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Archive for October, 2011

Halloween will be here in a few days, and many kids will be out trick-or-treating. It’s an exciting night for all of the costumed children. To help ensure safety, I’ll share some tips from the American Society of Pediatrics, as well as some of my own thoughts.

All dressed up

– Costumes should fit properly and be bright, reflective and flame-resistant.

– Facial makeup and hats are worth considering as an alternative to a face mask that can block vision.

– If a sword, cane or stick is part of a costume, it should not be too sharp or too long.

On the trick-or-treat trail

– A parent or responsible adult must accompany young children on their rounds in the neighborhood.

– Trick-or-treaters should only go to well-lit homes and should not enter any houses.

– Groups should remain on well-lit streets and use sidewalks or the far edge of the road, facing traffic.

– Each group should carry a flashlight and a cell phone.

– Walkers should cross the street at crosswalks and never cross between parked cars.

– Older children and teens going out without an adult should let parents know where they are going, have a curfew to return and stay in a group.

Home safe home

– Clear a path to your door to avoid tripping a child.

– Keep the pathway and the doorway well lit.

– Restrain pets that might cause harm to a child.

Carving a niche

– Adults, not children, should handle pumpkin-carving knives. Children can scoop out the insides and draw a face on the pumpkin for an adult to cut out.

– A battery-powered light is safer than a candle to give jack-o’-lanterns their eerie glow. It’s best to avoid using an open flame in any decoration.

A healthy Halloween

– Youngsters should have a good meal before they collect all their sweet goodies.

– When they return home, a responsible adult should inspect the treats and discard anything that is spoiled, unwrapped or suspicious.

– Rationing candy means it may be enjoyed for many days following Halloween.

Have a happy and safe Halloween!

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Halloween is soon upon us, and our little trick-or-treaters will be carrying home bags full of candy. As candy is full of sugar, I’d like to discuss the effects of sugar on our health.

The average American consumes a whopping 2 to 3 pounds of sugar a week, about 130 pounds a year. That’s up from 25 pounds per year just 20 years ago. This rapid increase in consumption is because sugar is increasingly being added to many of our daily foods, such as soda, breakfast cereal, bread, mayonnaise, peanut butter, salad dressing, canned goods and many other food products.

The main problem of eating too much sugar is that it adds extra calories to our diet; in most cases, much more than we need. Extra calories add up to weight gain and eventually to obesity, which is one of our greatest health epidemics. Obesity from eating too much sugar can cause health problems such as diabetes, high blood pressure, heart attacks and strokes.

Sugar is the main cause of dental cavities and tooth decay. It is also associated with an increase in triglycerides (a type of fat in the bloodstream), which can be another cause for heart disease.

There are many other possible — but not necessarily proven — health problems related to excessive dietary sugar, such as suppression of the immune system, hyperactivity in children, arthritis, asthma and many more diseases.

Some think that natural sugar, such as that found in fruits, dairy products and other foods, is healthy. This is true only to the extent that these foods also contain healthy amounts of vitamins, fiber and other nutrients.

Sugar is sugar, no matter what it’s called. There are brown sugar, high-fructose corn syrup, dextrose, glucose, lactose, maltose, sucrose, molasses, honey and others. They all contribute calories.

The American Heart Association says that women should get no more than 100 calories a day from added sugars. That’s about 7 teaspoons, roughly 25 grams, which is about equal to one typical candy bar. Men should get no more than 150 calories from sugar. That’s about 10 teaspoons, roughly 38 grams, the amount found in 12 ounces of soda. Most Americans get more than 22 teaspoons — 355 calories — of added sugar a day, far exceeding healthy guidelines.

The best way to cut back on added sugar is to limit, if not eliminate, soft drinks from your diet. Many other drinks are high in sugar, including ready-to-drink teas, sweetened alcoholic or caffeinated drinks, and juice drinks. To satisfy sweet cravings, try eating fresh fruit. For snacks, swap candy and sweets for air-popped popcorn, dry roasted nuts and baked tortilla chips.

Look at food labels, which list the ingredients and often give the amount of sugar measured in grams.

The bottom line is that most of us consume enough naturally occurring sugar in a well-balanced diet. The more we can cut back on candy, sodas, pastries, cakes and cookies, the healthier we will be.

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Patients seeking medical care today are having more frequent exposure to non-physician providers, such as physician assistants and nurse practitioners. Both of these groups of health care practitioners are professionals licensed to practice medicine under the supervision of a physician.
They can perform a wide variety of medical duties, from basic routine medical care to highly technical procedures. They may also work as surgical assistants to a surgeon. Their patients can range from newborns to the very elderly. They can be found in virtually every medical and surgical specialty.

In rural areas that are short of physicians, they often work independently, conferring with a supervising physician as necessary and as required by law. Their responsibilities are determined by their experience, their working relationship with the supervising physician and state laws.

The first physician assistant program began in 1965 at Duke University Medical Center in North Carolina. Many of the first students in this program were Navy corpsmen who had received considerable training and on-the-job experience in the Vietnam War but had no options to use their talents upon return home to the U.S.

The nurse practitioner program began at the University of Colorado, also in 1965. Unlike physician assistants, nurse practitioners first receive their registered nurse degree and then go through further training to practice medicine under a physician’s supervision.

Both nurse practitioners and physician assistants can:

**Take medical histories and perform physical exams.

**Prescribe medication and order medical tests.

**Diagnose and treat illnesses.

**Counsel patients and promote wellness.

**Perform minor surgical procedures independently.

**Assist in surgery.

Their practice may also include administrative services, education and research.

Both groups have to pass a national certification exam, be continually reexamined after a number of years and also complete a prescribed number of continuing medical-education hours to maintain their licenses.

Physician assistants and nurse practitioners can be found serving a wide variety of medical needs in settings from remote rural areas to major urban centers. They work in physicians’ offices, hospitals, clinics, the armed forces and government agencies.

I have worked with nurse practitioners and physician assistants for the major part of my career, dating back to the mid-1970s. They have been a tremendous asset to my practice, as well as to the many physicians who call upon their talents and skills.

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