Positively Beautiful

Have you ever rolled yourself out of bed, wiped the sleep from your eyes, looked in the mirror, and yikes! your face is puffy and eyelids swollen? Don’t get too worried; this typically disappears in an hour or two when the fluids that have accumulated in your eyelids drain. Gravity is sometimes a friend! However, looking like someone who has cried all night is still not the look you’re going for especially if you have to go to school or work, or out in public for that matter.

Morning face can be caused by prone position, lack of sleep, dehydration, allergies and imbalanced diet. If the body is dehydrated, water tends to accumulate in the eyelids. Alcohol and salty foods can also trigger this as it minimizes the hormones in the body that help us flush fluids, and triggers water build up in facial areas. As for allergies, morning face often accompanies itchy eyes and redness.

Want to get rid of the marshmallow look? Get adequate sleep. It gives your eyes precious recuperating time after a long day. Try to lay with your head elevated a bit, providing better circulation of fluids when sleeping.

Drink lots of fluids daily to help with hydration. Water is best. It may seem counter-intuitive, but it actually helps. Lower your salt intake and eat a healthy diet. The body can only store salt in fluid suspension form, so too much salt can cause pooling around the eyes. Basically, high sodium levels can cause water retention in all the wrong places.

Also, use a gentle make-up remover and never sleep with eye make-up on. This helps prevent allergic reactions from mascara or eye shadow particles from entering the eyes. With eye make-up, don’t use anything more than a few months old. Bacteria often grows after time and this can cause an adverse reaction.

Here are some final tips:

• Put on a morning mask of cold water, ice or gel for a few minutes.
• Wrap ice cubes in paper towels and place on eyelids. The cold temperature will reduce swelling and helps minimize water retention more quickly.
• Keep an eye cream in refrigerator, ready for morning usage if needed. Use your ring finger to gently tap eye cream on eyelids.
• Soak cotton pads in cold milk and apply to closed eyelids for a few minutes to remove puffiness, then rinse with cool water. This may brighten dark circles under the eye as well, since the lactic acid in milk is a mild exfoliant. History tells us that Cleopatra bathed in milk as part of her beauty ritual. Cold cucumber slices used as eye pads for a few minutes are also considered fast relief.

If symptoms of puffiness last for an extended period of time, contact your doctor to see if there is something more serious going on.

So much has been written about talking with and teaching our kids. We have a fire hose of information, perhaps to blast them into submission with facts and instructions about how to behave. The first time I asked my 4-year old son, Grant, to behave, he said “Who is Have?” in a very serious voice. He had never met Have, so why would he want to be Have? After I laughed so hard I cried, I thought about his profound statement. We want so much for our children. We want them to be smart, be healthy, be kind, be strong, be productive, and of course, we want them to behave! I’d love to share some strategies that I’ve come to appreciate as a mom and a doctor, though I’d be the first to admit Grant still gets a bit feisty sometimes. These strategies can be helpful with husbands too!

1. Address the child by name: Dale Carnegie taught us that the sound of a person’s name is music to her ears. Use your child’s name frequently in praise, and in teaching moments. Regardless of age, it gets attention!
2. Make eye contact and use our body language to connect: For the little shorties, squat down to their level, use a gentle hand and help them focus by asking them for their eyes and ears as you speak in a calm manner. As your child grows, and maybe surpasses you in height, try other strategies to connect at eye level to enhance communication.
3. KISS, repeat!: Make the main objective of a lesson short and sweet. For smaller children, one sentence is optimal, repeat if necessary, and then ask them to repeat so that you make sure they heard you. Older children will tune you out if you ramble, so don’t get side-tracked and ask them for feedback and repetition to clarify understanding.
4. Be a role model: Be polite, be respectful and speak to your child in the way you would want them to speak to you.
5. Begin with I: I want you to…, I would like…, I am so pleased when you… instead of You need to do this… “I” messages are non-threatening and non-accusing. They give a reason for the request (to please you!) instead of an order to be obeyed.
6. Don’t end with a question mark: Will you please clean up your room? or Let’s finish the puzzle, ok? implies that a negative answer or action is an option. I want you to clean your room, please. It makes your expectations crystal clear in a firm but pleasant manner.
7. Make an offer the child can’t refuse: Get dressed, so that we can go to the park!
8. Give choices: Having choices gives kids a sense of power and mastery, something that we all crave! The red shirt or the blue one?
9. Write it down: Lists, reminder notes and chore lists can be fun and humorous ways of encouraging and rewarding good behavior without repeated verbal reminders that are perceived as nagging. I wonder how my husband will feel about the gold stars on the fridge for him?
10. As your children grow up, making a habit of good communication opens things up for crucial conversations: Health, finances, spirituality, drugs, alcohol, sex, pregnancy, bullying and even suicide are difficult topics that can be broached in a calm and loving way. Expect the eye-rolling and resistance, but even a short conversation lets them know that these are topics you’re willing to discuss. Begin with a little story during a shared activity like making a meal, so that the conversation is natural and less intimidating. Take a trip down memory lane and think back to your awkward young self. Tell them about your pimples, boy/girl problems, the disastrous prom date you thought you’d never survive, mistakes you’ve made, loneliness you’ve felt and even how you dealt with your own parents. Looking back, what advice do you have for your kids? You can’t shelter them from all pain and disappointment, but by sharing you encourage them to do the same.

When I went to medical school, nutrition was not really on the radar. And taking vitamins was even trivialized by some as a great way to “make expensive urine.” Times have changed and most medical professionals feel that a multi-vitamin and in some cases omega-3 fatty acids can have a positive impact on health. Adding to this list, Vitamin D has become a media darling. What’s the hype? Turns out the Vitamin D plays a role in many physiologic functions, so it’s worth learning more about, and making sure that you get enough.

Vitamin D is a not truly a vitamin, but a fat-soluble hormone best known for working with calcium in your body to help build and maintain strong bones. Vitamin D is needed to help absorb calcium. Children who don’t get enough vitamin D may not grow as much as others their age. They also have a chance of getting a rare disease called rickets which causes weak bones. People who do not get enough calcium and vitamin D throughout life have an increased chance of having thin and brittle bones (osteoporosis) in their later years. We often here of elderly patients who break bones even with minor falls, and suffer major, life-threatening consequences. Your body also uses vitamin D to help your muscles absorb calcium and work well. If your muscles don’t get enough calcium, then they can cramp, hurt, or feel weak. You may have long-term (chronic) muscle aches and pains. Getting enough vitamin D helps prevent these problems. An interesting study showed that seniors with adequate levels of vitamin D had 22% fewer falls, suggesting better muscle and bone health.

Calcium is best taken along with vitamin D, because the body needs vitamin D in order to absorb calcium. The recommended daily intake (RDI) for calcium ranges from 700 IU for small children to 1200 IU for adults, while the RDI of vitamin D is 600 IU for small children to 800 IU for adults. RDI is a controversial topic for many supplements, and some researchers feel that we should take up to 2000 IU of vitamin D.

Calcium is in foods such as milk, cheese, and yogurt. Vegetables like broccoli, kale, and Chinese cabbage have calcium. You can get calcium if you eat the soft edible bones in canned sardines and canned salmon. Foods with added (fortified) calcium include some cereals, juices, soy drinks, and tofu. The food label will show how much calcium was added.

Vitamin D is in foods such as salmon, tuna, and mackerel. These are some of the best foods to eat when you are trying to get more vitamin D. Other foods that have vitamin D, but in small amounts, include cheese, egg yolks, and beef liver. You can also get vitamin D from fortified foods such as milk and some cereals, orange juices, yogurts, margarines, and soy drinks.

Supplements can help if you are having a hard time getting enough in your diet. Many multi-vitamins contain calcium and vitamin D, but if you need more, you can add them individually. Options for calcium: Calcium carbonate is best absorbed when it is taken with food. Calcium citrate can be taken with or without food. Vitamin D supplements are available as ergocalciferol (D2) and cholecalciferol (D3). Some research suggests that D3 is more effective at raising blood levels. The sun also helps our body produce vitamin D, but you don’t need to overdo it. Exposure of arms or legs for 15 minutes 3 times a week provides ample vitamin D for our bodies, though not easy to do during the winter here in the Upper Midwest. And I prefer to protect my face with sunscreen, to ward off wrinkles and worse.

Risk factors for low vitamin D levels include liver and kidney disease, gastrointestinal problems such and Crohn’s or celiac disease, age over 65, dark skin, and lack of exposure to natural sunlight. A blood test is available through your doctor to check your level. The U.S. Institute of Medicine recommends a blood level of 20 ng/mL of vitamin D for healthy bones, but some experts feel a higher level is optimal.

Can there be too much of a good thing? Yes, upper limits of calcium ingestion is 2000 IU for adults, and for vitamin D it is 4000 IU. Too much calcium can cause confusion, constipation, irregular heart rhythm, and kidney stones. I have personal experience here. I got a kidney stone in high school. I was working at Baskin-Robbins in the Northport Shopping Center at the time. I think it was a case of too much ice cream (quality control, right?) and not enough water! Too much vitamin D can cause nausea and vomiting, constipation, and weakness..

Calcium and vitamin D can impact how with other medicines work, sometimes making them stronger, in other cases, minimizing their effect. Some drug/supplement interactions can cause unusual side effects and be dangerous.Before you start taking calcium and/or vitamin D, or any supplement, tell your doctor about all of the medicines you take, including over-the-counter drugs, herbs, and pills. One of the advantages of computerized medicine and prescriptions is the ability to help screen for potential interactions.

While the effects of calcium and vitamin D are widely appreciated with respect to bone health, researchers are beginning to find that low levels of vitamin D may be linked to other diseases, including breast and colon cancer, prostate cancer, heart disease, high blood pressure, depression, and obesity. This doesn’t necessarily mean that too little vitamin D causes these conditions, but that people with higher levels of vitamin D are less likely to get these diseases. Vitamin D is also involved in regulating the immune system and cells, and researchers are investigating this as a potential cancer-fighting link.

What’s the take away?Take a close look at your diet, consider adding calcium and vitamin D if the numbers don’t add up. Get a few minutes of sunshine. Get your vitamin D level checked, and see how making some simple changes may improve your health. Over the years, it will be fascinating to see what science uncovers about the power of vitamin D and other nutrients!

Albert Schweitzer once said, “In everyone’s life, our inner fire goes out. It is then burst into flame by an encounter with another human being. We should all be thankful for those who rekindle the inner spirit.” Author, speaker and creative business strategist Danielle LaPorte is for many such a person, capable of helping others rekindle. Oprah’s life coach Martha Beck says “Danielle LaPorte is scary smart, yet so kind and practical that she kindles the fire in you without causing you to feel consumed by the flames. She has the knowledge you need to succeed. Lean in and listen close. What she has to say is what our spirits need to hear.”

Danielle’s soon to be released book, The Fire Starter Sessions, is a window to her soul’s work, part inspiring sermon and part practical action workbook. I’ve been a long-time reader of her WhiteHotTruth blog at DanielleLaporte.com, and have gone though the digital program, now called The Spark Kit, that inspired this book. I got a chance to interview her recently about her book, her life and her own dreams.

LaPorte was born to young parents in Windsor, Ontario, Canada. As an infant and young child, she accompanied her mother to college classes. She remarks “I am grateful that I was exposed to a big world at a young age.” She never graduated from college, but as her work-life began, she was conscious of her own natural gifts. She was good at telling people’s stories. This led to a career in public relations. She was later recruited to lead Washington, DC think-tank, researching future trends for the likes of politicians, media and even the Pentagon. Her next venture was creating a lifestyle/image consulting company, which attracted international buzz and big-time investors. LaPorte says that somehow her authentic vision got lost in the shuffle, and the company imploded. She learned a great deal through this painful demise, and started over with a blog, some small speaking gigs and a few coaching clients.

Honest about her failures and lessons, she likens herself to a phoenix rising from the ashes, and she started over with nothing. Slowly and surely, she attracted new readers, more clients and more speaking gigs through her work. She no longer does individual sessions, but her book and her internet presence allow her to reach many people.

Separated into three sections; Mojo, Moxy, and Results, the premise of the book is that we all deserve to have happy, fulfilling lives, but this requires intention, thoughtful choices and action. There are 16 sessions and worksheets under headings such as “Defining Yourself On Your Own Terms,” “The Strategy of Desire,” “Visioneering,” and “How You Show Up In The World.” Laporte says she was inspired to inspired to create this program based on past work with coaching clients. “You become a trailblazer by virtue of being your genuine self. It’s that simple- and that profound,” she states.

She resisted putting her process into a “seven steps to success” formula suggested with big name New York publishers. Her book has an interesting layout, with contemporary fonts of various sizes, and main take-aways in bold. There’s a bit of salty language that she’s known for, with plenty of love and humor on the pages as well. Well-chosen quotes from the likes of the great masters like Emerson and Rumi are mixed in with contemporary wordsmiths such as Seth Godin, Lady Gaga and JayZ. The book is just a starting point for a multi-media experience, with resources listed for a reader’s forum, videos, downloadable worksheets and even music playlists for creating a “FireStarting” mood. She encourages and welcomes connection through social media, listing her website, Twitter and Facebook pages, and gives suggestions for starting local Fire Starter groups.

Whether you are just starting out, full of possibility, or you feel like you’re at a crossroads, stuck in a creative rut, and ready to make changes, LaPorte’s book could be just the ticket. You might find a few pearls of wisdom that’ll help you see more clearly, and move forward with action. Of course, to really benefit from the book, you have to do some “homework.” It helped me to read through it once, then go back through revisit the worksheets: lists to write, big questions to ponder. I think the greatest “aha” moments will come through sincere effort. Are you ready to reflect, write and act?

Through her own journey and those of her client’s, LaPorte’s become a passionate crusader for leading an authentic life at home and at work. The themes are universal yet she uniquely and skillfully communicates issues and solutions that us move from dream to reality. She’s created that for herself, and describes almost every day as ideal, writing, traveling, and spending time with her fireman husband (how perfect) and their eight year old son. There are more books on the horizon for Laporte, and for that, I am very grateful.

The Fire Starter Sessions book is available locally in Fargo at Zanbroz, SHANNALEE, Barnes & Noble, and Catalyst Medical Center, as well as online at many of the top etailers.

Are you local?
I will be hosting an “Ignite the Conversation” book night covering The Fire Starter Sessions on Tuesday, May 1st at 6:30pm at my clinic, Catalyst Medical Center & Clinical Spa.

To RSVP for the book club, visit www.CatalystMedicalCenter.com.

I recently had to say no to an opportunity to lead a community group in their annual fund-raiser. It’s a wonderful organization, with great people helping the region in wonderful ways. For those of you who know me, I’m a yes-girl, so this was a difficult decision. My head was saying “Go for it!” but my heart and gut were saying, “Your plate is already too full.” I’m trying to listen a little harder to my heart and gut, so I eventually declined. But I wished I would have declined in a more graceful way, instead of procrastinating. In the end, I missed out on a personal conversation with the executive director because she was out of the office, and felt like a chump for sending an email message and a voicemail to say no.

Why is saying no so hard? Celeste Chua of The Personal Excellence Blog suggests that fear has a lot to do with it: We fear seeming rude, we fear conflict, disappointment, and burning bridges, or we may fear that it may limit future opportunities. But the biggest reason it’s hard to say no may be our kind hearts as most of us want to help others, even at our own expense. We feel guilty for saying no. Yet overcommitment leads to stress, burn-out and even illness, so it’s important to figure this out.

The bottom line is saying no more often is healthy. Time is a finite, precious resource and by saying no more often, we have the time we need for ourselves and our own priorities. Saying no allows us to honor existing obligations and devote energy and focus to them. Saying no also opens the door for someone else to step up and say yes to the opportunity.

Consider these tips:

1. Know your priorities. Cheryl Richardson, best-selling author and Oprah columnist, thinks we should all create an Absolute Yes list to help set personal boundaries and determine true priorities. She suggests that self-care be high on the list, along with activities that bring you joy and work that inspires you. A Stop Doing list is equally important. What activities or choices make you feel less than ideal? How can these be delegated or avoided? Evaluate new opportunities and obligations in light of these criteria.
2. You have a choice. Even if its your boss, you can say no. Diplomacy helps. Chau states “Rather than think that we can’t say no, it’s about learning how to say it and put it across in a manner that the other party can understand and accept.” My staff at Catalyst is getting really good at this, and I’m learning to understand and accept!
3. Suggest an alternative. It helps with the guilt factor if you can offer a few tips, leads or an introduction to someone else who might be able to help.
4. Keep it simple. The words ” No, I can’t” have more power than “I don’t think so.” Be brief, be honest, and be ready to repeat yourself if necessary. These phrases might work well: “I’m sorry, but I’m afraid I can’t take it up” “I’d love to but I can’t commit to this as I have other priorities at the moment.” Email is fine if the request came that way, but a picking up the phone is such a nice, quaintly polite gesture that it might win you a few brownie points even though you have to decline.
5. Be respectful. There are many good causes and good people and it can be tough to turn them down. Recognizing and appreciating the person or the group even though you can’t participate at this time shows your respect for their efforts and goals.

Life is so busy. Saying yes means saying no to something else. We all need to make decisions that support our own priorities and needs, and to fill our own vessels first. If we do this, the well never runs dry and we have more to give.

I read Meredith Holt’s Monday article about artificial sweetener’s with great interest. As a recovering Diet Coke addict, I always sensed that I didn’t feel quite right if I drank too much of it. And it certainly didn’t seem to help me lose weight. In the medical world there are many doctors that feel it’s fine to use diet sodas and artificial sweeteners. I admit that I still drink one a week, as Diet Coke is in the fridge at my surgery center where I operate. But I would hear an occasional warning about headaches and allergies, and as mentioned in the Monday article, the link to increased craving for carbohydrates.

Dr. Mark Hyman, past medical director of Canyon Ranch Wellness Center and current president of the Institute for Functional Medicine, boldly states, “Artificial sweeteners cause obesity.” He points out a number of different research findings supporting his claim.

Research indicates that just the thought or smell of food initiates a whole set of hormonal and physiologic responses that get the body ready for food. When you trick your body and feed it non-nutritive or non-caloric sweeteners, like aspartame, acesulfame, saccharin, sucralose, sugar alcohols like malitol and xylitol, or even natural sweeteners like stevia, it confuses our metabolic system because they do not provide any calories.
Dr Hyman references a study in the Journal of Behavioral Neuroscience has shown conclusively that using artificial sweeteners not only does not prevent weight gain, but induces a whole set of physiological and hormonal responses that actually make you gain weight.

He summarized the findings as follows: The researchers proved this by giving two different groups of rats some yogurt. One batch of yogurt was sweetened with sugar. The other was sweetened with saccharin. They found that three major things happened over a very short period of time in the rats that were fed artificially sweetened yogurt.

First, the researchers found that the total food eaten over 14 days dramatically increased in the artificial sweetener group — meaning that the artificial sweetener stimulated their appetite and made them eat more.

Second, these rats gained a lot more weight and their body fat increased significantly.

And third (and this is very concerning) was the change in core body temperature of the rats fed the artificial sweeteners. Their core body temperature decreased, meaning their metabolism slowed down.

So not only did the rats eat more, gain more weight, and have more body fat, but they actually lowered their core body temperature and slowed their metabolism. As I have said many times before, all calories are not created equal …

The most astounding finding in the study was that even though the rats that ate the saccharin-sweetened yogurt consumed fewer calories overall than the rats that ate the sugar-sweetened yogurt, they gained more weight and body fat.

So what should we do with our sweet tooth? Dr Hyman feels that eating a whole-foods diet that has a low glycemic load and is rich in phytonutrients and indulging in a few real sweet treats once in a while is a better alternative than tricking your body with artificial substances. If you want to stay away from regular sugar, here are a few alternative suggestions that I found:

1. Eat fresh fruit for your sweet treat.
2. Dehydrated fruit, fruit sauces with no added sugar, and fruit powders can be used to sweeten up cereal, smoothies and even baked goods. I never knew you could sprinkle banana powder! Palm sugar, also called coconut sugar, is granulated and tastes like mild brown sugar.
3. Syrups: Honey, coconut sap, carob syrup and and maple syrup can be used in drinks and baking. I have used agave syrup in the past, but have read this is controversial because processing renders it high in fructose.

I think I’m ready to give up my once a week Diet Coke now!

Have you ever wondered about your dreams? Lots of mental activity occurs during our sleep in the form of dreams, and they can vary from simple thoughts to elaborate events. We used to think that dreams occurred only during REM (rapid eye movement) sleep, but we know now that dreams can occur during all sleep stages. REM dreams seem to be the vivid, active and intense. Dreams can last from seconds up to 20 minutes.

Only 5% of our dreams are recalled. The ones that are remembered tend to be more intense, or if we wake up during or immediately after the dream. Dream recall seems to be better if you are motivated to write them down or tell someone about them as soon as you wake up. Some people think that deja’ vu maybe a form of dream recall that happens randomly, with a sense of having previously seen or experienced a similar situation or place.

Dreams seem to reflect real-life troubles and joys, however the experiences tend to be very distorted so that usually only the dreamer can see the relationship. Children tend to dream more often about animals. Women tend to have more verbal interactions in their dreams, while men’s dreams have more physical action. Unfortunately, most dreams are unpleasant for the dreamer; representing situations in a more negative light compared the awake state. Anxiety is the most common emotion recalled. Perhaps it’s why some people “wake up on the wrong side of the bed” if they have a dream that negatively affects their mood. Other emotions described are abandonment, anger, fear, joy, and happiness, but the negative one surface much more commonly than positive ones.

Most dreams happen only once, but some people have recurring themes. My mother frequently dreams of a murderous intruder. This dream started in the early 1960′s when she was a young nurse. There was an attacker in Chicago who killed several nursing students living in a campus house, and my mom was so scared and moved by the event that she continues to have a dream related to this 50 years later. I still have a dream about being in the school bus in my underwear. Embarrassing!

What about nightmares? Nightmares are well-elaborated dreams which have dangerous, horrifying or painful content. They tend to occur late in the night and come during episodes of rapid eye movement sleep. People awaken in a state of distress and can have difficulty sleeping because of them. Nightmares are a normal occurrence in children. Actually 20 to 50% of children between the ages of 5 to 10years experience occasional nightmares. They then decrease with age, but may persist through adulthood. Night terrors also affect children, but are characterized by sudden awakening early in the night with intense fear, though the source of the fear is not remembered.

Little is known about why we dream and what dreams really mean… Dr William Dement of Stanford University , considered the “father of sleep medicine,” believes that dreams contain personal messages linked to our emotions and our moods. But a few scientists believed that dreams were just meaningless, random events caused by shifting neurotransmitters in our brains during sleep. Only 1% of sleep research focuses on dreams, but that may change as PET scans and other new imaging allows researchers to “watch” the brain during sleep and dreaming, suggesting brain activity in our emotional, sensory and long-term memory centers.

Dreams may be a source for creative images and inspiration, and are sometimes used in psychotherapy as a technique for self-awareness. Dreams are a natural phenomenon and there is no harm in recalling them. We all search for meaning in our lives, and wonder if dreams provide a clue. Studies find that we focus more on dreams when good things take place, as most of us are inherently optimistic. Universal dream symbols can be found in popular books , and it will be interesting to see if research can help us make sense of these symbols.

Maybe you read the recent FDA report about lipstick…maybe not.  But whether you wear it, or kiss someone who does, you need to know. As a daily lipstick user, I was really appalled to learn that the majority of lipsticks contain lead.  The worst offender: Maybelline’s Color Sensational in Pink Petal, coming in at 7.19 parts per million in led content. To put this in perspective, candy sold in the US cannot exceed 0.1 parts per million. Not so pretty in pink.

The FDA counters that this is not a fair comparison, suggesting “It is not scientifically valid to equate the risk to consumers presented by lead levels in candy, a product intended for ingestion, with that associated with lead levels in lipstick, a product intended for topical use and ingested in much smaller quantities than candy. Although we do not believe that the lead content found in our recent lipstick analyses poses a safety concern, we are evaluating whether there may be a need to recommend an upper limit for lead in lipstick in order to further protect the health and welfare of consumers.”

The widely circulated statement that women eat about 5 pounds of lipstick over their lifetime has been calculated to be false,  but even if I’m not eating it, I’d rather not have lead in my lipstick. Lead is a proven neurotoxin that can cause learning problems and is also linked to infertility and miscarriage.

The FDA does control the dyes and colorants used in products, and lipsticks are required to processed using a more limited list considered safe for mucous membranes. The cosmetics industry and the FDA take the position that tiny amounts of hazardous chemicals found in personal care products pose no threat to human health. Safety data is able to show that there are no short term health consequences such as rashes, swelling or eye irritation. But  what about daily exposure over months and years? Most chemicals in cosmetics have not been tested for their potential to cause long-term health problems such as cancer, neurologic conditions or reproductive harm.  I think the ban of BPA is a prime example. It was found to be harmful, and eventually was taken out of circulation in many products. But it took time and effort on the part of concerned consumers to convince companies to do so. Likewise the Dr. Oz-inspired look into our orange and apple juice supply resulted in changes for healthier consumption. Cosmetic companies promote health and beauty and have large research and development budgets. I think it would be in their best interests as well as ours to reduce potential toxicities in their products, from a marketing perspective as well as an ethical standpoint. Though the medical literature has never reported a case of lead poisoning from lipstick, and likely never will, it makes sense to minimize its use.

Reading labels is a great idea, but lead is not on the disclosed ingredient list on my lipstick tube. Most exposures are related to lead based paints and plumbing solder, used until 1978. Primary prevention is necessary because the effects of lead appear to be irreversible and build up over time. The goal of primary prevention is to ensure that all homes become lead-safe and that we  reduce environmental exposures from soil, dust, paint and water. In the April 2008 issue of Current Opinion in Pediatrics, Dr David Bellinger suggested that no level of lead exposure appears to be ‘safe’ and even blood test readings under the current guideline of 10 micrograms per deciliter are associated with neurodevelopmental deficits. Primary prevention of exposure provides the best hope of stamping out this preventable disease.

We live in a safer environment than our parents and grandparents. And while we don’t want to live afraid of our own shadow, it seems reasonable that products should be made with the lowest levels of lead and other toxins possible. We keep questioning and learning and encouraging our families to lead healthier lives, and our companies to make safer products based on ever evolving data on what truly is safe. If you want to find out where your favorite brand and color of lipstick ranked in testing go to this article at www.fda.gov.

Despite being a traditionally trained physician, I consider myself open to many complementary therapies. I appreciate the value of meditation to soothe the nervous system; of prayer and visualization to improve surgical outcomes; and of massage, physical therapy and chiropractic treatment to improve our physical bodies. I think nutritional supplements and even more importantly, the foods that we eat, are vital to health and well-being. But when I read on Facebook of someone touting the wonders of ear candles to “cure” ear wax and hearing loss, I just have to say NO.

I have personal experience caring for a young woman who severely burned her ear canal while using and ear candle. She had extreme pain and hearing loss that required general anesthesia for removal of the candle wax that dripped into her canal. Recovery took several weeks.

For those of you who are not familiar with ear candles or ear cones, they are made of fabric soaked in wax and then shaped to form a hollow tube. In theory, the combination of heat and suction is supposed to remove ear wax. Technically marketed “for entertainment or recreational use,” it has also been touted to relieve sinus pain, cure ear infections, help relieve tinnitus and vertigo, and even strengthen the brain! While ear candles are widely available in the U.S., selling or importing them with medical claims is illegal. This means that one cannot market ear candles as products that “Diagnose, cure, treat, or prevent any disease”. Health Canada states “There is no scientific proof to support claims that ear candling provides medical benefits. … However, there is plenty of proof that ear candling is dangerous.”

The patient lies on one side with the treated ear uppermost and the candle vertical. The candle is sometimes stuck through a paper plate or aluminum pie tin to protect against any hot wax or ash falling onto the subject. This “candle” is placed in the ear and burned down to a stub 2-4 inches long. The process takes 20-30 minutes. After the procedure is finished, a brown waxy substance, believed by ear candling practitioners to be a mixture of ear wax, debris and bacteria, is left in the candle stub. Scientific studies show that this is not true. The residue and debris left in the stub is simply the melted wax and burned fabric from the candle itself. Research has also shown that no vacuum effect is created.

Locally I have seen this procedure offered by beauty salons and spas, as well as massage therapists. Some people order them of the Internet for home use.

Since it seems to cause so much trouble, why do we have ear wax? The scientific name for ear wax is cerumen, and it is produced in the outer third of the ear canal. It is a mixture of sebaceous secretions and skin cells. Fear, stress and anxiety result in increased production of earwax.

Earwax can have a soft caramel-like wet consistency, or be dry and flaky. Genetics play a role here. The wet type is dominant and found in people of Caucasian and African descent, while the dry type is recessive and noted more in Asians and Native Americans.

The ear canal is meant to be self-cleaning; as skin cells migrate from the tympanic membrane out of the ear canal. Wax in the canal also moves outward as the skin underneath grows outward, taking with it dirt, dust and any particulate matter that may have gathered. I always tease little kids that earwax keeps the bugs out. Earwax lubricates the skin, and seems to minimize bacterial and fungal growth in the canal. Movement of the jaw causes some movement of the cartilage of the ear facilitates the natural cleaning process.

Here are my tips for clean ears:

1. Don’t worry about it unless the wax is causing discomfort or blockage. Yes, use your washcloth to wipe the “bowl” of your ear, but, like Mom said, don’t put anything smaller than your elbow inside your ear canal.
2. Cotton swabs usually push the wax further into the canal, especially if you have wet wax.
3. Softeners in the form of drops like Debrox seem to emulsify the wax and help it come out. I also sometimes suggest a couple of drops of olive oil once a week if you have hard, dry wax.
4. If you get itching ears, especially after swimming, white vinegar drops are useful.
5. Don’t put anything in your ears or your child’s ears if tubes or a perforation is present.
6. Professional help is sometimes needed. Your family doctor may be able to flush out the wax with a syringe. Make sure the water is body temperature or it could make you dizzy. Stubborn wax might require a trip to an ENT specialist, where a microscope and special tools or suction will be used to get the wax out.

But please, no ear candles!

Tis the season…. for coughing, sneezing, colds, nosebleeds, flu and sinus infections. The medical office is really busy at this time of year.  And we are not immune at our house either.  My 4 year old son Grant gave  a really big sneeze and had long globs of mucous hanging out each nostril. He looked like a mini-walrus with tusks and  thought it was really funny. Thankfully, we got a tissue before this big mess ended up on his sleeve.
It always helps to know what’s going on up there, in the mysterious territory of your nose. Your nose is your personal  filtration system, the gatekeeper and defender of your airways. The external structure of the nose can affect how it functions internally, something  that we surgeons keep in mind when doing rhinoplasty. The internal state of your nose can make or break your day. We all know how awful if feels to have a congested nose, which leads to poor sleep, dry throat and a foggy head.

The nasal cavity is divided by the septum, which is made of cartilage in the front and bone in the back. The septum is the main culprit for nosebleeds, and 90% come from the front. There are also projections from the side walls of the nose, called turbinates. Ever wonder why our noses run when we cry? The tear ducts drain into the nose underneath the inferior turbinates. The middle turbinate covers the opening to the maxillary (cheek) sinuses, and the superior turbinate is just below the bone protecting our brains.

All interior nasal structures are lined with mucous membranes, which can expand and contract. Since the nose’s main functions are to filter, warm and humidify the air that passes through, these adjustments by expansion and contraction help to adjust the temperature of the incoming air. You may have noticed that sometimes you breath better on one side of your nose than the other. If you are always more restricted on one side, it may mean that your nasal septum is crooked and partially blocks one side of your airway. If airflow seems to change from side to side, you are aware of the natural cycle of your nose, with one side providing adequate passage of air, while the other does the filtering.  If both sides are blocked over a few days, it can be due to viral or bacterial infections or allergies. If they always seem blocked, it could be due to year-round allergies or even nasal polyps, which are jelly-like mounds of swolllen tissue blocking the nose and sinus cavities. In rare cases, nasal cancers can present with chronic blockage, so if you really have trouble breathing through your nose, it’s a good idea to get checked by your doctor.  Sometimes we can identify the problem by looking carefully with our special lights.  CT scans are useful for a deeper evaluation  if necessary.

The membranes secrete about one pint of mucous on a normal day. The cells also have hair-like projections called cilia, which help to move particles and pollens away from your nose. The cilia are stunned by cigarette smoke and other toxins and imparied by allergies  increasing the likelihood fo nasal problems.

I could write a book of practical tips for a healthy and beautiful nose, but here’s a few to get you started:

1. Wash your hands. Most bacteria and viruses get into our nose by direct contact.
2. Use a humidifier if your nose feels dry. Nosebleeds occur because we develop tiny cracks in the mucosal surface on our septum. If you do get a nosebleed, pinch the lower soft part of your nose, NOT the bony bridge, for 10 minutes. Lean forward so the you don’t get blood trickling down your throat, which can lead to nausea. This usually works, but if it is still oozing, moisten a small portion of a cotton ball with Afrin nasal spray (or the generic equivalent) and tuck that inside your nostril. Hold for another 10 minutes. Get checked by your doctor if it’s still going. Aspirin, fish oil supplement and high blood pressure make nosebleeds more of a risk.
3. Use nasal saline mist, like Ocean, Ayr or Simply Saline to keep nasal passages moist. If you’re congested, try a hypertonic (concentrated) rinse like NasoPure, NeilMed or a neti pot, if you can get the hang of it. Use clean water, of course. I think the squirt bottles are easier than the neti pot.  Many saline rinse kits come with pre-done salt and sodium packets. If you’d rather make your own, use one teaspoon of pickling or canning salt (not iodized table salt,)  and one-half teaspoon baking soda in 8 ounces of clean water. If it is safe to drink, it’s likely safe for rinses. You may have read however, that there were 2 deaths late this summer linked to neti pot usage in the South, where an amoeba infested the water supply. Thankfully, this organism is not found in our region, but boil then cool the water if you’d like.
4. Look at underlying factors: Stop smoking  if you do, stay away from second and third smoke. Check into allergy evaluation to see if allergies are part of the problem.
5. Consider some alternatives  like Xylitol (Xclear) nasal rinses, probiotocs and Manukah honey, if you are infection prone.