By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill
School staff and families are experiencing tremendous fatigue from the heroic work to maintain in-person education during the COVID pandemic. Millions of hours and millions of dollars have gone into mitigation efforts (like masks and distancing and ventilation).
Most schools use a hybrid model, with each student only in the building 2 days per week. Furthermore, close contacts are quarantined. These modifications significantly reduce the likelihood of COVID spread.
Given the benefits of in-person education and the health risks of COVID, decisions about if and when to temporarily shut schools are very complex — requiring wise judgment. It’s important to avoid being reactionary, when fear clouds fact. The fundamental question should be: “is having our school open right now making the pandemic here now worse?”
Massachusetts has its system of red, yellow and green communities, which marks the degree of caution each district should be using in its decisions. This is a particular challenge for urban cities, where both the rates of COVID and the harms of remote education are highest.
To use a baseball analogy, closing a school is like shifting the infield to double play depth when a runner is in scoring position with one out. It’s a tool that gets you out of a pinch. If this school year were a game, we’d be in the top of the 3rd inning. We need to encourage and reward good managers, who keep an eye on the long view and the final outcome.
By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill
A recent personal experience with the sadness and shock of suicide weighs on my mind these days. Suicide is the 2nd leading cause of death in the US, among ages 15-24. Rates have increased by 41% over the past 17 years. Males have a rate three times higher than females. Dismal statistics like these can sometimes be numbing, which discourages the hopeful proactive energy we need to bring, in order to prevent future tragedy.
When listening carefully to people who have considered suicide, one element that comes up invariably is psychological pain. The pain of loneliness or unworthiness can be as real and unbearable as physical pain. We humans are built for connectedness: an antidote to isolation. The time and energy invested in relationships reinforces that each of our days matter. We are grateful for those who help us, and we take joy in the opportunity to help others.
A primary care physician (PCP) is always there for you, whether you have a common cold, need help managing a chronic condition, or are due for an annual checkup. These doctors tend to be the entry point for patients first entering the medical system, and developing a good working relationship with one is very beneficial to you and your health. Here are five reasons why you should have a PCP by your side.
1. Your Primary Care Physician Knows You
Having an established relationship with your PCP allows him or her to be familiar with you and your family’s medical history. This makes it easier for them to find patterns in your health and know how your body responds to certain illnesses.
2. A PCP is Your Entry Point to the Continuum of Care
Having a PCP is a great way to learn how to navigate the somewhat complicated medical system. They can refer you to specialists who may be more knowledgeable about a specific health issue. Through Pentucket Medical you have access to a network of primary care, medical specialists and urgent care services throughout the Merrimack Valley.
3. You Have Lower Out-of-Pocket Costs
A primary care physician co-pay is typically much cheaper than a visit to an emergency room. Having a go-to doctor who you can easily set appointments with creates a much lighter burden on your wallet, especially in the long run. Take a look at your insurance card to see the difference in cost between an office and emergency room visit.
4. A PCP Can Help You Reach Your Goals
Have goals like weight loss, eating better or general wellness? Your primary care physician can work with you to plan out how you can achieve your goals. Your doctor can recommend diets, exercise plans, and more to help you on your wellness journey.
5. You Can Receive High-Quality Preventive Care
In addition to providing care for acute illnesses and chronic conditions, your doctor can help you take measures to prevent their onset. Your PCP keeps track of your health over time, performs preventive services and screenings to catch diseases early, and offers advice to help you maintain a healthy and happy life.
Establish a relationship with a Pentucket Medical clinician today and start on the path to a healthier you. Our doctors offer same or next-day appointments, online scheduling through the Patient Gateway and an extensive list of accepted insurance plans.
cite: Baylor Medical Center
U.S. News & World Report | How to Find the Best Primary Care Doctor
NCBI, U.S. National Library of Medicine | Contribution of Primary Care to Health Systems and Health
Keeping hydrated is crucial for health and well-being, but many people do not consume enough fluids each day. Around 60 percent of the body is made up of water, and around 71 percent of the planet’s surface is covered by water.
Perhaps it is the ubiquitous nature of water that means drinking enough each day is not at the top of many people’s lists of priorities.
Is catching up on “This is Us” on your weekend to-do list? Here’s what you need to know.
You sit yourself down in front of the TV after a long day at work, and decide to start watching that new show everyone’s been talking about. Cut to midnight and you’ve crushed half a season — and find yourself tempted to stay up to watch just one more episode, even though you know you’ll be paying for it at work the next morning.
It happens to the best of us. Thanks to streaming platforms like Netflix and Hulu, we’re granted access to several hundred show options that we can watch all in one sitting — for a monthly fee that shakes out to less than a week’s worth of lattes. What a time to be alive, right?
And we’re taking full advantage of that access. According to a survey done by the U.S. Bureau of Labor Statistics, the average American spends around 2.7 hours watching TV per day, which adds up to almost 20 hours per week in total.
As for the amount of binge watching we’re doing, a Netflix survey found that 61 percent of users regularly watch between 2-6 episodes of a show in one sitting. A more recent study found that most Netflix members choose to binge-watch their way through a series versus taking their time — finishing an entire season in one week, on average (shows that fall in the Sci-Fi, horror and thriller categories are the most likely to be binged).
In fact, according to Nielsen, 361,000 people watched all nine episodes of season 2 of ‘Stranger Things,’ on the first day it was released.
Of course, we wouldn’t do it if it didn’t feel good. In fact, the Netflix survey also found that 73 percent of participants reported positive feelings associated with binge-watching. But if you spent last weekend watching season two of “Stranger Things” in its entirety, you may have found yourself feeling exhausted by the end of it — and downright depressed that you’re out of episodes to watch.
A Netflix survey found that 61 percent of users regularly watch between 2-6 episodes of a show in one sitting.
There are a handful of reasons that binge-watching gives us such a high — and then leaves us emotionally spent on the couch. Here’s a look at what happens to our brain when we settle in for a marathon, and how to watch responsibly.
THIS IS YOUR BRAIN ON BINGE WATCHING
When binge watching your favorite show, your brain is continually producing dopamine, and your body experiences a drug-like high.
Watching episode after episode of a show feels good — but why is that? Dr. Renee Carr, Psy.D, a clinical psychologist, says it’s due to the chemicals being released in our brain. “When engaged in an activity that’s enjoyable such as binge watching, your brain produces dopamine,” she explains. “This chemical gives the body a natural, internal reward of pleasure that reinforces continued engagement in that activity. It is the brain’s signal that communicates to the body, ‘This feels good. You should keep doing this!’ When binge watching your favorite show, your brain is continually producing dopamine, and your body experiences a drug-like high. You experience a pseudo-addiction to the show because you develop cravings for dopamine.”
According to Dr. Carr, the process we experience while binge watching is the same one that occurs when a drug or other type of addiction begins. “The neuronal pathways that cause heroin and sex addictions are the same as an addiction to binge watching,” Carr explains. “Your body does not discriminate against pleasure. It can become addicted to any activity or substance that consistently produces dopamine.”
Your body does not discriminate against pleasure. It can become addicted to any activity or substance that consistently produces dopamine.
Spending so much time immersed in the lives of the characters portrayed on a show is also fueling our binge watching experience. “Our brains code all experiences, be it watched on TV, experienced live, read in a book or imagined, as ‘real’ memories,” explains Gayani DeSilva, M.D., a psychiatrist at Laguna Family Health Center in California. “So when watching a TV program, the areas of the brain that are activated are the same as when experiencing a live event. We get drawn into story lines, become attached to characters and truly care about outcomes of conflicts.”
According to Dr. DeSilva, there are a handful of different forms of character involvement that contribute to the bond we form with the characters, which ultimately make us more likely to binge watch a show in its entirety.
“‘Identification’ is when we see a character in a show that we see ourselves in,” she explains. “‘Modern Family,’ for example, offers identification for the individual who is an adoptive parent, a gay husband, the father of a gay couple, the daughter of a father who marries a much younger woman, etc. The show is so popular because of its multiple avenues for identification. ‘Wishful identification,’ is where plots and characters offer opportunity for fantasy and immersion in the world the viewer wishes they lived in (ex. ‘Gossip Girl,’ ‘America’s Next Top Model’). Also, the identification with power, prestige and success makes it pleasurable to keep watching. ‘Parasocial interaction’ is a one-way relationship where the viewer feels a close connection to an actor or character in the TV show.”
If you’ve ever found yourself thinking that you and your favorite character would totally be friends in real life, you’ve likely experienced this type of involvement. Another type of character involvement is “perceived similarity, where we enjoy the experience of ‘I know what that feels like,’ because it’s affirming and familiar, and may also allow the viewer increased self-esteem when seeing qualities valued in another story.” For example, you’re drawn to shows with a strong female lead because you often take on that role at work or in your social groups.
BINGE WATCHING CAN BE A STRESS RELIEVER
The act of binge watching offers us a temporary escape from our day-to-day grind, which can act as a helpful stress management tool, says Dr. John Mayer, PhD, a clinical psychologist at Doctor On Demand. “We are all bombarded with stress from everyday living, and with the nature of today’s world where information floods us constantly,” Dr. Mayer says. “It is hard to shut our minds down and tune out the stress and pressures. A binge can work like a steel door that blocks our brains from thinking about those constant stressors that force themselves into our thoughts. Binge watching can set up a great boundary where troubles are kept at bay.”
A binge can work like a steel door that blocks our brains from thinking about those constant stressors that force themselves into our thoughts.
Binge watching can also help foster relationships with others who have been watching the same show as you. “It does give you something to talk about with other people,” says Dr. Ariane Machin, PhD, clinical psychologist and professor of psychology. “Cue the ‘This Is Us’ phenomenon and feeling left out if you didn’t know what was going on! Binge watching can make us feel a part of a community with those that have also watched it, where we can connect over an in-depth discussion of a show.”
Watching a show that features a character or scenario that ties into your day-to-day routine can also end up having a positive impact on your real life. “Binge watching can be healthy if your favorite character is also a virtual role model for you,” says Carr, “or, if the content of the show gives you exposure to a career you are interested in. Although most characters and scenes are exaggerated for dramatic effect, it can be a good teaching lesson and case study. For example, if a shy person wants to become more assertive, remembering how a strong character on the show behaves can give the shy person a vivid example of how to advocate for herself or try something new. Or, if experiencing a personal crisis, remembering how a favorite character or TV role model solved a problem can give the binge watcher new, creative or bolder solutions.”
THE LET DOWN: WHAT HAPPENS WHEN THE BINGE IS OVER
Have you ever felt sad after finishing a series? Mayer says that when we finish binge watching a series, we actually mourn the loss. “We often go into a state of depression because of the loss we are experiencing,” he says. “We call this situational depression because it is stimulated by an identifiable, tangible event. Our brain stimulation is lowered (depressed) such as in other forms of depression.”
In a study done by the University of Toledo, 142 out of 408 participants identified themselves as binge-watchers. This group reported higher levels of stress, anxiety and depression than those who were not binge-watchers. But in examining the habits that come with binge-watching, it’s not hard to see why it would start to impact our mental health. For starters, if you’re not doing it with a roommate or partner, binge-watching can quickly become isolating.
When we disconnect from humans and over-connect to TV at the cost of human connection, eventually we will ‘starve to death’ emotionally.
“When we substitute TV for human relations we disconnect from our human nature and substitute for [the] virtual,” says Dr. Judy Rosenberg, psychologist and founder of the Psychological Healing Center in Sherman Oaks, CA. “We are wired to connect, and when we disconnect from humans and over-connect to TV at the cost of human connection, eventually we will ‘starve to death’ emotionally. Real relationships and the work of life is more difficult, but at the end of the day more enriching, growth producing and connecting.”
If you find yourself choosing a night in with Netflix over seeing friends and family, it’s a sign that this habit is headed into harmful territory. (A word of warning to those of us who decided to stay in and binge watch “Stranger Things” instead of heading to that Halloween party.)
HOW TO BINGE-WATCH RESPONSIBLY
The key to reaping the benefits of binge-watching without suffering from the negative repercussions is to set parameters for the time you spend with your television — which can be tough to do when you’re faced with cliff hangers that might be resolved if you just stay up forone more episode. “In addition to pleasure, we often binge-watch to obtain psychological closure from the previous episode,” says Carr. “However, because each new episode leaves you with more questions, you can engage in healthy binge-watching by setting a predetermined end time for the binge. For example, commit to saying, ‘after three hours, I’m going to stop watching this show for the night.”
If setting a time limit cuts you off at a point in your binge where it’s hard to stop (and makes it too easy to tell yourself just ten more minutes), Carr suggests committing to a set number of episodes at the onset instead. “Try identifying a specific number of episodes to watch, then watching only the first half of the episode you have designated as your stopping point,” she says. “Usually, questions from the previous episode will be answered by this half-way mark and you will have enough psychological closure to feel comfortable turning off the TV.”
Also, make sure that you’re balancing your binge with other activities. “After binge-watching, go out with friends or do something fun,” says Carr. “By creating an additional source of pleasure, you will be less likely to become addicted to or binge watch the show. Increase your physical exercise activity or join an adult athletic league. By increasing your heart rate and stimulating your body, you can give yourself a more effective and longer-term experience of fun and excitement.”
Article cite: NBC News. by Danielle Page / Nov.04.2017
In the last census baby boomers, those 65+, accounted for 13% of the population. This age group grew at a faster rate than the population under age 45, and it’s clear that the US is an aging population. Happily, aging is different now than it was for our parents and grandparents. Today, there are more people living longer than at any other time in history. In fact, boomers will number 78 million by 2030.
How to do it? Below are 10 easy health tips for seniors to live longer and thrive:
Quit smoking. Take this critical step to improve your health and combat aging. Smoking kills by causing cancer, strokes and heart failure. Many resources are available to help you quit.
Keep active. Do something to keep fit each day do something you enjoy that maintains strength, balance and flexibility and promotes cardiovascular health. Physical activity helps you stay at a healthy weight, prevent or control illness, sleep better, reduce stress, avoid falls and look and feel better, too.
Eat well.Combined with physical activity, eating nutritious foods in the right amounts can help keep you healthy. Many illnesses, such as heart disease, obesity, high blood pressure, type 2 diabetes, and osteoporosis, can be prevented or controlled with dietary changes and exercise. Calcium and vitamin D supplements can help women prevent osteoporosis.
Maintain a healthy weight. Extra weight increases your risk for heart disease, diabetes and high blood pressure. Use a BMI (body mass index) calculator to find out what you should weigh for your height. Get to your healthy weight and stay there by eating right and keeping active. Replace sugary drinks with waterâ€”water is calorie free!
Prevent falls.We become vulnerable to falls as we age. Prevent falls and injury by removing loose carpet or throw rugs. Keep paths clear of electrical cords and clutter, and use night-lights in hallways and bathrooms. Did you know that people who walk barefoot fall more frequently? Wear shoes with good support to reduce the risk of falling.
Stay up-to-date on immunizations and other health screenings. By age 50, women should begin mammography screening for breast cancer. Men can be checked for prostate cancer. Many preventive screenings are available. Those who are new to Medicare are entitled to a “Welcome to Medicare” visit and all Medicare members to an annual wellness visit. Use these visits to discuss which preventative screenings and vaccinations are due.
Prevent skin cancer.As we age, our skin grows thinner; it becomes drier and less elastic. Wrinkles appear, and cuts and bruises take longer to heal. Be sure to protect your skin from the sun. Too much sun and ultraviolet rays can cause skin cancer.
Get regular dental, vision and hearing checkups.Your teeth and gums will last a lifetime if you care for them properly, that means daily brushing and flossing and getting regular dental checkups. By age 50, most people notice changes to their vision, including a gradual decline in the ability to see small print or focus on close objects. Common eye problems that can impair vision include cataracts and glaucoma. Hearing loss occurs commonly with aging, often due to exposure to loud noise.
Manage stress. Try exercise or relaxation techniques, perhaps meditation or yoga as a means of coping. Make time for friends and social contacts and fun. Successful coping can affect our health and how we feel. Learn the role of positive thinking.
Fan the flame. When it comes to intimacy and aging, age is no reason to limit your ‘enjoyment’. Learn about physical changes that come with aging and get suggestions to help you adjust to them, if necessary.
Since it’s February, you may be thinking about sweetheart candy and heart-shaped boxes of chocolate. Did you know that it is also a great time to think about your own heart? February is Heart Health Month!
It’s important to know the risk factors and signs of heart disease as it’s the leading cause of death for both men and women with 610,000 Americans dying from heart disease each year. Continue reading “Heart Health Month”→
For decades parents have worried about the amount of time their children spend in front of electronic media.
Many of today’s parents grew up in the 1980’s and 90’s, when their parents worried about a per-child average of 3 hours a day spent watching network and cable TV.
Many of those kids have become parents to children growing up in a world of wireless media and limitless bandwidth. New channels of connectivity are literally reshaping our children, socially and developmentally and physically. The average total screen time for children today is an astonishing 7 hours per day, and of course there are many more types of screens.
From a health standpoint, there are significant concerns about children’s use of handhelds, whether these are smartphones or tablets.
Clinical concerns include:
A human head weighs about 12 pounds, and when standing up straight, it puts that amount of stress on the spine. But as we look down, the strain increases, to as much as 60 pounds as the chin nears the chest, which is the most common posture of texting and iPad use.
Repetitive Stress Injury
Holding a phone and tapping out words puts unnatural stress on the tendons and muscles of the thumb and forearm. Our powerful thumbs evolved for gripping – to put it simply, they are like the bottom half of a pair of pliers. They were never intended for hunting and pecking at tiny letters. Hours of daily texting can lead to tendonitis, carpal tunnel syndrome and other debilitating problems.
Another real physical risk involving mobile media is accidents. More than 3,000 teens die each year in crashes caused by texting while driving. (By comparison, roughly approximately 2,700 teens are killed in drunk driving accidents.) More than 50 percent of teens admit to texting while driving.
Pedestrian injuries related to cell phones ranged from falling off walkways or bridges to walking in front of moving traffic. The study found that in 2010, 1,500 pedestrians were treated in emergency departments for cell-phone related incidents, as opposed to a mere 559 in 2004.
The attractions of mobile devices are an undeniable challenge to parents who want to limit their children’s screen time, yet there are strategies that can be employed to counter their attraction.
Enabling and Encouraging Immersive Experiences
You can make a positive impact in your child’s relationship with devices by encouraging them to join in on activities that are engaging and exciting.
Phone-free walks and bicycling
Community based resources
Boys & Girls clubs
Social service opportunities
Additionally, most mobile devices have options for that will set time limits on session length. These controls are usually found in the “settings” area of the device.
Finally, engaging children in face-to-face conversation or games is a means of both building child-parent bonds and creating device-free time. Keep in mind that as adults we are far from immune from the distractions of our phones and iPads.
Leading by example is one of the best ways to ensure that our kids will develop media habits that are reasonable and balanced.
If you have any questions or concerns relating to these issues, speak with your doctor or pediatrician.
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