Al Sears, MD, is one of the pioneers in telomere biology. You may have seen telomeres in the news lately. The discovery won the Nobel Prize in 2009 for Medicine. Dr. Sears was the first doctor in the U.S. licensed to administer a new therapy based on this Nobel Prize-winning breakthrough.
And now he’s one of the first to apply this to skin care. His revolutionary skin cream keeps the cells in your skin younger, longer. The remarkable extract literally HALTS the aging of your skin cells and reduces the appearance of age on your skin by up to 30%.
You have the ability to rejuvenate your skin from the cellular level, adding decades of youth and vibrancy to your face. In just a few short weeks you can.
My Aunt Evelyn is in her 80s. She built her own business and is there at her desk every day. Why? She loves it and couldn’t imagine being anywhere else. The only thing wrong with this picture? She needs new knees -- after years of painful arthritis, she hobbles through her workdays and her leisure time, too. But because she has seen too many friends have terrible trouble getting through recovery, she is afraid to have the operation.
Well, there’s very good news for my intrepid aunt and for other folks with bad knees! Modifications in the way knee surgery is done now mean considerably less pain and a faster, easier recovery. I checked in with Friedrich Boettner, MD, who specializes in total knee and hip replacement at the Hospital for Special Surgery in New York City, to talk about the latest improvements.
First, he gave me a little background. Every year, nearly 300,000 Americans become owners of new knees, trading in their problematic joints for replacement prostheses. Having started in the 1970s, the procedure itself is not new. Although it has seen many improvements, until the current methods for performing total knee arthroplasty (TKA) patients experienced considerable pain, with hospital stays of seven to 14 days, oftentimes followed by inpatient rehabilitation and a long recovery of several months. Today, the hospital stay is significantly shorter (usually three to five days) and patients often are walking with a cane within a few days to weeks.
Anesthesia -- Less Is More
Dr. Boettner told me that many of the recent improvements have to do with the patient’s experience during the surgery and the first few days of recovery. For example, no more are knee-replacement patients intubated and sedated with heavy narcotic drugs. The new strategy is to inject regional anesthesia -- doctors use a spinal epidural that allows them to do the procedure and later to control pain with an epidural pain pump. With this more nuanced approach in place, patients are put to sleep with a milder drug than before, reducing the chances of postoperative nausea and confusion. The epidural catheter can remain in place for up to 48 additional hours, allowing for excellent pain control in the early postoperative period.
Yet another advance is the changed approach to nausea, that frequent and unwelcome postsurgical visitor. Nausea can be caused by anesthesia, pain medications or even pain alone. These days, doctors no longer wait for symptoms to appear but administer antinausea medication during surgery and again early after the surgery -- an approach that eliminates that awful queasy sensation completely for many patients. It also allows them to get up the day after the procedure. "Just being able to walk the day after surgery," says Dr. Boettner, "creates much more positive momentum for recovery."
Surgery -- More Is Less
There’s been an important improvement in the way surgeons actually cut patients’ knees, too -- and it’s the opposite of what you might think. The advent of minimally invasive surgical techniques in the last decade or so allowed doctors to perform knee-replacement surgery without having to cut muscle tissue or the quadriceps tendon to access the knee. Doctors could make smaller and smaller incisions and still get the knee replaced, and this was a source of real pride, says Dr. Boettner. But then a strange thing happened -- many doctors began to realize that smaller wasn’t really better after all. For surgeons performing knee replacement to position the prosthesis exactly right, they need a large enough incision to see and accurately place the implants. Dr. Boettner explained that surgeons know now that for optimal results, a four-inch to five-inch incision provides a better viewing area while still allowing muscles and tendons to be spared.
The upshot of these various advances -- it’s fair to say that the idea of putting off knee-replacement surgery for as long as possible is no longer valid. Surgery and recovery are far easier than they used to be... and for 85% to 90% of patients, the prostheses now last for 20 years. There is no reason (I hope you’re listening, Aunt Evelyn!) to live with a knee that you can’t come close to straightening or one that gets unbearably stiff and painful.
Source(s):
Friedrich Boettner, MD, who specializes in minimal invasive joint replacements of the hip and knees at the Hospital for Special Surgery in New York City.
The 10 Biggest and Deadliest Heart Myths
The number of heart attacks has increased by 27 percent over the past 20 years, in spite of all the supposed advances of modern medicine. What's going on here?
Could we be mistaken about some things? Perhaps we're under some major misconceptions about heart disease. Like...
Myth #1 -- Heart disease and heart attacks are an inevitable part of aging.
Myth #2 -- Cholesterol is the main cause of heart disease and heart attacks.
Myth #3 -- Blood pressure drugs help you avoid heart problems and live longer.
Myth #4 -- Aggressive, "type A" behavior increases your risk of a heart attack.
Myth #5 -- Low-fat, low cholesterol diets are good for you and your heart.
Learn more...
Can Pretzels Relieve Stress?
When you fly these days, the airlines ply you with salty snacks -- pretzels, munchy mix, peanuts and chips. For nervous fliers, these salty snacks may be just what you need to feel less anxious and a little more relaxed. A new study reported in the April 6, 2011 issue of The Journal of Neuroscience has found that at least in rats, a temporary rise in sodium levels can directly reduce stress. Researchers at the University of Cincinnati found that when they gave rats large doses of sodium and then exposed them to stressful situations, the rats secreted fewer stress hormones and their heart rate and blood pressure did not go up as much as in rats in the control group, where sodium levels remained "normal." The rats that were given sodium also recovered from those stressful situations more quickly, settling back into normal blood pressure and heart rates.
Salt helps stress? Wait a minute -- lots of people consider salt the enemy! This study struck me as so unusual that I immediately called its lead author, Eric Krause, PhD, in the university’s department of psychiatry and behavioral neuroscience to find out more about it. He explained that a temporary rise in sodium causes difficulty in regulating the body’s fluid balance, and this triggers two important shifts as the body goes into action to rebalance that fluid. First, the excess salt inhibits the action of the hormone angiotensin II, which plays a role in regulating blood pressure and is also a "stress hormone" that increases anxiety and drives the fight-or-flight response. Second, the fluid dysregulation prompts the release of the calming hormone oxytocin. So now, with sodium levels up, you have the stress hormone blunted -- and with the soothing hormone on the rise, you have a group of much calmer rats.
Behind the Salt
Dr. Krause notes that certain kinds of drugs that many people take to treat high blood pressure called angiotensin II receptor blockers (ARBs) -- including losartan (Cozaar) and valsartan (Diovan), among others -- also have a calming effect because they inhibit the action of angiotensin II. Indeed, Dr. Krause said, there is good evidence from a number of studies that they provide the secondary benefit of stress relief.
As for eating pretzels and other salty snacks during anxious times, remember that a diet of salty foods is never good for health. And when I asked Dr. Krause if he would advise having a salty snack for comfort in times of stress, he responded frankly, "I work with animals, not humans. It may be that having a salty snack when stressed would provide a bit of relief." But he added that salty food should definitely not be considered a treatment for anxiety -- on balance, it’s just not good for us.
Source(s):
Eric Krause, PhD, research assistant professor, division of basic science, department of psychiatry and behavioral neuroscience, University of Cincinnati.
Be well,
Carole Jackson
Bottom Line's Daily Health News
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