Mark Twain on Health

While cigar-smoking, mint julep-drinking Mark Twain may not seem like a paragon of healthy living, he did provide us with some thought-provoking quotes directed toward health.
           

“Be careful about reading health books.  You may die of a misprint.” 
~ Mark Twain
 

This quote, written prior to the development of personal computers or the World Wide Web, has particular significance today.  While a massive amount of health-related information is available on the Internet, the accuracy of this information is highly variable.  Not only is the information found on many health-related websites based on insufficient scientific evidence, the accounts of personal health issues on internet health forums are often misleading or biased.  Even studies published in respected medical journals can sometimes turn out to be flawed. A few years ago, researchers looked at the conclusions drawn from studies published in highly respected journals, such as the Journal of the American Medical Association (JAMA), the Lancet, and the New England Journal of Medicine to see if their findings stood the test of time. This analysis included 45 highly publicized studies reporting on a drug or other treatment that was considered to be successful.  Subsequent research contradicted the results of 7 of these studies and reported weaker than initially thought results for 7 others.  In other words, nearly one-third of the original reports did not hold up over time.  The refuted studies dealt with a wide range of drugs and treatments such as the use of estrogen to protect women from heart disease and use of Vitamin E to prevent heart attacks. The take home message from this is that a single study or internet source does not necessarily provide definite evidence of the effectiveness of a medication or other treatment. What is accepted as “gospel” this year may be refuted or found to be obsolete the next.
 

“Anger is an acid that can do more harm to the vessel in which it is stored than to anything on which it is poured.” ~ Mark Twain
 

It has long been thought that anger or hostility could lead to the development of coronary heart disease (CHD). In order to test this theory, researchers pooled the results of 44 separate studies that had previously looked for a connection.  After analyzing the data, it was found that anger and hostility was indeed associated with a higher occurrence of coronary heart events, both in people thought to be healthy as well as in those with underlying CHD. The study found that angry or hostile people with no prior history of heart disease were 19% more likely to develop CHD than their calmer counterparts. The mechanism for this seems to be related to the “fight or flight response” in which stress hormones, including adrenaline and cortisol, cause the heart rate to go up, blood pressure to rise and blood vessels to constrict. The authors of this study concluded that in addition to conventional forms of treatment for CHD, when anger or hostility is clearly present, psychological care should also become part of the management.  Anger and hostility may not be the only emotional issue related to the development of CHD.  Other researchers have also found that high degrees of anxiety or depression can contribute to heart disease development.

 “Giving up smoking is the easiest thing in the world. I know because I've done it thousands of times.” ~ Mark Twain
 

More people in the United States are addicted to nicotine, a drug that is found naturally in tobacco, than to any other drug. Research suggests that nicotine may be as addictive as heroin, cocaine, or alcohol.  Among all current U.S. adult cigarette smokers, nearly 7 out of every 10 (68.8%) reported in 2010 that they wanted to quit completely. But as many smokers have found, quitting smoking can be very difficult and often requires several attempts in order to succeed.  Some of the methods available today to help with smoking cessation include:

• Individual, group, or telephone counseling
   
• Behavioral therapies (such as training in problem solving)
   
• Programs to deliver treatments using mobile phones
   
• Over-the-counter nicotine replacement products---nicotine patch, gum, lozenge
   
• Prescription nicotine replacements---nicotine patch, inhaler, nasal spray
   
• Prescription medications: bupropion SR (Zyban®), varenicline tartrate (Chantix®)

The point is that quitting smoking is hard and may require several attempts.  Fortunately, a variety of methods, most of which were not available to Mark Twain, can help to improve the success rate.

Finger and toenails---What can they tell us about our health?

While changes in the normal configuration of nails usually indicate a problem affecting the nail itself, certain changes may also provide clues to an underlying medical condition.  Brittle nails, nails containing “pits” or small depressions, nails that are discolored yellow or green, or dark lines beneath the nail are examples of the changes that could point to a medical problem.  Let’s look at some of the most common nail abnormalities and learn when it is advisable to seek medical attention should they develop.
     
Thickened, discolored, crumbling nails:  Perhaps the most common nail abnormality occurs as a result of a fungal infection, also known as onychomycosis.  Fungi commonly reside in warm, moist environments, such as swimming pools and showers.  Infections develop when the fungus enters the nail through a small separation between the nail and nail bed.  Toenail involvement is more common than fingernail infections because fungi thrive in the moist, warm environment produced when wearing shoes.  These infections usually begin as a white or yellow spot under the tip of the fingernail or toenail.  As the fungus spreads deeper into the nail, thickening, discoloration and crumbing of the nail edge occurs.  Nail fungus can be difficult to treat and responds poorly to over-the-counter medications. Frequently, it is necessary to take a prescription oral antifungal medication for several weeks in order to effectively treat nail fungus.  Measures to prevent the occurrence of a nail fungus include not going barefoot in public showers, thoroughly drying your hands and feet (particularly between toes) after bathing, wearing synthetic socks to “wick” away moisture from the skin, and use of an antifungal spray or powder.

Green nail discoloration:  An infection under the nail caused by a particular type of bacteria known as “Pseudomonas” is associated with a very characteristic green nail discoloration.  Manicurists sometimes refer to this nail condition as “the greenies”.  Pseudomonas nail infections most commonly affect those whose hands are often in water, such as dishwashers. Initial treatment involves trimming back the nail and soaking in an acetic acid or antibiotic solution.  In some cases, particularly when the skin around the nail is also infected, treatment with oral antibiotics may be required.

Pitting and rippling of nails:  These are the typical changes noted when the nail abnormality is caused by psoriasis.  Psoriasis is a skin disease of unknown cause that causes itchy or sore patches of thick, red skin with silvery scales.  Up to 10% of those who develop psoriasis will have nail abnormalities as the initial finding and most of these go on to develop the characteristic skin rash also.

White spots beneath nails:  Also called “leukonychia”, white dots or lines beneath the nails are usually related to trauma, such as banging the end of finger. Since the injury affects the nail matrix located at base of the nail, the white spots are usually seen only after the nail begins to “grow out”.  With time and continued growth of the nail, the spots eventually disappear.

Red or black nail discoloration:  A hematoma, or collection of blood beneath the nail, is the most common reason for red or black nail discoloration.  Bleeding beneath the nail is typically related to trauma, such as hitting a finger with a hammer.  As with white spots due to trauma, with time the discolored area “grows out” and the nail returns to normal.  A black spot under the nail with no associated trauma, on the other hand, could indicate a much more serious problem, such as a melanoma tumor.  Dark nail pigmentation that develops without an injury should be evaluated promptly by a physician.

Brittle nails:  Many people believe that brittle nails are the result of a protein deficiency that can be addressed by consuming gelatin. This belief appears to have stemmed from a marking effort in the 1890s by the Knox family who developed a method of processing the hooves and hides of horses and cows into a powdered gelatin product.  They contended that eating gelatin would provide the protein necessary to develop strong nails.  We now know that protein deficiency has less to do with the development of brittle nails than does environmental dryness, heredity, and aging.  Other causes for brittle nails include low levels of iron in the body and an underproduction of thyroid hormone (hypothyroidism).  Laboratory testing may be necessary to confirm these diagnoses. The most important self-care measures for brittle nails are to limit the amount of exposure to water and soap and to apply moisturizers to the nails.

Understanding Autoimmune Disease

The immune system is a complex system of specialized cells, tissues, and organs designed to defend the body from germs and other invaders.  Central to the normal function of the immune system is its ability to distinguish between what is part of our own healthy bodies from a potentially harmful agent.
   
The part of the immune system that is primarily involved in the development of an autoimmune disease is called the "acquired" immune system.  This system develops during our lives as it responds to "attacks" on the body from invaders, such as bacteria and viruses.  One of the most important components of the acquired immune system is a type of white blood cell called lymphocytes. One type of lymphocyte, the T-cell, scans the body for foreign invaders and can directly kill infected cells or summon help from other disease-fighting cells of the immune system. Another type of lymphocyte, the B-cell, produces antibodies used for fighting infections and can also remind the body of a germ that has been encountered previously. Vaccines use the acquired immune system to prevent infectious diseases by stimulating an immune response in the body in a manner similar to the way the immune system fights off a real infection.
 
An autoimmune disease occurs when the immune system targets the body's own healthy tissues by mistake, signaling the body to attack them.  For reasons that are not completely understood, the antibodies and lymphocytes that would ordinarily provide protection to the body end up causing a number of autoimmune diseases.  The hallmark of an autoimmune disease is the development of inflammation, which can cause redness, heat, pain, and swelling. Autoimmune diseases can affect most of the organs or systems in the body.

The following are some of the most common:

Celiac disease---An autoimmune condition that causes inflammation in the small intestine. When people with celiac disease eat foods containing gluten their immune system reacts by damaging the villi, the finger-like projections protruding from the lining of the intestinal wall. This prevents the absorption of important nutrients, producing symptoms including diarrhea, weight loss and fatigue.

Type 1 Diabetes—In this condition, the immune system attacks and destroys insulin-producing cells of the pancreas.  This makes it impossible for the body to use glucose for energy and can even result in life-threating complication called diabetic ketoacidosis. The more common form of diabetes, Type 2, is not considered to be an autoimmune process.

Multiple Sclerosis (MS) -–In MS, an abnormal immune system response produces inflammation in the central nervous system (brain and spinal cord). The inflammation damages the myelin that "insulates" nerve fibers, resulting in slowing or stopping of nerve conduction.  Symptoms of MS include blindness, weakness, poor coordination, and muscle spasms.

Graves' disease---An autoimmune disease that affects the thyroid gland causing an overproduction of thyroid hormone. Symptoms of Graves' disease include heat intolerance, heart racing, weight loss and nervousness.

Rheumatoid Arthritis---In RA, the immune system produces antibodies that attach to the linings of joints. The immune system cells then attack the joints, causing inflammation, swelling, and pain. If untreated, rheumatoid arthritis can eventually cause permanent joint damage.

Psoriasis--- A disease that causes new skin cells to grow too fast and pile up on the skin surface. It is a life-long disease of the immune system that, in addition to causing skin lesions, is associated with a number of other health issues including arthritis, depression, and an increased risk of heart disease and diabetes. People with psoriasis develop thick red patches, covered with scales, usually appearing on the head, elbows, and knees.

Systemic Lupus Erythematosus (lupus)---In lupus, multiple systems including the joints, lungs, nerves and kidneys may be attacked by the immune system. Although the exact cause is not known, it appears that there are hereditary as well as environmental factors in it development. Symptoms of lupus can include fever, fatigue, joint pain, a rash on the face over the cheeks and nose, headaches, memory loss, shortness of breath and chest pain.

The immune system does an amazing job of protecting the body from infections and even cancer, often without us knowing it.  In the case of autoimmune diseases, however, the immune system is also capable of producing a variety of conditions that can be challenging both to diagnose as well as to treat.

The World's Most Deadly Animal

Although you might expect this Health Tip to be about large carnivores like polar bears or mountain lions, a tiny insect---the mosquito---is responsible for more deaths each year than all the 'man-eating' animals in the world combined.  These deaths do not occur due to a venomous bite or a sting causing an allergic reaction but from the diseases that they transmit.  Read on for other fascinating facts regarding 'skeeters'.

1.  Mosquitoes have been around since the Jurassic period, making them over 150 million years old.  The name comes for the Spanish word for house fly, 'mosca', with the suffix for small, '-ito' attached, literally translating to 'small fly'.  Fossilized specimens of mosquitos from prehistoric times show that they have undergone relatively few evolutionary changes since their origin.
    
2. Only female mosquitoes bite humans.  The 'bite' actually represents the act of inserting their skin piercing mouth component (proboscis) into a vein of a host in order to 'feed' on its blood.  They are thought to do this for the protein and nutrients found in blood in order to help with egg development.  Male mosquitos don't require blood feedings and instead feed on nectar and water.  When feeding, a female mosquito can suck two to three times her weight in blood.
    
3. Most mosquito bites do not result in disease.   The local swelling and itching associated with a mosquito bite is due to a minor allergic reaction to mosquito saliva.  This saliva contains both an anesthetic to lessen the sensation associated with the piercing proboscis and an anticoagulant to keep the blood that they are drawing from clotting. In most cases, mosquito bites stop itching and heal on their own without medical treatment. Treatment of uncomplicated bites includes the use of topical hydrocortisone cream or calamine lotion. An oral antihistamine, such as Benadryl, can help with itching.
    
4. Mosquitoes are capable of transmitting a number of disease-causing viruses.  They pass on these organisms without developing any signs of the disease in themselves. Viral diseases transmitted by mosquitos include yellow fever, dengue fever, Eastern equine encephalitis (EEV) and West Nile virus disease (WNV). Yellow fever has been eradicated from the U.S.  Dengue fever is primarily seen in travelers returning from the Caribbean, Central America, South America, and South Central Asia. In EEV and WNV, both of which are seen in the U.S., the virus is transmitted from infected birds to humans.  There are no documented cases of human immunodeficiency virus (HIV), the virus responsible for causing AIDS, due to mosquito bites.
    
5. Worldwide, the most important disease transmitted by mosquitos is malaria. Malaria is a serious and sometimes fatal disease caused by a parasite that commonly infects the Anopheles mosquito.  The parasite responsible for causing malaria is a micro-organism belonging to the genus Plasmodium.  The disease is passed on primarily from human to human via the mosquito bite.  When a mosquito bites a malaria-infected person, she ingests the parasites, which reproduce and travel to her salivary glands from where they can infect another human with the next bite. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness.
    
6. Mosquitoes locate their targets by detecting the carbon dioxide (CO2) emitted in the breath of animals. This is the rationale behind the use of 'mosquito traps' that use CO2 to lure female mosquitos to a capture or kill device.  Although the theory sounds good, the American Mosquito Control Association advises against putting too much faith in this single method of mosquito control.  Additional methods, such as removal of standing water around the house and community-wide mosquito control programs are also necessary for a significant reduction in biting mosquito populations. Methods such as 'Bug Zappers' and ultrasonic devices have not been shown to be effective in killing significant numbers of female mosquitos.  In fact, 'Bug Zappers' typically kill more beneficial insects than harmful ones.
    
7. As many people have learned the hard way, mosquitos are attracted to some people more than others.  Research has shown that approximately 20% of us are 'mosquito bait' and indeed get bitten more often. The reasons for this are uncertain, but may have to do with the amount of CO2 produced, blood type, substances produced in sweat, and body temperature. Fortunately, even for those who attract mosquitos, insect repellents have been found to be an effective method for preventing mosquito bites. DEET (Cutter, OFF!, others) and Picaridin (Cutter Advanced, Skin So Soft Bug Guard Plus, others) are considered to be 'conventional repellents', derived from chemical sources.  Oil of Lemon Eucalyptus (PMD) and IR3535 (e.g. Avon Skin-So-Soft with IR3535) come from natural materials and are classified by the EPA as 'biopesticide repellents'.  Any of these products will provide safe and effective protection against mosquito bites when used according to labeled instructions.

The 'deadliest animal' moniker for mosquitos is well-earned.  It is estimated that world-wide, mosquitoes kill nearly three quarters of a million people each year. Most of these deaths are as a result of contracting malaria. By comparison, on an annual basis, sharks kill fewer than a dozen people, crocodiles kill around 1000, and snakes are responsible for 50,000 deaths. Sadly, human beings themselves fall into the second deadliest category, accounting for approximately 500,000 deaths each year.

Seven common misconceptions regarding cholesterol

Cholesterol is a fat-like substance that is present in cells and tissues throughout the body.  In excess, it has received the deservedly bad reputation of being capable of blocking blood vessels. Indeed, having too much cholesterol does place you at higher risk for the development of heart attack and stroke. Misconceptions about cholesterol, however, may be keeping some people from having their high cholesterol recognized or from receiving appropriate treatment.

1. There is nothing beneficial about cholesterol---On the contrary, cholesterol contributes to a number of essential bodily functions.  It is the parent compound of several hormones including estrogen, progesterone and testosterone. It is also important in immune system function and brain development.  High-density lipoprotein, also known as "good" cholesterol, travels throughout the bloodstream, keeping "bad" cholesterol (LDL) from attaching to and potentially blocking blood vessels.
    
2. Cholesterol-containing foods are the major source of cholesterol in the blood stream. --- Most of the cholesterol that circulates in the blood stream does not come from cholesterol in foods but is produced in the liver in response to eating saturated and trans fat.  In American diets, the majority of saturated fat comes from animal products such as beef, pork, butter, cream, cheese and other full-fat dairy products.  Trans fats are found in many fried foods and baked goods such as pastries, pizza dough, pie crust, cookies and crackers.
    
3. Taking a cholesterol-lowering medication means you don't have to watch fat in the diet--- The first steps toward achieving a lower cholesterol level involves TLC. This stands for Therapeutic Lifestyle Changes and includes weight management, getting regular physical activity, and following a cholesterol-lowering diet. If these measures fail to bring the cholesterol level into the desired range, consideration is given to the use of cholesterol-lowering medications. Even when taking medication, however, TLC measures will need to be continued for the best treatment outcome.
    
4. High cholesterol is more of a problem in men than in women----Prior to the onset of menopause, women do have some protection from high levels of "bad" cholesterol (LDL).  This is due to the influence of estrogen that raises "good" cholesterol (HDL) levels.  Postmenopausal women, however, may experience a gradual rise in their cholesterol levels each year. This is why it is important for women to have their cholesterol level checked around the time of menopause.
    
5. High cholesterol is a problem that only affects older individuals--- Adults are not the only age group affected by high cholesterol. There is an abundance of scientific evidence indicating that the atherosclerotic process (buildup of fatty plaque in arteries) starts in childhood and progresses slowly afterwards. This can lead to the development of blockages in major blood vessels in the body causing strokes or heart attacks to occur at a premature age.  The American Academy of Pediatrics recommends that children who are overweight, have hypertension, or have a family history of heart disease should have their cholesterol tested as young as two years of age.
    
6. High cholesterol can cause symptoms such as chest pain---When cholesterol plaques narrow or block blood vessels supplying the heart, chest pain (angina) or heart attack may occur.  However, when blood cholesterol is high, but vessels have not yet been narrowed or blocked, no symptoms are produced. This asymptomatic nature of high cholesterol points out the importance of periodic blood screening, rather than waiting for symptoms to develop.
    
7. Only obese people have to worry about high cholesterol---People of any body type can have high cholesterol. Overweight people may be more likely to have high cholesterol, because of dietary indiscretion and consumption of high fat foods.  Elevated cholesterol levels can also develop in thin people who eat more fatty foods in an effort to gain weight. No one has the metabolic or digestive capability to "eat anything they want" without having to worry about the potential of having high cholesterol.

Cholesterol is a fascinating substance, essential to normal body function, but harmful when the levels of the "bad" type (LDL) is too high or the "good" type (HDL) is too low. It is important to know these levels in yourself so that you and your doctor can determine the best strategy to keep them in their proper range.
If you have any questions about cholesterol, please log into your account and send us your question. We are here to help.