A WORM'S EYE VIEW

MARCH-APRIL 2012

Welcome to the Doc Grubb newsletter for March-April 2012.

     The weather has started to change from Winter to Spring and we’re beginning to have warmer days with not as cold nights. In many parts of the country it seems we’ve skipped winter altogether!  But then again, we’re having huge snow storms in the Midwest in early March. We’ve got something fun to talk about in this newsletter, especially the Iditarod Race in Alaska!

     There are also some serious things to talk about, especially Autism and aging. Autism is being diagnosed more and more in children, getting a lot of attention from concerned parents and the medical establishment.

     The last thing I’m going to talk about is the “well-elderly.” I’m turning 65 this year and will have to sign up for Medicare. Historically everyone thinks that the common retirement age is 65 years, but here I am, retired once from the military, working a full-time job for the Government AND working 12 hours a week in an outpatient psychiatry clinic.

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KID’S CORNER

The Iditarod Race

            The word Iditarod comes from an Indian word that means "a distant place."

     Did you ever see the cartoon movie “Balto?” The movie commemorates the "Great Race of Mercy," a race of dog sleds running against time that saved lives threatened Diptheria, a deadly disease. In February 1925, a diphtheria epidemic threatened the lives of many children in the isolated city of Nome, Alaska. The native Inuit children were especially at risk to diphtheria because had no immunity against it as they had no previous contact with diphtheria. The only way available to save the children was to transport the medicine by dog sled almost 700 miles across the frozen land to Nome. Twenty teams of mushers and over 100 dogs delivered the medicine to Nome in about 5 1/2 days. The lead dog of the final team of dogs was Balto and the lead dog of the team that braved the toughest and longest part of the journey was called Togo.

     Just like the movie, the Iditarod, the "Last Great Race," is a dog sled race that takes place every March in Alaska to commemorate the incredible physical feat done by the dogs and their drivers, who are called “mushers.” The race is over 1150 miles long and goes from Anchorage to Nome and takes about 10 days to complete.  The trail leads them across frozen rivers, barren tundra, and steep mountains. Dogs are especially trained for pulling the sled over snow and ice. Alaskan malamutes and Siberian huskies are two types of sled dogs that are often used on mushing teams. The race is incredibly physically demanding on both the human drivers and dogs. Can you imagine trying to keep a team of strong, husky dogs working together for days running over snow and ice? There are incredibly strong and healthy women and men mushers who face the same extreme physical demands as their dogs.

     Because it covers over 1,000 miles, the Iditarod is a grueling race, even for veteran sled dogs. To combat fatigue, the dogs rotate positions on the train as the race progresses, from the lead to the middle to the back of the pack. Each position has its own physical and mental demands for the dogs. For example, the lead dog’s job is more mental than physical. The lead dog has to watch the trail and listen to the musher for directions. The dogs in the middle can go on autopilot but their view never changes. The two dogs directly in front of the sled have the hardest job because they physically do most of the pulling

     Weight is a significant handicap in the Iditarod because every ounce of weight makes it harder for the dogs to pull the sled (like me walking up steps). Iditarod mushers don’t want to be too heavy but also do not want to be skinny because need stored body fats to use for long-term energy. But what really separates Iditarod winners from losers is the ability to function well over the course of a week or more with little or no sleep. Cardiovascular fitness, that is heart and lung capacity, which can be built up with long distance running, helps people deal better with the stress of sleeplessness. Naturally warm hands and feet, grip strength which is important for hanging onto and moving the sled and flexibility to move with the sled are very important physical attributes that help to be successful in dog racing. The issue of body fat would seem to favor women, who naturally accumulate more body fat than men no matter how hard they train, and older people, who find it much easier to accumulate body fat than young people. If the physical demands don't wear the mushers out, the mental stresses certainly will. It takes intensity and focus to win the Iditarod, and intensity, instead of the physical demands, might be the hardest thing for an Iditarod athlete to maintain and overcome.

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MOM’S CORNER                          

What is Autism?

     Whenever I turn on television or listen to the radio I hear about autism and how common it is. I have seen multiple cases of autism in my private practice and ti can have huge impact on families. Autism is one of several types of pervasive developmental disorders (PDDs), which are also called Autism Spectrum Disorders (ASD). The severity of symptoms for autism varies greatly, but all people with autism have some symptoms in the areas of:

Social interactions and relationships.

• Significant problems developing nonverbal communication skills, such as eye-to-eye contact, facial expressions, and body posture.
• Lack of interest in sharing enjoyment, interests, or achievements with other people.
• Failure to establish friendships with children the same age.
• Lack of empathy which means it is hard for them to understand another person's feelings, or viewpoint.

Verbal and nonverbal communication.

• Delay in learning to talk  and verbal expression. As many as 40% of people with autism never speak.
• Stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they have heard previously (echolalia).
• Difficulty understanding their listener's perspective the same as having a problem in being empathetic.

Limited interests in activities or play.

• Autistic people can get overly focused on certain topics. For example, older children and adults may be fascinated by video games, trading cards, or license plates.
• A need for sameness and routines.
• Stereotyped behaviors. These may include body rocking and hand flapping.

 Symptoms during childhood

     Signs of the disorder can be difficult to identify or diagnose during infancy but are usually noticed sometime during the child's first 3 years. Many children with autism will be discovered during routine “well baby checks” and “developmental milestones” evaluations by pediatricians.  If the infant does not like to be held; does not seem interested in playing certain games, such as “peek-a-boo”; and does not begin to talk they should be evaluated for autism.

Symptoms during teen years

     During the teen years, the patterns of behavior of the child will often change. Many teens gain skills in speech and language and do better academically, but still lag behind other teenagers in their ability to relate to and understand others. Teens with autism are also at  increased risk for developing problems such as depression, anxiety, and epilepsy.

Symptoms in adulthood

     Some adults with autism are able to work and live on their own. Adults with high-functioning autism are often successful in their professions and able to live independently, although they typically continue to have some difficulties relating to other people. Some adults with autism need a lot of assistance such as a residential treatment program, especially those with low intelligence who are unable to speak.

     As I’ve seen on the television show “60 Minutes,” about 10% of people with autism have some form of special limited gifts such as the ability to memorize long lists of numbers or names, calculating calendar dates, drawing, or musical ability.  Some people with autism have strong food likes and dislikes and unusual preoccupations.

    It’s not clear if the incidence of autism is increasing, as you hear on the radio and television, or if it is because doctors are now closely looking at children. In either case, it is important that we know as much about autism as we can so we can better interact with people who are struggling to interact with the world around them.

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DAD’S CORNER    

Emotional Overeating

We are going to talk about the signs of emotional overeating, what foods most people are most likely to overeat, and how it can you cut-back on emotional overeating.

How to Tell the Difference

There are several differences between emotional hunger and physical hunger:

1. Emotional hunger comes on suddenly; physical hunger occurs gradually.

2. When you are eating to fill a void that isn't related to an empty stomach, you crave a specific food, such as pizza or ice cream, and only that food will meet your need. When you eat because you are actually hungry, you're open to options.

3. Emotional hunger feels like it needs to be satisfied instantly with the food you crave; physical hunger can wait.

4. Even when you are full, if you're eating to satisfy an emotional need, you're more likely to keep eating. When you're eating because you're hungry, you're more likely to stop when you're full.

5. Emotional eating can leave behind feelings of guilt; eating when you are physically hungry does not.

Comfort Foods

Emotional hunger means you're focused on a particular food, which is likely a comfort foods which you eat to obtain or maintain either feeling good or feeling bad.

For men and women, ice cream is first on the comfort food list. After ice cream, women prefer chocolate and cookies but for men it's pizza, steak, and casserole. All of these foods are high in fats and sugars.

How to Manage Emotional Eating

Recognize emotional eating and learn what triggers this behavior in you.

Make a list of things to do when you get the urge to eat and you're not hungry, and carry it with you, according to the Tufts Nutrition web site. When you feel overwhelmed, you can put off that desire by doing another enjoyable activity.

Try taking a walk, calling a friend, playing cards, cleaning your room, doing laundry, or something productive to take your mind off the craving -- even taking a nap, according to the Tufts Nutrition web site.

When you do get the urge to eat when you're not hungry, find a comfort food that's healthy instead of junk food. Fruits and vegetables give you a crunch and are nutritionally very filling.

Divide comfort foods into smaller portions and EAT SLOWLY. You’ll be surprised how much less you eat when you eat slowly and FOCUS on what you eat.

Moderation is the key. The first step to changing the pattern is becoming aware of what you’re doing.

                                       Feel good and eating well

If you think you might be an emotional eater, take comfort that you CAN do something about it. Gain awareness, explore emotional and physical causes, and make a plan. These steps can bolster your strength to make lasting changes in your life — and we are always here for support.

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THE PLANET EARTH

                                         National Garden Month

 My father always had a small garden in the back yard and would grow tomatoes every year. I remember how red, fresh and juicy they were. I think that having a garden puts us back in touch with the earth, and as we’ll talk about, the community.

Here are things you can do to get the community invovled:

1. Organize a yard share in your community. Yard sharing is basically pairing people without yards with people who have them so they can grow their own food. "Yard sharing is an arrangement between people to share skills and gardening resources; space, time, strength, tools or skills, in order to grow food as locally as possible, to make neighborhoods resilient, kids healthy and food much cheaper!"

2. Garden with a friend or neighbor or start a neighborhood garden club.

3. Clean out your potting bench, garden shed or garage, and take an inventory of all of your gardening "stuff." This includes everything you would use to garden; seeds, pots, gloves, potting soil, plant markers, etc. After keeping those things that you absolutely need, donate any excess to a community or school garden program.

4. Organize a flower "brigade" to bring fresh-cut flowers to a nursing home, care facility, or a local hospital.

5. Just Start Gardening
             Do you have some space in your yard to plant a garden? If not, have a balcony, windowsill, patio, deck, wall, or an outdoor spot you've got the okay to use? Great. Now: Start a garden. It's very simple, all you need is: Dirt, Water, Food. Maybe some containers. I promise you will kill some plants...but it's all about trial and error. Relax. Get some exercise and sunshine. Enjoy.

6. Get involved with community gardening

               Many cities have community gardens where you can plant your own plants and there is water available but unfortunately, many of the community gardent’s have a waiting list for vacant plots. But you might be able to start your own community garden. You can also try yard sharing, which is when people with yard space allow others to work their land. You can swap plants or seeds with your neighbors, or just sharing the bounty of your harvest. In our community you can join a group where you get a basket of vegetables every week. It’s a great way to experience different vegetables.

7. Read some great books about gardening
             You might want to learn a bit about gardening and plants BEFORE you start digging. For example, get a basic book or look on the web to learn what zone you're in and what types of plants grow in what season. You can read books about almost any type of gardening (permaculture, roses, organic, etc.).

8. Take a gardening class
Find a class that you'd like to check out about gardening. Most garden centers have free classes.

9. Talk to the people who grow the produce you buy at farmers' markets
My wife loves to talk to the farmers at the Farmer’s Market we go to. She talks to them about what they do, why and how they do it. They give her tips on fruits and vegetables and some cooking ideas and she ALWAYS learns something every time we go to the market.

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THE LATEST NEWS

Well-Elderly

            Here I am 65 and I’m still not retired, but my body is changing.

What changes occur in the body as we age?

     Even though the aging process cannot be stopped, being aware of these changes and adopting a healthy lifestyle can reduce their impact on overall health.

Expected changes in your body because of getting older include changes in:

• Skin: skin becomes dry, less flexible, thinner, and more fragile. Easy bruising is noticeable, and wrinkles, age spots, and skin tags may become more apparent.
• Bones, joints, and muscles: bones lose density and shrink in size making them more susceptible to breaks. Muscles shrink in mass and become weaker. Joints can suffer from normal wear and tear; joints become inflamed, painful, and less flexible.
• Mobility and balance: A person's mobility and balance may change because of problems with bones, joints, and muscle problems along with changes in nervous system. Falls become more common and can resul in further damage with bruises and fractures.
• Body shape: As a result of bony changes of aging, body stature can become shorter and curvature of the back vertebrae may be altered. Increased muscle loss and reduced fat metabolism can also occur. Fat can redistribute to the abdominal area and buttock areas.
• Face: Aging changes also take place in the face. You get wrinkles and age spots and your facial contour can change. This is because loss of volume from facial bone and fat can result in less tightness of the facial skin and sagging. Your face becomes droopier and bottom heavy. Your lifestyle has a huge impact on your face will look as you get older. “Your parents give you the face you are born with, you earn the face you die with.”
• Teeth and gums: Teeth can become more weak, brittle, and dry. Salivary glands produce less saliva. Gums can also recede (pull back) from the teeth. These changes may result in dry mouth, tooth decay, infections, bad breath, tooth loss, and gum disease.
• Hair and nail: Hair usually becomes thinner and weaker as a person ages. Nails may become dry, brittle and unshapely.
• Hormones and endocrine glands: The change in hormonal control of blood sugar and carbohydrate metabolism can lead to diabetes. Thyroid dysfunction and problems with fat and cholesterol metabolism are also commonly encountered.
• Memory: Problems with memory are common in seniors and do not mean that you have Alzheimer’s disease.
• Immunity: The body's immune system can get weaker with age.
• Hearing: changes in nerves of hearing and ear structures can dim hearing and cause age-related hearing loss. Higher frequencies become harder to hear especially if you’ve listened to loud music through headphones over the  years.
• Vision: Eyes can become drier and the lens can lose its accuracy and can cause vision to become blurry and out of focus. Glasses can help correct these problems but also, try reading in a brighter light.
• Taste and smell: Sense of smell and, less commonly, sense of taste may fade leading to poor appetite and weight loss.
• Bowel and bladder: Bowel and bladder control can cause problems with incontinence (involuntary loss of feces or urine). Additionally, bowel and bladder habit can change. Constipation is common in older adults, as are urinary frequency and difficulty initiating urine.
• Sleep: Sleep patterns can significantly change with age. Duration of sleep, quality of sleep, and frequent night time awakening are commonly seen in seniors

     Although my body is changing, it doesn’t mean my life is over. Here are Key things to do to age gracefully:

1. Laugh. If you can laugh at life’s ups and downs you will live longer and happier.

2. Stay involved with life. Stay engaged in some type of project. Have passion about a project or cause, or have a life mission that will get you out of bed in the morning.

3. Be religious. Religion used to be the center point of the family and community. People who attend church, synagogue or mosque and have an active faith life can add two to three additional years to your life.

4. Watch what you eat. Maintaining your weight gets more difficult with every year because you metabolism slows, and you can’t exercise with the intensity you used to put into your work-outs so as to burn off the calories that used to crank up your metabolic rate. Eat a sensible combination of raw and cooked foods daily

 5. Have a garden. Eat whole, organically grown grains, seeds, legumes, berries, fruits and vegetables.

Stay Active. Doing some kind of physical work daily or taking a leisurely walk in the morning to keep the blood moving properly

 Early to Bed and Early To Rise, makes a person healthy, wealthy and wise. Go to bed early, get up early and you’ll be surprised at how much you can get done in a day.

I’ve looked at MANY websites about aging, too many to give  credit to but here are some of the recommendations on “well-aging”

• Be happy and content with their lot in life
• Enjoy friends and family
• Be generous to all and less nervous
• Live a good life is more important than observing any special rules to be old
• Live simply and humbly
• Most important of all take care of your mental, emotional and spiritual life
• Distance yourself from tobacco smoke - first or second hand

     Don’t be too fanatical or overly strict about this business of getting old - nobody will take you seriously

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