Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Saturday, April 27, 2013

Better Doctors Focus on Mistakes


Everybody makes mistakes. But far too few people take the opportunity to learn from them. We'd all be better people if we did. And for doctors, acknowledging errors could mean the difference between a patient's life or death.
In a study where doctors were faced with a simulated medical emergency and had to choose from uncertain treatment options, a scenario requiring a certain amount of trial and error, doctors who paid more attention to their mistakes fared much better than those who focused on their treatment successes.

This is a message everybody could benefit from.
The doctors were presented with a situation where a patient had suffered a heart attack and given a simplified six-factor patient history. They then had to choose from two emergency drug treatments.
The key to choosing the right drug was whether the patient had diabetes. One drug had a 75 percent success rate in patients with diabetes and a 25 percent success rate in all other patients. The second drug gave completely opposite results. But the doctors didn't know this. They had to figure it out from seeing which of their virtual patients lived and which died.
They were given 64 computer simulated trials to learn from, with 10 seconds to select a treatment option for each patient. Results of their treatment were described as either success or failure. Then the same exercise was done as a test: 64 new patients, with no information given to the doctors on whether the treatment succeeded or failed.
Their success rates, their own written accounts, and brain scans taken while the doctors were going through this exercise all provided some very interesting results.
About one-quarter of the doctors eventually found the proper treatment pattern, choosing correctly between 77 and 98 percent of the time. The other doctors did much worse. Based on fMRI scans, which measure changes in blood flow to different parts of the brain, doctors who performed well tended to show high activity in their frontal lobe when treatments failed, while the doctors who performed poorly tended to activate the frontal lobe when a treatment was successful.
The researchers interpret this as meaning that the better performing doctors were focusing more on failed treatments and gradually learning from their mistakes. The poorly performing doctors focused more on successful treatments, with each success confirming what the doctors (falsely) thought they knew about which treatment was better. The researchers term this sort of behavior "success chasing." It's what happens when people ignore their mistakes.
The doctors' own written accounts give other clues about what was going through their heads as they tried to figure out why these drugs sometimes worked and other times didn't. Choosing the right drug was a puzzle. As they treated more patients, doctors altered their treatment strategies based on the results they were seeing. For example, at one point in the trial, one doctor was prescribing drug A for females over 55 and men under 55, and drug B for all other patients. As the trial progressed, the better-performing doctors made small adjustments to their treatment rules following both successes and failures, while low performers made large rule adjustments, and made significantly larger adjustments following successes than failures.
A very striking and unanticipated result was that the more experienced a doctor was, the poorer they performed during the trial.
So what's the take home message from the study? Probably that people can learn as much from their mistakes as their successes but tend to think that their successes are much more meaningful.
What about the fact that less-experienced doctors were better at solving the puzzle? The meaning of that was beyond the scope of the study and could have many explanations. Perhaps younger minds are more facile at solving puzzles. Or maybe older doctors simply are less fond of computer tasks. Nobody knows for sure. It's one more point to consider in the seemingly unanswerable question of whether people are better off with a younger doctor or a more experienced one.

Saturday, January 1, 2011

Top 10 Sleep Mistakes and Their Solutions



Although we may not like to admit it, many of the sleep problems we experience are the result of bad habits and behaviors. We stay up late or sleep in late. We eat foods that disagree with us or enjoy a drink late at night, oblivious to its disruptive impact on our sleep rhythms. Over time, we teach our body not to sleep. For relief we often turn to sleeping pills, which mask rather than solve the problem, and can lead to addiction. Ultimately for real success, with insomnia as with any chronic problem, one must look for the underlying imbalances and root causes and address those.
Here are the common sleep “mistakes” I see in my practice and their solutions.
MISTAKE #1 Not keeping a consistent sleep schedule.
We often think we can make up for lost sleep by going to bed extra early another night, but the body clock’s ability to regulate healthy sleep patterns depends on consistency. We stay up late on weekends, expecting to make up sleep later or use the weekend to make up for lost sleep during the week. Both practices disrupt bodily rhythms and late-night weekends in particular can cause insomnia during the workweek.
SOLUTION: Create a routine and stick to it.
Getting up and going to bed around the same time, even on weekends, is the most important thing you can do to establish good sleep habits. Our bodies thrive on regularity, and the best reinforcement for the body’s internal clock is a consistent sleep schedule.
Waking and sleeping at set times reinforces a consistent sleep rhythm and reminds the brain when to release sleep and wake hormones, and more importantly, when not to.
MISTAKE #2 Using long naps to counter sleep loss. 
Long naps during the day especially after 4 p.m. or even brief nods in the evening while watching TV can damage a good sleep rhythm and keep you from enjoying a full sleep at night.
SOLUTION: Nap for no more than 30 minutes.
If naps are absolutely necessary, make sure you only nap once a day and keep it under a half hour and before 4 p.m. In general, short naps may not hurt sleep and in fact a short siesta for half an hour after lunch or a 20 minute power nap before 4 p.m. works well for many people.
MISTAKE #3 Not preparing for sleep.
Expecting the body to go from full speed to a standstill without slowing down first is unrealistic. Our bodies need time to produce enough sleep neurotransmitters to send feedback signals to the brain’s sleep center, which will result in the release of sleep hormones to allow you to sleep.
SOLUTION: Take the time to slowly shift into sleep. 
a) Create an electronic sundown. By 10 p.m., stop sitting in front of a computer screen (or TV screen) and switch off all electronic devices. They are too stimulating to the brain and will cause you to stay awake longer.
b) Prepare for bed. Dim the lights an hour or more before going to bed, take a warm bath, listen to calming music or soothing sounds, do some restorative yoga or relaxation exercises. Getting your mind and body ready for sleep is essential. Remove any distractions (mentally and physically) that will prevent you from sleeping.
MISTAKE #4 Not giving your body the right sleep signals. 
Our bodies depend on signals to tell them when to fall asleep and wake up, the two most fundamental ones being darkness and light. But we live and work in artificially lit environments and often miss out on the strongest regulatory signal of all, natural sunlight. When we do go to sleep and our bodies need complete darkness for production of the important sleep hormone, melatonin, our bedrooms are not pitch dark, thereby interfering with this key process.
SOLUTION: At night, keep the room as dark as possible.
Look around your bedroom: the alarm clock read-out that glows in bright red; the charging indicator on your cell phone or PDA, the monitor on your computer, the battery indicator on the cordless phone or answering machine, the DVD clock and timer. Even the tiniest bit of light in the room can disrupt your pineal gland’s production of sleep hormones and therefore disturb your sleep rhythms.
Conceal or move the clock, cover all the lights of any electronic device and use dark shades or drapes on the windows if they are exposed to light. If all of that is not possible, wear an eye mask.
If you get up in the middle of the night, try keeping the light off when you go to the bathroom. Use a flashlight or night light.
MISTAKE #5 Having a bed time snack of refined grains or sugars.
These are metabolic disruptors which raise blood sugar and overstress the organs involved in hormone regulation throughout the body. This hormone roller coaster can affect sleep cycles by waking you up at odd times during sleep as the hormone levels fluctuate.
SOLUTION: If you have to eat, have a high-protein snack.
It is better not to have anything before bed. But if you must eat something, a high protein snack will not only prevent the hormone roller coaster, but also may provide L-tryptophan, an amino acid needed to produce melatonin.
MISTAKE #6 Using sleeping pills to fall and stay asleep. 
Sleeping pills mask sleep problems and do not resolve the underlying cause of insomnia. Many sleep studies have concluded that sleeping pills, whether prescription or over-the-counter, do more harm than good over the long-term. They can be highly addictive and studies have found them to be potentially dangerous (see references, page 11).
For short term use, there may be indications for needing sleeping pills, but over time, sleeping pills can actually make insomnia worse, not better. If you have been taking them for a long time, ask your doctor to help you design a regimen to wean yourself off them.
SOLUTION: Learn relaxation techniques. 
Aside from physical problems, stress may be the number one cause of sleep disorders. Temporary stress can lead to chronic insomnia and circadian rhythm sleep disorders. Many people tell me they can’t switch off their racing minds and therefore can’t sleep.
Do some breathing exercises, restorative yoga or meditation. These will calm the mind and reduce the fears and worries that trigger the stress.
MISTAKE #7 Using Alcohol to fall asleep.
Because of alcohol’s sedating effect, many people with insomnia drink alcohol to promote sleep. Alcohol does have an initial sleep inducing effect, but as it gets broken down by the body, it usually impairs sleep during the second half of the night leading to a reduction in overall sleep time. Habitual alcohol consumption just before bedtime can reduce its sleep-inducing effect, while its disruptive effects continue or even increase.
SOLUTION: Take nutrients that calm the body and mind, getting you ready for sleep. 
Don’t drink alcohol to help you sleep. Look for a calming formula that has some of the following: amino acids, L theanine, taurine, 5 HTP and GABA, and herbs like lemon balm, passion flower, chamomile and valerian root. Taking the minerals, calcium and magnesium at night is also helpful. For some people, especially those of us over 50, melatonin can be helpful too. This is because the body produces less melatonin with advancing age and may explain why elderly people often have difficulty sleeping and respond well to melatonin.
MISTAKE #8 Watching television to fall asleep.
Because we have no trouble at all falling asleep in the living room in front of the TV many of us watch TV in bed to fall asleep. But when we fall asleep in a bed watching TV, we invariably wake up later on. This sets up a cycle or conditioning that reinforces poor sleep at night. I have had many patients over the years develop insomnia due to this type of conditioning.
SOLUTION: Get the TV out of the bedroom.
Don’t watch TV in bed. The bed should be associated with sleep (and sex).
MISTAKE #9 Staying in bed hoping to fall asleep.
If you can’t fall asleep within 30-45 minutes, chances are you won’t for at least another hour, and perhaps even longer. You may have missed the open “sleep gate” or missed catching the sleep wave. A “sleep gate” is the open window of time your body will allow you to fall asleep. Researchers have found that our brain goes through several sleep cycles each night where all sleep phases are repeated. These cycles last from 90 minutes to two hours, and at the beginning of each cycle, the body’s “sleep gate” opens. You won’t be able to fall asleep when your sleep gate is closed. 
SOLUTION: Catch the sleep wave. 
If you find you can’t fall asleep within 45 minutes, get up and get out of the bedroom. Read a book, do a restorative yoga pose or do some other calming activity for another 1 -1 1/2 hours before trying to sleep again. Staying in bed only causes stress over not sleeping.
It is like surfing; you need to catch that sleep wave. Have you ever been exhausted and yet you avoid going to sleep and then a few hours later when you are ready for bed, you are suddenly wide awake? You missed the wave.
MISTAKE #10 Making sleep a performance issue. 
Often just thinking about sleep affects your ability to fall asleep. What happens frequently is that the way you cope with the insomnia becomes as much of a problem, as the insomnia itself. It often becomes a vicious cycle of worrying about not being able to sleep which leads to worsening sleep problems. Like so many things in life, it is about letting go, going with the flow. Sleep needs to become a natural rhythm like breathing, something that comes automatically and you don’t think about.
SOLUTION: Let go and go with the flow.
Use the time to practice breathing exercises or meditation and to become aware of how what you eat, what medications you take, what behaviors or certain activities can affect your sleep cycle.
Increase your awareness by paying attention to your body and becoming conscious of how you react to different foods and situations. Use this time productively, instead of getting upset that you can’t fall asleep.
One final point.
For chronic insomniacs, especially if you are a heavy snorer, make sure Sleep Apnea is not the cause. This is a serious condition that affects at least 12 million Americans, many of whom have not been diagnosed. Usually they are heavy snorers. What happens is that the tissues at the back of the throat relax and in so doing block the airways. The brain senses oxygen deprivation, and sends wakeup signals. There is a release of adrenaline and cortisol, the stress hormone. Not only does this interfere with sleep, it can increase blood pressure, raising your risk of heart problems and stroke. It can also interfere with insulin sensitivity, and increases your risk of diabetes.


Read more: http://www.care2.com/greenliving/top-10-sleep-mistakes-and-their-solutions.html#ixzz19mVyizKz

Monday, September 27, 2010

5 Health Mistakes Dog Owners Make



You want the best for your dog -- your pooch is your best friend, after all. Yet sometimes, pet owners who mean well make serious mistakes, especially when it comes to the health of their dog.
Are you on the right track to keep your dog in top shape? WebMD went to veterinarians to find out the most common health mistakes dog owners make and get their tips on how to avoid them.

Dog Health Mistake 1: Not Getting Preventive Care

Neglecting preventive health care is by far the most common mistake dog owners make, according to the veterinarians we interviewed.
"Taking your dog in to the vet for regular examinations, giving heartworm prevention, and getting your dog the appropriate vaccinations and dewormings can prevent many diseases," says Adrianne Brode, DVM, CCRP, associate medical director at the Canine Health Institute in Houston. For example, heartworm disease can be difficult to treat and ultimately fatal to dogs, but it's easily preventable.
Yearly exams help your vet catch problems early, according to Oregon veterinarian Marla J. McGeorge, DVM. Instead of coping with lengthy treatment of an advanced or chronic condition, your vet can catch issues at their beginning stages, when care may mean cure. And early care saves you money in the long run.
Although annual exams may coincide with needed vaccinations, simply getting your dog vaccinated isn't the same as a full physical exam. Among other things, a comprehensive checkup may include:
·                                 Blood work
·                                 A fecal examination for intestinal parasites
·                                 Examination of a dog’s gums, heart, lungs, teeth, eyes, and ears
Talk to your veterinarian to learn more.

Dog Health Mistake 2: Neglecting Dental Care

Neglecting regular dental care is also common, according to Shawn Messonnier, DVM, author of the Natural Health Bible for Dogs and Cats. Dogs need dental care for the same reason we do: to prevent gum disease.
As on human teeth, plaque forms on a dog's teeth after eating. If left alone, the plaque builds, causing inflammation, decay, and eventually bone and tooth loss. And while this silent war goes on in your dog's mouth, she’s probably experiencing pain you don't notice because dogs, like cats, instinctively hide pain.
Gum disease is actually five times as common in dogs as in people. But it's easy to prevent and to treat with dental care that includes:
·                                 Daily brushings
·                                 Good quality food
·                                 Regular oral X-rays, exams, and cleanings
·                                 Safe, teeth-cleaning treats and chew toys

Dog Health Mistake 3: Overfeeding

If too much love is ever a bad thing, it is when we show it to our canine companions in the form of too many tasty treats.”Rewarding and loving our dogs with food leads to obesity," Brode says. Overweight or obese dogs are at higher risk for arthritis and other orthopaedic issues, as well as other health problems. 
It can be difficult enough to balance our own diets, much less that of our dogs. So talk to your vet, who will help you select a good, high-quality food for your dog and give you tips on exercise and treats. That's right -- you don't have to stop sharing occasional goodies with your pooch, as long as 90% to 95% of your dog's diet is healthy and well balanced.

Dog Health Mistake 4: Sharing Medication

Another dangerous health mistake owners make is giving dogs human medications. "Pain medications like Advil or Tylenol can be very toxic to dogs," Brode tells WebMD. In fact, there is a host of seemingly benign human drugs that can pose grave health risks for pets.
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are the most common cause of pet poisoning in small animals, according to the ASPCA. Even small doses can be toxic. Antidepressants, muscle relaxers, decongestants, vitamin D derivatives, oral diabetes treatments, and other common human drugs can all pose risks to pets, from seizures to coma to death.
Always keep medication secure -- preferably in a high, locked cabinet -- and never discard medication where pets or children can get to it. If you’re worried that your dog may have gobbled up an over-the-counter or prescription pill you dropped -- or worse, taken an entire bottle from the trash -- don't hesitate.

Dog Health Mistake 5: Delaying Critical Care

We often delay medical care for ourselves, waiting for a bump, pain, or rash to go away. So it may seem natural to do the same thing with our dog.
There's a problem with that, however: Dogs don't have the words to let us know exactly what they're feeling. Your canine companion could be in pain, sick, and even gravely ill -- and chances are you wouldn't know it because of dogs’ instinct to hide infirmity.
Don't wait to see if a health problem in your dog gets better on its own. Call your vet if your dog isn't eating or is eating less, vomiting, lethargic, has diarrhea or fever, or just doesn't seem well.

http://pets.webmd.com/features/dog-health-mistakes

Thursday, May 6, 2010

The Most Common Exercise Mistakes



Do’s and Dont’s of Your Workout Routine

1) Stretching before you run. 

Most people walk out the door and start running while others bounce and hold stretching positions.  The truth is that muscles have an elastic plastic reaction.  Heat them and they become more pliable.  Stretch them while cold and you may injure the muscle or only stretch the connective tissue.  Best case for your workouts is to jog or walk for 5 minutes to increase circulation, bloodflow to the working muscles, and body temperature.  Then perform “dynamic stretching” which is MOVING through the patterns you will be doing during your workout.  Then hit the trail and move it!1 2

2) Skipping your stretch after you run. 

Second most common mistake is to finish the run and shower.  Your body needs time to recover, lower heart rate and return muscles to a relaxed state that permits correct alignment and reduced muscle tension.  Static stretching after your workout will return the “length tension” relationship to the muscles for better alignment, lower the heart rate and blood pressure slowly like a dimming switch on a light, and give you time to cool down the body’s temperature.  Failing to stretch might result in poor alignment, tight muscles and injury.3

3) Avoiding your workouts. 

A common concern I hear is “I have no time to workout”.  Health has to be your first priority.  We know that 1 in 3 women will die of a cardiovascular disease, so take control of4 your health to be clear of becoming just another statistic. Fitting in as little as ten minutes a day of exercise can help.  Intensity is key for the time constrained. Ten minute workouts and getting in 3-5 ten minute workouts a day do add up.  So don’t be afraid to move and find the time for you.5 6

4) Reading on the treadmill. 

Although some exercise is better than nothing, put your best foot forward and listen to that book.  Reading on the treadmill not only compromises your posture but can decrease your intensity.  If you only have a limited amount of time, use it wisely.  Stay engaged in your workout and breathe consciously in the moment.7

5) Doing the same old thing. 

I am happy you have found the time to exercise but doing the same patterns over and over again can damage the body and reduce the caloric output.  Our bodies become extremely efficient in activities we have repeated for years, so you will not be burning the same amount of calories as you did a few years ago doing the same 45 minute cardio. 8Worse, when we skip cross training, our muscles can “wear out the joints” by continually adding force in only one direction on the joint. 9Balance your workouts by moving in all planes of motion, forward, backward and rotationally.

Thursday, June 11, 2009

Ordering Up a Healthy Diet.

IT’s festival time, and restaurants dish out specialities. But that shouldn’t mean blowing out your diet. Here are some ideas for staying healthy while dining out:

Skip the buffet

Before going out choose a restaurant that offers healthy menu options. All-you-can- eat buffets and fast-food joints are diet –killers.

Choose steamed , not fried.

Look for dishes described as fresh , roasted , grilled or steamed. Avoid items with the words fried, creamy or extra-crispy.

Put it on the side

For an appetizer , look for broth-based soups, rather than cream. Apply any salad dressing very lightly .

Go ahead and ask

Don’t be shy-ask the waiter if the restaurant offers low-fat items, or if regular menu options can be cooked for you with less oil.

Spilt the difference.

Fresh fruit is the healthiest dessert. If you can’t resist something sweet, share it with a friend .

Move it out of sight

Stop eating when you’re full . Ask the waiter to clear your plate so you aren’t tempted to keep on nibbling.

Pace yourself.

Not eating all day so you can eat more at night is a bad idea-it encourages extravagant ordering and fast eating.

Watch the booze

Alcohol is high in calories, so determine the maximum amount you’ll consume before you start and stick to it. Avoid liqueurs and cream with coffee.

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