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To Your Good Health: Essential Thrombocythemia Comes With Bleeding Risk

Dear Dr. Roach: Recently, I was diagnosed with essential thrombocythemia. The recommended treatment is the drug hydroxyurea because I turned 60 this past year and have a mutation in the JAK 2 gene. If I had not turned 60, the recommended treatment would be aspirin alone. Currently, I am taking the recommended 81-mg aspirin dose daily. I have a very healthy lifestyle: I’m an avid runner, with workouts twice a week at the gym, and I have no history of blood clots, etc. I have no symptoms at this time. I’ve been getting monthly blood draws to monitor my platelet counts. They are climbing; my last was 659.

Looking at the possible side effects of hydroxyurea, I am hesitant to start that course of treatment just because I am over 60. What is your opinion of my wait-and-see attitude? — B.T.

Answer: Essential thrombocythemia is a myeloproliferative neoplasm, a case of the body making too many white or red blood cells or platelets. Whether it’s a blood cancer or not is debatable. It has some characteristics that are cancer-like, but the main concerns with ET are blood clotting, paradoxical bleeding and symptoms. It can rarely transform to acute myeloid leukemia, and there is no treatment to prevent the transformation.

Since you have no symptoms, the main risks to you are abnormal blood clotting and bleeding. Your clotting risk is considered intermediate, because of the JAK2 mutation and your being over age 60. In one study, that was associated with a clot risk of about 3.6 percent per year. In another study — of some patients similar to you and others with a history of clotting — 24 percent of people on aspirin alone had a clot in 27 months, whereas among those taking aspirin and hydroxyurea, only 3.6 percent had a clot. Because you have no history of clotting, the benefit for you from the hydroxyurea will likely be smaller than that seen in this study, but still pretty significant.

Bleeding may occur because the platelets, although numerous, are not normal. About 5 percent of people with ET will have a serious bleeding event.

Hydroxyurea certainly has side effects, including rash, oral ulcers and nail changes, but most people tolerate it pretty well, in my experience. I feel the reduction in risk of serious clotting events is worth a small risk of side effects, but only you can make the choice. I hope this information allows you to make a more informed choice.

Dear Dr. Roach: I am in my 80s, and for a year or so have been experiencing some imbalance. One morning I woke up and moved 2 feet to my left when I took my first step. Could this be Parkinson’s disease, or is it just normal aging? I fell once and was unable to get up until my son helped me. My neighbors recommended that I get an alert device. — Anon.

Answer: Abnormalities in gait and movement are common as people get older, but I am concerned that you may have more than just normal aging. Making a specific diagnosis of Parkinson’s or other movement disorder is not easy. It is best done by an expert, such as a neurologist, some of whom specialize in movement disorders specifically.

I agree with your neighbors that everyone at risk of a fall should consider a device that can allow them to easily call for help.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to or at 628 Virginia Dr., Orlando, FL 32803.

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Let us all have good health care

Just as the Affordable Care Act is commonly called “Obamacare,” the proposed American Health Care Act is for the majority of us, “The American Wealth Care Act.”

It takes health care from up to 24 million of our vulnerable elderly and our poorest community members and passes the resources to the wealthiest in the form of tax cuts.

I remember Donald Trump promised “to take care of” (wink, wink) the forgotten people. This legislation will “take care of them” by removing their health care or by allowing premium increases by private insurers of up to 40 percent of an older, lower-income worker’s pay.

Now I know that the Affordable Care Act didn’t perform as expected but many accommodations had to be negotiated to try to bring everyone on board. Then the “Party of No” refused to cooperate in needed revisions. I thought then and continue to think that the transition of several age groups each year into Medicare would allow us to become a single-payer health care nation.

The United States can become “greater.” Since adulthood I have supported my birthplace, the United States of America, in its struggle to become a less prejudiced, more just and more loving home for all its people. The Republican proposal for health care does not make us “great again” or “greater.”

And for those wealthy individuals and corporate interests grasping their entitlements, please keep your hands in your own pockets and let all of us have good and affordable health care.

Brenda Black, Port Matilda

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Go ahead and jump: Students promote good health, physical fitness

WAREHAM – The two dozen or so students of Minot Forest Elementary School who visited the school Saturday morning during an off-day were not jumping for joy.

Actually, they probably were, but more importantly they were there to “Jump Rope for Heart,” an annual fundraising program benefiting the American Heart Association. Coordinated by faculty member Michael Houdlette (along with several volunteers), Saturday’s program lasted for about two hours and consisted solely of students jumping rope in the school’s gymnasium.

Participating female and male students (hey, jump roping is not just for girls) solicited financial contributions in advance of Saturday’s session, with all proceeds donated to the AHA. The Society of Health and Physical Education is a collaborator for the “Jump Rope for Heart” program.

Students raising specific levels of funds were eligible to receive prizes from program sponsors.

The purpose of “Jump Rope for Heart” is to encourage young people to remain active and to develop good eating and living habits. In addition to raising funds for heart-disease research, the program also encourages youngsters to adopt sound eating regimens (such as drinking water instead of sugary drinks and eating fruits and/vegetables with all meals) and set a goal of remaining active for at least one hour daily.

Saturday’s participants at the MFES had no difficulty remaining active for long periods, jumping rope continually either solo, in tandems or at designated stations. Volunteers provided healthy refreshments – including bottles of water and fresh orange slices – to keep the youngsters fueled and refreshed.

And jumping for joy.

Follow Chris Shott on Twitter at @ChrisShottCour.


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Clinic prescribes a dose of jackfruit for good health

KOCHI: While jackfruit has caught the fancy of entrepreneurs of late, the time may well have arrived for it to take centre stage. From being extolled as a ‘health’ food, the giant fruit has now made the step up to a prescribed ‘medicine’.

In a move that could catapult raw jackfruit to the dining tables of the health-conscious and diabetic patients, Delhi-based naturopathy and wellness clinic Swami Parmanand Prakritik Chikitsalaya (SSPC) has started prescribing raw jackfruit-based food for its well-known customers.

“We were looking for a grain-free diet for our customers,” Dr Jayachandran Thampi, chief medical officer at SSPC, told Express.

“We came across a ready-to-use jackfruit product that can be powdered and used as flour to make chapattis. Ours is a holistic health centre, focusing on Ayurveda and naturopathy for our customers. Raw jackfruit-based food, after mixing flour to make roti, has become a part of the diet at our centre. I’m extremely happy with the results.”

The ready-to-use raw jackfruit bulb that Thampi is referring to, is a product from Kochi-based Jackfruit365, founded by James Joseph. The latter understood the potential of jackfruit and even quit a high-paying job at Microsoft to set up the company.

“I consider the move by SSPC as a significant step to create awareness on the benefits of eating raw jackfruit in major cities and across hospitals and naturopathy centres,” said Joseph. ‘Jackfruit365’ may be the only organised player selling freeze-dried jackfruits through retail stores and e-commerce sites such as Amazon.

The big challenge is to make jackfruit easily available in the market and ensuring it is lucrative for farmers. A study conducted recently by SB College Institute of Management, Changanassery found 80 per cent of the people eat jackfruit in raw form, and 60 per cent source the jackfruit from their backyards or from the neighbours. Only 16 per cent buy it.

“If every other vegetable has a market price, why can’t jackfruit be worth paying the price?” Joseph asked.
Thampi of SSPC said spreading awareness on the benefits of raw jackfruit could create demand for the health-product. “Hospital canteens are important centres that can help people understand and give importance to a health product. Endorsements from relevant personalities are always a boost. Diabetologists, endocrinologists and dieticians are professional groups who can bring in this awareness,” he said.

The doctor said jackfruit was a good alternative to a grain-based diet. “Already many centres are using alternative grains (ragi/bajra) and quinoa seeds).”

According to Thampi, people get a ‘psychological’ comfort with eating food items they are familiar with. “So, roti using jackfruit powder instead of wheat or maida is a good alternative and a practical solution.”

In metros like Delhi, avenues to spread awareness are high at general health stores, health super markets, hospitals and clinics.

“Initially, hospital canteens, diet centres and pharmacies are good choices. Reputed institutions like AIIMS are potential avenues as well,” he said.

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Good Reason To Look At Health Care Anew

I submit that the goal of health policy, stripped of its advocates, denigrators and rentiers, should be to get everyone insured for the minimum amount of money and best care result. Simple, eh?

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Living Well: Eating well for good health

With spring comes change, so mimic the season and consider adopting some new healthy habits. With warmer weather, you may want to get out and exercise more. That’s great. Add a few new healthy eating habits to the mix and you’ll boost your health even more.

“Take one step at a time for lasting change. Make one adjustment, like giving up soda. Do that for a few weeks, then add another,” suggested Carol Bolt, PA with Memorial Regional Health’s Medical Clinic.

While it might be tempting to dive in and start a whole new diet, take a pause and consider if it’s something you can maintain, rather than just do for a while. If you really enjoy eating breads and pastas and you ban them from your diet, it might backfire.

“If you love carbohydrates and you decide to go on the Atkins diet, it might be hard to stick to it, and you could find yourself yo-yoing on your weight,” Bolt said.

One change could simply be committing to drinking more water rather than juice or soda, or replacing your favorite white starch — like white bread, white rice, pasta, or tortillas — with a healthier whole grain alternative. Also, when grocery shopping, follow Bolt’s advice and shop the perimeter of the store rather than the middle.

“As a general rule, stay in the outside areas where everything is fresh and not processed, like in the produce and dairy sections. Avoid the boxed and canned food aisles. The exception is frozen vegetables, because they are a good alternative to fresh,” she said.

Another easy and healthy dietary change is reducing the amount of alcohol you drink. Alcoholic drinks are not only full of empty calories, but they can cause health issues over time. Also, you could consider packing a lunch on a few work days rather than going to your favorite fast food restaurant. Try it for three weeks and see if you can start a new habit. Or, give up a trigger for sweets, like grabbing a candy bar when you gas up or a cookie when you enter the break room, as eating a lot of sugar can have negative health effects.

“It’s false when people say eating too much sugar can give you diabetes. It can’t, but if you are at risk for diabetes, eating excessive sugar can rapidly increase the onset of diabetes,” Bolt added.

You likely remember the old USDA food pyramid. What you may not know is that it has been replaced with MyPlate, an easier concept to apply to your daily meals (for more go to MyPlate calls for dividing your plate in half, and filling one half with fruits and vegetables. The other half you split between grains and protein.

Allowing the occasional indulgence, or replacing it with a healthy substitute, makes it more likely that you’ll succeed in making lasting change. Before starting a diet or diving in to a lot of changes, consider seeing your primary care provider and reviewing your current eating habits so he or she can help you make a sustainable plan.

So what will it be? Consider your dietary downfalls and pick one habit to start improving upon today. If you’d like to set an appointment with Carol Bolt, PA, or another MRH physician assistant or physician, call 970-826-2400. You can also take the opportunity to come to the MRH Health Fair on April 1 from 8 a.m. to noon to learn more about healthy lifestyle habits.

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Missing 1-month-old Florida baby found in good health

ENGLEWOOD, Fla. – Florida authorities have found a missing baby hours after a Missing Child Alert was issued.

The Alert was issued for one-month-old Ashlynn Vanorman. The baby was found in good health Tuesday afternoon, but officials released no other information.

Officials believed Vanorman may have been in the company of Andrew Hall, 27, and Stephanie Draine, 36.


Copyright 2017 by WPLG – All rights reserved.

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Quality sleep, balanced diet key to good health

NAGPUR: Adequate sleep, along with a balanced diet and regular exercise, is essential for good health. In fact, with enough quality sleep, a person can prevent a number of diseases. Also, good sleep can even delay the ageing process.

Speaking on the eve of World Sleep Day, which is observed on March 17, sleep expert Dr Sushant Meshram said that there are 88 types of sleep disorders, including sleep apnoea syndrome, restless leg syndrome, insomnia and narcolepsy. People working in shift duties, especially night shifts, are particularly prone to sleep disorders. “Most sleep disorders are preventable or treatable, still less than one-third of sufferers seek professional help. Sleep problems constitute a global epidemic that threatens health and quality of life for at least 45% of the world’s population,” he said.

Dr Meshram added that the three elements of a good quality sleep are duration, continuity and depth. “One sleep cycle is of 90 minutes. It includes different stages. The Non Rapid Eye Movements (NREM) stage which runs over 70 minutes consists of 1, 2 light sleep cycles and 3 and 4 are deep sleep cycles. REM, which forms the second half (20 minutes), is when brain tissue rejuvenation and memory development takes place,” Dr Meshram said.

Research shows that we spend up to one-third of our lives sleeping. Sleep is a basic human need, much like eating and drinking, and is crucial to our overall health and well-being. Sleep, like exercise and nutrition, is essential for metabolic regulation in children. There is evidence for a link between sleep duration and childhood obesity.

The findings are more apparent in girls. Breathing regularly during sleep is critical to maintain well-being and health. Persistent interruption of the breathing function during sleep is called sleep apnoea. This is a pervasive and common disorder that affects 4% of men and 2% of women.

Sleep apnoea causes daytime sleepiness and fatigue, and may lead to conditions such as hypertension, ischemic heart disease, stroke and diabetes. Negative impact of sleep affect attention span, memory and learning.

Longer term effects are being studied, but poor quality sleep or sleep deprivation has been associated with significant health problems, such as obesity, diabetes, weakened immune systems and even some cancers. Lack of sleep is related to many psychological conditions such as depression, anxiety and psychosis.

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The unhealthy consequences of good health

At a chic dinner party last week, a friendly chow as big and black as a dog can be without being a bear sniffed a lady’s bum during pre-dinner drinks. I happened to be standing behind the lady and she raised her hand in anger. ‘It was Bessie the dog,’ I stammered. ‘What is wrong with you? I don’t do this no more.’ The lady in question is of a certain age, and the last one at the party I’d have goosed, but such are the joys of a bad reputation.

Oh yes, before I forget, Marina, Princess of Savoy, who one month ago accused me of having locked her up for two days on board my boat, has now recanted, and admits that it was another awful Greek ship owner who did the dastardly deed. She also admitted that had it been me — this happened 50 years ago — she would gladly have been locked up. ‘You used to be cute,’ was how she put it. I think she’s being much too kind.

As always, what bliss it is to feel healthy again. In fact, it leads to far too much partying. Arki Busson, seducer and impregnator of film stars and hedge-fund manager extraordinaire, blew into town and stayed next-door chez Geoffrey Moore. I was best man at Arki’s parents’ wedding more than 50 years ago, and such was the ensuing disaster that no one has ever asked me to perform that task again. But I love Arki because he is a very bad boy in the good sense of the word. His arrival at my new chalet caused an upheaval. We stayed up until 5 a.m. and left the place looking like a Cuban (before Castro) whorehouse on a Sunday morning. The Mother of My Children was not best pleased but she, too, loves Arki, so all was forgiven.

The festivities continued high up at the Eagle Club the next day, but wiser heads prevented me from attending. My son stood in for his grievously hungover father, and by taking a day off I was able to rejoin the fiesta until Arki finally bade us goodbye and took off to Hong Kong and pressing business deals with the tricky Chinese. The other good news is that Michael Mailer flew in from New York and hit the party scene without missing a beat. He went off skiing with me, on no sleep, and after the all-night blast skied with my speed-demon son and made it back alive.

Think of the peacock thrill of being looked at that a very fast skier enjoys courtesy of the safety-first crowd, and you have an accurate picture of my son. I worry about it but I’m also rather proud. My daughter also goes tearing around, but she prefers racing between gates. It’s strange how with age fear kicks in like a force-nine gale. I can no longer keep up with my children, something I find as humiliating as being barged out of the way by younger men on the dancefloor. Thank God I no longer dance. (Commodore Tim Hoare has decreed that my dancing is an act against nature and that I should stop. I have.) But getting off a ski lift with my Kinder and then watching two figures disappear in the distance is just as mortifying. Such are the joys of getting old. I now ski with the MoMC, who pretends that we are equally skilled as she negotiates our way down the baby slopes.

On a happier note, my old friend Sebastian Taylor threw a party for Sacha Lichine, whose Whispering Angel rosé received 20 out of 20 from leading wine experts. Lichine’s father, Alexis, was quite the legend. Like most legends, he was also a rogue, marrying six times and seducing all sorts of film stars. Alexis joined the OSS, the precursor to the CIA, and ran around occupied Europe making trouble for the Nazis and bedding women galore. He was a friend of the Rockefellers and introduced wine to America after the war. (Well, some Americans did drink wine before the war, but they were few and very upper class.)

When I arrived at the party, Sacha was standing outside in the cold having a smoke and drinking a martini. His opening line was that a martini is like women’s breasts. One is not enough, and three is too many. Quite right, I thought. The dinner was at the Jean Denoyer restaurant in town, a new place with very good food whose owner is deep in the grip of my past: he owned some very fun places in New York when I was younger. I wish him luck, but Gstaad is a hard nut to crack if you’re not a local. He’ll probably be discovered hundreds of years from now up in some glacier perfectly preserved, but I shouldn’t hint at such matters.

Mind you, everything is now hunky-dory. I’m skiing, drinking, partying, training and reading good books. What else could a man wish for? Well, I can think of a few things, but this is a family-oriented column in the world’s most elegantly written weekly, so I will desist. But if any young women out there happen to prefer older men, do get in touch. I’m as easy to catch as the flu I just got rid of.

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Detained Lebanese ‘in good health’

The family’s lawyer confirmed that Kassem Tajeddine was indeed detained by Moroccan authorities Sunday.

Mallat added that no charges have yet been brought against Tajeddine and that the Moroccan authorities were treating him well.

The U.S. Treasury Department’s Office of Foreign Assets Control added Tajeddine to its sanctions list in May 2009 .

Additional branches of Tajco in Ghana were added to the sanctions list in April 2012 .

Multiple reports as well as the U.S. sanctions list have previously asserted that the family has consistently diverted sizable sums – in the millions of dollars – to Hezbollah, which is itself designated a terrorist entity by the U.S. government.

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