STDs and "GOOD" kids

Do these belong in the same sentence? STDs and GOOD kids?? Yes, they do, on many levels. People ask me why on earth I wrote a book about STDs. I wrote Seductive Delusions for multiple reasons, but what spurred me over and over again was every time I diagnosed a young patient (male or female) with a sexually transmitted disease and they gasped in shock and through tears and disbelief saying "there's no way that's possible- I haven't even HAD sex!" Whether they had participated in oral sex or simply had physical intimacy with direct skin contact but no intercourse, these young people THOUGHT they had "drawn the line" soon enough to avoid disease. Instead, they ended up with herpes or HPV (the wart virus) and I have to tell them that we have only treatments for outbreaks but no cure. Their moment of passion resulted in a lifelong disease.
As parents, physicians, and educators of all types, we have got to do a better job teaching our youth about the real risks of physical intimacy. STDs are not hidden in some dark corner of our society! Let's use language they understand, and put a familiar face on these diseases. Up to one in four young American adults have genital herpes, and over 20 million Americans have active HPV. In 2006 and again in 2007, we had over 1 million cases of Chlamydia (which is TOTALLY curable if found, but is silent nearly 75% of the time in women and 50% of the time in men! Untreated, it can lead to chronic pelvic pain and infertility.) Please read my ten tips for talking to teens about STDs for addition information (go to my home page on JillGrimesMD.com.)

BOTTOM LINE:Don't assume all youth practicing "abstinence" are free from the risk of sexually transmitted diseases. Let's give our intelligent but hormonally driven youth all the facts they need to keep their bodies safe!

Resolutions still going??

Happy Ground hog's Day! Don't know if we'll have more winter or not, but regardless, it's time to check in with your New Year's Resolutions. Are they working? If not, why not?
Let's take the healthier eating resolution first. We've finally cleared out the holiday candy, and now here we are in Girl Scout Cookie season and Chocolate Pig Out Day (aka Valentine's Day) is around the corner! Does this mean you shouldn't support the scouts? Of course not!! But consider buying ONE box for yourself, and a couple boxes for your favorite local charity or food pantry. If you're seriously counting calories, ask your sweetheart for a personal training session gift certificate (or even a manicure certificate) rather than that box of Godiva chocolates. Keep focusing on eating MORE fruits and veggies, and healthy eating will become part of your life instead of an onerous "resolution".
And what about exercise? Did you join a gym, but now you're not going? If you did, find a friend and commit to one another to go. Reward yourself when you DO go- but make it a non-edible reward! Buy a new workout outfit or treat yourself to a romance novel or humorous book- whatever works for you, but doesn't ADD calories. Keep track of your exercise in a VISIBLE place- your calendar (on the computer or in your kitchen- whatever one you rely upon will work) and reward yourself at the end of the month.
BOTTOM LINE: If your healthy resolutions are working- WAY TO GO and KEEP IT UP! If not, figure out why, modify them so they WILL work, and get back at it!

Lose 30 lbs in 30 days!

Okay, please tell me you know that the only way to lose 30 lbs in 30 days is via a gastric bypass operation! This post is certainly NOT to convince everyone to sign up for surgery, but to make it crystal clear that advertisements that suggest this type of weight loss are all ridiculous! Of course, we'd all like to believe that weight loss could occur that fast, but let's look at the reality. It takes a deficit of 3600 kcal (calories) to lose ONE pound. Period. There are no short cuts (excluding temporary water weight shifts.)
If you simplify the math by rounding down to 3500 kcal and dividing by 7 days in a week, it takes a deficit of 500 kcal/day to lose a pound per week. Now, if you're snacking on a bunch of candy (271 kcal in a snickers, for example) or drinking frequent sodas (roughly 150 kcal/can), it can be simple to eliminate 500 calories per day, but if you're already making healthy choices, focusing on a 250 calorie daily deficit (which equates to a half pound weight loss per week) might be more realistic. Before you decide that a half pound per week weight loss isn't "worth it", realize that in one year, you're looking at 25 pounds coming off!
Of course, coupling fewer calories consumed along with exercise (more calories burned) is really the way to go. Again, realize that small efforts "count". An easy rule of thumb is that walking a mile burns around 100 calories and takes only 15-20 minutes. So, if you simply give up one Coke (or latte, or...) and add walking one mile per day, you'll be looking at a healthier, thinner you in 2010 by up to 25 pounds!
BOTTOM LINE: It's calories in/calories out that count- to the tune of 3600 calories per pound. Set your goals realistically, and watch your health really improve this year!

Realistic resolutions!

Happy New Year! Welcome to 2009. Let me challenge you to make THIS the year that you finally prioritize your health...for the FULL year (and hopefully beyond.) Almost everyone makes the annual resolution to lose weight and start exercising, but how many people are still focusing on this by the time February rolls around?  

This year, why not set yourself up for success? Create accountability for yourself around the time your motivation might begin to wane. Schedule a physical with your physician- for late February, or maybe March. Book  a few personal training sessions, and consider spacing them out to once or twice a month if finances are tight. Sign up for a race- it can be a walking 5K or a full fledge triathlon- but the point is to focus on a specific goal. Conquer that goal, and set another one!

Try to commit to specific, concrete changes. "I want to lose a bunch of weight" is much less helpful than "I will eat a minimum of 5 servings of fruits and veggies per day". 

Involve friends. Chances are you have one or two close friends or neighbors who would be delighted to commit to walking around the block together. Walking and talking seems much less like required exercise, and more like a stress release.

BOTTOM LINE: Look at your life and pick one or two very specific lifestyle modifications that will make a difference long term, and consciously decide what accountability you need to make them stick. Here's to a healthy year!

Gifts that keep giving!

Happy Holidays! In this season of gift giving, we need to remember that there are gifts for the here and now, and other gifts that "keep giving" long after the holiday decorations come down. Despite being the author of Seductive Delusions- How Everyday People Catch STDs- in this case, I am not referring to the undesirable "gift" of an STD...

What am I talking about is a gift of HEALTH. How many of us have friends and family members who struggle with their weight, and we give them a gift of chocolate or other calorie laden treats? Or the friend who perhaps drinks too much, and we give them a bottle of wine or scotch? We justify these gifts because, well, it's what they really like! And hey, it's an easy choice.

Let me challenge you, however, to think a bit harder and if you really care about that person, give them a gift that will promote their health. Yes, it can still be something fun. (Forget the bag of celery with a bow on top.) No, it does not need to be a $3000 elliptical machine or treadmill (although if you happen to be wealthy, knock yourself out!) 

How about a pedometer? A new workout top or shorts? Fun workout socks? A person training session? A healthy cookbook? (My all time favorite is Cooking Light's 5-Star Recipes- available on amazon) A gift certificate for a massage or manicure? How about a lesson- ballroom dance, kayak, or martial arts?

No money? Make a gift certificate to be a walking buddy every Tuesday morning (or whatever).

Bottom Line: This season, show you really care by encouraging your loved ones in the universal quest for health, and not undermine their efforts with "easy" gifts that aggravate existing health problems. 

'Tis the season...

'Tis the season for many things-goodwill, peace, holiday parties, and...coughs and colds. What can you to prevent getting sick during this hectic time of year? As should come as no surprise, the best defense you can have against germs is a combination of staying healthy (see how it always comes back to good nutrition, exercise, and sleep!) and washing your hands. Use those wipes that many grocery stores  now provide and wipe down the handle before you place your hands on that shopping cart. Cough and cold viruses are easily passed from one person covering their mouth to cough or rubbing their eyes and then putting their hands on a door knob, stair rail, or yes, shopping cart-allowing the next person to touch that same object and then touch their own face/mouth and pass the virus. Washing your hands frequently and being aware of NOT touching your eyes, nose or mouth will help reduce your chance of catching these common germs.

 What about extra vitamin C and zinc? Well, best evidence medicine has indeed shown that extra vitamin C will reduce symptoms and possibly shorten the course of the common cold. Zinc lozenges have been proven to decrease susceptibility to these germs, but do not shorten the course of illness once you are infected.

If you do get sick, remember the things your mom taught you. Stay well-hydrated (which keeps the mucus flowing, rather than being dried up and sticky), take tylenol or ibuprofen for fever and aches and pains, and remember feel-good home remedies like old fashioned vaporub (menthol topical decongestant) or the newer versions where you place a menthol-releasing tablet in your shower. 

If your nasal mucus turns green, does that mean you need antibiotics? No, typically not! Viruses can turn snot green as easily as a bacterial sinus infection. See your doctor if your symptoms are worsening or persisting beyond several days, or you have localizing symptoms (such as one sided ear pain or teeth pain) which may indicate an ear or sinus infection that could possibly require antibiotics. 

What about OTC antihistamines and decongestants? Adults may find the benefits outweigh the side effects, so SHORT term use of a topical nasal spray or oral decongestant may relieve stuffiness, and antihistamines are helpful if you have copious runny nose or itchy eyes.

BOTTOM LINE: Emphasize prevention to avoid colds- good nutrition, frequent hand-washing, perhaps some extra Vitamin C and Zinc, and of course, the flu vaccine.  If you get sick anyway, remember green nasal discharge does NOT equal need for antibiotics!

And she's...SAFE!

There has been quite a bit of media attention surrounding Gardasil, the vaccine for the prevention of cervical cancer- does it cause blood clots? miscarriage? shock? death? Well, the 2 year safety study of Gardasil is out, and the verdict is...Gardasil is safe.  Four independent reports on the vaccine's demonstrate safety and specifically the reports show no link between the Gardasil vaccine and potential problems such as blood clots, allergic reactions, strokes, seizures, and Guillain-Barre syndrome. 

What good does this vaccine do? Gardasil provides immunization against the two HPV (human papilloma virus) strains that cause 70% of cervical cancers, and the two strains of HPV that cause 90% of genital warts. Is that a big deal? Ask the families of the nearly 4000 American women who died of cervical cancer last year, or the 11,000 who were diagnosed with invasive cervical cancer. Ask any of the one million  Americans  each year who have to suffer the physical and emotional pain of being treated for genital warts- they'll tell you this is a great vaccine.

Why do some people fear the Gardasil vaccine will promote promiscuity? Did they complain when their child received the hepatitis B vaccine on day two of life? News flash- hepatitis is also transmitted via sex (or IV drug use, but I don't think vaccines promote drug use either.)

BOTTOM LINE: I believe Gardasil can virtually eliminate cervical cancer for our daughters' generation, and greatly reduce the trauma and drama of genital warts. Its safety is well documented, and yes, I will give it to my own daughters.