MORE ON FRUITS, CRAMPS & SPORTS DRINKS
Commenters' Questions Answered

BatJay and Jardine Davies: "Is it ok to go on a fruit diet alone?"

ANSWER: A fruit diet provides one with many advantages like no cholesterol, low calorie, low sodium, low glycemic indices, and high fiber contents which are all extremely beneficial to people with potential heart disease, stroke, obesity, diabetes, and bowel disorders. But subsisting on a pure fruit diet alone may lead to nutrient deficiencies such as protein, iron, calcium, zinc, Vitamin B-12 and may lack sufficient daily caloric requirements especially when excluded meat and meat-based products are not replaced with the appropriate alternatives. Poor meal planning, concomitant illness or stress, excessive use of supplements, and people like athletes, children, and pregnant females with high nutrient needs might be endangered with a pure fruit diet alone. I have always told my patients that the perfect diet is one tailored to your needs as an individual. Each person must have a tailor-made diet that is specifically designed to complement his/her health status and daily activities. If you want to know the right diet for you, click on this link (The Right Diet For You) and tell me how I can help with the diet you need.

Rolly: "I see how high the sugar content is in these fruits. Of course, I cannot eat them to my heart's content. Hay naku, ang buhay ng diabetic. (Oh, the life of a diabetic!)"

ANSWER: Don't be sad, Tito Rolly. I'm a potential diabetic myself, but I enjoy fruits. You know my secret? I have a new word for you: glycemic index. Glycemic index or GI, as we doctors like to shorten every term we see, is a ranking of the carbohydrate content of foods we eat. Foods with high GI values are those that breakdown quickly during digestion and spike your blood with glucose fast and quick --- hence, detrimental to diabetics like you and me. On the other hand, foods with low GI values improve your body's sensitivity to insulin and provide you with better blood sugar control. All we have to do as diabetics is consume food items that have low GI values, and like BatJay and Jardine Davies, enjoy the fruits they enjoy. The grapefruit mentioned by Bayi is a fruit with a low GI value. You should also learn about another term called glycemic load (GL) and how this can help you. Check out the glycemic index webpage here.

Bayi and delata: "How about gatorade? Does it have enough salt to rehydrate our body? So drinking a can of Gatorade after a sweaty exercise session will help? Is the lack of salt related to dehydration?"

ANSWER: As mentioned in a recent post, "sports drinks, often consumed to restore the nutrients exhausted by vigorous exercise, are close to worthless when it comes to replacing potassium. An 8-oz serving of a sports drink contains about 30 mgs of potassium. You would have to drink 12 servings of a sports drink, 600 calories, to consume the amount of potassium in one 65-calorie banana." Proper hydration is very important during exercise or any physical activity. Water is always best. If your exercise will last more than 30 minutes, you can increase your endurance by drinking fluids. If you are going to exercise for nearly an hour, you can increase your endurance with sugared drinks, which provide a quick source of calories. Fruit juices, sodas, sports drinks are examples of sugared drinks that can be absorbed just as rapidly as water. Exercise makes you lose more water through sweat. Sweat contains much less salt than blood does, and so you lose far more water than salt, which causes blood levels of salt to rise. Let me tell you that you have to lose nearly a liter or more than two pints of water for the salt concentration in your blood to rise high enough to make you feel thirsty. What happens when you exercise is that by the time you feel thirst, it is too late to catch up on your fluid loss and you will have to stop exercising because apart from exhaustion, you are already dehydrated and nauseous, get muscle cramps, or feel dizzy. If you ignore these warning signs of dehydration, you can convulse and pass out. You can either be in heaven or in a hospital when you wake up. So, in order to avoid any of those from happening, my tips are to eat a high-carbohydrate, low-fat diet 4-6hours before you exercise, drink about 500mL of fluids 2 hours before exercise, to drink every 15 minutes of exercise, and to keep drinks cooler than air temperature and beside you all the time.

Manang Kusinera: "I often experienced cramps when I was pregnant...a sign for me to increase my intake of milk."

Leg cramps during pregnancy are most likely due to leg muscles getting fatigued from carrying around extra weight. Leg cramps in pregnant women begin around the second trimester and get worse as pregnancy progresses. While these cramps can occur during the day, they are more noticeable during the night. They are aggravated by circulation problems in the legs as the uterus expands and puts pressure on the blood vessels that return blood from your legs to your heart and on the nerves leading from your trunk to your legs. These cramps can be relieved by stretching the calf muscles regularly during the day and several times before going to bed, by reclining on the left side when lying down to improve circulation in the legs, and by drinking water regularly to improve hydration. Increasing milk intake to get more calcium, as what ManangKu did, is also helpful.

Kano: "(Cramps) are agony, especially when woken from a deep sleep..!""

Next time this happens, Kano, you can try flexing your foot up (toes to ceiling) and hold until the cramping stops. Gentle massage and applying heat packs to the affected parts also helps. Also, I encourage you to eat plenty of potassium-rich foods like bananas, tomatoes, potatoes, broccoli, cantaloupes, oranges, and grapefruits.

Thanks for all your questions and comments. I apologize for replying a day later. I was quite busy yesterday. Thanks for regularly visiting this weblog, guys. I appreciate it.

MUSCLE CRAMPS
Do You Experience Them Often?

Yesterday also, Bayi asked the following:

"When I get muscle cramps, doctors tell me that I lack salt, because of my sweaty exercise schedules. What salt are they talking about, the deficiency of which causes cramps?"

A muscle cramp is an involuntary and forceful contraction of our skeletal muscles (usually the legs and arms) that does not relax. If the muscular contraction is brief and relaxes right away, the term used is muscular spasm. Muscular cramps usually last from a few seconds to about 15 minutes, sometimes even longer. In Tagalog, it known as "pulikat," and is the nightmare of every swimmer. Almost everyone has experienced a cramp in his/her life. Cramps are very common in adults and become increasingly frequent with aging. The more commonly affected muscle groups include the extremities, the feet, legs, and arms.

The "salt" that Bayi probably lacks when he experiences muscular cramps during his exercise schedules can be any of the following: potassium, calcium, magnesium, bicarbonate..

The muscle cramp caused by low potassium is usually associated with weakness. The more common "salts" that are lacking during vigorous exercise are calcium and magnesium salts. They cause cramps because low levels of these salts in blood directly increase the excitability of both the nerve endings and the muscles they stimulate. Too much bicarbonate in the body can also cause cramps.

There are also other causes of cramps like dehydration and injury. Vigorous physical activity usually results in excessive perspiration, which depletes body fluids and causes dehydration. A fracture or injury to a muscle can also cause cramps. The cramps in this case tends to be protective, as the persistent muscular spasm minimizes movement of the affected bone.

Thiamine(B1), pantothenic acid(B5), and pyridoxine(B6) deficiencies have also been implicated as causes of cramps. A poor blood circulation most common in the legs and calf muscles results in inadequate oxygen to the muscle tissue, and this causes severe pain in the muscle. While the pain experienced here is similar to that of a cramped muscle, the pain does not seem to be a result of the actual muscle cramping. This pain is due instead to lactic acid accumulation in the muscle tissues. Peripheral arterial occlusive disease is a condition that affects the abdominal aorta, its major branches, which includes arteries of the legs. Fatty material buildup reduces the elasticity of the artery and reduces blood flow beyond the area of accumulation. Most people with this condition have atherosclerosis so that when an artery in the leg is narrowed by atherosclerosis, that person will begin to feel tingling pain and an achy, crampy, or a tired feeling in the muscles of the leg during physical activity.

What can be done: Leg and feet cramps can be relieved by stretching and this can often be accomplished by standing up and walking around. A gentle massage of the affected muscle group also helps as well as applying warmth from a heating pad or hot soak. Ice packs may also relax a cramp. If the cramp is associated with dehydration, heat stroke, and massive loss of electrolytes, hospitalization in order to replenish the lost fluids and "salts" is usually recommended.

BANANAS AND APPLES
Do They Really Keep The Doctor Away?

Yesterday, Sassy asked if apples really keep the doctor away or is it just some sort of marketing gimmick? In order to answer the question, I created the graphic below to analyze the nutrient contents not just of the apple but also the banana.



Well, the answer seems that BOTH keep the doctor away. Eating either fruit or BOTH fruits will keep the doctor away. If you look carefully, there isn't much difference between the two. There is only one reason why the bananas will beat the apples in this match-up: the bananas has the better potassium-to-sodium ratio. And mind you, not only in this match-up. Of all food items, bananas are the champion when it comes to potassium-to-sodium ratio.

What is so important about this potassium-to-sodium ratio?

A diet high in potassium and low in sodium actually protects against cardiovascular diseases and cancer, while the reverse, a low potassium and a high sodium diet actually can induce these diseases. Most of us, you and I included, ingest twice as much sodium as potassium, in a ratio of 2:1. Our bodies, however, requires a ratio of 1:5, meaning that one should ingest at least five times more potassium than sodium. If we can only include about 5 servings of fruits each day, mainly bananas, most of us will be able to achieve the correct potassium-to-sodium ratio needed by our bodies. The reason is because most fruits and vegetables have a ratio of at least 50:1, fifty times more potassium than sodium. To illustrate and get more ideas, refer to the graphic below:

You should also bear in mind that too much salt depletes the body of potassium. The same is true also when we consume alcohol, coffee, whe we have excessive sugar in he body, when we have prolonged diarrhea, when we sweat too much from physical activity, and when we have vomiting episodes.

If you want more information on fruits, click on this link: The Fruit Pages

So, do bananas and apples keep the doctor away??? Oh, yes. More than you'll ever know.

POTASSIUM AND SODIUM
Are You Getting The Right Amounts?

Tito Rolly sent me this morning an email about the health benefits of eating bananas. Being a doctor, I usually associate bananas with potassium. Potassium and sodium are electrolytes. As such, they are responsible for regulating the electrical activities of the body, including the heart, muscle and nerves. Potassium is usually found inside our cells, while sodium along with chloride are found mainly outside cells. These 3 have to be in proper balance with each other to assure normal metabolic and neuromuscular functioning. An imbalance of high sodium and chloride in relation to potassium is thought to be a major factor in several serious chronic ailments. That's why when you get confined to a hospital, one of the first things a doctor orders is to get your electrolyte profile.

During prehistoric times, early humans survived mainly on diets rich in potassium and very low in sodium. They ate more fruits and vegetables than meat. But modern-day diets, be it American or Filipino, are the reverse of what those early humans consumed --- being loaded with sodium and relatively poor in potassium. There is also a notable increase in processed food consumption, which has a similarly higher sodium than potassium content. The average Western man consumes only 2/3rds the recommended amount of potassium each day, and the average Western woman consumes even less --- half of the 4,700 milligrams a day considered to be an adult's adequate daily intake. In the Philippines, regardless of gender, the recommendation for potassium is even lesser at 2000mgs per day (see table below) --- which, really makes me suspect that the average Filipino isn't really getting the proper electrolyte balance in his body. Filipino adults are advised to consume 500mgs of sodium and 750mgs of chloride each day or about 2gms of salt to replace the amount lost daily on average through perspiration and urination. Elevated blood pressure, which may lead to stroke, coronary heart disease, and kidney disease, is associated with sodium intake. On average, blood pressure rises progressively as salt intake increases. A value known as the upper intake level (UL) is the maximum amount that people should not exceed --- is set at 5.8 grams of salt (2.3 grams of sodium) per day. Older individuals and people with chronic diseases including hypertension, diabetes, and kidney disease are especially sensitive to the blood pressure-raising effects of salt and should consume less than the UL.
FNRI data, 2002. DOST Philippines
To lower blood pressure and reduce the risk of kidney stones and bone loss, American health authorities recommend a consumption of 4.7 grams of potassium per day. I personally think that the 2-gram Filipino recommendation is a bit low. The potential consequences of a chronic potassium deficiency are often unrecognized, and this often escape the notice even of doctors. The problems include high blood pressure, heart attacks, strokes, kidney stones and a loss of bone minerals that can lead to osteoporosis. A low potassium consumption can also cause a sensitivity to salt, further raising the risk of hypertension. Most people have no warning of their potassium deficiencies. They may feel exhausted, weak, and irritable, but unable to pinpoint the cause.

Two weeks ago, I visited the mother of a classmate (she was in her mid-60s) in a hospital in our province. She was brought there when relatives noticed her unusual lethargy, weakness, and inability to speak. They thought she was having her second stroke attack. Initial laboratory results revealed a potassium value of 2 mEq (normal value is 3.5-5.5mEq). Doctors usually panic when they see low values like this! After infusing her intravenous fluid with potassium, she recovered very quickly. She is now back in her home. Elderly people especially those with chronic illnesses are very prone to electrolyte imbalances. Their diet and liquid intake and output should always be carefully monitored.

To prevent electrolyte imbalances, you should eat ample amounts of fresh fruits and vegetables. In processed foods, potassium is commonly lost and sodium substantially increased. Nearly all processed foods are sodium rich and potassium poor. According to Jane Brody of the NYT:

"Among the foods richest in potassium, are leafy greens like spinach, romaine and cabbage; vine-grown foods like tomatoes, cucumbers, zucchini, winter squash and pumpkin; root vegetables like carrots, radishes, turnips and onions; dried peas and beans, and green beans; fruits like apples, oranges, bananas, apricots and strawberries; and tubers like potatoes and sweet potatoes, as well as milk and yogurt. Lesser amounts are found in meats, nuts, eggs, cereals and cheese.

"In physically active people, potassium is important to sustaining good muscle function. But sports drinks, often consumed to restore the nutrients exhausted by vigorous exercise, are close to worthless when it comes to replacing potassium. An eight-ounce serving of a sports drink contains about 30 milligrams of potassium. You would have to drink 12 servings of a sports drink, 600 calories, to consume the amount of potassium in one 65-calorie banana, or consume 375 calories of the drink to get the potassium in 27 calories of a half-cup of cantaloupe.

"If you consumed 100 calories each of spinach, tomatoes, carrots, chickpeas, oranges and potatoes, you would easily take in a day's recommended amount of potassium and only 600 calories. A potassium-rich diet is also great for weight control."

Isn't it time we really consume more fruits and vegetables, and less meat?

ANO ANG NAKAKATUWA?
What Is So Funny?

Screen Capture from today's INQ7.net

Ellen Tordesillas of Malaya newspaper has reproduced in her column an analysis by a certain Jorge Madlos, who according to her is the Mindanao spokesman of the National Democratic Front.

Read the full analysis here and tell me if indeed the last Philippine elections proved that it is possible for a winner to lose and for a loser to win. This might explain why Sassy was depressed on the day GMA was proclaimed.

HAMLET AND CASHEW NUTS
Wiping Out Pesky Warts

This is not about my favorite Shakespearean character. HAMLET is human alpha-lactalbumin made lethal to tumor cells, or in layman's terms, breastmilk as a cure for warts. It was termed HAMLET by Swedish researchers because of the proximity of their location to the scene of the Shakespeare play, which took place in Denmark.

While the researchers knew that breastmilk contains a natural antibiotic, its potential against viruses and tumors was discovered by accident. Dr. Catharina Svanborg, professor of clinical immunology at Lund University in Sweden, and her team were testing ways to fight what is called bacterial superinfection, which is a condition wherein bacteria infects cells already infected by a virus. Her team applied alpha-lactalbumin (a protein in mother's milk) to double-infected lung cancer cells. To their surprise, the cancer cells as well as the bacteria inside them were killed. That was because the milk protein had changed its configuration, bound to another milk component called oleic acid, and created the more powerful HAMLET compound. They then tested it against warts on patient's hands and feet, called plantar warts. The warts shrank by at least 75% over the first 3 weeks the compound was applied to the skin. The whole thing has been documented in the latest copy of the New England Journal of Medicine. Read here.

What the world and these Danes do not know is that as of 1997, a Filipino inventor by the name of Rolando dela Cruz has already been reaping rewards internationally for his topical herbal cream preparation for removing warts, moles and other skin growths using cashew extracts. His anti-wart creams can remove warts and unwanted moles in minutes! That makes the HAMLET look lame in comparison. His latest international award came from the 7th Moscow International Salon of Industrial Property or "Archimedes 2004" held at the Exhibition Centre Sokolniki, Moscow, Russia last April 2004. Check out his website here.

But since the international scientific and medical community frowns at people with no publication of his work at a peer-reviewed journal like the New England Journal of Medicine or the Lancet, Dela Cruz might be in danger of being labeled as a quack or simply ignored for his remarkable invention. He must take steps in order to get recognized and put on record that it was a Filipino who discovered a more effective way of getting rid of pesky warts.

Skin warts are caused by the human papilloma virus, which has about 130 known types. Almost all cases of cervical cancer are caused by two sexually transmitted types. Other types cause skin and genital warts, squamous cell skin cancer and lesions in the throat that are deadly in rare cases. Most persons carry the virus in skin cells, but it does not always cause disease. Discoveries like the anti-wart properties of cashew nuts and breat milk serve as a cause of optimism bacause it might one day also prove effective against cervical cancer and other lethal diseases caused by the same virus.

SUPERBOY IS BORN
Holds The Key To Inherited Muscle Wasting

Since yesterday when the New England Journal of Medicine published a case report about a "a baby Superman, born in Berlin with bulging arm and leg muscles," who "has muscles twice the size of other children his age and half their body fat," the newswires (see Google accounts and this one) have been buzzing. The 4-year old boy can hold 7-pound weights with arms extended, something most adults are not capable of.

Courtesy of NEJM
The boy has an inborn defect in a muscle-controlling gene called myostatin. According to his doctors, his lack of myostatin does not appear to be affecting his health, but they are keeping watch in case it causes key organs, like the heart, to increase in size also. This gene has previously been examined in mice by Se-Jin Lee at Johns Hopkins University and blocking it can make mice twice as brawny as normal. No one knew its effects in humans.....until now.

What this discovery means: it means that successful therapies for degenerative muscle diseases in mice that target this gene might be also be effective in humans. Therefore. if scientists can find ways to interfere with myostatin function, perhaps there can be a way to slow down muscle loss in muscle wasting diseases like Duchenne's and Becker's muscular dystrophies and hopefully extend the lifespans of these patients.

Muscular dystrophies are genetic diseases that progressively damages skeletal muscle. No effective treatment exists, and most patients die in their 20s from a combination of heart and breathing problems.

Last thing I heard is that Wyeth Pharmaceuticals already has synthesized a protein that disables myostatin. Human safety trial of the substance, known as MYO-029, is ongoing. The company, which has a patent on all human therapeutic uses of myostatin, also is planning a study with muscular-dystrophy patients. [Seattle Times]

What's next: super athletes? super soldiers? superlarge chickens? superlarge beef and pork servings?

ALL THE FLAVOR BUT NONE OF THE BITE
Natural Decaf Now Available

Real, natural, decaffeinated coffee from Ethiopia has just been discovered by Brazilian scientists. The decaffeination process available today results in the loss of important flavor compounds, and this results in a lesser-flavored coffee. Decaffeinated coffee makes up about 10% of the world's coffee market. Lead researcher Paulo Mazzafera, a professor of vegetal physiology at the Institute of Biology of the State University of Campinas in Brazil, said:

"This coffee plant has approximately 20 times less caffeine then regular coffee, and double the caffeine of industrially produced decaf coffee."

According to Nature magazine where the study will be published this week, "caffeine-free coffee plants have been found before, growing wild in Madagascar but they yield inferior beans unsuited for coffee production." This discovery is the first time ever anyone has found coffee belonging to the species Coffea arabica with naturally-occuring decaffeinated properties. Coffea arabica beans are the most cultivated and consumed coffee in the world. The newly discovered variety lacks the gene for an enzyme that is required to make caffeine.

Caffeine has been known to raise blood pressure, trigger palpitations and disrupt sleep. This is good news for hypertensive and people with heart conditions. They can now enjoy their full-bodied coffee fix minus the harm. According to Reuters, "If the decaffeinated arabica is commercially productive, naturally decaffeinated coffee could be on the market in 5 or 6 years."

MAKING A SUCCESSFUL STAND
The ED Market Today

I came home last night from a festive dinner celebration of the first anniversary of Lilly and Icos' Cialis at the EDSA Shangrila Hotel. Cialis is tadalafil, an erectile dysfunction (ED) medication that is currently competing with market leader Viagra (sidenafil citrate) made by Pfizer. In the Philippine market, there are 3 erectile dysfunction medications, the two just mentioned, and Bayer HealthCare and GSK's Levitra or vardenafil HCl.

Known as impotence two decades ago, erectile dysfunction (ED) is a medical condition wherein a man cannot get an erection to have sex or cannot keep an erection long enough to finish having sex (what is termed successful sexual intercourse). Current data says that 50% of men over 40 has some form of ED, and roughly this translates to more than 50 million males worldwide, although many cases may be temporary. Local data on Filipino males is still vague and sketchy, as being labeled "impotent" carries a dreadful stigma in our macho culture. Local urologists, however, will tell you that more and more Filipino males are coming out with this problem. Proof of this is the more than P500 million sales of Viagra locally since its introduction on April 1998 and noted urologist Dr. Eduardo Gatchalian's comment a year ago that,

"Maybe in the field of human relations, Viagra should be given the Nobel Prize." [INQ7.net]

Psychiatrist Ma. Luz Casimiro-Querubin of the University of the Philippines, said that:

"Sex is very important in marriage. The relationship of husbands and wives through the years will change. Lovemaking, in fact, becomes difficult after several years. Wives sometimes look at it as a chore. The reality is that marital relationships will develop according to certain interpersonal dynamics. Sexual relationship moves in cadence and in accordance with how that relationship improves or suffers through the years." [INQ7.net]

There are various causes of ED and, in some cases, unexpected. Alcoholism, chronic kidney and liver problems, heart disease and diabetes are some of the more common causes. A fractured pelvis, spinal injury or nerve damage from an operation on the prostate gland or rectum can also permanently damage erectile tissue and cause ED. Of course, not to be forgotten are the psychogenic causes: a recent divorce, sexual assault or marital discord.

The "fils," that is how I like to call the ED medications, because they have similar endings (sildenafil, tadalafil, and vardenafil) are all phospodiesterase-5 or PDE-5 inhibitors. Phospho...wwhat??? Don't be alarmed. I'm not getting technical here. I just want you to understand what happens when you have ED. In our bodies, there is a nitric oxide system (NOS) that causes relaxation of smooth muscle in blood vessel walls, ie, vasodilation, in various organ systems, including the muscles of the penis. A mediator termed cGMP, facilitates the NOS pathway. PDE-5 catalyzes the degradation of cGMP, and prevents erection from happening. When males get sexually excited, the normal reaction is to increase blood flow to the penis. The NOS promotes this process and results in an erection. What Viagra, Cialis, and Levitra accomplishes is to inhibit PDE from destroying cGMP, and thereby lengthen and promote penile erection.

Courtesy of USRF
This is also where the drug interaction and side-effects explanation come in. In patients taking heart medications like nitrates, or alpha-blockers, combination with any of the "fils," can cause a sudden blood pressure drop which can be fatal. Side effects like headache and muscle pain are due to overlapping PDE specificity of the "fils." You see, there are many PDE's in the body. There's PDE-1, PDE-2, so forth and so on, in charge with different organ systems. PDE-5 is for the penis. Viagra, unlike Cialis and Levitra, exhibit overlaps in its PDE specificity and hence, the observable side-effects.

In summary, all 3 "fils" have about 70% efficacy. Side effects are almost similar, except that blue discoloration of vision (overlap with PDE-6 in the retina) is seen only with Viagra (<0.5%) and muscle aches only with Cialis (~5%). Vasodilatory side effects (headaches, nasal congestion, flushing) are common with all, but are mild, and only rarely cause men to drop out of clinical trials (2-3% quit rate). All 3 will carry a contra-indication in men using organic nitrates. Otherwise, the long half-life of Cialis of about 17.5 hours is noteworthy, earning this drug the nickname "weekender Cialis" as a single dose taken on Friday would still be exerting an effect Sunday (or even Monday). [USRF report]

Guys, whatever your choice is, don't self-medicate. Don't also fall for those Internet scams that offer unbelievably low discounted prices of medicines that can be bought without a prescription! The most popular of these is Viagra and other erectile dysfunction drugs, weight loss medicines and drugs that "enlarge" whatever part of your anatomy. See your physician so you can get an accurate evaluation and a proper prescription.

DYING YOUNG
Smokers, Please Quit While You Still Can

"I can only advise people that if they enjoy life, if they think life is worth living, then it is damned silly to smoke because you are just not going to have as much of it to live."

Those are the words of Professor Sir Richard Doll, the world-famous researcher who first established a link between tobacco and lung cancer. Since 1951, Sir Richard has followed the lives of nearly 35,000 doctors and found that those who smoked were much more likely to die of the disease. Today, just 5,900 of the doctors in the study are alive and only 134 of those still smoke, prompting him to decide to publish one, final paper on his life's work. A total of 34,439 male British doctors, who were quizzed about their smoking habits and health at intervals thereafter - in 1957, 1966, 1971, 1978, 1991 and 2001.

Yes, you read that right --- doctors --- smoking doctors, to be more precise, were the subjects studied in this longest study ever conducted to look into the effects of smoking. This landmark study is due to appear in the June 26 issue of the British Medical Journal, 50 years to the day after the first landmark results from the same study, which confirmed the said link between lung cancer and smoking.

The most remarkable finding of this study show that half of all people who start smoking in their teens and do not give up will eventually be killed by their habit. While non-smokers have enjoyed progressively longer lives, the lives of smokers have shortened. Among men born after 1920 who are persistent smokers, the risks are even greater, with two-thirds either already dead or predicted to die as a result of their addiction.

I still can not fathom why smokers would not quit.

Here's another good soundbite from another Richard, Sir Richard Peto, professor of medical statistics and epidemiology at the University of Oxford,

"I think we have sometimes emphasized whether kids start almost to the detriment of whether adults stop. By the time you are 30, you've got some understanding of life and death, and when you are 40 you have substantial understanding of life and death; it is for people old enough to know that death is real. If you stop smoking then, you will probably get away with it. There is some risk left over, but it's really small in comparison with other things in life.

There are risks in life, but you don't have many things that kill half of those that do them. The key emphasis for practical purposes is how big the risk is if you smoke, and how big the benefit when you stop. Smoking kills half. Stopping works."

Read the full report here.

DOGS AS DOCTORS
Man's Best Friend and...Personal Neurologist?

The latest issue of the journal Neurology reveals that dogs can detect epileptic seizures 15 minutes before it occurs.

In a study done and published by Dr. Adam Kirton and colleagues of Alberta Children's Hospital in Canada, about 40% of 238 families surveyed who owned a dog said that their dog showed seizure-related behavior, even though none of the dogs were specially trained. Dogs were often observed to lick children who were going to have a seizure. Protective and caring behavior were also noted when the dogs would sit on a toddler to prevent her from standing up prior to a seizure. There was also a case when a dog would push a young girl away from the stairs about 15 minutes before the start of a seizure.

Although the researchers still cannot tell how the dogs can predict a seizure-epileptic attack, they theorize that dogs can pick up on visual cues that a seizure is about to occuror that they may also use their heightened smell sensitivity to sense an impending seizure.

You know, even if you don't have seizures to watch out for, or even if your dog cannot detect one, it is still beneficial to have a dog around. There are studies showing that owning dogs can be therapeutic. They can lower blood pressure in hypertensive patients and speed up recovery from surgery or any illness.

The dog is your best friend, bodyguard, and lately, your doctor.

DEADLY VIRUS IN TEARS
Easy To Pass, Hard To Cure

Singapore doctors led by Dr. Seng Chee Loon of the National University Hospital in Singapore and his colleagues just found the SARS virus (SARS-Cov)in samples taken from tear ducts from 36 patients suspected of being infected last year.

This is not at all surprising. In my opinion, since the SARS virus is a mutated flu virus, its infectivity and virulence are twice, perhaps thrice the ordinary flu virus. All body fluids from SARS patients like sweat, tears, urine, blood, cough and sneeze droplets should all be suspect as harboring the virus and therefore, avoided.

Initially recognized as a global threat in March 2003, SARS made its first appearance in Southern China in November 2002. After several months, the illness spread to more than 24 countries in North America, South America, Europe, and Asia, killing more than 800 and infecting more than 8000 people. The dreaded 2003 SARS global outbreak was already controlled and contained, but the chances that person-to-person transmission of SARS-CoV might recur remains a big possibility especially with the current finding.

LADIES, DO NOT WAIT TOO LONG
Doctor Claims The Clock Still Ticking

Just when you thought modern day progress and advances in the medical field can make most women relax about their biological clocks, comes a report from a doctor writing in the journal Human Reproduction that women can wait only as long as 35 years old. Beyond that, chances get slimmer as the years go on.

What waiting and delay are we talking about?

Delaying to have a baby, that's what.

"The message to women is: up to about 35 years, if you want a child, be patient. Even if you do not succeed in one year, your chances of success are still substantial. Beyond that age, be impatient."

Thus spoke Dr. Henri Leridon of the French National Institute of Health and Medical Research (INSERM) in Paris, who explained that some of the decline in fertility can be compensated for using assisted reproductive technologies (ART). He says that,

"ART cannot remove all effects of age and give to a woman aged 40 years the fertility of a 20-year-old. Do not wait too long before consulting for infertility, because the effectiveness of medical techniques is also decreasing as you grow older." [Reuters report]

I guess this puts more pressure on women to get married or get pregnant as soon as possible if they want to have a child to enjoy the rest of their lives.

DO YOU WANT A GMAIL ACCOUNT?
One More Invite Available



Does anyone want a GMail account? Since I have one more invite left, I have decided to raffle it to a lucky person this coming Sunday, June 20, 2004.

Simple rules:

Leave your full name, age, location, email address (important! this is where I will send your invite if you win), and why you want a GMail account. Please leave all these details in the comment box. Please do not send it via email. Thanks.

Closing time will be at 09:00am, Manila Time (01:00:00 GMT/UTC), 20 June 2004. Lucky winner will be drawn randomly using Microsoft's Excel software. I will notify the winner by email and confirm his identity. I will then send the GMail invite afterwards.

Goodluck!

UPDATE: Since only two people wrote to request for an invite, I decided to give both of them one GMail invite each, one from me and the other courtesy of my good friend Bayi! To Jeremy and Fidel, thanks and hope you enjoy your 1GB of email accounts. By this time, you must have received your invites. Any problems, leave a note here.

TWO REMEDIES FOR YOUR STRENUOUS LOVELIFE
But Would You Approve???

Two common lovelife problems --- infidelity for the males, and decreased sexual libido for the females --- may now have much-awaited scientific solutions.

Remedy No. 1 -- The Age of Australia described it as the "thing that separates a cad from a faithful lover," and Forbes magazine called it as a way of keeping "Mickey and Minnie together." Researchers have recently discovered that gene therapy can cure infidelity problems. The days of the philandering and promiscuous male are over! Isn't that wonderful ladies? At a flick of a genetic switch, we turn into faithful lovers. The researchers led by Miranda Lim from Emory University in Atlanta, Georgia, inserted a gene directly into the brains of male meadow voles or Microtus pennsylvanicus (laboratory rats). The gene inserted helps regulate social behavior and pair bonding. After a few days, the "normally promiscuous rodents lost their lust for the ladies" and were observed to have become faithful to their mates. Read the full report in this week's Nature.There has been no human testing yet. Any volunteers, guys? Girls, would you volunteer your husbands and boyfriends for possible therapy?

Remedy No. 2 -- Procter & Gamble, known for products like Tide, Mr. Clean, Head and Shoulders, Pampers, Pringles,etc., has just come up with a testosterone patch that aims to remedy decreased sexual function in women. To be marketed as Intrinsa, P&G's testosterone patch was shown to "significantly increase and satisfy sexual activity and sexual desire in menopausal women with Hypoactive Sexual Desire Disorder" (HSDD), and even in women who previously had both ovaries surgically removed. HSDD is defined as a lack of sexual desire that causes a woman personal distress. Testosterone has long been known to play a major role in influencing sexual desire in both women and men. Accurate estimates of women's sexual dysfunction in the overall US population reach as high 43%. Being the first mover into that market means big things for P&G's top line. The Intrinsa study results were just presented in the 86th Annual Meeting of The Endocrine Society, which is currently being held in New Orleans, Louisiana. Read the full report here. So ladies, in the future, when your partner complains how cold you are in bed, all you have to do is put on this transdermal patch and sexual desires come rushing in. Charge that to progress and creative minds.

PLANNING LIPOSUCTION? THINK AGAIN
No Real Benefits

From the New England Journal of Medicine (NEJM)Notice the decrease in size of the surrounding white structure,
which is the removed subcutaneous fat in liposuction.
Yellow arrows mine.

=Increased waist circumference

=Increased abdominal subcutaneous fat

=Increased visceral fat

The factors listed above are all manifestations of abdominal obesity. Abdominal obesity is a busy term used by cardiologists, endocrinologists, and internists. At one point in your periodic clinical visit, your doctor might have also mentioned this term to you. Abdominal obesity along with insulin resistance are known to be risk factors of coronary heart disease. Recently, in several journal reports (this one and this one), it has been suggested that liposuction can be curative for the metabolic complications of obesity.

I have no personal knowledge of the local numbers of liposuction cases in the Philippines, but in the US, there are more than 370,000 liposuction procedures done annually [ASAPS Data, 2002]. All of these are done mainly for aesthetic reasons. Nobody really thinks it is healthy, or that health should take precedence over beauty. From a doctor's point of view, I have long known that liposuction or any cosmetic procedure done on the body have little or no effect on the overall metabolic state of the individual. As such, insulin resistance and the risk for coronary disease does not go down when you undertake such procedures. The June 17 issue of the NEJM validates this in a report which showed that "abdominal liposuction does not significantly improve obesity-associated metabolic abnormalities and decreasing adipose tissue mass alone will not achieve the metabolic benefits of weight loss.".

Bottomline: Exercise, physical activity, and diet modifications are still best for improving your metabolic state and fighting off diabetes and coronary heart disease. Liposuction is the quickie method of getting rid of fat. It is expensive, might be dangerous (read this), and on a lighter note, it might be your easiest ticket to a legal battle (read this).

DETROIT PISTONS MAKE IT!
Motown Obliterates Lakers

From the Detroit Free Press

The Detroit Pistons just clinched the 2004 NBA Championship with a 100-87 rout of the LA Lakers in Game 5 of the series. Jack Nicholson, the actor fan of the Lakers who watched the game, must have been heartbroken. Mitch Albom, the Detroit Free Press sports' section columnist, described the victory as:

"They attacked all night, the way you attack a fire, the way you attack an enemy hill, no counting on luck, fate or chance, just sheer will and your own pounding lungs, drive the rim, drive the lane, until finally, the horn sounded to end their nine-month shift, which began in October and ended one week shy of summer. Rip Hamilton was jumping in place, a ball of energy. Mehmet Okur was hugging Tayshaun Prince. Ben Wallace took the spray paint and marked the last game with a big old "X." The team whose motto is "Goin' to Work" had put in a little overtime, and the once mighty Lakers hadn't just been defeated, they'd been stomped and crushed like Italian grapes. The Pistons didn't just beat L.A., they reduced it to a single letter: "L," as in loser. And as the music soared at the Palace the Pistons soared right with it." [Detroit Free Press]

Game 5 was a history of sorts. It was Phil Jackson's first loss in all the Finals he played in. It is also the first time an NBA team swept all three middle games in the homecourt to win the champioship. This is also the Pistons first championship in 14 years!

Everybody loves a winner. Everybody hates the loser. Even the San Francisco Chronicle now calls the Lakers as "dysfunctional." Can you believe that? Years ago they were praising the Lakers to high heavens and now... It even went as far as concluding that the

"...Lakers were supposed to be one of the best teams ever assembled after adding Karl Malone and Gary Payton to go with Shaquille O'Neal and Kobe Bryant. In the end, they looked old and tired." [San Francisco Chronicle]

The Lakers are now in limbo. Will it ever compete in the Finals again? Debatable, at this point. Phil Jackson and Kobe Bryant might not return anymore. Besides, it might be true that they're all very tired now and just want to fade in the sunset after basking in glory for so long.

If I were to point the blame for losing to one person in the Lakers, it has to be Gary Payton.

If I were to point the credit for winning to one person in the Pistons, it has to be Rip Hamilton.

And I agree with the Washington Post analysis that the success of the Detroit Pistons awakened a "dormant, old-fangled concept back to the NBA: the idea that five good, persevering players competing as one, could overwhelm a roster of stars, even the most brilliant duo of their generation."

FOOLISH DOCTOR TRIES A STUNT
Maybe He Thought It Will Pass

Due to rising medical malpractice costs, an American Medical Association (AMA) doctor by the name of Dr. J. Chris Hawk III, is currently drawing flak from colleagues and lawyers because of his ridiculous proposed resolution that zoomed in on trial lawyers. He wants to withhold medical care to lawyers. How crazy is that?

Resolution 202 has been introduced by Dr. J. Chris Hawk III from South Carolina to the AMA's Committee B. It read in part like this:

"RESOLVED, That our American Medical Association notify physicians that, except in emergencies and except as otherwise required by law or other professional regulation, it is not unethical to refuse care to plaintiffs' attorneys and their spouses." Full story here

I had a good laugh reading that. According to another account,

"The chilling explanation by Dr. Hawk for this proposed resolution is that lawsuits against medical-practice mayhem raise malpractice insurance premiums 'forcing physicians to reduce their scope of practice, relocate, and retire early.' Therefore, he concludes, trial attorneys should be given 'the opportunity to experience the access problems caused by the professional liability crisis,' [and] then 'perhaps they would be willing to help change the system.'

I wonder what my friendSassy would say. Should we also do the same to our erring senators and congressmen?

AGING GRACEFULLY
Making The Most Out of It

After reading the CA t's heart-warming blog about an old friend she encountered and befriended, I was inspired to post today something about aging and senior citizens.

Aging is a fact as definite as the sun rising and setting. No one can escape it. Everyone works hard to delay it and many business ventures have capitalized on it, gaining billions and billions of money in the process. Women have been observed to age faster then men, mainly due to the hormonal changes they experience starting with puberty, then through pregnancy, and culminating with menopause. During menopause, many women start to notice numerous skin changes, such as, wrinkles, drying of the skin due to decreased sebum (oil) production, loss of elasticity, and a reduction in the rejuvenation process. The onset and extent of skin aging depend on three factors: age, genetics, and lifestyle.

Extended sun exposure, smoking, drinking too much alcohol, obesity, and having too much stress physically and emotionally are the ingredients of a sure formula to hasten aging. Altering one or more of these factors helps in delaying the inevitable.

A good but often ignored anti-aging technique is drinking 5 to 6 glasses of water (standard glass = 250mL) daily. Since our bodies are made up of 50-70% water, we must always make sure that our hydration is always optimal. Water is constantly lost each day through perspiration, urine, and respiration. Water makes the skin healthy and helps us get rid of toxic substances.

Among the more recent tips to stay young include learning an extra language in order to "offset age-related declines in mental performance." The second recent finding reports that people "who ate three or more servings of fruit a day were 36% less likely to develop age-related maculopathy than people who ate less than 1.5 per day." Age-related maculopathy, or age-related macular degeneration, is the leading cause of blindness in people over 65. Blindness is caused by the deterioration of the macula, a part of the light sensitive layer in the eye called the retina. There is gradual cell breakdown, and the tissue is damaged by the growth of blood vessels under the retina. The third recent finding says that if you are the angry type, you should minimize alcohol intake, as the combination increases your chance to become more violent, and of course, contributes more to your aging process. And for men with receding hairlines, this report will surely make them happy. It seems advances in hair transplantation are making bald men more hopeful and optimistic.

Here in the Philippines, those who are 60 years old and above fall into the senior citizen classification. In the Inquirer's editorial today, the paper elaborated on the Expanded Senior Citizens Act of 2003. The new law will help senior citizens avail for themselves employment opportunities, livelihood training programs and self-employment assistance.

"Those who would like to continue their studies can pursue post-secondary, post-tertiary as well as vocational or technical education in private and government learning institutions for free. They will also be exempt from training fees for socio-economic programs. They will get free medical and dental services, diagnostic tests and laboratory examinations in government facilities." [Philippine Daily Inquirer]

I think these perks for senior citizens are long overdue. The best we can do for them is thank them for everything they did for us. Soon, we will all be like them, and we wouldn't want the present generation forget about us, would we?

ONE MORE TO GO?
Can The Lakers Come Back?
From the Detroit Free Press
I love basketball. I love Michael Jordan since his days at Chicago. The invincibility of the Chicago Bulls during their peak I attribute to both Michael Jordan and the Zen master, Phil Jackson. When the Chicago juggernaut broke up, I switched my allegiance to the Los Angeles Lakers. That was where Phil Jackson went and I think I was right after they won 3 NBA championships for 3 straight years. Now, the Lakers are back in the finals this year, but they are now against the wall against the Detroit Pistons at 3-1, in favor of the latter. Game 5 is on Wednesday. One more win by the Pistons, and the Lakers head to nowhere. What is happening to the Lakers? They got the Mailman, they got Payton, they got Kobe, and Shaq, and they're still falling down like London Bridge.

According to Mitch Albom of the Detroit Free Press:

"The giant is falling. The Lakers' machine is clanking in the city of motors and engines and it may not even have enough juice to take this series home. No team has come back from a 3-1 deficit in the Finals, which is where the Lakers are today, thanks to the Pistons' stirring 88-80 victory in Game 4 Sunday night [Monday morning here in Manila] at the Palace. By the end of the night, as the Pistons were high-fiving, the stars from L.A. were scowling and screaming at referees. Phil Jackson, who has never faced this kind of deficit, was visibly frustrated.

What's left? Unless Jackson has some hidden roster of young, fast and healthy players, Game 5 or 6 or 7 will ultimately, it seems, yield a similar result. The Pistons are simply well-matched against this team: when talent meets talent, when body meets body, and when hunger meets hunger. Especially when hunger meets hunger. What they are doing is a testament to guys working together and an indictment of guys working for themselves.

"Do you guys feel like it's over?" someone asked Jackson.

"They don't feel it's over," he said. "They just want a fair shake. They want an even break from the refs. They want to feel like they're not playing uphill."

Folks, when they start blaming the referees, it's over.

And Phil knows it.

So that's how the cookie crumbles?

I do hope Phil comes up with the triangle or the circular or the square offense. And Mitch Albom may be right. The Detroit Pistons may really be "working together," and the Lakers "working for themselves." That explains everything, don't you think? Whatever happens, the hungrier team will definitely win.

HUMILITY, HONOR, AND HUMOR
What Makes A Good President

Ronald Reagan was laid to rest yesterday. There were many eulogies given, but I liked best this one from Dubya's dad, George, Sr. Read on:

"When Franklin Roosevelt died in 1945, the New York Times wrote, 'Men will thank God 100 years from now that Franklin D. Roosevelt was in the White House.'

It will not take 100 years to thank God for Ronald Reagan. But why? Why was he so admired? Why was he so beloved?

He was beloved, first, because of what he was. Politics can be cruel, uncivil. Our friend was strong and gentle.

Once he called America hopeful, big-hearted, idealistic, daring, decent and fair. That was America and, yes, our friend.

And next, Ronald Reagan was beloved because of what he believed. He believed in America so he made it his shining city on a hill. He believed in freedom so he acted on behalf of its values and ideals. He believed in tomorrow so The Great Communicator became The Great Liberator.

He talked of winning one for the Gipper and as president, through his relationship with Mikhail Gorbachev, with us today, the Gipper and, yes, Mikhail Gorbachev won one for peace around the world.

If Ronald Reagan created a better world for many millions it was because of the world someone else created for him.

Nancy was there for him always. Her love for him provided much of his strength, and their love together transformed all of us as we've seen -- renewed seeing again here in the last few days.

And one of the many memories we all have of both of them is the comfort they provided during our national tragedies.

Whether it was the families of the crew of the Challenger shuttle or the USS Stark or the Marines killed in Beirut, we will never forget those images of the president and first lady embracing them and embracing us during times of sorrow.

So, Nancy, I want to say this to you: Today, America embraces you. We open up our arms. We seek to comfort you, to tell you of our admiration for your courage and your selfless caring.

And to the Reagan kids -- it's OK for me to say that at 80 -- Michael, Ron, Patti, today all of our sympathy, all of our condolences to you all, and remember, too, your sister Maureen home safe now with her father.

As his vice president for eight years, I learned more from Ronald Reagan than from anyone I encountered in all my years of public life. I learned kindness; we all did. I also learned courage; the nation did.

Who can forget the horrible day in March 1981, he looked at the doctors in the emergency room and said, "I hope you're all Republicans."

And then I learned decency; the whole world did. Days after being shot, weak from wounds, he spilled water from a sink, and entering the hospital room aides saw him on his hands and knees wiping water from the floor. He worried that his nurse would get in trouble.

The good book says humility goes before honor, and our friend had both, and who could not cherish such a man?

And perhaps as important as anything, I learned a lot about humor, a lot about laughter. And, oh, how President Reagan loved a good story.

When asked, "How did your visit go with Bishop Tutu?" he replied, "So-so."

It was typical. It was wonderful.

And in leaving the White House, the very last day, he left in the yard outside the Oval Office door a little sign for the squirrels. He loved to feed those squirrels. And he left this sign that said, "Beware of the dog," and to no avail, because our dog Millie came in and beat the heck out of the squirrels.

But anyway, he also left me a note, at the top of which said, "Don't let the turkeys get you down."

Well, he certainly never let them get him down. And he fought hard for his beliefs. But he led from conviction, but never made an adversary into an enemy. He was never mean-spirited.

Reverend Billy Graham, who I refer to as the nation's pastor, is now hospitalized and regrets that he can't be here today. And I asked him for a Bible passage that might be appropriate. And he suggested this from Psalm 37: "The Lord delights in the way of the man whose steps he has made firm. Though he stumble, he will not fall for the Lord upholds him with his hand."

And then this, too, from 37: "There is a future for the man of peace."

God bless you, Ronald Wilson Reagan and the nation you loved and led so well."
[From Newsday]

WHAT WOMEN MEAN
These Need Confirmation

A friend doctor sent this to me thru email yesterday. Do you think they are true?

These are words and sounds we often hear from the ladies in our lives. It appears they have deeper meanings and as males, I think, we need extra sensitivity to avoid any future conflicts. You be the judge.

"FINE."
This is the word women use to end an argument when
they feel they are right and you need to shut up.
Never use "fine" to describe how a woman looks - this
will cause you to have one of those arguments.

"FIVE MINUTES."
This is half an hour. It is equivalent to the five
minutes that your football game is going to last
before you take out the trash, so it's an even trade.

"NOTHING."
This means "something," and you should be on your
toes. "Nothing" is usually used to describe the
feeling a woman has of wanting to turn you inside out,
upside down, and backwards. "Nothing" usually
signifies an argument that will last "Five Minutes"
and end with "Fine"

"GO AHEAD." (With Raised Eyebrows)
This is a dare. One that will result in a woman
getting upset over "Nothing" and will end with the
word "Fine"

"GO AHEAD." (Normal Eyebrows)
This means "I give up" or "do what you want because I
don't care" You will get a "Raised Eyebrow Go Ahead"
in just a few minutes, followed by "Nothing" and
"Fine" and she will talk to you in about "Five
Minutes" when she cools off.

LOUD SIGH
This is not actually a word, but is a non-verbal
statement often misunderstood by men. A "Loud Sigh"
means she thinks you are an idiot at that moment, and
wonders why she is wasting her time standing here and
arguing with you over "Nothing".

SOFT SIGH
Again, not a word, but a non-verbal statement."Soft
Sighs" mean that she is content. Your best bet is to
not move or breathe, and she will stay content.

"THAT'S OKAY."
This is one of the most dangerous statements that a
woman can make to a man. "That's Okay" means that she
wants to think long and hard before paying you back
for whatever it is that you have done. "That's Okay"
is often! used with the word "Fine" and in conjunction
with a "Raised Eyebrow."

"GO AHEAD!" (Raised Voice)
At some point in the near future, you are going to be
in some mighty big trouble.

"PLEASE DO."
This is not a statement, it is an offer. A woman is
giving you the chance to come up with whatever excuse
or reason you have for doing whatever it is that you
have done. You have a fair chance with the truth, so
be careful and you shouldn't get a "That's Okay"

"THANKS!"
A woman is thanking you. Do not faint. Just say you're
welcome.

"THANKS A LOT!!!"
This is much different from "Thanks." A woman will
say, "Thanks A Lot" when she is really ticked off at
you. It signifies that you have offended her in some
callous way, and will be followed by the "Loud Sigh."
Be careful not to ask what is wrong after the "Loud
Sigh," as she will only tell you "Nothing"

RAY CHARLES SUCCUMBS TO LIVER DISEASE
The Man Behind The Music

"Music is nothing separate from me. It is me. I can't retire from music any more than I can retire from my liver...I believe the Lord will retire me when He's ready. And then I'll have plenty of time for a long vacation." -Ray Charles

Well, God is ready, and he retired Ray Charles, 73, on Thursday, 11:35 am PDT (2:35 am, Friday, in Manila) at his Beverly Hills home, surrounded by family and friends. He died after a long fight with liver disease. During his career, he achieved 13 Grammy Awards, including a lifetime achievement honor in 1987. According to Reuters, he played his 10,000th concert last May at the Greek Theater in Los Angeles and in 2002 celebrated the 40th anniversary of his first hit on the country music charts, "I Can't Stop Loving You."

He has been exposed to stress and problems since he was a child. At age 5, he watched powerless as his older brother drowned in a tub. The most he could manage at the time was scream for his mama to help. He lost his sight to glaucoma when he was six. At 15, he was devastated by the death of his Mama. During past interviews, Ray spoke highly of his mother, and praised her wisdom, love, and discipline.

"Mama was a country woman with a whole lot of common sense. She understood what most of our neighbors didn't --- that I should not grow dependent on anyone except myself. 'One of these days, I ain't gonna be here,' she kept hammering inside my head. Meanwhile, she had me scrub floors, chop wood, wash clothes, and play outside like all the other kids...And her discipline didn't stop just because I was blind. She wasn't about to let me get away with any foolishness." Ray Charles, in an interview.

In the same interview, he openly admitted the value of therapeutic crying,

"I suppose I have always done my share of crying, especially when there's no other way to contain my feelings. I know that men ain't supposed to cry, but I think that's wrong. Crying's always been a way for me to get things out which are buried deep, deep down. When I sing, I often cry. Crying is feeling and feeling is being human. Oh yes, I cry."

Though Ray Charles' Mama warned him that she will not be around forever, he was grief-stricken when she died:

"When a boy has just one parent and mama, he will cling to her like she's life itself. And he will never even start thinking about what life would be like without her. The thought is too terrible...I was unable to deal with the facts of death; I was unable to accept the reality of death. I had to make up my own mind, my own way, in my own time. I found the situation frightening but that week of silence and suffering also made me harder, and that hardness has stayed with me the rest of my life."

His 15 years of heroin addiction become public knowledge with his 1964 arrest in Boston for heroin possession. He stopped touring for all of 1965 to kick the habit and enrolled in the rehabiltation program at St. Francis Hospital near Los Angeles. His decision to withdraw from the world was an example of his determination. In St. Francis Ray learned how to play chess and cards in Braille. After the heroin addiction, came inner ear problems. He survived this one, too, and even urged Congress to increase funding for research into hearing loss in 1987, saying,

"Most people take their hearing for granted. I can't. My eyes are my handicap, but my ears are my opportunity. My ears show me what my eyes can't. My ears tell me 99 percent of what I need to know about my world."

Next came a hip replacement surgery after a hip fracture last year. Weeks before he died, he had been unable to speak, and his voice was reduced to a whisper. Quite an irony for the man who became famous because of the unique sound of his voice which expressed the emotions of his songs.

Unlike Reagan, not much was said about the liver disease which reports said finally did him in. I can only speculate that the liver disease was an off-shoot of the years and years of heroin addiction. Second to drug overdose, the most common cause of death of chronic heroin users is chronic liver disease (15.2%). Of course, I can be wrong, and we will never find out. But it really does not matter now, does it?

God be with you, Ray Charles!

WOMEN DON'T DO IT RANDOMLY
Their Urges Are Pregnant With Meaning

In his study published in the journal Human Reproduction, Professor Allen Wilcox, of the National Institute of Environmental Health Sciences in Durham, North Carolina, just discovered that during ovulation, which is a phase when a woman is most likely to become pregnant, the overall frequency of sex increased by 24%. His study included 68 women who had either been sterilised or were using an intrauterine device (IUD). It was shown that the frequency of intercourse increased during the six most fertile days of the menstrual cycle and peaked at ovulation --- despite the fact that these women clearly did not want a baby.

"There apparently are biological factors promoting intercourse during a woman's six fertile days, whether she wants a baby or not. It suggests that couples who 'take a chance' with unprotected intercourse have the deck stacked against them. Intercourse apparently does not happen randomly. It's more likely to occur on the fertile days, even though the average woman would not know when these days are." [BBC report]

In layman's language, this means that when your wife or girlfriend feels horny, it is with biologic purpose. It is because this is the time she is most fertile and the likelihood of getting pregnant is very high. This study validates that humans are similar to most mammals in terms of coordination between ovulation and sexual intercourse.
This is good news and a welcome tip for the women pictured above. This is the Obando Fertility Rites, celebrated here during May 17 to 19 of every year. It is a Filipino festival in which Obando streets congest with childless couples hoping for children, who dance in an immense procession, pushing before them wooden carts called carosas filled with images of the particular saint to whom they are appealing. The dance must be performed religiously with gyrating hips in harmony with the beat and tempo of the music and with utmost faith. Finally, the procession comes to lounge at the steps of the church, into which the inflamed childless couples extend their festivities up to the church's aisle.

With four Filipinos born every minute, I think our Filipinas are very, very fertile, and our fertility dance very effective indeed.

MORE YAWNS TO GO BEFORE I SLEEP...
Stolen Shot Tells All

From today's PDI

"Can you please tell Senator Pimentel not to delay any more the canvass?"

According to the PDI story, that was retired Cardinal Sin's plea as he called up the house of Senator Aquilino Pimentel Jr. in Marikina last Tuesday. The one who answered was Mrs. Pimentel, and she shot back at the Cardinal by saying, "Your Eminence, Nene [Senator Pimentel] is only seeking the truth and he is in fact only following the teachings of the Church."

Mrs. Pimentel unperturbed by the prelate's surprise phone call further said: "...the Church itself teaches that we must all seek the truth because the truth shall set us free. Nene was seeking the truth on who is the real, elected president."

One sees it as a delay, the other sees it as quest for truth.

I think one's perspective is strongly influenced by who he supported and voted for as President during the last elections.

My reaction: The Cardinal must have very good doctors taking care of him. He is still able to spring out of his retirement and even had the brazenness to voice out his Pido-like objection straight to the house of his perceived filibuster.

GERMAN STUDENTS HAVE HIGH GRADES
Want To Know Their Secret?

Read why German students probably do not need our Department of Education's "bridge program" as discussed by Sassy two days ago:

"German sociologist Werner Habermehl says that regular sexual activity can help university students pass their exams and get better results. Habermehl, who is based at the University of Hamburg, said that he and his team had tested students before and after sex. They found that regular sexual activity significantly increased mental capability, but discovered that celibate students found it harder to make the grade. As well as decreasing the length of time needed to complete a course, students with a healthy sex life also received better marks, said Habermehl." [Independent Online]

Medically speaking, there is basis for Habermehl's findings since sexual activity is perceived by the body as a good cardiopulmonary exercise. A good cardiopulmonary exercise increases blood flow to almost all of the body's vital organs including the brain, which is the significant body part needed to get a good grade in any examination.

Among the other health benefits derived from a normal sexual activity include stress reduction, lower cholesterol levels, improved immunity against diseases, and improved sleeping conditions. As a form of exercise, sexual intercourse has been demonstrated to burn approximately 300 calories per hour. Here's how it compares against some other activities that may be part of your fitness regime: walking-3mph and weight training, both 306 calories each per hour, and badminton, 348.

Now, before you get any ideas about me starting a movement to improve our pathetic education system, you must remember that before you can achieve the benefits I mentioned, you must first deal with the moral and lawful aspects of any planned sexual activity.

ON DEATH, DYING & DECISION-MAKING
When Do We Stop?

Since I wrote my June 6 post on Alzheimer's Disease and Ronald Reagan's demise, a commenter from Spain who signs his name as "Kano," and I have been exchanging views on death, dying, and the roles doctors and relatives alike should play in such dire situations.

As doctors, we often face situations in which patients are in critical conditions, meaning the degree of survival is very minimal. This happens in many cases: traumatic accidents, cancer, AIDS, extremely septic cases, stroke, heart attack and many, many more. A typical scenario is a patient in a critically unstable (read: he can expire anytime) condition transferred to the Intensive Care Unit (ICU), unconscious or comatose, hooked to a respirator, has had about 2-3 cardiac arrests but was revived, and being given intravenous cardiac medications like dopamine and dobutamine. In my young practice, the highest mortality rates among such cases are observed among the elderly population (65 years and above). In these cases, we usually talk to the relatives of the patient, informing them of the gravity of the patient's situation, probability of survival, and of the impending costs of maintainance. Sometimes, to curb expenses, they are advised to buy their own medicines and medical supplies directly to their pharmacy of choice. Worse, sometimes, they are asked to transfer to low-cost hospitals, again of their choice.

The valid and interesting points raised by Kano in situations like these were:

"I wonder why we, under the name of compassion or humanity or whatever you care to call it, would allow our closest family members to suffer prolonged, horrible deaths -- be it this disease or cancer or some other hopeless and incurable disease.

"Why can't we let them die in peace and dignity? Is it for our own sake that we prolong their pitiful existence? No farmer would allow his carabao to suffer something like that -- it would be 'inhumane'"

"For me, the Hippocratic oath is hypocritical when used to justify prolonging what in reality is only hopeless existence. Do no harm can also be seen in the light of this conundrum --- by artificially extending a person's life that is clearly and irrevocably over, thus prolonging their physical pain and suffering and the family's mental suffering (not to mention financial), isn't that in fact, doing harm?"

"This idea of course is anathema to most people. But why? Is it hope for some miracle? Is it guilt of making that decision? Is it selfishness? Is it that it is up to God to decide the time of death? Could I make that decision? All I know is that when we treat our animals more humanely than our closest family members, something is wrong."

False hopes? Continuous healing even when every indicator says the patient is on the losing end? The reality is these situations present real challenges to doctors and other healthcare givers.

In most hospitals here, they already have the DNR or the Do-Not-Resuscitate protocol, which, properly explained to the patients' relatives, is an option not to resuscitate the patient anymore in case of cardiopulmonary arrest. Pabayaan na lang mamatay. Just let them go peacefully, give them peace and dignity, spare them from further pain and agony, and of course, spare the relatives from sinking into bankruptcy paying skyhigh hospital bills.

The real problem, sometimes, or perhaps most of the time, is both doctor and relative do not know when to stop giving care.

When we stop giving care in these cases and we let the relative sign a DNR form, are we playing GOD and depriving the patient of his right to live? Or are we being selfless and kind, because we let him die peacefully?

HE SAYS IT ISN'T SO!
The Obesity Illusion



According to yesterday's issue of the NYT, there's one wise and respected doctor-professor in New York saying that Americans are not getting fatter and that all those talk about obesity is just an illusion. He is Dr. Jeffrey Friedman, head of the Molecular Genetics laboratory in Rockefeller University. According to the NYT health article,

[Dr. Friedman]"has watched the scientific data accumulate to show that body weight, in animals and humans, is not under conscious control. Body weight, he says, is genetically determined, as tightly regulated as height. Genes control not only how much you eat but also the metabolic rate at which you burn food. When it comes to eating, free will is an illusion."

He further says that:

"People can exert a level of control over their weight within a 10-, perhaps a 15-pound range, but expecting an obese person to decide to simply eat less and exercise more to get below the obesity range, below the overweight range? It virtually never happens. Any weight that is lost almost invariably comes right back. The same goes for gaining weight in general. A person who has the genes to be thin is not going to get fat because portion sizes increase. It makes no scientific sense."

Whoa!!! This is simply remarkable. He is saying that it does not really matter if you eat more or less, because everything has been pre-programmed and predestined by your genes. This is to be expected from somebody like him and I think Dr. Friedman speaks with a degree of authority since he is the one who discovered the ob gene, which codes for the hormone leptin which, if absent in our genetic makeup, predisposes us to be overweight or obese.

Futhermore, he labels the obesity mania as "political, [and] so rife with misinformation and disinformation." Using data gathered from 1991 to today by Dr. Katherine Flegal of the National Center for Health Statistics, he said "statistics demonstrate clearly that while the very fat are getting fatter, thinner people have remained pretty much the same."

He might have a point...but what a point it is. He is, in effect, subtly saying that it isn't exercise nor dieting that will save the day for obese persons, but his continuing studies and those of his associates on the protein hormone leptin and its effects in regulating body weight and metabolism. But how long will that wait be? And meanwhile, what will obese people do? Continue eating voraciously?

ADVANCES IN CANCER TREATMENT
Optimism In The Cancer Wars

European Yew

At the ongoing 2004 annual meeting of the American Society of Clinical Oncology in New Orleans, Louisiana, comes great news about the fight against what used to be a frustrating battle against cancer.

One of the most difficult types of cancer is brain cancer. Glioblastoma multiforme (GBM) is the most common and most malignant of the brain cancers. In the meeting, results of a multi-institutional clinical trial showed that treating patients with radiation and chemotherapy improves both progression-free survival and overall survival in GBM. This is remarkable because this is the first time that chemotherapy was shown to be effective in brain cancer treatment.

For breast cancer, a study showed that Evista, known generically as Raloxifene, lowered the risk of breast cancer by 72% among postmenopausal women with osteoporosis who took it for four years.

Two other new studies presented showed that for prostate cancers that are resistant to hormone therapy (hormone therapy is a primary treatment for prostate cancer), Docetaxel was shown to extend survival and aid in pain relief. Docetaxel, marketed as Taxotere by Aventis, comes from the plant called European Yew which is pictured above. It seems our insurmountable ailments can be relieved using indigenous plants found in our planet, after all. Well, this has been going on since the time of Fleming.

For seminoma, which is a type of slow-growing testicular cancer, results of a new European study show that one course of chemotherapy treatment with carboplatin (Paraplatin) is as effective as radiation therapy. It is also associated with a lower risk of a second cancer in the near term. In men who are at risk for developing cancer in the remaining testicle, this research suggests that the use of chemotherapy may allow doctors to preserve the remaining testicle.

Lastly, the June 3rd issue of the New England Journal of Medicine featured a positive report regarding the treatment for colorectal cancer. It featured the MOSAIC study (Multicenter International Study of Oxaliplatin/5-Fluorouracil/Leucovorin in the Adjuvant Treatment of Colon Cancer), and another study which showed a combined chemotherapeutic cocktail (adding Bevacizumab to irinotecan-fluorouracil-leucovorin, known as IFL) designed to improve survival in cases of metastatic colorectal cancer.

WIth these new pharmocologic advances, a glimmer of hope can finally be seen, and someday, we might be able to manage cancer treatment the same way we now handle high blood pressure or high blood sugar. We certainly can't boast (yet) of beating cancer, but at least we are now within (finally! whew!) striking distance of giving it a good fight.

VENUSIAN TRANSIT
Extremely Rare Astronomical Event

From the BBC

When I was a small kid and there were brownouts at night in the province where I grew up in, my Dad will often bring me to a window where he will show me the night sky. My Dad was not an astronomer, but perhaps out of hobby, he knew a lot about the map and the magnificence of the night sky. He was the one who taught me to appreciate the beauty of the planets and the constellations. That is why perhaps, up to this point, whenever there are rare astronomical events announced to happen (from Halley's Comet to simple Leonid showers), I always try my best to have time to see it.

Reports say that the best viewing places will be in Europe and parts of Asia, including the Philippines, but with cloudy and overcast skies as tropical depression Frank crawls slowly northward, I wonder if we will be able to observe the Transit of Venus later when it occurs at around 1:12:21 PM, Philippine Standard Time (PST), according to PAGASA (Philippine Atmospheric, Geophysical and Astronomical Services Administration). Also, since this event will occur with the sun involved, enthusiastic viewers (like me) need to take special precautions because of the risk of getting blind. It somehat reminds me of the story of Daedalus and his son Icarus, and the reward they got for getting too near to the sun.

NASA has a webpage devoted solely to this wonderful event, complete with history, a countdown, and detailed maps. Astronomers define the Transit of Venus as an event when "the planet Venus passes directly between the Earth and the Sun." [BBC Science and Nature Homepage] The event is touted as "extremely rare" because Venus orbits the Sun just over three times in the time it takes the Earth to orbit twice. This means that Venus passes between the Earth and the Sun roughly once every nineteen months. It is also historic, because one report said,

"The transit of Venus is a rare astronomical event -- and one of historic importance. Astronomers first figured out how to measure the distance of the Earth from the sun by timing Venus as it crossed the face of the sun. And the push to make measurements of the transit all over the world led to the European settlement of distant lands, including Australia".

The last time it happened in 1882, a fellow named John Philip Sousa, even composed a march about it. I hope the clouds clear up soon!

STRESS RELIEVERS
To Relieve You On Mayhem Monday

Well, what do you know? The Education Secretary suspended classes in elementary schools because of the rains. But the announcement came late again as most of the pupils were either on their way to school or were already in school. This has been a perennial problem, which sadly, has not been resolved up to this time. Anyway, before I become stressed out again thinking about my gazillion what-ifs and should-have-beens, I'm sharing with you stress relievers I found on my email inbox minutes ago:

Stress Reliever # 1
Wife: "You always carry my photo in your handbag to the office. Why?"

Hubby: "When there is a problem, no matter how impossible, I look at your picture and the problem disappears."

Wife: "You see, how miraculous and powerful I am for you?"

Hubby: "Yes, I see your picture and say to myself, what other problem can there be greater than this one???"


Stress Reliever # 2
Girl: "When we get married, I want to share all your worries, troubles and lighten your burden."

Boy: "It's very kind of you, darling, but I don't have any worries or troubles."

Girl: "Well, that's because we aren't married yet."


Stress Reliever # 3
Son: "Mom, when I was on the bus with Dad this morning, he told me to give up my seat to a lady."

Mom: "Well, you have done the right thing."

Son: "But Mum, I was sitting on Daddy's lap."

Stress Reliever # 4
A newly married man asked his wife, "Would you have married me if my father hadn't left me a fortune?"

"Honey," the woman replied sweetly, "I'd have married you NO MATTER WHO LEFT YOU A FORTUNE!!!"

Stress Reliever # 5
Father to son after exam: "Let me see your report card."

Son: "My friend just borrowed it. He wants to scare his parents."

Stress Reliever # 6
Interviewer to Millionaire: "To whom do you owe your success as a millionaire?"

Millionaire: "I owe everything to my wife."

Interviewer: "Wow, she must be some woman. What were you before you married her?"

Millionaire: "A Billionaire!" (cries)

Stress Reliever # 7
Girl to her boyfriend: "One kiss and I'll be yours forever."

The guy replies: "Thanks for the warning."

Stress Reliever # 8
A husband was asked: "Do you talk to your wife after sex?"

He replied: "Depends, if I can find a phone."

Stress Reliever # 9
"Why did they stop printing PAMELA ANDERSON commemorative stamps in the U.S.?"

Answer: "Because people started licking the wrong side."

Stress Reliever # 10
A wife asked her husband: "What do you like most in me --- my pretty face or my sexy body?"

He looked at her from head to toe and replied: "I like your sense of humor."