Nature Therapy (Ecotherapy) Medical Benefits

Nature therapy may mean that better health is right outside your door.

A stroll outside on a sunny day is a great pick-me-up. Now it may also be just what the doctor ordered.

The benefits of nature for both body and soul are finding their way to the prescription pad as more health care providers are telling their patients to take a hike -- literally.

Many health care researchers and practitioners say that ecotherapy (also known as green therapy, nature therapy, and earth-centered therapy) -- a term coined by pastoral counselor Howard Clinebell in his 1996 book of the same name -- can have regenerative powers, improving mood and easing anxiety, stress, and depression.

But that’s not all. Health care providers are also giving their patients “nature prescriptions” to help treat a variety of medical conditions, from post-cancer fatigue to obesity, high blood pressure, and diabetes.  

Scientists have long known that sunlight can ease depression, especially seasonal affective disorder (SAD). New research is expanding those findings. A 2007 study from the University of Essex in the U.K., for example, found that a walk in the country reduces depression in 71% of participants. The researchers found that as little as five minutes in a natural setting, whether walking in a park or gardening in the backyard, improves mood, self-esteem, and motivation.

The growing interest in ecotherapy has even given rise to academic programs, such as one begun at John F. Kennedy University, which offers a graduate-level certificate in ecotherapy, an umbrella term that includes horticultural therapy, animal-assisted therapy, time stress management, and managing “eco-anxiety.”

John F. Kennedy University ecotherapy professor Craig Chalquist, PhD, co-author of Ecotherapy: Healing with Nature in Mind, has acknowledged that research has not proven that spending time in nature can prevent, treat, or cure any particular condition.

But a growing body of research offers a “hopeful picture” of the effectiveness of ecotherapy, Chalquist says.

Kathy Helzlsouer, MD, director of the Prevention and Research Center at Mercy Medical Center in Baltimore, has long been recommending to breast cancer survivors that they get outdoors more.

For 30% to 40% of breast cancer survivors, persistent fatigue follows their treatment, says Helzlsouer. To help her patients learn how to manage this fatigue, Helzlsouer created “Be Well, Be Healthy,” a holistic program that includes tips not only on managing stress and improving diet and exercise patterns, but also on incorporating nature as part of the healing process.

“Among the frustrations we saw in our patients,” Helzlsouer says, “was that they didn’t have the energy to garden, a favorite activity for many of them.”

For people who enjoy gardening, Helzlsouer prescribes getting back outside, even if it’s starting out with five minutes of weeding. People who aren’t gardening enthusiasts are advised to find a nearby park where they can take a walk, "commune with nature," and reap the mind-body results of a relaxing setting and physical exercise.

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6 Serious Medical Symptoms

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Track your way to weight loss success Manage your family's vaccinations Join the conversation See more benefits Sign Up Why WebMD? My WebMD Show Menu My Tools My WebMD Pages My Account Sign Out FacebookTwitterPinterest WebMD Home Heart Health Center Atrial Fibrillation and Stroke Email a Friend Print Article if (pf_param == "true") {printElements();} Atrial Fibrillation and Stroke Next Article: Skip to Article Content Atrial Fibrillation and Stroke AFib Treatment Facts on AFib treatments, including blood thinners to prevent clots. Stroke Prevention Procedures to help control or stop AFib. Get the Facts on AFib Learn the basics of heart rhythm disorders. AFib: Causes and Risks Find out who's at highest risk for AFib, and why. How AFib Is Diagnosed Your practical guide to tests used to diagnose atrial fibrillation. AFib: Medical Care Getting the most from your medicine and your health care team. 6 Medical Symptoms Never to Ignore Is that medical symptom life-threatening? Facts you should know. Atrial Fibrillation Symptoms Symptoms of atrial fibrillation explained in easy-to-understand terms. The Warning Signs of Stroke How to recognize the signs and symptoms of stroke. Stroke: Who's at Risk? Stay proactive and informed. Find out who's at risk for having a stroke. AFib: Your Healthy Lifestyle How healthy eating, exercise, and relaxation help you feel your best with AFib. False 6 Serious Medical Symptoms Some medical symptoms are warnings that you need immediate care. Learn to recognize them. WebMD Feature

By Katherine Kam

Reviewed By Brunilda Nazario, MD

That new symptom is troubling: the inexplicable swelling in your calf or the blood in your urine. Could it be serious or even life-threatening?

"Your body flashes signals -- symptoms and signs -- that warn you of potential problems," say Neil Shulman, MD, Jack Birge, MD, and Joon Ahn, MD. The three Georgia-based doctors are the authors of the book Your Body's Red Light Warning Signals.

Fortunately, many symptoms turn out not to be serious. For example, the majority of headaches stem from stress, eyestrain, lack of sleep, dehydration, caffeine withdrawal, and other mundane causes.

But a sudden, agonizing "thunderclap" headache -- the worst of your life -- could mean bleeding in the brain. Being able to recognize this serious symptom and calling 911 may save your life.

Here are six important flashing signals.

1. Paralysis of the arms or legs, tingling, numbness, confusion, dizziness, double vision, slurred speech, trouble finding words, or weakness, especially on one side of the face or body.

These are signs of stroke -- or a "brain attack" -- in which arteries that supply oxygen to the brain become blocked or rupture, causing brain tissue to die.

Symptoms depend on which area of the brain is involved. If a large blood vessel is blocked, a wide area may be affected, so a person may have paralysis on one side of the body and lose other functions, such as speech and understanding. If a smaller vessel is blocked, paralysis may remain limited to an arm or leg, or even the face.

If you have symptoms, call 911 right away and get to an emergency room that offers clot-busting therapy for strokes due to blocked vessels. Such treatment, which dissolves clots in blocked vessels, needs to be given within the first 3 hours after symptoms begin, but newer treatments may work within a longer time frame, says Birge, who is medical director at the Tanner Medical Center in Carrollton, Ga.

Timing is urgent; fast treatment can potentially stop brain tissue death before permanent brain injury happens. "There is a time clock ticking as to when you might totally recover," Birge tells WebMD.

2. Chest pain or discomfort; pain in the arm, jaw, or neck; breaking out in a cold sweat; extreme weakness; nausea; vomiting; feeling faint; or being short of breath.

These are signs of heart attack. If you get some of these symptoms, call 911 immediately and go to the emergency room by ambulance. Shulman and Birge also recommend that patients chew one regular, full-strength aspirin (unless they're allergic to aspirin) to help prevent damage to the heart muscle during a heart attack.

Not everyone who has a heart attack feels chest pain or pressure or a sense of indigestion. Some people, especially women, the elderly, and people with diabetes, get "painless" heart attacks, the doctors say. Being aware of "painless" heart attack signs is crucial: symptoms may include weakness, sudden dizziness, a pounding heart, shortness of breath, heavy sweating, a feeling of impending doom, nausea, and vomiting.

1 2 3 #url_reference {display: none};#url_reference { display: block; line-height: 150%; margin-bottom: 10px; }#logo_rdr img { visibility: visible; }.titleBar_rdr .titleBarMiddle_fmt { padding-top: 1.5em;} Atrial Fibrillation Atrial Fibrillation Living With AFib AFib Treatments Heart Rhythm Reset Facts on AFib AFib Risks Diagnosing AFib For Family Medical Care Serious Symptoms Signs of AFib Signs of Stroke Stroke Risk Factors Live Well With AFib // self executing function for scope (function(){ // grabs pageview id out of global scope and makes sure it exists as we need to pass it to ads in that case var pageviewId = window.s_pageview_id || ''; var iframeURLOutOfPB = '//as.webmd.com/html.ng/transactionID=220340691&tile=775164985&tug=&pug=__&site=2&affiliate=20&hcent=&scent=948&pos=113&xpg=1629&sec=&au1=1&au2=1&uri=%2fheart%2fatrial-fibrillation-stroke-11%2fserious-symptoms&artid=091e9c5e80011096&inst=0&leaf=12948&segm=0&cc=10&tmg=&bc=_i_j45_r52_&mcent=µ=&pvid=' + pageviewId; var cleanIframeURL = iframeURLOutOfPB.replace(/&/g, '&'); var ad = { adLocation:'left', adURL:cleanIframeURL, trans:'220340691', tile:'775164985', pos:'113' }; // check to make sure this seed call functionality exists, if it does, dooo it if(webmd.object.exists('webmd.ads.handleAdSeedCall')) { webmd.ads.handleAdSeedCall(ad); } })(); // self executing function for scope (function(){ // grabs pageview id out of global scope and makes sure it exists as we need to pass it to ads in that case var pageviewId = window.s_pageview_id || ''; var iframeURLOutOfPB = '//as.webmd.com/html.ng/transactionID=220340691&tile=775164985&tug=&pug=__&site=2&affiliate=20&hcent=&scent=948&pos=121&xpg=1629&sec=&au1=1&au2=1&uri=%2fheart%2fatrial-fibrillation-stroke-11%2fserious-symptoms&artid=091e9c5e80011096&inst=0&leaf=12948&segm=0&cc=10&tmg=&bc=_i_j45_r52_&mcent=µ=&pvid=' + pageviewId; var cleanIframeURL = iframeURLOutOfPB.replace(/&/g, '&'); var ad = { adLocation:'right', adURL:cleanIframeURL, trans:'220340691', tile:'775164985', pos:'121' }; // check to make sure this seed call functionality exists, if it does, dooo it if(webmd.object.exists('webmd.ads.handleAdSeedCall')) { webmd.ads.handleAdSeedCall(ad); } })(); Life With Atrial Fibrillation Tips and facts to help you
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fibrillation. Atrial Fibrillation Poll Which atrial fibrillation symptom bothers you the most? Palpitations Shortness of breath Lightheadedness or dizziness Chest pain I don't have any symptoms View Results WebMD Video Series Atrial Fibrillation Atrial Fibrillation

Discover what happens during atrial fibrillation and what your doctor can do to manage it.

Spotting a Stroke Spotting a Stroke

Stroke is a leading killer of women, but the risk is higher for African Americans. Learn how one survivor is increasing awareness.

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Many U.S. Blacks Eager to Take Part in Medical Research

Title: Many U.S. Blacks Eager to Take Part in Medical Research
Category: Health News
Created: 4/4/2013 12:35:00 PM
Last Editorial Review: 4/5/2013 12:00:00 AM

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What’s the best way to prepare for travel when you have chronic medical conditions?

Posted June 07, 2013, 2:00 am

In a few months, my husband and I are taking our first trip abroad. We both have chronic medical conditions. How should we prepare for our trip?

Many people with medical conditions enjoy foreign travel. But your preparation will need to involve more than just reading some guidebooks.

First, check in with your doctor. He or she may have specific concerns or advice for you. If you have diabetes, for example, your blood sugar level is affected not only by how much you eat, but by how much you exercise. And during vacations, both of these can change substantially. So ask yourself what the impact on your eating and exercise is likely to be from the vacation you have planned.

Since you’re traveling internationally, find out if you need vaccinations or preventive medications. You can check the Centers for Disease Control and Prevention (CDC) website (cdc.gov/travel), or ask your doctor. Try to get your shots four to six weeks before your trip, as some vaccinations need time to kick in.

If you take prescription medications, pack more than enough to last through your trip, in case your return gets delayed. And carry your medications in your carry-on bag, not in your checked luggage in case it gets lost. (The TSA makes an exception to the “no more than 3.4 ounces of liquids or gels” rule for prescription medications and necessary medical supplies.) That’s what I have done ever since, 20 years ago, I spent the first two days of a trip trying to get replacement medicines in a foreign country because my luggage was lost.

Also, carry a list of your medications, with both the generic and brand names. And bring along a doctor’s note if you have a pacemaker or other implanted device; you may need it when going through security checkpoints.

Get the name of a doctor or hospital at your destination. There are organizations on the Internet that maintain the names of English-speaking doctors with good reputations in many countries around the world. They also identify trusted hospitals. One example is the International Association for Medical Assistance to Travelers.

I can’t personally vouch for the quality and integrity of the doctors and hospitals linked to these organizations. I can say that many of the organizations have boards of directors populated by doctors affiliated with major U.S. academic medical centers. And check with your insurance to see what you need to do in case of an emergency.

If you easily suffer from motion sickness, take medicine in your carry-on bag. In addition, pack the following in your checked luggage:

antidiarrheal medication, a laxative and an antacid;antihistamine and 1 percent hydrocortisone cream for mild allergic reactions;cold medicine;medications for pain relief or fever;antifungal and antibacterial ointments;lubricating eye drops;basic first-aid items (adhesive bandages, gauze, elastic bandage, antiseptic, tweezers, scissors, cotton-tipped applicators).

With a little advance planning, you and your husband can enjoy a healthy and safe vacation.

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Fewer Families Struggling to Pay Medical Bills: CDC

But some may be skipping needed care altogether, expert says

By Dennis Thompson

HealthDay Reporter

TUESDAY, June 4 (HealthDay News) -- The proportion of families in the United States that can't keep up with their medical bills declined between 2011 and 2012, according to a report from the U.S. Centers for Disease Control and Prevention. But the news might not necessarily be cause for celebration.

According to the report released Tuesday by the CDC's National Center for Health Statistics, the share of people under age 65 in families struggling to pay their health care bills decreased from 21.7 percent in the first six months of 2011 to 20.3 percent in the first six months of 2012.

Despite this improvement, the families of more than 54 million Americans continue to carry health care debt they cannot manage. This particularly holds true for families who are poor or have restricted access to health coverage, said study author Robin Cohen, a CDC health statistician.

"During this time period, those who were uninsured or who had public coverage were about twice as likely as those with private coverage to have problems paying medical bills," Cohen said.

Fewer families may face overwhelming medical bills because some are foregoing health care coverage due to joblessness and other economic factors, an expert said.

The report draws its conclusions from data gathered during the CDC's annual National Health Interview Survey. It defines medical bills as bills for doctors, dentists, hospitals, therapists, medication, equipment, nursing homes or home care.

A drop in the number of families struggling with medical bills may seem like a positive development, but it likely results from darker economic trends, said Kathleen Stoll, director of health policy for Families USA, a nonprofit and nonpartisan health care advocacy group.

Stoll believes that fewer families are struggling with medical bills because chronic unemployment is causing many to skip needed health care.

"When people have insurance, they go to the doctor," she said. "When they lose their job, they often lose their health insurance coverage. Without insurance, they are reluctant to go to the doctor at all. Because of that, they have fewer medical bills."

Stoll said the decrease observed in the CDC study comes while the United States is slowly recovering from its economic downturn, and before the major provisions of the Affordable Care Act become active in 2014.

Health care reform, however, may have contributed to improvements in one area: the ability of the families of young people to manage medical bills.

Health care reform requires private insurers to cover children and young adults up to age 26 under their parents' health plan, regardless of preexisting conditions. This provision took effect in September 2010.

The CDC study found that among children up to 17 years old, the percentage of those who were in families having problems paying medical bills decreased from 23.7 percent in the first six months of 2011 to 21.8 percent in the first six months of 2012. That improvement slightly outpaced the overall improvement in families' ability to pay medical bills.

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Shorter Shifts for Medical Interns May Not Boost Patient Safety

Title: Shorter Shifts for Medical Interns May Not Boost Patient Safety
Category: Health News
Created: 3/25/2013 4:35:00 PM
Last Editorial Review: 3/26/2013 12:00:00 AM

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1 in 600 Flights Involves Medical Emergency, Study Says

Physician passengers assist in nearly half of cases

By Maureen Salamon

HealthDay Reporter

WEDNESDAY, May 29 (HealthDay News) -- Medical emergencies occur daily on commercial airline flights, and physician passengers end up providing assistance during nearly half of such midair incidents, according to a new study.

Combing through records of nearly 12,000 in-flight medical emergency calls from five commercial airlines, researchers found that one emergency occurred for every 604 flights, but only 7.3 percent of such flights required a diverted landing to an alternate destination.

Dizziness or fainting were the most common midair medical problems, followed by respiratory symptoms, nausea or vomiting, and heart symptoms. Ill fliers ranged in age from 2 weeks to 100 years.

"Most medical emergencies can be handled with a simple onboard medical kit, and often a health care provider is on board," said study author Dr. Christian Martin-Gill, an assistant professor of emergency medicine at University of Pittsburgh School of Medicine. "And in all situations we describe, there was consultation with a ground-based physician with experience with in-flight emergencies. This allowed us to gain a very wide view of the types of emergencies encountered on aircraft, and specifically what the outcomes are for passengers."

For the study, published May 30 in the New England Journal of Medicine, Martin-Gill and his colleagues examined records of in-flight medical calls over nearly three years from five domestic and international airlines to University of Pittsburgh Medical Center's STAT-MD Communications Center, a 24-hour, physician-directed command center.

Most of the passengers treated in-flight had favorable results. One-quarter were transported to a hospital after landing, about 9 percent were admitted and only 0.3 percent died either onboard the aircraft or during transport to a hospital. The most common causes for hospital admission were stroke, respiratory or cardiac symptoms.

In addition to the 48 percent of emergencies attended to by physician passengers, medical professionals such as nurses provided help in another 28 percent of cases, the investigators found.

Dr. Paulo Alves, president of the Airlines Medical Directors Association, praised these good Samaritans for their contributions. "We're thrilled that medical personnel have an avid interest in learning and volunteering during in-flight medical events," said Alves, who was not involved in the research. "Their assistance and support is of great value to the flying public, airlines, crew members and the ground-based medical staff."

Martin-Gill said the research underscored the notion that most midair medical emergencies can be managed by flight attendants, who are trained in emergency protocols and have access to a U.S. Federal Aviation Administration-required emergency medical kit. Ground-based physician consultants provide additional guidance, he said, and assist the crew in determining if the plane requires diverting.

"What we hope to do is gain a better understanding of how we can manage specific emergencies," Martin-Gill said. "On a national scale, certainly we would support an evidence-based look at what should be included in the contents of medical kits."

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Most Docs OK With Medical Marijuana: Survey

Majority would give a prescription to an advanced cancer patient in pain

By Serena Gordon

HealthDay Reporter

WEDNESDAY, May 29 (HealthDay News) -- Three-quarters of doctors who responded to a survey about medical marijuana said they would approve the use of the drug to help ease pain in an older woman with advanced breast cancer.

In a February issue of the New England Journal of Medicine, doctors were presented with a case vignette, as well as arguments both for and against the use of medical marijuana. Doctors were then asked to decide whether or not they would approve such a prescription for this patient.

The results now appear in the May 30 edition of the journal.

Seventy-six percent of the 1,446 doctors who responded said they would give the woman a prescription for medical marijuana. Many cited the possibility of alleviating the woman's symptoms as a reason for approving the prescription.

"The point of the vignette was to illustrate the kinds of patients that show up on our doorstep who need help. This issue is not one you can ignore, and some states have already taken matters into their own hands," said Dr. J. Michael Bostwick, a professor of psychiatry at the Mayo Clinic in Rochester, Minn.

Bostwick wrote the "pro" side for the survey, but said he could've written the "con" side as well, because there are valid arguments on both sides of the issue.

"There are no 100 percents in medicine. There's a lot of anecdotal evidence that this is something we should study more. Forgive the pun, but there's probably some fire where there's smoke, and we should investigate the medicinal use of marijuana or its components," Bostwick said.

Marijuana comes from the hemp plant Cannabis sativa. It's a dry, shredded mix of the plant's leaves, flowers, stems and seeds. It can be smoked as a cigarette or in a pipe, or it can be added to certain foods, such as brownies.

The case presented to the doctors was Marilyn, a 68-year-old woman with breast cancer that had spread to her lungs, chest cavity and spine. She was undergoing chemotherapy, and said she had no energy, little appetite and a great deal of pain. She had tried various medications to relieve her pain, including the narcotic medication oxycodone. She lives in a state where the use of medical marijuana is legal, and asks her physician for a prescription.

Dr. Bradley Flansbaum, a hospitalist at Lenox Hill Hospital, in New York City, said he sided with the majority for this particular case.

"I think there's some context that needs to be considered," Flansbaum said. "This was a woman with stage 4 cancer who wasn't responding to [anti-nausea medications]. I'm not saying let's legalize marijuana, but this is a woman at the end of her life, so what's the downside, given that there might be a benefit. In a different situation, medical marijuana might not be so well embraced."

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Kids Poisoned by Medical Marijuana, Study Finds

Children helping themselves to drug-laced cookies, brownies

By Steven Reinberg

HealthDay Reporter

MONDAY, May 27 (HealthDay News) -- Legalizing marijuana may have unintended consequences. Since medical marijuana was legalized in Colorado, more than a dozen young children have been unintentionally poisoned with the drug, researchers report.

About half the cases resulted from kids eating marijuana-laced cookies, brownies, sodas or candy. In many cases, the marijuana came from their grandparents' stash, the investigators said.

"We are seeing increases in exposure to marijuana in young pediatric patients, and they have more severe symptoms than we typically associate with marijuana," said lead researcher Dr. George Sam Wang, a medical toxicology fellow at the Rocky Mountain Poison and Drug Center in Denver.

But doctors aren't familiar with marijuana poisoning in children, so unless the parents are forthcoming it can take time and tests to diagnose the problem, Wang said. Symptoms of marijuana poisoning in children include sleepiness and balance problems while walking.

"We hadn't seen these exposures before the big boom of the medical marijuana industry," Wang said.

The active chemical in marijuana, tetrahydrocannabinol, is in higher than normal concentrations in medical marijuana, and often is sold in baked goods, soft drinks and candies, the researchers said in the study, which was published online May 27 in the journal JAMA Pediatrics.

"We are seeing more symptoms because some of these products have very high amounts of marijuana in them," Wang said. "You get such a high dose on such a small child, the symptoms are more severe."

As with many similar poisonings, treatment is limited to supportive care and waiting until the marijuana clears the system, he said.

Children recover quickly in most cases, Wang said. "They don't need more than a day or two of hospitalization," he said. "There were no deaths or lasting side effects."

This report stems from one Denver hospital, and Wang said he doesn't know how extensive the problem is elsewhere. Colorado adults are allowed to possess up to 1 ounce of marijuana or six marijuana plants, according to the study. And Denver issued more than 300 sales tax licenses for marijuana dispensaries in 2010.

For the study, Wang's team compared the number of children treated in the emergency room for marijuana poisoning before and after the law was enacted in October 2009.

In all, almost 1,400 children under 12 were evaluated for accidental poisonings in this one hospital -- 790 before Sept. 30, 2009, and 588 after that.

After decriminalization, 14 children -- mostly boys and some as young as 8 months -- were found to have ingested marijuana. Eight had consumed medical marijuana, and seven ate marijuana in foods. Two were admitted to the intensive care unit.

Before Sept. 30, 2009, none of those possible poisonings was attributed to marijuana, the researchers found.

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Medical Groups Warn About Unnecessary Tests

Dozens of types of tests and treatments are too often recommended by doctors when patients don't need them, according to a warning issued Thursday by a coalition of leading medical groups in the United States.

This unnecessary care wastes time and money and sometimes causes harm to patients, according to the organizations that represent more than 350,000 doctors, the Associated Press reported.

The Choosing Wisely Coalition said patients need to ask their doctors, "Do I really need that?". The coalition was formed by the American Board of Internal Medicine Foundation.

Too many people "think that more is better, that more treatment, more testing somehow results in better health care," Dr. Glen Stream, former president of the American Academy of Family Physicians, told the AP. "That really is not true."

The academy contributed to this year's list of 90 examples of potentially needless care, which adds to 45 examples included on last year's list. Among the newly-added warnings:

Don't screen for a clogged neck artery in healthy people with no stroke signs. It could lead to risky surgery for a blockage that would cause no harm.Don't try feeding tubes in people with advanced dementia. Helping them eat is a better approach.Don't routinely give heartburn medicine to infants with reflux. This treatment hasn't been proven effective in babies and could cause side effects.Don't prescribe opioid painkillers for migraines except as a last resort. Opioids can carry the risk of addiction and can actually worsen migraines. Instead, use more migraine-specific drugs.Don't induce labor if a pregnant woman misses her due date and both mother and baby are doing fine.

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Weight-Loss Surgery Won't Cut Obesity-Related Medical Costs: Study

Title: Weight-Loss Surgery Won't Cut Obesity-Related Medical Costs: Study
Category: Health News
Created: 2/20/2013 4:35:00 PM
Last Editorial Review: 2/21/2013 12:00:00 AM

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Medical Marijuana: Voodoo or Legitimate Therapeutic Choice?

By Barbara Bronson Gray

HealthDay Reporter

WEDNESDAY, Feb. 20 (HealthDay News) -- Imagine a 68-year-old woman with advanced breast cancer, looking for a better way to ease her chronic pain, low appetite, fatigue and nausea. Should she or shouldn't she be prescribed marijuana?

That's the question physicians debate in the "Clinical Decisions" section of the New England Journal of Medicine released online Feb. 20.

According to the hypothetical case study in the journal, a woman named Marilyn has metastatic breast cancer that has spread to her lungs and spine. She's taking chemotherapy and two anti-nausea drugs that just aren't working. Despite taking 1,000 milligrams (mg) of acetaminophen, such as Tylenol, every eight hours, she's in pain. At night, she sometimes takes 5 to 10 mg of oxycodone, a narcotic pain reliever similar to morphine, to help relieve the pain so she can sleep.

Marilyn lives in a state where marijuana is legal for personal medicinal use, and her family stands ready to grow it for her.

Why not let Marilyn try it?

One reason not to, in the view of one of the "con" argument's authors, Dr. Robert DuPont, is that it probably wouldn't help her. "Although marijuana probably involves little risk in this context, it is also unlikely to provide much benefit," said DuPont, a clinical professor of psychiatry at Georgetown Medical School in Washington, D.C., and the first director of the National Institute on Drug Abuse under Presidents Nixon, Ford and Carter.

Marijuana is a dry, shredded mix of flowers, stems, seeds and leaves of the hemp plant Cannabis sativa. People usually smoke it as a cigarette or in a pipe. It's the most commonly abused illegal drug in the United States, according to the U.S. National Library of Medicine.

In an interview, DuPont said that because smoked marijuana has not been reviewed and approved by the U.S. Food and Drug Administration for safety, effectiveness and purity, it would be inappropriate for a physician to prescribe it. "It would divert the attention away from an effective medical treatment and get her into something that's at best voodoo," he said.

The cannabis (marijuana) plant contains hundreds of pharmacologically active compounds that could interact with the medications Marilyn's now taking, DuPont said. It's impossible to know the chemical make-up or potency of a given dose, he noted, adding, "Medical marijuana has no dose. There is nothing else in medicine like that."

DuPont said it's also uncertain how Marilyn might react to the experience of smoking marijuana. He said the drug could affect her ability to think effectively. And just the act of smoking, coupled with the impact of the cancer on her lungs, could reduce her ability to get oxygen to her brain, he added.

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'Protected Power Naps' Could Help Keep Medical Interns Alert: Study

Title: 'Protected Power Naps' Could Help Keep Medical Interns Alert: Study
Category: Health News
Created: 12/4/2012 4:36:00 PM
Last Editorial Review: 12/5/2012 12:00:00 AM

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The Treatment of Overweight and Obesity as Chronic Medical Conditions

To begin our discussion, let’s discuss the current thinking about overweight and obesity. Physicians and scientists now believe that overweight should be considered a chronic medical condition. Practically, this means that we should consider treating our weight like we would consider treating ourselves if we had high blood pressure.

For example, if you found out you have high blood pressure, most people would first go to see their primary care physician. The primary care physician would check your blood pressure and likely start out by asking you to do a few things on your own to help the blood pressure like cut out salt and decrease alcohol use. At your next visit, if the blood pressure was still high, your physician would likely prescribe medical therapy for your blood pressure in the form of a high blood pressure pill. At your follow up visit , if your blood pressure is well controlled, your physician would refill your medicine and arrange the for future monitoring. If after several adjustments in medication your blood pressure is not within normal limits or if your blood pressure is severely elevated which can lead to organ damage, your physician would then refer you to another physician, likely a nephrologist, a specialist in blood pressure control. Your blood pressure specialist will use tools and medications that your primary care does not use everyday as the nephrologist has more experience with hard to treat blood pressure. If at any time, you were decide to stop treatment with your blood pressure medicine or to have a really salty meal, it is no doubt that your blood pressure would go up again.

Let’s use weight in the same example as blood pressure. When you first seek treatment for overweight or obesity, the first person to visit is your primary physician. Your physician may recommend a particular diet and exercise regimen. Like easily controlled blood pressure, this may be all you need. If your weight does not respond adequately (your loss is not enough) or if the diet is too hard to follow or you have been on it prior and had weight regain or you have multiple medical conditions that your current weight is worsening like diabetes, high blood pressure or sleep apnea your physician should send you to a specialist in weight loss called a medical obesity specialist (see www.ASBP.org or www.ABOM.com). This physician is well trained in comprehensive medical weight loss and will use techniques not well studied or known to your primary care physician.

To treat our weight any other way than as a chronic disease (like blood pressure) would be to go against current medical and scientific thinking. Aggressive low calorie diets, exercise, behavioral modification and medical oversight including various weight loss medications are the current best known way to lose weight, and give you the best known way to keep it off. When you are successful in using dietary change, weight loss medicines, exercise and behavioral methods to lose weight, if you stop dieting, taking your weight loss medication or exercising, it is likely that you will regain your weight.

It is unfortunate that at this time we do not have a true cure for obesity. Medical science is continuing the pursuit for a cure. Until a cure is found, we will have to use comprehensive approaches to lose weight and continue these treatments for long periods of time to prevent regain.

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