Sound Medicine -- February 1, 2003

Hosts Barbara Lewis and Dr. David Crabb talk to experts about:

Exercises for the brain

Health decision guides on the Internet, a patient's view

Health decision guides on the Internet, a physician's view

Exercises for the brain

What difference does three pounds make? It's the average weight of the human brain. These three pounds are critical to our physical, mental and emotional health, so why don't we obsess about exercising it the way we do our bodies? Maybe we should. Richard Restak, M.D., thinks we'd be smarter if we only used our noggins more. Dr. Restak, neurologist and neuropsychiatrist, is clinical professor of neurology at George Washington University Medical Center and author of The Secret Life of the Brain, a book accompanying the PBS series of the same name.

Dr. Restak says performing brain exercises improves our ability both to think and remember, possibly even improve IQ scores. We can see the plasticity of the brain in the form of memory. If you do brain exercises to improve memory, you can test yourself with a shopping list, for example. He acknowledges it takes a little longer for older people's brains to remember and process information, but the brain can always improve capacity if challenged. Dr. Restak also talks about tai chi, an exercise regimen that activates the imaging parts of the brain as well as balance and coordination.

Resources:

Dr. Restak's latest book is Mozart's Brain and the Fighter Pilot. It offers techniques for improving intellectual health in the short term and helping prevent dementia in the long run. Read an excerpt at Amazon.com.

These brain exercises from About.com were created as study aids for students, but anyone can use them.

Research published in the February 2002 Journal of the American Medical Association showed that stimulating mental activity could reduce the risk of Alzheimer disease.

Interactive health decision guides on the Internet, a patient's view

Thanks to the Internet, today's patients take greater responsibility for their personal health care. Volumes of medical information are readily accessible to anyone who takes the time to find it. Now, a new genre of medical Web sites is popping up called the interactive decision guide. After entering information about their health status, patients receive treatment options, questions to ask their doctor, even a prognosis. This hour we hear both a patient's and a physician's view of these new Web tools.

First, a patient. Laura Landro, a senior editor with the Wall St. Journal, is a cancer survivor and health advocate. She's written an article about online decision guides for patients and a book for cancer patients.

A longtime user of medical Web sites, Landro likes the more interactive tools available today. She says it's important to know the sponsor of the site, and that typically governmental (.gov) and non-profit (.org) sites are more objective and less likely to distribute your medical information to others. Be on the lookout for "opt out" checkboxes where you must specify that you DON'T want to share your info or receive more information. On the other hand, Landro says, corporate sponsorship is often a good sign. As long as a company doesn't directly pay for the site, its sponsorship lends authority to a valuable and popular resource.

For people beginning their research, Landro recommends patient-sponsored sites as gateways to the best Web sites, such as the Association of Cancer Online Resources. Other tips: look for current information, info that doesn't wildly contradict other things you've read, and sites recommended by reasonable-sounding patients, not those pushing particular treatments.

Resources:

Read Laura Landro's essay describing her bout with cancer. Her book is called Survivor: Taking Control of Your Fight Against Cancer. Purchase and read excerpts at Amazon.com.

Landro highly recommends the patient-run Association of Online Cancer Resources, or ACOR.

Landro also likes Quackwatch.org, a guide for intelligent health searches online.

The National Library of Medicine provides the MEDLINEplus database for finding current research, news, and drug information, and PubMed, a database of professional journal articles.

Medline is another terrific database for researching professional literature. (registration required.)

Interactive decision tools recommended by Landro:

Mayo Clinic health decision guides and other health management software.

American Cancer Society treatment decision tools.

American Lung Association Lung Health Profilers.

Cancer Profiler from Cancerfacts.com.

Interactive decision guides on the Internet, a physician's view

Dr. Clyde Yancy helped develop the American Heart Association's Heart Profiler Web site. He is associate professor of internal medicine and director of the congestive heart failure program at the University of Texas Southwestern Medical Center.

Dr. Yancy is enthusiastic about the Heart Profiler, a tool for heart patients. Patients get confidential answers germane to their situation. There are no mandatory fields, and users can return at a later time to fill out their profile more completely. Patients get a list of current treatment strategies, their benefits and how they work. In addition, professionals can review the index medicus abstracts of the data sources that medical review boards use to reach the decisions offered by the Profiler. Dr. Yancy emphasizes that sponsorships came after the site was developed and strictly underwrite site maintenance.

This online information is better than brochures, Dr. Yancy argues, because it's unbiased, it's current, and the text provided ranges from the elementary to the complex. The site can't cure or diagnose you exactly, but it does help raise good questions.

Resources:

Heart Profiler from the American Heart Association.

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School children lugging heavy backpacks have been the subject of several health studies. Are children injuring themselves with overloaded backpacks? A recently published study concludes they are. Which of the following reasons is NOT a real cause of pack-related injuries?

A. Kids cause injuries by swinging the heavy packs and bashing other kids.

B. Heavy packs lead to future back injuries in the still-growing spine.

C. Kids trip over the heavy packs and injure themselves in falls.

Find out!

Coronary heart disease is the leading cause of death for American women, claiming more than 500,000 lives annually. Surprised? Then you'll be even more surprised to know that in the United States cardiovascular diseases -- heart failure, heart attack and stroke -- claim more women's lives every year than the next seven causes of death combined, and almost twice as many as all forms of cancer. And, more women have died of cardiovascular disease than men every year since 1984.

February 1-7 has been designated Women's Heart Week in Indiana to encourage women to learn the "Heart Truth" about their risk of heart disease. "Heart Truth" is a national campaign sponsored by the National Heart, Lung, and Blood Institute, the U.S. Department of Health and Human Services, the American Heart Association, and other organizations.

According to the American Heart Association, 38 percent of women who have heart attacks die within a year. The Women's Heart Foundation reports that two-thirds of women who die suddenly of a heart attack had no prior symptoms.

The risk factors for heart disease are:
• Smoking
• High blood pressure
• High blood cholesterol
• Overweight/obesity
• Physical inactivity
• Diabetes
• Family history of early coronary heart disease
• Age (for women, 55 and older)

The "Heart Truth" encourages women to see a physician or other health care provider to ask about their risk for heart disease and to find out what steps they can take to reduce their risk. For women with heart disease, the campaign urges them to work with their health care provider to control the disease and improve their heart health.

For more information on women and heart disease, contact the Office of Women's Health at the Indiana State Department of Health at 317-233-7256. Or, visit the NIH Heart Truth Web site.