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A Letter fro m th e Fir m
Dear Friends, I hope this issue of Living Safer finds you enjoying some time in the sun with family and friends this summer.
PUBLISHER John T. Bair
As a stakeholder in the civil justice community, I realize the importance of continuing a dialogue with trial lawyers and their clients about best practices around settlement planning and management. This is why our firm is a consulting firm. Our seasoned professionals are here to provide cutting-edge advice to trial lawyers and their clients, to educate plaintiffs, and to offer solutions tailored to the individual.
EDITORIAL Editor-in-Chief Stephanie Andre sandre@livingsafer.com Art Director Eva Talley etalley@livingsafer.com Associate Editor Brittany Monbarren bmonbarren@livingsafer.com
To that end, our latest endeavor, the not-for-profit Bairs Foundation, was created to provide low-cost access to capital so families can have the resources to go the distance with their lawsuit. Now several months in, we have provided non-recourse advances at seven percent simple interest to over 35 individuals in need and awaiting litigation. We aim to bring fairness to today’s plaintiff funding industry. For attorneys looking to make sound financial decisions, our robust attorney fee deferral program is a great opportunity for tax planning and wealth building. We are here to help you and your law firm plan how best to realize your earned fees. As a fellow advocate of civil justice, please keep our portfolio of companies in mind, and do consider sharing this publication with others who may take interest. Happy reading! Sincerely,
John T. Bair Founder/Member Milestone Consulting, LLC
i n l i f e , t h e r e c om e s a t i m e t o mov e forwa r d t o t h e n e x t m i l e s t on e
Inside This Issue ON THE COVER
32 The Medicating of America What pharmaceutical companies don’t want you to know
FEATURES
11
SIGNS YOU MIGHT HAVE THYROID DISEASE
26
PERSONAL ISSUES: WHAT YOU SHOULD—AND SHOULD NOT—”BRING” INTO THE OFFICE
39
DISEASE: IS DIET— NOT MEDICATION— THE REAL ANSWER?
45
SPECIAL NEEDS PARENTS AND PTSD: YES, IT’S REAL
53
TIPS TO MAKE SURE YOUR HOME INSPECTOR DOES THE JOB
There’s no denying that big pharma means big business—but the big question is, “who is the real benefactor?” While treating America’s ills seems like an altruistic endeavor on the surface, today’s pharmaceutical companies have gone beyond simply pioneering new treatments for age-old health problems and literally forged a burgeoning industry that caters to a continually growing marketplace which they, in part, have invented.
TRENDING TOPICS
10
5 REASON WHY YOU NEED AN EMERGENCY FUND
13
SALT LAMPS: SAVIOR OR SHAM?
22
WHY AND HOW YOU SHOULD SNIFF OUT FAKE NEWS
49
YOUNG DRIVERS WITH ADHD 36 PERCENT MORE LIKELY TO CRASH
DEPARTMENTS 05
THE PULSE
06
GADGETS & TECHNOLOGY
56
DOS & DON’TS
TRENDING
America:
It’s Time to Take Our Medicine
by Bryan Silver
As headlines continue to illuminate an opioid epidemic that some public health officials have called the worst drug crisis in the nation’s history and the use and abuse of prescription medication by individuals from all walks of life is at an all time high, there’s one glaring aspect of our self-created drug culture that gets far less attention than it deserves—and that’s how it’s affecting our children. There is the obvious injury to our nation’s young in the way of neglect or abuse at the hands of drug-abusing parents. Many of us have seen the viral images of toddlers left unattended in cars while their parents sleep off an opioid high in the front seat. We have heard of foster care systems in heavily affected areas being flooded almost to the point of failure with these victims of poor parental choices. Worst of all, we realize it’s an injury that extends throughout a family as some of these children are predestined to make the same mistakes in their lives and with their children as they grow older. The detrimental effect is not always this obvious, though. Case in point—the recent arrest of Tiger Woods. Once a role model for young want-to-be athletes everywhere, Woods recently brought attention to the rising “drugged” driving phenomenon when he was arrested in May after falling asleep at the wheel in the middle of a roadway near his home in Jupiter, Florida. For the first time in history, data (according to a recent study conducted
by the Governors Highway Safety Association) shows that fatal wrecks are more likely to be caused by driver’s with high levels of either prescription or illegal drugs in their system rather than alcohol. Couple these findings with the fact that one out of 12 children currently take some form of prescription medication to treat emotional or behavioral difficulties and you can see where things might be headed in coming years. The question is, what are we willing to do reverse this trend? Above all, let’s not overlook the physical effect that drugs are having on our youth. One study from Stanford researchers raises concerns over what drugs prescribed to elementary schoolaged children could be doing to their brain development, while our courts continue to weigh cause-and-effect with numerous cases of young men growing permanent breast tissue after years of taking Risperdal to treat autism. The point is that you don’t have to look far to see evidence of how today’s social choices are having a negative effect on our children. The question is whether or not, as a society, we’re going to let these serious issues continue. Maybe it’s time we own up to our indiscretions. That we face the music. Take our medicine. The problem is of our making, and so should be the solution—but if we don’t act soon, it could be too late for far too many kids. @LIVINGSAFER / LIVINGSAFER.COM / 5
Health Gadgets
That Can Change Your Life From smart pain relief and recovery devices to medical devices that monitor your vital signs and everyday activities, these health gadgets can help you lead a healthier and safer lifestyle.
by Brittany Monbarren
The Instant Hot or Cold Pain Relief Wand Say goodbye to those microwavable heat packs and drippy ice packs—or even those bags of frozen peas! This cordless handheld device instantly emits cold or heat to treat aching muscles and joint pain. The wand can quickly go from icy cold (43º F) to cozy and warm (104°F) at the touch of a button. It can be used to treat aching muscles, reduce pain, stimulate circulation and much more.
Withings Thermo Balance comfort and accuracy with this Withings Thermo thermometer. With its patented technology, this thermometer requires only a gentle press against your temple to check your temperature and delivers results from 16 sensors in two seconds. The Withings Thermo app lets you track temperatures, record symptoms, note medications and share information with your doctor.
Firefly Recovery This wearable device is designed to help accelerate sports recovery after exercise and minor injury. Firefly Recovery is worn behind the knee and delivers painless electrical impulses which activate the muscles of the lower leg to increase blood circulation.
ResMed S+ Say goodnight to sleepless nights with S+, the world’s first non-contact sleep tracking system that helps you sleep better from the very first night. S+ by ResMed monitors your body movements and breathing while you sleep. It also syncs with your smartphone; records the light, noise and temperature conditions; and has features to help you sleep more easily.
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GADGETS
Dring SmartCane Designed by walking stick company Fayet, the SmartCane is a game changer for those who need assistance. With an accelerometer, gyrosopce and GPS inside, the cane can understand its user’s habits and deduces which situations area not usual (low activity: disease or tiredness, fall, later and later awakenings, and so on). If a problem is detected, an alert with the user’s location is automatically sent to get help.
Muse Headband Muse, a lightweight headband and app, is your personal meditation assistant. Complete with 7 finely calibrated sensors, Muse monitors your brain activity during meditation and gives you accurate, real-time feedback on what’s happening in your brain when you meditate.
iHeath Smart FDA-approved and CE-certified, the iHealth Smart Gluco-Monitoring System gives you accurate blood sugar readings anytime, anywhere from your smartphone or tablet. This lightweight, portable glucometer works with the iHealth Gluco-Smart app to measure and save your readings on your secure iHealth account, and lets you share them with your doctor or family members right from your touchscreen.
QardioBase QardioBase is not your typical smart scale. This connected scale keeps an eye on not only your weight but also your body fat, body mass index (BMI), water makeup, muscle mass and water and cone composition. It syncs with the free Qardio app, allowing you to keep track of your health, share data with other users and your doctors, as well as set goals and reminders to achieve your health and wellness goals.
@LIVINGSAFER / LIVINGSAFER.COM / 7
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C O M M E N TA R Y
Your Personal Economy by John Bair et’s start with the basics: organization. We all know that personal finances can be complex, scary, and sometimes, paralyzing. What you should do, when you should do it, who to have help you—all of these are questions we face during different stages of our lives, and it’s easy to feel overwhelmed. One way to ensure you’re setting yourself up for success is to make sure
and password-protected, but you can also give shared file access to designated users, such as a spouse or life partner. Leading an organized financial life can reduce stress and encourage conversation amongst partners, spouses, and family members. These conversations can then help prepare you for future financial decisions. It’s also important to have a dedicated financial advisor who
you are organized. This way, you can step back and take a look at what you have and what you may be missing. Begin with a self or family audit. Where are all of your important personal documents? Passports, birth certificates, bank statements, wills…are they all kept in the same place and is that space safe? Do you have a health care proxy? Copies of previous years' tax filings? Make a mental or physical checklist of important documents and run through that checklist for every member of your household. Next, ask yourself, in what form do you keep these critical pieces of information, and is it the smartest and safest? Are you still clinging to paper? Do you have a filing cabinet overflowing with pieces of paper that you’re sure are important but couldn’t produce in a pinch? Maybe it’s time to switch to electronic files. There are several sites, apps, and tools out there that make it easy and secure for you to share and store your important documents digitally. One personal favorite of mine is Dropbox. Dropbox allows you to
communicates with you in the way that you prefer. Whether it be text, email, or you-refuse-to-give-it-up snail mail, trusting your advisor allows you to consolidate all of your holdings so you can have a whole picture. One great tool for communicating electronically is DocuSign. DocuSign enables you to upload documents that require signatures and safely delivers those documents to their recipient while allowing them to e-sign. This tool makes it faster and easier to get legal or personal documents exchanged back and forth. I encourage you to set aside some time to think about your personal economy, as well as ways in which you can protect the resources most important to you. You don’t have to start big— you can start small by consolidating what you have thus far and making sure you have safe and easy access whenever you need. If electronic organizing is not yet for you, that’s ok. The website www.pinterest.com is full of do-it-yourself home organization
store digital files in the cloud, and you can organize them into folders such as “home,” “work,” “health” and so on. The site is secure
hacks that just require some well intentions, a trip to Ikea, and some elbow grease.
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5 Reasons Why You Need an Emergency Fund by Michael J. Swanson “Gee, I wish I hadn’t saved up so much money,” said no one ever. However, you may have heard a financial planner say “So, what are you counting as your emergency fund?” The question leaves many of us dumbfounded. Anything extra each month goes toward credit cards or unexpected expenses, right? The rest is often tied up in retirement accounts or funds that we either cannot or are not supposed to touch for “emergencies.” But while we can cross our fingers hoping that a major household system like the heat won’t fail, or that everyone in our family will stay healthy, the truth is we’re only biding our time. At some point every person will experience an emergency—something “unexpected” that requires serious cash on hand.
Having some sort of liquid savings plan is critical. Here are some reasons you’ll appreciate having an emergency fund ready to go should you need it: Peace of mind
a familial fallback, it’s never fun to feel dependent on another—even a family member—for financial assistance. An emergency fund alleviates any burden you might otherwise put on others in times of hardship. On the flipside, this kind of financial freedom also allows you to be more generous with others or “pay it forward” for another friend or family member in a time of need.
Prioritizing health hen your finances are healthy, you will be healthier W mentally—and maybe even physically. Sadly, many people don’t seek appropriate medical care or will postpone care when they lack funds to cover medical costs. An emergency fund will put you in a position to take care of health issues promptly—and ideally be proactive about routine or preventive practices (e.g., mammogram, cholesterol checks, annual physical) that might save you thousands later on.
Sometimes you really can “buy” peace of mind. Even some of
HOW TO START BUILDING AN EMERGENCY FUND
the most successful people weren’t taught to set up an emergen-
Most financial experts recommend accumulating enough cash to be able to pay all of your normal living expenses for at least six months. If you’re starting from scratch and that sounds unattainable right now given your circumstances, just start wherever you are with whatever you can spare. Then give yourself a little pat on the back for kick-starting a savings plan in the first place. Try the “set it and forget it” approach. Put away a dedicated amount—however small—by setting up an automatic withdrawal from your main checking account into an online savings account that you can tap easily if you need it. You can also set up a bank savings account and have your employer direct deposit a budgeted amount of your pay. Finding out what number you are comfortable with starting to save each month will require looking at your monthly budget (or making one in the first place). Look critically at what “excesses” (dinners out, all those unused TV channels, last-minute trips, etc.) can go to clear a path to saving more. This might mean getting more serious about tracking your monthly expenses so you stop “going over” your budget and putting that overage toward that rainy day when you really need it. Remember, though, an emergency fund is not a line of credit or a handful of credit cards. Planning to borrow money to tide you over when times get tough will only dig a deeper hole. The best way to build an emergency fund is with great patience: it takes time, but it is so important. It can take several years to build up your emergency fund, but doing something is better than doing nothing at all. Good luck!
cy fund during the early stages of their careers. But as their assets and knowledge have grown, most would now attest to the sheer peace of mind that liquidity can bring. Imagine a high-stress scenario like a medical emergency. Having inadequate monies only adds to the anxiety. Having a tangible backup creates an intangible peace of mind.
Career flexibility With an emergency fund set aside, you can get more creative about career choices and decisions. Knowing you have some money in the bank, you can be more flexible about leaving an unsatisfactory job or starting a new venture—even if the timing doesn’t line up perfectly with severance or other temporary financial coverage. Should you lose your job, an emergency fund will give you time to find new employment that’s right for you, rather than being forced to take whatever you can find on short notice.
Preventive maintenance While it’s not something that is fun to spend money on, doing regular maintenance on a home, car or other piece of property can save you serious funds in the long run. With an emergency fund you can arrange prompt and proper maintenance so that small problems don’t become big, expensive ones. This will also help maintain the value of your greatest assets.
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WELLNESS
Signs You Might Have
Thyroid Disease by Florence Murray
In order to understand conditions of the thyroid, it is important to
»» Slowed heart rate
understand what the thyroid does. Part of the endocrine system,
»» Depression
the thyroid is made up of glands that produce, store, and release hormones into the bloodstream so that they can reach the body’s cells. The thyroid gland uses iodine from the foods you eat to make two main hormones: Triiodothyronine (T3) and Thyroxine (T4). Thyroid hormones synthesize the iodine contained in food and stimulate or enhance metabolic processes. More than eight out of 10 people with thyroid disease are women. Typically, a person will either suffer from hyperthyroidism or hypothyroidism. HYPERthyroidism is when the thyroid gland produces too much of the T4 hormone. This overproduction can result in symptoms such as: »» Feeling nervous, anxious, or irritable »» Experiencing mood swings »» Feeling very tired or weak »» Sensitivity to heat »» Enlarged thyroid (goiter). This can make the base of the neck look swollen. »» Losing weight suddenly with no known cause »» Fast or irregular heartbeat or palpitations (pounding in the heart) »» Increased frequency in bowel movements »» Shaking in the hands and fingers (tremor) »» Sleep problems
»» Impaired memory »» Constipation Consequently, a thyroid dysfunction can be mistakenly treated as just one of the symptoms, not for the totality of all of the symptoms for one diagnosis. Once a person has been successfully diagnosed with either an under- or overactive thyroid, the dysfunction is usually categorized by the condition, with the most common conditions involving the thyroid being: Hashimoto's Disease: The most common cause of hypothyroidism in the United States. It can occur at any age, and is most common in middle-aged women. The disease occurs when the body's immune system mistakenly attacks and slowly destroys the thyroid gland and its ability to produce hormones. Mild cases of Hashimoto's disease may have no obvious symptoms. Graves’ Disease: The most common cause of hyperthyroidism. It is an autoimmune disorder and occurs when the body's immune system mistakenly attacks the thyroid gland. This attack can cause the gland to overproduce the hormone responsible for regulating metabolism. The disease is hereditary and may develop at any age in men or women, but is much more common in women ages 20 to 30. Goiter: This is a noncancerous enlargement of the thyroid gland. The most common cause of goiter worldwide is an iodine
»» Thinning skin
deficiency in the diet. In the U.S. where iodized salt provides
»» Changes in the hair making it fine and brittle
plenty of iodine, goiters are often caused by, and is a symptom of, hyperthyroidism. Goiters are more common after the age of 40
HYPOthyroidism is where the thyroid gland doesn't produce enough of either (or both) the T3 and T4 hormones. The deficiency can result in symptoms such as: »» Fatigue »» Increased sensitivity to cold
and in women, who are more likely to have thyroid disorders. Thyroid Nodules: These growths form on or in the thyroid gland. Their cause is not always known, but can include iodine deficiency and Hashimoto's disease. The nodules can be solid or fluidfilled. Most are benign, but they can also be cancerous in a small
»» Weight gain
percentage of cases. As with other thyroid-related problems,
»» Muscle weakness
nodules are more common in women than men.
»» Elevated blood cholesterol level »» Muscle aches, tenderness and stiffness »» Pain, stiffness or swelling in the joints »» Thinning hair
Detecting an issue with your thyroid is straightforward affair. Physicians will usually order blood tests that can reveal levels of thyroid hormone, Thyroid Stimulating Hormone (TSH), and antibodies in the bloodstream. In some cases, the physician will also order an ultrasound of the thyroid. @LIVINGSAFER / LIVINGSAFER.COM / 11
Salt Lamps: Savior or Sham? by Bret Hanna
imalayan salt lamps have become very popular around the world, especially in eastern cultures where they originated. The reason they have become so popular, is because of claims of health benefits which range from air purification to increased blood circulation, increased cerebral serotonin levels, improved sleep, calming allergies, cancer prevention and more. The theory behind salt lamps is that salt is hygroscopic, or it draws water molecules from the air. In doing so, the salt traps pollen, dirt and smoke particles from water vapor in the air. The follow-up proposition is that after airborne contaminants are trapped in the salt of a salt lamp, “clean” water vapor would be released back into the air. As such, the air has been “purified” by the salt lamp. There is, however, a glitch in sustaining the purification process. Salt does absorb water vapor from the air, but it quickly achieves a state of equilibrium. That is, the salt quickly becomes saturated with water vapor and, therefore, cannot trap any more contaminants. But there is a solution to the equilibrium problem—heat. That’s where the lamp piece comes in. The bulb inside a salt lamp heats and dries the salt so it can keep absorbing water vapor and airborne contaminants. But what about those health benefit claims? Most are related or linked to salt lamps releasing negative ions into the air which offset positive ions, otherwise known as destructive free radicals. As to the specific claims:
Breathing Improvements – negative ions increase cilial activity in the trachea, while positive ions have the opposite effect. Cilia are the microscopic hairs that filter the air entering the lungs, so increasing the number of negative ions in the air is believed to reduce the number of foreign particulates and free radicals getting that far.
Reducing Electromagnetic Radiation Exposure – since negative ions cancel out positive ions, they have the power to reduce electromagnetic radiation in indoor spaces. Electromagnetic radiation is generated by the ubiquitous electronics present in homes and offices, and exposure to it has been linked to immune system suppression, chronic fatigue, increased stress levels and other maladies. The level of reduction caused by negative ion releases from salt lamps, however, is not clear. It certainly falls short of outright neutralization of electromagnetic radiation.
Increased Energy Levels – the claim is that positive ions reduce energy levels in the body, so offsetting them must increase energy levels. While that sounds logical, again there is no scientific support for the claim. When it comes to salt lamps, the claims of beneficial health benefits are many and bold. But they just are not well supported by scientific evidence. That said, there is little downside for trying one out. One can be picked up at a pretty affordable price and who knows, they may work as claimed.
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Reducing Allergy and Asthma Symptoms – people regularly use saline mist to help keep airways clear of pet dander, mold, mildew, dust and other indoor contaminants that can cause asthma and allergy symptoms, as well as other respiratory ailments. As such, it seems logical that using a salt lamp or two in the home or office would help as well. Mood Elevation – many proponents of salt lamps claim that they increase serotonin levels in the brain, which in turn elevate mood. Such claims, however, have never been proven. That said, studies have shown that salt lamps can help with some forms of depression, such as seasonal affective disorder. However, a causal link between salt lamps and those results has not yet been identified. Improved Sleep – the claim, or theory with respect to sleep, is that positive ions have a negative effect on blood circulation in the brain which can negatively impact sleeping patterns. However, no studies have proven the theory.
@LIVINGSAFER / LIVINGSAFER.COM / 13
Not as easy to lose the weight as it used to be? That's life, my friends by Lily Grace ave you tried losing weight lately, only to find that it’s a bit harder than it used to be? It’s not common. Unfortunately, it’s a natural part of aging—not just metabolism as many believe. Many studies have been done to understand why people gain weight as they age and the answer is clear—the change in body composition accounts for the vast majority of the decline in metabolism (the process by which your body converts what you eat and drink into energy.) There are also a growing number of studies, however, that suggest that body composition does not account for all of the weight gain associated with the aging process. Decreases in the calories used by the body's organs, such as the heart and liver, also seem to occur as the body ages. Of course, physical activity plays a role in both body composition and metabolism during the aging process. Research shows that most individuals gradually reduce their level of physical activity as they age, which further reduces their number of calories
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needed to maintain weight. Less activity also means less use of the body's muscles, which contributes to the general decline in muscle mass and subsequent changes in body composition. Overall, these age-related changes means that the average 50 year-old woman needs around 300-500 fewer calories per day than she did in her 20s to maintain the same body weight. So for those who gain weight while aging, the reason is not necessarily eating more; but rather eating the same, while needing fewer calories.
So why can’t I lose weight? Essentially, even when you're at rest, your body needs energy for all its "hidden" functions, such as breathing, circulating blood, adjusting hormone levels, and growing and repairing cells, according to the Mayo Clinic. The number of calories your body uses to carry out these basic functions is known as your basal metabolic rate—what you might call metabolism. Several factors determine your individual basal metabolic rate, including:
»» Your body size and composition. The bodies of people
body burns up each day. Physical activity is by far the most
who are larger or have more muscle burn more calories,
variable of the factors that determine how many calories you
even at rest.
burn each day.
»» Your gender. Men usually have less body fat and more muscle than do women of the same age and weight, burning more calories. »» Your age. As you get older, the amount of muscle tends to decrease and fat accounts for more of your weight, slowing down calorie burning. Energy needs for your body's basic functions stay fairly consistent and aren't easily changed. Your basal metabolic rate accounts for about 70 percent of the calories you burn every day. In addition to your basal metabolic rate, two other factors determine how many calories your body burns each day:
The blame game It may be tempting to blame your metabolism for weight gain. But because metabolism is a natural process, your body has many methods that regulate it to meet your individual needs. Only in certain cases do you get excessive weight gain from a medical problem that slows metabolism, such as Cushing's syndrome or having an underactive thyroid gland (hypothyroidism), the Mayo Clinic asserts. Unfortunately, weight gain is complicated. It is likely a combination of genetic makeup, hormonal controls, diet composition, and the impact of environment on your lifestyle, including sleep, physical activity and stress. All of these factors
Food processing (thermogenesis). Digesting, absorbing,
result in an imbalance in the energy equation. You gain weight
transporting and storing the food you consume also takes
when you eat more calories than you burn—or burn fewer
calories. This accounts for 100-800 of the calories used each
calories than you eat.
day. For the most part, your body's energy requirement to process food stays relatively steady and isn't easily changed.
While it is true that some people seem to be able to lose weight more quickly and more easily than others, everyone will lose weight when they burn up more calories than they eat.
Physical activity. Physical activity and exercise—such as
Therefore, to lose weight, you need to create an energy deficit
playing tennis, walking to the store, chasing after the dog and
by eating fewer calories or increasing the number of calories
any other movement—account for the rest of the calories your
you burn through physical activity or both.
Your Metabolism over Three Decades In your 20s…
In your 30s…
In your 40s…
Most women enjoy their highest basal metabolic rate in their late teens or early 20s, say most doctors. Some women will hit it a bit earlier, others later, which has a lot to do with genetics, but your activity level also plays a big role. After all, the more you run across campus or hit the gym, the more muscle you’ll build and the higher your metabolism will be. Plus, until you’re about 25 or so, your body is still building bone, and that process burns up calories. However, it doesn’t last that long. According to the American Council on Exercise, your basal metabolic rate drops roughly 1-2% per decade. Generally, by their late 20s, many women notice that they can’t eat the same things they used to without gaining weight and that the weight doesn’t fall off as easily as it once did. Since this drop starts right about the time people settle into the (largely sedentary) workforce—and start losing muscle—an office job might be partially to blame.
As you lose muscle, your natural calorieburning ability slows even more. And as you lose muscle and gain fat, fat can develop into the muscle and cause weight gain and metabolic dysfunction. Plus, during your 30s, you aren’t producing as much human growth hormone as before, which also leads to a dip in your metabolic rate. However, strength training can help you build muscle and produce more human growth hormone, both of which keep your metabolism running as fast as (or faster than) it did when you were 20. And then for women, there’s the pregnancy factor. A huge calorie burn comes from breastfeeding (should they choose to do so). The average woman who breastfeeding full time can expect to burn an extra 500 to 1,000 calories per day. Unfortunately, as soon as you start weaning your little one, your metabolism goes back to pre-pregnancy levels—as long as you haven’t lost any muscle since you got pregnant.
Women can say goodbye to your hormones. Around 40, levels of estrogen, progesterone, and (again) human growth hormone decrease. And metabolism follows suit. That means you'll have to focus on reducing your caloric intake during your 40s in order to maintain your weight. If you're working out, that might only amount to eating about 150 less calories per day. But if you don't exercise and sit most of the day, you'll probably have to cut more calories to stay svelte. Also by 40, your body’s natural decline in muscle mass, called sarcopenia, sets in. To combat the loss of lean mass and keep your metabolism revved, you really have to turn to strength training. According to research from the Harvard School of Public Health, people who lift weights put on less belly fat as they age than cardio bunnies. While any exercise will help you burn calories while you’re at the gym, strength training gives your metabolism the biggest boost after your workout ends. Eating the right amount of protein (about 100 to 120 grams a day) boost your efforts to get stronger. @LIVINGSAFER / LIVINGSAFER.COM / 15
Don’t Forget to Stretch
The many reasons why it’s vital toward keeping a healthy life by Jim Edward ost people think of stretching as something a runner, gymnast or dancer might do to prep for their actual workout. But there’s so much more to it. We need to stretch in order to protect our mobility and independence. Doctors agree, stretching needs to happen on a daily basis, according to Harvard Medical School.
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THE WHY Stretching keeps the muscles flexible, strong, and healthy, and we need that flexibility to maintain a range of motion in the joints. Without it, the muscles shorten and become tight. Then, when you call on the muscles for activity, they are weak and unable to extend all the way. That puts you at risk for joint pain, strains, and muscle damage. For example, sitting in a chair all day results in tight hamstrings in the back of the thigh. That can make it harder to extend your leg or straighten your knee all the way, which inhibits walking. Likewise, when tight muscles are suddenly called on for a strenuous activity that stretches them, such as playing tennis, they may become damaged from suddenly being stretched. Injured muscles may not be strong enough to support the joints, which can lead to joint injury. Regular stretching keeps muscles long, lean, and flexible, and this means that exertion "won't put too much force on the muscle itself," says Nolan. Healthy muscles also help a person with balance problems to avoid falls.
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HOW DO I START? With a body full of muscles, the idea of daily stretching may seem overwhelming. But you don't have to stretch every muscle you have. "The areas critical for mobility are in your lower extremities: your calves, your hamstrings, your hip flexors in the pelvis and quadriceps in the front of the thigh," David Nolan, a physical therapist at Harvard-affiliated Massachusetts General Hospital tells Harvard Health. Stretching your shoulders, neck, and lower back is also beneficial. Aim for a program of daily stretches or at least three or four times per week. Find a physical therapist who can assess your muscle strength and tailor a stretching program to fit your needs. If you have chronic conditions such as Parkinson's disease or arthritis, you'll want to clear a new stretching regimen with your doctor before you start. THE EFFECTS OF STRETCHING Stretching once today won't magically give you perfect flexibility. You'll need to do it over time and remain committed to the process. "It may have taken you many months to get tight muscles, so you're not going to be perfectly flexible after one or two sessions," says Nolan. "It takes weeks to months to get flexible, and you'll have to continue working on it to maintain it." THE PROPER EXECUTION We used to believe that stretching was necessary to warm up the muscles and prepare them for activity. However, mounting research
has shown that stretching the muscles before they're warmed up can actually hurt them. "When everything is cold, the fibers aren't prepared and may be damaged. If you exercise first, you'll get blood flow to the area, and that makes the tissue more pliable and amenable to change," says Nolan. All it takes to warm up the muscles before stretching is five to 10 minutes of light activity, such
as a quick walk. You can also stretch after an aerobic or weighttraining workout. Hold a stretch for 30 seconds. Don't bounce, which can cause injury. You'll feel tension during a stretch, but you should not feel pain. If you do, there may be an injury or damage in the tissue. Stop stretching that muscle, and talk to your doctor.
6 GREAT REASONS TO STRETCH Stretching – while it may not show on the scale – is an integral part of your overall health. Here are six reasons why you need to make time in your day:
keep moving. Simple rotational stretches throughout the day are extremely important if you drive, sit, or just stay in one place for a few hours of the day.
Better Blood Flow (and you feel good too!) – Stretching can lead to better posture, fewer aches and pains, greater confidence, and a cheerier outlook on life.
Better Balance – Daily use of muscles can cause them to get tight, especially if you regularly carry a purse or backpack – i.e., the heavier the bag, the more your body can tighten up on one side. Stretching can alleviate muscle tightness and bring your body back to feeling better balanced.
Great for Glutes – When you’re sitting, the nerves that activate your glutes can shut down in a very short period of time. This means that the glute muscle begins to degenerate (not in a good way). When your glutes shut down, other muscles and joints in your body become over-stressed and can result in pain in places such as the knees and lower back. Terrific for Your Thoracic Spine – Your thoracic spine, which is located in the middle of your back, is very important to stretch and
Workout Wonders – And obviously, if you are working out, stretching can do your body wonders. During weight training, your muscle length shortens; this can leave you feeling tight and sore. Stretch Smart – To reap the benefits of stretching, you have to do it the right way. Hold the stretch at the first sensation of resistance, then breathe your way through it. @LIVINGSAFER / LIVINGSAFER.COM / 17
Time to Divorce your Doctor? by Derek Braslow he just doesn’t seem interested in you anymore. Always distracted and running late. Seems like she doesn’t care like she used to. You clearly aren’t a priority. There’s always someone else who is spending more time with her. Always dismissive of your concerns. Spends no real time with you. Doesn’t show any empathy—even when you are really sick. The way she talks is condescending. I don’t trust her. Maybe I did when we first met, but not anymore. If this person was your wife, you’d consider divorce. Maybe marital therapy. But your doctor—you’ve been with her for over a decade—well, that’s a different story. She knows you better than anyone and could save your life. But does she still know you better than anyone? How could you possibly leave her? Like your marriage, your relationship with your doctor is a very important one. I’m here to tell you that you may be happier and perhaps healthier by moving on, playing the field for a bit, and finding someone new; especially if you have these issues in your doctorpatient relationship:
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Communication Issues he first question you should ask yourself is: does your T doctor really listen to your concerns? Does he or she spend enough time with you? At the outset of every visit—your doctor should allow you several minutes to discuss all of your concerns without interruption. Her answers should not feel rushed. Many mistakes are made in clinical care solely by lack of communication. If your doctor doesn’t have time for you, then it is time for you to find one who does.
Lack of Knowledge our doctor should not only be familiar with the latest studies Y and preventive care, but should also know you as a person. She should know what medications and supplements you are taking. She should be familiar with your prior medical and family history. If she is not taking the time to review your chart and ask you questions, she will lack the requisite
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knowledge to care for you—then it’s time to ask your friends if they know anyone who might be a good fit for you.
Lack of Empathy Nothing is worse than going into a doctor’s office and feeling like no one cares. You are sick, and sometimes there is nothing they can do to help. Prescribing needless antibiotics to make you feel better does not count. However, the least a doctor can do is show real concern about your life and empathy if you are ill. A doctor who doesn’t care is not a doctor worth spending time with; especially when you are most vulnerable.
Level of Comfort I f there are things you are hiding from your doctor because they are too embarrassing, it’s time to move on. You can’t hold back from telling your doctor everything, regardless of the sensitivity. Drugs, sex, alcohol, abuse… these are issues your doctor needs to know about in order to treat you.
Responsiveness his may not always the doctor’s fault—but it may be her T office staff. Are you able to see the doctor when you are sick? Are you able to communicate with the doctor after hours? Do they have hours that can accommodate you? Do they timely call you with important test results? Do they assist with insurance issues? If the doctor and/or her office is not responsive, what is the point of continuing to see her? Again, it is time to find someone who will respond to your needs. There are plenty of doctors out there who might be a better fit for you. There is no need to rush in making your decision. Perhaps try to talk to your doctor about your concerns. If nothing changes—it is time to consider divorce. It can be scary at first, especially if you’ve been with the same doctor for a long time, but your health is not worth the risk.
A Woman’s Age at First Pregnancy:
Why It Matters by Sarah Schindler
here is no question that women today are having children later than their mothers and grandmothers. The National Center for Health Statistics recently reported that in 2014, the average age of the first-time mother was 26.3—up from just 21.4 in 1970. While the shift is partially attributable to a downturn in the rate of teen pregnancies, there has also been a clear uptick at the other end of the spectrum. Across all the firsttime pregnancies reported in 2014, only 13.4 percent of women were under 20 years old, while 21.1 percent were aged 30-34, and
and over time the eggs decrease in number and become harder to fertilize. Women may find it helpful to keep these general milestone ages in mind, so they are prepared to deal with the challenges they may face when they do eventually try to get pregnant. Women should also be aware of how their age at pregnancy may affect their baby’s health. It is widely accepted that older women have an increased risk of having children with health problems caused by missing, damaged, or extra chromosomes—problems
9.1 percent were 35 and over. More and more women are waiting until their 30s and 40s to have babies, but they are not necessarily discussing the realities of age-related risks associated with pregnancy. Egg freezing companies encourage women to take steps to preserve their fertility, but with services costing upwards of $10,000 to 12,000, only a handful of women can give this option more than a passing thought. Many women are generally aware that there are risks associated with waiting longer to have babies, but they may be in the dark about the specific details. The reality is, a woman’s age can impact her ability to get pregnant, her chances of having a healthy baby, and her chances of developing certain health problems herself. For starters, The American College of Obstetricians and Gynecologists (ACOG) puts it plainly: a woman’s fertility starts to decrease at age 32 and decreases more rapidly beginning at age 37. This is because a woman is born with a fixed number of eggs,
including Down syndrome, Tay-Sachs disease, and cystic fibrosis. Perhaps least discussed are the potential effects of delayed pregnancy on a woman’s own health. ACOG cautions that as women age, they are at a higher risk for developing high blood pressure and diabetes during pregnancy. Additionally, there could be a connection between a woman's age at first pregnancy and her risk of developing breast cancer. Studies have shown a correlation between a woman’s exposure to the hormones estrogen and progesterone and her risk of developing breast cancer. Thus, per the Susan G. Komen Foundation, it is not surprising that pregnancy—a time of breast development and hormone changes—affects breast cancer risk. Women tend to lower their overall risk of breast cancer by having their first child before age 35. Ultimately, women should be empowered to make their own decisions about when to have children, but they should also be informed about the risks.
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THE CONSUMER’S GUIDE TO ALL THINGS SAFETY
We’re on the Web and in Your Hands. Welcome to the all-new Living Safer, the same magazine you’ve come to know and love...just with a more inviting look and feel. And while the face may have changed, our pledge ; the best in safety information— from new trends and wellness to lifestyle, home and more.
Join the Conversation. Share and comment on Living Safer stories by joining us on Facebook and Twitter and by visiting LivingSafer.com fb.com/LivingSafer / @livingsafer
LIFESTYLE
REALNEWS vs.
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Why and How You Should by Mike Daly On January 11, 2017, then President-elect Donald Trump responded to a CNN reporter’s request for a question with a startling accusation: “You are fake news.” The President-elect used his opinion of one of the major news organizations in this country—one of the many that had provided critical coverage of him in the run-up to the election—to justify his decision to ignore and demean the network. This strange moment marked the culmination of what had been a long, exhausting election season chock-full o’ allegations of “fake news” in response to unflattering coverage and actual fabricated news stories intended to sway the public. One week later, President Trump’s day-old administration released some fake news of its own when Sean Spicer oddly informed the public that the president’s inauguration crowd was “the largest audience ever to witness an inauguration, period, both in person and around the globe.” This statement didn’t seem accurate to anyone who observed the event, and was easily disproved in the coming days. Three weeks later, the president himself conveyed a false statement when he told reporters the margin of his electoral college win was the largest since President Reagan; in fact, Presidents Obama (twice), Clinton, and George H.W. Bush all had larger margins. The above are examples of the modern uses of “fake news”— as either a way to deliberately mislead the public, or a means to 22 / LIVING SAFER / VOL 9 ED 2
deflect or discredit potentially damaging, newsworthy information or sources. Sometimes, “fake news” can even materialize into physical danger. This past December, in order to “investigate” fake claims of a pedophilia ring, Edgar Maddison Welch brought an AR-15 rifle into a Washington D.C. pizzeria and fired shots. Fortunately, no one was hurt, but employees of the shop confirmed that they had been targets of harassment and threats for some time as a result of the fabricated “Pizzagate” conspiracy that had gone viral. What began as a wild and baseless tweet eventually became appealing content to mainstream conspiracy theorists like Alex Jones—who then spread the message to an audience of millions via his on-air and online radio program and his website, InfoWars.com. “Pizzagate,” all things considered, is a tale of “what if?” What if innocent lives had been taken because of the made-up story? It wouldn’t be the first time, of course, but its occurrence at the end of a political season that is now known to have been infested with “fake news” makes it a timely cautionary tale. Whether it originates from a foreign agent, a popular radio host or your pal’s Twitter feed, it’s important to understand how to detect “fake news,” so you can be armed with the truth and avoid the inadvertent spreading of false information. Long gone are the days where everyone got their news from the same ideologically neutral television news stations. Americans can forgive themselves for
C O M M E N TA R Y
Sniff Out ‘Fake News’ feeling frustrated and a bit lost when trying to wade through the muck of Internet media in order to get a story straight. The harsh reality nowadays is that people will have to do some homework if they’re truly interested in the truth. Fortunately, you needn’t be a detective or veteran journalist to determine with a high degree of confidence whether a bit of news is real or fake. Whether you’re digesting a news story, bit of gossip you hear from a friend, the source of the information is always the best first place to look. If there is a silver lining to the recent onslaught of “fake news,” it’s the emergence of reputable websites and diligent, credible journalists dedicated to its exposure. A simple Google search of the story’s source will likely turn up an extensive history of the source’s publications. You may even get lucky and see the source in question turn up in thoroughly researched articles debunking fake news. Pulitzerprize winning websites, such as PolitiFact, scrutinize statements that have drawn some attention by conducting research and assigning a “true or false” Pinocchio rating. And it’s OK if you’re hesitant to trust “fact checker” sites; you could still make use of them by analyzing the sources cited in the fact check and using them as sort of a “first stop” for your budding investigation. If the content you’re curious about is an opinion piece that comes to a particular conclusion (say, for example, an article on immigration policy) you’d be well-served to google articles or
sources that come to a different conclusion. Comparing the two points of view and the data upon which they rely may help you decide which argument has better support, and can serve you well in further researching the issue. Be wary of quotes as well. Such statements have a propensity for being taken out of context more than anything else. Often, the brevity of Twitter’s 140 characters can sometimes rob the reader of the proper context of a quote that may, at first glance, appear sensational. Spend an extra few minutes to google the full article—or, if plausible, the transcript—citing the quote to see if the language still has the same impact when viewed in the context of the full discussion. Finally, you might want to consider the “wait-and-see” approach; content comes thick and fast in the modern information era, and giving a story or a piece of news time “to breathe” before making a rushed conclusion on the matter may allow for a more in-depth (or updated) assessment of the topic. The truth is certainly worth the wait, and, in 2017, the wait is unlikely to be very long. Understand that “fake news” is very real and can be very dangerous. The best antidote isn’t increased censorship or the expansion of libel laws—it’s an informed populace. So by all means, read and watch the news with a critical eye. You’ll be doing your part to deprive the perpetrators of “fake news” the oxygen they need to survive. @LIVINGSAFER / LIVINGSAFER.COM / 23
4 Ways to Cut Through the Noise by Ken Riley No one can argue that one of the greatest byproducts of the Internet is the open access of information and knowledge provided to the masses. This unlimited accessibility has empowered individuals to recognize or create opportunities for themselves and their communities that would otherwise not be feasible. Before you share information on any digital platform, it is up to you to be sure the information is good. Here are some best practices to follow when processing information you feel is worthy of sharing:
Look at the comments section This can be a good starting point for most verification purposes. The comments section on a blog or news story can sometimes house intense debates regarding the story’s content. Look to see if the majority of the comments charge the author with false or misleading information. In most cases, the commenters have already done the research for you. If most comments seem to debate the veracity of the issue, continue to vet the information.
Recognize a reliable source Check the URL of the source. Is this publication from someone easily recognized? Be sure that the URL extension says “.com” and not “.com.co;” extensions like these should raise a red flag and cause you to research the story’s origin further. 24 / LIVING SAFER / VOL 9 ED 2
Examine the quotes and who was quoted A legitimate article will be heavier with quotes to support the author’s content. If the content is of a serious matter, you should expect more quotes. After you look at the number of quotes, examine who was quoted. Google the source to see if they are easily verified and reputable. Google the quotes themselves to see if they are documented in other reputable content or if you can find the original speech or presentation from where the quotes were pulled.
Does the source have an “about us” section? Whether it is a blog or a news site, the “about us” section can help verify if this source is reputable or not. Look for a strong mission statement from the organization, leaders who have sound backgrounds, and statements regarding the organization’s ethics. Google the organization’s leaders to be sure you can find information about them from sources other than their website. Those who share online content without following these steps increase the amount of circulating false information, while also making the person who shares the information seem less reputable. Practice these steps going forward and you may help fix the fake news epidemic, or at the very least save yourself a great deal of frustration!
PERSONAL ISSUES: What You Should—and Should Not—”Bring” into the Office by Cheryl Pope
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“Well, that’s 15 minutes of my life I’ll never get back…” Everyone has probably had similar thoughts at one point or another while at work, simply because of a co-worker that doesn’t know how to delineate between work and personal issues. Building meaningful relationships with co-workers leads to greater employee engagement, but bringing too much personal information to work can hurt an individual’s credibility. So when does that relationship actually create stress and challenge, and where is the line that separates what is and isn’t appropriate to bring to work? A lot depends on the work environment. What are the organization’s values? How important is work life balance? Read the obvious clues (i.e. quarterly family events that everyone is expected to attend) as well as the subtle signs (i.e. no personal pictures on any senior leader’s desk) to see how sharing information might be received. Also consider the perspective of the other individual when determining whether to share personal information. Ask several key questions: »» What will the person think and feel about what they are told (i.e. what underlying assumptions might they make)? »» What will the person hear (from the boss, peers, etc.)? »» What will they say (to others, to you)? »» What pain could come to them (their fears, frustrations, obstacles, etc.)? »» How could they gain from this information? Examine the intent behind wanting to share. Is this something that others can help solve or is this simply satisfying a need to vent? If it has the potential to come across as a complaint, gossip or a rant, then it is probably better to leave the issue at home. Then, think about if and how the issue might affect one’s own performance and the ability to fulfill key job responsibilities. If it won’t impact job performance, don’t needlessly create questions by sharing unrelated information. Next, think about whether the issue will have an impact on the performance of other individuals like a boss or co-workers. If the issue will cause an undue burden on another individual, then by all means talk to someone. But be realistic about the size and impact of the issue. Sharing too much can create long term doubt about the individual. While there are no clear cut rules about what is or is not appropriate to discuss, some things are helpful to discuss so that others aren’t unfairly judging a situation or making up their own version of events without all of the information. For example, someone going through a divorce might need to come in 30 minutes later every Wednesday because of the need to take a child to school as part of the separation agreement. It would be
important to talk the boss about this because absent that detail the boss might think that the person is slacking off or is lazy. Some general guidelines:
Carefully Consider »» Pregnancy »» Illness that will cause work to be missed »» Child or elder care scheduling issues
Leave at Home »» Personal finances »» Children issues like arrests, trouble in school »» Relationship trouble »» Neighbor disputes »» Lawsuits Problems and challenges are not the only things that people like bringing to work that can cause issues. Consider the “Girl Scout Cookie/Wrapping Paper/Popcorn” phenomenon. Before asking co-workers to participate in a child’s fundraising activity consider two things: first, does the company have a policy addressing these types of things? You should know the rules and avoid uncomfortable conversations. Second, can you identify the lowest common denominator? In other words, if it is not
Examine the intent behind wanting to share. Is this something that others can help solve or is this simply satisfying a need to vent? If it has the potential to come across as a complaint, gossip or a rant, then it is probably better to leave the issue at home. appropriate to ask everyone at work to participate, then it’s probably best to leave the sign-up sheets at home. Finally, words are not the only communication vehicle people use to bring personal issues into the workplace. Having too much personal stuff (souvenirs, baubles, etc.) might create a perception that the individual would rather be somewhere else. It’s also important to look at what type of pictures are brought into the workplace. For example, photos of parties might create an impression that the person isn’t serious about work. To sum it all up… if in doubt about whether something is appropriate to bring to work, then it probably isn’t!
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Meditation Studies that Support the Practice—
START AT WORK by Pete Mackey odd, a young lawyer, sat down at the seminar next to one of the most respected lawyers in his town. Todd thought he looked so confident, so accomplished. And he was. He had won large verdicts in David v. Goliath fights for years. He never lost his cool. At one of the breaks, Todd introduced himself. His older counterpart was more than friendly and invited him to lunch. As they ate, Todd asked what his secret was—how was he able to handle the pressure of big case after big case, year after year? The answer was not what Todd expected. “There are a lot of things: preparation, hard work, a good support staff... and meditation,” the older lawyer told him. MEDITATION? MEDITATION? “Yes, Todd, meditation.” He had been doing it for years and described the benefits: it reduced stress, improved concentration, increased self-awareness, and provided an overall better feeling. As Todd drove home from the seminar, he could not get the mediation thing out of his mind. In part, it surprised him that a veteran like his new friend could be engaged in such a new age concept. But, and more importantly, it might be the answer to his issues. Though Todd’s practice was doing okay—appointed criminal cases, some wills and deeds for friends, and a few personal injury matters—he was drowning in debt. Eighty percent of his monthly income went to student loans, rent and a car payment. The stress was almost unbearable at times. Todd started researching as soon as he got home. Site after site, study after study reinforced what he had heard at the seminar. After reading “how to” tips at a few websites, he dimmed the lights, sat in a comfortable chair and started inhaling for six seconds, holding the breath for five and exhaling for four. Just as he had read, he attempted to focus on his breathing, pushing all other thoughts out of his mind. The breathing he could do. Pushing
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out all other thoughts was another matter. The more he pushed, the more he thought of his student loans and the lawyer billboards all up and down the street his office was on. After 20 minutes, he gave up—frustrated. This was much harder than he thought. The next morning he gave it another try and the results were the same. And the next day. And the next day. After a week he was about to give up, but then he called the older lawyer. As he recounted his failing start, the older lawyer smiled. “You are trying too hard,” he told Todd. “Take it in bits and pieces.” “But I am,” said Todd, “and it’s not working.” The veteran attorney replied, “Well then, Todd, try a meditation app.” That was a year ago. Todd did buy a meditation app—there are several (ask Google)—and it is now the rare day that he does not meditate. As the due date for his student loan approaches each month, the left side of his brain starts obsessing about all the bad things that will happen if it’s not paid. Through meditation, however, he is able to reel those thoughts back in and let his right side figure out a rational path. The payment is the same and it is still due each month, but now he is dealing with it without the drama. One thing Todd understands now—meditation is Old School, not New Age. It goes back to prehistoric religions doing group chants, or mantras. The science is clear—meditation works. There are multitudes of studies, peer reviewed and not, that document the mental, spiritual and physical health benefits gained through meditation. It has been found to be helpful in combatting depression and for those in recovery from substance abuse. So how do you get started? Just like Todd did. Some people start with simple breathing exercises. Others seek out practitioners for lessons or groups that meditate together. And then there are the apps…pick the method and type most comfortable to you. Do not expect overnight success. Remember—it’s the journey, not the destination…
by Bryan Silver
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COVER
here’s no denying that big pharma means big business—but the big question is, “who is the real benefactor?” While treating America’s ills seems like an altruistic endeavor on the surface, today’s pharmaceutical companies have gone beyond simply pioneering new treatments for age-old health problems and literally forged a burgeoning industry that caters to a continually growing marketplace which they, in part, have invented. In other words, big pharma is both creating and satisfying needs for their products within large segments of our society—manipulating supply and demand through congressional lobbying and consumer marketing while controlling aspects of availability, pricing and even government regulation in the process. As an industry, it generates higher profit margins than any other—even with a constant litany of multibillion dollar lawsuits over product failures and adverse effects. Considering that this is an industry ripe with allegations of collusion, the manipulation of medical professionals, price-fixing and overcharging and you might wonder why we as a society allow such subversiveness to seep into our concept of adequate and readily available healthcare. And their lies the rub; should we consider big pharmaceutical companies to be a key element of what’s vital to our well-being, or are they simply a gang of large multi-conglomerates out to gouge good people who have real health concerns? Now, this is not to say that all those that are in this business are bad, because that’s certainly not the case. It’s an industry where many are forced to walk a thin line between best serving the needs of patients and putting money in the pockets of their shareholders, so we can’t have issue with every little wobble in their balancing act. But some deviate more than others, often to the point that they’ve left the line altogether. They’ve tossed values aside and become thoroughly entrenched in the idea of making money at all costs. What makes matters worse, they often brandish their scientific achievements as a shield in order to hide their selfish acts. We don’t deny that many pharmaceutical companies are making great strides in the world of medicine; developing drugs intended to help all of mankind—but we also know there are some things they’re not telling us, and it’s those aspects that could truly hurt us all.
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One Company Helped Fuel America’s Opioid Epidemic To better understand the potential for abuse in the pharmaceutical industry, it might help to look at the havoc a real-life situation has wrought on the world around us. While many know about the current opioid epidemic that is affecting our nation, most are unaware of the domino-like progression of events that brought about this blight—not to mention how much of it was orchestrated by a single pharmaceutical company for the benefit of a single family. While it would be a stretch to suggest that anyone purposely brought about such a rampant level of drug abuse on purpose, there’s far too much evidence that has been presented through an ongoing parade of lawsuits over the past decade to ignore, and it all points to a pharmaceutical manufacturer guided by greed and acting with an unchecked level of recklessness and misconduct. The story begins a little more than 20 years ago, when Stamford, Conn.’s Purdue Pharma first released OxyContin. At the time that it was introduced, OxyContin was heralded as a new class of opiate—one that utilized a time-release coating to avoid issues of abuse that had been previously experienced with longterm pain patients and opiate use. Purdue Pharma was quick to tout their new flagship drug as self-proclaimed “pioneers in the area of pain management” (before OxyContin, Purdue had been marketing healthcare products such as Senekot laxatives and Betadine antiseptic). A privately held company, Purdue Pharma is headed by mem-
bers of the Sackler family—a clan that’s currently ranked number 19 on Forbes Magazine’s list of America’s Richest Families, right after the Busch family of Anheuser-Busch. It’s important to note that the bulk of their fortune was not inherited, but built squarely on the foundation of sales from one of the most popularly prescribed painkillers of the 21st century. After moderate success at manufacturing over-the-counter type remedies, the Sackler brothers used their backgrounds in medicine to “tweak” a drug that had been around since 1917. The result was OxyContin, a so-called extended release formula of oxycodone thanks to a plastic coating around the pill. Prior to the FDA’s approval of OxyContin in 1995, opioid painkillers were primarily used to treat cancer patients—situations where the relief they brought was worth the risk of addiction. But by relying on marketing tactics taught to them by their late brother, Raymond, Mortimer Sackler was able to proclaim the new OxyContin as safe for a multitude of applications—basically treating common aches and pains that were just beyond the benefit of aspirin and NSAIDs. In hindsight, we now know this to be quite a stretch. OxyContin was far from addiction-free and, on the street, the protective coating could be bypassed by crushing the pills for an even more potent effect. Plus, with the company's aggressive marketing campaign, the drug soon made its way to the black market.
purdue pharma: masters at pill marketing It was in 1952 that psychiatrist-by-trade brothers Arthur, Raymond and Mortimer Sackler purchased a small pharmaceutical company called Purdue, Frederick and Co. While his brothers ran the enterprise, Arthur involved himself in other pursuits: namely a stint with New York advertising firm William Douglas McAdams. While most have never heard of the firm, you probably know the results of their work—Arthur was instrumental in marketing new uses for Valium (diazepam) that made it the first drug to ever achieve $100 million in revenue and put Arthur in the Medical Advertising Hall of Fame (posthumously inducted in 1997). Arthur was also one of the first marketers to create relationships directly with doctors in hopes of selling in product, a practice that is now the backbone of the drug marketing industry. Even though Arthur passed away in 1987, he taught his brothers well—they continued to hone their drug marketing skills in the 1990s. With the onset of OxyContin, the Sacklers starting amassing large databases that contained doctor profiles and their prescribing habits. Long before the terms "data mining" and "big data" entered the vernacular, Purdue Pharma was poring over the numbers and plying their skills to put OxyContin into the hands of 32 / LIVING SAFER / VOL 9 ED 2
any doctor they thought might prescribe it. In short order, the Purdue Pharma sales staff grew to more than 300. Then in 1996, Purdue contracted with Abbott Laboratories to help in selling the drug through their sales reps. Abbott devoted another 300 people to the cause, urging them to do whatever it took to convince doctors. Internal documents have recently surfaced, showing that the director of sales, Jerry Eichhorn, urged sales staff to downplay the issues with addiction and make other claims that had no scientific basis. He frequently referred to the mission at hand as a “crusade,” and often signed memos as “The King of Pain.” Ultimately, with Abbott’s help, OxyContin went from $49 million in sales to $1.6 billion in 2002 when the partnership ended. In 2007, Purdue Pharma pleaded guilty to a criminal charge of misbranding OxyContin in an effort to mislead doctors and consumers, resulting in $635 million in fines. In 2015, Purdue settled a long-running legal battle with the state of Kentucky to the tune of $24 million—accused of “misrepresenting the highly addictive nature of OxyContin and encouraging doctors not trained in pain management to over prescribe the drug to patients,” the company admitted no wrongdoing.
top 10 national tv pharmaceutical advertisers
To Advertise Or Not To Advertise? That Is The Question.
It might not come as a shock to hear that most pharmaceutical companies spend a significant amount on advertising their medications. Watch a few hours of nightly television and you’ll quickly lose count of how many commercials are promoting medications or describing ailments you may not have known even existed. So when did this all start? You need to go back a few decades, but there was a time when pharmaceutical companies did no direct-to-consumer advertising for prescription drugs. Most people in the business felt the medications (and the warnings that the FDA required to be present in all advertisements) were too complicated for the average person to understand. For many years, pharmaceutical companies advertised directly to doctors, the linch pins in the prescription process: patients came to doctors with a problem, doctors relied on their education and knowledge for a diagnosis, treatment was based on any number of medications they had learned about via the available literature, and the patient ultimately followed the doctor’s directions and took whatever drug might have been prescribed. Again, it was a process that worked, and many felt it was the correct process—it put control in the hands of a trained medical professional. The only problem was that some pharmaceutical manufacturers felt it was a slow process; new drugs sometimes took years to catch on with doctors who were set in their ways and slow to change, especially if they felt there was no reason to do so. Previously, marketing drugs directly to consumers was viewed as problematic. Up until the 1980s, the FDA required that all drug ads include the name of the drug, it’s purpose and detailed information on side effects. This alone had most shying away from broadcast
media because a scrolling screen of potential problems did not seem appealing. Then in 1986, the makers of a prescription allergy medication called Seldane, which was one of the first to claim non-drowsy status, hit upon a possible workaround; they discovered that if they didn’t communicate the name of the product, they didn’t have to include all the other information. The solution was an ongoing television campaign that showed allergy sufferers in allergic environments with the single ending message of, “Your doctor now has a treatment which won’t make you drowsy. See your doctor.” In an instant, the tables were turned and now patients were suggesting treatments to their doctors. The significance is that Seldane, a product grossing about $34 million a year, suddenly surpassed $100 million. And $300 million. And $400 million a year in sales. In an NPR interview, Joe Davis—the ad agency exec. behind the campaign, described the reaction, “...We were flabbergasted. And eventually it went to $800 million.” While the numbers might pale in comparison to what some drugs pull in today, it’s important to keep the timeframe in mind. An increase of over 2300 percent was big money, and this was the beginning of big pharma marketing directly to consumers. Now in 2017, drug companies spend $5.6 billion a year on drug advertisements aimed at consumers. Fueling this growth is the fact that the FDA “relaxed” the rules of pharmaceutical advertising in 1997—requiring only the drug’s name, main use and only the most significant potential side effects. Even so, the lists can dominate the better part of a 60-second spot—yet most consumers seem unaffected by the unappealing problems, as demonstrated by rising ad spending and revenue year after year. @LIVINGSAFER / LIVINGSAFER.COM / 33
Studies Drug Companies Don’t Want You To See Before a pharmaceutical drug can be sold in the U.S., it must first be approved by the FDA. Part of this process is requiring both laboratory and animal testing to understand the efficacy, or effectiveness, of the drug as well as reveal any potential risks or unwanted side effects. One might think that the FDA commissions such tests themselves. This is rarely the case, although test results must be submitted to them during the application process. No matter. Surely these tests are carried out by unbiased sources that report all significant findings, right? Wrong again, in many cases. In 1997, in an effort to provide healthcare professionals and the public easy access to information on publicly and privately sponsored clinical studies, Congress passed new legislation that allowed for the creation of a website called clinicaltrials.gov. Overseen by the National Institutes of Health, it acted as a registry for the results of many studies. In 2007, Congress expanded the submission requirements, mandating that medical researchers release results of all trials within a year of a study’s completion. Many editors of major medical journals decided to only publish study results that appeared on the website. At about the same time, an FDA medical officer by the name of Erick Turner led a research review that was looking to determine which studies of antidepressants, such as Prozac, Paxil and Zoloft, got published and which didn’t. The findings were published in The New England Journal of Medicine in January 2008, and revealed some interesting anomalies. For starters, Turner found that of the
clinical trials that were published, positive findings popped up 94 percent of the time—the indication being that the drugs were effective in treating depression. Yet, when Turner and his team looked at all studies that had been completed, published or not, they saw a different result. This time, it was a draw. Half the studies showed positive results and half the studies showed negative results; meaning that there was only a 50/50 chance that the drugs would have the desired effect. So almost a decade ago, Turner’s group put forth the idea of “publication bias” when it comes to pharmaceutical testing—the belief that most people are only aware of the studies that are published, and those are often the reports that only display the desired results. Understanding that this study occurred almost a decade ago, one might believe that the exposure led to a fundamental change in the selection and publication of clinical trials. Yet in 2015, a follow-up report was published in JAMA Psychiatry that determined 43 of 45 articles (96 percent) published offered positive conclusions. Additionally, the study showed that a “positive” study was five times more likely to be published when compared to trials that did not offer a positive outcome. Ultimately, the study concluded that various reporting biases were present in testing the efficacy of FDA-approved, second-generation antidepressants, which led to an overly positive representation of significant findings in the scientific literature.
escalating drug prices
Infamous EpiPen scandal isn’t the worst offender by far An anti-parasitic drug made by Turing Pharmaceuticals that in 2015, increased from $13.50 a pill to $750 a pill.
Emergency injector for those who overdose on opioid painkillers. Manufactured by Kaleo Pharma under the name Evzio, which has gone from $690 per unit to $4,500 in last few years.
Used to treat cardiovascular patients. Manufactured solely by Valeant Pharmaceuticals under the name Nitropress, jumped from $150 per unit to $790 per unit in 2015.
Anti-allergic reaction drug that raised its price more than 500 percent over seven years. Made by Mylan Pharmaceuticals.
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the history of clinicaltrials.gov A registry of clinical trial results, ClinicalTrials.gov is the world’s largest database of its kind—containing study results from over 230,000 trials from more than 195 countries.
Congress passed the Health Omnibus Programs Extension Act (HOPE) after the gay community demanded better access to clinical trials testing HIV treatment drugs. This served as an example of the positive gains that can be made with improved public access to such information.
Congress amends current legislation with the Food and Drug Administration Modernization Act of 1997 (FDAMA), which requires the NIH to establish a new public resource of such information, to become known as ClinicalTrials.gov.
A study of pre-2009 trials found that many had serious discrepancies between what was published in peer-reviewed journals and what was reported to ClinicalTrials.gov.
Is Big Pharma Simply Enjoying Profits or Fostering Profiteering? Five of the largest pharmaceutical companies in the world each made a profit margin of more than 20 percent last year—and have done so for more than the past decade. These include Pfizer, Hoffman-La Roche, AbbVie, GlaxoSmithKline and Eli Lilly. And it’s not just patients that notice the widening gap between what a company puts into drug development versus what it reaps in profits for years to come. Brian Druker, MD, director of the Knight Cancer Institute in Portland, Ore., puts it bluntly in a New York Times article from April 2013: “If you are making $3 billion a year on Gleevec, could you get by with $2 billion? When do you cross the line from essential profits to profiteering?” And Druker should know about the revolutionary cancer-treating drug Gleevec because it was his research in targeting cancer’s molecular defect in the human body while leaving healthy cells unharmed that led to the development of the product.
“when do you cross the line from essential profits to profiteering?” Almost immediately, Gleevec—generically referred to as Imatinib—was geared up for greatness as the FDA approved it for use in treating chronic myelogenous leukemia (CML), acute lymphocytic leukemia (ALL) and certain types of gastrointestinal stromal tumors (GIST)—it’s even featured on the World Health Organization's List of Essential Medicines. Manufactured by Novartis International, the appeal of this drug as part of a treatment regimen is global. In many parts of the world, a typical treatment of Gleevec can be obtained for a little over $19,100 USD a year (2016 pricing). In the United Kingdom, where a generic version became available in 2017, a typical treatment costs the National Health Service (NHS) about $28,327 USD a year. Yet in the United States, a typical yearly dose has a cost of about $84,400 USD. Monopolization of the market is not just a concern in the United States, either. The Supreme Court in India actually ruled that Gleevec could not be patented by Novartis, opening the door to
less expensive generics as they are developed. In fact, India’s pharmaceutical companies are known to be the world’s largest supplier of generic drugs. At one time, there competitive pricing lead to a deflation in drug prices across the U.S., but recent trends show that their business model has become a double-edged sword—lower drug prices in the U.S. and quicker approval of generics by the FDA have now led to other producers of generics to enter the market, including South Korea, China and New Zealand. Right now, about 25 percent of drugs consumed by U.S. residents are actually manufactured outside the country. Part of President Trump’s plan to get drug pricing under control is to offer pharmaceutical companies numerous incentives and tax breaks if they bring production (and jobs) back to the United States, but some consumer advocates believe this could result in higher drug prices as there are more complexities involved as to why a pharmaceutical company does or does not locate its production facilities within the U.S. More so than in the arena of generic drugs, consumers have yet to witness a lowering in the price of specialty and maintenance drugs. Many manufacturers are beginning to express the idea that certain drugs shouldn’t be priced in accordance with how much it costs to develop or produce the medication, but in relation to how it can improve the health or affect the quality of life for a given patient. In other words, the closer it is to a “miracle drug” then expect the price to be miraculously higher than what is justified by the cost of production. According to a study published in JAMA by the American Medical Association, drug spending in the U.S. increased by 20 percent between 2013 and 2015. Yet another study by the American Hospital Association and the National Opinion Research Center at the University of Chicago showed a similar increase of 23.4 percent spent during the same time frame—but they linked the jump specifically to an increase in drug unit pricing, not to an increase in the volume of drugs used. Thus, the Research Center found it difficult to explain the increase in dollars spent to anything other than price hikes by pharmaceutical manufacturers.
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Does Health Insurance Help or Hurt the Situation? Understanding the methodology of drug pricing can be frustrating, and it only adds fuel to the fire when you realize that the price of a drug might have little to do with what you actually pay once your health insurance company is involved. To decipher this aspect of the equation, you must first acknowledge the basic principles of insurance: only pay for what is necessary and, when deemed it’s needed, pay out as little as possible. (of course, this is ignoring the prime directive of, “take in as much as possible through premiums,” but that could be its own article.) In fact, health insurance companies rarely look at the co-pay that patients pay for a drug as compensation—instead they see it as a motivator or incentive to control which drugs you do or don’t purchase. For instance, you see a new drug advertised on television that addresses an ailment you suffer from, and the ad promises it does a better job than the drug you’ve been taking for years. Well, it could be that this new drug holds a patent, which the pharmaceutical company sees as valuable in regards to protecting their market share. But your health insurance doesn’t want to pay extra for that, so they make the old drug a Tier 1 for say, $15 and the new drug a Tier 4 for $75. What decision are you likely to make? Now before you think you understand the paradigm, consider this possibility; the maker of the new drug really wants to convert as many patients as possible from the old drug, so they negotiate with one or more of the larger health insurance carriers to sell them the drug at a special price. If the carrier sees potential with the new drug, they might declare it a “preferred” medication and offer it at a lower price than other carriers. Not to be outdone, drug makers often have yet another bargaining chip up their sleeve—the drug-specific savings card. Again, more of a marketing tactic for the manufacturer, these are issued to patients for any number of reasons that include: financial difficulties, having an uncooperative health insurance provider, or simply asking for one. Often, the
wording on the card states a maximum payout by the patient for a prescription fill (as opposed to a discount card) and is good for a limited time, although many are renewable through pharmacies and websites.
“it’s almost like pulling a slot machine...crossing your fingers and hoping you get paid more than it costs you to buy the drug.” Before you get too discombobulated over all this, get ready for the introduction of another player—the Pharmacy Benefit Manager or PBM. Such entities fall in between the pharmacy and the insurance company, and they claim to reduce the cost of many prescription drugs by a significant margin. It’s possible that your health insurance company has tried to direct you toward using a PBM, the biggest ones include Express Scripts, OptumRX and CVS Caremark. Of course, with any savings comes the realization that, as a consumer, you have no idea what you really paid for a medication or what that drug is truly worth. And you’re not alone. Often, the pharmacies themselves have no idea who’s paying what for a given drug until the transaction has run its course (i.e. been submitted to the insurance company). This means that sometimes the pharmacy can actually lose money, with some industry leaders estimating it could be as high as one out of every five sales that the dispensary fails to make a profit. “Filling a prescription is not knowing what you’re going to get paid,” says Scott Pace, CEO of the Arkansas Pharmacists Association. “It’s almost like pulling a slot machine and hoping, crossing your fingers and hoping you get paid more than it costs you to buy the drug and perform the service.”
What Do We Prescribe for the Future? Unfortunately, some of the topics touched on here are just the tip of the iceberg when it comes to Big Pharma and its relation to healthcare in the U.S. No one questions that prescription drugs are more expensive here than anywhere in the world, but everyone should be asking the question, why? We can point to pricing structures, odd bedfellows in the way of PBMs and pharmacies, the time and cost involved in testing drugs for FDA approval—all problems, but many believe that they’re superseded by one single factor: greed. Rarely is pharmaceutical development looked at as rectifying humanity’s ills, more often than not it’s simply seen as a way to raise one’s revenue stream. Eerily telling of this trend is the way we’ve attached “industry” to the idea of healthcare in the modern vernacular. Is pursuit of profit not the essence of industrialization? 36 / LIVING SAFER / VOL 9 ED 2
Statistics project that prescription drug prices will jump 11.6 percent in 2017; a hefty hop in comparison with life’s other necessities—food prices are projected to rise 2.8 percent and clothing 5.7 percent this year. The worst part is that most people have little choice. Many medications are necessities, and the current systems don’t allow for consumers to create value by shopping around the way they might with other commodities. Adding to this is the fact that all of the above or rising faster than the American wage, making for an untenable situation in many people’s future. How is this happening? Why is this happening and when is it going to change? As a nation, and as a society, we need to start collectively asking these questions—and we need to demand answers from the companies that are perpetuating the situation.
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NUTRITION
Disease:
Is diet—not medication— the real answer? by Wayne Parsons
T
he World Health Organization lists coronary heart disease
(CHD) as the leading cause of death in the world. 80 percent of all deaths are due to heart attacks and strokes. The United States leads the world with 735,000 people projected to have a heart attack this year. More than 200,000 people in Great Britain will be in the hospital each year with a heart attack. These people are treated exclusively with heart medications and surgery which do nothing to cure the underlying disease and only slow its progress. In a study of 246,000 Chinese men in rural Guizhou and 181,000 Chinese women in Sichuan between 1973 and 1975 not one single person died CHD before the age of 64. Epidemiologist T. Colin Campbell, author of The China Study (2006) found that when those people moved to the US and adopted a US diet, their incidence of CHD went up to the US numbers. Diet, not genetics is the cause of CHD. Is there anything other than heart drugs and surgery for CHD? Dr. Caldwell Esselstyn of the Cleveland Clinic put 18 patients with severe CHD on a whole foods plant-based (WFPB) diet. In the prior eight years, those 18 patients had suffered 49 coronary events such as angina, bypass surgery, heart attacks, strokes and angioplasty. The WFPB diet over the ensuing 11 years reversed their CHD. Cholesterol dropped from averages of 246 mg/dL to 132 mg/dL over the 11-year study and bad LDL cholesterol dropped in the same percentage. There was only one coronary event (angina) in the 11 years for a patient who dropped out for two years, had an episode of angina, resumed the diet plan and had no further incidents. The restricted arteries of these patients opened up allowing a measured increase in blood flow of 30 percent. The cure for CHD is a WFPB diet, not drugs or surgery. Added bonus: it’s free. This result threatened the meat, dairy and pharmaceutical industries as well as doctors and hospitals—a collective group that exerts powerful political influence. A lot of money is at stake here. What is a WFPB diet? “Whole foods” means grains, fruits and vegetables that have not been highly processed. Our bodies are designed to digest whole foods that contain complex carbohydrates, which our bodies break down during digestion— naturally extracting all of the nutrition that the body needs in the form that the body can use. Pills and supplements don’t work. Whole foods like beans, corn, fruit and leafy green vegetables
are also high in fiber. The healthy rural Chinese people that Dr. Campbell studied also consumed high-fiber plant-based diets. WFPB diets also eliminate meat, poultry, and fish. Dairy products are animal products and are not part of such diets, either. In a WFPB diet, plenty of protein can be obtained from plant sources without meat or dairy. Fad high-protein, low carbohydrate diets are unhealthy—a person should only get about 10 percent of their daily calorie intake from protein. This can easily be accomplished with grains and vegetables that are also high in fiber and low in fat. The only addition is a vitamin B12 tablet once a day. The natural oils in plants provide the fat a person needs in a healthy form that our digestive system is designed to digest. What about cancer? Dr. Campbell found that changing the amount of the casein, a protein that makes up 87 percent of cow’s milk, lowered or increased tumor growth in rats whose tumors were caused by the powerful carcinogen aflatoxin. Lower the casein and the tumor growth slowed, increase casein and it rises. Replacing casein with proteins from wheat or soy did not trigger tumor growth even when the amount of aflatoxin was increased. Thus, diet creates conditions in our bodies at the cellular level where cancer genes are activated and cancer flourishes. WFPB diets do not do this. This does not mean that if a person is diagnosed with cancer, they should try to use diet in place of surgery or cancer drugs. Do not think that once cancer has been activated it can be cured alone by diet and do not fall victim to fad cancer diets or “holistic” cures. Cancer patients must be treated by a good oncologist. However, a WFPB diet promotes lifetime health while avoiding CHD, type 2 diabetes and other illnesses—not to mention greatly reducing the chances of cancer. Few smokers diagnosed with lung cancer continue smoking. Most wish they gave it up before it was too late. WFPB diets are not for everyone, but you should take a look at those people with CHD or type 2 diabetes and ask yourself if the change to a WFPB diet might be a smart decision. Good resources for understanding the WFPB diet are Chickpea and Bean at www.chickpeanadbean.com, The McDougall Diet at www.drmcdougall.com or Dr. Neal Barnard’s Program for Reversing Diabetes found at www.pcrm.org. The China Study should also be on everyone’s bookshelf as a practical scientific reference on the truth about human health. @LIVINGSAFER / LIVINGSAFER.COM / 39
10 Foods to Help Alleviate Stress by Jon Lewis here are times that can be very stressful for everyone. Whether it’s a family situation, the political environment or concerns in your job/career, stress is probably an unwanted ingredient in your life. Could what you eat contribute to stress? Could your meals actually alleviate stress? While they may not be 100 percent the cause or cure, the answer is definitely a resounding yes! You can probably guess which foods are more likely to be stress inducing or stress relieving. Stress-inducing foods include: coffee,
T
Asparagus – One cup of asparagus provides 66 percent of your daily folic acid needs. Why is that important? Folic acid has been noted as a depression buster. When you are less depressed, you are less anxious and stressed.
FISH Salmon – Already well known as a healthy food, salmon is filled
alcohol, refined sugars and processed foods. The same ones that lead to weight gain and disease. On the stress relieving menu, you will find the healthier foods in life: fruits, vegetables, fish, nuts, cereals and low-fat meats. Let’s take a closer look at these and some of the science behind them.
with omega-3 fatty acids that help keep adrenaline from getting out of hand. In fact, a study in Brain, Behavior and Immunity showed that people who took a daily omega-3 supplement for 12 weeks reduced their anxiety by 20 percent compared to the placebo group.
FRUITS
Shrimp/Lobster – These two ocean dwellers have omega-3s as well as tryptophan, so they can help reduce those stress levels while you’re having fun at the beach.
Blueberries – Often referred to as one of the superfoods, blueberries are high in antioxidants and vitamin C. Our brains use vitamin C to help convert tryptophan into serotonin. Serotonin is considered a mood stabilizer, and at normal levels, you feel happier, calmer, more focused and less anxious. Kiwis, strawberries, papaya, oranges, grapefruit and guava can also be good sources for vitamin C which can help reduce stress. Avocados – Yes, these are considered fruits. High in vitamin B, avocados can fight vitamin B deficiencies which have been linked to feelings of anxiety. Also, the potassium and monounsaturated fat content in avocados help lower blood pressure.
VEGETABLES Spinach – Spinach is loaded with magnesium which can help reduce stress and anxiety. Additionally, stress and stress-related foods can lower the levels of magnesium in the body. Alcohol, caffeine, carbonated beverages and sugars all lower the body’s magnesium levels, so it’s good to have a good side of spinach to counterbalance those stress-inducing foods. One cup of spinach provides the body with forty percent of your daily magnesium needs. Red Pepper – Red peppers have almost twice the amount of vitamin C as do oranges. Again, vitamin C helps increase the serotonin levels, so add some red peppers to your salad and meals. 40 / LIVING SAFER / VOL 9 ED 2
NUTS AND CEREALS Almonds – Loaded with vitamin B, almonds help with our fight-or-flight stress responses. They can also help bolster the immune system during times of stress. Nuts such as pistachios also have potassium which can help lower blood pressure. Oatmeal – Not the instant kind. The thick cut and longer cooking oatmeal is another good source of serotonin. In addition, the fiber in oatmeal takes longer to digest—so while it is a carb, it’s more complex than white breads and pastas and won’t spike blood sugar.
LOW-FAT MEATS Turkey – Essentially, turkey helps the brain create serotonin as do oranges and their vitamin C. Turkey has the amino acid tryptophan which creates that sleepy feeling at Thanksgiving. What’s more stress relieving than sleep? While these aren’t the only stress-relieving foods, including them in your diet regularly will probably help lower your stress levels. Other good foods to consider are teas, herbs, milk and dark chocolate. Of course, a doctor should always be consulted before a person changes his diet in order to make sure it is the healthy choice for that individual.
Add a Little Spice to Your Life:
Why Spicy Food is Good for Your Health by Tobi Millrood It’s hard to walk down the grocery store aisles these days without seeing food packaging that promotes health benefits. “Cheerios will lower your cholesterol!” “Eat ketchup and make your heart healthy!” “Drink cranberry juice to strengthen your immune system!”
Most of these claims are pure advertising that take broad creative license with scant medical evidence. There are, however, a few store aisles worth noting that offer foods with no advertising, yet proven benefits for your health. Find the spicy foods section, with items such as cayenne, chili, habanero and jalapeno peppers, @LIVINGSAFER / LIVINGSAFER.COM / 41
as well as curries and turmeric—your body will be thanking you in no time. All too often, shoppers steer clear of spicy foods, worried they will negatively affect their health in ways that include increased risk for ulcers or other digestive problems. This is a myth. Spicy foods contain an ingredient called capsaicin—which puts the “hot” in hot peppers—and offers many health benefits, including pain relief. The ingredient has also been shown to be effective in the decrease in the incidence of cluster headaches, helpful in the treatment and prevention of cancer, psoriasis treatment, diabetes management and weight loss. What’s more, research shows that hot chili peppers even protect the stomach lining and may prevent damage that can occur with antiinflammatory painkillers. Additionally, they are rich in nutrients, such as calcium and vitamins A and C, leading to some evidence that such peppers can reduce the risk of cardiovascular disease. Another spice to consider: turmeric, a spice that gives curry its yellow color and has been used in India for thousands of years as a medicinal herb. It’s no wonder. The main active component of turmeric is curcumin, which has been shown to prevent cancer and decrease inflammation in the body—resulting in many other health benefits. Following gives more detail on the benefits of why adding a bit of spice to your life is a good thing.
Weight Loss. To begin with, chilies have very few calories. What’s more, eating hot peppers increases body heat, which, in turn, boosts metabolism 5 percent and increases fat burning by up to 16 percent. Research shows that spicy foods can even help decrease appetite and lower caloric intake. By burning fat, boosting metabolism and feeling full longer, chilies support weight loss.
Heart Health. Among the greatest benefits of spicy foods are the many benefits to heart health. Both red hot peppers and turmeric have positive effects on circulation. Capsaicin can cause blood vessels to dilate, which in turn, can lead to lowering blood pressure. Similarly, capsaicin can also prevent blood clots. Curcumin within turmeric has powerful anti-inflammatory properties, which can reverse damage to blood vessels, and, in addition, lower cholesterol and prevent bad cholesterol from building up. All of these lead to a healthier heart.
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Longevity. A study that looked at a massive number of people in China, where spicy food intake is common, found that those who eat spicy food regularly live longer. The study looked at nearly 200,000 men and nearly 300,000 women in China, ages 30 to 79, during the years 2004-2008. The findings were that, for those eating spicy food, the risk for death was lower. Incredibly, those who ate spicy foods six to seven days a week had a 14 percent lower risk of dying prematurely. Finally, because spicy foods help with weight loss, cancer prevention and heart healthiness, the combined effect is that adding spice to your life can help you live longer.
Cancer Prevention. Curcumin (within turmeric) has incredible proven results on cancer cells. Curcumin works to reduce the growth of cancer cells and prevents them as well. As a result, curcumin has the positive effect of slowing breast cancer, cervical cancer, stomach cancer and others. Capsaicin has similar cancer prevention properties. Research shows capsaicin helps to fight prostate cancer, stomach cancer, breast cancer, non-Hodgkin’s lymphoma and certain lung tumors.
Pain Relief. If your doctor has given you an over-the-counter pain relief cream, chances are it contains capsaicin. Because capsaicin provides analgesic relief, it has been used for many years to treat pain from osteoarthritis, rheumatoid arthritis, fibromyalgia and certain kinds of joint pain. The pain relief properties have also been proven to help debilitating cluster headaches. Curcumin, within turmeric, also can inhibit many of the molecules known to play a major role in inflammation. Because inflammation is a precursor to so many diseases, effectively limiting inflammation with turmeric promotes overall health. So what is the “right” amount of spicy food? How much is too much? The overall research shows that eating spicy foods two to three times a week will bring the health benefits described above. If for some reason it does affect the stomach, eat it along with yogurt, which will line the stomach wall. While daily spicy food intake should cause no problems, there is a point of overdoing it. One study from Mexico found that people who ate nine to 25 jalapenos per day had a slightly increased risk of stomach cancer. But, by adding the right amount of spice to your life, a healthier life is likely to occur.
Is White or Whole Wheat Bread 'Healthier'? by Lily Grace
espite many studies looking at which bread is the healthiest, it is still not clear what effect bread and differences among bread types have on clinically relevant parameters and on the microbiome. In the journal Cell Metabolism on June 6, Weizmann Institute researchers report the results of a comprehensive, randomized trial in 20 healthy subjects; comparing differences in how processed white bread and artisanal whole wheat sourdough affect the body. Surprisingly, the investigators found the bread itself didn't greatly affect the participants and that different people reacted differently to the bread. The research team then devised an algorithm to help predict how individuals may respond to the bread in their diets. All of the participants in the study normally consumed about 10 percent of their calories from bread. Half were assigned to consume an increased amount of processed, packaged white bread for a week—around 25 percent of their calories—and half to consume an increased amount of whole wheat sourdough, which was baked especially for the study and delivered fresh to the participants. After a 2-week period without bread, the diets for the two groups were reversed. Before the study and throughout the time it was ongoing, many health effects were monitored. These included wakeup glucose levels; levels of the essential minerals calcium, iron, and magnesium; fat and cholesterol levels; kidney and liver enzymes; and several markers for inflammation and tissue damage. The investigators also measured the makeup of the participants' microbiomes before, during, and after the study. "The initial finding, and this was very much contrary to our expectation, was that there were no clinically significant differences between the effects of these two types of bread on any of the parameters that we measured," says Eran Segal, a computational biologist at the Weizmann Institute of Science and one of the
D
study's senior authors. "We looked at a number of markers, and there was no measurable difference in the effect that this type of dietary intervention had." Based on some of their earlier work, however, which found that different people have different glycemic responses to the same diet, the investigators suspected that something more complicated may be going on: perhaps the glycemic response of some of the people in the study was better to one type of bread, and some better to the other type. A closer look indicated that this was indeed the case. About half the people had a better response to the processed, white flour bread, and the other half had a better response to the whole wheat sourdough. The lack of differences were only seen when all findings were averaged together. "The findings for this study are not only fascinating but potentially very important, because they point toward a new paradigm: different people react differently, even to the same foods," says Eran Elinav, a researcher in the Department of Immunology at the Weizmann Institute and another of the study's senior authors. "To date, the nutritional values assigned to food have been based on minimal science, and one-size-fits-all diets have failed miserably." He adds, "These findings could lead to a more rational approach for telling people which foods are a better fit for them, based on their microbiomes." Avraham Levy, a professor in the Department of Plant and Environmental Sciences and another coauthor, adds a caveat to the study, "These experiments looked at everyone eating the same amounts of carbohydrates from both bread types, which means that they ate more whole wheat bread because it contains less available carbohydrates. Moreover, we know that because of its high fiber content, people generally eat less whole wheat bread. We didn't take into consideration how much you would eat based on how full you felt. So the story must go on."
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F A M I LY
Special Needs Parents and PTSD: Yes, It’s Real by Florence J. Murray
A
lthough all children can be a challenge for parents at
there are other ways that parents respond, too. Some will fear
different stages during their lives, the parents of special
leaving the child alone and become hyper-vigilant to the point of
needs children face unique challenges. One of the least
causing severe stress and greater symptoms of PTSD in their self as
talked about areas is the stress that these parents experi-
well as increasing the corresponding symptoms in the child.
ence on a regular basis. It is precisely because of this repeated
Some parents may obsessively repeat telling others about the
stress that the parents, especially mothers, often suffer from Post
traumatic event every time the opportunity presents itself. This
Traumatic Stress Disorder (PTSD). Defined by being present for
obsession is very unhealthy to the parent and has been shown to
over a month, PTSD not only affects the parent’s physical and
even interfere with the parent’s ability to understand how to care
emotional health, but it also affects how that parent interacts with
for the child.
the medical community and with her own child(ren).
What Can Be Done to Help?
What Does PTSD Look or Feel Like?
Parents of these special children need to know that what they are
Symptoms of PTSD can be grouped into three buckets:
feeling is real and is recognized as occurring in many other parents.
»» The first consists of nightmares and/or recurrent distressing thoughts of the traumatic event which often interfere with sleep. »» The second bucket can be labeled as avoidance behaviors, such as avoiding thoughts, feelings, conversations, places, and people associated with the traumatic event. These symptoms can include difficulty remembering significant aspects of the trauma; decreased interest in activities that were previously important; feeling detached and even estranged from others; difficulty having positive feelings; and, feeling hopeless. »» The last bucket involves the opposite of the second bucket. These symptoms of hyperarousal can range from being easily startled, to feeling a constant sense of foreboding
They also need to know that they are not crazy and people around them can and will help if they let them. Those who work with special needs families or children need to be able to openly talk about the importance of the parent having an outlet to share and relieve stress. In addition, anyone who knows parents of special needs children can help by encouraging the parent to make and keep appoints with their own medical professionals. Here are four questions that are used to help screen for PTSD: In the past month, have you ever had any experience that was so frightening, horrible or upsetting that you: Have had nightmares about it or thought about it when you did not want to? Tried hard not to think about it or went out of your way to avoid situations that reminded you of it?
(such as that danger is lurking around the corner), to being
Were constantly on guard, watchful, or easily startled?
short-tempered or irritable, to having difficulty falling or even
Felt numb or detached from others, activities, or
staying asleep.
your surroundings? An answer of “yes” to any one of these questions indicates that
Why Does the Trauma to the Parent Continue?
the parent needs to get help, and with a trained professional. It is
Parents who are so used to visiting doctors or hospitals for the care
also important that the child knows that she or he is not the cause
of their children tend to avoid the same environment that triggered
of the parent’s issues or symptoms. For more help and education
the trauma associated with the child, or may even avoid bringing
on the subject, please visit the National Center for PTSD in the
the child back to that trauma associated environment. Of course,
U.S. Department of Veterans Affairs at www.ptsd.va.gov. @LIVINGSAFER / LIVINGSAFER.COM / 45
Keeping Up with Teenagers by Florence Murray As has happened with countless generations before, the younger set develops a form of speaking that becomes unintelligible to those who don’t speak the language. These changes are evidence of the natural progression toward independence from the adults surrounding them. Trying to understand the lingo can be challenging, especially when teenagers are trying to demonstrate to the world that they are different than the “old” people and do not want that older crowd to 1) understand their code; and, 2) embarrass them by trying to use their language. Here is a cheat sheet for some of the more common jargon that teens are currently using (at least in this “neck of the woods”). Be aware, though, that when confronted with the definitions, teens are likely to deny both the lingo and the accuracy. So, the following list should be used with discretion: »» “That’s a neck” is slang for telling someone what they did was idiocy and is sometimes accompanied with a literal slap to the back of the neck. »» “Boi” is also a saying used in similar context to “that’s a neck.” It too is often accompanied with a hand gesture, which is hard to describe. »» A “flame” is basically a roast or burn, as in “that was a flame.” »» “Ship” means to agree with putting two people in a relationship and sometimes people will also make “ship names” for them. »» “Shook” means to be shocked or to not be able to believe something. »» “Triggered” means to be very upset and angry. »» “Ratchet” means that something is horrible. »» “Fam” is used to describe their inner circle of friends. »» “Squad” is made up of your closest members of the fam. »» “Off the hook” means it is hot and happening. »» “Lit” is used to describe when something is cool. »» “Thirsty” means that the person just can’t wait any longer and is hot for another person’s affection. »» “Savage” is when someone does something cool or roasts someone hard. »» “Salty” means to be bitter or upset usually with or at someone else. »» “Clap back” means to give an unexpected comeback or burn in response to something the person says. This guide certainly does not encompass the entirety of teen jargon. There are many terms used that mean what one thinks it means, such as “fire,” which is often used to mean that something is really hot. But, as the saying goes, be careful with assumptions because that is exactly why teens are using the terms. They want to throw the older crowd off of their meaning by speaking in what they believe to be another language. The most important takeaway one can get from trying to understand teens, is to never try to use these code words in front of a teen as “that’s a neck” for sure! Teenager Tiernan Jesrani contributed to this article. 46 / LIVING SAFER / VOL 9 ED 2
@LIVINGSAFER / LIVINGSAFER.COM / 47
Turbulence Happens: Keep Your Child Safe by Matt Devoti
T
he situation was not unusual. On my way back from Dal-
Remember the first time you ever held your baby? The way her
las, the flight on which I traveled encountered turbulence.
head rested right in the crook of your elbow, and how her tiny
You know the feeling. The cabin shook and a moment of
feet tucked between your arms and your chest? Remember
weightlessness occurred. Shortly thereafter, the plane settled.
her hair, how it just whispered on the top of her head, and how
We weren’t surprised. The pilot had forewarned us of the
when she squirmed, it was always toward you? Now remember
turbulence. My wife was grabbing my hand when the cabin shook
this—no matter how much you love to hold your baby, you can
and, with her other hand, she held our youngest daughter’s leg.
never hold her tight enough on an airplane. If there is unex-
Lilly was safe; she rode in her car seat which sat secured to an
pected turbulence during a flight, the safest place for your little
airplane seat tucked between Lauren and the window. She was
one is buckled-up securely in a child safety seat. That’s because
asleep when the plane moved and never awoke. None the worse
every now and then, Turbulence Happens. And when it does, a
for wear for the experience.
safety seat is the safest place for your child—and the way you
Not all families are so lucky.
can be sure to hold on to her for a lifetime.
Tragedies occur from time to time because parents travel with their young children without proper restraint devices. Federal regulations permit a child over 14 days old and under two years of age to be carried free of charge when traveling with an adult so long as the child does not occupy a car seat. American airlines require a boarding pass to reserve a seat for your child. Of course, you must purchase the boarding pass to reserve the seat. Unfortunately, severe injury results when planes encounter unexpected turbulence or make an unplanned landing. The reality is that parents simply cannot hold onto their small children when a potentially violent episode occurs on a flight. The physics make sense—all of us can imagine the potential harm if we were holding onto our baby when the passenger car in which we rode was struck in traffic on the highway. Until regulations and airline policies change, parents must decide whether they wish to provide their children with the same level of security available to them when flying. The Federal Aviation Administration (FAA) issues public
For sure, the FAA recommends the following when traveling with a child: »» Secure your child in a child safety restraint system (CRS) rather than your lap when traveling on a plane »» Use a CRS approved for use on a plane; a flight-approved CRS will contain a label stating: “This restraint is certified for use in motor vehicle and aircraft” »» Measure the width of your CRS before your flight as most airplane seats are no more than 16 inches wide »» Ask your airline for a discounted fare for your child as purchasing a boarding pass is the only way to guarantee your use of a CRS »» Be prepared to install the CRS in a forward-facing position. My family made it to and from Dallas without a hitch. And, as a bonus, traveling with Lilly in a car seat ensured she was comfortable
service announcements (PSAs) from time to time on the subject.
and even made it enjoyable. Lauren packed toys and snacks for her,
One PSA, as part of a recent campaign entitled “Turbulence
and Lilly slept for much of both flights; much as she would when
Happens,” advises:
sitting in her seat and driving around town on the weekend.
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Study: Young Drivers with ADHD 36 Percent More Likely to Crash by Jim Edward dolescent drivers with attention-deficit hyperactivity disorder (ADHD) have a 36 percent higher crash risk than other newly licensed teens. Although elevated, this risk is far lower than previous reports of being four times higher. This is the first large-scale study, recently published in JAMA Pediatrics, to provide detailed information on crash risk of adolescents with ADHD compared to other newly licensed young drivers. Researchers from Children’s Hospital of Philadelphia (CHOP) conducted a unique linkage of more than 18,500 electronic health records (EHR) of children born from 1987 through 1997 and New Jersey driver licensing and crash data to determine the associations between ADHD, licensure, and crash involvement. Of the 18,500 records, nearly 2,500 patients were diagnosed with ADHD. Researchers also examined whether these associations varied by factors such as gender and licensing age and found crash risk persists during the initial driving years, regardless of gender or age when licensed. “Our results indicate that newly licensed adolescents with ADHD have a greater risk of crashing than other young drivers, but that this is a manageable risk,” says the study’s principal investigator Allison E. Curry, PhD, MPH, a senior scientist at the Center for
days before getting licensed. “We were surprised to find so few drivers in the study with an active prescription from CHOP doctors for an ADHD medication,” says the study co-author Thomas J. Power, PhD, ABPP, director of the Center for Management of ADHD at CHOP. “Although research indicates that medication likely reduces crash risk, the treatment can only be effective if teens are using it when driving.” Adolescents with ADHD may have characteristics that place them at a higher risk for unsafe driving behaviors, such as inattention, distractibility, impulsivity, and emotional regulation difficulties. Researchers say their findings point to the need for further research to help understand how ADHD affects teens’ crash risk. With this knowledge, tailored clinical, educational, and training programs can then be developed to manage that risk. Until then, the research team recommends that caregivers of teens with ADHD who are considering driving schedule a doctor’s appointment to address concerns, such as attention, impulse control, or communication issues. They may also want to seek the advice of a behavior therapist, an occupational therapist who specializes in driving, or a driver rehabilitation specialist who has training in working with individuals with special needs.
Injury Research and Prevention (CIRP) at CHOP. “Our findings point to the need to develop evidence-based training and education for adolescents with ADHD who want to drive.” Recent studies have emphasized the potential importance of medication in reducing crash risk for individuals with ADHD. However, based on EHR data, CHOP researchers found only 12 percent of the drivers with ADHD were prescribed medication in the 30
Dr. Curry and her colleagues, who are part of CHOP’s Teen Driver Safety Research team, are currently conducting rigorous research on adolescents with developmental disabilities. Funding for this study was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (NIH). The views and recommendations in this publication do not necessarily reflect those of the NIH.
A
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Raising a Well-Rounded Child by Matt Leckman eing a well-rounded adult is not always easy, and certainly the responsibility to shape your children into well-rounded mini-adults is no less difficult. Tackling the responsibility starts with an appreciation of what we want and why. What do we want? We want well-roundedness, which is really another way of saying we want to expose our kids to a wide variety of people, places, beliefs, and experiences in the hopes that they gain perspective. Why? Because perspective is a pathway to analytical reasoning and problem-solving. Perspective is a pathway to empathy. Perspective is one of the hallmarks of maturity, and, especially in a world of increasingly polarized political views and socio-economic realities, perspective can be a weapon for change
B
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and a tool for healing. Perspective is a sort of disciplined mindset that can guide a person in any challenge or endeavor. Of course there is no magic formula for fostering these attributes in our kids. The means can be both experiential and communicative, overt and subtle. And it requires more than simply shelling out the money and committing the travel time for your young one’s participation in every last sport and activity you find in your inbox. Overloading your kid’s schedule with non-stop commitments is more a recipe for fatigue and disinterest than it is a proxy for well-roundedness. On the experiential front, make it a point to put your children into new situations that serve as departures from their norms.
Expose them to cultural experiences—museums, plays, places of worship different than your own—that challenge them to see their world from new angles. Take them to places—not just beach vacations—that help them to better understand the diversity and interconnectivity of our world. If you have the budget, take them abroad. If not, take them on a road trip to a place that is culturally different from where you live. Force them to give. Whether an isolated instance of sharing with a friend or a trip with you to donate time at the homeless shelter, give them experiences that impart to them the importance of helping their fellow man. Expose them to the arts. Even if they do not play like Beethoven or paint like Picasso, show them those who do. Show them the magic of creating art and why it matters to everyone’s culture. Insist also that they see the worth of industry and the importance of building and creating. Every so often, make your kids fix something around the house or make a meal for themselves. Cleaning the bedroom or taking out the trash is a chore. Creating something from
nothing is a confidence builder and an emotional reward. On the communicative front, keep it simple. Whenever any kind of teaching moment arises, try to ask questions and listen more than you talk. No matter how well-reasoned and articulate your lecture, your child is young and it just might not sink in for him or her. Instead of attempting to push perspective into your children’s heads with your words, let them be the architects of their own perspective. Ask questions that draw out their own words and thoughts. Truths you come to on your own terms are often those that come with deeper understanding and more longevity. Trust your kids to do their own thinking in situations that present conflict. Guide them to perspective with your thoughtful inquiry, rather than your wagging finger. In short, force your kids into spaces and dialogue when possible. It’s your responsibility and not something they can ordinarily bring about without that little push. But once you get them in those spaces, stop the pushing. Give them the confidence to build ideas and beliefs from the ground up. You will be surprised how often they come to smart ideas and fundamentally good beliefs without your micromanaging. Well-roundedness and perspective will not be far behind. @LIVINGSAFER / LIVINGSAFER.COM / 51
HOME
Let Nothing Slip through the Cracks:
Tips to Make Sure Your Home Inspector Does the Job by Andrew Sciolla
@LIVINGSAFER / LIVINGSAFER.COM / 53
Y
ou’ve scoured the market looking for the perfect home to buy…visiting dozens of potential properties before finally settling on the right one. After getting the news that your offer has been accepted, it can be difficult to temper your excitement and focus on the fact that one of the most important steps in purchasing a house or condominium is still ahead. Unless you’re simply buying land or knocking down the existing structure, then your purchase agreement should be contingent upon the findings of the home inspection. Indeed, approximately 82 percent of homebuyers purchase a home inspection prior to closing. Of those, nearly 10 percent of prospective purchasing agreements will either fall apart or get delayed at the home inspection
able ladder, that’s the type of information that you need beforehand. Also, be sure to find out if the inspector intends to provide anticipated life expectancies of your major home systems and components (water heater, cooling system, furnace, washer/dryer, etc.). Some of the professional home inspector organizations have specific standards for their members with regards to providing life expectancies. International Association of Certified Home Inspectors (“InterNACHI”) does not require home inspectors to report on life expectancy, whereas American Society of Home Inspectors (“ASHI”) requires inspectors to report if components are near the end of their service life. After you have your list of what’s expected during your home inspection (professionally referred to as
stage, much to the dismay of the potential buyers, because of discoveries and disputes that arise during the inspection. Because you don’t want to be blindsided with unexpected and expensive repairs and conditions after making settlement, it’s recommended that you follow a few tips to make sure that your inspection is thorough and useful.
the "scope, limitations and exclusions"), you can now hold the inspector accountable.
Tip 1: Select a Home Inspector Based on Recommendations, Reviews and Sample Reports Your real estate agent certainly has a few names of home inspectors to provide you, but so do your friends and relatives who have recently purchased a new home. Make a list of them all. Narrow the list using websites like Yelp and Angie’s List for general reviews and comments about the home inspectors. Then contact each home inspector. Is the inspector a member of any professional home inspector organization (ASHI, NAHI, InterNACHI)? If so, you can find the organization’s professional standards of practice online. Does the phone conversation with inspector make you feel comfortable and confident in their abilities and attitude? If so, ask the inspector to email you a recent inspection report that has been finalized and see whether the finished product is both professional and thorough. Is it easy to follow? Does it include pictures? Does it differentiate between what needs immediate attention and what should be considered for future repairs? If more than one inspector passes the tests of recommendations, reviews, and sample reports, then why not just pick the least expensive one! Afterall, prices for home inspections generally range between $375-$550 according to Angie’s List.
Tip 2: Get a List of What Is and Is Not Covered During the Inspection The only way to make sure that nothing slips through the cracks is to actively ensure that everything gets done. In order to do that, you need to get a list from your prospective home inspector about what tests will be performed (radon, lead paint, termites, etc.) and exactly what areas of the home will be inspected (roof, attic, basement, plumbing, heating and cooling, foundation, electrical systems, etc.). If the inspector won’t go on the roof unless there’s easy access or an avail-
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Tip 3: Get Involved. Attend the Inspection, Read the Report, Ask the Questions With your list of expectations handy, it’s time for the inspection. Be sure to attend! Approximately 80 percent of homebuyers attended the home inspection, and that’s not enough. Mark off your checklist as you walk around with the inspector. See what the inspector sees. Take notes of what the inspector points out to you. The inspector is very likely to point out small facts or details about your prospective home and about maintenance in general that may not make it into the formal report but will help you plan for future repairs. You will learn a significant amount about the home by spending just a few hours with the inspector. If you don’t understand things, ask the inspector. You’ve hired the home inspector to perform an advisory service for you. Don’t be afraid to get explanations and gather knowledge. In truth, the inspector prefers that you be present for the inspection, and would rather deal personally with you rather than your agent should a problem arise. Understand, however, that the home inspector is there to merely point out issues that are visible. The inspector is not there to fix those issues for you on the spot, no matter how simple. Of course, the inspector may be able to direct you to trustworthy professionals to address any issues with the home. Finally, when you receive your detailed report (with pictures!), take the time to read it thoroughly. If you have questions about it, contact the inspector to inquire, but, by this point, nothing in the report should be terribly surprising since you’ve attended the actual inspection. Generally speaking, the issues that the inspector indicates require immediate attention are the ones that you should address with your agent and ultimately with the seller of the house. Negotiations may include actual repairs or a “seller’s assist” (credit) at the settlement table. Now that you’ve had a successful home inspection, it’s time to pay it forward. If you were happy with your inspector, then write a review, tell your agent, or just simply share the recommendation and the tips above with your friends and family. Happy home shopping!
Danger!
Some Household Products Should Never Be Mixed by Shelly White A popular word in our world today is “green.” You probably come across it daily, as many companies are geniusly employing it in their marketing and general practices. Used to label their businesses, methods or products as eco-friendly, the word green has come to mean life, renewal, natural, pure, clean, good earth, and other such adjectives. Because these attributes are positive and appealing to many people, using anything labeled “green” tends to be immensely popular. Consumers wish for their lives, bodies and environment to be natural, healthy, and pure—so green cleaning products are often the product of choice, as opposed to mainstream
the lungs, throat, nose, and eyes—even causing skin damage. Additionally, vinegar should not be mixed with Castile soap, again the acidic nature of vinegar reacts with the basic Castile soap to produce a white and curdled muck. Each ingredient on its own is useful, though, especially with the laundry. Just make sure to use the Castile soap alone for the wash cycle and the vinegar by itself in the rinse cycle. Finally, vinegar does not mix well with bleach—unless a toxic, dangerous gas is your goal, potentially injuring the lungs or eyes. Since bleach is not a chemical found in nature, not to mention one
products that contain chemicals which could possibly be more harmful than helpful. It is tempting to think that, when something is labeled “green,” that there are no harmful ingredients within and one shouldn’t worry about overexposure. However, there are green cleaning products that should never, ever be mixed and should remain in the original containers in which they were purchased. This ensures that the original labels are always accessible and can be studied carefully for instructions and warnings. Do note that green cleaning products often advertise or tout the ingredients contained within as non-toxic, pure, natural, and biodegradable. Sometimes these claims are subject to very little regulation, and a “green” consumer should seek education and professional expertise when making decisions on what products are safest and which should not be mixed under any circumstances. As an example, vinegar is known as a natural cleaning product that has hundreds of uses. However, what people often fail to understand is that it is very acidic and should not be mixed with many other products. Case in point, vinegar should never be mixed with baking soda—a base compound that can react with the acid in vinegar. The two products mixed will not only neutralize each other, but produce a chemical reaction resulting in a potentially dangerous explosion—especially if combined in a closed-up container. Vinegar should also never be mixed with hydrogen peroxide, as these two products will create something called peracetic acid. This acid, in very concentrated forms, can be dangerous to
that could produce toxic byproducts, the green-cleaning consumer should avoid it as a general rule of thumb—both for the good of people and the environment. If you do have bleach in your household, note that it should not be mixed with rubbing alcohol or ammonia either. A rubbing alcohol combination can create hydrochloric acid and chloroform while ammonia with bleach will cause a toxic gas called chloramine, which could result in breathing problems and chest pain if inhaled. Similarly, chlorine gas can be the result of simply mixing drain cleaners from different brand names and bottles, so treat such products with caution. Disinfectants and detergents, green or not, can create dangerous fumes and acidic reactions. The valuable lesson from all this information is that mixing green products with green products—or green products with any products for that matter—can net harmful results. In fact, the mixture of certain products can cause unwanted symptoms such as coughing, wheezing, chest pain, eye watering or damage, skin irritation, eye irritation/burning, throat irritation, a runny nose, shortness of breath, nausea or vomiting. Such effects, chemical reactions, explosions, and/or damage can cause injuries or prove fatal to a user who simply had the intention of using natural, eco-friendly cleaning products for the good of their home and world. Sticking to a green product’s intended use is the safest, most environmentally and health conscious thing to do for the green consumer, so always paying close attention to the ingredient list and product labels.
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Dos and Don’ts
Vitamins and Supplements by Brittany Monbarren
DO
DON’T
Talk to your doctor before taking vitamins.
Take more than the recommended dietary allowance.
Follow the instructions...ALWAYS!
Assume all vitamins are created equal.
Be careful if you’re already on medicine.
Try to replace healthy habits.
Keep food and drink recommendations in mind.
Overload your kidneys.
Understand what you’re taking and why.
Trust the labels blindly.
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The Ins and Outs of Deferred Attorney Fees by John T. Bair
F
or attorneys who want to create a supplemental retirement fund, manage the cash flow of their law firm, or protect themselves from being bumped into a higher tax bracket, attorney fees should be considered as a viable investment option. In Richard A. Childs, Et al. v Commissioner of Internal Revenue, the 11th Circuit U.S. Court of Appeals affirmed that attorneys who elect to structure their fees will not have to pay taxes on those payments until the year the income is received. This allows attorneys to spread out their income, rather than getting hit with a large tax bill in one year.
At what point do I need to decide to defer my fees? You must elect to structure your fees prior to settlement; it must be included in the settlement agreement. You can’t have constructive receipt of the money to be structured. It should be paid to the life insurance company via an assignment company.
What if I worked on the case with another attorney? Am I still eligible? Yes, you can still structure your fees. The stream of payments can be split among more than one attorney. Should more than one decide to structure, each gets their own unique payment schedule.
Is an attorney fee flexible? Yes. You should choose a plan that best fits your individual needs.
How is my “attorney fee deferral” accomplished? The attorneys deferred assets are custodied at TD Ameritrade Institutional, and our team develops an investment strategy that is customized specifically do you and your family. The best wealth management approach for most of our attorney clients is a well diversified individual stock portfolio that is mid and large cap dividend growth heavy.
What factors should I consider?
How are payments made?
There are a number of factors to take into account when deciding whether or not to do an attorney fee structure:
Payments can be made either to you or to your firm. Fee payments can be affected by a number of factors, including the type of incorporation the firm has (e.g. LLC, PC, etc.), dissolution plans of the firm, tax advantage, etc.
»» Age »» Health »» Present financial needs and goals »» Future needs and goals (college, retirement, etc.) »» Tax bracket »» Risk tolerance
Can I elect to defer a fee if my client elects to receive their settlement proceeds in a lump sum? In most cases, you may create your fees regardless of what your client decides to do.
About the Firm
What does it cost to do a deferral? As administrator, our firm charges 1% annually on the assets in the program. Monolith Advisers is our Registered Investment Adviser that provides the investment advice. Disclaimer: Milestone Consulting, LLC does not provide legal or tax advice. Please consult an attorney and/or estate planning expert if you have questions regarding the legal or tax implications of your structured attorney fees.
Milestone Consulting, LLC is a comprehensive settlement planning and management firm. We believe that injured plaintiffs and their families deserve strategies designed to ensure a lifetime of financial security. Our consultants are licensed in all fifty states to provide guidance on settlementrelated issues including government benefits preservation, trust planning, Medicare Set-Asides, wealth preservation and annuities. We also provide mediation support to assist the plaintiff in reaching a settlement that will meet their present and future medical and financial needs.
737 Main Street, Suite 100 Buffalo, NY 14203 (716) 883-1833 (855) 836-2676 www.milestoneseventh.com
In addition to our work with plaintiffs and trial attorneys, we actively support a number of civil justice organizations, including The Injury Board, the American Association for Justice, EndDD and statewide associations in Pennsylvania, Massachusetts and Washington, D.C. For more information, please visit our website at www.milestoneseventh.com.
ADDING
INSULT TO INJURY It is what lending companies will do—if you let them. Advocating for your injured clients requires two fights – legal and financial. It is a FACT that most seriously injured clients are underfunded. Borrowing during litigation is often a necessity, but it should not be injurious. With the Bairs Foundation, a first-of-its-kind not-for-profit, you can help them with both. Inspired by the Seventh Amendment, our 7% annual simple interest rate provides ethical financial relief many families need to survive.
Imagine if all plaintiffs were funded by not-for-profits.
bairsfoundation.org
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716.883.1833
Amy and John Bair, Cofounders