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22 beauty pretty-feet Product picks Spring 30 fitness tracking your heart rate to action 35 parenting 5 ways to treat How boys learn best & beat allergies 37 recipes 44 Try our Guiltless french toast 56 sleep The ABCs of catching ZZZ’s Green zone 57 pain How eco-friendly BACKACHE CARE basics is your home? 58 diabetes 50 is your diabetes in control? 61 allergies what are food allergies? 63 heart Are You under pressure? Modern mom 64 mind Julie Bowen on Is it more than baby blues? how she balances TV’s No. 1 comedy and three kids under 3! 38 What will help you lose weight? Introducing the the Magazine D I G I T A L WebMD Food & Fitness Planner features March/April 2011

In just a few clicks, customize a plan to help you reach your weight and fitness goals. Studies have shown that people who 38 parenting keep a food journal lose twice the weight than those who rely Modern Mom on diet and exercise alone.* After long days shooting TV’s top comedy, Modern Family, Julie Bowen goes home to a family including three kids under age 3. Backed by the world’s leading health experts and dietitians. How does this self-confessed control freak balance it all? With lots of help and a good sense of humor, Bowen tells WebMD contributing writer Lauren Paige Kennedy. The award-winning actor reveals her tips for managing motherhood and a career— and making it fun every step of the way.

The HEALTHY DOG AND CAT GUIDE Created for Your Vet’s Offi ce Created for Your Vet’s Offi ce

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Spring/Summer 2011 Scare tactics WebMDPets Help your dog deal with fear 83 p. 70 Animal Cat’s meow Decode your feline’s feelings Instincts 85 Actor and model Puppy love Isabella Rossellini taps into her animal instincts Isabella Rossellini on-screen and off 87 on her new TV Special Flip Issue! pet project and why she trains seeing-eye dogs. wellness allergies New 50 44 p. 72 What’s your cat telling you? Green Zone Spring to Action p. 74 Tips for scaredy dogs From your living space and yard to the Do you greet the warm weather air you breathe, going green can boost with a stuffy nose and watery eyes Your newborn and infant care WAITING ROOM COMPANION

your family’s overall health. WebMD instead of a happy heart? WebMD March/April 2011 webmd.com WebMDBaby contributing writer Heather Hatfield Bottle contributing writer Gina Shaw ground Choosing the right one 6 p. 80 Plus One offers easy eco-savvy strategies to make asks medical experts for five ways Cry baby What her wails 7 over your home inside and out. AND: really mean Math whiz and to cope with seasonal allergies’ Clean-and-green expert product picks. Wonder Years star peskiest symptoms. Danica Danica McKellar

McKellar 4 The Wonder Years star and math maven Best of all, it’s free. spotlight on her family’s latest addition adds a new role to her impressive So start planning today. nutrition résumé: mom. Golden Rules p. 82 A primer on baby bottles 20 How your diet changes p. 83 How to soothe a crying baby as you age. Cover photo By kate powers *American Journal of Preventive Medicine, August 2008 Learn more about these featured issues and all health topics. WebMD.com March/April 2011 | WebMD the Magazine 1 departments ® Everyone wanted to know March/April 2011 webmd.com the Magazine how the Princess was…

Ask the Experts Nan’s Note And CaringBridge made it easy to share. 4 18 Can she break the stress- binge connection? And what are the Healthy Start pros and cons of tubal ligation? 36Healthy Eats 6 What’s good for you this spring. 36 Anatomy of Vanilla The history of the PLUS: Take our Healthy Start Challenge second most expensive spice in the world. and win a prize! 37 Smart Start Chef Domenica’s healthy breakfast tips and her own recipe for Guiltless WebMD Wire French Toast. 8 Get the scoop on black rice’s benefits, OTC medicine dosing guidelines, and the dirtiest U.S. cities. take the test you can take to your doctor Click Here My WebMD assessments, quizzes, and reference 14 What’s new at WebMD.com A determined dad learns to information on every page right now. 19 live with vision loss. sleep Medical 56 The ABCs of catching zzz’s 15 File Living Well Tommy Hilfiger’s designs 22 pain 22 You Asked Step into spring with 57 Backache care basics on a cure as he helps Race to our expert product picks for softer, Erase MS. AND: NAME: Taylor sandal-ready tootsies. diabetes HEALTH CONDITION: Cancer WebMD mental health expert 24 Bright Start Get the scoop on 58 Is your diabetes in control? VISITS TO WEBSITE: 632,130 Patricia Farrell, MESSAGES OF SUPPORT: whitening your smile. 12,211 PhD, on the MS-depression diet link. 60 Is your kid overweight? Health Matters allergies Exam Room 27 What are food allergies? An undercover exposé: the 27 mind 61 16 Right Brain Can you really “teach” history of diapers. fairness? Studies show this quality cancer Rate your cervical cancer risk may already be programmed into 62 our brains. heart 28 sleep Are you under pressure? Sleep Starved The surprising 63 connection between shut-eye and mind childhood obesity. 64 Is it more than the baby blues? CaringBridge provides free websites that connect people facing a significant health 30 fitness WebMD challenge to family and friends, making it easy to share updates and receive support. Fit to a Fault Ladies, measuring 65Checkup your heart rate may not be the best Rap artist Nelly talks way to track your workout results. about the importance of 32 patient bone marrow donation Are You Covered? Do you have the and his personal ties to right kind of health insurance for the cause, how he stays your family’s needs? fit, and what being a 35 parenting dad has taught him Class Act Why “A” is for action about life. when it comes to educating boys.

2 WebMD the Magazine | March/April 2011 Making each health journey easier. ® nan’s note from the editor in chief webmd.com the Magazine

Editor In Chief • Nan-Kirsten Forte, MS

“Mom, I need to write a paragraph answering the question: Is there is a basic human need for jus- EXECUTIVE Editor • Colleen Paretty Vice President, publisher • Heidi Anderson [email protected] • 847-998-4773 tice, equality, and freedom?” my daughter announced. “Oh, and I need to give examples of each.” Deputy Editor • Kim Caviness This request came from our 7th grader while my husband and I were watching the events in Advertising Sales Senior Editors • Susan Davis, Andrea Gabrick Egypt unfold on television last month. My mind raced through my grade-school memory (oh, boy): New YOrk

justice…Emmett Till, equality, a woman’s right to vote, freedom of speech. Editorial Assistant • Chloe Thompson Dawn Carey • [email protected] • 212-624-3901

The news showed Cairo footage reminiscent of Tiananmen Square. I turned off the TV and looked Patria Cervantes • [email protected] • 212-417-9542 chief Medical Editor • Michael W. Smith, MD at my daughter. Here she was learning about our country’s history while we Board Certified, Internal Medicine Alisa Feiner • [email protected] • 212-624-3897 were watching another country’s history happening right before us, and it was Nancy Kaplan • [email protected] • 646-674-6915 senior Medical Editor • Brunilda Nazario, MD, Board Certified, steeped in matters of justice, equality and freedom. Internal Medicine, Endocrinology and Metabolism CHICAGO Some questions are best answered with other questions: “Olivia, can you Margaret Posh • [email protected] • 312-416-9277 Medical Editors • Louise Chang, MD, Board Certified, Internal Medicine; imagine a place where people are put in jail when they did not commit a Laura J. Martin, MD, Board Certified, Internal Medicine Meghan Rice • [email protected] • 312-416-9276

crime and not put in jail when they did? Where people are treated differently West Coast WEBMD.com executive editor • Sean Swint because of the color of their skin, whom they pray to, or whether they are a Elise Perlmutter • [email protected] • 424-248-0616 man or a woman? Where people cannot express their opinions or choose what BookIngs Director • Wendy Zipes Hunter they will do for a living, where or if they will get an education, whom they [email protected] • 954-344-0912 MARKETING

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4 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 5 WebMD and Sanford Health proudly announce healthy start good for you this month spring’s Quick Picks

healthy eats The destination that helps you and skin care Chore Joy your family achieve the fit lifestyle Cleaning the floors does more including: than make over the kitchen—it can help make over your body. “You • FOOD: Nutritional Fitness can easily burn 150 calories an • MOVE: Physical Fitness hour just doing those chores that torture you,” says WebMD fitness • MOOD: Emotional Fitness expert Pamela Peeke, MD. Pick up Doze Patrol • RECHARGE: Behavioral Fitness the pace by throwing on some tunes and dancing while Stifling yawns at your desk? mopping to burn up to Beat the afternoon slump Learning and living a healthy lifestyle is a family affair. fit is designed with that in 200 calories an hour. with these tips from WebMD mind with worksheets, videos, and games customized for different ages. There’s “Always have some nutrition expert Carolyn energy-pumping O’Neil, MS, RD. First, drink also a section just for parents. music on in the up. “Being dehydrated is one background,” of the top causes of lethargy a rr/G e tty I m ages Peeke says. and lack of focus,” O’Neil Fit: The Place for KIDS to Play & Learn About Healthy Habits Pennywise Pampering says. Next, “check your snack vi es a nd St scorecard,” she says. All-day In desperate need of a facial but don’t have the time or snackers tend to skip meals, the extra cash? Behold the power of the papaya, says fit tip which can zap energy. So WebMD skin care expert Susan Evans, MD. “It’s a great make sure your snacks are skin fruit,” she says. It contains vitamins A, C, and E, healthy and filling. “Snacks which help prevent signs of aging, and the papain should be about 150 calories, enzyme acts as a natural exfoliant. To put it to work for and high in fiber and pro- you, blend together a cut-up, seedless papaya with a tein,” O’Neil says. whole egg, and apply as a 10-minute mask. “You’ll see improvement in your skin’s texture and tightness, and you’ll have that fine glow,” Evans says.

Fore Good IS YOUR DIY BEAUTY TREATMENT A WINNER? Work on your swing and help those in need. March is When I’m feeling crafty, I make my own body National Kidney Month, a perfect time to sign up for scrub—brown sugar, grapeseed oil, and vanilla give back one of 40 National Kidney Foundation Cadillac Golf extract. Do you have a favorite do-it-yourself Classic tournaments held across the country this beauty recipe? Take our Healthy Start Challenge: year. One tourney takes place in Lakeland, Fla., in Share your recipe in the magazine community mid-April. For a full list, go to kidney.org. at WebMD.com for a chance to win a $20 Whole Foods gift card! J e ffr y C oolid ge /G tty I m ages ; om s tock Jill F rom r/G : Da se from top ri g ht: clockwi

Andi Gabrick Senior Editor, WebMD the Magazine

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

6 WebMD the Magazine | March/April 2011 T:3.125”

® ® wire SOME wirethe health news beat at WebMD.com THINGS Although the trend toward sunless Redux tanning (think sprays and lotions) Rice For years, brown rice has been the rice of choice is becoming increasingly popular, IN LIFE Fake Bake for people seeking a healthy alternative to processed new research shows that people grains. Now, studies show black rice is also extremely who use those products are also healthy because it contains antioxidants similar to YOU CAN’T more likely to go to indoor tan- those found in blackberries and blueberries. In fact, it ning salons—which expose them may be even healthier than brown rice. to cancer-causing UV rays. CONTROL. “Just a spoonful of black rice bran contains more Researchers at the University health-promoting anthocyanin antioxidants than…a of Minnesota in Minneapolis ana- buzzed spoonful of blueberries, but with less sugar and more lyzed the records of more than LOWERING YOUR RISK fiber and vitamin E antioxidants,” says Zhimin Xu, 2,800 people ages 18 to 64. They OF INFECTION DURING PhD, of Louisiana State University Agricultural Center. found that women are three times Kids “If berries are used to boost health, why not black CANCER TREATMENT, more likely than men to use indoor tanning facilities and that both men and women rice and black rice bran?” Anthocyanin antioxidants who use spray tanning products were more likely to visit tanning salons. The study show promise for fighting cancer, heart disease, and also showed that only 13.3% of the women and 4.2% of the men knew that avoid- Think most parents limit their kids’ caf- other health problems, Xu says. He adds that food YOU CAN. ing tanning beds is one way to decrease the risk of getting skin cancer. feine intake? Think again. A recent study found that a full 75% of children ages 5 manufacturers could use black rice bran or bran Source: Archives of Dermatology to 12 consume caffeine. What’s more, it extracts to boost the health value of breakfast cereals, The risk of infection during cancer

might be keeping them up at night. beverages, cakes, cookies, and other foods. treatment can be very high. T:10.875” After surveying 201 parents, research- Currently, black rice is used mainly in Asia for And infections can delay your ers at the University of Nebraska Medical food decoration, noodles, sushi, and puddings. treatment or stop it altogether. School in Omaha learned that children ages Source: American Chemical Society fall 2010 national meeting So do everything you can to get 5 to 7 had about 52 milligrams of caffeine healthy, stay healthy, stay strong. Double Duty a day (equivalent to half a cup of coffee or Talk to your doctor and go to about 1.5 cans of soda), and children ages manageyourtreatment.com 8 to 12 had 109 milligrams (equivalent to right now. Some things you can’t You know the old saying that “two heads are better than one”? It’s true, new research one cup of coffee or 3 cans of soda). Most Dare to Dream? finds, but only if both heads contain the same skill sets. control. But this, you can. of that caffeine came from soft drinks. It’s normal to daydream. In general, people In a study of shared decision-making, researchers from University College London Not surprisingly, the researchers found spend almost half their waking hours showed that two people of equal abilities solved problems better when they that the more caffeine individual children thinking about something other than what worked together, probably because individuals tend to lose focus over time. in the study consumed, the less they slept. they are doing in the present. But this kind But when a competent person was paired with someone who wasn’t And, taken on average, children ages 5 to e from top right: T im M acpher s on/ G etty I mage ; A nthony H arvie / an N eleman/ wi s e from top right: of mind wandering typically gives rise to so competent, group and indi- 7 slept an average of 9.46 hours per night, k cloc unhappiness, according to new research. vidual performance suffered. In while children ages 8 to 12 slept an aver- Researchers used a new type of iPhone those cases, the researchers say, age of 8.47 hours per night. (Sleep experts app to gather data about the thoughts, people are probably better off say school-age kids need 10 to 12 hours feelings, and actions of 2,250 volunteers at working alone.

nightly.) The study didn’t show that caffeine random intervals during the day. On aver- The findings suggest people was the only cause of that sleep loss in older age, the participants reported their minds can work together most children, but it did find a correlation. were wandering 46.9% of the time. In fact, effectively when they While the FDA has not established rec- the only time their minds wandered less understand their indi- ommended caffeine limits for children, the than 30% of the time was during sex, dur-

vidual competence an der M eer/ G etty I mage s study authors advise parents to be “pru- ing which their minds wandered only 10% level. dent” and regulate the amount of caffeine of the time. The researchers found that people in the study were least happy when But given that many their children consume. Caffeine can cause resting, working, or using a home computer. people aren’t that self- anxiety, and any resulting sleep loss can So what’s the best predictor of happiness? How often our minds leave the present, aware, the onus may be on affect school performance. Soft drinks and not the activities we’re doing. These research findings mirror the teachings of many business managers to evalu- sleep loss have also been linked to weight religious and philosophical traditions that preach happiness can be found through ate employees’ abilities and gain and related diseases, including heart “mindfulness” and by living in the moment. EDIE FALCO AND CYNTHIA NIXON STAND UP TO CANCER. match them accordingly. k / G etty I mage s ; B et ie V John B loc top: disease and diabetes. Source: Science Source: Science Source: Journal of Pediatrics

8 WebMD the Magazine | March/April 2011

Client: SU2C Document: S2L-101 DUO_WebMD_3.125x10.875. Date: 2-25-2011 10:44 AM Notes: WebMD Round: Job No.: S2L-GE-P9-101 Live: 2.375” x 10.125” DDB Office: Los Angeles Version: Nixon/Falco 1/3 page Vert Trim: 3.125” x 10.875” Printed at: 100% Issue: March 2011 Description: AMGEN PRINT AD Bleed: None Mech scale: 100% Pick-up Job No.: NONE Gutter: None Color(s): 4C FM Account Manager: [email protected] APPROVAL DATE OK/WC Inks: Cyan, Magenta, Yellow, Black Project Manager: Maria D x1750 APPROVAL DATE OK/WC Creative Director: Matt R. APPROVAL DATE OK/WC Fonts: ITC Avant Garde Gothic (Medium, Bold) Art Director: Ji B x1688 APPROVAL DATE OK/WC Copy Writer: Maureen Z x1566 APPROVAL DATE OK/WC Links: cynthiaedie_final.psd (CMYK; 912 ppi), Amgen_2_Blue_PC.eps, su2c_url_logo_whi.ai Production Manager: Paul N x1670 APPROVAL DATE OK/WC Pre-press: Toby F x1536 APPROVAL DATE OK/WC Art Buyer: Amy R x1530 APPROVAL DATE OK/WC Proof Reader: Dani x1518 APPROVAL DATE OK/WC Studio Artist: Steve B. APPROVAL DATE OK/WC Last edited by: Batchelor, Steve/Yoshimura, Steve ® ® wire wire Air Cleaning Filters 77% good for you Teens ages Up 12 to 19 You may not see who eat in the breakfast Air them, but they Source: CDC, Healthy Youth! fact sheet are in the air Walk This Way Forget about boots. Your brain was you breathe made for walking. Walking is a great way to help clear your head—and ward The Belt Way off dementia, according to new research You know those “Click It or Ticket” signs There are many reasons to keep your cholesterol in check, and here’s one more: that finds that walking seems to help you’ve seen on the roads? They work. A New research indicates that higher levels of HDL—the “good” cholesterol—may prevent brain shrinkage, which can recent CDC study finds that state laws that reduce your risk of getting Alzheimer’s disease. cause memory loss. fine motorists and passengers who don’t Researchers at Columbia University monitored 1,130 seniors for four years. Researchers at the University of buckle up really do increase seat belt use None had memory trouble or dementia at the start of the study. But by the end of Pittsburgh examined data on 299 dementia-free people with a mean age and decrease car crash injury rates. the study, those people with the highest HDL counts (over 55 mg/dL) were 60% Although air pollution levels have of 78 who recorded the number of The research shows that the kinds of less likely to develop Alzheimer’s than those whose HDL level was under 39 mg/ improved over the last 10 years, poor air blocks they walked weekly. Nine years laws states enact affect compliance. In dL. (However, high levels of “bad” LDL and total cholesterol did not appear to be quality is still a threat to the health of 58% later, the research team took brain states where police can give tickets to linked to a reduced risk of developing the disease.) of the U.S. population, the American Lung scans to measure brain size. Four years people who aren’t wearing seat belts, 88% Although the researchers aren’t sure exactly how HDL protects the brain against Association reports. after that, the team tested for cognitive of all people say they always wear their Alzheimer’s, they hypothesize that HDL reduces the risk of stroke, which in turn is The association’s 2010 State of the Air impairments or dementia. seat belts. In states where police can only associated with the disease. report ranks cities by their levels of ozone, The researchers discovered that give tickets for not wearing a seat belt if Not all studies have led to the same conclusion. A 2001 study found that short-term pollution, and long-term pol- those who walked at least six miles a they’ve already pulled the driver over for Japanese-American men with higher HDL levels were more likely to develop lution. Based on their year-round particle week had more gray matter volume in something else, fewer people, 79%, say Alzheimer’s-related plaques and tangles in their brains. Yet plenty of studies have pollution—from diesel and gasoline their brains nine years after the start of they always wear their seat belts. shown that higher levels of HDL protect the heart. So it’s smart to try to boost HDL engines, power plants, demolition and Allergens like mold spores, pollen and even the study than people who didn’t walk Data show that people wearing seat levels above 60 mg/dL, doctors familiar with the new research say. construction projects, dust, and soil, dust mite debris are floating in the air that as much. Thirteen years after the study belts are half as likely to be seriously According to the Harvard University School of Medicine, good ways to boost which can all trigger lung diseases—the you and your family breathe. Filtrete® Air began, the walkers had cut their risk of injured (and 45% less likely to die) than HDL cholesterol include getting regular aerobic exercise, losing weight (if needed), five dirtiest cities are: those not wearing seat belts. quitting smoking, avoiding trans fats and highly refined carbohydrates (such as developing memory loss in half. Cleaning Filters from 3M are electrostatically* How does your state stack up? Here’s a white flour), and taking certain kinds of medication. Earlier research found that moderate 1. Phoenix-Mesa-Scottsdale, Ariz. charged to attract and capture airborne G etty I mage s ; Y u j i Sa k ai/ Simon P otter/ hotolibrary H o s pach/ M artin wi s e from top left: list of the states with the highest and low- Source: Archives of Neurology exercise can enhance the connectivity of 2. Bakersfield, Calif. allergens and microscopic particles like k cloc important brain circuits, which in turn est percentage of residents who say they 3. Los Angeles-Long Beach-Riverside, Calif. household dust, pet dander and smoke always use seat belts. combats age-related performance on from the air passing through the filter. And Top 5 Seat-Belt-Wearing States: cognitive tests. 4. Visalia-Porterville, Calif. 16 Americans’ life satisfaction rank, compared to they are the best filters at trapping particles 1. Oregon (93.7%) Source: Neurology 5. Pittsburgh-New Castle, Pa. 2. California (93.2%) people in 132 countries. Denmark ranked No. 1. without restricting airflow. Source: Journal of Personality and Social Psychology; Gallup World Poll The five cleanest cities for long-term 3. Washington (92.0%) particle pollution are: * Electrostatic filters are most effective when the filter is clean and new. 4. Hawaii (91.4%) 5. Texas (91.1%) 1. Cheyenne, Wyo. ©3M 2011. 3M and Filtrete are trademarks of 3M. Particles not actual size. Bottom 5 Seat-Belt-Wearing States: 2. Santa Fe-Española, N.M. For illustrative purposes only. 1. Montana (69.4%) 3. Honolulu 2. Wyoming (67.4%) $ 00 3. New Hampshire (66.4%) 4. Anchorage, Alaska Get a 6. mail-in rebate ® 4. South Dakota (59.7%) 5. Great Falls, Mont. when you buy 3 Filtrete Air Cleaning Filters with a Microparticle Performance Rating (MPR) 5. North Dakota (59.2%) G etty I mage s s on/ G etty I mage ; T ere a A revalo/ A lexandra G rablew sk i/ etty I mage s ; Jo iah D avid wi s e from top left: Source: American Lung Association of 1000 or greater at

Source: Morbidity and Mortality Weekly Report, “Vital Signs” report k cloc Filtrete.com/WebMD 10 WebMD the Magazine | March/April 2011 Filter your world

3MFI_531_WebMD_ThirdPgVert.indd 1 12/8/10 7:55 AM ® ®

wire wire This is personal. dosing dilemma 1.75 million Ever been boggled by the dosing instructions printed on over-the-counter meds for Number of Medical Mistakes kids? It’s not you. people who When researchers at Atlanta’s Emory University School of Medicine recently examined the packaging of 200 of the best-selling kid-strength liquid medications visited To err is human. Even for doctors. A new study finds that, despite recent preventive (including cough and cold, emergency measures, serious medical mistakes continue to occur in the United States. allergy, pain, and gastroin- rooms for In the study, researchers examined data collected by an insurance company that testinal remedies), they dis- provided liability coverage to 6,000 doctors. They found that between 2002 and covered a slew of confusing asthma 2008, doctors performed the wrong procedures on 25 patients and performed a elements. One-fourth of the in 2007 procedure on the wrong part of a patient’s body in 107 cases. As a result, one person medicines didn’t come with died and several others suffered complications. The main factors in wrong-patient a dosing device (such as a medical mistakes were errors in diagnosis (56%) and errors in communication cup, dropper, or syringe), for instance. In 99% of those that did, the markings on (100%). Errors in judgment contributed to 85% of wrong-site medical errors, and the device were inconsistent with the label instructions; 80% of the dosing devices lack of verification before starting the surgical procedure was cited as the cause in included extra markings that had nothing to do with the recommended doses. And 72% of these mistakes. more than half of the medicines’ directions didn’t use standard abbreviations for The study authors are calling for stricter adherence to the Universal Protocol, which measurements such as milliliter or teaspoon. was introduced in 2004 by the Joint Commission (which regulates medical profes- These findings are important because more than half of U.S. children take at least sions) to help all hospitals and outpatient facilities reduce medical errors by verifying one medication per week. More than half of those are OTC drugs. Source: CDC’s National Center for Health Statistics the patient and surgical site before, during, and after a procedure. But surgeons aren’t the only ones at fault; general practitioners and internists, as well as emergency room doctors Macpherson Andrew Photo: Source: JAMA and pediatricians, were as much to blame, the study authors report. Source: Archives of Surgery “My mother died of colon cancer when she was only 56.” The WebMD Single Serving Poll Terrence Howard, actor/musician Q: What do you usually make

udra s / G etty I mage ; T itu The results are in from the January/February issue poll! for dinner when you’re feeding only yourself? Q: What’s your No. 1 way to spend ❍ Eggs, any style “me” time? ❍ Pasta with tomato sauce Colorectal cancer is the 2nd SHOPONLINE 37% Read a book ❍ A big salad leading cancer killer in the U.S., ERASEMS.ORG and propel us one step closer 17% Do nothing at all to fi nding a cure for multiple sclerosis. but it’s largely preventable. ❍ Cereal (with skim milk, of course) 16% What “me” time?! If you’re 50 or older, PARTICIPATING PARTNERS ❍ A bowl of popcorn please get screened. Arbonne, Doreen Nelson Jewelry for a Cause 14% Work out Archipelago Judith Ripka ❍ Ice cream (shh...don’t tell!) Avalon Hotel, Oliverio Kashwere 6% Soak in the tub 1-800-CDC-INFO (1-800-232-4636) The Bakery Boutique Kid Dangerous ❍ Leftovers! www.cdc.gov/screenforlife Bing Bang Jewelry Kitson 6% Shop Bold Girlz Laura Geller Bonnie Marcus Lifefactory 3% Try a new recipe Chelsea Taylor Lisa Hoffman Beauty Deuce Brand Mandarin Oriental, New York Don Francisco’s Coffee Peace and Love Jewelry Donni Charm by Nancy Davis Visit WebMD.com/magazine and Dry Divas Premier Moissante enter our March/April 2011 poll! EFX Performance, Inc. P.S. Koveralls Farm Fresh To You ProFlowers The Nancy Davis Foundation for Multiple Sclerosis is a non profi t organization dedicated Harry & David Red Envelope to the treatment and ultimate cure of MS. Funding research is the core focus of the Source: 2011 WebMD Poll Intermix Zaza Collection Foundation and all funds raised support our Center Without Walls program, a selected START SHOPPING Isaac Mizrahi network of the nation’s top MS research centers. E ric A / G etty I mage s ; O ppenheim B ernhard/ above: P hoto A lto/ M acie j T oporowicz, NYC from left: oppo s ite page, click here highlights at Webmd.com medical file people and pages

the Pulse by Colleen Paretty, Designs on a Cure WebMD Executive Editor

f you, like me, spent your teenage years especially for Tommy Hilfiger tackles MS Iin an era without Internet access to just and about with conviction and style about every fact known to humanity, how teens into did you find answers to those, ah, difficult one place. Designer Tommy Hilfiger has played a leading role in the questions—you know, about your body (We’re starting with girls—“boys” is com- world of fashion since he was 18. So it’s no surprise that his foray and your skin, emotions and friendships, ing soon.) Note I say “for” teens because nearly 15 years ago into a different arena—giving back—was done school pressures and family troubles? everything here speaks directly to them, GET GROCERIES FOR A NEIGH- with style. BOR. SHARE EXTRA FOOD. For me, select books from the library, not parents. The red, white, and blue ski jackets he designed for the Nancy ORGANIZE A RIVER CLEAN-UP. SUPPORT A SENIOR IN NEED. Seventeen magazine, and one or two Four areas—Your Mind, Your Body, Your Davis Foundation for Multiple Sclerosis were an instant hit at a DONATE WINTER COATS. SIGN trusted girlfriends were my lifeline. Having Relationships, and Your Life—cover sleep, fundraiser. “Everybody loved them,” Hilfiger, 59, recalls. That was UP TO TUTOR. DONATE YOUR EYEGLASSES. GIVE VEGETA- so few resources sounds pretty lame to fitness, nutrition, puberty, and more as just the beginning of his relationship with the foundation as well BLES FROM YOUR GARDEN. today’s teens, but I know two things: One, well as the less hard-facts kind of stuff, as a personal friendship with Davis, the daughter of oil and enter- tainment industry maven Marvin Davis. Shortly after his fashionable YOU HAVE THE they have the same questions and are just those iffy dilemmas that confused us all: contribution, Davis asked Hilfiger to be on the foundation’s board as flummoxed, embarrassed, and worried Why am I so moody? Why is my best POWER TO of directors and serve as co-chair of the annual fundraising gala, Hilfiger has helped Nancy Davis, founder of the Nancy Davis as adolescents have always been, and two, friend avoiding me? How can I talk to my CHANGE A LIFE Race to Erase MS (erasems.org). He eagerly accepted. Foundation for Multiple Sclerosis, raise more than $30 million. vast tidal waves of information from who parents (or let them know I don’t want to HELP FEED HUNGRY FAMILIES. His involvement was particularly apt—his younger sister has DONATE FREQUENT FLIER knows where are not always helpful. talk sometimes)? MS, a neurological disease that attacks the central nervous system, the charitable organization in 1993, two years after she was MILES. BRING A MEAL TO A SICK Which is why we are very proud of our We hope the teens in your life find the PERSON. BUY A HOMELESS resulting in problems with muscle control, vision, balance, diagnosed with MS, and to date has raised more than $30 mil- PERSON A SANDWICH. START just-launched Teen Health Center on answers they need here. Visit me in the and sensation (such as numbness). MS affects about 400,000 lion to help find a cure for MS. “I’ve watched Nancy relent- A WALKING GROUP. PLANT A TREE. DONATE SCHOOL SUPPLIES. WebMD.com, the first time we have magazine’s Community at WebMD.com Americans, with around 200 new diagnoses per week, according lessly grow the organization,” Hilfiger says. “I just wanted to corralled health and wellness information and let me know. I’m listening. to the National Multiple Sclerosis Society. Since she was first be able to help out the best way I could.” diagnosed when he was a teen, Hilfiger has watched Dorothy, 58, This year, the Race to Erase MS gala is on April 29 in Los struggle with the condition. “When you see someone’s life change Angeles and primarily funds Davis’ Center Without Walls pro- as a result of a disease, it really hits home,” Hilfiger says. “I’m a gram, which links seven multidisciplinary scientific programs healthy person, and I’m very grateful being able to get up in the and experts across the country to advance research toward Join Harrison Ford, Osteoporosis symptomchecker morning. Seeing [Dorothy] suffer makes me feel that I should be finding a cure. his son Ben Ford and top symptoms include able to do something.” “Hopefully, [that] will happen sooner rather than later,” thousands of others Backache Since he joined the board in 1995, Hilfiger has regularly partici- Hilfiger says. “If I could help out, I would do whatever I could who are helping to  pated in fashion shows and golf tournaments to promote the foun- possibly do, but certainly now the doctors are the ones who make the world a  Gradual loss of height and stooped posture dation’s mission and help raise funds and awareness. Davis founded really deserve all the credit.”—Chloe Thompson better place. For more Fractures of the spine, wrist, or hip SEARCH ideas, please visit:  None www.CreateTheGood.org  MS Success Healthy Read Osteoporosis, the severe thinning and weakening of the bones, Harrison Ford and Ben Ford are is a slow-growing disease that may first become apparent with Psychologist Patricia Farrell, PhD, resi- Sclerosis, Farrell takes of the mind-body connection in MS and EIF Ambassadors. Photograph by dent expert on WebMD.com’s anxi- up the “you can do this” the powerful potential of leveraging this Jesse Dylan. the above symptoms—or none at all, until a person sits down, SEARCH ety & panic disorders community and approach for managing connection for a better quality of life. lifts a bag of groceries, or just coughs and fractures her spine, reviewer of this magazine’s “Mind Mat- the psychological Farrell peppers her book with patient wrist, or hip. Those fractures, in turn, can result in chronic pain, ters” department, has always been symptoms that often stories and MS researchers’ recent find- disability, even the loss of independence. Risk increases with about self-direction. Her 2003 book, come with MS, an ings, but the best takeaways are detailed age (especially for post-menopausal women) and tests to detect How to Be Your Own Therapist: A Step- autoimmune disease self-help techniques to battle depression, its progression are available, but prevention is key. Get plenty of by-Step Guide to Building a Compe- that affects the body’s reduce pain, and boost the immune sys- GO calcium and weight-bearing exercise, such as walking, running, WATCH VIDEO tent, Confident Life, probably did keep central nervous system. tem. Exercise is especially highlighted. Key in your symptoms lots of people out of therapy (a rather odd The book’s title is a nod not only to the The result of taking charge of this com- and aerobics. If you have osteoporosis already, these measures, goal for someone who sees patients). historical (and continued) dismissal of these plex disease? “You turn something upset- plus medications, can help slow the rate of bone loss. FIND THE ANSWER In It’s Not All in Your Head: Anxiety, symptoms but also (and more optimistically) ting,” Farrell writes, “into something e g

Depression, Mood Swings, & Multiple to emerging research that points to the role good.”—Colleen Paretty a m reI i W

March/April 2011 | WebMD the Magazine 15

310.575.4441 2107 Sawtelle Boulevard, Los Angeles, CA 90025 Production: Linda Ehrke 310.575.1775 Production: _____changes _____approved AE: _____changes _____approved Job Number: 15-1639 Job Name: iParticipate - Harrison Ford Publication: WEBMD Copywriter: _____changes _____approved Live Area: 3/8” Trim: 2 1/4” x 9.5” Bleed: 1/8” Issue Date: 2. 25. 2011 Colors: CMYK V: 01 R: 00 I: 00 AD: _____changes _____approved File Notes: Designer: _____changes _____approved Euro RSCG Worldwide erw110205a Proof 1 B:8.625” T:8.375” S:7.625”

+ exam room A CLOSER LOOK AT EVERYDAY OBJECTS +

DIAPERS Where can people + living with lupus go to + Fresh Start Vend Trend The name “diaper” comes from the type of California began dispensing diapers fi nd their voice—and fabric used in the first cloth diapers. in vending machines in 1989. Diaper + vending machines are now in public many reassuring echoes? restrooms across the nation.

Miracle Material Procter & Gamble Aisle File first commercialized the disposable diaper Disposable in the 1950s. Nearly a diapers were so decade later, Pampers revolutionary made the diaper out when they were of cellulose rather introduced that than paper for retailers didn’t greater absorbency. know where to put them in B:11.125” the store. As someone who’s living with lupus, you may sometimes feel alone. But there’s a whole group of people living with lupus coming together. Stick to It Whether we have lupus or care about someone who does, we are taking The invention on our challenges together, and not giving in to them. We are learning Huge Waste of Velcro in the from each other and moving forward. We are the us in lupus. 1980s took the Americans throw away an average place of safety + Where can you fi nd us? At the usinlupus.com. There you’ll fi nd stories pins previously of 49 million for us—inspired by us. You’ll get access to information about living well used to hold diapers per day. together diapers. with lupus. Best of all, you’ll fi nd the voice of people living with lupus— and a community that embraces it.

Compost Crawl Traditional Basic Training Visit the usinlupus.com/joinus today. disposable diapers According to take about 300 Or call 1-855-USINLUPUS (1-855-874-6587). studies, babies years to biodegrade go through more (some newer than 5,000 diapers Some people featured in the us in lupus are paid spokespeople for options break down before being Human Genome Sciences, Inc. and GlaxoSmithKline. more quickly). toilet trained. —Chloe Thompson n o is Morr d Te

16 WebMD the Magazine | March/April 2011 ©2011 Human Genome Sciences, Inc. and The GlaxoSmithKline Group of Companies All rights reserved. Printed in USA. BEN233R0 Janua r y 2011

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ask the experts Your questions answered my WebMD personal stories from Webmd.com members

Gone Overboard? The stress-binge connection By Erik Weinstock Vision Quest WebMD.com community member

Q  I stick to my diet until my stress I’ve been going blind my whole life. I was born with choroi- level hits a certain point. Then I binge and I’ve heard deremia, a rare, inherited disorder that causes gradual vision loss. feel horrible. How can I stop? that I can’t My doctors diagnosed it when I was 14, after my pediatrician saw take my new- small spots in my eyes. I had known I was having trouble seeing, A  First off, a definition. A “binge” is the rapid born outside for especially at night, but at that age I didn’t care. But then the doctors consumption of an excessive amount of food a month. Is this true? said, “You’ll have a hard time in your 20s, a very hard time in your at one sitting, usually 1,000 to 2,000 calories The idea that babies have 30s, and you’ll be blind by 60.” or more. Many people binge because they are to stay inside the house for They were right. I am 49 now and almost completely blind, anxious or depressed. Many binge secretly, which several weeks after they’re except for a sliver of vision in my left eye. I can see some light and brings on more feelings of shame and guilt. born is FALSE. In fact, as some movement. But I don’t know what my 9-year-old son looks Research shows that consuming large quanti- long as your baby is healthy, like. I can’t walk down a sidewalk without a cane. ties of refined sugar and fat really does decrease getting some fresh air can be I accept this now, but I was in denial for 30 years. The vision levels of stress hormones. But the resulting calm- great for mom and baby if loss was so gradual it was hard to monitor. But I was trained as a ness is short-lived, and afterward, you’re likely you take a few precautions. mechanical engineer and working full time, and I didn’t want to to feel emotionally drained as well as physically First, be careful not to Q  I’ve had two children, and I don’t accept the fact that I was going blind. I didn’t want to ask for help. uncomfortable. over- or underdress your want any more. I’m thinking about getting In fact, I did not use a cane until 2004. At its core, binging is not about food. It’s baby when you leave the my tubes tied, but what are the risks? It was a wonderful optometrist at LensCrafters who told me about a consistent difficulty coping with life’s house. Your best bet is to that year to stop driving. She also said I could get disability pay- stresses. The key to nipping your binges in the put as many layers on her as A  The term “tubes tied” refers to a bilateral ments and training about how to live with blindness. At the bud is to learn how to adapt and adjust to the you’re wearing yourself, and tubal ligation (BTL), when a woman’s Fallopian 10-month training program at the Center for the Visually Impaired ups and downs of everyday life. keep a blanket handy. tubes are severed and sealed to prevent her eggs in Atlanta, I learned how to use public transportation, how to talk A few tips: Learn to be mindful of every Second, be sure to keep from becoming fertilized. BTLs can be done sev- to people, and how to use adaptive aids in my own home—like mouthful you eat. Try sitting down and breath- her out of direct sunlight. eral different ways, including using clips, rings, bumps on my appliance dials and software that “reads” the text on ing deeply when you feel stressed, rather than “Newborns’ delicate skin sutures, and cauterization to seal the tubes shut. my computer screen out loud. My phone also talks to me, as does running to the fridge. Get help burns easily, and that kind The physical side effects of getting your tubes the thermometer I use for taking my son’s temperature. learning new problem- of early skin damage can tied are usually minimal. Recovery from the sur- I’m more independent now, and my self-esteem is higher. I’ve solving skills—ones that increase their lifelong risk gery is relatively quick, and studies show most started volunteering with the Choroideremia Research Founda- are productive and of skin cancer,” says Anne women don’t have any changes afterward in tion, which is working to find gene replacement therapy for the constructive, not self- Hansen, MD, MPH, medical menstruation, sexual function, or moods. There disease. In 2008, my vocational rehab counselor told me about destructive. Keep junk director of the Neonatal is a slight risk of pregnancy after having a BTL— Dialog in the Dark, an exhibit that has been presented in more food out of your Intensive Care Unit at about 1.8%—and if you do get pregnant, there’s than 20 countries and is currently in Atlanta, where it made its house, so if you do Children’s Hospital Boston. a 30% chance of it being ectopic (when the fer- United States debut. (An exhibit is set to open in New York City binge, you do it on “Keep them fully shaded with tilized egg lodges in the Fallopian tube). But in this summer.) I’m one of the visually impaired guides who leads healthy food. Most clothing or an umbrella.” general, this is a safe procedure. visitors through several darkened galleries—replicating settings important: Learn to And third, while there’s Patients often ask me if it’s possible to have such as a food market and a park—so they can sense what daily forgive yourself when no preventing your baby from a BTL reversed. It is, but the procedure is fairly life is like for someone who is blind. It’s a rare chance for blind you binge. Falling getting sick, try to stay away expensive (between $1,500 and $6,500), and it’s people to lead, not to be led. off the wagon occa- from places where you know rarely covered by insurance. There’s also no guar- The goal isn’t to make people feel sorry for blind people. It’s to sionally is natural there are people who are ill. antee that you’ll get pregnant. Studies indicate help them discover how very capable blind people are—how they when you’re What’s most important, that women are able to conceive after the proce- use their other senses to navigate their world. It’s about helping learning new however, is for baby to have dure only about 55% of the time. So it’s best to people change their perceptions of otherness and difference. The habits. a happy, healthy, and well- think of a BTL as permanent birth control. experience is so exciting—peoples’ perceptions really do change.

rested mom, Hansen says. t I like to tell people, “I don’t want your sympathy. I want your “And natural light, exercise, Erik Weinstock lost his vision gradually throughout his life empathy, tolerance, and understanding.” And if you want to help Pamela Peeke, MD, MPH, FACP and fresh air can help.” Jane Harrison-Hohner, RN, RNP and now helps people understand what it’s like to be blind. a blind person, don’t grab their arm and push them. Simply say,

WebMD FITNESS EXPERT WebMD WOMEN’S HEALTH EXPERT id Roth/ G etty Images T ooga/ G etty Images; Dav left: n t r ell Colbe Qua “Can I offer you some assistance?”

Get expert answers to all your health questions. WebMD.com Read more stories and share your own in our community. WebMD.com

18 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 19 ◗ this content is selected and controlled by WebMD’s editorial staff and is brought to you by boost. ◗

spotlight nutrition Golden Rules Test your smarts about Choosing BOOST Glucose Control® Nutritional Drink as part dietary needs of a healthy diet helps me manage my blood sugar levels. as you age ® * Protein BOOST Glucose Control By Christina Boufis, WebMD Contributing Writer Glucerna® Shake Do you need to change what and how you eat in your 50s, age, she explains, “you don’t always respond Sugars to the need for food with the normal hunger 60s, and beyond? Yes, though maybe not in ways you might sensation,” perhaps due to neurological or Carbs think. Fallacies about nutritional needs later in life abound, chemical changes in the body. 0 5 10 15 20 25 and it’s not always easy to separate myth from fact, especially Frequently skipping meals can backfire g g g g g nutritionally. “It’s not good to go eight because a lot of information is aimed at younger adults. hours without protein,” Bales explains. “The body needs a regular supply of pro- • One Carbohydrate Choice You should eat less as you get older. case. Your body requires the same amount tein and essential nutrients to maintain • Contains 190 calories and 24 vitamins True. “Energy requirements decrease of protein, vitamins, and minerals and, in metabolism, and for making bone and & minerals per serving as a nutritious 1with every decade,” says Connie Bales, some instances, even more nutrients. muscle and enzymes.” Try to eat every few snack or meal replacement PhD, RD, professor of medicine at Duke Take B-12, for example. After age 50, hours—even if it’s a light meal like a peanut University Medical Center and associate your body’s ability to absorb the vitamin butter sandwich. • An excellent source of calcium director of the Geriatric Research, Education, often decreases due to reduced stomach and Vitamin D for strong bones and Clinical Center at Durham VA Medical acids needed to break it down from food Older people need to drink less Center. “We move around less, we have less sources. The same holds true for vitamin D. fluid. False. Though it may seem muscle, and our metabolic rate goes down.” Aging skin is less able than younger skin to 4that you aren’t as thirsty, that doesn’t But Bales says the challenge while eating less convert the vitamin from sunlight, which mean you need to drink less. “You don’t ® overall is to consume more nutrient-rich in turn affects the body’s ability to absorb always respond to dehydration with the Be your best with BOOST foods, such as low-fat milk and lean meat, calcium—and both vitamin D and calcium normal thirst sensation,” Bales says. “Our which calorie for calorie, pack more of a are needed to prevent bone loss. That’s why regulatory processes are just not as sharp.” nutritional punch. taking a daily vitamin/mineral supplement So you might not feel thirsty even when is a good idea; so is talking to your doctor dehydrated. Her recommendation? Drink BOOST Glucose Control® Drink is available nationwide Nutritional needs decrease with to see if you need additional supplements six glasses of water daily and other fluids near the pharmacy at your favorite retailers age. False. People often think because beyond the multivitamin, Bales says. as well. you need fewer calories as you age, Perhaps the biggest myth about nutri- 2 * BOOST Glucose Control® Drink is not a substitute for medication. Chocolate fl avor comparison. For complete nutritional information, you need fewer nutrients. That’s not the It’s OK to skip meals if you’re tion and aging? That older people are set please see manufacturer’s website. not hungry. It depends. “If it’s once in their ways, Bales says. “That really is not Reviewed by a week, that’s fine. But if this happens true. I’ve found that most are really moti- Brunilda Nazario, MD 3 regularly, I don’t think it is,” Bales says. While vated about their health, and many of them WebMD SENIOR MEDICAL EDITOR it’s true that you generally eat less as you are quite willing to try to change.” der Meer/Getty Im a g es Betsie Van SPECIALIZED NUTRITION GREAT TASTE GLUCOSE MANAGEMENT MAINTAIN HEALTH STAY ACTIVE

Get all the facts about your changing nutrition needs. WebMD.com © 2011 Except where noted, all trademarks are owned by Société des Produits Nestlé S.A., Vevey, Switzerland. Glucerna® is a registered trademark of Abbott Laboratories. NestleNutrition.com/us 20 WebMD the Magazine | March/April 2011

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1 Natural Selection Burt’s Bees Thoroughly Dr. Reynolds says: Therapeutic Honey & Bilberry Foot Creme is a buzz-worthy nighttime A. During winter months when treat for your feet. humidity is low, skin dries out more rapidly. Foot Soldiers In some cases, feet get so dry they peel or crack. While there are plenty of prescription Step into spring with our expert picks for Q. What can I do medications that work wonders, I like to start now to get my feet soft with home remedies, which are inexpensive Liquid Gold 4 softer, more radiant feet and can be just as effective. It’s OK to put and ready to show off To soften super-dry areas, soak your feet in your feet in your by sandal season? original Listerine Antiseptic mouthwash ($4) mouthwash—if it’s Listerine Antiseptic. Daphne LaSalle, 30, U.S. Air Force, Altus, Okla. (yes, Listerine!) once or twice a week. Mix one part Listerine with two parts warm water in a Dr. Tanzi says: basin and soak your feet for 15 to 20 minutes, A. Thick, dry patches pop up on heels then apply a moisturizer like Eucerin Plus 1 during winter months because feet are often Intensive Repair Foot Creme ($5.59), which Sole Salvation crammed into heavy socks and boots that don’t contains hydrating urea. In addition to skin- Spread L’Occitane Shea Butter Foot Cream on allow for effective exfoliation of dead skin. To sloughing benzoic acid, Listerine contains your tootsies to keep loosen up that scaly epidermis, use a nightly ethanol, which kills bacteria, fungi, and germs them hydrated. cream like Dr. Scholl’s Ultra Overnight Foot that can lead to athlete’s foot. Cream ($6.99), containing aloe and palm oil Coating feet in a cream like Burt’s Bees to soothe tough skin. Thoroughly Therapeutic Honey & Bilberry To buff the dead skin away once it’s been Foot Creme ($10), which is loaded with softened, try the PedEgg Pro Pedicure Foot moisture-replenishing honey and jojoba oil, File with Handle 2 2 ($12.99). It’s better than a and wearing socks to bed is an excellent way Close Shave pumice stone for gently sanding down thick to lock in moisture for softer feet. If you can’t Repair Shop Shed dead skin skin on the heel and ball of the foot because stand to sleep in socks, place a humidifier at Mend flaky feet with with the easy-to- its stainless-steel micro files stay sharp. Once the foot of your bed to keep feet hydrated. Eucerin Plus Intensive use PedEgg Pro Repair Foot Creme. Pedicure Foot the bottoms of your feet are smooth, keep Treat thick, dry patches on your feet by mas- File with Handle. them hydrated with an emollient-rich lotion saging them with Vicks VapoRub topical 3 like L’Occitane Shea Butter Foot Cream ointment ($3) in the p.m. to battle bacteria Treasure Chest ($26), which is packed with moisture- while you sleep.—Ayren Jackson-Cannady Battle bacteria and treat dry patches with locking shea butter. Vicks VapoRub topical ointment. If you painted your toes in rich, dark hues Eric Reynolds, DPM, throughout the winter, you may be noticing podiatrist, some nail yellowing. Take a break from polish Jersey City, N.J. for a week or two, and the discoloration will 3 4 slowly fade. Once you’re back to coating your Are they green? During the Sleep Walk Steer Clear toenails in polish, be sure to start with a clear Get some work done Toe the Line This might be a bacterial or fungal infection Use OPI Start-to-Finish base coat without formaldehyde, a chemical A normal nail bed is pink and smooth. winter months while you snooze caused by trauma to the nail—the tint could be Base & Top Coat to that can react with the keratin protein in Anything other than that may be a sign with Dr. Scholl’s protect your nails from from trapped fluid or pus underneath the nail. of a serious medical condition, says when humidity Ultra Overnight discoloration. nails and make them change colors. The Are there horizontal ridges? podiatrist Eric Reynolds, DPM. Foot Cream. formaldehyde-free OPI Start-to-Finish Base Bumpy lines that run across the nail may be is low, skin Here’s what to be wary of. & Top Coat ($12.50) is a good one to try. an indication of chronic eczema on the skin dries out Are your nails brown or black? under or around the toenail. Elizabeth Tanzi, MD, See a doctor ASAP. A black or brown spot Are there vertical ridges? more rapidly. co-director, Washington on your nail could be an indication of Some people with rheumatoid arthritis or Institute of Dermatologic Laser melanoma, the most dangerous form of problems with circulation have lines running Surgery, Washington, D.C. skin cancer. along the length of their toenails.

The opinions expressed in this section are of the experts Dan Saelinger Dan Saelinger and are not the opinions of WebMD. WebMD does not endorse any specific product, service, or treatment. Find more expert pedi cures and remedies. WebMD.com

22 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 23 Reviewed by Eric Yabu, DDS livingwell WebMD DENTAL CARE EXPERT for the health of your smile

White Wash Mark Wolff, DDS, PhD, offers some tips Bright for safely whitening your smile: Be sensitive. Tooth and gum sensitivity Start is a common side Get the scoop on effect of teeth whiten- ers. “You don’t want Does treating itchy skin leave you teeth whitening to use the strongest and fastest [solution] scratching your head? because it comes Everyone loves a dazzling smile. with the most side That’s why so many of us reach for the bleach effects,” Wolff says. WebMD’s America Asks crew went across the country to find the when our pearly whites start to look more like Avoid rainbow teeth. most common questions and get answers from top experts. kernels of corn. If you have bonding Common foods and drinks, such as cof- or veneers on your fee, red wine, and berries, and, of course, teeth, whiten before smoking, cause teeth to stain and lose their having dental work brightness. The effects are often exaggerated done or skip it alto- as we age, says Mark Wolff, DDS, PhD, profes- gether. “These don’t sor at NYU College of Dentistry. Wear and whiten with bleach- ing agents,” Wolff tear creates etchings on the tooth surface, says. Restorations “making teeth more susceptible to stains,” will maintain their Wolff says. That’s why you might notice that original color while foods you’ve been eating for years discolor that personalized fit will cost you: Profes- the teeth around your teeth more these days. sional whitening systems range from $400 them lighten. The Teeth whiteners, sold by dentists and to $800, compared with $25 to $100 for end result is a multi- drugstores, use a form of peroxide (hydro- products you buy in the store. colored smile. gen and carbamide are the most common) But lower cost doesn’t necessarily mean There’s only Go for strips. OTC of varying strengths to oxidize or eat away at poor quality, and OTC whiteners can be a a finite color whitening strips are a the tooth’s color particles to brighten smiles. good option, Wolff says. Whitening strips are change you better bet than store- The amount of peroxide in store-bought kits your best bet because they adhere reasonably can achieve. bought trays. “The ranges from 3% to 10%; in professional- well to the tooth surface, particularly on the trays tend to be looseWe bMD Logo with Tagline PRINT CMYK VERSION Two or three and so don’t pro- grade whiteners (available in your dentist’s top teeth, keeping gel where it can best pen- Blue c 100 Black c 0 shades vide a high enough m 34 m 0 office), it runs as high as 35%. etrate enamel. y 0 y 0 concentration [of k 2 k 100 It is true that professional whiteners are White teeth are alluring, but keep expec- lighter than your current solution] to really do generally more effective than those sold over tations in check. “There’s only a finite color the job of bleaching,” the counter, but not just because the con- change you can achieve,” Wolff says. Two or color is Wolff says. centration of peroxide used is higher. More three shades lighter than your current color reasonable. Know when to pass. important for effective whitening, Wolff says, is reasonable. And be sure to follow instruc- If you’ve been diag- is that whitening trays made by dentists are tions. Overdoing whitening efforts can harm nosed with gum molded especially for your mouth, keeping tooth structure, leading to translucence—see- disease, talk with bleaching solutions in close contact with through teeth that appear blue or gray. your dentist about the tooth’s surface. This not only enhances That’s why, Wolff says, transforming a alternate ways to the whitening effect but also increases safety dull, yellow smile into a bright, white one is brighten your smile. by minimizing the amount of peroxide that best handled like most things in life: “Every- Whiteners can accel- erate gum disease. contacts the gums or is swallowed. However, thing in moderation.”—Lisa Zamosky P eter Ru t h er a g en / Getty I ma es

Say “cheese” with more secrets to whiter teeth. WebMD.com Now available on mobile 24 WebMD the Magazine | March/April 2011 Reviewed by The banana diet is a great plan...for monkeys. mind matters Patricia A. Farrell, PhD WebMD MENTAL HEALTH EXPERT Fad diets don’t work. a head start on emotional wellness Creating a weight loss plan does work. Fairly Young Right Brain It’s probably a mix of Introducing the Learning to be fair may be more than good manners. nature and nurture that develops our sense It might be hardwired into our prefrontal cortex of fairness, Elizabeth WebMD Food & Fitness Planner Tricomi, PhD, says. Try these tips to help your When Lori West’s kids complain, “That’s It’s not surprising that, when the poor man saw the kids understand fair play. not fair!” she responds with, “Wow, you are so smart! potential of his receiving a bonus, the striatum and the Accept their feelings of You’ve already learned that, and you’re only 6.” ventromedial prefrontal cortex, two areas of the brain WebMD has created what we believe to be the most effective way disgust. There’s evidence West, a 39-year-old stay-at-home mother of five that decide how much we like something, showed that moral disgust may to manage your weight and wellness. in Virginia Beach, Va., found that her brood began more activity. What was surprising was that the reward develop from our early grappling with issues of fairness while they were still center of the rich man’s brain also showed more activ- aversion to icky food. In toddlers. Research shows we tend to dislike unfair ity at the idea of the poor man’s getting a payout. More that case, encouraging • Monitor your nutrient intake – like sodium and cholesterol situations, and that this aversion is part of the way the surprising was that when the rich man got even more a kid to express his • Track fitness & activity levels money while the poor gross-outs could make it more likely he’ll speak • Save your favorite meals for easy managing one stayed poor, brain From an evolutionary activity went down, out against injustice as a • No catch – It’s free! perspective, it makes sense showing that he found grown-up. that we might prefer a fair this less rewarding. Empower them. Tricomi It’s possible that says that, despite our split of resources. serotonin, a brain brains having an innate capacity to evaluate chemical that helps New what’s right, “we certainly control mood, teach our kids about contributes to the fairness; there’s definitely unpleasantness we a component we learn feel about injustice. early on,” she says. Help Research shows that kids develop this ability as serotonin falls, we by asking questions, such react more strongly as, “Was that fair? Why or to inequity. In other why not?” words, our sense of Explain and practice. fairness isn’t based Even if the sense of entirely on social fairness is rooted in Now that’s something to go bananas over. rules we’ve learned. our emotions, we still brain reacts to rewards. A recent study showed that It’s an integral part of the way our brain responds to use judgment to make Only at WebMD.com. complex moral decisions. our objection to unfairness holds true even for the rewards: We like to see the underdog win. As your kids grow person who benefits from the unfair situation. In this From an evolutionary perspective, it makes sense, up—and their brains study, one of a pair of strangers was randomly desig- says Elizabeth ­Tricomi, PhD, assistant professor of develop—continue nated as rich and given $50 in cash. The other person psychology at Rutgers University, who conducted to point out more Studies have shown that people who keep was “poor” and got no money. Then, as their brains the study. “When we cooperate, we all might get sophisticated examples a food journal lose twice the weight than were scanned, each was shown an additional amount something better than if we only cared about our- of sharing, as well

H elena I n k eri /G ett y mage s of money that one of them might receive. selves.”—Susan Kuchinskas as injustice. those who rely on diet and exercise alone.*

More than 75% of Americans think our morals are getting worse, a recent Gallup poll reveals.

*American Journal of Preventive Medicine, August 2008 Do you know the do’s and don’ts of teaching kids values? WebMD.com

March/April 2011 | WebMD the Magazine 27 #1885 DSM WebMD ad.qxd:#1366 DSM WebMD ad 2/9/11 1:13 PM Page 1

Advertisement Reviewed by sleep matters Michael Breus, PhD, D, ABSM WebMD SLEEP SPECIALIST for the rest of the story

Good Night Want your kids to sleep more? Amy Jordan, PhD, Sleep Starved director of the Media The surprising link between early-childhood and the Developing Child sector of the snooze time and weight problems later in life Annenberg Public Policy Center of the University of Pennsylvania, offers that increased not sleeping well, about 25 or so would wind up You’ve probably heard these tips. TV watching, high-calorie snacking, and decreased obese who otherwise wouldn’t be,” Zimmerman physical activity are linked to skyrocketing rates explains. Turn off the TV. “Television doesn’t of children’s obesity. But recent research points to That’s why researchers say “there is a critical effectively transition the a new culprit: lack of sleep. “Children who don’t window prior to age 5,” when inadequate night- child from being awake sleep enough are at much greater risk for obesity time sleep can set the stage for childhood obesity to being asleep,” says than children who do sleep enough,” says Frederick­ for years to come. The difference between those Jordan. Studies show who got enough sleep children who watch and those who didn’t? TV in the hour before Kids who had inadequate nighttime sleep bedtime stay up later YES About 45 minutes, Zim- You can control diabetes... had about an 80% higher merman estimates. and have a more difficult risk of obesity. The study didn’t time falling asleep. explore causal mecha- Shut down screen time. you have diabetes, you healthier, happier living. 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It gives you access --access to Answers to questions about diet the information and strategies and exercise. Strategies for pre-

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fitness matters By James Beckerman, MD, FACC WebMD Heart health expert working out what will work for you

Is Your Workout Too Hard? Fit to a Fault How do you know if you’re exercising Measuring your target heart rate may not be the best too intensely? Watch way to track your workout, ladies. Here’s why out for these four classic symptoms. Chest pain, irregular Fitness buffs have long turned to heart it by 85% to get your “target” heart rate. But the heartbeat, or extreme rate monitors—either ones they own or those studies that gave rise to this equation were only shortness of breath found on exercise machines—as a way of gauging done on men. And, after looking at the correlation These can all be signs whether they’re exercising hard enough. But heart between heart rate and heart attack in the exercise of heart distress. Stop rate monitors aren’t as helpful as you might think. tests of more than 5,000 women, researchers at exercising immediately The problem? First off, the numbers used to cal­ Northwestern Medicine in Chicago found the and get emergency help. culate your maximum heart rate are a little squishy. maximum heart rate for a woman really should Chills, muscle pain, be determined by or blurred vision subtracting .88 of her If these occur when age (her age multiplied you’re working out in the by 0.88) from 206. heat, stop exercising and The new math may get medical help. You Turns out the may be having sound like gobbledy­ heat stroke. traditional gook, but here’s the calculation takeaway: If you’re a Headache, dizziness, or lightheadedness woman and if you’ve isn’t right for, These can indicate oh, just about found the goals hyped dehydration. half of the by personal trainers and Stop what elliptical machines to you’re doing population. be too strenuous, you’re and take a justified in slowing water break. down a bit. A 40-year- If you don’t old woman who has feel better, been aiming for a maxi­ seek medical The traditional calculation has been based solely mum rate of 180 beats per minute (with a target attention. on age, but factors like fitness level and genetics rate of 153 beats per minute), for instance, can now Severe fatigue also play a role in just what heart rate is healthy or strive for a maximum rate of 171 beats per minute After exercise this could even safe for individuals. If you’re quite sedentary, (with a target rate of 145 beats per minute). signal overexertion or for instance, and you try to reach the peak heart More important, while treadmills and elliptical heart attack. If you’re pregnant, be alert for rate for your age group, you could get into cardio­ machines often let you monitor your heart rate (and all these symptoms, as vascular trouble quickly—trouble that includes even provide tidy charts of “fat burning” and “car­ well as vaginal bleeding, breathlessness and dizziness. In fact, the latest diovascular training” zones), tailoring your workout uterine contractions, and research suggests that the traditional calculation to your heart rate is not as important as tailoring it blood or fluid leaking isn’t right for, oh, just about half of the population. to how you feel. That is, you can have an excellent from your vagina. All can Under the old guidelines, you were told to workout at a lower or higher heart rate than what’s signal a serious problem subtract your age from 220 for an estimate of recommended, depending on what you do and how with you or your baby. or d /Getty I mag es y Cr awf your maximum safe heart rate and then multiply long you do it—and as long as it’s fun. ac k/Getty I mag es; An d 35% of American adults exercise

regularly, according to the CDC. A a ron Bl le f t:

Find solutions for your workout dilemma. WebMD.com

30 WebMD the Magazine | March/April 2011 Reviewed by Do you work shifts or a non-traditional schedule? patient matters Laura J. Martin, MD Do you struggle to stay awake when you need to be awake? WebMD MEDICAL EDITOR making the most of your health

Try NUVIGIL FREE! with the voucher Get Your Plan to in this magazine Are You Covered? work harder Do you have the right kind of health insurance Health plan expert Candy plan for your family’s needs? Butcher offers these tips for getting the most coverage out of your Once upon a time, having health insur- 100% of your costs? Any health plan without a maxi- health insurance. ance meant security. If you got sick, your care was mum limit on your out-of-pocket expenses puts you Watch it. If you’re having covered. At least that’s what we all thought. at risk for a whopping bill in the event of a major ill- surgery at an in-network But a 2009 study published in The American Journal ness or injury. hospital, make sure of Medicine found that in 2007, 62% of all bank- The same is true for plans with dollar limits on every health professional ruptcies in this country were related to medical hospital stays. “These plans can be tricky and mislead- you see while admitted expenses. And three out of four people with medi- ing,” says Candy Butcher, chief executive of Medical is in your network as cal debt had health insurance. Billing Advocates of America. The monthly premiums well. Surprise bills have been known to show may be low, but they up for out-of-network cover only a fraction of anesthesiologists, the costs associated with Know radiologists, and an inpatient stay, the pathologists a patient what your most expensive form of didn’t agree to see maximum care. For example, “cata- while hospitalized. financial strophic” or “hospital- Insist on it. Insurance only” plans might give plans with caps on exposure you the impression that services, such as lab tests is in a you’re covered if you and X-rays, often stop Your struggle to stay awake could be caused by shift work disorder (SWD). SWD is a medical worst-case become very ill. But processing your claims condition that affects millions of Americans who work non-traditional schedules.1-3 some only pay for certain with the in-network Excessive sleepiness (ES) is a common symptom of SWD.4 scenario. 5 diagnoses, Butcher says. discount once you’ve NUVIGIL is a prescription medicine used to improve wakefulness in adults who experience ES due to SWD. Does your health reached your limit. Examine all bills carefully Ask your doctor how you can try NUVIGIL FREE* with the voucher in this magazine. plan exclude care for and make sure you’re not For more information, visit www.NUVIGIL.com. certain health condi- being charged the full, Important Safety Information The difference between a good and not-so-good tions (maternity care is a common one), or require out-of-network amount. health insurance plan makes a huge impact on both a waiting period for pre-existing conditions (some- Check it. Speaking of NUVIGIL may cause serious side effects including a serious rash Do not drive a car or do other dangerous activities until you and your or a serious allergic reaction that may affect parts of your body doctor know how NUVIGIL affects you. your health and finances. So, how can you tell which thing that will go away when health reform goes bills, as many as 80% such as your liver or blood cells, and may result in hospitalization Avoid drinking alcohol. kind you have? Start by doing the math. Look beyond into full effect in 2014)? If the answer is yes, you’re contain inaccuracies, your monthly premium, and add up out-of-pocket essentially uninsured if you need to receive care. and be life-threatening. Common side effects of NUVIGIL are headache, nausea, dizziness, and according to Medical If you develop a skin rash, hives, sores in your mouth, blisters, trouble sleeping. expenses in the form of deductibles, co-pays, pre- “The best place to look for that information is in Billing Advocates swelling, peeling, or yellowing of the skin or eyes, trouble Individual results may vary. NUVIGIL may not stop all of your sleepiness scription costs, and co-insurance (the portion of the list of excluded benefits found in your summary of America. If you swallowing or breathing, dark urine, or fever, stop taking NUVIGIL and does not take the place of sleep. medical bills you pay once the deductible has been plan description,” explains Tracy Watts, health and don’t understand the and call your doctor right away or get emergency help. NUVIGIL is a federally controlled substance (C-IV), so use NUVIGIL only met and insurance coverage kicks in). benefits partner with the consulting firm Mercer. explanation of benefits NUVIGIL is not approved for children for any condition. It is not as directed and keep in a safe place to prevent misuse and abuse. Also, know what your maximum financial expo- Your best strategy is to go back to the basics. Boring (EOB) from your known if NUVIGIL is safe or if it works in children under the age of 17. This information does not take the place of talking with your doctor for sure is in a worst-case scenario. How much money as it may be, “Review your policy book from front insurance company, Stop taking NUVIGIL and call your doctor or get emergency help if you medical advice about your condition or treatment. Only you and your pick up the phone. get any of the following serious side effects: depression, feeling anxious, doctor can decide if NUVIGIL is right for you. will you have to lay out before your insurer picks up to back,” Butcher advises.—Lisa Zamosky sensing things that are not really there, increase in activity (mania), Please see Important Information for NUVIGIL on reverse side thoughts of suicide, aggression, or other mental problems; chest pain, and the Medication Guide for Patients in the full prescribing abnormal heart beat, or trouble breathing. information for NUVIGIL. *Limitations apply. References: 1. US Department of Labor, Bureau of Labor Statistics. Workers on fl exible and shift schedules. Bureau of Labor Statistics Web site. http://www.bls.gov/news.release/pdf/fl ex.pdf. Accessed January 8, 2010. 2. Schwartz JRL, Roth T. Shift work sleep disorder: burden of illness and approaches to management. Drugs. 2006;66(18):2357-2370. 3. Waage S, Moen BE, Pallesen S, et al. Shift work disorder among oil rig workers in the North Sea. Sleep. Health plans cannot charge you higher fees for 2009;32(4):558-565. 4. American Academy of Sleep Medicine. The International Classifi cation of Sleep Disorders: Diagnostic and Coding Manual. 2nd ed. Westchester, IL: American Academy of Sleep Medicine; 2005. 5. NUVIGIL [prescribing information]. Frazer, PA: Cephalon, Inc; 2010.

out-of-network emergency services. M ic h ael B la nn/G ett y I mage s www.NUVIGIL.com Need expert tips for health care coverage FAQs? WebMD.com

32 WebMD the Magazine | March/April 2011 ©2010 Cephalon, Inc. All rights reserved. NUV-2682 Dec 2010 Printed in USA.

2CEP_NVCR_X7530_JA.indd 1 12/8/10 4:32 PM

Reviewed by parentingsex mattersmatters Roy Benaroch, MD expert advice for kids’ sake WebMD PARENTING EXPERT

Important facts NUVIGIL® (nu–vij–el) Tablets [C-IV] Play’s the Thing Generic name: armodafi nil Leonard Sax, MD, PhD, Class Act and education expert Michael Gurian, MA, say What is NUVIGIL? What is the most important information parents can work with I should know about NUVIGIL? The sexes really do learn differently. A is for “action” NUVIGIL is a prescription medicine used to improve wakefulness in teachers and schools to adults who are very sleepy due to one of the following diagnosed NUVIGIL may cause serious side effects including a serious rash or a when it comes to educating boys best support their boys’ sleep disorders: serious allergic reaction that may affect parts of your body such as your liver or blood cells. Any of these may need to be treated in a hospital and learning needs. • Narcolepsy may be life-threatening. Stop taking NUVIGIL and call your doctor right Move it. Children should • Obstructive sleep apnea (OSA). NUVIGIL is used with other medical away or get emergency help if you have any of these symptoms: Shortly after my son started his first year of cortex (responsible for memory, attention, thought, treatments for this sleep disorder. NUVIGIL does not take the place of be allowed and encour- • Skin rash, hives, sores in your mouth, or your skin blisters and peels elementary school, I asked him to name his favorite and language), are dedicated to verbal functions. The using your CPAP machine or other treatments that your doctor has aged to move around • Swelling of your face, eyes, lips, tongue, or throat subject. “Basketball,” he answered without skipping a hippocampus—a region of the brain critical to verbal prescribed for this condition. It is important that you continue to use while they do their these treatments as prescribed by your doctor. • Trouble swallowing or breathing beat. “Everything else is boring.” memory storage—develops earlier for girls and is work. Leg tap- • Shift work disorder (SWD) • Fever, shortness of breath, swelling of the legs, yellowing of the skin Declarations like this—“I like recess and P.E. larger in women than in men. “That has a profound or whites of the eyes, or dark urine. ping, standing, NUVIGIL will not cure these sleep disorders. NUVIGIL may help the best!”—from young boys about their school effect on vocabulary and writing,” Gurian explains. sleepiness caused by these conditions, but it may not stop all your If you have a severe rash with NUVIGIL, stopping the medicine may not and doodling sleepiness. NUVIGIL does not take the place of getting enough sleep. keep the rash from becoming life-threatening or causing you to be experience sometimes raise concern for parents, but A greater part of the cerebral cortex of boys’ while kids permanently disabled or disfigured. Follow your doctor’s advice about good sleep habits and using brains, on the other hand, read, write, NUVIGIL is not approved for use in children for any medical condition. other treatments. is dedicated to spatial or take a NUVIGIL is a federally controlled substance (C-IV) because it can be It is not known if NUVIGIL is safe or if it works in children under the age of 17. abused or lead to dependence. Keep NUVIGIL in a safe place to prevent and mechanical function- test—activi- misuse and abuse. Selling or giving away NUVIGIL may harm others, ing. For that reason, boys ties often seen as and is against the law. Tell your doctor if you have ever abused or been What are possible side effects of NUVIGIL? distractions—can help dependent on alcohol, prescription medicines or street drugs. tend to learn better with many boys learn. NUVIGIL may cause serious side effects. Stop taking NUVIGIL movement and pictures, and call your doctor right away or get emergency help if you get Boys tend to learn rather than just words, Wait a year. Kinder- What should I avoid while taking NUVIGIL? any of the following: better with movement Gurian says. garten today is much • A serious rash or serious allergic reaction. (See “What is the most more academic than 40 • Do not drive a car or do other dangerous activities until you know important information I should know about NUVIGIL?”) “If teachers let boys how NUVIGIL affects you. People with sleep disorders should always and pictures, rather years ago. “We’re ask- • Mental (psychiatric) symptoms, including: depression, feeling anxious, draw a picture or story be careful about doing things that could be dangerous. Do not hearing, seeing, feeling, or sensing things that are not really there than just words. ing 5-year-olds to do change your daily habits until your doctor tells you it is okay. board before sitting down (hallucinations), an extreme increase in activity and talking (mania), what 6-year-olds used to to write, they’ll be better • You should avoid drinking alcohol. It is not known how drinking thoughts of suicide, aggressive behavior, or other mental problems do,” Sax says. Although alcohol will affect you when taking NUVIGIL. • Symptoms of a heart problem, including chest pain, abnormal able to access color and opinions vary, some heart beats, and trouble breathing. other details about what boys with a fall birthday Common side effects that can happen in anyone who takes NUVIGIL they are writing; they can What should I tell my doctor before taking NUVIGIL? include: headache, nausea, dizziness, and trouble sleeping. may benefit from delay- access more information,” ing school an extra year. Tell your doctor about all of your medical conditions including, Consult your boy’s if you: he says. teachers before deciding. • Have a history of mental health problems, including psychosis Who should not take NUVIGIL? There are biochemical • Have heart problems or had a heart attack Do not take NUVIGIL if you: they shouldn’t necessarily, says Michael Gurian, MA, differences, too. Boys have less serotonin and oxyto- Get out. Confirm that • Have high blood pressure. Your blood pressure may need to be • Are allergic to any of its ingredients. See the end of the Medication co-founder of the educational research and training cin—hormones that play a role in promoting a sense your son’s school offers checked more often while taking NUVIGIL. Guide for a complete list of ingredients in NUVIGIL. Gurian Institute and author of The Minds of Boys: Saving of calm—than girls. That’s why it’s more likely that playtime in the yard • Have liver or kidney problems • Have had a rash or allergic reaction to either armodafinil (NUVIGIL) or (many new schools modafinil (PROVIGIL®). These medicines are very similar. Our Sons From Falling Behind in School and Life. Instead, these young boys will fidget and act impulsively. “Teachers • Have a history of drug or alcohol abuse or addiction words should be understood as the clue that it is. think the boy who can’t sit still and is wriggling in are being built with no • Are pregnant or planning to become pregnant. It is not known if “What they are saying is, ‘If you want me to learn his chair and [making noise] is being defiant,” says playgrounds) and that NUVIGIL will harm your unborn baby. Need more information? well, you have to understand how my brain and body Leonard Sax, MD, PhD, author of Why Gender Matters and even on bad-weather • Are breastfeeding. It is not known if NUVIGIL passes into your milk. days he’ll have free time Read the Medication Guide that comes with NUVIGIL before you start work when I learn,’ ” Gurian says. Boys Adrift. “But he isn’t. He can’t be quiet. Talk to your doctor about the best way to feed your baby if you outside. Research shows take NUVIGIL. taking it and each time you get a refill. There may be new information. And studies show that boys do learn differently “There are no differences in what girls and boys This information does not take the place of talking with your doctor that kids learn better Tell your doctor about all the medicines you take, including than girls. Brain scans tell part of the story: In general, can learn,” Sax says. “But there are big differences in

about your condition or treatment. : I mage Sou r c e /G ett y mages ; Do l ing K inders y/G prescription and nonprescription medicines, vitamins, herbal after recess. supplements, and hormonal birth control. Talk to your doctor or pharmacist, go to www.NUVIGIL.com, l e f t more areas of girls’ brains, including the cerebral the way to teach them.”—Lisa Zamosky or call 1-800-896-5855. • Women who use hormonal birth control may have a higher chance for getting pregnant while taking NUVIGIL, and for one month after You are encouraged to report negative side effects of prescription drugs to stopping NUVIGIL. the FDA. Visit www.fda.gov/medwatch, call 1-800-FDA-1088, or by fax at 1-800-FDA-0178. The language center of the brain develops a year or two later in boys than in girls, giving girls a head start in reading and writing skills.

Find more childraising tips in the parenting community. WebMD.com ©2010 Cephalon, Inc. All rights reserved. NUV-2717 Dec 2010 Printed in USA. March/April 2011 | WebMD the Magazine 35

2CEP_NVCR_X7530_JA.indd 2 12/8/10 4:32 PM Reviewed and recipe by By Domenica Catelli, Kathleen Zelman, MPH, RH, LD chef, cookbook author, healthyeats WebMD Director of Nutrition Mom-a-licious founder nutritious and delicious

Anatomy of VANILLA Smart Start Sole Provider Time’s Up Vanilla is the only fruit-bearing The flower that produces the vanilla bean lasts only one day. The member of the orchid family. beans are handpicked and then cured, wrapped, and dried in a I would be thrilled if Eating a process that takes four to six months. drinking coffee was proven to be the most nutritious way to start the day. complete Unfortunately for me and all the other breakfast Sticker Shock caffeine addicts out there, it’s not. Besides, On Ice After saffron, I’m not just cooking for myself in the Nearly 30% of Americans choose vanilla as their improves kids’ vanilla is the most No. 1 ice cream flavor (followed by chocolate, at morning—I’m cooking for my family. expensive spice in academic and less than 10%). Just serving coffee won’t cut it. the world. And here’s why: Numerous studies behavioral show that eating a complete breakfast improves kids’ academic and behavioral performance Bee’s Knees performance as well as their school atten- Only the Melipona bee, found Sweet ’Script dance rate. The end result? Your family as well as in Central America, can In Europe, vanilla was needs a tasty, filling breakfast that provides pollinate vanilla. their school once used in the production them with energy for the whole morn- of certain medicines In other parts of ing—and gives you the satisfaction of attendance such as nerve stimulants and the world, humans as an aphrodisiac. duplicate the process using a knowing you fed them well. Here are some wooden needle. tips for getting your day started right. rate. Smooth it out. One of the fastest (and yummiest) ways to get fruit, protein, and Bean Count Simple Syrup calcium into your family is with smooth- Pure vanilla extract contains 13.35 ounces of vanilla beans per gallon One tablespoon of vanilla extract has 37 calories, a large portion ies. I like to use frozen organic berries during extraction, according to FDA specifications. of which comes from sugars and alcohol.—Chloe Thompson when fresh ones aren’t in season—they have more flavor and vitamins than out- of-season berries. And frozen bananas add a rich, creamy texture. healthy recipe Add it in. Adding healthy ingredients healthy recipe to standard breakfast fare can boost the Makes 4 servings Directions Per serving: nutritional level considerably. Try adding Guiltless French Toast Directions Vanilla 223 calories, ingredients Sprinkle gelatin over 1/3 cup milk in a small bowl and let Panna Cotta 1. 7 g protein, ricotta cheese and whole grain flour to Makes 4 servings (one slice per person) 1. Mix egg whites, vanilla, orange 1 1-oz envelope unflavored stand 5 minutes until thickened. 36 g pancakes, for instance, to create more juice, and cinnamon together in gelatin ingredients 2. Combine remaining milk, half-and-half, sugar, and vanilla carbohydrate, protein, calcium, and fiber per serving. a shallow dish. 11/3 cup whole milk, divided 7 g fat 8 large egg whites bean in heavy-bottomed saucepan and bring to a simmer Switch it up. Think of creative ways to 2. Soak the bread until it has absorbed 1 cup fat-free half-and-half (do not boil) over medium-low heat. Remove from heat, (2 g saturated 1 tbsp vanilla fat), 11 mg substitute healthy ingredients for not-so- most of the liquid. Heat a pan or 6 tbsp sugar remove vanilla bean, and add gelatin mixture. ¼ cup orange juice (or juice from two oranges) cholesterol, healthy ones (like fat, sugar, and refined griddle and add butter. ½ vanilla bean, split 2 g fiber, 3. Stir until gelatin mixture is completely dissolved. 1 tsp cinnamon 3. Put bread in pan and pour remaining lengthwise (can substitute 32 g sugar, carbohydrates). For example, I like to make S tu d io/Getty Imag es Yard 4. Pour mixture into individual ramekins coated with - 4 slices whole wheat bread (with no corn egg batter onto bread. Cook a few 1 tsp vanilla extract added and 117 a hippie version of eggs Benedict by using syrup or hydrogenated oil)

; S to k minutes, then flip. after custard is removed cooking spray. mg sodium. a whole grain English muffin and baby from heat) Calories from 4 pats butter 5. Cover and chill until set (about 6 to 8 hours). spinach, and replacing the sinful Hollan- 4. Toast is done when both sides are cooking spray fat: 26%. 2 tbsp pure maple syrup golden. Top with fresh berries and 6. Peel and chop mango into bite-size pieces. daise sauce with the runny yolk of the egg 1 mango 1 cup fresh blueberries maple syrup. itself. The kids think it tastes great, and I 2 tbsp chopped pistachios 7. Invert ramekins on individual plates, garnish with mangoes and pistachios. like the nutrition they’re getting in every Per serving: 200 calories, 11 g protein, 25 g carbohydrate, 5 g fat (3 g saturated fat), 11 mg cholesterol, 3 g fiber, : Visio n s/ S to ckF oo d Mu i ch Lei gh Beis ch P h oto graph y/ S to ckF oo d to p bite. Everyone wins. 13 g sugar, and 272 mg sodium. Calories from fat: 23%.

Extract more sweet and savory vanilla recipes. WebMD.com Find more healthy breakfast recipes and tips. WebMD.com

36 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 37 parenting modern

mJulie Bowen’s trickso and tips form balancing TV’s No. 1 comedy and family—no easy feat with three kids under age 3 On the spectrum of mommy sainthood, ­Julie Bowen is much like her character Claire Dunphy on ABC’s hit TV show Modern Family: She lands somewhere on the higher end of the scale but falls far short of perfection—and that’s OK with her. This proud working mom of three boys—all under age 3—remains a self- By Lauren Paige Kennedy admitted control freak, however: “I function on the belief that if I were not WebMD Contributing Writer around, the wheels would slowly fall off the bus, and no one would ever be dressed or fed,” she jokes. Still, after she and husband Scott ­Phillips, a software engineer, welcomed twins John and Gus, now 22 months, when their firstborn Oliver was just hit- ting the “terrible twos”—within weeks of her landing the role on what has Reviewed by Louise Chang, MD WebMD MEDICAL EDITOR become the No. 1 comedy on television—the in-demand actress knew some- t e Powers

Ka thing had to give.

38 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 39 Bowen with her oldest parenting son, Oliver.

“I breastfed for a year with my old- a certifiable fan favorite. The series hilari- est,” Bowen, 40, tells WebMD. “We did the ously depicts a dysfunctional clan of I’ve heard all mommy & me time Mommy & Me classes—we did everything. three interconnected couples who marry Striking a balance between motherhood and the rest of life’s demands is no easy task. But once the twins came along, I slid a lot themes of gay partnership, foreign adop- the evidence Psychotherapist Debra Gilbert Rosenberg, LCSW, offers some pointers for women faced farther down that scale.” tion, May-December romance, culture with the urge to be all things to all people, all of the time: She cites the new bar-setting trend of clashes, religious differences, warring about television making your own baby food: “Organic in spouses, and uppity teenagers. In other Know your needs. “It’s important to strike a balance that works for you on all lev- a jar is better than anything I’m going to words: real life. for kids, but els—financially and emotionally. Listen only to your needs and the needs of your family, come up with,” she riffs. “There’s a whole Bowen as Claire is a mom who believes to establish this balance, whatever it may be.” secret underground movement of people she knows best—but much to her chagrin every now and who feel like they’re being bullied by these (and the audience’s delight) very often Banish the guilt. “If finances dictate that you work a full schedule, or if you need to messages of ‘You must grow your own doesn’t. Women especially respond to Bow- work to maintain a healthy sense of personal identity, then good: Work. If this is what’s food and purée it!’ If you can do that and it en’s character because she makes so many then Yo Gabba best for your family, accept it. Then find nurturing child care and let the guilt go.” brings you pleasure, do it. But if it doesn’t laugh-inducing mistakes. They love her work for you…there are so many options because she mirrors just about every well- Gabba! is your Be a “good enough” mother. Rosenberg cites Donald Winnicott, a mid-20th out there that are healthy, why beat yourself meaning if fallible mother out there. century English pediatrician and psychoanalyst who made the concept of the “good- up because you can’t can your own peas?” best friend when enough” mother famous. “You don’t need to be Super Mom,” she says. “Your job as a Bowen’s views on TV-watching sound Under Pressure parent is to provide your children with healthy food, safe shelter, good education, love, just as liberated: “I’ve heard all the evi- The Baltimore-bred actress first earned you need to get respect, and nurturing. But no one ever said it all has to come solely from you.” dence about television for kids, but every household-name status as the primary now and then Yo Gabba Gabba! is your best love interest on the series Ed from 2000 to the dishes done Remember: No one has it all. “ ‘Having it all’ was not what the women’s move- friend when you need to get the dishes 2004. Bowen made additional star turns on ment of the 1960s and ’70s was about: It was about having choice and opportunity. done or just chill out for a minute.” Weeds and Lost, as well as in Adam Sandler’s or just chill out It’s been twisted into this notion that women are supposed to have the amazing career Sounds like a line her alter ego Claire 1996 film, Happy Gilmore. Along the way, and the amazing kids and the amazing husband and the amazing body—all at once. might deliver deadpan into the cam- she’s had to acquire some serious juggling Men don’t have it all—and they never have. Why do modern women believe they can era, a staple of Modern Family’s confes- skills to satisfy the demands of a skyrocket- for a minute. have—no, expect to have—everything, all at once? Something has to give.” sional, break-the-fourth-wall style. The ing career and burgeoning home life. show—which won an Emmy Award for Still, Bowen’s balancing act is not so dif- Outstanding Comedy Series last fall and a ferent from that of other working moms— perform before a live audience: “I pumped much pressure. I feel awful! An actress like the world revolves around them—and Screen Actors Guild Award for Outstand- she’s simply traded the office cubicle for a lot. I pumped in my car. I pumped at whom I adore—who helped me audi- that’s a good thing.” ing Performance by an Ensemble in a a studio set. Consider breastfeeding twin work…I pumped in a hotel room and tion—told me: ‘You’ve ruined it for all of Comedy Series in January—has become newborns while trying to memorize lines to sent it back to Los Angeles on dry ice. Not us. You were hired for Modern Family when Her Best Shot because I’m some kind of saint, but because you were eight months pregnant with One subject Bowen does sweat is the ongo- The Modern Family cast took home a Screen Actors Guild Award for Outstanding Performance by an it was easy for me. Again, if it’s not easy, twins, and now that’s the expectation— ing debate over vaccinations. Like many Ensemble in a Comedy Series in January. or if it’s painful…quit. I really resent the that we can all do that. Nobody’s getting a other mothers of young children, she felt militants who insist things must be one way break.’ How awful, that in any way, shape, daunted by anxiety-inducing mixed mes- or another. Do what works for you, and cut or form I’ve made it harder for any new sages delivered by the media and traded yourself some slack with the comparisons.” mom. Because I’m just as swamped as the among moms about the risks of annual With this mantra, Bowen’s earned rest of us.” and seasonal vaccine shots. In the end, she another big fan, Debra Gilbert Rosenberg, Swamped is right. In the world of consulted her favorite doctor for advice. LCSW, psychotherapist and author of network TV, actors often log brutal hours. “I cried making the decision, I’m not Mother­hood Without Guilt: Being the Best Mother You While Bowen is luckier than most, her gonna lie,” she says. “But I spoke with my Can Be and Feeling Great About It. schedule can be erratic. Bowen with husband Scott Phillips, a sister, who is an infectious disease doctor— “The pressures of modern-day mother- “The model for Modern Family is to do it software engineer. They have three boys: and then also with my own doctor and my hood can feel overwhelming,” Rosenberg quickly and inexpensively,” she explains. Oliver, 3, and Gus and John, 22 months. pediatrician, who said to me: ‘By not vac- says. “Women buckle under it. They simply “We try to shoot 10-hour days where most cinating your children, you’re putting them can’t be in three places at once—yet they shows shoot 12 or 14, so that happens to lives—a healthy relaxation, according at serious risk.’ That was it for me. Once I

try to be. With so many women working t hew Im a g i ng / W ire e dovetail nicely if you have a family…[but] to Rosenberg. made that decision, there were a few tears— full-time jobs while attempting full-time there are weeks when it’s in balance, and “With her first child,” the therapist mostly mine—but now all three boys are on motherhood, there are many false expecta- there are weeks when it isn’t. Put it this way: explains, “a mother is often vigilant about regular vaccination schedules.” tions. And this combination of factors pushes There’s a lot of kid time, and there’s a lot of every detail: counting every step on the While there are no guarantees in this pre- toward ever higher, often unattainable stan- work time. It works.” stairs, pointing out every flower. By the ventive approach, accepting it led Bowen to dards of what it means to be a good mother.” “It works” means fewer Mommy & Me time her third one arrives, it’s ‘Hurry up!’ join the American Lung Association (ALA; Are women under too much pressure classes these days and an ability to stop Believe it or not, the latter may actually be lungusa.org) as the national spokesperson : Chris t o p her Pol k /Ge tt y Im a g es; Ma t o p today? “Yes,” Bowen says. “There is too Jaso n Merri tt /Ge y Im a g es sweating the minutiae of her children’s better for children. Then they don’t feel in its ongoing public awareness campaign,

40 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 41 parenting WebMD and Sanford Health proudly announce

The destination that helps you and your family achieve the fit lifestyle including:

• FOOD: Nutritional Fitness Bowen as senior associate attorney Denise Bauer in Boston Legal; as Adam Sandler’s love interest in Happy Gilmore; and on Lost with Matthew Fox. • MOVE: Physical Fitness • MOOD: Emotional Fitness “Faces of Influenza” (facesofinfluenza.org), about the importance of getting an annual Running puts me in a better mood. • RECHARGE: Behavioral Fitness flu shot. “The flu is a significant disease,” says Learning and living a healthy lifestyle is a family affair. fit is designed with that in Norman H. Edelman, MD, chief medical For me, it’s brain medicine. officer of the ALA. “Each year between mind with worksheets, videos, and games customized for different ages. There’s 10% and 15% of all Americans get it. An Surprisingly, Bowen has worn a pace- also a section just for parents. estimated 15,000 to 40,000 die from maker since she was diagnosed in her early complications.” 20s with a cardiovascular condition where “It’s a privilege to get to educate people,” the regular heartbeat can drop to danger- Bowen adds. “Everybody should make the ously low levels. The pacemaker “serves as Fit: The Place for KIDS to Play & Learn About Healthy Habits choice that’s right for them. But, please,” a monitor for me,” she explains, kicking in she adds, “make an educated choice.” when her heart requires it. And while she doesn’t “hear or feel” the A Good Pace device, she’s grateful “to live during a time It’s clear that Bowen is a woman on the when the technology exists to treat my con- run. So it comes as no surprise that she jogs dition,” and is in “excellent health.” nearly every morning. “You can pick up a Managing a significant health complica- pair of sneakers anywhere and you’re off,” tion helps her understand the importance of she says. “And 45 minutes later, you’ve had staying fit. But there are emotional benefits, a great workout.” too. “Running puts me in a better mood,” Anyone who’s caught Bowen she says. “For me, it’s brain medicine.” glammed-up and glowing with good Still, Bowen is fast to repeat her philoso- health on recent awards shows can testify phy: “If this doesn’t work for people, she looks downright amazing, consider- I don’t begrudge them one iota. If ing the woman is in her fourth decade you like to work out once a week, of life and has birthed three babies or work out after work, great. since 2007. What’s her secret? I like to come home and just For starters, she’s the first one to be with the kids. So I exer- tell you that staying in shape takes hard cise early…I’m willing to give work. It also requires sleep, the afore- up late nights and going out mentioned daily runs, plus the commit- in order to get up early—and ment to do both. that’s fine.” “I front-load it,” she says of getting a Which seems like a perfectly Ev ere tt Colle ct io n ; un i v ersal/ A BC/ Bo b D’ Am c o/ BC : Da nn y F el d / ox/ good night’s rest, meaning she’s typically reasonable position to take for in bed before 10 p.m., a healthy habit that a seriously stretched, almost

enables her to rise by 5 a.m. and run a few comically busy modern mother wise fro m t o p lef

miles before the kids wake up. of three. ck c lo

42 WebMD the Magazine | March/April 2011 allergies to Action At last, the first warm days of spring! Time to open 5 ways to the windows, pack away the winter coats, get out in treat and the garden—and head to the pharmacy to stock up on allergy medications. help beat If you greet the arrival of spring each year with a stuffy nose and watery eyes instead Spring of a happy heart, it’s time to take a new look at your seasonal allergies. You may have seasonal been struggling with spring allergies for years, but that doesn’t mean you can’t learn a few new tricks about coping with them. allergies With the help of one of the nation’s top allergy experts, WebMD has put together some tips for managing seasonal allergies that can help you enjoy spring instead of just suffering through it. About 40 million people in the United States have some type of “indoor/outdoor” allergy, known as seasonal allergies, hay fever, or allergic rhinitis, says James Sublett, MD, FACAAI, a clinical professor and section chief of pediatric allergy at the University of Louisville School of Medicine and managing partner of Family Allergy and Asthma in Louisville, Ky. “Allergies have a strong genetic component—if your parents had allergies, you’re far more likely to have them yourself,” he explains. “Most allergies develop in child- hood, but in some people, they develop later after exposure to environmental factors ‘flips the switch.’ For example, we know that diesel particulate exposure can trigger allergies. The end result is a runaway response in the immune system,” he says. Among the most common allergy triggers, according to the Asthma and Allergy Foundation of America, are: ✹ Tree, grass, and weed pollen ✹ Mold spores ✹ Dust mite and cockroach allergens ✹ Cat, dog, and rodent dander Seasonal and other indoor/outdoor allergies aren’t just annoying. Asthma is some- times triggered by allergies (although most people with allergies do not develop asthma). But if you do have asthma and your allergies aren’t well controlled, you may be more likely to have asthma attacks, which can be dangerous and even life-threatening. Here’s what you need to know to control your allergy symptoms before they ruin a

perfectly good spring season. p hoto/a.collectionRF/Getty I ma g es Plus By Gina Shaw, WebMD Contributing Writer

Reviewed by Laura J. Martin, MD WebMD MEDICAL EDITOR

44 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 45 Euro RSCG Worldwide erw110836a Proof 1 Euro RSCG Worldwide erw111462a Proof 1

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

allergies

Start Early medicamentosa may occur, where rebound Spring pollen season starts much earlier nasal congestion (when congestion returns than many people think. In large swaths and gets worse) occurs each time the Join the of the country, including the Eastern Sea- medication wears off. I wanted to stop board and the Ohio Valley, pollen starts Also, oral decongestants can cause MyBONIVA® Program my bone loss. filling the air as soon as the weather significant side effects, including an warms up just enough for the trees to elevation in blood pressure, nervousness, for Sally’s Tips, begin budding. and sometimes heart palpitations. If you “Here in Kentucky, we’ll see pollen have high blood pressure, glaucoma, or plus one month of sometimes in mid-February,” says Sublett. heart conditions, talk to your doctor first BONIVA free! “As long as you’re not in the snow belt up before trying decongestants. around the Great Lakes, the pollen season starts very early, and by mid-March we’ll Control Your Environment have our first peak.” You don’t want to have to stay indoors on a This means that if you take medications beautiful day just because you have allergies. to control your seasonal allergies, the time to But if you’re going to be working outside, start them is mid- to late February, not late consider wearing a protective allergy face March. “Allergies create an inflammatory mask for tasks like mowing the grass, raking response that is like a smoldering fire. If leaves, or washing the car. Depending on you can keep it smoldering rather than how severe your allergies are, you can buy flaring, you’ll do a lot better,” says Sublett. a simple disposable paper mask or a more “By starting your medications early, you’re long-lasting “respirator mask” with a high less likely to have a snowball effect with efficiency particulate air (HEPA) filter. your symptoms.” Remember Sublett’s advice about start- ing allergy medications early in the season Know Your OTC Meds so your allergic response doesn’t get out B:11.25” B:11.25” T:10.5” S:9.75” T:10.5” Three main kinds of over-the-counter of control? That applies to your daily life S:9.75” medications are used to help control sea- as well. If you’re working outside in the sonal allergies: topical nasal sprays, inhaled afternoon, take your allergy medication at MyBONIVA is a free program that gives If you have osteoporosis, like me, calcium-rich foods, vitamin D, and exercise can help. corticosteroids, and antihistamines; oral lunch so it will have a chance to get into you tips from Sally, ideas, and support But they may not be enough to keep your bones strong. So ask your doctor if once-monthly antihistamines; and decongestants. your system before the pollen does. to help manage your osteoporosis. BONIVA can help you do more. If you have mild seasonal allergies, nasal “Keep an eye on the pollen counts, and You’ll get: “Eat plenty of calcium-rich foods BONIVA is a prescription medication to treat and prevent postmenopausal osteoporosis. like yogurt, spinach, and cheese.” sprays and inhalants and oral OTC antihis- try to plan more of your outdoor work for • One month of BONIVA free*. tamines can both effectively manage your days when pollen counts are expected to be Ask your doctor if BONIVA is right for you. symptoms. Despite what you might have low and it’s not so windy,” says Sublett. If • Sally Field’s tips on managing your Important Safety Information: You should not take BONIVA if you have certain problems with your esophagus heard, antihistamines are not addictive, you have a smartphone, download an app osteoporosis and building stronger (the tube that connects your mouth and stomach), low blood calcium, cannot sit or stand for at least 60 minutes, have although they can lose some of their effec- that gives you regular pollen updates. bones. severe kidney disease, or are allergic to BONIVA. Stop taking BONIVA and tell your doctor right away if you experience tiveness over a few months. What about inside? “There’s a myth that • Helpful monthly reminders to take difficult or painful swallowing, chest pain, or severe or continuing heartburn, as these may be signs of serious upper If your symptoms are not controlled, if you keep your windows shut, you’ll be your BONIVA, delivered by phone, digestive problems. Follow the dosing instructions for once-monthly BONIVA carefully to lower the chance of these events consider switching brands periodically to OK,” Sublett says. “But homes have to have e-mail, or mail. occurring. Side effects may include diarrhea, pain in the arms or legs, or upset stomach. Tell your doctor and dentist about make sure your medication is still packing ventilation, and about one-third of what’s all the medicines you take. Tell them if you develop jaw problems (especially following a dental procedure) or severe bone, the greatest punch. You may want to buy outside gets inside no matter what you do.” • Quarterly newsletters filled with joint, and/or muscle pain. Your doctor may also recommend a calcium and vitamin D supplement. the kind that read “nonsedating” on the bone-strengthening exercises and label (unless you’re planning to go straight simple, delicious recipes. You are encouraged to report negative side effects of prescription drugs to the FDA. to bed after taking them). Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. Sublett doesn’t advise using OTC decon- Please read Patient Information on the next page. gestants for allergies, although many peo- ple do. “They’re designed for use with a Enroll today. Call 1-888-434-6193 or cold, for seven days or less, while allergies visit BONIVAfreetrial.com and try BONIVA free. last for weeks,” Sublett explains. “They work by reducing the blood flow to your nose, letting you breathe better.” However, nasal decongestants should be taken on a short-term basis only. If used for

more than a week, a disorder called rhinitis B ETEM P S – 2010/Getty I ma g es Fanny *You must be 18 years of age or older to join MyBONIVA. The free trial offer is limited to one per patient. MyBONIVA is a registered trademark of Roche Therapeutics Inc. BONIVA and symbol are trademarks of Roche Therapeutics Inc. © 2011 Genentech USA, Inc. All rights reserved. 10297400 46 WebMD the Magazine | March/April 2011

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Imagewerks/Getty Images Trade allergy-battling tipsandfindexpert solutions. can signalthe presence ofallergies. Your also testfor antibodiesinyour blood that abrasion toseeifyou react. Allergists can small amountofanallergen through askin tests, involve which exposing you to a discussing your symptomsanddoingskin precisely what you’re allergic to by An allergist will help you determine a visittoanallergistrelief. canbring your medicinecabinet isn’t doingthe trick, If the latest of OTC batch antihistamines in Don’t Sufferinilence conflicting data. isneededtoresolveclinical trial the evidence say that alarge, randomized mixed. reviewing Researchers theoverall but studiesonthesubjectsofar have been Some swear by itasanallergy remedy, symptoms inthefirstplace.” removing thepollen, iscausingthe which tion outofyour nose. They’re notactually they’re- the mucus and irrita just rinsing gested andsymptomatic,” Sublett says. “But for minimizingseasonal allergy symptoms. tion. Studiesshow that netipotsare effective ing gravity themwithasalinesolu- torinse flushesout your nasalcavitieswhich by us- their limits. One populartoolis the netipot, symptoms, but keep in mind that they have Some natural remedies dohelpwithallergy Consider NaturalRemedies mold anddustmites,” says Sublett. in your homecanlead toproblems with your nose, andincreasing thehumidity droplets are so big that they don’t get into indoors: vaporizers andhumidifiers. “The with allergies,” Sublett says. air through thecar’s cabin filtercanhelp recirculate. “Studies show that recirculating windows shutandsetyour ventilation to vacuum andgettingaHEPA airfilter. allergens by usingaHEPA filteron your June. You canalsocutdown oncirculating early summer—for example, and in March iteverysure tochange andagain spring in or 12iswhat you’re lookingfor), andbe filter(MERVefficiency furnace level 11 ing throughout your house, getahigh- The jury isstillouton acupuncture.The jury “They definitely helpif you’re con- One “don’t” for copingwithallergies And whenyou’re inthecar, keep the To minimizetheallergens circulat- miserable,” Sublett says. “People often of adoctor.the supervision cant sideeffects andshouldbeusedunder inflammatory effect but can cause signifi- Corticosteroid eye drops have ananti- anti-inflammatory agents may help as well. with seasonalallergies. Eye drops with and waterinessthat oftengohand-in-hand reduce theredness, swelling, itchiness, histamines tocontrol congestion. fast-acting and work betterthanoralanti- allergens. are released when your body isexposedto knownchemicals asleukotrienes, which by theaction ofinflammatory blocking are available: allergic reactions. diary,” whenandwhere you tracking have allergist mightaskyou tokeep an “allergy Allergy ShotBasics Clustering Immunotherapy forallergies could benefitfromallergyshots,Sublettsays. ing upbutbarelyfunctioning.Somepeoplearehelpedbyprescriptionmedications,many leavethemimpaired—missingwork,missingschool,orshow- severe allergiesthatmayoften according toallergyspecialistJamesSublett,MD,FACAAI. Theotherhalfhavemoderateto About halfofpeoplewithseasonalallergiessaytheydofineover-the-counter medication, may even be able to discontinue them altogether without having your allergies return. may evenbeabletodiscontinuethemaltogetherwithouthavingyourallergiesreturn. monthorsothroughouttheyear, you’ll needthemonlyonceevery afewyearsyou andafter minimal—your allergistwillgraduallydecreasethefrequencyofyourinjections.Ultimately, shots—that is,you’vebuilt up atolerancetoyourallergens,andsymptomshavebecome the timefirsttulipspeekoutinApril. have agoodchancethatyoursymptomswillbesignificantlydecreased,ifnoteliminated,by process tookyearstobefullyeffective.Buttoday, and youcanbeginallergyshotsinJanuary the been around since the mid-20th century), When allergy shots were first developed (they’ve both, thenallergyshotsmaybetheanswerforyou. nor prescriptionmedicationsdothetrick,andyou’resufferingmiserablythroughspring,fall,or the body learns not to see itas a foreign invader and develops a tolerance to it. If neither OTC immune systemtosmallamountsofanallergen. Overtimeandinincreasinglylargerdoses, No matterwhichapproachyoutake,oncereachthe get anothershotlaterinthevisit,”saysSublett. come intotheallergist’sofficeforacoupleofhours. You getoneshot,andthenwait, “Twoyou canbuilduptofulleffectiveness within justfourtofiveweeks. timesaweek,you’ll “Eye symptoms can really make you ✹ Antihistamine eye drops, can which ✹ Intranasalantihistamines, are which ✹ ✹ Several allergy prescription medications Antihistamines Leukotriene modifiers,Leukotriene which work

is an even more aggressive approach. It takes more of your time at the outset, but is an even moreaggressive approach. It takes more of your time at the outset, but WebMD.com —commonly known as “allergy shots”—works by exposing the —commonly knownas“allergyshots”—worksbyexposingthe develop aplan.” find outexactly what you’re allergic to, and miserable,” Sublett says. “See an allergist, season issimple: You don’t have tobe tact lenses. some eye drops cannotbeusedwithcon- eyegood prescription drops.” But, headds, don’t really appreciate of theimportance “The take-home message thisallergy maintenance level

with allergy withallergy wellness

your home HEPA clean. You can vacuum till your fin- gers turn blue, but if you don’t have a HEPA- From the kitchen to the carpeting, most armed vacuum cleaner you’re just blowing homes can be made more eco-friendly and dust in the wind. An acronym for high healthy for every member of the family. efficiency particulate air, HEPA filters have a well-deserved reputation as green-worthy. Mold killer. Finding mold in your bathroom “HEPA filters basically suck air in and is easy—just look inside your shower or toi- clean it out,” says Darryl Zeldin, MD, let a few days after its last cleaning. Eliminat- clinical director at the National Institute of ing mold, however, means you need to get Environmental Health Sciences. “They pull creative if you want to be green. allergens like pet dander, mold, and fungi green “Vinegar is naturally acidic,” out of the air and trap them in an exhaust says William Rea, MD, a thoracic and system rather than blowing them back into cardiovascular surgeon and environmental your living environment.” Ready to make your home medicine expert at the Environmental You can retrofit your vacuum with a Health Center in Dallas. “And acid is the HEPA-designated filter. Or if you’re buying and yard more eco-friendly? key to getting rid of mold and other fungi a new vacuum, look for a certified HEPA that grow in humid environments like vacuum with a minimum efficiency of bathrooms.” 99.97% at a particle size of 0.3 microns. By Heather Hatfield Vinegar straight-up at 5% concentra- WebMD Contributing Writer tion—the kind you can purchase at the Humidity be gone. Dehumidifiers are a zone grocery store—with no water added, is home’s best friend when it comes to mini- a natural mold killer. Better yet, it earns mizing mildew, mold, and dust mites. Your home is where your health begins, bonus points for killing bacteria and germs “You want to keep your humidity so making your living environment as green as possible as well as fuzzy fungi. levels in your home below 50%,” says can only mean good things for your mind and body. Zeldin. “Dehumidifiers are an inexpen- Our living spaces, the air we breathe, and our yards sive way to lower your allergen and exposure levels to molds and dust mites.” offer numerous ways to make eco-friendly and health- So along with purchasing a dehumidifier, conscious choices. Three environmental medicine test the air moisture levels in your home experts offer tips for how to greenify your home to with a humidity sensor, and shoot for ensure your family’s well-being. that 50% mark. your air While you might take the air you breathe for granted, it is a golden opportunity to go greener. In fact, taking clean air action is a must when you’re improving your home to improve your health. t d ./Photol ib rary Potted plants take Co. L ark/Cor bi s; M IX A Co. in toxins and give out oxygen, which is a natural way to Reviewed by Michael W. Smith, MD WebMD CHIEF MEDICAL EDITOR purify the air. es; Beau L Peter Dazeley/Getty Ima g es; Beau left:

50 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 51 wellness cals, according to the National Cancer One of the cheapest and simplest Institute. Even thirdhand smoke—residue solutions to going green is to invest in a nice from tobacco smoke that clings to furni- pair of slippers and leave your shoes at the ture, clothes, rugs, and walls—can affect front door. your health. Researchers from the University of Cali- Grounds for improvement. Coffee fornia recently found that thirdhand smoke grounds are a little-known wonder for can hang around your house for months, enriching the soil and fertilizing your mixing with common pollutants to form flowers. According to Bark, the grounds carcinogens and tiny particles that hurt your are filled with nutrients like nitrogen that health. One in five U.S. adults still smokes, plants love. Zeldin says. If you’re among them, start So the next time you brew a pot of lighting up outside for the health of your coffee, just toss the grounds into your housemates. Better yet, quit altogether. compost pile and sprinkle the nutrient- rich mixture right on top of your flower beds before watering, about once a week. your yard It’s an excellent way to boost your garden and recycle waste, Bark says, without any Walking through a lush garden is an idyllic chemical fertilizers. way to pass the time—just be sure your flower beds are maintained the way nature intended. If you wear your Best for pests. Bugs are a nuisance, and DIY green-cleaning solutions the typical way to get rid of them is chemi- shoes in the house, Simple solution: Make sure the cal pesticides. Fortunately, the answer to Going green is an easy recipe to follow, and most of the venting over your stove is installed so it your pest problem just went au naturel. you are introducing ingredients you’ll need are already in your kitchen cabinets. Here’s a “Diatomaceous earth is a rock powder that chemicals into the sample of cleaning products you can make at home, from the book draws smoke outside instead of in, and kills bugs like fleas, ticks, and slugs,” says Healthy Child Healthy World: Creating a Cleaner, Greener, Safer Home Rea. “It’s completely natural and a harmless by Christopher Gavigan. way to eliminate pests.” environment. always turn it on when cooking. S he i la Jolley/Getty Ima g es Oc ean/Cor bi s; Photo g ra p her: left: Drain do’s. While harsh drain chemicals work magic on clogged drains, so can a simple solution of 1 cup baking soda poured into the sink or tub, followed by 1 cup Diatomaceous earth is made up of tiny vinegar. After some bubbling and fizzing, your drain should be flowing freely. Go green—literally. Placing houseplants experience every day without understand- fossilized water plants, and it works by around your home is just about as green as ing the cause,” Rea says. Throw a slab of dehydrating bugs that inhabit your garden Clean concoction. A simple mixture of ½ teaspoon washing soda (sodium carbon- it gets when you’re going green. meat on a gas stove, he says, and the levels and devour your plants. The mineral-based ate) and ½ teaspoon liquid Castile (vegetable-, not animal-fat based) soap mixed with “Potted plants take in toxins and give of polycyclic aromatic hydrocarbons and pesticide’s flower power comes from its 2 cups hot water in a 16-ounce spray bottle makes for an all-natural, all-purpose out oxygen, which is a natural way to other potentially harmful, cancer-causing all-natural composition, which chemical cleaner that can be used on most surfaces. purify the air you breathe,” says Toni Bark, substances in the air go up in smoke counterparts can’t compete with. Mold management. After donning gloves and a mask so MD, a medical consultant and Leadership in around you. you don’t inhale spores, eliminate mold by spraying with vine- Foot first. Energy and Environmental Design (LEED)- Simple solution? Make sure the vent- Leave your yard outside. Before gar at 5% concentration, or by scrubbing with a non-ammonia accredited professional at the Center ing over your stove is installed so it draws you step into your home, remove the dirt detergent such as borax, hydrogen peroxide, or tea tree oil. for Disease Prevention and Reversal in smoke outside instead of in, and always and germ magnets from your feet—lose Evanston, Ill. According to research funded turn it on when cooking. your shoes. Fresh scent. For a lemon-fresh smell to deodorize the air, by NASA, plants like the butterfly palm, “When you wear your shoes in the mix 1 teaspoon baking soda with 1 teaspoon lemon juice rubber plant, and philodendron strip toxins Kick the habit. You can properly vent house, you are introducing all kinds of and 2 cups hot water in a spray bottle. Spritz and savor! such as benzene, formaldehyde, and carbon your stove and install all the air filters you chemicals into the environment,” Bark Dog gone. You don’t need a pesticide to kill the pesky fleas on your monoxide out of the air. Water your plants want, but if someone inside your home is says. “There’s no point in making big dog. Instead, wash him with ¼ teaspoon of an essential oil that is frequently and breathe easy. smoking, environmental health experts say changes if you don’t start small and take insect-repelling, such as citronella, cedarwood, eucalyptus, rosemary, those efforts are a complete waste of time. your shoes off.” or bay leaf, with 1 teaspoon of a chemical-free shampoo and Smoke out. Gas stoves and the fumes they “Hands down, the biggest contributor to If you filled up your car with gas on the 1 cup water. Pour it over your pet, let it dry a little, then rinse. release, especially when frying meat, are poor indoor air quality is cigarette smoke,” way home, you just trekked gasoline into hotbeds of toxins. Zeldin says. “Any changes you make to try your kitchen, where you prepare food, she Buffed to shine. Two cups of olive oil and one juiced lemon “Gas fumes from gas-powered stoves to improve air quality in your home are explains. in a glass makes for a natural furniture oil. After testing on may cause dizziness, nausea, depression, trivial if you don’t quit smoking.” Or if you entered a public bathroom, a small section of your favorite furniture, apply with a soft muscle aches, allergies and asthma, and a Secondhand smoke is a known carcino- the industrial cleaners used to disinfect the polishing cloth and buff to a shine.—HH host of other symptoms that you might gen, containing nicotine and toxic chemi- i eu/Getty Ima g es; Dorl n Ki d ersley/Getty es Sp ohn M atth floors are now on your carpet.

How are you going green? Find tips in our Health eHome center. WebMD.com 52 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 53 Green and Clean Expert product picks for greening your home

It’s easy being green, especially when you get some pointers from William Rea, MD, founder of the Environmental Health Center in Dallas, and Toni Bark, MD, an environmental expert in Evanston, Ill., who is certified in healthy eco-living with a LEED (Leadership in Energy and Environmental Design) designation. They know phrases like phosphate- and chlorine-free on the label are good when it comes to buy- ing products that are better for your body. Even easier, look for green “stamps” that designate a product has eco- and body-friendly attributes, like chemical-free or organic, such as the “Green Seal” of approval, the A-OK from Green Seal, an independent nonprofit that certifies products and services that are greener and healthier. Here’s what Rea and Bark stock their cabinets with to keep their homes as clean as green can get.—Heather Hatfield

Bathroom Staples Heinz Distilled White Vinegar is all-natural, made from corn and water. Its 5% acidity is where the product gets its mold-fighting power, making it a good bathroom staple. ($2.19/32 ounces)

Biokleen Super Concentrated All Purpose Cleaner & Degreaser works in every room in the house, says Bark, including the bathroom, without harsh chemicals and fumes that can be released with steam when you hit a hot shower. ($5.75/16 ounces)

Dr. Bronner’s Sal Suds Liquid Cleaner contains natural ingredients such as fir pine oil, and biodegrades after it dries. ($11.59/32 ounces)

Kitchen Cleaners Bon Ami Powder Cleanser is an oldie but goodie. First produced in 1886, it’s still used today for scrubbing away grease and grime using all- natural ingredients like the mineral feldspar, limestone, and palm oils, Bark says. ($3.29/14 ounces)

Green Works Natural Dishwashing Liquid is made with plant-based, biodegradable ingredients and has no harsh chemical fumes. ($3/22 ounces)

Seventh Generation Natural Automatic Dishwasher Gel is made of lemon, grapefruit, and other natural ingredients, says Rea, to help keep your dishes clean and your air chlorine-free. ($3.99/ 42 ounces)

Mrs. Meyer’s Clean Day Liquid Dish Soap comes in extravagant scents, including basil, lavender, and lemon verbena—with no toxins such as ammonia and chlorine. ($3.99/16 ounces)

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. T e d M orr i son

54 WebMD the Magazine | March/April 2011 sleep pain Did you know?

Lower back pain is often triggered by some combination SHOPONLINE of overuse, muscle strain, or injury to the ERASEMS.ORG and propel us one step closer muscles and ligaments to fi nding a cure for multiple sclerosis. The ABCs of catching ZZZ’s The 411 of PARTICIPATING PARTNERS that support the spine. Arbonne, Doreen Nelson backache care Archipelago We spend (or should spend) about one-third of our life Avalon Hotel, Oliverio asleep. But sleep can be something of a mystery to most The Bakery Boutique of us. “I have no problem getting to sleep at night,” Eighty percent of Americans have back pain at some Bing Bang Jewelry macinthehouse writes in our sleep disorders community. point—pain that ranges from mild aches to breathtaking Bold Girlz “The problem is that if/when I wake up in the night, my Bonnie Marcus contractions. But learning what treatment is best for Chelsea Taylor mind starts racing and I often can’t fall back to sleep for your type of back pain can be confusing. “Is there Deuce Brand several hours. Is this a medical condition?” It could be, so ANYTHING that can be done for recurring muscle Don Francisco’s Coffee talk to your doctor and test your sleep smarts with this quiz. spasms other than fix the underlying cause?” Donni Charm uestions lifesajourney asks the WebMD back pain community. Dry Divas 1 Which age group needs the most sleep? Q for your doctor EFX Performance, Inc. ● “I am having these every month. I’m using ice...Any Farm Fresh To You  Newborns  Infants (up to age 2)  Teens other suggestions would be gratefully welcome!” What What can I do to prevent my back pain from Harry & David  Adults  Older adults (aged 65 and up) do you think the options are for treating back pain? 1getting worse? Intermix Isaac Mizrahi 2 During a 24-hour period, people feel sleepy 1 To avoid further injury, be sure to call a doctor right Why is my back vulnerable to pain and injury? Jewelry for a Cause ● ●  Once  Twice away if your back is in pain. Judith Ripka 2Is there anything I can do to prevent it? Kashwere  Four times  Six times  Yes  No Kid Dangerous What are my treatment options? Will I need Kitson ●3 Which of these problems can result from too little sleep? 2 Plenty of bed rest and relaxation is the best cure. 3medication or surgery? Laura Geller ● Lifefactory  Decreased immune response  Yes  No Lisa Hoffman Beauty  Depression If you advise surgery, what are the risks? How Mandarin Oriental, New York long does it generally take to recover?  Impaired memory and thinking ●3 Heat is the best treatment for back pain. 4 Peace and Love Jewelry by Nancy Davis  Weight gain or difficulty losing weight  Yes  No Premier Moissante  All of the above P.S. Koveralls ●4 Surgery can help all types of back pain. ProFlowers 4 Most health experts recognize this many sleep disorders:  Yes  No Get the 411: pain Red Envelope ●  20  55  88  125 Zaza Collection Sign up for the latest news Answers: 1. Newborns need about 16 to 17 hours of sleep daily; infants need Answers: 1. Yes—but only in certain circumstances. Try self-care for a 14 to 15.5 hours; teens need about 9; and most adults need 7 to 9, according couple of days if pain is persistent but moderate. But don’t hesitate to call and lifestyle management to the American Sleep Association. 2. People tend to feel sleepy twice during your doctor if pain is severe or if you have a fever. Call 911 if you have back tips—delivered directly a 24-hour period, usually between midnight and 7 a.m. and between 1 and 4 pain with chest pain or if you fell or suffered a severe blow, are vomiting, or to your email inbox! Go p.m. 3. A good night’s sleep helps you think clearly and solve problems, stave have weakness, tingling, or numbness in your legs. 2. No. Don’t stay in bed off depression, recover from illness, and, recent research suggests, maintain more than a couple of days. Getting up and moving about some will speed to WebMD.com and a healthy weight. 4. There are 88 sleep disorders that can cause trouble with your recovery. 3. No. Ice is generally preferred over heat. Apply ice packs search for “chronic pain FOLLOW US ON: falling asleep or staying asleep. for 20–30 minutes; repeat every two hours as needed for the first 48 hours. 4. No. Surgery usually helps only certain types of back pain, such as pain newsletter.” START SHOPPING Source: NIH and the Sleep Disorders Health Center caused by a pinched nerve, a compressed spinal cord, or too much move- ment between the vertebrae (spinal bones). The Nancy Davis Foundation for Multiple Sclerosis is a non profi t organization dedicated to the treatment and ultimate cure of MS. Funding research is the core focus of the Foundation and all funds raised support our Center Without Walls program, a selected good sleep SEARCHRCH back pain SEARCHRCH network of the nation’s top MS research centers. Source: American Association of Neurological Surgeons and the Back Pain Health Center

March/April 2011 | WebMD the Magazine 57 DIABETES Did you know? Blood glucose levels should be between 80 and­ 120 before meals (readings Is your diabetes taken from in control? monitors that read whole

If you have diabetes, “tight control”—monitoring and blood). managing your blood sugar levels to prevent the disease from getting worse—is crucial. But we know it’s not easy. “I am glad to hear you have cut out a lot of the unhealthy foods and soda,” DianeR01 tells another member of WebMD’s diabetes community. “You have uestions taken a step in the right direction. Congratulations on Q for your doctor quitting smoking! You have a great victory there.” But, she adds, “You still need to work on your weight. Have What kinds of dietary and fitness changes do you worked with a dietitian to put together an eating 1I need to make? plan that works for you?” How well are you keeping your own diabetes in control? What other doctors and medical professionals 2should I see? How often? ●1 I follow my diabetes food plan:  Every day  Most days  What food plan? Will I need to inject insulin or take medications? 3If so, how often? ® ●2 I check my feet for cuts and sores: Don’t brush it off—use Colgate  Very often  Rarely  When my doctor reminds me How do I avoid complications? What kinds of things do I need to be aware of? 4 People with diabetes have a 2x greater risk of developing gum disease. Colgate Total® ●3 I exercise: toothpaste reduces 90% of plaque germs that cause gingivitis, the most common  Regularly, checking my blood sugar before and after †  I prefer spectator sports form of gum disease, for 12 hours.* And, it’s the only FDA-approved toothpaste. get the 411: Diabetes ●4 I check my blood sugar levels: Learn more at OralHealthandDiabetes.com Sign up for the latest news  Per my doctor’s instructions  When I feel like it and lifestyle management  I rarely remember * vs ordinary, nonantibacterial toothpaste. tips—delivered directly to †Colgate Total® toothpaste is approved through the New Drug Approval process to help prevent Answers: 1. Follow your diabetes food plan. If you don’t have one, ask gingivitis. Not approved for the prevention or treatment of serious gum disease or other diseases. your doctor about seeing a dietitian/nutritionist who specializes in diabetes. your email inbox! Go to The ADA Council on Scientifi c Affairs’ acceptance of Colgate Total® Gum Defense toothpaste is 2. Check your feet every day and maintain proper foot care, including nails based on its fi nding that the product is effective in helping to prevent and reduce tooth decay, WebMD.com and search gingivitis and plaque above the gumline, and bad breath, and to whiten teeth by removing surface and skin. Check for cuts, blisters, red spots, and swelling. 3. Get 30 to 60 stains, when used as directed. minutes of activity on most days of the week. Before changing your level of for “diabetes newsletter.” routine physical activity, check with your doctor. 4. Check your blood glucose the way your doctor tells you to. High blood sugar can make you feel thirsty and tired, cause blurry vision, or make you urinate often. Low blood sugar can make you feel weak, tired, confused, or shaky. a national strategic partner of SEARCHRCH Source: American National Diabetes Education Program and the diabetes control Diabetes Health Center

58 WebMD the Magazine | March/April 2011

CPA-COL-F03893 TotalDiab Ad B Rv1.indd 1 2/7/11 5:12 PM Dry Mouth? diet allergies Time-Released Moisture Day or Night!

Is your kid overweight? what are food allergies?

Is it baby fat or a real problem? Only your child’s doctor can say for sure. But if Any number of foods can trigger an allergic reaction, with varying you’re worried about your child being (or becoming) overweight, it may be time to symptoms. “I have a 5-year-old who has just been diagnosed with reflect on your parenting style.“About one-third of the kids I see are medically cow’s milk, egg white, and shrimp allergies,” blossomrose recently overweight,” says Roy Benaroch, MD, one of WebMD’s parenting experts. wrote in WebMD’s allergies community. “What are the symptoms “Many of these children will remain overweight as adults, and many will suffer of allergies? I know the rashes, hives, cannot breathe, but can • Works for Hours from psychological and medical problems as a direct result.” There are no hyperactivity be part of the allergic reaction?” What do you think? • Proven Effective easy fixes, he adds, but a few changes can make a big difference in your child’s How much do you know about food allergies? health. For instance: • With Xylitol ●1 Which of the following foods commonly cause allergic ­reactions in ●1 Do you encourage your child to eat ●3 Do you avoid rewarding kids? slowly to detect hunger and fullness your child with food? a. eggs b. milk c. peanuts d. all of the above better?  Yes  No 2 Which body system sets off an allergic reaction?  Yes  No ● a. immune b. respiratory c. gastrointestinal d. nervous ●4 Do you plan fun forms of 2 Do you discourage eating in front of exercise, such as bike ­riding, ● 3 Food allergies do not usually trigger this symptom: the TV, which can promote overeating? dancing, or swimming? ● a. itchy mouth b. hyperactivity  Yes  No  Yes  No c. nausea and vomiting d. hives or eczema

Answer: If you answered yes to most of these Answers: 1. d. Eight foods account for questions, you’re on the right track. Consult a Get the 411: diet 90% of all food allergy reactions: milk, Get the 411: allergies ­doctor about whether your child is too heavy. eggs, peanuts, tree nuts, soy, wheat, shell- Kids grow in unpredictable spurts, which Sign up for the latest news and fish, and fish.2. a. Normally, your immune Sign up for the latest news and makes determining unhealthy weight gain system rushes to defend your body against OraMoist is a clinically proven, lifestyle management tips— tricky. For example, a boy may put on pounds harmful substances, such as viruses, lifestyle management tips— time-released patch that adheres first and catch up in height later. Your doctor delivered bacteria, and toxins. A food allergy will also delivered inside the mouth and then slowly will measure height and weight and will con- directly to trigger an exaggerated immune response. directly to dissolves, moisturizing for hours. sider age and growth patterns. If your child’s your email Reactions range from mild to very severe. The patch releases ingredients that body mass index is greater than the BMI of 3. b. Hyperactivity is not a symptom. your email 95% of children of the same age and gender, Symptoms of food allergies usually occur lubricate the mouth as well as xylitol inbox! Go to inbox! Go to he or she is considered overweight. Don’t put WebMD.com on the skin and include itching; hives; and and enzymes. Each patch lasts for your child on a weight-loss diet unless your swelling of the eyelids, face, lips, or tongue. WebMD.com hours—sometimes even overnight. child’s doctor prescribes it, though. Without and search Digestive symptoms can include cramps, and search enough healthy food, children may not grow for “weight vomiting, and diarrhea. Shortness of Free Trial Sample for “allergies and learn as well. control breath, difficulty breathing, dizziness, and 800-448-1448 loss of consciousness could signal a more newsletter.” newsletter.” serious allergic reaction requiring immedi- Store Locator/Coupons ate care (call 911).

www.OraMoist.com Source: NIH, the U.S. Department of Health and Human Services, and the Health & Parenting Center Source: U.S. Department of Health and Human Services; NIH; the FDA; the American Academy of Allergy, Asthma, and Immunology; and the Allergies Health Center

in Oral Pain Aisle overweight children SEARCHRCH food allergies SEARCHRCH cancer HEART Did you know? ●1 A healthy blood pressure for an adult is 140/90.  True  False Since its debut ●2 You have HBP if you have these symptoms: blurry in 1941, the vision, chest pains, or headache. Pap test has  True  False decreased U.S. ●3 Cutting back on salty snacks and foods is all you need cervical cancer to do to lower HBP. death rates by  True  False are you At risk for an estimated Are you under pressure? ●4 The only way to know if you have HBP is to have cervical cancer? 70%. your blood pressure checked.  True  False Answers: 1. False. A normal blood pressure for an adult is less than 120/80. Anyone with a blood pressure measured at 140/90 on at least two “I took birth control pills for about 20 years,” One in three American adults has high blood pressure (also called hypertension). Left untreated, HBP puts you occasions has HBP and requires treatment. 2. False. HBP does not cause LeftCABehind posted in WebMD’s cancer community. symptoms unless it is severely high. In fact, nearly one-third of people who “Then I was diagnosed with early cervical cancer. I at greater risk for stroke, heart disease, kidney failure, have HBP don’t know it. 3. False. While reducing sodium can help, other and eye problems. But even when it’s under control, lifestyle changes are usually necessary, such as losing weight, stopping went off the pill but want to get back on to help my smoking, eating healthy foods, and getting enough exercise. 4. True. Be PMS. But the women in my family are convinced the HBP can be worrisome. “On occasion I have a mild headache, and a sudden little vision impairment, sure to get your blood pressure checked regularly, especially if you have a pill caused my cancer. What are the risks?” Does your close relative who has HBP. uestions which lasts around five minutes,” Wilma_I_T tells medical history include: Source: American Heart Association and the Hypertension Health Center Q for your doctor WebMD’s hypertension and high blood pressure ●1 Human papilloma virus (HPV) infection? Based on my age and risk factors, how often community. “Would this be related to my BP?” She should I have a Pap test? needs to check in with her doctor to be sure, but how high blood pressure SEARCHRCH  Yes  No 1 much do you know about this disorder? ●2 Multiple sexual partners? What role does my family history play in determining risk factors?  Yes  No 2

If I get an abnormal result, what does that mean? 3 Chlamydia (an STD that doesn’t always have symptoms)? ● Will I need additional tests?  Yes  No 3 What else can I do to reduce my risk for 4 ● Cigarette smoking? 4cervical cancer? Situation #12:  Yes  No

●5 Oral contraceptives? Date Night  Yes  No Life presents dozens of situations get the 411: cancer when you need a picture perfect smile Answers: If you answered “yes” to any of the above questions, you may be at higher risk for cervical cancer. 1. HPV, a sexually transmitted disease, is Sign up for the latest news by far the major risk factor for cervical cancer. The virus has been found in and lifestyle management 99% of cervical cancer biopsy specimens taken worldwide. 2. Having mul- tips—delivered directly to tiple sexual partners increases your risk of contracting HPV, the major risk factor for cervical cancer. 3. Several studies show that a current or previ- your email inbox! Go to ous chlamydia infection increases a woman’s risk of cervical cancer. 4. WebMD.com and search Smoking cigarettes has been linked to changes in the cervix that can lead to cancer. 5. Taking oral contraceptives for more than five years has also for “cancer newsletter.” been linked to both a higher risk of HPV and cervical cancer. One theory is that women on the pill don’t take other safe sex measures. Another is that hormones in the pill affect cervical cells in a way that helps HPV enter le

them. Get regular gynecological checkups and Pap tests. SEARCHRCH Source: NIH, the American Cancer Society, the American College of Obstetricians and cervical cancer

Gynecologists, and the Cancer Health Center *data on fi Visit BetweenTeethCleaning.com

62 WebMD the Magazine | March/April 2011 mind WebMD checkupcancer Did you know? 10 questions about your life and well-being Did you know? If you’ve already had one episode of postpartum depression, NELLY RAP ARTIST you face a 50% You really don’t need an introduction, do you? In the past decade, you’ve recorded some of rap’s most popular records, chance of getting you’ve won three Grammy awards, and you have six studio albums under your belt. Your latest, 5.0, hit the charts four months ago. However, you do some of your most important work outside the music field. In 2003, you and your older it again with later sister, Jackie Donahue, who died of leukemia, founded Jes Us 4 Jackie. How did the campaign get started? is it More than pregnancies. When we first started, we were trying to find a bone marrow donor for my sister. It didn’t happen. But I hope to save somebody THE baby blues? else’s sister someday. One of the goals of this campaign is to educate minorities about the importance of bone marrow and stem cell transplant donations and to encourage them to sign up for the donor registry. How do you do that? Is it hard to Many moms have a brief, mild bout of the “baby blues” convince people to register? We’ve held bone marrow drives in New York and Los Angeles at the same time, in urban communities. A lot of people think donating is after delivery. But some new moms develop a more going to be dangerous, that it’s going to take weeks to recover, but it only takes a couple of hours. You’re in and out quickly. intense medical condition called postpartum depression. “I thought I had the baby blues at first, with the stress What did you learn from your sister’s illness? of my bf working 3rd shift and me being pretty much That you can live your life as a quote-unquote healthy person and have it all suddenly taken away from you. All that you took for alone with the baby all night and all day,” ssf10 wrote uestions granted, all the obvious, everyday things, they become so much more important…Theuestions best medicine outside of a cure is the love of recently in Baby’s First Year, a WebMD community. “But your loved ones. It was my sister who was sick. I can only imagine it as a lonely scenario. You can’t take away the pain, but you can Q for your doctor make them as comfortable as possible. Keep positive; it’s the only thingQ you can do.for your doctor it’s not going away. I still cry often, and I hardly see or talk to anyone anymore. I feel very overwhelmed How do I know if I am at risk for postpartum In the past year, you’ve released a hit single, a new record, an exercise video—part of the Celebrity Sweats series—and by it all, especially doing it alone.” About 10% of new depression (PPD)? 1 you’ve got your own clothing line, Apple Bottoms. Do you ever have time to relax? mothers develop PPD. Are you at risk? I don’t look for down time. I don’t take that many vacations. Maybe I should. But I have only got so much time. It’s hard to slow down If I develop PPD, what treatments—medication, when there are always new dreams, new options. ●1 Have you ever been diagnosed with depression 2counseling, or support groups—can help me? unrelated to pregnancy? You’re now 36. With so much to do, how do you stay fit? If I’m not in album-making mode, I work out five times a week. In album mode, it’s rough finding the time. But I always play basketball.  Yes  No What can my partner or family members do to help me? Basketball is the best for cardio. It’s better than a treadmill, better than running. It’s about fun and 3 cardio and hooping with the boys. You release stress, you channel your stress into the game. ●2 Do you have a family history of depression? What are the warning signs that I need  Yes  No What’s your best health habit? 4immediate medical help? My best health habit is going to the gym, even when there are a million excuses not to go. 3 Did something stressful happen during your preg- ● What’s your worst health habit? nancy, such as a death of a friend or relative? My eating habits. I can get away with a lot, because I’ve been blessed with a great metabolism.  Yes  No As a kid, I was skinny. I only got large from lifting weights. I know it gets harder to keep off the get the 411: mind weight as you get older, but as a child I always needed to gain weight. ●4 Are you facing life stresses, such as marriage or financial problems­? Sign up for the latest news Name one of your guilty pleasures. Waking up at 3 a.m. and eating chocolate mousse and ice cream.  Yes  No and lifestyle management tips—delivered directly to Answer: If you answered yes to any of these questions, you’re at increased You have two kids, Chanell Haynes, 17, and Cornell Haynes III, 12, and risk for postpartum depression, an illness that can strike anytime up to a year your email inbox! Go to adopted your sister’s kids. What has being a father taught you? after you give birth. While the baby blues fade on their own—usually within WebMD.com and search for It’s taught me to appreciate smaller, everyday pleasures, like just hanging out with 10 days after delivery—postpartum depression is more serious and lasting. “mental health newsletter.” them. I know they like my success, but there’s a bitter side to it, too, because I’m Left untreated, it can become disabling. Symptoms include sadness, anxiety, mood swings, and feelings of guilt or worthlessness. You may worry about not there as much as they want me to be. hurting yourself or your baby. You may also cry often and have less energy and motivation. Talk with your doctor­ about getting care—not just for your sake, Is your name on the donor registry?

but your child’s, too. M arc B aptiste I’ve signed up. Hopefully, I will get a call and be able to save someone.—Matt McMillen postpartum depression SEARCHRCH xxxx SEARCHRCH Source: NIH, American Academy of Family Physicians, and the Depression Health Center Read Nelly’s full interview. WebMD.com

64 WebMD the Magazine | March/April 2011 March/April 2011 | WebMD the Magazine 65 DID YOU KNOW? The HEALTHY DOG AND CAT GUIDE Created for Your Vet’s Office WebMD also provides tips and tools to keep your pet healthy!

INSIDE webmd.com Spring/Summer 2011 Cat’s meow you’ll find: Decode your feline’s feelings • Information on pet 72 symptoms and conditions

• Tried and tested solutions Scare to pet behavior problems tactics • From recalls to new Help your dog medications – the latest deal with fear pet health news 74

• Ask a Vet: Access experts in our WebMD Pet Health Community Puppy love Isabella Rossellini taps into her animal instincts on-screen and off 70 Frontline_Dog_WebMD:A 2/9/11 11:08 PM Page 1

ask the experts Your questions answered

Barking Mad How can she get her loud dog to make less noise?

Q  My cat is prone to coughing up hairballs. What are they, and can I do anything about them?

A  Hairballs, technically called trichobezoars, develop as a result of your cat’s healthy and fastidious grooming routine. Tiny hook-like structures on his tongue catch loose and dead hair, which is then swallowed. The majority of this hair passes all the way through the digestive tract with no problems. But if some hair stays in the stomach, it can form a hairball. Ultimately, your cat may vomit the hairball to get rid of it. Here are a few things you can do to reduce the likelihood your cat will have hairballs or to cut down on their frequency. Groom your cat regularly. The more fur you remove from your cat, the less fur that will end up as fodder for hairballs in her stomach. Combing or brushing your cat on a daily basis can be an effective way to minimize hairballs. If you can’t get your UnleashUnleash the complete cat accustomed to grooming or brushing, think about taking her to a professional groomer for a grooming and haircut (especially Q  How can I get my dog to stop barking so much? for long-haired cats) every six months or so. killing force Use a hairball product or laxative. There are againstaga fleas and ticks. A  Training your dog to bark less will take work, practice, and a number of hairball products on the market consistency. It won’t happen overnight, but with proper techniques today, most of which are mild laxatives and time, you can see progress. Here are a few tips. that help hairballs pass through the Don’t bark. Shouting stimulates your dog to bark more because digestive tract. he thinks you’re joining in. So the first rule is to speak calmly and Try a “hairball formula” cat firmly, but don’t yell. food. Many pet food manufactur- Silence is golden. Most dogs don’t know what you want when ers now make hairball-reduction you’re yelling at them to “shut up.” So train your dog to under- cat foods. These high-fiber for- u n d/G ett y I m age s stand the word “quiet.” Here are two methods: mulas are designed to improve When your dog is barking, say “quiet” in a calm, firm voice. the health of your cat’s coat, -E r i c Bergl Wait until he stops barking, even if it’s just to take a breath, then minimize the amount of shed- praise him and give him a treat. Just be careful never to reward him ding, and encourage hairballs while he’s barking. Eventually he will figure out that if he stops to pass through your cat’s barking at the word quiet, he gets a treat (and make it a high-level digestive system. treat, such as cheese or chicken bits). Alternatively, you can teach your dog to “speak.” Then once

: L ennette N e w ell /G ett y I m age s; P er he’s doing that reliably, signal him to stop barking with a different command, such as “quiet,” while holding your finger to your lips (dogs often pick up body signals faster than voice commands). Practice these commands when he’s calm, and in time he should learn to stop barking at your command, even when he wants to ® What makes FRONTLINE Plus complete? It annihilates the flea life cycle by killing fleass bark at something. as adults, eggs, and larvae. Ticks, too. FRONTLINE Plus also keeps killing for 30 days.. Satisfaction guaranteed. That’s why it’s the #1 choice of vets for their pets*—and yours.† Mark J. Stickney, DVM Drew Weigner, DVM, ABVP

completekiller.com i on ; top As cro f t /CPi S y n di cat R o b ert ON THE COVER: WebMD PET HEALTH EXPERT WebMD PET HEALTH EXPERT

*Data on file at Merial. †Vet-dispensed; MDI Data. ®FRONTLINE is a registered trademark of Merial. Get more cat and dog care tips in the Pet Health Center. WebMD.com ©2011 Merial Limited, Duluth, GA. All rights reserved. FLE11CNPRINTAD WebMDPets | Spring/Summer 2011 69 Reviewed by pet care Katherine Scott, DVM, DACVIM WebMD PET HEALTH EXPERT

Isabella Rossellini has played Jasmine in Aladdin), live with and train one a nightclub singer (Blue Velvet ), a legless beer baroness pup per year. They split custody between their Manhattan apartments and Rossellini’s (The Saddest Music in the World), and even a cuttlefish (in her Long Island home. This exposes the dogs Seduce Me shorts for the Sundance Channel). But what to noise and traffic in the city (where they encounter crosswalks and taxis) and wild- she’d really like to do is get inside the head of animals, life in the country (where they learn not to chase birds and fight with cats). To date, which is precisely what happens in Animals Distract Me, a they have raised eight guide dogs. Bau, a film that premiered at the 2011 Sundance Film Festival 6-month-old black Lab, is Rossellini’s new- est puppy in training, since Sweety finished and will air on April 22, Earth Day, on the Discovery her schooling last year. Channel’s Planet Green. Rossellini has had dogs all her life, and nearly every dog she’s encountered has a fascinating story. “My mama gave me my Rossellini, 59, is the director, star, and nearly 15 years. In addition to directing, first dog, a white Maltese called Yupee,” writer of her newest project, which follows Rossellini maintains a full acting schedule. Rossellini says. “She ran off and came back her and a pooch named Sweety through She recently shot Late Bloomers, a romantic pregnant. We gave away the puppies, and Animal a day in Manhattan. While Rossellini dis- comedy with William Hurt, and Chicken she was so desperate that night, searching cusses a fashion exhibit with Vogue editor With Plums, a new film by Marjane Satrapi, for her babies. The night after, we found André Leon Talley, attends a shoot with star the Iranian director of Persepolis. Her Seduce a little black cat meowing for its mother photographer Fabrizio Ferri, and lunches Me shorts about animal courtship were in the street. We rescued the cat. The dog with chef Mario Batali, she becomes preoc- released last year, following on the heels of nursed the cat and was convinced it was cupied by the animals around her. her award-winning 2008 Green Porno series, her baby. She was so proud her baby could Instincts “Even though I’m in an urban about the mating life of animals. climb trees and do things other dogs When she’s not training guide environment, I keep on going to animals, Rounding out her busy schedule is a couldn’t do.” whether it’s a dog or crickets or pigeons role she’s taken in recent years, away from Rossellini’s next dog was a dachshund dogs, Isabella Rossellini turns or cockroaches, and with each animal [I the limelight: training Labrador puppies named Nando who was with her for nearly notice] there is a little vignette,” Rossellini for the Guide Dog Foundation for the Blind 20 years. After meeting the Jack Russell ter- her lens on a wild world says. The movie shows scenes first through (guidedog.org). rier of director (and one-time boyfriend) the eyes of a human and then from Rossellini and her friend, actress Linda David Lynch while filming Blue Velvet, she the point of view of an animal, such as Larkin (best known as the voice of Princess got her own Jack Russell named Macaroni, starring non-humans her former guide dog, Sweety. She even who died a few years ago. “After that, I introduces puppet characters, including thought, I can’t go through another death,” one based on Charles Darwin (actually she says. But now, she says, working with played by Rossellini with a voiceover guide dogs connects her to the entire life by Campbell Scott) to help educate the cycle—including helping whelp puppies audience about animal behavior. every summer. “It is the drama of life,” she Exploring the world with a camera says. “It’s inevitable that they die, but it’s is natural for the legendary actress and so painful.” model, who grew up in the spotlight. She is But if she can help it, drama-free is how perhaps best known for her famous lineage, Rossellini likes to keep her daily activities, as the daughter of actress Ingrid Bergman including playtime with the pups. “I don’t and Italian director Roberto Rossellini, think life is as fun without a dog,” she and for being the face of Lancôme for says. “I cannot say that they cure my flu or my headaches, but for sure they give me a By Melanie D.G. Kaplan and Rossellini dresses up as Charles Darwin in great sense of companionship, and they’re Chloe Thompson Animals Distract Me to explain how over time, entertaining. [When they’re not there] you wolves became our household pets. i on As cro f t /CPi S y n di cat R o b ert WebMD contributing writers miss the little circus they always bring.”

WebMDPets | Spring/Summer 2011 71 Reviewed by pet care D. West Hamryka, DVM WebMD PET HEALTH EXPERT LITTER ODOR CAN BE DOUBLE TROUBLE. 4 ways body

language TRIM:Ê8.375ÓÓÊXÊ10.875ÓÊÊÊÊÊBLEED:Ê8.625ÓÊXÊ11.125ÓÊÊÊÊÊÊSAFETY:ÊÊ.375ÓAAÊÊÊÊÊÊCOPYÊCODE:ÊDOUBLEÊTROUBLE,ÊNEWÊMATSKL7985Ê-ÊWEBMDÊMAGAZINEÊÊDOUBLEÊDUTYÊPRINTÊ(DOUBLEÊTROUBLE)-ÊFULLÊPAGEÊBLEEDÊ-ÊMRACHÊÊ2011ÊÊÊPQDÊ reveals your The Fluttering Blink 2When a cat greets another cat or a per- son with slow, languid blinks, it’s communi- feline’s true cating affection. Why? Because in the feline world, to close one’s eyes in the presence of feelings another is the ultimate sign of trust. By blinking slowly at your cat, you are communicating that you are aware of its presence and pose no threat. So the next time your cat blinks at you, return the gesture. Cat Tall Tales 3One of the most accurate barometers of a cat’s mood is its tail. When held high, it communicates confidence. Curled around another cat’s tail or human legs, it signals Clues friendliness. And tucked below or between the legs, it signals insecurity or anxiousness. The upright bottle-brush tail is an unequivocal sign your cat is feeling threat- ened. And when combined with the arched back, upright hair along the spine, and YOUR LITTER MAY CONTROL URINE ODOR. unsheathed claws, this stance is a dead give- away that you should back off, Sueda says. BUT WHAT ABOUT FECES? By Adriane Bishko, WebMD Contributing Writer The Direct Stare What is your cat thinking? His body language may give it away. 4Although people can use direct eye Cats use a variety of signals (body postures, facial expressions, and contact to show affection, most cats find it vocalizations) to convey their message and avoid unwelcome con- threatening. That’s why in social settings, a cat usually gravitates toward the one person in frontations. By learning how to decipher these feline postures, you ® the room who is trying to ignore it. ARM & HAMMER can deepen the bonds of affection with your cat—and prevent mis- The more fearful a cat becomes, the wider understandings and potential aggression. its pupils expand, says Myrna Milani, DVM, a DOUBLE DUTY veterinary ethologist (animal behaviorist) at CLUMPING LITTER. Tummy Display Tipping Point Animal Behavior Consulting 1Feline body language is more nuanced than that of dogs, says Karen Sueda, DVM, Services in Charlestown, N.H. When dilated The only litter that combines Diplomate of the American College of Veterinary Behaviorists. “Part of the problem arises and wide open, the pupils take in as much ARM & HAMMER® Baking Soda when people take their knowledge of dogs and apply it to cats,” says Sueda, who works visual information as possible. This bug-eyed, with urine AND feces odor eliminators. at the VCA West Los Angeles Animal Hospital. saucer look signals that a cat is frightened and Have you ever wondered, for example, why your cat’s seemingly flirtatious behavior of wants to retreat. It’s the secret to destroying both odors on contact. rolling over to expose his belly may turn to overt aggression when you try to stroke him? In an aroused or angry cat, the pupils may Love it or your money back. When your cat is content and relaxed, he may stretch out and roll over. But in other situ- become narrowed to focus more effectively ations, when a cat feels cornered and cannot escape, this pose may be highly defensive, on detail. But cats’ eyes also respond to ambi- indicating she is prepared to fight—with fully extended claws and sharp teeth, says Pam ent lighting, Sueda says, so it is important to

Johnson-Bennett, a certified animal behavior consultant in Nashville, Tenn. observe the body language as a whole. K nape /G ett y I m age s

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KL7985_DBLTRB_WEBMD_MAR11.indd 1 2/8/11 2:28 PM Reviewed by pet care Audrey Cook, BVM&S WebMD PET HEALTH EXPERT DID YOU KNOW? WebMD also provides tips and Is your dog terrified of everything? tools to keep your pet healthy! Help your pooch fight fear with these expert tips “You don’t take the dog and put it in INSIDE the middle of whatever’s causing that fear,” Beaver says. For example, if lightning and thunder terrify your dog, don’t leave it near a big picture window during a storm. Instead, put your dog in an interior room and turn on a radio to help hide the sound.

Don’t punish a fearful dog. It’s never a good idea to hit your dog or use negative you’ll find: Scare reinforcement to try to help it overcome fear, experts say. “If your dog’s afraid of you, how could she possibly think you’re going to keep • Information on pet her safe?” Radosta asks. Instead, “Set up a really good, struc- symptoms and conditions tured, positive reinforcement relationship Tactic s with your dog. Teach your dog a trick, then By Katherine Kam, WebMD Contributing Writer reward it with a tasty treat,” she says. • Tried and tested solutions Dee Seiffer was charmed when she spotted a 6-month-old English “You’re setting up this paradigm where to pet behavior problems cocker spaniel at a shelter. The Milford, Conn., resident adopted the dog is looking to you for instruction the adorable stray, but right after little Ruby came home, she began and reinforcement and starting to view you showing signs of fear and aggression. as ‘safe,’ and that’s the key to changing fear. If the owner is not considered ‘safe’ in the • From recalls to new “She was afraid of everybody and every- running away. It can be crouching down, dog’s mind, the dog will try to keep herself medications – the latest thing. She was afraid of garbage cans, parked moving backward, trying to make your body safe and that’s how you climb that ladder of cars—she was terrified of a parked truck,” small. It can mean the face and head are the aggression.” pet health news Seiffer says. “She was so cute that people only things that retreat. Sometimes, it means Ruby, now 4, went on a brief course of wanted to walk right up to her and pet her. the head goes down or flexes toward one medication to calm her extreme fear. Seiffer She would go backward, with her eyes as shoulder, or the eyes avert down.” also took her on walks to unfamiliar places, • Ask a Vet: Access big as saucers, and bark and shake and hide “Read what your dog is trying to tell to parks and dog classes—all in an effort to behind me.” you,” says Bonnie Beaver, DVM, DACVB, MS, provide her the exposure she likely missed as experts in our WebMD Seiffer knew that fearful dogs can prog- past president of the American Veterinary a young puppy. Pet Health Community ress from growling and bristling to snapping Medical Association and a professor of vet- Although she’s still skittish about strang- and biting, so she turned to dog behavior erinary medicine at Texas A&M University in ers touching her, Ruby has overcome lots of experts for help. In fact, fear and aggres- College Station, Texas. Too often, owners do her initial fears. When Ruby went on a walk sion are top behavior problems of pet dogs, the opposite. “The dog doesn’t want to go, it during a recent garbage collection day, Seiffer according to veterinarians who specialize holds back on the leash, so what do we do? says, “she walked by scores of garbage cans in animal behavior. What can owners do? We drag it forward,” she says. and didn’t flinch.”

Learn to recognize when your dog is fear- ful. “There’s a world of dog body language The Vet Is In that the majority of dog owners have no clue Pets are good for our health—shouldn’t we make sure about,” says Lisa Radosta, DVM, DACVB, a we’re doing the best for their health, too? veterinarian at the Florida Veterinary Behavior Visit WebMD’s Pet Health center for dog and cat Service in Royal Palm Beach, Fla. nutrition, exercise, behavior, and head-to-paw care Fear, anxiety, and stress look like “retreat,” tips—all reviewed by top vets. : J e ss a my n H arr is/G ett y I m age s; enr i k Soren s en /G

she says. “Retreat doesn’t always mean top

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74 WebMDPets | Spring/Summer 2011 Your newborn and infant care WAITING ROOM COMPANION Get the Latest Health Information webmd.com March/April 2011 from Sent Right to Your Inbox Bottle Receive important news ground and expert views on 50 Choosing the topics including Women’s right one 82 and Men’s Health, Skin & Beauty, Parenting, Weight Cry baby Loss, Pet Health, and 30 What her wails health conditions. really mean 83

Always free and your privacy protected. Danica McKellar The Wonder Years star and math maven on her family’s latest addition 80 ask the experts Your questions answered

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

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

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

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

Roy Benaroch, MD Jennifer Shu, MD

c over p ho t o b y Ca WebMD Baby care EXPERT WebMD Baby care EXPERT Gerber® Good Start® Protect Plus® is a one-of-a-kind formula brand made with gentle whey protein and immune system supporting probiotics like those found in breastmilk. Find out more at Gerber.com. March/April 2011 | WebMDBaby 79

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

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80 WebMDBaby | March/April 2011 March/April 2011 | WebMDBaby 81 baby care Reviewed by Reviewed by Louise Chang, MD Hansa Bhargava, MD WebMD Medical editoR WebMD Medical editoR

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

tom. Instead, buy plastic bottles with the • 12 burp cloths t e d m orr is on A n d er s on R o ss /Ge tt y I m a g e refers simply to daily, extended crying spells deep relaxation.

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