October is Breast Cancer Awareness Month

Since October is Breast Cancer Awareness Month, I wanted to post some useful information and links.  It is very important that women over the age of 40 receive a yearly mammogram.  Depending on family history, some women start even earlier than that.  It is vital to have regular mammograms as well as regular breast self-examination.  The earlier cancer is found the easier it is to treat.  If caught early enough, chemotherapy is not needed.  Common treatment for early cancer is radiation therapy as well as tamoxifen or other hormonal therapy.

If you do not have insurance, many local health departments or community organizations offer free or low cost screening.  Also, the Susan B. Komen Foundation can help.   Komen Affiliates fund breast cancer education, screening and treatment projects for those who need it most.  Find information at

http://ww5.komen.org/LowCostorFreeMammograms.html.  They also have a page called Insurance and Other Financial Issues Related to Breast Cancer Care.

 

Common kinds of breast cancer are—

 

 - Ductal carcinoma. The most common kind of breast cancer. It begins in the cells that line the milk ducts in the breast, also called the lining of the breast ducts.

 

       - Ductal carcinoma in situ (DCIS). The abnormal cancer cells are only in the lining of the milk ducts, and have not spread to other tissues in the breast.

 

       - Invasive ductal carcinoma. The abnormal cancer cells break through the ducts and spread into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body.

 

- Lobular carcinoma. In this kind of breast cancer, the cancer cells begin in the lobes, or lobules, of the breast. Lobules are the glands that make milk.

 

        - Lobular carcinoma in situ (LCIS). The cancer cells are found only in the breast lobules. Lobular carcinoma in situ, or LCIS, does not spread to other tissues.

 

       - Invasive lobular carcinoma. Cancer cells spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.

 

(Above descriptions are from the Centers for Disease Control and Prevention)

 

For more information, check out these links:

 

Breast Cancer (PDQ): Treatment (National Cancer Institute)

 

 http://www.cdc.gov/cancer/nbccedp National Breast and Cervical Cancer Early Detection Program (NBCCEDP)

 

Breast Cancer (MedlinePlus health topic)

September is Ovarian Cancer Awareness Month

September is Ovarian Cancer Awareness Month.  I couldn't let the month go by without honoring my dear friend and colleague Michele, who lost her battle with ovarian cancer 2 years ago.

Michele Beaulieu

June 12, 1961 - June 9, 2010

An estimated 22,280 American women will be diagnosed with ovarian cancer in 2012, according to the American Cancer Society, and about 15,500 will die of the disease.

Ovarian cancer is the most fatal of all cancers involving a woman's reproductive tract.  It is very difficult to diagnose, with only 15% being diagnosed at an early stage when it is more easily treated.  Women diagnosed in the early stages have an 89 to 94 percent chance of surviving at least five years.

Here are some links to more information on ovarian cancer:

http://www.healthywomen.org/condition/ovarian-cancer

Ovarian Cancer (Mayo Foundation for Medical Education and Research)

How Is Ovarian Cancer Diagnosed? (American Cancer Society)

Drugs Approved for Ovarian Cancer (National Cancer Institute)

Ovarian Epithelial Cancer (PDQ): Treatment (National Cancer Institute)

Ovarian Germ Cell Tumors (PDQ): Treatment (National Cancer Institute) 

September is World Alzheimer's Month

Since Septemer is World Alzheimer's Month, I wanted to post some information and links to help you find reputable information on the Internet.

The National Institute on Aging has a helpful list of symptoms of Alzheimer's Disease by stage:

Mild Alzheimer's disease

-getting lost
-trouble handling money and paying bills
-repeating questions
-taking longer to complete normal daily tasks
-poor judgment
-losing things or misplacing them in odd places
-mood and personality changes

Alzheimer's disease is often diagnosed at this stage.

Moderate Alzheimer's disease

-increased memory loss and confusion
-problems recognizing family and friends
-inability to learn new things
-difficulty carrying out tasks that involve multiple steps (such as getting dressed)
-problems coping with new situations
-hallucinations, delusions, and paranoia
-impulsive behavior

Severe Alzheimer's disease

-inability to communicate
-weight loss
-seizures
-skin infections
-difficulty swallowing
-groaning, moaning, or grunting
-increased sleeping
-lack of control of bowel and bladder

For more information on Alzheimer's Disease, check out these useful links:

Caregiver Stress (Alzheimer's Association)

Alzheimer's Disease (National Institute on Aging)

10 WarningSigns of Alzheimer's Disease (Alzheimer's Association)

Women's Health

Women and men have many of the same health problems, but they can affect women differently. For example, women may have different symptoms of heart disease. Some diseases or conditions are more common in women, such as osteoarthritis, obesity and depression. And some conditions, such as menopause and pregnancy, are unique to women.

Women sometimes neglect their own health and focus instead on their partner's and their children's. Take care of yourself first:

- Plan for pregnancies and see your healthcare provider regularly while you are pregnant

- Have regular mammograms

- Get regular checkups and screenings. Early detection is important for treating breast, cervical, uterine and ovarian cancer.

For more information, check out the following links:

 http://www.cdc.gov/nchs/fastats/womens_health.htm

FASTATS: Women's Health (National Center for Health Statistics)

http://womenshealth.gov/health-topics/

Women’s Health Topics (National Women's Health Information Center)

 http://womenshealth.gov/publications/our-publications/lifetime-good-health/index.cfm

A Lifetime of Good Health: Your Guide to Staying Healthy

http://www.nlm.nih.gov/medlineplus/womenshealth.html

More information on women’s health from MedlinePlus

Fireworks Safety

I thought it would be a good idea to re-post something on fireworks safety that I did last year.  Here is some great information:

Since the Fourth of July is almost here, I have some information on fireworks safety for you.Fireworks laws vary from state to state so if you are unsure of what is allowed in your state, check out this site:http://www.americanpyro.com/State%20Laws%20(main)/statelaws.html from the American Pyrotechnics Association.If your state does not allow fireworks, DO NOT go to another state to buy fireworks.That is illegal and could get you in big trouble.

The Consumer Products Safety Commission (CPSC) released a report last year on fireworks safety.Here are some of the highlights to make you aware of the safety issues:

CPSC staff has reports of two fireworks-related deaths during 2009.

Fireworks were involved in an estimated 8,800 injuries treated in U.S. hospital emergency departments during calendar year 2009. CPSC staff estimated that there were 7,000 fireworks-related injuries during 2008.

An estimated 5,900 fireworks-related injuries (or 67 percent of the total fireworks-related injuries) were treated in U.S. hospital emergency departments during the one-month special study period between June 19, 2009 and July 19, 2009.

Of the fireworks-related injuries sustained, 73 percent were to males and 27 percent were to females.

Injuries to children were a major component of total fireworks-related injuries with children under 15 years old accounting for 39 percent of the estimated injuries. Children and young adults under 20 years old had 54 percent of the estimated injuries.

There were an estimated 1,200 injuries associated with firecrackers. Of these, 700 were associated with small firecrackers, 200 with illegal firecrackers, and 300 where the type of firecracker was not specified.

There were an estimated 1,000 injuries associated with sparklers and 300 with bottle rockets.

FIREWORKS SAFETY TIPS:

Here are some safety tips from the CPSC:

Never allow young children to play with or ignite fireworks.

Avoid buying fireworks that are packaged in brown paper because this is often a sign that the fireworks were made for professional displays and that they could pose a danger to consumers.

Always have an adult supervise fireworks activities. Parents don't realize that young children suffer injuries from sparklers. Sparklers burn at temperatures of about 2,000 degrees - hot enough to melt some metals.

Never place any part of your body directly over a fireworks device when lighting the fuse. Back up to a safe distance immediately after lighting fireworks.

Never try to re-light or pick up fireworks that have not ignited fully.

Never point or throw fireworks at another person.

Keep a bucket of water or a garden hose handy in case of fire or other mishap.

Light fireworks one at a time, then move back quickly.

Never carry fireworks in a pocket or shoot them off in metal or glass containers.

After fireworks complete their burning, douse the spent device with plenty of water from a bucket or hose before discarding it to prevent a trash fire.

Make sure fireworks are legal in your area before buying or using them.(Check out the link at the beginning of this post for this information)

Preventing Tick Bites

Summer is here.  It’s the season to spend more time outdoors and with the outdoors, comes the possibility of ticks.  Ticks carry many diseases so it’s important to avoid them as much as possible.

Here are some suggestions from the CDC for dealing with ticks this summer:

Avoid Direct Contact with Ticks

-Avoid wooded and bushy areas with high grass and leaf litter.

-Walk in the center of trails.

Repel Ticks with DEET or Permethrin

-Use repellents that contain 20% or more DEET (N, N-diethyl-m-toluamide) on the exposed skin for protection that lasts up to several hours. Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.

-Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents. It remains protective through several washings. Pre-treated clothing is available and remains protective for up to 70 washings.

-Other repellents registered by the Environmental Protection Agency (EPA) may be found at http://cfpub.epa.gov/oppref/insect/.

Find and Remove Ticks from Your Body

-Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you.

-Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.

-Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs. Tumble clothes in a dryer on high heat for an hour to kill remaining ticks.

If you find a tick on your body, here is the tick removal recommendation from the CDC:

-Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.

-Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.

-After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

Don’t use any of the folk remedies that have gone around over the years.  The goal is to remove the tick as quickly as possible and tweezers are the best way to do that.  Here’s a link to the instructions from the CD that has diagrams of the tweezers technique:  http://www.cdc.gov/ticks/removing_a_tick.html

Here is a diagram from the CDC of the stages and relative sizes of ticks:

Here’s an excellent link from the CDC for the prevention of tick bites: Stop Ticks (Centers for Disease Control and Prevention)

Other links:

Rocky Mountain Spotted Fever (National Institute of Allergy and Infectious Diseases)

Tick-Borne Diseases: The Big Two (MedlinePlus Magazine)

For Children:

Hey! A Tick Bit Me! (Nemours Foundation)

Tick Tactics (Centers for Disease Control and Prevention)

Life has been hectic so it's been a long time since I posted anything.  Things should be settling down soon but I did want to share some links.  May is arthritis awareness month so I thought that would be a good topic to share.  Here are some links to some great information on arthritis:

Arthritis and Rheumatic Diseases (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

Arthritis (Centers for Disease Control and Prevention)

Arthritis (Food and Drug Administration)

Arthritis Advice (National Institute on Aging)

Do I Have Arthritis? (National Institute of Arthritis and Musculoskeletal and Skin Diseases)

Click It or Ticket: Seat Belt Use

I saw in my local paper that the Click It or Ticket campaign is under way this week so I thought I’d post some information about seat belt use.  Thankfully, according to a National Highway and Traffic Safety Administration 2010 survey, seat belt use has been increasing steadily since 1994, accom­panied by a steady decline in percent of unrestrained pas­senger vehicle occupant fatalities during daytime (see figure 2).   

The 2010 survey also found the following:

Seat belt use for occupants traveling during weekdays increased significantly from 83 percent in 2009 to 85 percent in 2010.

Seat belt use continued to be higher in the States in which vehicle occupants can be pulled over solely for not using seat belts (“primary law States”) as compared with the States with weaker enforcement laws (“secondary law States”) or without seat belt laws. (see figure 1)

Seat belt use for occupants in rural areas increased significantly from 81 percent in 2009 to 83 percent in 2010.

Seat belt use for occupants traveling on expressways increased significantly from 89 percent in 2009 to 91 percent in 2010.

Figure 1. 

States With Primary Enforcement Seat Belt Laws*
Alabama		Alaska	Arkansas	California
Connecticut		Delaware	District of Columbia	Florida
Georgia		Hawaii	Illinois	Indiana
Iowa		Kentucky	Louisiana	Maine
Maryland		Michigan	Minnesota	Mississippi
New Jersey		New Mexico	New York	North Carolina
Oklahoma		Oregon	South Carolina	Tennessee
Texas	Washington		Wisconsin
* States with laws in effect as of May 31, 2010. The District of Columbia is included in the table. Figure 2.

So what all this is saying is:  Buckle Up!

Skin Cancer and Sun Safety

I know it’s a little early for this but since the weather has been so warm in most parts of the county and it is getting closer to summer, I thought I’d share some links on skin cancer and sun safety.  It’s never too early to start protecting yourself.

So you think a tanning bed is safer than being out in the sun?

For information on tanning equipment, visit the EPA website:

http://www.epa.gov/radtown/tanning-equipment.html#resources

Skin cancer treatment: sources of authoritative information

There are many kinds of treatments available depending on the type of cancer.  For melanoma, the options are surgery, chemotherapy, radiation therapy, and biologic therapy.  For more information on all aspects of melanoma, visit http://www.cancer.gov/cancertopics/pdq/treatment/skin/patient/

For basal cell carcinoma information, visit http://www.cap.org/apps/docs/reference/myBiopsy/SkinBasalCellCarcinoma.pdf

 For treatment information on Merkel cell carcinoma, visit http://www.cancer.gov/cancertopics/factsheet/Sites-Types/merkel-cell

Squamous cell carcinoma treatment information can be found at http://www.cap.org/apps/docs/reference/myBiopsy/squamous_cell_skin_cancer.pdf

Treatment options vary widely depending on the type of cancer and the stage of the cancer.  It is important to ask your doctor proper questions in order to make an informed decision about your treatment.  The previous links provide authoritative information on the various types of cancer.

For more information on all aspects of skin cancer, visit the MedlinePlus skin cancer page at http://www.nlm.nih.gov/medlineplus/skincancer.html#cat3

Types of Skin Cancer

To see what Basal Cell Carcinoma looks like, please visit the following website from the American Academy of Dermatology:

http://www.skincarephysicians.com/skincancernet/basal_cell_carcinoma.html

To see what squamous  cell carcinoma looks like, please visit the following website from the American Academy of Dermatology:  http://www.skincarephysicians.com/skincancernet/squamous_cell_carcinoma.html

To see what melanoma looks like, please visit the following website from the American Academy of Dermatology: http://www.skincarephysicians.com/skincancernet/melanoma.html

To see what Merkel cell carcinoma looks like and for more information, visit the following web site from the American Academy of Dermatology:  http://www.skincarephysicians.com/skincancernet/whatis_merkel_cell.html

Skin Cancer Self-Examination and Prevention

It is important to protect yourself in order to prevent skin cancer or to find it early.  For a great sheet with instructions for skin cancer self-examination, check out:  http://www.melanomamonday.org/documents/08_96%20Melanoma%20Monday%20Mole%20Map.pdf

For more information on protecting kids from the sun, visit http://kidshealth.org/parent/firstaid_safe/outdoor/sun_safety.html

With the overwhelming amount of sun protection products, it’s important to understand what all those claims mean.  The FDA is in the process of finalizing its long-awaited label changes to sunscreens.  One of those changes would be that no sunscreen would have higher than a 50 SPF.  All those claims of high SPF numbers and all the other claims can be very confusing.  To find out more information on sun protection and sunscreens, visit http://www.medicinenet.com/sun_protection_and_sunscreens/article.htm

Have you seen all those ads for special sun-protective clothing and wondered if it’s worth it?  Here’s a great article from the Mayo Clinic answering that very question:  http://www.mayoclinic.com/health/sun-protective-clothing/AN01975

The CDC has some great information on skin cancer and covering up when out in the hot summer sun.  Although the campaign has officially ended, they still have a lot of great information available online.  Check out these sites:

Choose Your Cover Campaign Materials

Brochures

Sunscreen for Your Sun Day [PDF-248KB]

Play It Safe in the Sun: A Guide for Parents [PDF-147KB]

Choose Your Cover [PDF-85KB]

Bullying Awareness

Bullying has become a big problem in this country.  There are many kinds of bullying from cyberbullying to bullying people with special needs and more.

Not all children show warning signs of bullying but here are some warning signs that may show that your child is being bullied:

- Unexplainable injuries

- Lost or destroyed clothing, books, electronics, or jewelry

- Frequent headaches or stomach aches, feeling sick or faking illness

- Changes in eating habits, like suddenly skipping meals or binge eating. Kids may come home from school hungry because they did not eat lunch.

- Difficulty sleeping or frequent nightmares

- Declining grades, loss of interest in schoolwork, or not wanting to go to school

- Sudden loss of friends or avoidance of social situations

- Feelings of helplessness or decreased self esteem

- Self-destructive behaviors such as running away from home, harming themselves, or talking about suicide

For more information on bullying, including how you can help your child if they are being bullied, visit these web sites:

www.stopbullying.gov

Bullying: It's Not OK (American Academy of Pediatrics)

Helping Kids Deal with Bullies (Nemours Foundation)

Avoiding Bullying (American Academy of Pediatrics)

Cyberbullying (National Crime Prevention Council)

Bullying (MedlinePlus Health Topic)

Some Great Parenting Links

It’s a challenge to be good parents.  There are so many things to think about when raising children.  Below are some parenting topics with links to some useful, authoritative information.

Helping Children Cope With Crisis

If your child has experienced a crisis in their life, they may exhibit some warning signs that parents should be aware of.  The following changes or behaviors may be signs of a problem:

- Clinging behavior

- Fears that won’t go away

- Nightmares

- Bedwetting

- Difficulty paying attention

- Jumpy, edgy

- Behavior problems in school

- Headaches, stomachaches, or dizziness for no known reason

- Sad or less active

- Always talking about or acting out a disaster

- Irritability

- Changes in eating behavior

- Decrease in academic performance

For more information, visit:

Helping Children Cope with Crisis: Just for Parents (National Institute of Child Health and Human Development)

Talking to Children about Terrorism and War (American Academy of Child and Adolescent Psychiatry)

Sometimes it’s hard to find the right words when you need to talk to your child about certain subjects.  Here are some links to information to help you:

Talk to Your Kids about Sex (Office of Disease Prevention and Health Promotion)

Talk to Your Kids about Tobacco, Alcohol, and Drugs (Office of Disease Prevention and Health Promotion)

Teaching Your Child Self-Control (Nemours Foundation)

General Parenting Links:

Effective Parenting (American Academy of Pediatrics)

Learn Some Positive Parenting Tips (Centers for Disease Control and Prevention)

Parents: ABCs of Raising Safe and Healthy Kids (Centers for Disease Control and Prevention)

Positive Parenting (Nemours Foundation)

Parenting MedlinePlus Health Topic

Food Allergy

The U.S. Food and Drug Administration requires food manufacturers to list ingredients on their products.  They also require food allergy labels for the eight most common ingredients that trigger food allergies.  The eight foods listed below account for an estimated 90 percent of allergic reactions.  The eight foods are:
 
- Milk
- Eggs
- Peanuts
- Tree nuts (such as almonds, cashews, walnuts)
- Fish (such as bass, cod, flounder)
- Shellfish (such as crab, lobster, shrimp)
- Soy
- Wheat

All domestic or imported packaged foods are labeled with an allergy warning if the product contains one of the above allergens.

The label lists the type of allergen, such as soy or wheat.  (see photo below)

It is very important to pay attention to these labels if you have food allergies.  Food allergies can cause serious illness or death.

Here are the most common symptoms of food allergy:

- Tingling or itching in the mouth

- Hives, itching or eczema

- Swelling of the lips, face, tongue and throat, or other parts of the body

- Wheezing, nasal congestion or trouble breathing

- Abdominal pain, diarrhea, nausea or vomiting

- Dizziness, lightheadedness or fainting

Treatment

The only way to avoid an allergic reaction is to avoid the foods that cause signs and symptoms. However, it is almost impossible to totally avoid all foods that cause allergies so if you have a reaction, you will need treatment.

For a minor allergic reaction, over-the-counter or prescribed antihistamines may help reduce symptoms.

For a severe allergic reaction, you may need an emergency injection of epinephrine and a trip to the emergency room.

For more detailed information of treatment and food allergies in general, check out these web sites:

Food Allergy (Mayo Foundation for Medical Education and Research)

Treating an Allergic Reaction (Food Allergy & Anaphylaxis Network)

Have Food Allergies? Read the Label (Food and Drug Administration)

Tips for Managing Food Allergies (Food Allergy & Anaphylaxis Network)

Food Allergy (MedlinePlus Health Topic)



Evaluating Consumer Health Web Sites

From time to time I like to repeat posts that I think are important in case you missed them the first time around.  A while back I posted information on evaluating health web sites.  I think it is important to repeat that from time to time to remind everyone of the importance of making sure the information is authoritative and up-to-date.  Here is some helpful information on how to evaluate health web sites:

Since it is possible for virtually anyone to post information on a web page, it is important to evaluate the information you find. Here are some points to look at when evaluating health sites:

1. Who developed this site? Is an author clearly identified? Are the credentials of the author listed?

It is always best to seek information from a “known quantity”. Find out as much as you can about the author or organization posting the health information. This may be expressed in listed credentials about the person or a description of the organization providing the site.

2. Does the page show when it was last updated? Are the links to other resources still active?

Many people have placed information on the web as a one-time effort without ever providing updated information. A date on the page will help you to assess if the information is current. Check to see if the links are current. If they aren’t, this may mean that the page hasn’t been updated.

3. Is contact information provided so that you can e-mail, call, or write the author?

Direct connection to the organization or author provides a mechanism for you to ask questions about the origin of the information on the site, and the authority of the author.

4. What is the purpose of the information?

Assess the reason for the information provided. Is the language of the article persuasive, trying to lead you to purchase something or join a program or is the information provided for informational purposes only? If the page is designed for commercial purposes, there may be conflict of interest with the information provided. It is best to stick with non-commercial sites.

5. Can the information be verified in other sources?

If a web site is not well documented, it is especially important to verify the information you find in other sources. If any questions arise about information discovered in any source, those questions should be directed back to a health care provider.

Here are some quality health web sites:

MedlinePlus from the National Library of Medicine

NOAH (New York Online Access to Health)

HealthFinder from the National Health Information Center

Spring Cleaning: Tips for Doing it Safely

Spring is here.  (Actually, it has been feeling like summer in many parts of the country.)  With spring, comes more outdoor activities and it is important to keep safety in mind as you do those spring cleaning chores.  I thought I'd repeat my post from last year with some great spring cleaning tips:

Keep safety in mind during the springtime cleaning spree. So says the American Academy of Orthopaedic Surgeons (AAOS) in a recent press release. Many people take advantage of the weather to clean both the inside and outside of their home, but there are many hazards associated with this springtime ritual. 

Statistics show that thousands of people injure themselves during their annual clean, whether it be using a step ladder, a lawn mower or moving furniture. The American Academy of Orthopaedic Surgeons (AAOS) urges people to take the proper safety precautions to reduce the number of spring cleaning-related accidents

STATISTICS:
According to the U.S. Consumer Product Safety Commission:
- In 2010, more than 35,500 people injured themselves using a stepladder;
- Over 41,000 Americans injured themselves while gardening or using gardening equipment;
- More than 127,000 were injured while operating a lawn mower.

AAOS SAFETY TIPS:-
- Proper techniques for lifting, carrying and bending should be part of any spring cleaning project to avoid back injuries:
- Separate your feet, shoulder-width apart and keep your back upright and bend at the knees while tightening the stomach muscles.
- Lift with your leg muscles as you stand up; don’t try to lift any object by yourself if it is too heavy or an awkward shape.

- When gardening, avoid prolonged repetitive motions during activities such as digging, planting, trimming and pruning and take frequent breaks.

- Use a sturdy step stool instead of a counter or furniture – such as a chair or the couch – when dusting high hard to reach areas.

- Ladders used for chores – such as washing windows, painting, cleaning gutters and trimming trees – should be placed on a firm, level surface. Never place a ladder on ground or flooring that is uneven, soft or wet.

- Use care with extension cords: be sure they are properly grounded. To avoid tripping or falling, do not drape extension cords across spans of crossing walkways.

- When working on a ladder, over-reaching or leaning too far to one side can make you lose your balance and fall. Your bellybutton should not go beyond the sides of the ladder. Never climb a ladder without a spotter.

- When mowing the lawn, be sure to wear proper footwear and eyewear for protection:

- Use a mower with a control that stops it from moving forward if the handle is released. Never pull backward or mow in reverse unless absolutely necessary – carefully look for others behind you when you do.

- Children should be at least 12-years-old before they operate any lawn mower, and at least 16- years-old for a ride-on mower.

- Read product labels for proper use and wear protective clothing and gloves when using chemicals for gardening or cleaning. Store all chemicals at the appropriate temperature, which is usually indicated on the package – in a place that is out of reach of both children and pets and never place chemicals into unmarked containers or containers labeled for a different substance.

- Take frequent breaks and replenish fluids to prevent dehydration and keep a cell phone within reach in case of accident or injury.

Here are some links to other useful information:

Gardening Health and Safety Tips (Centers for Disease Control and Prevention)

Lawnmower, Snowblower Safety (American Academy of Orthopaedic Surgeons)

Ladder Safety Guide (American Academy of Orthopaedic Surgeons)

Adaptive devices for gardening

This is a little different from the kinds of things I write about, but I wanted to share some useful links with you since spring is quickly approaching.  Actually, the way the weather has been in much of the country, it's felt like spring for most of the winter!  With spring comes gardening and there are many people who have trouble gardening because of health issues.  Whether it's a lifelong disability or arthritis later in life, gardening can literally be a pain.  If you enjoy gardening but have trouble because of health issues, here are some links to web sites that sell items that will make gardening easier:

WWW.WRIGHTSTUFF.BIZ

WWW.ARTHRITISSUPPLIES.COM

WWW.WAYFAIR.COM

Crohn's Disease

Crohn's disease is an inflammatory bowel disease (IBD), so called because it causes swelling and inflammation in the digestive or gastrointestinal (GI) tract. It may affect any part of the GI tract, but it usually affects the ileum or lower part, inflammation leads to abdominal pain and diarrhea. It is similar to other inflammatory bowel diseases like ulcerative colitis, which causes inflammation and ulcers in the top layer of the large intestines. However, in Crohn's disease, the inflammation can extend deeper, involving all layers of the intestines.

The exact cause of Crohn's disease is unknown. Current theories suggest that in people with Crohn's disease, the body has an abnormal immune response which causes white blood cells to accumulate in the lining of the intestines, leading to chronic inflammation, ulcers, and bowel injury. There may be a hereditary component as well.

Symptoms

Symptoms of Crohn's disease range from the moderate to the severe. There may even be periods of remission when the symptoms subside completely. When the disease is active, symptoms may include the following:

- Diarrhea

- Abdominal pain and cramping

- Blood in the stool

- Ulcers in the intestine

- Reduced appetite and weight loss

Crohn's disease may lead to complications. The most common one is blockage of the intestine. Crohn's disease may also cause ulcers that tunnel through affected areas and surrounding tissue, creating fistulas (abnormal connections between organs) or anal fissures (cracks). Malnutrition and vitamin deficiencies may also occur due to inadequate dietary intake or poor absorption. Anemia may also be present in some due to intestinal bleeding. Other complications may include the following:

- Arthritis

- Eye inflammation

- Skin disorders

- Diseases of the liver or bile ducts

- Delayed growth or development in children

There is also evidence that Crohn's disease and other inflammatory bowel diseases may increase the risk of colon cancer.

Treatment

There is no cure for Crohn's disease. The goals for treatment are to control the inflammation, thereby reducing the symptoms of pain, diarrhea, and rectal bleeding. Treatments may also be aimed at correcting nutritional deficiencies. To accomplish these goals, a combination of treatments may be necessary including medications and nutritional supplements; surgery; and lifestyle changes.

Anti-inflammatory drugs including corticosteroids are often the first step in the treatment of Crohn's disease. Medications called immune system suppressors may also be prescribed. Antibiotics are used to heal fistulas and abscesses. In addition to controlling inflammation, other drugs can be used to relieve the symptoms, including anti-diarrheals and pain relievers. Nutritional supplements may be needed including iron supplements to treat anemia; calcium and vitamin D to prevent osteoporosis: and vitamin B-12 shots. Additional nutritional therapies including high-calorie liquid formulas; enteral nutrition (diet given via feeding tube); or parenteral nutrition (nutrients injected into a vein) may sometimes be necessary.

When medications can no longer control the symptoms of Crohn's disease, surgery may be necessary. It has been estimated that nearly three-quarters of all people with Crohn's disease will need surgery at some point. The doctor may recommend surgery to close fistulas or drain abscesses. Another common surgery is a strictureplasty, a procedure that widens a segment of the intestine that has become narrowed by disease. Surgery is also performed to remove damaged parts of the intestine. Some people who have the disease in their large intestine must have the entire colon removed (colectomy). In these cases, a small opening or stoma is made in the abdominal wall and the tip of the ileum is brought to the skin's surface where waste is collected in a pouch. The majority of colectomy patients live normal, active lives.  Surgery is not a cure and it is not unusual for people with Crohn’s disease to have more than one operation.

Lifestyle changes can help the per­son with Crohn's disease feel more in control of their health, since they can help control the symp­toms and lengthen the time be­tween flare-ups. No special diet has been proven to treat or prevent Crohn's disease, but it is important that people with Crohn's disease eat a nutritious diet, avoiding foods that seem to worsen symp­toms. A food diary may help the patient track foods, which cause symptoms to flare. In addition, eat­ing 5 or 6 small meals throughout the day may be better than eating 2-3 larger ones. It is also very im­portant to drink plenty of fluids, particularly water, due to the fluid loss from diarrhea. Alcohol, caf­feine and carbonated drinks may worsen symptoms. Some people with Crohn's disease notice that signs and symptoms flare or worsen when they are under stress. Since stress is unavoidable, it is important for people with Crohn's disease to learn to manage it. With your doctor's approval, a moderate exercise program can reduce-stress, relieve depression, and help normalize bowel function. Other stress reduction techniques that may be helpful include biofeed­back and regular relaxation and breathing exercises like yoga or meditation. Classes, books, CDs or DVDs may assist in learning these techniques.

For more information and support, contact the following:

Crohn's and Colitis Foundation of America

1-800-932-2423 or 212-685-3440

www.ccfa.org

National Digestive Diseases Information Clearinghouse

1-800-891-5389

www.digestive.niddk.nih.gov

Written by C. Robeson