Friday, July 31, 2015

PASS THE SALT PLEASE


Everything you need to know about salt Published July 27, 2015. 

  1. Salt comes in many shapes and sizes.  Salt rocks. It's a culinary ringmaster, a literal rock with an undisputed role as balancer and enhancer of flavors. Name a more ubiquitous ingredient, one you use more than salt. You can't. We all have our go-to salts (or maybe just one), but if you don't know the difference between them, if you instinctively reach for the same box at the grocery store because other salts - and there seem to be many - look fancy or unfamiliar or unnecessary, it's worth exploring.  Our guide: Mark Bitterman explains.  Why do we think so little of salt as we shower it into pasta water and over ribeyes? Getting to know this kitchen workhorse makes buying it that much easier. The Main Types. There are two types of salt, broadly speaking: sea or evaporative salt, which comes from saltwater, and rock salt, which comes from the land. The majority of rock salt never makes it into the kitchen; it's for industrial use, such as deicing roads. The kind for old-fashioned ice cream makers is so named by manufacturers because it's rocky, not necessarily because it's rock salt, Bitterman told us. "It could be an evaporative salt. It could be anything," he said. Sea salt is produced by evaporating seawater in open pans or by boiling. Sea salt includes the uber-popular kosher salt and, on the opposite end of the spectrum, delicate fleur de sel. There are many nuances in between. Ageless, Never Tasteless. Salt never gets old. We're talking literally here. It'll never go bad on you. "I have Himalayan salt that's 600 million years old," Bitterman said. He suggests storing delicate salts in an airtight container to block humidity, which can mess with salt's supple texture. Glass is better at this than plastic. Related Image Expand / Contract Rock salt and fine salt should be used for different stages of cooking.  Refined salts such as kosher salt contain anti-caking agents, so there's no need to worry about storage and texture loss. The Specifics. Here are some salts, both refined and artisan, that you're most likely to come across when shopping. Kosher salt. Hands-down the all-purpose favorite of chefs and home cooks (and Epicurious editors!) for its coarse, uniform, easy-to-pinch granules. It's industrially produced by boiling off brine that's pumped in and back out of a salt deposit. Not kosher-certified; the name refers to how the crystals draw out moisture in the meat koshering process. "It's a processed chemical product," Bitterman said. Table salt. Otherwise known as the stuff in shakers on tables across America. This is industrial salt refined to about 99 percent sodium chloride, with additives aplenty so it doesn't clump. Iodized table salt serves a need among iodine-deficient populations in poorer countries; you can also get your fix by eating iodine-rich seafood and other foods. Sea salt. Much of what's generically labeled "sea salt" is industrial, made by evaporating sea water in vast open pans. Harvesting is mechanized and removes most of the salt's natural minerals. Commercial brands are inexpensive and often contain additives, Bitterman said. Fleur de sel. French for "flower of salt," this is the creme de la creme of sea salt, scraped by hand as it forms on the surface of a salt evaporation pond. It's been done this way for centuries in France. Irregular, delicate crystals are moist and mineral-rich. Ideal as a finishing salt.

 

Thursday, July 30, 2015

Update from thr Atlantic

Good morning all,
I am watching the sunrise over the Atlantic Ocean. It is beautiful! The force of nature is amazing. Watching the tide roll in and out has been good for the mind and soul. I am very thankful to have the opportunity to experience this time with my family.

Thanks again to all those who are pulling double duty in my absence!
Dr. Janet

Wednesday, July 29, 2015

COOK BOOK

This is another reminder about our upcoming cook book.  If you have a contribution please be sure to get it to Dr. Ford by July 31st.  She will be reviewing your submissions for inclusion in the book so send your best.  Send to:
This will likely be your last reminder.





Until tomorrow





Bob and Johnye

Tuesday, July 28, 2015

ANEMIA IS NOT A GOOD THING

14 signs you could be anemic By Julie Revelant Published July 27, 2015.  
 
The signs of iron-deficiency anemia can often be subtle and vague, but it's the most common form of anemia. In fact, 237,000 visits to the emergency room result in a primary diagnosis of the condition, according to a report by the Centers for Disease Control and Prevention (CDC). Iron is an essential mineral so if you lack it, your body can't make enough healthy red blood cells. Those red blood cells carry hemoglobin, an iron-rich protein that delivers oxygen from your lungs to the rest of your body's tissues. It's a good idea to know the symptoms of iron-deficiency anemia especially since they can often take time to develop. Here are 14. 1. Fatigue Fatigue is usually the first sign of anemia, but it's not just that sluggish feeling you get from burning the midnight oil or stress. "It's a different kind of fatigue-people will complain about being 'bone tired,' " said Dr. Dana Cohen, an integrative physician with a private practice in New York City. So if you're exhausted 24/7, can't seem to make it past dinner and it's affecting your quality of life, see your doctor. 2. Paleness One of the best ways to tell if you're anemic is to look at the mucous membranes of your eyes, also commonly referred to as the water line above your lower lashes. This is a vascular area so if it's pale, it's a good sign that you're not getting enough red blood cells to other areas of your body either. Your face, the palms of your hands and under your nail beds may also look pale, said Dr. Jack Jacoub, a medical oncologist and hematologist at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, Calif. 3. Shortness of breath If you feel like you can't catch your breath, especially during exercise, while climbing the stairs or when you're lifting something, it's a good sign that your body isn't getting the oxygen it needs. Feeling faint, lightheaded and dizzy are common too. 3. Heart palpitations If your heart is racing, you're having palpitations or hear a whooshing sound in your ears when you lie down, it could mean that your heart is in overdrive. "You're pumping faster to try to get more oxygen," Cohen said. What's more, an irregular heartbeat or heart murmur are more pronounced when you're anemic. 4. Anxiety A racing heart can make anyone feel anxious, but if anxiety is new for you, has intensified or there seems to be no other reason for it, it could be a sign that you're anemic. 5. Numbness Since your body will pull blood from your extremities to feed the places it needs to, you might have a numb or tingling feeling in your hands and feet or you may feel cold all the time, Cohen said. 6. Heavy periods and irregular bleeding The most common cause of iron-deficiency anemia in women are uterine fibroids, especially those located on the inside of the uterine cavity which can cause heavy, irregular and painful bleeding, said Dr. Kecia Gaither, a maternal fetal medicine specialist and director of perinatal outreach at Montefiore Medical Center and Albert Einstein College of Medicine in New York City. Polyps inside the uterus can cause heavy, painful periods too. 7. Strange cravings Some people with an iron-deficiency anemia crave and have a habit of chewing ice. It's not clear why, but a study in the journal Medical Hypotheses suggests that it may give a boost in mental sharpness the same way a 'cup' of coffee does. Some people may even have cravings for paper and clay too. 8. Brain fog If you're having trouble concentrating, remembering things or don't feel as sharp as you did in the past, it might not just be age, but a lack of iron, Jacoub said. 9. Headaches Tension headaches and migraines are common, but if you notice you're having headaches more often or nothing you do seems to alleviate the pain, see your doctor. 10. Restless Leg Syndrome It's estimated that up to 10 percent of people in the U.S. have restless leg syndrome, a neurological disorder that can cause uncomfortable sensations in the legs and other parts of the body and an uncontrollable urge to constantly move. Although the association is not well understood, about 15 percent of people with the condition also have iron deficiency, according to John Hopkins Medicine. 11. Pregnancy risks Although iron-deficiency anemia is common during pregnancy, left untreated, women have a higher risk for premature and low birth weight babies. The primary reason women are more likely to be iron deficient during pregnancy is due to the normal increase in water in the body. "Even though you have the same number of red blood cells, there's more volume for them to circulate around," Gaither said. Plus, iron stores can be depleted because they're needed for the placenta and the baby. If you had an iron-deficiency prior to pregnancy or are having multiples, your risk is even higher. 12. Hair loss According to the American Academy of Dermatology, 80 million men and women experience hereditary hair loss, or what's known as male pattern baldness. If you notice more hair in your brush or your hair is thinning, it might be that you're anemic. It could also be a vitamin deficiency or a hormonal condition like hypothyroidism so bring it up to your doctor. 13. Black stools Dark, tar-colored stools, blood in the stool or bleeding from the rectum could signal anemia. Yet it could also be a GI condition like Crohn's disease or stomach or colon cancer so it's important to see your doctor immediately. Abdominal discomfort or a change in your bowel habits are also important signs to look for. How to get enough iron. Experts agree, if you have iron-deficiency anemia, your doctor will likely run more tests and look at your medical history to find the root cause of it. "Its not enough to know you're iron deficient, the question is why? Jacoub said.  . 14. If you're pregnant, be sure to keep your prenatal appointments and always get your blood tests done to make sure your levels are sufficient. Eat Iron-rich foods including red meat, liver, oysters, beans, dark green leafy vegetables, dried fruit and iron-fortified cereal can give you what you need. Supplement Your doctor may also recommend a daily multivitamin and an iron supplement. There are also food-based iron supplements that are non-constipating and for women, can be taken only around their periods, Cohen said. Try Traditional Chinese Medicine A'cup'uncture and Chinese herbs can also help increase iron levels. 

Monday, July 27, 2015

COUNTING CARBS AND DIABEETES

The Basics of Carb Counting: How the Carbs You Eat Add Up to Blood Glucose Control by Allison Tsai.  

Diabetes can be managed with diet and exercise, or those who simply want to create more healthy eating habits for themselves. People without diabetes may glance at their dinner and see salmon, a salad, or a bowl of soup, but those with diabetes are faced with numbers-specifically, carbohydrate grams. If you're new to diabetes, you may wonder why you need to carb count at all, why carb counting is an important thing you can do to ensure blood glucose control, how to determine your carb needs, and which carb counting method is best for you. Why Do Carbs Matter? Carbohydrates are naturally found in certain foods. Grains, sweets, starches, legumes, and dairy all contain carbs in varying amounts. When foods and drinks with carbohydrate are digested, the carbs break down into glucose to fuel our cells, and the body's blood glucose level rises. In people without diabetes, blood glucose levels rise after eating, but the body's insulin response keeps levels from rising too high. "[The] pancreas will release a squirt of insulin to help facilitate getting the glucose from your bloodstream into your cells, where it can be used as fuel," says Alison Evert, MS, RD, CDE, coordinator of diabetes education programs at the University of Washington Medical Center and a dietitian and diabetes educator at the Endocrine and Diabetes Care Center there. If you have diabetes, the process doesn't work as designed. How carb counting can help your blood glucose control depends on your treatment regimen and whether or not your body makes insulin. Type 1: If you have type 1 diabetes, your pancreas no longer makes insulin, so you need to take background insulin as well as offset the carbohydrate in your food with mealtime insulin doses. To do this you have to know exactly how many carbohydrate grams are in your meal-cue carb counting. Type 2: Because people with type 2 diabetes are resistant to insulin and may have a diminished supply, they need to moderate their carbohydrate intake and eat a consistent amount at each meal throughout the day-instead of all at one sitting. People taking oral medications may use a more basic form of carb counting than those on insulin. How Do You Carb Count? The best carb counting method for you is the one that addresses your medication and lifestyle needs. If you take mealtime insulin, that means first accounting for each carbohydrate gram you eat and dosing mealtime insulin based on that count using what's known as an insulin-to-carb ratio. "People who take rapid-acting insulin-type 1 or type 2-at or just prior to food intake need to match the amount of carbohydrate in their meal to achieve glucose control," says Hope Warshaw.  Eating Healthy in Any Restaurant This advanced form of carb counting is recommended for people on intensive insulin therapy by shots or pump, such as those with type 1 and some people with type 2. People with type 2 diabetes who don't take mealtime insulin may not need detailed carb counting to keep their blood glucose in line. Some do basic carbohydrate counting based on "carbohydrate choices. One choice contains about fifteen grams of carb. Others use what's called the "plate method" to eat a reasonable portion of carbohydrate-containing foods at each meal by limiting grains and starchy vegetables to a quarter of the plate. Others still stick with traditional carb counting, too. Which method is best for those with type 2? "There is no evidence that any of those methods works better than others to help the person achieve good blood glucose control," says Patti Urbanski, MEd, RD, LD, CDE, a diabetes educator with St. Luke's Hospital in Duluth, Minnesota. The longer you practice carb counting, the more you'll remember the carb content of the foods you commonly eat, but it helps to reference nutrition labels, apps, books, and other sources that provide information about the carb content of specific food items. How Many Carbs Should I Eat? As for the ideal number of carbs per meal, there's no magic number. "How much carbohydrate each person needs is in large part determined by their body size and [his or her] activity level," says Urbanski. Appetite and hunger also play a role. In order to figure out how many carbs you should be eating, schedule an appointment with your dietitian or diabetes educator to work out an eating plan specifically for you. This service, when provided by a dietitian, is known as medical nutrition therapy. Diabetes self-management education sessions also may include creating an eating plan. During the sessions, you'll determine your carb needs and how to divide your carbs among your meals and, if desired, snacks. "Everybody's insulin response is going to be different, and we don't want to make the diet more restrictive than it needs to be," Evert says. That said, if you haven't figured out your individual plan yet, the general guideline for most adults with diabetes is forty-five to sixty grams of carbohydrate per meal, which is three to four carbohydrate choices. A snack would be around fifteen to thirty grams of carbs or one to two choices. That's just a starting point, however. Your total carb allowance should meet your energy needs, blood glucose targets, and weight management goals. What Should I Eat? Whether you count each carb gram or use one of the other meal planning methods, you'll want to choose foods that are rich in nutrients. "The quality of carbs is an important aspect," says Evert. Opt for foods that are unprocessed and in their natural state, such as whole grains, vegetables, and fruit that hasn't been broken down into smoothies or canned in syrup. "I encourage people to eat their carbs instead of drinking them," says Evert. "That will be a lot more satisfying. Try to eat more whole foods, such as fresh fruits and vegetables, which are minimally processed and free from additives and artificial substances. Processed foods, such as packaged cookies, crackers, and canned fruit usually contain added salt, sugar, carbohydrates, fat, or preservatives. Eating more whole foods and less processed foods will also make your body work harder to digest them, which is a good thing for weight management. If you eat mostly whole foods, and limit highly processed foods-whether that's swapping a doughnut for a bowl of fruit and yogurt for breakfast or switching from white to whole grain bread-you'll get plenty of nutrients, including vitamins, minerals, and fiber. As a bonus, you can indulge in a dessert from time to time, Urbanski says, "as long as you're thinking about the amount of carbohydrates in it and recognizing that you're not getting a lot of good nutrition in return for those grams of carbohydrates. It can be hard to change your eating habits overnight, so start by making small changes and sticking to them. Just knowing which foods are better choices is a step in the right direction. 

Sunday, July 26, 2015

Atlantic Ocean

good evening everyone,
The beautiful Atlantic Ocean is right outside my window. I plan to decompress for the next 10 days. If you have a problem, call one of my colleagues. Krystal, Barbara, Johnye and Bob are all stuck at home and will be willing to help! Thanks to those who help out so I can enjoy my vacation with the twins.
Toasting in the sun,
Dr. Janet

CHANGES ARE CHEAPER THAN DRUGS


Lifestyle changes may guard aging brain against memory loss Published July 24, 2015.  

The latest Alzheimer's research has a clear theme: Change your lifestyle to protect your brain. It will take several years for scientists to prove whether some experimental drugs could at least delay Alzheimer's disease, and an aging population is at risk now. Whatever happens on the drug front, there are generally healthy everyday steps people can take - from better sleep to handling stress to hitting the books - that research suggests just might lower the risk of Alzheimer's. Making these lifestyle changes "looks more promising than the drug studies so far," said Dr. Richard Lipton of the Albert Einstein College of Medicine in New York, whose lab researches what makes up healthy aging. The findings on stress prompted Lipton to take up yoga. Here are five tips to guard your brain against memory loss, based on research at the Alzheimer's Association International Conference: GET BETTER SHUT-EYE Studies of more than 6,000 people linked poor sleep quality - and especially sleep apnea - to early memory problems called mild cognitive impairment, which in turn can raise the risk of later Alzheimer's. Other research showed poor sleep can spur a brain-clogging protein named amyloid that's a hallmark of Alzheimer's. Talk to your doctor if you're having sleep problems, advises Dr. Kristine Yaffe of the University of California, San Francisco: "Sleep disorders are so common, and we think many are quite treatable. EXERCISE YOUR GRAY MATTER Seniors often are advised to work crossword puzzles, take music lessons or learn a new language to keep the brain engaged. The protective effects of learning may start decades earlier in life. In Sweden, researchers at the Karolinska Institute unearthed school report cards and work histories of more than 7,000 older adults. Good grades as young as age 10 predicted lower risk of dementia later in life. So did getting a job that required expertise with numbers or, for women, complex interactions with people - oc'cup'ations such as researchers or teachers. Why? Learning and complex thinking strengthen connections between nerve cells, building up "cognitive reserve" so that as Alzheimer's brews, the brain can withstand more damage before symptoms become apparent. GET MOVING What's good for the heart is good for the brain, too, and physical activity counters a list of damaging problems - high blood pressure, diabetes, high cholesterol - that can increase the risk of memory impairment later in life. Get started early: One study tracked the habits of 3,200 young adults for 25 years, and found those who were the least active had the worst cognition when they were middle-aged. Sedentary behaviors like TV watching played a role. Yaffe - who just had her desk raised so she can spend more time standing - worries about kids' screen time. DON'T FORGET MENTAL HEALTH Late-life depression is a risk factor for Alzheimer's. Harvard researchers found loneliness is, too, accelerating cognitive decline in a study that tracked more than 8,000 seniors for over a decade. Stress is bad for the brain as well, Lipton said. It's not just experiencing stress - we all do - but how we cope with it. Brooding over stressful events, for example, prolongs the harmful effects on brain cells. One study found seniors with the poorest coping skills were much more likely to develop mild cognitive impairment over nearly four years than seniors who could shrug off the stress. EAT HEALTHY Diets high in fruits and vegetables and lower in fat and sugar are good for the arteries that keep blood flowing to the brain. Type 2 diabetes, the kind linked to excess weight, raises the risk of dementia later in life. Weight aside, Lipton's lab recently found a healthy diet lowered seniors' risk of impaired "executive function" as they got older - how the brain pays attention, organizes and multitasks. 

Saturday, July 25, 2015

YOUR DOCTOR NEEDS TO KNOW


Many people seek alternative pain therapies, but don't tell doctors By Cari Nierenberg, Published July 22, 2015. 

Many people with chronic pain aren't telling their primary doctors about their use of alternative therapies such as a'cup'uncture and chiropractic work, a new study suggests. However, such communication is needed to ensure people get the best treatment for their pain, the authors of the research say. Chronic pain conditions can include back pain , arthritis, muscle pain, headache and fibromyalgia . "The study shows that a substantial percent of patients with chronic pain don't tell their primary doctors about their use of complementary and alternative medicine," said Dr. Charles Elder, the study's lead author and an investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon. Elder and his colleagues didn't look at the reasons that people who suffer from chronic pain conditions neglect to tell their doctors about their use of alternative treatments. Even so, he speculated these patients may not feel it's important to mention, may not think their doctor will care, or may believe their doctor will have a negative view of complementary and alternative medicine. [ 10 Odd Causes of Headaches ] Interestingly, most people involved in the survey said they would discuss their use of alternative therapies for pain control if their doctors had asked them.  Elder and his colleagues surveyed about 6,100 people with chronic pain conditions who were members of an HMO in Oregon and Washington. The researchers also had access to members' electronic medical records, so they could find out if the patients had seen practitioners inside or outside of the HMO network and whether any use of alternative therapies was documented in the patients' records. The researchers found that, between 2009 and 2011, 47 percent of people surveyed reported that they had used chiropractic care for pain relief and 32 percent had used a'cup'uncture. Twenty-one percent of participants had tried both alternative therapies. Overall, 42 percent of men and women with chronic pain conditions who had only been to a chiropractor reported they didn't discuss this treatment with their medical doctors; 35 percent of people who had only seen an a'cup'uncturist for pain did not bring it up with their health practitioners. Managing pain The researchers said they were surprised to find that the majority of patients with chronic pain use a'cup'uncture, chiropractic care or both, Elder said. But the study scientists didn't look at whether people believed they benefitted more from alternative therapies compared with more traditional methods of pain control. The most common reasons people gave for not seeking chiropractic care or a'cup'uncture were: They didn't think these methods would help; they hadn't considered these pain-relief approaches; they didn't know a reputable practitioner, or the cost of treatment was too high, according to the findings. (Some of the HMO members had health plans that covered alternative therapies, while others sought care outside the network and paid for it out of pocket.) The survey included only adults with chronic pain who lived on the U.S. West Coast, where the use of alternative therapies may be higher than in other parts of the country, and the HMO's coverage of these therapies may be better than other health insurance plans, Elder said. However, he said, the results are representative of overall usage within the chronic pain community. He added that people who have chronic pain are increasingly turning to complementary and alternative medicine, and the more dialogue that doctors and patients have about these approaches, the better care will be. "Managing pain is complex," Elder said. It can involve a variety of different approaches, such as behavior changes, medications, therapies and procedures, he said. When treating pain, doctors need to be aware of what approaches a person is and isn't using, what methods may be working, and which practitioners that individual is seeing, Elder said. "Doctors need to know the big picture so that we can offer patients the full spectrum of care in a coordinated way," he said. When it comes to treating pain, Elder said, "more communication is better.

Friday, July 24, 2015

LOVE YOUR BONES


How to prevent osteoporosis By Dr. Manny Alvarez Published July 21, 2015.  

As a doctor, I receive questions every day varying from heart health to infertility. Today, I received a question from a woman who wanted to know how to prevent osteoporosis. Dear Dr. Manny, I'm getting older, and I read online that osteoporosis is a concern among women my age. What can I do to prevent it? Thanks, Kathy The word "osteoporosis" means porous bone. A porous bone is one that is less dense and, therefore, more fragile and more susceptible to fracture. Some 44 million Americans suffer from osteoporosis, making it a major public health concern. And it affects men as well as women. One out of every two women and one out of every four men over 50 will have an osteoporosis-related fracture of the hip, vertebrae, or wrist in their lifetime. Some risk factors associated with the development of osteoporosis you can do nothing about. Gender, for example. Women tend to lose bone mass faster than men, and that has to do with the effects of the female hormones. Age is another factor we can do nothing about. The older we get, the more prone we are to bone loss. Body size is yet another factor. People who are small-framed and thin-boned have a greater tendency to develop osteoporosis. White or Asian women are in the highest risk categories; Hispanics and blacks are at a significantly lower risk. And if osteoporosis runs in your family, especially if your mother had it, then you are at risk for it as well. There are some risk factors you can do something about, however, with the help of your doctor. These include abnormalities of the menstrual cycle-the absence of your period, known as amenorrhea, low estrogen levels, or premature menopause -that put you at higher risk for osteoporosis. The same is true for the man who has low levels of testosterone before his forties, or in conjunction with obesity. People with eating disorders, whether anorexia or bulimia, can have metabolic reasons for developing osteoporosis. A lifetime diet low in vitamin D and calcium also puts you at risk. Taking medication like steroids, anticonvulsants, or anticoagulation therapy for a long time can affect your bone density. Cigarette smoking, drinking too much alcohol, and leading a sedentary life all put you at risk for osteoporosis as well. These risk factors suggest what you can do to help prevent osteoporosis. To begin with, you must incorporate calcium into your diet. There are many sources of calcium, of course, including milk products, leafy greens, broccoli, collard greens, spinach, sardines, and some other types of fish. Most vitamin D is made through the skin from exposure to light, but as people get older vitamin D production decreases significantly; so people in their sixties and seventies should take vitamin D supplements. You also need to do weight-bearing exercises that strengthen your legs and your hips, in order to maintain a healthy vascular flow to the bones. The symptoms of osteoporosis are silent; those with osteoporosis feel no pain. But some individuals, before they have any fractures, exhibit a loss in stature. If they have bone loss of their spine, of the vertebrae, you may see some bending of their back. This can create loss of height, spinal deformities, and maybe even some back pain . A doctor diagnoses the disease by doing a physical examination and perhaps a bone mineral density test, which you should have done every two or three years. This test is like an X-ray, and it can detect low bone density before a fracture occurs. It can predict chances of fracturing in the future by telling you how weak or strong the bone is. And it helps determine the rate of loss or monitors the effectiveness of treatment. The treatment of osteoporosis involves good nutrition, a variety of vitamin and mineral supplements, and exercise. Even if somebody has osteoporosis, exercise is important. The only difference is that the exercises should be specifically designed for people with weak bones. People with osteoporosis should not perform any kind of strenuous, high-impact aerobics. Now that estrogen replacement therapy has gone out of favor, doctors are prescribing bisphosfinates such as Fosamax and Actonel instead; these medications help increase bone mass and reduce the incidence of spine, hip, and other fractures without the increased risk of breast cancer. The most common side effects of bisphosphonates are stomach upsets, and recent reports seem to link them to osteonecrosis of the jaw, in which the bone does not heal after dental work. So now dentists are very careful not to do major dental work in people who are taking these drugs. Another type of drug being prescribed for osteoporosis is raloxifene, a selective estrogen-receptor modulator. Raloxifene is also being used for the treatment of breast cancer. Several calcium-related hormones have been tried for the treatment of osteoporosis, too. One is calcitonin, which is a natural-occurring hormone involved in calcium regulation and bone metabolism. Another one is teriparatide, an injectable form of human parathyroid hormone, which regulates calcium metabolism; it also has been approved for postmenopausal women and men. One of the things to take into consideration with people who have significant osteoporosis is fall prevention to avoid hip and spine fracture. If an individual has osteoporosis and has difficulty moving around, specific changes need to be made in their surroundings. This can involve installing bed guards and railings, as well as minimizing the use of stairs. Of course, you can use a cane; wear rubber-soled shoes for better traction; walk on grass rather than pavement; be especially careful walking outdoors in winter; and ensure that indoor rooms have no clutter, floors are not slippery, and rugs and carpets have skid-proof backing. In addition, don't walk with socks, stockings, or slippers, and make sure you use a rubber mat in the shower tub.  

 

Thursday, July 23, 2015

AMERICAN ADULTS DON'T EAT RIGHT

Few US adults meet fruit, vegetable intake guidelines: by, Rick Wilking  Published July 20, 2015.
  
Less than 15 percent of U.S. adults eat enough fruits daily to meet federal recommendations, but the numbers are even worse in some states, dipping as low as 7.5 percent in Tennessee, according to a new study. Even fewer adults eat enough vegetables to meet recommendations, Centers for Disease Control and Prevention (CDC) researchers found. "Fruit and vegetable intake has been persistently low for years but we just recently developed a way to look at how each state is doing" in terms of meeting recommendations, said lead author Latetia V. Moore of the National Center for Chronic Disease Prevention and Health Promotion at the CDC. "It is surprising how low intake is in some southern states but how disappointingly low it is across the U.S..  Moore and her coauthors analyzed the most recent Behavioral Risk Factor Surveillance System survey for all 50 states and the District of Columbia, using a new scoring procedure to compare state-reported numbers, which are usually expressed as "frequency of intake," to federal requirements, normally counted in "'cup's per day. Overall, in 2013, half of respondents consumed fruit less than once per day and vegetables less than 1.7 times per day. Researchers compared their responses to the Dietary Guidelines for Americans, which recommend that adults who get less than 30 minutes of moderate to vigorous physical activity each day should eat 1.5 to 2 'cup's of fruit and two to three 'cup's of vegetables daily. More active people may be able to consume more without adding too many calories to their diet. "All types of fruits and vegetables count, but the Dietary Guidelines for Americans recommend that most of our fruit intake come from whole fruit rather than fruit juice and that we eat fruits and vegetables that have limited amounts of added sugars and solid fat," Moore said. "The guidelines also recommend that we increase our intake of dark green and orange vegetables as well as beans. Overall, 13 percent of people in the U.S. reported eating enough fruit and 8.9 percent reported eating enough vegetables to meet that recommendation. Fruit consumption was lowest in Tennessee, with about seven percent of people meeting the recommendation, and highest in California, with 17.7 percent meeting the recommendation.  The proportion of Americans meeting vegetable recommendations ranged from 5.5 percent in Mississippi to 13 percent in California. The results are limited in that they rely on self-reported food consumption, which may not always be accurate, and because they did not include those living in nursing homes, long-term care facilities, military installations and correctional institutions, the study team cautions. It's also not possible to know whether these numbers represent an increase or decrease in fruit and vegetable consumption by state from the period prior to 2010, since the surveys changed the way they asked about produce consumption during that time, Moore said. "We do know that how many times per day adults eat fruits and vegetables did not change much from 2000 to 2009," and that children did start eating more fruits, but not vegetables, during that time, she said. Worksites, schools, childcare, and community settings should all have access to fruits and vegetables that are competitively priced, prominently displayed and promoted, she said. "Fruits and vegetables are major contributors of important nutrients that are typically lacking from Americans' diets and they can protect against many leading causes of illness and death like heart disease, stroke and some cancers," Moore said. "Eating fruits and vegetables in place of foods that are high in calories, added sxugars, and solid fat can also help with weight management.

Wednesday, July 22, 2015

COOKBOOK REMINDER

This is another reminder about our upcoming cook book.  If you have a contribution please be sure to get it to Dr. Ford by July 31st.  She will be reviewing your submissions for inclusion in the book so send your best.  Send to:




Until tomorrow




Bob and Johnye

Tuesday, July 21, 2015

EVERYBODY LOVES PIZZA

Surprising things you never knew about pizza By Dan Myers Published July 20, 2015. 
 
Ah, pizza. Ask a few people what their favorite food is, and it's bound to come up. Pizza is one of the most popular foods in America, and whether it's from a fast food joint, your supermarket's freezer section, a dollar-slice joint on the streets of New York, or an artisanal pizzeria, it always seems to taste good. But this magical combination of bread, cheese, and sauce didn't come into the world fully-formed, and we bet that there are some things you didn't know about it. People have been topping bread with stuff for thousands and thousands of years, and pizza can trace its roots to the earliest inhabitants of the Mediterranean. The ancient Greeks topped flatbreads with herbs, and the first documented use of the word "pizza" was in 997 AD in Gaeta, Italy. The precursor to modern pizza was developed in Naples, where by the late 1700s it became a local specialty of the city's poorer areas. Over time, two primary varieties developed in the city: marinara (topped with oregano, garlic, and olive oil) and Margherita (with tomato sauce, fresh mozzarella, and olive oil) - named in honor of Queen Margherita of Savoy, wife of the Italian king Umberto I. To this day, these are the styles preferred by Italian pizza purists. Pizza first made its way to the United States around the turn of the twentieth century, along with the thousands of Italian immigrants who descended on cities including New York City, Chicago, St. Louis, and Philadelphia. The first "pizza pies" sold in the United States were offered by street peddlers, and small pizzerias soon opened in Italian neighborhoods. America's first pizzeria is widely considered to be the one opened by Genarro Lombardi in New York in 1905. While it's still in business today, it's not America's oldest continuously operated pizzeria; more on that later. Today, pizza is far more than a regional Italian specialty or a delicacy of Italian enclaves. It's one of the most ubiquitous foods around, for one main reason: It's delicious. Whether it's a strictly Neapolitan-style Margherita pie, a meat-lover's pizza from your local chain, Chicago-style deep-dish, or a frozen pizza heated up in the microwave, there's just something about pizza that connects with us on a deeper level, one that hits all the pleasure sensors in the brain. Want to learn more about pizza? Check out these fun facts. 1.  There's an Organization That Verifies 'True' Neapolitan Pizza Around the World.  Founded in 1984, the Associazione Verace Pizza Nepoletana ("True Neapolitan Pizza Association") has set specific rules that must be followed if a pizzeria is going to call its product authentic Neapolitan: It must be baked in a wood-fired, domed oven; must be made entirely by hand (without the aid of even a rolling pin); must be no more than 35 centimeters in diameter; and can't be more than one-third of a centimeter thick at the middle, among other requirements. Crushed red pepper flakes are optional. 2.  Nobody Knows How the Word Originated.  There are a few competing theories for the etymological origin of the word pizza: The Ancient Greek words pikte (for "fermented pastry") and pitta ("bran bread"), the Italian word pizzicare (meaning "to pluck" as in "plucking quickly from the oven"); and the Old High German word pizzo ("mouthful"), brought to Italy in the sixth century by the Lombards. 3.  Tomatoes Weren't Always a Crucial Component.  Pizza was around long before European explorers first brought tomatoes back from the New World in the late 1500s, but they eventually made their way onto pizzas and became an essential component of the pies we know today. Nobody knows exactly who the first person was to add tomatoes to pizza, but we should all be very thankful for the development. 4.  The Outer Edge Is Called the Cornicione.  If you want to impress your friends, the next time you're eating pizza and somebody leaves the "bones" behind, ask them why they didn't eat the cornicione (say "cor-nee-cho-nay"), which means the cornice or the molding. Don't call it the crust; that's the name for the base that the toppings are added to. And yes, this does mean that Pizza Hut's latest creation should technically be called a hot dog-stuffed cornicione pizza. 5.  You Won't Find Pizza Slices in Italy.  Pizzas in Italy tend to only be served whole (the smallish Neapolitan ones, for example) or cut into squares or rectangles from a large tray, called pizza al taglio. The large, round pies you find in New York are an American invention - enlarged versions of Neapolitan pizza. Early New York pizza sellers sold whole pies for around five cents, but for those who couldn't afford a whole pie, the sellers cut them into wedges and sold them for a couple cents apiece, and the New York-style slice was born.  

Monday, July 20, 2015

Get ready Paragould.....

The Blind Bus will be rolling into Paragould on Saturday, August 8. Ms. Bonnie is checking on the church availability. When we have the location nailed down, I can set the time! Mark your calendar. Can't wait to see everyone!
Dr. Janet

VERY GOOD ADVICE

5 ways to be mentally strong: by Amy Morin, Published July 19, 2015.  

As a psychotherapist I've always had an interest in mental strength, but my interest in the subject became personal when I experienced a series of losses. In 2003, my mother passed away suddenly from a brain aneurysm. Then, on the third anniversary of her death, my 26-year-old husband died of a heart attack. A few years later, my father-in-law was diagnosed with terminal cancer and I found myself thinking things like, "Why do I always have to lose everyone? This is isn't fair. But ultimately, I knew that way of thinking wasn't going to be helpful. I knew indulging in unhealthy habits, like self-pity, would only provide a temporary distraction from pain. So I sat down and wrote my list of the "13 Things Mentally Strong People Don't Do" as a reminder to myself of all things I'd need to avoid if I wanted to face another loss with as much strength as I could muster. I never imagined that my list would go viral, or that I'd have an opportunity to expand my article into a book. I'm grateful those things happened, but initially, that list was meant for me. And I was glad that I had that list because within a few weeks of writing it, my father-in-law passed away. Here are 5 of the 13 things mentally strong people don't do: 1. Waste time feeling sorry for themselves While it's healthy to feel sad sometimes, dwelling on our misfortune and underestimating our ability to cope with pain is destructive. Self-pity keeps us focused on our problems, and prevents us from taking steps to improve our lives. Gratitude is one of the most effective ways to ward off self-pity. 2. Give away their power Blaming other people for the way we think, feel, or behave provides an easy way to shirk personal responsibility. But the truth is, no one has the power to make you mad. You're in control of your emotions and how you respond to others. Similarly, your boss can't make you work late. There may be consequences if you don't work late, but it's a choice. Take back your power by acknowledging your choices. 3. Fear taking calculated risks Emotions often cloud our judgement. When we're excited about an opportunity, we underestimate the risk. When we're anxious however, we overestimate the danger. Balance emotions with logic so you can calculate which risks are worth taking, and move forward with confidence. 4. Resent other people's success Watching other people achieve their goals can stir up feelings of envy. But every minute you spend resenting other people's success takes time away from working toward your goals. Write down your definition of success and focus on cooperating--rather than competing--with those around you. 5. Make the same mistakes over and over Sometimes, we're so focused on covering up our mistakes that we don't learn from them. Rather than make excuses for what went wrong, acknowledge your blunder. Invest your energy into learning from mistakes so you can avoid repeating them.

Sunday, July 19, 2015

NEED A NEW CASE FOR YOUR I THING

Apple touts 'tested to the limit' iPhone & iPad cases in new online store campaign By Sam Oliver Tuesday, July 07, 2015.

Apple on Tuesday updated its virtual retail outlet with a new section that describes the company's approach to testing and approving the third-party cases it stocks for the iPhone and iPad. "Each case design for iPad, iPhone, and iPod touch has to go through a series of tests before it reaches the Apple Store," the "Apple Tested Cases" page reads. "So you can be sure the case you buy is a perfect match for your iOS device. The new section touts five testing areas: design, camera, acoustics, sensors, and cellular and wireless. Apple says that design encompasses both fit-and-finish - ensuring that ports and jacks remain completely accessible - and durability, measured with a series of drop tests. Camera openings are tested to ensure that they don't interfere with the camera's field of view or photo quality. The company also checks that cases do not interfere with the quality and volume of speakers and the sensitivity of microphones, or cause problems with various sensors and wireless communications systems. While Apple has never made its Apple Store stocking requirements public, it has long been known to exert pressure on suppliers to deliver products that meet with its expectations, which in many cases results in custom Apple Store-exclusive variants. Combined with recent reports that Apple is planning to roll out new co-designed packaging for third-party accessories, Tuesday's move seems to hint at a continued expansion of Apple's "premium feel" retail revamp under Angela Ahrendts. . 

Saturday, July 18, 2015

update

Hello all,
Life sure gets crazy sometimes! This past week was my crazy time...hubby in hospital, MSU folks in town, everyone pulling me in a different direction...I felt like the old cartoon character "Gumby". Remember him, he was green and stretchy....that was my week, I felt like a rubber band--stretched to the limit! Thankfully, I have great friends, great staff and lots of portable technology!

Barbara, Ms. Betty and Ms. Helen pulled off a perfect luncheon. Krystal and Mr. Earl handled logistics and Bob and Johnye stepped in to assist. Dr. Boehm wowed everyone with his advice and approachability. A very special thanks to all of you for the help!

Hubby is home. We are determined to have our beach vacation with those adorable grandbabies....so if all goes as planned, I will be spoiling babies and dipping my toes in the Atlantic Ocean soon.

Cindy is recuperating from surgery so if you need OIB assistance please call Krystal.  She and Barbara will be handling things. We are sending prayers and good thoughts to Cindy. We wish her a speedy recovery!

Counting my blessings,
Dr. Janet

THERE'S AN APP FOR THAT

New app delivers prescription drugs to your door Published July 17, 2015. 
 
You've been ordering pizzas to your door, well now it's time you started getting your heartburn medicine delivered, too. Zipdrug, a New York-based tech startup, launched a mobile app this week that offers on-demand delivery of prescription drugs from your local pharmacy. To make it happen, a patient creates a profile on the app (including a photo of his or her insurance card) and enters details of the prescription and pharmacy. Patients can then specify whether they want the drugs delivered to their home or office. For a flat $10 fee, a bike messenger will show up with the prescription at any address in Manhattan within an hour. That's a big relief, Zipdrug says, for ailing patients who aren't up for the trip. "I've never been to a pharmacy and felt thrilled to be there" whether sick or not, says Zipdrug founder and CEO Stu Libby, citing the long lines and Soviet-style service familiar to many New Yorkers. The former Google exec finally got fed up when a hospital failed to give his own father the medication he was prescribed after a near-death, heart-related incident last year. Libby's father recovered, but the incident was a wake-up call, he says.  

Friday, July 17, 2015

HAVE ANOTHER THIN MINT


Things you didn't know about Girl Scout cookies By Dan Myers Published July 16, 2015.   

Every year when Girl Scout cookie season rolls around, thousands of troops take to the streets with a very noble mission: to sell as many boxes of cookies as humanly possible. Girl Scout cookies are win-win: Girl Scout troops get to keep the proceeds as a much-needed source of revenue, and everybody else gets cookies. But even if you've never missed an opportunity to stock up on Thin Mints, we bet that there are some things you didn't know about these popular cookies. Girl Scout cookies trace their roots all the way back to 1917, when an Oklahoma troop sold cookies as a fundraiser at their local high school. Five years later, scout magazine This American Girl published some cookie recipes for troops who wanted to fundraise, and in the 1930s the first official sales were held in major cities, and bakeries were licensed to produce cookies. Today, Girl Scout cookies are produced by two bakeries: ABC Bakers (a subsidiary of Interbake Foods, which is owned by George Weston Limited) and Little Brownie Bakers (a subsidiary of Keebler, which is owned by Kellogg's). Even though there are some major differences between the cookies they produce (more on that later), the "core five" cookies are the same (albeit with different names, occasionally): Thin Mints, Trefoils or Shortbread, Samoas or Caramel deLites, Tagalongs or Peanut Butter Patties, and Do-si-dos or Peanut Butter Sandwiches. If your cookies are called Samoas, Tagalongs, Trefoils, and Do-si-dos, they're produced by Little Brownie; If they're called Shortbread, Caramel deLites, Peanut Butter Patties, and Peanut Butter Sandwiches, they're produced by ABC. The only cookie name shared by both companies is Thin Mints. Once the cost of the cookies is repaid to the bakery, all of the net revenue raised through Girl Scout Cookie sales stays with the local councils and troops. They're allowed to set their own goals on how the money is spent, from financing outings to events and museums to buying materials for community projects and maintaining camps and properties. So whether you call them Samoas or Caramel deLites, it's hard to argue that buying Girl Scout cookies doesn't support a good cause 1.  Girl Scouts Sold Calendars.  During WWII Because of Rationing.  Everyone did their part to support the war effort during World War II, including the Girl Scouts. They weren't able to sell as many cookies as usual during the war, so they sold calendars as well, and also collected cans of fat to donate and sold War Bonds at no profit. 2.  Thin Mints Are the Top Seller.  About 25 percent of all Girl Scout cookies sold are Thin Mints. Samoas/Caramel deLites are in second place with 19 percent of sales. 3.  Gluten-Free, Vegan Girl Scout Cookies Are Now Available.  Both Little Brownie's Toffee-Tastic and ABC's Trios are now gluten-free. Little Brownie's Thin Mints and ABC's Lemonades, Thanks-A-Lots, Thin Mints, and Peanut Butter Patties are vegan. 4.  There Are Dozens of Discontinued Varieties.  Remember All Abouts? How about Cinna-Spins, Olé Olés, Savannahs, Snaps, or Van'chos? These are just some of the more than 40 Girl Scout cookie varieties that have come and gone throughout the years 5.  There's a Mobile Cookie-Locator App.  Looking for the nearest Girl Scout cookie seller? There's an app for that. Once you find the nearest seller, you can send her your email address, and she'll send you a link to her cookie selling site, where you can see what her troop plans to do with the money and place your cookie order online. Introduced last year as part of their national Digital Cookie platform, it's the biggest new initiative in the entire history of Girl Scout cookies.  

Thursday, July 16, 2015

AN INSPIRATION TO ALL


Blind vet completes Ironman triathlon Published July 13, 2015.  

The first blind active duty officer in the Army has accomplished another achievement: Completing the IRONMAN triathlon. Retired Army Captain Scott Smiley, 35, finished the IRONMAN Coeur d'Alene in Idaho on June 28, with the help of his guide and brother-in-law Andy Cooper. The triathlon consisted of a 2.4-mile open water swim, a 112-mile bike ride and a 26.2-mile run. Scott finished in 16 hours, 48 minutes and 25 seconds. Smiley, who lives in Spokane, Washington, was only six months into his deployment in northern Iraq in 2005, when a roadside suicide bomber left him badly wounded and completely blind. Half of his body was partially paralyzed. "I literally thought, my life is over, I have no reason to live, I have no reason to do anything, but it was the love of my wife, my family, my friends, and God that inspired me to drive on, to forgive and to push forward in life and to continue to fight and eventually continue to serve.  During the triathlon, Smiley was struggling after the first half of the run, but his wife, Tiffany, reminded him that he was doing it for those who serve, those who had given so much but couldn't be there. "That's truly why I wanted to do an Ironman," he said. "To motivate, inspire others. I publicly speak now and it's just to help others realize there's a reason to give and a reason to give back. The weather proved a challenge- 105 degrees Fahrenheit at the start of the marathon- but Smiley and his partner kept each other inspired and moving forward. "It was just about not quitting," he said. Smiley and Cooper worked in tandem to prepare for and complete the event. "It's true teamwork and working together that gives me the ability to become an Ironman," he said. Smiley, a public speaker, told Lee that his wife, three kids, family and friends keep him motivated. "It's the love that surrounds me that gives me the ability to fight, continue to move forward and continue to make an impact," he said. 

Wednesday, July 15, 2015

COOKBOOK REMINDER

This is another reminder about our upcoming cook book.  If you have a contribution please be sure to get it to Dr. Ford by July 31st.  She will be reviewing your submissions for inclusion in the book so send your best.  Send to:



Until tomorrow



Bob and Johnye

Tuesday, July 14, 2015

GOOD NEWS FOR INSULIN DEPENDENT DIABETICS


Insulin patches could replace injections for diabetics Published July 13, 2015.  

A joint North Carolina State University and University of North Carolina research project aims to replace insulin injections with an insulin patch.   Dr. Zhen Gu, a professor at the schools' Joint Department of Biomedical Engineering, says the work aims to make administering insulin autonomous for patients. "Basically we developed this kind of so-called smart insulin patch, which can sense the blood sugar level and release insulin at the right time only once the blood sugar goes up. And the insulin can be quickly released from the patch. And meanwhile once the blood sugar level goes to a normal range, less insulin is released or is just inhibited. Basically this kind of smart insulin patch is not only smart, it is also painless," Gu says. For the 21 million Americans diagnosed with diabetes and the more than 387 million world-wide affected by the disease, insulin injections and attached insulin pumps could become things of the past. Gu and others at the lab found a way to fit more than 100 microneedles onto the patch, which is less than the size of a dime. Each microneedle is filled with insulin and enzymes that can tell when blood sugar levels change. "Basically we designed this kind of material - a polymer-based material, which can be sensitive to blood sugar level changes," Gu says. "We are trying to mimic the functioning of the beta cells or the vesicles inside the beta cells and they can disrupt once the blood sugar goes up and release insulin quickly. Currently the patch works for up to nine hours, according to a recent study, but Gu hopes they can design it to last for several days. This measure, Gu says, will decrease the chance of human error when administering insulin shots, which he says can be imprecise both in location and in the amount of insulin injected. Administering too much insulin can induce hypoglycaemia when blood sugar levels fall too much. In the worst cases, it could result in death. The patch has been tested on mice and other animals and so far the results are promising, Gu says. "We are very proud of our technology and we really want to translate it as fast as possible. Currently we are working with our collaborators and testing it on animals like mini pigs in a study. If this mini pig study successfully demonstrates it, we will move to the human being testing immediately," Gu says. 

Monday, July 13, 2015

CAN YOU BELIEVE THERE'S STILL REAL CUSTOMER SERVICE AROUND


Customer service shocker By Jason F. Wright Published July 10, 2015. 

Many have knocked on Pam Jones' front door in Harpers Ferry, West Virginia. She's pulled it open to find family, friends, fundraisers, strangers and salesmen. Like most of us, nothing surprises her anymore. The evening of June 24 was no different. When the doorbell rang at 9:45 p.m., Pam wasn't surprised. No, she was shocked . Earlier that day, Jones shopped at a Costco Warehouse in Frederick, Maryland. She's been a member there 15 years and says she "dearly loves" that location. But several weeks earlier, she'd gotten all the way home before discovering the cheese she'd purchased was moldy. It was such a rare mistake, she let it go and chalked it up to just one stubbed toe in her long, satisfying dance with the warehouse giant. Mike Shake deserves to know that he made a difference that night at 9:45 p.m. at a front door in West Virginia. Not just for Pam Jones and her family, but for all of us who want to believe there are still companies and managers who put people first and go out their way to lead by example. Then on June 24 while putting away her Costco stash, Pam noticed she'd bought damaged, split bananas. Even though she accepted responsibility for not checking more closely, she was still irritated at the inconvenience. She hated to complain to her favorite store, but it was time for a phone call. Jones punched in the number and explained her frustration to an employee on the other end. They soon paged manager Mike Shake, and the rest of the story is the stuff of customer service legend. "He was the kindest manager I've ever spoken to," Pam said of the man she'd not previously met. After sharing her story, Shake didn't just apologize profusely, he refunded her for both purchases. Surprising? Not really - isn't this what any good manager would do? Later that evening, feeling satisfied that her favorite retailer had treated her well and would retain her loyalty, Jones slipped on her pajamas and prepared to say goodnight to her productive day. Then, the doorbell rang. "I couldn't believe it! Jones said. "There was Mike Shake at my front door holding fresh cheese and bananas. After working a very long day, Shake had truly gone the extra mile on his way home to Berryville, Virginia to demonstrate that his apology wasn't just about a hurried words on the phone. He didn't just want to say Costco was sorry, he wanted to show it. When I asked Jones what went through her head when she saw him at her front door, she described feeling like she was living in an episode of "Little House on The Prairie. "What a breath of fresh air! It was so refreshing that someone would care enough to stop by our home to make something right. It was so highly unexpected and greatly appreciated. Before calling it a night, Jones popped onto Facebook to share her experience. She believed that kind of service needed a spotlight bigger than just the one on her front porch. Her friends reacted with similar amazement and the post became one her most "liked" ever. That's not really surprising either, is it? We live in a contentious world saturated bad news and bad reviews. Everyone knows that social media can spread global fires from the tiniest of digital sparks. As I've written before , we waste too much air shouting into our angry bullhorns of dissatisfaction. Sometimes customer service isn't so awful. Sometimes it's good, other times it's great, and on occasion, it's downright extraordinary . As it should be, this remarkable Costco manager has no idea he's being highlighted in this column. When I reached out to him to confirm the experience and inform him Jones had shared it on social media, he said humbly, "Wasn't that nice of her? Then he changed the subject. Despite his likely embarrassment and this warehouse-sized shoutout, Mike Shake deserves to know that he made a difference that night at 9:45 p.m. at a front door in West Virginia. Not just for Pam Jones and her family, but for all of us who want to believe there are still companies and managers who put people first and go out their way to lead by example. Next time your doorbell rings and you're in your PJs, check your bananas. You just never know who's on the other side of the door.

Sunday, July 12, 2015

THE ORIGIN OF KETCHUP MAY SURPRISE YOU


Where does ketchup come from? Bizarre origin stories of popular condiments By Dan Myers Published July 10, 2015.       

When was the last time you gave any thought to a condiment? How often do you look at a bottle of ketchup and wonder how it came to be so popular? Not very often, most likely, but the fact of the matter is that these sauces are eaten all over the world, and many of them have global influences. Condiments like ketchup, mustard, mayonnaise, salsa, and barbecue sauce are essential components of just about every well-stocked refrigerator. They're so versatile that we put them on far more foods than we even realize, and no summertime cookout is complete without ketchup and mustard for topping burgers and hot dogs. But every popular food got its start somewhere, and the history of condiments is in many cases more fascinating then the history of the dishes with which they're paired. These spent years and years being perfected and working their way into the popular diet, and in some cases, dozens of brands and varieties popped up along the way. So the next time someone tells you how boring mayonnaise is, or you wonder why New Orleans-style barbecue shrimp doesn't resemble any barbecue you've ever seen, remember that these condiments all have a backstory that's more far-out than most people realize. 1.  Ketchup  Ketchup traces its history to a seventeenth-century Chinese sauce made of pickled fish and spices called kÄ™-chiap. It was discovered by English explorers, who brought it back to England, where they made it less fishy and added more mushrooms and shallots. Tomatoes didn't make their first appearance in ketchup until the early 1800s. 2.  Mustard  Mustard as a condiment dates back to ancient Roman times. The Romans mixed unfermented grape juice (called "must") with ground mustard seeds, and the resulting product was termed mustum ardens , or "burning must. The term was eventually shortened to just mustard . The recipe was exported to France, and by the 1200s the city of Dijon became the French capital of mustard (in 1336, 70 gallons of mustard was eaten at one gala there). In 1777, mustard maker Maurice Grey went into business with his financial backer Auguste Poupon and created a legend. Before this time, most mustard got its start as "mustard balls," which were made by rolling wet ground mustard seeds with flour and cinnamon, then letting them dry and mixing them with vinegar or white wine as needed. 3.  Mayonnaise  Mayonnaise is first mentioned in the early 1800s, but the sauce these sources refer to is more of an aspic or jelly. The first mention of the emulsion we know today comes from an 1820 work by chef Alexandre Viard. The actual origin of the cold sauce remains a mystery, but it was popular among the French upper classes before it became a condiment of the people. 4.  Salsa  Salsa is simply the Spanish translation of the word "sauce," which in turn derives from the Latin word for "salty. There are hundreds of varieties of salsa in Latin American countries, but the one we find in jars in the supermarket is a cooked version of pico de gallo or salsa cruda, which is simply diced tomatoes, peppers, and other vegetables. Fresh diced vegetables can't be jarred as-is, however, so they're cooked (and vinegar is usually added) to stabilize the mixture. Supermarket salsa is nothing like what you'll actually find in Mexico, but that's a big part of the reason why it's so popular. 

Saturday, July 11, 2015

Cook book

 Hi everyone,
If you would like to contribute to the cookbook with a recipe or good idea, please get them to me! Also,
If you have a hearing loss and would like to go to Helen Keller in New York to test new technology for our program, please let me know.
Dr. Janet

ARE YOU READY FOR A DRIVERLESS CAR


2 visions emerge for getting self-driving cars on road Published July 10, 2015.  

The plan of traditional automakers is to gradually automate more functions of driving until, perhaps by 2025, some cars will be fully capable of driving themselves. But Google, Alibaba, Baidu and other tech companies are aggressively working on their own self-driving vehicles, and could leapfrog the car industry in bringing them to market.   ) Two competing visions could determine how you first experience a driverless car. Traditional automakers like Mercedes and Toyota already make vehicles equipped with systems that keep cars within their lanes, apply the brakes or park by themselves. Their plan is to gradually automate more functions of driving until, perhaps by 2025, some cars will be fully capable of driving themselves. But Google, Alibaba, Baidu and other tech companies are aggressively working on their own self-driving vehicles, and could leapfrog the car industry in bringing them to market. Google, for instance, promises to deliver a self-driving car in five years. Some experts predict that car companies will continue to make the cars consumers buy and park in their driveway, and eventually some will be driverless. When the tech companies roll out driverless cars, they likely will be self-driving taxis for urban areas. But the outcome is far from certain. Tech companies could go into the business of making cars for consumers, or automakers could choose to develop and operate their own fleets of self-driving taxis. "One thing is clear. The next five to ten years are going to be the most disruptive we've ever seen in the history of personal transportation," says Karl Brauer, a senior analyst at Kelley Blue Book. Right now, automakers have several advantages. They have a decades-long history of research and development and a deep understanding of drivers' needs and habits. They're also not new to semi-autonomous driving: Mercedes-Benz pioneered adaptive cruise control in 1999, while Nissan introduced lane-keeping in 2001. Automakers also have the manufacturing capacity to make the vehicles and the dealerships to sell them. Those are cash-intensive parts of the business that tech companies likely want no part of. Advances are coming at a furious pace. Mercedes and Infiniti offer cars that steer themselves and stay within their lanes at highway speeds. Tesla Motors is expected to offer hands-free driving on the highway this summer; Cadillac will offer it next year. In 2017, Audi will offer low-speed, hands-free driving that works during traffic jams. But Google says a gradual approach to going driverless is wrong - and even dangerous. "The prevailing philosophy is that we're going to take the driver assistance systems that are in the vehicle today and we're going to incrementally make those better and better, and eventually we'll get to this point where we have self-driving cars," Chris Urmson, the director of Google's self-driving car program, said in May at an event in Mountain View. "We fundamentally don't believe that's the case. We believe that's like saying, 'If I work really hard at jumping, one day I'll just be able to fly.' Urmson worries that drivers might wrongly assume cars have autonomous features, or they might get overconfident in their car's abilities and forget to take back the wheel in an emergency. Case in point: Last month, a driver testing a Volvo XC60 in the Dominican Republic plowed into some bystanders. The driver thought the car had a system that would stop automatically if it detected pedestrians. But Volvo says the car wasn't equipped with that optional system. Google is currently testing a small fleet of self-driving cars with no steering wheel. It plans to drive the cars thousands of miles on California highways and backstreets, teaching them all the tricks of driving. Such an approach has its benefits. Unlike car companies, which have to constantly update current models, tech companies can take the time to dream big and perfect their self-driving systems. Customers would likely trust a self-driving system backed by Apple or Google. And tech companies have plenty of money: Google ended the first quarter with $65 billion in cash and marketable securities; General Motors had $21 billion. But many experts find Google's five-year timeframe overly ambitious. There are legal and ethical issues to work through before driverless cars go mainstream. Google's cars also require extremely detailed mapping, which has only been done in limited areas. David Zuby, the executive vice president of the Insurance Institute for Highway Safety, says the auto industry is cautious for a reason. "If someone sets the technology too far ahead and it fails, that could set things back more than if you would let it evolve more naturally," he said. Egil Juliussen, who analyzes autonomous technology for the consulting firm IHS Automotive, says both approaches can work. He says the automakers' gradual approach will cut down on accidents. In the meantime, Google, Uber and others will perfect their technology by focusing on low-speed, self-driving pods for urban areas. But at some point, Juliussen says, car companies will switch from semi-autonomous to fully autonomous driving. Automakers might ditch their own self-driving systems in favor of software from a tech company. Or they might try to fight off the tech companies and keep the profits to themselves. The demand for autonomous capability is there. Forty-four percent of U.S. car buyers say they would consider buying a self-driving car in the next decade, according to a recent survey of 1,500 consumers by the Boston Consulting Group. The biggest motivators: Lower insurance premiums and increased safety. For now, the most advanced systems are pricey and found on luxury brands. Buyers of the new Volvo XC90 SUV must pay $2,850 extra for lane keeping, adaptive cruise control and blind spot detection. But mainstream brands aren't far behind. More autonomous technology will hit the market as cameras and sensors get cheaper and consumers demand more safety features. Toyota promises automatic braking, pedestrian detection and lane departure warning for just a few hundred dollars on all of its vehicles by 2017. BCG expects fully autonomous cars that drive on highways and in urban environments by 2025. By 2035, the company predicts that about 10 percent of vehicles sold globally will be fully autonomous and 15 percent will be semi-autonomous, based on the past rate of adoption of other features like adaptive cruise control. Xavier Mosquet, who heads BCG's automotive practice, foresees a day when buyers will sacrifice things like engine power or a premium interior in favor of more autonomous technology. "They will say, 'What the car does for me is as important as other features in the car,'" he says. Then the question becomes whether they opt for a car with a Mercedes logo or a Google one. 

Friday, July 10, 2015

DO YOU UNDERSTAND HYPERTENSION


'Hypertension' doesn't mean 'too much tension' Published July 08, 2015.  

Not everyone understands what "hypertension" means, and as a result, some patients may not take their blood pressure medications as directed or manage lifestyle factors effectively. .  More than half of people with high blood pressure do not have the condition well controlled, which may in part be because patients often believe hypertension means "too much tension," or too much stress.  In fact, hypertension refers to high blood pressure, which happens when the force of the blood pumping through arteries is too strong. Chronic high blood pressure, which affects one in three U.S. adults, can strain the heart, damage blood vessels, and increase the risk of heart attack, stroke, kidney problems, and death, according to the National Institutes of Health. Patients who misunderstand the term hypertension may turn to stress management to control their high blood pressure, which they view as a psychological condition more than as a physiological one, according to Barbara G. Bokhour and Nancy R. Kressin of Boston University School of Public health.  These patients may focus more on stress management instead of taking effective blood pressure medications, like diuretics, calcium-channel blockers or ACE inhibitors. "It's always good to manage stress, that's always good for your health writ large, but for hypertension in particular stress management will not be enough,” Bokhour said. Lifestyle management and taking prescribed medications are much more important for controlling blood pressure, she said. Providers often use the term hypertension and don't always explicitly link it to blood pressure, she said. "They are using the words interchangeably, but patients do not always understand that they are interchangeable," Bokhour said. She and Kressin suggest that doctors should exclusively use the term "high blood pressure" rather than hypertension when talking to patients. "I tend to agree with the authors' suggestion," said Dominick Frosch of the David Geffen School of Medicine at UCLA, who has also studied common beliefs about high blood pressure and their effects on medication use. His own study found that patients who were told about "hypertension" were more likely to think that relaxing more would be an effective treatment, compared to patients who were told about the same condition under the name "Korotkoff syndrome. But regardless of label, patients still believed that evidence-based medications would be more effective than relaxing more, Frosch noted. "A substantial proportion of individuals who have high blood pressure inadequately control it, contributing to avoidable cardiovascular disease risk as well as kidney disease risk.  If we want our healthcare system to be patient-centered, why would we use ambiguous, potentially misleading language, when we can just as well avoid it," he said. "Tradition and habit are not good justifications, in my view. Patients may also be reluctant to take their medications regularly because in many cases high blood pressure does not cause symptoms, so they do not feel like they need medication, Bokhour said. Doctors should first ask patients what they understand about high blood pressure, then have a conversation clarifying any misunderstandings, she said. "Oftentimes providers give information in a very rapid format, using biomedical language," which is true for other conditions as well, not just high blood pressure, she said. "Hypertension is one of many, many examples where providers have an understanding of a word and patients do not, and if we don't start to bridge that gap we'll continue to over-treat and under-treat," she said. 

Thursday, July 9, 2015

EVERYBODY LOVES A BURGER


5 tips for a healthier burger By Tanya Zuckerbrot Published July 07, 2015.  

Some ingredients that make burgers juicier and tastier also make them better for you. Go grass-fed: Go with grass-fed beef. The flesh of animals raised eating grass (instead of corn and grain) is lower in fats and calories. Grass fed beef can have as much as 1/3 less fat compared to a similar cut of a grain fed animal, and it is also richer in omega-3s. Omega-3s has been proven to reduce a person's risk of heart attack as well as depression, schizophrenia, and Alzheimer's disease. Grass fed beef has also been shown to contain four times the amount of vitamin E, a fat-soluble antioxidant that protects cells against free radicals known to promote cellular aging. Serve on a high-fiber bun: Traditional white flour buns are pretty empty nutritionally and contain minimal traces of fiber. For a heartier and more satisfying burger, place your patty in between a sesame Ezekiel bun that contains 6 grams of fiber, 9 grams of protein, and 170 milligrams of healthy potassium! Ezekiel buns are made from sprouted grains, which have been shown to lower blood pressure while also helping control blood sugar levels. Swap ketchup for tomato slices: Check out the nutrition label and you'll see that just one tablespoon of ketchup contains a whopping 4 grams of sugar. Ketchup also contains the artificial sweetener high fructose corn syrup, which has been associated with the increase in obesity. Why settle for the extra calories and fillers when you can enjoy the juicy, sweet, and rich flavor of a nutrient-rich tomato? One medium tomato provides the body with 28 percent of its daily value of immune boosting Vitamin C. Add vegetables: For a juicier, tastier burger, try mixing chopped vegetables into your ground meat patties. Mushrooms, onions, and zucchini are great choices that add delicious flavor and texture, while also providing a host of energy producing nutrients such as thiamin, vitamin B6, vitamin C, and vitamin K. Water-rich vegetables also provide added moisture to burgers, which helps prevent them from drying out on the grill. Diet-friendly spices & herbs: Cooking wisely means using ingredients that taste good while also benefitting your health. Using nutrient rich spices offers an array of benefits, especially when it comes to weight control. Cayenne pepper for example has been shown to increase the rate at which the body burns calories. According to a study conducted at Tufts University, consumption of turmeric helps suppress the growth of fat tissue.

 

Wednesday, July 8, 2015

COOK BOOK

This is another reminder about our upcoming cook book.  If you have a contribution please be sure to get it to Dr. Ford by July 31st.  She will be reviewing your submissions for inclusion in the book so send your best.  Send to:


Until tomorrow


Bob and Johnye

Tuesday, July 7, 2015

DO YOU SLEEP WELL?


Awake again: Is it insomnia or just segmented sleep? By John Swartzberg Published July 06, 2015. 

Sleep is perhaps the most mysterious of all human activities. No one can really define its biological function - that is, why it is restful and necessary - or come up with a foolproof recipe for a perfect night's rest. Soldiers, shift workers, medical residents, flight attendants, pilots and most parents of small children suffer from insufficient sleep. Parents of adolescents who drive cars at night or stay out late, for whatever reason, may also find themselves unable to sleep. If you're older, you are likely to sleep less soundly. You need just as much sleep, but it's harder to get it in one stretch. You may have trouble falling asleep or staying asleep. But is it insomnia? There's a lot of buzz on television and in other media these days about insomnia. Several companies - which some doctors have taken to calling the "sleep-industrial complex" - have been busy persuading you that lack of sleep is an epidemic peculiar to modern life, as well as a serious health risk, and that the first logical step is to spend $1,500 on a mattress. (Everybody needs a comfortable place to sleep, but an expensive bed is not likely to solve your problems. Millions of people sleep well on mats on the floor.) And seductive ads for sleeping pills assure you that drugs are the answer - also not so. Commonly what plagues older people is a period of wakefulness in the middle of the night. You fall asleep easily, but at 3 a.m. you're wide awake. In fact, this may just be a normal function of human sleep rhythm, as I remind myself when this happens to me. It's more convenient to sleep eight hours straight, but not harmful if you don't. "Segmented sleep" is such a well-known pattern that many languages have names for "first sleep" and "second sleep. In medieval times, people used the waking interval to talk with their bed partner, make love while the children slept, or pray. Good ideas, but I find that reading is the most relaxing. After half an hour or so I fall asleep once more. [How Much Sleep Should You Get? New Recommendations Released] Falling back into blissful sleep I bring this up because in matters of insomnia, staying calm is important. Anxiety can make insomnia worse. Instead, try to retreat from your problems at bedtime. Read or listen to music - some quiet activity that relaxes you.  Cut down on caffeine during the day. And make your bedroom sleep-friendly. Keep it dark, quiet and use it only for sleep and sex. [ Mindfulness Meditation May Help Older Adults Sleep Better ] In most cases, such practical self-help (as opposed to medical approaches) does the trick. But if this doesn't help, and sleep deprivation is ruining your ability to enjoy life, you may need to go further. Talk to your doctor about going to a sleep disorders center, or trying cognitive behavioral therapy for insomnia. CBT for insomnia helps people recognize and change poor sleep habits. People often start by keeping a sleep diary. With the therapist's help, patients identify bad sleep habits, such as taking long naps, and gradually replace them with a healthy sleep schedule. You might also consider a sleeping pill, although most are recommended only for short-term use. Keep experimenting until you find what works for you.