How to Avoid Email Regret

“Resentment is like drinking poison and then hoping it will kill your enemies.”
– Nelson Mandela
Have you ever received some news via email, voicemail, word of mouth, etc, that has made you so angry that not only did you have physiological responses (increased heart rate, knot in your stomach, rise in body temperature, etc.), but you obsessed on this perceived or actual way in which you were wronged that you could think of nothing else but reacting as soon as possible?
If so, what did you do?  Did you take out your phone and bang away ferociously on your iPhone’s screen (good thing it’s made of Gorilla Glass) typing faster on your phone than you ever had before?  Maybe you only took some notes capturing the bullet points.  Maybe you waited till you were at your computer (assuming you weren’t at the time and “unleashed hell” like in “Gladiator” but in the form of email.
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Perhaps you showed some “restraint” and decided to deal with it later and were actually able to re-engage in your life for the remainder of the day.  For many, this “restraint” lasts until that night, when laying in bed, you can think of nothing else.  So, you become more and more angry / upset / resentful until you “can’t take it” and write that Manifesto to the individual or institution that has “wronged you.”   Read more ›

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More on the Suicide Epidemic

Suicide continues to be a significant problem in the United States, and remains the 10th leading cause of death. In 2011, 39,518 people took their own lives.

The numbers are more alarming when broken down by age and gender. Consider that almost 5,000 Americans between the ages of 10 and 24 die by suicide each year, making it the second leading cause of death in this age group.

Suicide is the second leading cause of death among persons aged 15-24 years as well as persons ages 25-34. It’s the fourth leading cause of death among persons ages 35-54, and the eighth leading cause of death among those 55-64.

Those suicides committed by the 15 – 24 year olds account for 20% of all suicides.

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The Heredity of Suicidal Behavior

Suicide is a leading cause of adolescent death in the United States. Screening of any adolescent for emotioal wellbeing therefore must include an examination into their parent(s) own suicidality.

A new study indicates that parents who have attempted suicide, have children who are five times more at risk for making a suicide attempt.

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33 Identified Definitive Autism Genes 33 (up from 9 previously ID’d)

Study completed by Mt. Sinai researchers and the Autism Sequencing Consortium examined several types of rare, genetic differences in more than 14,000 DNA samples from parents, affected children, and unrelated individuals – by far the largest number to date – to dramatically expand the list of genes identified with autism spectrum disorder (ASD).
Small differences in as many as a thousand genes contribute to risk for autism.
Brain machinery for communication, transcription, regulation implicated
– Genes underlying the neural machinery for shaping communication between brain cells, gene expression, and its regulation    by environment emerged as conferring the most risk.
– Rare glitches in 107 genes confer relatively higher risk.
– Among 2270 trios of patients and their parents, 13.8% carried such mutations.
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September is National Recovery Month, Not National Opioid Month As the Numbers Suggest

Every day, 46 Americans die from an overdose of prescription opioid narcotics such as Vicodin, OxyContin, and methadone.

Prescription Opioiod Abuse Alive and Well Along With A National Herioin Crisis:
The rise in heroin use is leading to more drug overdose deaths. In February of this year, SAMHSA issued an alert about a marked upswing in deaths linked to the use of heroin contaminated with the opioid fentanyl. Fentanyl is reported to be about 100 times more potent than morphine, the active ingredient of heroin.

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Frequent Marijuana Use Bad for Teens’ Brains

Multiple Sources – August 10, 2014

At the American Psychological Association’s 122nd Annual Convention, psychologists discussed the health implications of legalizing marijuana which in part included the effect of marijuana on teens. Generally, psychologists agreed that smoking marijuana just once weekly can have significant negative effects on the brains of teens and young adults. Such effects include, cognitive decline, poor attention and memory, and decreased IQ (APA, 2014).

Krista Lisdahl, Ph.D., director of the brain imaging and neuropsychology lab at the University of Wisconsin-Milwaukee said, “It needs to be emphasized that regular cannabis use, which we consider once a week, is not safe and may result in addiction and neuro-cognitive damage, especially in youth.”
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Teen Use of Synthetic Human Growth Hormone Doubles from 2012 to 2013

Between 2012 and 2013, the use of HGH (Human Growth Hormone) without a prescription more than doubled among teens, grades 9 -12 seeking to improve their athletic performance and/or appearance.  Although the Partnership for Drug-Free Kids who published their results state that these figures highlight teens’ growing interest in performance enhancing substances, the group’s statements about the effects of HGH as a PED (Performance Enhancing Drug) are highly debatable. The Partnership for Drug-Free Kids indicate that synthetic HGH stimulates growth and cell production, helping regulate body composition, muscle and bone growth. They further state that HGH can be used to improve athletic performance and appearance by building muscle, “like anabolic steroids.”

A group of researchers from Stanford would disagree with these statements as their study found that, the hormone shots, used by athletes seeking to boost performance, increased lean muscle mass mostly by making the body retain fluids. The Stanford study, published in the Annals of Internal Medicine also found that the added bulk not only failed to make individuals stronger, but actually appear to cause athletes to tire and get hurt more easily.

Penn State’s Professor of Health and Human Development, Charles Yesalis raises what might be the benefit of HGH as a PED. Yesalis reported that it has found to be rare that an athlete is taking HGH on it’s own, and that these athletes are taking HGH in conjunction with anabolic steroids. Several other scientists speculate that HGH enhances the strength building family of anabolic steroids.

Many of the side effects of anabolic steroids have been widely publicized, but the side effects from HGH appear to be significantly less publicized which may in turn, provide a sense of its use as posing little risk. However, HGH has been found to have such side effects as Injection-site reactions and to a lesser degree, individuals who use HGH can experience joint swelling, joint pain, carpal tunnel syndrome, and an increased risk of diabetes. These individuals in some cases, can produce an immune response against Growth Hormone. The most severe of the potential side effects, but with the weakest scientific evidence is HGH’s risk factor for Hodgkin’s lymphoma.

It would appear that the bigger news from the Partnership for Drug-Free Kids is their other findings included in their report which include:
– One in five teenagers said they had at least one friend who used steroids.
– The same percentage also said they thought it was easy to get steroids either online or from others who are thought to have obtained the steroids from the internet.
– The percentage of teens who considered use of synthetic HGH without a valid prescription a “great” or “moderate” risk, decreased by 5% from just one year prior (2012).

Growth Hormones in Our Milk:
In the United States, the FDA allows the agricultural industry to legally give a bovine Growth Hormone to dairy cows to increase milk production, although the FDA has made it illegal to give such hormones to cows raised for beef.

So I guess it’s ok for our society to ingest growth hormone via milk, but hey don’t worry, you and your family don’t have to worry about ingesting these hormones from eating beef.

This would appear to fit into the norm of the FDA’s long history of inconsistent guidelines, which are often found to either not be adhered to. That’s ok, because we all have seen the reports (that are known about publicly) about the other contaminants that wind up in our food. That’s a whole other conversation, which I can’t get into right now as I still have half a gallon of milk to finish before batting practice.

References
Freedman RJ, Malkovska V, LeRoith D, Collins MT (October 2005). “Hodgkin lymphoma in temporal association with growth hormone replacement”. Journal of Endocrinology, 52(5). pp. 571–575. doi:10.1507/endocrj.52.571.

Liu H, Bravata DM, Olkin I, Friedlander A, Liu V, Roberts B, Bendavid E, Saynina O, Salpeter SR, Garber AM, Hoffman AR (May 2008). “Systematic review: the effects of growth hormone on athletic performance”. Annals of Internal Medicine, 148(10). pp. 747–758. doi:10.7326/0003-4819-148-10-200805200-00215.

Partnership for Drug-Free Kids & deKadt Marketing and Research, Inc. (2014). The Partnership Attitude Tracking Study Teens & Parents 2013: The 25th annual Partnership Attitude Tracking Study (PATS). Retrieved from:
http://www.drugfree.org/newsroom/pats-2013-full-report-key-findings

Swerdlow AJ, Higgins CD, Adlard P, Preece MA (2002). “Risk of cancer in patients treated with human pituitary growth hormone in the UK, 1959-85: a cohort study”. Lancet 360 (9329): 273–7. doi:10.1016/S0140-6736(02)09519-3.

How To Apologize and Own It

Don’t let the clinical terminology deter you (ok, “Fartbag” is not actually a clinical term), this is a great synopsis and life lesson. Apologizing Like An Adult

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2014 World Cancer Report: “No Amount of Alcohol is Safe”

No Grey Area?

It doesn’t take a genius to know that alcohol abuse can cause serious health problems.  However, over the past 10-15 years the benefits, especially cardiovasculr of “responsible drinking” (e.g. one glass of red-wine per day) has received a lot of attention and has generally been accepted throughout society.  Well, it looks like the only benefits that alcohol provide come from not consuming it.  At least that what the 2014 World Cancer Report (WCR), created annually by the Agency for Research on Cancer (IARC), an agency that is part of the World Health Organization (WHO).

 

Ok, time for some educated speculation in the face of science. I’m not the booze police, and don’t frown on drinking in moderation for those who can actually drink in moderation.  Personally, I’ve seen the devastation that alcohol can cause to individuals, families, innocent bystanders, etc., that for those who choose to abstain, all the power to you.  That said, I’m not sure I believe that moderate drinking causes cancer, like the report says.  Please allow me to elaborate, starting with a simple question; How many people who drink too much don’t minimize the truth to not only doctors, law enforcement, family members, but perhaps most of all to THEMSELVES?

 

Isn’t There A River in Egypt Related to this Topic:

Denial is more powerful than alcohol and for centuries has played a huge part in the drinking habits of millions of people.  So maybe it’s a question of what the actual consumption is, not only in terms of quantity, but frequency as well (including days between drinks).  The report indicates that the risk is “dose dependent” meaning the more one drinks, the higher the risks.  Would it not be fair to then consider that the identified correlations between alcohol and certain cancers are seen in patients who actually consume more than reported?

 

Serious Science & Statements of Certainty:

Many are surprised to learn that alcohol was declared a carcinogen by the IARC in 1988 and is considered to be causually related to several cancers for certain, and speculated to be causally related to several others (IARC Working Group, 1988).

 

Cancers Caused By Alcohol:

According to Jürgen Rehm, PhD, WCR contributor on alcohol consumption, and Senior Scientist at the Centre for Addictions and Mental Health in Toronto, causal relationship exists between alcohol consumption and cancers of the mouth, pharynx, larynx, esophagus, colon-rectum, liver, and female breast.  The report also states that there is a significant relationship existent between alcohol consumption and pancreatic cancer.  Dr. Rehm states that the IARC is absolutely certain that alcohol causes these cancers.

 

There have been established connections between alcohol consumption and leukemia; multiple myeloma; and cancers of the cervix, vulva, vagina, lungs, kidneys, and skin, but admittadly, more research is needed.   For other cancers such as bladder, lung, and stomach cancers, the evidence for an alcohol-cancer relationship is conflicting (Rehm & Shield, 2013).

 

Circling Back to Denial and Under-Reporting Drinking:

I emphasize the importance of knowing real numbers, even in the face of a meta-analysis of 222 studies regarding “light drinking” where the combined sampled populations were comprised of 92,000 “light drinkers” and 60,000 non-drinkers.  Supporting the 2014 report, this meta-analysis concluded that light drinking was associated with risk for oropharyngeal cancer, esophageal squamous cell carcinoma, and female breast cancer (Bagnardi, et al., 2013).

 

The Practical Bottom Line:

Just as one needs to be honest with themselves about how much they drink, they also need to remember the evidence for the harmful effects of alcohol is stronger than the evidence for its beneficial effects.  Viewing drinking as engaging in a healthy activity is really a justification.  Sure, as Renaud and de Lorgeril illustrated (1992), there is evidence which shows lower risks for diabetes mellitus, stroke, heart failure, and total mortality, but lowered risks are minimal compared to the increased negative risks associated with excessive alcohol consumption.  Again, we’re talking excessive consumption.

 

To really benefit from light drinking, one needs to follow a consistent pattern of daily low-intake of alcohol (preferably redwine), before or during the evening meal, which is associated with the strongest reduction in adverse cardiovascular outcomes. The key being low-intake as heavy alcohol use causes hypertension, atrial fibrillation, ischemic and hemorrhagic stroke, and nonischemic dilated cardiomyopathy Renaud & de Lorgeril (1992).

 

Broken Down:

The evidence for the harmful effects of alcohol is stronger than the evidence for its beneficial effects.

 

We haven’t even discussed the consequences unrelated to health (accidents, social problems, violence, etc) nor underage drinking.  Those are the main reasons why alcohol abuse is the leading risk factor for premature death among males ages 15-59 (O’Keefe, et al., 2014).

 

Basically, as Dr. Rehm explains, “We still don’t know what causes 60% of cancers, but people can lower their risk by reducing their intake of alcohol.”

 

It seems that Dr. Pekka Puska, former Director General of the National Institute for Health and Welfare of Finland and contributor to the WCR, has the most realistic and practical advise regarding drinking.  He states that, “I would not be concerned about the use of alcohol in every patient. Clinicians should inquire about alcohol use and inform patients about the health risks. For most patients, especially the elderly, if they consume alcohol in moderation, I would not pressure them to stop alcohol altogether. In patients who have health problems related to alcohol, however, clinicians should be very firm in advising them to stop using alcohol and recommend specific cessation services.”

 

So, if you drink, like most things, do so in moderation and be honest with yourself.  However, if moderation is a problem for you in areas of your life (think “too much of a good thing”) abstinance is the only sure fire way to avoid an alcohol related problem.  I’ve said it before and I’ll say it again, if you think you have a problem with alcohol, then you probably do.  The good news is there is an abidance of ways to get help.  Behavior change and positive effects have been observed in adolescents, adults, older adults, and pregnant women following alcohol screening and brief interventions aimed at reducing alcohol intake.

 

Feel free to comment or contact me individually should you or someone you care about possibly have a problem with alcohol or substance abuse and desire some professional guidance.

 

REFERENCES

Bagnardi, V., Rota, M., Botteri, E, et al (2013). Light alcohol drinking and cancer: a meta-analysis. Annals of Oncology.;24,301- 308.

 

IARC Working Group, Lyon (1988). Alcohol drinking. IARC Monograph Evaluating Carcinogenic Risks in Humans,44,1-378.

 

O’Keefe, JH, Bhatti, SK, Bajwa, A, DiNicolantonio, JJ, and Lavie, CJ (2014). Alcohol and cardiovascular health: the dose makes the poison…or the remedy. Mayo Clin Proc.,89,382-393.

 

Rehm, J, and Shield, K (2014). Alcohol consumption. (In Stewart BW, Wild CB, eds. World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer; 2014.

 

Renaud, S, de Lorgeril M. (1992). Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet,1992,339,1523-1526.

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The Number of Children and Adolescents Taking Psychotropic Medications Continues to Rise

For the second year in a row there has been an increase in the number of children and adolescents being treated with psychotropic medications.  Mental health needs across both genders of American youth continues to be addressed in part with medication.  The study performed by Health Care Cost Institute (HCCI) unfortunately doesn’t quantify the frequency treatment includes both medication and psychotherapy, but rather examines the increased prescriptions by age, gender and generic vs name brand in its examination of spending on psychiatric medications for youths.

Interestingly, there is a wide disparity between the average genders as to what age these young people are begging to be treated with psycho-pharmecuticals.  For boys, the significant increase was found between ages 4 and 8 years, while for girls, this increase is seen in preteen years, mostly ages 9 – 12 years old.  The relationship between the age group by gender is more easily explained when the specific kind of medications are identified. 

For boys, the majority of this increase is almost exclusively due to medications used to treat Attention Deficit – Hyperactivity Disorder (ADHD) with two medications making up the majority of the increase in prescriptions for psychotropic medications for this group.  The two medications are the generic forms of Adderall (Amphetamine, Dextroamphetamine Mixed Salts) and methylphenidate drugs (such as generic forms of Concerta, Ritalin, Methylin, and Medate).  

Girls are half as likely to use those medications which is not surprising given that ADHD is twice as more frequent in male children than female children, the latter of which are more likely than males to present with inattentive features.  The increase in prescription psychotropic medications for girls is almost exclusively related to anti-depressant medications.  

Over these past 2 years there has also been an increase in Mental Health and/or Substance Abuse Treatment hospital admissions.  Although the rate of growth for these hospital admissions is equal amongst girls and boys, girls continue to significantly outnumber boys in these hospital admissions.  

With so much focus on “affordable health care,” analytics of such for the above issues are disproportionately low compared to other health related costs.  I would speculate that this focus on cost analytics of healthcare has been on more expensive forms of healthcare such as long term care including expensive surgical and diagnostic procedures as well as expensive treatment modalities that come with a long course of treatment, thus incurring huge expense.  

Hopefully the bigger picture will be considered sooner than later as untreated mental illness can lead to huge costs down the road.  More importantly, parents and families need to understand how new healthcare policies are going to impact both their children as well as their families.  

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