bright sun thinkstock 83404658After a long cold winter, we’re all happy to see and feel the warmth of the sun.  It makes us look and feel healthy, and we actually need some sun exposure to produce vitamin D, which helps in the absorption of calcium for healthy bones. Most of us are aware that the sun’s ultraviolet (UV) rays can cause serious damage to the skin that can lead to melanoma and other skin cancers. But we need to remember that the sun can be equally damaging to our eyes, causing cataracts and other eye diseases. So when you think about protection from the sun, remember that you also need to safeguard your eyes.

There are three kinds of UV rays: UVA, UVB and UVC. Only the first two reach the earth’s surface and the UVB rays cause greater risk than UVA, but both can cause serious injury.

Too much sun exposure can cause the growth of cataracts and pterygia, fleshy growths on the whites of the eyes that are also known as “surfers eye.” Excessive UV can also increase the risk of cancerous tumors on the surface and inside the eyes, and can result in sunburn to the eye itself. It can also increase the risk of developing macular degeneration.

The best way to protect yourself from the sun’s harmful rays is to limit sun exposure, but there are a number of other ways you can minimize the sun’s dangerous rays:

  • Purchase protective eye wear for you and your children. You don’t have to spend a fortune, but be sure they have labels saying they block 99-100 percent of UV rays or they say “UV400.” Gray-tinted lenses affect color the least; amber increases contrast. Polarized lenses reduce glare and are good for use on the water, but may dim the images from certain liquid crystal displays. Larger, wraparound frames are best for preventing sun damage to the sides and whites of the eyes.
  • Remember that snow, water and sand are great reflectors of UV rays, so you need to wear your sunglasses even under the beach umbrella. A wide-brimmed hat provides additional protection.
  • Wear your sunglasses whenever you go outside – even on overcast days.
  • Your everyday eye glasses should also have a coating that absorbs UV rays.
  • Do not use tanning beds. They use ultraviolet lights and can cause eye damage. If you want to get a tan, use a self-tanning product, but use it with sunscreen.
  • Use a water-proof, broad-spectrum (this means it protects against UVA and UBA rays) with SPF of at least 20-30 and apply very carefully around the eyes.
  • Never look at the sun – especially during an eclipse!

Finally, you should remember that your eyes need protection all year round – not just during the lazy, hazy, sunny days of summer!

David B. Glasser, M.D., is an ophthalmologist in private practice with Patapsco Eye MDs and is a member of the Howard County General Hospital Department of Surgery.


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Man sleepingAs director of the Johns Hopkins Center for Sleep at HCGH, I am thrilled to know that so many people in Howard County care about their sleep and want to do something about it. I always tell my patients that sleep is not a luxury item – it is a minimum requirement. Sleep deprivation experiments with mice have shown that even if they get everything else they need, without sleep they will die! So sleep is an absolute must for life, and healthy sleep is essential for a healthy life.

Anyone who has suffered from insomnia or other sleep disorders knows that getting a good night’s sleep is not always easy. And when we don’t sleep well for long periods of time, the results can be devastating: high blood pressure, stroke, diabetes, cardiac problems, weight gain, daytime drowsiness that can lead to accidents, depression and even sudden death.

So…what keeps us from getting good sleep and what can we do to help us sleep like babies again? To get on the path to healthy sleep, there are some basic things we need to understand.

How sleep works

The drive for sleep is extremely powerful – even greater than the need to eat and drink. You have to consciously act to eat and drink, but deprived of sleep for long enough, you WILL sleep, whether you want to or not. The average needed amount of sleep is 7 ½ to 8 hours per day, and that average usually remains the same throughout your life. If you don’t get enough, eventually you’ll have to repay your sleep debt.

There are two kinds of sleep – REM (rapid eye movement or dreaming sleep) and non-REM, and during a sleep session we should cycle four to five times between these two types of sleep.

How you fall asleep

As the day goes on, our need for sleep builds up naturally. Our circadian rhythm, however, keeps us awake and dips at certain times of the day. Our circadian rhythm is influenced by light and darkness. Light in the morning helps us stay awake and darkness at night helps us sleep. So maybe it’s a better idea to put on those sunglasses in the afternoon rather than on the way to work in the morning.  Keep your environment bright and well lit early in the day, and lower the lights as the evening progresses. A dim night light in the bathroom is better than turning the light on full blast during the night, because that light can affect your sleep.

Unplug at night!

We’re addicted to our devices and they can adversely affect our sleep. Laptops, iPads and cell phones that are pinging and blinking and lighting up in the bedroom during the night are bad, and the blue light they emit is especially deleterious to sleep. Watching TV in the bedroom can also be too stimulating and make it hard to fall asleep. So unplug and read a good book instead. Remember! Only three things should happen in bed: sleep, sickness and sex.

What about naps?

We have a normal physiological desire for sleep between 1 and 4 p.m. Is it ok to take a nap? If it doesn’t affect your sleep at night, go for it. But giving into a nap after dinner can affect your circadian rhythm and make it hard for you to sleep through the night. Studies show that when we break the normal sleep pattern we won’t have good sleep at night.

Sleep is a safety issue

Many disasters and accidents occur during these dips in our circadian rhythm and these rhythms may differ through age. For example, among the young, car crashes are more frequent at night; for middle age, in the afternoon and night; for age 60-65, in the morning; and over 65, in the late afternoon. The highest-risk populations for sleep-related accidents are shift workers, medical residents, truck drivers and people who work hard and play hard without getting enough sleep.

Because sleep is extremely important for not only our own health and safety but also for the wellbeing of our families and community, we shouldn’t take sleep problems lightly. Remember that the first step in resolving a sleep disorder is admitting that it exists and taking positive action to get the good sleep we need.

For information or to schedule an appointment, call 1-800-WESLEEP (1-800-937-5337) or visit hcgh.org/sleep.

Charlene Gamaldo, M.D., is the director of the Johns Hopkins Center for Sleep at Howard County General Hospital.

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Photo by Pascal (pasukaru76) on Flickr

Last year, when I spent some time in physical therapy rehab, I not only learned exercises for strengthening my legs, but also learned a lot about strengthening my arms. Previously, I felt the benefits of yoga exercises and stretches for my arms, but during a long recovery for a knee replacement I couldn’t continue my regular yoga practice.

The first step was an assessment with an occupational therapist looking at my strength and range of motion in my arms. Because I have had rheumatoid arthritis for many years I have limited motion and stiffness in my joints. Additionally, my arms needed some strengthening because I can’t exercise them well with my arthritis.

Stretching and exercising arthritic joints is very important for maintaining strength and mobility. Even sitting in a chair, I can do simple exercises like rolling my shoulders, circle motions and stretching one arm with the other.

However, I learned a great addition to my exercise regime was to use light weights. My therapist had me start low with just one pound to get comfortable. We used ankle or wrist weights that fasten with Velcro because I have trouble gripping anything heavy with my hands.

It didn’t take long for me to work up to exercising with a couple pounds. Right now I can do my exercises with 3.5 pound weights, but my goal is to reach five pounds. When the exercises feel too easy and not as challenging, I add a half pound, but then, decrease the repetitions of the exercises. I then work my way up to the previous repetitions with daily practice of the exercises.

One important lesson is to take a break or cut back on the exercises when I’m having an arthritic flare up or joint pain. Too much exercise can aggravate the joints further. On days when my shoulders or arms are feeling more pain and stiffness, I may exercise with less or no weight. On very bad days, I don’t exercise and may instead do something soothing for my joints like applying heat or getting extra rest.

After I began using weights for my arm exercises I noticed a gradual increase in strength and less stiffness in the joints. If I get out of the habit for awhile, I do feel more arthritic pain and less mobility in my arms. It also takes me time to work back up and feel better. For these reasons I definitely advise sticking with a regimen and not skimping on the daily practice!

Before adding weights to your exercises, consult with a physical or occupational therapist to make sure it is a good match for your physical condition. Take it slow and listen to your body when exercising. The goal is to strike a balance between challenging your body, but not harming yourself. If you feel too much pain or discomfort that is a warning sign to dial it back. On the other side, if you don’t feel your muscles tire or a little soreness then you may need to increase intensity.

Kelly Mack lives in Washington, DC, and works for a marketing communications firm.

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According to Michelle Seavey, M.D., an OB/GYN on staff at HCGH, the most common symptoms of uterine fibroids are:

  • Seven or more days of menstrual bleeding
  • Heavy menstrual bleeding or clots
  • More frequent menstrual cycles
  • Frequent urination
  • Trouble emptying your bladder
  • Pelvic pressure/pain
  • Constipation

What are Uterine Fibroids?

Uterine fibroids are typically noncancerous growths of the uterus that usually appear during your childbearing years. “They can vary greatly in size—from undetectable to the human eye to masses that enlarge your uterus. You can have just one or many, and they can grow quickly, slowly or stay the same size,” explains Melinda Afzal, D.O., an OB/GYN on staff at HCGH. “They also can enlarge during pregnancy and then shrink after pregnancy as your uterus returns to its normal size.”

What are the Symptoms?

“At least 60 to 70 percent of women will get fibroids at some point, however most women are unaware they have fibroids because they have no symptoms,” states Dr. Afzal. “Typically, fibroids are found incidentally during a routine pelvic exam. If your doctor feels irregularities in your uterus’ shape, he or she may suggest a pelvic ultrasound—the gold standard for diagnosis.”

How are They Treated?

“When most women find out they have fibroids, they are concerned and think the fibroids need to be removed. If you have a small fibroid and are not experiencing any symptoms, we will follow it at your annual visits. If you have a larger fibroid, we may monitor you every six months to see size change,” states Dr. Seavey. “Fibroids are not associated with an increased risk of uterine cancer. However, there are many options for treating uterine fibroids, and treatment recommendations depend on the severity of symptoms and the size and number of fibroids. If you have symptoms, talk with your doctor to determine which option is best for you.”

Medications. An injection that blocks the production of estrogen and progesterone, creating a temporary postmenopausal state that lasts three to six months, can shrink the fibroid’s size. “Hormone therapy, in the form of oral contraceptives, can help control menstrual bleeding but will not reduce fibroid size,” notes Dr. Seavey.

Minimally Invasive Procedures. “Uterine artery embolization uses a small device that is placed in the major blood vessel that supplies the uterus with blood to reduce the blood supply to the fibroid, causing it to shrink,” says Dr. Seavey. “This technique can be used depending on the size and location of the fibroid.”

Hysterectomy (the surgical removal of the uterus). “Depending on fibroid size, a hysterectomy can be performed laparoscopically with three to four small abdominal incisions and typically a one-day recovery in the hospital,” explains Dr. Afzal. “Patients who require an open hysterectomy typically have a three-day hospital stay and another four to six weeks for recovery after the procedure.” While a hysterectomy is not an option for those still wanting to bear children, it remains the only proven permanent solution for fibroids.

 

Howard County General Hospital is hosting a discussion called, “Understanding Fibroids” on Thursday, June 19, 7-8:30 p.m. at the HCGH Wellness Center. Presented by Phyllis Campbell, M.D., the presentation will include the symptoms, when treatment is appropriate and what treatments are available. For information, click here.

 


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PamPeeke_BrownLeather_webIn her publications – The Hunger Fix, Body for Life, Fit to Live, and Fight Fat After Forty - Dr. Pamela Peeke takes a holistic and integrative approach to mental, emotional, and physical fitness. From a perspective of full body health, she describes how to stay (or get) fit, healthy, and happy without endangering any aspect of your well being – a much needed and appreciated approach in our diet-obsessed culture.

The formula for weight loss is simple, right? Burn more calories than you eat – easy as that. However, becoming or staying truly fit takes more than eating the proper foods and getting enough exercise; it involves reducing stress and eschewing self-destructive habits. But how do you do that? Each aspect taken on it’s own seems easy enough, but taken as a whole it’s a hefty list: reduce stress, eat nutritious foods, decrease or eliminate self-destructive habits, and practice enough safe and satisfying exercise. Whew! I can’t even get to the end of that sentence without getting tired.

Luckily for all of us, Dr. Peeke has outlined a couple scientifically backed plans to improve health and wellness for people of any age or gender. Following Dr. Peeke’s three stage detox and recovery plan as outlined in The Hunger Fix or the five point plan she lays out in Fit to Live will ensure that all variables in the health and fitness formula are addressed. In The Hunger Fix, Dr. Peeke describes how dopamine rushes can be connected to unhealthy foods in the brain, and she lays out a plan to replace “false fix” foods with healthy fixes like meditating, writing, walking, or even laughing. In Fit to Live, she reframes healthiness with a simple question, “Are you fit to live?” Meaning, are you really mentally, emotionally, and physically fit enough to survive in the modern world with all it’s stressors and possibilities? With a lifestyle and health assessment, Dr. Peeke provides long term prognoses of different levels of fitness and a plan to improve by cutting out toxic lifestyle elements.

As you’ve no doubt seen previously on Well & Wise, Dr. Pam Peeke, internationally renowned expert on nutrition, stress, fitness, and public health, will be speaking tonight, Monday June 9th, at the Howard County Library System Miller Branch at 7:00pm. Registration is available online or by calling 410-313-1950. Come by to ask Dr. Peeke your nutrition, stress, and fitness questions directly!

Jessica Seipel is an Instructor & Research Specialist at the Savage Branch. She has worked for the Howard County Library System, in various positions, for a decade.

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Did you know that Columbia’s movie theaters offer free refills on tubs of large popcorn? Sadly, I not only know that, but I get the free refill, bring it home, and find myself eating a handful of popcorn without even having felt hungry or made a conscious decision to eat a snack. Because of this behavior and many others that inevitably will surface in future blogs, Dr. Pamela Peeke’s The Hunger Fix flew off the shelf and into my hands.

As I settle in for a motivational read, I wonder how the book will speak to me. I pride myself on being self aware. I try to be self critical on an as-needed basis, but often I feel free to put myself down just because. Since my childhood found me in a family where food was the solution to every problem, self-deprecation and food can be a vicious cycle for me. I dole out my own misery and its relief. Will Dr. Peeke recognize this pattern, acknowledge this person?

Dr. Peeke convincingly promotes the idea that food can be an addiction. One in three Americans is obese. Even many Americans who are not overweight struggle with food addiction. One’s body physiology helps fuel this food addiction by creating the urge to satisfy the “dopamine-driven reward pathway.” Unlike other addictive substances, food is needed for life. The challenge is to avoid “False Fixes” (destructive behavior) and the “dopamine-fueled pleasure burst” that lead to unhealthy overeating. The goal is to say “no” to false hunger and go for “Healthy Fixes” (productive behavior) instead.

When science is presented alongside advice, my attention is focused. Dr. Peeke’s advice hooked me. She points to studies of brain scans showing diminished dopamine receptors in the brains of obese subjects, causing these subjects to have to eat more to trigger the good feelings associated with food. This is the same physiology seen in the brains of substance abusers and alcoholics. Dopamine is released by the brain during pleasurable activities. Eating and thinking about foods we like causes dopamine release. The “high” we get with dopamine release leads us to seek that high. If the dopamine release continues to increase in frequency and amount, the body accommodates by decreasing the number of dopamine receptors. With fewer receptors, the “high” feels diminished, causing the addict to increase the consumption in order to achieve an equally powerful high. The activity in the brain’s prefrontal cortex (PFC) is also reduced in obese subjects. The PFC is the region of the brain associated with complex decision making. Decreased activity in this area of the brain may indicate an association with lack of willpower and reduced mindful behavior. Of note, stressful lifestyles increase the body’s acetylcholine and cortisol levels. Dopamine can counteract the uncomfortable feelings caused by those hormones.

The chemistry behind food intake as a means to cope with stress is real. The power of reward is just as real. We can form new habits regarding what we see as a reward. Just because food was a reward for me as a child does not mean it always has to be this way. Dr. Peeke applies her knowledge of neurochemistry to guide readers to the place of “Healthy Fixes,” taking us through the stages of detox and recovery. She provides abundant information on constructive thought processes (mind), nutritious dopamine-building foods (mouth), and healthy dopamine receptor-regenerative behaviors (muscle). As the “fix” proceeds, the PFC is strengthened. Just as overeating can become the body’s new normal, so too can healthy behaviors become what we are accustomed to and what we crave. A healthy relationship with food can be achieved.

Intriguing, right? Well, I invite you to explore The Hunger Fix further. Browse our blogs on Dr. Peeke’s books. The best news of all is that you can hear her in person when she visits the Miller branch on Monday, June 9, 2014 at 7 pm.

Cherise Tasker is an Instructor & Research Specialist at the Central Branch and has a background in health information. Most evenings, Cherise can be found reading a book, attending a book club meeting, or coordinating a book group.

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