eyeglasses, performing minor eye surgery), while ophthalmologists are medical-school graduates (M.D.s or D.O.s) who provide total eye care, from eyeglass prescriptions to surgery.

Often ophthalmologists and optometrists work in the same practice, where optometrists handle more basic care while ophthalmologists tackle more complicated procedures.

FELLOWS This label can be confusing, as it has two meanings. The first is a title given by a society or college to physicians who have passed a rigorous evaluation.

Common designations include FACS (Fellow, American College of Surgeons) and FACC (Fellow, American College of Cardiology). The second refers to doctors who have completed their residencies but are in the midst of undergoing more-specialized training: a general surgeon training to become a vascular surgeon, for example. ■

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SODIUM:

what you need to know TOO MUCH OF THIS COMMON FOOD INGREDIENT CAN CAUSE HIGH BLOOD PRESSURE

WE HEAR A LOT ABOUT THE DANGERS OF too much fat or sugar, but we sometimes neglect the hazards of excessive salt, or sodium. To explain the role of sodium in the diet—and the importance of limiting sodium for some people—Central Carolina Health and Life spoke recently with board-certified cardiologist Lukas Jantac, M.D., of Central Carolina Hospital: CCH&L: How much sodium should we consume daily?

DR. JANTAC: Sodium is a necessary mineral to build muscles and nerves and to absorb nutrients. However, too much sodium can contribute to high blood pressure, or hypertension. If you’re on a regular diet, the American Heart Association recommends that you limit your sodium intake to less than 2,300 milligrams per day (the equivalent of 1 teaspoon of salt). For those who need to restrict their sodium intake, the AHA recommends less than 1,500 mg Lukas Jantac, M.D. per day (slightly more than 1⁄2 tsp of salt).

You should not exceed 600 mg of sodium per meal.

CCH&L: How does sodium affect blood pressure?

DR. JANTAC: When you ingest sodium, it is absorbed into the bloodstream through the digestive system.

Increased sodium intake increases the blood volume and requires the heart to pump blood harder to all the tissues in the body. Sodium also reduces the amount of blood that goes back into the heart by restricting the blood vessels, or arterioles. Arterioles regulate blood pressure and flow by 8

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dilating and constricting, but excessive sodium is believed to decrease blood movement and add pressure to vessel walls, thus increasing the blood pressure. Research suggests that people’s sensitivity to sodium varies by age, genetics, weight and resting heart rate.

CCH&L: What is considered a “normal” blood pressure?

DR. JANTAC: Normal is 120/80 milligrams per deciliter.

Readings between 120/80 and 139/89 are labeled prehypertension, while those of 140/90 or above are deemed high blood pressure. People with blood-pressure readings of 150/100 or above should be seen by a physician.

CCH&L: What is considered low-sodium?

DR. JANTAC: Many foods naturally contain sodium— for example, meats, nuts, grains, fruits, vegetables and dairy products. But prepared and processed foods have added sodium as a preservative. If you look at labels, you will see many different terms describing the sodium content in prepared foods: sodium-free, low-sodium, reduced sodium or “unsalted.” Here are a few definitions: • Sodium-free or salt-free: less than 5 mg sodium per serving • Very low sodium: 35 mg or less per serving • Low sodium: 140 mg or less per serving Foods labeled as reduced sodium or “unsalted” may very well surpass 140 mg, so you should read the labels carefully before adding them to your meal plan. Remember too that some over-the-counter medications and prescription drugs contain sodium, so if you are limiting your sodium intake, check the labels or ask your pharmacist.

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The sleeper in fast food TAKE THE QUIZ BELOW AND LEARN HOW MUCH SODIUM YOUR NEXT ‘HEALTHY’ LUNCH MAY BE HIDING

LET’S SAY YOUR DOCTOR HAS TOLD YOU TO go on a low-sodium diet. That means you’re trying to stay under 1,500 milligrams of sodium per day (or under 600 mg per meal). You’ve had a good breakfast, but now it’s lunchtime, and you’re hungry. You need something quick to eat right now. So you enter the fast-food world of convenient gastronomy. You figure, “I’ll just go to [enter your favorite fast-food restaurant name here] and get a salad with grilled chicken.” But is that really the healthy option?

You may be surprised. It turns out that while menu items promoted as healthy may indeed be lower in calories, fat and carbs than other options, they’re sometimes loaded with salt. Think back: When have you heard fast-food commercials talk about their foods’ low sodium content? Finding a nutrition guide at a restau-

rant can be difficult, so we’ve prepared this quiz to see if you can guess which foods are truly better options.

Rank these items from lowest (#1) to highest (#4) in sodium content, and then turn the page for the answers —and some useful tips on watching your lunchtime sodium intake.

______ Wendy’s Mandarin Chicken Salad with Oriental Sesame Dressing

______ McDonald’s Chicken Selects Premium Breast Strips (3 pieces)

______ Burger King Tendergrill Chicken Sandwich

______ Hardee’s Low-Carb Charbroiled Chicken Club Sandwich

continued

25 secrets for healthy flavor Watching your sodium? Never fear—there are many ways besides salt to make a meal tastier. Don’t limit yourself to just one spice; explore wonderful gastronomic pleasures by combining some of the elements below to create different taste combinations, such as fruity and hot, sweet and sour, tart and spicy.

balsamic vinegar, dark and white

ginger, grated fresh

onion flakes, dehydrated

herbs, fresh chopped (basil, dill, thyme, rosemary, tarragon, mint)

orange zest

candied ginger, chopped carrot, grated

horseradish

celery seed

juniper berries

chipotles, flaked

lemon juice

roasted red peppers (roasted at home)

curry leaves

lemon zest

seeds of paradise

lime juice

sesame seeds

lime zest

vinegars, flavored

mustard seeds, yellow, black

wasabi powder

nuts (salt-free), finely chopped

pepper, fresh cracked red pepper flakes

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Quiz answers and strategies for limiting sodium Here’s how sodium content ranks in the four fast-food choices in our quiz on the previous page. You’ll note that the target of 600 milligrams per meal is one all four entrants miss by a mile. (Nutritional information retrieved from the nutritional guide on each restaurant’s web page.)

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1,010 mg sodium: McDonald’s 3-piece Chicken Selects Premium Breast Strips

23 g carbs); www.mcdonalds.com The

(400 calories, 24 grams fat,

McDonald’s menu has

some seemingly healthy options, with salads and grilled-

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1,250 mg sodium: Wendy’s Mandarin Chicken Salad with Oriental Sesame Dressing (550 calories, 25.5 g fat, 49 carbs); www.wendys.com

Each of the four Wendy’s

salads exceeds 1,000 mg of sodium, with the Oriental second

chicken options, but even though they appear to be lower

only to the Chicken Caesar. The chicken and the dressing are

in calories and fat grams, there’s quite a bit of hidden sodi-

again the main sources of sodium. If you need dressing, the

um. The trick is to find out where you can cut sodium.

Fat-Free French has only 170 mg sodium (70 calories, 0 g

Compare the 3-piece Chicken Breast Strips with the 4-piece

fat, 17 g carbs). It may surprise you that the baked potato is

Chicken McNuggets. The fried nuggets are actually a better

a reasonable alternative. Its 270 calories, 0 g fat, 61 g carbs,

choice, with fewer calories (190) and less fat (12 grams),

and 25 mg sodium for a 10-oz. spud are pretty low for fast

carbs (11 g) and sodium (400 mg)—provided you don’t use

food. If you opt for the Sour Cream & Chive potato, it’s still

dipping sauce.

a reasonable choice (320 calories, 3.5 g fat, 63 g carbs, and

Then there are the salads: Hold the butter garlic croutons! They add 140 mg sodium in just a ⁄2-oz serving.

1

50 mg sodium).

(Creamy Southwest) to 730 mg (Low-Fat Balsamic

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Vinaigrette) sodium, depending on what flavor you select.

their waistlines. The chain’s nutrition guide lists fewer healthy

Instead, use only half the packet or bring your own low-sodium

options than other fast-food restaurants. The closest item to

dressing. It’s not too convenient carrying around a big bot-

a salad here is a “small serving” of cole slaw with 140 mg

tle of salad dressing in your car, so here’s an idea: Mix your

sodium. A healthier lunch alternative to the Low-Carb Char-

salad dressing at home and carry a reasonable portion in a

broiled Chicken Club Sandwich is a Small Hamburger with

snack-size zipper plastic bag. If you can go without chicken

140 calories, 15 grams fat, 32 g carbs, and 500 mg sodium. ■

The salad dressings are also a high-sodium culprit. A packet of Newman’s Own salad dressing adds from 340 mg

1,290 mg sodium: Hardee’s Low-Carb Charbroiled Chicken Club Sandwich www.hardees.com

(360 calories, 23 g fat, 14 g carbs);

Just watch a Hardee’s commercial and

you can guess that they don’t target consumers who watch

and dressing, the Premium Southwest Salad has only 140 calories, 4.5 g fat, 20 g carbs and 150 mg sodium. Another reasonable alternative is the Fruit ’n Yogurt Parfait with gra-

Other fast-food choices in Sanford

nola (160 calories, 2 g fat, 31 g carbs, 85 mg sodium).

A rule of thumb for fast-food restaurants in general? The sal-

1,220 mg sodium: Burger King Tendergrill Chicken

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ads can be a reasonable option if you hold the chicken and

Sandwich (490

use your own low-sodium dressing. Oddly, the fried chicken

calories, 21 g fat, 51 g carbs); www.bk.com

Would you believe that at Burger King, a Triple

options had slightly less sodium than the “healthier” grilled

Whopper sandwich with mayo has less sodium (1,170 mg)

counterparts. Here are some other lower-sodium options

than a grilled chicken sandwich? Perhaps typical of a trend

(under 600 mg) at some of Sanford’s fast-food restaurants—

in fast food, the grilled chicken has a high sodium content,

provided that you don’t add any condiments or cheese,

nearly exceeding the daily total suggested intake for people

“supersize” or order a side dish:

watching their sodium. A 5-piece Crown Shaped Chicken

• Sonic Corn Dog—530 mg sodium (210 calories, 11 grams

Tenders has less than half the sodium at 380 mg, and it is not

fat)

a bad choice if you’re also watching calories, fat and carbs

• DQ Grilled Chicken Wrap—450 mg sodium (200 calories,

(230 calories, 13 g fat, 16 g carbs). Surprisingly, a pair of BK

12 g fat)

Burger Shots is another possibility (220 calories, 10 g fat, 18 g

• KFC Grilled Chicken Breast—440 mg sodium (180 calories,

carbs, 420 g sodium).

4 g fat) or Drumstick—200 mg sodium (70 calories, 4 g fat) • Bojangles Cajun Filet Sandwich, no mayo—401 mg sodium (337 calories, 11 g fat) or a Cajun Spiced Thigh—465 mg sod-

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ium (310 calories, 23 g fat)

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by Kristin Colella

Fad

or fact?

THESE 5 BALLYHOOED REMEDIES ARE ALL THE RAGE, BUT DO THEY REALLY LIVE UP TO THEIR CLAIMS?

1. Probiotic yogurts What they are: While all yogurts are made

with active cultures, those labeled probiotic contain additional strains of “good” bacteria. Some varieties, such as Dannon’s Activia, claim to regulate the digestive system; others, such as Stonyfield Farms’ yogurt, also claim to boost the immune system.

Do they work? Maybe. Research results have been mixed. “Most studies haven’t shown strong benefits, though some have suggested that the yogurts help prevent antibioticassociated diarrhea and may relieve constipation,” says gastroenterologist Josh Korzenik, M.D., co-director of the Crohn’s and Colitis Center at Massachusetts General Hospital in Boston. “We still have a lot to learn.”

2. Colon cleanses

ALAMY; ISTOCK; JUPITER IMAGES

What they are: Centered on the theory that toxic waste

can build up in the colon, these cleanses are intended to empty the colon of its contents to promote wellness.

They’re available in a variety of forms, including laxatives, teas, enemas and colonic irrigation, a procedure in which water is injected into the rectum through a tube to flush out fluids and waste.

Do they work? No. “There’s no good scientific research showing that colon cleanses bring therapeutic benefit,” says gastroenterologist Gerald Friedman, M.D., clinical professor of medicine at Mount Sinai School of Medicine in New York. That’s likely because the colon naturally cleans itself of impurities.

3. Neti pots What they are: Looking

like a cross between a teapot and Aladdin’s lamp, a neti pot supposedly works magic in relieving congestion, facial pain and pressure. To use, fill the pot with lukewarm water and 1⁄2 teaspoon of salt, then tilt your head and pour the solution into one nostril at a time, letting the fluid flow through the nasal cavity into the other nostril.

Do they work? Yes. Says Alexander Chiu, M.D., associate professor of otorhinolaryngology at the Hospital of the University of Pennsylvania in Philadelphia: “The saline solution helps thin out mucus and cleanse the nasal passages, relieving congestion and helping with overall sinus health.”

4. Ear candling What it is: A long cone made of waxed cloth is inserted

into a person’s ear, then lit at the opposite end. Proponents say the heat creates a vacuum effect that removes excess debris and earwax.

Does it work? No. “There’s no scientific evidence showing that it’s effective,” says otolaryngologist Tom Abelson, M.D., medical director of the Cleveland Clinic Beachwood Family Health Center in Beachwood, Ohio.

“And there have been reports of ear candling causing injuries, since the melted wax can scar the eardrum.”

5. Antibacterial hand gels What they are: These absorbable gels, such as Purell’s

Instant Hand Sanitizer, are marketed as an effective way to disinfect your hands when soap and water are not available.

Do they work? Yes. As long as alcohol is an active ingredient, antibacterial hand gels are just as effective in killing germs as soap and water, says William Schaffner, M.D., chair of the Department of Preventive Medicine at Vanderbilt Medical Center in Nashville. “They’re an excellent option if you don’t have access to a sink,” he says. ■

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Health

Watch

Germs vs. your child

BACK-TO-SCHOOL ADVICE FOR PREVENTING CONTAGIOUS ILLNESS

WHERE KIDS CONGREGATE, SO DO GERMS. SO you wonder as your children begin a new school year: How can a parent protect them? And the concern is greater than usual this year, with the H1N1 virus (formerly known as swine flu) presenting a new threat whose dimensions even the experts don’t know for sure.

According to Pascale Wortley, M.D., an epidemiologist and immunization specialist at the Centers for Disease Control and Prevention, children who have never had a flu shot before may require as many as four flu shots this fall—two to combat H1N1 and two for the usual seasonal flu.

But while H1N1 grabs the headlines, don’t forget to check with your pediatrician to make sure your children are up to date on all recommended immunizations—including the four relatively new ones described in the article below.

Also, children should be trained (and teens reminded) to wash their hands frequently and avoid drinking from a friend’s water bottle, rubbing their eyes with dirty fingers (to steer clear of conjunctivitis, or pinkeye) or sharing personal items such as combs (to protect against impetigo, a bacterial infection of the skin, and head lice). ■

Besides flu shots, don’t neglect these 4 Consult your pediatrician about getting your child the

receive prophylactic antibiotics.

influenza vaccinations he or she needs this fall—for the

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seasonal flu as well as the much-discussed H1N1 virus.

A TETANUS BOOSTER SHOT THAT PROTECTS AGAINST PERTUSSIS. The old childhood disease

Also, don’t forget to ask about these four vaccines,

whooping cough, or pertussis, has made a small come-

added to the recommended roster in recent years:

back in recent years. For that reason, the tetanus booster

1

THE MENINGOCOCCAL VACCINE. In the past, vac-

given at 11 or 12 now also includes protection against

cination for bacterial meningitis was suggested only

whooping cough.

in the summer before college; today, an improved con-

3

jugate vaccine is recommended at age 11 or 12, and

THE HUMAN PAPILLOMAVIRUS VACCINE. This shot is now recommended for 11-year-old girls to

protect against four types of the human papillomavirus,

However, parents should understand that though the

or HPV, a common virus that has been linked

vaccine is effective against four types of meningitis, it

to the development of cervical cancer.

doesn’t work on meningitis B, which accounts for about

4

one-third of cases. If there’s a meningitis outbreak, it may

THE ROTAVIRUS VACCINE. This one’s for the younger siblings of your back-to-school brood, to

not be clear which type of the disease is involved, and

protect babies against a bug that causes gastroenteri-

even students who have been immunized may need to

tis and severe diarrhea. It’s given at 2, 4 and 6 months.

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EDWARD POND/MASTERFILE

vaccination has helped to make the deadly illness rarer.

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In the news

Updates on staying well A LOOK BACK AT 3 TOP HEALTH REPORTS OF RECENT MONTHS— PLUS WHAT’S HAPPENED SINCE THE MEDIA SPOTLIGHT FADED

A promising cancer drug Background: Among people who carry the BRCA1 and BRCA2 gene mutations, the risk of certain malignancies—breast, ovarian and prostate cancers—is drastically increased. But a new class of drugs has been stirring excitement as a potential breakthrough. Known as PARP inhibitors, the drugs work by blocking the production of PARP, a protein that both healthy and cancer cells use to repair themselves.

What’s new: Olaparib, one PARP inhibitor

CLOCKWISE FROM TOP LEFT: CORBIS, PHOTOTAKE; SHUTTERSTOCK

Swine flu

tested in a recent study of cancer patients with

Background: After a frenzied arrival in the spring, the swine flu

the BRCA mutations, has shown effectiveness.

virus (or H1N1) spread to more than 70 countries, prompting the World Health Organization to declare it a global pandemic in June.

Though most sufferers recover without needing medical treatment, by late July the flu strain had contributed to 302 deaths in the U.S. What’s new: The government partnered with private manufacturers to create a vaccine that may control the virus. At press time, researchers were testing the vaccine’s safety and effectiveness by administering it to volunteers across the country, with hopes of releasing it by mid-October—a breakneck speed for this process. And officials were keeping a close eye on flu season in the Southern Hemisphere, where H1N1 seemed to be elbowing aside the usual seasonal flu—a possible preview of the coming winter in the U.S. Meanwhile, health professionals suggest frequent hand washing and avoidance of touching the eyes, nose and mouth as the best protection.

The drug shrank tumors in those with breast, ovarian and prostate cancer, causing only mild side effects. Two studies reported in June at the American Society of Clinical Oncology’s annual meeting seemed promising: In one, 41 percent of females with advanced breast cancer saw their tumors disappear after taking PARP inhibitors. In the other, combining PARP inhibitors with chemotherapy reduced patients’ risk of dying from the disease by about 60 percent and lengthened patients’ survival more effectively than did standard chemotherapy.

CONTAMINATED peanut butter Background: Nine died and hundreds were sickened earlier this year by a salmonella outbreak in peanut butter that spurred one of the largest product recalls in U.S. history.

This most-recent outbreak again cast a critical light on our government food-safety system.

What’s new: In July, the Obama administration announced plans to implement new regulations: To start, the government plans to battle E. coli by ramping up beef inspections, establish stricter testing and refrigeration rules to reduce salmonella in eggs and create new positions at FDA and the Department of Agriculture overseeing food safety.

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Don’t mix these 6 A HALF-DOZEN COMBINATIONS OF FOOD, DRUGS AND HERBS ARE MUSTS TO AVOID. HERE’S WHY o your habits hold hidden hazards? Could be, if you’re mixing certain foods,

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drugs and herbal remedies that can interact dangerously in your system. Here

are six such combinations you should shun, and the reasoning behind each. And remember: Keep your primary care doctor informed about all medications and herbal remedies you take regularly.

1 Grapefruit + Lipitor

Grapefruit may boast myriad nutritional benefits, but its interaction with the cholesterollowering medication Lipitor isn’t so sweet.

Grapefruit products, including the fruit, grapefruit juice and grapefruit supplements, are believed to slow the activity of the enzyme the body uses to metabolize Lipitor. Consequently, Lipitor levels in your blood may soar, increasing your risk of developing myopathy, a neuromuscular disease characterized by muscle weakness, and rhabdomyolysis, a condition in which the muscle fibers break down and kidney failure sometimes ensues.

2 Warfarin + Dong quai

The Native Americans first discovered the medicinal powers of echinacea centuries ago, utilizing the spinycentered flowering plant to treat infections and wounds.

Today echinacea is sold as an herbal supplement to alleviate cold and flu symptoms and help the body fight infection. But because of its powerful ability to boost the immune system, avoid echinacea if you’re taking drugs intended to inhibit immune function, such as cyclosporine (Neoral, Sandimmune, Gengraf) and corticosteroids (Kenacort, Medrol, Deltasone), because the herb may block the medications’ effect.

5 Digoxin + high-fiber foods

Though they’re touted for their ability to lower cholesterol and reduce the risk of heart disease, high-fiber foods such as oatmeal and bran muffins should not be consumed in large quantities if you’re taking Digoxin, a medication that regulates heart function. Fiber may impair the body’s ability to absorb Digoxin into the bloodstream, diminishing the drug’s effectiveness.

3 MAO inhibitors + tyramine

If you’re taking MAO inhibitors (brand names Nardil, Parnate, Marplan), an older class of antidepressants used to treat atypical depression, steer clear of Chianti wine, chicken liver, aged cheeses and other foods and beverages containing high levels of tyramine to avoid a hypertensive crisis. Here’s why: MAO inhibitors work by blocking monoamine oxidase, the enzyme that also metabolizes tyramine.

With monoamine oxidase suppressed, tyramine levels in the body can build up and increase blood pressure to potentially fatal levels.

6 Theophylline + caffeine Attention asthma sufferers: If you’re taking theophylline (Elixophyllin, Uniphyl, T-Phyl), a prescription medication that relaxes and narrows the airways, rethink those ’round-the-clock cups of tea and coffee. Theophylline and caffeine are so closely related—they both belong to the xanthine family and bear a similar chemical structure—that consuming caffeine products in large quantities with theophylline can overload your system, triggering toxic effects such as nausea, vomiting, rapid or irregular heartbeat and jitteriness. ■

CLOCKWISE FROM TOP LEFT: AMLET; STOCKBYTE/ALAMY; ALESSANDRO D’ESPOSITO

You’ll find Dong quai, a traditional Chinese medicinal herb, in a host of women’s supplements to relieve menstrual cramps, ease menopausal symptoms and regulate periods. But if you’re taking warfarin (Coumadin, Jantoven), a blood thinner prescribed to prevent heart attack and stroke, consuming Dong quai simultaneously can increase your risk of bleeding because of the herb’s blood-thinning effects.

4 Echinacea + immunosuppressant drugs

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