“Use good S-E-N-S-E, an acronym for Start Exercise Nice and Slow, Every single time.

Step 1: Start easy. Walk a comfortable pace and time. Use a watch to time your walk. Work up to walking for ten minutes at a moderate pace, three times a week.

Step 2: Stick with it for one week.

Step 3: Now, walk for 11 minutes, 3 times a week.

Step 4: Continue increasing your walking time by 10 percent each week. The American College of Sports Medicine recommends getting 30 minutes of moderate exercise, five days a week. But the 30 minutes can be broken up into ten-minute segments.

Remember: Start Exercise Nice and Slow, Every single time. You can do it!”

Watch for a future Medical Update posting to find out what Davis thinks about trendy new fitness shoes.

Click here for information on finding shoes that make you want to walk!

Dr. Page: They were introduced in the 1990s, and American Airlines began putting defibrillators on aircraft in 1997. I was at the University of Texas Southwestern Medical Center in Dallas at the time. We worked with American Airlines and I reported the experience in the New England Journal of Medicine. A study of AEDs in casinos was conducted at the same time and those results appeared back-to-back with the aircraft article. In 2000, the American Heart Association named the AED one of the top 10 cardiac research advances. It’s gratifying that AEDs are being placed in more and more venues. But it’s distressing that they aren’t everywhere yet.

It is important to note that AEDs are automated external defibrillators rather than automatic external defibrillators. People get this wrong all the time. There is a wearable vest defibrillator that automatically gives a shock for SCA.  But the AEDs in health clubs, hospitals, police cars, aircraft, and casinos are automated, not automatic. These devices will not deliver a shock until the human operator pushes a flashing red button.
 
Post: Who can use a portable defibrillator?

Dr. Page: I think anyone can. Some states require authorization to use these devices, and I support the American Heart Association’s efforts to train the public. But the simplicity of these devices was demonstrated by investigators in Seattle, who did a small study with mannequins, 6th graders, and paramedics. They instructed the 6th graders (who had no prior experience with an AED) to figure out the device and save the life of a mannequin. Results published in the journal, Circulation, one of the best heart journals, showed that 6th graders delivered a shock in 92 seconds. Well-trained Seattle paramedics accomplished it in 60 seconds. So it is better to be trained, but almost anyone can figure out how to use an AED.
 
Training is important, but if I had a cardiac arrest and no one knew how to use an AED, I’d much rather that a bystander try to figure it out than wait 10 minutes for an ambulance to get to me. In the casino experience, a setting in which every arrest was videotaped, three out of four victims survived if they were shocked within three minutes. In contrast, less than one in 20 survives SCA in most cities. 

Post: What about “no-hands” CPR?

Dr. Page: I was one of the co-authors that issued the AHA scientific advisory statement in 2008 recommending compression-only CPR for adults who experience sudden cardiac arrest outside of the hospital. The advisory group and the American Heart Association have gotten behind the idea of hands-only CPR.
 
This makes sense for many reasons. For example, if I have sudden cardiac arrest right now, I have plenty of oxygen in my blood—what I need is circulation. We know from some very important research in animals and in humans that in CPR you need to pump hard, fast, and continuously to maintain blood pressure. After every pause in chest compression, you have to work to build up the blood pressure again. Mouth-to-mouth breathing probably isn’t necessary. Chest compressions actually move some air, too.
 
Post: Can someone be sued for using an AED if the victim dies or gets brain damage?

Dr. Page: Probably not, because every state has Good Samaritan laws in place. The operator has almost no liability risk, as long as he or she is operating in the best interest of the individual.

Post: You mentioned earlier that these devices are more accessible, but there aren’t enough of them. Why is that?

Dr. Page: One challenge is public awareness, getting the word out. Another is a mistaken concern about liability, as we’ve discussed. And finally, cost is an issue. If AEDs cost the same as fire extinguishers or smoke detectors, we would have more of them out there. I don’t generally support AEDs in homes because the overall likelihood of one being used is so small that our health dollars would probably be better served in other ways.

Post: Even though most sudden cardiac arrests happen at home?

Dr. Page: Yes. The problem is that many of these events occur when the person is asleep or alone, so having an AED would be of no benefit. Although a home AED would not hurt, and some people elect to purchase these, I am primarily interested in campaigns to place AEDs in more public places.
 
Post: If people are interested in doing something like that, where do they start?

Dr. Page: They can contact the Heart Rhythm Society or the American Heart Association for advice. The Heart Rhythm Society has advocated strongly on behalf of patients at risk for and who have experienced cardiac arrest, and we maintain an active Web site. Area physicians may also be a good resource for grassroots campaigns and local champions.
 
Post: What do you expect might be the next breakthroughs in preventing SCA and saving lives?

Dr. Page: I envision two avenues. One is better identification of those individuals who are at the highest risk for SCA and would benefit most from an ICD to modify that risk. The second (because we won’t identify everybody at risk) is to increase awareness of SCA, improve accessibility to AEDs, and increase the number of people who are trained in CPR and AED use.  
 
I’ll tell you an interesting story that occurred while Charlie Jones, Heart Rhythm Society Vice President of Marketing, Communications and Membership, and I were visiting a number of media outlets on the east coast. After we landed in D.C. and were driving away from National Airport, Charlie noticed something unusual by the side of the road and said, “I think someone’s down there.”
 
We stopped, and there was a man in his 50s who had experienced sudden cardiac arrest while jogging along the road. Bystanders were already doing two-person CPR with beautiful respirations, so I didn’t interfere with that other than to take my turn at chest compressions. Occasionally the victim would make a gasping breath and people said, “Oh, he’s breathing, let’s stop.” But I said, “No, no, keep going” because I knew the gasping breath was a brain stem response, not a conscious one. When the ambulance arrived with the AED, a single shock was delivered. One shock, and he had been down probably 15 minutes or more! He awoke and actually gave us a thumbs-up when he got in the ambulance.
 
Isn’t that amazing? The experience reminded me that CPR, when well performed, pumps blood well to the heart and brain. CPR can keep someone alive until the person gets that lifesaving shock from the AED. Being familiar with CPR and AEDs really does save lives.
 
Click here for Part 1: Understanding SCA. 5 facts about sudden cardiac arrest and heart attack.
Click here for Part 2: Preventing SCA. Are you at risk?

Although anyone can get meningitis, preteens and teens are at higher risk of its most dangerous form than other age groups—and more likely to die from it, too. 

Meningitis caused by meninogococcal bacteria can take the life of an otherwise healthy young person in a single day. Fortunately, a simple shot is available to protect against the serious infection. 

The Centers for Disease Control and Prevention (CDC) recommend a vaccine to prevent four common types of bacterial meningitis for youngsters 11 to 18 years of age and college freshmen living in dormitories, as well as individuals with weakened immune systems, military recruits, and some overseas travelers. 

Meningitis occurs when the fluid-filled membranes (meninges, men-IN-geez) that cover the brain and spinal cord become infected and swollen. Viral meningitis usually resolves in two weeks with little treatment. However, bacterial meningitis is extremely serious and requires immediate treatment at a hospital with antibiotics and medicines to prevent amputation of arms, legs, fingers, and toes; brain damage; hearing loss; or kidney damage. 

Symptoms of the two types are similar, which is why anyone with a high fever, headache, and stiff neck should seek medical help right away. Other warning signs of the disease are nausea, sensitivity to light, confusion, and sleepiness. 

“I lost both of my legs, my kidney, my spleen, half my hearing, and almost my life to meningitis. And I’m one of the lucky ones,” recalls Amy Purdy, who contracted meningococcal disease when she was 19. 

Amy Purdy
Credit: Paul Smith Photography, courtesy of the Voices of Meningitis campaign

Safe and effective vaccines are available for people ages 2 through 55 who want to protect themselves from meningitis. Less than half of children age 11 to 18 have been immunized, however, placing millions at risk for the rare but potentially devastating disease. 

Remarkably, Purdy not only survived but later won medals in the USA Snowboard Association’s snowboarding competition and competed in the ESPN Extremity Games. Today, she is a motivational speaker and also works as a model, actress, and make-up artist. 

“If I knew about meningococcal disease, including meningitis, and that a vaccine existed to help prevent it, I would have made it a priority to get vaccinated,” she says. “I know firsthand how serious it can be, and I want to help raise awareness about meningococcal meningitis and encourage preteens and teens to get vaccinated.” 

Click here http://www.voicesofmeningitis.org/get-the-facts-the-basics.html for more about Purdy’s story, and additional information about meningitis from the National Association of School Nurses. 

Click here http://www.cdc.gov/meningitis/vaccine-info.html for details on the CDC’s meningitis vaccine recommendations.

Make the most of family time with these suggestions from Malcolm and Laura Gauld, parenting experts and co-authors of the parenting book “The Biggest Job We’ll Ever Have” (Scribner).

Build positive attitudes. Take time out every week to create and build upon family traditions. During the summer months, walk on a trail or to the park, prepare a meal together, or volunteer at the local animal shelter.   

Talk about the important stuff. Hold weekly family meetings (even for only 15 minutes) to share ideas, challenges, and stories. 

Share the load. Assigning family jobs teaches responsibility and gives teens an opportunity to learn what they enjoy – painting, repair work, gardening, etc. 

Insist on fun. Schedule a time to do something fun and silly. Sure, teens may resist at first, but the positive effect of laughing for 30 straight minutes cannot be overestimated. 

Don’t take yourself too seriously. Demand respect, but let the comments your teenager makes roll off. 

For more from Malcolm and Laura Gauld, visit their blog at greatparenting101.com. 

Seconds Save Lives

Practical advice (and a free brochure) from emergency care experts helps you take action in case of a medical emergency.

“Nobody plans an emergency, but you can take steps to be prepared for one,” said Dr. Angela Gardner, president of the American College of Emergency Physicians (ACEP). “The most important—and yet sometimes the most difficult thing to do—is to keep your composure. You will be better able to provide critical information to emergency responders and physicians, whether for yourself or someone else.”

To get started, enter emergency contact information into your cell phone under the name “ICE” (for In Case of Emergency) and make sure family medical information is organized and available to take to the emergency department.

Then, click here to download a free ACEP brochure that tells bystanders when to call for help, what to say, and what to do while waiting. Share the information with your family, and keep copies in your billfold or glove compartment.

“Everyone is only one step away from a medical emergency,” reminds Dr. Gardner, “and when it happens, seconds can save lives.”

Is Your Public Pool Safe? Test it!

Unhealthy swimming pools are more common than you may think, warn experts from the Centers for Disease Control and Prevention (CDC) who are encouraging swimmers to take action this summer with free test kits from the Water Quality & Healthy Council.

“Chlorine and pH are a key defense against germs that can make swimmers sick,” explains Michele Hlavsa, Chief of the Healthy Swimming Program at the Centers for Disease Control and Prevention. In contrast, improperly chlorinated water puts swimmers at risk for recreational water illnesses (RWIs) like diarrhea and ear and skin infections.

Last year’s survey by the Water Quality and Health Council found that one in five Americans pee in the pool.  Urine, as well as sweat and sunscreens, contains nitrogen that eats up some of a pool’s free chlorine, making it less effective in fighting off waterborne germs.  

“You can’t always trust your fellow swimmer to practice healthy swimming habits,” said Chris Wiant, Chair of the Water Quality and Health Council.  “But, what you can do is test the chlorine level and pH of the water to make sure your pool is properly treated – and immediately approach pool staff if it is not.”

RWIs are on the rise. Are you swimming in an unhealthy pool?  Don’t get in the water if you:

• Can’t see the floor drain in the deep end of the pool;
• Can’t hear the pool pump running;
• Do smell a strong chemical odor; or
• Do feel sliminess on tile walls.

Read more healthy swimming tips at the CDC’s website.

Finding a Missing Loved One

EmSeeQ device
Courtesy of EmFinders

What do children with autism, people with Down syndrome, and adults with Alzheimer’s have in common? All tend to wander—and with potentially life-threatening consequences, of course. 

Most of us have experienced panic and fear when a child has wandered in a store or other public place. But for families with loved ones affected by cognition disorders, the risk of wandering is a daily yet rarely talked-about reality. 

A new cellular device may help. The EmSeeQ from EmFinders is fully integrated with the nationwide 9-1-1 system. When triggered by the parent or caregiver, the watch-like device sends digital signals to emergency responders to quickly locate and recover the person who has become disoriented and lost.

For more information on price and coverage area, see emfinders.com.

“A major stroke can change everything—the ability to speak, to move, to work,” says Dr. Walter Kernan, professor of medicine at Yale University School of Medicine, in the Post article. “It may seem to rob a person of his life without actually taking it.” 

Fortunately, advances in the field of rehabilitative medicine are helping stroke victims regain their ability to walk and talk with family, friends, and co-workers. 

Specialized Speech Therapy

Doug Gillis, 44, owner a softball academy in Michigan, had a stroke in 2006 that left him with aphasia, a language disorder that affects about one million Americans.  

People with aphasia cannot always speak the words that they want to say. Some with the disorder also have trouble understanding others, or find it difficult to read or write. It does not affect intelligence. Stroke is the leading cause of aphasia. But brain tumors, infections, and head injuries, among other conditions, may be to blame.  
 
Gillis said his first word one week after the stroke, and his first sentence eight weeks later. He then enrolled in The University of Michigan Aphasia Program (UMAP) <http://www.aphasiahelp.com/>, and made significant progress. 

“We take a unique approach to aphasia therapy,” explains Annie Kennedy, M.A., CCC-SLP, Associate Clinical Services Manager, UMAP, “and provide an individualized therapy program with a limited number of clients to ensure a high ratio of staff-to-clients for the most direct and effective one-on-one treatment.  

“Our key distinguishing factors include: a six-week intensive therapy program, clinically trained professional speech language pathologists, and an approach that incorporates caregiver education and support. The UMAP is the oldest program of its kind for the treatment of aphasia in North America.”

Today, Gillis is back at work and often speaks before large groups of students, athletes, and coaches. 

“It was overwhelming to learn language all over again and frustrating when I couldn’t find the words I wanted to say,” Gillis said.  “But, with time and patience, and a good team of experts helping me at UMAP, I regained a high percentage of my language abilities.”

Specialized speech therapy programs for aphasia are available across the country. Click here https://www.aphasia.org/aphasia_community/programs_and_centers.html for a national listing of programs and other information from the National Aphasia Association.

Physical Therapy Breakthrough

A wearable device system from Bioness http://www.bioness.com/Home.php called the NESS delivers mild electrical impulses to the arm or leg and helps stroke survivors move again—offering hope even to those who suffered strokes years ago. 

The FDA-approved NESS L300 consists of a small transmitter worn in the shoe that sends electronic signals to a device strapped below the knee. When the person attempts to walk, mild impulses stimulate the peroneal nerve in the leg, prompting under-active muscles to lift the foot off the ground. The NESS H200 works in a similar way to improve hand function and mobility.

Bill Hefferon is back on the golf course, thanks to the NESS L300 from Bioness.

Bill Hefferon, 73, of Naples, Florida, was unable to walk on his own from his bed to the bathroom after suffering a stroke 10 years ago. But within months of starting therapy with the NESS L300 in 2008, Bill no longer needed a cane and was back on the golf course.

“Using the NESS L300 has increased my stability and stamina” says Hefferon. “Now, I can golf  and go dancing with my wife again, something we enjoy doing together.” 

At age 7, Joe Breiner of Wauwatosa, Wisconsin, had a stroke that immobilized his left arm and leg. Today, the NESS H200 enables the 40-year-old husband and father of two to open and close his hand.

“The Bioness H200 has provided me with hope,” says Breiner. “Since I started using the device, I can perform many daily functions that before were a real struggle for me. The H200 is not a magic cure—it takes hard work and dedication for users like myself to see results. But through hard work and the will to recover, great results are attainable.”

“The Bioness devices may help those who suffer from leg and hand mobility issues to gain back movement and independence,” explains Michael W. O’Dell, M.D., Chief of Clinical Services, Department of Rehabilitation Medicine at New York‑Presbyterian Hospital‑Weill Cornell Medical Center and Medical Director of the Inpatient Rehabilitation Medicine Center. “These devices are appropriate for individuals experiencing neurological conditions including stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, and some types of neurological cancers.

“Persons who have retained at least some degree of voluntary movement in their muscles may have a better chance of success with Bioness devices.”

Your Feedback Matters

Are you a stroke survivor or caregiver? The National Stroke Association http://www.stroke.org/site/PageNavigator/HOME?cvridirect=true is conducting an online survey to help gauge your awareness of two conditions that affect millions of stroke survivors: spasticity (uncontrollable tightening of muscles) and pseudobulbar affect (unpredictable episodes of laughing or crying, sometimes referred to as IEED or Involuntary Emotional Expression Disorder). To take the 10-minute survey, click here https://www.strokesmart.org/limesurvey/index.php?sid=52343

Hand in Hand for RA

Nearly 75 percent of people with RA are looking for ways to be more active and give back to their communities, according to a 2009 online survey of 501 men and women with the condition. In addition, about 30 percent of the respondents report volunteer work helps them better manage their RA symptoms.

Debbie McGrady, diagnosed with rheumatoid arthritis about 10 years ago, knows from personal experience that helping others is good medicine for one’s own health challenges, too.

Having a serious illness prompted the Indiana resident to reassess her life goals and priorities. As a result of her personal “revolution,” the mother of two let go of self-imposed physical limitations and began to connect with others in new ways. Today she works part time, drives seniors to their doctor’s appointments, and remains committed to staying fit.

Click here http://www.handinhandforra.com/ to read more about McGrady and other inspiring volunteers who are living well with RA. The Web site, sponsored by advocacy group CreakyJoints http://www.creakyjoints.org/ and drug companies Genentech and Biogen Idec, also provides a list of suggested volunteer activities that are easy on the joints in addition to tips for managing the disease. 

New Way RA

Now in its second season, Deborah Norville’s online talk show, New Way RA, http://www.newwayra.com/ features panelists Amye Leong, RA advocate and spokesperson for the United Nations Bone and Joint Decade, and Sara Nash, author of the RA blog The Single Gal’s Guide to Rheumatoid Arthritis <http://singlegalsguidetora.typepad.com/>.  

Monthly episodes will offer information and advice about diagnosing RA, connecting with a rheumatologist, and easy-to-wear looks for everyday style. Registration is free, but required to view current and past episodes.

For more Post coverage on living with RA, including foods to reduce inflammation, click here.

Preventing Sudden Cardiac Arrest

Every two minutes, someone collapses and dies from a malfunction in the heart’s electrical system—a condition called sudden cardiac arrest or SCA—and most of the victims have no idea they are at risk for the tragic event.

“That’s absolutely true,” says Dr. Richard Page, immediate past president of the Heart Rhythm Society and chair of the Department of Medicine at the University of Wisconsin School of Medicine and Public Health. “While a single individual’s chance of dying suddenly is quite small, there are so many people out on the street with some risk that the overwhelming majority of SCA victims have not ever demonstrated cardiac disease.”

The challenge for SCA researchers is two-fold, according to Dr. Page, who recently took time to discuss with us the latest findings on SCA risk factors and symptoms, as well as advances in preventing the heart emergency and saving lives. 

“It comes down to two questions,” explains the heart rhythm specialist. “How can we better identify those at risk? And, given the fact we can’t identify all (or even most) of the potential patients: How do we address sudden cardiac arrest when it does happen?

Post: About 250,000 Americans die of sudden cardiac arrest every year. Who is at most at risk?

Dr. Page: Ongoing research confirms that heart structure is an important risk factor. People with an enlarged heart, or heart damage from a prior heart attack, are at higher risk for SCA than those with normal heart structure.       

Remember, a heart attack isn’t a sudden cardiac arrest; a heart attack is death of heart tissue due to a blockage in an artery. A person who has a heart attack doesn’t lose consciousness, unless they have a cardiac arrest on top of that.

But it is clear from large, multi-center, randomized studies that many patients with prior injury to the heart or enlargement of the heart are better off with an implanted cardioverter defibrillator (ICD) than without one.

More recently, we have identified certain families who are at higher risk because of cardiomyopathy (a condition in which the heart is enlarged or thickened) or an electrical abnormality called long Q-T syndrome that can be seen on the EKG test. In addition, investigators are identifying the genetic abnormalities that underlie these conditions, as well as some genetic traits that may put one at higher risk of sudden cardiac arrest that are less subtle than abnormal heart structure or function.

Post: Is genetic screening for SCA risk available yet?

Dr. Page: Genetic tests for the general population are not ready for primetime because the genes don’t predict risk adequately. An abnormal EKG, for example, may or may not represent a significant risk to the individual. But we may have genetic tests for general screening five or ten years from now.

Likewise, there continues to be some debate as to the proper way to screen athletes. In Europe (particularly in Italy) everyone who participates in sports is screened with an electrocardiogram. The American Heart Association doesn’t yet recommend that. But they do advise that people be examined and asked about personal and family history. If someone has family members who died suddenly, he or she is clearly at higher risk for SCA and should be evaluated further.

Post: You mentioned that Italy recommends EKGs. Don’t we use echocardiograms (Echos) to screen U.S. athletes?

Dr. Page: We do both in some cases—but according to the risk. The most aggressive method of screening athletes is an exam, a history, an EKG, and an Echo. The echocardiogram defines heart structure. It provides a two-dimensional moving picture that shows chamber size and wall thickness. An EKG provides indirect evidence of structure. For example, alterations in electrical activity may suggest hypertrophy, or a prior heart attack. It doesn’t necessarily tell you if the heart is enlarged or damaged the way an Echo does, but it’s a simple and less expensive test.

Another point about universal screening: Some might say, “Well, let’s just screen everybody.” Well, the problem is that the tests aren’t perfect. If you screen a low-risk population, there will be some false positive results. I am concerned that the Italian protocols have excluded too many athletes. So universal screening of athletes might cause undue concern, and even cause some athletes at low risk to stop competing. Universal screening of low-risk individuals is a double-edged sword.

Are there any symptoms or warning signs of SCA?

Dr. Page: There may be symptoms in some cases. An important warning is passing out, or fainting. Most episodes of passing out are not a cause for alarm. But people should get checked out if they pass out while exercising, or if they experience palpitations and feel close to passing out. In addition, those with a history of heart attack or heart failure need to know their ejection fraction—a number that reflects the percentage of blood that is pumped from the left ventricle with each heartbeat. A good, efficient heartbeat pumps out more than half the blood in that chamber. When the heart is enlarged or scarred, however, the ejection fraction can drop below 35 percent or less. These people are at higher risk of SCA, and may be candidates for an ICD. A patient ought to be able to ask a doctor, “Is my heart enlarged, and if so, is there a number that would suggest I should have a defibrillator implanted?”

Post: What type of test is used to determine the patient’s ejection fraction?

Dr. Page: The most common test used to determine the ejection fraction is the echocardiogram. As I mentioned earlier, this test is basically a two-dimensional movie. Geometric calculations of the chamber volume just before and after the left ventricle squeezes suggest how much blood is pumped from the heart. For example, if the volume was a hundred before it squeezes and 50 after it squeezes, that’s an ejection fraction of 50 percent, which is good. But if the volume was 100 squeezing down to 75, that’s an ejection fraction of 25 percent, which is bad, and adds risk for sudden cardiac arrest. 

Post: What should people do to lower their risk of SCA?

Dr. Page: If you have a personal or family history of recurrent pass-out spells, see a doctor. But all of us (whether or not we have heart disease) should care of our hearts. Discuss your cardiovascular risk factors with your doctor. Then, stop smoking, eat properly, exercise, control diabetes, and keep blood pressure and cholesterol in check to protect your heart and blood vessels.  

Minimizing the risk of developing heart disease lowers the risk of heart damage and sudden cardiac arrest. Every day, I tell patients they ought to exercise. I don’t want to be a hypocrite, so I work out between 4:30 and 5:30 each morning, and then go to the office. I wish I ate a perfect diet, but I am trying!

Click here for more on SCA and an animation of the life-threatening emergency from The Heart Rhythm Society.

Watch for more from Dr. Page about saving lives with automated external defibrillators (AEDs) in a future Medical Update posting.

Check nutrition labels at local and online stores for pastas, breads, and snack foods with these three “super” ingredients to boost fiber consumption, lower cholesterol, and control your appetite:

Plant sterols

Derived from corn and soybeans, plant sterols help reduce artery-clogging low-density lipoprotein (LDL) levels by blocking cholesterol absorption in the gut. Consuming 800 mg of the sterols each day lowers LDL by 8 percent to 15 percent within four weeks, say federal health experts. People with high cholesterol may benefit from higher amounts, up to 2 g daily.

A new line of pastas and pasta sauces called Racconto Essentials Heart Health is fortified with 400 mg of CoroWise plant sterols per serving. The pasta also provides 28 percent of the daily fiber recommendation and is low in fat.

Chef Gerard Viverito, Director of Culinary Education
Courtesy of Gerald Viverito

Chef Gerard Viverito, Director of Culinary Education for Passionfish blends traditional recipes with nutritional ingredients for healthful results, a style of cooking that he refers to as “functional cooking.”

Click here for two Racconto pasta recipes created by Chef Viverito exclusively for Post readers.

Other products with plant sterols include: Benecol,
 Promise, and Smart Balance margarines;
 Minute Maid Premium Heart Wise Orange Juice,
 Kroger Active Lifestyle Fat Free Milk,
 Health Valley Heart Wise Cereal 
Nature and Chewy Granola Bars;
 Oroweat Whole Grain & Oat Bread;
 Right Direction Cookies;
 CocaVia Milk Chocolate Bars; and VitaTops muffin tops.

“To ensure you are getting an optimal amount of cholesterol-lowering plant sterols, look for the CoroWise logo on the label,” suggests Dr. Joe Keenan, a leading researcher on micronutrients for the heart, including plant sterols. “Combined with 45-60 minutes of aerobic exercise five to six days a week, you can help to significantly lower your risk of heart disease and still enjoy foods you love to eat!” 

Resistant starch

Commercial bread products with a Hi-Maize resistant starch logo contain a type of starch that staves off digestion until reaching the colon, where it may contribute to digestive health and offer other key benefits. Whole grains, fruits, and legumes are naturally rich in resistant starch (RS).

Click here http://www.saturdayeveningpost.com/2009/06/25/wellness/general-health/food-in-the-news/type-fiber.html to learn more about RS and foods that contain it.

Salba (chia)

The tiny seed of the Salvia hispanica L. plant, better known as chia and widely available online, is surprisingly nutritious. Sprinkling 2 tablespoons of Salba (a commercial chia seed product studied at the University of Toronto) on a serving of hot cereal, yogurt, and other food adds about 3.6 g of omega-3s and 6 g of fiber, along with calcium, iron, magnesium, and other nutrients to one’s diet.

For more information, products, and recipes, visit http://www.saturdayeveningpost.com/2009/02/11/wellness/general-health/research-front/wholegrain-promise.html

Birth defects, infections such as measles and meningitis, and excessive noise exposure can irreversibly damage delicate cells within the cochlea. As voices and sounds become muffled or distorted, people tend to withdraw from social gatherings as well as conversations at home and work.

“It’s easier than asking someone to repeat, and repeat, and repeat, Mary Kay Windham wrote in the January 2010 Post article “Wired for Sound” about the Envoy Esteem fully implantable hearing device that uses the natural eardrum to detect sounds and was FDA-approved in March.

Electronic cochlear implants bypass the eardrum and transmit sound by stimulating the cochlea to restore hearing. Once reserved for young children with severe to profound hearing loss, adults age 65 and older who aren’t helped by standard hearing aids can also derive significant benefit from modern versions of the sophisticated cochlear devices, according to a May 2010 study from the Medical College of Wisconsin, Milwaukee.

Courtesy of Cochlear Americas

Recently, an elite group of high school graduates was awarded the Graeme Clark Cochlear Scholarship for exceptional achievements in the classroom and community.

Each student has the Nucleus 5 cochlear implant http://products.cochlearamericas.com/cochlear-implants, a hearing system for children and adults with severe to profound hearing loss from Cochlear Americas that became available to the public in September 2009.

“What makes this new implant so remarkable is that it is significantly smaller than Cochlear’s previous implant and any others, resulting in a more natural fit for adults and children,” said Bruce Gantz, M.D., Professor and Head of the University of Iowa Department of Otolaryngology, Head and Neck Surgery.

Recipients of the four-year college scholarships are:

• Caroline Cook: Enrolled at York University, Caroline enjoys sprint canoeing and kayaking. Memorable “firsts” after receiving a cochlear implant include hearing the starting pistol at kayak races and the piano music that she herself was playing.
• Rahul Rajagopalan: Enrolled at Massachusetts Institute of Technology, Rahul credits his independent lifestyle and improving social skills to the hearing implant.
• Nathan Sarapas: Now studying civil engineering at Worcester Polytechnic Institute, Nathan says a cochlear implant helps him excel in the classroom and contribute to his community through the Boy Scouts of America.
• Jake Spinowitz: A student at the University of Pennsylvania, Jake opted for a cochlear implant while in the ninth grade and has since taught himself to play guitar. He also created a community program to collect used hearing aids for distribution to those who can’t afford them.
• Matthew Wolff: A TV and film major at Northwestern University, Matt received a cochlear implant at the age of three. To help others with hearing loss, he volunteers for the Hearing Loss Association.

“Cochlear Americas is proud to sponsor an initiative that encourages academic success among Nucleus recipients, providing a solid foundation for future professional and personal achievements,” said Chris Smith, president, Cochlear Americas. “The five winners of this year’s Graeme Clark Cochlear Scholarship, along with all of the applicants we considered, are examples of what young adults with a significant hearing impairment can achieve when given the opportunity and support to do so.”

The Post extends a congratulations and best wishes to these inspiring young people.

Top 5 Tips from the American College of Emergency Physicians:

Safe Meals: Use a meat thermometer. Cook fresh poultry to 165 F, hamburgers to 160 F, and beef to at least 145 F. Refrigerate all perishable food within 2 hours, 1 hour if the temperature outside is above 90 degrees F. Keep uncooked meats away from other foods.

Safe Grilling: Thoroughly clean a grill of any grease or dust. On gas grills, check tubes leading into the burner for any blockages from insects or food grease and replace connectors if needed. Do not use a grill in a garage, breezeway, carport, porch, or near any surface that can catch fire. Always follow the manufacturer’s instructions that accompany the grill.

Safe in the Water: Don’t drink alcohol when swimming or boating. Wear a lifejacket whenever you are on a boat. Make sure young children are supervised at all times when near the beach, on a boat, or by a pool or hot tub. Don’t swim alone or in bad weather. Learn to swim and teach your children to swim. We also recommend that you learn CPR in case of an emergency.

Safe in the Sun: Protect against sunburn and heat stroke. Wear sunscreen with an SPF of 15 or higher and apply it generously throughout the day. Wear a hat outdoors and UV-blocking sunglasses to protect your eyes. Drink plenty of water, especially when in the sun or sweating heavily. If you feel faint or nauseous, get into a cool place immediately.

Safe on the Road: Don’t drink alcohol and drive or travel with anyone who has been drinking. Wear your seatbelt at all times. Make sure your vehicle has been properly serviced and is in good working shape before a long road trip. Familiarize yourself with your surroundings and know the location of the nearest emergency room in case of an emergency.

“Many of the factors that will determine your safety over Memorial Day weekend—and any time this summer—come down to good decision-making and common sense,” said Dr. Gardner. “As someone who sees the consequences up close, my best advice is: know your limits, be mindful of certain risks and stay smart.”

In this two-part series, we offer exclusive online information about stroke symptoms, risk factors, treatments, and rehabilitation strategies to accompany the May 2010 Post Investigates feature: “Stroke Advances,” in which researchers tap into the brain’s remarkable ability to rewire itself, by Anne Underwood.

First Things First

Remember that strokes strike quickly, and you should, too. If you think someone may be having a stroke, think F-A-S-T:

F = FACE

Ask the person to smile. Does one side of the face droop?

A = ARMS

Ask the person to raise both arms. Does one arm drift downward?

S = SPEECH

Ask the person to repeat a simple phrase. Does the speech sound slurred or strange?

T = TIME

If the person shows any of these symptoms, time is important. Call 911 or get to the hospital fast. Brain cells are dying.

According to the National Stroke Association, a stroke occurs when a blood vessel breaks (called a hemorrhagic stroke) or a clot in a blood vessel that leads to the brain eventually becomes lodged and blocks blood flow to the brain (an ischemic stroke). Stroke symptoms can come and go as damage progresses, and may be difficult to recognize.

“This is the time when you need to be aware of specific stroke symptoms. Watch for them in loved ones especially, because they can be hard to notice in yourself,” advises Dr. Mateo Dayo of the Venice-Ocala Heart Institute.

Women at Risk

Stroke statistics for women are alarming. While many think of stroke as a man’s disease, women are more likely than men to suffer a disabling stroke, and, sadly, to die from it. In fact, strokes pose a greater threat to women’s health than breast cancer.

A unique set of risks—including hormones (related to birth control pills and hormone replacement therapy), migraines, and pregnancy—put women at special stroke risk.

Lack of awareness also plays a role. In a recent survey, 40 percent of women said they were only somewhat or not at all concerned about having a stroke in their lifetime.

Yet another challenge is that stroke symptoms in women may differ from those that men typically experience.

Common warning signs of stroke include: sudden numbness or weakness, especially on one side of the body; confusion and trouble speaking or understanding; trouble seeing in one or both eyes; trouble walking, dizziness, and loss of balance or coordination; and severe headache with no known cause.

But women may experience sudden face and limb pain, hiccups, nausea, general weakness, chest pain, shortness of breath, and palpitations, according to American Stroke Association experts.

Health professionals are aware of these differences. Unfortunately, many stroke victims and their loved ones aren’t.

“Women experience 60 percent more stroke deaths than men every year,” Dr. Dayo says. “That’s why it is so important for women to be aware of any changes in their body’s normal functions. Call 911 and remember when symptoms first appeared so early medical action can be taken.”

Plan Now For ER Stroke Care

Timely treatment with the clot-busting drug tPa (tissue plasminogen activator) at a hospital certified as a primary stroke center can help the 85 percent of patients whose strokes are caused by clots in the brain.

“Sadly,” says Dr. Ralph Sacco, a neurologist and president of the American Heart Association (of which the American Stroke Association is a division) in the May 2010 Post article, “only about 5 percent of patients actually get it because they don’t reach the hospital in time or they don’t go to a primary stroke center, which can give it rapidly.”

Six out of 10 Americans don’t know where stroke-certified hospitals are in their communities. To find stroke care near you, click here http://maps.heart.org/quality/ for a stroke Web mapping site from the American Heart Association and enter your address or zip code.

Care from a Distance

About 80 percent of Americans live within 60 minutes of a primary stroke center.

But, if you are not one of them, try searching for a nearby hospital that is equipped with a sophisticated telecommunications link to a specialized stroke center.

Such collaborations, called stroke “systems of care,” enable physicians in suburban and rural areas to provide fast and coordinated treatment and are gradually emerging across the country.

St. Luke’s Episcopal Health System in Houston, Texas, recently implemented a stroke system of care with the help of GE Healthcare.

“The minutes and hours following the initial onset of stroke symptoms are very critical to a patient’s outcome or survival. However, most often strokes don’t happen in the lobby of St. Luke’s,” said Connie Boyd, Service Line Director of Neuroscience and leader of the System of Care project within St. Luke’s. “Working with GE Healthcare, we realized that establishing relationships with community hospitals, some of which may even be considered competitive, was key to extending the reach of our stroke care capabilities and ultimately improving patient outcomes.”

Leslie Welborn and his wife, Ann, are grateful for the innovative approach to stroke care.

After her husband suffered a stroke in January, Ann took him to their local hospital, St. Elizabeth’s, which is located about three hours from Houston. Fortunately, the facility was involved in the St. Luke’s system of care.

Guidance from the experts in Houston enabled local physicians to quickly treat Welborn with tPA, dissolving the clot that was causing his stroke and buying much-needed time to transport him safely to St. Luke’s for surgery.

Less than one week later, Leslie returned home. “I can’t believe how well he is doing,” reports Ann—thanks to a system of collaborative care that stroke experts hope will help save countless lives.

Coming in Part 2: Promising new rehab methods help stroke survivors reclaim their lives.

Pronovost was no stranger to problems with the healthcare system. Before traveling to Nigeria, his father passed away from cancer that was misdiagnosed. By the time the correct diagnosis was made, it was too late for treatment.

“These and other experiences led me to believe that to improve health care, you have to affect policy,” says Pronovost. “That’s when I got the idea for the checklist.”

Peter J. Pronovost, M.D., Ph.D. was named one of the most influential people of 2008 by Time for using simple tools that greatly improved patient care.
Credit: Chris Hartlove/John Hopskins Medical Institutions

Pronovost tested his first checklist for medicine in 2001—a simple sheet of paper with five steps for doctors to follow in the intensive care unit at Johns Hopkins Hospital for a common but vital procedure, the placing of central venous catheters. The results were astounding: After 15 months, the hospital saved about two million dollars, prevented 43 infections and 8 deaths.

Today, the checklist program is saving lives (and billions of health care dollars) around the country and across the world.

Pronovost champions additional innovative patient safety initiatives in his new book: a federal program to help medicine learn from its mistakes, a systematic way to ensure valid measurement and accurate reporting of health care quality and safety, and creation of a government body devoted to patient safety research.

Here’s an excerpt from “Safe Patients, Smart Hospitals: How One Doctor’s Checklist Can Help Us Change Health Care From the Inside Out,” by Peter Pronovost, M.D., Ph.D., and Eric Vohr, released in February 2010.

Read more about Dr. Pronovost’s groundbreaking work as featured in the November 2008 Post article, “A Checklist That’s Saving Lives” by Eric Vohr.

Dr. Machelle M. Seibel, leading expert in women’s health and founder of HealthRock, a company that teaches health literacy through music and entertainment, answers questions women are afraid to ask.

What is the difference between a yeast infection and bacterial vaginosis?

Most women will have a vaginal infection at some time in their lives. Many will assume it is due to yeast. But it’s easy for women to confuse bacterial vaginosis (BV) with yeast infections. Here is why it matters.

Research shows that two-thirds of the women who suspect they have a yeast infection actually suffer from BV—a condition that occurs when the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of disease-causing bacteria.

Health professionals prescribe the antiobiotics metronidazole or clindamycin for BV. Left untreated, the infection can increase the chances of premature birth, urinary tract infections, pelvic inflammatory disease, and sexually transmitted diseases.

Symptoms of a yeast infection include itching, burning and an odorless thick vaginal discharge.  Signs of BV include itching, burning, and a discharge that typically has a fishy odor, especially after having sex.

But if you aren’t sure which type of infection your symptoms indicate, absolutely see your doctor for a BV screening before applying over-the-counter yeast treatments. And, when antibiotics are required, be sure to use all of the medicine, even if BV signs and symptoms go away.

Check out healthrockwomen.com for more about women’s and children’s health from author, songwriter, and popular speaker Dr. Seibel.

Laser energy

A new laser-equipped scalpel system from OmniGuide allows surgeons to more accurately aim energy beams deep inside the body, including the middle ear.

The innovative system directs infrared energy from a high-intensity carbon dioxide (CO2) laser through a flexible fiber tube lined with reflective material. Rigid lasers used for the past 30 years operate in a straight line only.

“The CO2 laser has been utilized in middle ear surgery for the past two decades,” explains ear specialist Dr. Bob Owens of Dallas, Texas, “But the OmniGuide BeamPath CO2 laser system allows an otologist (specialty ear surgeon) to hold the laser in a handpiece. This creates the greatest degree of surgical precision that can be obtained while operating in a microsurgical environment such as the middle ear space.”

Kayla, age 14, developed hearing loss from multiple ear infections that gradually immobilized tiny bones inside her ear. After undergoing the new laser procedure, she no longer needs a hearing aid.

“Conductive hearing loss occurs when patients have scarring or bone growth that ‘tethers’ the eardrum or ossicles (small bones of hearing),” Dr. Owens told the Post. “The OmniGuide laser divides the scar tissue and obliterates abnormal bone growth to free up the structures and allow better conduction of sound to the inner ear.”

Patients with cholesteatoma (abnormal tissue in the ear), a perforated eardrum, or otosclerosis (abnormal bone in the ear) may also benefit from the new laser surgery, according to Dr. Owens, who is one of the first doctors in the U.S. to use OmniGuide for hearing loss in children.

The FDA-cleared system is also utilized for brain, throat, and GI tract problems. Click here for video clips of laser therapy in brain cancer.

Radiofrequency waves

Calypso Medical’s “GPS for the body” uses tiny electromagnetic transponders to pinpoint the exact location of prostate cancer cells during radiation therapy. 

Experts know that organs in the body may shift during radiation treatments for prostate cancer. As a result, tumors may not receive the optimal treatment dose and nearby urinary and rectal tissue may be damaged by unintended radiation exposure.

Credit: OmniGuide

How the Calypso Works

1.     Doctors implant 3 transponders about the size of rice grains into the diseased prostate.

2.     Radiofrequency waves from the transponders communicate with external components of the Calypso System.

3.     A display screen continuously monitors the position of the prostate gland during treatment and alerts the therapist when the prostate drifts out of position. 

Findings from a February 2010 study show that Calypso’s real-time tracking technology enabled physicians to direct increased doses of radiation to the tumor while sparing surrounding tissue—a treatment strategy referred to as “margin reduction.” 

“This is the first comparative study to show that margin reduction in prostate cancer radiation therapy has clinically significant and measurable benefits in decreasing acute toxicity and short-term side effects,” said Dr. Constantine Mantz, radiation oncologist at 21st Century Oncology in Cape Coral, Florida and lead investigator of the study. “By reducing acute toxicity, we hope these patients may also experience a significant reduction of long-term side effects.”

Click here for more about the Calypso System.

Here are 5 facts from the ongoing HRS Apples and Oranges campaign to help you understand the difference between the two heart emergencies—and why it matters:

1. SCA is a malfunction of the heart’s “wiring” or electrical system that controls your heartbeat. Heart attacks result from bad “plumbing”, or problems within the blood vessels that carry oxygen to the heart muscle.

2. SCA immediately and completely halts blood flow throughout the body, starving the entire body of oxygen. Heart attacks (also called myocardial infarctions or MIs) reduce or block circulation to a particular area of the heart muscle.

3. SCA occurs without warning and is often the first indication of unsuspected heart rhythm problems. Loss of consciousness occurs within 20 seconds. Heart attacks are usually (but not always) preceded by chest discomfort or trouble breathing and happen to people with high cholesterol, high blood pressure, or a personal or family history of heart disease. Heart attacks can trigger the deadly heart rhythm called ventricular fibrillation that causes SCA.

4. SCA has a cure. It is to “shock” the heart back to normal rhythm with a machine called a defibrillator. But the window of opportunity is short—chances of survival decrease about 10 percent for each minute spent waiting for a defibrillator. Fortunately, many therapies exist for heart attacks and getting prompt emergency treatment can avoid or reduce heart muscle damage when symptoms are recognized early.

5. SCA occurs almost 1,200 times per day in the U.S. Heart attacks claim the lives of about 600 Americans daily, including 300 who die before reaching the hospital. Most of those deaths are from SCA.

Click here for more on SCA from The Heart Rhythm Society.

Watch for more about preventing SCA and saving lives in future weeks.

Without hard data from large clinical trials, it’s hard to make conclusions on the benefits of herbs for allergies. But European studies suggest these widely-available remedies may be worth considering:

Butterbur (Petasites hybridus) blocks the formation of compounds called leukotrienes that promote inflammation. Swiss researchers found that the flowering herb is less sedating but as effective as the OTC antihistamine cetirizine (brand name: Zyrtec). To reduce the risk of liver damage, it’s recommended that butterbur be taken for only six weeks a year. 

Rosmarinic acid, a chemical derived from rosemary leaves, reduced seasonal allergy symptoms in a preliminary Japanese study.  The compound seems to have anti-inflammatory properties and also suppress immune cell activity.

Stinging nettle (Urtica dioica) is a popular allergy remedy in Europe.  In one study, 58 percent of 69 volunteers reported that a daily 600 mg dose of freeze-dried nettle leaf relieved allergy symptoms—and 48 percent said its anti-inflammatory effect was more effective than standard OTC allergy medicines.

For research-based information on conditions and treatments, including diet supplements and herbs, visit The National Center for Complementary and Alternative Medicine http://nccam.nih.gov/.

“Warm weather causes tree and grass pollens to flourish, leaving millions sneezing and sniffling,” says allergist Dr. James Sublett of the American College of Allergy, Asthma and Immunology (ACAAI). “If spring allergy symptoms are hurting your quality of life, you may want to see an allergist to determine your specific allergies and find the right treatment to stop your symptoms.”

Here are some dos and don’ts about springtime allergies from the ACAAI:

Don’t spend blindly on over-the-counter medications. You may think you know what’s causing your allergy symptoms, but more than two-thirds of spring allergy sufferers actually have year-round allergies. Do get an accurate diagnosis and discuss which treatment options might be best for you with an allergist. Some OTC treatments  can be very effective. Immunotherapy (allergy shots and sometimes pills), can actually cure allergies, and keep you out of the drug store aisles for good.

Don’t delay taking allergy medicines until your symptoms are making you miserable. Do pay attention to the weather, and have a ready supply of the medication that worked for you in the past. Start taking it just before the weather turns warm and pollens and molds are released into the air.

Don’t invite trouble—steer clear of your allergy triggers. Finding the right treatment is important, but it’s also critical to avoid whatever is triggering your symptoms. Do keep windows shut if you have a pollen allergy. Take a shower when you come inside and stay indoors during midday when pollen counts are highest.

Don’t eat foods that aggravate sniffles and sneezing. If your mouth, lips, and throat get itchy and you sniffle and sneeze after eating certain raw or fresh fruits or other foods, you may have “oral allergy syndrome.” Do be aware that oral allergy syndrome affects about one-third of those with seasonal allergies. It occurs when the immune system reacts to similar proteins found in pollen and food. If you are allergic to tree pollen, you may need to avoid apples, cherries, pears, apricots, kiwis, oranges, plums, hazelnuts, and walnuts. Cooking or peeling the food may help, but first consult an allergist.

For more information about allergies and asthma, and to find an allergist near you, visit www.AllergyandAsthmaRelief.org.

Coming next week on Medical Update: Herbal Remedies for Seasonal Allergies.

Psoriasis, an autoimmune disorder that triggers inflammation and overgrowth of skin cells, affects about 7.5 million Americans. Its symptoms include red, raised patches of skin that may itch, burn, and crack.

Having the chronic condition also increases the risk of developing heart disease, according to experts who explain that both are inflammatory conditions.

Fitness expert Jackie Warner remembers her grandmother’s struggle with psoriasis.

“My grandmother lived with psoriasis for many years,” Warner tells the Post, “and she was very embarrassed by it—especially during flare-ups. This led to a sedentary lifestyle, and resulted in significant weight gain. Her struggle motivated me to become a part of a comprehensive wellness program designed with psoriasis sufferers in mind.”

Warner developed a new fitenss program to help psoriasis sufferers.

People without the skin disease can also benefit from the wellness plan.

“Fit in Your Skin offers fitness and nutrition guidance to help people get healthy and enjoy a more active lifestyle—whether or not they have the disease,” explains Warner.

AF occurs when the heart’s two upper chambers (the atria) quiver instead of beating effectively. In paroxysmal AF, the abnormal heart rhythm starts and stops on its own.

When drugs to control erratic heartbeats don’t work, doctors may use electric shock or thread catheters through blood vessels to zap cardiac cells with heat, a therapy called radiofrequency ablation. 

The innovative therapy reported at the American College of Cardiology (ACC) 2010 Scientific Sessions utilizes freezing technology, or cryoablation, instead.

“Cryoablation could offer a straightforward and significantly simplified treatment for patients with very symptomatic and obnoxious atrial fibrillation,” says Dr. Douglas Packer, professor of Medicine at the Mayo Clinic in Rochester, Minnesota, and principal investigator of the Stop AF (Sustained Treatment of Paroxysmal Atrial Fibrillation) study.

In the pivotal trial, the Arctic Front Cardiac CryoAblation Catheter System from Medtronic kept nearly 70 percent of AF sufferers symptom-free for one year, compared to 7.3 percent of those given the usual drug therapy.

 “There are 150,000 to 200,000 new cases of AF in the U.S. every year, Dr. Packer explained to Post editors. “Some will be asymptomatic and treated with blood thinners to prevent strokes. Others might be treated with anti-arrhythmic drugs. But the target population for ablation is people who don’t respond to drug therapy—and there are a lot of them.”

To date, more than 9,000 patients have been treated worldwide with the Arctic Front Cryocatheter. The treatment is not yet approved in the U.S., however.

“Seeking FDA approval for the system is the next step,” says Dr. Packer. “Data from Europe support the approach, but the FDA requires a large U.S. trial to demonstrate the device’s effectiveness and safety,” he explains. “This is the hallmark clinical trial in the U.S.”

Other ACC News on Atrial Fibrillation

Ablation therapy: Dr. Packer also reports that the CABANA pilot study of 60 patients with persistent or long-standing AF and underlying cardiovascular disease found that catheter ablation more effectively prevented recurrent AF than drug therapy. But the NIH-funded study is just getting started.

“The 4 to 5 year Cabana trial will consider longer-term issues of ablation: Does it reduce mortality, does it prevent strokes, and how much does it cost,” notes Packer.

Drug therapy: Analysis of pooled data from the EURIDIS and ADONIS trials suggest that it’s safe for doctors to prescribe dronedarone (brand name: Multaq) for their patients with atrial fibrillation within two days after discontinuing treatment with the drug amiodarone (brand name: Cordarone).

“Many doctors want to switch their AF patients from amiodarone to dronedarone,” says Dr. Peter Kowey, lead investigator and chief of the division of cardiovascular diseases at the Main Line Health System in Wynnewood, Pennsylvania. “These data will give some guidance until a randomized trial is completed.”

“The first week of DST is not the only time to think about sleep loss,” says Dr. Ronald Chervin, director of the University of Michigan Sleep Disorders Center and a professor of neurology at U-M.

Even though one hour of lost sleep can make it harder to wake up and to stay alert, many people get less than the recommended 8 to 8.5 hours of sleep each night—an often hard-to-break pattern that sometimes gets its start during childhood.

“We generally spend one-third of life sleeping—or at least we should,” Dr. Chervin explains. “And we’re learning more and more about how that one-third has critical impact on the other two-thirds.”

It’s hard to find any area of health untouched by the amount (and quality) of sleep that we get. Here are some of the health problems that researchers link to chronic insomnia and sleep disorders such as sleep apnea:

• Depression
• Anxiety disorders
• Emotional instability
• High blood pressure
• Heart disease
• Colds and flu
• Weight gain
• Type 2 diabetes
• Dying early

Dr. Chervin and his team at the UM Center for Sleep Science http://www.med.umich.edu/umsleepscience/ are researching the best ways to get the right amount of rest. Current clinical projects focus on aspects of sleep in newborns, pregnant moms, and Parkinson’s patients. They are also testing a new telephone-based therapy for chronic insomnia.