The Ol’ Meal Delay

You never know when you're going to miss a meal – at the airport, train depot, or because a business meeting went on too long. For those who have diabetes and are prone to too-low blood glucose, this can be worrisome.

What to do? Here are some tips from the American Diabetes Association (ADA):

If scheduled meal is delayed for 1 hour:

• Take your diabetes medication at your usual time before the meal.
• Eat 15 grams of carbohydrate at your usual mealtime. Always keep quick and easy carbohydrate foods with you in your purse, briefcase, locker, glove compartment or backpack: 6 saltines, 2 rice cakes, ¾ ounces of pretzels, 3 graham crackers, ½ ounce dried fruit, 3 prunes, or cereal bars that are 15 grams. 
• Eat your dinner when it's ready.

For meals that are delayed for more than 1-1/2 hours:

• Adjustments depend on when and what kind of diabetes medications you take.
• Many times you can switch a snack with a meal.

Before you run into a problem, it's a good idea to create a specific plan for such situations with diabetes professionals.

Compiled from 101 Nutrition Tips for People With Diabetes^[1] by Patti B. Geil and Lea Ann Holzmeister. Copyright by the American Diabetes Association. Used by permission. All rights reserved.

References

1. ^{^} 101 Nutrition Tips for People With Diabetes (www.amazon.com)

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One Woman’s Struggle With Restless Legs Syndrome

I went to a different doctor [from the one who diagnosed the fibromyalgia]. And I said, "My legs just kill me. It feels like a tightening up inside. You wouldn't think so, but when I walk, it relieves it."

What did your physician do for you? Did he give you an official diagnosis?
He thought I had arthritis^[1] so he put me on an arthritis medication. Evidently, one of its rare side effects was insomnia, so it did just the opposite of what it was supposed to do!

So I went in again and the doctor who had prescribed me the medication wasn't there, so I saw a certified nurse practitioner instead. She said it sounds like you have restless legs syndrome and prescribed a new medication, explaining that it was a nerve condition, not a muscle condition.

The new drug she gave me is supposed to be used for Parkinson's. The only side effect is that it makes you sleepy – so it's the best of all worlds. I also take magnesium supplements, which help me a lot.

They don't cure it, but it helps. Since I've been diagnosed with restless legs syndrome, if I run out of the magnesium, my legs hurt me twice as badly. I don't think there's any documented proof, it's just how it works for me.

References

1. ^{^} arthritis (www.lifescript.com)

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Patient Stories

Are you at risk of psoriatic arthritis?
Absolutely. They say about 30% of people with psoriasis develop PA. Some people get it before they get psoriasis and sometimes it's the other way. It doesn't discriminate.

Was your psoriasis always bad?
It got progressively worse as I grew up. By 13, I was covered about 70% [over my body]. Thankfully, I never got it on my face, but I got it on my hands, arms, feet, legs, stomach and back.

You'll always have the disease, no matter what, because it's internal. There's no absolute psoriasis cure.

How often does it flare up?
It can come and go, or it can be [constant]. It just depends on the patient.

It's not like you're going to have it for a year and it's going to go away. Once you have it, flare-ups can get worse.

How did you cope as a child?
I learned to mask it under long sleeves, pants – even during the hottest days of summer.

I'd see my friends in T-shirts, tank tops and shorts, and I was always very jealous. I didn't shave my legs until I was 20.

I got very aggravated, [thinking] 'Why do I have this?'

I knew other people had my disease, but I didn't see it on anybody else. As far as I was concerned, I was the only one.

How does psoriasis affect your daily life?
I had days where I didn't want to go out. Even going to a gas station, the clerks didn't want to hand me change because my hands were covered.

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Actress Julianne Moore Focuses Attention on Life With Alzheimer’s Disease

Does the movie offer an accurate view of life as an Alzheimer's patient? One expert we talked to says yes.

"In the movie, the way [Alzheimer's] was described was correct," says J. Wesson Ashford, M.D. Ph.D., chair of the Alzheimer's Foundation of America's Memory Screening Advisory Board and afflilated clinical professor in the department of Psychiatry and Behavioral Sciences at Stanford University.

"I have minor quibbles about the film, but 90% of the vignettes were presented extremely well," he says.

One "minor quibble" Dr. Ashford has with the movie: "Still Alice" came to an Alzheimer's diagnosis too quickly, he says.

In the film, Moore's character was worried about her memory, which led to a doctor's visit.

Typically, families have to drag the patient to see a doctor because they're displaying some signs of dementia, Dr. Ashford points out.

Alzheimer's symptoms and diagnosis
Alzheimer's disease is "an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks," according to the National Institute on Aging. Early-onset Alzheimer's patients, who are 65 or younger, experience similar symptoms to patients who are diagnosed after age 70.

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Breastfeeding may protect babies from arsenic exposure

(Reuters Health) - Babies who are breastfed have lower arsenic exposure than babies who are fed formula, according to a new study.

The powder and water used to make the baby formula may be sources of arsenic, which occurs naturally in the environment and in large doses is linked to serious health problems, the researchers write in the journal Environmental Health Perspectives.

It's not clear, however, whether the low levels of arsenic exposure in the study will turn out to be harmful, the researchers say.

Parents who need to use formula to feed their infants shouldn't feel badly about the new findings, said Kathryn Cottingham, one of the study's lead authors. Instead, they should pay attention to the water they're using to make baby formula.

"People who don't know what's going on in their water should test their water," said Cottingham, who works at the Center for Children's Environmental Health and Disease Prevention Research at Dartmouth College in Hanover, New Hampshire.

She and her coauthors note that arsenic occurs naturally in bedrock and is a common contaminant of well water. While the U.S. regulates how much arsenic is allowed in public drinking water, there's no regulation of private wells. And in New Hampshire, where this study was done, private wells supply water to 40 percent of the population. About one in 10 wells in the state have arsenic levels higher than the 10 micrograms per liter that's allowed in public drinking water.

Past research has shown that breast milk doesn't contain high levels of arsenic, even when mothers have been exposed to high levels of the element.

Baby formula powder, however, may have low levels of naturally occuring arsenic, the researchers say.

For the new study, the researchers analyzed urine samples from six-week-old babies of New Hampshire women who were pregnant and recruited for the study starting in January 2009.

Out of the 72 babies in the study, 70 percent received only breast milk, 13 percent received only formula and 17 percent received a combination of the two.

"Overall, exposure levels in this age group are low and that's great news," Cottingham said.

They did find that infants fed only formula had the highest concentrations of arsenic in their urine, followed by those who received formula and breast milk. Exclusively breastfed infants had the lowest levels of arsenic in their urine.

Based on samples of the participants' tap water and published data, the researchers say about 70 percent of the arsenic exposure in their study came from the formula powder.

"In conclusion, our findings suggest that breastfed infants have lower exposure to arsenic than formula-fed infants, even when drinking water arsenic concentrations are low," the researchers write.

They also caution that their study has limitations, including not having enough information to make estimates of arsenic exposure for individual infants. They also only had a handful of babies fed exclusively formula.

Cottingham also said they can't say that formula-fed infants or those exposed to higher levels of arsenic will have worse health outcomes later in life.

"As the (group of babies) ages, we'll be able to follow and see if there are any associations with that time period," she said.

SOURCE: http://1.usa.gov/1BCvql4 Environmental Health Perspectives, online February 23, 2015.

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Recommended for you

Yoga for Atrial Fibrillation

Yoga isn't a substitute for medical treatment, but it can be a good adjunct, Dr. Lakkireddy said.

Consult your doctor before starting yoga or any exercise program, especially if you have a health condition like atrial fibrillation, injuries or are pregnant. If you have high blood pressure, you may need to avoid yoga poses in which your head and heart are lower than the rest of your body, such as the Downward-Facing Dog, according to Anatomy of Hatha Yoga: A Manual for Students, Teachers, and Practitioners^[1] by H. David Coulter, Ph.D. (Body and Breath).

Here's a beginner's guide to starting a yoga practice.

The Basics
If you're new to yoga, you need to learn the basics – the breath. Breathe slowly and deeply, through the nose and into the belly. By learning to breathe properly, you'll be mastering the foundation of yoga and all its postures.

Yoga works best when bookended by meditations, which help you relax and promote your full attention as you flow through your poses. Take a few moments before and after your routine to be present and focus on your breath.

You can adjust yoga to any level or intensity: Simply hold each pose longer, try more advanced postures, move more quickly between poses, or all three.

Beginners should do yoga once a week for 15 minutes and build up to practicing every day for 90 minutes; it's adjustable based on your time, schedule and fitness level.

Wear exercise clothes that don't restrict movements, yet are snug enough not to bunch up or get in your way.

Yoga doesn't need much equipment, except for a mat, which prevents slipping and provides padding (especially if you're practicing on a hardwood floor, in which case you may want a thick one). A block helps stabilize standing poses and a yoga strap lets you move farther into seated poses.

Here are some simple poses to get you started. By concentrating on your breathing and being present in the poses, you'll feel the benefits immediately. Don't be afraid to start slowly!

References

1. ^{^} Anatomy of Hatha Yoga: A Manual for Students, Teachers, and Practitioners (www.amazon.com)

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Watch Out for Foot Ulcers

You know about stomach ulcers, but foot ulcers? Some diabetics, both type 1 and 2, encounter painful, red sores shaped like a crater that ooze pus and emit a foul-smelling discharge.

Foot ulcers occur in high-pressure areas, most commonly on the bottom or side of the big toe and on the ball of the foot, especially under the big toe joint. The break in the skin can be very small, but a larger ulcer may be hidden under a surrounding callus or under skin.

Foot complications are among the most frequent reasons for hospitalization in patients with diabetes. Whether you spend your day planted in a chair or padding around town, inspect your feet daily for red sores or breaks in the skin.

Consult a physician immediately if you suspect a foot ulcer. Untreated foot ulcers can lead to lower extremity amputation.

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Morning Rheumatoid Arthritis Exercises

Morning rheumatoid arthritis exercises: The Bridge
This targets muscles in the hip area, which are "most important for walking, using stairs, even going from a sitting to a standing position," Carr says.

1. While still lying on your back, bend your knees and plant your feet hip-width apart on the bed. "It's crucial that you don't squeeze your knees together," Carr advises.

2. Keeping your feet on the bed and arms by your side, raise your butt and squeeze your glutes.

3. Hold for 2-3 seconds – or longer, once you get the hang of it – and then slowly lower your butt back down to the bed.

4. If your knees hurt while doing the Bridge, lift yourself only as far as you can without pain.

5. Repeat at least 10 times. Gradually work up to 30 or more repetitions.

Morning rheumatoid arthritis exercises: The Clam
This third core exercise works the gluteus medius muscles in your hips while lubricating your hip joints.

1. Lie on your side, knees bent, with one hip, knee and ankle stacked on top of the other, Carr says.

2. Lift your top knee toward the ceiling. Hold for 2-3 seconds, then slowly lower the knee. Repeat at least 10 times.

3. For maximum effectiveness, make sure you lie straight on one side; don't roll forward or backward even a little when you lift your knee.

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8 Ways to Fight the Fatigue of Chemotherapy Treatment

"The tricky thing is, those [anti-nausea] drugs slow down digestion," she says.
 
"That can lead to constipation and food staying in the stomach longer than usual," Szafranski says.

If that happens, tell your doctor, who can recommend a laxative that's safe to use with your other medications.

4. Fortify your blood.
"Fatigue can often be attributed to anemia," Smith says.

Anemia is a condition in which the blood doesn't contain enough red blood cells to transport all the oxygen the body needs.

Chemotherapy drugs can cause anemia by affecting the bone marrow, where red blood cells are produced.

A multivitamin supplement with iron, one of the building blocks of red blood cells, can help reverse anemia, Smith says.

If blood tests indicate anemia, ask your doctor about supplements with iron or medications that can make your body produce more red blood cells.

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Control Your Diabetes With Tai Chi

The gentle martial art of tai chi may help manage or reduce the risk of type 2 diabetes, say two studies. Taiwanese researchers found that tai chi helped lower long-term blood sugar levels in 30 middle-aged adults with type 2 diabetes. In a second study, Australian researchers found that a combination of tai chi and qigong, a therapeutic Chinese breathing practice, helped 11 adults at risk of type 2 diabetes. Both studies were published in the British Journal of Sports Medicine.

In the Taiwanese study, researchers found that adults with type 2 diabetes who attended an hour-long tai chi class three times a week showed reduced long-term blood sugar control levels. In the Australian study, researchers found that after 12 weeks, participants showed a dip in both their average blood pressure level and waist size. Blood sugar control was also improved.

If you're interested in tai chi exercise, try these easy tips to start: To warm up, stand in front of a mirror and strike a gentle pose; this can be as simple as squatting in a lunge position. While maintaining your balance, sway forward and backward slowly in a controlled manner and regulate your breathing. If you can perform this exercise, you're ready to begin tai chi!

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