November 2014 Health Bulletins

	Ask the Doc Dr. Davis Smith is director of health services at Westminster School, Simsbury, Connecticut

“I feel every med I take needs another med to counteract the previous one’s side effect. Are meds making me sicker?”
— Omar N.*, Saddleback College, Mission Viejo, California
*Name changed for privacy

The short answer
Probably not. But they might not be making you better enough, or might seem to be making you feel worse in different ways.

Living with a difficult-to-treat condition is hard. We still struggle to treat many conditions, and even with conditions that are usually treatable, some individuals might not have as much success as others.

Here’s why, with tips on how to manage your condition:

How we think medicine works

• You notice that something doesn’t look or feel right.
• You consult a medical practitioner.
• The practitioner takes a history, performs an exam, and perhaps does some testing.
• The practitioner evaluates the data. Aha! Diagnosis!
• The practitioner prescribes a treatment.
• Your ailment rapidly resolves.

Real life is more complex

• Medicine is a stepwise process of trials and re-evaluations, culminating (ideally) in successful diagnosis and treatment.
• Disease activity can respond to any number of factors, e.g., sex, age, race, ethnicity, and other circumstances, like sleep or stress.

What you need to know about medication

• Medications can be too weak or too slow to take effect.
• Side effects can be more unpleasant or distressing than the underlying symptoms.
• The more medications you take, the higher your chance of problematic side effects.
• Sometimes we need to add medications to treat the side effects of other medications, e.g., a stomach acid suppressant treats the irritation that can result from pain relievers like ibuprofen.
• Initial side effects often improve as patients adjust to medications, but some side-effects remain intolerable.

Tips for patients with hard-to-treat conditions

• Keep track of what medicine(s) you’re taking, how and when you take them, and positive and adverse effects. Share these honestly and openly with your provider.
• Aim for a trusting, open relationship with a qualified provider. Mutually agree on your objectives and expectations. Putting these in writing helps.
• Don’t blow off follow-up appointments.
• Maintain realistic expectations, and focus on success. Consider involving a therapist.

If you’re struggling, stick with it. I’ve managed cases that have taken months to settle on a treatment strategy that balances therapeutic benefits with minimal side effects. In time, most people find a way out and are able to turn their attention back to the rest of their lives.

	Ask the Trainer Frankie Romeo is a certified personal trainer, small group training coach, and graduate student at Lipscomb University in Nashville, Tennessee

“How can I handle judgment and negativity?”
— Jessica S., University of Alaska, Anchorage

Sometimes it can seem like judgment is all around us—on Facebook, in class discussions, in the dining hall, on online comment threads. Negativity from others (and ourselves) can undermine our confidence and motivation, and make it harder to be physically active. That’s particularly true if we’re not comfortable with our body or the activity itself. Whether you struggle with judging others or being judged, here’s how to handle it.

1. Find supportive, active peers

• Spend time with people who have a positive outlook and care about you.
• Friends who live healthily, prioritize fitness, and respect others are likely to help you get and stay active.
• Tell these friends your fitness goals or invite them to work out with you.
• Going to the same fitness class each week will help you meet supportive peers.
• Knowing you have moral support helps you reach your goals.

2. You gotta believe (in yourself)

• Confidence is essential for success.
• You have the ability to reach your goals. But if you don’t think you do, you’ll fall short.
• Everyone starts somewhere. Even the young woman who dominates five-minute miles once didn’t know how to start the treadmill.
• Stay focused on making steady progress toward your goals. Your workout is for you. It doesn’t matter whether it works for the guy two benches over. (Chances are he isn’t noticing you anyway.)
• Ignore negativity. If it’s coming from you, actively challenge your thought process.

3. The golden rule
“Do to others what you would have them do to you.” Judge as you would like to be judged.

• Don’t stare, sneer, or say mean stuff.
• Find the good in everyone and keep an open mind.
• Remember: Everyone has a story; don’t assume you know the plot.
• Smile—your friendliness might surprise you!

	Ask the Relationship Educator Dr. Rick Hanson is a licensed psychologist and the director of the counseling center at Rockhurst University in Missouri.

“What are the basic elements of attraction? What makes two people fall in love? ”
— Sandy A., University of California, Los Angeles

Attraction happens all the time, and yet is hard to understand. Why are you attracted to one person though your friends are not? Why are some attracted to a wide range of people, while others are very particular? Attraction is equal parts science and mystery, so the answers aren’t clear. There are many elements to attractiveness, and we each prioritize them differently. But in general, we are attracted to people who make us feel good physically, socially, relationally, and/or emotionally.

Attraction in action
Depending on the situation, your attraction to someone—or their attraction to you—probably includes several elements. Depending on your preferences and experiences, some of these will be quite important while others will not:

• Physical experience How the body looks, sounds, smells, or feels.
• Internal chemistry The interaction of any number of hormones.
• Social status A person’s standing in society, including their clothes, career, and friends.
• Excitement/fun/stimulation How much you enjoy someone’s company.
• Companionship/friendship How much you value someone’s loyalty and support.
• Stability/security How well a person can help provide for your needs and comfort.

Lust? Love? Live-in BFF?
What we are looking for also affects the type of people we find attractive.
So what do you want?

• Friendship
• Romance
• A hook up
• A soul mate
• A life partner
• Some peace and quiet at long last

Let’s be honest
If you want to be attractive to others, consider the old saying: “You catch more flies with honey than wth vinegar.”

• Be the best version of you. Authenticity is compelling—so long as you’re not authentically mean.
• If you’re trying to be what someone else wants, and it doesn’t come naturally, what happens after you have their attention?
• Being attractive is about finding someone you’re truly compatible with. So let the real you shine through.

FIND OUT MORE
Is that musk ox-scented deodorant really a good idea? Answers from the Science of Attraction web series.

	Ask the Nutritionist Karen Moses, director of wellness and health promotion at Arizona State University in Phoenix.

“What’s the best way to ease into a healthy diet?”
— Julie,* Binghamton University, The State University of New York
* Name changed for privacy

The path to healthy eating is different for each person. Here’s how to get started:

• From the list below, choose a step you can take now.
• In a week, add another.
  Mark the date on your calendar.
• The week after, another. And so on.

When you practice a habit for about eight weeks, it becomes easier to maintain and build on.

• Make water and unsweetened tea your friends Yes, these can be the main beverages of your day. Cut the sugary drinks, which can lead to a quick spike of energy and then a crash (among other problems).
  
• Bump up your veggies Aim for 2–4 cups of vegetables each day. Eat them raw, steamed, stir-fried, or as juice. Fresh or frozen vegetables offer the best nutritional value. Find new recipes and new seasonings—oregano! garlic! cumin!—to liven up your plate.

A visual guide to that tricky veggie-to-cup-size ration

• Find a new sweet spot How often do you drink soda, or eat candy, ice cream, or other sweets? Think about how to cut your sugar consumption by half. For example:
• Limit desserts to weekends.
• Buy cookies on every other trip to the store, rather than every time.
• Identify alternative snacks and treats, and keep them available.
• Once you’re not missing it, cut back again.
  
• Eat “in” more often Fast food and restaurant food tends to be higher in fat, sugar, and salt than foods prepared at home. If you have a place to prepare your food, choose this option most of the time. Set a realistic limit on how many times you will eat out each week, and stick with it.
  
• Eat slower Often we eat so fast we hardly experience the food. Slow down. Taste it. When we eat slowly, we enable our body to regulate our hunger and consumption.
• Use a smaller fork or spoon, or even chopsticks, to make yourself linger over dinner.
• Try the Eat Slower app. The adjustable timer helps regulate your bites.
• For iOS.
• For Android.
• Eat a healthy snack before you go to a social event If you’re hungry when you get there, you’re more likely to eat one of everything and go back for seconds…of everything. Eating a healthy snack before the party helps you pace yourself and make conscious food choices.
  
• Spend time with people who share your interest in healthy eating This will make it a lot easier for you to make and maintain new habits.
  

Motivation and information, including a recipe for spinach-almond pesto.

E-CIGARETTES Unhealth-E or OK?

By Chris Stuck-Girard

A few years ago, they were rarely seen in the wild. Now you can find them next to the Blow Pops in gas stations. They’re E-cigarettes, and they got popular fast. Researchers are scrambling to determine the health impact of these gizmos, which emit vapor laced with chemicals—including nicotine—when users inhale.

Can E-cigarettes help you kick butts?
The pencil-sized machines are marketed as a convenient alternative to lighting up—and as a tool to help folks quit tobacco. With the Great American Smokeout on November 20, if you’re a smoker, you might be eager to join the 88 percent of college students who have not smoked in the last month. Can E-cigarettes really help you kick the butts?

Mixed findings
Few studies have addressed the question, and findings are mixed. But we do know that nicotine—which E-cigarettes deliver in varying doses—is bad. The drug can contribute to heart disease, cause complications during pregnancy, and act as a “tumor promoter,” the World Health Organization wrote in July.

Nicotine also has the potential to harm brain development among young people. That includes—please cancel your trip to Denial—college students.

Still, E-cigarettes are far less abrasive to your lungs than plumes of cigarette smoke, so they may be significantly less harmful. But we’re not sure.

In any event, “vapers” must be wary of nicotine overdose, which can result in bad things like vomiting, confusion, and seizures, according tothe US National Library of Medicine. (Users should keep E-cigs away from young children, who–being teeny-tiny–can overdose more easily.)

Bottom line
Bottom line, as we await more research: We should consider E-cigs a cousin of a pack of cigarettes. Stick to those Blow Pops.

How to stop procrastinating tomorrow

By Chris Stuck-Girard

Hold on—I gotta check Facebook just one more time before I finish this sentence. OK, I’m back. So! Procrastination: It’s bad.

Most of us want to be efficient, but time after time we find the day melting away as we watch “just one more” TV episode or click on “just one more” video of baby animals.

Good news! Procrastination isn’t just in your head. Experts have found that making some tweaks to the way you work can make it easier to buckle down.

Breaking up is easy to do
A task can seem easier if you break it into small segments, says Dr. Jesse Crosby, a psychologist at Harvard Medical School. Try doing one bit a day, and start small.

“I always feel I can do anything for five minutes, so I set a timer,” Gail McMeekin, author of The 12 Secrets of Highly Creative Women, told WebMD. “Once I start, I usually go over five minutes and may finish the job.”

Crack the door
Completing just a small part of a project creates momentum and helps dispel fears that a given task is too difficult or complex. Think of that quote from the ancient Chinese philosopher Laozi: “A journey of a thousand miles begins with a single step.” After you take a single step on that assignment, you’re moving.

Buddy up
Working with others can hold you accountable for making steady progress, says Gail McMeekin. Be sure, though, to discuss with a professor what sort of teamwork is kosher. You don’t want to be accused of cheating or plagiarism.

Find a Hermione
Find someone who’s consistently proactive, and stick close to that person. You could soak up some of his or her good habits. “Surround yourself with people who are doers,” Joseph Ferrari, a DePaul University psychology professor, told US News & World Report.