Examine Your Birthday Suit Yearly, Doc Says

A few blistering, lobster-red sunburns as a kid. Fair skin, light eyes, sprinkled with a hearty helping of freckles. A family history of melanoma.

When it comes to protecting your skin from cancer, you can’t be too safe. Each year there are more new cases of skin cancer than breast, prostate, lung and colon cancers combined, according to the American Center Society, with an estimated 76,690 new annual cases of invasive melanoma—a skin cancer related to UV exposure—diagnosed in the U.S. alone.

Luckily, skin cancer is almost always curable if caught early. But how can you discern between a normal, healthy mole and one that’s cause for concern? In the clip below (we’re re-sharing a favorite one from a couple years back, so please ignore the incorrect screening date at the end), you can hear URMC dermatologist Dr. Marc Brown discuss skin cancer, the importance of practicing “safe sun,” and some tips to help you identify suspicious moles (while wearing your birthday suit!) at home.

 

Free Skin Screenings May 11

What’s more, if you’re in Rochester, you can be proactive about your skin health this weekend by stopping by Strong Memorial Hospital’s Free Skin Cancer Screening Clinic between 8 a.m. and noon this Saturday, May 11. No registration is required; take the Silver Elevators to the 2^nd floor to find the Dermatology Suite. Each screening takes about five to ten minutes and offers a written report of findings. Information on skin cancer, including prevention tips, will be available.

“Sun damage is cumulative, so it includes exposures that can seem just a part of our daily lives such as walking the dog, mowing the lawn or a trip to the store,” Dr. Brown said. “Making a skin cancer screening part of your annual routine will not only make sure that you are identifying a current issue, but it’s a terrific way to uncover potential risk factors for the future.”

For more information about the free detection clinic, contact the Dermatology Department at (585) 275-3871.

Dr. Brown also recommends the following ways to protect your skin:

• Slather on sunscreen. The sun can damage your skin in as little as 15 minutes. Apply sunscreen, with SPF 30 or greater and both UVA and UVB protection, 15 to 20 minutes before you head outdoors. Don’t forget areas such as the back of your neck, top of your ears arms and legs, and scalp if you’ve lost some hair. Reapply every two hours—or sooner after swimming or actively sweating.
• Wear a hat and loose-fitting clothing.  A hat with a four-inch brim will shade more than 95 percent of the face, head, ears and neck. Wear light-weight clothes that cover your arms and legs.
• Avoid the most intense sunlight. Schedule outside activities for the early morning or late afternoon to keep out of the most intense sunlight between 10 a.m. and 3 p.m.
• Don’t tan indoors. Heading on vacation? Getting prepped for swimsuit season? Let’s bust  a relentless myth: Getting a base tan from a tanning bed or booth will NOT give protection from sun damage. In fact, it’s been linked to skin cancers.

This annual skin screening event is sponsored by the American Academy of Dermatology, Rochester Dermatologic Society, and URMC’s Department of Dermatology.

Dr. Brown specializes in the diagnosis, treatment and prevention of skin cancers. In addition to performing Mohs surgery on more than 1,200 patients a year, he also runs a multidisciplinary melanoma group practice.

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Would You Still Have a Voice If You Were Silenced? The Role of Health Care Proxies

From when the alarm blasts us awake until we drift off to sleep at night, the days are chock-full of choices—not only snap judgments, but those that require deeper thought. With the hundreds of decisions we face daily, who needs to sort through yet another one?

You do if you haven’t begun to consider how you’d like your medical care to proceed, in the event that you become ill or injured and are unable to then make or express your wishes.

For expert advice that might just save your loved ones a lot of heartache, we consulted Dr. Richard A. Demme, URMC associate professor of Medicine and Humanities.

Scripts: There seem to be several things people refer to when they talk about end-of-life planning—advance directives, living wills, and health proxies, to name a few. Can you provide a big-picture view here?

Demme: It certainly can feel a little confusing, which might contribute to the off-putting nature of this important subject. My own need to know more about end-of-life planning was sparked in my first week as an attending nephrologist, when a patient asked me for a lethal injection. That was over 20 years ago—I’ve been picking this stuff apart since. But thinking about this serious, somewhat tricky topic is essential.

The things you mention all fall under the same end-of-life planning umbrella. Advance directives, generally speaking, are instructions specifying how a person wants her health care to proceed should she become incapacitated and unable to communicate her wishes. A living will is an older type of directive outlining treatment instructions. For example, in an advance directive, you can choose to withhold certain life-support therapies, or ask for a trial period of treatment.

A health care proxy is a person who is supposed to interpret your wishes about health care decisions. The form appointing this person is also called a health care proxy. Proxies are broadly empowered in New York State, which means there’s more flexibility when doctors communicate with them than when referring to a printed document, which can’t talk back and clarify.

Scripts: So is end-of-life planning really for everyone? Kids, the young, the healthy?

Demme: If you’re over 18, you can and should name a health care proxy. There have been historical court cases—long, ugly battles—about which medical treatments should be continued for people in persistent vegetative states. Do you think a court would make a better decision for you than your own chosen proxy? Of course not. Your proxy, someone you trust to make decisions on your behalf, could ask to continue or stop treatments.

There are no fees or lawyers in appointing a proxy. Remember to choose wisely—not someone who’s consistently unavailable, or someone who just can’t live without you. Surprisingly, about 30 percent of people might not choose their spouse/partner to make their health care decisions. You need to count on your proxy to be able to know when to continue aggressive treatment, but also when to say Enough, now let’s concentrate on patient comfort. The hardest part about picking is figuring out who will make decisions according to your wishes, even if they personally would rather make a different choice.

Scripts: Some of the legal documentation asks that end-of-life decisions be put into words. How can we keep language broad enough to prevent potential confusion? We’ve heard that you don’t want to have been so specific with your wishes that you inadvertently complicate situations you couldn’t have anticipated. Are there good online resources you can point us to?

Demme: Try to avoid such popular boilerplate language as “extraordinary measures,” and “natural death.” Don’t say, “Do everything.” Due to the absence of agreed-upon medical definitions for these terms, sometimes we doctors are left with question marks hanging over our heads. Instead of unhelpful buzzwords, find precise language to help you articulate your message. You can write things like “If I am no longer able to recognize my family, and am not likely to recover, I would want treatments stopped.” Or, “I would prefer to try to eat by mouth, even if there is a risk of aspiration pneumonia.” But, it’s difficult to forecast all of the medical situations you might encounter, so it is more useful for physicians to know who you want us talking to when you can no longer tell us your wishes.

One excellent resource is this easy-to-use website (developed by a team of URMC medical students!) that fleshes out these topics a bit more fully and allows you to generate online, using their forms, some of the documentation we’re talking about now.

Scripts: So in summary, what’s the single action you’d recommend that readers take today?

Demme: You could probably guess, but here goes: Please consider appointing a health proxy—and don’t forget to communicate your health care wishes to him. Do it now.

Dr. Richard A. Demme has been a board certified nephrologist for over 20 years. He is a Fellow in the American College of Physicians. He chairs the URMC Ethics Committee, and is the co-director of the Division of Medical Humanities and Bioethics. His interests include ethical issues in transplantation, end-of-life care, medical decision making and informed consent, and the history of medicine.

Spring Blossoms Spell Sneezing, Itching for Allergy Sufferers

With the Asthma and Allergy Foundation of America’s (AAFA) recent release of its 2013 Spring Allergy Capital list, Rochester won 37^th place on the list of  “the 100 most challenging places to live with allergies” during the spring and fall seasons. The report takes into consideration pollen counts, the use of allergy medications (both over-the-counter and prescription), and number of board-certified allergists per patient.

With the warmer spring weather soon upon us—signaling plants to start budding and trees to pollinate—we can expect hay fever (or seasonal allergic rhinitis ) to be right on its heels. What’s an allergy sufferer to do? To learn more about managing runny noses, congestion, sneezing, itchy and watery eyes, we spoke to allergist Dr. Carolina Marcus.

Scripts: Is there any way to avoid exposure to pollen this spring?

Marcus: Indeed, there are several smart, simple things you can do.

First, when it’s hot out, use an air conditioner as opposed to cracking windows or propping open doors. You really want to keep them shut as much as possible, to limit the amount of pollen entering your home and car. You can also plan to avoid outdoor activities or exercise early in the day, instead engaging in these activities in the afternoon or evening, since tree pollen is heaviest in the morning and tends to dissipate as the day goes on. You might also consider taking a shower and wash your hair—even if it’s just with water— before bedtime. This helps rid your hair and scalp of accumulated pollen that could otherwise end up on your pillow, where you can inhale it. By that same token, wash your clothing frequently, and don’t go to bed in the same clothes you wore during the day.

Scripts: That’s all great, practical advice. But what about medications—can you highlight some options?

Marcus: Over-the-counter antihistamines can be very helpful. Loratadine, cetirizine and fexofenadine are long-acting antihistamines that can help alleviate itchy eyes and a runny nose. But for nasal congestion, the single most effective treatment is a nasal glucocorticoid spray, which you secure by prescription. You should ask your doctor if you think you might benefit from this kind of medication.

Scripts: And how can I pinpoint the exact cause/s of my troubles?

Marcus: You have to engage a specialist. Consultation with an allergist can help you identify specific triggers and manage your symptoms and/or asthma. In some cases, allergy shots might be the best therapeutic option. Talk to your primary care doctor if you think you might benefit from working with an allergy specialist. It’s really important that you communicate your symptoms and concerns to all of your caregivers, regularly, so that they can best care for you as a team.

Here’s to a happy and healthy allergy season!

Carolina Z. Marcus, M.D., is an assistant professor of Immunology at the University of Rochester Medical Center. Her clinical interests focus on the education of her patients and their families, as well as the community at large, on asthma, atopic dermatitis and allergies. Dr. Marcus has a particular interest in food allergy awareness and education.

Want an appointment? Dr. Marcus sees patients at URMC’s Allergy and Immunology Clinic, 400 Red Creek Drive, Rochester, NY 14623. Learn more by calling (585) 486-0147.

Life Beyond Stroke: Inspiration from a Three-time Survivor

According to the Centers for Disease Control, the Rochester region has one of the highest stroke rates in New York, affecting 14 people per 1,000. No doubt, strokes can be devastating—but there’s hope on the other side.

To prove it, we’re changing things up this week and showing off this quick video clip from Christina Goodermote, a local mother and three-time stroke survivor whose perseverance has allowed her to work, maintain her busy household, and be courageous enough to take karate and surfing lessons.

Grab a cup of coffee, take a moment, and be inspired.

Stroke: A Crash Course

Stroke occurs when blood flow to the brain is disrupted by either a blood clot or when a blood vessel in the brain bursts, spilling blood into surrounding tissues. Failure to recognize the symptoms often results in a delay in getting emergency care, which can reduce a person’s chances of survival and diminish quality of life.

You can remember the signs of a stroke with a simple acronym, FAST:

·         Face – Ask the person to smile. Does one side of the face droop?

·         Arm –  Ask the person to raise both arms. Does one arm drift downward?

·         Speech  – Ask the person to repeat a simple phrase. Is their speech slurred or strange?

·         Time – Seconds starved of oxygen cost you brain cells. If you observe any of these signs, call 911 immediately.

Anyone can have a stroke no matter their age, race or gender. And the chances increase if you have the following risk factors: high blood pressure, high cholesterol, diabetes, atrial fibrillation (abnormal heart rhythm), atherosclerosis (hardening of the arteries), alcohol use, smoking and tobacco use, obesity, family history, circulation disorders, age, and a history of strokes.

The good news is that as many as 80 percent of strokes can be prevented, and the best way to protect yourself and loved ones is to understand personal risk and how to manage it.

URMC’s Stroke Treatment Alliance

The Stroke Treatment Alliance of Rochester, or STAR, is a collaborative effort by University of Rochester Medical Center’s Strong and Highland hospitals, Unity Hospital and Rochester General Hospital to improve and unify stroke care and raise awareness of the warning signs for this potentially devastating health emergency.

To learn more about the Stroke Treatment Association of Rochester, click here.

Simple Prevention Steps Keep Athletes in Game, Off Bench

When it comes to sports, there’s big pressure on players—even ones who’ve barely just learned to tie their laces—to be bold, play hard, and make bleacher fans proud.

But at what cost? How hard is training too hard? How can you tell when you’re crossing the line, setting yourself up for short- and long-term—maybe even lifelong—pain? Whether you coach a little league team or are gearing up to tackle your first 5K, read on. We’ve talked with sports medicine expert Dr. Mike Maloney on the basics of avoiding athletic injuries, no matter what your sport.

Scripts: When it comes to injury prevention, are there fundamentals that every athlete should perform religiously before training/competing?

Maloney: Recommendations vary dramatically by sport, so I want to point you to really terrific resource—the “Stop Sports Injuries” website, sponsored by the American Orthopaedic Society for Sports Medicine. It’s a goldmine for coaches, trainers and athletes alike, serving up guidelines tailored to your team’s type of play, the unique pitfalls you might meet, and suggested steps you might take to avoid them.

More broadly, though, are basics we all can stick to. Like a proper warm-up and gentle stretching to loosen muscles and get blood flowing. You should also be intentional about taking time to rest—perhaps exercising alternate muscle groups each day, giving your body adequate chance to rebuild and recover.

Investing in the right, properly fitted protective gear—such as pads (neck, shoulder, elbow, etc.), helmets, mouthpieces, face guards, protective cups, eyewear—is important too. So is a supportive shoe, built for the stress inherent in your type of exercise. And of course, you can actively head off heat injury by drinking plenty of fluids before, during and after practice or play, wearing light, breathable clothing, and avoiding outdoor practice during periods of high heat or humidity.

Scripts: How do you know when you’re working too hard?

Maloney: Pain. It’s the body’s built-in alarm system, letting us know to stop and slow down.

Unfortunately, all too often young athletes fear that speaking up about troublesome symptoms might cost them their prized place on the team. There’s heavy social and psychological pressure to “be tough,” hide their injuries, and play through the pain. But that only ultimately makes things worse, and in extreme cases, can damage joints for a lifetime. I’d urge any athlete to keep the big picture—not just the next game—in mind, letting the right coach or trainer know if they’re uncomfortable, are hurting, or sense that their range of mobility is restricted. It takes courage, but it’s essential to voice these concerns.

Scripts: Are there some key injuries that spell death to a sports career?

Again, it depends on the sport. But some of the most devastating injuries we see are torn ACLs (anterior cruciate ligaments), a type of knee injury that can spell trouble (and the bench) for many young athletes—even leading to long-term disability from osteoarthritis (a painful joint condition). More than 50,000 debilitating ACL injuries occur annually in female athletes at the high school and college level. It can take between six to 12 months to return to a sport after ACL reconstruction; some sufferers may experience continuing knee symptoms that limit their participation.

Overuse injuries (in the form of stress fractures, shin splints, and tendonitis ) can develop when athletes boost the frequency, duration, intensity, or resistance of training too quickly—putting undue stress on a particular part of the body. Again, rest is really important. But sometime even that’s not enough; in more serious cases, treatment and medical intervention might be necessary.

Finally, concussions concern us. Research continues to evolve, most recently implicating repeated blows to the head with long-term brain trauma, and even dementia in later life.  We can’t exaggerate the importance of protective helmets and gear.

Scripts: So, what’s the bottom line?

Maloney: I think the overarching message is to train smart, sticking with a conditioning program that emphasizes fitness, strength, flexibility and endurance. Remember, we have one body to age with. It’s so important that we respect it, listen to it. The power of proper nutrition, rest, and prudent training cannot be overstated.

Want To Learn More about Injury Prevention—From a Local Olympian?

On Saturday, March 23, Olympic pole vaulter Jenn Suhr, who brought home the gold medal from the Summer 2012 games in London, will be the featured speaker at a free URMC Orthopaedics and Rehabilitation seminar. A graduate of Roberts Wesleyan College who makes her home in Churchville, Suhr will sign autographs and  share her Olympic experiences—and discuss the steps she takes personally to prevent injuries.

Dr. Michael D. Maloney, chief of URMC Sports Medicine and professor in the Department of Orthopaedics and Rehabilitation, will kick off the activities at 1 p.m. with a discussion about injury prevention and the proper steps that all athletes, whether middle and high school students or adults, should take to avoid injuries. Maloney’s medical practice is broad, including reconstructive surgery of the knee, shoulder, and elbow, and arthroscopy of the knee, shoulder, and elbow for patients of all ages in the Rochester region and beyond. He serves at team physician for the Rochester Red Wings, along with area college sports teams.

For more information on the free community event or to RSVP, please call (585) 275-8762 or e-mail ortho-info@urmc.rochester.edu.

More about URMC Sports Medicine

URMC Sports Medicine, the only medical practice in the nine-county region dedicated solely to sports medicine, offers the latest in medical and surgical care to prevent, evaluate, treat, and rehabilitate injuries for both recreational and competitive athletes of all ages. Its physicians are fellowship-trained sports medicine primary care physicians and orthopaedic surgeons who work together with physical therapists and athletic trainers to give complete medical care. For an appointment, call 585-275-5321.

This St. Patty’s Day: Hoist a Pint for Your Health?

We’re not suggesting that you overdo it this St. Patrick’s Day—but if you do enjoy a drink with your corned beef and cabbage, we want to share some heartening news: Moderate alcohol consumption might actually be good for your health.

We spoke to URMC investigator Dr. John Cullen, whose research found that moderate drinking decreased atherosclerosis, or hardening of the arteries, in mice. This narrowing and stiffening of blood vessels is a serious condition that can pave the path to a heart attack or stroke. With St. Patrick’s Day nearing, we thought it was timely to present facts on the link between alcohol and heart health. We met with Dr. Cullen to learn more.

Scripts: Your research is good news for folks who enjoy drinking.

Cullen: It is, but we must be clear. In our study, we found that moderate, daily alcohol consumption was cardioprotective. By moderate, we mean two drinks per day for a total of 14 per week. How you pace yourself clearly matters, because we also found that binge drinking—say, those same 14 drinks per week, only over a two-day period—actually increased the development of the disease.

Scripts: Can you explain what you mean by “cardioprotective?”

Cullen: We observed three groups of mice that were all put on diets mimicking high-fat Western fare, to encourage the development of fatty deposits – also known as plaque – in the arteries. In the daily, moderate-drinking mice, LDL (or bad cholesterol) plummeted 40 percent. Surprisingly, levels of HDL (or good cholesterol) went up in both the moderate and binge-drinking groups. The volume of plaque also decreased in the moderate-drinking mice, compared to the no-alcohol mice group.

Scripts: So naturally, we wonder: What might we drink, and how often? There’s a lot of information in the news about the health benefits of red wine. Is that better than a martini?

Cullen: The resveratrol ingredient in red wine is a polyphenol, with antioxidant properties that are inherently good for you; there are published studies showing the cardioprotective effects of resveratrol.  However, our recent study results are based on the ethanol (the alcohol itself) present in these drinks. That’s the substance we found (again, in the right amounts) protects arteries. So if you want to help your heart, Irish whiskey works just as well as wine. Just keep it in moderation.

The National Institute on Alcohol Abuse and Alcoholism has a great program called Rethinking Drinking, which explains low- and high-risk drinking, and suggests appropriate amounts to consume. Based on their data they recommend no more than four drinks in any one day and for a total of no more than 14 drinks per week for men. Recommendations for non-pregnant women are no more than three drinks per day and seven drinks per week.

Dr. John Patrick Cullen received a Ph.D. in Cardiovascular Pharmacology from the Queen’s University of Belfast, Ireland. He is currently a Research Associate Professor in the Department of Surgery’s Basic and Translational Research Division. His research interests, among other things, include the effects of alcohol consumption patterns on the development of atherosclerosis.

Dirty Work: Finding a Balance Between Cleanliness, Germs

A few months back, we came across a story carried by the NBC news website suggesting that exposure to dirt and germs might actually confer some possible positive health effects. That article referenced research published this fall in the Journal of Allergy and Clinical Immunology that found that Amish children who were raised on farms were less likely to develop allergies and asthma than their peers.

Before tossing aside our sponges with glee, we reached out to Ann Marie Pettis, director of Infection Prevention at Strong Memorial and Highland Hospitals, for more insight.

Scripts: We all know that keeping a clean house is important to our health. But how much is too much? Can you be too clean?

Pettis: I’ve certainly heard this message before, and it seems to make sense. The most important thing to remember on this topic is that striking a balance is key. Balance your cleaning and your aesthetics—no one wants to live in a dirty home—with your health. Exposure to the germs that we consider “good guys” makes sense, however there are germs you’ll never want exposure to, such as hepatitis, salmonella, HIV, etc. Don’t go overboard, like Lady MacBeth trying to “wash her evil deeds away,” but rather make good hygiene a priority. A baby is born with their mother’s immunity, which gradually wanes, as their own immunity develops. Recent studies seem to show that if babies are not exposed to those “good” germs (again, the kinds that don’t typically cause serious disease) he or she may be at a disadvantage. One is reminded of the old adage “You have to eat a peck of dirt before you die,” and perhaps there might be a grain of truth to that.

Scripts: Can you offer us some helpful guidelines as we go about our cleaning routines? Are there certain parts of the home that deserve more attention than others?

Pettis: Take a guess as to which room in our homes is the dirtiest. Many are surprised to find out that the kitchen, not the bathroom, takes the cake (or would it be the mud pie?) here. The number one offenders are dishrags and sponges. We encourage either the use of disposable dishrags, or to microwave sponges daily for two minutes, or soak them in bleach to kill the germs.

The sink is another culprit. Primarily, we’re concerned with germs that cause foodborne illnesses. The towels you use to dry your dishes can also get contaminated, so be sure to switch those out periodically. Be sure to use plastic cutting boards, not the pretty wooden ones (sorry!), and dishwash or bleach them when KP duty rolls around.

From there, it’s time to think about your faucets, toothbrush holders, and pet bowls and toys. A special note: if someone in your house is immunocompromised (sick), you need to keep both the bad and the good germs at bay. Make sure to wash their clothes in hot water, or, if you do use cold water, that you include some bleach if possible or then pitch them into the dryer on the hot cycle.

Scripts: On a related note, it seems pocket-sized hand sanitizers are all the rage. We know it’s important that health care workers are vigilant about clean hands, but is it possible for the average person to be overzealous in using these sorts of products? How often is reasonable, for application?

Pettis: Hands down, hand hygiene matters. Alcohol-based hand sanitizer is wonderful, but remember that if you overdo it, you could possibly break down your skin, which is your body’s best barrier against germs. When this starts to happen, you’ll see chapping and cracking. That’s a sure sign to slow down with it, or the germs will have an easier time getting past our defenses to make us sick.

Ann Marie Pettis directs Infection Prevention at both the University of Rochester Medical Center (Strong Memorial Hospital and Golisano Children’s Hospital) and affiliate Highland Hospital. An infection preventionist with more than 30 years experience, she’s published articles in peer-reviewed journals and trade publications, and lectures locally, nationally, and internationally. Leadership roles include serving as past president of Western New York Infection Control Organization and the Association for Professionals in Infection Control and Epidemiology (APIC) Finger Lakes Chapter. She recently completed her term as chair of the APIC Communications Committee.

A couple years back, she spoke to Scripts with some smart advice on whether or not handshakes should be taboo during cold and flu season. You can see that “Let’s (Not) Shake on It” video post here.

Folic Acid Part of Fight Against Autism?

New research out of Norway suggests that taking vitamin supplements containing folic acid before conception is linked with a reduced risk – perhaps by as much as 40 percent – of having a child who develops autism.

Folic acid is found naturally in foods like dried beans, peas, nuts and leafy greens, and celebrated for its work helping the body manufacture healthy new cells. It’s also regarded as highly important for soon-to-be-pregnant women, thanks to its power preventing major birth defects related to babies’ brains and spines (like spina bifada, where the two sides of an embryo’s spine fail to join, leaving an incomplete or exposed cord).

Eager to know more, NPR tapped URMC autism expert Dr. Susan Hyman for her take on the new research that included more than 85,000 women. We’re deviating from our traditional Q&A approach and instead pointing you directly to the full NPR report (you can also read a transcript), here.

Susan. L. Hyman, M.D., has three decades of experience treating and researching autism spectrum disorders and is the chair of the American Academy of Pediatrics committee on autism, often acting as a spokesperson for the organization. Hyman’s recent research has focused on the diet and nutrition of children with autism and on the most effective behavioral treatments for the developmental disorder.

URMC’s Division of Neurodevelopmental and Behavioral Pediatrics – in collaboration with the Strong Center for Developmental Disabilities – houses one of the largest Autism Spectrum treatment and research programs in New York State. In addition to diagnostic assessment and clinical treatment, school and community education and consultation, the Division also provides Information and Referral Services and web-based resources, all designed to aid people affected by Autism and those who care for them.

For more information about autism treatment, research and assessment at URMC, click here.

A Heart-to-Heart on Cardiac Health

February is overrun with the hearts and flowers fanfare of Valentine’s Day. But long after bouquets have wilted and chocolate boxes have been picked over, our hearts should continue a steady beat.

The statistics about heart disease are staggering – it causes more deaths each year than all forms of cancer combined, even though it’s preventable for some people.  Doctors use American Heart Month to remind us to be good to our hearts, so we’ve asked cardiologist Dr. Jeffrey Alexis for some tips.

Scripts:  What’s the best ways we can help prevent problems with our heart?

Alexis:  We can all work to keep our hearts healthy by avoiding tobacco, eating right and getting more exercise.  Smoking damages so many parts of our body; if you’re addicted to tobacco, do whatever it takes to quit.  Miraculously, your body can reverse the damage caused by smoking.   Check out New York State Smokers Quitline for tips and access to resources.

Obesity also contributes to a variety of diseases that can hinder heart functioning. Stay trim, eat a nutritious, plant-based diet – with low-salt and low-calorie foods. Don’t drink too much alcohol.  Make sure you get enough exercise – 30 to 60 minutes per day. This protects against heart disease by:

• helping the heart work more efficiently;
• reducing blood pressure;
• decreasing the tendency of blood to form life-threatening clots;
• moderating stress;
• helping your body use insulin; and,
• helping you maintain a healthy weight.

Scripts:  How do we know if cardiovascular problems are beginning? Are there warning signs?

Alexis:  Pay attention to your blood pressure and cholesterol levels; it’s really important that you know these numbers. 

Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more-frequent checks if your numbers aren’t ideal, or if you have other risk factors for heart disease. Optimal blood pressure is less than 120/80 millimeters of mercury. There are many inexpensive medications that doctors prescribe to help manage blood pressure or hypertension, and stave off heart disease, if your numbers are high.

Adults should have their cholesterol measured every five years. You may need more frequent testing if your levels are off, or if you have other risk factors for heart disease.  Doctors sometimes even check children’s cholesterol levels if there’s a strong family history of heart disease.  An ounce of prevention goes a long way.

Dr. Jeffrey Alexis is a member of the URMC Program in Heart Failure and Transplantation team, which cares for people with advanced heart disease. 

For more information about heart care, visit URMC’s Heart and Vascular Center or call 275-2877.

Channel Surfers: In Study, TV Time Linked with Lower Sperm Counts

Blustery winter nights, paired with hectic workdays, make a compelling case for sacking out on the couch. But new research cautions that too much TV – and too little exercise – could spell trouble for your fertility.

Known as The Rochester Young Men’s Study, the research draws on semen samples collected by a team from our own University of Rochester Center for Reproductive Epidemiology (based out of URMC’s OB/GYN Department). Young men from all over our city submitted samples and questionnaires probing their level of physical activity, diet, stress, and other lifestyle factors. (Our Rochester team then collaborated with colleagues at Harvard, who ultimately published the findings that are now making headlines nationally.)

To put the insights into perspective, we spoke with Dr. Emily Barrett, a reproductive epidemiologist who works in the research group that conducted the study.

Scripts: Rumor has it sperm counts have been in free-fall for decades. Can you tell us why this might be?

Barrett: There’s actually some controversy as to whether sperm counts truly are declining across the globe. But, if they are, it’s likely linked to a number of underlying factors, not any one particular thing.  It could be that environmental chemicals play a role; we’re starting to realize that diet and lifestyle choices might be important, too.

Scripts: That’s a big theme, apparently, in this study. The results suggest that two modifiable factors – exercise and TV watching – could be tied to sperm count. But the paper throws around some downright impressive stats – for instance, the big-exercisers enjoyed “a 73 percent boost in sperm count.”

Barrett: To put that in context, the average man has 15 to 20 million sperm per milliliter. That’s what’s considered normal. Go lower than that, and successful conception is less likely.

While we don’t know the mechanism behind the relationship found in the study, there are several hypotheses as to why sperm counts might be higher or lower, given these variables. The study authors speculate that increased antioxidant production, which is often linked with exercise, might actually be protective against the routine stress and cell damage that ultimately hinders sperm production. Yet another hypothesis is that the physical act of being scrunched up while sitting on the couch could lead to a higher scrotal temperature – and, consequently, less sperm. But it’s also entirely possible that exercise and TV watching are red herrings, and sperm production is actually associated with other underlying behaviors or factors that the researchers didn’t measure.

Scripts: Good point. What should men take away from this research?

Barrett: We have to be careful not to read too much into these results (this is the first study of its kind). Even so, this is yet another reason for men to get off the couch and exercise.

We know of several other lifestyle factors that are likely to affect sperm quality or quantity. Smoking, being overweight, and prolonged bicycling all may lower sperm counts. Many health conditions can also affect production, so staying in good general health will help to protect men’s fertility as well. It’s really important for men to realize that their lifestyle choices not only affect their general health, but also their fertility.

Emily Barrett, Ph.D., is an assistant professor in the Department of Obstetrics and Gynecology at URMC.

Last fall, we interviewed her for another blog post exploring a potential link between BPA and obesity in kids.