Health Heroes
Transcription
Health Heroes
The Waiting Room Companion Created for Your Doctor’s Office ® webmd.com the Magazine 11 mind Can dads get postpartum? 32 beauty holiday gift pampering picks 51 fitness is your workout wimpy? 52 parenting Nov./Dec. 2010 $4.95 Holiday recipes Top chefs’ festive faves 72 Child with a chronic illness? 54 recipes Three ways to cook chicken 78 allergies is it a cold or allergies? 79 diabetes Do you know your a1c? 80 heart the lowdown on cholesterol 81 sleep Is RLS keeping you up? 82 pain are your knees at ease? Health Heroes Meet our six visionaries! Taylor’s time 64 Music star Swift’s secrets for success, on and off the stage 60 COMPLIMENTARY waiting room COPY Presorted Bound Printed Matter U.S. POSTAGE PAID Clarksville, TN Permit No. 160 November/December 2010 the Magazine D I G I T A L features 58 wellness The chart-topping singer-songwriter’s Taylor Swift never set out to be extraordinary. Like most of us, all she wanted was to be heard. Little did she know as she sat in her childhood bedroom in Wyomissing, Pa., giving voice to feelings about crushes, heartache, and troubled friendships, that one day millions of people would respond. That she would secrets for healthy living and success on and off the stage onTour Taylor By Rebecca Ascher-Walsh, WebMD Contributing Writer with wellness On Tour With Taylor How does chart-topping music sensation Taylor Swift keep her feet on the ground when they are so often walking the red carpet in Manolo Blahniks? Swift reveals her secrets for personal balance and career success on and off the stage to WebMD contributing writer Rebecca Ascher-Walsh. PLUS: Taylor’s rules for healthy living on the road. Reviewed by Louise Chang, MD WebMD MEDICAL EDITOR 76 WebMD the Magazine | November/December 2010 November/December 2010 | WebMD the Magazine 77 Cover photo By Joseph Anthony BAker Focus On Depression SpeCIal FeaTure WebMD health heroes holiday recipes Three top chefs’ very own Yuletide recipes home Fighting for Boys This content is selected and controlled by WebMD’s editorial staff and is brought to you by AstraZeneca November/December 2010 Patricia Furlong Holidays W Taking the WebMD’s fifth annual tribute honors six visionaries who are changing the lives of others through their caring and hard work Next Step How are you managing your depression? 56 An author writes his way through the darkness 58 Ask our experts 60 Test your depression IQ 61 Questions for your doctor 62 2010 Health Heroes 55 82 43 Focus on Depression A special look at expert strategies for managing this complex disease. What’s Your Cough IQ? Test your cold-and-flu smarts with our quiz. spotlight 24 wellness 64 hen Patricia Furlong’s sons, Christopher and Patrick, were diagnosed with Duchenne muscular dystrophy in 1984, the doctor simply said, “There is no hope.” At that time there was no treatment for the disease, the major type of muscular dystrophy and the most common fatal genetic disorder. Duchenne strikes only boys and leads to progressive muscle weakness, an inability to move the arms and legs, and eventually death. Yet while Furlong, 63, a former intensive care unit nurse, was often overwhelmed, she didn’t give up hope. “I remember one day I told Chris, ‘I want a miracle,’ she recalls. “And he looked at me and said, ‘Miracles don’t just happen for one or two of us, Mommy. They have to happen for all of us.’” Furlong threw herself into creating those miracles. In 1994, she established Parent Project Muscular Dystrophy to bring parents, researchers, and doctors together to fundraise and advocate for better care for Duchenne patients. PPMD’s lobbying efforts resulted in Congress’s passing the MD-CARE Act in 2001, which designated funds for research on muscular dystrophy. As a result, boys with Duchenne now walk into their teens and 20s. Her own sons stopped walking at 9 and died at 15 and 17. But every time Furlong meets a new family, she thinks, “All I ever wanted was to buy five minutes more of life for my sons. I can’t fix everything for these families. But I can try to buy them five minutes more.” —Susan Davis 83 for the For a fresh take on festive foods, we asked Iron Chef Cat Cora, Mom-a-licious chef Domenica Catelli, and our own nutrition expert Carolyn O’Neil, MS, RD, for the family holiday recipes they return to most often. The result? Dishes that transform familiar tastes from “same old” to “something special.” From Cora’s Caribbeanthemed curried lentils with butternut squash to O’Neil’s can’t-skip-this salad to Catelli’s guiltless mashed potatoes, each recipe rethink provides inspiration on how a little redo leads to redux: newfangled favorites you’ll want to prepare again and again. Plus, stress-busting tips for home cooks to take the worry out of holiday prep. By Monica Kass Rogers, WebMD Contributing Writer Reviewed by Kathleen Zelman, MPH, RH/LD WebMD DIRECTOR OF NUTRITION 72 wellness Photography by Renée Comet; Styling by Lisa Cherkasky 91 90 recipes WebMD’s 2010 Visionaries Home for the Holidays WebMD’s annual tribute honors six Americans who are helping transform the health lives of others. This year’s roster includes Patricia Furlong, who is fighting for boys with Duchesne muscular dystrophy, T. Denny Sanford, who is building a national network of health clinics, and model/filmmaker Christy Turlington, who is speaking out about women’s rights to safer childbirth practices. We asked three top chefs what they’re serving at their own tables this year. Iron Chef Cat Cora shares her recipe for pomegranate-glazed Cornish game hens. Dietitian and food writer Carolyn O’Neil, RD, MS, is making a colorful fennel, orange, and pomegranate salad. And chef/cookbook author Domenica Catelli whips up her no-guilt mashed potatoes. Learn more about these featured issues and all health topics. WebMD.com November/December 2010 | WebMD the Magazine 1 departments 32 November/December 2010 5 Nan’s Note 8 Healthy Start Does cranberry juice really help a UTI, can dads get postpartum depression, and what’s the water–weight loss link? 18 21 Medical File Click Here What’s new at WebMD.com. Cincinnati Bengals wide receiver Terrell Owens tackles Alzheimer’s, and Larry King Live producer Wendy Walker writes about breaking health news. my Webmd Ricardo Mejia, 17, has lost more than 65 pounds. By Ricardo Mejia WebMD.com community member I started gaInIng weight when I was about 11. I just wasn’t very active. I would come home from school every day and watch tV. My parents are from el salvador—I moved here when I was 7—and they’re very protective. they didn’t feel comfortable having me out and about after school, so I became quite sedentary. and my diet wasn’t good: Most of the time we ate frozen, packaged foods and a lot of sweets. It was just more convenient for us. By the end of my freshman year in high school, I weighed close to 250 pounds and I was only 5 feet 8 inches tall. When I walked I couldn’t breathe well, and I could feel my heart pounding in my chest. going up and down stairs was difficult. When I had phys ed, I sometimes found it difficult to run and pass the fitness tests. But I tried my best. I decided I needed to lose weight when I was 15. I was wearing pants that had a 36-inch waist and 30-inch length, but even they were so tight they were uncomfortable. Plus, I knew that there was diabetes on both sides of my family. By that point, I was a freshman in high school. I had a little more independence. I decided to join my school’s dragon boat team. dragon boats are large, wooden, and very team-heavy boats, so I was getting a lot of exercise—not just the paddling, but running, push-ups, and sit-ups. It was more exercise than I had ever gotten in my life. I started feeling strong and healthy. By my sophomore year, I was down to 200 pounds. at that point, I joined the swim team, too. I don’t know how I kept up my grades, but I did. My grades have always been very consistent, but the fact that I had to keep my grades up to stay on the teams was a big, big motivation. My life was changing in a really good way. I started reading articles in sports magazines about how it’s important to eat well, so I changed my diet, too. I began eating peanut butter and green apples. I stopped eating packaged foods. My pediatrician sent me to a nutritionist who taught me a lot. she would tell me to keep going, keep trying, and that helped a lot. the rest of my family hasn’t changed how they eat, but lots of times I come home after they’ve already had dinner, so I make my own meals. sometimes my grandmother complains about how I’m eating differently—she thinks I have an eating disorder!— but they are impressed that I’ve lost so much weight. today I’m 17, 6 feet 1 inch tall, and I weigh 185 pounds. I feel good. If I had to tell other obese teens one thing, it’s this: It’s really easy to change your way of eating. teens get hooked on candy and soda, but it’s just as easy to drink mineral water instead. don’t get it in your head that you can’t fix it. You can. sooner or later you’ll end up losing the weight. Believe me, if I can do it, anyone can. Read more stories and share your own in our community. 28 WebMD.com WebMD the Magazine | November/December 2010 22 My WebMD How one determined high school boy lost more than 65 pounds. 27 Exam Room Making scents of the history of perfume. 21 2 32 Living Well 32 Gift of Beauty Shopping around for holiday gift suggestions? We asked our beauty expert for some of her favorite pampering products. 38 The Makeup of Makeup What’s in nail polish, anyway? 39 To Dye For Is it safe to permanently tint brows and lashes? 40 Sensitive Subject Do your favorite foods make your teeth hurt? personal stories from Webmd.com members Lost and Found webmd.com the Magazine 53 Healthy Eats What’s good for you this month: November’s healthy picks. PLUS: Take this issue’s Healthy Start Challenge! 10 WebMD Wire ® 51 Health Matters 51 fitness Easy Does It? Is your workout too wimpy, too hard, or just right? PLUS: Check out WebMD’s “Nine Least Effective Exercises” slideshow. 52 parenting No Kidding Parenting a child with a chronic disease can be tough on the whole family. 53 Anatomy of Cinnamon The healthy history of this posh spice. 54 Three Ways to Cook Chicken The bird is the word when it’s time to serve healthy meals. Try our grilled Tuscan chicken, Asian chicken stir-fry, and white chicken chili. 56 Poultry Pantry Picks Stock up the healthy way with our shopping list. 40 take the test you can take to your doctor a s s e s s m e n t s , q u i z z e s , a n d reference i n f o r m at i o n 78 79 80 81 82 85 o n e v e r y pa g e allergies Get the Latest Health Information from Sent Right to Your Inbox Receive important news and expert views on 50 topics including Women’s and Men’s Health, Skin & Beauty, Parenting, Weight Loss, Pet Health, and 30 health conditions. Is it a cold or allergies? diabetes Do you know your A1c? heart The lowdown on cholesterol sleep Could RLS be keeping you up? pain Are your knees at ease? cancer What’s your lung cancer risk? 86WebMD Checkup Carrie Fisher cracks wise about the ups and downs of her bipolar disease, her favorite cheat food, and the healthy role of humor. Note: To learn more about October issue cover star Christina Applegate’s Right Action for Women, an Entertainment Industry Foundation initiative, visit www.rightactionforwomen.org. Always free and your privacy protected. ® webmd.com E dito r I n C hie f • Colleen Paretty EX EC UTIVE E dit or • Sen io r Ed itors • Vice P resi d e n t, publ ish e r • Heidi Anderson handerson@webmd.net • 847-998-4773 Susan Davis, Andrea Gabrick Michael W. Smith, MD Board Certified, Internal Medicine Brunilda Nazario, MD, Board Certified, Internal Medicine, Endocrinology and Metabolism senio r M ed ic a l Editor • Louise Chang, MD, Board Certified, Internal Medicine; Laura J. Martin, MD, Board Certified, Internal Medicine M e d ica l Ed ito r s • W EBM D. co m executive edit or • Co n tr ibutin g W r iters • Daniel J. DeNoon, Jennifer Dixon, Liesa Goins, Heather Hatfield, Katherine Kam, Lauren Paige Kennedy, Matt McMillen, Gina Shaw, Stephanie Watson co mmun ity Edit orS • Eve Pearlman Leona Perry, Kate Royston Glenn Pierce, Melissa Miller Hamid W EBM D. C OM ART DIRE CTOR • Pr o d ucti o n director • Ph oto Edit or • Pr o d uction artist • co p y edit or • John P. Kay Mary Mieszczanski Nell Whiting a dvertising traffic manager • New YOrk Dawn Carey • dcarey@webmd.net • Alisa Feiner • afeiner@webmd.net • Nancy Kaplan Jennifer Morgan Brenda M. 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Patient names may have been changed to protect privacy. The information herein is meant to complement and not replace advice provided by a licensed health care professional. WebMD the Magazine is not responsible for advertising claims. WebMD the Magazine (ISSN 1553-9946), Vol. 6, No. 8, is published by WebMD, 111 Eighth Ave., Suite 700, New York, NY 10011. Send returns to: WebMD. To change your subscription (address, number of copies received or to stop delivery), contact WebMD, Magazine Subscriptions, 111 Eighth Ave., Suite 700, New York, NY 10011; or send to magazine_subscriptions@webmd.net. Printed in the U.S.A. All rights reserved under International and Pan-American Copyright Convention. This magazine may not be reproduced in whole or in part without written permission of WebMD. ©2010 WebMD, LLC. All rights reserved. WebMD’s mission is to provide objective, trustworthy, and timely health information. Our website and magazine provide credible content, tools, and in-depth reference material on a wide variety of health topics, all of which are reviewed by our board-certified physicians. Any opinions expressed are of the experts and are not the opinions of WebMD. WebMD does not endorse any specific product, service, or treatment.The content of each WebMD the Magazine “Spotlight,” while funded by an advertiser, is selected by and solely under the editorial control of the WebMD editorial staff. The c ontent in WebMD the Magazine is intended for informational use only; it is not intended as a substitute for professional medical care. Never disregard professional medical advice or delay in seeking it because of something you have read in WebMD the Magazine. 4 WebMD the Magazine | November/December 2010 from the editor in chief the Magazine Ch ief Executive O f f ice r • Wayne Gattinella CHie f o pe rati n g OFF ICER, Ch ief Fi n a n ci a l O f f ice r • CHie f TECHNOLOGY OFF ICER • Anthony Vuolo William E. Pence Executive Vice P resi d e n t, g e n e ra l c o u n se l , & secretar y • S e n i o r Vice P resi d e n t, Leg a l • Doug Wamsley Michael Glick S e n i o r Vice P resi d e n t, s a l es & s a l es o pe rati o n s • Dorothy E. Kelly Gemmell S e n i o r Vice P resi d e n t a n d Ge n e ra l M a n a g e r • Clare Martorana S e n i o r Vice P resi d e n t, Co rpo rate Co mmu n ic ati o n s • se n i o r Di rect o r, Pub l ic Rel ati o n s • Adam Grossberg Katherine Hahn Francesco Lagnese Dep uty E dit or • nan’s note I am pretty sure that I have retained nothing from seventh grade or ninth grade—as measured by my ability to help my daughters with their homework! What excites me beyond all belief, however, are the mind-bending conversations I am having with my tween and teen. They now want—and need—to discuss lessons from school at the dinner table: governance and leadership strategies from 400 years ago, the carbon footprint of our home, the importance of the horizon line in drawing. Inspiring. I am so touched by their journey of learning new things about our history, ourselves, and others. I love to see that sparkle of aspiration in the eyes of anyone learning something new. In this spirit, our November/December issue is packed with inspiration and insights into the journeys of some of our favorite people. “Recognize that anxiety’s not inherently bad. It’s uncomfortable while it’s happening, but it can also propel you out of a rut … it can also lead to something that takes you out of that feeling and into something creative.” Sage advice from 20-year-old singer-songwriter Taylor Swift (see page 58 for our cover story). When we interviewed producer extraordinaire Wendy Walker (page 21), the talent behind the talent of Larry King Live, I realized that she and Larry King were talking to real people and celebrities about health topics long before these became part of the public forum. I also enjoyed Wendy’s new book, Producer: Lessons Shared From 30Years in Television, a quick and easy read that reminded me there is always something to aspire to—and it can be within reach each and every day. Whether it is through the heartbreak of Alzheimer’s disease that prevents Cincinnati Bengals wide receiver Terrell Owens from sharing his football victories with the woman who inspired him (page 21); the humor and fearlessness of best-selling author and award-winning actor Carrie Fisher, who wants to join a support group for those who ingest too many peanut butter health bars (love her!, page 86); or the courage and dedication of our fifth annual WebMD Health Heroes (page 64), we hope to inspire you this holiday season. On behalf of the more than 1,000 stellar, hard-working, and passionate health information advocates I have the pleasure of working with and learning from here at WebMD every day, I warmly wish you an inspired and inspiring winter season filled with a bit of joy and laughter. Nan-Kirsten Forte, MS Editor in Chief, WebMD the Magazine We’ll let you in on a little secret. Generic drugs use the same active ingredients as brand-name drugs and are approved by the FDA. Which is why we can offer many generics for just $4 for a 30-day supply, or only $10 for a 90-day supply. So you’ll have more money to save for the things you really want. More questions? Come on in and ask us. Or, search pharmacy at Target.com. Target Pharmacies are not located in all Target stores, hours vary by location, services of pharmacist may not be available at all times when Target stores are open. Free translation services available. $4 prescriptions include up to a 30-day supply of covered drugs at commonly prescribed dosages. $10 prescriptions include up to a 90-day supply of covered drugs at commonly prescribed dosages. Physician permission may be required to change a 30-day prescription to a 90-day prescription. These drugs may be priced higher in CA, HI, MN, MT, PA, RI, TN, WI, and WY. Please ask your Target Pharmacist for specific pricing in these states. ©2010 Target Stores. Target and the Bullseye Design are registered trademarks of Target Brands, Inc. All rights reserved. 070310 Absolutely. are $4 generics really just as good? healthy start good for you this month If you have atrial fibrillation (AFib), november’s Quick Picks a clot can form in your heart, C Fare Oil Well travel to your brain, and cause strokes. Berry good news: Cranberries don’t just make your Thanksgiving spread festive. They make it extra healthy. One serving of the bright red berries, at their peak through December, provides nearly a quarter of your daily vitamin C needs. Nix dry wintry skin by adding essential oils when you scrub up, says WebMD skin care expert Susan Evans, MD. “Douse your body with oil, such as 5,000 IU Vitamin E Pure Beauty Oil from JASON ($6.99) when you get in the shower to lock in moisture.” Or, post-shower, fill the palm of your hand with a lotion containing petroleum-free oil such as Carol’s Daughter Body Jelly ($15), which contains jojoba and sweet almond oils, and then rub it in. healthy eats If you have AFib: fit You’re nearly 5x as likely to suffer a stroke than someone without AFib. tip These strokes are about twice as likely to be fatal or severely disabling. skin care Next snow day, skip the gym and hit the nearest hill. Sledding is as good for you as it is fun to do, says WebMD fitness expert Pamela Peeke, MD. “Sledding is a total body workout,” helping with balance and flexibility and engaging the entire upper body, core, and leg muscles as you trudge back up the slope after each run. Is Your Cold Weather Workout a Winner? Step Up What’s your outdoor fitness plan when the mercury dips? Take our Healthy Start Challenge! Tell us your go-to winter workout: go to the magazine community board (search “magazine community”) at WebMD.com for a chance to win a $20 Whole Foods gift certificate! Andi Gabrick Senior Editor, WebMD the Magazine Get up and give back this season. November is the official awareness month for both diabetes and Alzheimer’s disease. Join a Step Out walk for diabetes on Nov. 13 in Tampa, Fla., and Nov. 20 in Houston, or one of the many year-round Memory Walks for Alzheimer’s; find out more at stepout.diabetes.org and alz.org. Take this issue’s Healthy Start Challenge and you could win a prize! 8 WebMD the Magazine | November/December 2010 give back WebMD.com clockwise from top right: Lauren Nicole/Getty Images; Amana Productions Inc/Getty Images; Jonathan Kantor/Getty Images snow excuses Fill out the attached card to get your FREE book and the facts about AFib and stroke. Or call 1-877-796-AFib (2342) or visit www.afibstroke.com Copyright © 2010 Boehringer Ingelheim Pharmaceuticals, Inc. All rights reserved. (11/10) AFIB81822CONS ® wire Slow Burn the health news beat at WebMD.com Source: American Chemical Society fall 2010 national meeting 17,465 Estimated number of people treated for holiday decoratingrelated falls in emergency rooms 2000 to 2003. Source: CDC 10 WebMD the Magazine | November/December 2010 Blues clues College students are reporting more mental health problems these days, but that’s not necessarily bad news, according to a new study. John Guthman, PhD, director of counseling services at Hofstra University in Hempstead, N.Y., reviewed the records of more than 3,200 college students seeking counseling services at a midsized private university over the last 12 years. He found that in 2009, 41% of the students reported mental health problems—including moderate and severe depression—up from 34% in 1997. This could be because of earlier and better diagnosis, he noted, which means that students are arriving on campus with health conditions. Guthman also found that twice as many students were taking psychiatric medicines for depression, anxiety, and attention deficit hyperactivity disorder. But fewer were reporting problems such as thoughts of suicide (26% versus 11%)—also due, Guthman hypothesizes, to better diagnosis and treatment. If your own child has a history of mental health issues and you’re looking at colleges this fall, Guthman recommends asking if faculty and staff are trained to recognize the warning signs of mental illness. Source: American Psychological Association’s 2010 convention Source: American Journal of Health Promotion top: Henrik Weis/Corbis; Jade Brookbank/Getty Images Women have been saying for decades that cranberry juice can prevent urinary tract infection (UTI). But does it really work? New research says “yes.” The study—presented at the national meeting of the American Chemical Society in Boston—isn’t the first to say this is true. Previous studies have suggested that the active compounds in cranberry juice fight bacteria, including E. coli, in the urinary tract. But this latest study, conducted by scientists at Worcester Polytechnic Institute in Massachusetts, suggests that the beneficial substances in cranberry juice could reach the urinary tract and prevent bacteria from sticking together and multiplying within eight hours. The researchers grew strains of E. coli in urine collected from healthy people before and after they drank cranberry juice cocktail. (They chose the cocktail blend, which is sweetened with high-fructose corn syrup, because most people prefer it over straight cranberry juice.) Urinary tract infections are more common in women than in men. They account for 8 million trips to the doctor’s office every year and cost more than $1.6 billion to treat. Left untreated, the infections can become very severe and migrate to the kidneys. And while drinking cranberry juice may not be a way to self-treat a UTI, the researchers said, it could be an inexpensive way to keep E. coli at bay. clockwise from top right: Image Source/Getty Images; Ghislain & Marie David de Lossy/Getty Images; Petr Gros/StockFood Munich Berry Good Tai Chi looks so slow and lowkey that it might be hard to believe it’s a workout that’s good for you. But a recent review of studies of both Tai Chi and a similar Chinese practice, Qigong, shows that these exercises might help improve heart health, the immune system, and overall quality of life. Both Tai Chi and Qigong incorporate slow physical movements, meditative dance-like movements, and regulation of the breath, mind, and body. Arizona State University researchers analyzed 77 studies (which included some 6,400 participants) of how the practices affect emotional and physical health. The result? The practices appear to have improved the study participants’ bone health, cardiorespiratory fitness, physical functioning, balance, quality of life, and psychological health. How so? The researchers speculated that a combination of self-awareness with selfcorrection of the posture and movement of the body, the flow of breath, and mindfulness may help activate the body’s natural self-regulatory and self-healing capacity. Sad dads Brooke Shields’ experience helped bring greater awareness of postpartum depression among new moms a few years ago. But new research now suggests that fathers of babies are also at risk for this mental health disorder. Researchers examined health records from more than 350 doctors’ practices in the U.K. from 1993 to 2007. They found that close to 40% of new moms and 21% of new dads had a bout of depression during their child’s first 12 years of life. The risk was most pronounced during the first year after birth. The researchers attribute the paternal depression to the normal wear and tear associated with the birth of a baby, including lack of sleep and changes in the parents’ roles, responsibilities, and relationship. Younger parents, those dealing with financial pressures, and those with a history of depression were at greatest risk. I WILL PARTICIPATE TODAY When you serve your community you enrich your life. Helping others makes you healthier. Community work brings families closer together. When you lift other’s spirits, you feel better about yourself. Doing good is good for everyone. How will you participate? Visit: www.DoGoodLiveWell.org Gwyneth Paltrow is an EIF Ambassador. Photographed by Jesse Dylan. Source: Archives of Pediatric and Adolescent Medicine iParticipate is an EIF Initiative The One Day Canker Sore Patch Patch sticks directly to the sore inside your mouth and forms a protective gellike bandage. ® wire 96% Adults who say they always wash their hands in public bathrooms. Packing It In Tobacco use by middle and high school students has declined over the past decade, but it’s not dropping as fast as it could. And that means that comprehensive anti-tobacco programs need more funding, according to a recent CDC report. From 2000 to 2009, the CDC found, the percentage of high school kids using tobacco declined from 34.5% to 23.9%, and the percentage of middle school students using tobacco dropped from 15.1% to 8.2%. But between 2006 and 2009, the only real declines were among middle school and high school girls and non-Hispanic whites using cigarettes. As such, tobacco use among high school students remains above target levels, the CDC says. The CDC based its analysis on data from the National Youth Tobacco Survey, a school-based study that collects information on tobacco use and related behaviors. In this study, 22,679 young people answered questionnaires each year from 2000 to 2009. The questions covered not only cigarettes, but also cigars, smokeless tobacco, pipes, “bidies” (small brown cigarettes wrapped in leaves), and clove cigarettes. To address the problem, the CDC has called for tobacco tax increases, more tobacco-free policies, and more restrictions on tobacco advertisements. 85% The number who actually do, according to one observational study. Source: Interscience Conference on Antimicrobial Agents and Chemotherapy and The Cleaning Institute Source: CDC’s Morbidity and Mortality Weekly Report CREATE THE GOOD ® t • Shields from Irritants • Eat and drink pain-free for up to 12 hours *Based on results published in J.Pharm Sciences, Vol 93, NO. 12, 12/04 (78% of patients had 24 hour resolution); Drugs in R&D 2008 Vol. 9, No.1 (24 hour median time to resolution) Free trial sample: 1-800-448-1448 Store finder/coupons: CankerCover.com Seating Chart Using a rear-facing car seat reduces your baby’s risk of dying in a car accident by 71%. But new research shows that using the seat outside your car can increase your baby’s risk of injury, according to the National Highway Traffic Safety Administration. Based on an analysis of data from the Consumer Product Safety Commission, the researchers found that between 2003 and 2007 an estimated 43,562 babies nationwide went to the emergency room for car seat–related injuries that weren’t due to car accidents. Approximately 85% of those injuries occurred during falls—either when the baby fell out of the car seat or when the whole car seat (with baby inside) fell from an elevated surface, like a shopping cart or table. Slightly more than 8% of the 2,000 infants in the sample had to be admitted to the hospital. Three of the infants died. The researchers also discovered that the most vulnerable time for car seat injuries is when babies are 4 months and younger—perhaps because these babies aren’t yet mobile, so parents have a false sense of security. But even at that young age, babies can wiggle enough to slide right out of the seat. If you need to take your baby—in his car seat—out of the car (when he’s asleep, for instance), be sure to keep him strapped in and leave the car seat on the floor. Source: Pediatrics The results are in from the October issue poll! ’Tis the Season to... Q: What’s your can’t-say-no holiday indulgence? ❍Eating! I bake my way through the holiday season. Q: How do your routines change when the daylight hours get shorter? ❍Drinking! I can’t say no to eggnog. 75% M y routine doesn’t change at all. ❍Music! Dashing through the snow... 9% I work out in the morning. top: Image Source/Photolibrary; Martin Poole/Getty Images • Immediate Pain Relief Poll top: Stuart Paton/Getty Images; Luc Beziat/Getty Images Eliminates most Canker Sores in just one day* The WebMD 9% I skip workouts because it gets darker earlier. 4% I get to work earlier and leave earlier to enjoy more daylight. 3% I work later. Visit WebMD.com/magazine and enter our November/December 2010 poll! ❍Shopping! ’Tis the season to spend, spend, spend. There are so many ways to serve. Now more than ever, it is our time to work as one. Find out how you can ease a burden, create something beautiful, or be there for someone else. Help can come in so many forms. How will you participate? Visit: www.CreateTheGood.org Faith Hill is an EIF Ambassador. Photographed by Jesse Dylan. ❍Movies! I’ve seen It’s a Wonderful Life 100 times. Source: 2010 WebMD Poll iParticipate is an EIF Initiative ® wire Hands Off WIN $500 from WebMD Log on to www.webmd.com/magazine/survey and tell us why you read us. The wAITINg ROOM COMPANION Created for Your Doctor’s Office ® Want to raise a peaceful child? Don’t spank him, a new study shows. The study finds that children who are spanked (or otherwise punished physically) as 3-year-olds are more likely to behave aggressively by the age of 5. In the study, researchers at Tulane University in New Orleans asked 2,500 mothers how often they had spanked their 3-year-old in the past month. When the children turned 5, the researchers then asked the mothers about their kids’ aggressive behaviors, such as bullying, cruelty, and fighting with other children. Although the American Academy of Pediatrics “strongly opposes striking a child for any reason,” about 54% of the mothers surveyed said they had spanked their child in the month before. Spanking supporters claim hitting helps children learn to control their behavior and act appropriately. But even controlling for other factors (including maternal depression, stress, and drug use), the results clearly showed a link between spanking and later, aggressive behavior. Rather than striking children, the researchers recommend using age-appropriate, positive, nonphysical forms of discipline, such as timeouts and rewards for good behavior. A different approach to treating moderate to severe RA— ACTEMRA Julie W. Living with RA for 25 years For more information about ACTEMRA, call 1-800-ACTEMRA or visit www.ACTEMRA.com Source: Pediatrics webmd.com the magazine ACTEMRA is a prescription medicine called an interleukin-6 (IL-6) receptor inhibitor. ACTEMRA is used to treat adults with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a tumor necrosis factor (TNF) antagonist has been used and did not work well. July/August2010$4.95 21 beauty shaving products for guys helping children lose weight 32 parenting when kids fear the doctor 34 sleep can night owls change? Rock on Is mineral makeup right for you? 44 35 pain Big picture does everything hurt? 36 recipe peachy keen chicken salad 53 allergies Elizabeth Gilbert’s book-to-film journey test your food allergy iq 54 heart women’s heart attack smarts 55 cancer truth about breast cancer 16 Carrie Away Country star Underwood’s strategies for keeping it real and healthy on the road 38 COMPLIMENTARY wAITINg ROOM COPY Presorted Bound Printed Matter u.s. PostaGe Paid Clarksville, tn PerMit no. 160 Completing the survey will enter you in our sweepstakes to win a $500 American Express gift card, or one of five $100 gift cards. Your answers will help us give you more of what you want in WebMD the Magazine. webmd.com the Magazine No purchase necessary. A purchase will not increase your chances of winning. Legal residents of the 50 United States (D.C.) 18 years and older. Void where prohibited. Sweepstakes ends 1/15/10. For official rules, prize descriptions and odds disclosure, visit http://www.webmd.com/magazine/survey. Sponsor: WebMD LLC, 111 8th Avenue, New York, NY 10011. Forget the appetite-suppressing candies and meal-in-a-can weight-loss drinks. The most powerful diet tool may also be one of the most humble: water. Brenda Davy, PhD, an associate professor of nutrition at Virginia Tech and senior author of a new study, says that drinking just two 8-ounce glasses of water before meals helps people melt pounds away. In fact, over the course of 12 weeks, dieters who drank water before meals, three times a day, lost about five pounds more than dieters who did not increase water intake. In Davy’s study, 48 adults ages 55 to 75 were divided into two groups. Both groups ate low-calorie diets, but one group drank two cups of water before meals and the other did not. After 12 weeks, water drinkers lost about 15.5 pounds, compared to non-water-drinking dieters, who lost 11 pounds. Prior to the study, each adult drank about 1.5 cups of water per day. Davy theorizes that drinking water helps people lose weight because it fills them up without adding calories to their diet. The study is the first to report such findings, although anecdotal evidence has long suggested that drinking water helps wash the pounds away. Source: American Chemical Society fall 2010 national meeting TNF antagonists include Enbrel® (etanercept), Remicade® (infliximab), Humira® (adalimumab), Cimzia® (certolizumab pegol) and Simponi™ (golimumab).* Important Safety Information Some people have serious infections while taking ACTEMRA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Other serious side effects of ACTEMRA include tears (perforation) of the stomach and intestines, changes in blood test results, hepatitis B infection in those already carrying the virus, nervous system problems, and serious allergic reactions. Water Weight Common side effects with ACTEMRA include upper respiratory tract infections (common cold, sinus infections), headache, and increased blood pressure (hypertension). Tell your healthcare provider if you plan to become pregnant or are pregnant. It is not known if ACTEMRA will harm your unborn baby. Genentech has a registry for pregnant women who take ACTEMRA. If you are pregnant or become pregnant while taking ACTEMRA, contact the registry at 1-877-311-8972 and talk to your healthcare provider. top: Raoul Minsart/Masterfile; Cimbal/StockFood Munich 31 fitness You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call 1-800-FDA-1088. Please see next page for brief summary for additional safety information. *All trademarks are property of their respective owners. Ask your doctor if ACTEMRA is the right treatment for you. ACTEMRA® (AC-TEM-RA) (tocilizumab) This is the consumer brief summary. For more information, please refer to the full prescribing information. Rx only Read the Medication Guide that comes with ACTEMRA before you start it and before each infusion. There may be new information. This brief summary does not take the place of talking with your healthcare provider about your medical condition or your treatment. What is the most important information I should know about ACTEMRA? ACTEMRA can cause serious side effects including: 1. Serious Infections ACTEMRA is a medicine that affects your immune system. ACTEMRA can lower the ability of your immune system to fight infections. Some people have serious infections while taking ACTEMRA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. s9OURDOCTORSHOULDTESTYOUFOR4"BEFORESTARTING!#4%-2! s9OURDOCTORSHOULDMONITORYOUCLOSELYFORSIGNSAND symptoms of TB during treatment with ACTEMRA. 9OUSHOULDNOTSTARTTAKING!#4%-2!IFYOUHAVEANYKINDOF infection unless your healthcare provider says it is okay. Before starting ACTEMRA, tell your healthcare provider if you: sTHINKYOUHAVEANINFECTIONORHAVESYMPTOMSOFANINFECTION such as: - fever, sweating, or chills - muscle aches - cough - shortness of breath - blood in phlegm - weight loss - warm, red, or painful skin or sores on your body - diarrhea or stomach pain - burning when you urinate or urinating more often than normal - feel very tired sAREBEINGTREATEDFORANINFECTION sGETALOTOFINFECTIONSORHAVEINFECTIONSTHATKEEP coming back sHAVEDIABETES()6ORAWEAKIMMUNESYSTEM0EOPLEWITH these conditions have a higher chance for infections. sHAVE4"ORHAVEBEENINCLOSECONTACTWITHSOMEONE with TB sLIVEORHAVELIVEDORHAVETRAVELEDTOCERTAINPARTSOFTHE country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections (histoplasmosis, coccidiomycosis, or blastomycosis). These infections may happen or become more severe if you use ACTEMRA. Ask your healthcare provider, if you do not know if you have lived in an area where these infections are common. sHAVEORHAVEHADHEPATITIS" After starting ACTEMRA, call your healthcare provider right away if you have any symptoms of an infection. ACTEMRA can make you more likely to get infections or make worse any infection that you have. 2. Tears (perforation) of the stomach or intestines. s"EFORETAKING!#4%-2!TELLYOURHEALTHCAREPROVIDERIF you have had diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people taking ACTEMRA get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate. s4ELLYOURHEALTHCAREPROVIDERRIGHTAWAYIFYOUHAVEFEVERAND stomach-area pain that does not go away, and a change in your bowel habits. 3. Changes in certain laboratory test results. 9OURHEALTHCAREPROVIDERSHOULDDOBLOODTESTSBEFOREYOUSTART receiving ACTEMRA and every 4 to 8 weeks during treatment to check for the following side effects of ACTEMRA: sLOWNEUTROPHILCOUNT.EUTROPHILSAREWHITEBLOODCELLSTHAT help the body fight off bacterial infections. sLOWPLATELETCOUNT0LATELETSAREBLOODCELLSTHATHELPWITH blood clotting and stop bleeding. sINCREASEINCERTAINLIVERFUNCTIONTESTS 9OUSHOULDNOTRECEIVE!#4%-2!IFYOURNEUTROPHILORPLATELET counts are too low or your liver function tests are too high. 9OURHEALTHCAREPROVIDERMAYSTOPYOUR!#4%-2!TREATMENT for a period of time or change your dose of medicine if needed because of changes in these blood test results. 9OUMAYALSOHAVECHANGESINOTHERLABORATORYTESTSSUCHAS YOURBLOODCHOLESTEROLLEVELS9OURHEALTHCAREPROVIDERSHOULDDO blood tests to check your cholesterol levels 4 to 8 weeks after you start receiving ACTEMRA, and then every 6 months after that. Normal cholesterol levels are important to good heart health. 4. Cancer. ACTEMRA may decrease the activity of your immune system. Medicines that affect the immune system may increase your risk of certain cancers. Tell your healthcare provider if you have ever had any type of cancer. See “What are the possible side effects with ACTEMRA?” for more information about side effects. What is ACTEMRA? ACTEMRA is a prescription medicine called an Interleukin-6 (IL-6) receptor inhibitor. ACTEMRA is used to treat adults with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a Tumor Necrosis Factor (TNF) antagonist has been used and did not work well. It is not known if ACTEMRA is safe and effective in children. What should I tell my healthcare provider before receiving ACTEMRA? ACTEMRA may not be right for you. Before starting ACTEMRA, tell your healthcare provider if you: sHAVEANINFECTION3EEh7HATISTHEMOSTIMPORTANTINFORMATION I should know about ACTEMRA?” sHAVELIVERPROBLEMS sHAVEANYSTOMACHAREAABDOMINALPAINORBEENDIAGNOSED with diverticulitis or ulcers in your stomach or intestines sHAVEORHADACONDITIONTHATAFFECTSYOURNERVOUSSYSTEMSUCHAS multiple sclerosis sHAVERECENTLYRECEIVEDORARESCHEDULEDTORECEIVEAVACCINE 0EOPLEWHOTAKE!#4%-2!SHOULDNOTRECEIVELIVEVACCINES People taking ACTEMRA can receive non-live vaccines sPLANTOHAVESURGERYORAMEDICALPROCEDURE sHAVEANYOTHERMEDICALCONDITIONS sPLANTOBECOMEPREGNANTORAREPREGNANT)TISNOTKNOWNIF !#4%-2!WILLHARMYOURUNBORNBABY Pregnancy Registry: 'ENENTECHHASAREGISTRYFORPREGNANT WOMENWHOTAKE!#4%-2!4HEPURPOSEOFTHISREGISTRYISTO CHECKTHEHEALTHOFTHEPREGNANTMOTHERANDHERBABY)FYOUARE PREGNANTORBECOMEPREGNANTWHILETAKING!#4%-2!TALKTOYOUR HEALTHCAREPROVIDERABOUTHOWYOUCANJOINTHISPREGNANCYREGISTRY ORYOUMAYCONTACTTHEREGISTRYATTOENROLL sPLANTOBREASTFEEDORAREBREASTFEEDING9OUANDYOURHEALTHCARE PROVIDERSHOULDDECIDEIFYOUWILLTAKE!#4%-2!ORBREASTFEED 9OUSHOULDNOTDOBOTH 4ELLYOURHEALTHCAREPROVIDERABOUTALLOFTHEMEDICINESYOUTAKE INCLUDINGPRESCRIPTIONANDNONPRESCRIPTIONMEDICINESVITAMINSAND HERBALSUPPLEMENTS!#4%-2!ANDOTHERMEDICINESMAYAFFECTEACH OTHERCAUSINGSIDEEFFECTS Especially tell your healthcare provider if you take: sANYOTHERMEDICINESTOTREATYOUR2!9OUSHOULDNOTTAKE ETANERCEPT%NBREL®ADALIMUMAB(UMIRA®INmIXIMAB (Remicade®RITUXIMAB2ITUXAN®ABATACEPT/RENCIA®ANAKINRA (Kineret®CERTOLIZUMABPEGOL#IMZIA®ORGOLIMUMAB3IMPONI™ WHILEYOUARETAKING!#4%-2!4AKING!#4%-2!WITHTHESE MEDICINESMAYINCREASEYOURRISKOFINFECTION sMEDICINESTHATAFFECTTHEWAYCERTAINLIVERENZYMESWORK!SKYOUR HEALTHCAREPROVIDERIFYOUARENOTSUREIFYOURMEDICINEISONEOF THESE +NOWTHEMEDICINESYOUTAKE+EEPALISTOFTHEMTOSHOWTOYOUR HEALTHCAREPROVIDERANDPHARMACISTWHENYOUGETANEWMEDICINE How will I receive ACTEMRA? s9OUWILLRECEIVE!#4%-2!FROMAHEALTHCAREPROVIDERTHROUGHA NEEDLEPLACEDINAVEININYOURARM)6ORINTRAVENOUSINFUSION 4HEINFUSIONWILLTAKEABOUTHOURTOGIVEYOUTHEFULLDOSEOF MEDICINE s9OUWILLRECEIVEADOSEOF!#4%-2!ABOUTEVERYWEEKS s)FYOUMISSASCHEDULEDDOSEOF!#4%-2!ASKYOURHEALTHCARE PROVIDERWHENTOSCHEDULEYOURNEXTINFUSION s7HILETAKING!#4%-2!YOUMAYCONTINUETOUSEOTHERMEDICINES THATHELPTREATYOURRHEUMATOIDARTHRITISSUCHASMETHOTREXATE NONSTEROIDALANTIINmAMMATORYDRUGS.3!)$SANDPRESCRIPTION STEROIDSASINSTRUCTEDBYYOURHEALTHCAREPROVIDER s+EEPALLOFYOURFOLLOWUPAPPOINTMENTSANDGETYOURBLOODTESTS ASORDEREDBYYOURHEALTHCAREPROVIDER What are the possible side effects with ACTEMRA? ACTEMRA can cause serious side effects, including: s3EEh7HATISTHEMOSTIMPORTANTINFORMATION)SHOULDKNOWABOUT ACTEMRA?” s(EPATITIS"INFECTIONINPEOPLEWHOCARRYTHEVIRUSINTHEIRBLOOD )FYOUAREACARRIEROFTHEHEPATITIS"VIRUSAVIRUSTHATAFFECTS THELIVERTHEVIRUSMAYBECOMEACTIVEWHILEYOUUSE!#4%-2! 4HISHAPPENSWITHOTHERBIOLOGICMEDICINESUSEDTOTREAT2! 9OURDOCTORMAYDOBLOODTESTSBEFOREYOUSTARTTREATMENTWITH !#4%-2!ANDWHILEYOUAREUSING!#4%-2!4ELLYOURHEALTHCARE PROVIDERIFYOUHAVEANYOFTHEFOLLOWINGSYMPTOMSOFAPOSSIBLE HEPATITIS"INFECTION FEELVERYTIRED - skin or eyes look yellow - little or no appetite - vomiting CLAYCOLOREDBOWELMOVEMENTS FEVERS - chills STOMACHDISCOMFORT - muscle aches - dark urine - skin rash s.ERVOUSSYSTEMPROBLEMS-ULTIPLE3CLEROSISHASBEENDIAGNOSED RARELYINPEOPLEWHOTAKE!#4%-2!)TISNOTKNOWNWHATEFFECT !#4%-2!MAYHAVEONSOMENERVOUSSYSTEMDISORDERS s!LLERGIC2EACTIONS3ERIOUSALLERGICREACTIONSCANHAPPENWITH !#4%-2!4HESEREACTIONSMAYNOTHAPPENWITHYOURlRST INFUSIONANDMAYHAPPENWITHFUTUREINFUSIONSOF!#4%-2!4ELL YOURHEALTHCAREPROVIDERRIGHTAWAYIFYOUHAVEANYOFTHEFOLLOWING SIGNSOFASERIOUSALLERGICREACTION SHORTNESSOFBREATHORTROUBLEBREATHING - skin rash SWELLINGOFTHELIPSTONGUEORFACE - chest pain FEELINGDIZZYORFAINT Common side effects of ACTEMRA include: sUPPERRESPIRATORYTRACTINFECTIONSCOMMONCOLDSINUSINFECTIONS sHEADACHE sINCREASEDBLOODPRESSUREHYPERTENSION 4ELLYOURHEALTHCAREPROVIDERIFYOUHAVEANYSIDEEFFECTTHATBOTHERS YOUORTHATDOESNOTGOAWAY4HESEARENOTALLOFTHEPOSSIBLESIDE EFFECTSOF!#4%-2!&ORMOREINFORMATIONASKYOURHEALTHCARE PROVIDERORPHARMACIST #ALLYOURDOCTORFORMEDICALADVICEABOUTSIDEEFFECTS9OUMAY REPORTSIDEEFFECTSTO&$!AT&$!9OUMAYALSOREPORT SIDEEFFECTSTO'ENENTECHAT 3OUTH3AN&RANCISCO#! ¥'ENENTECH53!)NC!LLRIGHTSRESERVED highlights at Webmd.com Gift Rap A new squeak ball? A deluxe toy mouse? What to get the pet who has everything? We know your four-legged friends are part of the family— and your holiday shopping list. Look no further: WebMD’s Pet Gift Guide, with gift ideas vetted by veterinarians, has something sure to please all your furry family members. the Pulse by Colleen Paretty, WebMD Executive Editor W ould you like to be in the magazine? I would like you to be in the magazine. One of our goals is to bring people who read the magazine, like you, into our pages with your real-life stories, concerns, and questions. It’s really a no-brainer. You live and breathe health every day, though you probably don’t think about it You’re ready to ditch as obsessively as the staff of this magazine does (that would be the Pill and try to have unhealthy). And who better to team a baby. Now, what do up with our pool of top-notch experts you need to know? Find to answer your questions than, out how long it takes to well, you? Here are two places to start. We’d conceive after stopping like to know about your top skin care various types of birth challenges, everything from acne and control with the fourdry itchy skin to wrinkles and sun part “Getting Pregnant damage. What has you confused or After Birth Control” stumped? Or, tell us about food: What did you (or someone you series on WebMD’s SEARCH Pet Gift Guide know, like your spouse or child) Below the Belt blog. used to absolutely abhor—but now can’t get enough of? We’ll choose a few of your queries, pose them to our cosmetic dermatologists and top symptoms include SEARCH nutrition experts, and feature you Pain and swelling on one side of the knee (and them) in a future issue. Stiffness of the knee Visit the magazine’s Facebook and Twitter pages, or drop by A catching, popping, or locking sensation the magazine’s Community on in the knee SEARCH WebMD.com and “talk” to us there. The menisci are rubbery, C-shaped shock-absorbing discs that I promise it won’t be a one-way lie on either side of the knee and help stabilize it. They can tear conversation. You’ll hear from me as a result of both the wear and tear of age or a sudden twist or occasionally, and also from the turn of the knee, and studies show that men tend to tear theirs magazine’s senior (and social media) more often than women. Doctors use a physical exam, X-rays, editor, Andi Gabrick, who is keeping and MRIs to diagnose a torn meniscus. And, depending on the WATCH VIDEO an eye daily (if not hourly) on all size and severity of the tear and how active you are, treatment Key in your symptoms these places. can range from rest, wrapping, and ice to physical therapy or I look forward to seeing you in FIND THE ANSWER even arthroscopic surgery. our pages. Oh, Baby! Torn Meniscus 18 WebMD the Magazine | November/December 2010 Trusted Medical Information On the Go WebMD Symptom Checker Select the part of the body that is troubling you, choose your symptoms, and learn about potential conditions or issues. Conditions Find medically reviewed information about Conditions relevant to you and learn more about causes, treatments, and related symptoms. Drugs & Treatments Search our extensive database for information on Drugs, Supplements, and Vitamins. Access content such as Uses, Side Effects, Warnings, and more. Pill Identification Tool Identify your prescription drugs and over the counter medicines by pill shape, color, & imprint. First Aid Essentials Your handy guide for medical emergencies. From insect stings to broken bones, helpful treatment tips are always available, even without an Internet connection. symptomchecker Local Health Listings Find the closest physician, hospital, & pharmacy based on your current location or search by city, state or zip. left: Ted Morrison/Getty Images; Eric Bean/Getty Images click here GO Free Download ©2010 WebMD, LLC. All rights reserved. medical file people and pages In Her Memory NFL star Terrell Owens tackles Alzheimer’s for his grandmother LEFT: Larry Marano/Retna Ltd./Corbis Every time NFL wide receiver Terrell Owens steps onto the football field, his mind turns to the woman he credits with getting him there: his grandmother. She took him in when he was a young boy and raised him. What breaks his heart is that she will never know how far he’s come. Alice Black was diagnosed with Alzheimer’s disease 14 years ago, during Owens’ first NFL season. Now, she no longer knows her grandson. “The disease has robbed her of her memories,” says Owens, who plays for the Cincinnati Bengals and is considered one of the best NFL wide receivers of all time. “It’s like she is dying a slow death.” November is Alzheimer’s Awareness Month. For Owens, 36, bringing attention to the disease is a cause to which he has lent his celebrity since his grandmother was diagnosed in 1996. “Every team I have played for knew I did charity work,” says Owens, who has participated in numerous Memory Walks to raise money for Alzheimer’s care and research and has appeared in public service announcements. In 2003, he testified before Congress in an effort to increase federal funding for Alzheimer’s research. Owens did not know much about the disease at first, but working with the Alzheimer’s Association and doing research changed that. Over time, those efforts helped him understand and accept what was happening. “Learning to deal with it was a gradual process,” Owens says. “I had to come to grips with the fact that she was not going to get better.” That’s a prognosis more than 5 million people in the United States face, most of them age 65 or older. That number is expected to increase dramatically as more baby boomers enter prime Alzheimer’s territory. The National Institute on Aging says the number of Americans 65 and older will double within the next 25 years. The disease is the seventh-leading cause of death in the United States. Owens’ grandmother is now 76 and lives in an Alabama nursing home. “She’s in a state where she can’t really communicate,” says Owens. That’s the saddest part for him, because there is so much he would like to share with her and thank her for. “I would love to have her experience what I have achieved,” Owens says. “Here is someone I love dearly, who motivated me, who made me a better man, but she cannot see the man I’ve become.”—Matt McMillen Healthy Lead How Larry King Live broke health journalism barriers The front-row seat to the biggest stories in health and medicine over the past two decades has to belong to Wendy Walker. As senior executive producer of CNN’s Larry King Live for 17 years, Walker has been the power behind the legendary interviewer’s suspenders, helping him shine a light on many previously untold stories in health. “When I first started with Larry, people were really nervous about coming out and discussing their personal health issues,” Walker says. “Over the years, through our show, we’ve been able to bring information and guidance, and the sense that people are not alone. It’s allowed people to become their own best advocates.” Here’s just a sample: Olympic gold-medal diver Greg Louganis described living with HIV/AIDS. Actor and author Jamie Lee Curtis and comedian Tom Arnold talked about beating addictions, and journalist Ann Curry and singer-songwriter Sheryl Crow opened up about their breast cancer. For years, celebrities and ordinary people in the midst of extraordinary events have told their tales on Larry King Live. Now, with King about to retire, Walker’s telling hers. Walker’s new book, Producer: Lessons Shared From 30 Years in Television, hits bookstores Nov. 16. (And she’s doing a stint on Larry King Live in front of the cameras on Nov. 15.) Organized around chapters that highlight life lessons, Walker’s book relates behind-the-scenes sagas from her climb up the television ladder. Her favorite lesson, she says, is “Be grateful for every day of your life. ... As I get older, I don’t get as upset about things I used to get upset about. I’m grateful for the good things in my life: good people, good energy, health and happiness, and kindness.”—Gina Shaw November/December 2010 | WebMD the Magazine 21 personal stories from Webmd.com members Lost and Found Ricardo Mejia, 17, has lost more than 65 pounds. By Ricardo Mejia WebMD.com community member I started gaining weight when I was about 11. I just wasn’t very active. I would come home from school every day and watch TV. My parents are from El Salvador—I moved here when I was 7—and they’re very protective. They didn’t feel comfortable having me out and about after school, so I became quite sedentary. And my diet wasn’t good: Most of the time we ate frozen, packaged foods and a lot of sweets. It was just more convenient for us. By the end of my freshman year in high school, I weighed close to 250 pounds and I was only 5 feet 8 inches tall. When I walked I couldn’t breathe well, and I could feel my heart pounding in my chest. Going up and down stairs was difficult. When I had phys ed, I sometimes found it difficult to run and pass the fitness tests. But I tried my best. I decided I needed to lose weight when I was 15. I was wearing pants that had a 36-inch waist and 30-inch length, but even they were so tight they were uncomfortable. Plus, I knew that there was diabetes on both sides of my family. By that point, I was a freshman in high school. I had a little more independence. I decided to join my school’s dragon boat team. Dragon boats are large, wooden, and very team-heavy boats, so I was getting a lot of exercise—not just the paddling, but running, push-ups, and sit-ups. It was more exercise than I had ever gotten in my life. I started feeling strong and healthy. By my sophomore year, I was down to 200 pounds. At that point, I joined the swim team, too. I don’t know how I kept up my grades, but I did. My grades have always been very consistent, but the fact that I had to keep my grades up to stay on the teams was a big, big motivation. My life was changing in a really good way. I started reading articles in sports magazines about how it’s important to eat well, so I changed my diet, too. I began eating peanut butter and green apples. I stopped eating packaged foods. My pediatrician sent me to a nutritionist who taught me a lot. She would tell me to keep going, keep trying, and that helped a lot. The rest of my family hasn’t changed how they eat, but lots of times I come home after they’ve already had dinner, so I make my own meals. Sometimes my grandmother complains about how I’m eating differently—she thinks I have an eating disorder!— but they are impressed that I’ve lost so much weight. Today I’m 17, 6 feet 1 inch tall, and I weigh 185 pounds. I feel good. If I had to tell other obese teens one thing, it’s this: It’s really easy to change your way of eating. Teens get hooked on candy and soda, but it’s just as easy to drink mineral water instead. Don’t get it in your head that you can’t fix it. You can. Sooner or later you’ll end up losing the weight. Believe me, if I can do it, anyone can. Read more stories and share your own in our community. 22 WebMD the Magazine | November/December 2010 Clinically proven to: � Prevent Blood Sugar Highs & Lows � Control Hunger � Sustain Energy � Improve sleep & wake to better blood sugar Crunchy, Savory ExtendCrisps Smooth, Velvety ExtendShakes Doctor Developed; Clinically Proven. Invented by Dr. Francine Kaufman, past president of the American Diabetes Assn., ExtendSnacks convert to blood sugar more gradually than any other snacks. In fact, they’re clinically proven to help stabilize blood sugar levels for up to 9 hours! “They’re amazing. They really help stabilize my blood sugar. I no longer get the highs or the lows I used to get. And they’re very tasty too.” –Debbie Lehman, PA Say goodbye to blood sugar lows and highs. One before bed can help reduce nighttime blood sugar lows by 75% and morning highs an average of 28%. So you can sleep peacefully and start the day in control. Satisfy cravings; calm hunger. Satisfy your sugar and carb cravings with 13 delicious flavors of bars, crisps and shakes. They help curb hunger by preventing low blood sugar, a key trigger of appetite. One between meals has even been shown to help you eat 20% less at your next meal. Find with diabetes products Robert Houser my WebMD WebMD.com Call 1-800-887-2919 (mention WebMD) or visit www.ExtendSnacks.com/WebMD © 2010 Clinical Products, LLC. Chewy, Moist ExtendBars ©RBI 2010 ◗ this content is selected and controlled by WebMD’s editorial staff and is brought to you by DELSYM®. ◗ spotlight spotlight heart wellness Cough Take our quiz to test your cold and flu smarts IQ Think of it as a remote control for silencing coughs. Do you hear that? It’s cold and flu season, and people all around you are coughing. Why? “Coughing is a normal, protective reflex,” says Neil Schachter, MD, author of The Good Doctor’s Guide to Colds and Flu and professor of pulmonary medicine at Mount Sinai School of Medicine in New York City. “We cough to clear our airways,” he explains. Think of coughing as a defense mechanism designed to rid your lungs and windpipe of substances that don’t belong there. In the case of colds, this intruder is usually mucus, which builds up more than the airways can comfortably handle. At other times, the foreign substance might be something irritating, like smoke or pollution that you’ve inhaled and has gotten trapped in the flypaper-like coating of the air passages. First, your body senses an irritant, so the nerves in the lungs send an intruder-alert message to your brain. The brain responds by telling you to take a By Christina Boufis WebMD Contributing Writer Reviewed by Michael W. Smith, MD WebMD CHIEF MEDICAL EDITOR Artista: Mitch Tobias/Masterfile Use as directed. Only Delsym® cough liquid helps silence a cough for a full 12 hours. Its. patented time release formula gives you all day or all night relief, up to twice. as long as other cough liquids.* So, turn down your cough and turn up relief. Delsym. Silence is relief. ® Among OTC liquids per dose. † 24 WebMD the Magazine | November/December 2010 ™ www.delsym.com *Delsym is the #1 recommended Over-The-Counter single active ingredient cough suppressant among Internists, General Practitioners and Family Practitioners. IMS Health, NDTI, for the 52 weeks ending in 6/30/10. * exam room ◗ this coNteNt is selecteD aND coNtrolleD by WebMD’s eDitorial staff aND is brought to you by DelsyM®. ◗ spotlight perf u m e Latin Lover The word “perfume” comes from the Latin phrase per fumus meaning “through smoke.” How much do you know about coughing? 1. What can cause a cough? a. Allergies b. Acid reflux c. Secondhand smoke d. All of the above Answer: d. With allergies, a cough can be caused by postnasal drip—mucus from your nose or sinuses that builds up in your throat. With heartburn, it might be from acid reflux—acid that backs up into your throat. Exposure to secondhand smoke can also cause a cough. 2. If you are coughing because you have a cold or flu, it’s normal to cough up mucus. True False Answer: True. Coughing up clear or yellow mucus is normal with a cold. You should see your doctor if you’re coughing up mucus and have fever, chills, or shortness of breath. It could be a sign of pneumonia. 3. What kind of cough can be treated with cough medicine? a. Asthma b. Chronic bronchitis c. Cold or flu d. Pneumonia Answer: c. Cough medicine won’t cure a cold- or flu-related cough, but it can help calm a cough. Talk to your doctor before you use cough medicine for a cough that is helping to clear your lungs—such as one caused by smoking, emphysema, pneumonia, asthma, or chronic bronchitis. If your cough is due to asthma, it means your asthma is not under control. 4. Which of these home remedies can help calm a cough? a. Whiskey b. Milk c. Hard candy d. Chocolate Answer: c. Hard candies may ease a dry cough and soothe an irritated throat. Grandma might have prescribed a shot of whiskey for a cough, but there’s no proof that it works. Plus, some cough and cold medicines should not be taken when drinking alcohol. Read the label. Chocolate and milk won't hurt a cough, but they won’t necessarily help it. 5. You should see a doctor for a cough that lasts: a. One week b. More than 10 days c. More than three weeks d. More than eight weeks Answer: c. Most coughs from colds or flu go away in one to two weeks. But a cough that lingers two or more weeks after a cold or other respiratory tract infection might still go away on its own or it might need to be treated, so you should see a doctor for a diagnosis. Take the complete quiz online. Search cough. 26 WebMD the Magazine | November/December 2010 Like an Egyptian Egyptians packed sealed pots of oils and fragrances in royals’ tombs. When Tutankhamen’s tomb was discovered, traces of fragrance could still be smelled. Holy Smoke One of the earliest uses of perfume was for religious purposes: the burning of incense and aromatic herbs for ceremonies. Ted Morrison breath and close the epiglottis—the small flap behind the tongue that seals off the windpipe. This causes a tremendous amount of air pressure to build up in the lungs. The chest muscles get tighter and tighter until the epiglottis is forced open, releasing the pressure in a noisy propulsion of air. In other words, you cough. And just how forcefully do you expel air—and with it foreign substances, such as flu virus droplets? Well, let’s just say that moving at 4 to 64 miles per hour, those droplets could get a speeding ticket. Because you can also cough on command (such as when you clear your throat), coughing is not totally a reflex, Schachter says. But coughing is one of the top reasons people visit their doctors. When his patients come in to see him about their coughs, what is the No. 1 question they ask? “Is it good that I’m coughing something up? Or is bad that I’m coughing something up?” And he explains, “Well, if you’ve got mucus in your airways, it’s good that you’re coughing it up because bacteria just love to grow on [mucus].” But on the other hand, he says, “If you have an irritation and your chest is clear, then it’s not necessarily advantageous to produce a lot of mucus.” Most viral infections, such as the flu, are accompanied by a pretty dry cough, Schachter says, unless some complication occurs. “Colds, which irritate the upper airways, tend to produce wetter coughs because they generate more mucus,” he says. But the cough reflex is also influenced by a number of individual factors—how sensitive you are to irritants; whether you have an underlying condition such as allergies, asthma, or bronchitis; whether or not you smoke—as well as the type of infection. One infectious disease that’s made a comeback, Schachter says, is whooping cough, which as its name implies is distinguished by its particular sound: a fit of coughing followed by a whooping sound as you try to catch your breath. “But most coughs associated with colds and flu will ultimately get better no matter what we do,” he says. Coughing is one of the top reasons people visit their doctors. Joe Fox/Getty ImaGes heart wellness A closer look at everyday objects French Press Grasse in Provence, France, is still known as the perfume capital of the world for its production of herbs and flowers for potent mixtures. Bottled Up There are varying types of perfume depending on the concentration of essential oils. Perfume is the costliest, followed by eau de parfum, eau de toilette, and eau de cologne. Take 5 Today, famous perfume Chanel No. 5 supposedly sells a bottle every 30 seconds. Dollars and Scents The world’s most expensive perfume, valued at $215,000 per bottle, is Imperial Majesty, a limited edition bottle of Clive Christian. The bottle has a five-karat diamond topper. Skin You’re In Perfume smells different on every person because of unique body chemistry, which reacts with the scent’s notes. —Chloe Thompson WebMD.com November/December 2010 | WebMD the Magazine 27 SIMPONI, a full month of RA relief with one dose a month. SIMPONI, used with the medicine methotrexate, is for adults with moderate to severe rheumatoid arthritis (RA). SIMPONI, for moderate to severe rheumatoid arthritis (RA) in adults. IMPORTANT SAFETY INFORMATION ® ® Just one dose of SIMPONI monthly helps relieve the pain, stiffness, and swelling of RA. Results may not be the same for everyone. SIMPONI is used with the medicine methotrexate. Methotrexate is taken as directed. Once you and your doctor are comfortable with the self-injection process, you will inject SIMPONI just once a month under the skin. ® ® ® Ask your rheumatologist if SIMPONI (golimumab) is right for you. Please read the Important Safety Information on the adjacent page. ® ® ® ® ® ® ® Visit www.4simponi.com or call 888-4 SIMPONI to see if you qualify for a full year of cost support. © Centocor Ortho Biotech Inc. 2010 8/10 Heart failure can occur or get worse in people who use TNF blockers, including SIMPONI. Your doctor will closely monitor you if you have heart failure. Tell your doctor right away if you get new or worsening symptoms of heart failure like shortness of breath or swelling of your lower legs or feet. Rarely, people using TNF blockers, including SIMPONI, can have nervous system problems such as multiple sclerosis. Tell your doctor right away if you have symptoms like vision changes, weakness in your arms or legs, or numbness or tingling in any part of your body. Liver problems can happen in people using TNF blockers. Contact your doctor immediately if you develop symptoms such as feeling very tired, skin or eyes look yellow, poor appetite or vomiting, or pain on the right side of your stomach. Low blood counts have been seen with people using TNF blockers, including SIMPONI. If this occurs, your body may not make enough blood cells to help fight infections or help stop bleeding. Your doctor will check your blood counts before and during treatment. Tell your doctor if you have signs such as fever, bruising, bleeding easily, or paleness. Rarely, people using TNF blockers have developed lupus-like symptoms. Tell your doctor if you have any symptoms such as a rash on your cheeks or other parts of the body, sensitivity to the sun, new joint or muscle pain, becoming very tired, chest pain or shortness of breath, swelling of the feet, ankles, and/or legs. New or worse psoriasis symptoms may occur. Tell your doctor if you develop red scaly patches or raised bumps that are filled with pus. Tell your doctor if you are allergic to rubber or latex. The needle cover contains dry natural rubber. Tell your doctor if you have any symptoms of an allergic reaction while taking SIMPONI such as hives, swollen face, breathing trouble, chest pain. Common side effects of SIMPONI include: upper respiratory tract infection, nausea, abnormal liver tests, skin reaction at site of injection, high blood pressure, flu and cold sores. Please read the Medication Guide for SIMPONI and discuss any questions you have with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Call 1-800-FDA-1088 or visit www.fda.gov/medwatch. ® SIMPONI (golimumab) is a prescription medicine. SIMPONI can lower your ability to fight infections. There are reports of serious infections caused by bacteria, fungi, or viruses that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor will test you for TB before starting SIMPONI and will monitor you for signs of TB during treatment. Tell your doctor if you have been in close contact with people with TB. Tell your doctor if you have been in a region (such as the Ohio and Mississippi River Valleys and the Southwest) where certain fungal infections like histoplasmosis or coccidioidomycosis are common. You should not start SIMPONI if you have any kind of infection. Tell your doctor if you are prone to or have a history of infections or have diabetes, HIV or a weak immune system. You should also tell your doctor if you are currently being treated for an infection or if you have or develop any signs of an infection such as: •warm, red, or painful skin •fever, sweat, or chills or sores on your body •muscle aches • diarrhea or stomach pain •cough burning when you urinate • •shortness of breath or urinate more than normal •blood in phlegm • feel very tired •weight loss Unusual cancers have been reported in children and teenage patients taking TNF-blocker medicines. For children and adults taking TNF blockers, including SIMPONI, the chances for getting lymphoma or other cancers may increase. You should tell your doctor if you have had or develop lymphoma or other cancers. Tell your doctor about all the medications you take including ORENCIA (abatacept), KINERET (anakinra), RITUXAN (rituximab) or another TNF blocker, or if you are scheduled to or recently received a vaccine. People taking SIMPONI should not receive live vaccines. Reactivation of hepatitis B virus has been reported in patients who are carriers of this virus and are taking TNF-blocker medicines, such as SIMPONI. Some of these cases have been fatal. Your doctor may do blood tests before and after you start treatment with SIMPONI. Tell your doctor if you know or think you may be a carrier of hepatitis B virus or if you experience signs of hepatitis B infection, such as: •feel very tired •clay-colored bowel movements •skin or eyes look yellow • fevers •little or no appetite •chills •vomiting •stomach discomfort •muscle aches •skin rash •dark urine ® 25SMRC10022 ® ® ® ® ® Just one dose, once a month. 25SMRA10013 ® ® Medication Guide MEDICATION GUIDE SIMPONI® (SIM-po-nee) (golimumab) Read the Medication Guide that comes with SIMPONI before you start taking it and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking with your doctor about your medical condition or treatment. It is important to remain under your doctor’s care while using SIMPONI. What is the most important information I should know about SIMPONI? SIMPONI is a medicine that affects your immune system. SIMPONI can lower the ability of your immune system to fight infections. Some people have serious infections while taking SIMPONI, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that spread throughout their body. Some people have died from these serious infections. • Your doctor should test you for TB before starting SIMPONI. • Your doctor should monitor you closely for signs and symptoms of TB during treatment with SIMPONI. You should not start taking SIMPONI if you have any kind of infection unless your doctor says it is okay. Before starting SIMPONI, tell your doctor if you: • think you have an infection or have symptoms of an infection such as: • fever, sweat, or chills • shortness of breath • warm, red, or painful skin • feel very tired or sores on your body • blood in phlegm • muscle aches • weight loss • diarrhea or stomach pain • cough • burning when you urinate or urinate more often than normal • are being treated for an infection • get a lot of infections or have infections that keep coming back • have diabetes, HIV, or a weak immune system. People with these conditions have a higher chance for infections. • have TB, or have been in close contact with someone with TB • live, have lived, or traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, blastomycosis). These infections may happen or become more severe if you use SIMPONI. Ask your doctor if you do not know if you have lived in an area where these infections are common. • have or have had hepatitis B • use the medicine Orencia (abatacept), Kineret (anakinra), or Rituxan (rituximab) After starting SIMPONI, call your doctor right away if you have any symptoms of an infection. SIMPONI can make you more likely to get infections or make worse any infection that you have. Cancer • There have been cases of unusual cancers in children and teenage patients taking TNF-blocking agents. • For children and adults taking TNF-blocker medicines, including SIMPONI, the chances of getting lymphoma or other cancers may increase. • People with inflammatory diseases including rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis, especially those with very active disease, may be more likely to get lymphoma. What is SIMPONI? SIMPONI is a prescription medicine called a Tumor Necrosis Factor (TNF) blocker. SIMPONI is used in adults: • with the medicine methotrexate to treat moderately to severely active rheumatoid arthritis (RA) • to treat active psoriatic arthritis (PsA) alone or with methotrexate • to treat active ankylosing spondylitis (AS) You may continue to use other medicines that help treat your condition while taking SIMPONI, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and prescription steroids, as recommended by your doctor. What should I tell my doctor before starting treatment with SIMPONI? SIMPONI may not be right for you. Before starting SIMPONI, tell your doctor about all your medical conditions, including if you: • have an infection (see “What is the most important information I should know about SIMPONI?”). • have or have had lymphoma or any other type of cancer. • have or had heart failure. • have or have had a condition that affects your nervous system, such as multiple sclerosis. • have recently received or are scheduled to receive a vaccine. People taking SIMPONI should not receive live vaccines. People taking SIMPONI can receive nonlive vaccines. • are allergic to rubber or latex. The needle cover on the prefilled syringe and SmartJect autoinjector contains dry natural rubber. • are pregnant or planning to become pregnant. It is not known if SIMPONI will harm your unborn baby. • are breastfeeding. You and your doctor should decide if you will take SIMPONI or breastfeed. You should not do both without talking to your doctor first. Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially, tell your doctor if you use: • ORENCIA (abatacept), KINERET (anakinra), or RITUXAN (rituximab). You should not take SIMPONI while you are also taking ORENCIA or KINERET. Your doctor may not want to give you SIMPONI if you have received RITUXAN recently. • Another TNF-blocker medicine. You should not take SIMPONI while you are also taking REMICADE (infliximab), HUMIRA (adalimumab), ENBREL (etanercept), or CIMZIA (certolizumab pegol). Ask your doctor if you are not sure if your medicine is one listed above. Keep a list of all your medications with you to show your doctor and pharmacist each time you get a new medicine. How should I use SIMPONI? • SIMPONI is given as an injection under the skin (subcutaneous injection or SC). • SIMPONI should be injected one time each month. • If your doctor decides that you or a caregiver may be able to give your injections of SIMPONI at home, you should receive training on the right way to prepare and inject SIMPONI. Do not try to inject SIMPONI yourself until you have been shown the right way to give the injections by your doctor or nurse. • Use SIMPONI exactly as prescribed by your doctor. • SIMPONI comes in a prefilled syringe or SmartJect™ autoinjector. Your doctor will prescribe the type that is best for you. • See the detailed Patient Instructions for Use at the end of this Medication Guide for instructions about the right way to prepare and give your SIMPONI injections at home. • Do not miss any doses of SIMPONI. If you forget to use SIMPONI, inject your dose as soon as you remember. Then, take your next dose at your regular scheduled time. In case you are not sure when to inject SIMPONI, call your doctor or pharmacist. What are the possible side effects with SIMPONI? SIMPONI can cause serious side effects, including: See “What is the most important information I should know about SIMPONI?” Serious Infections Hepatitis B infection in people who carry the virus in their blood. • If you are a carrier of the hepatitis B virus (a virus that affects the liver), the virus can become active while you use SIMPONI. Your doctor may do blood tests before you start treatment with SIMPONI and while you are using SIMPONI. Tell your doctor if you have any of the following symptoms of a possible hepatitis B infection: • feel very tired • chills • clay-colored bowel • vomiting movements • stomach discomfort • skin or eyes look yellow • muscle aches • fevers • skin rash • little or no appetite • dark urine Heart failure, including new heart failure or worsening of heart failure that you already have. New or worse heart failure can happen in people who use TNF-blocker medicines like SIMPONI. • If you have heart failure, your condition should be watched closely while you take SIMPONI. • Call your doctor right away if you get new or worsening symptoms of heart failure while taking SIMPONI (such as shortness of breath or swelling of your lower legs or feet). Nervous System Problems Rarely, people using TNF-blocker medicines, including SIMPONI, have nervous system problems such as multiple sclerosis. • Tell your doctor right away if you get any of these symptoms: • vision changes • weakness in your arms or legs • numbness or tingling in any part of your body Liver Problems Liver problems can happen in people who use TNFblocker medicines, including SIMPONI. These problems can lead to liver failure and death. Call your doctor right away if you have any of these symptoms: • feel very tired • skin or eyes look yellow • poor appetite or vomiting • pain on the right side of your stomach (abdomen) Blood Problems Low blood counts have been seen with other TNFblockers. Your body may not make enough blood cells that help fight infections or help stop bleeding. Symptoms include fever, bruising or bleeding easily, or looking pale. Your doctor will check your blood counts before and during treatment with SIMPONI. Common side effects with SIMPONI include: • upper respiratory • fever tract infection • high blood pressure • sinus infection (sinusitis) • cold sores • nausea • bronchitis • flu • numbness or tingling • abnormal liver tests • dizziness • runny nose • redness at the site of injection Other side effects with SIMPONI include: • Immune System Problems. Rarely, people using TNFblocker medicines have developed symptoms that are like the symptoms of Lupus. Tell your doctor if you have any of these symptoms: • a rash on your cheeks or other parts of the body • sensitivity to the sun • new joint or muscle pains • becoming very tired • chest pain or shortness of breath • swelling of the feet, ankles, and/or legs • Psoriasis. Some people using SIMPONI had new psoriasis or worsening of psoriasis they already had. Tell your doctor if you develop red scaly patches or raised bumps that are filled with pus. Your doctor may decide to stop your treatment with SIMPONI. • Allergic Reactions. Allergic reactions can happen in people who use TNF-blocker medicines. Call your doctor right away if you have any of these symptoms of an allergic reaction: • hives • breathing trouble • swollen face • chest pain These are not all of the side effects with SIMPONI. Tell your doctor about any side effect that bothers you or does not go away. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. How do I store SIMPONI? • Refrigerate SIMPONI at 36°F to 46°F (2°C to 8°C). • Do not freeze SIMPONI. • Keep SIMPONI in the carton to protect it from light when not being used. • Do not shake SIMPONI. Keep SIMPONI and all medicines out of the reach of children. General Information about SIMPONI • Medicines are sometimes prescribed for purposes other than those listed in the Medication Guide. Do not use SIMPONI for a condition for which it was not prescribed. • Do not give SIMPONI to other people, even if they have the same condition that you have. It may harm them. • This Medication Guide summarizes the most important information about SIMPONI. If you would like more information, talk to your doctor. You can ask your doctor or pharmacist for information about SIMPONI that is written for health professionals. For more information go to www.simponi.com or call 1-800-457-6399. What are the ingredients in SIMPONI? Active ingredient: golimumab. Inactive ingredients: L-histidine, L-histidine monohydrochloride monohydrate, sorbitol, polysorbate 80, and water for injection. SIMPONI does not contain preservatives. Manufactured by: Centocor Ortho Biotech Inc. Horsham, PA 19044 US License No. 1821 Revised: 7/2010 25SMRA10017A This Medication Guide has been approved by the U.S. Food and Drug Administration. Reviewed by Karyn Grossman, MD WebMD SKIN CARE SPECIALIST livingwell Make the most of your life Gift of Beauty Zoya Nail Polish, $7 If you’re sick of the nasty fumes that come with a manicure, try Zoya nail polishes, which are free of such scary-sounding chemicals as toluene, formaldehyde, and phthalates and come in 300 fashionforward colors. And you can stay on trend with four seasonal color collections. Need to check off your holiday shopping list? Check out our expert’s top picks for pampering By Linda Formichelli WebMD Contributing Writer 4 8 5 7 6 Pamper the ladies on your list with a holiday-worthy, head-to-toe beauty boost of expert product picks. 7 Sweet tart ● Blinc resurf.a.stic Callus, $30 File this one away: Blinc resurf.a.stic Callus boasts medical-grade crystals embedded in a moisturizing stick, so you can slough away dry skin and hydrate all in one step— sans messy creams and scrubs. 4 Sole Searching ● Ahava Mineral Foot Cream, $19 Three products in one: Dead Sea minerals soften rough skin, camphor wakes up tired tootsies, and tea tree oil kills the bacteria that can lead to not-so-sweetsmelling feet. Dan Saelinger 3 Foot Soldier ● Dan Saelinger Weleda Wild Rose Moisture Cream, $27 Want a rosy complexion? This rosescented cream has organic rosehip oil, which is rich in antioxidants and essential fatty acids. 3 Yu-Be Moisturizing Skin Cream, $24 Vitamin E, vitamin B2, and camphor make this cream a must-have for severely dry winter skin. Moisturizing (and the exhilarating tingle of camphor) not enough for you? Walder notes that E and B2 are antioxidants that help protect the skin from sun damage. 1 about Face ● 2 Flower Power ● 1 6 soft sell ● It’s gift-giving season, and you’ve got a few names left on your holiday shopping list—mom, sister, best friend. Scratching your head about what to give? Pamper the ladies on your list with a holidayworthy, head-to-toe beauty boost. Grab a gorgeous box or festive bag and fill it with these luxurious treats, hand-picked by Diane Walder, MD, a cosmetic dermatologist and clinical professor at the University of Miami. Murad Pomegranate Exfoliating Mask, $22.50 You drink pomegranate juice for the antioxidants—why not feed it to your skin as well? The pomegranate and ginkgo biloba extract in Murad Pomegranate Exfoliating Mask balances combination skin, while the fruit enzymes in this weekly treatment help slough off dull cells so your skin looks radiant. 2 5 Natural selection ● Fresh Sugar Lemon Bath & Shower Gel, $18.50 The same brown sugar that’s in your worldfamous apple pie is an antibacterial ingredient in Fresh Sugar Lemon Bath & Shower Gel. Comfrey extract soothes winter-irritated skin, and shea butter and glycerin add moisture and softness for a healthy glow. The fresh scent of lemon makes it a bath gel that rivals any dessert. 8 honey do ● Rêve de Miel Fondant Exfoliating Shower Cream by Nuxe, $31 Honey beads, peach, and orange keep your skin smooth as a baby’s youknow-what. “The fruit acids help gently peel the skin away,” Walder says. Fruit oils and wood oil add moisture back into the skin to keep it supple. Give yourself a gift with more skin and beauty tips from the experts. 32 WebMD the Magazine | November/December 2010 The opinions expressed in this section are of the experts and are not the opinions of WebMD. WebMD does not endorse any specific product, service, or treatment. WebMD.com November/December 2010 | WebMD the Magazine 33 Important Safety Information1 HATE psoriasis. LOVE clearer skin. What is the most important information I should know about HUMIRA? • Serious infections. HUMIRA can lower your ability to fight infections. Serious infections have happened in patients taking HUMIRA. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your doctor should test you for TB before starting HUMIRA, and monitor you closely for signs and symptoms of TB during treatment with HUMIRA. • Certain types of Cancer. There have been cases of unusual cancers in children and teenagers using TNF-blocker medicines. For children and adults taking TNF-blocker medicines, including HUMIRA, the chance of getting lymphoma or other cancers may increase. Some patients have developed non-melanoma skin cancer; tell your doctor if you have a bump or open sore that doesn’t heal. Tell your doctor about all of your health conditions, including if you: Brittany S. HUMIRA Patient HUMIRA could help your moderate to severe chronic plaque psoriasis. Who is HUMIRA for? HUMIRA is used to treat moderate to severe chronic (lasting a long time) plaque psoriasis in adults who are under the ongoing care of a physician, have the condition in many areas of their body, and who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills). When considering HUMIRA, your physician will determine if other systemic therapies are medically less appropriate. Clearer skin is possible with HUMIRA. In one clinical trial for moderate to severe chronic plaque psoriasis patients, 7 out of 10 adults taking HUMIRA saw 75% skin clearance and 6 out of 10 patients had clear or almost clear skin at 16 weeks. Your results may vary. With the HUMIRA PROTECTION PLAN your co-pay could be $5 a month.* HUMIRA PROTECTION PLAN Helping Patients Access HUMIRA Please see accompanying full Prescribing Information, including Medication Guide, in brochure. 1.888.486.4723 RxBIN: RxPCN: RxGrp: RxID: Suf: XXXXXX XXXX OHXXXXXXX XXXXXXXXXXXX XX *Eligibility and other restrictions apply to co-pay program. Ask your dermatologist if HUMIRA is right for you. Learn more at HUMIRA.com or call 1.800.4HUMIRA HUMIRA is taken by injection and available by prescription only. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1.800.FDA.1088. If you cannot afford your medication, contact: www.pparx.org or call the toll-free phone number (1.888.4PPA.NOW) for assistance. Talk to your dermatologist about An example of 75% skin clearance. For illustrative purposes only. Your results may vary. ✓ Think you have an infection. Don’t start HUMIRA if you have any kind of infection. ✓ Are being treated for infection, or have signs of an infection, such as fever, cough, or flu-like symptoms ✓ Have any open cuts or sores ✓ Get a lot of infections or have infections that keep coming back ✓ Have diabetes ✓ Have TB or have been in close contact with someone with TB, or were born in, lived in, or traveled where there is more risk for getting TB ✓ Live or have lived in an area (such as the Ohio and Mississippi River valleys) where there is an increased risk for getting certain kinds of fungal infections, such as histoplasmosis. ✓ Have or have had hepatitis B ✓ Take other medicines, especially Kineret (anakinra). Some medicines that suppress the immune system may increase your risk of serious infections. ✓ Are scheduled for major surgery ✓ Have numbness or tingling or a nervous system disease, such as multiple sclerosis or Guillain-Barré syndrome. ✓ Have heart failure or other heart conditions ✓ Have recently received or are scheduled to receive a vaccine. Patients receiving HUMIRA should not receive live vaccines. ✓ Are allergic to rubber, latex, or any ingredients of HUMIRA ✓ Are pregnant, planning to become pregnant, or breastfeeding Call your doctor right away if you have an infection or any sign of an infection while on HUMIRA. HUMIRA can cause other serious side effects, including: • Allergic reactions. • Hepatitis B virus reactivation in patients that carry the virus in their blood. • Nervous system problems. • Blood problems. • New heart failure or worsening of heart failure you already have. • Immune reactions including a lupus-like syndrome. • New psoriasis or worsening of psoriasis you already have. Common side effects of HUMIRA include injection site reactions (redness, rash, swelling, itching, or bruising), upper respiratory infections, headaches, rash, and nausea. These are not all of the possible side effects with HUMIRA. For more information, talk to your health care provider. Reference: 1. HUMIRA injection [package insert]. North Chicago, IL; Abbott Laboratories. Please see additional Patient Information on the following pages. In one clinical trial for moderate to severe chronic plaque psoriasis patients, 7 out of 10 adults taking HUMIRA saw 75% skin clearance and 6 out of 10 patients had clear or almost clear skin at 16 weeks. ©2010 Abbott Laboratories | Abbott Park, IL 60064 | 64Y-437309 | September 2010 | Printed in the U.S.A. HUMIRA (HU-MARE-AH) (adalimumab) ® Patient Information What is the most important information I should know about HUMIRA? HUMIRA is a medicine that affects your immune system. HUMIRA can lower the ability of the immune system to fight infections. Serious infections have happened in patients taking HUMIRA. These infections include tuberculosis (TB) and infections caused by viruses, fungi or bacteria that have spread throughout the body. Some patients have died from these infections. • Your doctor should test you for TB before starting HUMIRA. • Your doctor should monitor you closely for signs and symptoms of TB during treatment with HUMIRA. Before starting HUMIRA, tell your doctor if you: • think you have an infection. You should not start taking HUMIRA if you have any kind of infection. • are being treated for an infection • have signs of an infection, such as a fever, cough, or flu-like symptoms • have any open cuts or sores on your body • get a lot of infections or have infections that keep coming back • have diabetes • have TB, or have been in close contact with someone with TB • were born in, lived in, or traveled to countries where there is more risk for getting TB. Ask your doctor if you are not sure. • live or have lived in certain parts of the country (such as the Ohio and Mississippi River valleys) where there is an increased risk for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis). If you do not know if you have lived in an area where histoplasmosis, coccidioidomycosis, or blastomycosis is common, ask your doctor. • have or have had hepatitis B • use the medicine Kineret (anakinra). You may have a higher chance for serious infections and a low white blood cell count when taking HUMIRA with Kineret. • are scheduled to have major surgery After starting HUMIRA, call your doctor right away if you have an infection, or any sign of an infection, including: • a fever CONSUMER BRIEF SUMMARY CONSULT PACKAGE INSERT FOR FULL PRESCRIBING INFORMATION Read the Medication Guide that comes with HUMIRA before you start taking it and each time you get a refill. There may be new information. This brief summary does not take the place of talking with your doctor about your medical condition or treatment with HUMIRA. • feel very tired • a cough • flu-like symptoms • warm, red, or painful skin • open cuts or sores on your body HUMIRA can make you more likely to get infections or make any infection that you may have worse. Certain types of Cancer. • There have been cases of unusual cancers in children and teenage patients using TNF-blocking agents. • For children and adults taking TNF-blocker medicines, including HUMIRA, the chances of getting lymphoma or other cancers may increase. • Some patients receiving HUMIRA have developed types of cancer called nonmelanoma skin cancer (basal cell cancer and squamous cell cancer of the skin), which are generally not life-threatening if treated. Tell your doctor if you have a bump or open sore that doesn’t heal. • Patients with RA, especially more serious RA, may have a higher chance for getting a kind of cancer called lymphoma. See the section “What are the possible side effects of HUMIRA?” below for more information. What is HUMIRA? HUMIRA is a medicine called a Tumor Necrosis Factor (TNF) blocker. HUMIRA is used in adults or children (as indicated) to: • Reduce the signs and symptoms of: • moderate to severe rheumatoid arthritis (RA) in adults. HUMIRA can be used alone or with methotrexate or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities. • moderate to severe polyarticular juvenile idiopathic arthritis (JIA) in children 4 years of age and older. HUMIRA can be used alone or with methotrexate or with certain other medicines. • psoriatic arthritis (PsA). HUMIRA can be used alone or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities. • ankylosing spondylitis (AS) • moderate to severe Crohn’s disease (CD) in adults who have not responded well to other treatments. • Treat moderate to severe chronic (lasting a long time) plaque psoriasis (Ps) in adults who have the condition in many areas of their body and who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills). People with these diseases have too much of a protein called tumor necrosis factor (TNF) in the affected areas of the body. HUMIRA can block the bad effects of TNF in those affected areas, but it can also lower the ability of the immune system to fight infections. See “What is the most important information I should know about HUMIRA?” and “What are the possible side effects of HUMIRA?” What should I tell my doctor before taking HUMIRA? Before starting HUMIRA, tell your doctor about all of your health conditions, including if you: • have an infection. See “What is the most important information I should know about HUMIRA?” • have any numbness or tingling or have a disease that affects your nervous system such as multiple sclerosis or GuillainBarré syndrome. • have heart failure or other heart conditions. If you have heart failure, it may get worse while you are taking HUMIRA. • have recently received or are scheduled to receive a vaccine. Patients receiving HUMIRA should not receive live vaccines. Except for live vaccines, patients may still receive vaccines while on HUMIRA. It is recommended that children with juvenile idiopathic arthritis be brought up to date with all immunizations prior to starting HUMIRA. • are allergic to rubber or latex. The needle cover on the prefilled syringe contains dry natural rubber. Tell your doctor if you have any allergies to rubber or latex. • are allergic to HUMIRA or to any of its ingredients. See the end of the Medication Guide for a list of ingredients in HUMIRA. Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. HUMIRA should only be used during a pregnancy if needed. Women who are breastfeeding should talk to their doctor about whether or not to use HUMIRA. Pregnancy Registry: Abbott Laboratories has a registry for pregnant women who take HUMIRA. The purpose of this registry is to check the health of the pregnant mother and her child. Talk to your doctor if you are pregnant and contact the registry at 1-877-311-8972. Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Especially, tell your doctor if you take Kineret (anakinra). You may have a higher chance for serious infections and a low white blood cell count when taking HUMIRA with Kineret. Also, tell your doctor if you are taking other medicines that suppress the immune system. Know the medicines you take. Keep a list of your medicines with you to show your doctor and pharmacist each time you get a new medicine. may be treated with medicine for TB before you begin treatment with HUMIRA and during treatment with HUMIRA. Even if your TB test is negative your doctor should carefully monitor you for TB infections while you are taking HUMIRA. Patients who had a negative TB skin test before receiving HUMIRA have developed active TB. Tell your doctor if you have any of the following symptoms while taking or after taking HUMIRA: • cough that does not go away • low grade fever • weight loss • loss of body fat and muscle (wasting) • Allergic reactions. Signs of a serious allergic reaction include a skin rash, a swollen face, or trouble breathing. • Hepatitis B virus reactivation in patients who carry the virus in their blood. In some cases patients have died as a result of hepatitis B virus being reactivated. Your doctor should monitor you carefully during treatment with How should I take HUMIRA? HUMIRA if you carry the hepatitis B virus in your blood. Tell your doctor if you have See the section, “How do I prepare and any of the following symptoms: give an injection of HUMIRA?” at the end • feel unwell of the Medication Guide that comes with • poor appetite HUMIRA for complete instructions for use. • tiredness (fatigue) • HUMIRA is given by an injection under • fever, skin rash, or joint pain the skin. Your doctor will tell you how • Nervous system problems. Signs and often to take an injection of HUMIRA. This symptoms of a nervous system problem is based on your condition to be treated. include: numbness or tingling, problems Do not inject HUMIRA more often than with your vision, weakness in your arms or prescribed. legs, and dizziness. • Make sure you have been shown • Blood problems. Your body may not how to inject HUMIRA before you do make enough of the blood cells that help it yourself. You can call your doctor or fight infections or help to stop bleeding. 1-800-4HUMIRA (448-6472) if you have Symptoms include a fever that does not go any questions about giving yourself an away, bruising or bleeding very easily, or injection. Someone you know can also looking very pale. help you with your injection. • New heart failure or worsening of heart • If you take more HUMIRA than you were failure you already have. Symptoms told to take, call your doctor. include shortness of breath or swelling of • Do not miss any doses of HUMIRA. If you your ankles or feet or sudden weight gain. forget to take HUMIRA, inject a dose as • Immune reactions including a lupussoon as you remember. Then, take your like syndrome. Symptoms include chest next dose at your regular scheduled discomfort or pain that does not go away, time. This will put you back on schedule. shortness of breath, joint pain, or a rash To help you remember when to take on your cheeks or arms that gets worse HUMIRA, you can mark your calendar in the sun. Symptoms may go away when ahead of time with the stickers provided you stop HUMIRA. in the back of the Medication Guide. • Psoriasis. Some people using HUMIRA had new psoriasis or worsening of What are the possible side psoriasis they already had. Tell your doctor effects of HUMIRA? if you develop red scaly patches or raised HUMIRA can cause serious side effects, bumps that are filled with pus. Your doctor including: may decide to stop your treatment with See “What is the most important HUMIRA. information I should know about Call your doctor or get medical care right HUMIRA?” away if you develop any of the above • Serious infections. symptoms. Your treatment with HUMIRA Your doctor will examine you for TB and may be stopped. perform a test to see if you have TB. If your Common side effects with HUMIRA doctor feels that you are at risk for TB, you include: • Injection site reactions such as redness, rash, swelling, itching, or bruising. These symptoms usually will go away within a few days. If you have pain, redness or swelling around the injection site that doesn’t go away within a few days or gets worse, call your doctor right away. • Upper respiratory infections (including sinus infections) • Headaches • Rash • Nausea These are not all the possible side effects with HUMIRA. Tell your doctor if you have any side effect that bothers you or that does not go away. Ask your doctor or pharmacist for more information. General information about HUMIRA Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use HUMIRA for a condition for which it was not prescribed. Do not give HUMIRA to other people, even if they have the same condition. It may harm them. This brief summary summarizes the most important information about HUMIRA. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about HUMIRA that was written for healthcare professionals. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. For more information go to www.HUMIRA. com or you can enroll in a patient support program by calling 1-800-4HUMIRA (448-6472). Rev. July, 2010 Ref: 03-A329-R21 U.S. Govt. Lic. No. 0043 Abbott Laboratories North Chicago, IL 60064, U.S.A. 64C-419212 MASTER 64Y-437309 make the most of your life The makeup of Makeup Status Symbol Each season may bring a new trendsetting shade, but nail polish has been a fashion staple for about 5,000 years. Historical evidence shows that the Chinese have been wearing nail color since 3000 B.C. Among the ancients, the higher your social class, the darker your shade of polish. Painting Class Most polish formulas are variants of the same recipe. They include nitrocellulose to form a film; a resin like tosylamide or polyester to help the polish adhere and harden; camphor or other plasticizer to prevent chipping and flaking; a solvent such as butyl acetate or ethyl acetate to keep all the ingredients in a liquid formula; and pigments such as mica and iron oxide to provide color, explains Mitchell Schlossman, a cosmetic chemist for Fiabila Inc, a nail polish manufacturer in Mine Hill, N.J. Triple Threat In recent years, many polish makers have removed three problematic ingredients— toluene, formaldehyde, and dibutyl phthalate (DBT)—to offer “three-free” formulas. People with allergies might develop reactions to formaldehyde. DBT and toluene are often removed due to concerns that the ingredients may be linked to cancer and birth defects in lab animals. Ji Baek, owner of Rescue Beauty Lounges in New York City, offers pointers on perfecting your polish: expert a’s to your beauty q’s To Dye For nail polish Explosive Personality On a Roll One of the main ingredients in nail polish, nitrocellulose, is an agent used to make dynamite, certain inks, and some furniture polishes. Polish is a suspension, or a mixture of solids in a liquid base, Schlossman explains. The solid pigments tend to be heavier than the other ingredients, so manufacturers Is it safe to permanently tint brows and lashes? Modern lacquer evolved from the paint used on Model T’s in the 1920s. include tiny metal balls inside to help mix the ingredients. But shaking the bottle creates air bubbles that will dry out the polish faster. To mix your polish, roll it between your hands. Need for Speed A quick-dry polish uses a different solvent than a regular polish, Schlossman says. But that doesn’t mean the polish will dry completely. “Nail polish takes at least 10 minutes to harden all the way through,” he says. “A quick-dry polish is just drying the surface in less time.”—Liesa Goins Masterfile Storing nail polish in the refrigerator is not a good idea. The enamel appears smoother at first, but as it warms, the ingredients change. You’ll get bubbles and stringing. Dcoedi-ng Get the beauty buzz. 38 WebMD.com WebMD the Magazine | November/December 2010 Reviewed by Karyn Grossman, MD WebMD SKIN CARE SPECIALIST livingwell Studio 504/Getty Images livingwell Reviewed by Karyn Grossman, MD WebMD SKIN CARE SPECIALIST “I’m not one to put on makeup every day,” says Stacy Sindlinger, 46, a home accessories designer in Philipstown, N.Y. But she wanted the effect she got from mascara, without the daily effort and the occasional irritation, so she tried something that many women have made part of their regular beauty routines. “I dyed my lashes.” Is eyelash coloring safe, given the sensitivity of the eye area? “If done by a well-trained and highly experienced esthetician who knows what she’s doing, it’s absolutely fine,” says Jeannette Graf, MD, a dermatologist in Great Neck, N.Y. Brows can also safely be dyed by an experienced hair colorist, she adds. Still, for the record, permanent eyelash and brow tints and dyes have caused reactions such as granulomas (small areas of inflamed tissue) or contact dermatitis (a rash), according to Graf, and the FDA does not condone the practice. If you wear contact lenses, be sure to take them out during the procedure (you can reinsert them the next day), and if your eyes are especially sensitive, have some saline or lubricating eyedrops to rinse your eyes afterward. You shouldn’t feel any stinging; in a good salon, the esthetician should be with you the entire time in case the dye gets in your eyes. Robin R. Corey, artistic director of JaCar Color Lounge in Gilbert, Ariz., applies a cotton pad moistened with a gentle toner under the eyes to keep the color off the skin. “We never use hair dye on lashes; it’s too harsh,” Corey says. Instead, she paints a vegetable-based, semipermanent stain on lashes with a small disposable mascara wand for each eye. She never doubledips, which can spread infection. After a few minutes, a color developer goes on (some brands are single-step). “You’ll see lashes immediately turn black—that’s the most popular color,” Corey says. Other choices for lashes and brows are blueblack, brown, and chestnut. In three to five minutes, she gently wipes off residue with a damp towel. For brows, Corey uses demi-permanent color—slightly stronger and more lasting than the veggie version. She brushes it on with a disposable wand and lets it process for 10 to 20 minutes. Sindlinger had no negative reaction when she had her lashes colored. She just didn’t like the results. “Because I don’t usually wear mascara, it looked too dramatic,” she says. Still, for many women the results are well-defined lashes and a little more free time in the morning.—Maria Ricapito Have more coloring questions? Get healthy beauty tips and expert advice. True Colors You shouldn’t feel any stinging; the esthetician should be with you the entire time in case the dye gets in your eyes. Want to dye your lashes or brows? Here’s the lowdown: Money matters. Lash dyeing costs around $25 to $75, and brow coloring starts at about $15, depending on the salon. Staying power. The results of permanent tints can last from one to three months. To make your dye job last longer, avoid using exfoliating alpha hydroxy and glycolic acid cleansers, which can strip color from brows, around your eyes. Magic wand. If you want more oomph to your tinted lashes, use mascara. WebMD.com November/December 2010 | WebMD the Magazine 39 livingwell Reviewed by Eric Yabu, DDS WebMD DENTAL CARE EXPERT for the health of your smile Sensitive Subject Gentle Touch One zing to the nerve of a tooth after a drink or bite of food is enough to send even the hungriest bear running from the kitchen. Sensitive teeth can seriously limit the enjoyment of your favorite fare. So if ice cream meeting your tooth has you seeing stars, the layer beneath the surface of your tooth (called dentin) has become exposed, says Eric Sung, DDS, professor at UCLA’s School of Dentistry. This happens when the hard outer covering of a tooth—enamel above the gum line and cementum on the root— wears away, exposing microscopic tubules in the dentin that lead to the nerve of the tooth. After that, biting into foods that are hot, cold, sweet, or acidic (like tomatoes, oranges, or lemons, whose acids can eat away at enamel and cementum) can cause searing pain. How does all this happen? A number of factors are to blame, Sung says. Gum recession, when gums pull away from the tooth and expose the root surface, is common with periodontal disease, which happens when plaque accumulates along the gum line. “As plaque builds, the bacteria release toxins that cause the gums to get infected and then recede,” Sung explains. “Grinding causes teeth to flex and crack, creating a notch that exposes dentin at the gum line, called an abfraction,” Sung says. If you grind, try wearing a mouth guard while you sleep to protect your teeth. Brushing with too much force, with a stiff toothbrush, or even with an old toothbrush can cause abfractions as well. Be sure to brush gently with a soft-bristled toothbrush that you replace every three months whether or not it looks worn-out. And, teeth whiteners give new meaning to the phrase “beauty is pain.” They are notorious for causing tooth sensitivity. “It’s usually transient, but can be long-term where it lasts for days, if not weeks,” Sung says. How sensitive is too sensitive? Sung offers up a few rules of thumb: “If pain lasts for only a few seconds, it’s not really an issue.” However, if your teeth are sensitive to hot foods and beverages (usually a sign of nerve problems), or if the pain lasts more than a minute or is spontaneous, you’ve earned yourself a trip to the dentist.—Lisa Zamosky Teeth whiteners are notorious for causing tooth sensitivity. The pain is usually transient, but can last for weeks. Keep smiling with more oral health care tips. 40 WebMD the Magazine | November/December 2010 WebMD.com Your Dental Questions Answered A new live and on-demand video channel providing you access to expert answers. Roger Wright/Getty Images Do your favorite foods make your teeth hurt? Strengthen sensitive teeth with these tips from Eric Sung, DDS, professor at UCLA’s School of Dentistry: Go easy. Toothpastes made specifically for sensitive teeth contain either potassium nitrate or strontium chloride, which help clog the dentinal tubules and prevent the painful stimulus (such as ice cream) from reaching the nerve. But don’t expect immediate results: It will take at least two or three weeks for these pastes to take the edge off. Filler up. Silver fillings are poor insulators, a particular problem if they’re deep—kind of like wearing metal earrings when it’s freezing outside. “If a filling becomes more sensitive over time, see your dentist,” Sung advises. A new filling or a different type of material may stop the pain. Cover up. Exposed dentin means a direct path to nerves. Ask your dentist about creating a shield for your teeth with one of a range of coatings—such as fluoride—that effectively reduce sensitivity. Focus On The new Humana Walmart-Preferred Rx Plan (PDP) puts an average of over $450* a year in your pocket and creates entirely new ways of giving hugs. Depression This content is selected and controlled by WebMD’s editorial staff and is brought to you by AstraZeneca SAVE AN AVERAGE of over $450 November/December 2010 * A YEAR $14.80 Visit Walmart.com/RxPlan today for more information. monthly plan premiums AND IN-STORE COPAYS as low as $2 Or call Humana at 1.800.844.1020. If you use a TTY, call 711, 8 a.m. to 8 p.m., seven days a week. *Based on a comparison of the projected average nationwide out-of-pocket costs between an average Medicare beneficiary enrolled in the Humana Walmart-Preferred Rx Plan (PDP) in 2011 and Medicare beneficiaries enrolled in other plans, utilizing, in part, industry weighted average PDP premium and benefit information from the “Medicare Part D 2010 Spotlight, Medicare Drug A MedicarePrescription Prescription Drug Plan Plans in 2010 and Key Changes over Five Years,” an independent review and analysis of CMS data by the Kaiser Family Foundation (September 2010). Actual savings may vary. For some beneficiaries, actual out-of-pocket costs may be more. See Walmart.com/RxPlan or call Humana at 1-800-844-1020 for more information. The Humana Walmart-Preferred Rx Plan (PDP) is a stand-alone prescription drug plan with a Medicare contract available to anyone entitled to Part A and/or enrolled in Part B of Medicare. You may enroll in the plan only during specific times of the year. You must continue to pay your Medicare Part B premiums. You must use network pharmacies except under non-routine circumstances. Other pharmacies are available in the Humana network. Quantity limitations and restrictions may apply. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. The “Spark” Design , Walmart and Save money. Live better. are marks and/or registered marks of Wal-Mart Stores, Inc. © 2010 Wal-Mart Stores, Inc. Y0040_GHA0989HHa_CMS File & Use 10012010 Taking the Next Step How are you managing your depression? 44 An author writes his way through the darkness 46 Ask our experts 48 Questions for your doctor 50 November/December 2010 | WebMD the Magazine 43 Depression Focus On This content is selected and controlled by WebMD’s editorial staff and is brought to you by AstraZeneca. How do you know if you’re doing everything you can to stay on top of this complex disease? 44 WebMD the Magazine | November/December 2010 D epression is a complex disease that is treatable, but it often can take time finding a treatment, working with your doctor, and monitoring symptoms to zero in on a regimen that works for you. Previous: Echo/Getty Images; Eric Audras/Getty Images Treati n g Depression Reviewed by Laura Martin, MD WebMD MEDICAL EDITOR Anatomy of a Diagnosis Why is depression so complex? Part of the reason is that researchers still aren’t sure exactly what causes the illness, although most believe that some interplay of genetics, biochemistry, environment, and psychology is involved. In other words, even if you’re born with a genetic predisposition toward depression, it may take a sudden life event, a serious illness, or chronic stress to trigger the biochemical changes in the brain that give rise to the disease. People who don’t have a family history of depression also can become depressed, and certain medications as well as substance abuse and, in some people, giving birth and changes in the seasons can also contribute to depression. If you haven’t already been diagnosed, how do you know if you’ve developed depression? In general, doctors will gauge what you’re feeling, how bad you’re feeling, and just how long you’ve been feeling that way. But the most common symptoms are “depression all day, every day, for about two weeks,” says Patrice Harris, MD, director of health services for Fulton County, Ga., “or else a two-week period of loss of interest in pretty much everything that used to bring somebody pleasure.” Other symptoms include fatigue or loss of energy, feelings of worthlessness or guilt, trouble concentrating, recurrent thoughts of death, and significant weight loss or gain. But again, you have to feel that way for at least two weeks before you qualify as having depression. Other people feel irritable, restless, and angry when they’re depressed; many develop physical symptoms, including fatigue, insomnia or excessive sleepiness, headaches or digestive problems, and a worsening of chronic pain symptoms. DEPRESSION To diagnose depression, doctors will first do a physical exam to rule out depression that might be associated with viruses, medicines, postpartum hormonal changes, or illness. The doctor will also take a family medical history to find out if anyone else in your family has had depression or other mental illnesses. Once you’re diagnosed, your doctor will help you decide if you need therapy, medications, or both to manage your symptoms. The most common medications prescribed for depression are antidepressants, which work by affecting levels of certain neurotransmitters in the brain—notably serotonin, norepinephrine, and dopamine. These chemicals help regulate mood, energy, and primal drives such as eating, sex, and sleep. One note: Antidepressants tend to take a while to take effect—sometimes as long as several weeks. And many patients need to try several different kinds of antidepressants before they find the one (or the combination) that works well for them. You’ll need to work closely with your doctor to find the mix of treatments that works best for you. Besides flooding people with feelings of helplessness, hopelessness, and sadness, depression can impair their ability to work, develop and maintain friendships, establish intimate relationships, take care of themselves, and raise families. In the very worst cases, depression can lead to suicide. But prolonged suffering isn’t inevitable. With the right combination of treatments and self-care, most people are able to recover from their depression and have balanced, healthy lives. Stay in close contact with your doctor to determine how best to treat your depression, even if you’ve already started a treatment plan. Depression treatment is not one-size-fits-all. With the right combination of treatments and self-care, most people are able to recover from their depression and have balanced, healthy lives. Go to Depression tv at WebMD.com to see videos about managing depression. November/December 2010 | WebMD the Magazine 45 Depression Focus On This content is selected and controlled by WebMD’s editorial staff and is brought to you by AstraZeneca. Lifting the Darkness By Andrew Solomon A Writer Learns to Live and Teach Others About Life With Depression In 1994, I was publishing my first novel, something that I thought I should feel very happy about, and I found that I had almost no feelings about it at all. And in the weeks that followed, I found myself less and less interested in what was happening and more and more exhausted and uninterested in the world. [Eventually] I thought I had had a stroke. I couldn’t even get out of bed. And finally the phone rang, and it happened to be my father, and I said, “I think you better come down here. I don’t know what’s wrong with me.” I was diagnosed shortly after that. found a middle place that is relatively unpopulated, and I think that’s important. In terms of avoiding relapse, there are several things that I’ve identified as important. One of them is sleep. If I get really overtired I become much more vulnerable to going over the edge. So I’m fiercely protective about getting enough sleep. Another is exercise. My natural impulse is to spend the day propped up on pillows, eating chocolates, and writing, but in fact I make an effort of exercising on a regular basis because there’s a lot of evidence now that shows that exercise can do as much for your depression as any medication can. And the other thing is to recognize when I’m getting incredibly stressed out. Sometimes I think, “I have five things going on right now and I’m not going to take on the sixth thing.” Andrew Solomon is the author But the primary things are sleep, exercise, and of The Noonday Demon: An Atlas solid nutrition, which are really not a bad idea of Depression and a lecturer in even if you’re not depressed. psychiatry at Cornell University. Depression is the complete death of being able to feel pleasure. But while you’re depressed you can’t articulate that. You can’t say what’s wrong. But because my way of being in the world—from the time I was a child—was to try to find the words for everything, I felt as though by writing it down I could actually gain some kind of control over it. I love being able to be in this funny translational role that I found for myself in which, for the people who are the sufferers, I can explain the medicine. And for the people who are doctors, I can explain the experience. I’ve somehow DEPRESSION 46 Three Tips for Managing Depression • Exercise Although Andrew doesn’t love to exercise, he has learned that it can help alleviate the symptoms of depression. • Stress management He knows that taking on too much can make him vulnerable to depression, so he carefully monitors his stress levels. • Call for help Andrew kept his distress to himself for some time before finally telling his father he needed help. That call is what allowed Andrew to get the help he needed. My Road to Recovery It’ s All Relative Deborah Stevenson is a painter and an art teacher living in Brooklyn, N.Y. A Family Legacy That Challenges and Unites By Deborah Stevenson I was first diagnosed with depression in 1982. I grew up with mental illness: My mom was sick with schizophrenia throughout most of my childhood. I didn’t know if I had something that was related to what my mother used to call “the family gene.” When it became clear that [I did have a mental illness], in one way I was relieved to know that this was something identifiable and treatable. Now my daughter, Jennifer, is having her own struggles with this. That’s kind of a grave thing to come to terms with. She says she was relieved with the diagnosis, and I know she was. But I was sad because I wondered, “Could we have treated it sooner? Could we have relieved her of any stressors earlier on in her life?” I think as a parent you always think, what could I have done differently? But on the other hand, we have a wealth of experience around it. As a family, we can help each other. My daughter doesn’t have as much of a sense of stigma and shame that I did or my mother’s generation did. The idea that she should feel that she has resources and a support system and a toolbox and a lot of things in place to make this something that isn’t a trauma in her life is a huge thing for me. So if she feels that her experience is one that makes her feel more flexible with her own mental health, then that’s a good thing. I was just recently diagnosed with chronic, lowgrade depression. It’s really new for me. So I need to take medication. I think it’s kind of funny. I feel like I’m following in my mom’s footsteps. But I feel that growing up with her with the same issues, I sort of saw how not to do it, how to get help right away. I always knew that depression is hereditary, Jennifer Stevenson, 24 because my grandmother had schizophrenia. This is separate, but knowing that it runs in families, it wasn’t like, “Oh, God, this is going to ruin my life.” I feel as though it’s made it a lot easier for me to deal with my own issues having seen my mother’s. Seeing what depression is like [helps]. Seeing how it’s not an overnight cure—it doesn’t make me worried that something hasn’t changed instantly. I feel that it’s made it a lot easier to deal with my own issues, having seen hers. Watch Andrew Solomon and Deborah Stevenson’s videos on WebMD’s Depression tv. WebMD the Magazine | November/December 2010 November/December 2010 | WebMD the Magazine 47 Depression Focus On This content is selected and controlled by WebMD’s editorial staff and is brought to you by AstraZeneca. lat st e res earch pe r Taking the Next Step People who are very severely depressed may need help even taking that first step. You may not be able to get out of bed or even think straight to make appointments on time, which is why reaching out to someone is so important. If you get the ball rolling, you can get treatment. so Are you getting the help you need? l na Melva Green, MD WebMD Depression tv Expert rie Med i ca Q s to ex l My husband tells me I’m not depressed, but that I’m angry, which confuses me a bit. What’s the connection? WebMD Logo pe rt s PRINT CMYK VERSION Blue c m y k 100 34 0 2 Black c 0 m0 y 0 k 100 A In my experience, anger is a com- Q I’ve been feeling depressed for a long time. How do I know if I need professional help? A The typical symptoms of depression are sadness and loss of enjoyment in your usual activities. The key question for deciding when to get treatment: “Is it starting to interfere with my life?” At that point, as with any medical condition, you have to say, “This hurts enough to ask for help.” That can be hard, of course— in some places in this country, we have no DEPRESSION 48 mental health providers. But you can start with a general physician if you have one. Some people believe they’re weak or have poor character. So they’re embarrassed about bringing it up. That’s actually part of the depression—they feel extreme guilt and worthlessness. They have low self-esteem and feel bad about being depressed. As hard as it is, the first step to getting good care is talking to someone: a friend, a doctor, a family member. It’s important to talk to somebody—whoever you’re most comfortable with. The next step is figuring out what kind of professional help you need: a counselor or “talk therapist,” a psychiatrist, or a general physician. All can help you decide on a treatment plan and if medications are needed. Go to Depression tv at WebMD.com to see videos about managing depression. WebMD the Magazine | November/December 2010 Depression tv: A comprehensive on-demand video series focused on living with Depression Go to www.WebMD.com OJO Images/Getty Images Thomas Schwartz, MD WebMD Depression tv Expert ponent of depression. Often it’s the only emotion depressed people can express. Let’s keep in mind that there are biological, psychological, and spiritual components to depression. It’s not just a brain condition. So the thought processes of people who are depressed are impacted. They may misread some of the things that are being said to them and overexaggerate their responses. People with depression also have limited coping skills and may move very quickly to being intolerant, irritable, and angry in a situation. Often people think they should suppress their anger. That’s very unhealthy. Anger is a healthy emotion. You have to express it. It’s more about how you manage and express your anger that counts. Take a step back, take a deep breath, reflect, and keep in mind that this is a vulnerable time. Getting some input from a therapist, doctor, or friends about how you may be engaging and responding can be helpful, too. And so can eating a healthy diet and getting enough exercise. ©2010 WebMD, LLC. All rights reserved. s Depression Focus On fitness matters This content is selected and controlled by WebMD’s editorial staff and is brought to you by AstraZeneca. working out what will work for you Talk to Your Doctor About Depression Easy Does It? Not sure how to restart the conversation with your MD? How can you tell if your exercise routine is too wimpy, too hard, or just right? Q.Why hasn’t my depression gone away? Q. Is it normal for depression to be hard to treat? Q. If the medication I’m currently taking doesn’t help, are there others that might? Q. Could alternative therapies Q.What lifestyle changes could I make to help alleviate my depression? have resources? PRINT CMYK VERSION Blue c m y k 100 34 0 2 Black c 0 m0 y 0 k 100 Q. Might my workplace organizations that could help me learn to live better with depression? Q. If I have depression, will my children also have depression? Focus On Depression Check out l Personal stories l Expert answers Depression tv l Depression treatment information for episodes l Connecting with others who have featuring: depression l Lifestyle tips! 50 WebMD the Magazine | November/December 2010 Q.Could my depression get worse? Q. Will I be depressed for the rest of my life? Visit WebMD’s Depression tv WaTCH real-life stories of people living with depression. assess your symptoms and management options. LeaRN the latest news on treating depression. GeT Tips for managing your depression symptoms. siGN up to get a reminder each time a new show airs. Depression tv SEARCH Hans Bjurling/joHnér images/CorBis have an effect? No matter how hard you exercise, you can always find people who are exercising harder. As they speed past you on foot or bicycle, crank up the elliptical machine, or lift seemingly superhuman amounts of weight at the gym, it’s only natural to wonder: Am I taking it too easy? Should I be doing more? The answer to that really depends on your goals, say exercise physiologists James Hagberg, PhD, of the University of Maryland, and Philip Clifford, PhD, of the Medical College of Wisconsin. In other words, if your goal is to improve your health, you probably don’t need to exercise as hard as people who are trying “If your goal is to lose a large amount of fat, gain a large weight loss, you amount of muscle, or train for competitive probably don’t sports. That’s especially true if you’re older and haven’t exercised in a long time. need to worry You should always check in with your so much about doctor before starting a new exercise prointensity as about gram. But once you’re cleared for take-off, increasing the “depending on what your goals are, there are no workouts that are too wimpy,” duration of time.” Hagberg says. “If we can get a [sedentary] 65-year-old out doing a slow walk for 30 minutes three times a week, it’s a great step forward.” For basic health, “it’s important to keep moving, and do some exercise five to six days a week,” Clifford adds. “If your goal is weight loss, you probably don’t need to worry so much about intensity as about increasing the duration of time that you’re exercising.” Clearly, staying on the move pays big dividends. To help prevent chronic diseases such as heart disease, diabetes, and some cancers, the U.S. Department of Health and Human Services recommends adults ages 18 to 64 exercise at moderate intensity for at least 2.5 hours per week or at vigorous intensity for at least 1.25 hours per week. To lose weight, the American College of Sports Medicine recommends up to an hour a day of physical activity. Of course, if you’re training for your first half-marathon, you might need to exercise more than that. But even if you just want to get in shape, you may have to keep challenging yourself once you reach your goal—both to boost your fitness levels and to alleviate the boredom that comes with doing the same old, same old routine day after day.—Rick Ansorge One exercise intensity scale uses 6 (no exertion) to 20 (the most you can do). Aim for the middle. Make over your workout with expert exercise tips. Rate Your Exercise Level Too easy or too hard? Here’s how to tell whether the intensity of your workout is in the right range for you: Talk Test If you’re exercising for health and fitness (fast walking or slow bicycling), you should be able to talk but not sing. Amping up to vigorous activity (think running or swimming)? You shouldn’t be able to say more than a few words without pausing for breath. Target Heart Rate The rule of thumb here is that when you’re exercising for health, you should aim for 50% to 70% of your maximum heart rate (which is 220 minus your age). Less than 50% is not much exercise, but better than nothing, especially if you’re just starting out. For a more vigorous workout, aim for 70% to 85%. Perceived Exertion Formal scales exist for rating just how hard you feel you’re working. But as a general guideline, when you’re exercising for health, you should feel you’re exerting yourself somewhat but not too much. To reach more serious goals, you’ll want to work harder, says exercise physiologist James Hagberg, PhD. WebMD.com November/December 2010 | WebMD the Magazine 51 Diane Collins and Jordan Hollender/Getty Images Try these questions. Q. Are there local groups or Reviewed by Michael W. Smith, MD WebMD CHIEF MEDICAL EDITOR No Kidding Parenting a child with a chronic illness can be tough on everyone in the family A few years ago, teenager Amy Johnson of Kansas City, Mo., was at a pet show with her family. When Amy, who has type 1 diabetes, began to feel sick, she checked her blood sugar. It was too high, so she used both her insulin pump and an insulin injection to try to correct it, both to no avail. After going to the emergency room, she ended up in the pediatric intensive care unit. She recovered—but the episode rattled her family. becomes a teen, the worries can get bigger because kids at that age want—and need—more autonomy. But when a teen has serious health issues and needs to be vigilant in managing them, letting go can be scary. Because of modern treatments, children can now lead long, productive lives, says Ron T. Brown, PhD, provost and senior vice president for academic affairs at Wayne State University in Detroit and a leading pediatric psychologist specializing WHeN A teeN HAs seRIous HeAltH in children and adoIssues AND NeeDs to Be vIgIlANt ABout lescents with chronic illnesses, but that mANAgINg tHem, lettINg go CAN Be sCARy. can raise additional challenges. In some cases, kids have to deal with the side effects of treatments, such as weight gain or low blood sugar with insulin. In addition, many teens with chronic illnesses This fall, with 18-year-old Amy in her first year fall behind in school from too many doctor of college, her father, David, an engineer with appointments and not feeling well. Still, chroniHewlett-Packard, is worried how she’ll cope with cally ill teens have to take time to be teens. alcohol, drugs, and adjusting to college life. With “Children need to be as normal as possible,” Amy, there’s a another kind of concern, too, since Brown says. “They need to be with peers and try she has a chronic illness.“She’s mature and she’s to fit in.” very up-front about her disease,” Johnson says. In her new dorm room, Amy is near a hospital “We’re sure she’ll take care of herself. But if her and a doctor and has talked with her roommate, blood sugar drops, it can be life-threatening. suitemates, and other residents on her floor about That’s hard to stop thinking about.” what to do if she is acting strangely or passes out. Having a child with chronic illness can be David says, “It has only been a few weeks since worrisome and exhausting. And when that child she left, but so far, so good.”—Susan Davis 26.6: the percentage of American children with chronic health conditions WebMD the Magazine | November/December 2010 Anatomy of Letting go Helping your teen learn to manage her own health is a huge responsibility—but a crucial one. Follow these tips for a smoother transition. Take heart. “We know chronic illness doesn’t necessarily lead to maladjustment,” pediatric psychologist Ronald Brown, PhD, says. “Children can be saddled with the most devastating of chronic diseases, yet still do well emotionally.” WebMD.com Dried Goods Posh Spice Cinnamon sticks, also called “quills,” are the dried bark of an evergreen tree. In Roman times, cinnamon was very valuable, perhaps up to more than 15 times more costly than silver. Battle Ground The high demand for cinnamon started a war in the 17th century between the Dutch and the Portuguese over the island of Ceylon—where much of the pungent spice is grown. There are two main types of cinnamon: Cassia (Chinese) and Ceylon, the sweeter variety. Globe Trotter Sri Lanka is the world’s largest producer of cinnamon. Find support. It’s not just kids who need support. Amy Johnson’s parents joined online groups and attended conferences. “We learned there are lots of people out there in the exact same situation,” Johnson says. Stay involved. When the Johnson family toured college campuses, they didn’t interview just teachers and students; they talked with doctors at the campus hospitals to learn who would be available to provide care if their daughter needed it, Johnson says. CINNAMON Type Two Talk about it. “We talked to our daughter about her diabetes and her care all the time,” David Johnson says. “We were constantly sharing information.” Visit the Parenting Center for more expert childraising tips. 52 nutritious and delicious Below: Leigh Beisch/Getty Images; right: Teubner Foodfoto/StockFood Munich expert advice for kids’ sake healthyeats Reviewed by Ari Brown, MD WebMD chilDRen’s heAlth expeRt leFt: Anthony BRADshAW/Getty iMAGes; ABoVe: coMstock/Getty iMAGes parenting matters Reviewed and recipe by Kathleen Zelman, MPH, RH/LD WebMD Director of Nutrition Iron King One teaspoon of ground cinnamon contains 1.4 grams of fiber. The spice is also a good source of calcium and iron. Historic Preserve Cinnamon was used as an embalming agent in ancient Egypt. Sugar Fighter Sweet Sorrow According to preliminary research, up to a teaspoon of cinnamon with food can reduce blood sugar levels. To show his remorse for killing his wife, Roman Emperor Nero ordered that a year’s supply of cinnamon be burned at her funeral. Bug Off Cinnamon and other strong-smelling spices have been used to repel ants.—Chloe Thompson healthy recipe Cinnamon Orange Glazed Chicken Breasts Makes 4 servings ingredients cooking spray 4 skinless, boneless chicken breast halves 1 tbsp light, unsalted butter 1 tbsp all-purpose whole wheat flour 2 tsp ground cinnamon ½ cup low-sodium chicken stock ½ cup orange juice ½ tsp dried tarragon ¼ tsp pepper ¼ tsp salt 1 orange, sliced Directions 1.Preheat oven to 375ºF. 2.Spray medium-size skillet with cooking spray, and heat to medium-high heat. 3.Add chicken and cook until golden brown, about 4 minutes per side. 4.Transfer chicken into a shallow baking dish coated with cooking spray. 5.Add butter, flour, and cinnamon to skillet until melted and combined. Slowly add chicken stock and orange juice and cook until thickened. Season with tarragon, salt, and pepper. 6.Pour sauce over chicken; arrange orange slices on top. 7. Bake chicken breasts in preheated oven until done, about 20 to 30 minutes or when meat thermometer reaches 165ºF. 8.Serve chicken and sauce over brown rice. Find more cinnamon-spiced healthy recipes for your holiday menu. Per serving: 191 calories, 29 g protein, 10 g carbohydrate, 4 g fat (2 g saturated fat), 72 mg cholesterol, 1 g fiber, 6 g sugar, and 172 mg sodium. Calories from fat: 17%. WebMD.com November/December 2010 | WebMD the Magazine 53 healthyeats Reviewed and recipes by Kathleen Zelman, MPH, RH/LD WebMD Director of Nutrition nutritious and delicious Three Ways to Cook Chicken The bird is the word when it’s time to serve healthy meals everyone will love healthy recipe healthy recipe healthy recipe ➜ Grilled Tuscan Chicken With Arugula and Tomatoes ➜ Asian Chicken Stir-Fry ➜ White Chicken Chili If your family doesn’t like arugula’s peppery bite, try using milder mixed greens. The Asian-inspired sauce’s sweet zing appeals to kids, making this a great way to get them to eat more produce. Make a batch of this super-nutritious chili on weekends and freeze individual portions for easy school-night dinners. Makes 4 servings Makes 4 servings ingredients 4 boneless, skinless chicken breasts ¼ tsp salt ½ tsp pepper cooking spray 2 tbsp extra virgin olive oil 2 tbsp fresh lemon juice 1 small shallot, finely minced 4 cups arugula 2 ripe beefsteak tomatoes, diced 2 tbsp freshly grated Parmesan cheese Makes 6 servings ingredients 1 tbsp honey 2 tbsp vinegar, any type 3 tbsp orange juice 2 tbsp low-sodium soy sauce 2 tsp fresh grated ginger or 1 tsp dried ground ginger 2 cloves garlic, minced 2 tsp cornstarch 1 tbsp vegetable oil, divided 2 boneless, skinless chicken breasts, cut into ½-inch strips 4 cups assorted vegetables, cut into bitesize pieces 2 cups cooked whole grain brown rice ingredients 2 tsp vegetable oil 1 large onion, finely chopped 4 garlic cloves, minced 1 lb boneless, skinless chicken breasts, cut into bite-size pieces 1 4.5-oz can chopped chiles, undrained 3 10.5-oz cans low-sodium chicken broth 1 19-oz can cannellini beans, rinsed and drained 1 cup frozen white corn, thawed 1 tsp cumin 1 tsp oregano 1 tsp white pepper Optional: Fat-free sour cream, sliced green onions, and chopped fresh tomatoes for garnish Directions 1. Preheat grill to medium high. Left to right: Tara Donne/Getty Images; Leigh Beisch/Getty Images; Keller & Keller Photography/StockFood Louise Lister/StockFood Munich Grandma was right: Chicken is good food. Tasty, versatile, and kid-friendly, chicken is chock-full of important nutrients and provides a concentrated dose of protein, offering more per ounce than beef or pork. In fact, 4 ounces of chicken includes about 70% of your recommended daily intake, says Peter R. Ferket, PhD, professor of nutrition and poultry science at North Carolina State University in Raleigh. At the same time, “chicken breast has about half the fat of a trim piece of T-bone steak,” Ferket says. The fat in chicken is less saturated than that of beef, so it’s less likely to raise blood cholesterol levels. A thin membrane between the skin and meat holds moisture in but keeps excess fat out. To keep fat and calorie content low, remove any skin from the cooked chicken before you tuck in. You can also think of it as brain food. Chicken supplies a hefty dose of niacin, which may protect against age-related cognitive decline, and choline, which new research suggests supports fetal brain development. Chicken also might reduce colon cancer risk. A 2005 study found that people who ate about four servings per week had a 20% reduction in adenomas (growths in the colon that can be precursors to colon cancer), compared with those who ate less than a half serving per week. That’s a whole flock of reasons why chicken deserves its spot on the table.—Erin O’Donnell 2. Place chicken breasts between sheets of plastic wrap; pound each piece to ½-inch thickness with a meat mallet or rolling pin. 3. Season chicken with salt and pepper. 4. Place chicken on a grill rack coated with cooking spray. Grill chicken 4 to 5 minutes per side or until done. 5. Meanwhile, whisk together olive oil, lemon juice, and shallots. Toss well with arugula until coated. 6. Place a piece of grilled chicken on each plate. Top with one cup prepared arugula and a quarter of the tomatoes. 7. Garnish with Parmesan cheese. Per serving: 259 calories, 33 g protein, 6 g carbohydrate, 11 g fat (3 g saturated fat), 76 mg cholesterol, 1 g fiber, 3 g sugar, and 401 mg sodium. Calories from fat: 38%. Directions 1. Combine honey, vinegar, orange juice, soy sauce, ginger, garlic, and cornstarch. Set aside. 1. Heat oil over medium-high heat in a heavy-bottom Dutch oven. 3. Stir-fry chicken for 3 to 5 minutes or until done; remove from pan. 2. Sauté onion for 5 minutes. 4. Add 1 tsp oil and stir-fry half the vegetables until crisp-tender. Remove from pan. Repeat with remaining oil and veggies. WebMD the Magazine | November/December 2010 3. Add garlic and chicken and sauté for 4 to 5 minutes. 5. Return chicken, vegetables, and sauce to wok or skillet. Cook briefly to thicken sauce and heat thoroughly. 4. Add remaining ingredients and simmer for 30 minutes or longer. For thicker chili, use a spoon or potato masher to mash some of the beans in the pot as it simmers. 6. Serve over rice. 5. Serve with optional garnish. Per serving: 282 calories, 18 g protein, 40 g carbohydrate, 5 g fat (1 g saturated fat), 34 mg cholesterol, 3 g fiber, 9 g sugar, 320 mg sodium. Calories from fat: 16%. Per serving: 259 calories, 28 g protein, 29 g carbohydrate, 4 g fat (1 g saturated fat), 43 mg cholesterol, 5 g fiber, 2 g sugar, 103 mg sodium. Calories from fat: 13%. What’s for dinner? Find more healthy chicken recipes. 54 Directions 2. Preheat wok or large skillet over medium-high heat. Add 1 tsp oil. WebMD.com November/December 2010 | WebMD the Magazine 55 healthyeats nutritious and delicious Poultry Pantry Picks Our three chicken recipes, page 72, feature standout ingredients that deserve a home in your fridge and pantry. WebMD’s director of nutrition Kathleen Zelman, MPH, RD/LD, offers a closer look at a few of these healthy ingredients, including advice on what to look for when you shop. Brown rice offers the heart-health and waistwhittling benefits of whole grains, along with yummy nutty flavor. Consider Uncle Ben’s Whole Grain Brown Ready Rice, which comes in a microwavable pouch and cooks in 90 seconds, or Birds Eye Steamfresh Whole Grain Brown Rice, found in the freezer section, which cooks in about four and a half minutes. L i q u i d g o ld Too much sodium increases the risk of high blood pressure and stroke, and the American Heart Association now recommends that adults consume no more than 1,500 milligrams of sodium daily. Using low-sodium chicken broth is an easy way to cut back; most people don’t notice the missing salt. Options include College Inn Light & Fat Free Chicken Broth, Kitchen Basics Chicken Cooking Stock, and Manischewitz Reduced-Sodium Chicken Broth. benefits of olive oil’s polyphenols, Zelman doesn’t heat it and uses it in salad dressings and to flavor foods after cooking. Look for extra virgin olive oils made by Alma Gourmet and Pompeian. C r e a m o f t h e cr o p For some of us, chili isn’t complete without a dollop of sour cream. Fat-free varieties like those made by Breakstone’s and Dean’s provide cool tanginess without saturated fat. Ted Morrison B r o wn I s B e s t Fl a v o r S a v e r A calorie-free condiment that wakes up the flavor of many dishes, vinegar is a valuable addition to your pantry. A splash of red-wine vinegar, for example, adds fat-free zip to steamed veggies, while cider vinegar and warm potatoes pair well in mayo-free potato salads. Check out vinegars made by Pompeian and Holland House. ‘Tis the season of giving. Since 1962, Target has given 5% of its income to support local communities. Today, that totals more than $3 million in giving every week. This holiday season, we celebrate our partners who take care of those in need, like The Salvation Army. B e a n t h e r e , D o n e t h at Legumes, including cannellini, pinto, and black beans, are an inexpensive way to pump up the protein and fiber in many dishes, and their soluble fiber content means they’re tummy-filling, too. But the cautions about sodium apply here as well: Some canned beans contain more than 450 mg of sodium per serving. Look for no-sodium or no-saltadded products from Bush’s Best or Eden Organic. We’re making it easy for you to help this season as well. Simply purchase a Target gift card* of $20 or more November 14–20, and we’ll donate $1 per card to The Salvation Army—up to $ 400,000. Shop and spread the joy. O i l R i ch Rich in monounsaturated fats, which can help reduce LDL (“bad”) cholesterol, extra virgin olive oil is Zelman’s go-to oil. To preserve the heart-health EXPECT MORE. PAY LESS.® The opinions expressed on this page are of the experts and are not the opinions of WebMD. W ebMD does not endorse any specific product, service, or treatment. ® Tk. Search tk. 56 WebMD the Magazine | November/December 2010 WebMD.com * Terms and conditions apply to gift cards. ©2010 Target Stores. Target and the Bullseye Design are registered trademarks of Target Brands, Inc. All rights reserved. 110325 wellness Taylor Swift never set out to be extraordinary. Like most of us, all she wanted was to be heard. Little did she know as she sat in her childhood bedroom in Wyomissing, Pa., giving voice to feelings about crushes, heartache, and troubled friendships, that one day millions of people would respond. That she would The chart-topping singer-songwriter’s secrets for healthy living and success on and off the stage ontour Taylor By Rebecca Ascher-Walsh, WebMD Contributing Writer with Reviewed by Louise Chang, MD WebMD MEDICAL EDITOR 58 WebMD the Magazine | November/December 2010 November/December 2010 | WebMD the Magazine 59 guaranteed success, she says she is “excited and nervous” to hear reactions to her latest work. “These songs are basically my journal entries from the last two years,” she says, “And that, of course, makes me much more vested in how people hear them.” So how does a young woman—who relies on her normalcy to connect with her audience—keep her feet on the ground, especially when they are so often walking the red carpet in Manolo Blahniks? By being grateful. “I remember dreaming about the possibility that if I worked really hard and things went miraculously well, some day people would care about what I had to say,” says Swift. “And I’ve never let go of that feeling. The fact that people care about my lyrics is so incredible to me.” Swift grew up with her stockbroker father, stay-at-home mother, and younger brother, Austin. She began writing poetry in second grade and turned to songwriting at 12 to help her deal with feeling like an outcast at school. After performing at every county fair, sporting event, and karaoke contest that would have her, she convinced her family to move to Nashville, Tenn., when she was 14. It didn’t take long to reassure the Swifts they had made the right choice: Within months, the prodigy had been signed as the youngest staff songwriter ever at Sony/ATV Publishing, a position she credits with her work ethic. “It was my job after school every day for two years,” she remembers. “I had this little office in the hall, and I was writing songs based on what other people might cut. It really immersed me in the gorgeous songwriting community, and I’ve never forgotten what it’s like to write for a job.” These days, Swift has the luxury of writing only for herself, a process she says keeps her honest. “From a young age, any time I would feel pain I would think, ‘It’s OK, I can write about this after school,’” she says. “And still, anytime something hurts, like rejection or sadness or loneliness, or I feel joy or I fall in love, I ask myself, ‘Can I write a song about this so I know how I feel?’” Making such private thoughts public doesn’t faze her. “I’m only thinking about the person I’m writing it for, so it stays personal,” she says, “and the fact that people actually care about what I have to say makes any fear pale in comparison.” No one will ever hear the naturally cheerful Swift whimper about any element of her fame, even if it has resulted in days spent touring and nights in hotel rooms while her peers are off at college and socializing. “I’ve been doing this so long that I don’t get road-weary,” she says. “I accept that I’m never going to be in the same place for too long and that’s just my life. What I feel is pure excitement.” Rules of the Road Still, Swift acknowledges that riding hours on a bus, strutting the stage, and not sleeping in her own bed can take its toll, both physically and mentally. Crucial to staying balanced is sticking to a comforting routine, no matter From left, Swift with icon Stevie Nicks at the 2010 Grammys, at which she won four Grammy awards; and with Jennifer Garner in the movie Valentine’s Day. 60 WebMD the Magazine | November/December 2010 Write On I have been doing this for so long that I don’t get road-weary. I accept that I’m never going to be in the same place for too long. What I feel is pure excitement. Austin Swift be a superstar before she could vote. Swift’s self-titled album was released in 2006 and went multiplatinum, setting the tone for what would become the then-16-year-old’s trademark: Disarmingly autobiographical songs that resonate across age and gender. Her follow-up, Fearless, released two years later, also sold millions and won four Grammy awards. Last year, Swift was the best-selling musician in the United States, according to Nielsen SoundScan, and Forbes ranked her the 12th most powerful celebrity this year, with annual earnings of $45 million. Most people would take this opportunity to do a victory lap. But Swift, who turns 21 in December, is far too busy performing at the 44th annual CMA Awards on Nov. 10 and canvassing the country on a tour supporting her latest album, Speak Now, which was released in late October to acclaim from critics and audiences alike. Plus, it’s not her style. Instead, she shows up for those in need, as she did this past summer when she appeared as part of Nashville Rising: A Benefit Concert for Flood Recovery, a cause to which she donated $500,000. Swift was also one of the first celebrities to call attention to the disaster, appealing to the public and media immediately after the devastation, which happened in May and caused an estimated $2 billion in damages to the Nashville and middle Tennessee area. It’s not a surprising reaction for someone so attuned to other people that, even though her new album would seem a PREVIOUS PAGE: Mary Ellen Matthews/Corbis Outline; THIS PAGE, Left to right: Michael Caulfield/WireImage; Dan MacMedan/WireImage; Ron Batzdorff/©New Line Cinema/Everett Collection wellness where she is. When she gets to her hotel room, the first thing she does is unpack— even if she’s there for only one night. “I do it everywhere I go,” she says with a laugh. “I really like the way it feels to have my clothes put away in drawers and my shoes in the closet.” Swift also always travels with candles, and she’s never without her iPod, onto which she is constantly downloading new music. Listening to fellow artists’ latest releases is what inspires Swift to exercise, and regardless of her tour schedule, she makes sure to squeeze in an hour-long run on a treadmill every day. “For me, running is about blasting a whole bunch of new songs and running to the beat. It’s also good because it makes me find a gym wherever I am,” she says. Unlike other famous colleagues, “I’m very much out in the world, and I love exploring the places we go when we tour. It’s important for me to live a full life.” Why putting pen to paper is good for you Because her life is so peripatetic, Swift knows that staying disciplined about how she eats is crucial to her well-being. While this lanky, 5-feet-11-inch star doesn’t need to watch her weight, she says she still pays attention to what she puts in her body … on weekdays. On weekends, all bets are off. “During the week, I try to eat healthily, so that means salads, yogurt, and sandwiches,” she says. “No sugary drinks. I try to keep it lighter, but it’s nothing too regimented or crazy. I don’t like to create too many rules where I don’t need them. We know what’s good for us, thanks to common sense.” On the weekends, “I allow myself to eat what I know from common sense is bad for me,” she says with a giggle. “I like comfort foods. I love a burger and fries, I love ice cream so much, and I love baking cookies. Actually, I love baking anything.” One daily treat is a Starbucks run, where she opts for skinny vanilla lattes “As a young kid, I learned to process my emotions by writing,” says singersongwriter Taylor Swift. Turns out, she intuitively hit upon a habit that studies suggest can be hugely beneficial to health in times of trouble. James Pennebaker, PhD, professor and chair of the psychology department at the University of Texas, has spent years studying the power of journalwriting and was the first person to publish on the subject. “Writing about upheavals in your life can be very helpful, with overwhelming evidence that when individuals write about those experiences there are improvements in both physical and mental health,” he says. Pennebaker says it isn’t necessary to keep a journal long-term, or when things are going smoothly. But he suggests that when worry or trouble sleeping kicks in, it’s time to pick up a pen and write about what’s happening for a minimum of 15 minutes for three consecutive days. “Traumatic experiences touch every part of people’s lives,” Pennebaker explains, “from financial to social to romantic, so it’s helpful to organize your thoughts about the event by writing.” There’s no right or wrong when it comes to expressing yourself, as long as you are honest. “Explore your deepest emotions and thoughts,” Pennebaker suggests, “and how it ties in to your childhood, your family, your future and past.” When you’re feeling better, you can put the journal back in your drawer until it’s next needed. “There’s no reason to write when you’re not troubled if you don’t want to,” says Pennebaker. “Enjoy the good times.”—RAW November/December 2010 | WebMD the Magazine 61 wellness Taylor’s Tips for Healthy living on the road I’m very much out in the world, and I love exploring the places we go when we tour. It’s important for me to live a full life. on weekdays and spiced pumpkin lattes on weekends. “The point,” she says, “is I’m never cutting out what I love, which is Starbucks.” Elisabetta Politi, RD, MPH, CDE, nutrition director of Duke University’s Diet and Fitness Center, lauds Swift’s simultaneously practical and celebratory approach to food, praising her for being a role model in an insanely dieting world. Swift also earns high marks for not depriving herself, although as Politi points out, “Taylor doesn’t have to lose any weight, so maybe someone who does would have a treat once a week, and after exercise.” Swift’s philosophy is perfect, says Politi. “Evidence shows that binge eating is connected to frequent dieting. Depriving ourselves leads to eating out of control. What’s crucial is having a healthy relationship with food,” Politi explains. “Food is not the enemy, and Taylor is 62 Home Girl To keep a balanced lifestyle, Swift is a homebody when she’s not touring. She recently moved out of her parents’ house and into her own apartment in Nashville, where she hangs out with friends and writes. “I’m not a party girl, because that’s not where my interests are,” she says. But she’s also aware that in making the choice to stay away from the nightlife she’s sending an important message to her fans. “I really do factor that into the decisions I make,” she says, “And it’s always a huge part of my thought process. In the last two years while I’ve been on my first headlining tours, I look into the crowd and I see all of these faces, and some of them are little. I remember when I was that age, and the choices that my favorite singers were making really mattered to me. I can’t block that out, and I don’t want to.” Swift is also cognizant of helping those in need and is a generous donor to groups like the American Red Cross. “My WebMD the Magazine | November/December 2010 Reward yourself. Work for your indulgences, and then enjoy. “I have a need to feel like I’ve earned things, so when I have a week of working really hard, I get to have a day or two off—whether it’s from exercise or watching what I eat,” says Swift. Skip the judgment. When it comes to dieting and working out, Swift is watchful rather than self-chastising. “I keep an internal gauge of whether it’s been a healthy week or not,” says Swift. Then she makes adjustments instead of beating herself up. Secret to Happiness As far as she’s concerned, Swift is already living her ideal life. She’s made forays into acting, appearing on a CSI: Crime Scene Investigation episode on CBS and in the movie Valentine’s Day. She is celebrated for her style and beauty in fashion magazines. But she insists that her driving passion is and always will be songwriting. “If I go more than nine days without writing a song, I get really antsy,” she says. “But I think the stress causes me to search my mind and helps me write. It starts with an idea that hits me at the most inconvenient time, like in the middle of a conversation or in the middle of the night, and my friends have gotten used to a glazed look coming into my eyes. Then I need to grab my phone and record a voice memo or a melody and lyrics. You never know what it will be!” The element of surprise is something Swift embraces, as long as the result continues to be songs that move her and her fans and as long as she is able to retreat to the security of close friends and family to reconnect with herself. “I always try to see what makes me most comfortable and happy,” she says. “Because right now, to have happiness, that’s the main priority.” Water it down. “I drink so much water my friends call me an alien,” jokes Swift, who says she always carries a bottle with her. Just to make sure she’s never short, the singer keeps a case in her car. Find your rhythm. To power up your workout routine, download songs or albums that you don’t let yourself listen to until you’re in motion. “I don’t like any kind of exercise other than running,” Swift says. “And I love that because it’s about the music.” MR Photo/Corbis Outline Swift with her mom, Andrea Swift contributions hit me like my song ideas,” she says. “It’s just a gut feeling about who needs help, whether it’s a flood in Nashville or a town that I’m in that has had some horrible tragedy or a letter I get from a family. Giving back like that makes you feel so incredible.” She believes the amount of time or money given is unimportant: “If you have the opportunity to put something good into the world, that only does good for your own life.” Kevin Mazur/WireImage really to be commended for enjoying what she eats. We should all be eating in a mindful way and enjoying every moment that we do.” As for following common sense rather than calorie charts, Politi is all for it: “Our grandparents had so much less information than we have; they only listened to their common sense, and we were a leaner country then.” For people who would rather rely on facts than intuition about what makes a healthy diet, Politi suggests going to the American Dietetic Association website, eatright.org. “Health is a big part of being happy,” says singer-songwriter Taylor Swift, who is committed to keeping herself in great shape physically and mentally even when she’s touring. Here are her rules of the road: Sit with your feelings. Recognize that anxiety is not inherently bad. The experience is uncomfortable while it’s happening but can also propel you out of a rut. “It’s awful to sit there feeling that way,” says Swift. “But if you let it, it can lead to something that takes you out of that feeling and into something creative.”—RAW November/December 2010 | WebMD the Magazine 63 WebMD health heroes Fighting for Boys Patricia Furlong W WebMD’s fifth annual tribute honors six visionaries who are changing the lives of others through their caring and hard work Health Heroes 64 WebMD the Magazine | November/December 2010 Chris Crisman 2010 hen Patricia Furlong’s sons, Christopher and Patrick, were diagnosed with Duchenne muscular dystrophy in 1984, the doctor simply said, “There is no hope.” At that time there was no treatment for the disease, the major type of muscular dystrophy and the most common fatal genetic disorder. Duchenne strikes only boys and leads to progressive muscle weakness, an inability to move the arms and legs, and eventually death. Yet while Furlong, 63, a former intensive care unit nurse, was often overwhelmed, she didn’t give up hope. “I remember one day I told Chris, ‘I want a miracle,’” she recalls. “And he looked at me and said, ‘Miracles don’t just happen for one or two of us, Mommy. They have to happen for all of us.’” Furlong threw herself into creating those miracles. In 1994, she established Parent Project Muscular Dystrophy to bring parents, researchers, and doctors together to fundraise and advocate for better care for Duchenne patients. PPMD’s lobbying efforts resulted in Congress’s passing the MD-CARE Act in 2001, which designated funds for research on muscular dystrophy. As a result, boys with Duchenne now walk into their teens and 20s. Her own sons stopped walking at 9 and died at 15 and 17. But every time Furlong meets a new family, she thinks, “All I ever wanted was to buy five minutes more of life for my sons. I can’t fix everything for these families. But I can try to buy them five minutes more.” —Susan Davis 65 WebMD health heroes Josh Estey/CARE W hen supermodel Christy Turlington Burns started hemorrhaging after the birth of her daughter in 2003, the staff at her modern birthing center in New York City treated her easily. But two years later, when she was pregnant with her second child, she traveled to Central America as a CARE ambassador and met with pregnant women who had to walk miles and miles just for clean water. That’s when a global crisis hit home for her. Hundreds of thousands of women die every year from pregnancy or childbirth complications, and more than 90% of these deaths are preventable or treatable when there is access to quality medical care and supplies, according to the United Nations. Turlington Burns, 41, whose mother is originally from El Salvador, decided to make a documentary, her first, about what she saw. Called No Woman, No Cry, it debuted at New York’s Tribeca Film Festival last May and is slated for general release next spring, around Mother’s Day. It portrays the state of maternal health in Tanzania, Bangladesh, Guatemala, and the United States. She also launched the interactive website, everymothercounts.org, to help create a worldwide maternal health movement. “Life and death are very close in that moment … and baby steps can make a powerful noise” about this issue, she says. “Calling women by their names, not numbers; using floral sheets instead of white, which signifies death in many cultures; using a curtain during delivery … you’d be surprised at what works.” Her passion goes beyond movie making, and she’s now studying for her master’s degree in public health at Columbia University. “Going to graduate school has given me credibility to be part of the dialogue,” she says.—Jenna Gallagher Mother’s Helper Christy Turlington Burns Tiffany Denyer T iffany Denyer always knew she loved animals and was interested in emotional and behavioral issues. “After I got my degree in psychiatric nursing, I started doing pet therapy with my dog, Maddie. We visited Alzheimer’s patients and the mentally ill and did play therapy with children.” Denyer, 36, earned a service dog certification and a degree in animal behavior, then merged her two interests by establishing Wilderwood Service Dogs in Maryville, Tenn., in 2005. Wilderwood is the first service dog organization specializing in training dogs to be companions to kids and adults with neurological conditions, including autism, dementia, and mild mental retardation. Over the last six years, Wilderwood has trained and placed 43 dogs with people with 66 WebMD the Magazine | November/December 2010 neurological disorders—about 90% of them children. Starting this winter, Wilderwood will partner with Breakthrough (a local treatment center for adults with autism) to provide job and social skills. Wilderwood is also working with University of Tennessee researchers to track how people with service dogs fare in the world, as well as another study on how people with service dogs communicate and cope. The results, Denyer hopes, will lead to more research and funding for this new field. “The dogs are trained to keep people safe,” Denyer says, but adds that’s not all—a dog also touches a child’s spirit. “The relationship with a service dog can impact a child’s life more than therapy or medicine combined,” she says. “It is truly life-changing.”—Susan Davis Tamara Reynolds Pet Cause November/December 2010 | WebMD the Magazine 67 WebMD health heroes Sister Act Caren hoffman Giving back by helping “ other kids is the best decision I’ve ever made. ” 68 Christopher Navin C aren Hoffman’s mission to help sick children began at age 13 when her younger brother, Sam, then 8, needed a bone marrow transplant. Sam had Fanconi anemia, a genetic disease that can lead to bone marrow failure at an early age, then leukemia, and then a variety of cancers. The family traveled to New York City for the transplant and decided they would live at the Ronald McDonald House during Sam’s hospitalization. At first, “I hated it and the hospital,” Hoffman says. “I missed my friends and my school and my house.” But when she started doing art with the children there, she discovered a passion. “Painting with these sick little kids made me feel good,” she says, “because I could tell that painting made them happy.” Because of his transplant, Sam didn’t develop leukemia. But Caren went on to become leader in training at Paul Newman’s Hole in the Wall Gang camp—also for chronically ill children—which further strengthened Hoffman’s love of helping children. So when she turned 15, she started Bromfield Against Cancer, a student club at her small public high school in rural Massachusetts, to raise money for other families with sick children. “Our town raised a lot of money for us when we went to New York with Sam,” she recalls. “I wanted to do the same for others.” In 2009, Bromfield Against Cancer took part in a local Relay for Life event, sponsored by the American Cancer Society, that raised $87,000. In addition, with one town-wide spaghetti dinner, BAC raised another $10,000 for their principal, whose daughter also has cancer. Now a senior in high school, Hoffman, 17, says her “dream job” is to “become a family counselor who works with kids who have cancer and their families.” Looking back to the time when Sam—now 12 and still cancer free—was sick, she says giving back by helping other kids “is the best decision I’ve ever made.”—Susan Davis November/December 2010 | WebMD the Magazine 69 WebMD health heroes Children’s Champions WebMD’s 2009 Health Heroes Two visionaries building solutions for kids’ health Where are last year’s winners today? Christopher Gavigan T. Denny Sanford’s childhood was not easy. At age 4, he lost his mother to breast cancer, and when he was 21, his father died of heart disease. His life could have gone in a bad direction. But he went on to achieve personal and financial success in business and 6 years ago devoted himself to funding health care initiatives and institutions, especially those dedicated to children. “I think health is an area where you can make the biggest difference and that’s what I’m trying to do,” he says. Sanford Health, the health care system he founded, is now building a network of Sanford Children’s Clinics around the world in communities lacking pediatric care. (Sanford Health is a sponsor of WebMD.) It is also establishing The Sanford Project, a cutting-edge initiative to cure type 1 diabetes. “You see these kids who have 15 pokes a day with a needle and the pain that they go through,” he says, “and you can identify with it. Diabetes is unfortunately one of those situations that we don’t recognize because the people otherwise act normal. But that’s only if they get the proper care and take the proper medications.” Sanford, 74, initially got involved with children’s health care “for the children,” he says, “but when you meet pediatric staff in hospitals and at schools, [you realize] it’s not just a job for them, it’s a passion to save lives and help these little tykes. Children do not have a voice, and we’re trying to give it to them.”—Susan Davis Top: Greg Latza T. Denny Sanford After getting a college degree in environmental science, Christopher Gavigan set up a company that provided wilderness expedition experiences for teens—many of whom had emotional and behavioral issues. “I discovered how they were affected by chemicals growing up,” he says. “That started my passion for children’s environmental health and creating a world free of toxic chemicals for them.” Gavigan, 36, knew he had to reach parents. In 2005 when he became executive director of Healthy Child, Healthy World, a nonprofit that works to improve children’s health by eliminating toxins from their environment, he focused on identifying small steps rather than big leaps for parents. Using a multimedia approach—award-winning website, DVDs, an iPhone app with shopping lists for healthy products, the book Healthy Child, Healthy World, videos, endorsements by such celebrity moms as actor Amy Brenneman (pictured below, with Gavigan), and guides to local, state, and federal policy initiatives—HCHW has reached hundreds of millions of parents. “Our goal is to make information available, inspiring, and doable for the modern family so they are empowered to create a safer, healthier world,” Gavigan says. Gavigan left HCHW in mid-October and isn’t yet sure what his next project will be. But wherever he lands, he says, he’ll be working to “make a positive impact on children, family, and the environment. That’s my life work.” —Susan Davis Sabrina Cohen Zane Gates, MD A car accident in 1992 left then-14year-old Sabrina Cohen a quadriplegic. After graduating from college, Cohen heard a presentation on stem cell research and had an “aha” moment that changed her life. “That talk ignited in me a hope that had long since simmered down,” she told us, “that someday I would walk again.” Cohen went on to found the Sabrina Cohen Foundation for Stem Cell Research, which advocates and fundraises for the many diseases that could benefit from stem cell research. Since she received her WebMD Health Heroes award last year, the foundation has given a grant to Miami cardiologist Joshua Hare, MD, who is studying the potential benefits of stem cells on heart attack and stroke patients. Cohen hopes to add to the $100,000 raised by her foundation thus far by selling 2011 “cellebrity” doctor calendars—complete with photos and bios of 12 leading stem cell researchers from around the country (available at CELLebritydocscalendar.com, launched in October). “I’ve devoted my life to what was a devastating aspect of it, and turned it into something positive,” she says. “I grew up in a rough neighborhood, and a lot of kids went to jail,” recalls Zane Gates, MD. But thanks to his mother, who volunteered much of her time to the Catholic church, many adults active in their community mentored her son, who stayed out of trouble. In turn, Gates, 43, always planned to go back to his hometown of Altoona, Pa., after medical school to return the favor. Now, each year 3,700 patients receive free health care through his Partnering for Health Services. And if a bill Gates spearheaded with state Sen. Ted Erickson passes in the Pennsylvania state House, uninsured people throughout his state could get the same care. In addition, with the help of his WebMD Health Heroes $2,500 donation and proceeds from two novels he has authored, the doctor expanded his after-school program to a third housing project. Says Gates: “My mother showed me that changing other people’s lives is complete fulfillment. And she was right.” Stan Curtis As a doctor of internal medicine in the heart of Los Angeles, Mark Hyman, MD, 52, sees his fair share of patients from the entertainment industry, among them actor Patricia Heaton. And since launching the annual Comedy for a Cure night to fight tuberous sclerosis eight years ago, Hyman and Heaton have enlisted star power from the likes of Julianne Moore, Ray Romano, and Teri Hatcher. Although the night centers around jokes, TS is no laughing matter. “The effects of this disease can be very broad and deep,” says Hyman. “The most prominent are seizures and mental retardation, as well as both benign and malignant tumors that can grow in many organ systems.” A genetic condition, TS affects 50,000 Americans. Thanks to Hyman, Comedy for a Cure has raised more than $2.5 million to date for research and the development of drugs to treat and possibly cure this debilitating disease. Last year’s WebMD Health Heroes recognition also increased awareness. “Some of my patients told me they sent in donations because they saw the article,” says Hyman. “People were like, ‘Oh, my God, there’s my doctor!’ ”—Jennifer Dixon Even in today’s tough economy, it’s easy to forget that 59% of public school children rely on government assistance for food each school week. No federal program exists, however, for weekends. This gap inspired Stan Curtis, whose USA Harvest distributes 2 million meals to low-income families per day, to create a new program, Blessings in a Backpack, in 2005. Through Blessings, low-income children receive a backpack filled with food each Friday. Hungry children “used to come to school on Mondays feeling disgruntled and mad,” says Curtis, 61. Now they arrive at school Monday nourished and ready to learn. Schools using the program are reporting increased scores on testing; one school in Boca Raton, Fla., saw reading comprehension scores jump a dramatic 80% among students participating in the Blessings program. This year, the program has expanded to 203 schools. Says Louisville, Ky., resident Curtis: “This is Americans saying we’re going to give our kids a shot at success.” Patricia Heaton & Mark Hyman, MD Know a WebMD Health Hero? Starting in January, nominate him or her online! 70 WebMD the Magazine | November/December 2010 WebMD.com November/December 2010 | WebMD the Magazine 71 holiday recipes Three top chefs’ very own Yuletide recipes home Holidays for the For a fresh take on festive foods, we asked Iron Chef Cat Cora, Mom-a-licious chef Domenica Catelli, and our own nutrition expert Carolyn O’Neil, MS, RD, for the family holiday recipes they return to most often. The result? Dishes that transform familiar tastes from “same old” to “something special.” From Cora’s Caribbeanthemed curried lentils with butternut squash to O’Neil’s can’t-skip-this salad to Catelli’s guiltless mashed potatoes, each recipe rethink provides inspiration on how a little redo leads to redux: newfangled favorites you’ll want to prepare again and again. Plus, stress-busting tips for home cooks to take the worry out of holiday prep. By Monica Kass Rogers, WebMD Contributing Writer Reviewed by Kathleen Zelman, MPH, RH/LD WebMD DIRECTOR OF NUTRITION 72 WebMD the Magazine | November/December 2010 Photography by Renée Comet; Styling by Lisa Cherkasky November/December 2010 | WebMD the Magazine 73 C holiday recipes Cat Cora Pomegranate-Glazed Cornish Game Hens With Wild Rice and Chestnut Stuffing “I love changing things up for the holidays,” says Cora, which is no surprise, coming from America’s first female Iron Chef, anointed by the Food Network’s reality cooking show. “For the celebration table, you want things to be comforting, but not boring. So I always keep a few old-standby dishes on the table but pick at least a few others that I mix it up with, making them a little more exotic, more unique—still ensuring that the recipes are very approachable and easy to do.” The key here? “Stay in the same flavor family when you substitute something different for something traditional.” For example, do coconut-sprinkled curried squash and lentils rather than marshmallowed sweet potatoes, or pomegranate-glazed Cornish game hens instead of one big turkey. I n g r e d i e n ts 4 Cornish game hens 1 cup uncooked wild rice ²/³ cup coarsely chopped chestnuts (eitherfresh or from a jar or can) ½ cup finely chopped yellow onion 2 tsp finely chopped fresh thyme 1 tsp finely chopped fresh sage 3 tbsp chopped Italian flat-leaf parsley freshly ground black pepper 1 cup pomegranate juice 1 cup all-purpose flour, divided 3 cups low-sodium chicken stock Don’t change your entire holiday menu over to exotica. Keep a few familiar dishes on the table that family members might mutiny without. Pin down your shopping list at least a week ahead, practicing any dishes you’re unsure of ahead of time and pre-prepping a day or two in advance whatever will hold. And delegate some of the dishes to trusted family members (those old standbys, for example). Holiday Directions 1. Rinse the rice in cool water, drain the water, and add the rice to a 2-quart saucepan with lid. Add 3 cups cold water and dash of salt. Bring the rice to a boil and stir once. Immediately reduce the heat to low, and cover the pot. Cook over low heat for 45 to 55 minutes, or until all of the liquid has evaporated. 2. Preheat the oven to 325ºF. 3. While the rice is cooking, remove the chestnuts from the jar or can, chop them roughly, and spread them on a baking sheet. Toast them in the oven for about 10 minutes to remove some of their moisture. When the chestnuts are done roasting, turn up the oven to 375ºF. In a large bowl, mix the cooked wild rice, toasted chestnuts, chopped onion, and herbs. 4. Pat the game hens dry with a paper towel. (If they have been frozen, be sure they are completely thawed, with gizzards removed.) Loosely fill each cavity with stuffing, leaving a little space in each bird to allow the rice to expand during roasting. Secure the legs, wings, and opening of each hen by trussing with cotton string. Spoon leftover stuffing into a small casserole dish with lid. During the last 25 minutes of roasting the hens, slide the casserole into the oven to heat. 5. Place hens breast-side down on a rack set in a roasting pan. Place pan on the center Tip rack of a preheated oven, and allow the hens to cook for 15 minutes before basting with the pomegranate juice (or with pomegranate-balsamic reduction option at the end of this recipe). 6. Baste again 15 minutes later, turning birds breast side up after 40 minutes of roasting. Continue basting with the remaining pomegranate juice until the hens are dark golden brown and the juices run clear when the hens are pierced at the thigh. Total cooking time will be about 50 to 55 minutes. An instant-read thermometer inserted into the thickest part of the thigh, not touching the bone, should register 175ºF to 180ºF. 7. Remove the birds from the oven, and transfer them to a platter. Cover them with foil and let them rest for 10 to 15 minutes. 8. Place the roasting pan with the juices on the stovetop over medium-low heat, add about ½ cup of the chicken stock (or water), and scrape up any roasted bits from the bottom of the pan. Sift the flour into the cooking juices and mix well. Slowly whisk in another 1½ cups of stock (or water) and stir well, and let simmer until the mixture is thick and has no lumps, about 5 to 6 minutes. Add a few more teaspoons of water or white wine if you’d like the gravy to be thinner. Season to taste with salt and pepper. 9. To serve, cut each bird in half lengthwise. Pool a little gravy on each plate, place a half bird on top of each gravy-pooled plate, and garnish with finely chopped parsley. Serve with a little extra rice stuffing on the side, if desired. WebMD the Magazine | November/December 2010 I n g r e d i e n ts 1 cup dry lentils (preferably French or green) 1 small butternut squash (about 1½ lbs), peeled and cut into chunks (equals 1½ cups) olive oil spray 1 tbsp curry powder 1 tsp grated fresh ginger 1 tsp chili powder dash of kosher salt and freshly ground black pepper ¼ cup unsweetened shredded coconut Directions 1. Spray olive oil in an 8x11-inch baking dish and set aside. Pour the lentils into a deep pot and cover with cold water. Heat water to boiling; reduce heat to simmer, and add the raw chunks of squash. Simmer until the squash is soft, lentils are tender, and liquid has reduced by two-thirds, about 25 minutes. Remove the pot from the heat. Spoon contents into a colander to drain. With tongs, pull out the chunks of squash and mash them roughly with a fork, ricer, or potato masher. 2. Preheat the oven to 375ºF. 3. In a large bowl, mix the drained cooked lentils and mashed squash with all of the spices. Spoon the mixture into the baking dish. (At this point, you can cover the dish and refrigerate it for a few hours or overnight.) Bake until piping hot (about 20 minutes if you’re putting it into the oven right after mixing; 25 to 30 minutes if it’s been refrigerated). Serve warm, topped with shredded coconut. Makes 4 servings Per serving: 285 calories, 14 g protein, 38 g carbohydrate, 10 g fat (8 g saturated fat), 18 g fiber, 3 g sugar, and 34 mg sodium. Calories from fat: 28%. PomegranateBalsamic Reduction For a more flavorful glaze, you can use a reduction of pomegranate-balsamic rather than straight pomegranate juice. 1. Combine equal parts pomegranate juice and balsamic vinegar (use a good balsamic but not your most expensive bottle). 2. Heat over medium-low heat for 15 to 20 minutes or until the reduction is syrupy but not as thick as molasses. Makes 8 servings Per serving: 526 calories, 35 g protein, 40 g carbohydrate, 24 g fat (7 g saturated fat), 170 mg cholesterol, 2 g fiber, 5 g sugar, and 316 mg sodium. Calories from fat: 41%. Makes 1/8 cup (2 tbsp per serving) Per serving: 45 calories, 0 g protein, 10 g carbohydrate, 0 g fat, 9 g sugar, and 10 mg sodium. Calories from fat: less than 1%. Tk. Search tk. 74 Curried Lentils With Butternut Squash WebMD.com November/December 2010 | WebMD the Magazine 75 holiday recipes Fennel, Orange, and Pomegranate Salad O’Neil discovered this recipe at a “girlfriends getaway” weekend in Rosemary Beach, Fla. “The pretty green, bright orange, and deep red created a picture-perfect platter on the brunch buffet. What a beautiful way to enjoy the fiber in the fennel, the vitamin C in the oranges, and antioxidants in the pomegranate,” she says. I n g r e d i e n ts C Carolyn O’Neil, MS, RD Dietitian, writer, and food expert Carolyn O’Neil’s first holiday makeover mission was to lighten up the standard green-bean casserole by using fresh green beans, fresh sautéed mushrooms, and caramelized onions instead of the typical canned veggie/ soup/fried onion trio. The result was such a hit at her house that O’Neil’s makeovers are now much anticipated. Her latest best twist on tradition? “The addition of fresh salads to the holiday table,” says O’Neil. Built with seasonal produce and flavors that complement the winter holiday theme, her salads haven’t replaced the obligatory Jell-O salad mold, but the family has created a welcome space for them on the table. 4 navel oranges 1 head (bulb) fennel 1 tbsp extra virgin olive oil ¼ cup pomegranate seeds (or dried cranberries) 1 tsp kosher or sea salt freshly cracked black pepper ¼ cup slivered almonds, toasted and cooled Directions 1. Segment the oranges, reserving ½ cup orange juice. Clean the fennel and trim and remove any browned or bruised areas. Cut the fronds off and reserve. Shave the fennel crosswise, using the finest slicing blade on the food processor or a mandolin. 2. In a large bowl, toss the shaved fennel with the orange segments, olive oil, and salt. Mince 2 tablespoons of the green fennel fronds and toss into the salad. Add the pomegranate seeds and orange juice and gently toss to combine. 3. Cover and chill for at least 30 minutes before serving so the flavors can develop. Season to taste with salt and freshly cracked black pepper. Garnish with toasted almonds and some of the fennel fronds. Makes 6 servings Holiday Tip 76 “Since I’m a dietitian, friends and family expect me to prepare ‘healthy dishes’ for holiday meals,” says O’Neil. “But the last thing I want to do is start a family feud by banning calorie-laden traditional favorites.” Instead, she recommends making lighter dishes an exciting addition to the usual holiday menu. You’ll be introducing some healthier fare and keeping the peace. WebMD the Magazine | November/December 2010 No-Guilt Mashed Potatoes D Mashed potatoes evoke thoughts of coziness, warmth, and comfort—but also indulgence and guilt! In this recipe, you enjoy all the benefits of comfort food— minus the guilt. The dish is surprisingly creamy without milk or butter in the mix. I n g r e d i e n ts 6 large Yukon Gold potatoes, peeled and cut into large chunks 1 box (32 oz) chicken broth (low-fat, low-salt) 3 to 5 cloves garlic, peeled ½ cup grated Parmesan cheese pinch of salt and pepper Directions 1. Place the potatoes in a pot with broth, a dash of salt, and garlic cloves. Add water to cover, 2 inches above the potatoes. Bring potatoes to a boil and cook until soft but not falling apart, about 15 to 20 minutes. 2. Drain most of the liquid into a large measuring cup. Smash potatoes with a hand masher, whisk, or electric mixer. 3. Add Parmesan cheese and enough reserved broth until you reach desired consistency. 4. Finish with a sparing salt spinkle and freshly cracked black pepper. Domenica Catelli Chef and cookbook author Domenica Catelli of Mom-a-licious is a believer in holiday recipes that are big in flavor, ease, and health. Her garlicky, no-guilt mashed potatoes won out in something of a family feud. “My mother-in-law let me know early on that I didn’t know how to make mashed potatoes,” says Catelli. “She knew how her son liked them, and chef or not, I wasn’t going to match up. I, of course, wanted to prove her wrong and came up with this no-cream, no-butter, healthy-but-flavorful recipe.” The verdict? “Once I made them, she conceded that I earned ‘best’ potatoes that Thanksgiving!” Catelli says. Aim for holiday menu recipes that will taste great and look beautiful but that won’t keep you in the kitchen too long. Assign some of the last-minute food prep to family and friends so you can gather together and talk while preparing the meal. “Whether it’s putting my nephews on picking thyme or having Uncle Matt grate Parmesan for the guiltless mashed potatoes, there are small things you can delegate that will take some pressure off you and create great memories in the kitchen,” she says. Holiday Tip Makes 8 servings Per serving: 251 calories, 10 g protein, 52 g carbohydrate, 2 g fat (1 g saturated fat), 6 mg cholesterol, 2 g fiber, 2 g sugar, and 390 mg sodium. Calories from fat: 7%. Per serving: 170 calories, 5 g protein, 19 g carbohydrate, 10 g fat (1 g saturated fat), 6 g fiber, 10 g sugar, and 408 mg sodium. Calories from fat: 49%. Find more healthy holiday spread recipes. WebMD.com November/December 2010 | WebMD the Magazine 77 allergies Did you know? About 10 million Americans are allergic to cats. Is it a cold or allergies? Allergy symptoms can be confusing, because they often resemble those of other ailments. “My daughter is 4 years old,” khb2010 posted in WebMD’s allergies community recently. “How do I tell if the symptoms she has right now are allergies or a cold?” That’s a good question—and only a doctor can tell for sure. Check this list before you go. Occurrence of symptoms Duration of symptoms Colds Allergies Often appear one at a time: first sneezing, then a runny nose, then congestion Occur all at once Generally last from seven to 10 days Continue as long as a person is exposed to the allergy-causing agent (allergen) Questions for your doctor 1 2 3 4 Can a test tell me which plant (or mold) is causing my allergies? Can my allergies be cured? Can they be managed so that I am practially symptom-free? Mucus Often a yellowish nasal d ischarge, due to an infection Generally a clear, thin, watery discharge Sneezing Less common than with allergies More common than with colds, especially when sneezing occurs two or three times in a row Time of year More common during the winter More common in spring or fall, when plants are pollinating Fever May be accompanied by a fever Not usually associated with a fever Source: the American Academy of Allergy, Asthma, and Immunology, the Asthma Foundation of America, the National Institutes of Health, and the Allergies Health Center 78 DIABETES WebMD the Magazine | November/December 2010 Are there prescription or over-the-counter medications I can take? Are there lifestyle changes I can make to relieve my symptoms? get the 411: allergies Sign up for the latest news and lifestyle management tips—delivered directly to your email inbox! Go to WebMD.com and search for “allergies newsletter.” allergies SEARCH RCH Did you know? About 6 million people with diabetes in the United States don’t know they have it. Do you know your A1c? If you have diabetes, you’ve probably heard about the HbA1c test—or A1c. But you may not understand what it is. “I have looked all over—how do you understand the results for the A1c test?” Lynnbrown45 asked in WebMD’s Diabetes community. The test gives an average of your glucose (blood sugar) measurements, expressed as a percentage, over the previous six to 12 weeks. The higher your glucose levels, the higher the percentage, as this chart shows. A1c Test Results Guide HbA1c test results (%) 5 6 Target 78 910 Suboptimal 11 12 Poor Average Plasma Glucose (mg/dL) For people without diabetes the normal range of A1c values is less than 6.5%. If you have diabetes, you should aim for an A1c result of less than 7%. The difference seems small, we know, but it’s important: Even a 1% rise in A1c test results increases your risk of diabetes-related complications, including eye disease, heart disease, nerve damage, kidney disease, and stroke. Your doctor will use this test, along with your home blood glucose monitoring, to develop the best diabetes treatment for you. Some doctors are also beginning to use the test to diagnose diabetes, not just manage it. Ideally, if you have diabetes you’ll take the test every three months or so. But no worries, this is an easy one: Just a quick blood draw and you’re done. Source: National Institutes of Health, American Academy of Family Physicians, National Diabetes Information Clearinghouse, and the Diabetes Health Center Questions for your doctor 1 2 3 4 Do I need to have my A1c level tested regularly? If so, how often? What do my results mean? What do I need to keep an eye on? Do I need to make a change in my medications to achieve better control? Are there ways that I can improve my blood glucose readings? get the 411: Diabetes Sign up for the latest news and lifestyle management tips—delivered directly to your email inbox! Go to WebMD.com and search for “diabetes newsletter.” diabetes SEARCH RCH November/December 2010 | WebMD the Magazine 79 cancer HEART The lowdown on cholesterol Without a doubt, cholesterol management can be confusing—and worrisome. “I am 24 years of age,” jennlynn85 posts in WebMD’s cholesterol management community. “I eat healthy and exercise. But I have high cholesterol. Is there something I can add to my diet?” Good question. Read on to see how much you know about cholesterol. 1 If a food product’s package reads “low cholesterol,” ● it’s also low in fat. True False 2 The best age to have your cholesterol level checked ● is 50 because that’s the peak age for heart attacks in men. True False 3 Women don’t get heart disease, so they don’t need to ● worry about cholesterol. True Did you know? There is no cholesterol in fruits and vegetables. The liver produces most of the blood cholesterol in your body. False Answers: 1. False. The two don’t necessarily go hand in hand. For example, coconut oil, a product ingredient, is cholesterol-free but high in saturated fat. 2. False. E veryone age 20 and older should have a blood test to check for cholesterol levels at least every five years. 3. False. Heart disease is the top killer of men and women. Because cholesterol plays a role in heart disease, women must watch their levels, too. 4. True. Dietary cholesterol comes from animal products, not plant foods, such as peanuts. Questions for your doctor 1 2 3 4 80 Guide to Cholesterol WebMD the Magazine | November/December 2010 DPrincess147 has had trouble sleeping for years. And one of her problems is that “most nights I have to ‘shake’ my legs out to get them to stop feeling funny,” she writes on the WebMD sleep disorders community. DPrincess147 may have Restless Leg Syndrome, which can cause burning, tugging, or creeping sensations in the legs. How much do you know about it? How do I know if I am at risk for a heart attack? What are my risk factors? 1 Lying down and resting can help ease restless legs. ● Can I control my cholesterol through lifestyle changes alone? 2 RLS may affect body parts other than the legs. ● Do I need to take cholesterol-lowering drugs? Will I need to take them long-term? 3 Drugs don’t treat RLS very effectively. ● How low can I realistically expect my cholesterol to go? What should I aim for? 4 RLS tends to last a lifetime. ● Staythe get Up on 411:Diabetes heart True True True True False False False SEARCH RCH Source: National Institutes of Health and the Center Did you know? Cutting down on caffeine, tobacco, and alcohol may ease RLS symptoms, though experts haven’t determined the connection. Questions for your doctor 1 2 What are the typical symptoms of RLS? How do I know if I have it? Do I have an underlying condition, such as diabetes or iron deficiency, that may be contributing to my symptoms? 3 4 Would lifestyle changes provide relief? If so, what kind of changes should I make? Do I need medication? How often and for how long will I need to take it? False Answers: 1. False. Sitting or lying down can trigger symptoms, such as burning or crawling sensations in the legs. 2. True. RLS usually causes discomfort in the lower legs, but also can affect the thighs, feet, arms, and hands, though it is less common in those areas. 3. False. Doctors treat RLS with many drugs, including ropinirole and other drugs that affect the brain chemical dopamine. Doctors surmise that RLS is related to dopamine, a chemical involved in body movement. The body’s dopamine system may not function properly in people with the condition. Other drugs prescribed to relieve RLS symptoms include opioids (narcotics that help people relax), seizure medications, and tranquilizers called benzodiazepines. 4. True. Usually RLS is a lifelong condition, but treatment can help control symptoms and increase restful sleep. Signthe Get up latest for thenews latestand news lifestyle and lifestyle management management tips for both type 1 and tips—delivered directly typeto 2—delivered your email inbox! directly Go to to your email inbox! Toand WebMD.com sign search up, go for to WebMD.com “heart health newsletter.” and search “diabetes newsletter.” cholesterol Source: Could RLS be keeping you up? False 4 There is no cholesterol in peanut butter. ● True cancer sleep Sleep Disorders Health Get the 411: sleep Sign up for the latest news and lifestyle management tips—delivered directly to your email inbox! Go to WebMD.com and search for “sleep well newsletter.” restless leg syndrome SEARCH RCH November/December 2010 | WebMD the Magazine 81 pain Join the MyBONIVA® Program for Sally’s Tips, plus one month of BONIVA free! Are your knees at ease? I wanted to stop my bone loss, but I did more. I reversed it with BONIVA.* Anon_61093 used to be a “pretty avid runner.” Then one day after a short run, his knee “locked up.” After a couple days of not being able to straighten it, he heard something “pop” and the pain eased although he’s still sore. “My goal is to get back to running ASAP so I don’t lose the progress I have been making in training,” he writes in WebMD’s Fitness and Exercise community. “But I don’t want to aggravate things and make matters worse.” Would you know what to do? Compression: To reduce swelling and provide extra support, compress your knee gently by wrapping it with an elastic bandage. Elevation: Limit swelling by elevating your knee above your heart level. If knee pain persists after three days, call your doctor. Source: Arthritis Foundation, the Centers for Disease Control and Prevention, Arthritis and the Health Center knee pain Get the 411: pain Sign up for the latest news and lifestyle management tips— delivered directly to your email inbox! Go to WebMD.com and search for “chronic pain newsletter.” SEARCH RCH • One month of BONIVA free*. • Sally Field’s tips on managing your osteoporosis and building stronger bones. • Helpful monthly reminders to take your BONIVA, delivered by phone, e-mail, or mail. • Quarterly newsletters filled with bone-strengthening exercises and simple, delicious recipes. B:11.125” Ice packs: Apply ice packs for 15 to 20 minutes at a time, four times a day, to keep swelling and pain down. MyBONIVA is a free program that gives you tips from Sally, ideas, and support to help manage your osteoporosis. You’ll get: T:10.5” Pain relievers: Over-the-counter drugs such as acetaminophen can ease pain, while ibuprofen and naproxen reduce pain and swelling. (Take only the recommended dose and for no longer than 10 days in a row without checking with your doctor.) Pain-relieving gels, salves, or creams that contain capsaicin may also relieve discomfort. S:9.125” Change activities: Hurting knees need time off. Stop running or doing anything that worsens the pain. Instead, stay fit with water workouts, swimming, walking, biking, and other activities that don’t put pounding pressure on knee joints. Also, weight training builds muscle strength, which helps support the knee. If you have osteoporosis, like me, calcium-rich foods, vitamin D, and exercise can help. But they may not be enough to keep your bones strong. So ask your doctor if once-monthly BONIVA can help you do more. Studies show, after a year on BONIVA, 9 out of 10 women stopped and reversed their bone loss.† And my test results proved I did, too. BONIVA is a prescription medication to treat and prevent postmenopausal osteoporosis. Ask your doctor if BONIVA is right for you. Important Safety Information: You should not take BONIVA if you have certain problems with your esophagus (the tube that connects your mouth and stomach), low blood calcium, cannot sit or stand for at least 60 minutes, have severe kidney disease, or are allergic to BONIVA. Stop taking BONIVA and tell your doctor right away if you experience difficult or painful swallowing, chest pain, or severe or continuing heartburn, as these may be signs of serious upper digestive problems. Follow the dosing instructions for once-monthly BONIVA carefully to lower the chance of these events occurring. Side effects may include diarrhea, pain in the arms or legs, or upset stomach. Tell your doctor and dentist about all the medicines you take. Tell them if you develop jaw problems (especially following a dental procedure) or severe bone, joint, and/or muscle pain. Your doctor may also recommend a calcium and vitamin D supplement. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. *Bone density measured at the lumbar spine after 1 year of treatment. Individual results may vary. † Bone density measured at the lumbar spine, total hip, or trochanter; 3 out of 4 at the femoral neck. Please read Patient Information on the next page. Enroll today. Call 1-888-434-6193 or visit BONIVAfreetrial.com and try BONIVA free. *You must be 18 years of age or older to join MyBONIVA. The free trial offer is limited to one per patient. MyBONIVA is a registered trademark of Roche Therapeutics Inc. Help Stop and Reverse Bone Loss BONIVA and symbol are trademarks of Roche Therapeutics Inc. © 2010 Genentech USA, Inc. All rights reserved. 82 WebMD the Magazine | November/December 2010 “Eat plenty of calcium-rich foods like yogurt, spinach, and cheese.” 10297400 T:6.75” cancer IMPORTANT FACTS ABOUT BONIVA (bon-EE-va) ibandronate sodium 150-mg tablet What is BONIVA? BONIVA, a bisphosphonate, is a prescription medicine used to treat and prevent osteoporosis in postmenopausal women, characterized by weakening of the bone. Taken once a month in tablet form, BONIVA may stop and reverse bone loss in most women. It has been clinically proven to help build and maintain bone density, which can help reduce fractures. What is the most important information about BONIVA? What’s your lung cancer risk? BONIVA may cause serious problems in the stomach and the esophagus (the tube that connects your mouth and stomach) such as trouble swallowing, heartburn, and ulcers. Who should not take BONIVA? Before you start BONIVA. Do not take BONIVA if you: Did you know? The No. 1 symptom of lung cancer is a persistent cough. If you have one, tell your doctor. Tell your health care provider if you: • have abnormalities with your esophagus, such as restriction or difficulty swallowing • have low blood calcium (hypocalcemia) • cannot sit or stand for at least 60 minutes • have kidneys that work very poorly • are allergic to BONIVA or any of its ingredients See Patient Information for complete list. • are pregnant or plan to become pregnant • are breast-feeding • have trouble swallowing or other problems with your esophagus • have kidney problems • are planning a dental procedure such as tooth extraction Smoking cigarettes is the most common cause of lung cancer. But it’s not the only one. As DavidK81719 notes on the Cancer Support message board, “Everyone is at some risk of lung cancer, just by the environment or genetics of our lives, but smoking increases the chance by a pretty good percentage.” Are you at risk? Tell your health care provider and dentist about all medications you’re taking, including vitamins, antacids, and supplements. How should you take BONIVA? 1 Do you smoke cigarettes, cigars, or a pipe? ● You must take BONIVA exactly as instructed by your health care provider. • Take first thing in the morning, on the same day each month. • After you take BONIVA, remain standing or sitting for at least 60 minutes before you eat, drink, lie down, or take any other oral medications, including calcium, vitamins, and antacids. Some medicines can stop BONIVA from getting to your bones. • If you take too much BONIVA, drink a full glass of milk and call your local poison control center or emergency room right away. Do not make yourself vomit. Do not lie down. Yes T:9.75” • Swallow whole (do not chew or suck) with a full glass (6 to 8 oz) of plain water (not sparkling or mineral). Do not take with tea, coffee, juice, or milk. • If you miss a monthly dose and your next scheduled BONIVA day is more than 7 days away, take one BONIVA 150 mg tablet in the morning following the day that you remember. Do not take two 150 mg tablets within the same week. If your scheduled BONIVA day is only 1 to 7 days away, wait until your next scheduled BONIVA day to take your tablet. Then return to taking one BONIVA 150 mg tablet every month in the morning of your chosen day, according to your original schedule. If you are not sure what to do if you miss a dose, contact your health care provider, who will be able to advise you. ● 2 Do you often breathe secondhand smoke? Yes No 3 Have you been repeatedly exposed to cancer-causing ● agents at work, such as asbestos, uranium, vinyl What are the possible side effects of BONIVA? Stop taking BONIVA and call your health care provider right away if you have pain or trouble swallowing, chest pain, or very bad heartburn or heartburn that does not get better. Follow dosing instructions carefully to decrease the risk of these effects. BONIVA may cause: Common side effects are: Less common side effects are: • Pain or trouble swallowing • Heartburn • Ulcers in stomach or esophagus • Diarrhea • Pain in extremities (arms or legs) • Upset stomach • Short-term, mild flu-like symptoms, which usually improve after the first dose Rarely, patients have reported allergic and skin reactions. Contact your health care provider if you develop any symptoms of an allergic reaction including skin rash (with or without blisters), hives, wheezing, or swelling of the face, lips, tongue, or throat. Get medical help right away if you have trouble breathing, swallowing, or feel light-headed. Rarely, patients have reported severe bone, joint, and/or muscle pain starting within one day to several months after beginning to take oral bisphosphonate drugs. Contact your health care provider if you develop these symptoms after starting BONIVA. Rarely, patients have reported serious jaw problems associated with delayed healing and infection, often following dental procedures such as tooth extraction. If you experience jaw problems, contact your health care provider and dentist. This summary is not a complete list of side effects. For a complete list, consult your health care provider or pharmacist. Want to know more? No c hloride, or coal products? Yes No 4 Have you had radiation therapy to the chest? ● Yes No 5 Do you have a sibling or parent who developed lung ● cancer? Yes No Answers: Each of these factors increases risk—especially smoking, which accounts for 80% to 90% of lung cancers. Cancer-causing substances at work and at home and radiation therapy to the chest, for example, after a mastectomy can up the risk—particularly if you smoke, too. Siblings and children of lung cancer patients may have a slightly higher risk, and some research suggests that a genetic abnormality makes certain people more susceptible. This summary is not everything you need to know about BONIVA. It does not take the place of talking with your health care provider about your condition or treatment. For more complete information, talk to your health care provider or pharmacist. Visit myboniva.com or call 1-888-MyBONIVA for the complete Prescribing Information, which includes the Patient Information. for your doctor 1 2 3 4 What are my risk factors for lung cancer? How much is due to lifestyle? Family history? Which risk factors can I change? What can I do to change them? How can I stop smoking? What’s the best way for me to quit—the patch, gum, medication? What are the lung cancer symptoms I should watch out for? get the 411: cancer Sign up for the latest news and lifestyle management tips—delivered directly to your email inbox! Go to WebMD.com and search for “cancer newsletter.” xxxx lung cancer Source: American Cancer Society and the Revised: March 2010 © 2010 by Genentech USA, Inc. All rights reserved. Questions SEARCH RCH Lung Cancer Health Center 10032001 November/December 2010 | WebMD the Magazine 85 WebMD checkup l love how a real clean smile smiles back at you.’’ ‘‘ 10 questions about your life and well-being CARRIE FISHER WRITER/ACTOR Your hit Broadway show and best-selling memoir, Wishful Drinking, is an HBO special airing in November. What’s been toughest: Living it, writing it, performing it, or watching it? Living it. I haven’t watched it yet. I don’t like watching myself because I’m overweight. I’m an overweight over-sharer. You’re hilariously frank about your misadventures: the pills, the men, plus growing up a celeb-u-spawn of the Brad and Jen of their day, Eddie Fisher and Debbie Reynolds. If you could change any of it, would you? It’s implausible; it’s not an option! Going through challenging things can teach you a lot; they also make you appreciate the times that aren’t so challenging. The only regret [I have with] my difficulties is making my daughter go through them. Note: Sadly, Eddie Fisher died two weeks after this interview was completed. You were born into celebrity royalty, then married and divorced music legend Paul Simon. And you’re an icon, too, famed for your star turn as an intergalactic princess. Was it tough to get past the infinite space of Star Wars? Have I gotten past it? I wasn’t aware that I had. I’m Princess Leia, no matter what. “Princess Leia” will be on my tombstone. Actor, writer, funny lady … bipolar disorder. Is it unsettling, empowering, or both to be a poster child for this condition? Well, I am hoping to get the centerfold in Psychology Today. It’s a combination of everything. But I define it, rather than it defining me. Stephanie Without the leveling effect of medication, are you more manic or depressive? Mostly mania. When I got older, depression became more of an issue. It turned into what they call agitated depression. I’d get really impatient. I was going much faster than everything else around me, and it drove me crazy. You feel out of step with the world. You’re a mom to Billie, now 18. Do you embarrass her, or does she embarrass you? I inspire a lot of eye-rolling. I have a manic personality. I’m not a master of the appropriate. Patrick Harbron/HBO You were officially diagnosed with bipolar at age 29, after initially being told you were an alcoholic and drug addict. Did your addictions mask bipolar behaviors? The first time they said the word bipolar to me, I was 24. The diagnosis when I accepted it? I was 29. I was a year sober and I was pretty crazy. I thought once I got diagnosed [as] an alcoholic, that was the problem. Well, yeah, that was part of it. But it was the solution, not the problem. What’s your guilty-pleasure, forget-the-diet-I-just-don’t-care-anymore food escape? I eat Peanut Butter Balance Bars to the point where they should have a support group for me. You recently appeared on HBO’s Entourage, and you were nominated for an Emmy in 2008 for your portrayal of a TV writer on 30 Rock. What’s next for you? When I was little I didn’t want to be an actress. I can do it, but my personality always comes along with me. I’m not an artist like Meryl [Streep, Fisher’s close friend]. I’m a writer and, it turns out, a performer. I’m a persona more than a person. I’m designed more for public than private. Is humor essential to good health? How often do you belly laugh? Yes! I laugh a lot, actually. A lot. I’ve gotten to an age where I enjoy my life. I’ve spent enough time struggling with it, and at this point it’s living on one side of the magnifying glass; I stay on the side of making big things appear small. I enjoy myself and I have a lot of good friends, good relationships. You learn to get there.—Lauren Paige Kennedy Love your toothbrush. Switch to Sonicare. Philips Sonicare Flexcare+ has been designed to make mouth care simpler than ever. Its patented sonic technology sets the highest standards for plaque removal, while the Gum Care mode safely and gently decreases gum bleeding and helps prevent gum recession. And with notable results in just two weeks you’ll have something to smile about. To find out why people around the world Read Carrie Fisher’s full interview. 86 WebMD.com WebMD the Magazine | November/December 2010 love their Philips Sonicare, visit www.facebook.com/PhilipsSonicare