With the New Year upon us, we often reflect on the year and begin to plan for the coming year. We do this by making resolutions- however; most of us break them- so this year, let’s keep it simple and see how long we can stick to our goals.
With cold and flu season amost here one of the frequently asked questions from patients is, “when should I get vaccinated?” The answer is, you should get a flu vaccine before flu begins spreading in your community.
It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body, so make plans to get vaccinated early in fall, before flu season begins.
CDC recommends that people get a flu vaccine by the end of October. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout flu season, even into January or later.
Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.
To schedule your flu shot contact your primary care clinician. (Schedule below).
Should you get sick know that you can be treated at one of our ExpressCare locations. (Andover or Riverwalk/ Lawrence) visit https://pmaonline.com/express-care/ to schedule an appointment online and for site hours.
What is vaping?
Vaping uses electronic cigarettes (or e-cigarettes) to simulate traditional cigarette smoking. E-cigarettes are battery-powered or chargeable smoking devices. Some look like traditional cigarettes or pipes. Others are designed to look like pens or USB memory sticks. They use a cartridge (or pod) filled with liquid. The liquid typically contains nicotine, flavorings, and other chemicals. When you puff on the mouthpiece of the device, it activates a heating element. This heats up the liquid in the pod and turns it into vapor. You then inhale the vapor. This is why it’s called “vaping.”
E-cigarettes are often marketed as a safer alternative to smoking. But they’re not safe. They still put an addictive drug and chemicals into your body and into the air around you.
How is vaping different from JUULing?
Vaping and JUULing are the same thing. JUUL (a brand of e-cigarettes that look like USB memory sticks) is a very popular vaping device among teenagers. So popular, in fact, that its brand name has become a verb to describe vaping. Teens may also use the term “ripping” to describe smoking an e-cigarette or JUUL. For more on JUULing and how it relates to teens, see “Teens and JUULing,” below.
Disputing common myths about e-cigarettes
The makers of e-cigarettes market them for a variety of uses. Researchers are still in the early stages of studying e-cigarettes. But studies have shown that e-cigarettes still contain harmful chemicals, including nicotine. Myths about e-cigarettes claim that the devices are:
- E-Cigs are NOT a safer alternative to smoking cigarettes. Makers claim that e-cigarettes don’t contain the harmful chemicals that cigarettes do. Of course, this is not true. Most devices contain nicotine. A JUUL pod contains either 3% or 5% nicotine. A JUUL pod that contains 5% nicotine is equivalent to the amount of nicotine in one pack of cigarettes.
- E-cigs are addictive. While there are some cartridges that don’t contain nicotine, most do. Any time a smoker inhales nicotine, he or she is inhaling an addicting and harmful chemical.
- You cannot use e-cigs indoors. At first, makers of e-cigarettes said that e-cigarettes were appealing because they could be smoked in places that didn’t allow traditional cigarette smoking. This is no longer true. Many states have created laws that prohibit vaping in the same areas where traditional smoking is not allowed.
- E-cigs are not really a way to quit smoking. Marketers claim it is easier to quit smoking if you switch to vaping first. In fact, e-cigarettes contain nicotine and may even lead to a user becoming a traditional cigarette smoker.
What are the dangers of vaping?
Experts have a number of concerns about the safety of e-cigarettes and vaping.
- E-cigarettes contain nicotine. In large doses, nicotine can be toxic.
- Nicotine stimulates your central nervous system. This increases your blood pressure, breathing, and heart rate. Higher doses of nicotine can cause blood pressure and heart rate to go up higher. This can lead to an abnormal heart rate (arrhythmia). In rare cases, this can cause heart failure or death. Over time, nicotine can lead to medical problems. These include heart disease, blood clots, and stomach ulcers.
- Nicotine increases the level of dopamine in your brain. This chemical messenger affects the part of the brain that controls feelings of pleasure. It can motivate you to use nicotine again and again to get that feeling of pleasure. You do this even though you know it is a risk to your health and well-being. That is what makes nicotine addictive.
- The ingredients in the liquid are not labeled. This means that we don’t know for sure what’s in the liquid.
- There are often chemicals in the liquid. Some of these are known to cause cancer. One study found a toxic chemical that is found in antifreeze.
- Tiny particles are released by the heating element and may be harmful. These particles can cause inflammation in the lungs, which can cause bacterial infections or pneumonia.
- The liquid in the cartridge can be poisonous if someone touches, sniffs, or drinks it. There has been an increase in poisoning cases of children under 5 who have had access to the liquid.
- “Secondhand smoke” is still a problem for e-cigarettes. Secondhand e-cigarette vapor contains chemicals that harm the lungs and hearts of people who aren’t vaping.
- They serve as an introductory product for preteens and teens. Many kids start with vaping and then move on to other tobacco products.
- Right now, there is little regulation when it comes to e-cigarettes. Even if it isn’t a JUUL product, there are many other kinds of e-cigarettes available. Doctors do not know what may be in them.
Teens and JUULing
E-cigarettes are popular among teens and are now the most commonly used form of tobacco among youth in the United States, according to the National Institute on Drug Abuse. As of August, 2018, JUUL accounts for an estimated 71 percent of the teen e-cigarette market. Reasons for this include:
Teenagers face increased risks from JUULs/e-cigarettes. The teen years are a critical time in brain development. This puts young people uniquely at risk for long-lasting effects. Nicotine affects the development of brain circuits that control attention and learning. It puts kids at higher risk of having mood disorders and permanent problems with impulse control. It also affects the development of the brain’s reward system. This can make other, more dangerous, drugs more pleasurable to a teen’s developing brain.
Kids who use e-cigs like JUULs are also more likely to become smokers than kids who do not, according to a three-year study. The study followed high school students as they transitioned from e-cigarettes to traditional ones.
There is much still to be learned about e-cigarettes and vaping. Since it’s relatively new, there aren’t long-term studies on the effects it may have. Until these long-term effects are known, doctors are encouraging patients to avoid e-cigarettes.
How do I talk to my child about JUULing?
If you suspect your child is JUULing (and even if you don’t), ask him or her about it. Start a conversation. Ask if they’ve seen friends doing it or seen JUULing at school. Use this opportunity to tell them the dangers of JUULing. JUULing is addictive. JUULing has been shown to lead to smoking. Smoking causes cancer, heart disease, and emphysema. Smoking is responsible for 1 in 5 deaths in the United States.
What if my child is already JUULing?
Talk to your child about quitting. Make an appointment for you and your child to talk to your family doctor about the best ways to quit JUULing. Your doctor may suggest a plan that includes some of the FDA-approved elements for smoking cessation listed below.
Things to consider
The FDA has approved 7 medications for smoking cessation in adults. These include nicotine gum, nicotine patches, and medicines. (Vaping is not one of the 7 approved methods.) There is little evidence that these same tactics will work for vaping. If you are trying to stop vaping, here are some tips to consider:
- Talk to your doctor. He or she may be able to suggest nicotine replacement therapy. They also may be able to prescribe medicines to help you quit.
- Make a plan. Set a date to begin the quitting process. Set goals as part of your process. These can be as small as having one less e-cigarette a day for a week. Then you can continue to cut back on a schedule until you no longer smoke or vape.
- Stay busy. Keep your mind off smoking by keeping busy. Do activities with your hands to keep them ovvupied. Plan ahead for times when you know you’ll want to smoke, such as after a meal or when you go out.
- Put off cravings. Cravings can be hard to resist, but they usually pass. Tell yourself to wait until a certain time, and the urge to smoke will often be gone by then.
- Get support. Surround yourself with people who support you. Tell your friends and family that you are quitting so they can be supportive. If you don’t want anyone to know you smoke or vape, join an online or in-person support group.
Questions to ask your doctor
- Can I quit JUULing cold turkey?
- Is there any sort of nicotine replacement I could try while quitting JUUL? Do you recommend this?
- How long should it take me to quit JUULing?
Keeping hydrated is crucial for health and well-being, but many people do not consume enough fluids each day. Around 60 percent of the body is made up of water, and around 71 percent of the planet’s surface is covered by water.
Perhaps it is the ubiquitous nature of water that means drinking enough each day is not at the top of many people’s lists of priorities.
How to use your smartphone without ruining your health
Our smartphones are our constant companions. We hunch over their screens, gaze at their blue-tinted light, and sacrifice human companionship for digital company. Over time, all these habits can wreak havoc on our health.
We hunch over their screens, gaze at their blue-tinted light, and sacrifice human companionship for digital company. Over time, all these habits can wreak havoc on our health.
Luckily, you can avoid some of these negative effects without entirely relinquishing your pocket computer’s company. Here’s how to protect your health from your smartphone.
Improve your posture
How do you stand or sit when you’re occupied with your smartphone? If you bend over the screen, neck cricked, then you’re not alone.
Unfortunately, this unnatural position, dubbed “text neck,” could be causing an increasing number of neck and spine injuries, research suggests. As we gaze down at our phones for hours every day, we’re reversing the typical backward curve of the neck, Todd Lanman, spinal neurosurgeon at Cedars-Sinai Medical Center in Los Angeles, told Reuters last year.
He has a fix, although it might attract a few odd looks from the people around you. Keep your phone at eye level when texting, emailing, or social networking (the higher you hold your phone, the better). This habit lets you hold your head up and your shoulders back, as you should when you’re trying to sit ergonomically at your computer.
The posture coaches at Vertical Align also recommend that you hold your phone at eye level. In addition, they suggest that, while standing, you keep your arms close to your body. When you’re sitting, lean forward—again with your phone at eye level—with your elbows supported on your knees.
Your hand position also matters. Experts also recommend operating your phone with two hands in symmetrical positions. This spreads out the strain on the arms and spine. If you’re tapping and swiping with one hand, according to the Vertical Align team, you should switch hands regularly.
Cutting down on prolonged smartphone sessions will also help improve your posture and prevent other potential problems like eye strain. Essentially, you should avoid spending extended periods staring down at your phone. If you must use your phone, break up the time with small stretches, such as rolling your neck.
Reduce blue light
The sun and your digital devices both emit short-wavelength high-energy blue light. These waves are great when they’re coming from our star—they help us stay awake during daylight hours by blocking the brain’s production of melatonin, which makes us sleepy. But when the light keeping you up is coming from a screen as you lie in bed, that’s not so good. Darkness naturally makes us sleepy, and staring at a phone late at night interferes with that.
That’s not all. Recent research has identified a process through which too much blue light can significantly damage cells in the eye. If the light kills off enough of these photoreceptor cells, scientists say, it can cause serious conditions like macular degeneration.
Luckily, both Android and iOS come with settings that can help reduce your exposure to blue light.
On an Android device, head to Settings > Display > Night Light. Select Turn on now to change the screen’s color to an amber tint, reducing the blue-wavelength light it emits. To schedule this change so it occurs automatically at a certain time of day, tap Schedule.
For iOS, you’ll find a similar option called Night Shift. Access it by going to Settings > Display & Brightness > Night Shift. To switch it on only when you need it, tap Manually Enable Until Tomorrow. Or make it turn on and off automatically by hitting Scheduled.
These color-changing options should reduce the damage blue light does to your eyes and sleeping patterns. But we’d recommend restricting your nighttime phone use as well. No matter what light settings you adjust, keeping your mind racing with social media or Netflix shows isn’t the best preparation for a smooth night’s sleep. With that in mind, think about replacing that late-night Twitter check with a book or asking your Amazon Echo to read the evening news aloud so you don’t have to look at the text.
Manage screen time
One of the best ways to protect your health from your phone is to use the gadget less frequently. To help with this goal, both iOS and Android are introducing so-called “digital wellness” tools that inform you about and help you limit your smartphone use. However, you may not be able to access them just yet. Apple’s new suite, called Screen Time, will appear in the iOS 12 update due to roll out in September; Google’s version, an app dubbed Digital Wellbeing, is in beta testing, so you need to install Android 9 Pie on a Google Pixel phone in order to try it out.
When you get the iOS update, you’ll be able to play around with it by heading to Settings > Screen Time. It will display your daily device usage, broken down into app categories, such as gaming or education. Tap the name of your device at the top of the screen to see additional stats: weekly usage, lists of the most frequently-used apps, and charts showing how frequently you pick up your phone and receive notifications. To restrict the amount of time you spend on a given app, tap that program and then hit Add Limit. You can also set limits by category by heading to the front page of the Screen Time menu and tapping App Limits. Once you reach your time limit, the apps in question will appear grayed-out on the home screen, although you can manually override this block.
When your Android phone receives an update that will enable its time-management app, you’ll see a new Digital Wellbeing entry in Settings. Here, you can view recent information on the apps you’ve used, how many times you’ve unlocked your phone, and how many notifications you’ve received. Tap on the pie chart that displays this information to access a more detailed day-by-day breakdown, and swipe right to see your statistics over the previous days and weeks. As on iOS, you can set limits: Tap the No timer button next to a given app. Again, when you reach that limit, the app appears grayed out, and launching it produces a deterrent message. To override your self-imposed limits, you need to go back to the Digital Wellbeing menu and disable the timer.
Both Screen Time and Digital Wellbeing also include tools—Downtime on iOS and Wind Down on Android—that wean you off evening phone time by blocking your app access after a certain hour. Wind Down can also also gray-out the screen or switch into Night Light mode during that time.
While you wait for the Android and iOS tools to arrive, try a third-party creation like the free app Flipd, which gently nudges you when you’ve spent too long on your phone, or the $2 purchase Forest, which encourages you to take breaks by growing a virtual forest when your phone is idle. For more options, check out this list of time-management apps.
Cite: Popular Science, August 31, 2018
June is Alzheimer’s & Brain Awareness Month –a time to shine a purple light for the millions of people living with Alzheimer’s.
Alzheimer’s is the most common form of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases.
Alzheimer’s is not a normal part of aging.
The greatest known risk factor is increasing age, and the majority of people with Alzheimer’s are 65 and older. But Alzheimer’s is not just a disease of old age. Approximately 200,000 Americans under the age of 65 have younger-onset Alzheimer’s disease (also known as early-onset Alzheimer’s).
Alzeimer’s worsens over time. Alzheimer’s is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer’s, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer’s is the sixth leading cause of death in the United States. Those with Alzheimer’s live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions.
Alzheimer’s has no current cure.
However, treatments for symptoms are available and research continues. Although current Alzheimer’s treatments cannot stop Alzheimer’s from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer’s and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.
Help is available
If you or a loved one has been diagnosed with Alzheimer’s or a related dementia, you are not alone. The Alzheimer’s Association is the trusted resource for reliable information, education, referral and support to millions of people affected by the disease.
How Does Stress Affect Your Health?
Stress. We’ve all felt it. Sometimes stress can be a positive force, motivating you to perform well at your piano recital or job interview. But often — like when you’re stuck in traffic — it’s a negative force. If you experience stress over a prolonged period of time, it could become chronic — unless you take action.
A natural reaction
Have you ever found yourself with sweaty hands on a first date or felt your heart pound during a scary movie? Then you know you can feel stress in both your mind and body.
This automatic response developed in our ancient ancestors as a way to protect them from predators and other threats. Faced with danger, the body kicks into gear, flooding the body with hormones that elevate your heart rate, increase your blood pressure, boost your energy and prepare you to deal with the problem.
These days, you’re not likely to face the threat of being eaten. But you probably do confront multiple challenges every day, such as meeting deadlines, paying bills and juggling childcare that make your body react the same way. As a result, your body’s natural alarm system — the “fight or flight” response — may be stuck in the on position. And that can have serious consequences for your health.
Even short-lived, minor stress can have an impact. You might get a stomach-ache before you have to give a presentation, for example. More major acute stress, whether caused by a fight with your spouse or an event like an earthquake or terrorist attack, can have an even bigger impact.
Multiple studies have shown that these sudden emotional stresses — especially anger — can trigger heart attacks, arrhythmias and even sudden death.1 Although this happens mostly in people who already have heart disease, some people don’t know they have a problem until acute stress causes a heart attack or something worse.
When stress starts interfering with your ability to live a normal life for an extended period, it becomes even more dangerous. The longer the stress lasts, the worse it is for both your mind and body. You might feel fatigued, unable to concentrate or irritable for no good reason, for example. But chronic stress causes wear and tear on your body, too.
Stress can make existing problems worse. In one study, for example, about half the participants saw improvements in chronic headaches after learning how to stop the stress-producing habit of “catastrophizing,” or constantly thinking negative thoughts about their pain.
Chronic stress may also cause disease, either because of changes in your body or the overeating, smoking and other bad habits people use to cope with stress. Job strain — high demands coupled with low decision-making latitude — is associated with increased risk of coronary disease, for example.
Other forms of chronic stress, such as depression and low levels of social support, have also been implicated in increased cardiovascular risk. And once you’re sick, stress can also make it harder to recover. One analysis of past studies, for instance, suggests that cardiac patients with so-called “Type D” personalities — characterized by chronic distress — face higher risks of bad outcomes.
What you can do
Reducing your stress levels can not only make you feel better right now, but may also protect your health long-term.
In one study, researchers examined the association between “positive affect” — feelings like happiness, joy, contentment and enthusiasm — and the development of coronary heart disease over a decade. They found that for every one-point increase in positive affect on a five-point scale, the rate of heart disease dropped by 22 percent.
While the study doesn’t prove that increasing positive affect decreases cardiovascular risks, the researchers recommend boosting your positive affect by making a little time for enjoyable activities every day.
Other strategies for reducing stress include:
- Identify what’s causing stress. Monitor your state of mind throughout the day.
- If you feel stressed, write down the cause, your thoughts and your mood. Once you know what’s bothering you, develop a plan for addressing it. That might mean setting more reasonable expectations for yourself and others or asking for help with household responsibilities, job assignments or other tasks.
- List all your commitments, assess your priorities and then eliminate any tasks that are not absolutely essential.
- Build strong relationships.
- Walk away when you’re angry. Before you react, take time to regroup by counting to 10. Then reconsider. Walking or other physical activities can also help you work off steam. Plus, exercise increases the production of endorphins, your body’s natural mood-booster. Commit to a daily walk or other form of exercise — a small step that can make a big difference in reducing stress levels.
Rest your mind.
According to APA’s 2012 Stress in America survey , stress keeps more than 40 percent of adults lying awake at night. To help ensure you get the recommended seven or eight hours of shut-eye, cut back on caffeine, remove distractions such as television or computers from your bedroom and go to bed at the same time each night.
Research shows that activities like yoga and relaxation exercises not only help reduce stress, but also boost immune functioning.
Get help. If you continue to feel overwhelmed, consult with a psychologist or other licensed mental health professional who can help you learn how to manage stress effectively. He or she can help you identify situations or behaviors that contribute to your chronic stress and then develop an action plan for changing them.
Cite: American Psychological Association’s Practice Directorate 2013
Arthritis is very common, but is not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. So knowing who can be affected and how to seek help is the first step:
Arthritis is the leading cause of disability among adults in the U.S.
· By conservative estimates, about 54 million adults have doctor-diagnosed arthritis.
· Almost 300,000 babies and children have arthritis or a rheumatic condition.
· The most common type of arthritis is osteoarthritis, which affects an estimated 31 million Americans.
· Number of people expected to have doctor-diagnosed arthritis by the year 2040: more than 78 million.
Who Gets Arthritis
Doctor-diagnosed arthritis is more common in women (26 percent) than in men (18 percent). In some types, such as rheumatoid arthritis, women far outnumber men.
Primary care providers are usually the first stop for joint problems. Someone who has been searching for answers for a while may choose to see a rheumatologist, a doctor who specializes in diagnosing and treating arthritis and rheumatic conditions,
If you or someone you know are seeking a diagnosis or follow up care with a rheumatologist contact 888-227-3762 to schedule an appointment.
For more information visit www.arthritis.org
Longtime Haverhill physician Dr. Carl F. Rosenbloom has resigned from the city’s health board, Mayor James J. Fiorentini said Friday. His tenure ends on March 31.
A pediatric physician at Pentucket Medical, Rosenbloom has served on the city’s three-person board since the mid-1980s after being appointed by then Mayor William H. Ryan.
“Dr. Rosenbloom represented the city with honor and distinction and was an outstanding member of the Board of Health for many decades,” Fiorentini said. “He is defender and promoter of the city of Haverhill and has been an outstanding public servant for a very long time. It’s going to be very difficult to replace him.”
The city is actively looking to fill Rosenbloom’s spot on the board and Fiorentini is hopeful a candidate with a public health background will step up. The new member would serve a three-year term alongside current members Peter Carbone and Dr. Alexander Matolcsy of Holy Family Hospital.
“I’m looking for someone who can help expand the board’s role in vaccine clinics and developing strong public health programs around nutrition, exercise and other quality of life issues,” the mayor said, adding that candidates need not be medical doctors.
Interested candidates should send a letter of interest and resume to email@example.com.
February is Heart Health Month
What You Should Know About Heart Disease
Since it’s February, you may be thinking about sweetheart candy and heart-shaped boxes of chocolate. Did you know that it is also a great time to think about your own heart? February is Heart Health Month!
It’s important to know the risk factors and signs of heart disease as it’s the leading cause of death for both men and women with 610,000 Americans dying from heart disease each year. Continue reading “Heart Health Month”