Wednesday, October 10, 2007
Mind body relationship and stress
As a neurosurgeon, I have long been fascinated by the real link between the mind and the body. I guess intuitively we have known for some time that there is an obvious connection, but now scientists are putting more energy and resources toward studying it than ever before. From time to time, I blog about things I've found particularly interesting in this arena, and a story today caught my eye.

There is a negative relationship between workplaces stress and your heart health. Ok, so you already knew that one. But, researchers in Canada decided to take it a step further. They studied nearly a thousand men and women who returned to work after having a heart attack. They were followed for the first six weeks after their return, and then again two years later. They found that people who reported chronic job strain were twice as likely to have another heart attack. Twice as likely! Now, in case you're curious (I was) as to what constitutes job strain, the researchers specifically defined it as high psychological demands with low decision control.

Adding more evidence to the link between workplace stress and heart health was another study that more heart attacks and cardiac events occur on Monday, as compared with any other day. And, apparently, it's not just the workplace that can have a negative impact on your health. While marriage can be good for your health, it is important to be more specific. It's more accurate to say a "good marriage" can be good for you health, and a bad marriage can be awful for your heart. In fact, another study showed hostile, angry relationships can boost the risk of heart disease by 34 percent, as compared with people who are on good terms with their spouse.

No question, stress and the associated effects of cortisol and high blood pressure can be a killer. We are seeing more evidence than ever about this relationship. On the other hand, being able to mitigate stress and the perception of stress can be significantly advantageous. Do you have any of your own stories of the mind/body relationship?
Tuesday, October 09, 2007
Fighting presenteeism
A voice from the hallway said, "Hold the elevator."

We did. On reflection, perhaps we made the wrong choice.

A man with weepy eyes and a runny nose got on. Sneezing, he looked like death warmed over.

A few days later, my throat was scratchy, my body achy and I was sneezing constantly. I looked like death warmed over... but wearing fuzzy slippers.

Now I have no way of knowing for sure whether the elevator "germ man" got me sick. And before my mom calls, let me say I know it is not nice to call people names, but it is hard to be compassionate when you feel dizzy every time you stand up. Fortunately, the fever has passed. But my opinion is still the same: I am sick (yes, pun intended) and tired of people coming to work ill when they should be at home recuperating.

You might wonder why I am downright evangelical about this topic. I use to be just like the "germ man." My conversion happened a few years back when I developed a pinched nerve in my neck. A supervisor made me feel guilty for calling in sick. (Apparently MY pinched nerve was an inconvenience for HER.) So, high as a kite on pain pills, I worked. And I seethed. Perhaps it was the influence of the drugs, but I had an epiphany: Sick days exist for a REASON. From that point, I vowed to stand my ground when I was sick.

Staying home when you are sick is not only the best thing for you, but also your company. According to a study released last year, "presenteeism" is a growing concern for businesses. When people come to work sick, they are less productive and are likely to infect co-workers. Interestingly, the study also found that companies with low morale also have more ill workers showing up for work.

With flu and cold season quickly approaching, I want to know what you think. Is "presenteeism" a problem at your office? Do you feel obligated to work even when you are sick? And if so, why?

I look forward to reading your responses. In the meantime, I need to grab some disinfectant. I just heard someone sneeze.
Monday, October 08, 2007
Are Tasers safe?
"Don't tase me bro!"

After University of Florida student Andrew Meyer was subdued last month at a Senator John Kerry event, (Watch Video) CNN and other media outlets played the video over and over again. And we were all fascinated by CNN's own correspondent/anchor Rick Sanchez getting Tasered a few years back. (Watch Video) In a classic report, Sanchez stands ready in front of police officers, gets Tasered, and his knees buckle. Just a few seconds later he continues with his report. For good or bad, I can't help but stare when someone gets Tasered. More importantly, I can't help but wonder how safe could a Taser be?

Law enforcement uses Tasers to immobilize people. Taser devices use compressed nitrogen to shoot two probes at a speed of over 160 feet per second at a range of 15 to 35 feet. An electrical signal sends a current through the probes rendering the immediate loss of a person's neuromuscular control for the duration of the impulse. "Typically a Taser can pack 50,000 volts, when it actually makes contact with a person 1,200 to 1,300 volts pulse through the body," says study author Dr. William Bozeman. A shock of just a half a second causes intense pain and muscle contractions. The manufacturer says that recovery is instantaneous, and long-lasting side effects are rare. This new study contends that most injuries are related to the fall to the ground, not the actual electrical current of the Taser itself.

A new study out of Wake Forest University School of Medicine finds that Tasers are relatively safe. Tactical physicians (doctors who work with SWAT teams) looked at 1,000 cases of law enforcement use of Tasers in six locations around the country. They found that 99.7 percent of the cases had mild injuries, such as scrapes or bruises, or no injuries at all. In the study, only three people suffered severe enough injuries to be sent to the hospital. Of those, two had injuries from falling immediately after being Tasered. The third person was admitted to the hospital two days after being Tasered, but researchers says it is unclear whether the hospitalization had anything to do with being Tasered. It's important to note that the new study followed patients only if they had to be hospitalized or needed follow-up care from initial injuries. There was no long term follow-up with all of the patients. The study was funded by the National Institute of Justice, but researchers say that the study was independently designed and conducted.

Amnesty International points out more than 245 people in the United States have died, many from cardiac arrest after being shocked with Tasers. Amnesty and other groups call for more investigation into how dangerous these devices may be. The Wake Forest researchers acknowledge that there have been roughly 270 people who have died in police custody after being Tasered, but they say that there is no clear evidence that the deaths can be attributed to Tasering or other causes.

Do you think tasers are safe? Have you or anyone you know ever been Tasered?
Friday, October 05, 2007
Kids and Drinking Revisited
I am a child of the "Just Say No" generation. My junior high school had a "No Team," and I was an officer. We took a pledge to not drink alcohol, use drugs or have sex. At the first "No Team" meeting, a heated debate ensued as we discussed whom to select as our honorary chairman. The two top contenders were Mr. T and Nancy Reagan. I rallied for Mrs. Reagan. In my junior-high earnestness, I tried to convince my fellow "No Teamers" that Mrs. Reagan would give our group integrity and a dash of panache. After much debate, Mr. T was selected. Over 20 years later, I still think Mrs. Reagan should have won.

I thought about the "No Team" when I sat down to talk with Stanton Peele. He is the author of "Addiction-Proof Your Child." A psychologist, Peele argues that the American "Just Say No" culture surrounding teen drinking actually encourages kids to binge drink. He says parents should let their kids drink at home, but in moderation. When Peeleā€™s children were in their early teens, he allowed them to have a sip of wine or beer. By the time his children were in high school, they were allowed to have a glass of wine or beer with dinner.

Critics say that Peele is flat wrong and that teens are not psychologically or physically mature enough to drink, period. The response to Peele's story (Full Story) has been passionate and provocative. Many CNN.com readers have weighed in. Says Don, "This is as stupid as 'safe' sex. The smart answer is abstinence." Another reader, Andrew, says, "One simply needs to look at the numbers between Canada and the U.S. ... It's "madd" (pun intended) to have a forbidden fruit attitude. If the U.S. finally got out of the dark ages on the issue, we wouldn't have nearly the problem."

We want to know what you think. Should the U.S. lower the drinking age? Do you think kids drink more now than they did in previous generations? Also, what about "social hosting"? Do you think it is safer to have kids drink at home? If you are a parent, would you ever allow your child to have a party in your home that involves alcohol? You can hear more from Peele and his critics tonight on "Out in the Open" tonight at 8 ET.
Wednesday, October 03, 2007
Concussions and girls
When you think of high school sports concussions, whom do you envision getting banged up? Usually it's a strapping young football player - a male - isn't it?

But in sports that both girls and boys play such as basketball and soccer, girls are more likely to suffer these dangerous brain injuries - more than 1 1/2 times in basketball and almost three times more likely in soccer. That's according to a new study published in the Journal of Athletic Training, which looked at high school students at more than 100 schools nationwide. And, girls take much longer to recover and get back on the field than boys do.

What I find even more intriguing are the possible explanations behind the surprising stats. On one hand, researchers point to biophysical phenomena - for instance, the fact that boys have stronger neck muscles and larger heads than girls, so they can tolerate stronger blows.

But there is also a sociocultural explanation: The suspicion that girls tend to report their concussion symptoms more than boys, and boys hold back when they may be feeling a bit dizzy or nauseated because they want to be tough and keep playing, despite the potential long-term dangers of getting hit again too soon. (By the way, those possible dangers are no joke: repeated concussions can lead to long-term loss of cognitive function and memory loss.) And as far as returning to the field - coaches, athletic trainers and parents tend to be more cautious about letting girls back on to the court or field, more so than with their male counterparts.

So what do you think? Does it seem more plausible that girls are more protected (by themselves and others), and that boys are allowed to be more aggressive and less cautious about these injuries? Or do you think it's just a physical thing? Or both? Or something else altogether?
Tuesday, October 02, 2007
Panic attack may lead to another kind of attack
Most people know intuitively that our psychological well being and physical well being are connected, but it is pretty hard to prove. Sure, depression, anger, hostility, even "Type A" behavior are linked with physical health problems, but no one is exactly sure why. It could be that stress hormones are released in such high concentrations that they negatively impact the heart. It might simply be that people who are susceptible to those behaviors also are more likely to skip doctor's appointments and engage in higher-risk behavior.

Still, a new study in a publication from the Journal of the American Medical Association caught my eye today (Full Story). After studying post menopausal women who had heart attacks or strokes, something interesting emerged as a potential cause. Researchers found that having just one panic attack seemed to increase the risk of future heart attack or stroke by threefold over the next five years (Full Study). That's right, just one panic attack, and it could have a devastating physical consequence down the road.

To be fair, the absolute risk of heart problems or stroke remains low. So a panic attack may increase your risk from 1 to 3 or 4 percent. Still, it really makes you think - if you are having a psychological meltdown, what exactly is it doing to your body?

Sometimes, it is hard to even tell the difference between a panic attack and a heart attack. The symptoms of panic attack might be chest pain, shortness of breath, dizziness, trembling, sweating or a feeling of choking. The signs of a heart attack might be the same, and the only way to tell the difference is to get checked in a hospital. So, how do you avoid a panic attack in the first place? Sometimes it is easier said than done, given that most of us are at risk of having at least one in our lifetime.

Have any of you experienced a panic attack? What do you think the relationship is between the mind and the body?
Monday, October 01, 2007
Alcohol linked to breast cancer?
I've been with women at every stage of breast cancer - from the disbelief at the diagnosis... to sitting with a single mom in the office of a patient navigator amid a sea of insurance claims and bills... to struggling to connect the dots on being out of work, chemo and child care. And I have been with women in end-stage breast cancer who have that "look"- an almost otherworldly mix of resignation, wisdom and fear. All wonder - why me?

Provocative new science adds booze - with an exclamation point- to that list of "what could have gone wrong."

Kaiser Permanente researchers looked at data on more than 70,000 women, and found that if a woman drinks just one or two alcoholic drinks a day, she's increasing her risk of breast cancer by 1o percent. If that consumption increases to three or more drinks a day, the risk shoots up to 30 percent.

It's fair to say not a whole lot of women drink three or more drinks a day. But researchers say that 30 percent increase in the relative risk of breast cancer from heavy drinking might translate into approximately an extra 5 percent of all women developing breast cancer as a result of their drinking.

The American Cancer Society has been telling women for some time now alcohol increases your breast cancer risk. This study really zeroed in, on the drink type. Researchers found it doesn't matter what you're drinking - white wine, red wine, beer, bourbon or another hard liquor-- each can raise your breast cancer risk. That certainly throws a wrench into the idea that red wine can be good for you.

Research has shown red wine does have protective benefits for your heart - but if just a drink or two a day raises your breast cancer risk, should you drink it? Every woman needs to balance her own risk of heart disease and breast cancer, says the American Cancer Society, which recommends that women who choose to drink limit consumption to one drink a day. Of course, there are other lifestyle factors that can reduce your risk, including keeping your weight down and being physically active -- which can reduce your risk of both breast cancer and heart disease.

Women, will this relationship between alcohol and breast cancer influence what, or how much you drink? We'd love to hear from you.
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