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January 8, 2009

Alternative Medicine for Kids

Posted: 11:52 AM ET

Nursing is supposed to be a calming, tranquil time for a newborn, but when Deb Kruse-Field put her son, Luke Field, to her breast, instead of cuddling up and eating, he arched his back and screamed.

"We would both end up miserable," says Kruse-Field. "And he started eating less."

Kruse-Field tried everything she and her pediatrician could think of to help Luke. She cut out foods from her diet that could be irritating her son's stomach, such as dairy, soy and chocolate, and her doctor prescribed medicine for his acid reflux. Both helped, she says, but Luke was still gassy, had diarrhea and spit up frequently.

Frustrated that Luke was still in pain, his parents, who live in Madison, Wisconsin, were nonetheless reluctant to take their baby to see more doctors. They'd gone that route when their older child, Anna, had stomach problems, and nothing the specialists recommended worked terribly well.

But then a family friend suggested they contact Dr. Adam Rindfleisch, a University of Wisconsin family doctor who specializes in integrating traditional Western medicine with alternative medicine.

Rindfleisch suggested probiotics  - "friendly" bacteria that he says have been shown to help babies and children with diarrhea. While probiotics didn't cure Luke, Kruse-Field said, they seem to have helped.

For Kruse-Field, finding a pediatrician who knew about both approaches - traditional and alternative - was crucial to solving Luke's stomach problems. While not everything billed as "alternative medicine" is suitable for children, there are several alternative treatments that have been shown to be safe and effective for kids. Here are some of the top ones.

1. Probiotics for diarrhea

"These are incredibly safe," Rindfleisch says. "We've even used them on preemies with gastrointestinal issues."

He recommends finding a probiotic designed especially for children, adding that kids who are severely immune-compromised, such as those with end-stage HIV, shouldn't take them.

The Web site for the Consortium of Academic Health Centers for Integrative Medicine, or CAHCIM, has information about using alternative medicine to treat diarrhea. 

2. Chamomile tea for colic

In many cultures, from the Middle East to Latin America, parents give chamomile tea to their cranky babies. "What that tells me is that over thousands of years, people have figured out that it works," says Dr. Sandy Newmark, who's on the faculty at the Center for Integrative Medicine at the University of Arizona.

Newmark recommends steeping a teaspoon of dried chamomile, or a tablespoon of fresh, in hot water for five to 10 minutes. Cool it off and then give the baby a half an ounce to an ounce every few hours in a bottle, spoon or medicine dropper.

For other information on treating colic with alternative medicine, go to CAHCIM's site.

3. St. John's wort for mild to moderate depression

When her teenage patients get depressed, Cora Collette Breuner sometimes suggests they take the herb St. John's wort. She recommends 300 milligrams three times a day for teenagers. Breuner, an associate professor of pediatrics and adolescent medicine, says the herb should not be used for depression for children under 13.

The CAHCIM Web site has more information about alternative medicine and depression.

For more tips on how to treat your kids with alternative medicine, check out my column at CNNhealth.com

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December 5, 2008

Help! I can't get in to see the doctor!

Posted: 10:14 AM ET

On the Sunday before Thanksgiving, Barb Lighthall was walking into church when her feet slipped out from under her and she hit her head on the parking lot's black ice.

Barb Lighthall had to wait a week to see her regular doctor after a head injury sent her to the ER.

"You know how most people break their fall with their hands? I broke my fall with my head," says Lighthall.

An ambulance took her to the emergency room, where she was prescribed pain pills, discharged, and told to check in with her regular doctor in the next three days.

But that would prove impossible. When Lighthall called her internist the next day, the appointment secretary said the doctor wouldn't be able to see her for another week.

"I told them I'd take a cancellation, I'd do anything, but they said she was all booked up," says Lighthall, who lives in Munnsville, New York. "So I spent the week of Thanksgiving dizzy. When I walked from my bed to the bathroom, I hit every piece of furniture and every wall in between."

When Lighthall did finally get in to see her physician the next week, she was prescribed medicine to treat the dizziness, and felt much better.

"It would have made my Thanksgiving week a whole lot better if I'd gotten in to see her earlier," she says.

So what should you do if you need to see your doctor right away, but he or she is all booked up? Here are some insider tips from doctors themselves.

1. Find your doctor's e-mail address

This will require some Internet sleuthing, but it could be worth it.

"This is a true story," says Dr. Indu Subaiya, co-founder of a health care forum called Health 2.0.

"A friend of mine needed to get his wife into a doctor at UCSF for back pain. All the secretaries told them it would be weeks for an appointment. They found the e-mail address of one doctor who seemed like a good fit and just wrote him a personal note explaining the urgency. He responded at 11 p.m., and she was in to see him the first thing in the morning the next day."

2. Ask to speak to the manager

The person answering the phone is often the lowest person on the totem pole. Ask to speak to the office manager or the nurse in charge, who might have the authority to squeeze you in. Leave a voice mail if you don't get a real person.

"Be polite but persistent," says Dr. John Santa, director of the Consumer Reports Health Ratings Center.

3. Call first thing in the morning

Place your call the minute the office opens, and you'll greatly improve your chances of getting an appointment.

"Doctors will often have a few slots saved throughout the day for same day appointments. They fill up fast, so call ASAP in the morning," advises Dr. Delia Chiaramonte, an internist in Maryland. "Don't wait to see if you feel better. You can always cancel it."

For more information on how to get into the doctor fast, check out my column, The Empowered Patient at cnn.com/health.

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November 25, 2008

Should you use a drug off label?

Posted: 04:14 PM ET

If your doctor prescribes you some medication, you probably think its going to work, right? A new study suggests that may not be the case.

 

 

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More and more physicians are prescribing drugs off label without evidence the drug will work. And according to a paper in the December issue of Pharmacotherapy some of the most common drugs used off label, are in need of additional study to determine whether they are safe and effective.

 

When a doctor prescribes a drug off label, that means it is being used to treat a disease or medical condition different from the one for which it was approved by U.S. Food and Drug Administration.   For example, some doctors prescribe the anti-depressant Zoloft for bipolar disorder even though it has not been approved for treating it.  Taking a drug off label isn't necessarily a bad thing, but there are some questions you should ask your doctor before picking up your prescription.

 

Is this off-label? Your doctor may not always tell you up front.

 

Is there proof that it works? There may be some scientific proof behind it or your doctor could just be going out on a limb! If he can't give you an answer, it's OK to insist he does.  And if the answer doesn't satisfy you, ask about other treatment alternatives.

 

What are the side effects? Have your doctor's office check beforehand whether your insurance will pick up the tab for the off label drug.  Often, insurance companies will deny those claims.

 

For more information on how to be an Empowered Patient check out my column at CNN.com/empoweredpatient

 

 

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November 20, 2008

Five ways to keep Alzheimer's away

Posted: 02:55 PM ET

   Many people take the herb gingko biloba in hopes of staving off Alzheimer’s Disease, but a new study in the Journal of the American Medical Association says it doesn’t work.

 

          In the study of 3,000 people over the age of 75, some took gingko, while others took a placebo, or sugar pill. University of Pittsburgh researchers found that those who took gingko were just as likely to get Alzheimer’s Disease and other forms of dementia as those who took the placebo.

 

          Gingko manufacturers say this isn’t the first – or the last – word on the herb. “There is a significant body of scientific and clinical evidence supporting the safety and efficacy of ginkgo extract for both cognitive function,” said Mark Blumenthal, executive director of the American Botanical Council.

 

          But many experts are still skeptical. Edythe London, a professor of psychiatry and pharmacology at UCLA, says her 86-year-old mother once asked her if she should take gingko, but London told her not to bother.  “But I do tell my mother there are other things she can do,” says London, who’s studied the brain and aging. “I tell her to go out and do things and see people every day and be active.”

 

          Here are five tips for staving off Alzheimer’s from London and other brain experts.  

 

1. Antioxidants

          London makes sure her mother takes Vitamins A, C, and E. “There are studies that suggest antioxidants might prevent dementia,” she says.

 

2. Fish Oil Supplements

          Dr. Gary Small, director of the UCLA Center on Aging, says aging brains show signs of inflammation, and fish oil has anti-inflammatory properties.

 

3. Phosphatidylserine supplements

          Phosphatidylserine is a lipid found naturally in the body. Small says he’s not 100 percent convinced these supplements will help stave off dementia, but they’re worth a try. “If I start having memory problems when I get older, I’ll give them a trial run and see if they help,” says Small, author of the new book “iBrain: Surviving the Technological Alteration of the Modern Mind.”

         

4. Curry

          Small, who’s 57, says as he gets older he might also try eating more foods with curry in them. “Some studies in Singapore show that those who ate curry once a week had better memory scores,” he said.

 

5. Crosstraining your brain

          “Our brains can be made stronger through exercise,” says Andrew Carle, assistant professor of in the departent of health administration and policy at George Mason University. “In the same way physical exercise can delay many of the effects of aging on the body, there’s some evidence cognitive exercise can at least delay the onset of Alzheimer’s.”

          But Carle says it’s not enough to do just one kind of brain exercise. “Doing a crossword puzzle every day is good, but it’s the equivalent of only doing pushups – your arms will get strong, but  not the rest of your body.” He recommends doing other activities in addition, such as computing numbers in your head instead of using a calculator, or using one of the “brain gym” computer games designed to enhance brain function.

 

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November 17, 2008

What vitamins to take and which to avoid

Posted: 03:19 PM ET

Americans love to take their vitamins. More than 150 million Americans take dietary supplements according to the Council for Responsible Nutrition, a supplement industry trade group. But it’s hard to know what vitamins to take – any grocery store aisle has a dizzying array. That's why this week the Empowered Patient asked two wellness experts what supplements they take every day – and what supplements they say you shouldn’t take.

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Dr. Andrew Weil; Age: 66; director, Arizona Center for Integrative Medicine; drweil.com

What he takes:

1. A daily multivitamin/multimineral

2. Vitamin D. Vitamin D deficiency has been linked to breast cancer, colon cancer, prostate cancer, heart disease, and multiple sclerosis, as well as other conditions. Studies show many of us are vitamin D deficient. Weil says look on the label to make sure you're getting vitamin D3, not vitamin D2.

3. Magnesium. Lack of magnesium may lead to irritablity, muscle weakness, and irregular heartbeat.

4. Juvenon (or "Omega"), a compound believed to enhance cellular health and function. This supplement contains two nutrients, acetyl-L-carnitine and alpha lipoic acid. The company that makes Juvenon says benefits include "more energy," a "sharper mind", and "more restful sleep."

5. Co-Q-10, a supplement that boosts coenzyme Q10, which is produced by the human body and is necessary for the basic functioning of cells. Animal studies have found that coenzyme Q10 helps the immune system work better and makes the body better able to resist certain infections and types of cancer.

Weil, author of 10 books including, "Eight Weeks to Optimum Health," says it is important to take studies, like the one in JAMA, with a grain of salt. "I believe vitamins E and C are important as part of our antioxidant defenses, even if we have not yet documented specific preventive effects," says Weil.

What not to take

Weil says men shouldn't take iron unless they've been diagnosed by a physician as having iron deficiency anemia. He also advises against men taking calcium supplements; he's concerned they could increase the risk of prostate cancer.

Dr. Christiane Northrup; Age: "50 something;" author, "The Secret Pleasures of Menopause;" Drnorthrup.com

What she takes:

1. Antioxidant supplement

2. Fish oil. Some studies have found fish oil, which contains omega 3 fatty acids, can help lower triglyceride levels, lower blood pressure, and help depression, among other uses.

3. Calcium, which can help prevent osteoporosis - a problem in particular for older women

4. Magnesium

5. Coenzyme Q10

6. Vitamin D

Northrup, an authority on women's health and wellness and author of the new book "The Secret Pleasures of Menopause," says it is important to remember that vitamins are not drugs. They don't work the same way in the body.

"Vitamins are best taken in the correct proportions to each other," says Northrup. For example, she says if you are taking folic acid, which is a B vitamin, you'll do better when you also take the other Bs that make up the B complex. Says Northrup, "That's how nutrients occur naturally and how the body best utilizes them."

What not to take

Northrup says postmenopausal women almost never need iron, and taking too much might pose a risk for heart health.

For more tips on taking vitamins, check out my column at CNN.com/empoweredpatient

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September 11, 2008

How to talk to your doctor about God

Posted: 03:05 PM ET

A new study finds that many Americans believe in medical miracles. In the study, 57 percent of randomly surveyed adults said God's intervention could save a deathly ill family member even if physicians said treatment would be futile.

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However, just under 20 percent of doctors and other medical workers said God could reverse a helpless outcome.
The study was published last month in Archives of Surgery and is one of many to show a "faith gap" between doctors and patients.
"Patients are scared to death to talk to their doctors about this issue," said Dr. Harold Koenig, co-director of the Center for Spirituality, Theology and Health at Duke University.
Given this gap, how can you discuss God with your physician?
1. It's OK to ask for a doctor who also has strong religious convictions
Koenig suggests this approach when talking to a physician: "I would say: 'My religious beliefs are very important to me and influence my medical decisions and the way I cope with illness, and I want a doctor who has those same convictions. If you don't come from that perspective, do you know a doctor you can refer me to?' "
If you're a Christian, you might find a like-minded doctor through the ZIP code search at the Christian Medical and Dental Associations.
2. Don't be surprised if you find No. 1 difficult to do
"Religion is the last taboo in medicine," said Dr. Daniel Sulmasy, an internist, a Franciscan friar and director of ethics at St. Vincent's Hospital and New York Medical College in New York. "Doctors and patients talk about intimate details like sexual practices and drug use but still have this great reluctance to talk about religion."
Sulmasy suggests not asking directly about the doctor's own religious beliefs but instead focusing on your own religious needs.
3. It's OK to ask your doctor to pray with you
According to a 2006 study by the University of Chicago, 53 percent of doctors surveyed said it was appropriate to pray with patients when asked.
This can work even when doctor and patient don't share the same faith. For example, Koenig, who's Christian, has prayed with Jewish patients. "In most cases, a general prayer asking for God's comfort, support and healing will be sufficient," he said.

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August 28, 2008

How to get out of medical debt

Posted: 03:53 PM ET

One issue sure to be mentioned in Barack Obama’s acceptance speech is health care and the millions of Americans who are fighting to get out of medical debt.

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A report out last month from the Commonwealth Fund found that 28 percent of the population said they were paying off medical debt in 2007, up from 21 percent in 2005.
"Two-thirds of the people who go into medical debt have insurance," said Mark Rukavina, executive director of the Access Project. "When medical debt hits, it hits very quickly. It's a jolt, and it's generally not very predictable."
"These are all honest, hardworking people," added Jessie Maurer, a medical billing advocate in West Des Moines, Iowa "This could happen to just about anybody."
By avoiding the mistakes below, you can get your medical debt under control.
Mistake No. 1: You ignore your bills
"The most dangerous thing people do when they get into debt is ignore the statements and notices," said Mary Jean Geroulo, a former hospital administrator and now a partner at Stewart and Stimmel, a health care law firm in Dallas, Texas.
"They think doctors and hospitals won't send them to collection agencies, but they absolutely will," she added.
To find an advocate, visit the Medical Billing Advocates of America, The Fairness Foundation and the National Foundation for Credit Counseling also offer help to those in debt.
Mistake No. 2: You don't look for errors in your bills
"I had a client once who was charged for a surgery she never had," said Nora Johnson, vice president of Medical Billing Advocates of America in Caldwell, West Virginia. "Another one was charged more than $5,000 for disposable gloves."
To catch errors, you have to get an itemized bill. Often, say experts, you have to ask for one.
Mistake No. 3: You don't negotiate the price down
"People think they have to pay the amount on the bill. But doctors and hospitals are very willing to negotiate," Rukavina said. "Remember, the squeaky wheel gets the grease."
Maurer, for example, says one of her clients owed $14,000 for a five-hour stay in a hospital emergency room. "She could afford to pay $4,000, so I told her, 'Show them a certified check for $4,000.' She did and told them, 'This is all I have in the world,' and they took it."
For more tips, check out my column at CNN.com/health

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August 18, 2008

Top tips to prepare for a hurricane

Posted: 01:55 PM ET

"Be prepared." It is the Boy Scout motto, but it is also true when it comes to hurricanes and other weather emergencies. Here's a list of things you should keep close at hand in case you are ever in a weather emergency.

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1) Emergency supply kit: According to ready.gov, keep these things in your kit: a first aid kit, prescription medicines, bottled water, a battery-operated radio, a flashlight and batteries.

2) Important documents: Make sure you have a copy of the following documents: driver's license, Social Security card, list of doctors, insurance policies, wills, deeds, birth and marriage certificates and tax records.

3) Family evacuation plan: You may not be with your family when disaster strikes. According to the American Red Cross, you should decide ahead of time where to go if you have to evacuate. You should also discuss ahead of time how you are going to get in touch with one another in case you get separated. Experts suggest making an out-of-town friend or relative a contact in case the phone lines are down in your community.

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August 14, 2008

How to avoid getting sick while traveling overseas

Posted: 04:54 PM ET

While downing margaritas in Brazil one evening, Sheila Scott Hula's drinking mate suggested they "jazz up" their drinks with a little local liquor.

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Hula, who's always ready for an international gustatory adventure, ordered some from the waitress, tossed it into her drink, took a swig, and all of a sudden couldn't breathe.

"I popped a Benadryl, but that didn't act fast enough. My chest felt constricted, and the people around me started to panic," she said. "Then I pulled out my inhaler, and that did the trick."

Keeping certain medicines with you is just one of the many tricks Hula has learned during her 11 years of travel covering the Olympics (she’s in Beijing now and travels four months out of the year). Here are some others:

1. Keep your “travel health kit” with you at all times.

Read the CDC's complete list of what to pack in your travelers' health kit.

2. If you're worried about the food or water, bring an antibiotic with you

Dr. Phyllis Kozarsky, an expert consultant in the division of global migration and quarantine at the Centers for Disease Control, recommends either azithromycin or a drug in the quinolone family, such as ciprofloxacin. You can get these only with a doctor's

3. Learn about your destination

The CDC has country-by-country information on health hazards, and the State Department does, too.

Take with you a list of U.S. embassies and consulates in case of an emergency. You can also register your trip with the State Department so the agency can find you easily.

If you're going someplace unusual, Kozarsky suggests joining the Listserv at the International Society of Travel Medicine. "If I'm going to Tanzania, I can go on there, and in a few minutes someone will chime in and say, 'Hey, I have a buddy there who runs a terrific clinic,' " she says.

For more tips on traveling healthy, check out my column at CNN.com/health.

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August 7, 2008

How to have a baby when it's not so simple

Posted: 01:15 PM ET

Pamela Madsen knows a thing or two about getting pregnant. She did it twice, and it took several teams of doctors, six rounds of artificial insemination, six rounds of daily injected drugs, and four rounds of in-vitro fertilization.

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She's madly in love with the results - son Tyler is 19 and Spencer is 15 - but she didn't always love the process. That's why she started the American Fertility Association - to help other couples in the same position.
"Getting pregnant isn't always an easy thing to do," said Madsen. "Doctors are not gods, and you have to remember that no one's going to care about you as much as you are."
Here are a few things Madsen said she did right while going through infertility treatments.
1. Get Dad out of the hot tub
"Sitting in a 103-degree tub for prolonged periods of time may impair sperm quality," said Dr. Alan Copperman, with Reproductive Medicine Associates in New York.
2. Stay healthy
Drinking heavily, using illegal drugs, smoking, and being overweight can decrease fertility for both men and women.
3. Go to a clinic that's open seven days a week
When it comes to procedures such as harvesting eggs and implanting embryos, one day can make a difference," Madsen said. "If they're not open seven days a week, they're manipulating your cycle to fit their schedule."
For help finding a fertility clinic, check success rate statistics at the Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technology.
Want more tips on how to increase your chances of getting pregnant?  Check out my column at CNN.com/health

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Clark Howard helps you become a wise consumer. We know you're busy, and that's why Clark's tips are quick and effective. He'll arm you with the information you need to make smart choices. During these tough economic times, Clark wants to help you save more, spend less and avoid getting ripped off!