Dr. Dave Hnida's Blog

OVER-PAPPED?

Posted by Dr. Dave Hnida

Jolly Santas around the country arent so jolly today. Their worry: asking a cute youngster if theyve been good this year, then getting a sneeze in return.

Yep, Santas are worried about Swine flu this year, so much that one of the major Santa unions, the Amalgamated Order of Real Bearded Santas, wants their members to ho-ho-ho it to their front of the vaccine line.

In a way, it makes sense. After all, there's a lot of little kiddies who are perfectly willing to share their germs with Old Saint Nick. And sitting in close firing range on Santa's lap makes for a target thats hard to miss.

But should Santa push his way to the front of the line, swinging his bag of goodies at pregnant women or little kids with asthma so he can get protection? Im not so sure. Some cookies and milk I can agree with, but a "priority one" status, is something that may not sit well with a lot of people.

I suppose there are exceptions to every rule, but I dont think the CDC thought of this one when it devised its vaccine priority list. I mean, what were they thinking? Dont they know if Santa gets sick, you can kiss your presents goodbye? A sick Santa wont just make for a bunch of disappointed youngsters, theres a Mrs. Santa to deal with as well. She wont be pleased if her chubby hubby is down with the flu on Christmas Eve.

(Okay, you can tell Im couching my bets here. The first part of the blog makes the case that Santas shouldnt take priority over others. Thats the doctor talking. Then I shift and worry Santa might be too sick to make his appointed rounds. Thats the guy who doesnt want to get Mrs Claus steamed- and doesnt want to get a load of coal dumped under my tree this year. I admit it, this is one blog where Ive got to cover all my bases.)

So every Bronco fan is having chest pain this week: will Orton be able to play this weekend against the hated Chargers? Im sure even young Coach Josh is feeling a few decades older as he bites his nails awaiting word.

Here's the deal. No one knows this early in the week. Its impossible to tell how bad an ankle sprain is when it first happens- the day after it happens- and even the day after that. Then maybe, you start to get a small clue where things might lead. Frustrating, but true.

We've seen "minor" twists" turn into weeks-long disability. We've also seen some nasty looking sprains turn out to be no big deal.

The key is always getting the swelling down quickly, then getting the range of motion back. Swelling delays healing and is considered evil in the world of sporst medicine. Thats why we use ice, ice, then more ice. Then progress onto ultrasound, electric stimulation, and so forth, to promote healing. We gently begin range-of-motion exercises to relieve stiffness (especially of the achilles, which tends to snap tight like a bear trap after a sprain.) We make you use crutches until you can walk pain free, then we let you jog in a straight line, try some gentle inclines, begin to run, then finally perform change of direction cuts. Then, and only then, you might be allowed back on the field. That is, after we fit you with a nice brace.

Then you hope. And keep in mind that even after a person starts moving well after a sprain, it takes 6-12 weeks for the tissue to fully come together and heal- making you prone to re-injuring the ankle with even a mild twist. (I dont even want to think about a 350 pounder landing on it.)

It will be a game time decision.

The National Institutes for Health has an interesting interactive tool to give you a rough idea of your risk of developing breast cancer. According to the web site, its for health professionals only, but frankly I think anyone can use it. The tool is simple and offers excellent explanations for each question. It might be worth running a little self-assessment, then talking to your doctor.

http://www.cancer.gov/bcrisktool/

A smack-in-the face study came out over the weekend that compared using the vitamin niacin versus the drug Zetia for lowering the risk of heart disease. And it's not the first time the more expensive, highly touted Zetia took a hard shot.

The research comes from the New England Journal of Medicine and finds people who took niacin, a form a vitamin B, had fewer heart attacks than than those who took Zetia.  The study revolved around looking at how each drug affected plaque buildup in arteries: the niacin people were protected while the Zetia users continued to have a slight buildup of blockages.

Zetia is supposed to work by lowering LDL, or bad chlesterol, while Niacin raises HDL or good cholesterol.

Admittedly it was a small study, but nonetheless one that got lots of attention. And if youre at risk for heart disease, one worth talking to your doctor about.

For the record, I take fish oil and niacin to boost my HDL, which tends to run low in every member of my family, The cost is pennies a day. Add a daily baby aspirin, and Im still at pennies a day.

As long as its a dark chocolate Hershey's kiss. Interesting new study out today on how chocolate can improve mood. Now we've heard these before but this is the first time we've seen some physiologic evidence of chemical changes int he body that take place with a regular dose of dark chocolate.

In the study, people who ate a small piece of dark chocolate every day for two weeks showed lower levels of stress hormones, stress chemicals, inflammatory chemicals, and so forth. They also had, clinically, lower signs and symptoms of anxiety.

Now I know a lt of people reach for a piece of chocolate when their stress level skyrockets- but I think the "feel good" response is more psychological than physical. And even the physical changes are short lived.

What makes this study so interesting is that a regular daily dose of chocolate seems to make those chemical changes persist- almost like taking a blood pressure pill each day, the longer you take it, the better it works. And one occasional dose doesnt fix the problem.

Now some people have criticized the study, saying if you tell people to eat chocolate every day, theyll gain weight. Well, heres the way I look at it. Lower your stress- youll feel better, sleep better, exercise more, have more control over your eating habits, and generally be in better health. Obviously if you have  medical reason that chocolate is bad for your health, stay away from it.

But for the rest of us, just say yes to chocolate. Its an easy, and tasty way, to feel better... and Im not talking placebo here. You may want to keep a small piece of chocolate next to your daily vitamins.

More and more people are turning to neti pots to irrigate their nasal passages to ward off sinus infections. But a new study from the American Academy of Allergy and Immunology says using neti pots regularly may backfire and actually cause infections.

If you use a neti pot, you know how it works. If you dont, the best way to think about it is to imagine a mini teapot filled with a watery solution which you pour into your nose (for most people, its in one nostril and out the other.)

Researchers looked at people who used the pots daily for a year to prevent sinus infections. Most got infections anyway. But when a group in the study nixed the neti, their infections went away and didnt return.

The thinking is  over-irrigation of the nose is not a good thing, removing "good" mucus and antibodies which actually ward off infection.

Experts says occasional use of the neti pots is okay- maybe 3-4 days in a row maximum. Do more than that, and you may do more harm than good.

I thought it was my imagination: younger people complaining of sore necks and sore shoulders for no apparent reason. Couldnt blame it on computers, cellphones, video games, or something similar.

But I got to thinking: 2 much texting?

Now comes a study from the American Public Health Association which shows neck and shoulder pain is indeed on the rise from texting OD. It seems most people text with their bodies held in a weird, rigid position- neck slightly flexed and shoulders hunched. And just like too many hours on the computer, too many hours hitting those little keys can do you in as well

So, the message: If ur sore, look @ ur time spent texting. It isnt anything to LOL about.

Who tolerates cold weather better, men or women?

I overheard a slightly heated discussion the other day about women "always" feeling colder than men- even when dressed similarly in the same environment.  And somehow I got sucked into the male vs female conversation even though I really just wanted to run away.

 My astute opinion was, "I don't know- it depends."

So I checked it out and here's what I found:

Women tend to have warmer core temperatures- 97.8 - compared to men- 97.4. So warmer internal temperatures.

But hand temperatures for women were chillier- 87 degrees compared to 90 degrees.

So my official opinion now is women probably do feel a little colder in the same circumstances compared to men- when your extremities are cold, your perception of temperature is  a little different. Probably.

 It all depends.

Ive never thought of myself as a veteran so Ive been caught a little off guard with the "thank you" for your service comments today. I'm still in the Army, and though Ive been overseas a few times, I still dont feel like the word fits me. Yet I guess I technically qualify as one because of my prior service.

My image of a veteran is someone like my dad, who served in WWII, my uncle, who served in Korea, my older brother, who served in Vietnam, and my younger brother, who served in the Cold War (strategic bombers against the Soviets, among other things.)

Then I think of my friends who Ive had the honor of serving with. They were all volunteers. Great men and women. And realize we have a bond as veterans that few others have. I tend to keep in touch with many that Ive been overseas with, but it tends to be hit or miss. Then something like Fort Hood happens, and my email box and voice mail is flooded with messages from people who are just making sure Im  okay. And I fill up everyone elses message boxes. Im thankful to know my friends care about me, and that I am lucky to live a life where I have a special group to care about.

Then I think of all of the others who have served, and are serving. Its a lot. And a little.

 As my Commander-in-Chief tries to make a wise decision regarding Afghanistan, I tend to think about the number 1. As in less than one percent . Thats the percentage of Americans who currently serve in the Armed Forces. Not that many... and the strain shows. Especially among their loved ones.

So I guess as you think about our nation's veterans today, I have a favor. Sure, say thanks. Then think about what you can do to make our country a better place. You dont need to carry a rifle to become a "veteran." You can take time from your busy life to make our community a better place. School, church, civic organizations, looking in on your next door neighbor-- that's serving your country. And I thank you for that.

Its your day, too. And when you think about it, it's our day together.