This Isn't Your Husband's Prescription

Oh, gender.

It's inspired entire sub-disciplines of anthropology, sociology and psychology; it's made the author of Men Are from Mars, Women Are from Venus one rich human; it's the villain of many a marital spat.

Now, it may change the way certain illnesses are treated.

In a recent study published in a very fancy science journal (Clinical Chemistry and Laboratory Medicine, for you fellow nerds), investigators have identified five clinical areas with considerable evidence for treating men and women differently: cardiovascular disease, cancer, liver diseases, osteoporosis and pharmacology (or drugs.)

Why the misunderstanding? Because women are better multi-taskers, have a mothering instinct and tend to act with more emotional intelligence.

Oh wait, were we talking about medicine? Okay, well it applies there, too.

Medical treatment to this point has not considered applicable social and psychological differences between the sexes, in addition to not properly acknowledging differences in the interpretation of symptoms.

In an additional (and shocking) bit of gender bias, much of the medical research over the past 40 years has focused almost exclusively on male patients.

We get colon cancer later, react differently to chemotherapy, have GI symptoms during a heart attack and enjoy long walks on the beach after surprise candlelight dinners.

Taking notes?

Vitamin D kicks type 2 diabetes' butt in obese children and adolescents

It's just another brick in the endocrine wall toward proof that "vitamin D" has fewer vitamin powers than it does hormonal ones.

Published in the American Journal of Clinical Nutrition is evidence that this super-vitamin can help obese children and adolescents control their blood sugars, potentially warding off Type 2 diabetes.

How? Glad you asked.

Obesity is a two-fold risk for Type 2 diabetes, contributing to both high levels of glucose in blood (which is damaging to tissues over time) and increased insulin resistance (which hinders the body's ability to decrease the sugar circulating in blood.)

After studying 35 pre-diabetic, obese children and adolescents who either took high-dose vitamin D supplements or placebo (sugar pill) for six months, the amount of circulating glucose was significantly decreased--with a decrease in circulating insulin as a result--without any changes in body weight or physical activity…meaning the vitamin D did that work all by itself.

Even the researchers state that this high level of vitamin D isn't for everyone.

The recommended vitamin D supplement for individuals ages 1-70 is 600 IU per day, but the individuals in this study received about double that. Vitamin D--along with its cohorts vitamins A, E and K--are members of the fat-soluble vitamin clan, or the type which can accumulate to toxic levels. While the risk is less for the population in this study given obese individuals can only process vitamin D at about half the normal rate, supplementation of this type is not considered safe for the general population.

While the final word on the significance of this sort of treatment has yet to be seen, checking a vitamin D level on obese children and adolescents might be a great way to broaden the patient picture.

Yay, science!

Colorectal cancer a family affair

As published in the Washington Observer-Reporter.

For the first 12 years of his life, Hector Riva belonged to a family like any other, until a pattern began to emerge.

The pattern was a genetic one, though this detail would elude the family's doctors for some time since the year was 1957, and the discovery of DNA had just celebrated its fourth anniversary.

The pattern involved colorectal cancer marching down Riva's family tree to the quick tempo of a silent cadence, claiming a few lives along the way.

"I knew a problem with the bowels ran in the family," said Riva a 68-year-old Monongahela resident, "But, I didn't know the cause."

Riva's wife, Carol Riva, attributes that hazy understanding not only to the lack medical technology but also to the culture of the time.

"Our parents told us a little more about the family history as we got older," said Carol, "But, back then, you didn't talk about that stuff."

Even without genetic tests or a perfect understanding of his family history, Hector knew enough to place a colonoscopy--the diagnostic tool of choice for the surveillance of colorectal cancer--on his mental to-do list.

Hector, like many men, was reluctant.

"I said I would wait around until a sign came--some blood (in my stool) or something like that," said Hector, "Which I didn't realize at the time would have been too late."

In addition to blood in the stool, changes in bowel habits, weight loss, persistent abdominal discomfort, weakness and fatigue are all potential symptoms of colorectal cancer.

Hector had decided to wait for a sign, but fate had other plans.

In 1996, when Hector was 52-years-old, he was lucky enough to develop a hernia.

After learning of his family history, the surgeon slated to perform Hector's hernia repair refused to perform the surgery until Hector agreed to a colonoscopy, which involves a scope of the lower digestive tract, beginning with the rectum and advancing through the large intestine, also known as the colon.

The ten pre-cancerous polyps that were removed earned Hector a yearly appointment for a scope of his rectum and colon. Each of the next four years brought the discovery of 14, 75, 0, and then hundreds of polyps, respectively.

Those polyps also brought the family's multi-generation battle with colon troubles to light. They were afflicted with a rare condition called familial adenomatous polyposis, or FAP, characterized by the presence of hundreds-to-thousands of benign polyps (or growths) in the large intestine and an early onset with 95-percent of affected people developing polyps by age 35.

The term "benign" is rather misleading, however. Though not cancerous from the outset, there is a 100-percent chance that the polyps will develop into cancer if the the colon is not surgically removed in those with FAP, a procedure Hector endured in his late-50s.

In the Riva family, however, colon removal is the norm. Hector and his three sons have all had their small intestine connected directly to their rectum in order to live colon, colostomy and, hopefully, colorectal cancer-free.

While the Riva's variant may be rare, colorectal cancer is the second most common type of cancer in Pennsylvania, with 150,000 Americans diagnosed with the disease each year.

The prevalence of colorectal cancer is countered by a fortunate truth of modern medicine: It is also one of the most preventable forms of cancer, where up to 60-percent of all cases can be avoided with proper screening--a piece of information which earns a special amount of advertisement during March, National Colorectal Cancer Awareness Month.

What makes colonoscopy the gold standard for detecting colorectal abnormalities?

Dr. John Hauser, a board-certified gastroenterologist in Monongahela, explains it this way: "Accuracy…assuming it's in the hands of a professional that's trained and does colonoscopy for a living," said Dr. Hauser. "There are some people out there in the community that dabble in it, that don't do it well and don't do it right."

Someone qualified to do colonoscopies, according to Dr. Hauser, is either a board-certified gastroenterologist or colorectal surgeon who has been trained in colonoscopy during their surgical residency. It's someone who can guide a scope all the way to the beginning of the colon at least 95-percent of the time.

For those without a family history of colorectal cancer, screening should begin at age 50, with repeat screenings every 10 years if the previous test was clear.

If there are one or a few "sporadic" cases in the family--meaning, the cases aren't believed to have a genetic cause--screening should begin at age 20-25 or 10 years before the earliest age of onset in the family, whichever comes first.

Scientists have pinpointed a the gene responsible for FAP, and are now able to test the youngest generation of afflicted families with a simple blood test. With its inheritance in a dominant pattern, there is only a 50-percent chance that an individual in an affected family will inherit the gene, but a 100-percent chance they will endure its effects, if inherited.

For FAP families, testing begins at age 10-12 and includes a one-time genetic blood test and yearly colonoscopies, which is just fine with the Rivas.

"If they can be genetically tested and help other people," said Carol, "That's the greatest thing going."

What Job Stress Really Means to Your Health

As published in the Washington Observer-Reporter. 

When dream jobs become real jobs, not everyone can tolerate the disparity.

By "not everyone", I mean the vast majority.

According to a recent study, a whopping 75-percent of the workforce considers themselves "job seekers." 

Think about that. 

In an economy that has marginalized glitterati and gas pump attendants alike, 75-percent of us still can't wait to jump ship. 

Our work culture is either that bad, or we are the most ungrateful group of miserable schmucks alive.  

I, for one, have more faith in us that that. 

I think we all had dreams about our jobs, no matter how mundane or highfalutin they might be. Once upon a time, there was something great about them which motivated us to fill out each annoying block of the employment application and made our hearts sputter with excitement when we got the job offer. 

While a vocational love affair isn't necessary to bring home the bacon, the term "burnout" does have a clinical definition and set of warning signs for which we should be vigilant. 

To know if you're possibly suffering from job burnout, a type of job stress, think about your habits and how they might have changed. 

Think about your work day: Do you drag yourself to work, have trouble getting started or lack energy to be productive? Consider your sense of pride: Are you satisfied with your achievements or do feel disillusioned about your work environment? 

In an additionally crappy turn of events, burnout doesn't only affect your life at work. Recall some of your habits at home: Have your eating, drinking or sleeping habits changed? Do working-hour worries bombard your thoughts even after you've punched out?

I can hear some of you calling me a bleeding-heart for even addressing this. 

Perhaps it seems that I belong to the coddling generation responsible for the overindulgence and entitlement rampant in our culture. Yes, I know that it's a relatively privileged few who actually enjoy going to work most of the time. In this economy, maybe it's downright short-sighted for anyone with a profitable job to complain. But, you do need to know that these symptoms can have more consequences than a need to get the lead out on Friday night. 

Agreed: Sometimes, we all need to evoke our best drill sergeant stereotype, get in our own faces, spit as we talk and just go to work. That applies to job dislike. 

Job burnout, on the other hand, is owed a more thoughtful reaction. 

Those who truly suffer from job burnout and ignore their needs may experience excessive stress, fatigue, insomnia, a negative spillover into personal relationships, depression, anxiety, even stroke and heart disease. 

To add even more legitimacy to the clinical understanding of burnout, check this out: The ICD-10, a medical classification list developed by the World Health Organization and the code system by which our medical treatments are catalogued and reimbursed, contains a code for those individuals suffering from the condition. 

Meaning, a doctor can charge your insurance company for a visit related to, well, hating your job.

I don't intend to argue that the unhappy 75-percent should quit their jobs to become Call of Duty experts--not in the least. 

However, there those for whom the act of going to their current job causes a degree of stress that does, or has the potential to, compromise their well-being. For them, a little self-exploration is in order. 

See a professional; make a pro-con list; put your favorite playlist on loop. Employ whichever constructive coping techniques you must to brighten your work-related thoughts, but don't ignore the intimate relationship between health and happiness.

Eczema: The itch that rashes

As published in the Washington Observer-Reporter.

When preparing to send her 8-year-old son, Jonathan, to his first day of third grade, Amy Berry had more to worry about than assembling a backback or learning a few teachers’ names.

Jon, who had been diagnosed with eczema – also called atopic dermatitis – just a few months prior, had a breakout of the red, flakey rash all over his face. 

"He didn't want to go to school,” said Berry, a Pancake resident and mother of two. “He was going to be embarrassed, and [he felt like] all the kids were going to stare at him.”

Unfortunately for kids like Jonathan, many misunderstand the habits of eczema, an incurable but non-contagious skin disorder. 

In order to increase awareness, November marks National Eczema Awareness month as promoted by the National Eczema Association (NEA). 

Often recognized in childhood, eczema can lead to a full-body, cracking rash that can sometimes leave children ostracized. It can also result in days of work or school missed and those afflicted feeling isolated.

These individuals, however, couldn't be further from "alone.”

Up to 20 percent of Americans now suffer from eczema – a proportion that has been on the rise since World War II. While the exact mechanism has yet to be discovered, experts have identified oddities in the skin barrier – the fats and oils that protect our skin – as a part of the cause. When this defense is weakened, substances in the environment are able to penetrate the relatively tough outer layers of our largest organ, to reach the more sensitive layers of skin beneath. For those with eczema, this leads to an allergic-type of reaction. 

What happens next is the hallmark of this chronic skin condition. 

"Eczema is 'the itch that rashes' ” explained Dr. Paul Ruschak, a board-certified dermatologist practicing in Monongahela. “Usually, itching precedes the rash, and one induces the eczema by itching and scratching.

“It's imperative to really make the effort not to rub and scratch."

Why are so many more people, both children and adults, suffering from this itchy and sometimes disfiguring disease? The answer might surprise you.

"I think we're too clean," says Dr. Ruschak. "I think we're not being exposed to the entities like cockroaches and fungi early in our life, and, as a result, we are having more incidences of atopic dermatitis."

The theory, referred to as the Hygiene Hypothesis, associates our society's near-obsession with cleanliness and the avoidance of disease – in the form of anti-bacterial wipes, hand sanitizer, vaccines, etc. – with a hypersensitivity of our immune systems. 

In other words, without enough exposure to common "germs" in childhood, our immune system views too many of these substances as threatening. So, when our bodies encounter these germs – however non-threatening – our body mounts a response to fight against them.

Dr. Peter Lio, an eczema researcher and NEA Scientific Advisory Board member, couldn't agree more. 

"I don't want to vilify vaccines because they get vilified for lots of other stuff, but in the best possible way, they've done such a good job of rooting out these illnesses,” Lio said. “Kids don't get sick any more in the same way, and we have these idle immune systems."

Another culprit: Over-bathing.

"The first thing I tell a patient is to avoid over-bathing," says Dr. Ruschak. "Bathe briefly: in and out in 5 minutes."

In fact, a vigilant skin care regimen – to avoid stripping the skin of natural oils and avoiding irritants – Is central to controlling eczema.

After a day out searching for Native American artifacts with his father – a favorite pastime of theirs – Jonathan Berry is forced to have a higher priority than displaying his discoveries. To prevent an outbreak, he has to immediately get into the shower, then slather himself in lotion and steroid cream.

Not exactly a favorite activity for an 8-year-old boy.

Other tips for those with eczema from Dr. Ruschak: Showers should be taken with tepid, not hot, water. Soap should only be used on the body areas that require it, meaning underarms, genitals, etc. Pat yourself dry with a towel – don't rub. Lock in the moisture immediately after a shower with a non-fragranced moisturizer.

When skincare regimens and over-the-counter hydrocortisone creams aren't enough, a visit to a dermatologist or allergist is in order.

But even their recommendations may be on the verge of changing.

"We've never seen so much active research in eczema," said Dr. Lio. "We're going to understand that eczema isn't just one disease. We're going to see subtypes better, and that is going to be huge catalyst for treatment." 

For now, kids like Jonathan can be helped by awareness, understanding and good advice from their mothers.

"I try to explain to him,” Amy Berry said, “ 'It's a part of life, unfortunately, and it could be a lot worse.' "

When the Lack of Sunlight Is More than a Bummer: Identifying Seasonal Affective Disorder

As published in the Washington Observer-Reporter

With another summer of beach vacations and trips to Kennywood in our rearview mirror, sun worshippers joke of the "depression" this time of year brings. While this is meant in jest for many, up to 10% of Americans have a diagnosable depression whose trigger is the unavoidable flip of a calendar.

Seasonal Affective Disorder (or SAD, for short) is the name of this wintertime menace.

As the earth tilts away from the sun – what we commonly call fall and winter – our days shorten. Our bodies are able to sense this decrease in light due to receptors on the top of our heads, in our eyes and on the back of our knees. (Yes, the back of our knees.) This decrease in light can throw off our circadian rhythm (or sleep-wake cycle) and the 24-hour cycle our body is used to, leading to changes in mood, energy, appetite and more.

Apparently, it's like jet lag.

"When people have jet lag it's because their bodies have been operating at a certain circadian rhythm,” said Dr. Michael Franzen, chief psychologist at the West Penn Allegheny Health System with 30 years in practice. “They suddenly go to a different area, the sun is entering receptor areas at a different time than they used to, and they're out of sorts with their circadian rhythm. Those are the same receptors that are probably involved in SAD,"

Dr. Franzen – who, more specifically, is a neurophysiologist and studies the intersection of the psychological with the physiological – explains that the production of chemicals in our bodies such as melatonin and perhaps serotonin and some hormones are dependent upon these light receptors. Ultimately, a change in light means a change in the amount of these chemicals available to our bodies.

Okay, circadian-schmircadian, but what does SAD feel like?

Seasonal Affective Disorder is really just a variant of Major Depressive Disorder and is characterized by sluggishness, loss of interest, lower energy/tiredness, withdrawal from social activities, weight gain (because of carbohydrate cravings), loss of interest in sex, irritability and hopelessness – all symptoms seen in classic depression.

Another similarity between the two disorders: They are both more likely to affect women.

According to Dr. Franzen, "The main thing is, for people who may think they have it, does this tend to increase during the time that the days are shortening – especially mid-to-late fall with peak levels in the dead of winter – and tend to subside as the days get longer?’

“If they have those symptoms, whether they're related to the seasons or not, they should still seek help."

Help in this case isn't a medication you can't pronounce with side-effects you can't tolerate. It's light.

Since a decrease in the shiny rays – as sensed by those eye, head and knee receptors – is the culprit, increasing one's exposure to light is one of the solutions. And, no, you don't have to shine it on the back of your knees.

Sitting two feet in front of a specially made lamp that emits ultraviolet light – called a "light box" – for 20-60 minutes either at the beginning or end of the day is successful treatment for 40% of those suffering from SAD. For the other 60%, a mixture of therapies ranging from light box therapy, to talk therapy to the use of anti-depressants are used to beat the "winter blues".

But that may change.

"Where the research is going now is to try to find the underlying neuro-chemical basis for [SAD] in order to make pharmacological treatment more precise and more effective," said Dr. Franzen.

What might change is the definition of "pharmacological.” As more is discovered about the genetics and naturally-occurring chemicals involved in SAD, don't be surprised if future treatments include vitamins or hormonal supplements.

Bottom line? Be aware. If you recognize these symptoms in yourself or fellow man, remember the importance of seeking treatment from a trained professional.

Also, on a far-less-serious note, be aware that back-of-the-knee light receptor discussions at parties will absolutely label you "quirky.”

Stylish and au Naturale? Bridgeville, PA Salon Fits the Bill

As American women, we often get the short end of the mascara wand when it comes to beauty.

We're bombarded with images of "ideal" women enhanced by time-consuming, expensive and not-so-healthy beauty regimes, but simultaneously we are warned of the cancer-causing and hormone-altering molecules in nearly every beauty product that might elevate all of us to bombshell status.

"Where's the middle ground?" the little voice in our heads might scream.

Newly-remodeled in turquoise and black and celebrating their fifth year in business, Hair 2 Sole Beauty Studio in Bridgeville meets the south-of-Pittsburgh woman right where she is.

With the perfect mixture of traditional beauty services provided with low-toxin and organic products, the mascara wand just got longer.

"We're local, but we're not that stuffy salon where you can't have fun," said salon owner Alana Gibbs, who’s a Chartiers Valley High School graduate

And, it's affordable. While the term "organic" can sometimes imply a devastating price tag, Hair 2 Sole’s prices allow us all to become low-toxin beauties, with women's haircuts starting at $20 and basic facials starting at $35.

While Hair 2 Sole offers services that even the most extreme of earth-lovin'-mothers might seek, Gibbs has created a very accessible atmosphere for the Bridgeville salon. No incense; no PETA advertisements. What you will find, however, are bottles of olive oil, bags of sugar and fresh-ground strawberries--all ingredients for the salon's specialty facials. 

"A lot of the things that are so great for you internally are also great for you externally," says Hair 2 Sole aesthetician and strawberry-grinder, Carrie Sullivan. 

It isn't all fun and games for this civic-minded staff of seven, however. Aside from their environmentally conscious products, the beauty mavens at Hair 2 Sole just spent their fourth year volunteering at Camp Raising Spirits, a retreat for adult cancer patients held each June in Laurelville.

"They do a lot of things to help us out and provide us with their expertise in foot and leg massage,” said Sandra Lee Schafer, Camp Raising Spirits core committee co-chair and H2S open house attendee. “They have the gift to be able to approach people correctly.”

Okay, okay. So they're all-around do-gooders, but what about the quality of these products?

It's definitely time to rid ourselves of the "if it burns, it means it's working" mentality; Hair 2 Sole lacquers nails with Zoya, a non-carcinogenic, low-odor, safe-for-pregnant-women nail polish that’s made in Ohio and usually lasts 7-10 days. At only $8 per bottle, you might consider taking one home with you at the end of your $14 manicure.

That's right, only $14.

And, the hair color is no different. L'Oreal Professional-made Inoa hair color uses an oil delivery system instead of the usual ammonia, which not only pampers your locks but also seals in more of the color.

"Even after the second or third shampoo no color washed out,” said H2S client Randi Kania. “My hair wasn't dry after. I barely need to condition it. It's really nice.”

So, whether you're mainstream and fabulous or a kale-eating queen, Hair 2 Sole on Hickman Street in Bridgeville brings you beauty services conscious of your body, community and wallet.