PAGE A GOOD DEATH: RETHINKING END OF LIFE 44
OCTOBER WEBMD.COM 2018
TEENS AT CUTTING-EDGE RISK: WHAT IS DRUNKOREXIA? COSMETIC PAGE 30 PROCEDURES PAGE 20 THE HEALING MAKE EVERY NIGHT POWER TACO TUESDAY PAGE 51 OF LIGHT THERAPY PAGE 40 ‘GIRL, YES’ TIFFANY
HADDISHON THE POWER OF POSITIVE THINKING PAGE 34 WEBMD MAGAZINE Contents OCTOBER 2018
FEATURES 34 Positively Hilarious Tiffany Haddish on the power of therapy
40 Healthy Glow Light therapy might have potential as a “If I focus treatment option for several conditions on positive
44 thoughts and A Good Death Looking at dying attitudes, and the end of life in new ways then it’s least likely I’ll fail.” TIFFANY HADDISH PHOTOGRAPHY BY: SMALLZ & RASKIND/GETTY IMAGES RASKIND/GETTY & SMALLZ BY: PHOTOGRAPHY
1 WEBMD.COM WEBMD MAGAZINE Contents OCTOBER 2018
CANCER UPDATE
12 Men’s Health How risks associated with women also endanger men
14 Fitness Smarts Exercise may reduce treatment side effects, lower recurrence risk, and extend survival
26 Parenting How to tell your kids you have cancer
31 Pets Spot the warning signs of cancer in your dog or cat
56 On the Horizon The latest news in cancer research
61 Quiz Are you up to speed on advancements in breast cancer? GETTY IMAGES
2 WEBMD.COM WEBMD MAGAZINE Contents OCTOBER 2018
15 33
NEW HOPE FOR 16 PEOPLE WITH DEPRESSION PG 55 50 CHECKUP 55 Cutting Edge | The latest research on mental illness
58 Who’s Who? | On the job with LIVING pediatricians 59 By the Numbers | Facts and stats 11 Spousal Support on oral health Are you tuned in to your partner’s feelings? 60 Health Highlights | Tips for the cold and flu season 15 Mind Matters How negative self-talk can affect your health 16 Women’s Health When to avoid sex 28 In Every Issue 4 EDITOR’S NOTE BEAUTY FAMILY FOOD 6 UPFRONT News about research 17 Healthy Hair 24 Early Interaction 49 Good for You on teens and marijuana, Get a quick fix for A surprising way to Roast Brussels sprouts new diagnostic gray roots boost your child’s for hearty and healthy 62 techology, and more 62 TAKE 10 18 Expert Picks language development fall meals Actor Andy Serkis on An arsenal of 27 Pregnancy 50 Build a Better Mowgli, his work with at-home treatments What’s safe to do when Tips for mastering children, and why 19 Derm Q&A you’re pregnant vegetable soup he’s excited about the next generation Check out the lastest in 28 Baby 51 3 Ways: Tacos hair-removal options Get the scoop on Dress up this 20 Beauty Smarts infant eczema kid-friendly favorite Innovative treatments 30 Teen Health 53 Root Vegetables 101 On the Cover for hair loss, wrinkles, What you should know Get the scoop on PHOTOGRAPHY BY: and skin texture about drunkorexia beets, sweet potatoes, ELTON ANDERSON, JR. 23 Anatomy Of . . . 25 Kids’ Health and more What’s in hair mousse? Beware of apps that may be tracking kids
3 WEBMD.COM EDITOR'S NOTE
FROM THE WEBMD TEAM WHAT PROMISING ADVANCE IN CANCER TREATMENT ARE YOU MOST EXCITED ABOUT?
John Whyte, MD, MPH, WebMD Chief Medical Officer
The use of real- world evidence driving outcomes— in real time. Instead Brenda of waiting days and weeks Goodman, for treatment response, new tools WebMD Senior will figure out the right dosing and News Writer correct treatment regimen for each patient. And this will minimize Cancer dreaded side effects. diagnosis and treatment used to be based on location. If you ver the years, the ability to both Arefa Cassoobhoy, had a tumor in test for cancer and treat the MD, MPH, your breast, for disease has greatly improved. WebMD Senior example, you got O Medical Editor As a result, more people who get cancer breast cancer are living longer. From immunotherapy I’m excited about drugs to treat it. to precision medicine, you can read the recent firsts in More and more, about some of the latest cancer break- genetics research though, doctors are sequencing throughs in our Checkup section in this translating to cancer treatment. Now with gene therapy, immune cells can be the genes issue (page 55). Despite the advances, of tumors to there is so much more research that genetically altered to attack cancer cells. Another treatment fights cancer more precisely needs to be done, and it takes time. That based on the genetics of the cancer diagnose and said, there have been great strides and cells rather than location. In the future, treat them. The the future of cancer research is hopeful. we’ll see more patients benefit from ability to This month, we asked WebMD journalists these kinds of therapies. match cancer- and physicians what promising advance killing drugs to in cancer research most excites them. specific genetic changes is Correction: In the September 2018 cover story about exciting and Kristy Hammam Sonequa Martin-Green, we misspelled the name of Editor in Chief her Walking Dead co-star Lauren Cohan. We regret potentially life- [email protected] the error. saving.
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WebMD Magazine is distributed to doctors’ offices throughout the U.S. and online at WebMD.com. WebMD Magazine is not responsible for advertising claims. WebMD Magazine (ISSN 1553-9946), Vol. 14, No. 7, is published by WebMD LLC and may not be reproduced in whole or in part without written permission of WebMD LLC. All editorial content is reviewed by our board-certified physicians, is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. WebMD does not endorse any specific product, service, or treatment. Always seek the advice of your health care provider with any questions regarding a medical condition and never disregard professional medical advice or delay seeking it because of something you have read in WebMD Magazine. If you think you have a medical emergency, call your doctor or 911 immediately. © 2018 WebMD LLC. All rights reserved. TIMELY TOPICS Upfront NEWS YOU CAN USE
CANCER The Path Ahead First, there’s reason to cheer: Cancer deaths are on the decline thanks to earlier detection, better treatments, and fewer Americans smoking. However, we’re still a long way from putting this deadly disease into the annals of history where it belongs.
1.7 729,000 266,000 Number of cancers diagnosed in 2018 that Number of new breast cancer diagnoses $ million could have been prevented if more people in 2018, making it the most common 80.2 billion Number of new cancers that stopped smoking, lost weight, exercised, type of cancer among women. Prostate Amount of money Americans spent on will be diagnosed in 2018. ate more nutritious foods, and practiced cancer is the most common type in men, cancer treatments in 2015.
GETTY IMAGES other good health habits. with 165,000 new diagnoses this year.
6 WEBMD.COM UPFRONT
IN THE NEWS A Better Death
When you think about it, the way death and dying are not a big part of American conversation is a little strange. After all, probability is a solid 100%, but most of us tend to shy away from end-of-life topics. That is starting to change. More people are determined to speak up, plan, collaborate, and get in front of their own demise instead of chancing the outcome so common to so many: Dying away from home, in a hospital,
COLLEEN PARETTY hooked up to machines, enduring invasive treatments that may not help Editorial Director and only prolong the inevitable. The idea of a “good” death is here, in state colleen@ webmd.com legislatures, in medical facilities, even in “death cafes,” where friends, family, and strangers meet to discuss this once-taboo topic. “The more we talk about it early, the less scary it becomes,” notes one expert we spoke to. Explore “A Good Death” on page 64, and then take a seat at—or start up—a death cafe near you. Let me know what happens. —
TOO MUCH BEEF? In a 22-year study of 2,441 men ages 42 to 60, those who ate the most protein— mostly from meat—had the highest risk of heart failure. Risk increased among men who ate 97 grams—that’s the amount of protein in nearly 14 ounces of ground beef—or more per day. Daily protein needs are based on weight and physical activity. You need about .8 grams of protein for each kilogram of body weight. So, a 200-pound sedentary man needs 73 grams per day. You’ll get that in about 10 ounces of ground beef or 8.5 ounces of chicken breast.
SOURCE: Circulation: Heart Failure
Fight the Resistance Headway in the fight against antibiotic 30,000 resistance: Prescription rates are down NUMBER of fatal falls among older adults from 8.4% of all children’s prescriptions in in the last year. Staying active 2002 to 4.5% today. You and your children can help maintain balance and lower fall risk. should only take antibiotics for bacterial, SOURCE: CDC not viral, infections.
SOURCE: JAMA GETTY IMAGES
7 WEBMD.COM UPFRONT
PIGMENT PREDICTIONS Scientists have discovered 124 new genes that determine hair color. The finding can advance research into diseases, such as melanoma, that affect people differently based on pigmentation.
SOURCE: Nature Genetics Follow-Up Facts Millions of people get concussions, or Arlington, Virginia’s mild traumatic brain rank among the nation’s injuries, every year, yet healthiest cities; it has the lowest smoking rate only about half receive and highest self-reports the necessary follow- of excellent health. At the up care to check for bottom of the list: possible long-term DRUG OF CHOICE Toledo, Ohio. physical, psychiatric, SOURCE: American College of and cognitive problems. More kids than ever now Sports Medicine # stay away from smoking If you are diagnosed with a concussion, and drinking, according to 1 ask your doctor about a survey of 275,559 young follow-up care.
people ages 12 to 21. Almost SOURCE: JAMA half of the people surveyed said that they don’t drink or smoke anything. But among those who do, the number who try marijuana before tobacco and alcohol is rising MAN VS. MACHINE Do you have annual skin checks in which a doctor fast. In 2004, one in 20 kids inspects your moles for signs of melanoma? One tried pot first. Today, that day, the doctor might snap a few pics and feed number has nearly doubled them into a machine to get your results. Researchers to one in 12. That’s important taught a computer to recognize melanoma by showing it more than 100,000 photos of either because kids who try malignant melanomas or benign moles. When the marijuana before booze and researchers pitted the trained machine against 58 cigarettes are more likely dermatologists from around the world, the computer to become heavy users or caught 95% of the melanomas while the live dependent on the drug. experts identified just under 89%. SOURCE: Annals of Oncology SOURCE: Prevention Science GETTY IMAGES
8 WEBMD.COM UPFRONT
THE LOW-ALCOHOL EFFECT Beware of wine and beer labels touting low-alcohol levels. Researchers asked 264 regular drinkers to taste-test wines and beers with regular, low-alcohol, or super-low-alcohol labels. The lower the listed alcohol content, the more the taste-testers imbibed.
SOURCE: Health Psychology
DIET AND BREAST CANCER 48 A low-fat diet could help fight breast cancer. Researchers followed 48,835 postmenopausal women for eight years. The ones who ate a diet rich in million fruits, vegetables, and whole grains and got only 20% of their calories from NUMBER fat were 8% less likely to develop breast cancer than the women who ate of Americans who contract a food-borne their usual diet. Low-fat dieters who did develop breast cancer outlived illness each year. Rigorous hand-washing, their usual-diet peers. They were also less likely to die from any cancer or proper food storage, kitchen cleanliness, and heart disease. Ten years after breast-cancer diagnosis, 82% of the low-fat checking restaurant grades help reduce risk. dieters were still living compared to 78% of their counterparts. SOURCE: C.S. Mott Children’s Hospital
SOURCE: JAMA Oncology
SCANS FOR SMOKERS Lung cancer is the leading cause of cancer death. An estimated 154,040 people will die from it this year. Yet less than 2% of current or former heavy smokers get recommended lung cancer screenings. The United States Preventive Services Task Force recommends that people ages 55 to 80 years old who have smoked at least 30 pack-years—that’s the number of packs smoked per day multiplied by the number of years smoked—have a lung CT scan.
GETTY IMAGES SOURCE: American Society of Clinical Oncology
9 WEBMD.COM UPFRONT BYE-BYE, BULLY Bullying can do long-lasting their peers to show signs of damage. Researchers followed eating disorders and signs of 50 600 kids for five years from the depression. Parents should seventh grade to the eleventh. take action right away to million The ones who reported being address bullying and its long- NUMBER bullied at any time during the term consequences. of people who have dementia worldwide. study were more likely than SOURCE: JAMA Psychology
SOURCE: Psychological Medicine
PATIENT PORTAL
DIRECT LINE Many doctors offer a smartphone app or online patient portal that provides quick and easy access to your doctor and your health Fish Fight Heart Disease records. But older adults, the Two 3.5-ounce servings of fish each week may ward off heart people who may benefit the most disease. Go for oily ones with omega-3s. Think salmon, albacore from a fast-track to their health tuna, mackerel, lake trout, herring, and sardines. care providers, don’t seem to take SOURCE: Circulation advantage of these tools. A recent study found that only about half of adults ages 50 to 80 set up an account on an online patient portal when their health care provider offers it. The top reason for avoiding the portals was concern about handling health information online.
SOURCE: University of Michigan Institute for GETTY IMAGES Healthcare Policy and Innovation
10 WEBMD.COM GETTY IMAGES HEALTHY HABITS Do youDo when know blue? feels your spouse Mind the Gap the Mind Living even in a long-standing relationship, inalong-standing even instead they assume everything isall assumeeverything they instead University showsthat couplesdon’t your partner’s mood,pay attention. WHEN YOU LIVE WITH SOMEONE FOR partner’s emotionalstate. Arecent right. Missing these cues dayright. Missing after these cues pick up on subtle everyday signals pick uponsubtleeveryday think alike. You begin mighteven Learn how to read the signs. the signs. how read to Learn day couldgradually damage your relationship. To stay intunewith to lookalike, researchshows.Yet Assume less and listen more,the lessandlisten Assume their spouseissadordown,and study fromSouthernMethodiststudy authors say. you may notbe attuned toyour any to length oftime,youstart SPOUSALSUPPORT —STEPHANIE WATSON
MEANINGFUL CHANGE WEBMD.COM 11 12 WEBMD.COM Cancer risks commonly associated with women also endanger men endanger women also with associated commonly risks Cancer WatchCancer MEN’SHEALTH WebMD.com./findadoctor. Physician Finder. WebMD’s Use adoctor? for Looking mine if they had genetic mutations hadgenetic linked tocancer.mine ifthey Suchmutations In 2015, about 2.5 million people in the U.S. testing to deter underwent among men and the medical professionals who treat them. among menandthemedicalprofessionals whotreat them. women. New research,however, shows that bothshouldraise redflags andovarianto breast cancerareriskscommonly associated with THE HUMAN PAPILLOMAVIRUS (HPV) AND DNA MUTATIONS LINKED BREAST AND PROSTATE CANCER
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13 BY Sonya Collins LIVING REVIEWED BY Michael W. Smith, MD, CPT Search for the article Your WebMD Chief Medical Editor Cancer Recovery Wellness Plan on WebMD.com.
FITNESS SMARTS Work Out Your Cancer Care Plan New research shows how exercise may reduce treatment side effects, lower recurrence risk, and extend survival
Among women with breast cancer, those who exercise the most are least likely to die from the disease, research shows. “The studies include a variety of breast cancer stages, but particularly advanced breast cancer, and the more exercise you did, the longer you lived,” says Master. Women whose physical activity is equivalent to about three to five hours of walk- ing each week got the greatest survival benefit. When people with colon cancer walk about five hours a week at a normal pace—or do other exercise of the same intensity—they are 35% less likely to die from that cancer than people with colon cancer who don’t exercise. “When you look at people of the same age, stage, and tumor status, the person who exercised lived longer,” says Master. In a study of 2,705 men with prostate cancer, men who did vigorous activity—think ARE YOU IN TREATMENT FOR CANCER? EXERCISE SHOULD BE PART OF YOUR jogging, swimming, biking—for three or more treatment plan, says a recent report from the Clinical Oncology Society of hours each week were 61% less likely to die of Australia. People who have a cancer diagnosis should avoid inactivity and prostate cancer than those who exercised less progress toward 150 minutes of moderate aerobic exercise and two to three than an hour a week. Prostate cancer survivors moderate-intensity resistance exercise sessions each week. who walked briskly for three or more hours a “Exercise makes people feel better and have less fatigue, less depression, and week had a 57% lower risk of recurrence than fewer side effects from their therapy, and it might actually augment the effects survivors who walked less than three hours at of therapy to help patients live longer and better lives,” says Viraj Master, MD, an easy pace. director of the Urology Clinical Research Unit at Winship Cancer Institute of “The strongest benefits of exercise are in the Emory University in Atlanta, Georgia. The report adds to growing evidence of top cancers in the U.S. today,” says Master. “It the benefits of exercise before, during, and after cancer treatment, especially for seems evident that in other cancers we will three of the most common cancers in the U.S. today: breast, colon, and prostate. also see these benefits.”
4 Tips START EARLY DON’T OVERDO IT LISTEN TO YOUR BODY STAY SAFE YOUR CANCER Begin an exercise If you’re new to exercise, “If you’re fatigued from Certain kinds of cancer TREATMENT PLAN program before start out slow and easy and chemo and after five treatment can weaken your COULD BRING BETTER any planned build up, whether that means minutes at the gym, immune system. If you’re RESULTS WHEN IT surgery. “If we can walking at a slower speed or you’re even more getting treatment during flu INCLUDES EXERCISE. ‘pre-habilitate,’ not a shorter distance or using fatigued or start to feel season, that might not be a VIRAJ MASTER, MD, rehabilitate, before lighter weights. “The best faint, that’s not the time good time to go to the gym SUGGESTS SOME WAYS surgery, it is quite thing you can do is to start, to up the incline and the where other people may be TO DO THAT. likely you’ll do well,” and starting anywhere is OK,” speed on the treadmill,” sick. Work out at home for
GETTY IMAGES Master says. says Master. says Master. a while.
14 WEBMD.COM BY Sonya Collins LIVING REVIEWED BY Patricia A. Farrell, PhD Search for the article WebMD Medical Reviewer What Is Positive Thinking? on WebMD.com.
MIND MATTERS Easy Does It People who show themselves some love have better health overall
and may include name-calling, like, ‘I’m a mean mom,’” says Neff. That’s the kind Soothe Yourself you want to avoid. Positive self-talk can Self-compassion, on the other hand, is lower stress levels. about cutting yourself some slack. A self- compassionate response to losing your patience with your child could include phrases such as, “I’m under a lot of stress. What can I do to take care of myself right now? All parents lose their patience with their children sometimes. That doesn’t make me a bad mother.” When you replace criticism with a little love, you could see a range of health benefits. Research shows that self- compassionate people report fewer signs of depression and better overall physical health. They are also more likely to practice healthy behaviors, such as getting enough sleep, that can lead to better health. When people learn self-compassion, practicing it improves several markers of good health. First, levels of cortisol in the saliva—a sign of stress that can be a precursor to inflammation and disease—drops. At “I’M SO FAT.” “I’M A TERRIBLE MOTHER.” “I STINK AT MY JOB.” CHANCES ARE, YOU’VE the same time, immunoglobulin A in the hurled one of these—or worse—insults at yourself at some point. Sure, you have high saliva—a hallmark of a healthy immune expectations of yourself. But did you know that putting yourself down could take a system—rises. What’s more, the act of self- toll on your health? compassion seems to increase heart-rate “When we attack ourselves, [stress] levels go up and we have an inflammation of the variability, which is an indication that the immune system,” says Kristin Neff, PhD, co-author of The Mindful Self-Compassion body is relaxed rather than under stress. Workbook. That’s why, Neff says, self-compassion, rather than self-criticism, is the If it feels strange to talk to yourself this healthier choice. way at first, Neff assures, “it comes more Harmful self-criticism isn’t constructive. “Constructive criticism is ‘I could have naturally to some people than others, but spoken more kindly to my child,’ while unconstructive self-criticism is judgmental it’s definitely a learnable skill.”
4 Steps TAKE NOTICE BE KIND KNOW YOU HAVE COMPANY KEEP PERSPECTIVE NOT EVERYONE HAS A “Notice your self- Self-critical state- When you’re self-critical, Remind yourself that NATURAL TENDENCY TO talk,” Neff advises. ments, such as “I’m you tend to think you are the even though you’re SHOW THEMSELVES LOVE, “Is that the way you fat,” are judgmen- only one who’s made this struggling, it’s not BUT ANYONE CAN LEARN, would talk to a close tal. Self-compas- mistake or has this flaw. “The the end of the world. SAYS KRISTIN NEFF, PhD. friend who is feeling sionate ones, such self-compassionate person bad about herself?” as “losing weight is says, ‘Everyone struggles. It’s
GETTY IMAGES hard,” are kind. not just me,’” says Neff.
15 WEBMD.COM BY Stephanie Watson LIVING REVIEWED BY Brunilda Nazario, MD Search for the Women’s WebMD Senior Medical Editor Health Message Board at WebMD.com
YOU HAVE A HIGH-RISK PREGNANCY As long as you have a normal pregnancy, you can have sex all the way into your ninth month, Turan says. However, the advice is different if you’re at risk for preterm labor. Sex triggers the production of prostaglandins— hormones that can cause contractions.
YOU’VE RECENTLY DELIVERED After childbirth—whether you deliver vaginally or via C-section—your body needs time to heal. Generally, that takes a few weeks, but your doc- tor can tell you how long to wait. Even if you’ve been cleared for sex, the drop in estrogen after delivery and during breastfeeding can dry out your vagina and make sex more painful. Hold off on intimacy for a few extra weeks, or use a lubricant, Turan says.
YOU HAVE AN INFECTION When you or your partner have an STD like WOMEN’S HEALTH chlamydia (in women) or gonorrhea, bacteria can travel from your vagina into your uterus and other reproductive organs during sex and Unsafe Sex cause pelvic inflammatory disease (PID). “And, Sex is a healthy part of any relationship, but sometimes it’s if you don’t use a condom, you could infect your not a good idea partner,” Turan says. Hold off on sex if you or your partner have symptoms of an STD. TIMING IS EVERYTHING WHEN IT COMES TO MAKING LOVE, AND ASIDE FROM NOT being in the mood, sex can be unsafe or unwise in certain cases. Here are five YOU’VE RECENTLY HAD SURGERY times when you should abstain. Your doctor will advise you to delay sex after any procedure involving your belly or YOU HAVE A GYNECOLOGIST APPOINTMENT THE NEXT DAY reproductive organs. After a hysterectomy, Having sex the night before your annual visit can inflame your cervix and make Turan tells his patients to wait at least eight your Pap test results harder for your doctor to interpret. “Also, sometimes it’s weeks until they fully heal. difficult to see the cervix because there’s semen in it,” says Ozhan Turan, MD, When deciding whether it’s safe for you to associate professor of obstetrics and gynecology and director of the Division have sex, “the most important thing is to be of Maternal and Fetal Medicine at the University of Maryland School of aware of your body,” Turan says. Pay attention Medicine. He suggests that you use a condom or avoid sex 24 hours prior to to warning signs like bleeding and pain, and use your appointment. them as a guide to call your gynecologist.
Q Am I at risk for Q How do I know if I Q What should I do Q What if I’m never an STD? have an infection? if sex hurts? in the mood? Having unprotected sex— Abnormal bleeding, Many factors can lead to Everyone loses desire once especially with multiple foul-smelling discharge, and painful sex, from endometri- in a while, but if you’re per- ASK YOUR partners—increases your painful sex are some of the osis to vaginal dryness. For sistently uninterested in DOCTOR odds of getting an infec- signs of an infection that vaginal dryness, a lubricant sex and it affects your rela- tion. If you’re not in a mo- should put your sex life on can make sex more comfort- tionship, you might have a nogamous relationship, hold and prompt you to see able, but still see your doc- problem that needs to be consider using condoms. your gynecologist. tor to check for treatable treated. Talk to your doctor GETTY IMAGES medical causes. about treatment options.
16 WEBMD.COM BEHIND THE SCIENCE Beauty INSIDE OUT
HEALTHY HAIR Get to the Root of It Keep dyed roots bold and beautiful until your next salon appointment. Here’s how.
NO ONE WANTS TO SIT AT THE salon for hours every three to four weeks. But unless you’re ready to rock your natural gray hair, you really can’t avoid it. You can, however, prolong the time between appointments in a few ways. First, try a root concealer such as Color Wow, as New York City colorist Kali Ferrara suggests. “Just find the color that best suits you and apply to roots for a quick, temporary fix that will hold you over until your next appointment,” she says. Another option: Use your hair’s natural texture to keep the focus off of the grays growing in. If you’re overdue for your hair color and you like the look of your natural hair, tease strands for a little volume that goes a long way toward hiding the roots. —AYREN JACKSON-CANNADY
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17 WEBMD.COM BY Ayren Jackson-Cannady BEAUTY REVIEWED BY Karyn Grossman, MD WebMD Medical Reviewer
FRESH START SkinCeutical Clarifying Clay Masque ($52) “Made with hydroxy acid for sloughing away dead skin, Kaolin and bentonite clay to absorb excess oil, and calming plant extracts, this mask leaves skin feeling healthy and balanced.”
FINISH LINES Avène RetrinAL 0.1 Intensive Cream ($70) EXPERT PICKS “This concentrated cream contains a peptide that helps prevent wrinkles with Powerhouse less irritation or redness.” Products Keep your skin in check before your next dermatologist EYE SPY appointment with ROC Retinol Correxion Eye Cream ($18) “I love this non-greasy and hypoallergenic cream—it’s these recommendations gentle enough to use around the entire eye area, but from Marie Jhin, MD, strong enough to help ward off wrinkles.” a dermatologist in San Francisco, for at-home treatments that address everything from blackheads to wrinkles. MOISTURE MAGNET THE OPINIONS EXPRESSED IN THIS Neutrogena Rapid Wrinkle Repair Regenerating Cream ($21) SECTION ARE OF THE EXPERTS AND ARE NOT THE OPINIONS OF WEBMD. WEBMD DOES NOT ENDORSE ANY SPECIFIC “If your skin is looking dull and blah, this is the product. PRODUCT, SERVICE, OR TREATMENT. On top of fine-line-fighting retinol, it has super hydrating hyaluronic acid to plump skin up. It’s so moisturizing, you can use it on your neck, too.”
WIPE OUT Dr. Dennis Gross Alpha Beta Universal Daily Peel Packettes ($88) “These convenient at-home peel packets help improve uneven skin tone, fine lines, and large pores. The best part is that they’re designed to do all of
PHOTOGRAPHY: RICK LOZIER RICK PHOTOGRAPHY: that with little to no irritation.”
18 WEBMD.COM BY Kara Mayer Robinson BEAUTY Looking for a doctor? REVIEWED BY Mohiba K. Tareen, MD Use WebMD’s WebMD Medical Reviewer Physician Finder. Go to WebMD.com./findadoctor.
DERM Q&A Clean Sweep To wax, pluck, shave, laser, or thread? No matter which body part you’d like to make smooth, silky, and hair-free, our expert has answers. can use at-home devices. I like and cheaper ways to temporar- Luma Rx. It works using ily take care of unwanted hair. intense pulsed light. Waxing gives longer-lasting results because you’re pulling Q What are the benefits and the roots. But shaving and drawbacks of laser hair waxing can cause ingrown hair removal? when the hair comes back. MAURICIO With light skin and dark hair, it’s very effective— Q After removal, will hair and when done properly, very grow in thicker and darker? safe. When you have skin of MAURICIO Everyone’s response color, you’re at a higher risk for varies. If the areas are under- burns and complications. The treated with laser or light cons are higher cost and having energy, there’s a chance it to go to the doctor’s office. You’ll won’t work or even cause need a series of treatments—on more hair growth, so it pays average, seven—and may need to go to an expert. maintenance over time. Q Can prescription drugs Q What’s electrolysis—and is slow hair growth? it effective? MAURICIO Vaniqa (eflornithine) MAURICIO Electrolysis is the cream is prescribed by your use of electricity to target and doctor and has been shown to kill individual hair follicles. decrease hair growth, but you It’s good if you have blond have to continuously use it or WITH ADVANCES IN TECHNOLOGY, YOU HAVE MORE HAIR-REMOVAL or gray hairs because laser the effect diminishes. Many options than ever. But with so many at your disposal, how do hair removal won’t work. dermatologists also prescribe a you choose? That depends on your goal, budget, and mainte- Electrolysis isn’t practical for pill called Aldactone (spirono- nance level. Beverly Hills dermatologist Tess Mauricio, MD, large areas because you have lactone) that’s FDA-approved CEO of MBeautyClinic.com, clears things up. to destroy individual hair for blood pressure manage- follicles one at a time. ment. At lower doses it helps Q What’s best for unwanted facial hair: upper lip, chin, and regulate hormones in the skin sideburns? Q Are traditional at-home and can lead to reduced facial MAURICIO Laser or light-based hair removal offers the best techniques good options? hair growth. But, again, you chance for permanent hair reduction. These small areas MAURICIO Waxing, depilatories, have to take it continuously to shouldn’t be very expensive to treat in a doctor’s office. Or you and shaving are instant, quick, maintain its effect.
IS IT A GOOD OPTION HOW MANY WHAT RESULTS CAN WHAT ARE THE 4 Questions FOR ME? TREATMENTS WILL I EXPECT? RISKS? READY FOR LASER HAIR REMOVAL? Lasers don’t work for every- I NEED? Also ask: Will I see an Are there side effects? THE AMERICAN ACADEMY OF one. Your dermatologist will Find out how long improvement right Is there anything I DERMATOLOGY RECOMMENDS consider your hair color, skin each treatment takes, away? How long does it can do to prepare in RUNNING THESE QUESTIONS BY color, hair coarseness, where how many office visits take to get full results? advance? YOUR DERMATOLOGIST FIRST. it is on your body, and where you’ll need, and total How long do results it is in the growth cycle. cost involved. last? GETTY IMAGES
19 WEBMD.COM BY L iesa Goins BEAUTY REVIEWED BY Mohiba K. Tareen, MD Search for the slideshow WebMD Medical Reviewer No-Knife Cosmetic Fixes at WebMD.com.
THE SCOOP Pore-fect A SIMPLE GUIDE FROM NEW YORK CITY BEAUTY SMARTS DERMATOLOGIST MICHELE GREEN, MD, FOR BEATING BLACKHEADS ONCE AND The Old Is New Again FOR ALL. Innovations in treating hair loss, wrinkles, and skin texture are built off insights from existing treatments. Check out these cutting-edge non-invasive cosmetic procedures.
WHILE SO MUCH OF MEDICINE IS A CALCULATED SCIENCE, SOME OF THE platelets, and injecting them into the scalp. the hair,” she says. “I like PRP because collagen and elastin. As a result, skin looks most common treatments evolved from their originally intended How this technique works in the joints it’s pretty much risk-free. It’s your own more even-textured, Brauer explains. purpose—Rogaine was originally a high blood pressure medication, and the scalp is the same as how your body blood—you’re using a treatment directly An added benefit of the picosecond Warfarin started as a rat poison, and Viagra treated angina. heals a wound. “If you cut yourself, platelets from your own body.” The downside is that lasers is their ability to target uneven The same has happened with cosmetic dermatology. Doctors have are the first cells that start the healing insurance doesn’t cover it, and costs can pigmentation on a variety of skin tones. discovered, often accidentally, new uses for existing lasers and injectables. process,” says Manjula Jegasothy, MD, a rise to $1,000 per treatment—you’ll likely “Pico technology is unique because it’s As a result, they have a growing menu of non-invasive cosmetic dermatologist in Coral Gables, Florida, need three sessions over the course of a safe for all skin types,” Holcomb says. “The DON’T RELY CLEANSE advancements available. “This is an exciting time for the field of cosmetic and an associate professor of dermatology year and then periodically after that. energy can address the pigment cells that ON STRIPS CORRECTLY News alert! Look for cleansers medicine,” says Anthony Youn, MD, a plastic surgeon in Troy, Michigan. at the University of Miami, Miller School But results are encouraging. “I’m cause brown spots with less risk to darker Blackhead strips with acne-fighting “Dermatologists and plastic surgeons have so many technological of Medicine. “They contain growth factors seeing results in one treatment and some skin tones,” she says. won’t prevent ingredients advances available now—and the innovation continues every day.” that stimulate the creation of new cells. The patients grow up to 50% of the hair Recovery from each session is minimal blackheads (pores such as salicylic These three new applications for existing treatments now offer same premise works on the hair follicle to they’ve lost,” Jegasothy says. and usually involves slight redness. clogged with acid or benzoyl benefits beyond their original intent. create healthier hair growth.” Each session can cost between $300 grease and dead peroxide. Salicylic In terms of thinning hair, PRP PICOSECOND LASERS FOR GENERAL to $1,400 depending on the area. You skin that turn dark acid helps clear PLATELET-RICH PLASMA THERAPY FOR HAIR RESTORATION essentially “wakes up” dormant follicles, SKIN REJUVENATION and your doctor will have to determine when exposed to blocked pores and oxygen) because reduces swelling Originally an orthopedic treatment used to reverse joint degeneration, telling them to grow new hair and Picosecond lasers were designed to remove how frequent your visits should be, but they don’t affect and redness, while platelet-rich plasma therapy (PRP) is now a routine option for addressing stimulate follicles that have shrunk in size tattoos, but new versions of the technology Holcomb reports seeing results in as few your skin’s oil benzoyl peroxide hair thinning and loss, says Katherine Holcomb, MD, a dermatologist at so that the hair grows thicker, Holcomb are now part of the anti-aging arsenal. “Pico as one or two treatments. production. They exfoliates the skin Pure Dermatology in Metairie, Louisiana. The procedure involves with- explains. “Anything that stimulates lasers have become a great way to smooth can, however, and kills bacteria. drawing the patient’s own blood, spinning it in a centrifuge to separate the hair growth will improve the quality of the skin, reduce fine lines, and tighten skin MINI INJECTIONS OF NEUROMODULA- temporarily make with minimal downtime,” Youn says. TORS TO PREVENT WRINKLES your pores look smaller. EXFOLIATE “Picosecond lasers were an innovation in Botox, Dysport, and Xeomin, a class of REGULARLY tattoo removal because they deliver energy injectable neuromodulators, may be syn- Acne-fighting so quickly that they can efficiently break onymous with smoothing wrinkles, but READ THE LABEL chemical up tattoo ink,” says Jeremy Brauer, MD, a the injectable was originally employed as Comedogenic oils exfoliators such as and pore-clogging clinical assistant professor of dermatology a way to control eyelid spasm. glycolic acid and ingredients that salicylic acid are Aisle Do at New York University Langone Medical An ophthalmologist used it to treat are common in able to get into the SALVAGE CHAPPED LIPS WITH Center in New York City. When researchers patients with blepharospasm. When skin-care products lipid barrier of the THESE EXPERT FAVORITES PRODUCT PICK PRODUCT PICK PRODUCT PICK treated tattoos that happened to be near one remarked on how the injections and cosmetics skin, eliminating THAT LOCK IN MOISTURE. VASELINE LIP THERAPY TIN ($4) BURT’S BEES BEESWAX LIP BALM EOS LIP BALM ($3) stretch marks, the marks also improved, also reduced her forehead lines, the are a major cause blackheads. ”This is the best moisturizer, and it ($3) “My lips tend to get dry when I work which led to research in how these devices doctor mentioned it to her dermatologist of blackheads. Look for handy, keeps the skin barrier healthy. I also “The balm makes a protective barrier out. This lip balm contains shea If you have pore can address issues including fine lines, sun husband—and the rest is history. Over the disposable pads love the cherry flavor and nice tint. that’s not a bit heavy on lips. It’s very butter and vitamin E, so it’s great problems, make saturated in these And if you have kids, it doubles as a soothing, and I like that it contains for hydration.” damage, and loose skin. last two decades, doctors have used the sure your skin-care ingredients to get wound healer for scrapes on the go.” vitamin E, a natural moisturizer.” Debra Jaliman, MD What makes the picosecond lasers injectable to treat a host of medical and products say “non- easy at-home peel Mona Gohara, MD Diane Madfes, MD dermatologist, author of Skin Rules: an advance is that they deliver pulses of cosmetic issues. The newest evolution uses comedogenic.” benefits. associate clinical professor, Yale assistant professor of dermatology, Mount Trade Secrets from a Top New York THE OPINIONS EXPRESSED IN THIS SECTION ARE Department of Dermatology Sinai School of Medicine Dermatologist energy to the skin at one-trillionth of a very small doses of a neuromodulator to OF THE EXPERTS AND ARE NOT THE OPINIONS OF second. These pulses vibrate the lower level prevent wrinkles before they appear and WEBMD. WEBMD DOES NOT ENDORSE ANY SPECIFIC PRODUCT, SERVICE, OR TREATMENT. of the skin to stimulate the production of provide a subtler effect in the short term. GETTY IMAGES Continued on page 22 20 21 WEBMD.COM WEBMD.COM Continued from page 21 Dirty Secret “Many people aren’t looking for a “I USE THE SAME DISPOSABLE RAZOR FOR MONTHS AT A TIME. SAFE—OR NOT?” frozen effect,” Holcomb says. “Younger patients like the subtle results.” When SHAVING TIME have more opportunity “You shouldn’t keep your to grow. If one of those muscle movement is limited, the skin razor around for more microbes enters a cut, isn’t creased, she says. So you aren’t able than a month—your blade you’re risking an infection to form the wrinkles to begin with—these can dull in just four or five of the hair follicle (follic- smaller doses are able to prevent or delay uses, depending on how ulitis), impetigo, or even their formation. often you shave and how cellulitis.” large the areas are. No Elizabeth Tanzi, MD, a dermatologist matter how new a razor SMOOTH MOVES in Chevy Chase, Maryland, agrees. “For is, you should toss it if “To extend the life of those who want softer results, I’ll use you see rust spots or the your razor and reduce a lower dose so the treated areas look blade looks warped.” the risk of irritation, use a shaving cream to natural, not stiff,” she says. “This benefits STAY SHARP diminish friction. Clean my patients under 50 with early fine lines “As the razor’s edge dulls, your razor in hot water who don’t need as high a dose.” you have to exert more after each use, taking You’ll pay about the same as you would pressure to slice each extra care if you’ve cut for a standard injectable treatment hair, and that increases yourself. Store it in an the odds you’ll knick upright position so the because doctors usually charge per or cut yourself. Plus, blades can dry between treatment area—about $500 on average. pressing and dragging uses to ensure you’re not Bottom line: Cosmetic treatments are the dull metal over your providing an environ- evolving almost daily, so a visit to your skin causes irritation in ment in which bacteria can thrive.” doctor’s office might surprise you with new the form of razor burn. And the longer your shav- —Papri Sarkar, MD options that go above and beyond what you er sits in a damp shower, dermatologist, Brookline, may already be familiar with. bacteria and fungus Massachusetts BY Liesa Goins BEAUTY REVIEWED BY Mohiba K. Tareen, MD WebMD Medical Reviewer
ANATOMY OF… NOT JUST DESSERT L’Oreal introduced hair mousse, French for “foam,” to Hair Mousse Europe in the early 1980s and The story behind the styling foam it shortly became ubiquitous in the U.S. Mousse has become so common because it’s so versatile and useful for many hair types. Formulas READY WHIP are able to volumize, hold, The basic recipe for mousse condition, smooth, and even includes water and alcohol deposit color. to carry and disperse the ingredients. Polymers and resins do all the heavy lifting. They CATCHING AIR form a flexible film on each The essential ingredient in strand that is able to deliver a mousse recipe is air. The styling benefits without leaving injection of oxygen, with an the hair feeling stiff. aerosol can or through a manual pump, transforms the runny liquid into a fluffy foam that you GET EVEN can apply easily. For the most even mousse application, squeeze it directly into your palm. Take a fine-tooth MOUSSE IS LOOSE comb and apply the foam directly What makes mousse novel in to your roots, working in small the world of hair styling is that sections. For all-over application, the coating agents adhere rub the mousse between your to individual strands. As the hands to break it down before product dries, the film holds working it throughout your hair. each hair while pushing away from the others, creating shape and fullness BRUSH OFF without gluing them For springy coils, comb together like a spray or damp hair and apply mousse gel does. throughout. Then keep your hands—and brush—off. After air- drying or using a diffuser on your blow dryer, your coils will hold their shape. GETTY IMAGES
23 WEBMD.COM GETTY IMAGES the library. time at yoga classes,andstory daddy-and-me groups,baby to-baby chatter at mommy/ stages ofspeechdevelopment. may theearliest support that thisfascination suggests Disorders inMontreal. She Communication Sciencesand sor at theMcGill Schoolof PhD, anassociate profes- emotions,” saidLindaPolka, times promptingpositive hold infantattention, some- speech seemstocaptureand tions arequitepotent;infant making thesamesounds. other infantsthantoadults “goo-goos” and “ga-gas”of 40% longer tothe listening 5-month-old babiesspent versity. foundthat They at Canada’s McGill Uni- fromresearchers study new themselves, accordingtoa babbling start they before other babies’voices,even BABIES LOVE THE SOUND OF HEALTHY TOGETHER language development? development? language your child’sboost other infants out with hanging Could listen. babies other sounds, When babies make Talk Baby EARLY INTERACTION You canencourage baby- “Infants’ ownvocaliza- —GINA SHAW
Family SMARTER LIVING WEBMD.COM 24 25 WEBMD.COM BY THE NUMBERS trauma, touting research that correlates early adversity with damaged health in adulthood in health damaged with adversity early correlates that research touting trauma, about childhood the alarm sounds Burke Nadine Harris herIn pediatrician new book, Toxic Stress KIDS’HEALTH 676,000 protective (CPS) in2016. services or neglect reported to child Number ofvictims ofchild abuse Is Stress? What article the for Search the CDC reports that oneinfourchildrensuffers the CDCreports andthat abuseorneglect, increased oddsfordepression,obesity, abuse,too).Considering andsubstance ease, stroke, autoimmunedisorders,andcancerinadulthood(with greatly dis- physical conditionssuchasheart hadofdeveloping person inthesurvey overlaid thesefindings withindividualhealthoutcomesinadulthood. Researchers thendirectly imprisonment, mentalhealthissues,andneglect. adults wereyoung.It alsonotedparentalseparation throughdivorceor and/oremotional, substance, abuseinthefamilyhomewhenthese sexual ofphysical, college-educated adults.Its measuredoccurrences 10questions 17,000 (ACE) thathood experiences surveyed white,middle-class, mostly San Francisco, happened upon amid-1990s researchon adverse study child A DECADE AGO, NADINE BURKE HARRIS, MD, A PEDIATRICIAN BASED IN The results shocked her: The highertheACE resultsshocked score,thehigherriska her:The The
at WebMD.com. at 1 neglected inthepast year. One inseven children have beenabused or according to anon-CPS survey estimate. form ofchild abuse orneglect intheirlifetime, Number ofchildren whohave suffered some
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BURKE HARRIS impact ourbodies? of ChildhoodAdversity. Well: Healing the Long-Term Effects message of her book, TheDeepest ACE and the mainauthor discusses Here, nearly 4millionviews. thedebut ing Ted talkthat todate hasgarnered Wellness, andin2015 shegave arally- co-founded theCenterforYouth problems downtheline.In 2013 she causesphysicalstress andbehavioral negative effects chronic now—before living withadversity tohelptreat its Burke Harris identifies youngpatients Today,sion at herclinicalpractice. child’s formative years. andtreatment duringa on prevention more healthprovidersweren’t focused Burkeexperiences, Harris wassurprised pediatricians screenfortraumatic few term adrenaline. It’s whenwehave an enhance clearthinkingfromshort- hormonescanamounts ofstress the fearcenterofbrain. Small blood pressureandsugar. We activate stronger andfaster. We increaseour beatrespond toathreat. Ourhearts our bodies hormones, it toactivates of stress When we releasehighlevels was designedful events to be adaptive. way- The ourbodiesrespondtostress Q
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Roy Benaroch, MD WEBMD.COM
26 ------GETTY IMAGES Medical Center, issues. key addressesafew at ColumbiaUniversityInfertility andgynecology andassociate professorofobstetrics Williams,Zev MD, and PhD, Endocrinology oftheDivisionReproductive chief anditcanbehardtotellwhat’sstraightforward, moveandwhat’s asmart overkill. answerisn’t The always need tochange delivery? duringthoseninemonthsbefore you sitting it’s foralongtime—whether still onaplaneorincar—canraise yourrisk dangerous, but youdon’t wanttogo intolaboroverthePacific. rules aboutwhen,exactly, pregnantwomenarenolonger allowed tofly. It’s notbecauseit’s WILLIAMS Q YOU KNOW THAT HAVING A BABY WILL CHANGE YOUR BUT HOW LIFE, MUCH DO 4 Tips ZEV WILLIAMS, MD, P MD, WILLIAMS, ZEV FROM ABOUT KNOW AND DON’TS TO DOS PREGNANCY MORE An expert weighs in on weighs in what’s OK—and expert An what’s not—during pregnancy Can ItravelCan by plane? If youdoopttotravel at any point during yourpregnancy, youshouldknowthat Absolutely, as long as you’re not too close to your due date. Many airlines have on WebMD.com Dos,Myths, and Don’ts Pregnancy article the for Search
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WEBMD.COM 27
BY Erin O’Donnell FAMILY Search for the slideshow REVIEWED BY Hansa Bhargava, MD Baby Skin Care: Simple WebMD Senior Medical Editor Tips to Keep Baby’s Skin Healthy at WebMD.com.
BABY Red Alert Staying on top of eczema, a skin condition common in infancy, might prevent your baby’s risk of allergies as she grows baby in tepid water for about 10 minutes, washing dirty areas gently with a non-soap cleanser. Do not scrub the rash. After the bath, pat baby dry. If your doc- tor has prescribed an anti-inflammatory steroid ointment, apply it now, and fol- low immediately with a moisture barrier. Assa’ad recommends products such as Vaseline and Vanicream. Avoid products that contain alcohol or fragrances, which can irritate the rash. Assa’ad also warns against products that contain nut or seed oils, such as almond or sunflower seed oil, which can enter the baby’s body through tiny cracks in rashy skin and may increase her risk of serious food allergies as she grows. “The skin is an unusual route into the YOU MAY THINK OF BABYHOOD AS A TIME OF SOFT, SMOOTH SKIN, BUT AT LEAST body, so the immune system responds by 10% of babies develop eczema before age 2. Also known as atopic derma- creating allergy antibodies, which can trig- titis, eczema is an inflammatory skin condition that makes skin unable ger an allergic reaction,” Assa’ad says. In fact, to hold onto moisture, creating red, itchy, rough patches. It often runs in research suggests that babies with eczema families and can appear in babies as young as 3 months old. have an increased risk of peanut allergy “Infantile eczema often shows up only on the face, and babies look like they have a because peanut particles enter through dry, sunburn,” explains Amal Assa’ad, MD, clinical director of the division of allergy and cracked skin, prompting the immune system immunology and director of the FARE Center of Excellence for Food Allergies at to react when they eat peanuts. Keeping skin Cincinnati Children’s Hospital Medical. But the rash may also appear in elbow folds healthy and well-moisturized may reduce or behind your baby’s knees; in fact, Assa’ad notes she has seen it almost everywhere the risk of such allergies, Assa’ad says. on the body. Affected skin can be intensely itchy, she adds, which prevents good sleep To prevent eczema flare-ups, keep your and leads babies to scratch their skin or rub against bedding or other surfaces for baby at a comfortable temperature—heat, relief, creating an infection risk. sweat, and cold can all worsen symptoms. Eczema treatment involves keeping the skin well-moisturized, in part through Eczema triggers can be highly individual, short daily baths. “A lot of people think of bathing as drying, but if you do it Assa’ad adds, so be attentive to spot your the right way, the skin actually becomes more moisturized,” Assa’ad says. Soak baby’s patterns.
Q I’m doing everything Q Should my baby see Q How can I prevent my right. Why is my baby’s an allergist? baby from scratching skin still flaring up? Moderate to severe eczema may her eczema? Check in with your child’s doctor, signal that baby is at increased risk Keep her nails trimmed short, cover ASK YOUR who may prescribe medicated for peanut allergy or other allergies, itchy areas with light clothing, and DOCTOR ointment or suggest other tweaks Assa’ad says. Ask your pediatrician consider covering her hands with for relief. if you should have your infant infant mittens or sleeves. evaluated for allergies. GETTY IMAGES
28 WEBMD.COM GETTY IMAGES “ARE YOU GOING TO DIE?” WHAT SAY YOU CAN TO DIE?” “ARE GOING YOU The BigQuestion cancer ishappeninginthefamily, kidswillsensetheemotionalandphysical changes. Remember: You knowyourchildbest.” “You begetting treatment forguidance. canalsoaskatherapist at thehospitalwhereyou’ll adult familymembersabouthowyou’re going tosharetheinformation,” says. Borstelmann tell them.“Take orother yourselffirst. timetoabsorbthenews talkwithyourpartner Then ofsocialworkat Dana-Farberdirector CancerInstitute Butit’s inBoston. better that youdo to thinkaboutitmyself? children Ihave cancer?How doIhelpthemcopewiththisdiagnosiswhenI’m barelyable But whenyou’re ofworries:How comeswithanother set aparent,thenews doItellmy CONSIDER ONE OF THESE ANSWERS. BORSTELMANN, P BORSTELMANN, SAYS NANCY PROGNOSIS, ITS AND CANCER YOUR ABOUT WHAT ON KNOW YOU DEPENDING ALL? OF QUESTION HARDEST SCARIEST, BIGGEST, THE YOU ASKS CHILD YOUR WHEN RECEIVING A DIAGNOSIS OF ANY KIND OF CANCER IS TERRIFYING FOR ANYONE. It’s asbig butwhensomething natural childrenfrombadnews, towant toprotect You have don’t totellyourchildrenrightaway, says PhD, Nancy Borstelmann, MPH, When You Have Cancer WebMD.com./findadoctor. Physician Finder. WebMD’s Use adoctor? for Looking An expert suggests ways to have this most difficult difficult most have to ways this suggests expert An h D, MPH D, Go to to Go , YOU MIGHT conversation with children with conversation PARENTING
to me.” that to happen not expecting doctors, andI’m I have good good treatment. getting really cancer, butI’m do dieof “Some people FAMILY recovering.” good chanceof me Ihave avery The doctor told to getbetter. everything Ican I amdoing the future, but know about “We don’t always
the time.” treatments all new andbetter developing scientists are treatment, but to cancer differently responds “Everyone and worries.” to comeyouwiththeirquestions “Mostly, need toknowit’s they okay conversations,” says Borstelmann. “It’s okay tobreakthisupintoseveral allat once. tosay everything Don’t try aboutthat.”worry tagious. Even olderkidssometimes reassure them that cancer isn’t con- or Dadsick,” says “And Borstelmann. somehowmadeMom they believe tend topersonalizethingsandmay this. “Younger children,inparticular, Make didn’t knowthey cause surethey I willcomebackandtellyou.” to have aboutthat toaskmy and doctor “That’s a really good I’m question. going don’t knowtheanswer. You cansay, Welcome openly, questions ifyou even day.the next alot school, andyoumightneedtorest Jane orGrandma willbetakingthemto Friday, that explain on those days Aunt begetting chemotherapy every you’ll and them.For ifyouknow example, you— treatment andhowitwillaffect Explain what will happen with your and teenswillneedmorespecifics. limited information, while olderkids age childrenwillneedvery elementary Preschoolersunderstand. and early Tell thetruthinaway yourchildcan cancer,” says Borstelmann. scarierthan even imagining something ofoverhearingitor instead you directly “It’s from hearthenews that best they HOW DO YOU HAVE THIS TALK? REVIEWED BY WebMD Medical Reviewer going on.” you exactly what’s promise I’lltell together, and I out whatto do worse, we’ll figure if thingsget right now. Even I’m notdying but“I amsick, BY
Roy Benaroch, MD Gina Shaw Gina WEBMD.COM 29 GETTY IMAGES 4 Questions THOSE IN COLLEGE. COLLEGE. IN THOSE YOUNG ADULTS, ESPECIALLY PROBLEM FOR TEENS AND DRUNKOREXIA, A GROWING HAS ANSWERS ABOUT DIPALI RINKER, P from food set themselves up for sexual assault, bad grades, and poor and health grades, bad assault, up themselves for set food from sexual calories restricting while Older college and who binge students teens drink Drunkorexia of Dangers The TEENHEALTH has increased for both genders, who share the same level ofrisk. has increasedforbothgenders, whosharethesamelevel likely asthepressure to stay because social media shines a light upon it even slim People engaged inthisbehavior tendtodrinkmore.” orlaxativestakes todrinkwithoutgainingweight,that’s diuretics ‘drunkorexia.’ or college says, someonewithholdsfood calories,over-exercises, students, “When the University ofHouston ondisordereddrinkingamong andco-authorofastudy males, accordingtotheNational Institute ofMental Health (NIMH). increase ofdisorderedeating and25%among up32%amongfemalestudents untreated eating disorder. Data at over13yearsshowsan oneuniversity collected collegetimeframe. freshmenarrivewithapre-existing, Andnearly6%ofallnew drink alcohol monthly, with two-thirds binge drinking at once within least the same THE NATIONAL INSTITUTES OF HEALTH (NIH) REPORTS 60% OF COLLEGE STUDENTS Disorders Guide to Understanding Eating AVisual slideshow the for Search Drunkorexia isdefined asfourormoredrinksinonesitting for womenandfive Rinker 10years, addstheproblem hasbecome“alotmorenoticeable”inthepast Dipali Rinker, at PhD, ofpsychology professorinthedepartment LPC,assistant So, what happenswhenthesetwo unhealthy behaviors collide? h D, D,
on WebMD.com. on interconnected.” hownecessarily they’re concerns, butnot sexual assaultare all body image, and “They know alcohol, Not yet, Rinker says. THIS PROBLEM? THIS RESPONDING TO ARE UNIVERSITIES
FAMILY actually very dangerous.” some drinkingbehaviors are Rinker “Explainhow advises. they leave for school,” with your children before conversation aboutalcohol Andhavekids drink. the “Be aware ofhow college DRUNKOREXIA? HELP PREVENT APARENT CAN HOW the disorder. can alsobesignsof fatigue, anddepression poorgrades, meals, or skipping classes andexercise,partying reveal alot.Excessive Social mediapostscan LOOK FOR? TO FLAGS RED SOME WHAT ARE alcoholism, downtheline.” can leadtoalcohol-related problems,or capacity foralcoholconsumption—which drunker,get faster, tendtohave agreater caloriesthe sameto students who restrict more likely tohave missedaclass. asaresultofdrinkingandfiveproject times or poorlyonatest binged toperform never times morelikely thanthosewhodrank but threetimesperweekwereroughlysix least college whoconsumedalcoholat students binge-drinking NIHreports result. The the ages of18and24. werebetween students dents. Allsurveyed related injuries,includingautomobileacci- diedfromalcohol- and 1,825students who’dby anotherstudent beendrinking; beingassaulted reported 696,000 students assaultordatealcohol-related rape; sexual 97,000this assertion: suffered students oncollege drinkingbacks national survey under theinfluence of alcohol.Arecent driving andtheaddedriskofassaultwhile to consider,” Rinker adds, such as drunk aresocialissues,too, headaches. “There ing, blackouts, disruption, stomach and include poor nutrition, alcohol poison- within threemonthsofbeingsampled.” in oneormore‘drunkorexic’ behaviors identified heavy drinkers saidthey’d engaged of1,184self- inoursurvey of thestudents or moredrinksformen,shesays. “Up to80%
Intervention iskey, says Rinker, “because Poorer isanother academic performance physical dangersThe of drunkorexia
BY BY REVIEWED BY Lauren Paige Kennedy WebMD SeniorMedical Editor Association (NEDA). Eating Disorders theNational Or contact search “CollegeAIM.” drinking problems— resources for student comprehensive The NIHshares TO FOR HELP? FOR TO TURN PARENTS CAN WHAT RESOURCES
Hansa Bhargava, MD WEBMD.COM
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31 WEBMD.COM Know the warning signs and help and signs keep healthy. your pet the warning Know disease. develop deadly dogs and can this people,Just cats like Cancer with Dealing PETS
Cancer Canine video the for Search Minnesota Colege ofVeterinary Medicine. Just like inpeople,we have Antonella Borgatti, DVM,associate professorofoncology, University of cer istheleadingcauseofnatural death inoldercats anddogs,” says canceristreatable. that In tounderstand often “can- important fact, five cats cancer, willget accordingtotheNational CancerInstitute. according to the Veterinary Cancer Society. And each year, about one in ABOUT ONE IN FOUR DOGS WILL GET CANCER AT SOME IN THEIR POINT LIVES, While these numbers may well strike fear owners, into it’smany pet on WebMD.com. on FAMILY
your vet in your pet,consult changesnoticeable If you seeany Your Bet Best problems aswell,headds. canspotany other earlier andyourvet cancer, prevent won’t itmay befound Whilethis yearly checkupwiththevet. ages, be sure to takepet him in for a inmiddleandolderage.mostly That’s cats anddogsarediagnosedwithcancer of Veterinary Medicine. University ofCalifornia,Davis School atfessor inradiation the oncology early,” says Michael Kent,DVM,pro- about it if it’sto do something caught a muchbetter chanceofbeingable such asweight losscouldbecaused spell cancer. Many nonspecific signs you find don’t necessarily them. They panicif don’t of thesesignsinyourpet, saysgated byyourvet, Borgatti. mouth sores,whichshouldbeinvesti- ignorebadbreathadds. Anddon’t or dogs, couldbeasignofbonecancer, she says Borgatti. any nonhealing sores or wounds, changes inurination; andlethargy; abdominal swelling;discharge; breathing, eating, orswallowing; difficultyloss; a change in appetite; both dogsandcats,” says Kent. look forareany lumpsorbumpsin “Probably common thingthe most to haschanged. for signsthat something outwell, soyouneedtokeep aneye Pets can’t tellyouifthey’re notfeeling WATCH FOR SIGNS As with their human counterparts, with their human counterparts, As Yet towhile any you want to be alert especiallyinlarger-breed Lameness, Other redflags? Watch for weight . says Kent. As your says your Kent. As tend to live longer, dogs, though cats for bothcats and 6, 7, or8yearsold generally around
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GETTY IMAGES 50 especially light-colored ones,pets, types ofskintumors.” Try tokeep squamous cellcarcinomaorother to UV damagesubject and can get Kent. “Just like withpeople,they’re besunbathing,”noses shouldn’t says dogs andalsowhitecats withpink phoma, Kentsays. may increasethepossibility oflym- on your lawn where your dog plays gests that pesticides using certain says sug- Kent.Also, someevidence bearoundit, yourpet let shouldn’t so youaccording to some studies, the riskofcancerincats anddogs, second-hand smoke may increase toand cats? Exposingyourpet cancerindogsCan youprevent attention assoonpossible. ofyourvet bringthemtothe changes inyourpet, rare. arevery though they be cancerous(calledliposarcomas), Lipomascan checked outbyyourvet. thesethingsBut youdowanttoget which areusuallybenign,” headds. fatty deposits,what wecalllipomas, and bumpsthat little couldbejust aremany lumps says Kent.“There by otherconditions,suchasdiabetes, BY THE NUMBERS PROTECT YOUR PET “We doknowthat light-colored Bottom line: If you notice any % Association (AVMA). Veterinary Medical according to theAmerican will develop cancer, older thanage10that Percentage ofdogs quality oflifeourpatients.” medicine—themuch in veterinary very westress Kent. “That’s something having sick,” ourpatients very says in people,sheadds. are thanthey usually farlesssevere says Borgatti. Any sideeffects are radiation therapy, andchemotherapy, those inhumans,includingsurgery, long periodsoftimeafterward.” help many more [animals] live for many,But wecure andwe’re ableto it’s found,andhowlongit’s beenthere. depends on the type of cancer, when ily adeath sentence,says Kent.“It cancer? Knowthat it’s notnecessar - doesgetWhat happensifyourpet and cat,” sheadds. for the overall health of your dog diet fit,active, healthy, andonabalanced “it’sprevented, tokeep pets important says Borgatti. tumorslater on, andtesticular mary ofmam- thedevelopment against any yourpet earlyage canprotect maythey loveit,hesays. though sunlight, even from direct DIAGNOSIS AND TREATMENT “We doseforquality oflifeandnot Treatment options are similar to be While overall cancerscan’t most Finally, spaying andneuteringat 66 according to theAVMA. the U.S. thathave acat oradog, Percentage ofhouseholds in % 4 Questions Borgatti, DVM. Michael Kent, say DVM, issues, Ask your veterinarian important these about cancer diet? cancer diet? my dogorcat? nutritionist first. to aveterinary talk pet, your for cook to decide do you If or home-cooked.” commercial food whether that’s nutrition, balanced good, want “You Kent. really, says Not about?” concerned be we should something this “Is to ask, hesitate says Borgatti. Don’t of signs aging, simply not are changes bodily Many behavioral or Q Q Is there a Is thisnormalfor checkup, according to arecent survey. been to aveterinarian inthepast year for a Percentage ofcats intheU.S. thathave not 52
% REVIEWED BY BY BY effects? chemotherapy side supplements? says Kent. Kent. says fur, their lose don’t addition, most dogs In manageable.” are do that those and effects, side any have Borgatti. “Some don’t says chemotherapy,” with well very do cats and dogs of majority vast “The drugs. other with interact may they supplements, since to give decide you if Talk vet Kent. to your says exists, plements sup about research little market, the on are many While Q Q WebMD Medical Reviewer What about What about IgiveCan my pet Christina Boufis
and and
Will Draper, DVM Antonella Antonella WEBMD.COM 32 - GETTY IMAGES New research suggests the majority are illegally tracking kids. tracking illegally are the majority suggests New research the appsDo on your child’s phone her privacy? violate Alert Privacy KIDS’HEALTH use it to develop targeted advertising—including junk mail, spam, or pop-up ads—for junkmail,spam,orpop-upads—for advertising—including targeted use ittodevelop researcher at theInternational ComputerScienceInstitute inBerkeley, California. ‘OK’ button withoutknowingwhat itmeans,” says authorSerge study Egelman, a give “parental consent.” “If you’re a child who can’t read, you can easily click a big younger withoutparental consent. browsing habits,photos,andotherpersonalidentifiers from childrenage 13and lists, oflocations, phonenumbers,emailaddresses,contact prohibits thecollection half appear to violate the Children’s (COPPA), Online Privacy Protection Act which pediatrics at theUniversity ofWisconsin. name of commercial marketing,” said Dipesh Navsaria, MD, an associate professor of clicks orareaware oftheprofiles that arebeingbuiltaboutusandourchildreninthe violating federal laws. privacy want toaskinthewake that many ofresearchsuggesting freeappsforkidsmay be information doesshegiveaway—and more parentsmay isaquestion towhom?This BY THE NUMBERS WHEN YOUR CHILD CLICKS ON AN APP ON A PHONE OR TABLET, HOW MUCH Egelman says such private information is often gathered and sold to third parties, who Egelman says suchprivate who gathered information andsoldtothirdparties, isoften also study found thatThe many apps make it easy for a small child to inadvertently ofnearly6,000popularchildren’sOne recentstudy appsfoundthat morethan “Most ofushave throughallthose noideahowmuchinformation isbeingcollected 57 federal privacy data laws. that appear to violate apps researchers tested Percentage ofchildren’s WebMD.com. Children’s Health Newsletter on Parenting the and for Search %
without parental consent. track children’s location Percentage ofappsthat 5 %
security measures.”security without “applying reasonable children’s personal information Percentage ofappsthatshare 40 FAMILY %
and across devices. be used to track achildover time identifiable information thatcan fully collect andshare personally Percentage ofappsthatunlaw 19
sharing toomuch.” an earlyage that thereissuchathingas themknowat sharing information: “Let ing themtoaskyouforpermissionbefore on whichappsthey’re using,andremind- your child’s keeping aneye phoneortablet, taking acloselookat settings theprivacy on sites complywiththelaw. appsprovidedthroughtheir child-targeted and Apple to do more to ensure that Google calling on lawmakers and tech giants like children younger than13.) countered that the site is not intended for olds use—violates COPPA. (YouTube has YouTube—which 80%of6-to12-year- Trade allegingthat Commission(FTC), groups filed acomplaintwiththeFederal That’s why therearelaws it,” against hesays. tothemisinherentlyexploitative. to market now. “To data fromchildrenanduseit collect sharetodaythey may beusedyearsfrom sight to envision how personal information ment andreality, andpre-teenslackthefore- know thedifference- anadvertise between not cognitivelyoften mature enough to other sensitiveinformation fromthepast. his orhersocioeconomichealthstatus, or tion aboutwhereapersonlivedaschild, employers oruniversitiestogleaninforma- could alsoultimately beusedbypotential information both childandparent.This % What canparentsdo? Navsaria suggests Meanwhile, Egelman and Navsaria are In April,two dozenchildadvocacy Navsaria notesthat youngchildrenare REVIEWED BY - WebMD SeniorMedical Editor www.appcensus.mobi. apps studied, goto about specific For details BY
Lisa Marshall Hansa Bhargava, MD WEBMD.COM 33 34 WEBMD.COM
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GETTY IMAGES ARI OUS PLENTY OF HUMOR OF PLENTY WITH PAST HER PAINFUL BEHIND A HADDISH PUTS TIFFANY ACTOR AND COMEDIAN BY BY HIL LAURENPAIGE KENNEDY positively | REVIEWED BYREVIEWED MICHAEL W. SMITH, MD, WEBMD CHIEF MEDICAL EDITOR
WEBMD.COM
35 36 WEBMD.COM I parent routinely physically andemotionally abused loving home,this previously Once shereturned (TBI). hermomwithatraumatic brainleft injury ble caraccidentwhenHaddish accident was9.The Angeles byhermother, whowasinvolved in aterri- Haddish was raised inSouthCentral inpoverty Los herwithsome emotionalscars. of—her parents,wholeft Haddish on—andgenerously forgiving isreflective HISTORY woman—she istoday. ing thebreakout thehealthy, star—and confident a fierce andyearsoftherapy, workethic withbecom- says Haddish. thoughts andattitudes, fail,” thenit’s likely least I’ll negativity; it’s on positive more pain. If I focus just isonthebadstuff.your focus There’s noresiliencein time? You don’t bounce backfromnothin’, because happiness. “People on the negative who focus all the of positivity.” laugh.’ In ordertodothat, youhave tohave somekind meseeifIcanmakelaugh. Iwaslike, people ‘Hmm,let Framed Roger Rabbit,andhetriestomake everybody Haddish says now. Isaw that movieWho “Then a longtime,Ikept tomyself becauseIwasafraid,” young adulthood. overcame a traumatic childhood, followed by a rocky buoyant attitude—all themoreremarkableishowshe comedy clubs.What makes hertriumph—and at familybarmitzvahs andtouringof performing overnight success.Shebuiltacareerovertwo decades Unicorn, isaheadline-makingbestseller. Awards inJune. Andher2017 memoir, TheLastBlack theMTVMovierave Shehosted reviews. &TV comedyspecial,“SheReady,”standup earned forasecondseason.Herrenewed first Showtime in the witty, OG,” Last gritty TBS series, “The She shares the small screen with Tracy Morgan Night School,whichhit theaters inSeptember. Hart opposite herfriendandmentorKevin in box office year’s withlast Trip Girls , shestars her way breakingoutat the tothetop.After defenseless. stripes Abandoned byherfather whenshewas3, She credits this smiling determination, coupled with coupledwith She creditsthissmilingdetermination, ateenager shemade aconsciouschoicetochaseAs “As a little kid I was happy-go-lucky, but later, for But don’t mistake thisfamouslyfunny ladyforan In itseemsHaddish, fact, 37, haslaughed actors, talk show hosts, and audiences of all andaudiencesofall talkshowhosts, actors, Her “up”viberendersA-list infectiously “It Girl”Tiffany Haddish, it’s positive. f there’s onewordtodescribeHollywood
OF A BUSE
MENTAL HEALTH of Texas, explains this discrepancy incare. disparities at the Dell Medical School at the University for Mental Illness (NAMI). before apsychiatrist, according to National Alliance Americans call apastor or primary care physician overcoming atraumatic youth—even ifmost African Tiffany Haddish credits years oftherapy for William Lawson, MD,PhD, associate dean for health
GAP Carmichael Show.” RIGHT: LEFT: TOP: Taran Killam in Night School.
Kevin Hart, Haddish, and “The Haddish on “The
Haddish in GirlsTripHaddish .
CREDIT TK LEFT: GETTY IMAGES; TOP: ELI ADE / UNIVERSAL PICTURES; RIGHT: MICHELE K. SHORT / UNIVERSAL PICTURES mental health facility. system,” he says, rather than a to end up inthe correctional with psychosis are more likely nity. Also, “African Americans menting on the black commu history ofmedically experi Lawson says. The U.S. has a diagnosis” among this group, there’s fear that comes with mental health issues. But American community, over nities, not justthe African “Stigma exists inall commu HISTORICAL SUSPICION - - - black neighborhoods. there” inpredominantly simplyproviders aren’t properly refer patients—and mental health training to many ofthem don’t have the physicians do incredible jobs, ders. “While primary care says ofmental health disor health outcomes,” Lawson we have better long-term works. Ifwe intervene early “We know early intervention LACK OFACCESS I madealotofbadchoicesand her younger self. “Just notdestroyed. “I wasdefinitely broken,” shesays of EMOTIONAL launching acomedycareer. working oddjobsanddreamingof lived off Metro, and on in her Geo adult now—andonherown.Haddish grandmother announced she was an hershe foundherselfhomelessafter when Haddish at 18, was15.Then, until hergrandmother gainedcustody bounced aroundfromhometo Separated,in aninstitution. thekids care,foster and her mother was placed vened; sheandhersiblingsentered When Haddish was12,thestate inter- see it’s notnecessarilyherfault.” trauma tothehead,that helpedmeto and learningaboutbrain injuriesand going tocounselingme .butafter loved.Andthenforhertohurt I ever love hersomuch.She’s thefirst person had so much hatred for her is because I Haddish admits. “But the only reason I asverbaland/orfest physical” innature. consequences” ofTBIand“may mani- common is one of the most “aggression by theNational Institutes ofHealth, postedTBI. According to one study someonehasa after canoccur bursts half-siblings. both Haddish andheryounger The mistreatment went on for years. mistreatment wentonforyears. The “I hadsomuchhate formy mother,” Uncontrolled violentout- andeven - RESCUE FEWER INSURED District ofColumbia. Mississippi and 52%inthe states, approaching 50%in varies widely between the elderly African Americans insurance among non- Kaiser Family Foundation, According to the Henry J. or reimbursement rates.” provide affordable services “psychiatrists often do not ance,” Lawson adds. And, likely to have private insur “African Americans are less Alliance forMental Illness(NAMI), Americans. AccordingtotheNational with amessage forherfellowAfrican I needasession!” tell’em inaminutethat, shoot: me, I’ll I’m feelingdespair?Anybody whoasks got someemotionsIneedtounload,or happilywaxon:“IfI’ve therapy? She’ll her favorite film andGet Out. Buton inunhappyunions:Belikeare stuck advicetocoupleswhothis practical much.Butshedoesofferyou very rather thank nottalkabout herex, home, ISkype withmy therapist.” Now, month.IfI’m not Igo every therapy at theendofmy marriage. IwentbackintoI got married.Then through my when mid-20s.Istopped to therapy in my early 20s and again was like, ‘Huh. Shewasright.’ Iwent and Isaid,‘Uh,no!’Ayearlater, I aboutmyself,told mesomething I oncesat downwithatherapist who years, yearsoftherapy! Iremember hedge:doesn’t “Girl,yes!Years, pains,Haddishthrough herpast sought professionalhelptowork I learnedfromthoseexperiences.” because, youknow, I’m ahuman! But was pretty negative fromtimetotime, book withself-deprecating humor:“I inhersingle, willingcallgirl,detailed runasapimpto as ashort-lived aswellnumerous romanticdisasters, mistakes.” likely include These The comedian then gets serious comedianthengets The Haddish isdivorced,andshe’d ornotsheWhen asked whether
- nami.org. NAMI’s website at suggests visiting community, Lawson and links for your For resources Medical Association. or the National Health Association, American Public of America, Inc., the Black Psychiatrists Black Psychologists, the Association of Or contact WEBMD.COM 37 38 WEBMD.COM scores] can transcend negativity, with a mother who’s often tothepointwhen[thosewithhighACE istoget of thekeys meditation, therapy,exercise, andemotionalhealing.“One blood pressure—nowcontrolled underadoctor’s care.) (Haddish fits yearshelearnedhadhigh thisbill;last problems, cancer, andhighbloodpressuredecadeslater. depressionandanxiety,developing aswellcardiovascular emotional and physical abuse as kids—are at greater risk for abandonment,and/or neglect, meaning, peoplewhoreport juvenile offenders ofchildhoodtrauma. withhistories Psychology University at Loyola whoworkswith Chicago, Garbarino, PhD, Maude inHumanistic C.Clarke Chair suffered (ACE), says adversechildhoodexperiences James improving bothmentalandphysical healthinadultswho’ve have giventomehadshenotbeenhurt.” Andgivingtoherwhat Iknowshewouldher existence. haveweight andherdiabetes gone away. I’m elevating just [extra] threeorfourtimesaweek.The I got herexercising She’s nutrition. thebest going psychologists, gets tothebest way better now,” shesays. “Igot heroutoftheinstitution. big bucks—andshe’s usingherfinancial gainforgood. Now that Haddish isindemand,sherightlyearnsthe RIGHTING to? goin’money Oh,they thesetearstoday!” toget gonna thinkyouweak!Butcounselors,whoIpay allthis mind! Or, infrontofyourfriends,’cuz they youcan’t cry canbehaters! Ormessedupinthefamily becausethey OK,” says Haddish. “You can’t always dothat withyour aplacetocry,just orhave someonetellyouit’s gonna’ be with becauseyou’re notholdingontoallthat, youknow?” you can figure them out. And move on! Life is easier to deal talk aboutthingsinyourheadyou’re tofigure trying out—and your emotionalthoughts.Bygoing, youhave that safeplaceto make it 10 times worse? need to break up you just Sometimes talk toyourfriends?Andfriendsspreadbusinessand or nothin’ like that! Just have aconversation.’” notallowedtotouchyourbody talk.They’re selor andjust Haddish says. “I’m always like: ‘Hey. You cango toacoun- .theblackcommunityon you,orwhatever is afraid,” doexperiments [therapy you,orthey’ll is]going tohurt their whitecounterparts. from apsychologist orpsychiatrist, comparedto40%of Yetfactors. only15%seekhelp despitethistroublingfact, duetosocialandeconomic such asdepressionandanxiety this groupis20%morelikely tohave mentalhealthissues But thesehealthriskscanbereduced throughregular showadultswithhighACE studies scores— Long-term Overcoming oldemotionalwoundscanplay avitalrolein “MyShe bought her mother anapartment. mama’s doing And let’s it’s about frenemies. “Sometimes not forget Besides, sheargues,it’s “You discreet. to knowwhenyoutry “From my theblackcommunity experience, thinks OLD WRONGS love most.” like hardwork.I’m doingthethingI But formeworkisfun,soitdoesn’t feel then comehometodoitallover again. early, 4or5a.m., worktilllate at night, sleep 12hoursaday! Now, Iwake up out. “Imisssleeping,” shesays. “Icould love forGroupon’s deals.) writinginhermemoirabout after a spokeswoman rolewiththe company using Grouponcoupons.(She scored admits totakingoccasionalPilates classes happen,” shesays, laughing,althoughshe dancefor20minutesinstead.”I’ll pumping. AndIlovetodance.Sometimes jumprope—anything my toget heart inary like 10minutes.Idoplanks,legkicks,imag- day,” she says. “Plus, [daily] I exercise for andtakegreen vegetable, my vitaminevery a gallonofwater, toeat at onedark least try taking careofherself. up. agents ashernameblew paychecks fromcomedyclubsandher demanding headlininggigsandbigger howtodothisprofessionally,understood Sheinnatelyembrace herself-worth. Haddish hasalsohadtolearnhow THE with pleasure. taughtTiffanylike, ‘Who howtodo that?’” Trip showedherGirls sister Andshe’scute. learningaboutmy life.my She’s todomotherlythings. It’s trying really says, ‘Make sureyoutake yourvitaminC!’ proud ofme,” Haddish says. “Shecallsand relationship. “Now, my mamatellsmeshe’s enjoying thebenefits oftheirrenewed ofyourlife.”in yoursoulfortherest itsitstherelike alumpofcoal “Otherwise, physically andmentallyinthelongrun. old emotionalwoundsdobetter both thosewhoworkthroughsuggesting of[Haddish’s]“That’s part successstory.” place of reconciliation,” Garbarino says. toa abandoned orabusedthem,andget Success, however, can tucker a girl Still, “thegluten-freethingwillnever down on alcohol,”“I cut she says. “Idrink Now, she does it physically, too, by Haddish laughsat thethought Both Haddish and hermotherare research backs this up, he adds,The GREATES T LOVE and she was andshewas
ELTON ANDERSON, JR. THEM OUT. THEM FIGUREYOU CAN TO FIGURE OUT—AND HEAD THINGS YOUR IN TALK TO ABOUT PLACE SAFE THAT YOU HAVETHERAPY], “ BY GOING [TO YOU’RE TRYING ” WEBMD.COM 39 40 WEBMD.COM R x
GETTYGETTY IMAGES IMAGES HEALTHY GLOW TREATMENT OPTION RESEARCH SHOWS ASA S POTENTIAL A LIGHT THERAPY REVIEWED BY NehaPathak, MD IT MIGHTHAVE AND ONGOING FOR SEVERAL IS MAKINGA CONDITIONS COMEBACK, WebMD MedicalEditor BY LisaMarshall WEBMD.COM 41 42 when medications and rising fearsabout performance. to boost bathedathletes beneath UVrays races before (lupus).Intuberculosis the1920s,Olympic for inventing agiantlamptotreat skin physician NielsFinsenwontheNobel Prize treatment orpsoriasis. In forrickets 1903, placed patient bedsonsunny balconiesas farbackastheearly20thcentury, As doctors ofthecost.”fraction issues,anditisa safety same, therearefew themselves at light is basically home. The the on them,consumerscannowshinelight king tothedoctor’s office tohave lightshined at Harvard Medical School. “Instead of trek PhD, anassociate professorofdermatology nitely increasing,” says Michael Hamblin, treating acne,depression,andpainonline. you canfind for moredo-it-yourselfgadgets and safer—light-emitting diodes(LEDs), recent availability heat-free— oflow-cost, to treat skinproblems.Andthankstothe high-end spasroutinelyuselighttherapy Alzheimer’s offices disease.Dermatology and mentaldeclineinpeoplewith canstall device asimilar whether arestudying scientists University ofCalifornia,SanFrancisco, patients recover.matic brain injury Atthe a red-light-emitting canhelptrau- helmet Hospital, whether researchersarestudying health problems.AtMassachusetts General specific wavelengths oflightcanhelptreat to theskinoreyes exposing ing whether among dozens of ongoing explor studies 61-year-oldretired nurse.“Butitworks.” had amigraine since. to herasshewindsdownat night.Shehasn’t LED lighttwo hoursperday, setting itnext bathes herselfinthegreenglowofaportable up. Months ended,shestill thestudy after for migraine, shedidn’t hesitate tosign greenlighttherapyclinical trialtesting seated andincapacitated. toadarkroom,nau- forcing hertoretreat at bay. days few anyway, cameevery They tokeep thecrushingheadaches everything Ossipov hadherfirst migraine, she’s tried In the 30yearssinceDonnaKeller- WEBMD.COM So-called phototherapy fell outoffavor inlighttherapy“I thinkinterest isdefi- trial, atThe the University of Arizona, is “I don’t know how it works,” says the learnedofa So whenKeller-Ossipov THERAP HOW LIGHT Y WO Y RKS
- - based dermatologist Meghan Feely, MD. more like youthfulcells,” says New York City- mitochondria, itmakes oldercellsbehave youstimulate used totreat wrinkles.“When offices doctors’ totreat acne,whileredlightis fights blue lightisroutinelyusedin bacteria, uses areindermatology. Becauseoftheway it common and accepted most medical The of melatonin, whichhelps withsleep. ithindersproduction When itenterstheeye, good at makingyouwakeful. blue lightisvery wavelengthColumbia. Shorter orvisibly at theUniversityof psychiatry ofBritish MD, Lam, a researcher in the department mine, whichaffect Raymond mood,explains neurotransmitters like serotoninanddopa- to the brain. influences of That production that lead from the retina stimulates nerves at theWellman CenterforPhotomedicine. Hamblin, who’s alsoprincipalinvestigator mechanismsinthecells,”protective says that mildformofstress activates is a“very or disease-fighting light antioxidants. The ofhealinganti-inflammatories production moreefficientlymake energy andboost mitochondria (acell’s powerhouses)to the skin, it nudges visibly redlighthits longer wavelength or and whereit’s used. length, or color, oflight depending on the wave responsevaries,That aresponse. kick-start insidecells,which cules light-sensitive mole- they’re absorbedby of light hit the skin, tolight.Whenparticles chemical reaction plants throughphotosynthesis—have a byFuturea report Market Insights. decade,accordingto 5% annuallyinthenext togrow isprojected and theglobalmarket spent $309milliononlighttherapy in2016, iscomingback—U.S.practice consumers with minimalskin-damagingUVrays, the and LEDsthat deliverprecisewavelengths lasers decade, withtheriseoflower-cost skin cancercamealong.Butinthepast LIGHT THERAPY FOR If the light comes through the eye, it If thelightcomesthrougheye, For when instance, HamblinAs people—like explains, doesitwork? But howexactly SKIN ANDMOOD - “I THINKTHESEDEVICES ADJUNCT TO EXISTING TREATMENT TOOLS.” CAN BE AGREAT combo groupimproved. the light therapy group and 76% of the 33% oftheplacebogroup),while 50%of pressant group felt better (less than the that didboth. took antidepressantsdaily;andagroup of morningsummerlight);agroupthat fluorescent lightbox (aboutthebrightness minutes perday toa10,000-lux exposed a placebogroup;groupthat spent30 lookintothelight. when they offeel-good neurotransmittersduction benefit pro- too,possiblybyboosting who have nonseasonal depressioncan regular sleeppatterns mood. andboosting anoff-kilterreset biologicalclock,restoring byday,promote alertness thetreatment can By using artificial light to theory: scarce. The andbrightnatural shorter lightcanbe get of depressionthat tendstohitwhendays to treat seasonalaffective disorder, aform whiteorbluelightboxes primarily tabletop treatment tools.”to existing canbeagreat adjunct I thinkthesedevices “As longaspeoplehave expectations, realistic andblackheads,says Feely. cysts more severe the light.) may At-homegadgets nothelp a creamtomake theskinmoresensitiveto treatments. (In the office, apply often doctors are not likely to workaswell as professional treatment whenneeded.Butthey sun after glassesandstay outofthe wear protective typically to safeifpatients followdirections moderate psoriasisat home. totreatwearable mildto bluelightdevice In July, theFDA clearedBlueControl,a out blue light therapy masks to treat acne. People with bipolardisorder should steer eightweeks,29%oftheantide- After One 2015 comparedfourgroups: study Lam’s that people researchsuggests To mental boost have health, doctors used are say homegadgets inexpensive Doctors companieshaveSeveral recentlyrolled
GETTY IMAGES thing,” shesays. “I’m not giving that lightback.” amaster’s school toget degree.“Icantellyouone her medication inhalfandbeenabletogo backto bytheresults.” excited very more researchisneeded,” “Butweare hestresses. and experimental, very isstill them.“This prevent them) butrather touseit dailyfor10weeksto during a migraine can aggravate (light exposure attacks. orlesssevere fewer Ossipov reported trial inhumans,patients withmigraine like Keller- couldbewhy,the spinalcord.That inapreliminary ofnaturalduction painkillerscalledenkephalins in pro- itboosts green LEDlightthroughtheretina, than blue,forchronicpain. green light,whichhasaslightlylonger wavelength thebulkofhisresearchon Arizona, isfocusing of the pain management clinic at University of are intheworks. trials Larger andthinkingtests. better onmemory did for 20to25minutesdaily12weeks,they near-infrared lighttotheskullandinsidenostril thatfound thatwore a givesdevice off when they therapy pillowsforneckpain. follow. market has since been The flooded with light treatmentpain immediately andforweeksto after wavelength thanred)applied totheskineasedneck found that near-infrared light(aslightlylonger and thinkingskills. orders like chronic pain and decline in memory wealth ofunrealizedpromiseforwidespreaddis- doses, wavelengths, andtechniques,itholdsa thattherapy withtheright for30years,believes been inconclusive. onstudies light therapy for wound healing have patients wasdiscontinuedearlyfor“futility.” Other is scarce,andresultsaremixed. ous diseases,skepticism ishigh,researchinhumans When itcomestousinglighttherapy forotherseri- for nonseasonaldepressionislesswell-known.” winter depressiononly. ideathat itmightwork The “Most for peoplethinkoflighttherapy assomething alongside medication forpatients withdepression: says. prescribes light therapy Lam Butheoften canaggravateclear oflightboxes, asthey mania, Since starting thegreenlighttherapy,Since starting she hascut So isKeller-Ossipov. tousethelight never Ibrahim cautionedsubjects His researchshowsthat whenrats to areexposed Meanwhile, Mohab M.Ibrahim, MD, director ofpatientsAnother smallstudy withdementia of16trials totaling 820 patients One review But Hamblin, light whohasbeenstudying One recentlarge oflighttherapy study forstroke FUTURE FRONTIERS some studies show.some studies chroniceasing pain, inflammation and the skin, reducing red) can penetrate wavelength than a slightly longer is invisible and has Infrared light (which INFRARED: INFLAMMATORY ANTI- the office. blue-light fixtures at encourage the use of before bedtimeand emitting electronics the use of blue-light- experts discourage That’salert. why making you more melatonin levels, it will suppress your Look at blue light and skin inflammation. with red light, calm and, when combined deep within follicles acne-causing bacteria to the skincan kill Blue light applied CLEANSING BLUE: for dermatology at Harvard MedicalCenter. While using lighttherapy is still controversial brain, fending off depression. good neurotransmitters inthe of all colors) may boost feel- light (which is a combination that exposure tobright white Numerous suggest studies MOOD-BOOSTING WHITE: Different colors, or wavelengths of light, can have , says andhumanhealth cells, tissues, Michael Hamblin, an associate professor of many conditions as researchers optimal wavelengths,about learn duration, and THE frequency,
HEALING here’s acloser look at what some research shows so far. POWER OFCOLOR on distinctly different on impacts alertness andimprove alertness experts say it can also experts say itcan also boosting hair growth, boosting hair growth, making old or injured making old or injured ones, dermatologists dermatologists ones, therapies popular for popularfor therapies boost appetite—one boost appetite—one minimizing wrinkles, minimizing wrinkles, use orange in logos. use orange in logos. spinal cord, making spinal cord, making cell’s powerhouses, ORANGE: minutes may boost mayminutes boost to pain. Studies are are to pain. Studies GREEN: restaurants tend to restaurants tend to say. While research light hits the skin, it light hits the skin, it rejuvenating effect has made red light has made red light compounds in the compounds inthe natural pain-killing natural pain-killing REJUVENATING them less reactive reactive them less younger, healthier show that looking show thatlooking stimulates energy energy stimulates at an orange light at an orange light and accelerating and accelerating cognition. Some cognition. Some that exposure to that exposure to PAIN-KILLING reason fast food cells behave like STIMULATING RED: for as little as 10 for aslittle10 wound healing. wound healing. production in a production in a green light can green light can now underway boost levels of boost levels of in rats shows in rats shows is mixed, this is mixed, this in humans. inhumans. WEBMD.COM When red When red Research Research Studies Studies 43
By R. Scott Rappold
Reviewed by Brunilda Nazario, MD, WebMD Senior Medical Editor
Illustrations by Nicole Xu
a death
When Beth Wood’s cancer returned in 2014 after 20 years of remission, she made an instant choice: no chemotherapy, radi- Growing numbers of ation, or other life-altering treatments that could only stave off the inevitable. people are talking She told her husband as much in the about death, dying, same breath as informing him the cancer was back, after what was supposed to be a and the end of life routine visit to the doctor. in new ways “She made a decision to say, ‘I’m not going back through that again. I want quality of life, not quantity,’” says her hus- band, David Wood, of Nashville. “And we were given almost three more years.” They traveled the country and spent a final Christmas with the children and grandchildren, and when she died at the age of 65 on Dec. 29, 2016, it was peaceful, at home, with Beth secure in her faith she was going to a better place. It was, says her widower, a “good death.” “I thought a lot about those two words. I think to understand death, you have to understand the life of the person. For her, she was not scared of death,” he says. This is a concept more Americans, from the elderly to the terminally ill to the doc- tors who care for them, are embracing. Eight states have passed laws allowing doctor-assisted suicide, although a judge
45 WEBMD.COM AID-IN-DYING LAWS They held hands as she drifted find the most opposition in rural headlines, Herb Myers’ phone rang work one-on-one with people who are dying, By the end, Kathy Myers into unconsciousness. A short areas and at medical facilities with constantly with people asking for helping them memorialize their lives and couldn’t even get out of bed on time later, a hospice nurse con- religious affiliations or out-of- help finding a doctor. Those calls plan their deaths. her own. A lifelong smoker in firmed she had no vital signs. It state ownership. Medical facilities have diminished as the process in “I think in America, we live in a very Aurora, Colorado, she had was, Herb said, “very gentle and can opt out of the law, prohibiting Colorado has gained more accep- youth-centered culture, a very kind of chronic obstructive pulmo- very quick.” She would’ve been 63 their pharmacies from filling such tance. And while he misses his wife anti-aging culture. There’s a lot of denial of nary disease. the next day. prescriptions or avoiding such of 38 years, he has no regrets. death. We don’t usually see people die in our There were no more In the first year of Colorado’s deaths occurring on the premises, “Anything else we did would homes anymore,” Farr says. Becoming an bike rides with her hus- law, 69 people were prescribed but they can’t forbid doctors from have just prolonged her life and end-of-life doula has become popular, with band, no more trips to aid-in-dying drugs by 37 doc- taking part. her suffering. I think it was the 18 training sessions held around the country the mountains, no more tors, and 78% were able to die at “It really is a two-pronged right thing to do,” he says. “I think in 2018 alone, according to the International working in her garden, home, according to the Colorado approach to getting acceptance. everybody should have the right to End of Life Doula Association. no more doing anything Department of Public Health and We need patients to know their go the way they want.” According to Deathcafe.com, on any given without an oxygen tank. Environment. rights and be willing to have a day half a dozen such meetings convene So when Colorado voters Nationwide, the movement hard conversation with their doc- TALKING ABOUT DEATH around the country. Farr put out chairs for approved doctor-assisted has come a long way since Jack tor, but we also need to educate Sarah Farr is an end-of-life doula 15 at the last gathering she hosted; 50 peo- suicide in 2016, she was deter- Kevorkian went to prison in the doctors . . . so patients feel in the Washington, D.C., area. ple showed up. Discussions run the gamut mined to use it. But because of 1999 for assisting patient sui- comfortable discussing [ending While doulas are better known for of death-related topics, and attendees range “We need patients to misunderstandings or a reluc- cides. Oregon in 1994 became their lives] and the doctors feel providing help for births, Farr hosts from young people to the elderly. Most have tance to act under the new law, the first state to pass an aid-in- comfortable prescribing or refer- regular meetings known as death witnessed a death or have had someone in know their rights and be she had a hard time finding a dying law, which has been used ring them to someone who will cafes for people to discuss this once their life pass away, and Farr sees them look- willing to have a hard doctor willing to help. more than 1,000 times. In that prescribe,” DeWitt says. taboo topic. Other ing for some control over what is essentially “What we came up against was state, Catholic groups and other After Kathy Myers’ story made end-of-life doulas uncontrollable: their own deaths. conversation with their a lot of ignorance. Our family conservatives remain opposed, “A lot of people want to maybe share doctor, but we also need to doctor said it was going to take although they are not actively stories of a death they witnessed,” she says. court orders and years before we fighting the law. “People say, ‘If I could have a say in it, this is educate the doctors.” could opt for that,” says her hus- Sam DeWitt is the how I’d want to die.’ Choosing [the] day and band, Herb Myers. Colorado access cam- time of our deaths; it’s just something we recently overturned California’s three- After the couple pleaded for paign member for don’t have control over. But that doesn’t year-old law. Conversations about death, help through local media, a doc- Compassion and mean we can’t plan for it if it was to once taboo, are now held around the tor got in touch and made a house Choices, a Denver- happen, in terms of using hospice care, world at so-called death cafes. Before for- call, agreeing that Kathy met the based nonprofit that dying in a hospital versus dying at home, mer first lady Barbara Bush died earlier criteria under the new law: a advocates for such exploring different things you can do this year, she received support on social prognosis of less than six months legislation around with your body after you die, discussing media when she decided to forgo further to live and sound mental capac- the country. The home funerals.” medical treatments. ity. A second doctor confirmed, organization and its Of course, a “good death” could be After all, at no point in history have peo- as required by the law, and on staff and volunteers something different for each person. ple lived as well as Americans today. So, March 12, 2017, Herb emptied have worked to edu- Emily Meier, PhD, a clinical psycholo- more people now ask: Why shouldn’t we 100 capsules of Seconal into a cate doctors about gist at UC San Diego Health, recently focus on the quality of our death as well? glass of Gatorade. the new law. They studied research from around the
Deathcafe.com: An international calendar of upcoming “death Prepareforyourcare.org: This nonprofit website lets you download Inelda.org: The International End of Life Doula Association RESOURCES FOR A cafes,” this website lists when and where people of all ages can an advance directive form for whatever state you live in, so loved includes a directory of these experts who can help people come meet to discuss life and death matters. ones and medical professionals will know your health-care wishes to terms with issues related to their deaths. Some, much like in the event you are incapacitated or unable to communicate. birthing doulas, will work with a person to help memorialize their GOOD DEATH Theconversationproject.org: An initiative of the Institute for Videos have step-by-step instructions on how to fill out the forms. lives and face their death. THESE WEBSITES AND ORGANIZATIONS Healthcare Improvement, this website is full of resources for ARE A SAMPLE OF RESOURCES FROM families who want to discuss end-of-life options with a loved one. Compassionandchoices.org: This nonprofit advocates for aid-in- Nhpco.org: The National Hospice and Palliative Care Organization You can download or print out a “conversation starter kit,” as well dying laws across the country. The website includes information on website is full of resources on this end-of-life option, including WHICH YOU CAN FIND MORE INFORMATION as guides for talking to your doctor about end-of-life options and existing laws, how you can help your state adopt such a law, and a helping patients find a hospice to meet their need. ABOUT END-OF-LIFE OPTIONS. choosing a health care proxy to make decisions if you are unable. hotline for people to call if they need to discuss end-of-life issues.
46 47 WEBMD.COM WEBMD.COM world on death and identified 11 others who work in core themes for a good death. a variety of health Among these are lack of pain, reli- care fields. gious and emotional well-being, a “We actually feeling of life completion, dignity, ask them: What closeness of family, and quality of are their expecta- life. Being able to die at home is tions? What are also a strong desire. their desires? It’s Meier says talking about a good fairly common they death and what that means in don’t want to suffer advance is the best way to make physically, with it happen. No matter the age, she pain and nausea encourages people to prepare and swelling, so we advance directives, wills, and other address all that,” end-of-life documents and share Berkompas says. their wishes with loved ones. But what if they “If the conversations are only want to stay ongoing, and even when you’re alive long enough healthy, if you have conversations for an upcoming about, ‘What’s most important to wedding? What if me at this point in my life?’ a lot their treatment plan of those things are going to stay has side effects that the same at the end of life,” Meier make their final days says. “The more we talk about it unbearable? earlier, the less scary it becomes “We let the patient because it’s very challenging direct as much of their per- to have those conversations in ception of what a good death your final days in an ICU or a hospital,” the last moments and trying to would be and work with that,” he says Berkompas. scramble together to make sure says. “If we can give them a great For David Wood, whose wife declined people are having, so to speak, a deal of control within the hospice aggressive treatment for her terminal good death.” environment, I hope we’re giving cancer, Alive Hospice made all the differ- them the best of both worlds.” ence in making her final months bearable. THE HOSPICE ALTERNATIVE As a doctor trained to always Nurses visited their home every other Some people think of hospice as fight illness, Berkompas had to week, giving her medication to deal with a place people go to die. At Alive change his philosophy. He works pain. And when she couldn’t get out of Hospice in Nashville, it’s where with other doctors to help them bed on her own, a nurse came. If he had they go to live as well as possible get away from the treat-at-all- questions at 2 a.m., he called and someone until they die. costs approach. from the hospice answered. It gave him Chief medical officer Robert “When we say, ‘I really don’t the confidence to keep her in the house Berkompas, MD, says the non- have any more treatment for that and be her caregiver until the end. profit hospice has only 55 beds but illness that is effective or promis- It was the most intimate time in their 43 treats 4,000 patients a year who ing,’ I can say, ‘But I still have a years of marriage. have a prognosis of six months treatment for you.’ It’s going to be “She wanted me to live again, to love again, or less to live. Most of the care is helping you through this process to play again,” says David, who has since given in patients’ homes by a team of dying, and hopefully it will be remarried. “She had time to tell me things to of nurses, doctors, counselors, and a good death and not spending let me go. At the same time, I was letting her go. She was comfortable. She told me, ‘David, I am not scared about where I’m going “The more we talk about it . . . the less scary it because I know who I’m going to.’ Hospice just gave me and her the confidence to have a becomes, because it’s very challenging to have good death. To me, it’s to make the transition those conversations in the last moments.” from this world to the next.”
48 WEBMD.COM DELICIOUS BITES Food MEALS MADE EASY
GOOD FOR YOU Little Sprouts Scope out your grocery store or farmer’s market for Brussels sprouts, in season now. Roasting this super food brings out a nutty sweetness perfect for fall meals.
IF YOU’RE A BRUSSELS SPROUT SKEPTIC, CHANCES ARE YOU HAVEN’T HAD them prepared well. They offer impressive nutrition: Just one half-cup provides 81% of an adult’s daily value of vitamin C (which supports immunity), 8% of fiber (which promotes healthy digestion), and 12% of the B vitamin folate (which appears to protect DNA from damage). They’re also chock-full of glucosinolates, compounds that inhibit cancer cell growth. Roasting makes them delectable. Rinse sprouts, trim their bottoms, and cut in half length-wise. Toss them with olive oil, salt, and pepper. Roast on a sheet pan at 400ºF for about 20 minutes, until browned and leaves are crispy. Drizzle with balsamic vinegar and enjoy. —ERIN O’DONNELL PHOTOGRAPHY: RICK LOZIER; FOOD STYLING: CHARLIE WORTHINGTON CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY:
49 WEBMD.COM BY Matt McMillen FOOD REVIEWED BY Hansa Bhargava, MD Search for the slideshow WebMD Senior Medical Editor Stir It Up With Soup at WebMD.com.
MAKE IT • Double the recipe. Cool uncov- ered then freeze half your soup for nights you don’t want to cook. • Use a heavy-bottomed pot, like a good Dutch oven. This allows you to lightly caramelize the veggies without the risk of burning them. • Build a base of flavor. Sweat some onions in olive oil until they begin to color, then add garlic and a little salt. • Use leftovers. Didn’t eat all the roast parsnips or sweet potatoes last night? Add them for depth of flavor and to help thicken your soup. • Add flavors at the right point. A good rule of thumb: Dry herbs go in at the start; add fresh herbs at the end to preserve their flavor. • Salt frequently but judiciously. To bring out flavor, sprinkle a little salt in as you add veggies and broth. • Plan the proper order. Determine which vegetables take longer to cook than others and add them first. BUILD A BETTER • Chop uniformly. Cut your veggies into similar-size pieces so that they cook evenly, but don’t stress Vegetable Soup about being too precise. Celebrate each season’s bountiful and nutritious produce with a hot bowl of • Take your time. Soup should be vegetable soup, a dish that’s easy to master and make your own simmered to draw out the maxi- mum amount of flavor. Your taste VEGETABLE SOUP, SAYS KATE McMILLAN, BOASTS SO MANY QUALITIES VALUED BY HOME COOKS: buds will tell you when it’s ready. It’s full of flavor and good-for-you ingredients and can be as simple or sophisticated as • Top it off. Give your soup a final you want it. “The number of recipes and variations you can make are endless, and it’s so flavorful finishing touch— shredded cheese, grilled bread, nourishing and comforting” says McMillan, author of Soup of the Day. “Experiment and or a spoonful of sour cream, have fun.” Incorporate some of her tips the next time you cook. smoked paprika, or lemon juice.
Frozen Burgers
CRAVING A BURGER? TRY ONE OF THESE F U L L- F L AVO R E D, READY-TO-COOK ENGINE 2 POBLANO GRASS-FED BUBBA BEYOND MEAT’S APPLEGATE HENRY AND LISA’S VERSIONS, SELECTED BLACK BEAN BURGER BURGER BEYOND BURGER ORGANICS TURKEY WILD ALASKAN BY REGISTERED “Get 6 grams of pro- “A high-quality, “Boasting 3 grams BURGER SALMON BURGER DIETITIAN KATIE tein in this 130-calorie slimmed down version of fiber, 20 grams of “A leaner, lower- “Made with sustain- CAVUTO, MS, veggie burger, which of Bubba’s popular protein—comparable calorie alternative able, wild-caught salm- on, each burger offers AUTHOR OF WHOLE provides balanced nu- original patties, these to beef burgers—and to traditional beef a generous 650mg of COOKING AND trition, all from whole will satisfy your burger only 5 grams of burgers, these or- food ingredients like cravings and supply carbs, this veggie ganic ground turkey heart-healthy omega-3 NUTRITION. beans, whole grains, 21 grams of protein patty looks and tastes burgers bring on the fatty acids and about and seeds.” with less fat and fewer like the real thing.” protein: 20 grams per half the calories of calories.” four-ounce serving.” comparably sized beef patties.” PHOTOGRAPHY: RICK LOZIER; FOOD STYLING: CHARLIE WORTHINGTON CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY:
THE OPINIONS EXPRESSED IN THIS SECTION ARE OF THE EXPERTS AND ARE NOT THE OPINIONS OF WEBMD; WEBMD DOES NOT ENDORSE ANY SPECIFIC PRODUCT, SERVICE, OR TREATMENT. 50 WEBMD.COM BY Erin O’Donnell FOOD RECIPES BY Kathleen Zelman, MPH, RD, LD Search for the Healthy Eating Newsletter at WebMD.com. LIME JUICE
3. THE WEEKNIGHT SPECIAL 3 WAYS
Tacos AVOCADO Tacos are tasty, kid-friendly, and easy to load with healthy ingredients. Try three new ways to Tortilla Trick turn every night into Taco Tuesday. To make corn Superfood Tacos tortillas warm and 1These tacos hold a host of flavor and disease-fight- GRILLED GINGER CORN pliable, cover a ing antioxidants. The addition of sweet potato NONFAT GREEK stack with a damp and avocado makes them especially satisfying. YOGURT paper towel and This recipe includes queso fresco, a soft Mexican heat briefly in the NAPA CABBAGE cheese, but any shredded cheese will do. microwave.
MAKE IT Sauté sliced red and yellow peppers, sliced red onion, and minced garlic in olive oil until just tender. CORN Add a can of rinsed black beans, 1 tsp cumin, and ½ tsp TORTILLAS red pepper flakes and cook 3 to 5 more minutes. Add the mixture to warmed corn tortillas. Top with chopped tomato, avocado, roasted sweet potato, and a sprinkle APPLE of shredded queso fresco. SERVES 4
1. THE VEGETARIAN OPTION PER SERVING (2 TACOS) | 398 calories, 14 g protein, 58 g carbohydrate, 14 g fat (4 g saturated fat), 8 mg cholesterol, 14 g CORN fiber, 7 g sugar, 137 mg sodium. Calories from fat: 37% RED ONION TORTILLAS
SWEET POTATO
GARLIC
HONEY CHICKEN BREAST COTIJA 2Fish Tacos with Honey-Ginger Grilled3 Chicken Tacos with CHEESE Dressing Avocado, Corn, and Cotija Cheese The combo of flavorful fish, crunchy coleslaw, A tasty marinade makes chicken breast the CORN TORTILLAS and savory sauce makes the fish taco a winner. star of these tacos. This recipe calls for grilled WHITE Any white fish will work here; consider mahi-mahi, corn; throw two ears on the grill as you cook the CARROT FISH cod, or tilapia. For the slaw, we like delicate Napa chicken or find grilled corn in the frozen veggie cabbage, but a blend of red and green cabbage section of your supermarket. It also includes 2. A HINT OF BAJA also works. cotija, a salty Mexican cheese.
AVOCADO MAKE IT In a large bowl combine ½ cup nonfat MAKE IT Place 1 lb chicken breast in a zip-top bag with Greek yogurt, 2 tbsp honey, a splash of lemon juice, the juice of 2 limes, ¼ cup olive oil, 2 cloves chopped and 2 tsp fresh grated ginger. To the dressing add garlic, 1 tsp cumin, salt, and black pepper. Marinate at CUMIN 3 cups of shredded Napa cabbage, 1 cup shredded least 30 minutes. Discard marinade and grill chicken over SHREDDED carrot, and a small shredded apple; toss. Season medium-high heat, about 14 minutes, or until the internal QUESO FRESCO 1½ lbs of white fish with salt and pepper and sauté temperature is 165ºF, turning once halfway through grill- RED AND YELLOW in a pan for 4 to 6 minutes per ½-inch thickness of ing. Meanwhile, grill 2 ears of corn for 15 to 20 minutes. BELL PEPPERS fish, or until flaky, turning once halfway through Cut kernels from the cob. Warm tortillas on the grill until RED PEPPER cooking. To serve, top warmed tortillas with the fish soft. Fill each tortilla with sliced chicken, corn, avocado, FLAKES and coleslaw. SERVES 4 cilantro, and a sprinkle of cotija cheese. SERVES 4
PER SERVING (2 TACOS) | 328 calories, 37 g protein, 33 g PER SERVING (2 TACOS) | 371 calories, 34 g protein, 39 g carbohydrate, 6 g fat (1 g saturated fat), 72 mg cholesterol, 6 carbohydrate, 10 g fat (2 g saturated fat), 73 mg cholesterol, 7 g GARLIC BLACK PHOTOGRAPHY: RICK LOZIER; FOOD STYLING: CHARLIE WORTHINGTON CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY: g fiber, 9 g sugar, 290 mg sodium. Calories from fat: 16% fiber, 1 g sugar, 273 mg sodium. Calories from fat: 23% BEANS
51 52 WEBMD.COM WEBMD.COM BY Matt McMillen FOOD REVIEWED BY Hansa Bhargava, MD Search for the video The Basics: WebMD Senior Medical Editor Root Vegetables at WebMD.com.
BEETS Deeply colored—either garnet or golden—beets have a rich, earthy flavor. Try them roasted, raw, pickled or even in sweet treats like red velvet cupcakes. You can also sauté the tops.
CELERY ROOT CARROTS With its beautiful creamy white interior Right for both sweet and and distinctive flavor, celery root can be savory dishes, carrots mashed like potatoes, pureed for delicious cross so many world soups, or cut into thin raw sticks to add cuisines. Make a pesto SWEET crunch to salads. FOOD 101 from their green tops, POTATOES shave them into salads, or roast them to concentrate Grill them, bake their sweetness. Know them like fries, or make them into a pie filling. Versatile Your Roots sweet potatoes, Root vegetables may not which absorb the flavors of what PARSNIPS win any beauty contests, they’re cooked with, Creamy white with a sweet, but beneath their skin should be a year- nutty flavor brought out by lie wonderful flavors and round staple. WORTHINGTON CHARLIE RICK STYLING: PHOTOGRAPHY: FOOD LOZIER; roasting or braising, serve them for dinner or dessert. Think loads of nutrition soups, mashes, or as a sub for IN THE RIGHT COLD AND HUMID carrots in a classic carrot cake. conditions, root vegetables can be stored for months. But don’t let them linger in your vegetable drawer— add them to your next meal. “These richly flavored nutrition powerhouses are true superfoods,” says Diane Morgan, author of Roots: The Definitive Compendium. They can be prepared in a great variety of ways, both raw and cooked. Here are five of Morgan’s favorites. GETTY IMAGES EXPLORE HEALTH is hope. the 30%ofpeoplewhodon’t findrelief, there get completerelief oftheirsymptoms. For antidepressants eventuallypeople whostart treatment within90days. Aboutseven in10 people whoreceives adiagnosisstarts ity among15-to44-year-olds. causeofdisabil- Depression istheleading and schizophrenia. bipolar disorder, such asdepression, illness, with mental Americans lives about oneinfive Every year, EDGE CUTTING depression improves on an older depression improvesonanolder treatment formedication-resistant trackfast toFDA approval. nasalspray—isesketamine onthe treatment fordepression—an first ketamine-based as well.The people withbipolardepression medications, helps ketamine hours. Combinedwithother including suicidalthoughts,in symptoms, torelieve can start drug depression.The resistant soon beavailable formedication- andpain-killer,anesthetic could KETAMINE, AN FDA-APPROVED New research shows thatonlyoneinthree An experimental, non-drug non-drug An experimental,
Checkup
resistant depression. Shorter depression.Shorter resistant in peoplewithmedication- as wellorbetter thantheoriginal version works shows that theshort form ofthetherapy. Research stimulation, offersathree-minute treatment, intermittent burst theta week, foruptosixweeks.Anew minutes perday, fivedays per stimulation takes 40 magnetic transcranial effective, Though associated withmoodregulation. ofthebrain to stimulate apart casesofdepression in stubborn the U.S. have pulses usedmagnetic in approach. Since2008,doctors
— treatment strategies. and prevention to customizable increase riskfordepressioncan lead Better ofgenes understanding that associated withdepressionrisk. sum totalofaperson’s DNA— points inthehumangenome—the unknown uncover 30previously researchers collaborated to More than200international treatments fordepression. effective lay thegroundworkfornew, more treat many morepatients. to sessions couldallowdoctors SONYA COLLINS Major genetic research could Major researchcould genetic TAKE ACTION WEBMD.COM 55 56 disease that takes many forms invariousResearchers fields multiplepaths totreat explore a Mission Cancer ONTHEHORIZON WEBMD.COM BY THENUMBERS 63 63 at WebMD.com. WebMD.com. at Treatment Breakthroughs Cancer article the for Search a drugthat reprograms aperson’s ownimmunecells,theT-cells, torecognize year,recognize it as a threat. Last the FDA approved the first CAR-T cell therapy, inthebody,be sodeadly:Whencancerdevelops doesn’t theimmunesystem unseen.That’s theimmunesystem Cancers cansneakpast can onereasonthey Science Therapy at The University atTherapy The ofTexas M.D. AndersonCancerCenter. MD,Bernstam, oftheInstitute medicaldirector for Personalized Cancer from whichtherapy orcombination oftherapies,” says Funda Meric- withtheimmunesystem. the cancerinteracts based onthetype ofcancer, thetumor’s andhow unique characteristics, who have cancerhave personalizedtreatment optionsavailable tothem approaches.Today,therapy aregivingway tocustomized many people it.One-size-fits-allsurgeries followedbychemo- gle approachthat cures THE SEARCH FOR “A CURE FOR CANCER” IS ALMOST AN OUTMODED IDEA. IMMUNOTHERAPY “Precision medicinelooksat pick who’s howwecan best going tobenefit
tells usthat cancerisnotasingledisease,anditwon’tbesin- tumors. 24 different of types 78 different usesand the last five years for drugs approved in Number ofnew cancer 14 targeted therapies. approved in2017. Allare Number ofnew cancer drugs CHECKUP 23 possible treatment. inhibitors” are a “checkpoint fortypes which Number oftumor those two proteinsfrom attaching others inclinicaltrials,canblock FDA-approved drugs,andmany Severaltrick theimmunesystem. look harmless too. That’s how they cells have proteinsthat make them cells alone. toleaveimmune system thenormal attach toeachother, that signalsthe protein andthehealthy cellprotein non-threatening. WhentheT-cell protein that identifies themas normal cells haveThose another attacking yourhealthy, normalcells. them from switchtoprevent “off” proteins onyourT-cells asan act as Hodgkin’s lymphoma.Certain andheadneck,aswellkidneys, cancers oftheskin,lungs,bladder, the outlookformany peoplewith with T-cell behavior, have changed inhibitors, whichalsointerfere transformational,” says Meric-Bernstam. of immunotherapy treatments hasbeen evolution were onceinvisible toit.“The to fightimmune system cancers that immunotherapy the that trigger one of several approaches called cancer-killing machines. more preciselyeditimmunecellsinto technology, calledCRISPR-Cas9,to the use of cutting-edge gene-editing further, scientists are now exploring blood cancers.Taking that conceptastep CAR-T celltherapy isapprovedforthree bloodcancers.Today,and killcertain The problemisthat somecancerThe Drugs dubbed checkpoint re-engineering ofThe T-cells is $ $96 billion in2013. worldwide in2017. That’s upfrom Dollars spentoncancer medicine 133 billion
GETTY IMAGES melanoma outcomes.” Comparedto BRAF inhibitors have transformed ofBRAFgene mutations, the discovery such as the breast, lung, or pancreas. lung, or pancreas. such asthebreast, as,thesiteofcancer,important than,orat as least more important so-calleddriverscouldbeThese be responsiblefortumorgrowth. Many different genes or proteins could that makecharacteristics themunique. Tumors, like just people, have have gainedFDA’s notyet approval. promising resultsinclinicaltrialsbut Vaccines forothercancershave had thecancer,cure life. butitcanextend already presentinthebody. It doesn’t advanced prostate cancerthat is toattack theimmunesystem trigger thecancer. against immune system to each other, which unleashes the 700 TARGETED THERAPY An FDA-approved vaccine can tumor, whileanothergene drives One gene mightfeedoneperson’s someone else’s. hope todiagnoseswith approach hasbroughtnew some tumordrivers.This off or seriously slow down Targeted drugscanshut once-bleak outlooks. Bernstam. “WithBernstam. years“Only afew ago, wehad + options for no treatment says Meric- melanoma,”
60% inthelast decade. development. That’s up currently inlate-stage of cancer drugs Estimated number make decisionsaboutoptimal therapy.” toand potentially immune factors belookingat RNA, DNA, think we’ll says Meric-Bernstam. “Eventually, I properly.but don’t function are supposedtosuppresstumorgrowth genes that called oncogenes, ordefective transform normal cells into tumor cells, genes could target that technology This growth orotherharmfulprocesses. fortumorthat carries instructions toliterallyscientists killthemessenger could one day allowtechnology a gene’s RNA-interference function. for messenger that carriesinstructions the helpofRNA—ribonucleic acid—the promoting thegrowthofatumor, with therapy choiceforthem.” individual patient’s diseaseandthebest platform forbetter each understanding says Meric-Bernstam, “andnowit’s a questions,” patients orselect for select sequencing was once a research tool patient growsincreasinglyeasier. “Gene identifying therightdrugfor drugs.What’s fornew be targets more, uncover additionaldriversthat could has flourished. Researchers continually sequence oftumors,scientific discovery ofreadingtheDNAthe fallingcost cancer.as wellHER2+breast cancers, includinglungandcolorectal treatments areavailable forcertain can have sideeffects. fewer These cells andhealthy therapy cells,targeted chemotherapy, whichattacks cancer “Precision medicine’s heretostay,” suchas theirfunction, perform Genes With theincreasingspeedand 34 currently inclinical trials. could benefit from immunotherapy drugs Number ofdifferent that types tumor GLOSSARY to fight cancer. to fight system immune own body’s the stimulate that inhibitors, point check including medications, to grow. tumor that causes that tumor a in agene in a variant athreat. as recognizes the cells system immune the those proteins, so blockinhibitors cells. Checkpoint normal, healthy like look them make that proteins carry cells cancer Somecancers. of types certain on attack system immune- an trigger medications that IMMUNOTHERAPY: MUTATION: DRIVER INHIBITORS: CHECKPOINT 14 REVIEWED BY -
developer apatent. files the market after the new drugto reach of years ittakes a Average number WebMD SeniorMedical Editor
sentences. then and words form similar to how letters runs, body the how the instructions for determines chemicals the of order The and thymine. cytosine, guanine, chemicals: adenine, four of consists that acode of form the in information contains DNA body. person’s a in cell every almost in lives that offspring to parents from down material passed hereditary the acid, deoxyribonucleic DNA : DNA Arefa Cassoobhoy, MD, MPH medicine. called personalized and Also lifestyle. genes, environment, aperson’s in variation individual account into takes that treatment medical PRECISION MEDICINE: BY BY
Sonya Collins WEBMD.COM 57 GETTY IMAGES 1, 01 115,4 form routine screenings for hearing and jaundice levels; the first im- thefirst form routinescreeningsforhearingandjaundice levels; Hospitalbirth. andper- pediatricians areoncalltoassessnewborns Babies have appointments withpediatricians theirfirst rightafter medical caretopint-sizepatients requiresgrown-upcredentials. for well-behaved patients, butpediatrics isserious business.Providing THERE MIGHT BE CARTOON CHARACTERS ON THE BANDAGES AND LOLLIPOPS CARE STARTS AT BIRTH BY THENUMBERS the United States. Number ofpracticing pediatricians in to WebMD.com/findadoctor. Go WebMD’s Physician Finder Looking for a doctor? Use What does this medical professional do?What thismedicalprofessional does Pediatrician
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BY Matt McMillen
REVIEWED BY Hansa Bhargava, MD WebMD Senior Medical Editor Search for the slideshow Is It a Cold or the Flu? at WebMD.com.
HEALTH HIGHLIGHTS ‘Tis the Season Don’t let colds and the flu get you down. Follow these expert tips.
Prevention Coughing or sneezing into your sleeve or a tissue instead of your hands is a good way to reduce contamination.
10 Ways to Cope
1. ACT FAST 6. KEEP IT CLEAN Take antiviral flu medication within 48 To kill cold and flu viruses, disinfect hours of symptoms for the best results. surfaces you often touch.
2. STAY HEALTHY 7. KNOW THE DRILL Reduce stress and get plenty of sleep Learn the flu prevention plan at your to keep your immune system strong. child’s school or day care program.
3. DRINK UP 8. PROTECT YOURSELF Loosen congestion and avoid Have a doctor’s appointment? Wear a dehydration with lots of water—but skip mask in the waiting room. alcohol and caffeine. 9. PROTECT OTHERS 4. DON’T WAIT Cough or sneeze into a tissue or your If you—or someone you’re caring sleeve, not your hands. for—have trouble breathing, get help immediately. 10. AVOID ANTIBIOTICS Remember that antibiotics don’t help 5. FLUSH PROPERLY colds and flu. To avoid infections, use only boiled,
GETTY IMAGES sterile, or distilled water in your neti pot. GETTY IMAGES Quiz Answers cines totreatcines it. need specificmedi- breast cancer, you HER-2-positive If you have an 1. targeting this protein. by cancers breast itive HER-2-pos treat drugs available few currently A cells. cancer her of surface the on HER-2 protein the of much too has cancer breast with women five in ___
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least partly responsible for these survival gains. Take survival forthese responsible partly least thisquizto disease dropped by about 40%. New tests andtreatmentsdisease droppedbyabout40%.New areat tests True. About one one About True. Over the past 25years,Over thenumberofwomen thepast dyingfrom this FALSE TRUE see how much you know about breast canceradvances. see howmuchyou knowaboutbreast at WebMD.com. WebMD.com. at Visual Guide to Breast Cancer A slideshow the for Search Breast Cancer— - What’s New? What’s a woman’s urine. look for markers in cancer, doctorscan To monitorbreast ___ them using blood tests. tests. blood using them find Doctors urine. the not blood, the in are cancer breast for Markers markers. called substances of levels higher produce cancer, to respond that body your in cells other 2. ___ 2 False. Cancer, and and Cancer, False. FALSE TRUE
QUIZ
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ART STREIBER sharpen your Igothrough senses. pe- need to create anatmosphere where become aware ofyour responsibilities. forward to therigor. Thebigtrickisto yearning to doitagaininasecret way. riods leading uptoriods leading production where do everything inmoderation, butI’m really your helpclear does mindand and trekking. Icycle to work quite a Sonny, 17; andLouis, 13. Whatdid observing myobserving wife, Lorraine, whois soloing andiceclimbingasmuch I try toI try notdrinkwhenI’m filming.It I dolove environ beinginmountain - I’ll dopress-ups, sit-ups, allofthat, When you have afamily, you to start but I’m notaweight-lifting person. feels they canfunctionto thebest everything. It’s methatyou taught I’m really notagymperson. I’m an climbing inmy youth—hill walking lot. We, asafamily, gofor walks in I did—althoughI’m probably of sort Oct. 19. You directed it,andyou I try toI try gethealthier. Iactuallylook Your new movie, Mowgli outdoor junkie. Iabsolutely crave ments, butIdon’t dothehardcore everyone isvalued andeveryone As ahumanbeing,it’s me taught you from learn beingaparent? a bitofanall-or-nothing person. You have three kids:Ruby, 19; wilderness. Iusedtowilderness. doalotof of theirability. thatby Ilearned play Baloo. How didyou stay Why didyou stopclimbing? healthy whilefilming? TEN QUESTIONS Do you work out? the nearby hills. brilliant atit. 4 3 2 1
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Take 10 family we tohealthily. try eat We make alotof hours ofsleep. Icanfeel very sluggishduring I’d beenavegetarian sinceIwas 18, thenIstart protein. But Ihaven’t sinceIwas eatenmeat 18. I’m aterrible sleeper. Iliterally getaboutfour shooting juices—beet, carrot,juices—beet, orange. We alotof eat ed eating fishwhenIwased eating about30. We were the day, butIhave 10-minute power naps Andy Serkis I try toI try keep offsugar, whichishard.a As What’s your habit? health best Lord of theRings andIneededmore Actor, 54,London avocado, alotofquinoa. Are you avegetarian? Do you sleepwell? 7 6 5
- because changeisgood.I’m excited about the next generation, where my children are Is the best part oflife part Is thebest behindyou orin in somesmallway to helpothers have as Is there asecret toagood,healthy life? going, andwhatthey’re goingto bedoing. tell you drop thatIcaneasily off to sleep. ter thatI’m goingto take on.I’m constantly being withandto bepresent isthemost your laptop into bed,butI’m ridiculously film I’m goingto direct orthenext charac- bring your phoneinto thebedroom and I’m passionate about children having an development, andBarnardo’s, which I’m always equallyexcited aboutthenext between 5and6inthemorning.That’s how luckythey are, andIfeel obligated and feel fullyrecharged. Myfriendswill undisciplined when it comes to that. I’ll toundisciplined whenitcomes that.I’ll nod off. [At night]Iknow you shouldn’t equal start inlife.equal start Ilookatmy children, changing, and I learn so much from the somuchfromchanging, andIlearn the children atriskby their supporting helps children exposed topoverty, Oh, wow. Ialways think it’s ofme ahead When work isdemandingsomuchof I canliterally beinaconversation and physical, emotional,andlanguage domestic violence.domestic Why ishelping tell you what:I’m atmy mostcreative sexual exploitation, disability, and generally whenIhave my ideas. best you, beingwithpeoplethatyou love You dofundraising andadvocacy living inthemoment,beingpresent. for Beginnings,whichhelps Best I thinkit’s absolutely all aboutreally solid a start asthey possiblycan. solid astart children toyou? important different Ihave.experiences —KARA MAYER ROBINSON important thing. important front ofyou? REAL LIFE 10 9 8
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PREVENT JOINT DAMAGE · 1 | KNOW YOUR RA NUMBERS · 3 FOUR THINGS TO ASK WHEN YOU VISIT YOUR DOCTOR · 4
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THIS CONTENT IS CREATED AND CONTROLLED BY WEBMD’S EDITORIAL STAFF FOCUS ON Joint Damage 101 A LEADING RESEARCHER EXPLAINS HOW RA HURTS JOINTS AND WHY YOU SHOULD ACT TO PREVENT FURTHER DAMAGE By Stephanie Watson The signs of rheumatoid arthritis (RA)—swollen, stiff, and tive tissue that cushions and inflammatory factors like sore joints—are pretty obvious to anyone who lives with this protects bones at the joint. IL-6 and TNF-alpha, disease. Much less obvious are the processes going on under Inflammatory factors in the people with RA no longer the surface that make joints swell and ache. joint lining—like interleu- have to settle for a lifetime Unlike osteoarthritis (OA), in which joint cartilage gradu- kin-1 (IL-1), interleukin-6 of pain and disability. ally wears away over years of use, RA is a disease of inflam- (IL-6), and tumor necrosis “These drugs are effective mation. “That inflammation leads to the production of factor-alpha (TNF-alpha)— at controlling inflamma- factors that drive joint destruction,” says Ellen Gravallese, trigger the production of tion in rheumatoid arthri- MD, Myles J. McDonough Chair in Rheumatology at the destructive enzymes that tis,” says Gravallese. University of Massachusetts Medical School. break down cartilage. In- “If inflammation is under Gravallese and her colleagues have been studying how flammation also destroys the good control, you can inflammation destroys cartilage and bone in RA for the scaffolding of bone that sup- prevent the progression better part of two decades. What they’ve discovered is ports the cartilage. “It’s like of bone destruction in that a few separate processes are behind joint damage, you’re building a house and the disease.” Preventing pain, and deformity. you lose the scaffold you’re inflammation also does a One process damages bones in the affected joints. Cells trying to build upon. There- pretty good job of control- within the inflamed joints produce a substance called RANK fore, the cartilage attached ling RA pain, she adds. ligand (RANKL), which increases the production of osteo- to that scaffold is going to be As a result, far fewer clasts. Normally, osteoclasts break down bone as part of the destroyed,” Gravallese says. people with RA have to natural repair process. Then, other cells called osteoblasts re- Pain is often a sign that undergo joint replacement build bone. When inflammation produces massive numbers the inflammation isn’t well surgery today than in years of osteoclasts, they break down bone too rapidly to rebuild. controlled, she adds. The past. “That’s because we’re “It’s like putting fuel on a fire,” Gravallese says. better you control inflam- so good now at controlling A separate process damages cartilage, the rubbery connec- mation, the less likely inflammation, and we can you’ll be to progress to joint prevent the joint damage damage. That’s why it’s im- that previously required portant to let your doctor surgery,” Gravallese says. know right away if you have
ongoing joint pain. Reviewed by Thanks to a new genera- Michael W. Smith, MD tion of drugs that block WebMD Chief Medical Editor
? ASK YOUR DOCTOR 1. Will my RA get worse if I don’t treat my pain? Joint pain in RA is often a sign of persistent inflammation. If you’re in pain, see your rheumatologist, who can adjust your medication to better control inflammation. 2. What else can I do to protect my joints? Exercise is very important to keep your joints flexible. Swimming, walking, and tai chi are some of the best—and safest—exercises for people with RA.
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THIS CONTENT IS CREATED AND CONTROLLED BY WEBMD’S EDITORIAL STAFF HEALTH SMARTS Loving Care CAREGIVERS ARE AN ESSENTIAL SUPPORT SYSTEM FOR PEOPLE WITH RHEUMATOID ARTHRITIS By Stephanie Watson When Andre Marcial mar- person deal with a painful ried Chantelle, his childhood and debilitating disease can sweetheart, four years ago, also be frustrating. “I wish he immediately assumed I could help ease the pain two new roles: husband and more,” Andre says. caregiver. Since Chantelle One way he tries to help was diagnosed with rheuma- is by making sure Chantelle toid arthritis (RA) nearly 20 gets to all of her appoint- years ago, her day-to-day life ments so her doctor can ad- has been marked by pain, dress any issues she’s having. fatigue, and other disabling Because she stays on top of symptoms that often pop up her treatment, “my rheuma- unexpectedly. toid arthritis is pretty well “One thing about rheu- controlled. I work with an matoid arthritis is that it’s amazing team of doctors, unpredictable,” says and my rheumatologist is Chantelle. “Some days my wonderful,” she says. hands hurt. Some days my Andre’s support is hips or knees hurt. It can be from his overnight security drugs that more effectively invaluable. “I would not be fatigue, which is sometimes job to an appointment. “It’s relieve symptoms like joint functioning if it weren’t for extreme. My medication tiring because by the time pain and stiffness. Yet even him,” she says. “To have can also cause side effects. we get back it’s usually late. people with well-controlled somebody who’s not only Waking up and just being I’m trying to head off to bed RA need help—and emo- supportive but who an- able to go doesn’t happen to get ready for the next tional support. ticipates what the next step much anymore.” day,” he says. “I guess the most im- will be is crucial.” Once they wed, Andre More than 43 million portant thing I do is try to If you’re an RA caregiver took over, anticipating what people in the U.S. are stay positive and encourage and need support, you can Chantelle’s needs and doing caregivers to a spouse, her,” Andre says. “I always find it from arthritis advo- the things she can’t manage, parent, child, or other loved ask, ‘What’s going on to- cacy groups like Creaky- like running to the grocery one with a chronic illness. day?’ I just try to be helpful Joints (creakyjoints.org) store after work, reminding The burden of caring for and realize that she doesn’t and the Arthritis Founda- her to take her medicines, someone with RA has lifted even know sometimes.” tion (arthritis.org). or driving her to doctor’s somewhat in recent years, Though caregiving is Reviewed by appointments. Sometimes, thanks to a new genera- a rewarding endeavor for Neha Pathek, MD WebMD Medical Editor that means going straight tion of disease-modifying those who do it, watching a
4 TIPS Be Understanding Go to Appointments Ask for More Options Get Vaccinated A good caregiver can make a RA flares are unpre- Doctors’ appoint- It can take up to three months Doctors recommend big difference for someone with dictable. Understand ments can sometimes to get relief from a new RA that people with RA RA. Here are some ways to help, that a person can be overwhelming, so drug. If a person’s current treat- stay up to date on their from Veena Ranganath, MD, have good days—and go along to listen, ment isn’t helping, ask his or vaccinations to prevent UCLA Health rheumatologist bad days—and adapt note, and remember her doctor about adding faster- infections. Get vac- and associate clinical professor as needed. all of the doctor’s acting drugs like corticosteroids cinated, too, and you’ll of rheumatology at the David recommendations. or NSAIDs as a bridge until the protect your loved one
GETTY IMAGES Geffen School of Medicine. drug starts working. even more.
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THIS CONTENT IS CREATED AND CONTROLLED BY WEBMD’S EDITORIAL STAFF
BY THE NUMBERS Rheumatoid Arthritis By Heather Hatfield MILLION 1.5 U.S. adults with rheumatoid arthritis
Portion of 2x to 4x the global Estimated increased likelihood population of depression if you have with rheumatoid arthritis rheumatoid arthritis Number of % women vs. men 1 with rheumatoid arthritis 26% Global percentage of rheumatoid Projected arthritis patients younger than 65 percentage eventually unable to work of American adults with 37% arthritis by 2040 20% 14.6 to MILLION U.S. adults with any type of arthritis who have $ billion severe joint pain 39.2 % Annual U.S. cost of 40Percentage of patients rheumatoid arthritis whose drug treatment leads to lasting remission 33% Increased risk of Reviewed by % Michael W. Smith, MD rheumatoid arthritis Increased40 chance of early death among WebMD Chief Medical Editor if you are obese women with rheumatoid arthritis
Sources: Arthritis Foundation, CDC, American Journal of Managed Care, Arthritis Research & Therapy GETTY IMAGES
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CHECKUP Your RA Visit THESE SMART QUESTIONS WILL HELP KEEP YOUR HEALTH ON TRACK By Barbara Brody
have less stiffness,” says Russell. It’s especially important to keep the muscles around both- ersome joints strong. “If you have bad knees but really strong thigh muscles, that will make it easier to get around,” she says. Losing weight if you’re overweight is also a good idea.
Q I’m worried about catching an infection. What can I do? You can take steps to keep Trust. Honesty. Openness. These qualities are key in any good relationship, and from getting sick. Most when you have moderate to severe rheumatoid arthritis (RA), that includes your people with moderate to relationship with your doctor. severe RA take methotrex- ate along with a biologic To start, you should Q Does pain mean I’m your dosage of medica- drug that targets specific see a physician, usually having a flare? tion, try changing medica- parts of the immune a rheumatologist, every Possibly. “If you’ve already tion, or give you a short system. Biologics work three months. “You want had significant damage to a course of oral prednisone really well to prevent joint to continually assess joint, then it might still hurt [a steroid that fights damage, says Russell, but disease activity and side even if you’re in remission,” inflammation],” says Rus- because they suppress effects of medication. says Russell. This problem is sell. If only one joint is the immune system, they We also do blood work more likely if you developed involved, then you might also leave you vulnerable to check inflammation RA before the introduction be able to get an injection to infection. Your doctor markers and make sure of biologic drugs (the first of cortisone instead of can explain which vac- taking oral steroids. that your kidney and liver one hit the market in 1998). cines to get and when. That said, you should always function is OK,” says Avoiding sick people and tell your doctor about any Q What can I do, Linda A. Russell, MD, practicing good hygiene is pain so he or she can check besides take medica- a rheumatologist at the also important. If you’re it out. Joints that are warm, tion, to improve my Hospital for Special currently sick, your doctor tender, or swollen with fluid pain and mobility? Surgery in New York. might advise stopping are tip-offs of inflammation Being active is really your biologic drug for a While testing is impor- important, though you that needs to be treated. few weeks. tant, you also want to have may need to ease up a an in-depth conversation Q I think I’m having a little during a flare. “Most with your doctor. These flare. What should I do? people who participate Reviewed by four questions will help Speak up and alert your in a regular exercise Michael W. Smith, MD WebMD Chief Medical Editor
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