HEALTH TIPS FOR SENIORS

Aging is a natural process and doesn't have to leave you feeling overwhelmed. A positive approach is very important to the aging process. Practicing good health can make you feel more comfortable as you greet the changes that come with aging.

"You dehydrate faster now than when you were younger"

Getting the proper nutrition and staying active are some ways to enhance your potential for successful aging and ensure you enjoy your golden years.

Nutrition

Proper nutrition and good eating habits are some of the key components for healthy aging. Good nutrition can prevent or delay the onset of many chronic illnesses such as osteoporosis, diabetes and heart disease.

Nutritional needs of older people differ from those who are younger. As you age, your body's metabolism may be less efficient or slower. Also, there may be less absorption and greater excretion of nutrients. Hence, you need to eat more nutrient-dense food. Nutrient-dense food are those that provide substantial amounts of vitamins and minerals and relatively few calories such as whole-grains, vegetables and fruits.

Another important part of good nutrition is getting adequate hydration. You dehydrate faster now than when you were younger and as you get older, you have lower levels of saliva and digestive juices. Water makes swallowing food easier, aids digestion and prevents constipation. Aging bodies also hold less water and some medications may cause water loss.

Drink six to eight glasses of fluid daily, depending on your height and weight as bigger people require more fluid. Water can come from drinking water, fruit juices, milk and soups. Try to limit the amount of caffeinated drinks such as coffee and tea as they can cause you to lose body water. Have a drink available around mealtimes and take water breaks throughout the day.

People often wonder whether it is necessary to take vitamin and mineral supplements. Unless directed by your doctor, vitamin and mineral supplements are rarely necessary if you eat enough food to meet your energy needs. It is also important that you do not use supplements in place of food or in extremely high amounts.

Be sure to check with your doctor or dietitian before starting any dietary supplements or when you have specific health problems or changes.

Physical Activity

Exercise is important for all age groups, particularly for the elderly. Many older people do not exercise as they think of it as a chore, boring or disappointed by the lack of immediate results. Regular physical activity not only make you look and feel better, it can help your body function more effectively in many ways, protect you from chronic illnesses and lower your chances of injury.

There are many types or exercise that you can do to enhance your level of physical activity. Choosing a type of exercise that is fun and enjoyable will enrich all aspects of your life and easily maintained over the long term.

Walking is a great way to exercise. If you find it boring, walk together with a partner and carry on a conversation while you're walking. You can also try different exercise programs such as joining swimming or tai chi classes and taking up a hobby like gardening. Try to work on making exercise a regular part of your day and build on your daily routine.

However, before starting an unfamiliar activity or new exercise program, you should always get help from your doctor to decide which type of exercise suits you best and discuss on any special conditions you might have. It is also important that if you feel pain or discomfort, you should stop the activity, take a break and consult your doctor.

Disclaimer: While every effort has been made to ensure accuracy of facts, the articles and information above must never be construed as giving professional health advice and as such Kurnia does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in the above article. Kurnia cannot be held responsible for any losses, injury or death resulting from the use of the above information.

VITAMINS

Vitamins are vital to metabolic processes such as bone formation, blood-clotting and tissue repair. Vitamins A, D, E and K are fat-soluble, and can be stored in the body. Water-soluble vitamins - the B group and vitamin C - cannot be stored, and must be eaten regularly.

"Small amounts of iodine are vital for making thyroid hormones, and a lack of iodine causes thyroid overactivity" Vitamin RDA* Good Sources Function in body A Retinol 0.8-1 mg Egg yolks; fish oils; offal. Made by body from carotene in green, yellow and orange vegetables. Growth; immunity; maintains health of mucous membranes; vision (especially in dim light). B1 Thiamine 1-1.4 mg Beans; fortified cereals; fortified flour; nuts and seeds; pork; brown rice; wheat germ. Carbohydrate metabolism; maintains health of muscular and nervous systems. B2 Riboflavin 1.2-1.6 mg Avocados; fortified cereals; dairy products; eggs; nuts offal; wheat germ; yeast. Cellular respiration; tissue maintenance and repair. B3 Niacin 13-18 mg; excess harmful Fish; fortified cereals (not natural maize) and flour; liver; meat; peanuts; yeast; wholegrains. Carbohydrate metabolism; maintains health of skin, nerves and digestive system. B5 Pantothenic acid 4-7 mg Fish; legumes; poultry; wholegrains; yogurt. Also made by intestinal bacteria. Carbohydrate, fat and protein metabolism; maintains health of nervous system. B6 Pyridoxine 2 mg Bananas; fish; meat; potatoes. Also made by intestinal bacteria Protein metabolism; red blood cell and antibody formation. B9 Folic acid 0.2-0.4 mg Meat, orange juice; pulses; green vegetables; wheat germ; wholemeal flour; yeast. DNA production; cell division (with B12) - including red and white blood cell formation. B12 Cobalamin 0.003 mg Fortified cereals; cheese; eggs; fish; meat; oysters. DNA production; maintains health of nervous system; helps functioning of folic acid. Biotin (B group; not numbered) 0.1-0.3 mg Egg yolks; nuts; offal; soy products; wheat germ; yeast. Also made by intestinal bacteria. Fat metabolism. C Ascorbic acid 60 mg (100mg for smokers) Fruits and vegetables, especially raw blackcurrants, citrus fruit, tomatoes, peppers and potatoes. Antioxidant (protects against disease); maintains health of connective tissue and cell walls. D Calciferol 0.01mg Mainly sunlight on skin. Also full-fat dairy products; eggs; liver; fortified margarine; oily fish. Facilitates absorption of calcium and phosphorus from intestines and bone growth. E Tocopherol 8-10 mg Butter; cereals; eggs; fortified margarine; nuts and seeds; wheat germ; vegetable oils. Antioxidant (protects against disease). Thought to protect cell membranes. K Menaquinone/ phylloquinone 0.07-0.14 mg Leafy green vegetables. Also made by intestinal bacteria. Facilitates blood-clotting. * Recommended daily amount for adults. Iodine Small amounts of iodine are vital for making thyroid hormones, and a lack of iodine causes thyroid overactivity. In places where the diet is lacking in iodine - because there is little seafood or the soil (and thus food and water) contains no iodine - people can develop a swollen thyroid gland, known as a goiter. Disclaimer: While every effort has been made to ensure accuracy of facts, the articles and information above must never be construed as giving professional health advice and as such Kurnia does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in the above article. Kurnia cannot be held responsible for any losses, injury or death resulting from the use of the above information.

WAYS TO KEEP HEALTHY AND VITAL

Health is something most people take for granted. To those who are ill, health is seen as a crown worn by those who are healthy. Many illnesses that we experience now are actually the cumulative effects of the unhealthy habits that have been acquired over the years as a reflection of our lifestyle.

"Get at least 20-30 minutes of exercise everyday" Some of us fall ill not due to our own actions but because of genetic predispositions. This is unavoidable, but many people this category do lead healthy lives by knowing and actively modifying their risk factors. Although studies shown that morbidity and mortality rates from infectious diseases in developing countries like Malaysia have reduced, diseases of lifestyle are now killing us Malaysians. Even our children are at risk for developing cardiovascular diseases such as obesity and asthma. This has become more apparent with the advent of the IT era because people are encouraged to rely so much on modern technology that we hardly find ourselves 'sweating' after completing a manual task. Even our children lead lives as computer game addicts and 'couch potatoes'! Other obvious risk factors include overeating, smoking and over dependence on medicinal drug supplements. Unfortunately, many people these days choose the easy way out when it comes to health. They would rather diet and take slimming pills then exercise. Disorders that can develop due to this sedentary lifestyle include chronic fatigue, shortness of breath, obesity, stomach discomforts, headaches, anxiety, muscular weakness and atrophy, high blood pressure, arteriosclerosis and coronary heart disease. Knowledge on these diseases however, are not enough to motivate an individual to make long-term positive behavioral changes. Skills for successful and healthy living must be taught to the young and reinforced periodically so that the individuals will be empowered to change their lifestyles positively. Pharmacists can encourage changes by advising individuals to be aware of risk factors that can affect their health in the long run. Advocating regular exercise combined with healthy eating habits and having a positive attitude in life is a good start for a vital and healthy life, regardless of age. Tips on staying vital and healthy: Get a balanced diet. Eat more fresh vegetables, fruits, soups and wholegrain products such as bread and pasta. Take less preserved foods that come in cans or packs- chances are they might be overloaded with sugar or salt. Instead of eating three big meals in a day, keep it to five or six smaller snacks a day. Get at least 20-30 minutes of exercise everyday. Do this by walking, jogging, cycling or even dancing to fast pace music of your choice. Housework does not count. Arm yourself against snack attacks with ready-to- eat, tummy filling snacks such as cold vegetable juice, raw veggies or fresh fruit. Nibble them to keep your mind off sugary snacks when you're bored, angry, frustrated or feeling blue and want to soothe your mind with a treat. Instead of deep-frying, try to cook your food by steaming, roasting or grilling. There's less oil involved this way. Learn the difference between physical hunger and mental hunger. Only eat when you need to. Do not smoke. If you already do, lower the number of cigarettes you smoke or stop altogether. Instead of driving, why don't you walk or cycle? It could be more fun and you need not worry about traffic. No booze please. Alcoholic beverages increase your caloric consumption and can boost your appetite. . Drink lots of water especially in our hot Malaysian weather. Don't overeat. Keep your mind on your food because having distractions such as watching TV will encourage you to overeat. Don't overdo it at buffets either! When exercising, bring your children or family along. This would make it more enjoyable. . Stay busy. Watching TV or playing computer games all day isn't going to help you stay healthy. Eat most of your calories early in the day. As they say, breakfast like a king, lunch like a prince and dine like a poor man. If you decide to take extra vitamin supplements, please get advice from the pharmacist or doctor first. You might end up consuming too much or having something that isn't suitable for you. Get regular medical checkups. Prevention or early knowledge safeguards you from any diseases that may be untreatable if left undiagnosed for too long (especially if you have a family history of a disease or illness). Do not be fooled into taking up a fad diet program. Here are ways to spot them: It focuses on one or a limited variety of food and cuts out entire food groups. It incorporates special dieting foods, pills or formula. It makes recommendations on vague studies and research. It claims that exercise or increase in physical activity is not necessary. Give yourself a treat once in a while as an incentive. You might lose interest to live healthily if you don't. Good luck! Disclaimer: While every effort has been made to ensure accuracy of facts, the articles and information above must never be construed as giving professional health advice and as such Kurnia does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in the above article. Kurnia cannot be held responsible for any losses, injury or death resulting from the use of the above information.

GETTING A GOOD NIGHT'S SLEEP

Going to sleep is one of the most wonderful sensation a person can have. However, it is estimated that millions of people around the world suffer from insomnia and have trouble getting quality night sleep. This is the beginning of sleep-anxiety where the mere worrying about getting enough sleep will keep you awake all night. Left untreated, these sleep disorders can turn into long-term problems that will adversely affect the quality of your life.

"You should have your dinner at least 3 hours before bedtime because a digesting stomach will not let you sleep." Why do we need sleep? It is yet to be discovered the full benefits of sleep. It is generally thought however, that sleep is a regenerating process that restores the body's energy supplies. Most repair work is also done during sleep where damages or torn body tissues are rebuilt. Mental energy is also restored, hence the saying that if you sleep on a problem, you will find a solution when you wake up. When deprived of sleep, you become moody and less coordinated, make more mistakes and is more prone to illnesses. What is Insomnia? Insomnia is inadequate or poor quality sleep due to one or more of the following: Difficulty in falling asleep Waking up frequently during the night with difficulty returning to sleep Waking up too early in the morning Unrefreshing sleep It may cause problems during the day, such as tiredness, lack of energy, difficulty concentrating and irritability. Types of Insomnia Transient - lasts from one night to a few days Intermittent - lasts a few days to a few weeks Chronic - lasts a few weeks to a few months What causes Insomnia? Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following: stress, environmental noise, extreme temperatures, varying bedtimes, changing work shifts, and the side effects of medication. Chronic insomnia is more complex and may be due to a combination of factors including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes include heart problems, breathing disorders, kidney disease, asthma, Parkinson's disease and arthritis. Chronic insomnia may also be due to behavioral factors including the misuse of caffeine, cigarettes, alcohol or other substances, disrupted sleep/wake cycles, excessive napping in the daytime, and chronic stress. Some behaviors may prolong existing insomnia, and may be responsible for causing the sleep problem in the first place: expecting and worrying about difficulty sleeping, taking excessive amounts of caffeine, consuming alcohol or smoking before bedtime, excessive napping in the daytime, and irregular or continually disrupted sleep/wake schedules. Stopping these behaviors may eliminate the insomnia altogether. What is the treatment? Transient and intermittent insomnia may not require treatment since they last only a few days at a time. However, for some people who experience daytime sleepiness and impaired performance as a result of transient insomnia, the use of short-acting sleeping pills may improve sleep and alertness the following day. As with any medication, there are potential side effects. Treatment for diagnosed chronic insomnia includes identifying behaviors that may worsen insomnia. by stopping or reducing them. Sleeping pills may be used (although the long-term use of sleeping pills for chronic insomnia is controversial) with behavioral techniques such as relaxation therapy, sleep restriction therapy and reconditioning to improve sleep. Contact your family doctor for further advice. Food A diet that promotes health naturally promotes good sleep. Replace instant foods such as canned foods and preserved items with fresh wholesome foods. Instant foods additives such as sugar, salt, coloring and flavorings stimulate the body into hyperactivity. Insomnia sufferers should take more Vitamin B found in whole meal breads and brown rice because it is known to alleviate symptoms. You should also have your dinner at least 3 hours before bedtime because a digesting stomach will not let you sleep. Exercise Sleep is a body's natural response to tiredness. By building exercise into your daily routine, you help yourself sleep better because it releases tension in the muscles and nerves. Avoid exercising late in the evening or at night however, because raised adrenaline will keep you awake throughout the night. If it is the only time you can exercise, choose deep relaxation exercises such as yoga or t'ai chi. Environment If you live in a city and you find the environment too noisy, opt to move to a quieter area or sleep in a room with less exposure to noise. Use curtains to block out the noise or light from windows and close your room door if it helps. Sleeping Habits Modern living plays a big part in meddling with our sleeping schedules. Due to work and our need for entertainment, most people have irregular sleeping habits. Sleep researchers suggest waking up at the same time each day regardless of how many hours you got to sleep the night before. Replacing sleep debts on weekends also do not work- you just end up more tired than before! Emotional Distress When your mind is not in peace, it is next to impossible to sleep. Anxiety, resentment, jealousy, guilt and grief are negative feelings that can ruin sleep. If you suffer from depression, you are likely to suffer from insomnia. Advising an insomniac to leave all their troubles before going to bed is easier said than done. Learning how to do this takes practice and a commitment to improve one's waking life. Re-orientate your long-term plans and always reassure yourself that things are never as bad as they seem. Substance Abuse Relying on quick fixes to banish stress can be another sleep hazard. It is ironic how we load ourselves up with cigarettes and coffee in the daytime to keep us awake and turning to alcohol and sedatives to go to sleep at night. Notorious sleep- thieves such as caffeine and smoking keeps you awake, edgy and anxious by triggering adrenaline and stimulating the nervous system. Illness and Medication Having illnesses such as breathing problems and pain can affect the quality of your sleep. Medications such as those used for arthritis can actually cause insomnia in some people. Find out the side effects of the medication or drug that you are using and whether there are alternative medication that you can take for your condition. When to seek help? It's important to ask for help if you are having sleep problems. You should consider getting medical advice if your sleep has been disturbed at least several times over the past month, or if sleep problems interfere with the way you feel or function during the day. Your doctor will evaluate your general health and ask about your usual sleep habits. Sometimes all that is needed is helpful advice. Disclaimer: While every effort has been made to ensure accuracy of facts, the articles and information above must never be construed as giving professional health advice and as such Kurnia does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in the above article. Kurnia cannot be held responsible for any losses, injury or death resulting from the use of the above information.

Getting some sleep

A look at ways to manage insomnia.
THE body rests and recovers from previous activities during sleep. Normal sleep comprises cycles of non-rapid eye movement (NREM) and rapid eye movement (REM). NREM sleep is followed by REM sleep, which occurs four to five times during the usual eight-hour sleep period.
The first REM period of the night may be last less than 10 minutes, while the last may exceed an hour. The NREM and REM cycles vary in length from 70 to 100 minutes initially, to 90 to 120 minutes later in the night.
Restful: Normal adults need six to 10 hours of sleep.
During the first third of the night, deep NREM sleep predominates, while REM sleep predominates in the last third of the night. REM sleep takes up 20% to 25% of total sleep time.
Insomnia
Insomnia refers to the disturbance of a normal sleep pattern. The different types of insomnia are:
·Difficulty getting to sleep (sleep onset insomnia) which is most common in young people.
·Waking up in the night which is most common in older people.
·Waking up early in the morning, which is least common.
·Not feeling refreshed after sleeping, leading to irritability, tiredness and difficulty concentrating during the day.
·Waking up due to disturbances such as noise or pain.
The duration of insomnia varies. It may be:
·Transient, lasting two to three days
·Short-term, lasting more than a few days, but less than three weeks
·Chronic, that is, it occurs on most nights for three weeks or more.
Everyone has experienced insomnia. It is generally accepted that about one-third of the population has insomnia.
How much sleep?
The need for sleep varies with age. A newborn may sleep 16 to 20 hours, and an infant 12 to 14 hours. Toddlers may sleep 10 hours or more. Primary schoolchildren need nine to 10 hours of sleep, while normal adults need six to 10 hours of sleep.
It takes an adult about 10 to 20 minutes to fall asleep. Most of those who have less than five to six hours of sleep are probably not getting enough sleep.
After a good sleep, a person would feel refreshed on waking and can stay alert throughout the day, without the need for naps or sleeping in on weekends.
Symptoms and causes
The symptoms of insomnia vary. They include lying awake for a long period at night prior to sleeping, waking up several times at night, waking up early in the morning and not being able to go back to sleep, feeling tired and not refreshed, inability to function properly during the day, and feeling irritable.
The causes of insomnia:
·Physiological: working at night, light, noise, snoring, partner’s movements, and jet lag.
·Medical: pain or discomfort caused by arthritis, headaches, back pain, menopausal hot flushes, gastrointestinal disorders and pruritus (excessive itching).
·Psychological and psychiatric: examination stress, work worries, relationship problems, anxiety, depression, bereavement and dementia.
·Sleep disorders: sleep apnoea and sleep walking.
·Medicines: antidepressants, appetite suppressants, beta-blockers, corticosteroids and decongestants.
·Alcohol.
Management
Consult a doctor. He will look into the history of your condition and conduct a physical examination. The doctor will enquire about your sleeping routines, previous and current medical conditions, psychological or psychiatric conditions, if any, consumption of caffeine, medicines and alcohol, substance abuse including narcotic drugs, diet and exercise. The cause may be detected through this approach in many instances.
If the cause is not obvious, the doctor will ask for a sleep diary to be kept. This involves recording the time when one goes to sleep, when one wakes up in the morning and when one wakes up at night.
A referral to a specialist may be necessary if the cause is still not obvious. Laboratory tests and polysomnography may be carried out. The latter is used in the diagnosis of sleep apnoea and sleep disorders. This involves recording many parameters when one is asleep, including brain electrical activity; movements of the eye, jaw and leg muscles; and heart and lung functions. The doctor will discuss with the patient prior to any videotaping which may be considered necessary.
Once a diagnosis of the underlying condition has been made, the cause will be treated. For example, if the cause is anxiety or depression, the problem will go away once it is treated.
General measures which do not involve the use of medicines are preferred. It may involve counselling if the insomnia is due to stress or bereavement. Cognitive behavioural therapy which involves changes in thinking and behavioural patterns is useful. Measures like limiting caffeine or alcohol intake, exercise and keeping to a regular sleep routine are helpful.
Sleeping pills may be considered by the doctor for severe or short-term insomnia if general measures do not work. Doctors are usually reluctant to prescribe sleeping pills as they relieve the symptoms but do not address the underlying cause. An individual can also become dependent on sleeping pills, which are not without side effects.
Many of the sleeping pills available belong to a group of medicines called benzodiazepines which require a doctor’s prescription. Benzodiazepines are anxiolytics and hypnotics, that is, they reduce anxiety and promote calmness and sleep. Benzodiazepines can lead to dependence and side effects like a hangover and drowsiness during the day. This can lead to accidents when driving. Examples of benzodiazepines include lormetazepam and temazepam.
The short-acting “Z-pills” that is, zopiclone and zolpidem, act on the same receptors as benzodiazepines but are not classified as such because their molecular structures are different. They were initially thought to be less addictive and habit forming than benzodiazepines but this view has changed with reports of addiction in the past few years. The side effects are similar to benzodiazepines.
The lowest possible dose of sleeping pills should be taken for the shortest possible time. One should only take them under medical supervision. There is no place for self-medication. Do not stop intake abruptly as this may cause withdrawal effects. The doctor’s advice is crucial here.
Melatonin is a hormone that is involved in the regulation of the sleep cycle or circadian rhythm. It is a short-term medicine for insomnia and cannot be consumed for more than three weeks. Although side effects are uncommon, they include dizziness, migraines, irritability, constipation and abdominal discomfort.
Getting good sleep
Getting a good night’s sleep is vital. This can be achieved by various means:
·Having a routine facilitates sound sleep. This means going to bed and getting up at about the same time every day. It is important to relax before getting into bed as activity just before bedtime may keep one awake.
·Having an early dinner helps. The digestive system goes to sleep at about 7 o’clock. A light dinner is helpful.
·Avoid caffeine after lunch as caffeine keeps one awake.
·Avoid alcohol as its breakdown produces chemicals that stimulate the individual. It also increases the likelihood of snoring as it relaxes the muscles. This leads to lighter and less refreshing sleep.
·Avoid naps. The afternoon nap may keep one awake at night.
·Avoid light. This is because melatonin, the hormone that helps a person sleep, is produced in the dark.
Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with.

EATING RIGHT: BE ON THE RIGHT TRACK OF DIET DURING THIS RAMADAN

Ramadan is the ninth month of the Islamic calendar and Muslims fast daily from dawn to dusk throughout the month. During this fasting period, health problems may emerge as a result of excessive food intake and unbalanced diet. Food abstinence will also slow down your metabolism in a response to conserve energy.

"Eat slow digesting food and fiber-rich food"

Below are some simple guidelines to ensure your diet remains balanced and healthy during this Ramadan.

Maintain a well-balanced diet

It is important to eat a wide variety of food to make sure that you get all the nutrients needed. To do so, consume the right proportions from various food groups such as meat, vegetables, beans, fruits, bread / cereal, milk and dairy products.

Meat is a good source of protein and minerals. Vegetables and beans are relatively low in calories and contribute to our daily fiber intake. Dairy products are good sources of protein and calcium which are essential for maintenance of body tissues while bread / cereal are a good source of energy, provide minerals and dietary fiber. Due to the long hours of fasting, you should also eat slow digesting food and fiber-rich food in order to have a sustained amount of energy throughout the day. These include wheat, oats, beans, grains and seeds.

Chew your food slowly and do not over eat as this will burden the digestive system and makes you feel sluggish.

Avoid unhealthy food

Avoid eating very spicy food or fried food that may cause indigestion and health problems. Take less salty food as they will lead to dehydration. Also, reduce intake of sweet and sugary food as such food will turn into fat and causes weight gain that may lead to other health problems. Although it may be difficult to completely avoid these unhealthy food, it is wise to eat them in moderation.

Drink sufficient fluid

It is essential to have sufficient intake of fluids daily to avoid dehydration. Water is one of the best sources of fluid for your body. Other fluids such as milk and juices can contribute to your daily fluid intake. Drinking juices also help to maintain water and mineral balance in your body and the sugars they contain are sufficient to give energy. However, limit your intake of caffeinated drinks such as coffee and tea that causes dehydration.

Exercise

During the fasting period, it may be difficult to pursue your regular exercise, however it is not necessary that you stop completely. Physical activities help to boost energy and accelerates metabolic rate. It is good to at least perform some kind of light exercise and movement that will not lead to excessive sweating and dehydration, such as stretching or walking in order to maintain your body weight and reduce stress.

Intake of a balanced diet is critical to maintain good health and with the right approach, you can attain the full benefits of Ramadan.

HAND, FOOT AND MOUTH DISEASE

Hand, Foot and Mouth Disease (HFMD) is a common illness of infants and children featuring mouth sores, fever and rash caused by a virus. It is usually a mild, self-limiting illness but can be more serious in some children. Let's read on to understand more and know how you can prevent and control the spread of this disease.

"A person is most contagious during the first week of the illness"

HFMD most often occurs in children under 10 years old but can also occur in older children and adults. It is caused by a number of enteroviruses in the family Picornaviridae. One such virus is enterovirus 71. HFMD is not to be confused with foot-and-mouth disease, which is a disease affecting sheep, cattle and swine which is unrelated to HFMD.

Symptoms of HFMD

HFMD begins with a mild fever, poor appetite, feeling sick and frequently a sore throat. One or 2 days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums and inside of the cheeks. The skin rash develops over 1 to 2 days with flat or raised red spots, some with blisters on the palms of the hand and the soles of the feet. A person with HFMD may have only the rash or the mouth ulcers.

The usual period from infection to onset of symptoms ("incubation period") is 3 to 7 days. Fever is often the first symptom of HFMD followed by blister/rash.

Is HFMD contagious?

Yes, HFMD is moderately contagious. It is usually spread by person to person contact with nose and throat discharges, saliva, fluid from blisters or the stool of infected persons. A person is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals.

Treatment

There is no specific treatment available for this infection. Treatment given is usually to provide relief from fever, aches or pain from the sores.

Prevent and control the spread of this disease by:

Practising good hand washing techniques, especially after using the toilet, changing diapers or handling other stool-soiled material. Cleaning and disinfecting contaminated items and surfaces using diluted solution of chlorine-containing bleach. Daily examine children for HFMD. Covering the mouth and nose when coughing or sneezing. Washing toys and other surfaces that have saliva on them. Excluding children with HFMD from schools or childcare facilities until the child feels well.

QUIT SMOKING

Smoking is a major public health problem. It affects a person's health in many serious ways, having both immediate and long term ill effects on your quality of life.

"Smoking raises your risk of certain cancers"

Effects of smoking

Cigarette smoke is a complex mixture of chemicals produced by the burning of tobacco and the additives. Smoking raises blood pressure and heart rate. This puts you at a much higher risk of having a heart attack and can cause strokes. In chronic smokers this can cause heart disease.

Smoking also raises your risk of certain cancers. These can be lung cancer, stomach cancer, throat cancer, oral cancer and many more.

Effects on Pregnant Women

Smoking during pregnancy is a risky move. It can cause serious health problems for both mothers and babies.

Sudden Infant Death Syndrome: Women who smoke during pregnancy expose their babies to Sudden Infant Death Syndrome as these babies are more likely to die from the harmful effects of smoking.

Stillbirth: Smoking has repeatedly been associated with risk of stillbirth. Smoking cigarettes or breathing in somebody else's smoke reduces the amount of oxygen in your blood stream. Your baby gets its oxygen supply from your blood, so less oxygen in your blood deprives your baby of oxygen essential for growth and development.

Low birth weight of the baby: The more a pregnant woman smokes, the greater her risk of having a low birth weight baby. Low birth weight can lead to many complications. Being born too small is the major cause of infant illness and newborn death.

Respiratory Infections: Your baby is more likely to have asthma and other respiratory diseases if you expose your baby to smoking or second hand smoke.

Premature birth: Smoking during pregnancy can lead to premature birth. The child can have underdeveloped bone structure and maturity level mentally. The baby can be deformed, with retarded brain functions and have problems during their learning period. It can also result in death of the newborn.

Miscarriage: It is known that mothers who smoke are at a greater risk of miscarriage if they continue to smoke during pregnancy. Since passive smoke is also dangerous, make sure no one in your household smokes during the pregnancy.

Methods to quit

Most people who quit smoking use a combination of quit methods. You will need to find the combination of methods that works best for you. Here are some quit methods.

Cold Turkey Cold turkey is the term used to describe quitting smoking with no help from quit aids of any sort. With this method, individuals abruptly stop smoking cigarettes. It is simple, self-managed and low cost. Withdrawal symptoms may be severe for some people, especially if they have been smoking a brand of cigarette with a high nicotine level.

Gradual Reduction A slow gradual reduction in the number of cigarettes you smoke over time is a method that you may try. Try smoking only half the cigarette, waiting an hour longer each day before lighting up your first cigarette or smoking only during odd or even hours.

Nicotine Replacement Therapy (NRT) NRT refers to a number of quitting aids that ease withdrawal symptoms by delivering nicotine to your body in amounts you can regulate. There are several forms of nicotine replacement available such as patches, gums, lozenges, nasal spray and inhalers. Over time, you can reduce the nicotine dose, thus weaning your body from the addiction. Using these products helps reduce the cravings for cigarettes and the withdrawal symptoms associated with quitting. NRT is much safer than smoking but if you have a medical condition, any health worries or are pregnant, it is important that you consult your doctor first.

Atropine and Scopolamine Combination Therapy Some smoking cessation clinics offer a program using shots of the drugs atropine and scopolamine. You might want to talk to your physician or doctor before using this therapy as they may not be suitable for everyone. If you have chronic medical problems, take certain medications or are pregnant, then you shouldn’t use this therapy.

Hypnosis and acupuncture Not everyone wants to take medicines to help them quit smoking. Techniques such as hypnosis and acupuncture may help some smokers to quit.

Quitting smoking can be really hard, but it is one of the best things you can do for your health!

What is a chiropractic adjustment?

Specific spinal adjustments are the hallmark of chiropractic care. An adjustment is a gentle force introduced into the spine intended to release a vertebral segment from its abnormal motion and/or position thereby reducing the vertebral subluxation.

The adjustment can consist of a light comfortable dynamic thrust, as in Diversified technique, to several ounces of sustained pressure, as found with the Toftness system. There are more than 20 adjusting systems utilized in chiropractic today. Each system has a specific adjusting rationale to restore the spine to normal function. This reduces the negative neurologic impact, and returns the body to more normal efficiency. Spinal adjustments, regardless of which system is utilized, are tailored to the patient's age and spinal condition.

Chiropractic analysis utilizes x-ray examination for visual assessment of the subluxated spine, to detect any possible contraindications to spinal adjustments, and to rule out bone disease or spinal pathologies. Other technologies used in subluxation detection include heat measuring, or thermographic, instruments. Since blood flow and subsequent skin temperature are indirect measures of autonomic nervous system function, abnormal temperature patterns measured along the spine can be a sign of autonomic nerve dysfunction. Non-invasive testing, such as surface EMG, is an up-and-coming technology that is being utilized in chiropractic to better analyze the impact subluxation has on spinal muscle function. The chiropractor may utilize these technologies in addition to traditional spinal palpation, motion palpation and orthopedic and neurological examinations.

How early should prenatal care begin?

A home test indicated I was pregnant, but I haven't yet been to a doctor. A couple of midwives in my area said that a prenatal exam wasn't necessary until 10 to 12 weeks. However, I know my family physician would see me right away, and I thought there were important tests to be done early on. I'm also concerned because this is my first pregnancy and I feel as though it hasn't been validated by anyone in the health profession.

I couldn't agree with you more. It is not so much the testing, but the education about what is good for babies and what is harmful, that mothers miss when they don't get the earliest possible care.

Folic acid should be begun as soon as possible. Diet is vitally important right from the beginning, as is education about about drugs, alcohol, smoking, infections, sexuality, family changes and much more. Paps, blood work, etc., could be done safely at 10 to 12 weeks, unless you have a history of complications or a family history of an inherited trait that should be screened for right away. However, it is important to verify dates as early in the pregnancy as possible.

I would look for another care provider who is more compatible with your preventive philosophy.

10 questions to ask when choosing a pediatrician

Many parents-to-be have discovered it's a good idea to interview possible baby doctors before the baby is born. And though today's health care plans have perhaps severely limited your choice of doctors, most plans still do have some choices. Physicians usually welcome these appointments and do not charge for prenatal interviews, but occasionally some do.

Ask if there will be a fee when you call to make the appointment. Also, ask how much time you'll have with the physician, so that you can pace your questions. Have your questions written down, and take someone with you -- your partner or a friend. One of you needs to take notes. When grandparents live nearby, some parents-to-be bring along their mom or dad, especially if this person will be seeing a lot of the grandchild.

Here's a list of common questions. Ask what is most important to you first.

1. What is your philosophy about child rearing? Do your homework and know your issues before you have this conversation. For example: Do many of the mothers in your practice breastfeed their babies successfully? Do you think children should be fed on a schedule? Sleep in the same bed with their parents? Wean at a particular time? What is your usual recommendation for babies who cry when they're put to sleep at night? What is your philosophy about antibiotics or other medication for children who have colds or other ailments? What is your opinion about infant vaccinations or circumcision?

   You'll think of other questions over time as your baby grows up, but it's important to get some sense in advance of how much a baby doctor and you agree on child rearing. Otherwise, if you disagree often, you'll probably change baby doctors later anyway, or you'll avoid discussing those issues on which you disagree and you won't get the benefit of a professional opinion sometime when you'd like to have it.

Does a pediatric nurse practitioner (PNP) work in your office? A PNP is a nurse, often already with a masters degree, who with additional training becomes the pediatric equivalent of the certified nurse midwife in an obstetrician's office. (American Nurses Association News Release, 11 July 1995, p.2) A PNP can handle "well-child" checks and minor illnesses, and consults with the pediatrician as needed. Many parents like to work with PNPs, as they often spend more time with them, and their fees are lower than a doctor's.

Do you charge for phone calls? Most physicians do not charge for these calls, but some do. Typically, most parents of firstborn children call frequently.

Do you return every call? Some doctors make every callback. Others have office personnel return the calls. Occasionally, the nurse who hand les your phone call may not have the same attitude about the issue in question (breastfeeding or sleeping habits, for example) that you or your doctor have. If you find that the person who's handling your phone call is not on your wavelength, request that the doctor call you back instead.

What is the scheduled length of your appointments? The closer her appointments are (10 to 15 minutes apart, rather than 20 or 30 minutes, for instance), the more likely it is you'll do some waiting, as well as be rushed through your appointment when you do see your health care provider.

How often do you want to see the baby in the first year? Why? Pediatricians more than family practitioners will schedule several "well-child" visits for your child. Pediatricians believe this to be a form of preventive care and an opportunity for parent education. Feel free to discuss in advance with your doctor or nurse the purpose of these "well-child" visits, so that you can decide what's appropriate for your child's care. We all need encouragement as parents, but you decide if it's always worth an office-visit fee to find out how much your baby, especially if it's not your first child, weighs and the fact that your doctor thinks your baby is doing well.

Do you have a "sick-child" waiting room? Some doctors try to avoid mixing the well children and the sick children in the same reception area. Young children are very susceptible to contagious diseases.

If you share a practice, will I always see you? Not likely. If you are scheduling an exam well in advance, it's easy to ask for a day that your doctor will be in the office. However, if you have a sick child, you'll get whomever is in the office or on call. If it's important to you, arrange to meet all the doctors who might cover for your baby's doctor in an emergency, or when you're in the hospital.

Do you have evening or Saturday hours? Although daytime hours are still the rule, a growing number of doctors are accommodating working parents.

Pregnant without health coverage

My wife is pregnant and we do not have health insurance, although I will soon have coverage through my job. Will I have to lie and pretend it is not preexisting, or am I faced with paying huge bills?

It is fairly easy to determine when conception occurred based on last menstrual period (don't give them a false date here because it is very important to date your pregnancy accurately) and uterine size from ultrasound, so it may not be prudent to mislead your prenatal care providers about when the pregnancy began.

Many women are faced with the dilemma of becoming pregnant with no medical insurance or switching jobs or plans when they are already pregnant. The following information comes from an organization called Consumer Insurance Guide: Insurance News Network. Their mission is to deliver accurate, unbiased insurance news for consumers. They offer tips, in-depth stories, and expert guidance on auto, homeowners, health, life, and business insurance, plus annuities. They are an independent news site that does not sell insurance and are not owned or operated by an insurance company.

Pregnancy complicates health insurance options. Federal law bars pregnancy from being considered a preexisting condition, which means if you change health plans while you're pregnant, your new insurer can't deny claims related to your pregnancy. But a variety of loopholes means pregnant women could still lack insurance coverage for their prenatal care if they don't do some careful planning.

Under a law known as HIPAA, the Health Insurance Portability and Accountability Act of 1996, health insurers cannot consider pregnancy a preexisting condition. So, unlike illnesses such as diabetes, they can't deny you coverage when you go from one job to another and switch health plans.

"It was not good public policy to have a pregnant woman with no access to health insurance," says Kansas Insurance Commissioner Kathleen Sebelius. "We want to encourage prenatal care and regular checkups during the course of a pregnancy and having pregnancy as a preexisting condition would block access to health care." There are exceptions to the rules, however.

Unfortunately, there are a lot of "buts" to HIPAA. For one thing, HIPAA doesn't apply to someone who previously had no health coverage at all and then gets into a group health plan through a new job. So if you had no insurance, got pregnant, then landed a new job with insurance, your new health plan would not have to immediately cover your pregnancy. You might have to sit out a preexisting condition waiting period, a period that could be longer than your pregnancy and in the meantime pay for your visits yourself.

Second, HIPAA applies only to group health plans. So if you have individual insurance and are pregnant, then buy group health insurance, you again could be subject to a preexisting condition waiting period. Likewise, if you move from one individual health plan to another individual health plan, you might not get pregnancy coverage at all. You might have to sit out a waiting period, or if you are offered insurance that covers your pregnancy, you might find it's very expensive.

"HIPAA is really the only protection against pregnancy being treated as a preexisting condition, and there are lots of people to whom HIPAA rules don't apply," Sebelius notes. Eligibility waiting periods are possible.

Here's another scenario. Say you have group health coverage and then switch jobs. Your new health plan has a one month eligibility period before it begins and you're pregnant. What can you do? "Probably nothing," Sebelius warns. The health plan isn't required to cover your pregnancy until the plan takes effect. While that might not be a problem if you're early in your pregnancy and you don't mind paying for a prenatal visit or two out of your own pocket, it could be trouble if you're in your eighth or ninth month and have no coverage.

If you find yourself without insurance, organizations such as Catholic Charities and Lutheran Social Service often have reduced cost prenatal services available.