Lift Up Your Hearts!

Studies have already confirmed the traditional wisdom that drinking cranberry juice contributes to a healthy urinary tract. Now researchers at the University of Wisconsin have discovered potential benefit to our arteries as well, causing clogged arteries to relax and function more like normal ones. I'm off to have a glass of Bay Punch!

Bay Punch, a primary ingredient of which is cranberry juice, was developed at the University of Rochester Computing Center in the 1970's. It is one of the greatest drinks in the world, and absolutely the best thing to drink with pizza. The "Bay" in the name comes from Bay and Goodman Pizza, the original source for our Tuesday night feasts. I'll post a recipe if I can get permission from the only one of the Bay Punch creators with whom I've kept in touch.

UPDATE: I did get permission, and the recipe is here.

When Terri Schiavo dies, there's going to be cheering, and I don't understand why. I know there will be cries of exultation because of the commentary I've heard, and the rude jesting, even from as mainstream a production as National Public Radio's Wait, Wait, Don't Tell Me. Perhaps people make light of tragedy in self-defense; I know my family was able to find humor even as our father lay dying. There was, however, an enormous difference: our humor was suffused with an undeniable love for the man and a determination to do all we could for him.

Why are we laughing now, and why will we cheer? Terri is someone's daughter. I will not say she is someone's wife, because I don't think Michael Schiavo will be sad to see his wife die. Perhaps he still loves Terri, although his living with another woman, with whom he has two children, tends to provoke doubt. I assume he accepted losing her years ago, and has no more grief left to give at her death. But Terri's parents still love their daughter dearly, and why would anyone exult in another's grief? Perhaps the hard-hearted would say the body Terri's parents treat so tenderly is not really their daughter, and when she dies they will lose nothing they haven't already lost. Even so—when a family's house burns to the ground, and they lose the treasured, irreplaceable pictures of their children, do we cheer? Don't we mourn with them? Is Terri worth less than a photograph?

Some, no doubt, will just be happy the prolonged battle is over, but they will be wrong. All three branches of government have been invited into a personal, private, agonizing medical decision—not to mention the Fourth Estate in all its glory, and voyeristic lay people all over the world. This camel's nose will not easily be shoved out of our tent. For that we should grieve, if nothing else.

Once again, Florida is making national headlines, this time because of the mysterious outbreak of serious kidney disease, hemolytic uremic syndrome. Most, although not all, of the sufferers had attended either the Plant City Strawberry Festival or Orlando's Central Florida Fair. What else did they have in common? High on the list of suspects is the petting zoos, and the e. coli bacteria often found in animal feces. This is by no means the only source being considered, but it has been jumped on by the media and parents seeking answers. Panicked parents and teachers have cancelled planned zoo trips, and it's not hard to understand why.

What I can't help wondering, however, is why these children, and why now? For millenia children have been growing up on farms, having far more contact with animals, far less concern for hygiene, and no antibacterial soaps. Have we bred a super strain of bacteria that our human bodies cannot handle? Or have we bred a weakened strain of humans, unable to respond effectively when exposed to normal germs? Are we too clean to be healthy?

When I consider this problem, ever present in my mind is a picture of a farm family I visited recently in Pennsylvania, a handful of boisterous, happy children tumbling in from outside, covered in farm dirt, drinking unpasteurized milk, and incorrigibly healthy.

Cleanliness is important, certainly, and simple hygiene goes further than anything else in the fight against disease. Nonetheless, I wonder if modern, "complex hygiene" is more of a problem than a solution. Could it be that our hospital birthed, antiseptically washed, indoor raised, well protected children are more vulnerable than their country cousins?

The whole world is now following what once was just a Florida story: the tragedy of Terri Schiavo, the woman who collapsed 15 years ago and suffered severe brain injury due to lack of oxygen to her brain. She continues to survive—it's hard to call this "living"—in a nursing home, breathing on her own, but dependant on a feeding tube. Doctors say she is completely brain dead, her brain has atrophied, and what looks like reaction to stimulus is really only reflexive movement. Terri has no living will nor other end-of-life directive. Her husband insists that she would not wish to linger in this state, and is trying to have her feeding tube removed. Terri's parents, on the other hand, believe there is hope, and are fighting for their daughter's life. I do not presume to be able to judge either Terri's neurological state nor her desires, but wish to emphasize an aspect of this mess that has always seemed of primary importance, but which has been generally ignored.

Decisions on when to maintain and when to remove artificial life support are difficult at all times. Ideally, the decision to remove artificial life support is made reluctantly but unaimously by all parties involved, including spouse, parents, siblings, and adult children. When there is disagreement, I believe that a hierarchy should prevail: First the patient, of course. If the patient is not able to express his wishes, and has left no written directive, then the decision belongs next to the spouse. That's the nature of marriage, as hard as that can be for parents to bear.

The case of Terri Schiavo is not as clear-cut as that, however. Although Michael Schiavo is legally Terri's husband, he has lived for years with another woman, and indeed has two children by her. It's hard not to sympathize with him, and many will see nothing wrong with his actions. Nevertheless, by so doing he has forfeited all moral and ethical, if not legal, rights as Terri's husband, and should leave all decisions concerning her care to her parents, who have demonstarted that they truly will stick by Terri, "for better, for worse, for richer, for poorer, in sickness, and in health, to love and to cherish, till death do us part."

It's not news that tea (Camellia sinensis) can be good for our health, offering benefits related to heart disease, cancer, stroke, rheumatoid arthritis, dental health, and even weight loss. However, good things in excess do not always remain good, as in the case of the woman who drank one to two gallons of double-strength iced tea per day. Tea contains naturally elevated levels of fluoride, which is part of its contribution to good dental health. Too much fluoride in the diet can cause skeletal fluorosis, a painful condition in which bones become both more dense and more brittle. Researchers at the Washington University School of Medicine in St. Louis tested regular strength preparations, in fluoride-free water, of several commercially available instant teas. Fluoride concentrations ranged from 1.0 to 6.5 parts per million. The maximum level allowed in drinking water is 4 ppm (Environmental Protection Agency), in bottled water and beverages the limit is 2.4 ppm (U. S. Food and Drug Administration), and the U.S. Public Health Service recommends a concentration in drinking water of no more than 1.2 ppm. Brewed and bottled teas were not included in this study.

The Virus and the Vaccine: The True Story of a Cancer-Causing Monkey Virus, Contaminated Polio Vaccine, and the Millions of Americans Exposed, by Debbie Bookchin & Jim Schumacher (St. Martin’s Press, New York, 2004)

Let me state at the outset that I am in favor of vaccinations. I’m very grateful to all those folks whose work has given us some measure of victory over so many horrible diseases. (And to the animals involved, whose sacrifices are usually even greater.) That said, it needs to be more clear that those little jabs to which we subject ourselves, our babies, and our soldiers, are neither miracle nor magic.

There are always risks, and the only reason for a vaccination is if the risks from the disease exceed those from the vaccine itself. I first had my eyes opened to this when I asked my doctor why smallpox wasn’t on the list of recommended vaccines for our children: With smallpox all but wiped out, and biological terrorist attacks not even on the horizon, it would have been foolish to subject children to the dangers of the smallpox vaccine when their chance of being exposed to the disease was infinitesimal.

Worse than the natural, inherent dangers are the human failings: mistakes, hasty or slipshod work, ignorance, pride, political infighting, collusion, and cover-ups. Much of what I said in my comments on The Virus Within applies to this book as well.

When I first heard that the polio vaccine that my generation received as children had been contaminated because it was produced using monkey kidneys, I was incredulous. What did monkey kidneys have to do with producing vaccines? As Edward R. Murrow asked, when he interviewed Jonas Salk, the vaccine’s creator, “The only thing I know about this vaccine is that it starts with a monkey’s kidney and it ends up going into a child’s arm. Could you explain a little to us the process in between?”

Polio was a terrifying disease that reached from the poorest slum dweller to the president of the United States himself, and pressure to develop a vaccine was enormous. (The recent theories that Franklin D. Roosevelt had Guillain-Barré Syndrome rather than polio are immaterial—whatever the actual cause of his problems, it was believed at the time to be polio.) The task was especially daunting because the polio virus could only be grown in living monkeys: Inject monkey with virus, wait for monkey to get sick, kill monkey, extract virus-containing fluid from ground-up spinal cord. Repeat until you have enough virus to work with. Develop a vaccine to test. Inject vaccine into monkeys. If they get sick, start over—the vaccine isn't safe. If they don’t, infect the monkeys with the virus. If they get sick, start over—the vaccine doesn’t work. If they are protected, proceed to human field testing, first on a small scale that would require the use of hundreds of monkeys, then a larger trial with more monkeys, and finally mass testing requiring hundreds of thousands of monkeys. If your vaccine passes all the tests and is approved for production, it will take tens of millions of monkeys to produce enough for mass immunization. Even if that were possible, it would take years—and America in the late 1940’s did not want to wait years.

Enter the Harvard Medical School laboratory of John Enders, which demonstrated that it was possible to grow the polio virus in certain tissue cultures. (Enders and two of his coworkers eventually received the Nobel Prize in medicine for this work.) Their report was largely ignored by polio researchers, but Dr. Jonas Salk, then at the University of Pittsburgh, grabbed the idea and ran. By growing the polio virus in ground-up monkey kidneys suspended in a nutrient broth, Salk was suddenly producing large quantities of virus in little time. At last, a vaccine seemed possible.

And so it was. Those of us who were born post-vaccine cannot fully appreciate what a miracle the polio vaccine seemed to parents who lived in terror of this disease, which killed and paralyzed and particularly targeted children. But it wasn’t quite a miracle, because there was a time-bomb hidden in the vaccine: SV-40, a monkey virus that survived inadequate purification procedures to contaminate nearly every dose of polio vaccine between 1954 and 1963, affecting about a hundred million people in the United States alone. Even after the contamination was discovered, the dangers were downplayed—contaminated batches were not recalled, but continued to be used—because it was widely accepted that the monkey virus, being from a different species, would do no harm.

Unfortunately, that proved to be a false and costly assumption. SV-40 is now known to be carcinogenic, and since the mid-1990’s has been discovered in many formerly rare brain and bone cancers, as well as lymphomas and leukemias. Is this a cause and effect connection, or a coincidence? The government is still downplaying the issue, as you can see from the CDC’s much less alarmist version of the story. They may be right, and I certainly understand their dilemma, since they must weigh the risks of vaccines against the dangers of disease. Eradication of polio worldwide had nearly been accomplished by 2003. However, some Muslim clerics in Nigeria expressed fears that the vaccine had deliberately been contaminated in order to give Muslims AIDS or to render them infertile, and the vaccination program fell apart in that country. Before long polio had returned to twelve neighboring, polio-free countries, and hundreds of children had been paralyzed. So I understand why the government might be afraid of panicking parents into refusing all vaccinations for their children. Still, I’d be a lot less likely to panic if I were convinced that the government were doing its best to find, publish, and advertise the truth. The Virus and the Vaccine has not increased my confidence that this is the case.

Government got it wrong on advice to pregnant women

Folic acid advice has had little impact on birth defects

Recommendations for women planning a pregnancy to take folic acid supplements have had no impact on the number of babies born with neural tube defects, says an international team of researchers.

Recommendations on use of folic acid consumption have had no detectable impact on the incidence of neural tube defects, according to an international study.

Upon reading these headlines and summaries, wouldn't you, as a pregnant woman taking folic acid supplements on the recommendation of your doctor, begin to think that you had been misled and might as well throw away your remaining pills? Doesn't it sound as if the relationship between folic acid deficiency and birth defects has been disproved? Not so!

Reading further, what the study shows is not that the recommendations are wrong, but that not enough people are following them. Birth defects haven't diminished because too many women are still not getting enough folic acid. When folic acid is added to fortified foods, such as enriched flour, birth defects do decrease. Whether or not it is ethical to sneak supplements into people's diets this way is another matter. What concerns me is that people will scan the headlines, not reading the stories, and come away with a subliminal impression that folic acid makes no difference in their baby's health.

(An aside relating to food fortification: I attended an otherwise excellent baking class given by the folks at King Arthur Flour. In explaining the benefits of their flour, the speaker emphasized that it is pure flour, with absolutely no chemicals added. What she meant was that the flour is not bleached nor bromated, but that's not what she said. When I questioned the breadth of her statement, asking "Isn't your flour enriched?" (I knew it was), she replied, "Of course. But there are no chemicals added.")

The Virus Within: A Coming Epidemic, by Nicholas Regush (Dutton, 2000)

I know that my brother had roseola when he was 14 months old, because I found mention of the episode in one of my father’s journals. Although it was not documented, I assume the rest of us also contracted the disease. Most children do, before they are two years old, often with symptoms so mild they evade diagnosis.

Although roseola was officially described in 1910, and studies in the early 1950’s led scientists to believe that it was caused by a virus, it was not until the 1980’s that the virus was isolated and named: Human Herpes Virus-6 (HHV-6). What was being discovered about this virus would have roused great concern, had not the attention of the scientific and medical communities, and the media, been overwhelmed by the more obvious medical problem of the time: AIDS.

Although most children apparently handle roseola with little difficulty, for others an HHV-6 infection can be devastating, often swiftly fatal. Furthermore, just as chicken pox (another herpesvirus, HHV-3) sometimes resurfaces as painful shingles after years of lying dormant in the body, HHV-6 can reactivate. Research is still in the preliminary stages, but reactivated HHV-6 infections have been implicated in a wide range of serious illnesses, including multiple sclerosis, chronic fatigue syndrome, some cancers and mental illnesses, and an array of other neurological or immune system diseases.

The Virus Within is not only a frightening medical thriller, it’s a sad object lesson in the politics of medical investigation, which I glimpsed briefly in my research laboratory days. As much as we would like to believe that the governmental agencies responsible for overseeing our health, and the academic institutions pursuing the conquest of disease, are primarily interested in truth and the benefit of mankind, in reality the support, funding, and publication of scientific research is tainted by politics, self-seeking, and prejudice at all levels.

I found The Virus Within to be frightening and frustrating, but not discouraging. It has strengthened my opinion that the most serious “health care crisis” in the United States is not lack of universal medical insurance, nor litigation and high malpractice rates, nor the vagaries of managed care. It is that we depend too much on the blessings of medical and technological breakthroughs, to the neglect of critical lifestyle concerns. HHV-6, like so many other diseases, preys primarily on those with weakened immune systems. Very few of us can influence governmental health policies or make medical breakthroughs, but most of us can take steps to strengthen our immune systems.

Eat healthy foods. Avoid junk food. Exercise more. Have a positive attitude. Breastfeed your babies (good for their immune systems and yours!). Get plenty of rest. Drink plenty of water. Minimize your exposure to harsh chemicals (smoke, pollution, food additives). Avoid legal drugs whenever possible and illegal drugs at all times. Drink alcohol only in moderation. Practice sexual restraint (an act of rebellion against modern culture if there ever was one, but you will save your immune system from a host of assaults). Smile a lot. Practice forgiveness. Reserve your anger for injustice against others rather than yourself, and even then indulge in it only when you can translate it into action. Meditate on the good, the true, and the beautiful. Make music. Do whatever is necessary to strengthen your family life. Turn off the television. Learn to appreciate silence. Read an uplifting book. Achieve and maintain a healthy weight. Reassess your schedule, your job, your expectations, and your priorities. Know the difference between healthy and unhealthy stress. Consider getting your food more from “organic,” or “natural” sources, and less from factory farms with their artificial fertilizers and feed, their added hormones and antibiotics, and their highly-stressed animals. Take a long walk in the woods or by the ocean. Hug a child. Spent time with uplifting, optimistic people. Think more of others than you do of yourself. Relax. Look at the sky. Count your blessings.

I cannot do everything, but still I can do something; and because I cannot do everything I will not refuse to do the something that I can do.

Don't you just love it when things you like to eat turn out to be good for you? Turmeric is a spice commonly found in Indian curries and other Asian dishes, as well as good old American French's mustard. Curcumin, the component responsible for turmeric's yellow color, apparently provides numerous health benefits. Most recently, a study at UCLA has shown that curcumin may be efffective in treating and preventing Alzheimer's disease. In those tests, curcumin succeeded in preventing the formation and growth in the brain of the amyloid plaques that are the hallmark of the disease.

Since amyloid plaques are also present in the brains of people afflicted with the human form of mad cow disease and other spongiform encephalopathies, this finding may be of even wider importance.

Hmmm...perhaps we'll have curry for dinner...or maybe something Thai....

We have a friend who just delivered her third child after two previous Caesarean sections that followed non-progressive labors. According to a recent report in the New York Times, that blessing would not have been possible with many doctors and hospitals. For a number of reasons, many hospitals are refusing to allow patients to attempt VBAC's (vaginal births after Caesarean).

The largest factor in the restriction is undoubtedly fear of lawsuits. Another is an observed increase in the number of cases of ruptured uterus in recent years. What the otherwise excellent article does not mention is changes in obstetrical practice that may have contributed to the rise in uterine ruptures, such as interference with the natural process of labor (e.g. unnecessary anesthesia and augmentation of labor), and use of single intead of double rows of sutures when closing the Caesarean incision.

Women are not giving up without a fight. They give birth at home, or wait until the last minute (or later) to head for the hospital, or even labor in the hospital parking lot to avoid being forced into a c-section. Dr. Cherouny, of the University of Vermont, tells hospitals, "You must be ready. Even if you don't want to do VBAC's, you will. The patients will make you."

Because the risks to both mother and child are elevated after a c-section, no matter whether the subsequent birth is by VBAC or repeat Caesarean, it is critical that freedom of choice be preserved. Mothers, fathers, doctors, midwives, and hospitals must work together to make intelligent, informed decisions that are right for each individual family.

To view the entire article, you must register with the New York Times, but it is free and worth the effort.

Here is part of the story at the Seattle Post-Intelligencer where you don't need to register.

And here is a good overview of the risk factors associated with VBAC's.

A study in London showed that chocolate is a more effective cough medicine than those terrible-tasting syrups, and has fewer side effects. Patients in the study were given theobromine in amounts equivalent to two cups of cocoa, or codeine, or a placebo. Codeine, traditionally used to suppress persistent coughs, was only slightly more effective than the placebo, but the theobromine excelled. The next questions: Is more better? Is less just as effective? Since milk chocolate contains less theobromine than dark chocolate, do I need to eat more M&M's than chocolate chips for the same result? <Ahem>, <ahem>, excuse me while I go nip this cough in the bud....

Worried about putting on extra pounds with upcoming holiday feasting? Remember what your mom always told you, and be sure to get enough sleep! A study by Columbia University researchers shows a strong inverse correlation between the amount of sleep people receive and their tendency toward obesity. Compared with those who slept seven to nine hours per night, people who slept less than four hours a night were 73% more likely to be obese; those who got five hours of sleep were 50% more likely, and those who averaged six hours were 23% more likely.

Sleep—the new weight loss program!

A technique for protecting premature infants, developed in Colombia because of a shortage of incubators, is proving so effective that Colombian doctors are urging more affluent nations to adopt it as well. Called "kangaroo mother care," the therapy begins when the child no longer needs special medical support, and ends when he is able to regulate his own temperature, typically at the time he would normally have been born.

Wearing nothing but a cap, a diaper, and a supportive sling, the baby is snuggled against his mother's (or father's) naked chest, 24 hours a day. The constant skin-to-skin contact keeps the baby warm, promotes breastfeeding, and improves communication between mother and child. Research indicates that the technique is as safe and effective as incubator care. In addition, it reduces the severity of infections and strengthens the parent–child bond.

"It's at least as good as taking care of babies in incubators," says lead author Juan Gabriel Ruiz-Pelaez, a pediatrician at Javeriana University in Bogota. "And we are convinced it has distinct advantages—especially regarding the emotional aspects of the relationship between mother and infant."

Ruiz-Pelaez says medical personnel may be resistant to the technique because "instead of having a baby carefully scrutinised with alarms and monitors, you go back to something that looks very simple and unreliable—a human body."

"Western" medicine and medical practicioners have contributed incalculably to the health of developing nations, often at great sacrifice. Without demeaning those efforts and successes in any way, it's nonetheless essential that we have the humility to recognize that our solutions aren't always the best, and develop the grace to accept non-technological, non-pharmaceutical therapies from third-world countries, midwives, grandparents, "old wives," and other sources of creative wisdom.

Especially a solution as elegant and as beautiful as this.

An Austrian study of the benefits of walking is both encouraging and perplexing. During the four-month study, 45 healthy adults walked 600 meters, three to five times per week. Each participant walked uphill for half of the study, and downhill for the other half, taking a cable car for the opposite trip.

It's not surprising that the walkers benefitted from their exercise; what is peculiar is the distribution of their improvements. Both uphill and downhill walkers experienced a decrease in their LDL ("bad") cholesterol. Uphill walking also lowered triglyceride levels and increased the body's ability to handle fat. Downhill walking significantly increased the body's ability to handle sugar. Walking uphill did not help with sugar, nor downhill with fats.

The obvious solution is to walk both uphill and down whenever possible. What I want to know, however, is the reason for the differences. It's easy to make a case for walking uphill as the "best" exercise: it expends more energy, makes more demands on the heart and lungs, and seems to be a better workout for the muscles. Walking downhill is certainly easier, although I do find it harder on the knees. What is it about downhill walking that confers the unique positive effect on blood sugar? What is different about going downhill? It uses different muscles, and is a higher impact walk, jarring the body somewhat. No doubt the walkers also covered the same distance in a shorter time. Can any of these differences explain the benefit? If not, what? I hope someone is looking into this question, as well as trying to replicate Dr. Heinz Drexel's findings.

In the meantime, I'll keep walking, though it's mighty hard in Florida to find hills to walk either up or down.

Florida is being labeled as an unhealthy state, ranking 42nd in a study by the United Health Foundation. On looking further into the study, I discovered that the risk factors they considered were far different from the ones I would have chosen to get a picture of how living in a certain state might be a health risk or benefit. I would have asked questions such as:

• What are the risks of climate-related injury and death (heat stroke, frostbite, and other risks of exposure or inadequate shelter)?
• What are the risks/benefits of the state's relationship to the sun (increased risk of skin cancer, decreased risk of rickets)?
• How many days per year are people likely to engage in outdoor activity (not driven indoors by cold or heat)?
• How likely would one be to find a good doctor/hospital when necessary?
• How free are people to make their own health care choices?
• What is the general quality of the air and water?
• What regulations are enforced concerning a healthy environment—everything from industrial and agricultural pollution to building codes and smoke-free workplaces?
• What is the rate of violent crime?
• How likely is one to be killed or injured in an auto accident?
• What is the threat of potential disasters (earthquake, volcanic eruption, tornado, hurricane, terrorist strike)?
• Are there any state-specific disease problems (high incidence of hepatitis, tick-borne disease, plague)?
• What is the general infectious disease rate?

In other words, when considering how good or bad living in a state might be for one's health, of greatest interest are those factors over which an individual has little or no control. While this study includes some of those, it confuses the data with factors that I see as irrelevant, such as the percentage of the population that smokes (a marginally important enviromental factor), and the high school graduation rate (utterly unrelated to a particular person's health risk).

Check it out for yourself, and see your own state's ranking.