How to Choose the Best Sunscreen

July 06, 2011

Reblog

I remember when there were basically two types of sunscreen – lotion or oil. Nowadays, there’s over 10 different brands and types.  So, how do you choose your sunscreen?

 There are so many different labels, it is easy to become confused. They all have different SPF numbers. Some say they are “waterproof”; others say “water resistant”. What is the difference? Still others say “broad spectrum” while others are labeled “high UVA”. Many of my patients want to know which should they put on before they head out into the sun.

Hopefully, all these different labels will be less confusing. Starting next summer, the Food and Drug Administration (FDA) will require new labeling that cracks down on confusing claims and makes choosing a sunscreen easier. Meanwhile, we’ve still got a big chunk of summer left—prime time for being out in the sun. Here's a look at the new labels and some tips on how to choose the right sunscreen for you.

What Does the SPF Rating Mean?

I’m sure you already know that SPF 30 means more protection than SPF 15. But did you know that SPF, which stands for “sun protection factor”, only measures one element of sunlight?  SPF tells you about protection against ultraviolet B radiation (usually called UVB). UVB is the main cause of sunburn. However, it’s only part of the picture.

“Broad spectrum” sunscreens protect against both UVB and another type of radiation in sunlight, ultraviolet A (UVA). Both UVA and UVB rays can cause skin cancer as well as premature skin aging. Right now, it’s hard to tell how much UVA protection you’re getting in a “broad spectrum” sunscreen. Starting next year, when you see “broad spectrum”, it will mean the level of UVA protection meets a certain standard, proportional to the SPF number.  

How Much Protection Do I Really Need?

So far, it’s not certain that SPF levels above 50 really provide extra protection. The FDA is thinking about making “SPF 50+” the highest level you’ll see on a sunscreen label. At the same time, sunscreens with an SPF between 2 and 14 must state that the product has not been proven to prevent skin cancer.

Are They Really Waterproof?

Now about “waterproof” sunscreens. It sounds like you could go swimming all day and never bother to reapply your sunscreen, right? But that’s not quite true. Beginning next year, manufacturers can only say that a sunscreen is water resistant, and they have to give you an idea of how long it lasts while swimming or sweating. There will be two categories, 40 minutes and 80 minutes. The term “sweatproof” will also be gone because it’s simply not a true claim.

Remember, the reasons why you should wear sunscreen isn’t just to prevent skin cancer; it’s also to prevent sunburn as well as premature aging, such as wrinkles. So wear at least SPF 15, and reapply every few hours. Make sure you get a product that protects against UVA and UVB. And don’t forget about wearing sunglasses and hats – they help with protection too!

More on Summer Skin Care:

FDA Q&A on Sunscreen Regulation Changes

American Academy of Dermatology - Skin Care Safey

5 Spots Commonly Missed When Applying Sunscreen

 

Photo Source: Thinkstock/Stockbyte

How to Make Working Work for You

August 30, 2010

Reblog

Patients often ask me how they can best prepare for a new addition to the family while juggling the stress of their jobs and everyday life. Let’s be honest – it’s tough! Did you know that nearly 60 percent of married mothers with children under 3 years old are active in the workforce?

This is almost double the number of working moms in 1975, and the latest studies show that fathers feel just as stressed as mothers do! It’s no easier for single parents: In single-parent families with children under 3 years, 57 percent of mothers and 77percent of fathers are employed. As it becomes more common for both mothers and fathers to work, parents find themselves struggling to handle the demands of a baby while providing for the family. With some simple adjustments, though, parents can ensure a less stressful experience for themselves and more time for the family.

Working too hard is a serious consequence for parents. You’ve probably heard of burnout from work, but did you know it can also drain you of your enthusiasm at home? How can you avoid burnout? Here are 3 easy tips:

• You can start by using your breaks more wisely for a little bit of de-stress time. Do some deep breathing or close your eyes and envision something relaxing. Try this during your coffee breaks or when you have a bit of down time at work.
• Use your commute as time to unwind from work and to separate work from home. Let this time serve as a gap between the pressures of work and the joys of spending time with family, and change your mindset accordingly. Stop using commute time for e-mails and texting!
• In addition to prioritizing and improving your time management, keep your expectations as real as possible. Sometimes, it’s not going to be possible to go to the movies because Junior has an ear infection.

Now that you’re effectively avoiding burnout, what else can you do to be a successful working parent?

• Many parents find managing a new addition much easier when they are able to work from home, using baby’s frequent naps as the perfect time to get work done.
• Some employers also offer compressed work weeks or flextime schedules. Compressed work weeks let you work only four days per week as long as you work a couple of extra hours each day, leaving a full day open to take care of things at home. Flextime allows employees to choose when they want to work, as long as they meet the required number of work hours.
• Great news for fathers: Some employers are also offering paternity leave.

Check with your employer about your options when you are expecting a baby. Many employers are willing to reasonably accommodate their employees when it comes to a new baby.

Armed with these tips, parents can now focus on what’s most important: enjoying the newest addition to their family and knowing that the family’s needs are met. Don’t let your job boss you around at the expense of your family life; make working work for you.

(Image Credit: Andrew Taylor/istockphoto.com)

Home Made Baby Food

June 30, 2010

Reblog

Did you know that it can cost $15,000 to raise a baby in the first year? Let's face it: raising a baby can be expensive. But what may not be so obvious is that there's a simple way to save money AND protect your baby's health at the same time. Have you ever thought about making your own baby food at home? You'll be surprised at how convenient it can be - for both you and your baby.   

You’re probably wondering, "What's the point of making my own baby food?" Here are just some of the benefits of doing it yourself:

• Homemade will be fresher than store-bought. You can select the freshest items yourself and make a batch of food just prior to baby’s next meal. Does it get any fresher than that?
  
  
• You can control quality by selecting ingredients yourself. You can inspect produce for ripeness, for example, and use only the best selections for your baby. You also can add vitamins and supplemental nutrients to make sure that your baby’s diet is healthy.
  
  
• You can choose foods that your baby prefers, making it more likely that your baby will eat instead of spitting out unpalatable food. Like the rest of us, babies have taste preferences. All parents know how difficult it can be to try to feed your baby something he/she doesn’t like. If you’re worried that your baby’s taste is interfering with proper nutrition, you can even mix ingredients to disguise disagreeable flavors while feeding baby the foods he/she needs.
  
  
• You ensure the safety of your baby’s food. Food-borne illnesses and safety recalls of baby food have become more common in recent years. By preparing baby food yourself and following sanitary practices, you can limit contamination and keep your baby safe.     
  

So how exactly do you make baby food? You don't need high-tech devices or factory equipment. All you need are your carefully chosen ingredients, water, and a blender. Cook the food as you like, but it's best to steam your veggies and bake your meats because these methods preserve the most nutrients. Once cooked, just puree in a blender while adding water to reach your desired thickness. Remember, younger babies require thinner food than older ones. You can even add nutrients like liquid Vitamin D to ensure that your baby is properly nourished. Store leftovers by freezing in a clean ice tray or a sterile, freezer-safe glass container. When baby is ready to eat again, just thaw the frozen food in a warm water bath or in a sealed container in the fridge overnight.  

Yes, making baby food is that easy. There's a wealth of resources in print and online to guide you, so take some time to explore. It's safe, simple, and affordable - and that’s nothing to cry about.

Texting Is More Dangerous Than You May Think

June 14, 2010

Reblog

As I was driving to work this morning, I noted a number of people shuffling along the sidewalks, eyes peering down at their mobile devices with their fingers tap-tapping away. While stopped at an intersection, I actually witnessed someone collide with a passerby walking in the opposite direction….kaboom!  The "typer" was so engrossed in what he was writing that he simply did not realize he was on a collision course with someone else.  Luckily, there was no serious damage, except for perhaps some scattered papers and a bruised ego.  But the result could have been more serious.  And this isn’t the worse I have seen – I’ve even seen bicyclists text and ride --- how they do it, I don’t know nor do I want to try it!

Indeed, with the rising popularity of mobile technology, this is not uncommon to see. We have grown increasingly connected to the world around us through laptops, cell phones, personal organizers, and mobile everything -- but what many of us do not realize is that being so connected can be harmful to our health.

The risks of working at a computer for too long have been well emphasized for years. Overuse of electronic devices -- commonly computers but also video games and mobile phones -- can lead to repetitive strain injuries. This is a general term that refers to the strain in the upper extremities from prolonged repetitive activities, like typing. Have your heard of the “Blackberry thumb”?  This is a relatively new term to describe the pain arising in one’s thumbs and wrists from repetitive typing on the tiny keypads.  It’s not just our arms that can become painful.  Poor posture while using these devices puts us at risk for chronic low back pain, neck pain, and even eye strain.

I’m sure you know about the dangers of driving while texting. According to NHTSA, 5870 deaths and 515,000 injuries were caused by distracted drivers in 2009; of these, texting drivers were 23. times more likely than nontexting drivers to be involved in a collision.  Everyone, especially Oprah, is rightfully raising awareness of the dangers of distracted drivers.  But you may not be aware that there are numerous other types of injuries occurring from excessive use of computers.  Did you realize that in the last few years, there have been over 70,000 emergency room visits for computer-related injuries, most commonly tripping and falling over computer equipment?  This is certainly a testament to how dangerous technology can be!

Technology certainly can improve many aspects of our life.  But like most things, it needs to be used in moderation to maximize our health. Though we may think it absolutely essential to send that email or text message immediately, sometimes it’s best to take a break and disconnect for a little while. Our thumbs will thank us.

Shining a Light on Mental Wellness

April 07, 2010

Reblog

I have not been a physician as long as some colleagues, but even in my more than a decade of practicing medicine, I’ve seen a change in how patients and physicians address mental illness.  I remember when patients would be embarrassed to bring up issues of depression, post traumatic stress disorder, obsessive compulsive disorder, or any other mental health topic.  Now, as part of medical training, physicians are taught to actively ask about someone’s mental health.  And many clinics and hospitals have instituted mental health screens to make sure we catch any problems early on. 

We have moved from mental illness to mental wellness.

It really was not that long ago when characters with mental illness were portrayed in television and film as either the perpetrators of violence or the victims of violence. They were hidden away in state asylums, made into dangerous villains and psycho killers on the big screen, or had small chunks surgically removed from the front of their brains in a procedure called a frontal lobotomy.  Think “Psycho”, “Silence of the Lambs”, “Sybil”, “American Psycho” and of course a personal favorite, Kathy Bates in “Misery.” Now characters with mental illness are portrayed as likeable and active members of society: think “Monk” on television, or “United States of Tara.” And who could argue that some of the folks on reality shows have some degree of mental illness, and remain likeable! (Don’t assume I’m saying you’re likeable, Ms. Snookie on “The Jersey Shore”.) In addition, substance abuse has changed from a condition viewed as personal failure to one of imbalance in brain chemicals which require medical intervention. 
 
These changes in thinking about mental illness are likely due to the evolving understanding of mental illness. The stigma of mental illness is not gone, but it has been reduced. Mental illness is much more common than one might imagine. The National Institute of Mental Health reports that every year, one in four adults, about 57.7 million Americans, experience a mental health disorder.¹ Most of us know someone with mental illness or might have experienced a bout of mental illness ourselves.  The reality is that mental illness or mental wellness is a spectrum where most people function well in society. 
 
No one would suggest that Glenn Close’s character in “Fatal Attraction” was functioning well mentally.  I was pleasantly surprised to learn that Glenn is involved with an organization called Bring Change 2 Mind, a national campaign whose goal is to conquer bias and misconception about mental illness as well as providing people with mental illness as well as their loved ones, resources and information to help manage the condition. 
 
Unfortunately, getting rid of stigma does not cure mental illness.  Much work remains to be done in the areas of research, diagnosis, treatment and prevention. One of the most important benefits of eliminating stigma is that people with mental illness will not hide from society, and family, friends, and colleagues will be more willing to reach out to them.  This will allow people to be identified sooner, get help earlier, and remain active, contributing members of society.  Ideally, we will learn more to prevent mental illness.  We are not yet at that point, but reframing the discussion to give it a more preventive medicine spin will help to decrease the burden of mental illness. By focusing on the wellness end of the mental health continuum, patients are striving for more than just an absence of any psychological disease. They create a personal state of mental and emotional fitness so they are strong enough to handle whatever curve balls life may throw at them.
  
Resources

National Mental Health Information Center http://mentalhealth.samhsa.gov/
American Psychiatric Association www.psych.org
Mental Health America www.mentalhealthamerican.net
Bring Change 2 Mind www.bringchange2mind.org

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¹ What is Mental Illness: Mental Illness Facts. Available at: http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Mental_Illness.htm

A Gym Class a Day Keeps the Doctor Away

March 24, 2010

Reblog

I can easily recall a time when “gym” was the response I got when asking a niece or nephew or family friend’s child his or her favorite subject in school. I would gently correct the child saying something to the effect of: “gym doesn’t count.” Recent research suggests I may need to rethink that view!

A year-long study showed that 45-minutes of daily exercise in the school day resulted in a significant increase in overall fitness. The scientists also measured a special type of cell lining in blood vessels -- a sign of healthy vessels -- and found it was increased. They also found that though all kids who exercised daily benefited, the poorest children reaped the greatest reward.

But some food for thought: If kids from lower socioeconomic areas benefit most from regular exercise at school, why does it seem that these schools must cut funding for physical education? 

I know that federal policies mandate that schools perform a minimum standard in core academic subjects, namely math and English, to maintain funding and viability. That results in the unfortunate situation where the lion’s share of the available resources are often funneled toward achieving that end -- leaving little to nothing for physical education (not to mention art, sports, and music). In the absence of recess and gym, many kids have little opportunity for physical exertion at school. That combined with “grease-on-a-stick” for lunch and neighborhoods without safe play areas, its no wonder the childhood obesity epidemic is raging across America faster than a kid through a candy shop.

Many of our nation’s leaders would agree with the authors of the study about the importance of teaching children how to be physically fit. For example, some California schools have challenged core classroom teachers to instruct students in physical education, nutrition, and character building. A Michigan state senator has proposed legislation to require a minimum amount of phys ed in elementary schools. And who hasn’t noticed First Lady Michelle Obama’s “Let’s Move” campaign, which  focuses on exercise in schools, in addition to better nutrition, to slim down the childhood obesity crisis.

I’ll admit it – I was a bookworm in school and never really enjoyed gym.  However, I do realize now the importance of it! There is increasing evidence that gym class may provide a foundation for a lifetime of health much like reading, writing, and arithmetic provide the foundation for lifelong social and professional participation. So the next time I hear that gym is some future scholar’s favorite subject, I’ll shake hands and congratulate him on a solid choice for the future.

AHA: Daily Gym Class Reduces CV Disparities (Nov 18, 2009) Available at: http://www.medpagetoday.com/MeetingCoverage/AHA/17084

Bill would increase physical education requirements in elementary, middle schools: http://www.mlive.com/news/grand-rapids/index.ssf/2009/05/educators_skeptical_of_bill_th.html

Michelle Obama's formula for healthy children: http://articles.latimes.com/2010/feb/12/opinion/la-ed-obesity12-2010feb12

How Big is Your Teaspoon?

February 17, 2010

Reblog

All moms and dads know the drill—the sick kid, middle of the night shuffle into the bedroom with a syrup of some kind in hand. You pour it onto a spoon, send it down the hatch, feel junior’s forehead, then try to go back to sleep. Parents have performed this ritual since the beginning of time, but getting the right amount of medicine into your child is an inexact science at best.

Blame it on the spoon. Sometimes you’ll pour too little, sometimes too much, depending on its size. Like everyone else, you probably assume the dose is close enough -- that it all evens out in the end. But the practice isn’t as benign as you might think. Spoons have actually been linked to dosing errors and pediatric poisonings.  

A recent article in the Archives of Pediatric and Adolescent Medicine¹ looked at how close moms and dads came to giving their children a 5 milliliter dose of a common liquid medicine using various methods, including spoons and those little cups that come packaged with medications. After testing nearly 300 parents, researchers discovered that 50% or them made mistakes, even the ones who were confident they’d gotten it right. The spoons you take out of your kitchen drawer and the convenient cups were among the worst culprits.  

The FDA recommends against using kitchen utensils to give, or take, liquid medications. So do I. Safer alternatives are out there, and I encourage my patients to use them. The best bets are measuring droppers, dosing spoons, and oral syringes, especially the ones with bottle adapters. Any of these options will get you within safe range of the desired dose, and you can pick them up  at your local pharmacy.

Research shows that no matter how sure you are of your ability to dole out the recommended dose, getting it right is a tricky business. So the next time you have to give your child liquid medication, skip the spoon and play it safe.

[1] Arch Pediatr Adolesc  Med. 2010;164(2):181-186

Resolutions need to be from the heart, and for the heart

January 11, 2010

Reblog

Oh yes, 2010 has finally arrived. The start of a new decade!  Hard to believe that many of us were worried about the "Y2K" bug just a decade ago!  Does that really seem ten years ago? Where has that time gone? Before we know it, we will be writing about 2020.

 Just as in 2000, certain traditions prevail, including the esteemed tradition known as the New Years Resolution. I bet you have made one or two...and by this point, some of us have already broken those resolutions.

My good friend, Dr. Mehmet Oz, has discussed this issue as part of the "Ultimate 20," and believes that resolutions have the best success rate when they have a personal meaning.  Specifically, he believes that people do not simply follow through on their resolutions based on what they know alone (the "factual component"); instead, they require an emotional component for the greatest success rate. So what exactly comprises the "emotional component" for successfully obtaining a New Year's resolution?

For instance, let's say you are trying to focus on removing two "vices" from your lifestyle, specifically  smoking and unhealthy diets. Already, many of us know about the need to quit smoking or follow a healthy diet. Smoking has been linked in literature with lung cancer and increased mortality. Diseases such as hypertension and diabetes can result, in part, from an unhealthy diet that is high in salt and sugar. Surely the literature proclaims a need to change your lifestyle, but one is often left pondering the question- "what is in it for me besides some academic findings from literature?" And somebody always knows somebody who smokes and seems fine.

The answer is simple- other people are depending on you and your attainment of these New Year Resolutions! When you know a spouse, dear friend, or significant other wants you to quit smoking and improve your diet, this strikes at your emotions. You certainly don't want to let them down; of course they believe in you and they will certainly be there for support! So this embodies the "emotional support." Facts are good to know, but they do not always have a personal touch!

But of course, training for this lifestyle modification will not be easy. In light of this challenge, Dr. Oz mentions that the pathway to better health is similar to a marathon. If you are aiming for a successful completion- you need to keep on a constant training regimen. You cannot start one day and then stop a few days later.  Of course, similar to an exercise program, if you have someone who is ready to "practice" with you on that "marathon" to fulfill your New Year's resolution, it makes achieving and maintaining your goals all that much easier.

So, when feeling that your New Year's resolutions are somehow unobtainable, think of Dr. Oz and his philosophy. Don't just think of only yourself, think of the benefits you will give for others!  Think of the way that achieving your goals will help both you and your special team of support! Here's to a great 2010 for all of you and to making sure that you both accomplish your New Year's resolutions and maintain them going forward!
 

Sleep—Too Much of a Good Thing?

January 08, 2010

Reblog

I realize that everyone is talking this month about the need to get more sleep. With the
holiday season over and busy work days back upon us, we are flooded with messages
urging us to get sleep despite the numerous time constraints of our daily lives. And I
have even written in the past to sleep better.

It is true that too little sleep is bad for your health – it can cause a heart attack, it can
make you gain weight, as well as increase your risk for cancer and even make you die
prematurely. But what about the flip slide – is it possible to get too much sleep? And
what counts as “too much”?

A recent article in the Journal of Sleep Research looked at the association between the
number of hours we sleep and the possible health risks. After looking at the results from
over 20 other research studies, researchers discovered that adults who sleep on average
more than 9 hours per night experienced more health problems such as obesity and stroke
than those who got a restful 7-8 hours. Some scientists believe that too much sleep is
actually more dangerous to our health than too little sleep.

Now I’m not talking about those of us try to “catch up” on sleep on the weekends, trying
to make up for the nights we sleep too little. (And I might point out there’s no such thing
as “catching up on sleep.”!) The exact mechanism for the increased health problems is
not known but some think longer sleep leads to less exposure to daylight, as well as lower
levels of beneficial stress. That’s right…some stress can be beneficial.

 I often find that when patients come in complaining of too much sleep that there is often
an underlying problem. Often, they are depressed and don’t have an interest in getting
out of bed. Depression is often under-diagnosed and too much sleep can be an early sign.
Luckily there are good therapies – both with and without drugs to fight depression.
Others actually are equating the number of hours in bed with sleep, when in fact they are
getting too little sleep due to restlessness and sometimes chronic pain. And if you are
sleeping during the day, that could be a sign of obstructive sleep apnea.

I also want to point out that as we get older, we do not need more sleep. I can’t tell you
how many patients come in with elderly parents and complain they sleep all day. Well,
something is wrong there and should be evaluated. As we get older, the quality of our
sleep decreases but the total amount of sleep should stay the same --- 7-8 hours.

Like many of you, I do like to sleep! One of the reasons I did not go into surgery or
anesthesiology is that I don’t like to get up before 6 am! I do recognize, however, that
developing a good sleep regimen is important for good health. So like many others have
told you, establish a regular sleep time in the evening and wake-up time in the morning
and stick with it every day, including weekends. Sleeping longer on weekends actually
messes up our biologic clocks. It’s only natural that there are going to be days when you

sometimes get more, and sometimes get less. But aim for 7-8 hours of sleep a night, and
you will do well! Like a lot of things, too much sleep isn’t good for you!

What is the National Body Challenge, and why does everyone need to join?

December 18, 2009

Reblog

Why? Why should you enter another online weight-loss challenge? I bet that’s what you’re asking yourself and it’s a reasonable question. To answer whether you should participate in the National Body Challenge, I have some questions for you. Do you want to get help in breaking bad habits? Do you want the tools necessary to adopt healthy living? If either of those answers is yes, then our National Body Challenge is for you!

I do want to clarify an important point: National Body Challenge is not about losing weight; rather, it’s about learning to live healthy. Many of you will participate this year in order to lose weight, but others will enter to maintain a healthy weight, and still others will want to tone up. Personally, I’m entering because I need to learn more about the right things to eat. That’s right – I need to learn more about nutrition and exercise. Even though I’m a doctor, we really don’t learn about nutrition or physical activity in medical school. So I’m eager, just like you, to hear from experts about simple ways to break bad habits and learn good ones.

Did you know that exercise has been shown to help prevent stroke, heart disease, and even cancer?