The headlines read, “Study shows virginity pledgers as sexually active as peers,” or, “Virginity pledges don’t work.”  OK, I thought, I’m not too keen on public pledges myself.  They were probably done in the emotion and peer pressure of the moment.  I wish all programs would undergo similar scrutiny.

But, then, I read an interview with the study’s author and found ”the rest of the story,” to quote Paul Harvey.  I didn’t take my own advice and believed a headline without reading the details.

In this month’s Pediatrics journal, Janet Elise Rosenbaum, Ph.D., A.M., looked at a survey from teenagers regarding sexual activity.  Some had taken a public pledge to remain virgins until married.  Past studies have shown the pledge may have an positive effect, but Dr. Rosenbaum thought the pledgers were not being properly compared with their peer group, other churchgoing teens.

After matching for over 100 traits, including attitudes toward sex, family and religious beliefs, Dr. Rosenbaum found that by five years, an equal percentage of pledgers and the matched nonpledgers had lost their virginity.  In addition, the pledgers were less likely to use birth control and STD protection.  She concluded that every teen should know about birth control and STD prevention. Her implication was that teaching only sexual abstinence was worse than a waste of time.

By chance, I found an interview with Dr. Rosenbaum. In it she mentioned that religious teenagers, as a group, delay sex by an average of three years longer than their peers. So I looked at a few of her references and found she cited one study that concluded religious teens who were having sex were more responsible about STD protection and birth control.

I agree with Thomas B. Collins, a layman who wrote a response to the study, saying:

The most interesting finding of this research is not the data with respect to pledging vs non-pledging, but the differences in sexual behavior based on religiosity, or overall religious activity, of adolescents. The religious teens were found to delay sex an average of three (3) years relative to non-religious. This is significant if we want to reduce teen pregnancy and STDs. Pledges are often taken in emotional rallies, and teens sign on the emotion of the moment. This is not likely to hold up in the heat of sexual passion later on. Teens will “forget about” their pledges. However, teens more deeply socialized within a religious environment growing up, and with the ongoing support of a religious community, and with continued peer religious activity, may be more likely to delay sexual activity and avoid related problems. This is the most important interpretation I have of this study.

Now I don’t know how “religious” was defined in any of these cases, but I have another question.  Were all pledgers churchgoers?  If not, should there not be a matched-peer comparison of non-churchgoing pledgers to churchgoing pledgers also?

The last question is, is it not a stretch to conclude anything about a related, but different subject: abstinence-only teaching in schools?

I have asked the author, and other experts, to comment.  I look forward to the answers. 

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Many people use nutritional supplements, herbs, vitamins to try to boost immunity and ward off colds.  It is only natural (pun intended) since we don’t have a cure for the annoying and frequent set of viruses that cause colds.

A few days back, I wrote about some general tried and true methods to increase your immunity that have good studies to back them up and don’t cost money.   They should be your base for protection.  Only implement other methods after you have put the base in place.

Good, reliable studies of herbs, vitamins and supplements that prove efficacy and safety are harder to find.  Although many people swear by their home remedy, the mainstream medical world has not taken these seriously, in the past.  We are now trying to catch up but have a long way to go.

The reason I reneged on my promise to post this information, on boosting your immune system with herbs, supplements and vitamins on yesterday, was I wanted to wait on access to the information at www.naturalstandard.com, where they utilize a group of medical experts and scientists to review all of the reliable data we have on alternative medicines.  Their mission is ”to provide objective, reliable information that aids clinicians, patients, and healthcare institutions to make more informed and safer therapeutic decisions.”

Here is what they say about specific supplements, herbs and vitamins fighting the common cold.

• Andrographis (Kan Jang)
  I had never heard of this one until I read, at Natural Standards, it was one of the most proven herbs to decrease the symptoms of a cold.  It also may be effective against the flu symptoms.  Key points are:
  - Take it within 36-48 hours of onset of symptoms.
  - There have been three known instances of severe allergic reactions; otherwise, it is relatively safe.
  - There is limited research on treating children.
  - It may interact with blood pressure, diabetic, blood thinner or anti-inflammatory medicines.
  - Don’t take if you may be pregnant.
• Vitamin C
  Although there were over 30 studies cited, the consensus is no evidence that Vitamin C prevents or treats the common cold.
• Echinacea
  - Mixed studies show it might help decrease symptoms in adults and kids, but does not prevent colds.
  - It has been known to cause allergic reactions, aggravate asthma.  It may cause a rash in kids.
• Zinc
  - Conflicting views again.  It may be helpful in some cold rhinoviruses and not in others.  Not sure of   effective dose.
  - Nasal zinc has been suspected to cause a loss of the sense of smell in some people.

One big problem with commercial supplements is you don’t always know what you are getting.  Dangerous contaminants have been found in some.  According to the Natural Standards, one study examined 59 echinacea preparations and found 10 percent contained no echinacea at all.  Of the 21 that were supposed to had a “standardized” dose, only 43 percent actually had the dose on the label.

I have only scratched the surface on treating colds. If you decide to take a supplement or herb, always check with your doctor if you are taking medications, have a chronic illness or could be pregnant.  At the least, learn extensively of the interactions and side effects.

Bottom line.  Andrographis may be your best bet for colds.  Elderberry has been shown to decrease flu symptoms.  Chicken soup helps the symptoms of a cold.

My wife has a secret recipe to prevent or treat what ails you.  The family swears by it.  What has been your experience?  Do you have a “cure” to share?

No one should have to bury their child.  A universal truth that will never be cliche.  There is nothing worse than the death of your son or daughter.  It haunts you forever.

I know from second-hand experience after my parents had to do just that when my sister died in an auto accident in her twenties.  The Travoltas know first-hand.  You can only try to cope.  But how?  What common lessons can be learned from such an unthinkable tragedy?

If they are like most, for one, they will feel guilty.  Seeing the past television interviews it is clear the Travoltas thought they had, somehow, been responsible for their son getting Kawasaki disease when a child  (see my previous post.) Although the cause of this disease is unkown, it appeared they were convinced it was their incessant carpet cleaning and chemicals used that were the culprit.  Whether the disease had anything to do with his death is uncertain, but, no matter the cause, they will feel guilt.  Surely they could have done something, they will think.

Also, they will look for someone or something else to blame.  Whether it is conscious or not, we all think there has to be a reason for horrible events.  Unfortunately, most look at the ones closest to them.  Divorces are frequent after the death of a child.

They will go through stages of grief.  In 1969, Elizabeth Kubler-Ross, M.D. wrote an excellent book called On Death and Dying.  She had spent countless hours with people at various stages of dying, and noted five common stages they went through.  Those who go through a loved one’s death experience similar stages.

1. Denial
   You think, this is not really happening.  It is a mistake.
2. Anger
   You blame God, or (fill in the blank).  You ask, why me?
3. Bargaining
   You promise to be a better person, if only for a second chance.
4. Depression
5. Acceptance

The goal is to work through the first four and get to number five.  Not everyone does.

With the sudden death of a loved one, all of these stages are bunched up, condensed and confused.  They crop up at unpredictable times, later, and can last a lifetime.

It is important to acknowledge these feelings and experience the pain, but not by yourself.  Talk to a counselor, or someone you trust.  Maybe you can find someone who has gone through similar heartbreak.  You won’t be able to suppress the feelings.  They will manifest sometime, somehow, and often in very unhealthy ways.

Has anyone else been through similar circumstances?  Do you have suggestions, tips, experiences?

Whenever there is a public tragedy such as the death John Travolta and Kelly Preston’s son, Jet, we are all sad, and some of us worry how it might relate to us. At least, I do.  It is a realty check. Don’t we all, sometimes, fear the worst for our children or is it just me?

We don’t know the cause of his death yet, but we do know that both parents have talked about their son getting Kawasaki disease when a child.  So, for now, if our own child gets sick we think, could it be Kawasaki Disease?  What if I, or the doctor miss the diagnosis?  How serious a threat is it to my family? 

Knowledge and perspective may help a little.                                 
                                                                                                            photo CDC.strawberry tongue                        

Kawasaki disease inflames the lining of the heart and arteries.  The cause is unknown but thought to be related to a virus, bacteria or environmental chemical or pollutant (pretty broad spectrum there).  You can’t do anything to prevent it, at present.  It usually affects children under 5 years old.  There is no specific test for diagnosis, but is suspected if a fever lasts over 5 days (sometimes higher than 104) and the child has 4 of the following:

• Rash
• Swollen, red (strawberry) tongue
• Red, irritated looking conjunctiva (the white part of the eyes)
• Swollen, red soles of feet or palms of hands
• Sore throat
• Swollen lymph nodes in the neck

You may recognize that your child has had these problems, probably more than once, but Kawasaki disease hits only 9-19 children per 100,000.  If my math is correct that is less than 1 child out of 500.  So keep it in perspective.  Don’t panic, just take proper action and see your doctor.

More facts:

1. It is treatable.  Kawasaki disease seriously damages the heart and arteries in about 25 percent of children if untreated, and 2-4 percent of those treated.   
2. The fever, rash, sore throat, etc. are much more likely to be some sort of viral illness, scarlet fever (strep throat with a rash) or a reaction to a medicine (Stevens-Johnson syndrome).  It might even be measles, but this has become less common that Kawasaki disease.

Bottom line: Kawasaki disease is uncommon.  Death occurs, but is rare.  If Jet died of it at his age, it would be extremely rare.  On the other hand, one of the first things I learned in medical school was rare diseases and events are not rare for the ones who experience it.  If my child had the above symptoms and a high fever for more than 5 days, without a clear diagnosis, I would ask about further testing such as an echocardiogram.  Early treatment is key.

My heart goes out to the Travolta family.

As usual, my writing is for information only.  If your child has some of the above symptoms follow your doctor’s advice.

Has anyone had experience with this disease or other like-scares?

Looking for a cure for the common cold or flu?  Sorry to disappoint.  You won’t find one that is proven to work.  Trying to boost your immunity to fight off those pesky viruses?  You’ve come to the right place.  As a reminder, colds and influenza are caused by viruses that affect your upper respiratory system.  Antibiotics kill bacteria, not viruses.  They don’t work on colds or the flu.  If you do get one of these nasty viruses, it has to run its course as your body’s immune system fights it to the finish.  Here are some ways you can boost and strengthen your immune system to help in the battle.

Let’s get the boring remedies out of the way first.  The ones that actually have been proven to work.

• For the full blown, lab diagnosed, rip-roaring influenza, the immunization shot and nose spray do work most of the time.  This flu season, the CDC reports that the majority of strains of influenza, so far reported, are related to the 2008-2009 vaccine. In other words, the scientists guessed correctly, and the vaccine or spray is working relatively well.  Specifically, 75 percent of the strains tested, so far, are similar to those included in the influenza vaccine.  However, the early news regarding the oral antiviral drug, Tamiflu (generic oseltamivir) is not so good.  A majority of this season’s early influenza strains has been resistant to this drug, which is prescribed, when you get the flu, to decrease the symptoms and duration.  Tamiflu is not working.  That is all the more reason to go ahead and get the vaccine.  It is not too late in the season, yet.

Other proven methods to boost your immunity are:

• Exercise.  One study has shown the flu shot works better in older patients if they walk regularly.  It boosts their immune response.  Similar responses have been found with Tai Chi and muscle building exercises.
• Good nutrition.  A variety of fruits and vegetables is the best way to get the ideal combination of immunity boosting vitamins and minerals.
• Physical and emotional stress weaken your immunity.  Get plenty of rest and sleep, keep a positive outlook and don’t overwork, or even over-exercise.  Laughter helps, as does meditation and prayer.
• Don’t smoke or be around the second hand variety.  Children, especially, should avoid exposure.

For more details on these proven methods, and more, read Dr. Elizabeth Pector’s totally non-boring article titled, oddly enough, “How to Boost Your Immunity”.

Next post, I will write about which nutritional supplements have been shown to boost immunity against the colds and flu.

I know you have other valuable tips.  Please share.

Photo by James Gathany.

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Will this be Dr. H by year's end?

Let’s go over my reasoning.

1. Exercise.
   I always say it is the closest to a fountain of youth we have, and I am not getting any younger.  For me, it is an inertia thing.  Once I get started, I feel better and look forward to it.  I will try to build it up to 300 minutes per week, since a recent report showed you need, at least, 275 minutes per week to keep weight off.  An old friend, Jimmy, suggested I keep up with my miles and chart a goal, such as walking to New York in 2009. I think I may buy a pedometer at the  walking spree website and give it a go.  Jimmy uses a treadmill with an incline, but I have enough foothills here in Colorado Springs to give me a workout.
2. Be more empathetic to my patients.
   Time and experience help this to be easier.  There is so much, in medicine, we don’t know.  Sometimes, an open mind can lead to underlying solutions.
3. Narrow my magazine and website focus.
   I just need to find out what to narrow it down to, then use a little disciple.
4. Never speed.
   Just for the record, I rarely do.  I am going to try to keep it under 5 mph over the limit at all times.
5. Give my magazine managing editor less work.
   Keeping four out of five resolutions is pretty good, don’t you think?

I wish you all a Happy New Year and that you are able to keep all of your resolutions, and more.

I am still trying to decide what my New Year’s health resolution will be.  Something I can keep, but have to work and focus on.  A long-term goal with short-term steps and rewards.  I have a few in mind, and thanks for your suggestions Sagan and Judy.

I know what your are thinking, Dr. Parker.  How can I improve on perfection, but it is worth a try.

Here is what I have come up with so for (get ready for major imperfections).

1. Exercise for 50 minutes 5 days a week.
   This includes 30 minutes of aerobics and 20 minutes of resistance training.  Most of you will poo-poo that as being so low a goal (Dr. J), but I know I will improve my health and should be able to keep it.  I have had several 13 hour workdays lately, but I am going to cut back on them so it should be more attainable.  Thirty minutes of fast walking followed by core strength, per Mark Salinas, of push-ups, sit-ups and some leg strengthening should do it.  Who knows? I might even get the incentive to hike Pike’s Peak by the end of the summer.  Two years ago I made it to the halfway point before pulling a calf muscle playing with my dog.
2. Be more empathetic with my patients.
   It is the workers’ compensation injuries I think are faking and the drug seekers I have the most problems with.  I should work on giving them the benefit of the doubt before shooing them out of the office.  I have noticed that when I personally have to go to see a doctor, or get a test, my empathy rises significantly short-term.
3. Narrow the focus of my magazine and website.
   I think I may have a little attention deficit because I love variety and the multiple aspects of medicine too much.  Experts, and advertisers, have told me I should hone down the information to mostly one group or speciality, such as women or men over 50, asthma, etc.
4. Never speed while driving.
   Well, let’s make it more reasonable, like never more than 5 mph over the speed limit in town nor 10 mph on the interstate.
5. Give less work to my magazine managing editor.
   (just kidding)

There they are.  Nothing earth shaking.   Do you have any suggestions?  Can you help me chose a more original resolution?  What is your resolution, or is it to resolve not to make one?

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I used to make New Year’s resolutions when I was very, very young.  They were bold and visionary.  I never kept them and forgot what they were by January 2.  Since my late teens, when people would ask me if had made a resolution, I would tell them something like sweat less, age a year or some other nonsense.

Maybe I should compromise and make one good resolution that I try my best to keep.  Something specific and doable.   Any ideas for me? (keep it civil now)  What is your resolution?

If you smoke, may I suggest to stop by the end of 2009?  Many patients I advise to stop smoking give me a frustrated look that implies easier said than done.  I know.  But what if you make it the one thing you resolve to do, your number one priority for 2009?

Here is one incentive.  Dr. Norman Edleman of the American Lung Association says half of smokers die of lung disease.  Have you ever seen anyone with chronic lung disease?  Most of you can imagine cancer, but there are other more long term diseases that slowly destroy your lungs to the point you become constantly short of breath and nothing (including oxygen) relieves you.  Fully half.  I know most of you think you will not be in that half.  Maybe, if you are lucky (sarcasm goes here), you may die of one of the many other associated cancers, or heart disease.

Here are some tips to help you stop.

Some go cold turkey.  My father did.  It could work for you.  Twenty some-odd years ago, I told one of my patients that he “really should stop smoking?”  He looked at me quizzically and said, “Honest?  I have never been told that.  If you really think it is harming me, I will quit.”  He never smoked again and is alive and breathing well.

More the norm is to try an average of 7-10 times before complete success. For many, breaking the nicotene addiction is the easy part.  You, also, have to deal with the habit of picking one up and the comfort of the feel you get while smoking.  What do you do with your fingers?  What do you chew on?  Try gum, or suckers maybe?

One good tip is to pick a quit date.  Plan ahead.  Get your prescription from your doctor or your over-the-counter aids, get rid of all your tobacco temptations, announce it to your loved ones and stick to it.

Here’s what the American Lung Association has to say.

1.      Talk to your doctor or pharmacist about the different over-the-counter and prescription
medications to help you quit smoking.
2.      Look into the different kinds of self-help options available to smokers.  Visit
www.lungusa.org for suggestions.
3.      Take time to plan. Pick your quit date a few weeks ahead of time and mark it on the
calendar. If you can, pick a day when life’s extra stresses are not at their peak, such as
after the holidays. Mark a day on the calendar and stick to it.
4.      Get some exercise every day. Walking is a great way to reduce the stress of quitting
Exercise is proven to not only combat weight gain but also to improve mood and energy
levels.
5.      Eat a balanced diet, drink lots of water and get plenty of sleep.
6.      Ask family, friends and co-workers for their help and support. Having someone to take a
walk with or just listen can give a needed boost.
7.      You don’t have to quit alone. Help is available. Consider joining a stop-smoking program
like Freedom From Smoking from the American Lung Association.

You can find a support group near you by clicking on www.lungusa.org.  There is also free American Lung Association online support at Freedom from Smoking Online.

If you don’t smoke, email this post to a friend that does.  It could be lifesaving.

I don’t smoke, never have.   So I need ideas for my resolution.  Please help.   Do you make them for yourself?

Pictured: healthy lung (top), lung with emphysema (bottom); courtesy, American Lung Association.

Irritable Bowel Syndrome (IBS) affects 20 percent of U.S. adults.  Although it doesn’t actually harm the intestines, it can wreak havoc on the sufferer with any combination of abdominal bloating, cramping, diarrhea and constipation.  In a recent post I reported a study showing that the old standby treatments of fiber, peppermint oil and antispasmotics still work for most people.

The American College of Gastroenterologists has released updated treatment recommendations, as reported by the University of Michigan. New recommendations of note are:

• Patients who have diarrhea, even if mixed with constipation, should be screened for celiac disease (an intestinal intolerance of gluten, a protein found in wheat, rye and barley).
• Antidepressants, given at bedtime in low doses, can reduce bloating and discomfort.  This effect works independently of the antidepressant or anti-anxiety effect.
• The probiotic supplement Bifidobacterium infantis has been helpful in IBS with diarrhea.
• There are several prescription medications available for subsets of patients depending on the severity and type of symptoms.

Anyone with IBS probably has already discovered foods that can make the symptoms worse.  These can include gas-producing food, carbonated drinks, milk (due to lactose sugar intolerance), and other sugars such as fructose and sorbitol.

Has anyone found these things helpful, harmful?  Other tips?

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I must admit I slip on the ice frequently.  Sometimes I fall.  Luckily, I have always gotten back up with only my pride bruised.  However, I do see serious injuries after every significant snowfall.  You really don’t want a cast for Christmas, do you?

Dr. Ronald Grelsamer, a knee and hip orthopedic doctor from Mt. Sinai hospital in New York, gives his winter walking tips to avoid serious injuries.

1. Move your feet ever so slightly apart as you walk, for more balance.
2. If the area is really slippery, bend your knees slightly as you walk.
3. When walking down a slippery slope, walk sideways, but do not cross one foot over the other.  Bend your knees slightly.
4. Protect your dominant arm so if you fall, you will not be fully bracing with it.  You can do this by grabbing on to the lapel of your coat or using that hand for carrying.
5. Be especially careful when exiting trains, buses or cars.

I would add to be aware.  I usually fall when I’m not paying attention to what I am walking on.  Even then, that black ice can fool anyone.

Does anyone have additional tips?

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