Tired Truths Hot Picks

The Waiting Room Companion Created for Your Doctor’s Office

webmd.com the Magazine May 2011 $4.95

33 beauty Healthy gifts for Mom 46 parenting happily married with kids? Hot picks 48 fitness Is barefoot running for you? Which sunscreens do derms use? 54 recipes Try our Asian Bok Choy Salad 66 76 diabetes head-to-toe checkup Tired 78 allergies what are your top symptoms? truths 80 pain What’s your Pain IQ? Exhausted? Top 7 81 heart fatigue triggers heart attack smarts 72 82 sleep Rate your sleep habits 83 mind blues or depression? does it Edie Nurse Jackie’s Falco on beating addiction, her new play, and her starring role: mom 60 Trim: 16.75" Trim: .375" Safety: 16.75" Trim: Safety: .375" Safety: .375" Gutter .375"

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Target Pharmacies are not located in all Target stores, hours vary by location, services of pharmacist may not be available at all times when Target stores are open. Free translation services available. $4 prescriptions include up to a 30-day supply of covered drugs at commonly prescribed dosages. These drugs may be priced higher in CA, HI, MN, MT, PA, RI, TN, WI, and WY. Please ask your Target Pharmacist for speci c pricing in these states. © 2011 Target Stores. The Bullseye Design and Target are registered trademarks of Target Brands, Inc. All rights reserved. 51310 Safety: .375"

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TRACKING NUMBER 51310 JOB TARPHAM11065 CD Guy Seese / Kathy Hepinstall AE Jennifer Richardi PUB WebMD TITLE Target Healthcare – Pocket AD Nate Miller AB Amy Carleton ISSUE May FINAL CLIENT Target CW Brian Murphy PHOTO Grant Delin / Kyle Pero BLEED 17.25"w x 11.125”h BOARD FILE M11065_Pocket_16.75x10.875_51310 SA Alisha Henson ILLUS n/a TRIM 16.75"w x 10.875"h 03.24.11 OFFICE USA–Portland SM Michael Frediani DESIGN Nate Miller SAFETY 0.375" each side ECD Susan Hoffman / Mark Fitzloff PM Brian Mork COLOR Amy Corcoran / Kyle Pero / Saskia Thomson GUTTER 0.375" each side

USAGE Usage is 1 year North America, print mediums including consumer and trade print, PR, collateral, internet/digital and industrial. Photographer retains copyright. Client/agency owns concept. Usage expires after 1 year from first run date. May 2011 contents ® Everyone wanted to know features how the Princess was… webmd.com the Magazine And CaringBridge made it easy to share. wellness fatigue Life Stages 60 Tired Truths 72 Edie Falco reveals to WebMD Feel fatigued? You’re in good contributing writer Jenna Bergen company. It’s one of the most- how her past battle with alcoholism searched health terms on helps her get into character as Nurse WebMD.com. Contributing Jackie. The award-winning actor— writer Stephanie Watson asks starring opposite Ben Stiller in leading health experts about The House of Blue Leaves, which just the reasons so many women premiered on Broadway—also opens are exhausted. Do you know up about her favorite role of all, the seven culprits mom. PLUS: Falco’s seven rules for most often health and happiness. to blame?

NAME: Taylor HEALTH CONDITION: Cancer VISITS TO WEBSITE: 632,130 MESSAGES OF SUPPORT: 12,211

skin care Sun Day Best 66 The heat is on! Have you stocked up on sunblock? WebMD contributing writer Ayren Jackson- Cannady talks to top dermatologists who bust the biggest misconceptions about wearing sunscreen. AND: We asked a top derm about the sun care products she slathers on herself.

CaringBridge provides free websites that connect people facing a significant health challenge to family and friends, making it easy to share updates and receive support.

2 WebMD the Magazine | May 2011 Cover photo By Showtime Making each health journey easier. ® departments 22 May 2011 webmd.com the Magazine

Healthy Start 6 What’s good for you this month. 55 Three Ways to Cook Pork Try one of PLUS: Take our Healthy Start challenge! these quick-and-easy recipes tonight. 59 How I Got Myself to Eat Cilantro One woman’s spicy love story. 8 Nan’s Note take the test you can take WebMD Wire to your doctor What are the top 10 allergy cities, 1 2 assessments, quizzes, and reference what is the mood-smarts link, and which Living Well 35 information on every page veggie do your kids like least? 35 The Makeup of Makeup What’s in eye shadow, anyway? diabetes Click Here 36 Thinking Ink? What you need to 76 Head-to-toe diabetes checkup 18 What’s new at WebMD.com know about tattoos. right now. 39 You Asked Skin care pros reveal diet Could you have IBS? their go-to anti-aging face products. 77 Medical allergies 20 File 78 ID your top allergy symptoms After a personal scare, 42Health Matters Good Morning America’s Sam 42 sleep pain Champion is helping raise melanoma What’s Up? Can’t sleep before your 80 Truths about chronic pain awareness. AND: An inspiring new book on time of the month? Here’s why. becoming a parent after cancer. heart 43 patient Heart attack smarts Car Trouble When and how do you 81 Exam Room get your aging parents off the road? sleep 22 An oral history of mouthwash. 45 mind 82 Do you have good sleep habits? The Teen Brain A peek inside your ® Ask the Experts teen’s neurons explains a lot, parents. mind Could your blues be depression? Don’t brush it off—use Colgate 25 Are UV nail dryers a cancer risk, 46 parenting 83 and does airplane air make us sick? Parent Trap Do you know the keys to staying happily married with kids? WebMD Checkup People with diabetes have a 2x greater risk of developing gum disease. Colgate Total® WebMD 5 47 sex Surfing champ Bethany Hamilton toothpaste reduces 90% of plaque germs that cause gingivitis, the most common Test your smarts with these Baby Boon Struggling to conceive? 84 30 on her best and worst health habits, how she form of gum disease, for 12 hours.* And, it’s the only FDA-approved toothpaste.† five FAQs about lupus. The scoop on infertility options. stays inspired, and what it’s like seeing her life 48 fitness story on the big screen in Soul Surfer. Vanity Fare Foot Loose It’s the latest trend in Learn more at OralHealthandDiabetes.com 33 Make Mom’s day with these running: sans shoes. pampering, healthy gift ideas. 50 pets * vs ordinary, nonantibacterial toothpaste. †Colgate Total® toothpaste is approved through the New Drug Approval process to help prevent Bringing Up Baby Kitten and puppy gingivitis. Not approved for the prevention or treatment of serious gum disease or other diseases. care tips from top vets. The ADA Council on Scientiﬁ c Affairs’ acceptance of Colgate Total® Gum Defense toothpaste is based on its ﬁ nding that the product is effective in helping to prevent and reduce tooth decay, n Noah H amilto b ottom right: Mutt Manners The do’s and don’ts gingivitis and plaque above the gumline, and bad breath, and to whiten teeth by removing surface stains, when used as directed. of canine etiquette at the dog park.

46 Healthy Eats 54 a national strategic partner of 54 Anatomy of Bok Choy All about this cabbage family member.

CPA-COL-F03893 TotalDiab Ad B Rv1.indd 1 2/7/11 5:12 PM healthy start good for you this month

May’s Quick Picks Number Crunch Think granola is the ideal snack? Be careful not give back to overindulge, says WebMD nutrition expert Carolyn O’Neil, MS, RD. “You have to look beyond granola’s health halo,” O’Neil says. Granola is usually high healthy eats in calories and fat. She suggests limiting yourself to about ¼ cup per serving and making your own with oats, flax seed, walnuts or almonds, Mole Patrol and dried fruit (not Melanoma is the most more than 10% of the dangerous type of skin cancer, total serving). skin care but also the most easily treated if detected early. And May is Melanoma Month—the Helping Hand perfect time to spread the

Mother’s Day is the perfect time for a DIY word. St. Louis, Mo., holds mother-daughter manicure. “It’s great bonding a Moonlight and Melanoma time,” says Karyn Grossman, MD, WebMD skin Walk of Hope May 14, and care expert. But she has one word of caution: Ocean City, N.J., holds a walk While prepping nails for a good polish, leave May 21. Visit melanoma.org the cuticles on your hands alone. “Your for more of the Melanoma hands are exposed daily to soaps and more Research Foundation’s yearlong caustic things, and if you manipulate the cuti- prevention efforts. cles a lot on the more delicate skin, you may end up with inflammation, irritations, Run for It or infection,” she explains. When it comes to shopping for new running kicks, leave it to the pros, advises Pamela Peeke, WebMD fitness expert. Head to a specialty running store so a qualified salesperson can evaluate what type of shoe is best for your feet. Another tip? Shop in the late afternoon or What’s your crunch quotient? just after a run, Peeke says. “Your feet are expanded to their greatest I love adding granola to my yogurt, but width, and you need the most accurate width measurement.” sometimes the store-bought options leave a little to be desired. So I want to make my own. That’s fit tip where you come in—do you have a DIY granola recipe to share? Take our Healthy Start Challenge: Post your recipe in the magazine community at WebMD.com to win a $25 gift card to Whole Foods!

Andi Gabrick Senior Editor, WebMD the Magazine ction/Glow I m ages ; F r a nz Ab e rh m/G tty Gr eg or Schu s t r/G I m ages ; F oodcoll e ction/Glow Te tr a I m ages /Glow se from top l e ft: clockwi

Take this issue’s Healthy Start Challenge and you could win a prize! WebMD.com

6 WebMD the Magazine | May 2011 nan’s note from the editor in chief

This issue is dedicated to resilience, from the cover story—Emmy Award-winning actor Edie Falco’s ability to get sober, fight breast cancer, and then joyfully become a parent—to our back page “WebMD Checkup,” with 21-year-old Bethany Hamilton’s return to surfing after losing her arm to a shark attack (her story is now a major movie, Soul Surfer, in theaters). Here at WebMD, we are bringing a spirit of resiliency to the obesity epidemic in America. We have more hope for this next generation than ever before. Our optimism comes from knowing that information, personal awareness, and understanding can free children to thrive in a healthy environment. Together with our partner Sanford Health—the largest nonprofit U.S. rural health care provider and an organiza- tion comprising the leading researchers, physicians, diabetes educators, nutritionists, and healthy living specialists in the country—we are proud to introduce fit, a new website for children ages 2 to 18 with three separate age-appropriate destinations for kids only: fit jr. (launching soon), fit kids, and fit teen. Find all three at fit.WebMD.com. And on WebMD.com itself, you’ll find Raising Fit Kids for parents and families. All told, it is an entirely new platform for kids and families to look at whole health. fit is learning disguised as fun, while also a refreshingly new approach to understanding the total picture of feeling and looking better starting from a young age. You and your kids will have to see for yourselves, but I can assure you that the children and teens who helped us develop fit truly enlightened us. What they wanted to learn and understand was more far-reaching than we imagined: nutrition (fit food) and fitness (fit move) for sure, but also emotional fitness fit( mood) and restorative fitness fit( recharge), both unmet needs when it comes to kids’ health. We wish you the loveliest May ever with the most satisfying smile ( ), the greatest night’s sleep (zzz), the yummiest healthy meal (mmm), and an endorphin-raising workout (phew!).

Nan-Kirsten Forte, MS Editor in Chief, WebMD the Magazine Francesco Lagnese

8 WebMD the Magazine | May 2011

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WebMD the Magazine is distributed to doctors’ offices throughout the United States. Patient names may have been changed to protect privacy. The information herein is meant to complement 111 Eighth Ave., Suite 700, New York, N.Y. 10011 and not replace advice provided by a licensed health care professional. WebMD the Magazine is not responsible for advertising claims. WebMD the Magazine (ISSN 1553-9946), Vol. 7, No. 3, is Chief Executive Officer • Wayne Gattinella published by WebMD, 111 Eighth Ave., Suite 700, New York, NY 10011. Send returns to: WebMD. To change your subscription (address, number of copies received or to stop delivery), contact CHief operating OFFICER, Chief Financial Officer • Anthony Vuolo WebMD, Magazine Subscriptions, 111 Eighth Ave., Suite 700, New York, NY 10011; or send to [email protected]. Printed in the U.S.A. All rights reserved under International CHief TECHNOLOGY OFFICER • William E. Pence and Pan-American Copyright Convention. This magazine may not be reproduced in whole or in part without written permission of WebMD. ©2011 WebMD, LLC. All rights reserved. WebMD’s mission Executive Vice President, is to provide objective, trustworthy, and timely health information. Our website and magazine provide general counsel, & secretary • Doug Wamsley credible content, tools, and in-depth reference material on a wide variety of health topics, all of which are reviewed by our board-certified physicians. Any opinions expressed are of the experts Senior Vice President, Legal • Michael Glick and are not the opinions of WebMD. WebMD does not endorse any specific product, service, or treatment.The content of each WebMD the Magazine “Spotlight,” while funded by an advertiser, is Senior Vice President, sales & sales operations • Dorothy E. Kelly Gemmell selected by and solely under the editorial control of the WebMD editorial staff. The content in WebMD the Magazine is intended for informational use only; it is not intended as Senior Vice President and General Manager • Clare Martorana a substitute for professional medical care. Never disregard professional medical advice or delay in seeking it because of something you have senior Director, Public Relations • Katherine Hahn read in WebMD the Magazine.

May 2011 | WebMD the Magazine 11 ®

Air Cleaning Filters wirethe health news beat at WebMD.com You may not see More Sneeze City Than Meets the Eye Do April showers bring sneezes and sniffles Children diagnosed with attention them, but they instead of May flowers? Are your allergies so bad deficit hyperactivity disorder (ADHD) that you find yourself scanning the apartment are often struggling with other mental rental listings in other cities? Before you start are in the air or physical problems as well, a new packing, check out the Asthma and Allergy Foun- study reports. And like ADHD, those dation of America’s “spring allergy capitals.” problems can harm both schoolwork you breathe The list ranks 100 metropolitan areas accord- and personal relationships. ing to how challenging they can be for people Good Egg The research, based on surveys of with allergies, based on pollen counts, city size Good news for those watching their 62,000 school-aged children nation- (larger cities have more pollution, which can cholesterol levels: The average amount wide, found that nearly 70% of young- worsen allergy symptoms), weather conditions, of cholesterol in an American egg has sters formally diagnosed with ADHD the number of people who use allergy medica- dropped in the last decade, according have at least one other problem, such as tions, and the number of board-certified aller- to a new study by the U.S. Department a learning disorder, conduct disorder, gists in that location. of Agriculture. autism, epilepsy, depression, anxiety, The top 10 cities with the worst conditions for And not just by a little bit. The or a hearing or speech disorder. About people with allergies are: study, which analyzed regular, large- 20% of children with ADHD have three shell eggs from 12 spots across the or more of these issues. 1. Knoxville, Tenn. 6. Birmingham, Ala. country, found that eggs now have Put another way, the researchers found 2. Louisville, Ky. 7. Dayton, Ohio 14% less cholesterol compared to that children with ADHD were nearly 3. Charlotte, N.C. 8. Richmond, Va. 2002, when they were last examined. eight times more likely than other chil- 4. Jackson, Miss. 9. McAllen, Texas There’s more good news: The dren to have learning disabilities, nearly 5. Chattanooga, Tenn. 10. Madison, Wis. amount of vitamin D in eggs has 13 times more likely to have conduct dis- increased a whopping 64% in the Source: Asthma and Allergy Foundation of America orders, and more than eight times more same period. likely to have depression. Researchers theorize that a change The researchers said the study points Allergens like mold spores, pollen and even in nutrient levels might be due to to the need for better screening of changes in hen feed. But nutritionists dust mite debris are floating in the air that children already diagnosed with ADHD you and your family breathe. Filtrete® Air Mood Master still recommend eating just one egg a to identify other disorders they may be No one really likes to be in a bad mood, but now there’s even more reason to be day to keep cholesterol levels in check. Cleaning Filters from 3M are electrostatically* living with. in a good mood. A new study suggests a cheerful frame of mind can help with Source: USDA

charged to attract and capture airborne problem-solving. Source: Pediatrics allergens and microscopic particles like In the study of 87 student volunteers, researchers at the University of Western household dust, pet dander and smoke Ontario found that those who were in a good mood performed from the air passing through the filter. And better on tasks such as classifying pictures with visually com- plex patterns than students who were in a bad or neutral they are the best filters at trapping particles mood. The reason? A positive mood seems to enhance without restricting airflow. people’s ability to solve problems creatively as well as to think both flexibly and carefully. * Electrostatic filters are most effective when the filter is clean and new. The researchers also identified two ways of getting OO M i mag e/Getty Imag e s ; oppo ite: F l ickr/Getty Pu re tock/Getty ©3M 2011. 3M and Filtrete are trademarks of 3M. into a good mood: watching a video of a giggling Particles not actual size. For illustrative purposes only. baby and listening to one of Mozart’s peppier com- positions. Ultimately, however, they advise people $ 00 to find the music or videos that make them feel Get a 6. mail-in rebate happiest so they know what to use to get ® when you buy 3 Filtrete Air Cleaning Filters their creative juices flowing.

with a Microparticle Performance Rating (MPR) Source: Psychological Science of 1000 or greater at top: A ma n a P ro du ction s I nc./Getty Imag e ; BL top: Filtrete.com/WebMD Filter your world May 2011 | WebMD the Magazine 13

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Not actual patients. T:3.125” ® wire SOME control room Sleep, You might think your child’s potential THINGS is shaped by factors like intelligence and Interrupted self-esteem. But it turns out that another You know that resentful feeling you get when factor is equally important: self-control. you’re up in the middle of the night, comforting A 32-year study, which followed a crying baby, and your husband is fast asleep? A 1,000 New Zealanders from birth, IN LIFE new study shows that women are more likely to found that the differences between chil- give up sleep to take care of others. And that’s one dren with self-control and those with- YOU CAN’T reason women tend to get less sleep than men. out it start showing up as young as age To do their research, sleep experts at the Uni- 3. The researchers asked parents, teach- versity of Michigan studied time diaries kept by ers, friends, and the children to judge CONTROL. more than 20,000 working parents as part of the how well kids in the study were able to handle frustration, stick to a task, and persist in U.S. Census. They found women are about two- reaching goals—and, conversely, how often they acted before thinking, had difficulty tak- and-a-half times more likely than men to take the ing turns, or were restless or not conscientious. LOWERING YOUR RISK night shift for caregiving. And when they get up, When the children reached adulthood, those who had scored the lowest on self-con- OF INFECTION DURING they stay up longer than men—an average of 44 trol as kids were more likely to have health problems than those who scored higher. Low CANCER TREATMENT, C-Notes minutes versus 30 minutes. Worse, the women in the study got up more often even when scorers also had more trouble with money, were more likely to be single parents, had New hepatitis C virus (HCV) infec- they were the sole breadwinners in the house. higher rates of substance abuse, or had criminal records. tions in the United States declined by Part of the reason women do this might be biological—if they’re breastfeeding, for While the researchers note that most people don’t break out of their self-control “rank,” YOU CAN. more than 90% between 1990 and instance, it’s easier for women to feed a baby at night. Women’s brains also appear to be all is not lost if a child has trouble with self-control at an early age. Seven percent of the 1992 and have remained relatively more attuned to the cries of children, one 2007 brain-imaging study found. Still, loss of kids improved their levels of self-control in the course of the study; the researchers think The risk of infection during cancer stable ever since, new figures from the sleep is a real health hazard. Take a stand and ask for help with the nighttime duties, gals! this may be partly because they attended schools that stressed structure and achievement. treatment can be very high. T:10.875” CDC confirm. Researchers tracked the Source: Social Forces: International Journal of Social Research Encouraging children to develop autonomy and problem-solving skills can also help. And infections can delay your national incidence and transmission Source: Proceedings of the National Academy of Science of new HCV infections between 1982 The WebMD treatment or stop it altogether. and 2006 by analyzing data from six Veggie Might The number of babies’ and toddlers’ So do everything you can to get county health departments. Poll healthy, stay healthy, stay strong. About 3.2 million people in the The results are in from the Q: What’s the one vegetable emergency room visits each year related Talk to your doctor and go to United States are chronically infected March/April issue poll! you have the hardest time to accidents involving cribs, manageyourtreatment.com with hepatitis C, and about 17,000 feeding your kids? right now. Some things you can’t new infections occur each year. playpens, and bassinets Q: What do you usually make for ❍ Broccoli control. But this, you can. Roughly 14% of new HCV infections dinner when you’re feeding Source: Pediatrics 9,500 identified during the survey period only yourself? ❍ Brussels sprouts were among people who said their You know about the dangers of smoking cigarettes only risk factor was having sex with an 34% Leftovers! ❍ Eggplant and the health risks of breathing in secondhand infected partner or having multiple sex 19% Cereal (with skim milk, ❍ Zucchini smoke. But what about exposure to thirdhand smoke? partners. There was little evidence that of course) Smoke Defined as the nicotine residue left on furniture, cosmetic practices such as tattooing ❍ Lima beans walls, and carpeting after a cigarette has been smoked and body piercing contributed sub- 18% A big salad in a room, thirdhand smoke can become—and ❍ Peas stantially to HCV infections. And the 14% Eggs, any style Signals stay—airborne a long time, a new study shows. And HCV infection risk from blood transfu- ❍ Kale when that happens, the nicotine can combine with sions fell to near negligible levels— 9% Pasta with tomato sauce other indoor air pollutants in particles so small they about one infection for every 2 million are capable of penetrating the deepest parts of the 4% A bowl of popcorn units of transfused blood—following lungs, which can contribute to cancer and breathing the introduction of tighter donor 2% Ice cream (shh...don’t tell!) problems like asthma. The nicotine can also combine screening practices and better tests. with substances in paper, cellulose, and cotton to cre- Even so, about one in 30 baby Visit WebMD.com/magazine and ate compounds that may be dangerous if absorbed boomers is infected with hepatitis C, enter our May 2011 poll! through the skin. but most do not know it. One more reason to stay in a nonsmoking room Source: CDC Source: 2011 WebMD Poll the next time you’re at a hotel.

rer/Getty Imag e s ; F us e/Getty B a r ba M au top: Source: Environmental Science & Technology C hri s T o b in/Getty Imag e ; Pu re tock/Getty EDIE FALCO AND CYNTHIA NIXON STAND UP TO CANCER.

16 WebMD the Magazine | May 2011

Client: SU2C Document: S2L-101 DUO_WebMD_3.125x10.875. Date: 2-25-2011 10:44 AM Notes: WebMD Round: Job No.: S2L-GE-P9-101 Live: 2.375” x 10.125” DDB Office: Los Angeles Version: Nixon/Falco 1/3 page Vert Trim: 3.125” x 10.875” Printed at: 100% Issue: March 2011 Description: AMGEN PRINT AD Bleed: None Mech scale: 100% Pick-up Job No.: NONE Gutter: None Color(s): 4C FM Account Manager: [email protected] APPROVAL DATE OK/WC Inks: Cyan, Magenta, Yellow, Black Project Manager: Maria D x1750 APPROVAL DATE OK/WC Creative Director: Matt R. APPROVAL DATE OK/WC Fonts: ITC Avant Garde Gothic (Medium, Bold) Art Director: Ji B x1688 APPROVAL DATE OK/WC Copy Writer: Maureen Z x1566 APPROVAL DATE OK/WC Links: cynthiaedie_final.psd (CMYK; 912 ppi), Amgen_2_Blue_PC.eps, su2c_url_logo_whi.ai Production Manager: Paul N x1670 APPROVAL DATE OK/WC Pre-press: Toby F x1536 APPROVAL DATE OK/WC Art Buyer: Amy R x1530 APPROVAL DATE OK/WC Proof Reader: Dani x1518 APPROVAL DATE OK/WC Studio Artist: Steve B. APPROVAL DATE OK/WC Last edited by: Batchelor, Steve/Yoshimura, Steve click here highlights at Webmd.com This is personal.

the Pulse by Colleen Paretty WebMD Executive Editor t WebMD, we often ask you what you think, and Asometimes what you say kickstarts a whole new initiative. Take the “Vaccines: What Today’s Parents Should Know” report we just launched on WebMD.com. It was inspired by a WebMD survey a few months ago of parents who said they worry a lot about vaccine side effects and risks (including autism, even though a hyped-up study linking vaccines to autism is now being called a fraud). And while 77% of parents said they intended to vaccinate their kids, many others said they will select only some vaccines, follow a modified schedule, or refuse vaccines altogether. Clearly, deep concerns remain. To help you sort through the disparate (and sometimes misleading or just plain wrong) information online, we corralled a good overview of the issues in one place, including: • a vaccine benefits vs. risks guide, which explains risks, side effects, and ingredients • an interactive U.S. map showing unvaccinated kindergartner rates by state Photo: Andrew Macpherson Andrew Photo: • coverage of the recent vaccine study/autism controversy • vaccine stories: Three moms (and their husbands) tell us in their own words how “My mother died of they came to very different vaccination decisions. colon cancer when The last one is particularly eye-opening. For these parents, long and thoughtful deliberation has replaced what was once a routine visit to the pediatrician’s office with few she was only 56.” questions asked. I hope our report eases your own path to an informed decision. Visit me Terrence Howard, actor/musician on the magazine’s Community page and let me know.

Glaucoma symptomchecker top symptoms include

Colorectal cancer is the 2nd  Seeing halos around lights leading cancer killer in the U.S., Vision loss  SEARCH but it’s largely preventable.  Loss of peripheral (side) vision If you’re 50 or older, Too much fluid pressure within the eyeball increases your please get screened. risk of glaucoma, which often has no symptoms until the intraocular pressure has damaged the optic nerve. If the 1-800-CDC-INFO (1-800-232-4636) SEARCH www.cdc.gov/screenforlife pressure isn’t treated with medication, glaucoma develops, which can lead to permanent blindness. Risk factors include having parents with the condition, being older than age 60, having poor vision, having diabetes, and being African-American over the age of 40. If you’re at risk, a key GO to prevention is to get a dilated eye exam every one to two WATCH VIDEO Key in your symptoms years. Treatment includes eye drops to reduce the intraocular pressure and laser and microsurgery to change the FIND THE ANSWER eye’s structure and help drain fluid out of the eye.

18 WebMD the Magazine | May 2011 medical file people and pages Health Champion GMA anchor spotlights skin cancer awareness

Good Morning America weather anchor Sam Champion will be reporting on more than just the elements throughout May, which is Skin Cancer Awareness Month. He’ll be urging ABC view- ers to get informed about the disease, and on Melanoma Mon- day—May 2 this year—he will deliver an on-air message about the deadliest form of skin cancer. It’s not the first time Champion has broadcast about skin cancer. Last May, he underwent live-on-the-air surgery for the most MEET THE MEET THE common form of the disease, basal cell carcinoma. According to the American Cancer Society, skin cancer is the most common type of cancer, and about 2 million cases of basal cell carcinoma are diagnosed in the United States annually. That Sam Champion has turned his personal battle against melanoma into a WILLIAMS WILLIAMS number has been increasing for many years. national call to action to help others be sun safe. Basal cell carcinoma is a slow-growing cancer that usually shows they’re wondering how heathcare reform they’re wondering how healthcare reform up on parts of the body that get the most exposure to the sun, “And I realized there are a lot of people like me who had been will impact their employees’ benefits will impact their kids’ coverage when they such as the head, neck, and arms. It often appears as flesh-colored misled and were at risk.” graduate college bumps or pink patches of skin. Though it rarely spreads, it can When his dermatologist discovered five suspicious moles last cause damage and disfigurement to nearby nerves and tissues if left year and told him he would need surgery, he decided to use the untreated. Staying out of the sun or using a strong sunscreen when opportunity to teach people about the dangers of skin cancer outdoors is the best way to prevent skin cancer of all types. and the importance of protecting themselves. “I said, ‘Let’s do Champion, 49, puts the blame for his own skin cancer on bad this live,’” recalls Champion, who spends his time in the sun advice he got when he was growing up. “Get your first burn of the very safely these days. All of these families share the same name, but season, then your skin will acclimate to the sun,” he recalls being “I used to be like George Hamilton—always at the beach, their lives and their questions regarding healthcare told. But that’s not true, as he found in his 20s, when he was first always tan,” he says. “Now, going to the beach, getting on reform are very different. That’s because treated for skin cancer. That early experience left him unsettled. a boat, I use a sunscreen with an SPF of 30 or higher every “The first time was a shock. I didn’t understand it,” he recalls. single time. I don’t mess with that.”—Matt McMillen healthcare reform affects everyone differently. Introducing AskBlue Healthcare Reform. Your personal guide to understanding the basics of fertile hopes Healthy Read reform. To find answers to your healthcare reform It’s no surprise to anyone here at WebMD Before and After fertility before and after cancer treatment? questions visit bcbs.com/askblue. that one of our favorite longtime writers Treatment and Important questions all, since fertility has authored a simply lovely book. If Build the Family often takes a backseat to fighting the you’ve admired articles in the pages of of Your Dreams disease. Shaw answers these and more, this magazine and on WebMD.com that charts a path and also covers various adoption choices are sensitively written, often moving, full for women with for cancer survivors. of humanity, and always heartfelt (not to (and after) can- Today a mom of three, Shaw writes, mention excellently reported), chances cer who want “Cancer steals so much...It shouldn’t are you’ve read Gina M. Shaw’s work. to have children steal our hopes for a family as well. Now, in her first book, she tells of being but don’t know If you want to have a child or more newly married, about to start a family, and how to go about it or even if it’s safe. children, there’s no reason a cancer suddenly, shockingly diagnosed with breast Can you conceive? If you do, does the diagnosis should close the door to those MEET THE cancer at age 36. Having Children After risk of the cancer’s returning increase? dreams.” Shaw’s book makes sure it Cancer: How to Make Informed Choices What are the options for preserving doesn’t.—Colleen Paretty Id a A stute/ BC WILLIAMS they’re wondering how healthcare reform will affect their new baby 20 WebMD the Magazine | May 2011

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+ exam room A closer look at everyday objects + Where can people MOUTHWASH + living with lupus go to + Chew on This Off Duty ﬁ nd their voice—and The ancient Egyptians, Greeks, and Romans Alcohol-based oral rinses are often used freshened their breath by chewing eucalyptus for other tasks, including combating + many reassuring echoes? leaves and cinnamon sticks. foot fungus, sprucing up unkempt lawns, and cleaning computer screens, although there are no conclusive studies about their effectiveness. Rinse Cycle There are two main kinds of mouthwash: therapeutic and cosmetic. Therapeutic rinses help prevent cavities, gingivitis, and other Cash Crop oral health problems. Cosmetic mouthwashes Americans spend temporarily freshen breath. about $2 billion a year on dental products, including mouthwash.

In the Mix B:11.125” Generally, As someone who’s living with lupus, you may sometimes feel alone. mouthwashes are Under Cover But there’s a whole group of people living with lupus coming together. made of materials for A common use of strong flavor dilution, Whether we have lupus or care about someone who does, we are taking mouthwash is to such as alcohol and on our challenges together, and not giving in to them. We are learning eliminate or mask water. The rest of from each other and moving forward. We are the us in lupus. bad breath; consistent the liquid contains bad breath is called antibacterial agents, + Where can you fi nd us? At the usinlupus.com. There you’ll fi nd stories “halitosis.” flavorings, soaps, and for us—inspired by us. You’ll get access to information about living well dyes for color. with lupus. Best of all, you’ll fi nd the voice of people living with lupus— Brand View and a community that embraces it. A 2010 market Doc Side survey reported The popular that only 44% of Visit the usinlupus.com/joinus today. mouthwash consumers bought now known as the brand of Or call 1-855-USINLUPUS (1-855-874-6587). Listerine was first used mouthwash they as a surgical antiseptic most wanted; the Some people featured in the us in lupus are paid spokespeople for by a doctor named others switched Human Genome Sciences, Inc. and GlaxoSmithKline. Joseph Lister before it to less costly was commercialized generics.—Chloe Thompson as mouthwash. Ted Morrison

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presents ask the experts Your questions answered

Dry Idea The scoop on salon UV nail dryers

Q  A friend told me that nail-drying Q  I have machines emit UV rays that can give you Is it a myth severe skin cancer. Do I need to be careful? that airplane rheumatoid air can make arthritis (RA), A  The nail-drying machines used in pro- people sick? and I’m finding fessional nail salons come in two varieties: air Lots of people believe this, that my husband Your drying and UV drying. And yes, you do need but it’s actually FALSE. isn’t very to be careful about exposing your skin to the Here’s why: Airplane supportive or Questions UV type. That’s because the rays emitted by cabins come equipped helpful. In fact, these machines are UVA rays, the kind that with HEPA (high-efficiency he gets angry penetrate the skin most deeply and have been particulate air) filters that are when I’m not Answered. associated with skin cancer. as good “as those found in able to do more The level of UVA rays is equivalent to that isolation units in hospitals,” housework. Is of a tanning bed. But in addition to exposing says David Freedman, MD, it normal for Top dermatologists your skin to cancer-causing UVA rays, using professor of medicine and RA to impact a marriage this way? these nail-drying machines increases your risk epidemiology at University answer questions on of getting the telltale signs of photo-aging, of Alabama at Birmingham A  It is not at all unusual for marriages (or including spots, wrinkles, and loss of elastic- and a board member of entire families) to be affected when a spouse skin care, anti-aging ity. These aren’t on your face, of course, but the International Society develops RA—or any other chronic illness. they can still be of Travel Medicine. “And Both partners’ roles change, and the healthy and more. unsightly. viruses and bacteria are spouse may express anger due to the pressure When you big enough that they are of additional responsibilities. The anger might get to the trapped in those filters.” also be a result of your spouse’s anxiety about Only on WebMD.com. salon, ask The health risk with what further changes are around the corner. an employee airplane travel, Freedman Sometimes, too, a new diagnosis can high- which type adds, “isn’t the recirculated light pre-existing problems in a relationship. of machine it air. It’s the people sitting next Your husband may not have been very sup- uses, and make to you.” That’s because when portive before you were diagnosed with RA, sure they know people cough and sneeze, but you weren’t as aware of it because you about the risks. the droplets can travel three were able to do so much yourself. There are to six feet in any direction. Whatever the case, what’s clear now is two things What to do? Try to move that you need some help and he needs a bet- you can do to your seat if you discover that ter understanding of your limits. Having WebMD Logo with Tagline PRINT CMYK VERSION reduce your exposure. First, you can decide someone sitting near you him go to your doctor’s appointments might Blue c 100 Black c 0 to forgo the nail-drying machine altogether is sick. Of course, all those help him get more educated and feel more m 34 m 0 y 0 y 0 k 2 k 100 and take a few minutes longer to let your nail germ-laden droplets also land involved in your health. It sounds as though polish air dry (although some gel manicures on trays, window shades, couples counseling might also be in order, as do need UV light to cure). Second, you can seats, and surfaces in the well as, perhaps, a support group for you. slather on sunscreen after the aesthetician bathroom. So be double It’s important to address this situation. Mari- washes your hands and feet but before she sure to wash your hands, tal stress can make your RA worse and put your applies the nail polish. “especially before you eat,” husband at risk for health problems of his own. Freedman advises. “Bacteria and viruses can live for hours—and in some cases, Susan Evans, MD days—on inanimate objects.” Scott Zashin, MD, FACP, FACR

alet/Glow Ima g es F use/Getty Ima g es; Cor i nne M alet/Glow left: WebMD SKIN & BEAUTY EXPERT WebMD RHEUMATOLOGY EXPERT

Get expert answers to all your health questions. WebMD.com Now available on mobile May 2011 | WebMD the Magazine 25 FOLD

ACTEMRA: A different option for treating adults with moderately to severely active RA after at least 1 anti-TNF treatment has been used and did not work well

“If I knew then what I know now about Rheumatoid Arthritis, more I would proactive.”have been -Julie W. ACTEMRA patient since 2005. Hear Julie’s story at ACTEMRA.com

ACTEMRA OFFERS A DIFFERENT WAY TO TREAT RHEUMATOID ARTHRITIS (RA) Other serious side effects of ACTEMRA include tears (perforation) of the stomach or intestines, changes in blood test results (including low neutrophil count, low platelet count, and increase in certain liver function tests), hepatitis B infection • The FIRST AND ONLY medication specifically designed to target the action of IL-6 in those already carrying the virus, nervous system problems, and serious allergic reactions. • Some people taking ACTEMRA saw improvements in the pain, swelling and stiffness of RA Common side effects with ACTEMRA include upper respiratory tract infections (common cold, sinus infections), as early as 2 to 4 weeks headache, and increased blood pressure (hypertension). Indication Tell your healthcare provider if you plan to become pregnant or are pregnant. It is not known if ACTEMRA will harm ACTEMRA is a prescription medicine called an interleukin-6 (IL-6) receptor inhibitor. ACTEMRA is used to treat your unborn baby. Genentech has a registry for pregnant women who take ACTEMRA. If you are pregnant or become adults with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a pregnant while taking ACTEMRA, contact the registry at 1-877-311-8972 and talk to your healthcare provider. tumor necrosis factor (TNF) antagonist has been used and did not work well. Call your healthcare provider for medical advice about any side effects. You may report side effects to the FDA at ACTEMRA® (tocilizumab) 1-800-FDA-1088. You may also report side effects to Genentech at 1-888-835-2555. This information does not take the place of talking to your healthcare provider about either your medical condition or your treatment with ACTEMRA. Talk with your healthcare provider if you have any questions about your treatment with ACTEMRA. Important Safety Information FIGHT BACK AGAINST RA Some people have serious infections while taking ACTEMRA, including tuberculosis (TB) and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Talk to your doctor about something different, today. Please see Important Safety Information on the following pages. Please see full Prescribing Information and Visit www.ACTEMRA.com or Medication Guide for additional important safety information at www.ACTEMRA.com. call 1-800 ACTEMRA (1-800-228-3672)

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ACTEMRA® (AC-TEM-RA) • get a lot of infections or have • low platelet count. Platelets are diverticulitis or ulcers in your Know the medicines you take. - feel very tired - fevers (tocilizumab) infections that keep coming back blood cells that help with blood stomach or intestines Keep a list of them to show to your - skin or eyes - chills This is the consumer brief summary. • have diabetes, HIV, or a weak clotting and stop bleeding. • have or had a condition that affects healthcare provider and pharmacist look yellow - stomach For more information, please refer to immune system. People with these • increase in certain liver function your nervous system, such as when you get a new medicine. - little or no discomfort the full prescribing information. conditions have a higher chance for tests. multiple sclerosis How will I receive ACTEMRA? appetite - muscle aches Rx only infections. You should not receive ACTEMRA if • have recently received or are • You will receive ACTEMRA from - vomiting - dark urine Read the Medication Guide that • have TB, or have been in close your neutrophil or platelet counts are scheduled to receive a vaccine. a healthcare provider through a - clay-colored - skin rash comes with ACTEMRA before you contact with someone with TB too low or your liver function tests are People who take ACTEMRA should needle placed in a vein in your arm bowel movements start it and before each infusion. • live or have lived, or have traveled too high. not receive live vaccines. People (IV or intravenous infusion). The There may be new information. This to certain parts of the country Your healthcare provider may stop taking ACTEMRA can receive infusion will take about 1 hour to • Nervous system problems. Multiple brief summary does not take the (such as the Ohio and Mississippi your ACTEMRA treatment for a non-live vaccines give you the full dose of medicine. Sclerosis has been diagnosed rarely in people who take ACTEMRA. It is place of talking with your healthcare River valleys and the Southwest) period of time or change your dose • plan to have surgery or a medical • You will receive a dose of not known what effect ACTEMRA provider about your medical where there is an increased of medicine if needed because of procedure ACTEMRA about every 4 weeks. may have on some nervous system condition or your treatment. chance for getting certain kinds of changes in these blood test results. • If you miss a scheduled dose of • have any other medical conditions disorders. What is the most important fungal infections (histoplasmosis, You may also have changes in other • plan to become pregnant or are ACTEMRA, ask your healthcare • Allergic Reactions. Serious information I should know about coccidiomycosis, or blastomycosis). laboratory tests, such as your blood pregnant. It is not known if provider when to schedule your allergic reactions can happen with ACTEMRA? ACTEMRA can cause These infections may happen or cholesterol levels. Your healthcare ACTEMRA will harm your unborn next infusion. ACTEMRA. These reactions may serious side effects including: become more severe if you use provider should do blood tests to baby. • While taking ACTEMRA, you may not happen with your first infusion, ACTEMRA. Ask your healthcare check your cholesterol levels 4 to continue to use other medicines 1. Serious Infections Pregnancy Registry: Genentech and may happen with future provider, if you do not know if you 8 weeks after you start receiving that help treat your rheumatoid ACTEMRA is a medicine that has a registry for pregnant women infusions of ACTEMRA. Tell your have lived in an area where these ACTEMRA, and then every 6 months arthritis such as methotrexate, non- affects your immune system. who take ACTEMRA. The purpose healthcare provider right away if infections are common. after that. Normal cholesterol levels steroidal anti-inflammatory drugs ACTEMRA can lower the ability of this registry is to check the health you have any of the following signs • have or have had hepatitis B. are important to good heart health. (NSAIDs) and prescription steroids, of your immune system to fight of the pregnant mother and her of a serious allergic reaction: After starting ACTEMRA, call your 4. Cancer. baby. If you are pregnant or become as instructed by your healthcare infections. Some people have - shortness of breath or trouble healthcare provider right away if you ACTEMRA may decrease the activity pregnant while taking ACTEMRA, provider. serious infections while taking breathing ACTEMRA, including tuberculosis have any symptoms of an infection. of your immune system. Medicines talk to your healthcare provider about • Keep all of your follow-up - skin rash (TB), and infections caused by ACTEMRA can make you more likely that affect the immune system may how you can join this pregnancy appointments and get your blood - swelling of the lips, tongue, or face bacteria, fungi, or viruses that to get infections or make worse any increase your risk of certain cancers. registry or you may contact the tests as ordered by your healthcare - chest pain can spread throughout the body. infection that you have. Tell your healthcare provider if you registry at 1-877-311-8972 to enroll. provider. - feeling dizzy or faint Some people have died from these 2. Tears (perforation) of the have ever had any type of cancer. • plan to breast-feed or are breast- What are the possible side Common side effects of infections. stomach or intestines. See “What are the possible side feeding. You and your healthcare effects with ACTEMRA? ACTEMRA include: • Your doctor should test you for TB • Before taking ACTEMRA, tell your effects with ACTEMRA?” for more provider should decide if you will ACTEMRA can cause serious side before starting ACTEMRA. healthcare provider if you have had information about side effects. take ACTEMRA or breast-feed. You effects, including: • upper respiratory tract infections should not do both. (common cold, sinus infections) • Your doctor should monitor you diverticulitis (inflammation in parts What is ACTEMRA? • See “What is the most important closely for signs and symptoms of the large intestine) or ulcers in ACTEMRA is a prescription medicine Tell your healthcare provider about all information I should know about • headache of TB during treatment with your stomach or intestines. Some called an Interleukin-6 (IL-6) receptor of the medicines you take, including ACTEMRA?” • increased blood pressure people taking ACTEMRA get tears prescription and non-prescription ACTEMRA. inhibitor. ACTEMRA is used to treat • Hepatitis B infection in people who (hypertension) in their stomach or intestine. This medicines, vitamins and herbal You should not start taking adults with moderately to severely carry the virus in their blood. If you Tell your healthcare provider if you happens most often in people supplements. ACTEMRA and other ACTEMRA if you have any kind of active rheumatoid arthritis (RA) after are a carrier of the hepatitis B virus have any side effect that bothers you who also take nonsteroidal anti- medicines may affect each other infection unless your healthcare at least one other medicine called (a virus that affects the liver), the or that does not go away. These are inflammatory drugs (NSAIDs), causing side effects. provider says it is okay. a Tumor Necrosis Factor (TNF) virus may become active while you not all of the possible side effects of corticosteroids, or methotrexate. antagonist has been used and did Before starting ACTEMRA, tell Especially tell your healthcare use ACTEMRA. This happens with ACTEMRA. For more information, • Tell your healthcare provider not work well. your healthcare provider if you: provider if you take: other biologic medicines used to ask your healthcare provider or right away if you have fever and It is not known if ACTEMRA is safe and pharmacist. • think you have an infection or have • any other medicines to treat your treat RA. Your doctor may do blood stomach-area pain that does not effective in children. symptoms of an infection such as: RA. You should not take etanercept tests before you start treatment Call your doctor for medical advice go away, and a change in your ® ® What should I tell my healthcare (Enbrel ), adalimumab (Humira ), with ACTEMRA and while you about side effects. You may report side bowel habits. ® - fever, sweating, sores on your provider before receiving infliximab (Remicade ), rituximab are using ACTEMRA. Tell your effects to FDA at 1-800-FDA-1088. or chills body ® ® 3. Changes in certain laboratory ACTEMRA? (Rituxan ), abatacept (Orencia ), healthcare provider if you have any You may also report side effects to - muscle aches - diarrhea or test results. ® ACTEMRA may not be right for you. anakinra (Kineret ), certolizumab of the following symptoms of a Genentech at 1-888-835-2555. stomach pain ® ® - cough Your healthcare provider should do Before starting ACTEMRA, tell your (Cimzia ), or golimumab (Simponi ), possible hepatitis B infection: - burning when - shortness of blood tests before you start receiving healthcare provider if you: while you are taking ACTEMRA. breath you urinate or ACTEMRA and every 4 to 8 weeks Taking ACTEMRA with these • have an infection. See “What is the - blood in phlegm urinating more during treatment to check for the medicines may increase your risk of often than most important information I should following side effects of ACTEMRA: infection. - weight loss normal know about ACTEMRA?” - warm, red, or • low neutrophil count. Neutrophils • medicines that affect the way South San Francisco, CA 94080-4990 - feel very tired • have liver problems painful skin or are white blood cells that help the certain liver enzymes work. Ask your • have any stomach-area (abdominal) healthcare provider if you are not sure • are being treated for an infection body fight off bacterial infections. pain or been diagnosed with if your medicine is one of these. © 2011 Genentech USA, Inc. All rights reserved. ACT0000069400

R6170_F_4Pg_M2.indd 2 2/22/11 2:32 PM FOLD ADVERTISEMENT webMD expert answers to webmd community questions HER2+ METASTATIC BREAST CANCER How do you get the disease? EMILIA/TDM4370g Clinical Trial 2We have no idea. It’s an autoimmune disease, which means your immune system—which is made to protect you from + Lupus viruses and bacteria and other infections— HER has gotten confused and has recognized parts of your own body as foreign and tries 2 to attack them. We think people probably Smarts inherit a susceptibility for getting lupus, but it’s not a single gene; it’s probably a Test your IQ combination of different genes. In addition, If you or someone you know we think something else has to happen that about this triggers the disease. meet the following criteria you

autoimmune Does lupus get may be eligible to participate. disease progressively worse? 3Not necessarily. It can behave so dif- 18 years of age or older ferently in different people. It can be very mild in somebody forever—only a few Previously treated for metastatic rashes and some joint pain here and there. On the other end of the spectrum, it can be or advanced breast cancer a very devastating disease and cause seizures and kidney failure. Most of the time people HER2+ tumor type with lupus live relatively normal lives. The About 1.5 million Americans have lupus (systemic lupus erythematosus, disease certainly can be fatal in some people, but that’s a very small proportion. or SLE, the most common form), according to the Lupus Foundation of To review the full list of study criteria and to ﬁnd America. The majority—90%—are women, who usually develop the What about pregnancy study locations, use the following resources: disease between ages 15 and 44. African-American, Hispanic, and Asian if you have lupus? women have a higher risk. Eliza Chakravarty, MD, assistant professor of 4If you’re interested in becoming preg- Web nant, it’s a good idea to talk with your doc- medicine in the division of immunology and rheumatology at Stanford tor to make sure your lupus is under control www.EmiliaClinicalTrial.com University School of Medicine, sheds light on a disease you might not and the medicines you’re taking are not ones that can cause birth defects. There’s probably Genentech Trial Information Support Line know much about. a very small subset, maybe 5% of women, 888.662.6728 who would be at high risk for having a lot How do you know if have a positive ANA, but you must have of pregnancy complications. But the majority you have lupus? more things happening, such as swell- of women who want to have children can— 1A lot of people who come to see me ing of the joints, very particular kinds of and can have healthy pregnancies. have “tested positive for lupus,” meaning rashes, evidence that there’s something EMILIA/TDM4370g is a clinical trial that compares the eﬀects of trastuzumab emtansine they have a positive ANA (antinuclear anti- going on in your kidneys, or inflamma- What’s ahead for body) test. That doesn’t necessarily mean tion in different parts of your body. people with lupus? (T-DM1) with capecitabine (Xeloda®) plus lapatinib (Tykerb®) in patients with HER2+ advanced they have lupus or will ever get it. To make A lot of lupus is not really that vis- 5Now is a very exciting time because or metastatic breast cancer. Currently enrolling at 107 locations in 36 states throughout the U.S. a positive diagnosis, you typically will ible, so you can have lupus and look we’re learning more and more about the completely healthy. The other tricky thing disease every day, with the specific goal of is that people often have symptoms like trying to understand what causes it so we tiredness, fatigue, and achiness, and it’s can try to prevent it as well as [develop] Reviewed by hard to tell whether that’s due to the better and safer ways of treating it. These Laura J. Martin, MD lupus itself because such symptoms are days, we have much better therapies than I ma g es u s T ied g e / Glow

WebMD MEDICAL EDITOR common in a lot of people. we had even 20 years ago.—Christina Boufis K la

A clinical trial of trastuzumab emtansine (T-DM1) in HER2+ MBC Find more expert A’s to your lupus Q’s. WebMD.com

30 WebMD the Magazine | May 2011 What will help you lose weight? vanity fare grooming essentials for women Introducing the Mom Time Make her Mother’s Day with gift-worthy WebMD Food & Fitness Planner beauty essentials ideas from Pantea Tamjidi, MD, a dermatologist and owner of Tamjidi Skin Institute in Chevy Chase, Md. In just a few clicks, customize a plan to help you reach your weight and fitness goals. Studies have shown that people who 1 Body of Work The Body Shop Mango Body Scrub, $16 Some 1 keep a food journal lose twice the weight than those who rely body scrubs can dry out skin, but this one con- on diet and exercise alone.* tains organic sugar and salt to gently exfoliate, plus mango seed and organic soy oil to hydrate. 2 Backed by the world’s leading health experts and dietitians. 2 Hair Apparent Denman Natural Boar Bristle and Nylon Brush, $25 The brush’s boar bristles help dis- tribute oil from the scalp down the hair shaft, and the nylon pins help your hair dry faster so the dryer does less damage.

3 Paint Job Zoya Nail Polish, $7 Get colorful nails the healthy way with polish that doesn’t contain harmful chemicals like formaldehyde or toluene.

4 Sole Searching Tweezerman Sole Mates Dual Sided Foot File, $20 This tool is the next best thing to a profes- 3 sional pedicure, with a steel microfile on one side to remove dead skin and a soft file on the other side to buff heels and soles smooth.

5 Here’s the Rub Clinique 7 Day Scrub Cream Rinse-Off Formula, New $18.50 This scrub helps minimize fine lines by removing dead surface skin cells and clears the way for moisturizer to do its job. 7 5 6 Base Camp 6 Olay Regenerist Micro-Sculpting Serum, $24.99 This serum boasts amino-peptides, proteins that act as antioxidants to help build collagen, hydrate and plump the skin, and reduce signs of sun damage.

7 Skin Saver Best of all, it’s free. Aveeno Positively Radiant Daily Moisturizer SPF 30, $13.99 This moisturizer is full of soy, So start planning today. a triple threat that plumps the skin, smooths fine lines, and reduces the appearance of brown spots. —Linda Formichelli

The opinions expressed in this section are of the experts and are not the opinions of WebMD. WebMD does not 4 Te d M orrison *American Journal of Preventive Medicine, August 2008 endorse any specific product, service, or treatment.

May 2011 | WebMD the Magazine 33 Reviewed by WebMD and Sanford Health proudly announce Karyn Grossman, MD livingwell WebMD SKIN CARE EXPERT Make the most of your life

The makeup of Makeup De- eye shadow coding The destination that helps you and Made in the Shade Greek Life Eye shadow formulations start In ancient Greece, eye shadow was your family achieve the fit lifestyle with a base filler. Cosmetics- known as fucus and tended to be including: grade talc or mica are the go-to greens and blues made from filler ingredients, but some lapis lazuli and malachite. • FOOD: Nutritional Fitness formulas include kaolin clay, Greek women wore the • MOVE: Physical Fitness says cosmetics chemist Jane shades and exported • MOOD: Emotional Fitness Hollenberg, director of JCH them to share with the • RECHARGE: Behavioral Fitness consulting in Red Hook, N.Y. rest of the world.

Learning and living a healthy lifestyle is a family affair. fit is designed with that in Frosted shades, violets, and blues are hard mind with worksheets, videos, and games customized for different ages. There’s to compress and break more easily. also a section just for parents. In a Bind Kids are complicated. Getting your family healthy doesn’t have to be. Binders are essential to ensure the powder will adhere to skin. The most common binders are derivatives of zinc or magnesium. Fast Break In addition to pigment, some Before you manufacturers add silica, nylon, pack your favorite dimethicone, boron nitride (a shadow, consider which ceramic material), or bismuth Dream Cream are more likely to crumble oxychloride for “slip” so the The big difference between a in your bag: Frosted shades, powder slides more easily over cream and a powder shadow violets, and blues are difficult to the lid. And a bit of preservative is waxes and oils in the base. a standard shadow. Once the wax compress into cakes and break like glycol (a type of alcohol) or Beeswax, castor oil, jojoba or oil dries, the pigment tends to more easily. Matte shadows are tocopherol (a form of vitamin E) oil, shea butter, or silicone are wear longer due to the way the more likely to hold together. helps prevent bacteria growth. among the options for liquefying ingredients bond with the skin. All That Glitters Napoleon Perdis, Do some eye shadows irritate celebrity makeup your skin? Large particles in artist and creator of To minimize the mess of shadow NP Set cosmetics, application, use a firm small brush shadow that can cause abrasion offers his secret rather than a fluffy brush. The stiffer are the most common culprits, for shadow bristles help keep color in place. Hollenberg says. If you have application. And always apply mascara first. any sensitivities, stay away from glittery shadows.—Liesa Goins 212 I mages nc /Co r b is

Get more eye-opening expert beauty tips. WebMD.com

May 2011 | WebMD the Magazine 35 Euro RSCG Worldwide erw110836a Proof 1 Euro RSCG Worldwide erw111462a Proof 1

B:3.4375” B:8.625” T:2.5625” T:7.875” S:2” S:6.875”

Reviewed by Michael W. Smith, MD livingwell WebMD CHIEF MEDICAL EDITOR make the most of your life Join the I wanted to stop MyBONIVA® Program my bone loss. for Sally’s Tips, Thinking plus one month of Ink? BONIVA free! What you need to know about tattoos

Kate Beschen spent years con- templating a tattoo. So when the 37-year-old Philadelphia-based doula finally went for her ink last year, she thought she had covered all the bases. “I had my son and daughter drawn as superheroes on my upper arm,” Beschen says. “I decided this was an image I’d be proud to have for the rest of my life.” B:11.25” B:11.25” T:10.5” T:10.5” S:9.75”

But there was one angle Beschen didn’t S:9.75” anticipate: her daughter’s reaction. “My 15-year-old is making comments about MyBONIVA is a free program that gives If you have osteoporosis, like me, calcium-rich foods, vitamin D, and exercise can help. wanting a tattoo,” she says. “Now I’m not so you tips from Sally, ideas, and support But they may not be enough to keep your bones strong. So ask your doctor if once-monthly sure how I feel about the process—I want her to help manage your osteoporosis. BONIVA can help you do more. to be safe, and I don’t want her to regret it.” You’ll get: “Eat plenty of calcium-rich foods BONIVA is a prescription medication to treat and prevent postmenopausal osteoporosis. like yogurt, spinach, and cheese.” Are tattoos safe? The FDA regulates the infection. As the surface skin heals, the pig- • One month of BONIVA free*. inks in tattoos, but the actual practice of ment remains trapped below. And pain is Ask your doctor if BONIVA is right for you. tattooing is regulated by local jurisdictions, always a factor. Depending on the part of • Sally Field’s tips on managing your such as cities and counties. That means the body you’re tattooing, the experience osteoporosis and building stronger Important Safety Information: You should not take BONIVA if you have certain problems with your esophagus there is no standardized certification for can feel like a pin scratch or like being bones. (the tube that connects your mouth and stomach), low blood calcium, cannot sit or stand for at least 60 minutes, have those doing the tattooing or an overall carved by nails. And since the skin is punc- severe kidney disease, or are allergic to BONIVA. Stop taking BONIVA and tell your doctor right away if you experience • Helpful monthly reminders to take governing body supervising the health and tured, bleeding is involved, which can put difficult or painful swallowing, chest pain, or severe or continuing heartburn, as these may be signs of serious upper your BONIVA, delivered by phone, safety of tattoo parlors. you at risk for blood-borne illnesses such digestive problems. Follow the dosing instructions for once-monthly BONIVA carefully to lower the chance of these events e-mail, or mail. “When you are injecting a substance into as hepatitis B. occurring. Side effects may include diarrhea, pain in the arms or legs, or upset stomach. Tell your doctor and dentist about all the medicines you take. Tell them if you develop jaw problems (especially following a dental procedure) or severe bone, the skin, you risk infection,” says Elizabeth The most likely downside for anyone • Quarterly newsletters filled with joint, and/or muscle pain. Your doctor may also recommend a calcium and vitamin D supplement. Tanzi, MD, co-director of the Washington getting a tattoo is regret. “Tattoos are very bone-strengthening exercises and Institute of Dermatologic Laser Surgery in difficult to remove,” Tanzi says. “You can simple, delicious recipes. You are encouraged to report negative side effects of prescription drugs to the FDA. Washington, D.C., and assistant professor of lighten them, but complete removal is a Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. dermatology at Johns Hopkins University. challenge. You have to accept the fact that Please read Patient Information on the next page. “Although small, the risks include hepatitis, the skin will never look the same.” staph, or warts.” Regret is what worries Beschen about Enroll today. Call 1-888-434-6193 or There are other possible health risks: A her daughter’s interest in ink. “I think of gun equipped with needles punctures the myself as a teenager, and I know I would visit BONIVAfreetrial.com and try BONIVA free. top layer of the skin to deposit ink in the not be happy with any permanent decision dermis, the deep layer of the skin. Unsteril- I made then,” she says. “I just hope the fact ized tools such as the needles or gun and that I have a tattoo will make it seem less

ink that has been contaminated can lead to cool when she’s older.”—Liesa Goins C hristi n a G riffiths /G ett y I mages

*You must be 18 years of age or older to join MyBONIVA. Find out what you need to know before you tattoo. WebMD.com The free trial offer is limited to one per patient. MyBONIVA is a registered trademark of Roche Therapeutics Inc. BONIVA and symbol are trademarks of Roche Therapeutics Inc. © 2011 Genentech USA, Inc. All rights reserved. 10297400 36 WebMD the Magazine | May 2011

Cyan Magenta Yellow Black

Genentech/Boniva This advertisement prepared by: Sally 7 – 1/3 Page Resize Euro RSCG Worldwide Client Name: Genentech/Boniva 350 Hudson Street Job Number: 0000034270_0000034333_M01R New York, New York 10014 0000032264_0000040335_M01Q.indd User / PrevUser Johnny Ho / Damian Gerndt Caption: “Join the Boniva…” Job # 40335 Filename Last Modi ed 2-1-2011 2:04 PM Client Boniva Art Director P. Coutroulis Bleed 8.625” x 11.25” Path Transfer:Volumes:Transfer:T0_ CMYK Media: Magazine Ad AD: P.Coutroulis DD:02_01_11:boni Create 1-26-2011 2:12 PM Artist Damian Trim 7.875” x 10.5” va:0000032264_0000040335_ CW: Hubbert M01Q.indd Proof Page 4C Bleed AE: K. Doose 1_RELEASE Traf c J. Batista Saftey 6.875” x 9.75” B: 3.4375” x 11.25” Traf: J. Batista x4175 Fonts Futura Std (Bold, Book, Light, Medium, Book Oblique; OpenType), Times New Roman MT Std (Italic; OpenType), Helvetica Neue LT Std (55 Roman, 75 Bold; OpenType)

T: 2.5625” x 10.50” Prod: P. Gravenhorst x4380 Art L10BON00028.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00028.tif), L09GSKVVVV9.eps (Arts_Logos:Glaxo_Smith_Kline:Logos:Customer_Logo:L09GSKVVVV9. S: 2” x 9.75” eps), L3200BO02OP.eps (Arts_Logos:Genentech:Logos:BONIVA:L3200BO02OP.eps), L10BON00041.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00041.tif), L10BON00040.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00040.tif), L10BON00039.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00039.tif) BILL OOP TO JOB NUMBER: 32264 Line Screen: 133 BILL LABOR TO JOB ClientNUMBER: Name: 34270 Genentech/Boniva B: 8 5/8 x 11-1/4 This advertisement prepared by: T: 7 7/8 x 10 1/2 Euro RSCG Worldwide Job # 0000034335_M01R Filename 0000034270_0000034333_M01R.indd Last Modi ed 1-6-2011 11:24Job AM Number: User / PrevUser 0000040335_M01Q Damian Gerndt / James Liew S: 6 7/8 x 9 3/4 350 Hudson Street Client Boniva Art Director P. Coutroulis Bleed 3.4375” x 11.25” PathCaption:Tonic:Volumes:Tonic:Tonic_Me Sally #7 CMYK chs:GlaxoSmithKline:Boni New York, New York 10014 Create 1-5-2011 4:32 PM Artist Jliew Trim 2.5625” x 10.5” “I wanted to stop…” 4/C Screen: 133 Proof 1_RELEASE Traf c J.Batista Saftey 2” x 9.75” (Sally’s Tips) AD: P. Coutroulis Fonts Futura Std (Book; OpenType), Times New Roman MT Std (Italic, Bold Italic; OpenType), Times New Roman (Regular,Media: Bold; OpenType) Web MD March-April AE: K. Doose Bill Studio Time / OOP to: 40770 Traf.: J. Batista 4175 Art L10BON00028.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00028.tif), L10BON00014.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00014. tif), L10BON00043.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00043.tif), L10BON00042.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00042.tif), Bill Labor to: 40688 Prod.: P. Gravenhorst 4380 L10BON00017.tif (Arts_Logos:Genentech:Art:Live_Art:BONIVA:2010:L10BON00017.tif) Euro RSCG Worldwide erw104171a Proof 1

T:6.75”

IMPORTANT FACTS ABOUT BONIVA livingwell (bon-EE-va) ibandronate sodium 150-mg tablet expert a’s to your beauty q’s

BONIVA, a bisphosphonate, is a prescription medicine used to treat and prevent osteoporosis in What is BONIVA? postmenopausal women, characterized by weakening of the bone. Taken once a month in tablet form, BONIVA may stop and reverse bone loss in most women. It has been clinically proven to help build and maintain bone density, which can help reduce fractures.

What is the most important information about BONIVA? Baby Face BONIVA may cause serious problems in the stomach and the esophagus (the tube that connects your mouth and stomach) such as trouble swallowing, heartburn, and ulcers. Want to make up for lost time? Our experts share their anti-aging product picks Q. Why isn’t the Who should not take BONIVA? Before you start BONIVA. makeup routine I used Do not take BONIVA if you: Tell your health care provider if you: when I was younger • have abnormalities with your esophagus, such as • are pregnant or plan to become pregnant cutting it anymore? restriction or diffi culty swallowing • are breast-feeding Joanne Balassone, 56, sales representative, • have low blood calcium (hypocalcemia) • have trouble swallowing or other problems with your esophagus Florham Park, N.J. • cannot sit or stand for at least 60 minutes • have kidney problems • have kidneys that work very poorly • are planning a dental procedure such as tooth extraction 1 Prime Time Get off to a smooth start Dr. Sarnoff says: •are allergic to BONIVA or any of its ingredients Tell your health care provider and dentist about all medications See Patient Information for complete list. with Smashbox Photo you’re taking, including vitamins, antacids, and supplements. Finish Foundation Primer. A. Younger skin naturally produces more oil and skin cells renew themselves every How should you take BONIVA? 21 days, so the “canvas” stays smooth. But as we 4 age, skin gets thinner and feels dehydrated, and You must take BONIVA exactly as instructed by your health care provider. cell turnover slows to about every 28 days. The • Take fi rst thing in the morning, on the same day each month. •If you miss a monthly dose and your next scheduled BONIVA day is more Mist Opportunity trick to ensuring your makeup looks luminous than 7 days away, take one BONIVA 150 mg tablet in the morning following Spritz a little Evian Facial • Swallow whole (do not chew or suck) with a full glass (6 to 8 oz) of and not cakey is to apply products in a way that

plain water (not sparkling or mineral). Do not take with tea, coffee, the day that you remember. Do not take two 150 mg tablets within the same T:9.75” Spray on your face for a juice, or milk. week. If your scheduled BONIVA day is only 1 to 7 days away, wait until dewy look. will boost your skin’s moisture levels. •After you take BONIVA, remain standing or sitting for at least 60 minutes your next scheduled BONIVA day to take your tablet.Then return to taking Start by washing your face with a super- before you eat, drink, lie down, or take any other oral medications, one BONIVA 150 mg tablet every month in the morning of your chosen day, hydrating liquid cleanser. Then, when your including calcium, vitamins, and antacids. Some medicines can stop according to your original schedule. If you are not sure what to do if you miss skin is still damp, rub in a dollop of mois- BONIVA from getting to your bones. a dose, contact your health care provider, who will be able to advise you. turizer. One pumped with SPF, vitamins, •If you take too much BONIVA, drink a full glass of milk and call your local poison control center or emergency room right aw ay. Do not make yourself vomit. Do not lie down. and antioxidants, such as Olay Total Effects 7-in-1 Anti-Aging Daily UV Moisturizer + What are the possible side effects of BONIVA? SPF 15 ($19.99), will reduce fine lines and help prevent future ones. Stop taking BONIVA and call your health care provider right away if you have pain or trouble swallowing, chest pain, or very Mature skin is full of ridges. For makeup bad heartburn or heartburn that does not get better. Follow dosing instructions carefully to decrease the risk of these effects. to glide on smoothly without getting stuck BONIVA may cause: Common side effects are: Less common side effects are: in cracks, apply a primer after moisturiz- • Pain or trouble swallowing • Diarrhea • Short-term, mild fl u-like symptoms, which ing. Smashbox Photo Finish Foundation • Heartburn • Pain in extremities (arms or legs) usually improve after the fi rst dose • Ulcers in stomach or esophagus • Upset stomach Primer ($36) is infused with antioxidants, including vitamin A and grapeseed extract. Rarely, patients have reported allergic and skin reactions. Contact your health care provider if you develop any symptoms of an allergic reaction including 2 skin rash (with or without blisters), hives, wheezing, or swelling of the face, lips, tongue, or throat. Get medical help right away if you have trouble breathing, Finally, use a makeup brush to apply a swallowing, or feel light-headed. Miracle Whip foundation like Cover Girl & Olay Simply Olay Total Effects Rarely, patients have reported severe bone, joint, and/or muscle pain starting within one day to several months after beginning to take oral bisphosphonate drugs. Ageless Foundation ($13.99), which is 7-in-1 Anti-Aging Daily Contact your health care provider if you develop these symptoms after starting BONIVA. UV Moisturizer + SPF infused with SPF 22. If you see caking at Rarely, patients have reported serious jaw problems associated with delayed healing and infection, often following dental procedures such as tooth extraction. 15 fights past and the end of the day, spritz your face with a If you experience jaw problems, contact your health care provider and dentist. future fine lines. moisturizing spray like Evian Facial Spray This summary is not a complete list of side effects. For a complete list, consult your health care provider or pharmacist. ($10) to remoisten your makeup and give skin a dewy quality. Want to know more? Deborah Sarnoff, MD, This summary is not everything you need to know about BONIVA. It does not take the place of talking with your health care provider about your condition or clinical professor of treatment. For more complete information, talk to your health care provider or pharmacist. er ng

i 3 Bases Loaded dermatology, NYU Langone Visit myboniva.com or call 1-888-MyBONIVA for the complete Prescribing Information, which includes the Patient Information. l Face the day with Cover Girl & Olay Simply

Sae Medical Center n

Da Ageless Foundation. The opinions expressed in this section are of the experts and are not the opinions of WebMD. WebMD does not Revised: March 2010 © 2010 by Genentech USA, Inc. All rights reserved. 10032001 endorse any specific product, service, or treatment.

May 2011 | WebMD the Magazine 39

Client Name: Genentech/Boniva Job Number: This advertisement prepared by: 0000032217_0000032250_M01Rev.indd Euro RSCG Worldwide Caption: “Important facts about…” 350 Hudson Street Media: Standard Magazines New York, New York 10014 AD: P. Coutroulis/CW: D. Hubbert AE: K. Lewandroski Page Non-Bleed Traf. : A. Green-El 4345/Prod: P. Gravenhorst 4380 6.75 x 9.75 4/C Screen: 133 Bill OOP/Studio to : 0000032250 Bill Labor to: 0000032252

Job # 0000032250_M01 Filename 0000032217_0000032250_M01Rev.indd Last Modi ed 3-29-2010 7:11 PM User / PrevUser Johnny Ho / Jimmy Choi

Client GSK Boniva Art Director P. Coutroulis Bleed None Path Transfer:Volumes:Transfer:T0_D Black D:03_29_10:0000032217:0000 Create 3-25-2010 5:24 PM Artist Kerry Trim 6.75” x 9.75” 032217_0000032250_M01Rev. indd Proof 4_RELEASE Traf c A. Green-El Saftey None

Fonts Helvetica Neue LT Std (55 Roman, 77 Bold Condensed; OpenType), Times New Roman MT Std (Condensed; OpenType), Times (Regular; True Type)

Art L3200BO02GK.eps (Arts_Logos:Genentech:Logos:BONIVA:L3200BO02GK.eps), L3200GE01AK.eps (Arts_Logos:Glaxo_Smith_Kline:Logos:Genentech:L3200GE01AK.eps) livingwell expert a’s to your beauty q’s

Dr. Goldberg says: A. First, the buzz-killing fact of life: As we age, we start to lose fatty tissue, and skin- Girl Powder 1 plumping collagen production slows, revealing Get natural coverage and 2 fine lines. But certain ingredients in makeup UV protection with Jane Under Line Hide fine lines with the We’re always on the move. products can make your skin look and feel Iredale PurePressed Base Mineral Foundation. plumping L’Oréal Visible ™ more supple and hydrated. Lift Line-Minimizing FUTURO Supports are You’re used to reading the labels on your & Tone-Enhancing skin care products, and it’s just as important to Concealer. there for every step. do the same with your cosmetics, especially if you’re seeing signs of aging. The zinc oxide and titanium dioxide in Jane Iredale PurePressed Base Mineral Foundation ($49.50) provide UVA/UVB sun protection for wrinkle prevention. Hyaluronic acid, which is infused in L’Oréal Visible Lift Line-Minimizing & Tone-Enhancing Concealer ($11.95), plumps up fine lines by enhancing the skin’s ability to retain more moisture. Antioxidants like the vitamin E and soy in Neutrogena Healthy Skin Custom Glow Blush & Bronzer ($12.49) help block wrinkle-causing free radicals from seeping into pores. To prevent caking, apply makeup to freshly exfoliated and moisturized skin. Try an all-in- one product like Aveeno Positively Radiant Tinted Moisturizer SPF 30 ($14.99), which is infused with light-reflecting minerals to lighten the appearance of sun spots. 3 And avoid using makeup that con- 4 Tint Condition tains talc, a common filler that can clog Sweet Cheeks Soften your skin and pores and increase the appearance of fine Neutrogena Healthy get glowing with lines.—Ayren Jackson-Cannady Skin Custom Glow Aveeno Positively Blush & Bronzer Radiant Tinted David Goldberg, MD, fights free-radicals Moisturizer SPF 30. clinical professor, Mount and brightens. Sinai Department of Dermatology, New York City

If you want…fuller cheeks As we age, we Tricks of the Trade As you age, the cheek area hollows out. Use a cream blush on the apples of your cheeks and start to lose fatty FUTURO™ Knee and Ankle Supports provide protection to joints If you want...plumper lips on your cheekbones to plump them up. “Add a tissue, and skin- weakened or injured by strains, sprains and arthritis. Developed in Due to fat loss, lips get thinner over time. hint of shimmer on your cheekbones to make collaboration with medical professionals and supported by 3M, Fill out your kisser by using a lip pencil them look higher,” Kashuk says. plumping collagen FUTURO Supports provide the comfort, support and fit to keep you to slightly overdraw your lip line, says makeup artist Sonia Kashuk. Also, steer If you want…brighter eyes production slows. moving all day. clear of dark lipstick shades, which will Lashes tend to straighten as you get older, instantly shrink your pout. After you apply Kashuk says. To instantly open up the eyes, your lipstick, dab a dot of clear gloss in the always use an eyelash curler after you’ve WATCH THE VIDEO NOW center of your lips to visually puff them up. applied eye shadow. Scan the tag to learn more about this product. Da n Sae l i ng er Visit futuro.com/coupon and save $3.00.

Overhaul your makeup bag with more anti-aging products. WebMD.com Get the free app for your phone at 40 WebMD the Magazine | May 2011 http://gettag.mobi/ © 3M 2011. 3M, FUTURO and LIVE MORE are trademarks of 3M. Reviewed by Reviewed by sleep matters Louise Chang, MD patient matters Laura J. Martin, MD WebMD medical editor WebMD MEDICAL EDITOR for the rest of the story making the most of your health

What’s Up? Car Trouble Driving Test PMS & Zzz’s How to tell if your parent Can’t sleep before your time of the month? To combat menstrual- How do you know when it’s time to take still drives safely? Patrick related sleep problems, Baker, a specialist at the Here’s why—and what you can do Kathryn Lee, RN, PhD, your aging parent’s keys? Cleveland Clinic Driver who has been studying Rehabilitation Program, Most nights, Karin Wacaser, 48, a public during their menstrual cycles. Another 16% report women and sleep When Nancy Levitt’s mother was first Levitt says, “and I didn’t want to be the one taking her has a few tips. relations consultant in Dallas, sleeps soundly for missing one or more days of work in the past patterns for more than a diagnosed with dementia 14 years ago at age 78, everywhere, but it got pretty scary.” Ride along. Go on a about 10 hours. But three days before her period, month because of sleep problems. decade, recommends: the doctor told her she could safely drive to famil- If your parent shows signs of unsafe driving, start drive with your parent like clockwork, Wacaser has intense insomnia, wak- The menstrual cycle is divided into two main Exercise more. “Exercise iar places. But Levitt, 61, who volunteers at UCLA’s by scheduling an appointment with your parent’s and ing up every hour or two. “It’s crazy,” she says. phases: follicular (day one of menstruation to ovula- helps to promote deep- Center on Aging in Los Angeles, was still nervous. doctor, says Joseph Shega, MD, associate professor of look for “And frustrating. Sometimes I’ll toss and turn for tion) and luteal (after ovulation). Kathryn Lee, RN, sleep stages,” says Lee, Unexplained nicks and dents started appearing on her medicine in geriatrics and palliative medicine at the problems the kind of restorative with an hour until I can go back to sleep.” At other PhD, associate dean of research at the University of mother’s car. She forgot where she parked. Levitt tried University of Chicago. Some pain medications can sleep where growth specific California, San Francisco hormone, necessary for cause changes in atten- driving School of Nursing and cell repair and If your parent shows signs of unsafe tion span or the issue behaviors Around day women’s sleep expert, regeneration, is driving, start by scheduling an might be an undiag- or tasks, 14, estrogen explains that during the secreted. appointment with his doctor. nosed condition. such as difficulty backing suddenly kicks follicular phase, estrogen Avoid alcohol. The physician might up or turning around, or up another builds up until ovulation. Progesterone refer your parent to a riding the brake and gas “Estrogen is almost like is highest driver rehabilitation spe- pedals at the same time. notch, and an energy supplement,” around ovulation cialist, a certified profes- Look for patterns. This we see a Breus says. Then at, ovu- and during the sional trained to evalu- isn’t about changes in tremendous lation, around day 14, luteal phase, ate people with medical driving style but about “estrogen is suddenly which can issues that can affect things your parent should number kicked up another notch, exacerbate the effects driving. Such specialists know how to do, such of sleep and we see a tremendous of alcohol (or any other are employed in hospi- as come to a full stop central-nervous system at a stop sign or check number of sleep distur- tals, rehabilitation cen- disturbances depressant). Though the blind spot before for women. bances for women.” having a glass of wine in ters, and private driving changing lanes. Your After ovulation, your the evening may induce schools, and their ser- mom or dad should also progesterone rises. Lee sleepiness, drinking vices are typically cov- be comfortable driving calls this “the soporific alcohol at night can ered by insurance, says in unfamiliar places and times, Wacaser lies awake all night, finally falling hormone”—in other words, one that can make you cause wakefulness and Patrick Baker, a specialist amid road construction. asleep around 7 a.m. drowsy. Then, just a few days before the start of your fragmented sleep. to discuss driving safety with her mother, but she at the Cleveland Clinic Driver Rehabilitation Program. Gauge sightlines. How What is going on? “Each phase of the menstrual next period, estrogen and progesterone levels drop. Keep a sleep diary. angrily denied there was a problem. Then, she would But if an older unsafe driver refuses to stop operating well can your parent see? cycle has different effects on sleep,” explains Michael And this is when many women have trouble sleep- Record the days of the forget their talks about driving altogether. a vehicle, you may have to take drastic steps like hid- “You should have about Breus, PhD, D, ABSM, WebMD’s sleep expert and ing. “The thinking is women who have a more abrupt month you have trouble At her wit’s end, Levitt finally asked her mother’s ing the car keys or writing to the state, Shega says. three inches above the author of the “Sleep Well” blog on WebMD.com. Ris- withdrawal of progesterone—or maybe had a higher falling or staying asleep, doctor to write to the state, hoping it would revoke her Levitt and her mother worked out a solution. steering wheel to view ing and falling levels of the hormones estrogen and amount and it fell faster—have insomnia,” explains Lee. as well as when you mother’s driver’s license. But before he could do so, she Levitt drove her mother some places and hired a over as a minimum. progesterone, which regulate the menstrual cycle, And how does Wacaser cope? “Now I know what it wake early or have discovered her mother’s car insurance company had driver for a few hours a week. In time the driver But as we lose height, can affect a woman’s ability to fall and stay asleep—as is and when so I can plan for it. I don’t plan any early daytime sleepiness canceled her policy, citing five auto accidents. Reluc- became a friend, accompanying her mother to sometimes we’re too low and fatigue. to actually see where well as influence the quality of her sleep. morning meetings or calls [just before my period] tantly, Levitt took possession of the keys. “I didn’t want the hairdresser. “And my mother loved it,” Levitt we’re going,” Baker says. According to a 2007 National Sleep Foundation because I know more than likely I’m not going to get to because I wanted her to have her independence,” says.—Joanna Broder poll, 33% of women say their sleep is disturbed any sleep.”—Christina Boufis

67% of women report having a sleep Fatal crash rates increase starting at age B rand N ew I mage s/G ett y s problem a few nights a week. PNC/G ett y I mage s 75 and increase notably after age 80.

What’s your snooze snafu? Get expert shut-eye tips. WebMD.com Give and get tips for helping aging parents. WebMD.com

42 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 43 Reviewed by mind matters Roy Benaroch, MD WebMD Children’s health EXPERT Get the a head start on emotional wellness Latest Health The Teen Brain Brain Boosters Information How can you help your Did your teenager lock himself out—again? A peek kid avoid brain glitches inside his neurons helps explain why without coming across as from a nagging parent? Doris Trauner, MD, has some Eva-Marie Fredric thought her then-14- According to Trauner, the brain doesn’t complete pointers: Sent Right to year-old son, Dylan, could handle the task of packing its development until a person reaches his or her Set limits. Because for their trip to the mountains. But when the two mid-to-late 20s, although it continues changing your teen’s brain is still Your Inbox arrived at the campsite, she found the tent—but no throughout life. During the initial development developing in response tent poles.“We slept outside on an inflated air mattress, phase, nerve cells, or neurons, are busy making to experience, you can freezing our bums off, with the dog huddled between connections with each other. actually help shape it by setting clear limits us,” recalls the L.A.-based writer and producer. The frontal lobe and parietal cortex are two areas Receive important news and providing precise of the brain that don’t guidelines for what is and complete development is not acceptable. and expert views on 50 until the late teens or Model behavior. As topics including Women’s early 20s, and both important as setting limits are involved in what’s is showing your kid how and Men’s Health, Skin & known as executive to behave. “If you model functioning—the ability reasoning or considering to perform tasks such as the consequences of Beauty, Parenting, Weight planning, paying atten- your actions, your child Loss, Pet Health, and 30 Part of the tion, and reasoning. is going to pick that up problem is A child’s brain has and incorporate that into the learning of executive that their many more nerve cells health conditions. and connections than functioning,” she says. brains are an adult’s. Before not developed the frontal lobe enough to and parietal cortex do things mature, children and teenagers can make consistently use of some of these and well. “extra” neurons to Teach cause and effect. remember, plan, and rea- Thinking about possible son. “Yes, a child or teen- consequences of our Teens often frustrate their parents with their ager can plan and remember, but not as well as you actions before we do Always free and inability to remember key information and keep would like them to,” Trauner says. “It doesn’t mean them is an important your privacy protected. track of their stuff. Part of the problem is that you shouldn’t have expectations. But if they make executive function. A their brains are not developed enough to do these mistakes, cut them a little slack.” good way to teach your teen this, Trauner says,

uis Pelaez/ G etty Im ages things consistently and well, says Doris Trauner, MD, Since the tent fiasco, Fredric learned to remind is to simply list some professor of neurosciences and chief of pediatric herself when Dylan makes a gaffe that the situation possible consequences neurology at the University of California, San Diego could be worse. She adds, “To this day, he’ll tell you it to an action. School of Medicine. was his favorite camping night ever.”—Susan Kuchinskas

Teen drivers ages 16 to 19 are four times

w Im ages; Jose L Im age S ou rc e/ G lo f r o m left: more likely than older drivers to crash.

Need teen parenting tips from experts and other parents? WebMD.com

May 2011 | WebMD the Magazine 45 Reviewed by Reviewed by parentingsex mattersmatters Leslie Becker-Phelps, PhD sex matters Brunilda Nazario, MD expert advice for kids’ sake WebMD RELATIONSHIPS EXPERT TUNing IN TO WHAT TURNS YOU ON WebMD senior medical editor

Parent Trap Baby Boon What can you do? Raising kids ain’t for sissies. Do you know the keys Trying but not yet con- the two of you Struggling to conceive? Get the scoop ceiving? Have your doc- to staying happily married with children? Charles and Elizabeth on infertility and treatment options tor check the health of Schmitz traveled the your eggs and your part- world to study thousands ner’s sperm, your tubes Ah, the joys of raising children: The pitter- babies takes the shine off faster than when couples of successful couples. Anyone who’s struggled with infertility Some women are as fertile as they were in their 20s, and uterus, and whether patter of little feet, the tiny plump hands slipped into remain child-free. Their book, Building will tell you this: It can be quite the roller-coaster ride. while others very quickly reach the proverbial point of you have hormonal yours, the first day of school…and the bitter argu- “The writer Nora Ephron once said, ‘Having a Love That Lasts: “The hardest thing for us was not having answers,” no return. A simple blood test can measure hormone imbalances that can lead ments with your spouse over who gets to go to the a baby is like throwing a hand grenade into a The Seven says one woman, now 38. She and her 45-year-old levels to determine where you are on this spectrum. to infertility, says David gym after work tonight. marriage,’” says Charles Schmitz, PhD. “I’ve always Surprising husband were derailed for several years while doctors Age aside, if either you or your partner shows L. Keefe, MD. Treatments While children are wonderful, there’s no ques- thought that was pretty apt.” Schmitz, who is dean Secrets of tried to figure out the cause of their infertility. signs of problems that need immediate attention, such might involve: tion that their arrival can put strains on a marriage. emeritus of counseling and family therapy at the Successful Marriage, as a lack of ovulation or Surgery in either partner University of Missouri– details what they an undescended testicle, to correct any structural St. Louis, and his wife, learned, including these which can impair nor- obstacles to pregnancy. A recent study of couples Elizabeth Schmitz, EdD, findings: Although the mal sperm production, Oral or injectable drugs president of Successful Time in Whether it’s a aging of eggs the first step is to find a to improve the timing or found 90% were less happy Marriage Reflections, date night, a walk in the doctor you trust. number of eggs released. with their marriage once LLC, have studied park, or going for a bike is inevitable, It’s OK to start with Intrauterine insemina- ride, “you have to spend thousands of couples there’s great your OB/GYN, Keefe tion (IUI) to give sperm they became parents. time together to keep the in 45 countries in their variability in says, but many couples a “free ride” into the flame alive,” Elizabeth uterus. Doctors use a search for the secrets to says. “You have to allow fertility in benefit from seeing a a happy marriage. And specialist who is board catheter to place sperm time for each other.” into the uterus via the one of the key ones, they the mid-30s. certified in reproduc- Time out Conversely, cervix around the time of say, is figuring out what alone time is also tive endocrinology and ovulation. your priorities are and infertility. You also want crucial. “In the best In vitro fertilization should be. to look for a doctor who marriages, spouses (IVF) to unite eggs and “The relationship allow each other time is a good fit for you per- sperm in a laboratory between husband and for solitude, so they can sonally, “someone who dish before one or more wife should trump every- think private thoughts will let you cry, help you eggs is transferred to thing else,” Charles says. or just get things done,” cope, and guide you in the uterus. Sometimes a Between the lack of sleep, fragmented attention, and, “You have to keep it strong, keep the romantic energy. Elizabeth says. Unlike this couple, about 80% to 85% of U.S. making sense of things and finding meaning in the single sperm is injected in some cases, strained finances, parents often find Everything else comes from that. Children are beautiful, Touchy, touchy couples are able to get pregnant after a year of try- different alternatives,” Keefe says. Immediately find the directly into the egg. themselves losing the connection that brought them but they’re not the sole purpose of marriage.” Successful couples use ing. When you get past the year mark, however, it’s exit, Keefe adds, if a doctor dismisses your questions Egg or sperm donation together in the first place—if not fighting like cats That’s why, they say, when married-with-children the “Morse code of time to seek help. If you’re over age 35, it’s best not with something like, “Don’t you worry. Just let me tell if your eggs or his sperm and dogs over who does more housework, who pays couples start to bicker or grow apart, it’s time to marriage,” Charles says. to wait longer than six months. That’s because fertility, you how this is done.” are unable to unite and “It’s called touching. more bills, and who knows best how to raise a child. change the patterns they have fallen into. “We especially in women, is profoundly influenced by age, The couple got their happy ending: three kids, develop. It’s a substitute for A recent study of 218 couples over the first eight believe that sometimes you have to jolt your mar- talking about feelings. says David L. Keefe, MD, professor and chairman of one through gestational surrogacy, using their own Gestational surrogacy years of marriage found a sudden negative aspect riage from negative to positive,” Elizabeth says. You are saying, ‘I love the department of obstetrics and gynecology at NYU fertilized embryo, and twins two months later, with that involves a woman to measures such as relationship satisfaction once “If your husband comes home and you imme- you so much I have to Langone Medical Center. the help of donor sperm. They advise couples in simi- carrying and delivering a couples became parents, compared to those who diately start arguing about housework, you have to touch you.’ ” Although the aging of your eggs is inevitable, lar situations to connect with others and to “keep an child for another person didn’t. And while the researchers found that childless change the conversation. Don’t start with complaints. there’s great variability in fertility in the mid-30s, says open mind. The path that ultimately leads to success or couple. marriages also lose some luster over time, having Start with an expression of appreciation.”—Susan Davis Keefe, whose clinical practice focuses on infertility. may not be the one you start on.”—Annie Stuart

Two-thirds of first marriages last How quickly your eggs age is mostly

10 years or more, according to the CDC. w Im ages Big Ch eese/ G lo w Im ages Im age S ou r ce/ G lo determined by genetics.

Find more expert advice for a happy, lasting marriage. WebMD.com Give and get support in the trying to conceive community. WebMD.com

46 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 47 ® Reviewed by Get the Body You Want in Half the Time! fitness matters Michael W. Smith, MD WebMD CHIEF MEDICAL EDITOR working out what will work for you “I lost 30 pounds!” * “My name is April Stuart. I am married and Foot Loose Ready to Run a mother of two. As a pharmacist, I know the importance It’s not for everyone, but some runners are trying Barefoot? of diet and exercise in maintaining a healthy lifestyle. However, after out a new trend: hitting the road sans shoes If you have a history of having children, I focused my attention on them and not myself. foot problems, check with your doctor before going One day I went to get dressed for work and realized nothing in Six miles into an 18-mile race along the fractures. In contrast, barefoot runners land on the barefoot. If you decide to my closet ﬁ t. Everything was too tight, and in that moment I knew Pacific Crest Trail in 2010, Kate Clemens felt a sharp balls of their feet, generating less impact when ditch your running shoes, I had to do something. I knew that diet alone was not going to be pain in her knee. Instead of stopping, the 29-year- their foot strikes the ground. there are a few things you old personal trainer from San Francisco took off “We’ve oversupported our feet [in running shoes] should know, says enough. Exercise was going to be her shoes and ran barefoot. Without shoes, her to the point that our foot doesn’t have to do what it’s Irene S. Davis, PhD, PT. < BEFORE crucial. A friend of mine told me her knee pain disappeared and she was able to finish designed to do,” explains Irene S. Davis, PhD, PT, pro- Start slow. You’re more Bowﬂ ex® TreadClimber® helped her likely to suffer injuries if “ I started at the race. “I felt a difference the minute I took my fessor of physical medicine and rehabilitation at Har- 140 lbs and lose weight. So I went online, got more vard Medical School and your foot and leg muscles aren’t properly conditioned director of the Spaulding dropped information, and then told my husband for running barefoot. Start to 110! exactly what I wanted for Christmas. Barefoot runners National Running Center. with walk-jog intervals, automatically flex “When you support a walking for nine minutes, From a size muscle, it doesn’t have It was the best gift their knees, hips, running for one minute, 12 to size 2!” to work as hard; when it and repeat, working up I have ever received.” and ankles for a doesn’t have to work as to longer distances. In softer landing on hard, it gets weak.” addition, the skin on your feet needs to thicken hard surfaces. Davis believes your The TreadClimber® body instinctively knows to get used to barefoot CALORIES BURNED IN 30 MINUTES: running. combines the motions of how to adjust when ® you shed your shoes or Think twice. Though a treadmill, a stepper and TREADCLIMBER 3 MPH, INTENSITY LEVEL 12 321 run in “barefoot shoes,” there is a risk of an elliptical. It works like stepping on glass or ultra-lightweight shoes 3 machines in one and TREADMILL designed to mimic bare- pebbles, Davis 3 MPH, INTENSITY LEVEL 12 150 believes it’s can burn up to twice the foot running. Barefoot Source: Adelphi University Modality Study safe to run calories of a treadmill! runners shorten their barefoot on shoes off,” she recalls. “When I’m barefoot, my strides, reducing the impact on their lower bodies, the pavement. alignment is better and I run more from my core.” and automatically flex their knees, hips, and ankles If you’re nervous Clemens is following in the footsteps of the grow- for a softer landing on hard surfaces, Davis says. about foot-to- ing number of runners who have been hitting the Ditching your shoes means the muscles in your asphalt contact, “If I can do it anyone can!” streets and trails without their sneakers. Proponents calves and feet will have to work harder to accom- wear barefoot running GET of barefoot running believe wearing shoes hinders modate to a different foot strike and shorter stride; shoes instead. Call today for your FREE DVD and their natural stride, causing pain and injuries. it takes time for new barefoot runners to build up Know when to say no. ∆ INFO KIT or text STEP to 467467 ® According to a 2010 study published in the those muscles. Runners who have any FREE journal Nature, runners who wear shoes tend to But Clemens is on board. She’s become a regular loss of feeling in their feet, SHIPPING strike the ground with the heels of their feet first. barefoot runner since the day she abandoned her including people who Log on to www.getatreadclimber.com or call WITH THIS AD This gait, called a heel-strike, generates a force up shoes on the trail. “Without shoes, I’m more attuned have diabetes, should the number below and you’ll automatically wear sneakers. to three times the body’s weight, which can lead to how my body moves,” she says. “It’s grounding to receive FREE SHIPPING when you order! to injuries such as Achilles tendinitis and stress feel the earth beneath my feet.”—Jodi Helmer

Of the 206 bones in the human skeleton, y/G ett y I mages 1.800.775.6060

J oh n Kell ‡ 26 are in the foot. FINANCING AVAILABLE * Individual results will vary. In a recent study average fat loss for participants over 6 weeks was 18.8 lbs. Average weight loss was 17.4 lbs. Participants also followed the meal plan provided with every TreadClimber®. ‡ O er subject to change without notice. Not valid with any other o er. On your Nautilus™ credit card, subject to credit approval. Trade tips with other road runners in the WebMD community. WebMD.com Call for complete details. ∆ No spam promise, standard messaging rates apply. ©2011 Nautilus, Inc. All rights reserved. Bowﬂ ex, the Bowﬂ ex logo, TreadClimber, and Get the Body You Want in Half the 48 WebMD the Magazine | May 2011 Time are either trademarks or register trademarks of Nautilus, Inc. (0511) P0511WBMDAPRIL Reviewed by pet matters Drew Weigner, DVM, ABVP WebMD PET CARE EXPERT healthyTRIM: 3.125” X 10.875” SAFETY: .375” AA BLEED: .125 COPY CODE: LOST & PAWS REVISED KL3916 - LOST PET TAG AD - WEBMD MAY 2011 - PQD dogs and cats LOST PRINCESS THINKS TRIM: 8.375” X 10.875” BLEED: .125” AA SAFETY: .375” AA COPY: TAGGED KL7992 - CAT LITTER PRINCESS TAGGED FP BLEED - WEBMD MAY 2011 PQD LESS THAN 5% OF LOST HER STUFF DOESN’T STINK. CATS MAKE IT HOME. Bringing EVEN INDOOR CATS ARE AT RISK. at P * et vi T Up Baby 2 a m ag A a O RM il w ffer.com & hen HA you buy any MM ® Kitten and puppy care tips ER Cat Litters

We’d had our new kittens for about two weeks when one of them developed diarrhea. It was a stinky mess in the litterbox—and GET YOUR one that had me worried something was seriously wrong. A quick consultation with a veterinarian * helped us figure out that the culprit was the leftover milk the kitten had lapped out of a cereal bowl one morning. Though I had shooed her away from it, she drank just enough to FREE upset her tender tummy. Like human babies, animal babies are susceptible to all sorts of illnesses and conditions. Here’s what you should know: Your first step after getting your pet is to take her to a veterinarian to make sure she’s gotten the vaccinations she needs. The vet will also give her a thorough physical exam, PET ID including checking her stool for signs of internal parasites (not unusual in young animals). “This first visit is important for all new pets,” says Scott Shaw, DVM, an assistant professor of clinical sciences at the Cummings School of Veterinary Medicine at Tufts University. But it’s especially important if you get them from sources other than adoption agencies or TAG breeders, he notes. “When you get animals as strays or through other families, you never THANKS TO THE AMAZING LITTER SECRET *via mail when know what health issues might be smoldering.” you buy any 2 Both kittens and puppies are vulnerable to internal parasites (such as roundworms, hook- THAT DESTROYS URINE AND FECES ODOR, ARM & HAMMER ® worms, and coccidiosis) and external parasites (such as ear mites, fleas, and ticks). Symp- Cat Litters toms of internal parasites include diarrhea, a potbelly, and weight loss. Symptoms of external SHE’S RIGHT. parasites include scratching, dandruff, and black crust inside the ears. Kittens are also vulnerable to: Millions of lost cats end up in Upper respiratory infections. Kittens pick up respiratory viruses fairly easily, and they shelters each year. A visible ID tag often develop secondary bacterial infections as well. Symptoms include sneezing, eye dis- charge, and loss of appetite. “Because they’re so young, they just become miserable little increases your pet’s chance at things,” Shaw says. being found and returned safely… Accidents. “We see a fair number of kittens who get sat on or crushed in reclining chairs,” Shaw says. “Owners need to be very, very careful. “Kittens can also sprain or ® Go to PetTagOffer.com for details fracture their legs if they fall from counters or table tops and tear their nails if they get ARM & HAMMER caught in fabric.” DOUBLE DUTY The makers of Puppies are prone to getting: The only clumping litter that combines ® Pneumonia. This condition is so common that “it’s unusual for a day to go by that we ARM & HAMMER are supporting don’t have a puppy in the intensive-care unit getting treated,” Shaw says. “It’s most often ARM & HAMMER® Baking Soda local shelters across America caused by bacteria, but the stress of traveling to a pet store or new home also plays a role.” with urine AND feces odor eliminators. with a $50,000 donation. This is a life-threatening disease that requires veterinary care. Love it or your money back. GI issues. Puppies’ gastrointestinal systems are immature and therefore vulnerable to stress (like going to a new home). Symptoms include vomiting, diarrhea, lack of appetite,

and bloating.—Susan Davis T rac y Mo r g a n/ Gett I ma e s

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KL3916_LOST_PET_TAG_MAY2011_WebMD 1 4/5/11 11:24 AM Frontline_Dog_WebMD:A 2/9/11 11:08 PM Page 1

Reviewed by pet matters Elizabeth A. Martinez, DVM healthy dogs and cats WebMD PET HEALTH EXPERT Mutt Manners The do’s and don’ts of hitting the dog park without a breach of canine etiquette

For a pent-up pooch, a trip to the dog park can be pure bliss. The dog burns off

energy, gets some exercise, and plays off-leash with other dogs. But just like any playground, GET GROCERIES FOR A NEIGH- dog parks can be scenes of bullying and fighting. What happens when one dog starts a fight BOR. SHARE EXTRA FOOD. ORGANIZE A RIVER CLEAN-UP. or guards the area like his own front lawn? And what if—heaven forbid—the offending SUPPORT A SENIOR IN NEED. pooch is yours? WebMD consulted dog behavior experts about the best ways to avoid con- DONATE WINTER COATS. SIGN UP TO TUTOR. DONATE YOUR flicts and make the EYEGLASSES. GIVE VEGETA- know the most out of your trip BLES FROM YOUR GARDEN. to the dog park. YOU HAVE THE difference Think ahead. If between dogs your dog is sick or in POWER TO who are playing heat, don’t bring it CHANGE A LIFE to the dog park. The and fighting. HELP FEED HUNGRY FAMILIES. same goes for dogs DONATE FREQUENT FLIER UnleashUnleash the complete MILES. BRING A MEAL TO A SICK with a history of PERSON. BUY A HOMELESS aggression, says Kim- PERSON A SANDWICH. START berly Anne May, DVM, A WALKING GROUP. PLANT A killing force TREE. DONATE SCHOOL SUPPLIES. MS, an assistant direc- againstaga fleas and ticks. tor at the American Veterinary Medical Association. “You can work with a trainer or a veterinary behaviorist to try to get your dog’s aggression curbed so it can be a good citizen at dog parks,” May says, but for some dogs, “it’s just not appropriate.” Join Harrison Ford, Stay in command. Most problems can be avoided if your dog is trained to come his son Ben Ford and when called, “meaning that you call and the dog, within a split second, turns and runs thousands of others full speed toward you,” says Sophia Yin, DVM, MS, spokesperson for the American Vet- who are helping to erinary Society of Animal Behavior and author of How to Behave So Your Dog Behaves. make the world a Know your dog. Understand the difference between playing and fighting. Well- better place. For more socialized dogs will display a relaxed posture, take turns chasing each other, and pause ideas, please visit: frequently to calm themselves down, says Cheryl S. Smith, certified dog behavior con- www.CreateTheGood.org sultant and author of Visiting the Dog Park: Having Fun, Staying Safe. Act quickly if a fight starts. If you have access to a garden hose or spray bottle, spray Harrison Ford and Ben Ford are EIF Ambassadors. Photograph by the dogs until they back away. If that doesn’t work, the owners should grab the dogs’ back Jesse Dylan. legs and pick them up like a wheelbarrow, backing up slowly, Smith says. “Most people grab for the head, and you’re likely to get bit unintentionally,” she adds. If your dog causes an injury or you suspect it might be injured, be sure to exchange names and phone numbers with the other dog owner before leaving the park.—Daphne Sashin

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completekiller.com K e n dall McMini m y/G ett y Image s Nearly 800,000 require medical care.

*Data on file at Merial. †Vet-dispensed; MDI Data. ®FRONTLINE is a registered trademark of Merial. Can’t curb your canine’s behavior problem? WebMD.com ©2011 Merial Limited, Duluth, GA. All rights reserved. FLE11CNPRINTAD May 2011 | WebMD the Magazine 53

310.575.4441 2107 Sawtelle Boulevard, Los Angeles, CA 90025 Production: Linda Ehrke 310.575.1775 Production: _____changes _____approved AE: _____changes _____approved Job Number: 15-1639 Job Name: iParticipate - Harrison Ford Publication: WEBMD Copywriter: _____changes _____approved Live Area: 3/8” Trim: 2 1/4” x 9.5” Bleed: 1/8” Issue Date: 2. 25. 2011 Colors: CMYK V: 01 R: 00 I: 00 AD: _____changes _____approved File Notes: Designer: _____changes _____approved Reviewed and recipe by Reviewed and recipes by Kathleen Zelman, MPH, RH, LD Carolyn O’Neil, MS, RD healthyeats WebMD Director of Nutrition WebMD Nutrition EXpert nutritious and delicious

Anatomy of BOK CHOY Three Ways to Cook Pork Festive and flavorful, nutrient-rich tenderloin is as lean as chicken breast

Name Game Fresh Start Bok choy is sometimes referred to as white cabbage, not to be The leaves and the stalks can both be cooked, but confused with Napa cabbage, which is also a type of Chinese cabbage. should be separated before washing to ensure that If the word “pork” brings to mind fatty There are many kinds of bok choy that vary in color, taste, and size, both parts are thoroughly cleansed. indulgences like bacon and ham, think again. Pork tender- including tah tsai and joi choi. loin is a surprisingly healthy option. “The beauty of pork is that over the years farmers have bred it to be leaner and Time Limit leaner,” says Debra Krummel, PhD, RD, endowed professor Green Team For optimal freshness, don’t wash bok choy until of nutrition at the University of Cincinnati. “You can now you’re ready to use. Unused parts can stay fresh in Bok choy might look a lot like celery, but it’s a find pork that is just as lean as chicken breast.” the refrigerator for up to six days. member of the cabbage family. As the leanest part of the pig, pork tenderloin has very little saturated fat and therefore won’t affect your blood cholesterol levels significantly, Krummel says. Pork is also Great Haul Mighty Bite one of the richest food sources of thiamin, a B vitamin The Chinese have been cultivating the The veggie is packed with vitamins A and C—one cup that helps the body produce energy from food, and a good vegetable for more than 5,000 years. of cooked bok choy provides more than 100% of the source of zinc, a mineral needed for immune system func- recommended dietary allowance of A, and close to tion. And it might help keep hunger at bay. A recent Aus- two-thirds the RDA of C. tralian study found that when people ate pork, their bod- Domestic Travels ies produced more of an appetite-suppressing hormone Although the veggie is still grown in China, bok choy is known as PYY than when they ate chicken. now also harvested in California and parts of Canada. Good to Grow The veggie takes about two months from planting to Pork tenderloin is versatile, equally at home at the cen- harvest and thrives best in milder weather. ter of an elegant dinner or at a tailgate party. But because it’s so lean, prepare it with care. “I think some people get Gentle Giant turned off because they overcook it, or they don’t mari- Bok choy, known for its mild flavor, is good for Spoon Fed nate, or they don’t use a moist cooking method, and then stir-fries, braising, and soups and can also be Bok choy is sometimes called a “soup spoon” because it tastes like shoe leather,” Krummel says. She recom- eaten raw. of the shape of its leaves.—Chloe Thompson mends using an instant-read thermometer and cooking the meat just until the internal temperature reaches 160˚F, a surefire way to keep the tender healthy recipe in your tenderloin.—Erin O’Donnell Sesame Asian Makes 4 servings ingredients Directions Per serving: Bok Choy Salad 229 calories, 9 g protein, Salad Salad Dressing 1. Place all salad ingredients in a 22 g carbohydrate, 3 cups thinly sliced bok choy 2 tbsp low-sodium soy sauce large bowl and toss 14 g fat (1 g 1 cup chopped Napa cabbage 1 tbsp brown sugar to combine. saturated fat), 6 g fiber, 9 g Pork tenderloin has 1 large red pepper, sliced 1 tbsp rice vinegar 2. To prepare dressing, sugar, 348 mg ½ cup shredded carrots 2 tbsp lime juice whisk together sodium. Calories all salad dressing from fat: 44%.

y/Stoc k foo d . o pp s ite: Ke ll e r & P h otog raph very little saturated ½ cup chopped, seeded 1 garlic clove, minced ingredients. cucumber 1 tbsp fresh ginger, minced 3. Drizzle dressing over ½ cup snow peas, blanched 2 tsp sesame oil salad and toss gently fat and won’t affect ¼ cup sliced green onions 1 tbsp olive oil to coat. ¼ cup chopped cilantro ¼ cup unsalted peanuts your blood cholesterol : Si an Ir vi n e/Stoc k foo d ; Jo hn H a

to p levels significantly.

Go green this spring with more bok choy recipes. WebMD.com

54 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 55 Reviewed and recipes by Carolyn O’Neil, MS, RD healthyeats WebMD Nutrition EXpert Pork Tenderloin Pantry Picks

Our three pork tenderloin recipes, on the opposite page, feature healthy ingredients that deserve a permanent home in your fridge and pantry. Carolyn O’Neil, MS, RD, co-author of The Dish on Eating Healthy and Being Fabulous!, offers a closer look at some top cooking staples. healthy recipe healthy recipe healthy recipe Brine Time Low Sat Fat ➜ ➜ ➜ Pork Piccata Pork Tenderloin Mango Pitas Pork Tenderloin The unopened flower buds of a Mediterranean O’Neil keeps canola oil in her pantry because This simple but elegant recipe takes pork Pork in pita pockets is a natural for a With Spicy Rub plant, capers provide a powerful dose of of its impressive fat profile: It contains the least tenderloin on a trip to Tuscany with the lunchbox treat or simple weeknight The combination of ingredients in antioxidants. Researchers from the University saturated fat of popular cooking oils and provides of Palermo found the antioxidants in capers classic Italian flavors of olive oil, lemon, dinner. Packed with healthy veggies, this rub delivers a lively flavor with heart-healthy monounsaturated and omega-3 fats. and capers. the exotic taste of mango, and a kick of neutralized harmful compounds formed during the It also stands up to medium-high temperatures, very little salt. Serve the pork tender- digestion of fats in meat. (Digestion oxidizes fats, salsa, they are filling on their own but making it a good choice for sautéing, and its Makes 4 servings loin with long-grain brown rice and a creating byproducts that may contribute to heart are great with a salad or bowl of soup. subtle flavor doesn’t overpower foods. Her favorites ingredients tossed green salad. disease and cancer.) Capers are sold pickled in include Wesson and Pompeian OlivExtra, a blend Makes 6 servings Makes 4 servings brine or packed in salt. Give both types a rinse to of canola and extra-virgin olive oil. 1 whole pork tenderloin, about 1 lb reduce their sodium content before adding them to 3 tbsp flour ingredients ingredients dishes. O’Neil recommends Reese and Crosse and Cumin on In 2 tsp lemon pepper 1 whole pork tenderloin, about 1 lb 1 whole pork tenderloin, about 1 lb Blackwell brands, which are brined and readily This peppery spice, a staple of Mexican and 2 tsp olive oil cooking spray 1 tbsp smoked paprika available in many supermarkets. Indian cuisine, is a decent source of iron and aids ¼ cup dry white wine 1 red pepper, coarsely chopped ½ tsp salt digestion, possibly by stimulating the release of ¼ cup lemon juice Wheat Treat ¼ cup chopped fresh cilantro 1½ tsp brown sugar pancreatic enzymes. O’Neil uses McCormick and 4 to 6 slices lemon, very thin Whole-wheat pitas are a tasty way to sneak more 2 cups shredded cabbage 1½ tsp sugar Spice Islands cumin, readily available in most 4 tbsp capers, drained ½ cup shredded carrots whole grains into your diet and get more potential grocery stores. She recommends keeping spices in 1½ tsp chili powder protection against heart disease and diabetes. 1 jalapeño pepper, minced (optional) a cabinet away from heat and light and using them Directions 1½ tsp ground cumin But it’s important to read labels closely to ensure 1 mango, peeled, sliced within six to nine months for best flavor.—E.O. 1. Slice tenderloin into 8 equal pieces. 1½ tsp black pepper that you’re getting the real thing. Look for brands 6 (4-inch) whole-wheat pita Place pieces between sheets of plastic Directions that list “100% whole wheat” on the label, such wrap; pound each piece to 1/8-inch pockets, warmed as Kangaroo Salad Pockets, Toufayan Bakeries thickness with a meat mallet or 6 tbsp salsa 1. Preheat oven to 425ºF. Pitettes, and Flatout Artisan 5 Grain Flax Fold rolling pin. Directions 2. Make the spice rub: In small bowl, It Flatbread. 2. Dust cutlets lightly with flour and thoroughly combine paprika, salt, sprinkle with lemon pepper. 1. Preheat oven to 450°F. Spray brown sugar, sugar, chili powder, Main Squeeze ovenproof nonstick skillet with ground cumin, and black pepper. t s o n /Stoc k foo d Lemon juice offers a hefty dose of vitamin C and Add olive oil to nonstick pan over 3. cooking spray and heat over potent antioxidant compounds known as limonoids, medium-high heat. Quickly sauté cut- medium-high heat. 3. Rub enough of the mixture on the lets, about 4 minutes per side, or until tenderloin to lightly coat the entire which research suggests may fight mouth, skin, and golden brown. 2. Add pork to skillet and sear 2 to surface. Store remaining spice rub in a lung cancers. And because it lends dishes a tart 3 minutes per side until brown. sealed container for future use. kick, lemon juice can be a substitute for salt. O’Neil 4. Add wine and lemon juice to skillet; prefers the bright flavor of freshly squeezed lemons, 3. Transfer to oven and roast 15 to Place tenderloin in shallow pan and shake pan gently and cook 2 minutes, 4. but in a pinch, she suggests stocking your fridge with until sauce is slightly thickened. 18 minutes until meat thermometer roast 30 to 35 minutes, or until a meat reaches 160°F. thermometer inserted in the thickest the lemon juice from Sunkist and ReaLemon, or 5. Garnish with lemon slices and capers part registers 160ºF. Sicilia, an Italian brand some supermarkets carry. and serve. 4. Remove from oven, and let rest 5 minutes. Slice into bite-size pieces. 5. Remove pork from oven and let rest 5. Place pork, fruit, and vegetables into 5 minutes. Slice tenderloin and serve. pita pockets and top with salsa. The opinions expressed on this page are of the experts and are Per serving: 194 calories, 24 g protein, 6 g Per serving: 232 calories, 21 g protein, 30 g Per serving: 147 calories, 23 g protein, 3 g not the opinions of carbohydrate, 6 g fat (2 g saturated fat), 73 mg carbohydrate, 4 g fat (1 g saturated fat), 49 mg carbohydrate, 36 g fat (4 g saturated fat), 73 mg WebMD. WebMD does cholesterol, 311 mg sodium. Calories from fat: 29%. cholesterol, 5 g fiber, 8 g sugar, 315 mg sodium. cholesterol, 3 g sugar, 349 mg sodium. Calories not endorse any specific Calories from fat: 15%. from fat: 24%. product, service,

eft: Ke ll e r & P h otog raph y/Stoc k foo d ; We s te rmann /Stoc Le w Ro b f r o m l eft: T e d Mo rr i s o n or treatment.

Find more healthy pork tenderloin recipes. WebMD.com

56 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 57 Reviewed by Kathleen Zelman, MPH, RH, LD healthyeats WebMD Director of Nutrition nutritious and delicious

How I Got Myself to Eat Cilantro Rebecca Rose, 33, Huntington, N.Y., life-insurance case manager healthy recipe Cooking With Cilantro Cilantro adds fresh, lemony, bright, and spicy flavors as well as earthy undertones to Asian Of all the bright-green herbs out soups, spring rolls, salads, and Southwestern dips, salsas, stews, and sandwiches. Pulsing there, cilantro—the fresh, leafy stalks of the cilantro into dips or pestos tames the herb’s scent somewhat, making it more approach- coriander plant—may be the most polar- able for a wider audience. izing. The millions who love cilantro pile it Cilantro is a good source of dietary fiber, vitamin K, iron, magnesium, and manganese. on soups, salsas, wraps, and roll-ups. And the The herb is super low in calories (only 1 calorie per quarter cup) and super high in a long people who hate it, really hate it, tend to post list of plant-based nutrients called phytochemicals, including limonene, camphor, and vitriolic rants in online food blogs. But even quercetin. These compounds, abundant in vegetables and fruit and in cilantro’s essential dedicated cilantrophobes can have a change oils, are powerful antioxidants, which help the body fight disease and aging. of heart, mind, and tastebud. Take WebMD Fresh cilantro leaves may also be a natural antibiotic: Studies community member Rebecca Rose. show a compound called dodecenal in the leaves may be as Rose’s first cilantro moment came at a effective as a commonly used antibiotic drug at killing restaurant in New York, when she was a salmonella. To get the most out of these benefits, eat teenager. “I scooped up a chip full of pico de cilantro when it’s fresh and vibrantly deep green. gallo, took a bite, and basically freaked out,” Leaves should be crisp and spot-free. she remembers. “I couldn’t get it out of my mouth fast enough. I was convinced I had ➜ Cilantro-Spiked Guacamole eaten a bug!” But there was no bug in the Combine one or two thin slices of jalapeño pep- salsa, just a lot of cilantro. “I was completely per with ¼ cup fresh cilantro leaves (bottom unfamiliar with the herb,” says Rose. of stems removed), 2 ripe avocados (pitted and For years, Rose was on cilantro high- peeled), ¼ tsp salt, ½ tsp ground cumin, the juice alert, carefully avoiding the herb, which she of one lime, and ½ cup water in food processor. called “The Great Parsley Pretender.” Finally, Pulse/blend until smooth. Mix in 3 tbsp chopped white she decided to give it another try. “I love, love, or red onion and serve with fresh veggies or baked tortilla love avocados. And my favorite guacamole- chips for dipping. making restaurant includes cilantro in the guac. I think that’s what converted me.” ➜ Cilantro Pesto Today? Rose not only tolerates the herb, Combine 1 bunch of very fresh cilantro (bottom of stems removed) with four cloves of she seeks it out. “My mom always said, garlic, ¼ cup of grated Parmigiano-Reggiano cheese, 1 slice of jalapeño pepper (or ½ tsp red t/Getty Im a g es; F oo d e S ou r ce/Getty ve r “‘Your tastes change. You might not like chili flakes), and ½ cup toasted pine nuts or blanched almonds in a food processor. Pulse. something today that you’ll like farther With motor running, slowly pour in ½ cup extra-virgin olive oil. Add 1 tbsp lime juice and down the road.’” And cilantro-wise? “She blend. Mix in sea salt to taste and toss with 6 to 8 servings of your favorite prepared : Rose m a r y C l

to p was right!”—Monica Kass Rogers whole-grain pasta.

What’s your family food challenge? WebMD.com

May 2011 | WebMD the Magazine 59 wellness As she returns to Broadway in The House of Blue Leaves, Edie Falco opens up about beating alcoholism, getting into character as Nurse Jackie, and her most important role of all, mom LifeStages Edie Falco may spend her days tending to trauma victims and juggling the hectic demands of a Lower Manhattan hospital on the set of Showtime’s dark comedy Nurse Jackie, but playing Jackie Peyton—a top-notch ER nurse and quick-tongued, functioning drug addict with a penchant for Percocet—is as close as the Emmy-winning actress gets to living on the edge. The only thing this mother of two craves, she says, is popcorn and curling up on the couch for cartoon movie marathons with her kids. Reviewed by Louise Chang, MD WebMD Medical Editor By Jenna Bergen, WebMD Contributing Writer

60 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 61 wellness

“The greatest thing I’ve ever learned is ruled by addiction,” says Falco. “It’s heart- acceptance,” says Falco, 47, who, in addi- breaking to remember what that feels like: tion to gearing up for the third season that every other thing pales in compari- 7 Rules for Health and Happiness of Nurse Jackie, returned to Broadway in son to feeding your addiction. It’s a great April, starring alongside Ben Stiller in the luxury to be freed from that.” Sweat for your sanity. To actor Edie Falco, the gym is for more than staying revival of John Guare’s comedy, The House toned and trim. “It always clears my head,” says Falco, who was running up to five of Blue Leaves. “To just take life as it occurs, Life Lessons miles a day until knee pain recently caused her to cut back. “You feel better all day learn from it, and make it as enjoyable as Falco’s victory over alcoholism came about because of the endorphins running through your system. I do it more for my brain possible. That’s what life is. And it’s often like many other accomplishments in her than anything else. It just makes me feel good.” spectacular.” life: It was hard won. “It was actually “Spectacular” is also a fitting word for unimaginable in the beginning that I could Say “yes” to siestas. Scoring eight straight hours of shut-eye rarely happens Falco’s career, which started on the stage succeed because my life so revolved around for Falco, as she’s often up early with her children and stays up late to cross items and in indie films, then built momentum alcohol,” says Falco, who credits a large off her to-do list. However, whenever she has the chance, she’ll catch some midday in the early ’90s with recurring roles on part of her success to a group of pals who zzz’s. “I love to nap in the afternoon,” says Falco. “I’ll grab my dog and we’ll go up Falco channels her in my bedroom and sleep for a few hours. It’s not consistent, but it seems like the Law & Order, Homicide: Life on the Street, and a experience beating put down the bottle first. “Some of the greatest luxury in the world.” much-talked-about role on HBO’s prison alcoholism in Nurse Jackie. closest friends in my life right now are drama, Oz. Finally, in 1999, Falco sky- people who got sober before me. I’ve got a Make exercise “me” time. As an Emmy-winning actress and a single mom of rocketed to household-name fame when very strong network of people who would two, finding time to exercise or sneak in alone time isn’t always easy. Her solution? she was cast as Carmela, the outspoken, simply not have it if I were to drop out of Combine the two: While a babysitter watches the kids, “I’ll do an exercise of some home décor–obsessed wife of New Jersey The greatest thing I’ve ever learned the club.” kind and listen to music,” says Falco. “It’s very quiet time, very private time.” mobster Tony Soprano, on another HBO Finding a fellowship of people who no hit series, The Sopranos—a role that gar- is acceptance. To just take life as it occurs, longer drink can have a huge influence Don’t be crazy about cardio. In the past, if Falco had a 5 a.m. nered her three Emmys and two Golden on staying sober, says Harry Haroutunian, start time, she’d be up at 3:30 a.m. to work out. “I used to be sort Globes as dramatic lead actress. In 2003, learn from it, and make it as enjoyable MD, physician director of the Betty Ford of obsessive about exercise,” admits Falco. “But now, I fit it in she became the first actress to ever claim Center’s Residential Treatment Programs where it’s manageable and reasonable. As always, just do the best Emmy, Golden Globe, and Screen Actor’s as possible. That’s what life is. in Rancho Mirage, Calif. “Alcoholism is a you can.” Guild awards in the same year. She also has disease that loves to hide in the dark and appeared in the hit comedy 30 Rock, as Alec And it’s often spectacular. to stay cloaked in denial, but having a fel- Reward yourself with a healthy treat. Forget chocolate, cookies, Baldwin’s love interest, and has kept up her lowship holds you accountable to a power or cake. Falco’s must-have treat is popcorn. “There’s something about film work, working with Harrison Ford, Nurse Jackie clearly identifies with that outside of yourself,” says Haroutunian. watching TV and eating popcorn that’s so satisfying,” says Falco. “It’s got Julianne Moore, and other stars. power. She’ll do just about anything to Falco’s Emmy award-winning role as “For some people, that fellowship might all the perfect flavors, and I can almost tell myself it’s a vegetable.” Carmela on The Sopranos. With Nurse Jackie, which debuted in 2009 score a hit—even if it means having an be a recovery group like Alcoholics Anony- on Showtime, the drama queen proves she affair with the hospital pharmacist. In the mous, and for others, like Edie, it could be Cave to your cravings—occasionally. Though Falco mainly has a knack for comedy, too. In 2010, she last two seasons, she’s tossed back Vicodin, a group of sober friends.” eats a healthy diet full of fresh fruit and vegetables and lean proteins, like took home the Emmy for Outstanding Lead snorted Adderall in the ladies room, and Watching a loved one struggle with fish and low-fat dairy, now and then she indulges in her favorite foods. “I go through Actress in a Comedy Series for the show, gulped down vials of morphine. addiction can make many family members periods of time, like the holidays, that are just ridiculous,” says Falco. “But I always a success Falco credits largely to her past But while Jackie is certainly flawed, feel helpless—something Falco under- go back to ground zero. I just feel better when I eat well.” personal struggle with addiction. Though in Falco’s capable hands she’s also quick- stands, too. Boycott boredom. In addition to running, Falco stays active with Pilates, you’d never think it by looking at the Long witted, smart, and lovable, an imperfect, “When I was little, I used to break my yoga, and the elliptical machine. “I’m always switching it up to stay interested,” Island native now, she says her life closely big-hearted heroine who cares for her parents’ cigarettes all the time to get them says Falco. The healthy bonus: Varying your fitness routine is a good way to avoid mirrored her current character’s struggles patients, will tell off any MD who gets in to stop smoking. They would get furious frustrating plateaus and helps prevent over-use injuries, too.—J.B. for many years. The only major difference: her way, and is raising two young girls. with me, and then just go out and buy Nurse Jackie pops painkillers and Falco “She’s a wise guy, you know?” says more cigarettes,” says Falco. struggled with alcohol. Falco. “She’s not that careful about the way “It’s hard to talk to an addict who “I think having gone through alcohol- she’s perceived, which is very freeing to doesn’t want to hear anything. But there is decided to take better care of myself,” says Finally, in February 2004, the clouds ism really helps me understand how Nurse someone like me, who spends a certain a way out. You get to the point where you Falco, who discovered she loved logging lifted: Falco entered remission. But despite Jackie functions,” says Falco, who’s been amount of time attending to those sorts think there isn’t, and I can say from the miles outdoors for the mood-boosting her soaring career and regained health, sober since she was 29. “It’s hard for peo- of things.” other side that there is always a way out if benefits. Then, in September 2003, Falco she realized something was missing: She ple who aren’t addicts to understand the But despite the dark laughs, the show you ask for help.” received the life-changing diagnosis of wanted to be a mom. nature of [addiction]—how irrational it is also carries a serious message, one that is stage 1 breast cancer. Suddenly, exercise “I had been pursuing this career for so and, at the same time, how deeply power- personal and important to Falco and the New Beginnings became much more than a way to stay fit long and living, literally, by the seat of my ful. If you’re an ex-addict, you understand show’s executive producers, Liz Brixius and After kicking the bottle, Falco cleaned and firm—it became a source of solace. pants, that it never occurred to me that I it completely because you have to. You drink Linda Wallem, both past addicts as well. up her diet and swapped her unhealthy Even on days when she was depressed would have children,” says Falco who, after because your body tells you that is what “Playing Nurse Jackie makes me grateful addiction for a healthy one: running. “Back over losing her hair to chemo, Falco’s runs graduating from the prestigious Conser-

you need.” every day that I’m no longer living a life Ken Regan/ S ho w ti m e; H B O / E ve r ett Co ll e c tion opening sp r ea d : S ho w ti m e; top: when I drank, I didn’t exercise at all, and I made her feel strong and calm. vatory of Theatre Arts and Film, lived in

62 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 63 wellness

The moment her son, Anderson, was placed in good at, the ways in which I fall short. But it’s also very moving and gratifying.” Expert Tips for Battling the Bottle her arms, Falco burst into tears. So gratifying, in fact, that the actor hasn’t Nearly 18 million people in the United States—about one in 12 adults—abuse dated seriously since becoming a mom. alcohol or are alcohol dependent. While actor Edie Falco relies heavily on non- It’s as big as it gets in one’s life. “My kids came into my life, and what- drinking friends for support, there are numerous ways to get help. “Alcoholism is a ever it was that was driving me to get chronic disease that requires lifelong management, but you can live a long, healthy, I learned a capacity for love I didn’t think involved with someone really went up and fulfilling life beyond your wildest dreams if you recover from this disease,” says in smoke,” says Falco, who’d been dating Harry Haroutunian, MD, physician director of the Betty Ford Center’s Residential I had. A selfless kind of love. steadily since her teen years. Treatment Programs. Here, his top tips for getting—and staying—sober. “Every human wants love, and here it was in such large quantities and in such Admit you have a problem. “There aren’t always red flags that clearly show love.” That she wasn’t the baby’s biological purity that I just no longer felt that drive that someone is an alcoholic, but there are signs that allow us to recognize problem mother made no difference to her. “It feels to go out and meet someone. I have life in drinkers,” says Haroutunian. “Drinking more than intended at any specific time, loss very clear to me that the second they hand my house. And I have deep friendships that of control while drinking, or continuing to drink despite adverse consequences are you a newborn it’s your child, and it makes are, on average, about 30 years old. My life absolute hallmarks of this disease.” Not sure you have a problem? Find a simple absolutely no difference what body it came Falco with her daughter, is very full and satisfying.” questionnaire at aa.org. out of,” she says. She likens the experience Macy, now 3. Reach out. There’s a reason more than 2 million Americans are members of to her instantaneous love-bond with her Looking Ahead Alcoholics Anonymous, the nonprofit group that originally proposed the “12-step beloved dog, Marley, 12, a yellow Lab– education and discipline, and I don’t want No matter how busy Falco may be, she always program” as a method of recovery from alcoholism: It works. “In my experience, white shepherd mix. “It’s sort of embar- to compromise with anybody.” finds time to do more—a habit she sustains recovery is possible when the 12-step program is used,” says Haroutunian. “If you rassing, but I love Marley so much that I Of course, Falco quickly found out that through the occasional afternoon nap and attend the meetings and practice the steps on a daily basis, your chances for recov- have a hard time believing she did not come doing everything entirely on her own would a wholesome, vegetarian diet chock-full of ery are very, very high.” from me. In a way, all dogs are adopted.” In be too much, even for someone with her energizing fruits and vegetables. In 2009, 2008, Falco adopted a sibling for her son, a level of energy. “At first, I tried to do it all,” she appeared in a Stand Up To Cancer public Find new ways to de-stress. Many people become addicted to alcohol baby girl she named Macy. says Falco, who finally gave up singlehand- service campaign with actor Cynthia Nixon because it eases stress and lessens anxiety, says Haroutunian, and alcoholics must “They couldn’t be more different from edly managing every night and day feed- to raise awareness about the increased risk of learn new coping mechanisms, such as meditation, exercise, or cognitive behavioral Falco with her son, Anderson, each other,” Falco says of her duo, now ings for her son after almost walking into infection during cancer treatment. therapy. So, instead of reaching for a drink the next time you’re under the gun at now 6, last fall. 6 and 3. “My son is deeply intense, oncoming traffic. “I got a nanny to help Fifteen years ago, she began studying work or have a fight with your spouse, hit the gym, go for a run, call a friend to vent, crazy-smart, and shy, and my daughter is me during the days, and I kept shifting my Buddhism and recently joined a cabaret or try another healthy activity that eases tension.—J.B. Manhattan and worked odd jobs to support crazy-comfortable in her skin, creative, plans until I found a very workable one.” act. “I’m always doing stuff that keeps me her acting career. and really social—very girly. It’s such a joy Opting to navigate motherhood alone occupied, interested, and challenged,” says watching them become these little people has become a viable option for many Falco. “It’s just the way I stay happy.” Call of Motherhood they were always destined to be, with or women, says Argie Allen, PhD, MFT, direc- In addition to looking forward to seeing “I traveled in a circle of poor artists, and without me.” tor of clinical training at the couple and what season three holds for Nurse Jackie, Falco All that I I just never thought I would be a mom. While becoming a mother has undoubt- family therapy program at Drexel Uni- has been prepping for her return to Broad- I didn’t think it would be something I edly cut down on Falco’s gym time and versity in Philadelphia. Being a single way in The House of Blue Leaves. “I saw the play know is that would be good at, and it didn’t seem like trips to the masseuse, she couldn’t be mother can be wonderfully rewarding to a million years ago, and I remember leaving something I wanted. And then...it did!” happier. “I love being a single mom,” says both your child and you. “However, it’s the theater with this glowing feeling, think- I love what She laughs. “It kind of snuck up on me and Falco, who, despite past relationships with important to have support systems in place ing ‘God, that was beautiful,’” says Falco, who grabbed ahold of me—and it wasn’t going other well-known stars such as Stanley to ensure the child is adequately cared was only 18 at the time. “Here it is all these I do. I just see to let go.” Tucci, has never married. for and the mother is still able to have a years later and I’m getting to do it. It’s just That Falco was 40 and single didn’t mat- “I did this very much on purpose. I healthy amount of alone time,” says Allen, one of those glorious things about this career what comes my ter to her. She knew it was time and quickly wanted to raise my children by myself. I who recommends scheduling biweekly that I’ve had that’s been such a gift.” began looking into adoption. “It’s an ardu- feel strongly about being consistent for sleepovers at a close friend’s or family But ask Falco what she’s planning next, way and what ous process, but I imagine the nine months them and being there for them, and all I member’s house. and she’ll laugh and tell you “nothing.” “I moves me. of watching your body change [during can promise is that I will be those things. “Sleepovers can be a wonderful thing. The tend not to think that way,” says Falco. pregnancy] is sort of an arduous process I can’t make those promises to them when children get to play and socialize with their “What has worked for me has been not as well,” Falco says, laughing, recalling the it involves other people,” says Falco, who peers, and the parent can take some time to plan anything. All I know is that I love what mountains of paperwork and days of wait- recalls growing up enduring her parents’ to relax.” Also, creating a small network of I do. I don’t want to direct, I don’t want to ing expectantly for a phone call. arguments and long, cold silences until friends or relatives who can commit to help- write. I really just love to act. Thus far, I just The moment her son, Anderson, was they divorced. ing with chores and errands is key, Allen adds. see what comes my way or gets offered to me placed in her arms that December, Falco “I just feel this is the way I can do this Still, even with additional hands, par- and what moves me. burst into tears. “It’s as big as it gets in most cleanly. It’s very painful to see one enting—single or partnered—is a chal- “As a result,” Falco says, “I’ve had this one’s life. I learned a capacity for love parent leave. I also have strong feelings lenge. “It just puts everything front and tremendous journey that’s much better than

I didn’t think I had. A selfless kind of about the way to go about things, such as center,” says Falco, “the things that I’m G ett y Im ages (2); V i c to r ia Wi ll /Co rb is O ut l ine K r opa/ A n dy fr o m l e f t: anything I could have planned.”

Get expert childraising tips and support from other parents. WebMD.com 64 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 65 skin care Sun Day Best The heat Don’t believe the hype. It may be shady Sunscreen only needs to be applied to exposed skin. outside. Your skin may be naturally tan. FALSE. The average T-shirt offers an SPF of about 7, notes Gilman. is on! Are And you may be wearing foundation Darker fabrics and tighter weaves provide more protection, but it is much safer to apply sunscreen to your entire body before you get pumped with SPF. But that’s no reason to dressed. Or better yet, wear clothing made of UV protective fab- you covered? stow away your sunblock. WebMD talks to rics. These have been specially treated with colorless UV-absorbing dyes, and most offer an ultraviolet protection factor (UPF) of 50, top dermatologists who reveal the biggest which blocks both UVA and UVB. Don’t want to invest in a whole Our experts misconceptions about wearing sunscreen. new summer wardrobe? Spike your detergent with a wash-in SPF product you can toss in with your laundry. debunk top Using makeup with SPF is just like wearing regular facial sunscreen. The higher the SPF, the better the protection. FALSE. Certainly, applying makeup that contains SPF is better sunscreen FALSE. It sounds right—a sun protection factor of 100 should be than skipping it altogether, but it’s not as effective as wearing a twice as protective as SPF 50. But it’s only a few percentage points facial lotion with sunscreen underneath. Generally, most makeup more effective. An SPF of 15 screens 93% of the sun’s rays and an cracks on skin, allowing UV rays through. “For makeup to provide myths SPF of 30 screens 97%. “But the number becomes irrelevant if adequate ultraviolet protection, it would need to be applied in a you aren’t applying enough in the first place,” says Mona Gohara, really thick layer, which most women do not do,” Gilman says. So MD, a dermatologist in Danbury, Conn., and an assistant clinical unless you plan to spackle on your foundation, smooth on a layer professor at Yale University Department of Dermatology. Studies of lotion with sunscreen first, and then apply your makeup. show the average person slaps on one-seventh to one-tenth of the By Ayren Jackson-Cannady amount of SPF needed to reach the number that’s on the bottle. Sunscreen can cause cancer. WebMD Contributing Writer “For better protection apply 1 to 2 ounces (the size of a Ping-Pong FALSE. The only way sunscreen could be hazardous to your ball) of sunscreen on your body 30 minutes before going outdoors health is if it is absorbed into the body, which does not happen, [so your skin can absorb it completely], and every two hours to any says Amy Wechsler, MD, dermatologist and author of The Mind- exposed skin after that,” Gohara says. For your face, apply a dollop the Beauty Connection: 9 Days to Reverse Stress Aging and Reveal More Youthful, size of a silver dollar every day, no matter what the weather. Note, too, Beautiful Skin. “UV rays break down the chemical molecules in some that SPF refers to protection from UVB (the burning rays) only, not sunscreens relatively quickly, long before they can seep into skin.” UVA (the aging rays). You need to guard against both, since both can Still concerned? Use a sunscreen containing physical blocking lead to skin cancer. (See “What’s in a Label?” on page 80 for ingredi- ingredients such as zinc oxide and titanium oxide, which stay on ents to look for on sunscreen product labels.) the surface of the skin as a protective barrier. Don’t be tempted to use babies’ or children’s sunscreens, which don’t necessarily It’s OK to use last year’s bottle of SPF. TRUE. Most sunscreens have a shelf life of about two years, says Jordana Gilman, MD, a New York City dermatologist. If you are using sunscreen properly, however, you shouldn’t have any left, Reviewed by Karyn Grossman, MD since it takes about 1 to 2 ounces of sunscreen to cover the entire WebMD Skin Care Expert

Pe r Eriksso n/Ge tt y I m a g e s body, so a 4-ounce bottle should last for only four applications.

66 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 67 Euro RSCG Worldwide erw110463a Proof 1

B:8.625” T:7.5” S:7”

skin care

Wearing sunscreen can lead to “Antioxidants are a good way vitamin D deficiency. Always running to the bathroom? FALSE. There’s no denying that our bodies need vitamin D Maybe your internal plumbing isn’t working like it should. to catch the UV radiation that (which can be obtained though sun exposure) to function—without it, the body can’t use calcium or phosphorus (minerals neces- This checklist can help you talk to your doctor about it. ‘sneaks’ past the sunscreen.” sary for healthy bones). And according to a study published in Ar- chives of Internal Medicine, three-quarters of Americans are deficient in YES NO When I go out, I always make the crucial vitamin. But that doesn’t give you a no-SPF pass. “You sure there’s a bathroom nearby. contain physical blocks. And make sure to check the “active ingre- still get enough sun to make plenty of vitamin D through the sun- dients” section on the label to see what the bottle contains. Even screen,” says Brett Coldiron, MD, a dermatologist at the University Once I get the sudden urge to go, the same product can vary from year to year. Some dermatologists of Cincinnati. If you’re worried about vitamin D deficiency lead- I can’t wait. believe people should wear physical blocks only. They might be ing to brittle bones, Wechsler says, ask your doctor about taking a safer than a mix but are harder to find and not as easy to wear supplement. The Institute of Medicine’s recently revised guidelines I wear pads sometimes because since they tend to be thicker and goopier products. Try a few to recommend most adults get 600 international units a day; some I worry I might accidentally leak. find one you like. people may need more. I’ve had enough, and I’m ready “Waterproof” sunscreen doesn’t need Sunscreen with antioxidants provides to do something about my to be reapplied after swimming. better UVA/UVB protection. urges and leaks. FALSE. It’s no surprise researchers at the Colorado School of TRUE. While they aren’t necessarily active sunscreen ingredients, Public Health recently found that vacations near the water were antioxidants are great SPF supplements. Sunscreen alone does not If you answered “Yes” to any of these, tear out this checklist and talk to your doctor about associated with a 5% increase in small skin moles, which in turn block all of the damaging rays from the sun—even an SPF of 50 your results. Only your doctor can determine if you have overactive bladder. Once-daily boosts a person’s risk of melanoma. While the FDA recognizes blocks out only 98% of UV rays. “Antioxidants are a good way to VESIcare is proven to treat overactive bladder with symptoms of frequent urges and leaks.* the term “water resistant” (which means a sunscreen offers SPF catch the UV radiation that ‘sneaks’ past the sunscreen,” Gohara That’s because it can help control your bladder muscle, day and night. So ask your doctor protection after 40 minutes of exposure to water), it does not says. Sunscreens infused with antioxidants such as skin-loving about taking care with VESIcare. acknowledge the term “waterproof.” “No sunscreen is truly wa- green tea extract or polyphenols from tomatoes and berries are

*Results may vary. B:11.125” T:10.5” terproof,” Wechsler confirms. Sunscreen should be reapplied every proven to reduce the formation of free radicals (small chemical S:9.75” two to three hours—and every time you get out of the water if particles that wreak havoc on skin and can cause skin cancer) in USE AND DOSE you’re doing laps in the pool or splashing around in the ocean. the presence of UV light. VESIcare is for overactive bladder with symptoms of urgency, frequency, and leakage. The recommended dose of VESIcare is 5 mg once daily. If the 5-mg dose is well tolerated, your doctor may increase the What’s in a label? dose to 10 mg once daily. IMPORTANT SAFETY INFORMATION To ensure that you’re getting These ingredients block UVA VESIcare is not for everyone. If you have certain stomach or glaucoma the best protection possible, rays (the rays that cause aging): problems, or trouble emptying your bladder, do not take VESIcare. look for a broad-spectrum l Avobenzone VESIcare may cause allergic reactions that may be serious. If you experience l UVA/UVB sunscreen. How do Ecamsule (Mexoryl) swelling of the face, lips, throat or tongue, stop taking VESIcare and get l Zinc oxide you know you have the right emergency help. Tell your doctor right away if you have severe abdominal pain, l Titanium dioxide or become constipated for three or more days. VESIcare may cause blurred product? Even if the front label vision, so use caution while driving or doing unsafe tasks. Common of the bottle advertises UVA These ingredients block UVB side effects are dry mouth, constipation, and indigestion. and UVB protection, turn to rays (the rays that burn skin): Please see Important Patient Information on the following page. the back and scan for a com- l Octyl methoxycinnamate bination of these ingredients. l Octyl salicylate Sometimes the front labels l Octocrylene can be misleading. l Zinc oxide l Titanium dioxide

First 30-day prescription Take care with Clip here, tear out, and pipe up to your doctor. out, and pipe up to your Clip here, tear free† at vesicare.com, ow I m a g e s or call (800) 403-6565. †Subject to eligibility. Restrictions may apply. n/Gl T om Me rto You are encouraged to report negative side effects of prescription drugs to the FDA. What’s in your summer beach bag? WebMD.com Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. 68 WebMD the Magazine | May 2011

Cyan Magenta Yellow Black

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Client Name: GSK - Vesicare Page 4/C Bleed AD: B. Previdi x5832 CW: L. Kaufman x4231 Job No.: B: 8.625" x 11.125" T: 7.5" x 10.5" S: 7" x 9.75" AE: K. Lewandroski x3968 0000034822_0000038274_M01 Line Screen: 133 Traf: R. Rodriguez x4408 Prod: K. Daly x4359 Caption: “Always running to the bathroom? This advertisement prepared by: Bill OOP/Studio To Job No.: 0000034822 (Doris Print ad) Media: Magazine Euro RSCG Worldwide Bill Labor To Job No.: 0000034823 Southern Living, Vim & Vigor, WebMD, Changes, 350 Hudson Street Family Circle, Ladies Home Journal, Better Homes & New York, New York 10014 0000032797_VESI_Print_3_30 Garden, Health, Cooking Light, Health Monitor, AARP Euro RSCG Worldwide erw110464a Proof 1

T:2.125” skin care

Patient Information VESIcare® – (VES-ih-care) (solifenacin succinate) BEST FOR LIPS Read the Patient Information that comes with VESIcare before you start taking it and each time you get a refill. There may be new information. This leaflet does not take the place of talking with Nivea A Kiss Of Protection Lip your doctor or other healthcare professional about your condition Care SPF 30 ($2.49) contains or treatment. Only your doctor or healthcare professional can What’s your risk? determine if treatment with VESIcare is right for you. Screen Stars What is VESIcare? sun-shielding titanium dioxide, VESIcare is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder: When 24-year-old tabbiecat_PCSM asked the WebMD skin cancer community plus moisturizing shea butter to • Having to go to the bathroom too often, also called “urinary frequency” A top derm’s SPF • Having a strong need to go to the bathroom right away, also called “urgency” about a mole on the back of her thigh, the moderator quickly responded. “Because protect your pout. • Leaking or wetting accidents, also called “urinary incontinence” VESIcare has not been studied in children. skin cancer runs in your family and you are worried, I would definitely get it product picks What is overactive bladder? Overactive bladder occurs when you cannot control your bladder BEST FOR SPORTS contractions. When these muscle contractions happen too often or cannot checked out,” she wrote. Family history is just one risk factor for melanoma. Do be controlled you can get symptoms of overactive bladder, which are Neutrogena Wet Skin Sun- urinary frequency, urinary urgency, and urinary incontinence (leakage). you know the others? Who should NOT take VESIcare? block Spray SPF 85 ($8.99) can Do not take VESIcare if you: • Are not able to empty your bladder (also called “urinary retention”) be applied over wet skin after • Have delayed or slow emptying of your stomach (also called “gastric Do you have fair or freckled skin that burns easily? retention”) swimming or exercising (and it • Have an eye problem called “uncontrolled narrow-angle glaucoma” ● Yes ● No • Are allergic to VESIcare or any of its ingredients. See the end of this 1 leaflet for a complete list of ingredients ● doesn’t leave white marks!). What should I tell my doctor before starting VESIcare? Before starting VESIcare tell your doctor or healthcare professional about all of your medical conditions including if you: Do you have light-colored eyes or red or blond hair? • Have any stomach or intestinal problems or problems with constipation FOR YOUR LAUNDRY • Have trouble emptying your bladder or you have a weak urine stream ● Yes ● No • Have an eye problem called narrow-angle glaucoma 2● Spike your detergent with • Have liver problems • Have kidney problems Ever wonder what sun- Hawaiian Tropic Sensitive SunGuard ($1.99), a powder • Are pregnant or trying to become pregnant (It is not known if Have you had a lot of sun exposure or a history of blistering sunburns? VESIcare can harm your unborn baby) Skin Oil-Free Face Lotion laundry aid that amps up the • Are breastfeeding (It is not known if VESIcare passes into breast milk screens top dermatologists and if it can harm your baby. You should decide whether to breastfeed 3● ● Yes ● No SPF 30 ($6.99) is lightweight ultraviolet protection factor or take VESIcare, but not both) Before starting on VESIcare, tell your doctor about all the medicines slather on themselves? and nongreasy—a great option (UPF) of your clothing to 30 you take including prescription and nonprescription medicines, vitamins, and herbal supplements. While taking VESIcare, tell your doctor or Do you have a family history of melanoma? “It has to be SPF 30 or for those with sensitive or healthcare professional about all changes in the medicines you are taking and lasts through 20 washes. including prescription and nonprescription medicines, vitamins and herbal ● Yes ● No acne-prone skin. supplements. VESIcare and other medicines may affect each other. 4● higher, and I like it to pro- How should I take VESIcare? Take VESIcare exactly as prescribed. Your doctor will prescribe the tect against both UVA and The opinions expressed on this page are dose that is right for you. Your doctor may prescribe the lowest dose if BEST FOR BODY you have certain medical conditions such as liver or kidney problems. Do you have many large, irregularly shaped moles? of the experts and are not the opinions of • You should take one VESIcare tablet once a day UVB,” says dermatologist • You should take VESIcare with liquid and swallow the tablet whole ● Yes ● No Aveeno Positively Ageless WebMD. WebMD does not endorse any • You can take VESIcare with or without food 5 Sunblock Lotion SPF 70 specific product, service, or treatment. • If you miss a dose of VESIcare, begin taking VESIcare again the next T:9.125” Jordana Gilman, MD. day. Do not take 2 doses of VESIcare the same day • If you take too much VESIcare or overdose, call your local Poison ($11.99) is infused with fever- Control Center or emergency room right away Answers: Each is a risk factor for skin cancer. Sun exposure and sunburn are big risk Here are some SPF picks What are the possible side effects with VESIcare? few, soy, and vitamin E, power- VESIcare may cause allergic reactions that may be serious. Symptoms factors; most skin cancers occur on areas that have been regularly exposed to the sun. she swears by (all these of a serious allergic reaction may include swelling of the face, lips, ful antioxidants. throat or tongue. If you experience these symptoms, you should stop People with light eyes, skin, and hair are at greatest risk—even during cold-weather taking VESIcare and get emergency medical help right away. protect against both types The most common side effects with VESIcare are: months. But even those with darker complexions can get all forms of skin cancer, so • Blurred vision. Use caution while driving or doing dangerous activities of rays). Lubriderm Advanced Therapy until you know how VESIcare affects you everyone should practice sun safety. Having lots of large, irregular moles makes you more • Dry mouth SPF 30 Lotion ($8.99), which • Constipation. Call your doctor if you get severe stomach area likely to get a form of skin cancer called melanoma. So can a family history of melanoma (abdominal) pain or become constipated for 3 or more days is pumped with a healthy dose • Heat prostration. Heat prostration (due to decreased sweating) can or severe, blistering sunburns during childhood or adolescence. Ask your doctor to occur when drugs, such as VESIcare, are used in a hot environment of vitamins B5 and E, dries on Tell your doctor if you have any side effects that bother you or that examine irregular moles, and make a thorough skin exam part of your regular checkups. BEST FOR FACE do not go away. contact (non-SPF formula pictured). These are not all the side effects with VESIcare. For more information, La Roche-Posay Anthelios ask your doctor, healthcare professional or pharmacist. How should I store VESIcare? 60 Ultra Light Sunscreen • Keep VESIcare and all other medications out of the reach of children • Store VESIcare at room temperature, 50° to 86°F (15° to 30°C). Fluid ($29.50) is made with a Keep the bottle closed • Safely dispose of VESIcare that is out of date or that you no longer need filtering system of avobenzone General information about VESIcare Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not use VESIcare for a condition for and octocrylene to protect which it was not prescribed. Do not give VESIcare to other people, even if they have the same symptoms you have. It may harm them. against both UVA and UVB

This leaflet summarizes the most important information about VESIcare. : Te d M orriso n If you would like more information, talk with your doctor. You can rays, while boosting photo- ask your doctor or pharmacist for information about VESIcare that is written for health professionals. You can also call (800) 727-7003 stability (the rate at which a toll free, or visit www.VESIcare.com What are the ingredients in VESIcare? sunscreen breaks down Active ingredient: solifenacin succinate Inactive ingredients: lactose monohydrate, corn starch, hypromellose under sunlight). 2910, magnesium stearate, talc, polyethylene glycol 8000 and titanium dioxide with yellow ferric oxide (5 mg VESIcare tablet) or red ferric oxide (10 mg VESIcare tablet) Rx Only Coppertone Oil Free Foaming Manufactured by: Astellas Pharma Technologies, Inc. Sunscreen Lotion SPF 75+ Norman, Oklahoma 73072 Marketed and Distributed by: ($9.99) is easy to apply over Astellas Pharma US, Inc. Deerfield, Illinois 60015-2548 facial hair, plus it’s noncom- Marketed by: a g e: J u l i en Ca pm e l/Ge tt y I m s ; bottom right GlaxoSmithKline edogenic (meaning it won’t Research Triangle Park

North Carolina 27709 opposit e p clog your pores).

May 2011 | WebMD the Magazine 71 Client Name: GSK - Vesicare This advertisement prepared by: Job No.: Euro RSCG Worldwide 0000034822_0000038275_M01 350 Hudson Street Caption: PI Page New York, New York 10014

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By Stephanie Watson, WebMD Contributing Writer

Worn out and weary, women across the country named fatigue among their top five health concerns of 2010 in WebMD’s annual Year in Health survey (the other four were period problems, “superfoods” best for nutrition, thyroid conditions, and sex and relationship issues). Here are seven of the biggest reasons you may be dragging, and ways to put the spring back into your step.

Illustrations by Scott Bakal

Reviewed by Brunilda Nazario, MD WebMD Senior Medical Editor

72 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 73 fatigue

Thyroid Problems daily D. If not, a supplement can get you with a mask on your face, CPAP can “really into another room and read or do another The thyroid—a little butterfly-shaped gland to the amount you need each day. The change your life,” Fryhofer says. relaxing activity for about 15 minutes, then in your neck—produces the hormones Institute of Medicine, which published go back to bed and try it again. that regulate how your body burns fuel new guidelines in 2010, recommends that Lack of Sleep for energy. It can be overactive or under- most adults get 600 international units a While juggling a job, family, and a million Depression active, but either way you’ll feel sleepy. day. For people 71 and older, the recom- other responsibilities, it’s hard to squeeze Depression and fatigue are both common in Why? “With an underactive thyroid you mended amount climbs to 800 IUs. At in the full seven to eight hours of sleep women, and the two conditions appear to can’t get your engine going. With an over- these amounts, you’re getting enough D you need each night. “A lot of women fuel one another. People who are depressed active thyroid your engine’s on overdrive to benefit your bones without overdoing have a very hectic lifestyle and don’t have a are more than four times as likely to be tired, and you start to burn out,” says Sandra it and causing kidney problems or other schedule that allows them to get sufficient and those who are fatigued are almost three Fryhofer, MD, clinical associate professor of side effects. sleep,” says Hadine Joffe, MD, MSc. Joffe is times as likely to be depressed. The stress and medicine at the Emory University School associate professor of psychiatry at Harvard worry that are hallmarks of depression can of Medicine in Atlanta. Iron Deficiency (Anemia) Medical School and director of research for keep you tossing and turning all night, and Thyroid problems are more common When your blood can’t carry enough oxygen the Center for Women’s Mental Health at if you drag through every day you’re bound in women, although doctors aren’t sure to your body, you’re bound to feel sluggish. Massachusetts General Hospital. to feel miserable. why. “That’s the big mystery. It may be “Anemia is more of a symptom than a related to genetics or hormones—we don’t disease,” Fryhofer says. It could be a sign that What to do: “You want to make sure when What to do: “Treating the depression will know,” says Hossein Gharib, MD, professor you’re losing too much iron in your blood you want to go to sleep you can sleep,” give you more energy,” Fryhofer says. Talk of medicine at the Mayo Clinic College of during your period, or you may be deficient Fryhofer says. Get into a calming bedtime to your doctor about how you’re feeling. Medicine in Rochester, Minn. in other vitamins and minerals. routine. Turn on soft music. Spray a whiff of He or she will want to know when your lavender on your pillow to help calm your symptoms began, how long they have What to do: Tests can reveal whether you What to do: See your doctor for a blood nervous system and encourage relaxation. lasted, and how severe they are. Together, need to take a manmade version of thyroid test to find out whether you’ve got an Sip a cup of chamomile tea, a fragrant flower you can then determine the best course of hormone to rev up an underactive thyroid, iron deficiency or other medical problem extract that some health experts believe helps treatment, which may include antidepres- or antithyroid medicine to calm down an that’s affecting your red blood cell count. ease anxiety. If you still can’t fall asleep, go sants, psychotherapy, or both. overactive thyroid. The solution could be as easy as taking an iron or B vitamin Heart Disease supplement. “We think it’s just a man’s disease, but it’s not,” says Fryhofer. In fact, heart dis- Sleep Apnea ease is a serious threat to women—more Your husband jokes that you serious than every type of cancer, includ- sound like a buzz saw when you ing breast cancer, even though many sleep, but snoring is no laughing matter. It could be a sign of sleep apnea, a condition that halts your Vitamin D Deficiency breathing over and over again “When your heart isn’t pumping efficiently, “There’s been an epidemic of vitamin D defi- throughout the night. Every time ciency over the last few decades because we’ve your breathing stops, your brain it can’t get enough blood out to your body, been avoiding the sun,” Volgman says. Other jolts you awake to restart it. “You reasons include having a milk allergy, follow- are never getting a restful sleep, and that can make you tired.” ing a strict vegetarian meal plan, and having so your body never has time darker skin (the pigment melanin reduces the to recuperate and recharge,” Fry- skin’s ability to make vitamin D from sun- hofer says. As a result, you end women believe cancer is a bigger concern. professor of medicine and medical direc- light). For some people, their digestive tract up feeling drained. According to the American Heart Asso- tor of the Heart Center for Women at Rush cannot absorb vitamin D well. For others, the ciation, nearly twice as many American University Medical Center in Chicago. kidneys have trouble converting the nutri- What to do: Being overweight women die of heart disease, stroke, and ent to its active form. And being overweight can put pressure on your airway other cardiovascular diseases as from all What to do: If you have heart risk factors makes vitamin D less available for use in the at night, which is why weight forms of cancer. such as obesity, high blood pressure, and body. Whatever the reason, too little of this loss is the prescription to help When your heart isn’t pumping effi- a family history of heart conditions, you essential vitamin can sap your bone strength, sleep apnea. To help you breathe ciently, it can’t get enough blood out to need to have your heart checked out. Mea- and some research links a deficiency of vita- more easily while sleeping, a your body, and that can make you tired. suring your blood pressure and other sim- min D to chronic fatigue syndrome. continuous positive airway pres- “Fatigue is one of the most common ple tests such as an electrocardiogram or sure (CPAP) device will keep air complaints of women with heart disease,” an echocardiogram can pinpoint whether What to do: A blood test can determine flowing into your airway. Once says Annabelle S. Volgman, MD, associate your heart is the source of your weariness. whether you’re getting enough of your you get the hang of sleeping

Why are you tired? Find expert snooze tips. WebMD.com 74 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 75 DIABETES diet Did you know? Did you know? IBS can be painful, but it does not damage the bowel or cause any other conditions. If you have diabetes, smoking makes you prone to gum disease, Head-to-toe especially if you’re Could you have IBS? diabetes checkup 45 or older.

Diabetes isn’t just a disorder of the pancreas—it also Plenty of people have trouble with their digestive can cause serious complications in other parts of your system—but it’s not always easy to figure out what body. That’s why it’s important to pay close attention you have. “I’m not quite sure how Irritable Bowel to your symptoms. “The pain in your foot could be Syndrome starts,” Anon_81297 wrote to the IBS neuropathy due to high blood sugar,” MrsCora01 support community, “but for about 2 or 3 months posted to a WebMD member in our diabetes uestions now I’ve had diarrhea after nearly every meal. It uestions community recently. “You should see your doctor.” Q for your doctor doesn’t matter what I eat, it all gives me diarrhea Q for your doctor Do you know these four ways diabetes can affect your about 10 minutes after eating.” Diarrhea can be a overall health? Should I see a diabetes educator to learn more symptom of IBS (as well as other conditions). Here are What types of things will trigger my symptoms? 1about body care? some other signs: 1How can I prevent this? Your Vision Get a dilated eye exam once a year. Diabetes can cause What kinds of things can I prevent? What steps  You have frequent abdominal pain. How does stress contribute to my condition? small blood vessels to leak into the retina, leading to 2should I take? 2What can I do about it? blurry vision and possibly blindness. Cataracts and  Your stomach feels bloated. glaucoma can develop, too. When I examine my body, what warning signs What dietary, fitness, and other lifestyle changes 3should I watch for?  Having a bowel movement relieves the ache or 3should I consider? Your Mouth discomfort. See your dentist twice a year. High blood sugar from dia- What tests do I need to check for diabetes What types of medications are available? Are they betes makes tooth and gum problems more likely. 4complications? How often?  How often you have a bowel movement has changed. 4right for me? Your Skin  The stool comes out lumpy and hard or loose Moisturize and check it often. Diabetes can cause your and watery. skin to become dry, itchy, and cracked. When the skin is injured, germs can enter and spur infection. get the 411: Diabetes  Having a bowel movement feels uncontrollably urgent, Get the 411: Diet difficult to pass, or unfinished. Sign up for the latest news Sign up for the latest news Your Feet Keep an eye on your feet. Diabetes can cause nerve dam- and lifestyle management  You notice mucus in the stool. and lifestyle management age and circulation problems, which in turn can lead to tips—delivered directly to tips—delivered directly to serious foot problems, such as infections that are slow to your email inbox! Go to your email inbox! Go to WebMD.com and search Answer: These problems are among the most common symptoms of IBS, WebMD.com and search for heal and, in extreme cases, amputation. Every day, check though everyone’s case is different—and may not indicate IBS at all, but your feet thoroughly for cuts, cracks, redness, swelling, for “diabetes newsletter.” some other digestive condition. Tell your doctor about any symptoms you “GI disorders newsletter.” sores, blisters, calluses, splinters, and other injuries. have. If you do have IBS, you can find relief with lifestyle changes and medications.

Source: Centers for Disease Control, the National Institute of Diabetes and Digestive SEARCHRCH SEARCHRCH and Kidney Diseases, the Agency for Healthcare Research and Quality, and the diabetes health Source: National Digestive Diseases Information Clearinghouse, the American College IBS Diabetes Health Center of Gastroenterology, and the Irritable Bowel Syndrome Health Center

76 WebMD the Magazine | May 2011 May 2011 | WebMD the Magazine 77 allergies DID YOU KNOW? Did you know? WebMD also provides tips and 17.7 million: tools to keep your pet healthy! the number of American adults who INSIDE have hay fever. 7.2 million check your top American allergy symptoms children also have this allergy. Talk of allergies is common this time of year—and some people have them worse than others. “My you’ll find: husband has suffered from seasonal allergies for the past 4 years,” jermanda23 posts in WebMD’s allergies • Information on pet community. “During the fall and spring, he will spend the entire season with symptoms like sneezing uestions symptoms and conditions constantly, eyes swollen and watery, and runny nose. Q for your doctor He can barely function.” Sound familiar? Take our quiz to find out if you have allergies, too. What is causing my allergy symptoms? What kind • Tried and tested solutions 1of allergies do I have? to pet behavior problems Nasal congestion What are my treatment options? What lifestyle  Never  1–2 weeks  2 months changes can I make? •  6 months  All year 2 From recalls to new Will allergy shots work for me? How often will I medications – the latest Runny nose need to get them? pet health news  Never  1–2 weeks  2 months 3  6 months  All year Will I need to take medications in conjunction with shots? • Ask a Vet: Access Itchy eyes or nose 4 experts in our WebMD  Never  1–2 weeks  2 months  6 months  All year Pet Health Community Red eyes get the 411: allergies  Never  1–2 weeks  2 months Sign up for the latest news  6 months  All year and lifestyle management Sneezing tips—delivered directly to  Never  1–2 weeks  2 months your email inbox! Go to  6 months  All year WebMD.com and search for “allergies newsletter.” Answer: If you marked two or more symptoms for more than one to two weeks out of the year, you may have an allergy. Talk with your doctor.

allergy basics SEARCHRCH Source: Guide to Allergies Health Center

78 WebMD the Magazine | May 2011 pain Did you know? WALK People with AS IF YOUR LIFE chronic pain are at risk for DEPENDS ON IT. Photograph by Jesse Dylan sleep disorders, depression, and drug abuse. WALK Painful truths BECAUSE SOMEONE’S Millions of people suffer from chronic pain in this Michael C. Hall country, and it’s not just the pain that hurts them. LIFE DOES. “Living with chronic pain can be so lonely at times,” Anon_153921 told the WebMD back pain community recently, “because if you have not suffered pain you Register at lightthenight.org really don’t understand.” How much do you know uestions to help in the ﬁght against blood cancers. about chronic pain? Take our quiz to find out. Q for your doctor The Leukemia & Lymphoma Society® is the world’s largest voluntary health agency dedicated to ﬁghting blood cancers. Learn more at www.LLS.org. ●1 Migraines and severe headaches are most common What is causing my chronic pain? Should I see among postmenopausal women. 1a specialist?  True  False Will medication, steroid injections, or surgery ●2 The shoulder is the most common site of joint pain. 2help my type of pain? HEART  True  False Are there alternative therapies that can help me? ●1 Most heart attacks occur suddenly, without warning.  True  False ●3 People with recent lower back pain are twice as likely 3What about exercise? to be psychologically distressed as those without back ●2 The medical term for heart attack—myocardial infarc- pain. Can counseling help me address pain-related tion—means “death of heart muscle.” emotional issues?  True  False 4  True  False 3 Women rarely have heart attacks. 4 Diabetes can cause chronic pain. ● ●  True  False  True  False Get the 411: pain ●4 You can have a “silent” heart attack. Answers: 1. False. These headaches are most common during women’s  True  False childbearing years. Migraines and severe headaches affect twice as many Sign up for the latest news Heart attack smarts Answers: 1. False. Most heart attacks begin with mild discomfort; half of women as men—21% compared to 10%. 2. False. Knees top the joint pain and lifestyle management list, followed by the shoulder, fingers, and hips.3 . False. The true number all people who are having a heart attack delay more than two hours before is higher. People with recent back pain are more than four times as likely to tips—delivered directly seeking attention. 2. True. When an artery that supplies fresh, oxygenated report serious psychological distress as those without back pain, according to your email inbox! Go blood to the heart becomes blocked, the starved heart muscle can die— to a 2006 U.S. government survey on the nation’s health. Back pain also Heart attacks can have a lot of symptoms beyond the and this defines a heart attack. The longer the blockage lasts, the more disrupts daily life. In the same survey, 28% of adults who reported low back to WebMD.com and crushing chest pain so often dramatized in movies. Take damage done. The sooner the blockage can be opened, the less damage pain said a chronic condition limited their activity, compared with only 10% search for “chronic pain the case of Aacro, a 22-year-old man who recently occurs. 3. False. Heart disease is the No. 1 killer of women older than 40. Women tend to get heart attacks later in life than men. 4. True. “Silent” of adults who did not report low back pain. 4. True. Diabetes can cause nerve newsletter.” posted in WebMD’s heart disease community. “I get damage that leads to chronic pain in hands, arms, feet, legs, and other areas. heart attacks, which most often affect the elderly, women, and people with these symptoms—chest pain all over, feeling like diabetes, tend to go unrecognized because they cause subtle pain or no something is in the middle of my chest (sorta burning pain. But they can still damage the heart muscle. Source: National Institutes of Health, the American Heart Association, and the pain relief SEARCHRCH feeling),…” he writes. “When I stand, my heart beats Source: Centers for Disease Control, the National Institutes of Health, and the Heart Disease Health Center Pain Management Health Center harder, increasing my pulse from 70 to over 100… Always just feeling like there’s something wrong with my heart.” Only a doctor can really tell Aacro what’s heart disease SEARCHRCH 80 WebMD the Magazine | May 2011 going on. How much do you know about heart attacks? sleep mind Dry Mouth? Did you know? Time-Released Relief During middle age, sleep patterns Day or Night! alter: We wake up more than in our younger years.

Do you have good Could your blues be depression? sleep habits? Anon_55577 is 22, married, and the mother of two. She loves her husband but, she says, “we are so utterly broke.” She feels guilty for schraderj4, a member of the WebMD sleep disorders not making more money, she’s losing weight, she has no energy, and she community, doesn’t have a problem falling asleep. Her doesn’t want to leave her house. “Am I possibly feeling depressed, or are problem, she posted recently, “is STAYING asleep! I these things that everyone deals with and just a part of becoming an • Works for Hours adult?” she asked the WebMD depression community recently. How much sleep for about an hour at a time, sometimes a little • Proven Effective more or less. It affects everything in my life now do you know about the symptoms of depression? as I am always tired, can’t remember things I’ve uestions • With Xylitol known for years, can’t concentrate on simple tasks.” Q for your doctor ●1 Depressed mood ●7 Feelings of guilt or worthlessness schraderj4 may have a problem with her sleep habits,  Yes  No  Yes  No also called “sleep hygiene.” Do you know how the What are some things I can do to improve following factors can affect your sleep? 1my sleep? ●2 Little or no interest ●8 Trouble concentrating in activities ●1 Do you watch TV, eat, or discuss emotional issues Do I have health or psychological problems that  Yes  No  Yes  No in bed? 2might be affecting my sleep?  Yes  No ●9 Thoughts of suicide 3 Sudden weight gain or loss (at or death What are the common types of sleep disorders? ● ●2 Do you drink fluids after 8 p.m.? least 5 pounds) 3Could I have one?  Yes  No  Yes  No  Yes  No 3 Do you smoke or drink alcohol before sleeping? Do I need to see a sleep specialist? What can I ● ●4 Change in appetite  Yes  No 4expect at that appointment? get the 411: mind OraMoist is a clinically  Yes  No Sign up for the latest news and proven, time-released patch ●4 Do you exercise before bedtime? that adheres inside the mouth 5 Trouble sleeping lifestyle management tips—  Yes  No ● and then slowly dissolves, delivered  Yes  No moisturizing for hours. The ●5 Does your pet sleep with you? Get the 411: sleep directly to patch releases xylitol, lipids and your email  Yes  No Sign up for the latest news ●6 Feeling tired or loss enzymes to lubricate the mouth. of energy inbox! Go to Each patch lasts for hours– Answers: If you answered “yes” to any question, you may need to improve and lifestyle management WebMD.com day or night. your sleep hygiene. 1. Use your bed only for sleeping or sex; associating it tips—delivered directly to  Yes  No with other activities can make it harder for you to fall asleep. 2. Stop drink- and search your email inbox! Go to Free Trial Sample ing fluids after 8 p.m. so that you don’t wake up to urinate. Don’t consume Answer: If you notice you have five or more of for “emotional caffeine in coffee, tea, sodas, or medications for six to eight hours before WebMD.com and search these symptoms for two weeks or more, and 800-448-1448 they are interfering with your life, talk to your wellness bedtime. 3. Nicotine is actually a stimulant. Alcohol may help you fall for “sleep well newsletter.” asleep, but it can disrupt your sleep. 4. Exercising regularly makes it easier doctor. You could have depression, and depres- newsletter.” Store Locator/Coupons to fall asleep and contributes to sounder sleep, but do it at least five hours sion can be treated. www.OraMoist.com before bedtime. 5. Keep pets out of your bed so they don’t wake you or trigger allergic reactions. If you improve your sleep habits and still don’t sleep well, talk with your doctor. Source: National Institutes in Oral Pain Aisle SEARCHRCH depression SEARCHRCH Source: National Sleep Foundation; the National Heart, Lung, and Blood Institute; and sleep of Health and the the Sleep Disorders Health Center Depression Health Center

82 WebMD the Magazine | May 2011 Your newborn and infant care WAITING ROOM COMPANION WebMD checkup 10 questions about your life and well-being BETHANY HAMILTON surfer It’s been more than seven years since you were attacked by a shark while surfing in your native Hawaii as a 13-year- webmd.com May 2011 old. Despite losing your arm, you’ve gone on to a career as a professional surfer, competing all over the world. Your autobiography recently hit the big screen in the movie Soul Surfer, where you’re played by AnnaSophia Robb and which also stars Dennis Quaid and Helen Hunt. Did you immediately know you had to get back to surfing, or did you worry you might have ridden your last wave? At first, my family and I were just grateful that I was even alive. It was kind of a miracle because I lost more than 60% of my blood. But I knew I wanted to try surfing again. I had a really good doctor and he encouraged me by saying, “There’s a long list of things you’ll be able to do, and a very short list of things you won’t be able to do.” And it’s true—there really aren’t many things I can’t do. What was it like when you got back in the water? Bottle I went out for the first time about two weeks after I got out of the hospital. Once I got up on the board and was riding, it came back naturally. It just took time and creativity to figure out how to paddle out with only one arm. ground You’ve been able to inspire people—especially young people—through your story. What lessons do you try to impart? We all go through hard times and struggles, and I just try to encourage kids that they can overcome those problems. Look what hap- Choosing the pened to me, and I still continued my dream of being a professional surfer. right one 90 What health condition would you like to see eradicated in your lifetime? Obesity. It’s an epidemic that’s taking over, and it leads to a lot of other diseases. I want to encourage the youth of America to eat healthier and exercise. A lot of schools are taking out PE, which is awful because it’s like taking away a big part of a child’s health. If you’re healthy, life can be so much more adventurous and fun and successful. Cry baby What is your best health habit? I have a lot, but my favorite is surfing. It’s a really good place to go where you can be strong and get exercise and sunshine. What her wails What’s your worst health habit? really mean 91 I consider myself pretty healthy. Let me see…for me, something unhealthy is some dark chocolate. Does that count?

Barely! You don’t ever crave a cheeseburger or french fries? I’ll have a couple fries if they’re cooked in good oil. I don’t eat hydrogenated oil or fast food at all. I like chocolate pudding, but I have this recipe that I make: I’ll get a packet of unsweetened acai and avocado and chocolate powder and blend that up with a little bit of honey and maybe a dash of mint. It’s really good.

What is your favorite part of your body? I don’t know! I guess I like my smile.

Are you excited about seeing your life story in a movie theater? Yes! I just saw the final finished product and it turned out amazing. It’s really Danica inspirational and something I hope people can relate to if they’re going through a hard time. And for people who haven’t been around the ocean much, you really experience the power and the beauty of it.

Are you scared of sharks now? I’m not that scared, actually. There are certain times when the water is murky or brown and no one is out on the ocean with me that it can get kind of eerie. But McKellar for the most part, I’m fine.—Julia Dahl The Wonder Years star and math maven on her family’s latest addition 88 Read Bethany Hamilton’s full interview. WebMD.com N amilto h

84 WebMD the Magazine | May 2011 Noah ask the experts Your questions answered

Feed Back Get the 411 on spitting, burping, and bottles

Q  What are some common bottle-feeding do’s and don’ts?

A  The main thing is to engage in lots of trial-and-error to be sure you find a bottle and nipple combination that works for your baby. Don’t stock up on too many of the same kind of bottle unless you know she is going to take it well. When you’re bottle-feeding, make sure milk is filling up the nipple. Otherwise, she could swallow a lot of air. One problem is the way parents position babies: Some lay them completely flat, which can make babies choke when feeding on the bottle. Be sure to have your baby semi- Q  My baby spits up a lot and also vomits after I feed inclined or upright. him. What causes this, what’s normal, and when do I Another common mistake is prop-

Gerber recommends breastmilk as the best start for babies. All trademarks are owned by Société des Produits Nestlé S.A., Vevey, Switzerland. © 2010 Switzerland. Vevey, Nestlé S.A., Société des Produits by owned All trademarks are as the best start babies. breastmilk for Gerber recommends need to worry? Did you ping the bottle. Don’t prop it—it can be know? a choking hazard. That is also why you A  After your baby swallows milk, it glides past the back of the should always be present when your baby throat into a muscular tube called the esophagus and then into the 6 months is is feeding, even when she’s old enough to stomach. Where the stomach and esophagus join, there is a ring of the average hold her own bottle. muscle called the lower esophageal sphincter that’s meant to prevent If an infant is going to burp, it will milk and stomach acid from coming up backward into the esophagus. age at which a usually happen in the first minute or two In babies, this sphincter doesn’t always work perfectly. If stomach con- baby’s mature after feeding. Still, some parents worry tents go back up into the esophagus, this is called “reflux.” hair begins to if their baby doesn’t burp, but Infants are especially prone to reflux. Their stomachs are small, grow in. That it’s OK. Some babies just don’t about the size of a golf ball, and the lower esophageal sphincter might burp very well, and some not tighten up when it should. And babies will occasionally take in hair she was don’t need to very often. A more than they’re ready to handle. born with is lot of babies will burp on Every baby spits up, or refluxes, occasionally. Some babies may spit temporary and their own, but for the up at least a little bit with almost every feeding. For most babies, these will start to first few months, most spit-ups don’t cause any problems. As long as your baby isn’t very do need a little help. fussy and is growing well, ordinary reflux episodes don’t need any shed at about If your baby hasn’t treatment. Typically, the lower esophagus valve tightens up sometime 1 month. burped and you feel t ura/Ma st er fi le; Pe Dazeley/Ge tt y I m a g e s in the first year, and spitting lessens. she needs to, put : C ul Reflux is called gastroesophageal reflux disease or GERD when Source: American Academy her in your lap in a of Pediatrics h. t o p t h. the spitting up is causing significant problems. GERD symptoms can sitting position and include pain and fussiness, breathing problems, and poor weight gain. tap her back gently. If your baby shows any of these signs, talk to your pediatrician. sw or t hryn Farn

Roy Benaroch, MD Jennifer Shu, MD

cover p ho t o b y C a WebMD Baby care EXPERT WebMD Baby care EXPERT Gerber® Good Start® Protect Plus® is a one-of-a-kind formula brand made with gentle whey protein and immune system supporting probiotics like those found in breastmilk. Find out more at Gerber.com. May 2011 | WebMDBaby 87

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“My goal was to do natural childbirth,” they need to eat a ‘perfect’ diet to make support and professional help to get over she explains. “But I didn’t know if it nutritious milk,” says Marianne Neifert, the initial hurdles: difficult latching, sore would [fully] go that way until the baby MD, a pediatrician, national breastfeeding nipples, low milk supply, and mastitis, was actually born.” McKellar gave birth expert, and author of Great Expectations: The a painful breast infection, all of which to her son, Draco—named for a constel- Essential Guide to Breastfeeding. “I like to keep McKellar had. Math whiz and lation in the sky—“on Labor Day” she it simple,” Neifert advises. “Maintain your If a woman can breastfeed, there are says, in a Los Angeles-area hospital under good eating habits from pregnancy while significant health benefits for both mother Wonder Years the supervision of a doctor, who happily you nurse, and keep taking and baby, says Neifert, including a lower worked with her doula. “I wanted Western your prenatal vitamins.” risk of ear infections, asthma, and type 1 star Danica medicine close…I wanted to be prepared, and 2 diabetes for babies, and a reduced just in case.” Feeding Time risk of type 2 diabetes as well as breast and McKellar McKellar’s reward, she says, for resist- McKellar used her own ovarian cancers for women, she says. adds a new ing an epidural (pain medication delivered advice to conquer her Still acting (McKellar has done TV through a needle inserted into the spinal initial challenges with guest spots on ABC’s How I Met Your Mother role to her cord, numbing the spinal nerves that cause breastfeeding. Her books and CBS’s The Big Bang Theory, and voices feeling in the lower body) was that she address the mental blocks an animated character on Young Justice for impressive was alert and mobile enough to “pull out that can stall potential math stars before Cartoon Network) even as she celebrates Draco myself.” When her baby was ready, they even attempt to solve that first equa- her third best-seller, she’s loving mother- résumé: mom her doctor invited her to sit up and “come tion. “So many girls say ‘I can’t do math’ hood so much that she and her husband and get him!” Beaming, she relates, “It before they even try it. They have to build are already planning for baby No. 2. was one of the most amazing moments their confidence and know that by sticking “The plan is to have them two and of my life.” with it, they can have success.” a half years apart,” she says, calculat- The same holds true for nursing, ing the optimal time between siblings. Natural Selection McKellar believes. Some women and Which means, if you do the math, she’ll McKellar, 36, says she’s a firm believer babies face physical challenges that make be pregnant again this time next year. that “every woman has an inner sense it impossible, while others simply need Stay tuned. that guides her” when it comes to pregnancy, labor, and breastfeeding, and “that we should never judge another woman’s choices.” She says that a strict approach to nutrition before and after birth, the goal of natural labor, and exclusive I kept thinking breastfeeding for at least six months was right for her. about what I tell After a miscarriage in October 2009, Plus One McKellar and husband, composer Mike my readers about Verta, decided to keep mum when she found herself pregnant again just months their abilities in “During the toughest moments,” later—even when Maxim magazine asked Do natural childbirth and the quadratic McKellar tells WebMD of her 36-hour her to do a sexy lingerie shoot timed to math, and it reso- equation share a common denominator? labor, “I kept thinking about what I tell my when she was 11 weeks along. “I wasn’t readers about their abilities in math, and really showing yet, but I couldn’t suck in nated with labor, It just might be Danica McKellar, the former child actress who it resonated with labor, too: You’re more my stomach,” she laughs about the photos. first stole hearts as Winnie Cooper on the late ’80s hit show The capable than you think you are.” “Let’s just say no one asked me if I’d had too: You’re more Which is not to say McKellar didn’t any work done,” she adds, referring to her Wonder Years before carving out a new niche as a math advocate struggle, like many girls do as they tackle suddenly swollen breasts. capable than you for girls with three best-selling books: Math Doesn’t Suck: How to algebraic problems just as puberty hits, as Her discipline translated to other areas: she rode out one painful contraction after She gave up sugar, white flour, gluten, any- think you are. Survive Middle School Math Without Losing Your Mind or Breaking a Nail; Kiss another. She faced moments where she thing artificial, caffeine, and alcohol during My Math: Showing Pre-Algebra Who’s Boss; and Hot X: Algebra Exposed. wanted to quit. With the support of her pregnancy and continues with the same doctor, her husband, and her doula (birth diet now that she’s breastfeeding. By Lauren Paige Kennedy, WebMD Contributing Writer coach) and the practice of self-hypnosis, But not every woman needs to follow Photography by Cathryn Farnsworth she got through her long labor. McKellar’s choices. “Many women think

Know what to expect. Sign up for Baby’s First Year newsletter. WebMD.com

88 WebMDBaby | May 2011 May 2011 | WebMDBaby 89 baby care Reviewed by Reviewed by Louise Chang, MD Hansa Bhargava, MD WebMD Medical editoR WebMD Medical editoR

Bottle Recap How to Cry Baby choose the By Wendy Fries, WebMD Contributing Writer What her wails really mean, and When to call the doc Sometimes crying is a sign of true When it comes to baby bottles, nipples, bibs, and more, the array of right one for how to soothe her like a pro illness. That’s why a doctor should choices facing new parents can be confusing: Should you go with examine a baby that you just can’t your baby soothe. “Babies don’t have strong glass, plastic, or disposable bottles? Should bottles be BPA-free? Do By Susan Davis, WebMD Contributing Writer immune systems and can get very you need a bottle warmer and sterilizer? We cover the essentials. All babies cry. It’s a basic way of communicating their wants and needs. But for sick very fast,” Karp says. “And the younger they are, the less prepared many new parents, a crying baby can be frustrating and heart-rending. Fortu- their immune systems are to fight off Bottles nately, parents can do a lot to help their little ones calm down and be happy. infection. It’s always better to be safe Which should you choose? Ask for advice numbers 1 to 6 on the bottom, or choose than sorry.” from friends, family, or your baby’s pedia- glass baby bottles. In 2009 the top six To start, think of your newborn as not spells (usually for three hours or more). trician, or try several kinds to see which manufacturers of baby bottles in the United entirely ready to be out of the womb. “I Other symptoms of colic include crying Warning signs of illness you and your baby like best. There are three States agreed to stop using the chemical in believe the key to understanding babies that worsens in the evening, a worried or include: basic choices of baby bottles: their bottles. The FDA supports the indus- is to recognize that they come into the pained look on the baby’s face, and crying ■ Rectal temperature try’s actions to stop making BPA bottles for world three months before they’re fully that starts during or after a meal. of 100.4˚F or more Glass the U.S. market. ready,” says Harvey Karp, MD, an assistant But even a colicky baby who seems to Pros: Glass bottles last a long time and can professor of pediatrics at the USC School be screaming in pain can be soothed, Karp ■ Rash also be deep-cleaned by boiling. Nipples of Medicine and author of The Happiest Baby notes.“Crying doesn’t necessarily spell cri- ■ Cough, congestion or Cons: They’re heavier than plastic and may Baby bottle nipples are usually rubber or on the Block. sis. The vast majority of fussy babies are breathing problems shatter if dropped. silicone and may be rounded, wide, flat, or “That’s why a big part of soothing your just homesick for the ‘5 S’s’ that constantly shaped to mimic mother’s nipple when in baby—and getting some extra sleep your- calm them in the womb.” ■ Vomiting and/or diarrhea Disposable baby’s mouth. Depending on the size of the self—is giving at least three months, a fourth Here are Karp’s 5 S’s—things you can ■ Blood in the urine or stool Pros: These are essentially reusable plastic nipple hole, they also have different flow trimester, of extra rocking and touch.” do to imitate the environment in your bottles that use a disposable sterilized liner rates, from slow to fast. Once you’re equipped with that per- womb and trigger your little one’s calm- ■ Not looking well or not for each feeding. They’re very convenient As with baby bottles, babies may show a spective, the next step to soothing a fussy ing reflexes. feeding well for quick cleanups. preference for a certain nipple type. To get baby is figuring out what’s making him Swaddling: Wrapping your baby Cons: The disposable inserts may not be started, ask friends, family, and your baby’s or her cry. Learn to recognize these clas- snugly in a blanket is “the cornerstone of environmentally sound, and the bottles are doctor which types and brands they like sic signals: calming,” Karp says. The arms should be usually more expensive than regular plastic most. • Opening the mouth and turning the head snug and straight; the hips should have or glass. Plan on buying at least 12 nipples and from side to side is a sign of hunger in a some wiggle room. covers, but because nipples crack and leak Don’t sterilize glass young baby. Side or stomach position: Babies should Plastic with use, you may end up buying more baby bottles and nipples • Yawning, blinking, and drooping eyelids always sleep on their backs. But to soothe a Pros: Plastic bottles are lightweight, strong, over time. before every use. (That was neces- can be signs of fatigue. baby, hold her in your arms either on her and unbreakable. • Looking away is often a sign of overstimu- stomach or resting on her side. sary in the past, when municipal Cons: They may not last as long as glass; Bottle Gear lation. It means “I need a little break.” Shushing: White noise can be a young safety concerns have been raised about plas- Bottles and nipples are just the beginning; water supplies were not as reliably • Frowning, grunting, and straining can be baby’s best friend because the noise in the tic bottles that contain bisphenol A or BPA. manufacturers offer a big assortment of clean as they are now.) Do, how- signs of gassiness or needing to poop. womb is “as loud as a vacuum,” Karp notes. The National Toxicology Program feeding accessories, from brushes and bottle ever, sterilize new glass baby bottles If you’ve ruled out these problems and Try making a loud and steady “shhhh” noise released a report in 2008 that noted “some carrying cases to sterilizers and special dish- and nipples by putting them in your baby is still fussy, you may have a to calm your baby. concern” about BPA’s potential effects on washer bottle baskets. boiling water for five minutes. more serious issue on your hands. Swinging: Whether it’s bouncing or the brain, prostate gland, and behavior of Pediatricians and parents generally agree Babies who cry loudly for several hours something slower, rhythmic motions rep- fetuses, infants, and children. that it’s helpful to have: a day may have “colic,” which can start licate movement in the womb. Remember If you want to buy BPA-free baby bottles, • 1 baby bottle brush Do replace a plastic baby bottle around two weeks of age and end at three to be gentle when using motion to soothe. steer clear of bottles with the number 7 or • 1 nipple brush if it’s cracked, leaks, is discolored, or four months. Although associated with Sucking: Mouthing a nipple, pacifier, or the letters PC (polycarbonate) on the bot- • 6 to 12 bibs or smells bad. abdominal discomfort, “colic” in babies clean finger helps many babies settle into

tom. Instead, buy plastic bottles with the • 12 burp cloths te d m orriso n And erso n R oss/Getty Im a g es refers simply to daily, extended crying deep relaxation.

What are the must-have diaper bag essentials? WebMD.com Have a new-parent question? Visit the Health & Baby center. WebMD.com

90 WebMDBaby | May 2011 M3272_M3347_A_V1.indd 1

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