Part I

By Barbara Ficarra, RN, BSN, MPA

There’s no doubt that prescription drug abuse is a major problem in America, and it’s escalating in epic proportions.  Prescription drug abuse affects men, women and teens.  Concerning trends include older adults, adolescents and women.

On MSNBC’s website, Karen Asp writes, Superwoman syndrome fuels pill-pop culture, and it’s about how “Overwhelmed overachievers turn to prescription drugs for an edge.”

This article is a little misleading since there are many women who are hardworking “superwomen” who do not indulge in illicit drug use.

There are many of us women who try to do it all.  Women, in general are master multi-taskers.

Think about what women go through in a day, especially if they’re a mom.  Just trying to juggle work, family and friends and it can be overwhelming.  As women we try to be the best friend, the best wife, the best partner, the best mother; we try to succeed at work and we’re always giving.

How do you balance it all?

The first step is to figure out your work-life balance.  It’s important to realize many of us have stressors and it’s up to us to figure out how to channel our energies to help us stay balanced without abusing drugs.   Take time for yourself each day, take a “selfish” moment and learn to prioritize.

(There are many healthful ways to stay balanced, find out how to be “selfishly healthy” and tips on prioritizing plus more in a future blog, Part II).

It’s important to realize that if you’re a woman who is trying to do it all, it doesn’t automatically mean you’ll be popping pills.  While there are women who do, it’s possible to have a balanced life without even thinking about abusing drugs.

Popping Pills

Turning to prescription drugs isn’t a fix for life stressors; it’ll only wreak havoc on your life and health.

Does  Asp’s article mean that any woman trying to achieve it all, trying to be the best, trying to be “superwoman” will end up popping prescription pills?  Of course not.

The important message

It’s really important to understand the prescription drug abuse is a brain disease.

Most drug abusers have an underlying genetic predisposition, says Carl R. Sullivan, MD, FACP, professor and vice-chair of the Department of Behavioral Medicine and Psychiatry at West Virginia School of Medicine, Medical Director of Substance Abuse Programs for West Virginia and director of the largest office-base opioid treatment clinic in West Virginia.  “The strongest predictor of who will develop addiction is whether the addiction is in the immediate family, especially parents and siblings,” he says.

Asp writes:

“To blame may be what some are calling the superwoman syndrome. Overworked, overwhelmed and overscheduled women juggling families, friends and careers are turning to stimulants, painkillers and anti-anxiety meds to help launch them through endless to-do lists.”

The question

Does it mean the woman that gets a prescription from her doctor or nurse practitioner to help relieve the symptoms of anxiety will become addicted to her meds?

“It’s a complicated question.  There are predisposing factors; family history, and personal addiction to other drugs or alcohol.   And while many women will not become addicted to these drugs, it’s possible.  How can you tell?  First, ask whether the woman takes the drugs as prescribed and is she truthful about her usage.  Second, if a woman is getting drugs from more than one doctor, from friends or family, then that is not normal.  Also, if she finds herself making excuses or minimizing/lying about her usage, then that is a red flag,” says Dr. Sullivan.

Prescription drug abuse doesn’t discriminate

Who is the face behind drug addiction?

The fact is, your best friend could be addicted to prescription drugs and you may not even know it.   Your boss, your brother, your sister, aunt, uncle, your neighbor can be drug addicts and they can be employed in any job.

The Facts

[Source:  Results from the 2008 National Survey on Drug Use and Health (NSDUH):  National Findings National Survey on Drug Use and Health:  U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Office of Applied Studies]

Illicit Drug Use (Illicit drugs include:  marijuana, cocaine, heroin, hallucinogens, and inhalants; and the nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives).

• In 2008, an estimated 20.1 million Americans aged 12 or older were current illicit drug users.
• In 2008, the rate of current illicit drug use among persons aged 12 or older was higher for males than for females (9.9 vs. 6.3 percent, respectively).
• Males and females had similar rates of nonmedical use of psychotherapeutic drugs –(prescription pain pills, sleeping pills and anti-anxiety pills (2.6 and 2.4 percent, respectively).

Substance Dependence or Abuse

• For males in 2008, the rate was 11.5 percent, which was down from the 12.5 percent in 2007, while for females, it was 6.4 percent, which was higher than the 5.7 percent in 2007.
• In 2008, an estimated 22.2 million persons aged 12 or older were classified with substance dependence or abuse in the past year.
• Approximately 52 million Americans aged 12 or older reported non-medical use of any psychotherapeutic at some point in their lifetimes, representing 20.8% of the population aged 12 or older.

The most commonly abused drugs  (Generics are in parentheses)

Opioid Painkillers –

• OxyContin (oxycodone hydrochloride)
• Vicodin , Lorcet, Lortab, Norco, (acetaminophen and hydrocodone)
• (Codeine)-generic only
• MS Contin, Roxanol (morphine)
• Duragesic (fentanyl)
• Dilaudid (hydromorphone)

Stimulants –

• Ritalin, Concerta, Metadate, Methylin (methylphenidate)
• Adderall (amphetamine and dextroamphetamine)

CNS depressants –

• Valium (diazepam)
• Librium (chlordiazepoxide)
• Xanax (alprazolam)
• Klonopin (clonazepam)
• Restoril (temazepam)
• Serax (oxazepam)
• Ativan (lorazepam)
• Soma (carisoprodol)
• Barbiturates including Fiorinal, and non-benzo sleeping pills in excess such as Ambien (zolpidem), Sonata (zaleplon), Lunesta (eszopiclone)

Treatment

The good news is, is that there is treatment for addiction.

For more info, please visit The Center for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services (HHS).

Future Post- Part II

The next blog on addiction will focus on prevention.  We’ll give you information to help keep your work-life balanced and intact.
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For further info:

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES – Substance Abuse and Mental Health Services Administration – Results from the 2008 National Survey on Drug Use and Health: National Findings

American Psychiatric Association – Healthy Minds.  Healthy Lives.

American Psychological Association

Drug Info

WebMD

Medline Plus
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Source:  Substance Abuse and Mental Health Services Administration. (2009). Results from the 2008 National Survey on Drug Use and Health:National Findings (Office of Applied Studies, NSDUH Series H-36, HHS Publication No. SMA 09-4434). Rockville, MD.

By Barbara Ficarra, RN, BSN, MPA

Are you thinking about the classic Hollywood example?

Hollywood Loves Drama - Know the Signs of a Heart Attack

The classic example of a Hollywood heart attack is a person clutching their chest, gasping for a breath and falling to the ground.

After all, Hollywood is hot for drama, and when it comes to portraying a person having a heart attack, the exaggerated Hollywood version is far more riveting than a person sitting quietly wondering if their very slight arm discomfort is anything they should be concerned about.

The Hollywood version can be very misleading.

Real life

The reality is that sometimes the signs of a heart attack are so subtle the person experiencing the attack may ignore it.

I remember when my family member had a heart attack.  There was no excruciating chest pain; there was no clutching of the chest.  The symptom was so minor he was ready to ignore it.  The feeling was just a slight discomfort in his arm.  He knew something was wrong, he just wasn’t feeling right.

Thankfully, he didn’t ignore it.  While he was waiting for the ambulance to get there after calling 911, he called me from his cell, “Barb, I think I’m having a heart attack.”

Just as the ambulance arrived, he quickly told me what hospital he was going to.  I got in the car and cruised without encountering any traffic over the GW Bridge or the FDR.

I got to the ER and as I approached the room he was surrounded by doctors and nurses.

Signs of a heart attack you don’t want to ignore

• Chest pain
• Chest discomfort
• Feeling discomfort or pain in the jaw, neck or back
• Discomfort in arms or shoulder
• Shortness of breath with or without chest discomfort
• Feeling lightheaded, weak or faint – feels like you’re going to pass out
• Breaking out in a cold sweat
• Nausea and vomiting
• Anxiety
• Stomach pain that may feel like heartburn

[Source:  CDC Morbidity and Mortality, American Heart Association and Mayo Clinic]

Signs of a Heart Attack Can Be Minor

CDC Morbidity and Mortality Study

According to a report in the CDC’s Morbidity and Mortality Weekly Report, February 22, 2008, “Disparities in Adult Awareness of Heart Attack Warning Signs and Symptoms — 14 States, 2005,” it is estimated that approximately 920,000 people had a heart attack in 2005.

A survey was conducted to find out how many adults recognize the signs of a heart attack and how many adults understand how critical it is to call 911 immediately.

The following questions were asked in the survey to a total of 71,994 people

“Do you think pain or discomfort in the jaw, neck, or back are symptoms of a heart attack?” “Do you think feeling weak, lightheaded or faint are symptoms of a heart attack?” “Do you think chest pain or discomfort are symptoms of a heart attack?” “Do you think pain or discomfort in the arms or shoulder are symptoms of a heart attack?” “Do you think shortness of breath is a symptom of a heart attack?”

Results of the survey

• 48% of the respondents were aware that pain or discomfort in the jaw, neck, or back are symptoms of a heart attack
• 62% of the respondents were aware that feeling weak, lightheaded or faint are symptoms of a heart attack
• 92% of the respondents were aware that chest pain or discomfort are symptoms of a heart attack
• 85% of the respondents felt that pain or discomfort in the arms or shoulder are symptoms of a heart attack
• 93% of the respondents were aware that shortness of breath is a symptom of a heart attack

What you can do:  A critical step to help save lives

Recognizing the warning signs of a heart attack, even the most subtle symptom and calling 911 immediately are vital to saving lives.

It is critical for treatment to begin immediately because it is reported that half of the cardiac deaths occur within one hour on onset “before patients reach a hospital.” [Source:  According to a report in the CDC’s Morbidity and Mortality Weekly Report, February 22, 2008]

Creating awareness

It’s important to be aware that the signs and symptoms of a heart attack that are portrayed by Hollywood are not always accurate.  Hollywood is spectacular at creating drama, but when it comes to health education it’s important to seek information from your health care professionals.

This report revealed that only 86% of the respondents would call 911 if someone was having a heart attack or stroke.

Bottom line

• Know the signs of a heart attack
• Call 911 immediately if you, your family member or someone you encounter is having a heart attack

Helpful online sites

American Heart Association
Mayo Clinic
Medline Plus – A service of the U.S. National Library of Medicine and the National Institutes of Health
CDC

By Barbara Ficarra, RN, BSN, MPA

Mediterranean Diet is a healthful diet for men with and without metabolic syndrome, and with or without sexual dysfunction.

The Mediterranean diet has been in the headlines recently because a new study shows that the diet is beneficial to help avoid strokes.

Recognized for its ability to help improve heart health, the Mediterranean Diet also can help kick-start a flagging libido in men with metabolic syndrome.

I asked John La Puma, MD (ChefMD) to suggest some foods that can help set the stage for a happier, healthier love life.

In fact, to help stimulate sexual health, Dr. La Puma is a fan of foods commonly associated with the Mediterranean diet…in fact, the whole Mediterranean Diet.

What is the Mediterranean Diet?

The common Mediterranean dietary pattern consists of five characteristics:  [source: American Heart Association]

• A high consumption of fruits, vegetables, whole-grain breads and cereals, potatoes, beans, nuts and seeds
• Olive oil as a key source of monounsaturated fat (monounsaturated fat doesn’t raise blood cholesterol levels the way saturated fat does)
• Dairy products, fish and poultry in low to moderate amounts; little red meat is eaten
• Eggs consumed zero to four times a week
• Wine in low to moderate amounts

While studies show that the Mediterranean Diet can help overcome erectile dysfunction (ED), or impotence in men with metabolic syndrome, the Mediterranean Diet is a healthful diet for men with and without metabolic syndrome, and with or without sexual dysfunction.

What is metabolic syndrome?

According to the CDC, about 34% of U.S. men have metabolic syndrome.

Metabolic syndrome is a group of conditions that put you at risk for heart disease and diabetes. These conditions according to the National Institutes of Health are:

• High blood pressure
• High blood sugar levels
• High levels of triglycerides, a type of fat, in your blood
• Low levels of HDL, the good cholesterol, in your blood
• Too much fat around your waist

What does the Mediterranean diet do for sex?

For men with metabolic syndrome, about one-third of all U.S. men, the diet helps to overcome erectile dysfunction (ED), or impotence.

In fact, studies show that one-third of these men with ED cure their problem after following a Mediterranean-style diet, combined with exercise, for two years. Over 100 million men have ED worldwide.

No one knows with certainty how the Mediterranean Diet works, says Dr. La Puma, but because it reduces whole body inflammation and CRP (C-reactive protein) measurements, and improves endothelial (arterial lining) function, researchers think the Diet improves blood flow.

Belly fat, a big part of the metabolic syndrome, lowers testosterone levels. Losing that fat might improve androgen levels and improve the elasticity of blood vessels. By choosing foods on the Mediterranean Diet, it’s possible to have better erections. “Less inflammation, better flow, better hormone levels, better erections,” says Dr. La Puma.

What is it about Mediterranean diet foods that make them so powerful?

Beans, legumes and seeds, especially kidney beans, peanuts and sunflower seeds are rich in arginine. This amino acid allows blood vessels to dilate (widen) and increase blood flow to the sexual organs.

Walnuts

You might also consider eating walnuts to help enhance sexual performance (not drive), especially after consuming a fatty meal. Walnuts can protect the arteries from constricting and responding abnormally to exercise and exertion. “Dosage: Take 8 walnuts with your meal, 4 hours before sex, ” says Dr. La Puma.

To spice up your love life,

ChefMD recommends the following Mediterranean Diet recipe:

Spaghetti Frittata with Toasty Walnuts and Cheese

We’d love to hear from you.  Do you follow a Mediterranean Diet?  What are your favorite foods?  What are your favorite recipes?

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Thanks for reading this post.  You can follow me on twitter.

By Barbara Ficarra, RN, BSN, MPA

A quick update

After reading a tweet by Dr. Sanjay Gupta:

“Want to swim/bike/run the NYC tri with me? It’s a chance to lose forever. Need a serious 6 month commitment tho… http://bit.ly/90HBoK,”

I posted a blog about it, and it got a great deal of attention.

I was bombarded with emails from readers interested in submitting their video and hoping to get chosen for the challenge.

After learning about the challenge from Healthin30, our Healthin30 reader,         Linda Fisher-Lewis decided to submit her story on video.

Linda was chosen as one of the participants to compete with Dr. Sanjay Gupta in CNN’s Fit Nation Triathlon Challenge.

Best of luck to Linda and to the rest of the participants.

Part 1

By Barbara Ficarra, RN, BSN, MPA

Before the 15 minute doctor visit is up...what you can do

Kevin Pho, MD, primary care physician in Nashua, N.H., blogs at KevinMD.com, member of USA TODAY’S board of contributors and a guest to the Health in 30® Radio Show, writes about the importance of doctors engaging in social media to communicate with patients.

He writes in an op-ed in USA TODAY “Doctors ignore Internet at their own peril” on January 27, 2010:

“Raise your hand if you’ve ever left a physician’s office without fully understanding what the doctor just told you. According to The New England Journal of Medicine, half of patients admit to not understanding what their doctor told them during an office visit.

As a primary care physician, being unable to clearly communicate with patients is frustrating. The typical, 15-minute office visit often is not sufficient for a thorough discussion. A better way to connect with patients is needed.”

Patients value face-to-face connection with their doctor (and other health care professionals) and the amount of time with your doctor will vary depending on your reason for the visit.

Yes, it’s frustrating when time is limited. Since time is limited, too many of us have left an appointment only to remember a question we planned to ask.

Unless your doctor is engaging in social media to communicate with you online, it’s important that you’re prepared for your face-to-face office visit.  Bring a notebook with your questions.

Make sure you write your questions down before your visit

By writing down your questions in advance you won’t leave without the answers you need necessitating a follow-up visit or a string of phone-tag calls with your doctor.

Here is a list of questions that may help you get the conversation started:

• What are the causes of my symptoms?
• Will the symptoms go away?
• How long will they last?
• What tests are needed to determine the cause of this condition?
• How is this condition diagnosed?
• What are the criteria for diagnosis?
• What is the treatment?
• Are there alternative therapies?
• What over-the-counter medications would be helpful?
• What prescription medications would be helpful?
• What are the side effects?
• Will my present medications interfere with any of these new medications?
• Should my diet change?
• Are there certain foods that I should be eating?
• What lifestyle changes should be made?

Don’t forget to ask for a copy of your test results.

We’d love to hear from you

Have you ever left an office visit and forgot to ask important questions? Do you write your questions down in advance? How do you make the most of your visit with your doctor or other health care professional?

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[Part II will focus on participatory medicine, patients partnering with their doctor].

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I’d like to thank our sponsor, Scrubsgallery for their continued support.

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