What is Frostbite?

Most people living in northern climates have heard about frostbite. Exposing the skin and underlying tissues, especially of the extremities including the hands and feet, to extremely cold temperatures can lead to the development of frostbite. If cold exposure is severe enough, tissues can actually die.

frostbite

Ice Formation Inside Tissues

The body works hard to maintain the temperature of all of its tissues, both at the core of the body and at the periphery. Peripheral tissues such as the fingers, the toes, the ears, the nose and the lips are, however, at highest risk for damage as a result of exposures to extremely cold temperatures. When conditions are most dangerous, this extreme exposure can lead to the actual formation of ice crystals inside the tissues, first occurring near to the surface tissues just below the external skin, and then progressing to deeper tissue structures. When this happens, frostbite develops.

How Ice Damages Tissues

When ice crystals start to form in tissues, the cells that make up the tissues are not equipped to deal with its effects. Cells start to get injured because of disruption of cell membranes and the loss of cellular integrity. If the exposure continues, the body tries to deal with the exposure to the cold by regulating the performance of the circulatory system. Unfortunately, this typically means that the first response is to shunt more of the blood to the vital organs at the core of the body, worsening the cooling of the extremities. Soon afterwards, the blood vessels in the extremities try to overreact and start dilating and then constricting before the body recognizes that it needs to stop supplying blood to the extremities altogether to preserve as much heat in the core as possible.

Loss of Tissue Oxygenation

As the freezing progresses, a reduction in blood flow and the damage sustained by the blood vessels themselves can lead to loss of oxygenation of the tissue, what is known as necrosis. When tissues stop getting the oxygen that they need, the tissue begins to die. After a frostbite injury it is not uncommon for surgeons to have to wait for several days before they can determine how much of the tissue has actually died. Injuries to tissues can be severe enough to warrant amputation, and rewarming of the tissues must be done carefully in order to minimize further injury.

Preventing Frostbite

When it comes to frostbite, prevention is absolutely the best approach. It is not simply enough to dress more warmly as the temperature drops. Awareness of overall conditions can be very important. For those into mountaineering, exposure to a low temperature at higher altitudes can be more rapidly destructive. Combining low temperature with exposure to water can also be extremely problematic. And frostbite is not only a province of winter extremes, it can occur in those people who work with dry ice or with liquefied gases such as liquid nitrogen and liquid oxygen.

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Vitamin D Essential to Good Health

vitamin d

The results of the first Canadian study of the effects of vitamin D deficiency have been released by Toronto’s Hospital for Sick Children, and they look worrying.

Northern Latitudes Lack Vitamin D

Health Canada says that “Vitamin D is synthesized in the skin upon exposure to ultraviolet B (UVB) radiation.” That, of course, comes from the sun, so Vitamin D is often called the “sunshine vitamin.”

However, Canada being a northern country means that the sun’s UVB is weaker than in tropical regions. The result, according to Health Canada is that “Vitamin D synthesis in the skin is absent during the winter months (October to March), and for an even greater part of the year in far northern latitudes. This means that for a significant portion of the year, Canadians must rely on dietary intake of vitamin D to maintain adequate levels of vitamin D in the body.”

Sources of dietary vitamin D include milk, fatty fish, and egg yolks. Also, inexpensive supplements in pill form are available at pharmacies and health food stores.

Canadian Kids Don’t get Enough Vitamin D

Doctors at Toronto’s Hospital for Sick Children say that one third of Canadian youngsters living in urban areas don’t get enough of the sunshine vitamin. In a report released on May 4, 2009, researchers say their “finding is markedly higher than the data from a previous study of toddlers in Boston that found 14 percent of that population was lacking Vitamin D.”

Between November 2007 and June 2008, the study team “evaluated 92 healthy children aged 24 to 30 months who were attending routine well-child visits at a community-based pediatric practice in Toronto.” They monitored dietary intake through questionnaires filled in by parents and established Vitamin D levels through blood tests.

“The study revealed that factors associated with lower levels of vitamin D included lower milk intake, higher Body Mass Index (BMI), and watching television while snacking.”

Negative Health Effects of too little Vitamin D

The study’s lead author is Dr. Jonathon Maguire, an Academic Fellow in the SickKids Division of Pediatric Medicine who is pursuing a Master’s degree in Clinical Epidemiology at the University of Toronto. He is quoted by the hospital as saying, “Vitamin D deficiency is associated with a number of chronic medical conditions.”

He lists these as including rickets (a disease that may cause severe bone deformities and seizures), Type 1 diabetes, multiple sclerosis, and certain types of cancers.

Other researchers have suggested that vitamin D deficiency may be associated with tuberculosis, high blood pressure, seasonal affective disorder, and memory loss.

Writing about the study in The Globe and Mail (May 4, 2009) Martin Mittelstaedt noted that researchers believe babies get enough vitamin D from fortified formula and/or breast milk. He added that the story with toddlers seems to be different: “The finding of widespread insufficiency indicates most children aren’t getting enough vitamin D either through diet or through sunlight exposure. Dr. Maguire said that developing strategies to prevent deficiencies “would seem to be a prudent thing to do.’ ”

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Using Generic Drugs

generic drugs

Generic drugs can save you money because they cost less than brand-name prescriptions.

Unlike other types of generic products such as cereal or soup where the brand is often better, generic medications are just as pure, effective and high quality as their brand counterparts.

Generic drugs, by law, must have the same active ingredients than the brand names, and they are plentiful – generic options are available for about half of all prescription drugs currently on the market, a recent Consumer Reports report stated.

According to the Consumer Reports article, “Shopper’s Guide to Prescription Drugs” from 2006, generics are simply copies of the medications that have expired patents. It can take any where from 10 to 14 years for a patent to expire, at which point the brand-name manufacturer loses the right to be the only seller of the drug.

What’s Causing All the Confusion?

The confusion between choosing a generic or name brand often is because the name brand stays on the market while the generic is being sold. Seeing the two together, many people tend to choose the name brand because, as is the case with the soup they like to eat, they think the name brand must be better.

Another reason people are not using generics is because they may have been using the brand name for a while and don’t want to switch for fear it won’t work as effectively.

Still another reason generic medications haven’t caught on is because they often look different from the name brands. Again, this goes back to the comfort level of the patient. People like to stick with what they know without considering other options. Pharmaceutical companies have spent millions selling the image of their drugs to people, and, according to this logic, it’s no wonder. Once the idea is planted, it’s hard to uproot and plant another.

Ask Your Doctor About Generics

According to Providence Health Plans’ Web site, generic drugs are now available in all major therapeutic drug classes and are usually subject to a lower copayment or coinsurance, and generics offer effective treatment for many of the common conditions treated in routine care and are equivalent to brand-name products in safety, quality and performance.

If you are interested in trying generic medications, you must speak with your doctor. Pharmacists can change a doctor’s order from brand name to generic, but they have to ask you, by law. If you want more information, even after speaking to your doctor, consult your pharmacist. He or she will be able to provide additional insight about whether or not you should choose a name brand or generic.

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How to Recognize and Prevent Burnout

burnout
What is it?
Burnout occurs when a person feels overwhelmed by work and/or social circumstances and is unable to cope due to high levels of stress and emotional and physical exhaustion. Experiencing burnout can cause a person to feel unmotivated and extremely unhappy. High stress levels in all areas of life can reduce productivity and interrupt normal work, family and social relationships. It may also have an adverse affect on one’s health. It may be caused by lack of control, job boredom or monotony, extreme pressure to meet constant and excessive demands and lack of recognition.

Who is at Risk?
People who are dealing with a stressful environment on a daily basis, who must fulfill certain objectives and are under pressure due to time, financial or employer constraints. These people could be executive high flyers or even carers for the disabled. Any job or environment that can become monotonous and make a person feel like their achievements go unrecognized has the potential to increase the likelihood of burnout.

Signs of Burnout
Early signs of burnout relate closely to high levels of stress and the mental rather than physical state of a person’s well-being. Feelings like frustration, hopelessness, irritability and lack of emotional energy are all early signs. As they are also feelings experienced with depression fast diagnosis and early prevention of further burnout is required to.

Introduce positive change. As the state of burnout progresses physical symptoms such as fatigue, insomnia, weight gain or weight loss may manifest and a person is at higher risk of developing extreme mental depression and even other emotional problems, for example, anxiety attacks.

Prevention
Burnout can be prevented or alleviated with the same methods used to combat stress. Having good physical health and maintaining strong relationships within the family and workplace will ensure a foundation of support, if and when it’s needed. A person that can socialize and connect with like-minded people is able to relax easier and counter stress more effectively. To prevent burnout a person may request different duties in a monotonous job or indeed make a career change altogether. A clear expectation of work duties may help as will a clean and relaxed office environment. If the first signs of burnout are being experienced, a person may reassess personal and private life goals and realise and set limits on their capabilities in certain situations. Taking regular breaks may help reduce stress in a highly demanding work environment. Once burnout has occurred, positive changes may be undertaken through counselling, doctor’s advice and help from family and friends. The best defense against burnout is for a person to remain connected with others and practice good communication within work, social and family circles.

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What You Really Need to Know About Cholesterol

cholesterol
When a person eats fatty foods, those fats are ultimately absorbed by the small intestine and sent along to the liver, which breaks them down into various other fat products, but mostly cholesterol. The liver then transforms 80 percent of this cholesterol into cholic acid (bile), which is necessary to digest fats and proteins.

The rest of the cholesterol is then used as building blocks for all cell membrane construction, all hormone fabrication, stem cells and the insulation of nerves cells in the brain. Pretty important stuff. In fact, huge amounts of cholesterol are required for these functions. Remember that the brain is 80 percent fats by weight, mostly cholesterol and omega-3.

Cholesterol's Bad Rap

Then why does cholesterol have such a bad reputation? It’s because there are two types of cholesterol. The first is high density lipid (HDL) cholesterol, which is beneficial and does not harm blood vessels. In fact it protects them because it actually collects some of the negative cholesterol and carries it back to the liver for removal.

The negative cholesterol is low density lipid (LDL) and it acts as a free radical in the body. A free radical has nothing to do with the 1960s. It is an unstable protein molecule that can do great damage to the body and cells. The damage done by LDL cholesterol attracts inflammation which obstructs blood vessels and allows excess cholesterol in the circulation to be deposited in the damaged vessel walls. It is when clots form on these blockages in the blood vessels that flow is restricted and heart attacks or strokes may result. That is the cause of cholesterol's negative reputation.

Arteriosclerosis

This inflammation and blockage of the blood vessels is called arteriosclerosis. (By the way, calcium is also deposited in the vessels when inflamed and in this case is as dangerous as cholesterol.) And since it can have such dangerous consequences for human health it's worth understanding more clearly how it develops.

The lining of blood vessels can be damaged by many factors, not just cholesterol. The inflammation caused by the free radicals actually tries to repair damage, but the swelling it causes allows cholesterol and calcium to deposit. There has to be damage for cholesterol to stick and cause and arteriosclerosis.

So it's not so much LDL cholesterol, but the damage done by free radicals that are created by LDL cholesterol, that eventually lead to heart attacks and strokes. The blockages in the blood vessels cause protrusions, which lead to clots, which deprive the heart or brain of oxygen.

Guarding against arteriosclerosis

  • Exercise is the best cure. It can actually reverse arteriosclerosis.
  • Maintain a high intake of potassium. Bananas, orange juice, tomato paste and potatoes are among the foods high in potassium, or take a supplement.
  • No smoking.
  • Eat a balanced diet, low on toxins, fats and meat. Also avoid high amounts of sugars, starches and prepared foods.
  • Lower intake of saturated fat, but don’t cut it out entirely.

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Exercises for Air Travel

exercises for air travel

Travel often involves extended flights. Long periods of time seated in a cramped atmosphere can lead to reduced movement. In addition to general discomfort, this immobility can lead to dangerous health events.

Excessive sitting has the potential to cause blood clots in the legs. This condition is referred to as Deep Vein Thrombosis (DVT), sometimes also called traveler’s thrombosis. When blood pools in the legs, these clots can form which may have varying degrees of size and effects on health. Small clots often go unnoticed. Moderately sized clots can cause swelling, stiffness and pain.

Unfortunately, large clots can have life threatening consequences. The clot can break off and transfer to the lungs causing a pulmonary embolism, also termed a venous thromboembolism (VTE). The effects of a pulmonary embolism may not result until hours after it has occurred. The signs include chest pain and shortness of breath. In some cases it may cause sudden death.

The World Health Organization (WHO) has recently launched a project evaluating DVT and its relationship to air travel. The project, WHO Research Into Global Hazards of Travel (WRIGHT), is evaluating if higher risks of DVT and VTE are related to air travel versus other modes of transportation such as sitting in a car.

Preliminary research from the WRIGHT project indicates that the risk of VTE doubles for flights that last four hours or more. The risk increases as the flight time increases and can also be present in instances where travelers take several flights within a short time frame.

Move to Reduce Risk

Regular movement is advised during long flights to improve blood circulation. This can be done through standing and walking around the cabin every 60 to 90 minutes. Exercises performed in a seated position can also be beneficial in reducing the risks of DVT. Focus on the calf muscle may be related to increasing the blood flow in the legs and the prevention of clotting.

Many airlines provide suggestions and even explanations of exercises on their web-sites. Northwest Airlines provides a list of 10 possible movements complete with graphics for instruction.
A few examples of exercises that can improve blood flow include:

Ankle Circles

Slowly rotate the feet at the ankle in circles both clockwise and counter clockwise.

Seated Calf Raises

Start with the feet flat on the floor. Slowly raise the heels off the ground bringing the feet up on the toes. Lower the heels and press them into the floor and try to raise the toes off the ground.

Knee Raises

Lift the knees up towards the chest. This can be performed with both knees together or one at a time.

Reach

Raise the arms above the head and elongate the finger tips towards the ceiling, stretching the upper body.

Neck Stretch

Slowly drop the head to one side, almost to touch the shoulder. Circle the head to the front, chin to chest, and over to the other side.

More Tips

Travelers can incorporate additional practices during long flights for comfort and safety. Avoid tight fitting clothing when traveling. Garments should be loose and comfortable while seated. Also, increase leg room by removing items from under the seat in front. If there is no room in the overhead bin, pull the bag out and allow it to sit under the knees so that the legs can be stretched out. Air travel can be very dehydrating to the body. It is beneficial to regularly consume water and fruit juices throughout the duration of the flight.

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