June 1-7: CPR & AED Awareness Week

If you were with someone who had a heart attack or almost drowned, would you know what to do? When blood flow or breathing stops, seconds count. Permanent brain damage or death can happen quickly. If you know how to perform cardiopulmonary resuscitation (CPR), you could save a life. CPR is an emergency procedure for a person whose heart has stopped or is no longer breathing. CPR can maintain circulation and breathing until emergency medical help arrives.

Even if you haven’t had training or if you do not have a face shield and fear disease, you can do “hands-only” CPR for a person whose heart has stopped beating. “Hands-only” CPR uses chest compressions to keep blood circulating until emergency help arrives.


If you’ve had training, you can use chest compressions and rescue breathing. Rescue breathing helps get oxygen to the lungs for a person who has stopped breathing. To keep your skills up, you should repeat the training every two years.


CPR facts and statistics

• About 80 percent of all out-of-hospital cardiac arrests occur in private residential settings, so being trained to perform cardiopulmonary resuscitation (CPR) can mean the difference between life and death for a loved one.
• Effective bystander CPR, provided immediately after cardiac arrest, can double a victim’s chance of survival.
• CPR helps maintain vital blood flow to the heart and brain and increases the amount of time that an electric shock from a defibrillator can be effective.
• Approximately 95 percent of sudden cardiac arrest victims die before reaching the hospital.
• Death from sudden cardiac arrest is not inevitable. If more people knew CPR, more lives could be saved.
• Brain death starts to occur four to six minutes after someone experiences cardiac arrest if no CPR and defibrillation occurs during that time.
• If bystander CPR is not provided, a sudden cardiac arrest victim’s chances of survival fall 7 percent to 10 percent for every minute of delay until defibrillation. Few attempts at resuscitation are successful if CPR and defibrillation are not provided within minutes of collapse.
• Coronary heart disease accounts for about 446,000 of the over 864,000 adults who die each year as a result of cardiovascular disease.
• There are 294,851 emergency medical services-treated out-of-hospital cardiac arrests annually in the United States.
• There are about 138,000 coronary heart disease deaths within one hour of symptom onset each year in the United States. 
• Sudden cardiac arrest is most often caused by an abnormal heart rhythm called ventricular fibrillation (VF). Cardiac arrest can also occur after the onset of a heart attack or as a result of electrocution or near-drowning.
• When sudden cardiac arrest occurs, the victim collapses, becomes unresponsive to gentle shaking, stops normal breathing and after two rescue breaths, still isn’t breathing normally, coughing or moving.

If you are in the DFW area and wish to learn more or get certified visit:
www.malechealtheducation.com

Visit to learn more: http://cprweek.com/

Homemade Garden: Hydroponic

There are two basic types of hydroponics systems: active and passive. This article will explain how to set up these simple hydroponic systems, as well as the mediums best suited for each. Both have there advantages and disadvantages, and all factors (what watering and soil moisture retention needs does your plant have) must be considered when deciding on the system that would be best for your plants.

Active hydroponics systems work by actively passing a nutrient solution over your plants roots. They usually involve a large size planting medium such as pea gravel, vermiculite and perlite. To make a simple, active, hydroponic system, for one plant.

You will need the following materials:
1 one gallon planting pot with drainage holes

1 two gallon bucket-no drainage holes, (used for nutrient solution reservoir)

1 small aquarium water pump (to pump nutrient solution to your plant)

1 small bag of vermiculite, perlite, or pea gravel(enough to fill your planting pot with)

1 small table with a whole in the top, large enough to place your planting pot in without it being able to fall all the way through

2 small plasic tubes, long enough to reach from the nutrient solution to the water pump and from the water pump to the planting pot

2 clothes pins, to attach your plasic tubes to the top of your containers

1 on/off timer, to attach to the water pump to control the amount of water
supplied to your plants


Setup:
Place your planting container, the one with drainage holes, in the hole in the top of the table. With the hole being larger than the pot it should fit into position securely with little or no movement. Fill your planting pot with your selected medium, up to about one-two inches from the top of the container. Set the two gallon bucket(reservoir) directly underneath the drainage holes of your growing container, so it will catch all water draining out of the one gallon pot. Set your water pump on the floor beside your reservoir. Attach one of your plastic tubes to the water intake on your water pump and place the other end into your reservoir, making sure the bottom of the tube is at the lowest point in the bucket without being placed too close to the bottom of the container, preventing water from being drawn in. Attach the tube to the rim of the reservoir, being careful not to cut off water flow to the water pump, using the clothes pin. Connect your other plastic tube to the top of the growing container, with the other clothespin, placing the end right at the top of the medium, so it flows across the top of the "soil" line. The other end should be connected to the outflow spout on your water pump.

Plug your water pump into the timer, and we are ready to test your active hydroponic system out. Fill the reservoir about half way up with water, making sure the water line is above the intake of your tube. Plug your timer into an appropriate electrical socket, and place the timer in the "on" position. The water pump should begin a lite humming noise, and after a few seconds(water pumps can take a few seconds to prime themselves up) the water should begin to flow up the tube and out the reservoir. The water should continue it's course through the plastic tube, into the water pump, out into the other plastic tube and up into the growing container. After the water has begun to sink through the medium in your container, it should begin to drain out into the reservoir, that is placed below it. Check carefully for any leaking that may occur, and fix as needed. It may not be prebuilt by a manufacturer, but it will accomplish the same purpose. Just add a plant to your container and the proper nutrient solution(specifically for the type of plant you choose to grow) into the reservoir and voila, you have an active hydroponic system, which supplies nutrients, and oxygen needed to process them, to your plants roots.


An inactive hydroponic system is a system that provides your plant with nutrients through a capillary or wick system. Working like a kerosene lamp, the wick draws the nutrient solution from the reservoir, up to the plants medium and root system. This method is the least used of the two, using mainly sand, sawdust or peatmoss as a growing medium. It involves no moving parts and is easy to setup.

All you need are the following materials:

1 one-gallon planting cotainer, with drainage holes

1 hydroponic absorbtion wick, found at local garden supply centers

1 table with a hole in the center, slightly smaller than the one gallon planting container, allowing the container to sit in the hole, but not fall through one small bag(enough to fill the growing container up) of medium, i.e. sawdust, sand or peatmoss

1 one-gallon bucket, with no drainage holes, to use as a reservoir


Setup:
Setup of the wick system is a very simple and easy to accomplish task. First you place your hydroponic wick into your growing container, following it's usage directions for your specific container. When inserted, it should line the wall of the container and protrude from the bottom, through the drainage holes. The wick has to be long enough to reach the reservoir, but your container should be no more than about 6-8 inches above your reservoir to allow proper absorbtion into the growing container. Next, fill your growing container, up to about 2 inches below the rim, with your desired medium; sand, peatmoss or sawdust. Place your growing container, placing the wick through first, into the hole in your prepared table. It should slide halfway into the hole and then become stuck, giving rigid placement to the container. Place the two-gallon reservoir under the table, directly below the growing container. Place the wick inside the reservoir, making sure the wick will be fully submersed by the water it will contain, and your ready to test your inactive hydroponic wick system. Simply fill the reservoir under the table with water, filling it to within approximately 2 inches from the top. Within about thirty minute to an hour, you should be able to touch your medium and feel the moisture in the soil or see it beginning to dampen. Add a plant and some nutrient solution(specifically for your type of plant) and your growing in a nonactive hydroponic system thats easy to maintain, and supplies nutrients constantly.
Hydroponic gardening can take a little bit to get used to, but once you have learned how to use it, it can be a very efficient way to grow any kind of plant. Beginning with these simpler versions you can develop the skills and experience needed to grow hydroponically with out the expensive setups. Good luck growing with your inactive, as well as active hydroponic systems.

Preventing Lower Back Pain in Grappling and Martial Arts

It is no secret that many people suffer from back pain and it’s no different for students of grappling and martial arts. The sad part is that most of the time it can be prevented.


About the author: These are tips from David Malec; a 25 year practitioner in Martial Arts (Tae Kwon Do, Jujitsu, Karate, Kickboxing) , a 16 year military veteran (8 years in the Marine Corps Infantry), 15 years as a Certified Personal Trainer, and 11 years as a Nurse. David suffers from chronic back problems and only by utilizing the techniques below has he been able to combat the debilitating pain and live an active, exciting life.

If you have lower back pain, it is your job to educate yourself about what specifically is causing the pain and what you can do to eliminate or reduce it. All too often, people with back pain walk away from physicians and chiropractors with no clue as to what is causing them pain and more importantly, what THEY can do to prevent it.

Just taking some pain killers or seeing a chiropractor three times per week for adjustments is not really addressing the issue at hand. Hopefully you will find the following 6 tips helpful in preventing and relieving lower back pain.

This guy forgot to read this article!

1. Learn proper biomechanics not only when participating in grappling and martial arts.

Many people injure their backs while lifting. Most likely, these people developed back pain from a combination of things and the lifting was “the straw that broke the camel’s back.” With that said, it is important to learn how to lift safely. Bend at the knees while keeping your eyes forward and your back in its natural alignment. Keep the object close to your body and avoid twisting.

2. Find out which sleeping position works best for you.

Sleeping on your side - Place a pillow between your knees to keep your spine in a neutral position
Sleeping on your back - Place a pillow under your knees to keep your spine in a neutral position
Sleeping on your stomach - Place a pillow under your stomach to keep your spine in a neutral position

3. Strengthen your stomach.
Weak abdominals can lead to an excessive arch or lordotic curve. This will cause a strain in the lumbar region (lower part) of your back. Great ways to safely strengthen your stomach are crunches and side crunches. Abdominal strengthening is especially important for helping to keep your core strong for grappling and martial arts training.

For crunches, lay flat on your back with your knees bent and feet flat on the floor. With your arms crossed at your chest and your hands touching opposite shoulders, contract your abdominal muscles and bring your shoulder blades three inches off the floor.

It is important to keep your lower back pressed into the floor at all times and your eyes should be focused on a point on the ceiling. For side crunches, do the same as crunches but twist your torso to alternating sides as you come up.

4. Treat any muscular imbalances you may have.
Believe it or not, this may be the single biggest cause of back pain. I have had many clients who suffered from back pain prior to meeting me. They were happy to soon be living free from lower back pain and from upper back pain after achieving muscular balance. If you have questions about muscular balance, consult with a physical therapist or highly qualified fitness professional for an evaluation.

Poorly conditioned individuals suffer more from back pain and are at a higher risk than those who are conditioned. An example of a muscle group that is commonly too weak is the hamstrings. People who are inactive tend to have much stronger hip flexors (muscles at the top of your front thigh) and quadriceps than glutes and hamstrings. This can be due to contracting of hip flexors and quadriceps mostly from walking or just getting up and down.

This lack of balance within the muscles will cause your pelvis to shift forward. You are now left with an anterior pelvic tilt which causes an exaggerated arch in your lower back and possibly some unwanted pain. This can be easily solved with a few hamstring exercises, including backwards walking or going in reverse on the elliptical machine.

5. Lose Weight.
If you are overweight, the elimination of low back pain is just another reason to lose weight. The further your belly protrudes the more force it exerts on your lower back. Your spine will thank you for losing the excess pounds!

6. Stretch.
The more limber your muscles are, the less stress there is on your lower back. It would be in your best interest to stretch all of your muscles but particularly important are the hamstrings and the lower back.

For the hamstrings: Lay on your back with one leg straight in the air. Keeping the leg straight, wrap a towel around your foot, holding an end of the towel in each hand. Slowly pull the ends of the towel toward your head until slight discomfort is felt in your hamstrings. Hold for 20 seconds and switch sides.

For the lower back: Single or double knee-to-chest stretch.

There you have it -- six easy ways to prevent low back pain in grappling and martial arts! I hope you are able to get rid of any aches and pains you may have.

Teens and Alcohol

Tips for Teens: The Truth About Alcohol

Slang--Booze, Sauce, Brews, Brewskis, Hooch, Hard Stuff, Juice

Alcohol affects your brain. Drinking alcohol leads to a loss of coordination, poor judgment, slowed reflexes, distorted vision, memory lapses, and even blackouts.
Alcohol affects your body. Alcohol can damage every organ in your body. It is absorbed directly into your bloodstream and can increase your risk for a variety of life-threatening diseases, including cancer.
Alcohol affects your self-control. Alcohol depresses your central nervous system, lowers your inhibitions, and impairs your judgment. Drinking can lead to risky behaviors, such as driving when you shouldn’t, or having unprotected sex.
Alcohol can kill you. Drinking large amounts of alcohol at one time or very rapidly can cause alcohol poisoning, which can lead to coma or even death. Driving and drinking also can be deadly. In 2003, 31 percent of drivers age 15 to 20 who died in traffic accidents had been drinking alcohol.¹
Alcohol can hurt you--even if you're not the one drinking. If you're around people who are drinking, you have an increased risk of being seriously injured, involved in car crashes, or affected by violence. At the very least, you may have to deal with people who are sick, out of control, or unable to take care of themselves.




Know the law. It is illegal to buy or possess alcohol if you are under age 21.
Get the facts. One drink can make you fail a breath test. In some States, people under age 21 can lose their driver's license, be subject to a heavy fine, or have their car permanently taken away.
Stay informed. "Binge" drinking means having five or more drinks on one occasion. Studies show that more than 35 percent of adults with an alcohol problem developed symptoms--such as binge drinking--by age 19.²
Know the risks. Alcohol is a drug. Mixing it with any other drug can be extremely dangerous. Alcohol and acetaminophen--a common ingredient in OTC pain and fever reducers--can damage your liver. Alcohol mixed with other drugs can cause nausea, vomiting, fainting, heart problems, and difficulty breathing.³ Mixing alcohol and drugs also can lead to coma and death.
Keep your edge. Alcohol is a depressant, or downer, because it reduces brain activity. If you are depressed before you start drinking, alcohol can make you feel worse.
Look around you. Most teens aren't drinking alcohol. Research shows that 71 percent of people 12-20 haven't had a drink in the past month.⁴
 



How can you tell if a friend has a drinking problem? Sometimes it's tough to tell. But there are signs you can look for. If your friend has one or more of the following warning signs, he or she may have a problem with alcohol:

• Getting drunk on a regular basis
• Lying about how much alcohol he or she is using
• Believing that alcohol is necessary to have fun
• Having frequent hangovers
• Feeling run-down, depressed, or even suicidal
• Having "blackouts"--forgetting what he or she did while drinking

What can you do to help someone who has a drinking problem? Be a real friend. You might even save a life. Encourage your friend to stop or seek professional help. For information and referrals, call the National Clearinghouse for Alcohol and Drug Information at 800-729-6686.




Q. Aren't beer and wine "safer" than liquor?
A. No. One 12-ounce bottle of beer or a 5-ounce glass of wine (about a half-cup) has as much alcohol as a 1.5-ounce shot of liquor. Alcohol can make you drunk and cause you problems no matter how you consume it.

Q. Why can't teens drink if their parents can?
A. Teens’ brains and bodies are still developing; alcohol use can cause learning problems or lead to adult alcoholism.⁵ People who begin drinking by age 15 are five times more likely to abuse or become dependent on alcohol than those who begin drinking after age 20.⁶

Q. How can I say no to alcohol? I'm afraid I won't fit in.
A. It's easier to refuse than you think. Try: "No thanks," "I don't drink," or "I'm not interested." Remember that the majority of teens don't drink alcohol. You're in good company when you're one of them.

 For more information visit:
Reference: http://ncadi.samhsa.gov
This article is a re-print from:  http://ncadi.samhsa.gov/govpubs/ph323/

Top 10 things that annoy people who use wheelchairs

This is a re-post from http://www.christopherreeve.org


Do you know what really irks people who use wheelchairs? Following up on a lively discussion in the community, we ran a poll to find out.
Here's the official list of the
Top 10 Things that Annoy
People who use Wheelchairs...

1.	Able-bodied people parking in accessible parking spaces	37%
2.	Accessible bathroom stalls being used by an able-bodied person	12%
3.	Talking over my head as if I'm not here	9%
4.	Continuing to insist on helping me after I've said no thanks	8.3%
5.	Congratulating me for things like going to the grocery store like it's worthy of an Olympic medal	6.1%
6.	Strangers asking what happened to me	5.7%
7.	Not inviting me to an event because you are protecting me from some frustration (let me figure it out)	5.3%
8.	Patting me on my head. Don't.	5.0%
9.	Holding on to the back of my chair so I can't move	4.4%
10.	Speaking slowly to me because I'm in a wheelchair	3.5%

Now that we have the Top 10 List, we just have to get people who are behaving badly to cut it out!
We are sharing these results far and wide this week to raise awareness and help start a conversation. I hope you will join us in this effort.
If you're using a wheelchair, tell us how you deal with rude behavior -- do you try to ignore it, correct the person nicely but firmly, make a joke?
And if you're not using a wheelchair, how would you deal with a friend who misbehaved while you were out together -- apologize for your friend, let it go but bring it up later, or ignore it, and try to display better manners in the hopes that your friend would learn from it?
Give us your thoughts on how to make life less annoying for people who use wheelchairs. We will create a follow up list with some of the best ideas for educating the rude and ignorant individuals among us.

What is Traumatic Brain Injury?

Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.  Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain.   A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking.  A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.

Is there any treatment?

Anyone with signs of moderate or severe TBI should receive medical attention as soon as possible. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize an individual with TBI and focus on preventing further injury. Primary concerns include insuring proper oxygen supply to the brain and the rest of the body, maintaining adequate blood flow, and controlling blood pressure. Imaging tests help in determining the diagnosis and prognosis of a TBI patient. Patients with mild to moderate injuries may receive skull and neck X-rays to check for bone fractures or spinal instability. For moderate to severe cases, the imaging test is a computed tomography (CT) scan. Moderately to severely injured patients receive rehabilitation that involves individually tailored treatment programs in the areas of physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), psychology/psychiatry, and social support.

Diabetes: HgbA1c

The hemoglobin (hgb) A1c blood test is like a 2-3 month average blood sugar. What you ate the night before the Hgb A1c blood test does NOT affect the result. The test can be done at any time of the day in a lab using a sample of blood from your arm. There are also home kits -see a few paragraphs below.

You do not need to be fasting to have an Hbg A1c blood test done. It can also be known as HbA1c, hemoglobin A1c, A1c, glycosylated hemoglobin, glycohemoglobin or glycated hemoglobin.

Let's compare A1c to candy apples. Imagine your red blood cells are like candy apples in a zooped up candy factory - maybe Willy Wonka's - where the apples get soaked in syrup for 3 months! The more sugar in the syrup, the sweeter the apple. Well, the more sugar in your blood, the sweeter the red blood cell. Blood sugar sticks to the hemoglobin in red blood cells - and the red blood cells live for 3 months while floating around in your blood. There you have it - candy coated hemoglobin.

The medical profession calls it glycosylated hemoglobin. (Any protein with sugar attached to it is called "glycosylated").

Home or Disposable A1c Kits:

There are some home Hbg A1c blood test kits available. "Choice A1c" or "Choice DM A1c" is a kit that provides results within minutes at your own home. Please do an internet search for "home A1c kit". I cannot comment on which brand is more reliable or still available.

There are also mail in A1c kits. All can usually be purchased over the counter for a reasonable price - ask your pharmacist for details. You provide a small sample of your blood (eg. wiped on a test card/strip) and mail it in to the company. However...

I must tell you that there have been complaints about sending in kits, not receiving a response and not being able to contact the company afterward. You may wish to call the company prior to purchasing their kits to be sure they are still in business. You may wish to consider researching the company thru the Better Business Bureau prior to committing to anything (boy, that seems like a lot of work doesn't it??). Also talk with your pharmacist about the reputable mail-in options or deal through a large company that may offer refunds (eg. be sure to check the policies on Amazon if you order through them as you would hope they wouldn't be selling mail-in kits that could no longer be serviced). All of a sudden it sounds like it might just be easier to go to the lab.

PLEASE NOTE: The A1c blood test does not match the readings you get on your blood glucose meter at home. For conversions of A1c versus blood sugar values that you see on your home meter, please see hgb A1c conversions to home meter readings.

What is a "good" result for Hbg A1c blood test?

The Hgb A1c blood test can have different normals depending on the lab methods used. However, most labs in North America have 6% ( 0.060) or less as the normal hgb A1c for people without diabetes.
For people with diabetes, guidelines for the A1c test are typically 7% ( 0.070) or less. In Canada, a target of under 6% is recommended if it is safe to do so without frequent or severe hypoglycemia (see here for the definition of hypoglycemia). Since target levels for the Hbg A1c blood test can be individualized, be sure to check with your doctor.

Why should I have the Hgb A1c blood test?

. . . Because it tells you your risk of getting diabetes complications to eyes, kidneys, nerves (impotence included) and heart.

Much of the damage caused by diabetes happens because of glycosylation (sugar coating) of proteins in the body. Measuring the amount of sugar stuck to part of the hemoglobin (a1c blood test) is a good indicator of what might be happening in other tissues. Particularly if the A1c stays high.

The DCCT and UKPDS are excellent landmark studies for type 1 and type 2 diabetes. They clearly show the higher the A1c over a period of a few years, the more complications arise. But the reverse is also true: Lowering A1c levels greatly reduces the risk of complications.
How much can you lower your risk of complications?

•In type 2 diabetes, every 1% drop in A1c lowers the risk of complications by 37% !

•In type 1 diabetes, lowering the A1c from 9% to 7% reduced complications by 34-76%! The continuation of DCCT - the EDIC study - also showed that lower A1c values also reduced the risk for heart disease by whopping 50%!

Doesn't this make you want to learn your A1c so you can work to lower it if it's high? So you can see your progress? So you can work with your diabetes team and doctor to get it down even just a smidge? Remember, dropping from 9% down to 8% could reduce your risk of complications by 37%!!

How often should I have the Hbg A1c blood test ?

Guidelines vary slightly between countries. Canada recommends the A1c every 3 months. The U. S. suggests every 3 months but every 6 months may be acceptable if your blood sugars are stable and in target with the guidelines blood sugar levels. Please check with your doctor.

Make life easier . . . ask for a "standing order" for the Hbg A1c blood test from your family doctor. Then you can go directly to the lab every 3 months without getting a requisition from your doctor every time.

Why should I follow the trends in my A1c blood test results?

. . .Because, diabetes changes. To be proactive and protect your health, diabetes educator's tell you to follow the trend of your A1c to give you more information about your diabetes.

For example, if your A1c blood test is in target at 6.5% but the next one is 7.0% this tells you your glucose levels have been rising somewhere in the day. You might do more blood sugar testing at home to see where you are getting those slightly higher numbers. Then work to lower them. You don't want to wait for that A1c to rise above 7% if that is your target.

IF your A1c has dropped from 10% down to 8%, then you have reason to celebrate. This is a great reduction. You might wait until the next A1c test to see if it comes down further. However, keep your eye on your home glucose tests to be sure things are moving in the right direction. You'd hate to wait 3 months just to find out, - oops - you are at 9%.

If your Hgb A1c blood test is significantly high or refusing to drop significantly then you may need to meet with your doctor and diabetes team to discuss methods to help you lower the A1c.

Remember: The Hgb A1c blood test only tells you if you've been in target most of the time or not. It does not tell you where in the day your sugars might be high or low. Also, it does not tell you about recent changes to your blood sugars. Very often we'll see or hear from patients because their sugars have been high for the past month even though their last A1c was great. These are very proactive people who want to fix the high numbers they see on their meters BEFORE their A1c blood tests rise.

So . . . Using blood sugar monitors at home is important! These numbers tell you where in the day you are in target or not in target compared to guidelines blood sugar levels.

How do I lower the A1c . . .

For reducing A1c, you need to know what times of the day your blood glucose levels are the highest or are out of target. Diabetes educators specialize in fine-tuning advice to fit into people's lives, priorities and their problem times of the day. Some of the tips you will get you'll find below. Please work with your doctor or educator.

•Tips to lower fasting blood sugars.

•Tips to lower lunch blood sugars.

•How to lower supper glucose readings.

•How to lower bedtime glucose levels.

•How to lower 2 hr post prandial sugars

There are a number of people who insist that their Hgb A1c blood test should be lower because their fasting blood sugars are great. But the A1c rarely lies. Unfortunately, if these folks aren't testing their sugars at other times of the day, they simply won't find those high blood sugars that are pushing up the A1c. That means, numbers that are pushing up their risk of getting damage to eyes, kidneys, nerves as well as heart attack and stroke.

Can the Hgb A1c Blood Tests give false reading?

The A1c test can read lower than it really is if you are anemic (have low levels of hemoglobin). The more anemic you are, the more the Hgb A1c blood test is falsely lowered.
If you frequently have blood sugars that meet the definition of hypoglycemia, then your A1c blood test could be in target even though you might have high blood sugars often. The highs and lows seem to average out. Don't fool yourself into believing all is well. The highs can still do damage despite all the low sugars (which can also be unsafe).
If you have great blood sugar readings at home (for all times of the day including after meals) but your Hgb A1c blood test is high, your meter might be inaccurate. Check for diabetes test strips accuracy problems.
If your glycated hemoglobin is high but your before meal tests are in target, then please consider doing post prandial or "after meal" blood sugar tests. These too can affect your chance of getting complications.
The Hgb A1c blood test can be higher than it really is if you have unusual hemoglobin. For example, a very small population of people (particularly of African descent) have some fetal hemoglobin which can falsely elevate the A1c reading.

Hgb A1c Conversion to Blood Sugars

The Hgb A1c blood test (or glycated hemoglobin) done in people with diabetes does not equal the values you see on your home blood glucose monitor. For example, an A1c of 8% does not mean your blood sugars for the past 3 months have been about 8 mmol/L. See below.

Keep in mind, that the "average" blood sugar (glycated hemoglobin) includes all blood glucose values from the past 3 months. Blood sugars during sleep, before eating, after eating, during work . . . etc. - whether you were testing using a home meter or not.

There are different references for converting glycated hemoglobin to meter readings. They do differ, so what your educator says may differ from what you see here. I have chosen the information from the American Diabetes Association Standards of Medical Care in Diabetes.

7 Secret Health Foods: Tell your Friends!

There is some mystique about them, isn’t there? Imagine a food--or a group of foods--that alone can elevate moods, enrich your body with almost hundreds of minerals and taste great all at the same time?

The 7 foods I want to talk about do all this and more... and are not just the "ordinary" superfoods like the cherry, the avocado or extra virgin olive oil. These foods are from the corners of the world and they will pack a super-punch into your everyday diet.

Superfood #1: Cacao (Raw Chocolate)

Want more energy? Try some raw chocolate.

Raw chocolate is one of the most powerful sources of magnesium on the planet. Not only does magnesium help with alertness and activity, it also helps elevate your mood.

Magnesium is one of the most deficient minerals in the human body. Depending on where you find your studies 60-80% of Americans are deficient in magnesium. No wonder we're sluggish, agitated and stressed!

Raw chocolate is the same reason you've heard that chocolate is good for you... except that the cooked and processed form that you get in your Hershey's bar does not have the same composition as it does when it's raw.

Raw chocolate also contains tryptophan--an essential amino acid--which helps naturally produce serotonin in your body. This is great news for those who need an emotional boost.

You can buy raw chocolate in the shell (it is a bean), but it's easiest if you buy it without.

Since the cacao bean is actually fairly bitter, it is best to mix it with various other superfoods--pumpkin seeds, goji berries--for a super, power-packed, nutrient rich snack that will get you through even the toughest days.

Superfood #2: Goji Berries

Move over carrot.

This little, bright red berry from China is one of the most potent sources of beta-carotene and vitamin C. These are both fantastic antioxidants.

Goji berries also contain 18 amino acids and over 21 minerals which give them a serious power-punch to anyone’s system.

Goji berries help stimulate your body’s natural human growth hormone which is critical in anti-aging and longevity.

You can only get them dried in the US, so don't expect to find them in any produce section. Some health food stores will carry them, but you're best bet is online.

Goji berries are a fantastic snack--eat them just like you would raisins--to add to your superfood arsenal and are a great addition to any herbal tea.

Superfood #3: Maca

Maca is a Peruvian root powder that is used to increase strength and vitality. It has more mineral content than potatoes and carrots--containing iron, magnesium, calcium, potassium, and iodine.

The Peruvians and many others claim, Maca can help fight depression, help with anemia and improve overall memory and vitality.

This powerful food is also a libido stimulant!

Maca powder is best taken mixed with warm water in a tea. Maca has a strong taste and this can be softened with goji berries or honey.

Superfood #4: Raw Honey

I'm not talking about the honey in the little bear. I'm talking real, unprocessed, raw honey.

Raw honey contains enzymes, phytonutrients, resins and propolis--bee glue. This unique combination of properties makes it versatile not only as a food, but as an anti-bacterial agent.

As a food, raw honey can raise antioxidant levels in the body, restore muscle glycogen after a workout and help lower cholesterol and the risk of certain cancers.

As a topical substance, it can decrease infection and work just as well as alcohol solutions.

Use it as a sweetener, put some in your teas or your water, or just have a small spoonful for a quick pick me up.

(Be sure not to heat it to a high temperature. Heat will destroy many of its best qualities.)

Superfood #5: Spirulina

This superfood and next might scare some people off.

Don't compromise your health by not trying these two foods!

The first, spirulina, is an algae that has high vegetable protein content, is high in B-12 vitamins and Gamma Linolenic Acid (GLA).

GLA and Vitamin B-12 are connected to mood, memory and general energy vitality. Many people believe that low B-12 levels for long periods of time is actually the cause of "old age" symptoms--fatigue, memory loss, confusion, etc.

Just because it's algae doesn't mean that it's gross! The first time I tried it, I was surprised that it tasted so good.

Buy it in flakes and sprinkle it on your salads, add it to a smoothie, sauces or soups.

Superfood #6: Sea Vegetables

Sea vegetables are grown in an environment full on minerals that our body needs for optimal health--the ocean.

The ocean water has up to 92 minerals can be absorbed by the plants growing in the sea.

This makes sea vegetables are one of the most nutrient dense foods on the planet. Seaweed--compared to land vegetables--is one of the best vegetable sources of calcium, which is fantastic for muscle and bone development, strength and growth.

Don't worry if the idea of eating seaweed grosses you out. Your health food store will have different seaweed granules that you can use as a salt substitute and you’ll never know the difference.

Nori, dulce, and kelp are three of the most readily available sea vegetables.

Superfood #7: Pumpkin Seeds and More...

The raw pumpkin seed, just like the cacao bean, is another feel good food. It is a great source of magnesium and tryptophan. You can find this super-seed right in your backyard if you live in the Northeastern US!

Pumpkin seeds also are great sources of protein, fat and other essential minerals.

Other great seeds are hemp seed, flax seed and raw sunflower seeds. These all contain good fats and good protein for optimal health.

If you’re eating a primarily vegetarian or vegan diet, be sure to add these seeds to your diet to get some good protein. If you’re NOT a vegetarian or vegan, be sure to add these seeds to your diet to get some good protein (not a typo!).
They are great to add to salads as an extra garnish or great as a snack or mixed in with some other superfoods.

Weight Management: Portion Control TIps

1. Break Leftovers Down

Instead of using one large container to store leftovers such as casseroles, side dishes, or pasta, why not separate them into individually-sized containers?

That way, when you reach in the fridge to find something to reheat, you're retrieving just enough for one helping. Breaking down meal-sized servings into single servings will help you limit your food intake with no additional effort.

2. Say Yes to Salads

Eating a salad before lunch or dinner is a sure-fire way to keep from overeating. It will help curb your appetite and give you a sense of satiety sooner.

Of course, we're not talking a little bit of iceberg lettuce here. To reap full portion control benefits from rabbit food, load up your salad with veggies or even lean meat like turkey cubes. The fiber in the veggies will help you feel fuller and lean meat's protein will give you an instant energy boost.

3. Single out Trigger Foods

Buy snack foods in single serving sizes or divvy up full size packages into smaller, indvidual bags.

It may be difficult to stop eating, oh, say, tortilla chips (My biggest weakness!) straight out of the bag while watching Desperate Housewives, but am I as likely to inhale the contents of 12 zipper bags without some forethought? Doubtful.

4. Master Mini Meals

You can make sure your blood sugar stays at an even keel and keep hunger at bay by eating healthful small meals throughout the day.

My friend Jenn has maintained a 30 pound weight loss for three years and is in such great shape, she became an aerobics instructor! She swears by mini meals to maintain her weight and keep her energy level up. Mini meals are by far the best way to prevent overeating because you'll get never too hungry and lose control of your portion intake.

5. Keep Seconds Out of Sight

Don't serve family meals family-style. Keep pots and dishes away from the table where it's all too easy to go for seconds.

I can't tell you how many times I've rethought my second helpings as I've made my way from the table to the stovetop. I've often told myself to sit back down and wait it out. Remember, it takes about 20 minutes to feel satiated. By giving myself that "breather" I've realized I wasn't hungry enough for another helping after all.

6. Make Meat a Side Dish

Treat meat or meat-based entrees as a side dish rather than the main part of your meal.

By loading up on veggies and healthy grains as the bulk of your meal instead of using them as sides, you'll feel full sooner and get extra vitamins and fiber. Experiment with new vegetables and preparation methods to keep things interesting.

7. Meet Yourself Halfway

Make lunch a two-fer. Your mid-day meal can work double duty by being shared or serving as dinner.

At work, why not split take out with a buddy? At a restaurant, pack up half of your meal before you even start eating: Voila! You have an instant dinner!

8. Be a Kid at Heart (or Tummy?)

Order a kid's size meal when you go to fast food places to automatically control portions (and save money!).

Don't be embarrassed about asking for a child's meal. It's really no big deal. I've even got a trick for places that have a "12 and under sign" -- I order it to go and then plop right down in the dining room, eat my meal, and give the toy to a kid sitting nearby!

9. Serving Standards

Learn to "eyeball" standard portion sizes and stick to them when dining out or dishing up meals.

Keep these tips in mind: 3 oz. of meat is the size of a deck of cards or an audio tape; 1 oz. of meat is the size of a matchbook; 1 cup of potatoes, rice or pasta looks like a tennis ball.

10. Treat Yourself

And last, but not least ... indulge!

Treating yourself once in a while to a "forbidden" food will keep you from feeling deprived; a sense of deprivation can easily lead to overeating. Stop a binge before it starts by indulging every now and then.

Women & Karate: Fitness focused for women

Karate is a great workout, but not for just men. Women also can receive the same health benefits. These include: increased cardiovascular fitness, weight loss/ maintanence, comraderie, self defense training, increased endorphins to alleviate depression... Read this short article for more: http://bit.ly/a5b4DK 
When you are ready to start your new life visit   http://www.bushokai.com/   and sign up for a new improved you!!

CPR Facts and Statistics

(Excerpt from American Heart Association)
CPR facts and statistics

About 80 percent of all out-of-hospital cardiac arrests occur in private residential settings, so being trained to perform cardiopulmonary resuscitation (CPR) can mean the difference between life and death for a loved one.

Effective bystander CPR, provided immediately after cardiac arrest, can double a victim’s chance of survival.

CPR helps maintain vital blood flow to the heart and brain and increases the amount of time that an electric shock from a defibrillator can be effective.

Approximately 95 percent of sudden cardiac arrest victims die before reaching the hospital.

Death from sudden cardiac arrest is not inevitable. If more people knew CPR, more lives could be saved.

Brain death starts to occur four to six minutes after someone experiences cardiac arrest if no CPR and defibrillation occurs during that time.

If bystander CPR is not provided, a sudden cardiac arrest victim’s chances of survival fall 7 percent to 10 percent for every minute of delay until defibrillation. Few attempts at resuscitation are successful if CPR and defibrillation are not provided within minutes of collapse.

Coronary heart disease accounts for about 446,000 of the over 864,000 adults who die each year as a result of cardiovascular disease.

There are 294,851 emergency medical services-treated out-of-hospital cardiac arrests annually in the United States.

There are about 138,000 coronary heart disease deaths within one hour of symptom onset each year in the United States.

Sudden cardiac arrest is most often caused by an abnormal heart rhythm called ventricular fibrillation (VF). Cardiac arrest can also occur after the onset of a heart attack or as a result of electrocution or near-drowning.

When sudden cardiac arrest occurs, the victim collapses, becomes unresponsive to gentle shaking, stops normal breathing and after two rescue breaths, still isn’t breathing normally, coughing or moving.

Women, Heart Disease and Stroke

Heart disease isn't just a man's disease. Heart attack, stroke and other cardiovascular diseases are devastating to women, too. In fact, coronary heart disease, which causes heart attack, is the single leading cause of death for American women. Many women believe that cancer is more of a threat, but they're wrong. Nearly twice as many women in the United States die of heart disease, stroke and other cardiovascular diseases as from all forms of cancer, including breast cancer.

The American Heart Association has identified several factors that increase the risk of heart disease and stroke. The more risk factors a woman has, the greater her risk of having a heart attack or stroke. Some of these risk factors you can't control, such as increasing age, family health history, and race and gender. But you can modify, treat or control most risk factors to lower your risk.

What are the risk factors for heart disease and stroke that you can't control?

Increasing age — As women grow older, their risk of heart disease and stroke begins to rise and keeps rising with age.

Sex (Gender) — Men have a greater risk of heart attack than women, and they have attacks earlier in life. Each year about 55,000 more women than men have strokes, and about 60 percent of total stroke deaths occur in women.

Heredity (family history) — Both women and men are more likely to develop heart disease or stroke if their close blood relatives have had them. Race is also a factor. Black women have a greater risk of heart disease and stroke than white women. Compared with whites, African-American men and women are more likely to die of stroke.

Previous heart attack or stroke or TIA — Women who've had a heart attack are at higher risk of having a second heart attack; 22 percent of women ages 40 to 69 who survive a first heart attack will have another heart attack or fatal coronary heart disease within five years, and 22 percent ages 40 to 69 who survive a first stroke will have another within five years. A transient ischemic attack (TIA or "mini-stroke") also is a risk factor and predictor of stroke.

What risk factors can be modified, treated or controlled by focusing on lifestyle habits and taking medicine, if needed?

Tobacco smoke — Smoking is the single most preventable cause of death in the United States. Smoking is a major cause of cardiovascular heart disease among women. Women who smoke have an increased risk for ischemic stroke and subarachnoid hemorrhage. Constant exposure to others' tobacco smoke (secondhand smoke) at work or at home also increases the risk, even for nonsmokers. Women smokers who use birth control pills have a higher risk of heart attack and stroke than nonsmokers who use them.

High blood cholesterol — High blood cholesterol is a major risk factor for heart disease and also increases the risk of stroke. Studies show that women's cholesterol is higher than men's from age 55 on. High levels of LDL (low-density lipoprotein) cholesterol (the "bad" cholesterol) raise the risk of heart disease and heart attack. High levels of HDL (high-density lipoprotein) cholesterol (the "good" cholesterol) lower the risk of heart disease. Research has shown that low levels of HDL cholesterol seem to be a stronger risk factor for women than for men.

High blood pressure — High blood pressure is a major risk factor for heart attack and the most important risk factor for stroke. Women have an increased risk of developing high blood pressure if they are obese, have a family history of high blood pressure, are pregnant, take certain types of birth control pills or have reached menopause. African-American women have higher average blood pressure levels compared to Caucasian women.

Physical inactivity — Various studies have shown that lack of physical activity is a risk factor for heart disease and indirectly increases the risk of stroke. Overall, they found that heart disease is almost twice as likely to develop in inactive people than in those who are more active. When you're inactive and eat too much, you can gain excess weight. In many people overweight can lead to high blood cholesterol levels, high blood pressure, diabetes and increased risk of heart disease and stroke. The American Heart Association recommends accumulating at least 30 minutes of physical activity on most or all days of the week.

Obesity and overweight — If you have too much fat — especially if a lot of it is located in your waist area — you're at higher risk for health problems, including high blood pressure, high blood cholesterol, high triglycerides, diabetes, heart disease and stroke.

Diabetes mellitus — Adults with diabetes have have heart disease death rates that are two to four times those of adults without diabetes. People with diabetes often have high blood pressure and high cholesterol and are overweight, increasing their risk even more.

What other factors contribute to the risk of heart disease and stroke in women?

High triglyceride levels — Triglyceride is a common type of fat in the body. A high triglyceride level often goes with higher levels of total cholesterol and LDL, lower levels of HDL and increased risk of diabetes. But scientists don't agree that it's a risk factor for heart disease by itself. Research suggests that having high triglycerides may increase the risk for women more than for men.

Excessive alcohol intake — The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women per day) is lower than in nondrinkers. However, it's not recommended that nondrinkers start using alcohol or increase the amount they drink. Excessive drinking and binge drinking can contribute to obesity, high triglycerides, cancer and other diseases, raise blood pressure, cause heart failure and lead to stroke. Pregnant women should not drink alcohol in any form.

Individual response to stress — Research hasn't yet defined the role stress plays in the development of heart disease. People respond differently to situations they find stressful. Unhealthy responses to stress may lead to other risk behaviors like smoking and overeating.

Health issues for lesbians: Tips to stay healthy

Health issues for lesbians may include substance abuse, obesity and depression. Understand these important health risks and know how to protect yourself.

Lesbians and women who have sex with women are at increased risk of a number of health issues, including substance abuse, obesity and depression — but there are steps lesbians and bisexual women can take to improve their health and well-being. Find out about these important health issues for lesbians and understand ways to promote a healthy lifestyle.

Prevent cancer

Lesbians may have a higher prevalence of risk factors for breast cancer, colon cancer and ovarian cancer than do other women. Potential reasons include higher rates of obesity and alcohol abuse, choosing not to bear children and inconsistent medical care, which may result in lower rates of routine screenings.

Making healthy lifestyle changes — such as maintaining a healthy weight, including physical activity in your daily routine, limiting the amount of alcohol you drink, and seeking routine screenings and health care — may help reduce your risk of cancer.

Prevent obesity

Lesbians are more likely to be overweight or obese than are other women. This may be in part due to different values concerning physical appearance and what's perceived to be attractive or desirable. Overeating may be a form of self-comfort in response to stress, abuse and discrimination. Obesity may also serve as a method of protection from the undesired sexual attention of men.

If you're obese, you're more likely to develop a number of potentially serious health problems — including many types of cancer, gynecologic problems, depression, heart disease and type 2 diabetes. You can take steps to prevent unhealthy weight gain and related health problems. Make a commitment to include physical activity in your daily routine, eat a healthy diet and monitor your weight. If you're struggling to lose weight, ask your doctor for help and support.

Seek help for substance abuse

Alcohol abuse is common among lesbians and bisexual women. Risk factors for lesbian alcohol abuse include:

■Relying on women's bars for socializing and peer support

■Impact of sexism and discrimination

■Stress related to passing as a heterosexual or coming out

■Low self-esteem related to the perception of being different

■Trauma due to bullying, violence, abuse or self-abuse

Women who abuse alcohol are at risk of alcohol-related accidents, fatty liver disease, alcoholic hepatitis, cirrhosis, muscle weakness and pain, and osteoporosis. Lesbian and bisexual women who use injectable drugs are at high risk of hepatitis B, hepatitis C and HIV/AIDS.

If you have a substance abuse problem, remember that help is available. Local lesbian, gay, bisexual and transgender health, mental health, or community centers often provide substance abuse treatment. Organizations such as the National Association of Lesbian and Gay Addiction Professionals also may provide referrals.

Stop smoking

Lesbians and bisexual women are more likely to smoke than are heterosexual women. Potential reasons include stress, depression and discrimination.

Smokers are more likely to develop disease and die earlier than those who don't smoke. If you smoke, take the first step and decide to quit. Then take advantage of the variety of resources available to help you successfully quit smoking.

Tackle depression


Lesbians and bisexual women may be at higher risk of depression, suicidal thoughts and self-harm. Contributing factors may include social alienation, the threat of or loss of family support, discrimination, abuse, and anti-gay violence. The problem may be more severe for lesbians who remain in the closet, aren't traditionally "feminine," aren't in satisfying relationships or lack social support.

Left untreated, depression may lead to a downward spiral of emotional, behavioral, health, and even legal and financial problems. If you think you may be depressed, talk to your doctor or seek help from a mental health provider. If you're reluctant to seek treatment, confide in a trusted friend or loved one. They can help you take the first steps toward getting treatment.

Recognize domestic violence

Domestic violence can affect lesbians, as well as heterosexuals. You may be experiencing domestic violence if you're in a lesbian relationship with someone who:

■Intimidates you or threatens you with violence

■Tries to keep you from seeing friends or family

■Uses finances to control you

■Threatens to tell friends, family, colleagues or community members your sexual orientation or gender identity

■Tells you that authorities won't help a homosexual, bisexual or transgendered person

■Tells you that leaving the relationship means you're admitting that homosexual relationships are deviant

■Tells you that abuse is a normal part of homosexual relationships or that domestic violence can't occur in homosexual relationships

■Justifies abuse by telling you that you're not "really" homosexual, bisexual or transgender

■Says women can't be violent

■Portrays the violence as mutual and consensual

■Depicts the abuse as part of a sadomasochistic activity

Staying in an abusive relationship may leave you depressed, anxious and hopeless. If you don't want to disclose your sexual orientation, you may be less likely to seek help after an assault. Still, the only way to break the cycle of domestic violence is to take action — the sooner the better. If you're a victim of domestic violence, tell someone about the abuse, whether it's a friend, relative, health care provider or other close contact. Consider calling a domestic violence hot line and creating a plan to leave your abuser.

Protect yourself from HIV/AIDS and STDs

Many lesbians are unaware that certain sexually transmitted diseases (STDs) — such as human papillomavirus (HPV), bacterial vaginosis and trichomonas — can spread between women. Oral sex and sexual behavior involving digital-vaginal or digital-anal contact, particularly with shared penetrative sex toys, can spread infections as well. Female sexual contact is also a possible means of contracting HIV. To protect yourself:

■Get tested and have your partner tested. Don't have unprotected sex unless you're certain you and your partner aren't infected with HIV or other STDs. Testing is important because many people don't know they're infected, and others may not be honest about their health.

■Use protection. During oral sex use a split-open condom, dental dam — a small piece of latex — or plastic wrap. Keep sex toys safe by cleaning them and protecting them with a condom. Don't share sex toys. If you have sex with a male partner, use a new latex or polyurethane condom or dental dam every time you have sex.

■Be monogamous. Stay with one sex partner who has tested negative for HIV and other STDs and who won't have sex with anyone but you.

■Limit the amount of alcohol you drink and don't use drugs. If you're under the influence, you're more likely to take sexual risks. If you choose to use injectable drugs, don't share needles.

■Get vaccinated. Vaccinations can protect you from HPV and the serious liver infections hepatitis A and hepatitis B, which can spread through sexual contact.

■Remain vigilant. Remember, there isn't a cure for HIV/AIDS and many STDs, such as HPV. The best way to stay healthy is to protect yourself.

Seek routine health care

Many lesbians struggle to find a doctor knowledgeable about lesbian health issues and with whom they feel comfortable discussing their needs and concerns. In addition, some lesbians are reluctant to use mainstream health care services — but don't let the stigma associated with homosexuality prevent you from taking charge of your health. Look for a doctor you feel comfortable talking to. Identify yourself as lesbian or bisexual, and ask about routine screenings recommended for women in your age group. If you're not in a long-term, mutually monogamous relationship, schedule regular screenings for STDs. Share any other health concerns you may have with your doctor as well. Early diagnosis and treatment is often the key to long-term health.

Gall Stones:

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that's released into your small intestine.
Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time.
Gallstones are common in the United States. People who experience symptoms from their gallstones usually require gallbladder removal surgery. Gallstones that don't cause any signs and symptoms typically don't need treatment. Gallstones may cause no signs or symptoms. If a gallstone lodges in a duct and causes a blockage, signs and symptoms may result, such as:
■Sudden and rapidly intensifying pain in the upper right portion of your abdomen

■Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone

■Back pain between your shoulder blades

■Pain in your right shoulder

Gallstone pain may last several minutes to a few hours.
When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you.
Seek immediate care if you develop signs and symptoms of a serious gallstone complication, such as:
■Abdominal pain so intense that you can't sit still or find a comfortable position

■Yellowing of your skin and the whites of your eyes

■High fever with chills
 
It's not clear what causes gallstones to form. Doctors think gallstones may result when:
 
■Your bile contains too much cholesterol. Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your bile contains more cholesterol than can be dissolved, the cholesterol may form into crystals and eventually into stones. Cholesterol in your bile has no relation to the levels of cholesterol in your blood.

■Your bile contains too much bilirubin. Bilirubin is a chemical that's produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders.

■Your gallbladder doesn't empty correctly. If your gallbladder doesn't empty completely or often enough, bile may become very concentrated and this contributes to the formation of gallstones.

Types of gallstones that can form in the gallbladder include:

■Cholesterol gallstones. The most common type of gallstones, called cholesterol gallstones, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, although they can also have other components.

■Pigment gallstones. These dark brown or black stones form when your bile contains too much bilirubin.
 
Factors that may increase your risk of gallstones include:

■Being female

■Being age 60 or older

■Being an American Indian

■Being a Mexican-American

■Being overweight or obese

■Being pregnant

■Eating a high-fat diet

■Eating a high-cholesterol diet

■Eating a low-fiber diet

■Having a family history of gallstones

■Having diabetes

■Losing weight very quickly

■Taking cholesterol-lowering medications

■Taking medications that contain estrogen, such as hormone therapy drugs
 
Complications of gallstones may include:


■Inflammation of the gallbladder. A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.

■Blockage of the common bile duct. Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to your small intestine. Jaundice and bile duct infection (cholangitis) can result.

■Blockage of the pancreatic duct. The pancreatic duct is a tube that runs from the pancreas to the common bile duct. Pancreatic juices, which aid in digestion, flow through the pancreatic duct. A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization.

■Gallbladder cancer. People with a history of gallstones have an increased risk of gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of cancer is elevated, the likelihood of gallbladder cancer is still very small.
 
You're likely to start by seeing your family doctor or a general practitioner. If your doctor suspects you may have gallstones, you may be referred to a doctor who specializes in the digestive system (gastroenterologist) or to a surgeon.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do:

■Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.

■Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

■Write down key personal information, including any major stresses or recent life changes.

■Make a list of all medications, as well as any vitamins or supplements, that you're taking.

■Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.

■Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For gallstones, some basic questions to ask your doctor include:

■Are gallstones the likely cause of my abdominal pain?

■What are other possible causes for my symptoms?

■What kinds of tests do I need?

■Is there a chance that my gallstones will go away without treatment?

■Do I need gallbladder removal surgery?

■What are the risks of surgery?

■How long does it take to recover from gallbladder surgery?

■Are there other treatment options for gallstones?

■Should I see a specialist? What will that cost, and will my insurance cover it?

■Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time to cover other points you want to address. Your doctor may ask:

■When did you first begin experiencing symptoms?

■Have your symptoms been continuous, or occasional?

■How severe are your symptoms?

■What, if anything, seems to improve your symptoms?

■What, if anything, appears to worsen your symptoms?
Tests and procedures used to diagnose gallstones include:

■Tests to create pictures of your gallbladder. Your doctor may recommend an abdominal ultrasound or a computerized tomography (CT) scan to create pictures of your gallbladder. These images can be analyzed to look for signs of gallstones.

■Tests to check your bile ducts for gallstones. A test that uses a special dye to highlight your bile ducts on images may help your doctor determine whether a gallstone is causing a blockage. Tests may include a hepatobiliary iminodiacetic acid (HIDA) scan, magnetic resonance imaging (MRI) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered using ERCP can be removed during the procedure.

■Blood tests to look for complications. Blood tests may reveal an infection, jaundice, pancreatitis or other complications caused by gallstones.
Gallstones that don't cause signs and symptoms


Gallstones that don't cause signs and symptoms, such as those detected during an ultrasound or CT scan done for some other condition, typically don't require treatment.

Your doctor may recommend you be alert for symptoms of gallstone complications, such as intensifying pain in your upper right abdomen. If gallstone signs and symptoms occur in the future, you can have treatment. But most people with gallstones that don't cause symptoms will never need treatment.

Treatment for gallstones that cause signs and symptoms

Treatment options for gallstones include:

■Surgery to remove the gallbladder (cholecystectomy). Your doctor may recommend surgery to remove your gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder. You don't need your gallbladder to live, and gallbladder removal doesn't affect your ability to digest food, but it can cause diarrhea.

■Medications to dissolve gallstones. Medications you take by mouth may help dissolve gallstones. But it may take months or years of treatment to dissolve your gallstones in this way. An experimental treatment to inject gallstone medications directly into the gallbladder may dissolve gallstones more quickly. Tests are ongoing to determine whether this procedure is safe and effective. Medications for gallstones aren't commonly used and are reserved for people who can't undergo surgery.
Remedies to prevent gallstones from causing complications


If you have gallstones that aren't causing signs or symptoms, you may worry that you'll experience pain or other symptoms of gallstones in the future. For this reason, some people turn to complementary and alternative medicine for gallstone cures.

No alternative therapies have been proved to cure or dissolve gallstones.

Some alternative therapies may help reduce your risk of gallstone complications, though. Ask your doctor about which therapies may be safe for you to try. Options might include:

■Eating a high-fiber diet that includes healthy fats. Choose a diet that's full of a variety of fruits and vegetables. These high-fiber foods may help prevent additional gallstones from forming. Also include healthy, unsaturated fats in your diet. Foods that contain unsaturated fats include fish and nuts.

■Taking vitamin supplements. People who don't get enough vitamin C, vitamin E or calcium may have an increased risk of gallstones. There isn't enough evidence to suggest that supplements containing these vitamins can prevent gallstones. Ask your doctor about the benefits and risks of vitamin supplements. The safest way to get more vitamins is to choose foods that contain them.
 
You can reduce your risk of gallstones if you:

■Don't skip meals. Try to stick to your usual meal times each day. Skipping meals or fasting can increase the risk of gallstones.

■Exercise most days of the week. Being inactive may increase the risk of gallstones, so incorporate physical activity into your day. If you haven't been active lately, start slowly and work your way up to 30 minutes of activity on most days of the week.

■Lose weight slowly. If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose 1 or 2 pounds (0.5 to about 1 kg) a week.

■Maintain a healthy weight. Obesity and overweight increase the risk of gallstones. Work to achieve a healthy weight by reducing the number of calories you eat and increasing the amount of physical activity you get. Once you achieve a healthy weight, work to maintain that weight by continuing your healthy diet and continuing to exercise.

Gall Bladder Removal: Cholecystectomy

Gallbladder removal surgery is a fairly common procedure, with some cases being unquestionably necessary, such as when the organ is extremely inflamed and infected. Other times, a cholecystectomy is recommended only because of a build-up of gallstones. Although removal of the gallbladder can relieve symptoms - the horrible pain, indigestion, bloating, and diarrhea, long-term relief is not guaranteed; in fact, four out of ten patients still experience the same problems as before surgery.

This may be due to the fact that a cholecystectomy does not address the root of the problem, which is diet, not the gallbladder itself. The most effective way to prevent a reoccurrence of the issues that existed before gallbladder removal surgery, including the formation of stones, is to follow a specific diet after gallbladder surgery.

What is the Function of the Gallbladder?

The gallbladder is a small, eggplant shaped organ located directly below the liver, on the right side of the body. Its function is to assist the liver in breaking down fats and eliminating toxins from the body through bile. Bile is a digestive substance which originates in the liver. It is made up of cholesterol, lecithin, bile pigments, and bile salts. Bile is held in the gall bladder temporarily. When there is food present in the small intestine, the bile travels through bile ducts to join the digested food on its journey out of the body. In this way, excess cholesterol and toxins are eliminated from the body.

After removal of the gallbladder, the liver is on its own. It has to work harder to break down fats and filter waste compounds. Even without this organ, stones can still form in the liver, whenever the bile fluid becomes over-saturated with cholesterol. Because of this, it is very important to eat a careful diet after gallbladder surgery, making sure not to consume the same foods that contributed to the formation of gallstones in the first place.

Foods to Eat and Foods to Avoid after Gallbladder Removal

After a cholecystecotmy, it is important to eat foods that will help support the liver, and minimize the workload of digestion. Healthy, unprocessed vegetable oils, particularly those rich in omega-6 and omega-3 fatty acids, such as flax seed oil and hemp seed oil, should be consumed on a regular basis. Both of these nutritious oils are available in supplement form, or they can be used to make salad dressings; they should not be used as cooking oils. These oils, as well as other vegetable oils such as olive oil, help the body naturally eliminate unhealthy LDL cholesterol build-up. Being of a slippery nature, and liquid at room temperature (as opposed to saturated fats, which are solid at room temperature), unsaturated fatty acids slide through the body's pathways with ease, taking toxins and harmful build-up with them.

Tantrums of the child type:

They can be embarrassing, frustrating, and annoying — but less so if you recognize that tantrums are a natural part of babyhood (and toddlerhood). It's not that your child is trying to be manipulative or malicious with his outbursts. Tantrums signal his frustration when he's having trouble communicating or becomes upset at not getting what he wants. Especially when language skills are still developing and a sense of preference is growing, your child has little choice but to fall back on the primitive "babyish" responses of crying and screaming.
The good news is he'll eventually outgrow this phase. For now, here are a few sanity-saving tips to keep in mind:
Be responsive. Your child develops a sense of self-worth and happiness as you take care of his wants and needs, so it's best to fulfill his "requests" whenever possible and practical. If you can't give your little one what he wants and he reacts emotionally, be calm and comforting. It also helps to offer another option.

Recognize the good. Be sure to praise your child when he's well behaved so that he gets positive reinforcement for good behavior.

Practice prevention. You can prevent some tantrums by avoiding situations that may upset your child or by planning for them ahead of time — for example, by having snacks on hand to avoid a hungry meltdown. Giving your child the chance to choose among alternatives (food, activities, and so on) and minimizing your use of "no" will also help bolster his emotional resilience and stability.

Keep your cool. When your little one is having a tantrum, be calm and neutral about it. If you can, resist giving your child too much attention, which will only fuel the tantrum. Acknowledge his feelings: "Mad? You're mad because you want a cookie?" Then calmly state your rule: "No cookie now, but after lunch." A flailing toddler isn't going to absorb much discussion or teaching at this point. Avoid arguing with your child — yelling or threatening is likely to escalate the tantrum and frighten him (the tantrum itself may scare your child because he feels out of control emotionally). Stay close to him and hold him if possible. If your child becomes violent, take him to a safe place where he can settle down.

Emergency preparedness:

"CLICK HERE" for the official FEMA site for personal emergency preparedness.

"CLICK HERE" for the CDC official emergency preparedness site.

"CLICK HERE" for a fun link to test your emergency preparedness.

Some of the things you can do to prepare for the unexpected, such as making an emergency supply kit and developing a family communications plan, are the same for both a natural or man-made emergency.

However, there are important differences among potential emergencies that will impact the decisions you make and the actions you take. Learn more about the potential emergencies that could happen where you live and the appropriate way to respond to them.

In addition, learn about the emergency plans that have been established in your area by your state and local government.

Emergency preparedness is no longer the sole concern of earthquake prone Californians and those who live in the part of the country known as "Tornado Alley." For Americans, preparedness must now account for man-made disasters as well as natural ones. Knowing what to do during an emergency is an important part of being prepared and may make all the difference when seconds count.