MISGUIDED POLITICIANS AND UNWANTED PREGNANCIES

 

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Recent medical research, as reported in the highly respected New England Journal of Medicine, has provided us with both good and bad news about unwanted pregnancies:

First, the good news: The rate of unintended pregnancies in the U.S. has recently diminished. Less than half (45%) of pregnancies were unintended in 2011, as compared with 51% in 2008, declining by 18% overall in women between the ages of 15 to 44 years. While this reduction is not eye-popping, it represents progress, especially when compared with a minor increase between the years 2001 and 2008.

But now the bad news: Rates of unintended pregnancies during this last period among those who are below the federal poverty level are two to three times higher than the national average noted above.

Although the study explored several possible explanations for the reduction of unintended pregnancies, they concluded the most likely was an increased use of contraceptives, especially long-acting types such as intrauterine devices (IUDs) and hormonal injectable implants, both of which are relatively expensive. Although birth control is a basic and essential health care need for most women in all socioeconomic categories, those least able to afford these methods are placed at the greatest disadvantage.

Fortunately, the Affordable Care Act (ACA) requires that health insurers cover women’s preventive care services with no out-of-pocket costs. Although the ACA has brought the establishment of health insurance marketplaces nationwide and Medicaid expansions in 32 states, low-income women are disproportionately affected by limited information and access to the preferred methods. To fill this need, Planned Parenthood has constantly advocated for health care reforms and provided publicly funded programs that support expanding women’s access to all forms of birth control.

But here is where politics becomes the “fly in the ointment”. Those politicians with extreme views on reproductive health—often based upon incomplete facts and specious arguments—are trying to cut public funding for family-planning services through programs such as Medicaid and Title X, which have been critical in reducing costs and expanding access to preferred and effective contraceptives for low-income women.  Medicaid sources provide a range of methods that are twice as successful in comparison with those provided by similar providers that do not receive such funds.

But can we verify the negative consequences of such public fund withdrawals? The state of Texas provides a good (or bad?) example. Beginning in January, 2013, Texas withdrew support for Planned Parenthood affiliates from a Texas Medicaid fee-for-service family planning program. After the funding exclusion, there was a 35% reduction of provision of long-acting—the most preferred—forms of contraception, and during the same period, the number of pregnancies increased by 27%. The inescapable conclusion is that the vast majority of these births were unintended.

Sadly, withdrawing funds from Planned Parenthood has occurred in many states, including Ohio (Governor Kasich can bear responsibility there).  Unfortunately, Indiana is attempting similar action. Government agencies, such as local and county health departments, would be prevented from funding Planned Parenthood affiliates or abortion providers for services that include birth control as well as cancer screenings. Importantly, since the Hyde amendment was passed many years ago, Planned Parenthood has been denied the use federal funds to provide abortion services anywhere.

All these measures are obviously affecting those vulnerable women who are least able to provide support for unwanted children, or even their own health. Regardless whether one is for or against abortion—legal or otherwise—these data indicate that the numbers of these unfortunate souls seeking abortions by any means in states such as Texas are likely to increase in the future. Obviously, pregnancy, delivery, and early post-natal care are far more costly than preventive measures.

Sooner or later, the taxpayers will be penalized—directly or indirectly—and I for one subscribe to the old adage, “An ounce of prevention is worth a pound of cure”!

Our lawmakers would be well advised to stop the ill-informed decision to defund Planned Parenthood!

 

 

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TEA, COFFEE AND HEALTH: THE LATEST FACTS

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Tea, especially green tea, is often said to be good for your health. But if tea is good for you, how good? And why?

It turns out that tea does contain substances that have been linked to a lower risk for heart disease and even cancer. But if you just don’t like tea, take heart: Tea drinking alone will never come close to the most potent health promoter we know of—a healthy lifestyle. And coffee may also provide a similar health boost, as we discuss below.

Tea consumption, especially green tea, may not be a panacea, but it can be provide extra dividends when incorporated in an overall healthy diet with whole grains, fish, fruits and vegetables, and less red and processed meat.

WHY IS TEA BENEFICIAL?

     Tea contains certain substances linked to better health, including chemicals called polyphenols, in particular catechins and epicatechins found in tea—especially green tea. The fermentation process used to make green tea boosts levels of polyphenols. Black and red teas have them, too, but in lesser amounts that are less strongly tied to improved health. Although we’re not quite sure why polyphenols are beneficial, they have “antioxidant” properties that may neutralize potentially harmful chemicals called oxidants, and elevated levels of oxidants can cause harm by attacking artery walls and contributing to cardiovascular disease. Unfortunately, in studies of antioxidants in humans, as opposed to experiments in rodents and test tubes, this effect has not been substantiated.

Polyphenols seem to provide additional help by lowering the risk of diabetes, lowering blood pressure and improving cholesterol, all of which contribute to heart disease and stroke.

             WHAT’S THE EVIDENCE OF BENEFIT?

Some of the best circumstantial evidence on tea and health has come from large, long-term studies of doctors and nurses based at the Harvard School of Public Health: the female Nurses’ Health Study and the male Health Professionals Follow-up Study.

By following these groups for long periods, researchers determined that tea drinkers are less likely over time to develop diabetes, compared with people who drink less tea. That makes sense, in light of research showing that polyphenols help regulate blood sugar (glucose).

Further support is provided by a study presented at the American Heart Association’s Epidemiology/Lifestyle 2016 Scientific Sessions. In it, researchers studied available information on 6,212 adults to determine how tea drinking might be associated with coronary artery calcium progression, a marker for blood vessel disease, and heart attacks, angina (chest pain), cardiac arrest, stroke and death from other types of heart disease. They divided the participants into those who never drank tea, less than one-cup-a-day drinkers, one cup-a-day drinkers, two to three cups a day and four or more cups a day tea drinkers. The study followed patients for an average 11.1 years for major cardiovascular events and more than five years to determine changes in coronary artery calcium scores. The researchers found that adults who drank one and two to three cups of tea daily had more favorable coronary calcium scores than those who never drank tea. They also noted a graded relationship between the amount of tea a person drank and a progressively lower incidence of major heart-related events starting with the one-cup-a-day tea drinkers, versus never tea drinkers.

            WHAT’S THE BOTTOM LINE?

Drinking tea of all types regularly seems to be associated with better health. However, it remains unclear whether the tea itself is the cause and, if so, how it works its magic. The studies attempt to rule out the possibility that tea drinkers simply live healthier lifestyles, but it’s difficult to be sure. Nevertheless, tea itself appears to have no harmful effects except for an occasional case of the jitters if you drink too much caffeinated brew. It fits in perfectly fine with a heart-healthy lifestyle. So if you drink tea, keep it up, but don’t take up the habit thinking it will have a dramatic impact.

But in any event, stay away from processed sugar-sweetened tea beverages. These products may be loaded with extra calories, and consuming more than the occasional sweetened tea drink may be counterproductive. If there are any health benefits to tea consumption, it’s probably completely offset by adding sugar, as I have pointed out in a previous post.

         BUT WHAT ABOUT COFFEE?

Coffee contains a complex mix of chemicals with known biological effect including polyphenols that may account for coffee’s purported health benefits. Animal studies suggest the polyphenol chlorogenic acid, which is abundant in coffee, could reduce risk of diabetes. Recent research pooled 36 studies involving over 1.2 million people and found that, when compared with coffee abstainers, people who drank three to five cups of coffee per day had a lower risk of heart attacks and strokes. Complete coverage noted on http://www.mortontavel.com/2013/10/07/

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Vertigo, and How to Combat it

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         Have you ever experienced a spinning sensation, sometimes causing nausea and vomiting, typically aggravated when you change the position of your head? If so, you’re not alone, and here are the facts.

This condition is typically short-lived, bearing a long name: benign paroxysmal positional vertigo, or BPPV. This benign ailment, whose vertigo symptoms are usually worsened by a change in the position of the head—such as rolling over in bed or tilting the head to the side, for example—is quite common, affecting about 5 percent of the population each year. The blanket term “dizziness” is often used to describe a variety of different feelings and sensations—from lightheadedness or near-fainting to vertigo to imbalance—and can mean something different to everyone. In this instance, however, we are referring specifically to vertigo, i.e. a spinning sensation unassociated with changes in—or loss of—consciousness.

         Vertigo and “Ear Crystals”

Tiny calcium carbonate crystals are thought to be behind the vertigo of BPPV. When these crystals, sometimes called stones, come loose from their normal home in the utricle (part of the ear’s balance system) and travel into the inner ear’s fluid-filled canals, their movement sends false messages to the brain, causing that spinning feeling or sensation of being off-balance.

For many people, this inner ear problem causes nausea and vomiting and temporary equilibrium problems. The sensations generally resolve quickly (an episode usually lasts less than one day, but can last three to five days). Exceptionally, the vertigo may come and go for up to a couple of weeks, rendering life miserable and even causing driving to be dangerous.

The older you get, the more likely you are to experience BPPV. And the disorder can come on after a blow to the head—which can knock inner ear crystals loose. People also seem to get it more when they are flying or lying down doing exercises like yoga and Pilates, where the head can be far back for an extended period of time. Some research suggests that allergies and respiratory infections can precede BPPV episodes. It is uncertain whether fatigue and stress can also trigger this disorder.

Experiencing Vertigo for the First Time?

If you think you might be experiencing BPPV for the first time, try sitting quietly for a few minutes. This gives the vertigo a chance to diminish and allows you to pay close attention to the sensations you’re experiencing and take the appropriate steps.

If what you notice is primarily a spinning feeling that seems to be triggered by a change in the position of your head, you can probably wait a few days before consulting a physician—the BPPV is likely to subside in that time. But if your dizziness is accompanied by symptoms such as severe headache, double vision, weakness of one side, slurred speech, chest pain, ringing in the ears or hearing loss, you’re likely experiencing something much more complex than BPPV—such as stroke or a heart problem—and should get immediate medical attention.

Treating This Type of Vertigo

If the distressing symptoms last more than a few days, see your doctor, who will ask about symptoms and may put you in positions that bring on the vertigo to confirm that you have BPPV—there are other types of vertigo as well.

The gold standard for treating BPPV is the Epley Maneuver, in which involves moving your head into specific positions designed to move those wayward ear crystals into a less sensitive spot in the inner ear. This maneuver can be self-administered or conducted by a health care provider. It generally has a 90 to 95 percent success rate after one or two treatments. If unsuccessful, however, your healthcare provider may move on to other maneuvers, which position the head in slightly different ways. After a successful maneuver, the problem should be fixed for at least a year, though we have a few, usually older people, who seem to get it back every three to four months. And in the event that the BPPV recurs—as it does for 30 percent of people in the first year after their initial experience with it and in 50 percent of people over five years—it can usually be managed successfully at home. What’s really important for people to realize is that this is a benign condition that can be fixed quickly; it’s not something you have to suffer with—it’s pretty easy to figure out what you have and pretty easy to fix.

The Epley Maneuver

This maneuver is used to treat benign paroxysmal positional vertigo. It seems to work by allowing free floating particles from the affected semicircular canal to be relocated, using gravity, back into the utricle, therefore terminating the bothersome vertigo. It is often performed by a caregiver such as a medical doctor, audiologist, or physical therapist, after confirmation of a diagnosis of BPPV with the Dix-Hallpike test (a positional maneuver that provokes specific eye movements) that has a reported accuracy of between 90–95%.

Self Administered Maneuver

Although often performed by a therapist, the Epley maneuver can be self-administered at home. The procedure is as follows:

  1. Sit upright.
  2. Turn your head to the side causing the majority of symptoms at a 45 degree angle, and lie on your back.
  3. Remain up to 5 minutes in this position.
  4. Turn your head 90 degrees to the other side.
  5. Remain up to 5 minutes in this position.
  6. Roll your body onto your side in the direction you are facing; now you are pointing your head nose down.
  7. Remain up to 5 minutes in this position.
  8. Go back to the sitting position and remain up to 30 seconds in this position.

    The entire procedure may be repeated two or three more times, in the same or reversed direction. During every step of this procedure, some vertigo may be provoked.

          Post-treatment phase

Following the treatment, one should be cautious of bending over, lying backwards, moving the head up and down, or tilting the head to either side. In addition, one should perform periodic horizontal movements of the head to maintain normal neck range of motion. This should prevent neck muscles from stiffening.

It is uncertain whether activity restrictions following the treatment improve the effectiveness of the canalith repositioning maneuver. However, patients who were not provided with any activity restrictions needed one or two additional treatment sessions to attain a successful outcome. The Epley maneuver appears to be a long-term effective conservative treatment for BPPV that has a limited number of complications (nausea, vomiting, and residual vertigo) and is well tolerated by patients.

To most individuals, this simple program will seem like a godsend!

 

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MEDITERRANEAN DIET: NOW IT MAY EVEN PROTECT YOUR EYESIGHT!

Medit D Blindness

It is well known that the so-called Mediterranean diet is an effective way to ward off vascular diseases of the heart and brain, but new information suggests that it may even protect against the leading cause of blindness in older Americans—age-related macular degeneration. A recent study analyzed dietary patterns on 2,525 participants in the Age-Related Eye Disease Study. They evaluated individual intakes of most food categories, comparing the highest consumers of vegetables, fruits, legumes, whole grains, nuts, fish, and monounsaturated fats (e.g. olive oil), with those that consumed a plethora of saturated fats, red and processed meats. Those who scored highest for intake of the former constituents were 26% less likely to progress to advanced age-related macular degeneration.

This information accorded well with previous research that linked high consumption of the Mediterranean foods with reduced visual loss. By contrast, previous work has also indicated that consumption of red meat and trans fats—avoided in the Mediterranean diet—have been associated with an elevated risk.

Uncertainty surrounds reasons why the Mediterranean diet is protective, but speculation centers on its tendency to reduce inflammation and oxidative stresses, the factors that are believed to promote arterial disease (sclerosis) in general.

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