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Dear Mayo Clinic Q and A: Simplify health Annie Annie Lane goals for success Syndicated Columnist that includes things such as: every other day with a meal. This can be By Cynthia Weiss – Ridding homes of any desserts, candy, something you can easily manage and Mayo Clinic News Network soda and processed food. feel successful with. Just remember not Dear Mayo Clinic: I am a mom of three – Promising to buy and eat only whole to overload it with dressing. Or instead of kids under 10, and I have struggled with foods made from scratch. grabbing a handful of chips for a snack, Twin brothers weight loss for years. I am challenged – Going to the gym five or more days a grab an apple or a cheese stick. Consider the between family and work obligations to week and working out for an hour each time. same substitutions for your children so you maintain a healthy lifestyle. I always start – Hiring a life coach to help get their life won’t be tempted. can’t get along off strong, but then I get overwhelmed and together. Over time, one change will lead to stop. Last month, despite trying to eat right – Reducing work stress. another. As you implement healthy things Dear Annie: I come from a big family. I and working out daily, I gained weight after Does this sound familiar? into your routine, you will build more have seven brothers and two sisters, and I’m two weeks instead of losing it. And then Most people start out strong and do OK success. And that success will make these their third sister. if I miss several days at the gym, I start for three to four weeks, but then they slowly lifestyle changes sustainable. The older five brothers and two sisters wondering what’s the point. I feel as if I am revert to old habits that leave them with With respect to physical activity, take a are living in a different town, but it is within in a constant battle with myself to live better. excess pounds and feeling discouraged. moment to focus on the amount of physical driving distance of where I live. Do you have any advice for helping to stay Once they get motivated to try again, they activity per week you want to aim for rather The younger two brothers, who are twins, motivated? do, but the cycle tends to repeat itself. than a number of days at the gym. Ideally, live in the same town that I am in. Let’s Answer: Life can be busy, as you juggle I recommend simplifying your goals. we know that for optimal cardiac health call them “Nick” and “Luke.” We are all in kids, work and family, along with many Adjust your outlook of better health to break and weight loss, the recommended amount our 50s and live within two minutes of one other obligations. Understandably, this the vicious cycle of exercise and diet plans of moderate physical activity is about 175 another. Nick and Luke do not get along. hectic pace can make it difficult to cook a that aren’t sustainable. Start with a few small minutes a week. Although that translates to They can’t even stand to be in the same healthy meal or find time to work out and things that are realistic given your lifestyle, about five sessions of 30 minutes of aerobic room. Whenever we are invited to family take care of yourself. The side effects of work and family needs. exercise, start smaller. functions, if Nick shows up first, I have to this behavior often can be an increase in Rather than identify six or seven goals, If you give yourself some grace to find text Luke and inform him that Nick is here. body weight or a standstill when it comes to select and focus on one simple thing you something that works, you can then build on Luke will only show up after Nick leaves. losing pounds. can change today. For instance, identify a it until it’s more sustainable. I love both of my brothers and have made Adding insult to injury, yo-yo weight single thing related to your diet, such as As a working mom of young kids, getting it clear that I will not let one brother talk losses and gains can cause such issues as cutting out sugary drinks and increasing to the gym daily may be challenging. Can negatively about the other, but they slip it prediabetes with borderline cholesterol your water intake. If you are someone who you find two 15-minute slots in your day into the conversation, and I have to shut it levels or prehypertensive blood pressure. drinks multiple sodas daily, you can lose to go for a walk outside? Can you and your down. If I go to lunch with one, then the Justifiably, this can cause higher levels of upward of 10 pounds a year by reducing family — kids included — go for a walk other one gets upset. I feel like I don’t want stress, guilt and depression, and lead to your intake by one soda per day, even if after dinner? Over time, increase your to talk to either one right now. — Stuck in negative behavior like comfort eating and you change nothing else. This is a perfect behaviors. Commit to a 30-minute walk or the Middle additional weight gain. example of creating success for yourself by visit the gym once or twice a week for 30 Dear Stuck in the Middle: You are When I talk to patients, I find that people just changing one thing. minutes. Recent studies show that even one literally stuck in the middle. Not allowing often come up with a plan to lose the weight Another idea would be to eat a salad visit to the gym, although not optimal, is each brother to say negative things about the other in front of you is a great place to start. The next step would be to see if they can forgive each other or try to talk about why they don’t get along. You are all one family. Remind each twin that we don’t get to choose our family. They spent nine months Rare erythromelalgia causes burning in extremities together in the womb, and their anger toward each other might simply be on the Dear Doctors: Could you please address becoming dehydrated, or even wearing a surface, hiding their intense feelings of erythromelalgia? I’m told I have this warm pair of socks. Ambient temperatures closeness that they refuse to acknowledge. condition, and from everything I’ve read, the Ask the in the low to mid-80s and above are I would suggest counseling for yourself to prognosis isn’t very uplifting. I’ve had mild associated with the onset of symptoms. come up with a plan to help Nick and Luke. symptoms for as long as five years, but now, Doctors Although erythromelalgia cannot be And don’t forget, all those older brothers at age 71, it’s become much worse. Any cured, it can often be successfully managed. and sisters might be able to help. information is greatly appreciated. Dr. Ko and Once you’re diagnosed, it’s important to Dear Annie: Although I know that Dear Reader: Erythromelalgia is a Dr. Glazer avoid the triggers we mentioned. Patients “Karen” is used as an example of entitled condition marked by periodic episodes find that resting, avoiding stress, keeping the women, I don’t think it was necessary of stinging or burning pain that occurs in affected limbs elevated and exposing skin to for your reader to use it in the customer the extremities, along with a rise in skin The specific underlying cause of cold air or cool water can relieve symptoms. etiquette column. She could have said a temperature and visible flushing in the erythromelalgia is not yet clear. Up to 15% It’s important to avoid the use of ice or client books an appointment, making the affected area. It’s a rare syndrome that of cases are attributed to a certain genetic other more extreme means of cooling, as it’s same point without using the name Karen. affects fewer than 2 out of every 100,000 mutation that interferes with the proper possible to damage the skin, and rewarming The message would have been the same. people. The condition is more common in functioning of sodium channels. These are can cause a new flare. Your doctor may I am not sure why it is OK to use women than in men, and although it can specialized proteins in the cell membrane advise the use of certain cooling creams or someone’s name for a stereotype. My name appear at any time of life, it’s seen most that help with the transmission of electrical gels, or something containing capsaicin, is Karen, and to me, it is hurtful. — Karen often in middle age. impulses. an active ingredient in chili peppers, which Dear Karen: You are absolutely right, Erythromelalgia typically affects the Ongoing research suggests that other can desensitize heat receptors in the skin. and I apologize to you and to everyone feet. However, it can sometimes progress cases may be tied to autoimmune disorders. Depending on the specific case, aspirin, who has the name Karen who might have to involve the legs, arms or hands, and, Each of these is believed to interfere anti-seizure meds or beta blockers may be been offended. This brings up a larger very rarely, the ears or the face. The pain it with the ability of blood vessels in the prescribed. problem with our polarized politics and causes is often intermittent and ranges from affected area to either widen or constrict The Erythromelalgia Association social media, where someone designates mild to severe. When mild, it’s a distinct in an appropriate fashion, thus leading to offers additional information, resources something, such as a person’s name, as tingling sensation. Episodes of intense pain abnormalities in blood flow. Symptoms and support for this rare syndrome at being symbolic of something that is bad. and heat can be severe enough that they are often triggered by an increase in body erythromelalgia.org. This is a form of bullying, and we all need interfere with standing, walking and sleep. temperature. This can happen following Eve Glazier, M.D., MBA, is an internist to be aware of it and avoid it. Thank you for Additional symptoms may include swelling exercise, standing for a period of time, and associate professor of medicine at writing. of the affected body part and a purplish cast from a too-warm bath or shower, on a hot UCLA Health. Elizabeth Ko, M.D., is an Send your questions for Annie Lane to to the skin between flare-ups. The condition day, eating spicy food, stress or excitement, internist and assistant professor of medicine [email protected]. usually affects both sides of the body. at UCLA Health.

ISAAC ASIMOV’S SUPER QUIZ Take this Super Quiz to a Ph.D. Score 1 point for each correct PH.D. LEVEL answer on the Freshman Level, 7. 1987, “Wall Street,” M.D. 2 points on the Graduate Level Answer______and 3 points on the Ph.D. Level. 8. 1988, “Rain Man,” D.H. Answer______Subject: BEST ACTORS OF THE 9. 1989, “My Left Foot,” D.D.-L. 1980s Answer______Name the winner of the Best Actor Oscar. The year the film ANSWERS: 1. Henry Fonda. 2. was released, film title and Ben Kingsley. 3. Robert Duvall. actor’s initials are provided. 4. F. Murray Abraham. 5. William (e.g., 1980, “Raging Bull,” R.D.N. Hurt. 6. Paul Newman. 7. Michael Answer: Robert De Niro.) Douglas. 8. Dustin Hoffman. 9. Daniel Day-Lewis. FRESHMAN LEVEL 1. 1981, “On Golden Pond,” H.F. SCORING: Answer______18 points — congratulations, 2. 1982, “Gandhi,” B.K. doctor; 15 to 17 points — honors Answer______graduate; 10 to 14 points — 3. 1983, “Tender Mercies,” R.D. you’re plenty smart, but no grind; Answer______4 to 9 points — you really should hit the books harder; 1 point to GRADUATE LEVEL 3 points — enroll in remedial 4. 1984, “Amadeus,” F.M.A. courses immediately; 0 points — Answer______who reads the questions to you? 5. 1985, “Kiss of the Spider Woman,” W.H. Super Quiz is a registered Answer______trademark of K. Fisher 6. 1986, “The Color of Money,” Enterprises Ltd. © 2021 Ken P.N. Fisher Answer______