Saturday, August 27, 2011

Tackling COPD

I have had several friends now struggle with coughing incessantly. They have both been diagnosed with COPD often confused with emphysema but not quite the same.

Chronic Obstructive Pulmonary Disease (COPD) refers to two lung diseases—chronic bronchitis and emphysema (often co-existing), and is the fourth leading cause of death in America. Obstructing airflow, COPD is usually but not always caused by cigarette smoke (80-90% of COPD deaths), or inhaling chemicals, dust or pollution for a long time.

According to the National Institute of Health, “The airways branch out like an upside-down tree. At the end of each branch are small, balloon-like air sacs. Healthy airways and sacs are clear and open, elastic and springy. In COPD patients, they lose their shape and become floppy. The airway walls become thick and inflamed (swollen), and the walls between the sacs are destroyed. The airway cells produce more mucus, become clogged, and cause a continual cough.

Chronic bronchitis is the inflammation and scarring of the bronchial tube lining, and emphysema causes permanent holes in the lung tissue. Shortness of breath and coughing is the result. Symptoms can begin as early as 32-40 years of age but are often left untreated, resulting in incurable respiratory problems and even heart failure.

COPD limits physical movement, affects involvement in family and social activities, impacts the ability to do household chores and even work. Patients may eventually rely on mechanical respiratory assistance—supplemental oxygen and even ventilators.

Though there’s no cure, there is treatment. Medications don’t modify long-term decline, but can provide relief. Bronchodilator medications (inhaled as aerosol sprays or taken orally) relax and open air way passages. Oxygen therapy, antibiotics and steroids are used in acute cases, as steroids, in particular, can cause serious side effects long-term. Lung transplantation is more common now, but those with severe emphysema are at higher risk of death from the procedure.

COPD patients should be vaccinated for pneumonia and influenza. They should quit smoking, avoid pollutants, and increase exercise under a physician’s supervision. Visit www.lungusa.org.


Saturday, August 20, 2011

Teaching Woes

School is beginning and with it comes both the excitement and trepidation of working with new students. They can single-handedly make the year productive and pleasurable or a real nightmare. Needless to say, I am hoping for the first scenario.

So much of the success of a student is dependent on attitude. There are many wonderful students who are self-motivated, hardworking and interested in learning and working, and it is a thrill to encourage and enlighten them.

Too many of the others, however, are not driven to succeed at all, have no real interest in learning or working hard, and have, in fact, an attitude that will destine them to failure. They have the desire to make lots of money and they insist that they are entitled to a good life, but they don’t want to do the work necessary. They think somehow that success is just going to happen because they want it.

As evidenced by testing, students today generally know less. They don’t read much anymore and so they can’t write or communicate well. They don’t pay attention in class, and they don’t do their homework because not only do they think it unimportant but an impingement on the free time, to which they also feel entitled. I once had a student tell me that she couldn’t complete an assignment for a significant grade because she had cheerleading practice and that was more important to her. I asked her if she thought writing well or cheering well would pay her bills in the future. She looked at me with confusion. She had no interest in looking that far ahead.

This is the sound-byte generation. Students are accustomed to immediate and constant entertainment, doled out in snippets and teasers on a myriad of screens. The result is a short attention span and an unwillingness to invest time and energy to achieve long-term goals. There is also a lack of respect for authority and a lack of caring about consequences. Couple all this with education not being our main priority anymore and you can see why we are in trouble.

This is a particularly tough year for teachers in my district. They have not been given even a cost of living raise and often have to spend their own money for school supplies. They had one of their two conference periods taken away, resulting in doing even more work at home on their free time, and they have been told that they are going to be accountable with their jobs for the success of their students.

The district theme song is to achieve differential teaching in the classroom. This means that teachers are to assess what each student in each of their seven classes is capable of and to create a program specific to that individual. Sounds good in theory doesn’t it, but what is the reality? Our staff has been significantly reduced in number and classes average 35 students. Now, given what I have said about the majority of students with regard to skill level, knowledge and attitude, how do you imagine that objective being achieved?

I’m nearing the end of my teaching career. I have loved it and been gratified to have impacted the lives of my students, but I worry daily about where education in America is going. Teachers cannot teach manners, morals and life skills in addition to subject matter, and yet we are expected to, and for little pay, lots of abuse and even some danger.

They say there is going to be an epidemic need for teachers soon because good teachers are getting out and students are not choosing it as a career path. It is not difficult to understand why.

Saturday, August 13, 2011

Fighting Alzheimer's

What I like least about going to the doctors at my age is that their answer to every problem now is "how we can manage the situation." When I was young, afflictions were resolvable. Not so much as I have grown older. But I am grateful because for the most part, I'm healthy and haven't been afflicted by too many issues...yet.

The one illness that scares me most is losing my mind. My dad suffered briefly with dementia near the end of his 92 years. It was frustrating for him and terribly sad to watch, and that was only sporadic dementia. We had a family friend who suffered for 10 long years with Alzheimer's in an institution because she remembered no one in her family, nothing about her past, and she was either terrified of everything or catatonic most of the time. She had to be cared for by professionals and death was actually considered a happy consequence.

I can't imagine anyone wanting to leave this world that way, and we can prevent it. Gary Small, M.D. and director of the UCLA Center on Aging, said, "The idea that Alzheimer's is entirely genetic and unpreventable is perhaps the greatest misconception about the disease."

"Researchers now know that Alzheimer’s, like heart disease and cancer, develops over decades and can be influenced by lifestyle factors including cholesterol, blood pressure, obesity, depression, education, nutrition, sleep and mental, physical and social activity."

In Jean Carper's newest book "100 Simple Things You Can Do to Prevent Alzheimer's and Age-Related Memory Loss" (Little, Brown; $19.99), she reveals the simple things that you can do every day that might cut your odds of losing your mind to Alzheimer's.

Here are 10 of the strategies that she includes that I found fascinating and easy to do.

"1. Have coffee.
In an amazing flip-flop, coffee is the new brain tonic. A large European study showed that drinking three to five cups of coffee a day in midlife cut Alzheimer's risk 65% in late life. University of South Florida researcher Gary Arendash credits caffeine: He says it reduces dementia-causing amyloid in animal brains. Others credit coffee's antioxidants. So drink up, Arendash advises, unless your doctor says you shouldn't.

2. Floss.
Oddly, the health of your teeth and gums can help predict dementia. University of Southern California research found that having periodontal disease before age 35 quadrupled the odds of dementia years later. Older people with tooth and gum disease score lower on memory and cognition tests, other studies show. Experts speculate that inflammation in diseased mouths migrates to the brain.

3. Be a “Googler”.
Doing an online search can stimulate your aging brain even more than reading a book, says UCLA's Gary Small, who used brain MRIs to prove it. The biggest surprise: Novice Internet surfers, ages 55 to 78, activated key memory and learning centers in the brain after only a week of Web surfing for an hour a day.

4. Grow new brain cells.
Impossible, scientists used to say. Now it's believed that thousands of brain cells are born daily. The trick is to keep the newborns alive. What works: aerobic exercise (such as a brisk 30-minute walk every day), strenuous mental activity, eating salmon and other fatty fish, and avoiding obesity, chronic stress, sleep deprivation, heavy drinking and vitamin B deficiency.

5. Drink apple juice.
Apple juice can push production of the "memory chemical" acetylcholine; that's the way the popular Alzheimer's drug Aricept works, says Thomas Shea, Ph.D., of the University of Massachusetts . He was surprised that old mice given apple juice did better on learning and memory tests than mice that received water. A dose for humans: 16 ounces, or two to three apples a day.

6. Protect your head.
Blows to the head, even mild ones early in life, increase odds of dementia years later. Pro football players have 19 times the typical rate of memory-related diseases. Alzheimer's is four times more common in elderly who suffer a head injury, Columbia University finds. Accidental falls doubled an older person's odds of dementia five years later in another study. Wear seat belts and helmets, fall-proof your house, and don't take risks.

7. Meditate.
Brain scans show that people who meditate regularly have less cognitive decline and brain shrinkage - a classic sign of Alzheimer's - as they age. Andrew Newberg of the University of Pennsylvania School of Medicine says yoga meditation of 12 minutes a day for two months improved blood flow and cognitive functioning in seniors with memory problems.

8. Take D.
A "severe deficiency" of vitamin D boosts older Americans' risk of cognitive impairment 394%, an alarming study by England 's University of Exeter finds. And most Americans lack vitamin D. Experts recommend a daily dose of 800 IU to 2,000 IU of vitamin D3.

9. Fill your brain.
It < http://brain.it/ http://brain.it/ > 's called "cognitive reserve." A rich accumulation of life experiences - education, marriage, socializing, a stimulating job, language skills, having a purpose in life, physical activity and mentally demanding leisure activities - makes your brain better able to tolerate plaques and tangles. You can even have significant Alzheimer's pathology and no symptoms of dementia if you have high cognitive reserve, says David Bennett, M.D., of Chicago 's Rush University Medical Center .

10. Avoid infection.
Astonishing new evidence ties Alzheimer's to cold sores, gastric ulcers, Lyme disease, pneumonia and the flu. Ruth Itzhaki, Ph.D., of the University of Manchester in England estimates the cold-sore herpes simplex virus is incriminated in 60% of Alzheimer's cases. The theory: Infections trigger excessive beta amyloid "gunk" that kills brain cells. Proof is still lacking, but why not avoid common infections and take appropriate vaccines, antibiotics and antiviral agents?

A great way to keep your aging memory sharp and avoid Alzheimer's is to drink the right stuff.

a. Tops: Juice.
A glass of any fruit or vegetable juice three times a week slashed Alzheimer's odds 76% in Vanderbilt University research. Especially protective:blueberry, grape and apple juice, say other studies.

b. Tea:
Only a cup of black or green tea a week cut rates of cognitive decline in older people by 37%, reports the Alzheimer's Association. Only brewed tea works. Skip bottled tea, which is devoid of antioxidants.

c. Caffeine beverages.
Surprisingly, caffeine fights memory loss and Alzheimer's, suggest dozens of studies. Best sources: coffee (one Alzheimer's researcher drinks five cups a day), tea and chocolate. Beware caffeine if you are pregnant, have high blood pressure, insomnia or anxiety.

d. Red wine:
If you drink alcohol, a little red wine is most apt to benefit your aging brain. It's high in antioxidants. Limit it to one daily glass for women, two for men. Excessive alcohol, notably binge drinking, brings on Alzheimer's.

e. Try to avoid: Sugary soft drinks,
especially those sweetened with high fructose corn syrup. They make lab animals dumb. Water with high copper content also can up your odds of Alzheimer's. Use a water filter that removes excess minerals.

5 Ways to Save Your Kids from Alzheimer's Now:

Alzheimer's isn't just a disease that starts in old age. What happens to your child's brain seems to have a dramatic impact on his or her likelihood of Alzheimer's many decades later.

Here are five things you can do now to help save your child from Alzheimer's and memory loss later in life, according to the latest research.

1. Prevent head blows.
Insist your child wear a helmet during biking, skating, skiing, baseball, football, hockey, and all contact sports. A major blow as well as tiny repetitive unnoticed concussions can cause damage, leading to memory loss and Alzheimer's years later.

2. Encourage language skills.
A teenage girl who is a superior writer is eight times more likely to escape Alzheimer's in late life than a teen with poor linguistic skills. Teaching young children to be fluent in two or more languages makes them less vulnerable to Alzheimer's.

3. Insist your child go to college: Education is a powerful Alzheimer's deterrent.
The more years of formal schooling, the lower the odds. Most Alzheimer's prone: teenage drop outs. For each year of education, your risk of dementia drops 11%, says a recent University of Cambridge study.

4. Provide stimulation.
Keep your child's brain busy with physical, mental and social activities and novel experiences. All these contribute to a bigger, better functioning brain with more so-called 'cognitive reserve.' High cognitive reserve protects against memory decline and Alzheimer's.

5. Spare the junk food: Lab animals raised on berries, spinach and high omega-3 fish have great memories in old age.
Those overfed sugar, especially high fructose in soft drinks, saturated fat and trans fats become overweight and diabetic, with smaller brains and impaired memories as they age, a prelude to Alzheimer's."








Saturday, August 6, 2011

Beating the Bullies

Last night, I had dinner with a group of friends. Four of the eight or 50% reported that they had been the object of intimidation, threats and bullying in the workplace.

One has been with her employer for three years and each of her evaluations had been stellar until this year. He dropped her in 20 categories not because her performance had changed at all but because he was building a case so he could terminate her higher paying position.

She refused to take it laying down though and politely confronted her employer about the evaluation. She went to the conversation armed with reasons why each demotion was incorrect. Ultimately, he changed ever category back to exemplary, told her that she did not have to attach her rebuttals to her original evaluation, and that their discussion should stay between the two of them. He was clearly going to have to concoct another reason besides incompetence, because despite the fact that she is doing an excellent job, he still terminated her.

My friend has been smart though. Besides making sure her evaluation and ultimately her professional reputation was accurate, she also recorded the conversation, so she has his comment about keeping their conversation hush/hush on tape. By the way, it turns out that it is legal to tape a conversation without your announcing that you're doing so. She has a case now to take to the human resource department, but it is going to be a battle to keep her position as a counselor to children and program director.

A second friend is a teacher. She works with blind children and though the need for those types of teachers is still great, she was also terminated. Because of budget cuts, services to these children are being scaled back or eliminated altogether. Her principal told her that her contract was not going to be renewed but that it had nothing to do with her job performance. To add insult to injury, he told her that he wanted her to resign rather than have it be recorded as a reduction in force, and that if she did, he would make sure she got a good recommendation. He went on to say that if she did not resign, that she would not get a recommendation letter and that her termination would result in not being hired by others. He gave her by the end of the work day to decide.

It turns out that school districts don't want to look bad to their parents and the press. They don't want their records to show the real number of terminations. It is a public relations problem that they want to avoid, so they are intimidating teachers into resigning instead.

My friend chose not to resign. Instead, she wrote a letter saying that she preferred that the truth of her termination be recorded and that she hoped that because he said that it had nothing to do with her performance that he would in deed give her a recommendation letter that she had clearly earned.

The last two stories had to do with abuse from other colleagues. The one that is particularly horrific has been ongoing for over five years. It included public chastisement, public humiliation and private intimidation and threats of job loss unless my friend towed the line. Well my friend, who teaches handicapped children, finally had it and exposed not only the problem but the hierarchy protecting this teacher who usurped authority, terrified her team, and broke every rule of professional conduct that exists.

It turns out that my friend, who really risked everything by making the decision to go public, has not only exposed a collusion and cover-up in her own district, but has exposed the growing problem of bullying and intimidation in the workplace. Her efforts have resulted in both statewide and now national attention to the problem.

It is extraordinary to imagine that in this day of greater enlightenment not to mention work place laws that this kind of thing goes on, but it does and far more often than we like to think.

The lesson is clear but it takes courage. As each of my friends did, we must counter intimidation when it occurs. We must stand up to the bullies, and we must demand our rights. Otherwise, the bullies win and we are doomed to a life of fear.