IT WOULD BE MORE FUN if cysts had better names, like boils have furuncle and carbuncle. There is “Bible bump,” which refers to a common, ganglion cyst usually located on the wrist or ankle — the name comes from a traditional treatment: a good smash from the family Bible.
A cyst is a sac-like structure that moves freely under the skin’s surface when pressed. Cysts usually contain a semisolid, liquid or gaseous substance; and can range in size from microscopic to large enough to displace an organ. Ganglion cysts occur more commonly in women than men, and more commonly between the ages of 20 and 50. Most disappear spontaneously, although a splint to restrict the joint’s movement can help speed the cyst’s shrinkage. Those that linger, especially large cysts that compress nerves and cause pain, are removed surgically.
Boils, by contrast, are caused by bacteria that enter the skin through improperly cleaned cuts or scrapes. Boils usually need to be lanced or drained. A furnuncle refers to a boil occurring within a hair follicle, and a carbuncle refers to a larger abscess involving a group of hair follicles. Having recurrent boils is called furunculosis or carbunculosis.
My orthopedist called a hard, painful lump behind my knee a “Baker’s cyst” — making me wonder if it came from an impressive amount of time spent cooking, though doubtful. The capital letter should have given it away: the cyst is named after the surgeon who discovered it. The label distinguishes a Baker’s cyst from hundreds of different kinds of such lumps. As many cysts do, this one went away on its own – but Baker’s cysts can burst, creating a sharp pain, swelling and redness, and a feeling of fluid running down the calf.
My other personal cyst experience involved a common epidermal cyst – often incorrectly called a “sebaceous” cyst. Most of the time it looked like a half-inch wide red bump on my thigh, but when I was overtired or sick, it became larger, redder and slightly painful. As I was making plans for a month-long trip in southern Africa, and worrying over many disease possibilities, I asked my dermatologist about removing it. She agreed, made a little incision, and out came a completely intact, tiny white sac, looking like a bouquet garni – albeit a distasteful comparison.
Most cysts are asymptomatic and require no treatment. They can occur when synovial fluid leaks from a joint capsule or tendon, often as a result of a local injury or arthritis. Other causes include infections, chronic inflammatory conditions or blockages of ducts in the body. Cysts that are large and/or painful, particularly those that form on the ovaries, are usually removed and biopsied, because in rare cases they can be malignant.
One of the most painful kinds of cyst is the “pilonidal cyst,” also known as a tailbone cyst, which occurs on the tailbone, or coccyx, and is most common among males ages 15 to 24. It is thought to be caused by constant friction — either from activities such as cycling and horseback riding or from wearing very tight pants.
Among natural cyst treatments, the one most often mentioned is turmeric: mixed with a teaspoon of honey – or in curry. Also, follow a healthy diet and exercise to keep the blood flowing, and practice “personal hygiene.”
“IT’S ALL IN YOUR MIND” is what sufferers of chronic pain hear repeatedly to downplay or even dismiss their difficulties. But these days that charge also brings new truths that can help to corroborate and hopefully one day to better treat both acute and chronic pain.
Using “functional” Magnetic Resonance Imaging (fMRI) of the brain, a computer algorithm recognizes a complex pattern of activation in the brain using signals dependent on blood oxygen levels.
Researchers led by Tor Wager at the University of Colorado Boulder observed the effects in the brain of “painful and non-painful” heat applied to the forearm; defined a pattern of activity that correlated with the subjects’ pain scores; and were then able to predict a “signature response” of pain in a new group of subjects. The magnitude of the response correlated with both the temperature and intensity of self-reported pain.
Wager’s group also showed that “looking at pictures of an ex-partner after an unwanted romantic breakup” activated similar brain regions as physical pain and that this “signature response” matched that of physical pain. Responses to both physical and emotional pain decreased after treatment with an opioid analgesic, a response that also decreased for subjects who didn’t know they were receiving the drug – indicating that the “signature response” may occur independently of self-reports.
According to the “gate control theory of pain” that emerged in the early 1960s, “pain messages originate in nerves associated with damaged tissue and flow along the peripheral nerves to the spinal cord and on up to the brain,” William Deardorff writes on the website Spine-health. En route to the brain, the pain messages encounter “nerve gates” in the spinal cord that open and close, although the details of this process are not completely understood.
Among the different types of message-sending nerve fibers, some carry faster responses to sudden pain while others carry slower signals. After a blow to the elbow or head, rubbing the area can provide relief by activating the sensory nerve fibers that send faster signals than those responding to the sudden pain, and that can thereby override the sudden pain messages.
For chronic pain, differing actions of various nerve fibers helps explain why treatments such as massage, hot or cold packs or acupuncture can be effective, according to Deardorff. These treatments can stimulate endorphins and other factors that close nerve gates so that the pain signal never reaches the brain; conversely, in times of anxiety or stress, descending messages from the brain can amplify the pain signal.
Sensory, cognitive and/or emotional factors can help open or close pain gates as messages move up and down the spinal cord. Sensory factors that can increase suffering include injury, inactivity and long-term narcotic use; while those that can ameliorate it include increased physical activity, relaxation training, meditation, biofeedback and hypnosis.
Cognitive factors range from focusing on pain to using visual imagery and other thoughts as distractions to help cope with the pain. Emotional factors include feeling more or less in control of one’s chronic pain and life, as well as stress management and having a positive attitude.
Wager used fMRI images to identify which factors are involved in an individual’s pain by seeing exactly where in the brain their pain signals go — with the eventual goal of determining which therapy is best for each sufferer.
Another “functional” imaging technique uses Positron Emission Tomography (fPET) to more accurately map inflammation when there’s no obvious tissue damage: in the neck to show whiplash, or near the elbow for “tennis elbow.”
Aware of the risk that imaging could someday be misused as a lie detector, however, medical experts emphasize that pain is still “by definition a subjective experience, and so the self-report of the pain experience is what tells us if someone is in pain,” according to Karen Davis, pain specialist at the University of Toronto in Ontario.
REMEMBER STYPTIC PENCILS, those little white sticks that were once standard items in shaving kits? They are still around, but today a myriad of products compete for the hemostatic, anti-hemorrhagic, blood-stopping market.
“BloodSTOP,” marketed by both LifeScience and Curad, looks like a typical gauze pad but is made of cellulose from plants, which initiates blood coagulation and creates a protective layer over the wound. BloodSTOP is a good option for scrapes and abrasions, especially when they are of a size or shape difficult to bandage. For someone who gets nosebleeds, keeping these on hand can be very helpful. (Styptics, which would not be great in these cases, contain astringents, usually “alum,” which causes blood vessels to contract – and which is why they can sting when applied.)
BloodSTOP pads can be removed after bleeding stops, although for larger wounds they can be kept in place using bandaging tape, but must be replaced every day. The key to removing BloodSTOP without reopening the wound is using water to wash the bandage away, even for nosebleeds.
For smaller cuts, an Israeli product, for which the name is translated as “20 Bandaids with Blood-Clotting Agent”– looks like a bandaid and contains a blood clotting agent, obviating the need for extra tape to hold the blood-clotting material against the wound. On Amazon, a package of 20 costs $7.99 versus 10 BloodSTOPS by LifeScience at $13.34, and 10 by Curad for $9.49 (although they are the same product).
Before applying any blood-stopper, wounds must be cleaned well to make sure they’re not closed with dirt or bacteria inside. This is especially true for hemostatic powders such as WoundSeal and BleedArrest, which can be poured onto deep wounds to stop the bleeding until you get to a doctor. (These are not okay for nosebleeds because they might be inhaled.)
When a questioner on Amazon asked, “Would this [powder] work in a stab or gunshot wound?” the answer was to choose the QuickClot Trauma Pak: a pouch of zeolite beads that can be held against the wound until medical help arrives.
But the best first measure to deal with bleeding should always be direct pressure – along with pressure on pulse points if you have learned where they’re located in the arms and legs.
Medical professionals warn that hemostatic products do nothing to repair wounds: any wound bleeding so badly as to need a hemostatic agent should be seen ASAP in a medical setting. But they concede that if the bleeding cannot be stopped by pressure, hemostatic products can be helpful until a medical professional can take over.
Treating wounds can be complicated by the use of products that contain granules or powder, which are difficult to clean from the wound later. Removing pads also risks removing the clots, which causes bleeding to start all over again.
So we’re back to nosebleeds and scrapes: if you’re prone to these, keeping a supply of BloodSTOPs around might be a good idea — but then you might want the Israeli bandaids, too.
WHEN RESEARCH subjects pedaled their bikes for three months using only one leg — 45 minutes, four times a week — the most surprising effect on the pedaling leg was altered DNA.
Well, not exactly DNA, but the epigenome, described as packaging material for DNA. The epigenome is compared to software, determining how the hardware DNA functions by acting on genes to prompt physiological responses.
The epigenome can turn some genes permanently on or off, and it plays a role in the specialization of cells, turning cells into liver cells that will produce more liver cells, etc. The face is a good example: skin, eyes, teeth and hair all contain the same DNA but the genes in each are expressed — turned on or off – differently.
It turns out that the epigenome can be altered — by the environment, stress, diet, behavior, toxins and the environment.
The bad news is that bad epigenomic modifications or “marks” can be passed along to create vulnerabilities in future generations. But the good news is that these propensities are potentially reversible: once the causes of epigenomic marks – for example, those creating a vulnerability to cancer — have been determined, the risk could be lowered by changing behavioral or environmental factors.
“Epigenetic changes represent a biological response to an environmental stressor,” writes John Cloud in TIME magazine. “But if you remove the environmental pressure, the epigenetic marks will eventually fade, and the DNA code will – over time—begin to revert to its original programming.”
Operating changes to the epigenomic software have been observed — along with the potential for altering them — in an array of instances:
Diet — the best human example comes from the remote north of Sweden where boys who lived through rare winters of abundant food, i.e. “who went from normal eating to gluttony in a single season,” produced sons who lived shorter lives, and subsequently grandsons with decreased life expectancies of “an astonishing 32 years,” according to the TIME article.
When the females of a breed of mice that are yellow, fat and prone to diabetes and cancer are fed with a cocktail of vitamins prior to and during pregnancy, their babies are brown, slim and healthy – and these offspring have babies similar to themselves. Researchers quip: you are what you eat, and now your grandchildren are what you eat.
“Nutritional epigenetics,” using diet to prevent or delay diseases, has been considered an “attractive tool” for use with type 2 diabetes, obesity, inflammation and neurocognitive disorders — including “to delay aging-associated processes.”
Cancer — epigenetic changes could silence a tumor suppressor gene, thereby allowing the uncontrolled growth of tumors, or could turn off genes that help repair DNA. The hope is that treatments less toxic than chemotherapy could reverse these changes to treat the cancer.
Memory — mice with inherited memory limitations problems, when exposed to a rich environment with toys, exercise and extra attention, showed significant improvement in one neural activity key to memory formation. Even without the extra attention, their offspring showed the same improvement.
Allergic reactions – a British university study recruited some 14,000 pregnant mothers in the early 1990s and then followed their children, finding: high maternal anxiety during pregnancy may cause a child’s asthma; baby lotions containing peanut oil may help cause peanut allergies; and kids kept too clean are at a higher risk for eczema. These epigenetic marks have been suspected to make future generations more susceptible to allergies – but the marks could also be altered or reversed, for example in the latter case, by increasing exposure to bacteria.
Twins – epigenetics could explain why only one twin can develop asthma or bipolar disorder, despite having exactly the same DNA as the other.
While the Human Genome project, completed in 2000, located some 25,000 genes at a cost of about $3 billion, a project now underway in the U.S. and Europe to map the human epigenome will need to investigate millions of patterns of epigenetic marks, requiring untold billions of dollars as well as “major advances in computing power.”
The TIME article concludes: “Now we can imagine a world in which we can tinker with DNA, bend it to our will…Be assured: the age of epigenetics has arrived.”
Nail Biter? Hair Fiddler? You Could Be a Perfectionist.
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STARTING IN MIDDLE SCHOOL study halls until I cut my hair very short in my early 20s, I spent many minutes every day searching for and removing split ends: it was a habit, an addiction, definitely not a successful treatment for split ends.
Although my split-end search qualifies as a “body focused repetitive behavior” (BFRB), the more serious version is trichotillomania: pulling out hair, especially from the scalp, eyebrows and eyelashes – from just a few hairs to large clumps, entire eyebrows and eyelashes. Other BFRBs are dermatillomania – skin-picking, and onychophagia – biting or picking fingernails until they bleed.
Yuk – is what sufferers as well as observers think, but it’s very hard to stop. Repetitive behaviors like these, which most experts place on the OCD (obsessive-compulsive disorder) spectrum, change the brain’s physical structure by creating new neural pathways, which in turn continue to direct these behaviors. BFRBs affect more females than males, and the estimated prevalence is five percent of the population – some 10 million Americans.
They have traditionally been deemed nervous habits, problems with impulse control or signs of anxiety. But recently, researchers at the University of Montreal linked bouts of hair-pulling to personality traits – to both perfectionism and to becoming easily frustrated, bored or stressed.
Twenty-four study subjects with BFRBs, along with 24 control subjects, were placed in situations designed to elicit these three feelings along with a fourth, relaxation. To trigger frustration, participants were asked to complete a task that was supposedly easy and quick, but wasn’t either – just the sort of task I would try to hurry through and then get annoyed when it couldn’t be completed quickly. For boredom, each participant was left in a room alone for six minutes. For stress, a video showed a plane crash; and for relaxation, waves on a beach.
“We believe that individuals with these repetitive behaviors maybe perfectionistic, meaning that they are unable to relax and to perform tasks at a ‘normal’ pace,” explained principal investigator Kieron O’Connor. “They are therefore prone to frustration, impatience and dissatisfaction when they do not reach their goals.”
BFRBs seem to have a genetic component: sufferers can usually point to family members with a related behavior, as well as to those with related personality traits. And perfectionism in turn further explains the repetitive behavior: an effort to perfect the hair or nails by removing hair that feels “different” or repairing cuticles that appear rough or uneven.
The first step in treatment for most sufferers is keeping a diary. Whether the BFRB is focused or unfocused (hair-pulling that occurs unconsciously), the diary helps pinpoint where, when, how and why the behavior begins each time, which can provide clues to work on stopping it. How is important, for example, because barriers can help: if “pulling” – as they refer to it — is done with certain fingers, then band-aids or gloves can impede it.
The most often-prescribed treatment, Cognitive Behavior Therapy (CBT), encourages sufferers to alter their behavior by identifying triggers and then learning skills to interrupt and redirect their responses. “Stimulus control” involves identifying and then altering or avoiding environmental cues that trigger the behavior or make it easier to do. Some common triggers, however, such as reading, watching TV and talking on the phone, are difficult to avoid.
In “habit reversal training,” the sufferer learns to replace the repetitive behavior with a substitute, usually a competing response that makes it hard or impossible to pull or pick – such as making a fist and keeping that fist in your lap. With CBT, new neural pathways can be formed to make the new response more automatic than the old habit.
My friend Deb, who struggled with hair-pulling for years, found the best relief from medication – but she didn’t like the side-effect of sleepiness. Ultimately, cognitive-behavior therapy helped stop the trichotillomania, but she has moved on to skin-picking. According to Deb, the worst part of these disorders is the shame: “Someone should educate hairdressers,” she said. “If it’s compared to [a disease like] cancer and not seen as an issue of willpower, hairdressers might be more sensitive.”
A good local resource is The Behavior Therapy Center of Greater Washington in Silver Spring, which began by treating trichotillomania but now works with all OCD issues. The success rate is best with children, Deb explained, because the longer the disorder lasts, the harder it is to get rid of.
In a new book, “Life is Trichy,” author Lindsey Muller describes her struggle with trichotillomania – both to hide it from others and at the same time to stop doing it — after which she became a psychologist treating people with BFRBs. Muller says her hair-pulling started with efforts to create “the perfect ponytail,” which took longer and longer each morning. But her first repetitive behaviors came earlier, in kindergarten: skin-picking and then nail-biting.
Muller traces her BFRBs to boredom due to sensory deprivation, because she usually did them when obliged to sit still at school, but rarely when eating a meal or listening to music. For her, the behaviors acted as an “internal regulator of attention in the highs and lows of daily life.” In the end, what Muller found most helpful was redefining “normal,” and realizing that “if I were to ever attain the level of perfection I so long desired, I would not be normal.”
Most familiar to me was her contention that “I was identifying my sense of worth and sense of self from my external appearance.” When she mentioned that everyone in her family was a nail-biter — I remembered my mother picking her skin.
I still fiddle with my hair – and my fingers – not very noticeably, though I’m still embarrassed by both. As with anorexia, alcoholism and many other dysfunctional behaviors, “you are never recovered, only in recovery.” I’ve been fiddling for too many years to expect total and permanent cessation, but I recently started trying the fist-in-the-lap maneuver: I seem to be doing a little better.
MY IDEA OF “EXERCISING” is to do whatever I’m doing very efficiently so as not to devote unnecessary time or effort. But it turns out that one’s exercise choices change depending on the desired effect.
For one important goal — keeping weight down, or losing it when necessary, so I can eat pasta and ice cream for dinner – I have three aerobic activities: walking where I can be with friends, riding a stationary bike where I can read and swimming where I can stretch and enjoy the water. Because I do none of these before breakfast, however, I don’t achieve the increased fat burning that occurs “in a fasted state,” according to recent Belgian research.
At the rate I do each of these — low to moderate — based on a body weight of around 130 pounds, swimming uses the most calories, about 410/hour, followed by cycling at around 275/hour, with walking behind: even at 3.5 mph, which is considered a “brisk pace,” only 224 calories/hour.* I have considered doing any of these for about 45 minutes sufficient.
Aerobic exercise is associated with improving mood, reducing and even reversing the effects of aging on human skin, protecting against age-related vision loss and improving creativity. A recent study showed that “fit people were biologically younger than others of the same chronological age,” according to the New York Times.
Exercise has also been shown to stave off and in some cases reverse cognitive decline. In a small study of women ages 70 to 80 exercising twice/week, the women who did resistance training, including lunges, squats and weights, did better on tests of selective attention and associative memory — associative memory is impaired in early stages of Alzheimer’s disease — compared to those who did moderate aerobic exercise.
The women doing aerobics increased the size of their hippocampi — the hippocampus is the area of the brain involved in verbal memory and learning and is sensitive to neurological damage associated with aging. But they did worse on verbal memory tests, a reversal from early studies that showed aerobic exercise improved brain health – a result that researchers suspect is due to the greater intensity of exercise in the earlier studies.
Intense is the new magic word. Several recent studies have shown that aerobic exercise accomplishes a lot more if it’s “intensive,” that is using 80 to 90 percent of one’s maximum aerobic capacity.
Although government guidelines for years have advised exercising most days at a moderate level of 30 minutes, or 15 minutes at a more vigorous pace, there has been very little science to support these numbers, reports Gretchen Reynolds in The New York Times. But in a study published last summer, researchers put together a huge database from which they chose 55,137 healthy men and women. Of these, 24 percent identified themselves as runners, and it turned out that the risk of dying from any cause was 30 percent lower for runners than for non-runners.
The runners’ risk of dying from heart disease was 45 percent lower, and “even overweight smokers who ran were less likely to die prematurely than people who did not run.” Duration was barely significant: those who ran 150 or more minutes /week didn’t live significantly longer than those who ran as little as five or ten minutes a day at 10 minutes/mile or slower.
The latest rage is HIIT, high intensity interval training — 30 to 60 seconds of intense exercise followed by a recovery period of easier activity, repeated for a total of about 20 minutes three times a week. HIIT increases the body’s ability to use oxygen efficiently, a good indicator of cardiovascular fitness, and the same for insulin – increases that can occur after as little as two weeks of training. High-intensity exercise has also been shown more effective for patients with conditions like arthritis and heart disease. Another intense possibility is the “exercise snack:” one minute of “brisk” walking followed by one minute of strolling, repeated six times for a total of 12 minutes done three times a day. I try to imagine doing this: with a shower after each snack?
Shortest of all is the “Scientific 7-Minute Workout,” which equals “a long run and a visit to the weight room,” according to New York Times’ Reynolds. The 12 positions use body weight, a chair and a wall, and include jumping jacks, lunges, side planks and others. They should be performed in rapid succession, with 30 seconds for each – again the key is intensity: “at about an 8 on a discomfort scale of 10,” with a 10-second rest between exercises, according to Chris Jordan, one of the workout’s developers. With frequency recommendations unclear, I worry that the workout should be done every day.
Intense and uncomfortable can be challenging. During an echocardiogram, I was put on an increasingly steep and fast treadmill until I could go no longer: my daily aerobic choices are nowhere near that intensity. The closest might be spinning class, which gets the blood vessels pulsating in my forehead but is so unpleasant it’s hard to consider doing more than a few times a year. And running, with my knees? Finally, I wonder how well short and intense deals with my pasta and ice cream requirement?
Another recent addition to the exercise equation: drinking 200 mg. of caffeine – a 12-ounce coffee or 32 ounce-tea, which sounds like too much caffeine for me – 15 minutes before a workout may help spur you on, because “caffeine causes muscles to release more calcium, which cues muscle fibers to contract with added force [so you] get this surge of I-can-do-it energy,” according to SELF magazine. Caffeine may also “dull signals from neurotransmitters in your brain that perceive pain,” Mark Tarnopolsky, M.D. at McMaster University told SELF.
Finally, whatever exercise you choose, the latest advice is to spend less time sitting — which has been shown to change the neurons that regulate blood pressure, effectively remodeling the brain — as in “sitting is the new smoking.” (See MyLittleBird July 28, “Don’t Just Sit There.”)
For now, I’m trying to include intensity, a minute or two here and there, in my otherwise non-intense preferred activities — when I remember.
–Mary Carpenter
*adapted from research data from Medicine and Science in Sports and Exercise, the journal of the American College of Sports Medicine.
THE ALLERGY SEASON is coming early this year to the DC area. The late blasts of winter weather cause trees like maples that usually begin pollinating in February to delay, and as a result they will be pollinating along with other trees, such as ash and oak, according to allergist Thomas Fame of Salem, Virginia.
Many DMV (DC, Maryland and Virginia) residents believe they live in one of the worst areas in the country for allergies, also that those who move here allergy-free quickly develop them. But in annual lists of top 100 “Allergy Capitals,” DC never even places in the top third.
The DC area always has a lower (less bad) allergy score – based on the area’s pollen score, duration of the peak season, percentage of affected people and allergy medicine use as well as the number of specialist allergy docs — than New York City and much lower than Philadelphia. Different cities’ positions on the list, created by the Asthma and Allergy Foundation of America (AAFA), change every year for each spring and each fall.
On the other hand, pollen thrives in high humidity – and DC has that. Also, there’s what the AAFA calls “Spwinter,” spring overlapping with winter. When tree buds begin appearing in February but winter conditions continue, especially with excess precipitation, “an increased presence of mold…as well as intermittent tree pollination… can trigger allergic reactions,” Mike Tringale, senior vice president of external affairs for AAFA, told Reuters.
Above all, allergy risks are personal, which means pollen counts are not always relevant. What matters is which specific trees and plants produce an allergic reaction in you: maple tree pollen might get you when ragweed has no effect. In the Northeast, tree pollens – especially birch, cedar, cottonwood and pine — begin in February and March along with mold; grass pollens begin in May and June; and weed pollens begin in August and last through the fall.
Seasonal allergic rhinitis, nicknamed “hay fever,” occurs when the immune system overreacts to a trigger substance and causes symptoms such as itchy eyes and a scratchy throat. These symptoms are most likely part of an allergic reaction – and not a head cold — when they are accompanied by fatigue, caused by the immune system working so hard. Unfortunately, antihistamines, one of the best weapons against allergic reactions — especially when taken before the worst symptoms appear — often create their own fatigue.
Also unfortunately, among steps advised for alleviating symptoms, many are impractical:
Stay indoors when pollen is worse from 5 a.m. to 10 a.m., — and plan outdoor activities for later in the day. Stay indoors, especially on days with high pollen counts, and especially on dry, hot and windy days, because pollen decreases during and after rain. Before or immediately after coming indoors, remove your clothes and put them in the washing machine. Wash your hair before going to bed… and risk catching a real head cold.
A little more doable: before coming indoors, remove or wipe your shoes; shower at night; and adjust your diet. If ragweed is your problem, stay away from zucchini, cucumbers, bananas, melons – because your body confuses these proteins with those of ragweed. If birch or alder trees, watch out for apples, cherries and celery; if grass, tomatoes, potatoes and peaches.
And then there’s the “sinus rinse” to flush allergens from the nasal cavity: run lukewarm water through one nostril so that it comes out the other side — using neti pots or squeeze bottles available in the drug store, the most popular made by NeilMed. Slightly gross, but when you’re suffering, it’s a good option.
For the severely afflicted, there are injections, new immunotherapy tablets that must be started months before allergy symptoms begin and face masks. Also, keep your windows closed, use your air-conditioner and vacuum often using a HEPA filter.
The number of allergy sufferers has been increasing steadily since the early 1980s, an “increase that can be linked directly to a rise in pollen production,” according to Tringale, who speculates that increases in environmental carbon dioxide may be making “plants grow bigger and thus pollinate more.”
Allergies currently affect about 45 million Americans, who account for more than 17 million outpatient office visits each year. Allergies are the sixth leading cause of chronic illness in the U.S., costing in excess of $18 billion,” according to the American College of Allergy, Asthma and Immunology.
TO DEAL WITH THINNING HAIR, the latest buzz touts hair tattoos – which are not really tattoos but ink marks inserted under the scalp skin that mimic the look of tiny hairs. These go by many names: “cosmetic transdermal hair replication,” “cosmetic hair follicle replication,” “micro hair technique,” and “scalp pigmentation.” Bryce Cleveland, founder of Scalp Aesthetics in Bethesda, calls it “scalp micropigmentation” (SMP) and insists on its difference from tattoos: “getting tattooed hair to serve the same purpose is another story altogether.”
The hair thinning that occurs with every decade of life after the 20s is usually in fact the diminishing diameter of the hair shaft, called” involutional alopecia” — so the number of hairs doesn’t diminish but each strand is thinner. Thinner strands can break more easily, and, because hair grows more slowly with age, the overall effect is less hair.
Every day, everybody loses some hairs – which are actually a string of dead keratin cells, pushed through the surface of the skin as follicles produce new hair cells – around 100 hairs a day. For some women in their 40s and older, a genetic condition called female pattern baldness or “androgenic alopecia” causes thinning all over the scalp, especially at the crown.
Causes of temporary hair loss include stress and illness, very low-protein or calorie-restricted diets, and cosmetic procedures such as shampooing too often, dyeing hair, using rollers and heated curlers, and combing, especially through tight curls.
“The development of new treatments, including drugs and cell-based approaches, for hair loss is at an all–time high,” NYU Clinical Assistant Professor Kenneth Washenik told WebMD. Hair tattoos or any of the alternate epithets, however, were not on his list.
Cell-based hair follicle regeneration, also called “fully functional hair organ regeneration,” involves taking cells and stem cells from around hair follicles, manipulating them in the lab and then re-injecting them into the scalp. While Washenik calls this method “promising,” its actual use appears to be a long way off.
Then there are drugs. Because thinning hair can be due, in both sexes, to higher levels of male hormones, drugs that block their production can help: besides the prescription drug Propecia (finasteride), there are over-the-counter (OTC) preparations such as Hairomega – for which at least one LittleBird colleague has high hopes.
Latisse, an FDA-approved, a prescription liquid for eyelash growth, may help regrow scalp hair, but it seems to work best in combination with medication used to treat allergies, and can cause redness and itching. Rogaine (minoxidil) is an OTC lotion applied to the scalp, but has a long list of side effects. Because minoxidil was designed to treat high blood pressure, it can cause lightheadedness; because lotion can spread, especially when you sweat, it can drip on the ears and nose, and other places where you don’t want hair; and oddly, it can even cause hair loss.
Low-level light combs and helmets may help, and laser combs seem most effective in combination with other methods such as Rogaine. Various hair products, including “volumizing” shampoos, “flexible” hair sprays and mousse can also fake fuller hair.
Finally there are hair tattoos. Compared to normal tattooing, the SMP needle is thinner and doesn’t go as deeply into the skin, and the ink is different. “The success of this procedure is dictated by the color, shape, density and placement of the pigments,” writes Cleveland. Scalp Aesthetics Treatment (which Cleveland calls “the SAT”) should last four to six years, but if the “vibrancy” of the pigments fade, they can be touched up. Cleveland says the SAT can sometimes stimulate new hair growth.
Treatment at Scalp Aesthetics can run $3,000 to $4,000, with more precise quotes available by uploading your photo to the website. The time involved: 3 to 5 hours for the first session, and 2 to 3 for the second. There’s a one-year guarantee for touch-ups.
For any hair tattoo, the general advice is to do a small patch test first, and then to proceed carefully. Start with a conservative hairline, especially because natural hairlines recede with age, and because removing mistakes can be difficult and very painful, advises Elizabeth Leamy of ABC news. “You can always add more.”
Because the SMT procedure is relatively new, long-term effects are not entirely predictable. Fading can be a problem, especially if the pigment fades unevenly. And although some clinics can add or change the dye to match changes in your hair color as it grays or when you decide to dye it, long stretches of fading color or even the weeks between dye jobs as the hair grows out can be especially challenging.
ON A RECENT WALK through downtown Rehoboth with my son, in his mid-20s, we passed the Salon LaRoc Oxygen Bar. “Huh?” I probably said, and he probably answered, “Oh yeah, you don’t know about these? – because such an exchange has been repeated between us on innumerable occasions over the years.
A search for oxygen bars closer to DC turned up one at the Aria Spa in Huntington, Maryland – but portable oxygen bars have been rented by DC clubs, events and trade shows from Airheads Oxygen Bars, Inc.
At an oxygen bar, “oxygen concentrators” take ambient air and separate out the nitrogen to create 90 to 95 percent oxygen – which proponents call 0xygen Plus or O+ — although by the time it’s pumped through a hose and then through aroma-saturated water, the client gets about 50 percent pure oxygen. The air we breathe is composed of around 21 percent oxygen and 78 percent nitrogen.
Purported benefits of oxygen bars include improving cognitive performance such as memory, concentration and reaction time; increasing stamina and helping muscles recover faster from fatigue; increasing energy levels before, during, and after intense physical activity; and helping to offset the effects of high altitudes. And of course: reducing stress, removing toxins, strengthening the immune system and curing cancer.
But the owner of Salon LaRoc, Peter DiRocco, gets right to the point, in a Delaware Today article, when he mentions hangovers. DiRocco keeps the bar open on New Year’s Day – it’s not far down Rehoboth Avenue from Dogfish Head Brewing & Eats – and offers aromas, including pina colada as well as lavender and mint. He got the idea of adding an oxygen bar to his hair and nail salon from people telling him how oxygen bars enabled them to party in Las Vegas for three days at a time without sleep.
Most oxygen bars charge $1 per minute. Airheads Oxygen recommends 10 to 15 minutes “for optimum benefits,” and their most popular flavors are eucalyptus, gardenia and peppermint. Concentrated oxygen passes through “aromarizers,” bottles containing the selected aroma in water — in part because the oxygen is very dry and needs to be humidified – and then forced from the bottle into nasal cannulas, tubes that go beneath the nose that are also used for medical oxygen. Consumers inhale the O+ while breathing normally.
Originally the idea for oxygen bars came from “air stations” scattered through downtown Beijing and Tokyo to help people cope with pollution. By the late 1990s, the bars had spread to New York, California, Florida and Las Vegas; also the Rocky Mountains, where they reportedly help people who suffer from symptoms of altitude sickness — dizziness, nausea and headaches — often compared to those of a hangover.
But therapeutic benefits of oxygen bars lack scientific support. For one, once the air we breathe is processed by our lungs, the blood that carries it through our bodies is already about 97 percent saturated with oxygen – so not much room for more. In a small study done in 2004 on students at Indiana University, researchers gave concentrated oxygen to some while others got regular compressed air. Those receiving concentrated oxygen showed no increase in oxygen content of their blood, and their elevated heart rates were traced to a placebo effect. One study on athletes showed that they recovered more rapidly – lowering lactate concentrations in their blood – if they walked around after exercise rather than sitting and breathing concentrated oxygen.
The American Lung Association stated that concentrated oxygen is unlikely to have a beneficial effect, but also that there is no evidence that oxygen bars can be dangerous. The FDA, while also debunking the possibilities for beneficial effects, advised caution concerning the aromas: aroma oils can cause inflammation in the lungs, and even oil-free, food-grade particles can include allergens or irritants that can cause wheezing or infection.
“The oxygen bar is now the conversation piece of every corporate and social event that we service,” says the Airheads website. “Health conscience (sic) people all over the globe are purchasing Personal Oxygen Bar systems for their homes and personal use.” Complete with two aromas and 20 “nose hoses,” these retail for $1,295.
LIGHT HELPS CONQUER the blues, cope with jet lag and shed excess weight. Certain cancers, heart disease and diabetes as well as depression have been linked to disturbances of circadian rhythms – which can be rejiggered using light.
The best light to combat ills is the light of early morning, from 6 to 9 a.m. Not for everyone, especially when Daylight Saving Time jolts us ahead an hour – for some, stealing a precious hour of the Sunday sleep-in.
To conquer the daylight-saving yawns, some tips from WebMD:
Expose yourself to light — as much as possible and as early as possible — during waking hours, and as little as possible when it’s dark outdoors. If you get up during the night, do not turn on a light: set up a night-light ahead of time if necessary. For added help, use “light therapy” (see below), especially during the morning hours.
Practice “sleep hygiene:” reduce or eliminate caffeine and alcohol, create calming rituals before bed (like a hot bath), wear ear plugs and eye masks. Consuming carbohydrates in the evening may make it easier to fall asleep compared to large protein meals.
Try exercising four to five hours before bedtime: 20 to 30 minutes of vigorous exercise raises the body temperature as much as two degrees, for up to five hours, after which it drops lower than without exercise. Decreased body temperature is a signal to the body that it’s time to sleep. (Conversely, exercising within three hours of bedtime can stave off sleep.)
Called “blue light,” early morning light contains more wavelengths in the blue portion of the spectrum than light at other hours. Blue light inhibits the creation of melatonin in the brain, which tells the body it’s daytime.
Mathematicians at the University of Michigan have created an iPhone app called Entrain: “entrainment” refers to synchronizing circadian rhythms with the actual time of day wherever you are. If your rhythms are off – due to shift work or travel across time zones – the app can schedule blocks of time each day when you should be exposed to the brightest or the least light possible. If initially that schedule does not synch with the outdoor light in your location, you can substitute a light box like the Verilux (see below) for the hours you are meant to spend in sunlight; to create dark periods when it’s daytime, wear pink glasses to block out the blue wavelengths.
Blue light also affects metabolism, including the hormones that control appetite. In a Russian study of obese women, exposure to bright morning light lowered their percentage of fat, their fat mass and their appetite, compared to a control group exposed to a machine emitting ions instead of light – although the light did not significantly affect their weight.
Fifty-four volunteers at Northwestern University’s School of Medicine wore wrist monitors that measured their light exposure as well as their sleep patterns and kept a log of everything they ate and drank over a seven-day period. For every hour that light exposure was delayed, subjects’ BMI rose 1.28 points, according to results published in the journal PLOS One.
Luckily for us night owls, light exposure any time throughout the day helps regulate body weight. The most important variables in the Northwestern study were: light of at least 500 lux, which exists naturally around sunrise and sunset; and exposure as early in the day as possible. Lux is a measurement of a light’s intensity related to size of the area illuminated; full daylight provides about 10,000 lux and direct sunlight, 32,000 to 100,000 lux, but even a cloudy day can measure 1,000 lux.
For those who use computers, cell phones or e-readers into the early morning hours, there is the F.lux software or app that can be used for most electronic screens to adjust the monitor display’s “color temperature.” The colors — ranging from cooler (white through bluish white) to warmer (yellowish white through red) – change based on the device’s location and the time of day.
F.lux, which also reduces eye strain, is “freeware,” available at JustGetFlux, and has thousands of enthusiasts. Sleep Junkies blogger Jeff Mann writes that it took him a day or two to adjust to the new evening hue, which looked “a little more ‘red…’” but now he would “find it almost unimaginable to go back to my pre-F.lux display settings.” Without F.lux, Mann writes, to use a computer at night is like “staring at the sun.”
Circadian clocks present in almost every cell and tissue of our bodies orchestrate daily rhythms in sleep/wake patterns and metabolism. Researchers at England’s University of Manchester have discovered that an enzyme called CK1epsilon (casein kinase 1 epsilon) controls the ease with which our bodies’ clocks can be reset by environmental cues, including light and temperature. Drugs that that inhibit this enzyme allow for faster resetting of the circadian clocks in mice and may one day help people with the nasty effects of jet lag.
Then there’s “light therapy.” One winter, my son (then in middle school) and I began struggling with the long, dark days. Getting out of bed in the morning became a bigger challenge until I bought us each a SunRise Alarm clock with a light that starts brightening 30 minutes before your wake-time and reaches 250 lux. I also got a small Verilux lamp that weighs in at 5,000 lux to sit on my desk. We both felt better. Even now, years later, if my attic office feels a little gloomy, I turn on the Verilux, and my day improves.
So, when you need a light boost, plan to spend time outdoors. But for short days or bad weather, don’t forget about the SunRise and the Verilux — with one caveat: when Floridian Alissa Nutting was transplanted to Cleveland, what her psychiatrist called “happy lamps” fell short. Writing a New York Times Op-ed, Nutting described the lamps as having a “low-calorie feel…the wavelength equivalent of margarine.” In the end, she decided to treat the lamps’ light as a “supplement rather than a replacement, and now the moment I turn on the lamp and light floods throughout the room, I can’t help thinking, something is happening in here.”
Come spring, however, Nutting can’t wait to pack the lamp back in its box and return to the real outdoors. Here’s hoping Spring is right around the corner in our neck of the woods.
“The sorrow which has no vent in tears may make other organs weep.” — Henry Maudsley, British psychiatrist
MORE THAN FOR ANY OTHER REASON, I cry — even sob — at tales or images of rescuers: sometimes I have only to see a fire truck, and don’t get me going on working firemen. I worry about crying too easily and so was reassured to see the steel-encased tissue box at the Newseum’s 9/11 exhibit. There I was not alone.
Besides emotional tears, there are basal tears that clean and lubricate the eyes, and reflex tears caused by irritants like the compounds in onions or pollen. Tears start at the lacrimal glands, located on the upper eyes; and most tears flow over the surface of the eyes and drain out through the tear ducts, which lead into the nasal cavity – the reason copious tears can cause a runny nose.
Emotional tears may have evolved to protect us from predators, because they make it harder to tell where we are gazing, according to evolutionary biologist Oren Hasson. Or they could show others we are vulnerable and would prefer to make peace, signaling our willingness to trust and join a supportive community.
Whether or not animals cry to express emotions is debated. Elephants appear to cry when family members die, and chimpanzees have also shed tears – though some insist that animal tears are released only to cleanse the eyes.
Crying has been shown to have real benefits: it relieves stress — which over time can damage the heart and brain – and tears can remove chemicals that build up during stress; it can lower blood pressure, and it reduces manganese, a mineral found in the highest concentrations in tears, according to William Frey, a Minnesota neuroscientist who spent some 15 years studying crying and tears. Because manganese affects mood, there is some thought that shedding manganese helps you feel better. Frey also found that more tears are shed between 7 and 10 p.m.; and the average length of crying bouts is six minutes.
Crying habits in the population as a whole are on a spectrum, probably related to temperament: those who feel more comfortable crying are usually more extroverted and empathetic. Women feel less sad and angry after crying than men. And on average, women cry 47 times a year while men cry only 7 times, according to Frey’s research.
Women who say they feel more comfortable crying are those who report anxiety, according to psychologist Jonathan Rottenberg and colleagues at the University of South Florida in Tampa, who analyzed over 3000 reports of sobbing.
Criers are helped more if they are comforted by others, but responding to crying can be difficult. Many people feel uncomfortable around criers, because they exhibit vulnerability, and that shifts “the level of intimacy of the environment,” California psychologist Stephen Sideroff told WebMD. “Just being in that more intimate environment makes the other person uncomfortable in some cases.”
Doing nothing can make the crier feel worse: even in a large group, criers welcome support from those they don’t know well. But Sideroff cautioned: “the less intimate the relationship, the more it is appropriate to begin by asking how you can help,”
Studying crying, the Tampa researchers found that lab-induced crying is different: those who cried at a sad movie clip reported feeling worse afterwards than those who did not. Others who feel worse after crying are those who score higher on measures of depression, as well as those who try to suppress their crying or feel shame as they cry.
As Dr. Maudsley famously noted above, there are perils of not crying: suppressing tears can make us deaden ourselves, “to suppress or not even notice we have those feelings inside,” said Sideroff. “When you cry it’s a signal you need to address something,” according to Tampa neuropsychologist Jodi DeLuca. Crying can prevent new hurts from getting buried or release old ones – as in “getting it out of your system.”
Some people cry in response to beauty, to good news, to seeing loved ones – maybe because crying calms us, it may help regulate “overwhelming positive emotions,” Yale psychologist Oriana Aragon told Scientific American. Feeling “too positive” can interfere with decision making and cause people to act impulsively.
For those who don’t cry easily, there are endless Youtube entries under “crying.” Or there’s Adweek’s entreaty to “Watch the Thai Commercial that has Half the World Sobbing uncontrollably.” I didn’t go there.
MY IDEA OF EXERCISING is to do whatever I’m doing very efficiently so as not to devote unnecessary time or effort – but it turns out that one’s exercise choices change depending on the desired effect.
For one important goal — keeping weight down, or losing it when necessary, so I can eat pasta and ice cream for dinner – I have three aerobic activities: walking where I can be with friends, riding a stationary bike where I can read and swimming where I can stretch and enjoy the water. Since I do none of these before breakfast, however, I don’t achieve the increased fat burning that occurs “in a fasted state,” according to recent Belgian research.
At the rate I do each of these — low to moderate — based on a body weight of around 130 pounds, swimming uses the most calories, about 410 per hour, followed by cycling at around 275 an hour, with walking behind: even at 3.5 mph, which is considered a “brisk pace,” only 224 calories an hour.* I have considered doing any of these for about 45 minutes sufficient.
Aerobic exercise is associated with improving mood, reducing and even reversing the effects of aging on human skin, protecting against age-related vision loss and improving creativity. A recent study showed that “fit people were biologically younger than others of the same chronological age,” according to The New York Times.
My other goal: prevent cognitive decline, which exercise has been shown to stave off and in some cases reverse In a small study of women ages 70 to 80 exercising twice a week, the women who did resistance training, including lunges, squats and weights, did better on tests of selective attention and associative memory — associative memory is impaired in early stages of Alzheimer’s disease — compared to those who did moderate aerobic exercise.
The women doing aerobics increased the size of their hippocampi — the hippocampus is the area of the brain involved in verbal memory and learning and is sensitive to neurological damage associated with aging. But they did worse on verbal memory tests, a reversal from early studies that showed aerobic exercise improved brain health – a result that researchers suspect is due to the greater intensity of exercise in the earlier studies.
Intense is the new magic word. Several recent studies have shown that aerobic exercise accomplishes a lot more if it’s “intensive,” that is using 80 to 90 percent of one’s maximum aerobic capacity.
Whereas government guidelines for years have advised exercising most days at a moderate level of 30 minutes, or 15 minutes at a more vigorous pace, there has been very little science to support these numbers, Gretchen Reynolds writes in The New York Times. But in a study published last summer, researchers put together a huge database from which they chose 55,137 healthy men and women. Of these, 24 percent identified themselves as runners, and it turned out that the risk of dying from any cause was 30 percent lower for runners than for non-runners.
The runners’ risk of dying from heart disease was 45 percent lower, and “even overweight smokers who ran were less likely to die prematurely than people who did not run.” Duration was barely significant: those who ran 150 or more minutes /week didn’t live significantly longer than those who ran as little as five or ten minutes a day at 10 minutes/mile or slower.
The latest rage is HIIT, high intensity interval training — 30 to 60 seconds of intense exercise followed by a recovery period of easier activity, repeated for a total of about 20 minutes three times a week. HIIT increases the body’s ability to use oxygen efficiently, a good indicator of cardiovascular fitness, and the same for insulin – increases can occur after as little as two weeks of training. High-intensity exercise has also been shown more effective for patients with conditions like arthritis and heart disease. Another intense possibility is the “exercise snack:” one minute of “brisk” walking followed by one minute of strolling, repeated six times for a total of 12 minutes done three times/day. I try to imagine doing this: with a shower after each snack?
In a similar version of the snack tested in Japan over the past decade, intervals of three minutes of “somewhat-hard” walking followed by three minutes of strolling are repeated five times for a total of 30 minutes, at least three times a week. Compared to people who walked at a continuous, moderate pace, “the interval walkers significantly improved aerobic fitness, leg strength and blood-pressure readings,” according to this week’s New York Times Magazine.
The Japanese researchers offered the option of dividing each day’s total into 10 minutes in the morning, 10 in the afternoon and 10 in the evening. Other research has found that exercising for shorter times more often during the day can result in lower blood pressure and make it easier to lose weight.
Shortest of all is the “Scientific 7-minute workout,” which equals “a long run and a visit to the weight room,” according to Reynolds in the New York Times. The 12 positions use body weight, a chair and a wall, and include jumping jacks, lunge, side plank and others. They should be performed in rapid succession, with 30 seconds for each – again the key is intensity: “at about an 8 on a discomfort scale of 10,” with a 10-second rest between exercises, according to Chris Jordan, one of the workout’s developers. With frequency recommendations unclear, I worry that the workout should be done every day.
Intense and uncomfortable can be challenging. During an echocardiogram, I was put on an increasingly steep and fast treadmill until I could go no longer: my daily aerobic choices are nowhere near that intensity. The closest might be spinning class, which gets the blood vessels pulsating in my forehead but is so unpleasant it’s hard to consider doing more than a few times a year. And running, with my knees? Finally, I wonder how well short and intense deals with my pasta and ice cream requirement?
Another recent addition to the exercise equation: drinking 200 mg. of caffeine – a 12-ounce coffee or 32 ounce-tea, which sounds like too much caffeine for me – 15 minutes before a workout may help spur you on, because “caffeine causes muscles to release more calcium, which cues muscle fibers to contract with added force [so you] get this surge of I-can-do-it energy,” according to SELF magazine. Caffeine may also “dull signals from neurotransmitters in your brain that perceive pain,” Mark Tarnopolsky, M.D. at McMaster University told SELF.
Finally, whatever exercise you choose, the latest advice is to spend less time sitting — which has been shown to change the neurons that regulate blood pressure, effectively remodeling the brain — as in “sitting is the new smoking.” (See MyLittleBird’s, “Don’t Just Sit There.”)
For now, I’m trying to include intensity, a minute or two here and there, in my otherwise non-intense preferred activities — when I remember.
*adapted from research data from Medicine and Science in Sports and Exercise, the journal of the American College of Sports Medicine.
IF ONLY I’D KNOWN ABOUT the “Healing environments” — the crystal salt therapy room, the tropical rain shower and the waterfall, not to mention the steam bath, cold plunge and sauna — I might have budgeted more time for Still Point’s newest spa, Haven on the Lake in Columbia, Md. (The other two are in Takoma Park and Clarksville, Md.)
Or I might have signed up to try unfamiliar body treatments, including the Hydrating Sugar Polish and the Warm Salt Glow — sugar or salt formulations applied to the entire body to treat the skin. A wellness spa, Haven offers the services of a naturopathic doctor, who might recommend any of a number of services, including Detoxification or Weight Loss and Metabolism.
Instead, I was curious about the Qigong (pronounced chi-gong) class and needed a pedicure. Qigong, a traditional Chinese practice, uses meditation, rhythmic breathing and flowing movements to cultivate and balance chi or “life energy.” In Haven’s small mid-afternoon class, the balance poses seemed most useful, but I also appreciated the teacher weaving in some of the ideas and movements related to the flow of energy around the body, as well as giving the names of poses, such as “Divine maiden scattering flowers” and “Embracing the moon.”
The Renew pedicure, a little pricey ($85 for 45 minutes), took place in a dimly lit room in shades of greenish gray and grayish green, colors that make much of Haven spa feel like canyon outcroppings — rock-like but spacious and airy. And it felt more welcoming to me than other upscale spa/salons like Elizabeth Arden where my clothes, my hair and especially my toes suddenly seem to look a little scruffy.
Cynthia, who was my beautician, picked out a gorgeous-color polish for me from Deborah Lippmann. Although I usually play Words with Friends or relax in silence during such treatments, I was intrigued to hear Cynthia describe the friendly, almost family-like experience she has had at Haven, both during her training and afterwards — engendered by the founders, and perhaps explaining some of the comfort I felt there. (I’m glad to know that personnel are happy, compared to what I’ve heard about other local spa options.)
Marla Peoples and Tori Paide — one of whom I later met as she was walking around checking on things — opened Haven in December, 2014, as a big step up from the other two Still Point spas with its “mind/body movement classes” and “healing environments.” (Paide founded the Takoma Park location in 2007, and the two women started Still Point’s second location in Clarksville together.) Peoples and Paide have created their own line of “wild-crafted” skincare products, as well as a holistic collection of essential oil tonics for physical well-being.
Most enticing at Haven is the space itself, the very high-ceilinged rooms with huge glass windows overlooking Lake Kittamaqundi, in winter a frozen landscape edged by bare trees. I could also imagine springtime greenery creating a sense of lush countryside. There is no swimming in the lake, but stand-up paddle boarding, the latest rage and slightly less difficult than it looks, is available for Haven guests.
Getting to Haven involves a 30- to 45-minute drive from DC — it’s off Route 29 in Columbia, so probably best not attempted during rush hour — but the spa environment helps soothe the post-drive fatigue and wafts you farther from the city’s stresses. Haven hosts girls’ night outings with a half-day spa package ($230, which includes two of the following: a 50-minute custom massage; Warm Salt Glow; Renew Facial; and Renew Manicure and Pedicure). For $20 more you can add a “mind body” like yoga, pilates, etc. Food from the Whole Foods upstairs is on sale at the spa, to be consumed overlooking the lake, outdoors in nice weather or at indoor tables placed near the floor-to-ceiling windows. The next time my friends say they’re thinking of a place for a Sunday spa outing, I’ve got a suggestion.
I WAS ADVISED to try an infrared sauna by a physical therapist/personal trainer, who told me I hadn’t completely “de-toxed” from the Lyme disease I had six years ago. The theory goes that while antibiotics kill off the Lyme-causing spirochetes, endotoxins released by the bugs remain. Although I was unconvinced about the need or effectiveness of being “de-toxed,” going to a sauna seemed like a small and possibly enjoyable effort to make.
Elevated body temperatures created by infrared saunas — used for many health problems including high blood pressure, heart disease, arthritis and Type 2 diabetes — have shown “some evidence of benefit [although] larger and more rigorous studies are needed,” according to the Mayo Clinic website. Infrared saunas are popular in Japan, called “Waon therapy,” used mostly to treat chronic heart failure.
The “most far-reaching assertions for this technology center on detoxification,” according to a Scientific American article — but the article goes on to quote USC M.D. Roger Clemens’s assertion that “the most efficient system” for detox is the kidneys, liver, GI tract and the immune system: “Except when one of the major organs breaks down, there isn’t a medical device…that can accelerate the body’s natural process of detoxification.”
Conventional saunas use heat to warm the air, up to between 150 and 185 degrees F — with a maximum 194 degrees allowed at ceiling level; both the heated air and the heat concentrated in piles of rocks warm your body. By contrast, infrared saunas use light waves from the infrared part of the electromagnetic spectrum to create heat without heating the surrounding air – compared to feeling the sun’s warmth on a cold day. (“Sunshine” refers to light plus heat, and “sunlight,” to the light alone.)
The goals of all saunas — sweating and increased heart rate similar to that created by moderate exercise — can be reached at lower temperatures in infrared saunas, making them preferable for people who can’t tolerate the high heat of conventional saunas.
Compared to these, some estimates have infrared saunas inducing two to three times the sweat volume, as much as 500 grams, and consuming around 300 calories, which is equivalent to running several miles. Supporters claim that the toxin content of sweat from infrared saunas is as high as 15 percent, versus less than 1 percent while sweating as a result of exercise. Also, sweat produced during exercise is ineffective for de-toxing, which requires you to be in a state of calm, rest or sleep — under the effects of the parasympathetic nervous system.
The infrared sauna I was advised to try was “far infrared” or FIR*. While some believe that FIR saunas emit more harmful waves than plain infrared saunas, FIR supporters contend that their thermal effects penetrate deeper into the tissues, causing blood vessels and capillaries to dilate more and leading to better circulation and better evacuation of body toxins and metabolic wastes via sweat.
Because I couldn’t locate a far infrared sauna in the DC area, I opted for plain infrared and chose one at Tulsi Holistic Living – Natural Health Center on MacArthur Boulevard. Entering Tulsi, I descended from the noisy street into a newly renovated space with calming shades of green and hushed voices. Before the sauna, I had a (required) 5-10 minute consultation with a Tulsi “holistic practitioner” to check out my health issues.
At Tulsi, one can also have a full “Detoxification Consultation,” a thorough exam leading to the creation of a “customized protocol” that can include diet, bodywork and lifestyle recommendations. The “Detoxification Massage Treatment” includes Swedish/lymphatic massage as well as “dry brushing” treatment with a soft brush to stimulate the skin, and “castor oil treatment” – not consumed but placed on the skin.
The general advice on infrared saunas calls for one or two a week in four-to-15-minute sessions to avoid mobilizing too many toxins at once. Among the local options I found, however, 45 minutes was the minimum — at Tulsi costing $65.
After stripping down to a bathing suit (brought by me), I entered the sauna, the size of a large phone booth, located in the back of a larger room. The staff member who interviewed me called in several times during the sauna to make sure I was okay.
My main impression: very hot! While infrared saunas can go as high as 145 degrees F., I was unable to go much above 125 without opening the door and fanning in cooler air. The drawbacks: trying to get comfortable for 45 minutes on a hard seat that was too short for lying down; and no shower available afterwards. Compared to a traditional sauna, I sweated less and thus felt less “cleansed.”
Infrared light therapy can also be obtained using a Biomat, a body-length pad that produces infrared light via amethyst crystals and sounds more comfortable. At The George Washington Center for Integrative Medicine, Biomat therapy can be covered by insurance as part of a physical therapy course or pain clinic treatment.
Unfortunately, as with most of the well-being options I’ve sampled, health benefits require more than one shot. Also, it surely helps to start off with serious health complaints. As I have written about other well-being options such as acupuncture, I’m glad these are available in the event of future health issues too subtle for traditional MDs to diagnose or treat. For now, my local well-being to-do list is still pretty long.
*Within the infrared part of the electromagnetic spectrum, “far” infrared waves are longer, closer to the length of microwaves, whereas “near” are closer to those of visible light.
— Mary Carpenter
Editor’s Note:This article is part of an ongoing series that samples local healthy-body experiences, including integrative health, acupuncture, yoga therapy and flotation tanks – most of which claim to aid in de-tox. Suggestions are welcome.
AS COLD TEMPERATURES turn puddles into treacherous paths of ice, moisture in the nose flows more freely than ever. And just because your nose runs both when you have a cold and when it’s cold outside doesn’t mean cold weather causes colds.
The nose conditions inhaled air to make it warm and moist when it reaches the lungs. When the weather is cold, and usually dry, more mucus is secreted by glands in the membranes lining the respiratory system — nose, throat, lungs — and other body cavities to keep those membranes moist. In one study, almost 100 percent of skiers reported runny noses — also called “skier’s nose,” and officially, rhinorrhea. The colder the weather, the more mucus is produced and the thicker it becomes.
Mucus –- of which a healthy nose secretes about 32 ounces/day — not only moisturizes the membranes, but its sticky consistency is designed to trap outside contaminants and prevent them from entering the body. If the body is fighting a bacterial infection, the immune system will mobilize white blood cells that make the mucus green or yellow; respiratory illnesses like colds and flu provoke less of an immune response, allowing the mucus to remain clear.
In addition to working the mucus glands, cold weather makes tiny capillaries in the nose dilate to bring in more warm blood, which heats incoming cold air almost immediately to body temperature. Although colder air can irritate the lungs and throat, swollen capillaries can also cause nasal congestion.
And finally, because cold air cannot hold as much moisture as warm air, when warm exhaled breath meets cold air at the end of your nose, water is released to run out or remain hanging there in a large droplet. This trifecta of physical reactions to cold weather keeps you healthy but also creates a stuffy, runny nose that resembles that of a cold.
One good solution is to add moisture to the air you’re breathing in. Drench a washcloth in hot water and drape it over your nose and sinuses for several minutes, followed by 30 seconds with a cold cloth. Humidifiers and bowls of water placed around the house can help moisten the air. Also, eat hot bowls of soup and take hot showers. And coping with thickening mucus is one more reason to drink a lot of water.
Outdoors, wrap a wool scarf around your nose and mouth: breathing into the space between your face and the scarf will warm and moisten the air so that your sinuses produce less moisture. Because cold, dry air can cause a sore throat and cough, avoid breathing through your mouth.
When a cold causes swelling in the sinus tissues, gargling with salt water or using a saline nose spray can help, because mucus liquefies better in salty water. The nose can be cleared using a neti pot, but the water should be distilled or boiled to avoid a rare amoeba that lives in warm water.
Try to avoid nasal sprays that narrow the blood vessels, such as Afrin or Neo-Synephrine, because they can have a rebound effect that causes congestion and damage to the nasal membranes. And be careful about blowing your nose too often, which can actually push mucus farther into the sinuses.
Sometimes a runny nose and congestion are a true allergic response to cold temperatures, in which case steroid inhalers like Flonase can help. Other prescription inhalers can help with “vasomotor rhinitis,” triggered by smoke, bright sunlight and strong odors such as perfume.
Finally, “gustatory rhinitis” is a non-allergic reaction to certain foods, such as black pepper, horseradish, chili peppers and onions, which can cause sneezing, sniffling and watery eyes, with no itching — symptoms that usually disappear soon after eating the trigger food.
In my early-70s Cambridge commune, dinner table debates frequently and endlessly focused on what exactly you needed to eat to get enough protein – in our case, from a vegetarian menu. We read “Diet for a Small Planet,” bandied about terms like “complete protein” and “complementarity,” and usually came to the same conclusion: beans must be eaten with rice; curried veggies need yogurt, etc. So years later when I heard a tomato being touted for its good protein, I guffawed; next came egg whites! Could these be true protein?
Proteins are called “the building blocks of life.” Well-run bodies rely on 20 amino acids, 13 of which our bodies produce. The remaining nine “essential amino acids” we get when we digest protein — which involves breaking it down into its component amino acids and then reassembling them to create hormones, enzymes, neurotransmitters, etc.
One amino acid that we must get from food is tryptophan, featured in a recent Washington Post article, “The Turkey is not to Blame…” Tryptophan is used to produce the brain chemical serotonin, which makes you feel relaxed and sleepy. When consumed in a complete protein like turkey, however, other amino acids compete for the same transporter proteins that carry them to your brain, with the result that eating complete protein actually blunts the production of serotonin. Thanksgiving Day side dishes and desserts, like sweet potatoes and pecan pie, on the other hand, are rich in carbohydrates, which “clear the path for [serotonin] to get to the brain fast,” according to the Post article, which quotes Judith Wurtman, author of “The Serotonin Power Diet:” “Carbohydrates soothe and tranquilize.”
The label “complete protein” can be applied only to foods that contain all nine amino acids: meat, poultry, fish, dairy products and eggs, with a few other controversial possibilities including quinoa, hempseed, buckwheat, soy. Foods that are “incomplete proteins” – most nuts, seeds, vegetables, grains – are missing or low in one or more amino acids, and thus must be combined with other foods to meet the body’s needs. Combinations such as red beans and rice, or spinach salad with sesame seed and almond dressing provide high amounts of all the essential amino acids. These combinations do not need not be consumed together or at the same meal as long as all nine bases are covered throughout the day.
Another variable in evaluating foods for protein content is the PDCAAS (protein digestibility corrected amino acid score), which measures the “quality” or absorbability of proteins. Because animal protein, including meat and dairy, is more easily absorbed than that in buckwheat, for example, and in incomplete-protein foods like beans, you need to eat less of it to get the desired amino acid combination.
As for how much protein you should eat, the Recommended Daily Allowance for adults is .36 grams/pound of body weight, or about 45-50 grams/day for a 136-pound woman. Alternatively, a 1,600/day-calorie diet should include 10-35 percent protein or 40-140 grams of protein.
In general, though, such parameters should not be considered too rigorously. “Eating for complete protein isn’t a scientific system of food combining [but] a natural traditional way of eating,” according to Dr. Linda Posch in the Savvy Vegetarian.
As for tomatoes and egg whites, one tomato contains one gram of protein, which, while not providing complete protein, is considered to make an important contribution to a “complete protein day.” In the same way, an avocado contributes three grams of protein; and a potato with skin, four grams. Egg whites, along with the whey in milk, are themselves complete proteins.
IN MAY 2014, the editor’s note of the publication “What Doctors Don’t Tell You” (WDDTY) told a personal story about stem cell therapy. Editor Lynne McTaggart learned, based on an ultrasound and arthroscopy, that her daughter’s ACL (anterior cruciate ligament in the knee, a frequent victim of sports injuries) was “beyond repair without surgery.” But she also knew that — compared with leaving the injured ACL alone — many who undergo reconstructive surgery continue to have pain, never regain full strength and often require additional surgeries; ten years down the road they have a greater likelihood of developing arthritis.
For years now, embryonic stem cells have been touted as providing exciting possibilities for treating everything from diabetes to neurodegenerative diseases, including Parkinson’s and Alzheimer’s as well as multiple sclerosis. Embryonic stem cells have the potential for developing into different kinds of specialized cells — muscle cells, red blood cells, brain cells — which, because theoretically these new cells can continue to divide without limit, could serve as permanent repair systems for the body.
But embryonic stem cell therapy for most of these conditions remains “pre-clinical” — that is, studies have not yet begun in people. Dr. Doug Melton leads the research team at Harvard that in October, 2014, announced a “giant step toward new diabetes treatment…We are now just one pre-clinical step away from the finish line,” he said. But still years away from treating people.
The only currently approved stem cell therapy is bone marrow transplantation, which has been used for more than 30 years to treat cancer patients with leukemia and lymphoma.
An alternative to embryonic stem cells are adult stem cells — especially self-derived or “autologous” stem cells from the patient’s own body, making it less likely the body will reject them. For treating multiple sclerosis, human trials using self-derived adult stem cells are now underway but enrollment is limited. Some MS sufferers who have traveled abroad for this therapy have reported improvement in symptoms.
Meanwhile, most mainstream orthopedists are cautiously awaiting the results of additional trials. In the interim, treatment for orthopedic problems using self-derived adult stem cells is being offered at centers around the U.S., including at Emory University’s Orthopaedics and Spine Center. Compared to conventional treatments for pain associated with osteoarthritis — physical and occupational therapy, steroids and hyaluronic acid (a substance found in joints) — stem cell therapy is the most exciting, according to Emory University physical and rehabilitative expert Kenneth Mautner. He points out that, while hyaluronic acid can help lubricate joint and sometimes relieve pain, “it does nothing to restore lost tissue.” In Dr. Mautner’s opinion, a stem cell injection is a small gamble when the outcome may postpone major surgery.
At StemCell Arts in Fairfax, Dr. Mayo Friedlis, a specialist in pain management at the National Spine and Pain Centers in Chevy Chase and Fairfax, uses self-derived stem cells to treat rotator cuff problems, tennis elbow, hip arthritis, ankle sprains — “any place that there’s a ligament or tendon injury is amenable to this.”
The StemCell Arts therapy, called Regenexx, uses healthy stem cells extracted from the patient’s own hip bone marrow. These stem cells are mixed into platelet-rich plasma (PRP) — blood from which red and white cells have been removed — which has been shown to spur cell proliferation and cartilage repair.
Dr. Friedlis explains that “those bone marrow cells will turn into cartilage cells, into ligament cells, tendon cells; wherever the area of injury is, the stem cells are smart enough to figure out what they have to create.”
The most recent and most impressive study on adult stem cell therapy for orthopedic problems, led by USC orthopedist Thomas Vangsness, Jr. and colleagues, looked at patients in seven medical institutions. Among those who had partial meniscus (knee cartilage) surgery, 35 received injections of stem cells while a control group of 19 received hyaluronic acid. Among those patients receiving stem cells, there was evidence of meniscus regeneration and “a significant reduction in pain,” compared to those who received the control.
The FDA’s recent ruling that one’s own stem cells should be considered a drug — and subject to the agency’s control — is currently being challenged by a group of Colorado physicians. The American Association of Orthopaedic Surgeons takes the position that “stem-cell procedures in orthopedics are still at an experimental stage… and are performed [only] at research centers as part of controlled, clinical trials.” As a result, most insurance companies will not cover the treatment, which costs between $4,000 and $6,000.
Lynne McTaggart’s daughter received injections of PRP and stem cells into her meniscus, into a damaged tendon, and into the knee capsule, a ligament that encircles the knee. The goal was to strengthen each of these sufficiently to protect the knee without repairing the ACL. At last report, her daughter was doing well and preparing for upcoming sports seasons.
WHEN YOU HEAR that little ping or buzz–or whatever sound indicates that a new message has arrived on your mobile device–both the anticipation of a reward and the unpredictability of what message you will see stimulate the brain’s dopamine system to increased excitement and activity. Tweets are the most addictive because the information is too small to fully satisfy, another stimulation booster.
Dopamine, a brain hormone that functions as a neurotransmitter, has always been thought of as the “feel-good messenger” and “controller of the body’s pleasure system.” But new evidence consigns feelings of pleasure to the opioid system, while dopamine makes us want and search; makes us attentive, curious, aroused and goal-directed. Even with food nearby, rats with their dopamine neurons removed will starve. The dopamine system is stronger than the opioid system, making us continue to seek even when we are satisfied.
Dopamine is released in response to the promise of rewards– sex, money, drugs, novel situations–and tells your brain something like “pay attention,” writes Richard Friedman, psychiatrist and pharmacologist at Weill Cornell Medical College in New York, in a recent New York Times article about attention deficit hyperactivity disorder (ADHD).
Both texting and the Internet in general, because they provide almost instantaneous gratification, can create a “dopamine-induced loop,” making it increasingly more difficult to stop checking to see if something new has arrived. Such distractions are more compelling in the midst of a much less exciting task or meeting, especially those that should not be interrupted to read tweets.
Adults with ADHD have significantly fewer dopamine receptors–making their reward circuits less sensitive–compared to healthy controls, according to research by Nora Volkow, director of the National Institute on Drug Abuse. These adults respond better to anything varied and unpredictable, and can find repetitive and routine tasks so unrewarding as to become “painfully boring,” Friedman writes. In short, he says, “People with ADHD may not have a disease so much as a set of behavioral traits that don’t match the expectations of our contemporary culture.”
Friedman notes the enormous increase in childhood ADHD diagnoses and treatment: from 2003 to 2011, rising from 7.8 to 11 percent of the population–“a whopping 41 percent increase;” and he points to an “increasingly stark contrast between the regimented…school environment and the highly stimulating digital world.” ADHD occurs in 3.5 percent of adults, a much smaller percent possibly because adults have greater freedom to choose activities suited to their interests.
What helps both kids and adults with ADHD is selecting “situations that are a better fit for their novelty-seeking behavior,” for example: those with hands-on learning, self-paced computer assignments and tasks that build specific skills. Also helpful are small goals, such as making it through the morning without checking Facebook.
Dopamine also appears in the perennial argument about the benefits of breakfast. A study of 16 overweight 19-year-old females found that those who ate a high-protein breakfast had a 34-fold reduction in cravings for high-fat foods. Complex proteins raise levels of tyrosine, which leads to increased production of dopamine–which in turn regulates food cravings and intake.
Because dopamine levels are blunted in individuals who are overweight, it takes more food to elicit feelings of reward. Elevating dopamine via high-protein meals can make it easier to resist carbohydrates, such as pancakes or that mid-morning croissant, which are especially tempting when the body’s blood sugar is low after a night’s sleep.
(A previous study on 300 typical-weight people, however, showed no difference in weight over time between those who skipped or ate breakfast. Other research found that breakfast-skippers ate less over the course of the day than breakfast-eaters, though they also burned fewer calories.)
Stress and lack of sleep deplete dopamine, and variable dopamine levels can create peaks and crashes. Consuming tyrosine-rich foods, such as fava beans, edamame, almonds, avocados, bananas and sesame and pumpkin seeds, in addition to a high-protein diet, may help stabilize dopamine levels.
Exercise can also help by increasing blood levels of calcium, which in turn helps stimulate dopamine levels. Exercise also ups the body’s endorphins, which can provide good feelings when your dopamine is low–as can stretching and laughing.
WHEN YOU HEAR that little ping or buzz–or whatever sound indicates that a new message has arrived on your mobile device–both the anticipation of a reward and the unpredictability of what message you will see stimulate the brain’s dopamine system to increased excitement and activity. Tweets are the most addictive because the information is too small to fully satisfy, another stimulation booster.